| U. S. Environmental Protection Agency | ||
| Clean School Bus(CSB) Grant Program | ||
| Supplemental Application Template | ||
| Burden Statement for EPA Form Number: 5900-680 | ||
| This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2060-0754). Responses to this collection of information are voluntary (2 CFR 200 at 2 CFR 1500). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The public reporting and recordkeeping burden for this collection of information is estimated to be 7.2 - 7.6 hours per response. Send comments on the Agency’s need for this information, the accuracy of the provided burden estimates and any suggested methods for minimizing respondent burden to the Regulatory Support Division Director, U.S. Environmental Protection Agency (2821T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address. | ||
| Instructions | ||
| This supplemental application template should be completed and submitted as part of the application materials for the Clean School Bus Grant Program. Please work with relevant parties (i.e., transportation contractor, bus dealer, etc.) to ensure information submitted is as accurate as feasible at the time of application. The applicant must fill out shaded cells highlighted blue with a diagonal pattern (///) to the best of their ability. Cells highlighted yellow are automatically populated based on previous responses in this spreadsheet. Fields shaded in white are encouraged, but may not be known at the time of application. Additionally, some fields will hash out with a bold diagonal pattern (///) if those fields are not applicable based on the information provided in previous cells. Please complete tabs in this workbook according to the instructions below. | ||
| Excel Workbook Tab | Definition | |
| 1. Instructions | Basic instructions for all worksheets in this reporting workbook. | |
| 2. Fleet Description | The Fleet Description tab should detail all vehicles impacted under the project. The Fleet Description should be completed at the time of application; if selected, awardees will update this table according to the cadence determined by your Project Officer with all vehicle upgrades completed. For third-party applicants, please list ALL school districts in this one worksheet. You do NOT need to make a separate worksheet for each school district. The applicant must fill out shaded cells highlighted blue with a diagonal pattern (///) to the best of their ability. Fields in yellow will be automatically populated based on previous responses. Fields shaded in white are encouraged, but may not be known at the time of application. Additionally some fields will hash out with a bold diagonal pattern (///) if those fields are not applicable based on the information provided in previous cells. This Fleet Description is broken into two sections: 1) Current Vehicle Information, and 2) New Vehicle Upgrade Information. The sheet has capacity for 100 vehicles. Please refer to the Fleet Description data definitions on tab 4 (Data Dictionary) for data field definitions. |
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| 3. Infrastructure | The Infrastructure tab should detail all electric vehicle supply equipment (EVSE) and other eligible supporting infrastructure planned as part of the project; if selected, awardees will update these tables according to the cadence determined by your Project Officer as EVSEs and other infrastructure are procured and installed. For third-party and large school districts applicants, the Infrastructure needs to be listed by school district and/or city. That is, if School District A and School District B are procuring the same EVSE, the EVSE Equipment Information with appear as two separate EVSE Groups. Similarly, for large school districts, if EVSEs are being installed in two different locations, the EVSE equipment information needs to appear as two separate EVSE Groups. The applicant must fill out shaded cells highlighted blue with a diagonal pattern (///) to the best of their ability. Fields in yellow will be automatically populated based on previous responses. Fields shaded in white are encouraged, but may not be known at the time of application. Additionally, some fields will hash out with a bold diagonal pattern (///) if those fields are not applicable based on the information provided in previous cells. Additional rows may be add as needed to capture all units of supporting infrastructure. The final text field on this tab may be used to supply information about other types of eligible infrastructure under this program. Please refer to the Infrastructure data definitions on Tab 4 (Data Dictionary) for data field definitions. Reminder: All Level 2 EVSEs must be ENERGY STAR certified, and all infrastructure must comply with Build America, Buy America (BABA) requirements. |
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| 4. Data Dictionary | Please refer to the dictionary on this tab for support in completing the Fleet Description and Infrastructure Tabs. | |
| U. S. Environmental Protection Agency | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Clean School Bus (CSB) Grant Program | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Fleet Description | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Applicant Name | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| SAM.gov Unique Entity ID | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Project Title | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Instructions | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| The Fleet Description should detail all vehicles anticipated to be replaced under the project and, to the extent details are known at this time, all replacement vehicles that will be purchased using Clean School Bus Grants funding. For third-party applicants, please list ALL school districts in this one worksheet. You do NOT need to make a separate worksheet for each school district. Please fill out shaded cells highlighted blue with a diagonal pattern (///) to the best of your ability. Fields in yellow will be automatically populated based on previous responses. Fields shaded in white are highly encouraged, but optional, as these data may not be known at the time of application. Additionally, some fields will hash out with a bold diagonal pattern (///) if those fields are not applicable based on the information provided in previous cells. This Fleet Description is broken into two sections: 1) Current Vehicle Information and 2) New Vehicle Upgrade Information. The sheet has capacity for 100 vehicles. Please refer to the Fleet Description data definitions on tab 4 (Data Dictionary) for data field definitions. |
