Sample Memorandum for Approval of Agreement with a Private Entity

264 FW 2
Exhibit 3, 264 FW 2, 1/2/2018


To:                   Director (or supervising Directorate Member (i.e., Assistant Director, Regional Director), if allowed)

Through:          Assistant Director – Management and Administration

From:               Supervising Directorate Member (i.e., Assistant Directors, Regional Directors) (or Deputy/Assistant Regional Director, if allowed)

Subject:           Request for Reimbursable Authority with [name of private entity]

In accordance with U.S. Fish and Wildlife Service Manual chapter 264 FW 2, I request your approval to enter into an agreement with [name of private entity] for reimbursable work.

Consistency with the Service’s Mission

The [name of private entity] requested that the Service’s [Region/field station/program] perform the following work:

Summary of services or product that we will provide and estimated reimbursement.

We estimate that completion of this work will help to [benefits to be achieved], consistent with the Service’s mission.

[Name of private entity] is requesting the Service’s expertise because [Provide a summary of scope of work and cost of agreement].

[Name of private entity] is not prohibited as defined in section 2.19, 264 FW 2.

After both parties accept this agreement, [name of private entity] agrees to make an advance payment to the U.S. Fish and Wildlife Service in the amount of $[dollar amount].




_____Not Approved                Director, U.S. Fish and Wildlife Service/Date

(or supervising Directorate Member, if allowed) (see sections 2.5, 2.13, and 2.18 of 264 FW 2 for conditions of approval)