Challenge Cost Share
Mountain-Prairie Region
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Instructions for Completing the Challenge Cost Share Agreement (CCSA)

Note: Upon notification of selection committee approval, use these instructions to prepare a CCSA cover page and forward it to the CCS Coordinator along with a Statement of Work, signed SF-424s from each cooperator, and a signed commitment letter from each cooperator.

1. DOCUMENT CONTROL NUMBER – Enter the document control number provided by the field station. Use the following format 6XXXXAJXXX (station org code, fiscal year, J, next number in series). In this same block, enter an amount identified to be obligated to a cooperator or the statement “No Funds” (indicating no funds will be obligated to a cooperator).
2. PURCHASE REQUEST NUMBER – N/A – (completed).

3. TYPE OF AGREEMENT – N/A – (completed).
5. COOPERATOR ADMINISTROR – Enter cooperator’s information.
6. FWS PROJECT OFFICER – Enter the information of the field Station contact most familiar with overseeing the project.
7. COOPERATOR PROJECT OFFICER – Name of cooperator’s Project Officer w/information.
8b. FUNDING AUTHORITY – N/A – (completed).
10. DUNS AND EIN/TIN – Only required if obligating to or receiving funds from a cooperator.  Dun & Bradstreet number information available at
11. PROJECT PERIOD – Enter the end date of the period of performance.
12. TYPE OF COOPERATOR(S) – Check at least one description of primary cooperator.
13. COST SHARE INFORMATION – Enter the amount of CCS funds and matching value from the cooperator(s) in the appropriate box. In addition, enter CCS accounting data in the following format 6XXXX-126X-CXXX (org code; sub-activity 1261 or 1263; project code) – this information will be made available with the release of the approved project list.
14. PROVISIONS – N/A – (completed by CGS prior to obtaining signatures).
15. PROJECT TITLE AND BRIEF SUMMARY OF THE PURPOSE AND OBJECTIVES – Enter title of project and a brief summary.

Note:  After the initial completion of the CCSA, the “Statement of Work” (Attachment 1), the SF-424 (Attachment 2), and the commitment letter; forward the documents to the CCS Program Coordinator. Do not obtain the signature(s) from the cooperator(s) on the CCSA cover page or signature addendum until after the Regional Office (RO) edits and reviews the CCSA. After the CCSA has been reviewed, it will be forwarded back to the field station for the cooperator(s) signature(s).

16a. NAME AND TITLE OF SIGNER – Enter name and title of the cooperator.
16b. COOPERATOR SIGNATURE – Signature of cooperator representative.
16c. DATE SIGNED – Dated signed by cooperator.
Note:  Mail the CCSA with original signatures to the CCS Coordinator after the Cooperator(s) signature(s) have been obtained to finalize the agreement process. When the CCS Coordinator receives the CCSA, it will be forwarded to Regional Director for final signature and the account will be fund targeted thereafter. Once the account has been fund targeted, the CCS coordinator will notify the Service Project Officer that the Agreement is finalized and forward them a copy of the CCSA.

17a. NAME AND TITLE OF FWS OFFICIAL – N/A – (completed by RO).
17b. U.S. FISH AND WILDLIFE SERVICE BY – Signature of Regional Director.
17c. DATE SIGNED – Date signed by the RD (official start date of project period).

Please direct any comments or questions to the CCS Coordinator at 303-236-4307

Last Updated: March 9, 2015