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| Table 1. CURRENT VEHICLE INFORMATION | Table 2. NEW REPLACEMENT VEHICLE INFORMATION | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 1a. Basic Vehicle Information | 1b. Vehicle Disposition Process | 1c. Current Vehicle Place(s) of Performance | 2a. Upgrade Vehicle Information | 2b. Upgrade Cost | 2c. New Vehicle Place(s) of Performance | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Primary Place of Performance | Secondary Place of Performance (if applicable) | Additional Location Details (if applicable) | Primary Place of Performance | Secondary Place of Performance (if applicable) | Additional Location Details (if applicable) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Optional, but highly encouraged if known* | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Vehicle | Group Name | Current Fleet Owner | Vehicle Identification Number | Vehicle Manufacturer | Vehicle Model | Baseline Vehicle Model Year | Baseline Engine Fuel Type (select from dropdown) |
Engine Family Name (if unregulated, then enter N/A) |
Gross Vehicle Weight Rating (GVWR) | Vehicle Class (select from dropdown) |
Current Odometer (in miles) |
Annual Miles Traveled (miles per vehicle) | Annual Idling Hours (hours per vehicle) | Annual Amount of Fuel Used (gallons/year per engine) | Remaining Life of Baseline Engine/Vehicle | Anticipated Vehicle Disposition Method | If sold or donated, provide the state in which the existing vehicle is expected to primarily operate (if known) | If sold or donated, provide the county in which the existing vehicle is expected to primarily operate (if known) | Place of Performance: School District | Place of Performance: NCES ID | Place of Performance: State | Place of Performance: County | Percentage of Time operated in this County | Place of Performance: City | Place of Performance: Zip Code | Place of Performance: School District_2 | Place of Performance: NCES ID_2 | Place of Performance: State_2 | Place of Performance: County_2 | Percentage of Time operated in this County 2 |
Place of Performance: City_2 | Place of Performance: Zip Code_2 | Additional Counties Where Vehicle Operates | Additional School Districts where Vehicle Operates (Name & NCES ID) | Percentage of Time Operated in Each Additional County | Year of Upgrade Action | New Vehicle Fleet Owner | New Vehicle Class (select from dropdown) |
New Vehicle Fuel Type | New Vehicle Manufacturer (if known) |
New Vehicle Model (if known) |
New Vehicle Model Year (if known) |
New Vehicle GVWR (if known) |
New Engine or Vehicle Family Name (if known) |
Capable of Bidirectional Charging? (Yes/No/NA) | Equipped with Auxiliary Heater? (Yes/No/NA) | Estimated Range in Miles (if known) |
Estimated Acquisition Cost per Vehicle | Total EPA Funds Requested Per Vehicle ($ of Total Cost per Unit) | Place of Performance: School Distric_3 | Place of Performance: NCES ID_3 | Place of Performance: State_3 | Place of Performance: County_3 | Percentage of Time operated in this County_3 | Place of Performance: City_3 | Place of Performance: Zip Code_3 | Place of Performance: School Distric_4 | Place of Performance: NCES ID_4 | Place of Performance: State_4 | Place of Performance: County_4 | Percentage of Time operated in this County_4 | Place of Performance: City_4 | Place of Performance: Zip Code_4 | Additional Counties Where Vehicle Operates_2 | Additional School Districts where Vehicle Operates (Name & NCES ID)_2 | Percentage of Time Operated in Each Additional County_2 |
| Example Vehicle | ESBs for District A | Sarah Smith | 12345678910ABCDEFG | Manufacturer Name | Model Name or # | 1995 | Diesel | N/A | 10150 | Class 6 | 1500000 | 140000 | 12000 | 6000 | 6000 | Scrapped | CA | Alameda County | Warren 01 | 123456 | SC | Warren | 50% | Springhill | 22190 | Warren 01 | 123456 | SC | Warren | 40% | Springhill | 123454 | Pima County, AZ; La Paz County, AZ | 3847539; 3847563 | 5% in Pima; 5% in La Paz | 2025 | Walton School District | Class 6 | Battery Electric | Manufacturer Name | Model Name or # | 2025 | 12000 | ABC | Yes | Yes | 200 | $375,000.00 | $325,000.00 | Warren 01 | 123456 | SC | Warren | 100% | Springhill | 22190 | Warren 01 | 123456 | SC | Warren | 100% | Springhill | 38202 | Pima County, AZ; La Paz County, AZ | 3847539; 3847563 | 5% in Pima; 5% in La Paz |
| Vehicle 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| U. S. Environmental Protection Agency | ||||||||||||||||||||||||||||||
| Clean School Bus (CSB) Grant Program | ||||||||||||||||||||||||||||||
| Infrastructure Description | ||||||||||||||||||||||||||||||
| Instructions | ||||||||||||||||||||||||||||||
