Form FS-1500-0049 Infrastructure Investment and Jobs Act Financial Assista

WOOD PRODUCTS INFRASTRUCTURE
ASSISTANCE APPLICATION
(Reference Public Law 117-58)

FS-1500-0049 (REV. 10/2023)
OMB No: 0596-0254
Exp: MM/DD/YYYY

PUBLIC BURDEN STATEMENT
A Federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply
with an information collection subject to the requirements of the Paperwork Reduction Act of 1995, unless the information collection has a currently valid
OMB Control Number. The approved OMB Control Number for this information collection is 0596-0254. Without this approval, we could not conduct this
survey/information collection. Public reporting for this information collection is estimated to be approximately 5.25 hours per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the information collection.
All responses to this information collection are voluntary. Send comments regarding this burden estimate or any other aspect of this information collection,
including suggestions for reducing this burden, to the USDA Forest Service email address SM.FS.InfoCollect@usda.gov and include the OMB Control
Number in the subject line.
NONDISCRIMINATION STATEMENT
In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices,
and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin,
religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a
public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not
all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident.
Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign
Language, etc.) should contact the responsible agency or USDA’s TARGET Center at (202) 720-2600 (voice and TYY) or contact USDA through the
Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.
To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at How to File a Program
Discrimination Complaint and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form.
To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture,
Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or
(3) email: program.intake@usda.gov.
USDA is an equal opportunity provider, employer, and lender.
PRIVACY ACT STATEMENT (5 U.S.C. § 552a)
The Privacy Act of 1974 (5 U.S.C. § 552a) requires that when the Federal Government requests personally identifiable information from individuals, we tell
them our legal right to ask for the information, why we are asking for it, whether providing it is mandatory or voluntary, any effects on individuals not
providing it, and how it will be used. The U.S. Department of Agriculture (USDA) Forest Service (FS) established the Wood Products Infrastructure
Assistance program to provide financial assistance to facilities that purchase and process byproducts from ecosystem restoration projects in areas at risk of
unnaturally severe wildfire or insect or disease infestation through funding from the Bipartisan Infrastructure Law (BIL). FS has launched the Wood Products
Infrastructure Assistance program to partner with private, non-profit, and government sectors including Tribes, local and state governments, businesses and
for-profit entities, institutions of higher education, as well as public utility, fire, conservation, and school districts to assist in collecting information. The
purpose of this information collection is to determine an applicant’s eligibility to receive funding under Funding Opportunity Announcement USDA-FS-WPIA
to establish, reopen, retrofit, expand, or improve a sawmill or other wood-processing facility in close proximity to federal or Tribal lands that needs
ecosystem restoration and will generate byproducts from the restoration activities. This program is authorized by the Infrastructure Investment and Jobs
Act / Bipartisan Infrastructure Law, Public Law 117-58, Section 40804(b3).
We are collecting information on facility type, North American Industry Classification System (NAICS) code, project location, current and future facility
feedstock amounts and sources, planned usage of project funds, and whether the project will benefit disadvantaged communities. Providing this information
is voluntary but necessary to process your application for approval to receive program benefits. If you choose to apply for the Wood Products Infrastructure
Assistance program, you must provide all requested information. Failure to provide complete information may delay or prevent processing or review of your
application for benefits.
This information could be disclosed to the Department of Justice for the purpose of litigating any civil, administrative, or judicial proceeding or criminal
prosecution (including the presentation of evidence, disclosures to opposing counsel or witnesses, in discovery or in settlement negotiations, or in response
to a subpoena) where the United States, USDA, or its employees (in their official capacities or where the government has decided to represent them) are
parties; and to provide information to congressional offices in response to inquiries made at the request of the individuals to whom the information pertains.
A System of Records Notice (SORN), which would describe the routine uses of the information, is not necessary for this collection. According to the Privacy
Act of 1974, while records containing PII are maintained by the Agency, records related to this collection are not retrieved using a personal identifier. The
system of records to be used for this collection is internal only and neither government-wide nor central. The records for this collection will be stored in a
secure cloud-based content storage system. Files stored in this system are not accessible via indexing and cannot be retrieved by name or other personally
unique identifier. The Privacy Impact Assessment for Pinyon, Section 6.1, states that a SORN is not required if records are stored using this system.
CONFIDENTIALITY STATEMENT
The Privacy Act of 1974, 5 U.S.C. 552a, and the Freedom of Information Act (FOIA), 5 U.S.C. 552, govern the confidentiality to be provided for information
received by the Forest Service. Materials submitted to the Forest Service, such as grant applications and progress reports, are subject to FOIA. Upon
request, the Forest Service may be obligated to disclose such records. However, documents or portions of documents will be protected if they satisfy the
requirements of one or more FOIA exemptions. FOIA Exemption 4 protects commercial and financial information that constitutes a trade secret, or whose
release would cause competitive harm to the organization that provided the information. FOIA Exemption 6 protects information whose release “would
reasonably be expected to constitute an unwarranted invasion of personal privacy.
In the event that the Forest Service receives a FOIA request seeking information provided by your organization, Executive Order 12600 requires the Forest
Service to consult with you regarding the potential release of this information. When assembling your application, you may wish to highlight any information
that constitutes a trade secret, whose release would cause you competitive harm, or whose release would impact personal privacy. For more information
about the FOIA and its exemptions, please consult the Department of Justice Guide to the Freedom of Information Act.

