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U.S. Department of Justice Investigative Operations <br /> United States Marshals Service Obligation Document <br /> INSTRUCTIONS: See page 2 for detailed instructions. <br /> SECTION 1:OBLIGATION <br /> The obligation number will be entered once all parties have signed the form 11SM614. <br /> UFMS OBLIGATION#: N4-17-A34-000856 <br /> SECTION 2: PARTICIPATING AGENCIES <br /> Notification to state and local agencies of funding provided in support of U.S.Marshals Service operations,pursuant to the Memorandum of Understanding(MOU) <br /> between: <br /> Everett Police Department <br /> and <br /> Western District of Washington(86) <br /> SECTION 3: PROJECT/OPERATION NAME <br /> Beast Mode <br /> SECTION 4: PERIOD OF PERFORMANCE <br /> July 10.2017 to August 18,2017 <br /> SECTION 5:APPROPRIATION DATA <br /> FISCAL\'EAR ORGANIZATION Ft NI) PROJECT SOC PURPOSE DOLLAR AMOUNT <br /> 21000 Travel/Per Diem <br /> 3101 I Investigative Expenses <br /> 2017 D86 0324 FWB3000F 25200 State& Local Overtime S5,271.04 <br /> 26001 Supplies& Materials <br /> ADD APPROPRIATION DATA TOTAL OBLIGATION AMOUNT: S5,271.04 <br /> SECTION 6:CONTACT INFORMATION <br /> DISTRICT/HQ CONTACT: S_TATE/LOCAL CONTACT: <br /> Name: Brian Allan Name: Mike Atwood <br /> Phone: (206)718-0802 Phone: (425)508-1242 <br /> E-mail: brian.allan gni usdoj.gov E-mail: matwood a,everettwa.gov <br /> SECTION 7:AUTHORIZATION <br /> This obligation document serves as notification of funding provided to support state and local agencies participating in U.S.Marshals Service Operations subject to the <br /> availability of funds.The U.S.Marshals Service reserves the right to remove unused residual funds upon completion of payments under this obligation. <br /> USMS Administrative Representative-Certification of Funds: <br /> Signature: KAYLA CELAYA - Date: 7/10/2017 <br /> Kayla Celaya,ACDUSM <br /> USMS Operational Representative-Obligation Approval: <br /> Signature: Date: 7/10/2017 <br /> acob Green. U. . v arshal <br /> Departmental Representative-Acknowledgement: <br /> Signature: Date: <br /> Dan Templeman,Chief of Police <br /> SECTION 8:STATE/LOCAL FINANCIAL CONTACT INFORMATION: <br /> A.The state/local agency will be applied by the state/local agency financial contact information. <br /> B.The state/local agency will provide a valid DUNS number from the SAM.gov database. <br /> Name: Tracey Versteeg E-mail: tversteeg everettwa.gov <br /> Phone: (425)257-8447 State/Local Agency DUNS#: (A c 1 q ` Sw <br /> ATTEST: Form USM-614 <br /> Page 1 oft Rev.01/17 <br /> City Clerk <br />