| Below are three tables (Table 3, Table 4, and Table 5), and an additional question below Table 5. Please complete all 4. The EVSE Equipment Information (Table 3) should detail all electric vehicle supply equipment (EVSE) and supporting infrastructure purchased under the project. Table 4 focuses on on-site power generation systems and Table 5 on battery energy storage systems. For all three tables, the infrastructure needs to be listed by school district and/or city. That is, if School District A and School District B are procuring the same EVSE, the EVSE will appear as two separate EVSE Groups. Similarly, for large school districts, if EVSE are being installed in two different locations, the EVSE needs to appear as two separate EVSE Groups. Please fill out shaded cells highlighted blue with a diagonal pattern (///) to the best of your ability. Note, additional rows may be added as needed to capture all equipment. Fields in yellow will be automatically populated based on previous responses. Fields shaded in white are highly encouraged, but optional, as these data may not be known at the time of application. Additionally, some fields will hash out with a bold diagonal pattern (///) if those fields are not applicable based on the information provided in previous cells. Please refer to the Infrastructure data definitions on Tab 4 (Data Dictionary) for data field definitions. Reminder: All Level 2 EVSEs must be ENERGY STAR certified. All EVSE, on-site power generation systems, battery energy storage systems (BESS), and any other infrastructure components must comply with Build America, Buy America (BABA) requirements. See below for more information on BABA. |
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| Build America, Buy America (BABA) requirements | ||||||||||||||||||||||||||||||
| On November 15, 2021, the Infrastructure Investment and Jobs Act ("IIJA"), Pub. L. No. 117-58, which includes the Build America, Buy America Act (BABA), Public Law 117-58, §§ 70901-52, was signed into law. BABA requires that on or after May 14, 2022, all of the iron, steel, manufactured products, and construction materials used in infrastructure project are produced in the United States. If award recipient will be installing, upgrading, or replacing “infrastructure,” then BABA requirements apply to the infrastructure project, regardless of whether or not the infrastructure project was the primary basis for the award. Additionally, BABA requirements apply even if the award recipient will be using another source of funding, whether in part or wholly, for the infrastructure project. For more information, please visit https://www.epa.gov/cwsrf/build-america-buy-america-baba. | ||||||||||||||||||||||||||||||
| Do you attest that you have read the BABA requirements described above? | ||||||||||||||||||||||||||||||
| Table 3. Electric Vehicle Service Equipment | ||||||||||||||||||||||||||||||
| Table 3a. EVSE Equipment Information Overview | Table 3b. Location of EV Infrastructure | Table 3c. Owners & Anticipated Users of EVSE | Table 3d. Infrastructure Installation Information | Table 3e. EVSE Cost Summary | Table 3f. BABA Compliance | |||||||||||||||||||||||||
| Optional, but highly encouraged if known* | Optional, but highly encouraged if known* | Optional, but highly encouraged if known* | ||||||||||||||||||||||||||||
| Type of Charger | If Level 2, is it ENERGY STAR certified | EVSE Manufacturer | EVSE Model | EVSE Manufacture Year | EVSE Maximum Output Power (kW) | Number of Plugs on EVSE | Will the EVSE Be Capable of Bidirectional Charging? | Will the Vehicle and EVSE be Used for Vehicle to Grid (V2G)? | Number of EVSE Units | Total Estimated Acquisition Cost per EVSE Unit | Total EPA Funds Requested for Acquisition of Each EVSE Unit | Total EPA Funds Requested for EVSE Acquisition | State (Select from dropdown) |
County (Select from dropdown) |
City | Zip Code | Street Address | Who will own the charger? | Anticipated User(s) of the charger | Will the EVSE serve multiple school districts within this project? | Name of the School District(s) the EVSE will serve (if applicable; use a semicolon between school districts) |
NCES ID of School District that the EVSE will serve (if applicable; use a semicolon between school districts) |
Total Estimated Cost for EVSE Installation | Total EPA Funds Requested for Installation Cost | Does the Infrastructure Equipment Cost Include Installation? | Installation Work Performed By | Total EPA Funds Requested for EVSE Equipment and Installation | Estimated Total Cost for EVSE Equipment and Installation | Is a waiver being used to fulfill BABA compliance for this EVSE? | |
| Example EV Infrastructure | Level 2 | Yes | Manufacturer Name | Model Name | 2023 | 24 | 2 | No | No | 2 | $16,000.00 | $12,000.00 | $24,000.00 | VA | Arlington County | Alexandria | 22305 | 400 1st Street | Walton School District | Electric school buses serving Walton School District | Yes | Walton School District; Franklin School District | 1234567; 7654321 | $12,000 | $7,000 | No | XYZ Electric Co. | $31,000.00 | $44,000.00 | No - Infrastructure meets all BABA requirements |
| EVSE Group 1 | $- | |||||||||||||||||||||||||||||
| EVSE Group 2 | $- | |||||||||||||||||||||||||||||
| EVSE Group 3 | $- | |||||||||||||||||||||||||||||
| EVSE Group 4 | $- | |||||||||||||||||||||||||||||
| EVSE Group 5 | $- | |||||||||||||||||||||||||||||
| EVSE Group 6 | $- | |||||||||||||||||||||||||||||
| EVSE Group 7 | $- | |||||||||||||||||||||||||||||
| EVSE Group 8 | $- | |||||||||||||||||||||||||||||
| EVSE Group 9 | $- | |||||||||||||||||||||||||||||
| EVSE Group 10 | $- | |||||||||||||||||||||||||||||
| EVSE Group 11 | $- | |||||||||||||||||||||||||||||
| EVSE Group 12 | $- | |||||||||||||||||||||||||||||
| EVSE Group 13 | $- | |||||||||||||||||||||||||||||
| EVSE Group 14 | $- | |||||||||||||||||||||||||||||
| EVSE Group 15 | $- | |||||||||||||||||||||||||||||
| EVSE Group 16 | $- | |||||||||||||||||||||||||||||
| EVSE Group 17 | $- | |||||||||||||||||||||||||||||
| EVSE Group 18 | $- | |||||||||||||||||||||||||||||
| EVSE Group 19 | $- | |||||||||||||||||||||||||||||
| EVSE Group 20 | $- | |||||||||||||||||||||||||||||
| EVSE Group 21 | $- | |||||||||||||||||||||||||||||
| EVSE Group 22 | $- | |||||||||||||||||||||||||||||
| EVSE Group 23 | $- | |||||||||||||||||||||||||||||
| EVSE Group 24 | $- | |||||||||||||||||||||||||||||