File Code: 1580

For technial questions and Section 508 accommodation, please contact SM.FS.fseforms@usda.gov

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Cover Page for Part 1: Cooperator Contact Information

Required Actions - Ensure that your organization is registered with the System for Award Management (SAM),
which is located at https://sam.gov.

1. Project Title:
2. Project Length (Typically 2-3 years up to a maximum of 5 years):
3. Legal Business Name of Applicant:

4. Project Facility Type (Check all that apply):

Wood Processing Facility

Wood-to-Energy Facility

Sawmill

5. Physical Location of the Current or Propsed Project Facility (Provide physical address, weblink from an online
mapping service, or geographic coordinates):

6. Project Cost & Cooperator Funding
A. USDA Forest Service Funding Request:
B. Cooperator Funding1 (Amount of non-federal funds allocated to project):
C. Cooperator Funding as a Percentage of USDA Forest Service Funding Request (B / A x 100):
D. Total Project Cost (A + B):
7. Contact Information
Financial Agreement Contact (Responsible official for the financial administration of the grant agreement)
Name:

Title:

Organization/Company:
Street Address/P.O. Box:
City, State Zip:
Phone:

E-mail Address:

Project Contact (Responsible for the management/coordination of the project) If listed above, check box
Name:

Title:

Organization/Company:
Street Address/P.O. Box:
City, State Zip:
Phone:

E-mail Address:

While a match is not required, cooperator funding is a project selection criterion. Applicants are more likely to be funded if at least 25% of the
total project cost originates from non-federal dollars.

1

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Project Questionnaire, Description of Project and Financial Plan, Budget Table and Justification, and Appendices

Part 1: Project Questionnaire, Description of Project and Financial Plan, Budget Table and Justification, and
Appendices
A. Project Questionnaire - Answer each question as accurately as possible.
Q1 . Primary purpose of the financial assistance request. (Select all that apply).
Establish a processing/manufacturing facility where previously there had been no facility.
Reopen a facility that was shut down or idled.
Retrofit or convert an operation or idled facility.
Expand an operational or idled facility to increase wood or biomass utilization and or manufacturing
capacity.
Improve a facility to increase operational efficiencies and or reduce operational costs.
Other purpose (Provide concise details in space below).

Q2 . Status of the facility that is the primary purpose of the financial request (Select all that apply).
Not operating but will be at more than 50% capacity in less than 6 months.
Currently under construction.

Seeking non-federal financing to initiate construction.

Development/engineering phase.

Operating at less than 50% capacity or idled.

Operating at full production capacity.

Permanently shut down.

Other (Provide details below).

Q3 . What percentage of raw materials used at the project facility are currently or will be byproducts (logs, woody
biomass, etc.) from ecosystem restoration projects on federal or Indian lands?

Check this box if the project facility utilizes wood waste from other facilities and enter below, the
percentage estimate of raw materials from the wood waste facility that originate from ecosystem
restoration projects on federal or Indian lands.

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Q4 . (a) At current operating status, list the volumes and types of raw materials, on an annual basis, that are
procured for the project facility (e.g., 150,000 green tons of whole-tree chips per year).

(b) Of the above amounts, identify the volumes and types of materials that originate from federal or Indian
lands.

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Q5 . How much additional byproducts from federal or Indian lands is projected to be utilized as a result of the
financial assistance being requested? List the additional volume quantities (tons, board feet, or CCF) and
types of byproducts that would be procurred for the project facility if the financial assistance is awarded. Please
provide justification for the projected volumes.

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Q6 . (a) Identify any ecosystem restoration projects that the project facility is currently or planning to collaborate
with. Identify if the ecosystem restoration project is primarily occuring on federal, Indian, state, private lands,
or a combination.

(b) What is the furthest distance the byproducts travel to the project facility from the ecosystem restoration
projects?

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Q7 . (a) Identify any federal or Tribal forestland or rangeland that the project facility currently has under
contract with that allows for the removal and utilization of merchantable or unmerchantable wood products
and/or woody biomass. Please provide copies of these contracts in the Appendix of Part 1 of this application.

