LEGAL--Agreement Forms 9-1482, 9-1482-A, and 9-1483
United States Department of the Interior
GEOLOGICAL SURVEY
Reston, VA 22092
In Reply Refer To:
Mail Stop 403
WATER RESOURCES DIVISION MEMORANDUM NO. 94.08
Subject: LEGAL--Agreement Forms 9-1482, 9-1482-A, and 9-1483
The purpose of this memorandum is to describe revised procedures for completing agreements for the installation,
maintenance, and use of a test hole, observation well, and/or gaging station on private property. It also delegates signature
authority for these agreements to the District Chiefs and designates the originating office as the official repository for
completed agreements.
Effective immediately, form 9-1482-A is cancelled. It will be replaced by Form 9-1482, Agreement for Installation and
Maintenance of Gaging Station on Private Property, and 9-1483, Agreement for Installation, Maintenance, and use of a
Test Hole and/or Observation Well on Private Property (rev. 11/93) (see attachments) which can be ordered from General
Services Administration, National Form Center, Ft. Worth, Texas.
Complete the original and one copy of the agreement. Assign a number consisting of the first four digits of your cost
center, hyphen, a sequential number beginning with 01, and the year in which the agreement is processed. For example:
4060-0193, 4060-0293, etc. This number should be referenced on invoices submitted to the Office of Financial
Management for payment to a property owner. When submitting an invoice to Office of Financial Management for
payment to a property owner, refer to the assigned number on the agreement.
In preparing this agreement form, the county in which the gaging station, test hole and/or observation well will be located
must be shown in paragraph 2 (site location). When the Licensor feels a "hold harmless" clause is necessary, please
contact the Water Resources Division Administrative Officer or the Solicitor servicing your area for an appropriate
addendum to the agreement. Return the fully executed signed agreement to the property owner, and retain a copy in the
district files.
William B. Mann IV
Assistant Chief Hydrologist for Operations
2 Attachments
Distribution: Regional Hydrologists, NR, SR, CR, WR, FO, PO
This memorandum supersedes WRD Memorandum No. 78.144, same subject, dated September 13, 1978.
9-1482 (Rev.)
Nov. 1993
AGREEMENT FOR INSTALLATION AND MAINTENANCE OF GAGING STATION ON PRIVATE OR PROPERTY
THIS AGREEMENT is entered into this day of '19 by
and between , hereinafter called
"Licensor," and the United States of America, by and through the U.S. Geological Survey. U.S.
Department of the Interior, hereinafter called "Licensee," pursuant to the Act of December 24, 1942, as
amended (43 U.S.C. sec. 36 b).
WITNESSETH:
1. Licensor, for and in consideration of the faithful performance by Licensee of all covenants and conditions herein contained and
payment of the amount hereinafter provided, hereby consents and agrees to the installation, maintenance and use of (describe physical
characteristics of gaging station)
hereinafter collectively referred to as "Structure," by the Licensee upon and over the property of the Licensor as described in
Paragraph 2 hereof. and the Licensor grants the right of ingress to and egress from the said Structure and property described herein.
2. The said Structure shall be located on the property of Licensor as shown on attached drawing and further described as follows: (site
location)
3. The said Structure and appurtenances thereof shall be maintained in a good, safe and workmanlike manner.
4. The said Structure and appurtenances and all equipment and tools for the maintenance and use thereof placed in or upon said
described property shall remain the property of the Licensee and may be removed by the Licensee at its own cost and expense at any
time during the life of this agreement or any renewal thereof. or within 90 days after the expiration of this agreement or any renewal
thereof. or within a reasonable time from date of receiving written notice from the Licensor to change the location of said Structure
and appurtenances or any part thereof upon the said described property. Upon removal or relocation of said Structure and
appurtenances the Licensee shall restore the described property to. as nearly as possible. the same state and condition existing prior to
the installation of said Structure and its appurtenances.
5. Licensee agrees to cooperate to the extent allowed by law, in the submittal of all claims for alleged loss, injuries. or damages. to
persons or property arising from the acts of Licensee's employees. acting within the scope of their employment. in the installation.
use, maintenance. removal or relocation of said Structure. appurtenances. equipment and tools pursuant to the Federal Tort Claims
Act 28 U.S.C.. sec. 2671 et seq.)
6. As consideration for the rights and privileges granted herein. the Licensee shall pay to the
Licensor the sum of $ upon presentation of bill therefor, subject to the availability of
appropriations by the Congress
7. This agreement shall become effective on the day and year first above written, and shall continue in full force and effect until
terminated by either Licensor or Licensee at any time on 30 days written notice.
8. No Member of, or Delegate to, Congress or Resident Commissioner after his election or appointment, either before or after
he has qualified and during his continuance in office, and no officer, or agent or employee of the Government. shall be admitted
to any share of this agreement, or to any benefit arising therefrom, but this provision shall not be constructed to extend to this
agreement if made within a corporation for its general benefit.