| EVSE Group 25 | $- | |||||||||||||||||||||||||||||
| EVSE Group 26 | $- | |||||||||||||||||||||||||||||
| EVSE Group 27 | $- | |||||||||||||||||||||||||||||
| EVSE Group 28 | $- | |||||||||||||||||||||||||||||
| EVSE Group 29 | $- | |||||||||||||||||||||||||||||
| EVSE Group 30 | $- | |||||||||||||||||||||||||||||
| Note: If the wind or solar power generation includes an energy storage system, information for such system needs to be documented in the table below this one (Table 5). | ||||||||||||||||||||||||||||||
| Table 4. Solar and Wind Power Generation Equipment | ||||||||||||||||||||||||||||||
| Table 4a. Solar and Wind Power Generation Equipment Information Overview | 4b. Location of Solar and Wind Power Generation Infrastructure | 4c. Ownership and Use of Solar and Wind Power Generation Infrastructure | 4d. BABA Compliance | |||||||||||||||||||||||||||
| Optional, but highly encouraged if known* | Optional, but highly encouraged if known* | |||||||||||||||||||||||||||||
| Type of energy generation | Manufacturer of Solar or Wind Power Generation System | Model of Solar or Wind Power Generation | Manufacture Year of Solar or Wind Power Generation | Generation Capacity of the system (please indicate kW or MW) | Total Estimated Acquisition Cost Per Power Generation System | Total EPA Funds Requested Per Power Generation System | Total Estimated Cost for Installation | Total EPA Funds Requested for Installation | Total Estimated Cost of Equipment and Installation | Total EPA Funds Requested for Installation | State | County | City | Zip Code | Street Address | Who owns the equipment? | Anticipated Users of Solar or Wind Power Generation Infrastructure | Name of the School District(s) the Solar or Wind Power Generation will serve | NCES ID of School District that the Solar or Wind Power Generation will serve | Is a waiver being used to fulfill BABA compliance for the Solar or Wind Power Generation? | ||||||||||
| Example Solar or Wind Power Generation | Solar | Manufacturer Name | Model Name | 2023 | 15 kW | $45,000.00 | $45,000.00 | $7,000.00 | $5,000.00 | $52,000.00 | $50,000.00 | VA | Arlington County | Alexandria | 22305 | 400 1st Street | Walton School District | Walton School District & NoVA Community College | Walton School District | 1234567 | No - Infrastructure meets all BABA requirements | |||||||||
| Solar or Wind Power Generation 1 | $- | $- | ||||||||||||||||||||||||||||
| Solar or Wind Power Generation 2 | $- | $- | ||||||||||||||||||||||||||||
| Solar or Wind Power Generation 3 | $- | $- | ||||||||||||||||||||||||||||
| Solar or Wind Power Generation 4 | $- | $- | ||||||||||||||||||||||||||||
| Solar or Wind Power Generation 5 | $- | $- | ||||||||||||||||||||||||||||
| Solar or Wind Power Generation 6 | $- | $- | ||||||||||||||||||||||||||||
| Solar or Wind Power Generation 7 | $- | $- | ||||||||||||||||||||||||||||
| Solar or Wind Power Generation 8 | $- | $- | ||||||||||||||||||||||||||||
| Solar or Wind Power Generation 9 | $- | $- | ||||||||||||||||||||||||||||
| Solar or Wind Power Generation 10 | $- | $- | ||||||||||||||||||||||||||||
| Table 5. Battery Energy Storage System (BESS) Equipment Information | ||||||||||||||||||||||||||||||
| 5a. BESS Overview | 5b. Location of BESS Infrastructure | 5c. Ownership and Use of BESS Infrastructure | 5d. BABA Compliance | |||||||||||||||||||||||||||
| Optional, but highly encouraged if known* | Optional, but highly encouraged if known* | |||||||||||||||||||||||||||||
| Type of Battery | Manufacturer of BESS | Model of BESS | Manufacture Year of BESS | Energy Capacity (please indicate kWh or MWh) | Total Estimated Acquisition Cost Per Unit of Equipment: | Total EPA Funds Requested Per Unit: | Total Estimated Cost for Installation: | Total EPA Funds Requested for Installation: | Total Estimated Cost for Equipment and Installation | Total EPA Funds Requested for Equipment and Installation | State | County | City | Zip Code | Street Address | Who owns the equipment? | Anticipated Users of BESS | Name of the School District the BESS will serve | NCES ID of School District that the BESS will serve | Is a waiver being used to fulfill BABA compliance for the BESS? | ||||||||||
| BESS Example | Lithium-Ion | Manufacturer Name | Model Name | 2023 | 36kWh | $48,000.00 | $20,000.00 | $12,000.00 | $10,000.00 | $60,000.00 | $30,000.00 | VA | Arlington County | Alexandria | 22305 | 400 1st Street | Walton School District | Walton School District & NoVA Community College | Walton School District | 1234567 | No - Infrastructure meets all BABA requirements | |||||||||
| BESS Group 1 | $- | $- | ||||||||||||||||||||||||||||
| BESS Group 2 | $- | $- | ||||||||||||||||||||||||||||
| BESS Group 3 | $- | $- | ||||||||||||||||||||||||||||
| BESS Group 4 | $- | $- | ||||||||||||||||||||||||||||
| BESS Group 5 | $- | $- | ||||||||||||||||||||||||||||
| BESS Group 6 | $- | $- | ||||||||||||||||||||||||||||
| BESS Group 7 | $- | $- | ||||||||||||||||||||||||||||
| BESS Group 8 | $- | $- | ||||||||||||||||||||||||||||
| BESS Group 9 | $- | $- | ||||||||||||||||||||||||||||
| BESS Group 10 | $- | $- | ||||||||||||||||||||||||||||
| Are there any other infrastructure projects associated with this grant that are not listed above? | (Y or N or N/A) | |||||||||||||||||||||||||||||
| If no, please leave this section blank. If yes, please provide details in the box below on the infrastructure project, cost, and describe how BABA compliance was determined. |
||||||||||||||||||||||||||||||
| U. S. Environmental Protection Agency | |
| Clean School Bus (CSB) Grant Program | |
| Data Dictionary | |
| Please refer to the following data field dictionary for support in completing tabs 2 & 3 | |
| Tab 2. Fleet Description | |
| Applicant Name | Enter the name of the applicant associated with this application, as entered into Grants.gov |