(b) What is the furthest distance the byproducts travel to the project facility from the ecosystem restoration
projects listed above?

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Q8 . (a) Using the Climate and Economic Justice Screening Tool, please identify if the project facility is or will be
located in a disadvantage community or if the feedstock for the facility will be originating from a disadvantaged
community.
Yes

No

Could not be determined

(b) If you have additional comments and sources on how the proposed project will disadvantaged communities,
please add them in the space below.

This funding program is intended to provide financial assistance to facilities that purchase byproducts from
high and very high priority areas for ecosystem restoration involving vegetation removal. Applicants are asked
in Questions 9 through 12 identify if their project will help treat areas at high or very high risk of severe wildfire
or insect and disease infestation. Several options to categorize these lands include Critical Firesheds, Wildfire
Crisis Strategy Landscapes, Wildfire Risk to Communities, and the National Insect and Disease Risk Map.
Q9 . Identify if the raw material sourcing areas for the project facility are located within one of the Top 10 USDA
Forest Service designated Firesheds - Critical Firesheds Interactive Map Weblink.
Yes

No

Could not be determined

Q10 . Identify if the raw material sourcing areas for the project facility will include materials from within the boundaries
of the USDA Forest Service Wildfire Crisis Strategy Landscapes using the following interactive map
Wildfire Crisis Strategy Landscapes Interactive Map Weblink.
Yes

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No

Could not be determined

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Q11 . Using the Wildfire Risk to Communities Interactive Map, search by county and then select Wildfire Likelihood,
for the county that will be the main source of raw material for the project facility (Stevens County, WA used as
an example).

What is the Wildfire Likelihood percentile for the county or counties, that will serve as the main source of raw
materials for the project facility, as compared to other counties in the United States?

Q12 . Using the National Insect & Disease Risk Map, identify Proportion of Treed Area at Risk for the area(s) that
will be supplying raw material to the project facility. Click on the legend symbol in the upper right of the map to
identify how the map colors correspond to the propoportion categories (Select all that apply).
0% of Treed Area at Risk
1 - 4%
5 - 14%
15 -24%
25% or greater
Could not be determined
I have provided additional forest health
information as an Appendix item.

CONTINUE ON TO SECTION B OF THE APPLICATION

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B. Description of Project and Financial Plan (Address the following in spaces provided beginning on page 10)
Describe the intended project activities and financial need of the project facility. Describe the planned project
activities that will (1) Utilize meaningful volumes of byproducts from ecosystem restoration activities on federal
lands or Tribal lands and/or (2) Improve manufacturing efficiencies to ensure continued operations at the project
facility. In addition, describe how the financial assistance will play a role in creating long-term wood utilization that
will support continued ecosystem restoration work on federal or Tribal lands. Identify the following:
1. What are the project goals and objectives?
2. How will the financial assistance be used to increase wood utilization capacity or manufacturing efficiencies at
the project facility?
3. What is the anticipated impact of the financial assistance on the ability of federal or Tribal land managers to
reduce wildfire risk or insect and disease infestation?
4. Identify how the project will assist in reducing the cost of conducting ecological restoration projects that
generate byproducts such as logs and woody biomass.
ADDRESS THE ABOVE ITEMS IN THE SPACE PROVIDED ON THE FOLLOWING PAGES

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B. Description of Project and Financial Plan (Information to be provided is limited to the space on pages 10 and
11. Additional space is provided on the next page.)

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B. Description of Project and Financial Plan Continued (Information to be provided is limited to the space pages
10 and 11.)

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C. Budget Tables and Justification
The Project Budget Table and Justifications are required in Part 1 of the application. While no match is required, if
applicant is using non-federal funds as match to the project, identify these contributions in Column ll of the Project
Budget table and in the Cooperator Match Funding Table. The budget tables should support the Description of
Financial Need and mirror data entered in the required financial form SF-424A (Budget Information for NonConstruction Programs).
Instructions for the Project Budget Table:
Lines 1-8: Enter the dollar amount for each item.
Line 4: Only stationary equipment is eligible for Forest Service grant funds. The leasing of mobile equipment is
allowed if the lease agreement is not lease-to-own. Indian Tribes seeking financial assistance will be allowed to use
the Forest Service funding for the purchase of mobile equipment.
Line 9: Sum of Lines 1 through 8.
Line 10: Costs not directly attributable to accomplishing the project, such as overhead or indirect costs. Indirect
costs are limited to 10% of total direct costs unless a federally negotiated indirect cost rate agreement (NICRA) has
been established.
Line 11: Sum of Lines 9 and 10
Line 12: Use the total in Line 11, Column III to determine the percentage of each share in Line 12, Columns I and II.
Project Budget Table
Budget Categories

