NERI_Dun-Glen-Ark_RFP_Attachment-B_Form-10-354_NPS-Leasing-Organization-Information-(Corporation-Limited Liability-JV)_508_Compliant.docx
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About this file
This file is NPS Form 10-354, a required offeror information form for entities submitting proposals to lease National Park Service property. The form is designed for corporations, limited liability companies, partnerships, or joint ventures and must be completed for the NERI_Dun-Glen-Ark_RFP solicitation (Proposal Package L-NERIDGA-27). Offerors must provide comprehensive organizational details including entity name and trade name, business address, telephone, email, principal contact information, Tax ID, state of formation, and formation date. The form requires disclosure of ownership structure, including percentage ownership interests, current investment values, names and addresses of all owners, and total outstanding interests with their types.
Additionally, the form mandates identification of all principals as defined under 2 C.F.R. 180.995, along with their addresses, titles, and affiliations. The form is governed by the Privacy Act and Paperwork Reduction Act, with an OMB Control Number 1024-0233 valid through May 31, 2026. The estimated burden to complete the form ranges from 5 to 10 hours depending on business complexity. Information collected is used to evaluate lease proposals and manage the NPS Leasing Program for residential and commercial uses within National Park System units, with routine disclosures permitted to federal, state, local governments, tribal organizations, and the public regarding lease holder contact information and available services. Submission of this form is voluntary but failure to provide requested information may impede NPS ability to manage and monitor the leasing program and public services.
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OMB Control No. 1024-0233 Expiration Date: 05/31/2026 ##/##/#### NPS Form 10-354 (Rev. 10/2026) National Park Service
OFFEROR INFORMATION
Corporation, Limited Liability Company, Partnership, or Joint Venture
PROPOSAL PACKAGE
L-NERIDGA-27
Note: Either a Form 10-353 or Form 10-354 is completed for each proposal, depending on the nature of the Offeror.
Complete separate forms for each Offeror, if more than one. If the Offeror is an individual or sole proprietor, use Form 10-353.
Name of Entity and Tradename, if any Click or tap here to enter text.
Address Click or tap here to enter text.
Telephone Number Click or tap here to enter text.
Email Address Click or tap here to enter text.
Contact Person Click or tap here to enter text.
Title Click or tap here to enter text.
Tax ID# Click or tap here to enter text.
State of Formation Click or tap here to enter text.
Date of Formation Click or tap here to enter text.
| Ownership |
| Percentage of Ownership Interests |
| Current Value of Investment |
Names and Addresses of Owners Click or tap here to enter text.
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| Total Interests Outstanding and Type(s): |
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| Principals (as defined at 2 C.F.R. § 180.995) |
| Address |
| Title and/or Affiliation |
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NOTICES PRIVACY ACT STATEMENT
Authority: 54 U.S. Code Chapter 1021—Privileges and Leases; 54 U.S. Code § 306121—Lease or exchange.
Purpose: The purposes of the system are (1) to assist NPS employees in managing the NPS Leasing program allowing for residential and commercial uses within a unit of the National Park System to ensure that business activities are conducted in a manner that complies with Federal laws and regulations; (2) to monitor resources that are or may be affected by the authorized residential and/or commercial uses within a unit of the National Park System; (3) to track applicants and holders of leases who are planning to conduct or are conducting business within units of the National Park System; and (4) to provide to the public the description and contact information for businesses that provide services in national parks.
Routine Uses: In addition to those disclosures generally permitted under 5 U.S.C.552a(b) of the Privacy Act, records or information contained in this system may be disclosed outside DOI as a routine use pursuant to 5 U.S.C. 552a(b)(3) to other Federal, state and local governments, tribal organizations, and members of the general public upon request for names, addresses and phone numbers of lease holders conducting business within units of the National Park System for the purpose of informing the public of the availability of the services offered by the leaseholder. In addition, records or information contained in this system may be disclosed outside DOI based on an authorized routine use when the disclosure is compatible with the purpose for which the records were compiled as described under the system of records notice for this system.
Disclosure: Voluntary, however, failure to provide the requested information may impede our ability to 1) manage the National Park Service (NPS) Leasing Program allowing for residential and/or commercial uses within a unit of the NPS, 2) monitor resources that are or may be affected by the authorized residential and/or commercial uses, and 3) provide the public the description and contact information for businesses that provide services in national parks.
PAPERWORK REDUCTION ACT STATEMENT
We collect this information under the authority of 54 U.S.C. Chapter 1021. We use this information to evaluate a lease proposal. Your response is required to obtain or retain a benefit. We may not collect or sponsor and you are not required to respond to a collection of information unless it displays a currently valid OMB control number. OMB has approved this collection of information and assigned Control No. 1024-0233.
ESTIMATED BURDEN STATEMENT
We estimate that depending on the complexity of your business organization it will take between 5 and 10 hours to complete this form, including time to review instructions, gather and maintain data, and complete and review the form. You may send comments on the burden estimate or any aspect of this form to the Information Collection Clearance Officer, National Park Service, 1201 Oakridge Drive, Fort Collins, CO 80525. Please do not send your completed form to this address.
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