| SAM.gov Unique Entity ID | Enter the SAM.gov Unique Entity ID (UEI) associated with this applicant. The SAM.gov UEI is a 12-character alphanumeric ID assigned to the applying entity by SAM.gov |
| Project Title | Enter the name of the project's title, as entered into Grants.gov |
| Table 1. CURRENT VEHICLE INFORMATION | |
| 1a. Basic Fleet Information | |
| Group Name | Enter the name of the vehicle group to which the vehicle described on this row of the table belongs; this may refer to a group of vehicles referenced in the application or a fleet to which the vehicle belongs. |
| Current Fleet Owner | Enter the name of the current vehicle owner |
| Vehicle Identification Number | Enter the VIN number for each vehicle. |
| Vehicle Manufacturer | Enter the manufacturer of the existing vehicle. |
| Vehicle Model | Enter the model of the existing vehicle. |
| Baseline Vehicle Model Year | Enter the model year of the existing vehicle. |
| Baseline Engine Fuel Type (select from dropdown) | Select the type of fuel that is currently being used (prior to upgrade); options include: USLD (diesel), Biodiesel 5, Biodiesel 20, CNG (ft3), CNG (lbs), LNG, LPG/Propane, Gasoline |
| Engine Family Name | Enter the Engine Family name of the existing engine. NOTE: unregulated engines will not have an Engine Family Name. If unregulated, then enter "NA" |
| GVWR | Enter the gross vehicle weight rating (GVWR) of the existing vehicle. |
| Vehicle Class (Select from dropdown) | Select Vehicle Class from dropdown menu: Class 3 - Class 8 |
| Odometer | Enter the existing vehicle's current odometer reading, in miles. |
| Annual Miles Traveled | Enter the average number of vehicle miles traveled per year per vehicle. |
| Annual Idling Hours | Enter the average number of hours the vehicle idles per year, using the average for the prior 2 years. |
| Annual Amount of Fuel Used | Enter the amount of fuel used in gallons per year. |
| Remaining Life of baseline Engine/Vehicle | Enter the remaining life of baseline engine/vehicle in years at the time of the upgrade action. |
| 1b. Vehicle Disposition Process | |
| Anticipated Vehicle Disposition Method | Select a vehicle disposition option from dropdown menu; options include: Scrapped, Sold, Donated |
| If sold or donated, provide the state in which the vehicle is expected to primarily operate (if known) | Select the state from the dropdown menu. Note: the state field is required to enter the specific county field. |
| If sold or donated, provide the county in which the vehicle is expected to primarily operate (if known) | Select the county from the dropdown menu. Note: the list of counties will not populate until the state is selected. |
| 1c. Current Vehicle Place of Performance | |
| Primary Place of Performance | |
| School District Name | Enter the name of the school district in which the vehicle to be scrapped, sold, or donated has operated in. |
| NCES ID | Enter the name of the National Center for Education Statistics (NCES) ID associated with the school district in which the vehicle to be scrapped, sold, or donated has operated in. If you are unsure of the district's NCES ID, you can search for the district at https://nces.ed.gov/ccd/districtsearch/. |
| State (select from dropdown) | Select the two letter postal code for the state from the dropdown menu in which the vehicle to be scrapped, sold, or donated has operated in. Note: the state field is required to enter the specific county field. |
| County (select from dropdown) | Enter the county in which the vehicle to be scrapped, sold, or donated has operated. Note: the list of counties will not populate until the state is selected. |
| Percentage of Time operated in County | Enter a value from 0 to 1, where 1 = 100%, to reflect the estimated percentage of time this vehicle operated in the listed county. |
| Place of Performance: City | Enter the city in which the vehicle to be scrapped, sold, or donated has operated in. |
| Zip Code | Enter the zip codes where the vehicle operates |
| Secondary Place of Performance (if applicable) | |
| School District Name | Enter the name of the school district in which the vehicle to be scrapped, sold, or donated has operated in. |
| NCES ID | Enter the name of the National Center for Education Statistics (NCES) ID associated with the school district in which the vehicle to be scrapped, sold, or donated has operated in. If you are unsure of the district's NCES ID, you can search for the district at https://nces.ed.gov/ccd/districtsearch/. |
| State (select from dropdown) | Select the two letter postal code for the state from the dropdown menu in which the vehicle to be scrapped, sold, or donated has operated in. Note: the state field is required to enter the specific county field. |
| County (select from dropdown) | Enter the county in which the vehicle to be scrapped, sold, or donated has operated. Note: the list of counties will not populate until the state is selected. |
| Percentage of Time operated in County | Enter a value from 0 to 1, where 1 = 100%, to reflect the estimated percentage of time this vehicle operated in the listed county. |
| Place of Performance: City | Enter the city in which the vehicle to be scrapped, sold, or donated has operated in. |
| Zip Code(s) | Enter the zip codes where the vehicle operates |
| Additional Location Details (if applicable) | |
| Additional Counties where Vehicle Operates | List the county name and state for additional counties where the vehicle operates; if there are more than one, separate using a semicolon (e.g., St. Lucie County, FL; Martin County, FL) |
| Additional School Districts where Vehicle Operates (Name & NCES ID) | List the name and NCES ID for additional school districts where the vehicle operates; if there are more than one, separate using a semicolon (e.g., Springdale School District, 2837293; Hamilton County School District, 2839872) |