I. Forest Service Funds

II. Cooperator Funds
(non-federal funds)

III. Total

N/A

N/A

1. Personnel
2. Fringe Benefits
3. Travel
4. Equipment
5. Supplies/Materials
6. Contractual
7. Construction

N/A

8. Other
9. Total Direct Charges
10. Indirect Charges
11. Total
12. Percentage of Total
Note: Applicants should be aware that the purchase of stationary equipment (>$5,000) with USDA Forest Service funds creates a federal interest
in the quipment. Any proposed equipment purchase is subject to the regulations at 2 CFR § 200.310, 200.313, and 200.316. These and other 2
CFR § 200 regulations are available for viewing at the Code of Federal Regulations website https://www.ecfr.gov/

Cooperator Match Funding Table - Identify the value of the contributions your organization or partners will be
bringing to the project. The totals in this table should equal Column II Cooperator Funds in the above Project
Budget Table. Letters of financial support from partners should be included as an Appendix item.
Cooperator

Cash

Materials

In-Kind Services

Total

Totals

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Budget Justification
On the following pages, please provide specific details on how USDA Forest Service funding will be used for each of
the budget categories identified in the previous two budget tables.
Budget Line 1. Personnel: This is the actual estimated salary cost paid and does not include fringe benefits. Show
job titles or positions, estimated days or hours, and the estimated cost per day or hour. Clearly delineate if the
personnel costs listed below are being used as in-kind match or if the personnel costs are part of the overall financial
request. Cost must align with regulations listed in 2 CFR § 200.430. (This field is limited to 4,700 characters with
spaces)

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Budget Line 2. Fringe Benefits: Fringe benefits are generally expressed as a percentage of salary cost. Provide the
rate and total estimated cost or in-kind contribution. (This field is limited to 1,625 characters with spaces)

Budget Line 3. Travel: Show anticipated trips, number of travelers, locations, and an estimated cost per trip. Clearly
delineate if the travel is being requested as part of the federal financial assistance or if travel is being used as in-kind
match. (This field is limited to 1,625 characters with spaces)

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Budget Line 4. Equipment: Identify all equipment that is being funding with federal financial assistance and which
equipment will be used as in-kind match. When possible provide documentation of equipment cost or quotes as an
appendix item. (This field is limited to 5,000 characters with spaces)

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Budget Line 5. Supplies/Materials: Identify all materials and supplies that is being funding with federal financial
assistance and which items will be used as in-kind match. When possible provide documentation of cost estimates or
quotes as an appendix item. (This field is limited to 5,000 characters with spaces)

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Budget Line 6. Contractual: Identify contractual costs that is being funding with federal financial assistance and
which items will be used as in-kind match. When possible provide documentation of cost estimates or quotes as an
appendix item. (This field is limited to 5,000 characters with spaces)

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Budget Line 8. Other: Identify other project costs, that do not fit in the previous categories that are being
funding with federal financial assistance and which items will be used as in-kind match. When possible provide
documentation of cost estimates or quotes as an appendix item. Note: Federal funds cannot be used for construction
activities and construction activities cannot be used as in-kind match. In addition, federal funds cannot be used for
activities that improve land as defined in 26 CFR § 1.856-10 Definition of real property. (This field is limited to 4,000
characters with spaces)

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D. Appendices
The following items are required appendices of Part I and do not have page limitations or formatting
requirements.
1. Resumes of project team members and highly relevant partners.
2. If applicable, a list of all funds (federal, state, private) received, that are closely related to this financial
request within the last five years (include agency, program name, and dollar amount).
3. A screen shot from SAM.gov showing either an active registration or that the registration process has been
initiated in SAM.gov. Click for instructions for capturing screen shots using Windows or Mac operating
systems.
4. Letters of financial support specifying commitment of non-federal funding contributions (cash or in-kind) to
the project.
Appendices should be well organized with an index so reviewers can readily find information of interest. Include
only relevant information in the appendices that will help the review panel understand and evaluate your project.
The following are examples of optional appendices of Part I and do not have page limitation or formatting
requirements.
1. Copies of current contracts for the removal, disposal, or purchase of wood products from federal, tribal,
state, county, city, or private lands.
2. Cost quotes from equipment manufacturers or firms for items or services directly related to this financial
request for assistance.
3. Feedstock supply studies related to the project facility.
4. Letters of support for the project from land management agencies, tribal governments, or private
landowners.

ATTACH THE REQUIRED AND OPTIONAL APPENDIX DOCUMENTS TO THIS APPLICATION FORM

File Code: 1580

For technial questions and Section 508 accommodation, please contact SM.FS.fseforms@usda.gov

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