9. The Licensor warrants that he has not employed any person to solicit or secure this contract upon any agreement for a
commission. percentage, brokerage, or contingent fee. Breach of this warranty shall give the Licensee the right to terminate the
license, or, in its discretion, to deduct from the license amount or consideration, the amount of such commission, percentage,
brokerage, or contingent fees. This warranty shall not apply to commissions payable by Licensor upon licenses secured or made
through bona fide established commercial or selling agencies maintained by the Licensor for the purpose of securing business.
10. This agreement shall inure to the benefit of. and be binding upon, the successors, assigns, and transferees of the parties
hereto. including successors of the Licensee in control of the project or the portion thereof affected by this agreement.
IN WITNESS WHEREOF. the parties have caused this agreement to be executed the day and year first above written.
LICENSOR:
LICENSEE:
NAME- UNITED STATES OF AMERICA
DEPARTMENT OF THE INTERIOR
GEOLOGICAL SURVEY
ADDRESS By
Tide
APPROVED:
By
District Chief
Water Resources Division
9-1483 (Rev.)
Nov. 93
AGREEMENT FOR INSTALLATION, MAINTENANCE AND USE OF A TEST HOLE AND/OR OBSERVATION WELL ON PRIVATE OR PROPERTY
THIS AGREEMENT is entered into this _ day of '19 by and
between , hereinafter called "Licensor," and the
United States of America, by and through the U.S. Geological Survey, U.S. Department of the Interior, hereinafter
called "Licensee," pursuant to the Act of December 24, 1942, as amended (43 U.S.C. see 36b).
WITNESSETH:
1. Licensor, for and in consideration of the faithful performance by Licensee of all covenants and conditions herein contained and
payment of the amount hereinafter provided, hereby consents and agrees to the excavation, installation, maintenance, and exclusive
use of (describe physical characteristics of hole and/or well, maintenance facilities, and purposes of excavation, use and maintenance.)
herinafter collectively referred to as -Structure," by the Licensee upon and over the property of the Licensor as described in Paragraph
2 hereof. and the Licensor grants the right of ingress to and egress from the said Structure and property described herein for the
purpose stated herein.
This test hole is an opening which extends into the earth and is produced by drilling or augering methods.
This observation well is a hole which extends into the earth and is produced by drilling or augering, which may or may not be cased
or screened. and exist-, solely for the purpose of obtaining geologic and hydrologic information.
2. The said Structure shall be located on the property of Licensor as shown on attached drawing and further described as follows: (site
location)
3. Excavation and/or installation of said structure shall begin with days or a mutually
agreeable time after the effective date of this agreement. The said Structure and appurtenances thereof shall be
excavated, installed and maintained in a good. safe. diligent and workmanlike manner.
4. The said Structure and appurtenances and all equipment and tools for the maintenance and use thereof placed in or upon said
described property shall remain the property of the Licensee and shall be removed, filled and/ or plugged. etc., by the licensee at its
own cost and expense within a reasonable time after the expiration of this agreement or any renewal thereof. Upon removal. filling
and/or plugging, etc. of said Structure and appurtenances the Licensee shall restore said property to. as nearly as, possible. the same
state and condition existing prior to the excavation, and/or installation of said Structure and its appurtenances.
5. The Licensee agrees to cooperate. to the extent by law. in the submittal of all claims for alleged loss, injuries, or damages to
persons or property arising from the acts of Licensee's employees, acting within the scope of their employment, in the excavation,
installation. use. maintenance. and/or removal of said Structure appurtenances, equipment and tools pursuant to the Federal Tort
Claims Act (28 U.S.C. 2671 et seq.)
6. As Consideration for the rights and privileges granted herein, the Licensee shall pay to the Licensor the
sum of $ upon presentation of bill therefor, subject to the availability of appropriations by the
Congress.
7. This agreement shall become effective on the day and year first above written, and shall continue in full force and effect until terminated by
Licensee at any time on 30 days written notice.
8. No Member of, or Delegate to, Congress or Resident Commissioner after his election or appointment, either before or after he has qualified and
during his continuance in office, and no officer, agent or employee of the Government, shall be admitted to any share of this agreement, or to any
benefit arising thereErom, but this provision shall not be construed to extend to this agreement if made with a corporation for its general benefit.
9. The Licensor warrants that he has not employed any person to solicit or secure this contract upon any agreement for a commission, percentage,
brokerage or contingent fee. Breach of this warranty shall give the Licensee the right to terminate the agreement, or, in its discretion, to deduct from
the agreement amount or consideration, the amount of such commission, percentage, brokerage, or contingent fees. This warranty shall not apply to
commissions payable by Licensor upon agreements secured or made through bona fide established commercial or selling agencies maintained by the
Licensor for the purpose of securing business.
10. This agreement shall inure to the benefit of, and be binding upon, the successors, assigns, and transferees of the parties hereto, including
successors of the Licensee in control of the project or the portion thereof affected by this agreement.
IN WITNESS WHEREOF. the parties have caused this agreement to be executed the day and year first above written.
LICENSOR:
LICENSEE:
NAME UNITED STATES OF AMERICA
DEPARTMENT OF THE INTERIOR
GEOLOGICAL SURVEY:
ADDRESS
APPROVED:
By
District Chief
Water Resources Division