| % of time operated in each Additional County | List the estimated percent of time operated in each additional county; if there are more than one, separate using parenthesis and semicolons (e.g., St. Lucie County (10%); Martin County (5%)) |
| Table 2. New Replacement Vehicle Information | |
| 2a. Upgrade Vehicle Information | |
| Year of Upgrade Action | Enter the year the upgrade is anticipated to happen. |
| New Vehicle Fleet Owner | Enter the name of the new vehicle fleet owner |
| New Vehicle Class (select from dropdown) | Select Vehicle Class from dropdown menu: Class 3-8 |
| New Vehicle Fuel Type | Select the fuel type of the new vehicle: Battery Electric, Propane |
| New Vehicle Manufacturer | Enter the manufacturer of the new vehicle. |
| New Vehicle Model | Enter the model of the new vehicle. |
| New Vehicle Model Year | Enter the model year of the new vehicle. |
| New Vehicle GVWR | Enter the gross vehicle weight rating (GVWR) of the new vehicle. |
| New Engine or Vehicle Family Name | Enter the Engine or Family Name of the new engine. |
| Capable of Bidirectional Charging? (Yes/No/NA) | Use the dropdown menu to select whether the vehicle will be capable of bidirectional charging. |
| Equipped with Auxiliary Heater? (Yes/No/NA) | Use the dropdown menu to select whether the vehicle will be equipped with Auxiliary Heater. |
| Estimate Range in Miles | Enter the estimated range in miles for the zero-emission vehicle. |
| 2b. Upgrade Vehicle Information | |
| Upgrade Cost per Bus | Enter the cost of vehicle in dollars per unit. |
| Total EPA Funds Expended Per Vehicle | Enter the EPA funds expended per vehicle in dollars per unit. |
| 2c. New Vehicle Place(s) of Performance | |
| Primary Place of Performance | |
| School District Name | Enter the name of the school district in which the new vehicle is expected to operate in. |
| NCES ID | Enter the name of the National Center for Education Statistics (NCES) ID associated with the school district in which the new vehicle is expected to operate in. If you are unsure of the district's NCES ID, you can search for the district at https://nces.ed.gov/ccd/districtsearch/. |
| State (select from dropdown) | Select the two letter postal code for the state from the dropdown menu in which the new vehicle is expected to operate in. Note: the state field is required to enter the specific county field. |
| County (select from dropdown) | Enter the county in which the new vehicle is expected to operate in. Note: the list of counties will not populate until the state is selected. |
| Percentage of Time operated in County | Enter a value from 0 to 1, where 1 = 100%, to reflect the estimated percentage of time this vehicle is expected to operate in the listed county. |
| Place of Performance: City | Enter the city in which the new vehicle is expected to operate in |
| Zip Code | Enter the zip codes where the vehicle operates. |
| Secondary Place of Performance (if applicable) | |
| School District Name | Enter the name of the school district in which the new vehicle is expected to operate in. |
| NCES ID | Enter the name of the National Center for Education Statistics (NCES) ID associated with the school district in which the new vehicle is expected to operate in. If you are unsure of the district's NCES ID, you can search for the district at https://nces.ed.gov/ccd/districtsearch/. |
| State (select from dropdown) | Select the two letter postal code for the state from the dropdown menu in which the new vehicle is expected to operate in. Note: the state field is required to enter the specific county field. |
| County (select from dropdown) | Enter the county in which the new vehicle is expected to operate in. Note: the list of counties will not populate until the state is selected. |
| Percentage of Time operated in County | Enter a value from 0 to 1, where 1 = 100%, to reflect the estimated percentage of time this vehicle is expected to operate in the listed county. |
| Place of Performance: City | Enter the city in which the new vehicle is expected to operate in |
| Zip Code | Enter the zip codes where the vehicle operates. |
| Additional Location Details (if applicable) | |
| Additional Counties where Vehicle Operates | List the county name and state for additional counties where the vehicle operates; if there are more than one, separate using a semicolon (e.g., St. Lucie County, FL; Martin County, FL) |
| Additional School Districts where Vehicle Operates (Name & NCES ID) | List the name and NCES ID for additional school districts where the vehicle operates; if there are more than one, separate using a semicolon (e.g., Springdale School District, 2837293; Hamilton County School District, 2839872) |
| % of time operated in each Additional County | List the estimated percent of time operated in each additional county; if there are more than one, separate using parenthesis and semicolons (e.g., St. Lucie County (10%); Martin County (5%) |
| Tab 3. INFRASTRUCTURE | |
| Table 3. Electric Vehicle Service Equipment | |
| 3a. EVSE Equipment Information Overview | |
| Type of Charger | Enter the type of charger, either Level 2 (AC charging up to 19.2 kW) or DC Fast Charging. |
| If Level 2, is it ENERGY STAR certified | Confirm and select yes if applicable. Please see https://www.energystar.gov/ |
| EVSE Manufacturer | Enter the manufacturer of the charging equipment |
| EVSE Model | Enter the model name of the charging equipment. |
| EVSE Manufacture Year | Enter the year the charging equipment was manufactured. |
| EVSE Maximum Output Power (kW) | Enter the maximum power output of the charging equipment, measured in kilowatts. |
| Number of Plugs on EVSE | Enter the number of plugs installed on each unit of the charging equipment. |
| Is the EVSE Capable of Bidirectional Charging? | Select yes or no into the cell to specify whether the charging equipment is capable of bidirectional charging. |
| Will the Bus and EVSE be Used for V2G? | Select yes or no into the cell to specify whether the vehicles and charging equipment will be used for vehicle-to-grid (V2G) services. |
| Number of EVSE Units | Enter the quantity of charging equipment unit acquisition. |
| EVSE Equipment Cost only Per Unit: | Enter the cost of the charging equipment per unit acquisition. |
| Total EPA Funds Expended Per EVSE Unit | Enter the total EPA funds expended for charging equipment per unit acquisition. |
| Total EPA Funds Expended for EVSE | Autopopulated field: This field multiplies the number of EVSE units by the Total EPA Funds Expended per EVSE Unit to calculate the total of EPA funds expended for EVSE acquisition |
| 3b. Location of EV Infrastructure | |
| State (select from dropdown) | Select the two letter postal code for the state from the dropdown menu in which the new vehicle is expected to operate in. Note: the state field is required to enter the specific county field. |
| County (select from dropdown) | Enter the county in which the new vehicle is expected to operate in. Note: the list of counties will not populate until the state is selected. |
| City | Enter the city in which the charging equipment will be located. |
| Zip Code | Enter the zip code in which the charging equipment will be located. |
| Street Address | Enter the street address in which the charging equipment will be located. |
| 3c. Owners & Anticipated Users of EVSE | |
| Who will own the charger? | Enter the name of the school district or organization that will own the charging equipment. |
| Anticipated User(s) of the charger | Enter the name(s) of the school district(s) that are anticipated to regularly use the charging equipment. |
| Will the EVSE serve multiple school districts within this project? | Select from dropdown: Yes, No, or NA- School Districts not served by this equipment |
| Name of the School District(s) the EVSE will serve (if applicable; use a semicolon between school districts) |
Enter the name(s) of school district(s) the EVSE is expected to serve. Use a semicolon to separate entries when entering multiple districts. |
| NCES ID of School District that the EVSE will serve (if applicable; use a semicolon between school districts) |
Enter the NCES ID(s) of school district(s) the EVSE is expected to serve. Use a semicolon to separate entries when entering multiple districts. |
| 3d. Infrastructure Installation Information | |
| Total Funds Expended Installation Cost | Enter the total installation costs for the charging equipment for the EV infrastructure group column. |
| Total EPA Funds Expended Installation Cost | Enter the total EPA funds expended for installation costs for the charging equipment for the EV infrastructure group column. |
| Does the Infrastructure Equipment Cost Include Installation? | Please enter yes or no into the cell to specify whether the indicated cost of the charging equipment above includes any installation expenses. |
| Installation Work Performed By | Enter the name(s) of the organization(s) that performed the installation work described. |
| 3e. EVSE Cost Summary | |
| Total EPA Funds Expended on EVSE Equipment and Installation | Automated cell that will calculate the total EPA Funds expended for the charging equipment and installation for an EV Infrastructure Group. |
| Total Funds Expended on EVSE Equipment and Installation | Automated cell that will calculate the total Funds expended for the charging equipment and installation for an EV Infrastructure Group. |
| 3f. BABA Compliance | |
| Is a waiver being used to fulfill BABA compliance for this EVSE? | Please use the dropdown menu to select which of the following best describes how this infrastructure's compliance with Buy America Build America (BABA) will be fulfilled. Options include: No - Infrastructure meets all BABA requirements; Yes - EPA's De Minimis Waiver; Yes - EPA's Small Project Waiver; Yes - EPA's Pacific Island Territories General Applicability Waiver; Yes - Project-Level Waiver |
| Table 4. Solar and Wind Power Generation Equipment | |
| 4a. Solar and Wind Power Generation Equipment Information Overview | |
| Type of energy generation | Select a type of energy generation, solar or wind. |
| Manufacturer of Solar or Wind Power Generation | Enter the name of the manufacturer of the on-site power generation equipment |
| Model of Solar or Wind Power Generation | Enter the model name of the on-site power generation equipment |
| Manufacture Year of Solar or Wind Power Generation | Enter the manufacture year of the on-site power generation equipment |
| Generation Capacity of the system (please indicate kW or MW) | Enter the generation capacity of the system as either kW or MW. Please indicate unit of measurement. |
| Total Estimated Acquisition Cost Per Power Generation System | Enter the total estimated cost for the acquisition of each unit of equipment |
| Total EPA Funds Requested Per Power Generation System | Enter the EPA funds requested for the acquisition of each unit of equipment |
| Total Estimated Cost for Installation | Enter the total estimated cost for the installation of each unit of equipment |
| Total EPA Funds Requested for Installation | Enter the EPA funds requested for the installation of each unit of equipment |
| Total Estimated Cost of Equipment and Installation | Autopopulated field: this field sums the total entered for estimated costs of acquisition and installation of this equipment |
| Total EPA Funds Requested for Equipment and Installation | Autopopulated field: this field sums the total entered for total EPA funds requested for the acquisition and installation of this equipment |
| 4b. Location of Solar and Wind Power Generation Infrastructure | |
| State | Enter the state in which the On-Site Power Generation Infrastructure will be installed from the dropdown menu |
| County | Enter the county in which the On-Site Power Generation Infrastructure will be installed from the dropdown menu |
| City | Enter the city in which the On-Site Power Generation Infrastructure will be installed |
| Zip Code | Enter the zip code in which the On-Site Power Generation Infrastructure will be installed |
| Street Address | Enter the street address in which the On-Site Power Generation Infrastructure will be installed |
| 4c. Ownership and Use of Solar and Wind Power Generation Infrastructure | |
| Who owns the equipment? | Enter the name(s) of the organization(s) that own the equipment |
| Anticipated Users of Solar or Wind Power Generation Infrastructure | Enter the name(s) of the entities and/or organizations that are anticipated to use this equipment |
| Name of the School District(s) the Solar or Wind Power Generation will serve | Provide the name of the districts the On-Site Power Generation equipment will serve; in the event that multiple districts are served, please include a semicolon between district names |
| NCES ID of School District that the Solar or Wind Power Generation will serve | Provide the NCES ID of the districts the On-Site Power Generation equipment will serve; in the event that multiple districts are served, please include a semicolon between NECS IDs |
| 4d. BABA Compliance | |
| Is a waiver being used to fulfill BABA compliance for the Solar or Wind Power Generation? | Please use the dropdown menu to select which of the following best describes how this infrastructure's compliance with Buy America Build America (BABA) will be fulfilled. Options include: No - Infrastructure meets all BABA requirements; Yes - EPA's De Minimis Waiver; Yes - EPA's Small Project Waiver; Yes - EPA's Pacific Island Territories General Applicability Waiver; Yes - Project-Level Waiver |
| Table 5. Battery Energy Storage System (BESS) Equipment Information | |
| 5a. BESS Overview | |
| Type of Battery | Use the dropdown menu to select the type of battery in this BESS. Options include: Lithium-Ion; Lead-Acid; Flow; and Flywheels |
| Manufacturer of BESS | Enter the name of the manufacturer of the battery energy storage system equipment |
| Model of BESS | Enter the model name of the battery energy storage system equipment |
| Manufacture Year of BESS | Enter the manufacture year of the battery energy storage system equipment |
| Energy Capacity (please indicate kWh or MWh) | Enter the generation capacity of the system as either kW or MW. Please indicate unit of measurement. |
| Total Estimated Acquisition Cost Per Unit of Equipment: | Enter the total estimated cost for the acquisition of each unit of equipment |
| Total EPA Funds Requested Per Unit | Enter the EPA funds requested for the acquisition of each unit of equipment |
| Total Estimated Cost for Installation: | Enter the total estimated cost for the installation of each unit of equipment |
| Total EPA Funds Requested for Installation: | Enter the EPA funds requested for the installation of each unit of equipment |
| Total Estimated Cost for Equipment and Installation | Autopopulated field: this field sums the total entered for estimated costs of acquisition and installation of this equipment |
| Total EPA Funds Requested for Equipment and Installation | Autopopulated field: this field sums the total entered for total EPA funds requested for the acquisition and installation of this equipment |
| 5b. Location of BESS Infrastructure | |
| State | Enter the state in which the On-Site Power Generation Infrastructure will be installed from the dropdown menu |
| County | Enter the county in which the On-Site Power Generation Infrastructure will be installed from the dropdown menu |
| City | Enter the city in which the battery energy storage system Infrastructure will be installed |
| Zip Code | Enter the zip code in which the battery energy storage system Infrastructure will be installed |
| Street Address | Enter the street address in which the battery energy storage system Infrastructure will be installed |
| 5c. Ownership and Use of BESS Infrastructure | |
| Who owns the equipment? | Enter the name(s) of the organization(s) that own the equipment |
| Anticipated Users of BESS | Enter the name(s) of the entities and/or organizations that are anticipated to use this equipment |
| Name of the School District the BESS will serve | Provide the name of the districts the battery energy storage system equipment will serve; in the event that multiple districts are served, please include a semicolon between district names |
| NCES ID of School District that the BESS will serve | Provide the NCES ID of the districts the battery energy storage system equipment will serve; in the event that multiple districts are served, please include a semicolon between NECS IDs |
| 5d. BABA Compliance | |
| Is a waiver being used to fulfill BABA compliance for the BESS? | Please use the dropdown menu to select which of the following best describes how this infrastructure's compliance with Buy America Build America (BABA) will be fulfilled. Options include: No - Infrastructure meets all BABA requirements; Yes - EPA's De Minimis Waiver; Yes - EPA's Small Project Waiver; Yes - EPA's Pacific Island Territories General Applicability Waiver; Yes - Project-Level Waiver |
| Additional Questions | |
| Are there any other infrastructure projects associated with this grant that are not listed above? | Select Yes or No from dropdown menu to reflect if the applicant's project will feature any other infrastructure components eligible for funding by this program. |
| If no, please leave this section blank. If yes, please provide details in the box below on the infrastructure project, cost, and describe how BABA compliance was determined. |
For projects that include additional eligible infrastructure components, provide details in the box below on the infrastructure project, equipment type, manufacturer, anticipated cost, location, and describe how BABA compliance was determined. |
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |