5900-683 K_Clean Heavy Duty Vehicle Project Reporting Template

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Overview

1. Instructions
2. Work Plan
3. Amendments
4. Financial Summary
5. Year 1
6. Year 2
7. Year 3
8. CHDV Priorities
9a. Current Fleet Description
9b. New Fleet Description
10. Infrastructure
11. Final Report
12. Data Dictionary

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Sheet 1: 1. Instructions

U. S. Environmental Protection Agency
Clean Heavy-Duty Vehicles (CHDV) Grant Program
Project Quarterly AND Final Reporting Template
Burden Statement for EPA Form 5900-683
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 range from 11.3-14.4 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 Director, Information Engagement Division, 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
Per grant agreement terms and conditions, this reporting template should be submitted 1) quarterly throughout the project period of performance and 2) a Final Report (120-days after) the completion of the grant period. Please work with relevant parties (i.e., transportation contractor, bus dealer, etc.) to ensure information submitted is accurate. Information that is submitted on quarterly reports should NOT be changed in future quarterly report submissions unless approved by EPA. Please only update information for the specific quarter in which this report is being submitted. The grant recipient only needs to fill out shaded cells highlighted blue with a diagonal pattern (///). Cells highlighted yellow are automatically populated based on previous responses in this spreadsheet. Additionally, some fields will automatically hash out (///) in the event they are inapplicable based on previous descriptions. Please complete tabs in this workbook according to the instructions below; all fields are required, unless otherwise stated. If you have questions about applicability of a particular fields or tables, please reach out to your Project Officer and refer to your grant’s Terms and Conditions.
Excel Workbook Tab	Description
1. Instructions	Basic instructions for all worksheets in this reporting workbook.
2. Work Plan	The tab should be completed by the time you submit your first quarterly report and reflects the approved work plan. Please complete shaded cells highlighted blue. Cells highlighted yellow are automatically populated based on previous responses in this spreadsheet; note for Table 1b, these responses will be autocompleted based on your entries on the Fleet Description tab (tabs 9a and 9b) and Infrastructure tab (10). For school district applicants, only the first row of Table 2 will be completed. Refer to the Data Dictionary tab 12 for additional guidance on each field.
3. Amendments	The Amendments tab should be used to update any changes in vehicle numbers, charger numbers, and/or funding amounts post-award. Please update this tab on an annual basis at the end of each year of project performance and at project closeout using the shade cells highlighted in blue. Cells highlighted yellow are automatically populated based on previous responses in this spreadsheet.
4. Financial Summary	Financial summary for the entire grant period of performance. Please complete shaded cells highlighted blue that contain grantee and original project budget information. Yellow cells on this worksheet will automatically feed from information in tabs 5-7 (Year 1-Year 3). If a modification to the grant is approved, please update the financial tabs accordingly.
5. Year 1	Financial summary for the first year of the project period. For each quarterly report, please complete all financial and narrative descriptive cells highlighted blue for each quarter the report is submitted. Cells highlighted yellow are automatically populated based on previous responses in this spreadsheet. Below the financial information, please ensure to complete the programmatic questions regarding the grant.
6. Year 2	Financial summary for the second year of the project period if grant period of performance is longer than one year. For each quarterly report, please complete all shaded financial and narrative descriptive cells highlighted blue for each quarter the report is submitted. Cells highlighted yellow are automatically populated based on previous responses in this spreadsheet. Below the financial information, please ensure to complete the programmatic questions regarding the grant.
7. Year 3	Financial summary for the third year of the project period if grant period of performance is longer than two years. For each quarterly report, please complete all shaded financial and narrative descriptive cells highlighted blue for each quarter the report is submitted. Cells highlighted yellow are automatically populated based on previous responses in this spreadsheet. Below the financial information, please ensure to complete the programmatic questions regarding the grant.
8. CHDV Priorities	The tab should be completed based upon community engagement, project sustainability, workforce development, extreme weather resiliency, and/or leveraging of additional external funds commitments defined in the finalworkplan. Please complete this tab QUARTERLY, if the final workplan committed to ANY, community engagement, project sustainability, workforce development, extreme weather resiliency, and/or leveraging of additional external funds commitments as referred to in the evaluation metrics defined in the NOFO. During each quarterly reporting period of the project period of performance, please complete updates on these defined project commitments. The final report submission for the project should contain the end results of community engagement, project sustainability, workforce development, extreme weather resiliency, and/or leveraging of additional external funds commitments completed during the project period.
9. Fleet Description (9a and 9b)	The Fleet Description should detail all vehicles impacted under the project. The Fleet Description should be updated quarterly with all vehicle upgrades completed during that quarter. Please fill out shaded cells highlighted blue. Cells highlighted yellow are automatically populated based on previous responses in this spreadsheet. You do NOT need to make a separate worksheet for each school district or fleet. This Fleet Description is broken into two tabs: Tab 9a. Current Vehicle Information and Tab 9b. New Vehicle Upgrade Information. Each sheet has capacity for up to 250 vehicles. Please refer to the Fleet Description data definitions on tab 12 (Data Dictionary) for additional guidance on each field.
10. Infrastructure	The Infrastructure Description should detail all electric vehicle supply equipment (EVSE) and other eligible supporting infrastructure purchased under the project. The Infrastructure worksheet should be updated quarterly as EVSEs and other eligible supporting infrastructure are procured and installed. Please fill out shaded cells highlighted blue and add additional rows as needed to capture all units. Cells highlighted yellow are automatically populated based on previous responses in this spreadsheet. Please refer to the Infrastructure data definitions on Tab 12 (Data Dictionary) for data field definitions. Reminder: All Level 2 EVSEs must be ENERGY STAR certified. All EVSE and infrastructure must comply with Build America, Buy America (BABA) requirements.
11. Final Report	Final project details including actual programmatic results. Please complete shaded cells highlighted blue. Cells highlighted yellow are automatically populated based on previous responses in this spreadsheet.
12. Data Dictionary	Please refer to the dictionary on this tab for support in completing the Current and New Fleet Descriptions (tab 9a and tab 9b) and the Infrastructure tab (tab 10).

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Sheet 2: 2. Work Plan

U. S. Environmental Protection Agency

Clean Heavy-Duty Vehicles (CHDV) Grant Program

Work Plan

Instructions

Please complete Tables 1-4 below on this tab using information from your approved workplan. The grant recipient must fill out shaded cells highlighted blue. Cells highlighted yellow are automatically populated based on previous responses in this spreadsheet or from fields that will be populated in the Financial Summary tab (Tab 4.)

Table 1a. Project Overview

Field

Response

Grant Recipient

Grant Number

Project Period of Performance - Start date (mm/dd/yyy)

Project Period of Performance - End date (mm/dd/yyy)

Project Title

Project Sub-Program

EPA Project Award Amount

Estimated EPA Funds for All Vehicles

$-

Estimated EPA Funds for Class 6 or 7 Electric School Buses

Estimated EPA Funds for Class 6 or 7 Vocational Battery Electric Vehicles

Estimated EPA Funds for Class 6 or 7 Hydrogen Fuel Cell Vocational Vehicles

Estimated EPA Funds for EV Chargers and/or H2 Fueling Infrastructure

$-

Estimated EPA Funds for AC Level 2 Chargers

Estimated EPA Funds for DC Level 3 Chargers

Estimated EPA Funds for H2 Fueling Infrastructure

Estimated EPA Funds for Other Infrastructure (BESS, On-Site Power Generation, or other eligible infrastructure components)

Table 1b. Project Summary and Approach

Question

Answer

Did any planned activities or commitments change between the submitted application and the approved workplan? If yes, please provide context and details to the approved changes (example: the number of electric vehicles was reduced due to partial funding).

Does the project include school buses?

Does the project include non-school-bus zero-emission Class 6/7 vehicles?

If you intend to purchase hydrogen fuel-cell electric vehicles (FCEV), may we contact you about them?

Please use the space provided to add a short narrative description of the project summary and approach to cover anything not captured in Table 2. Work Plan. Language from the Project Summary and Approach section of the application may be used here.

Table 1c. Financial Summary (Values will be auto-populated based on values entered into the Financial Summary Tab and Annual Reporting Tabs (Tabs 4-7).

Award Component

Value

Federal Project Award Amount

$-

Reported EPA Funds for Vehicles

$-

Reported EPA Funds for Class 6 or 7 Electric School Buses

Reported EPA Funds for Class 6 or 7 Vocational Battery Electric Vehicles

Reported EPA Funds for Class 6 or 7 Hydrogen Vocational Vehicles

Reported EPA Funds for Infrastructure

$-

Reported EPA Funds for EV Chargers

$-

Reported EPA Funds for AC Level 2 Chargers

$-

Reported EPA Funds for DC Level 3 Chargers

$-

Reported EPA Funds for H2 Fueling Infrastructure

$-

Reported EPA Funds for Other Infrastructure (BESS, On-Site Power Generation, or other eligible infrastructure components)

$-

Table 2. Work Plan

Please complete the following table of information. For school district applicants, only the first row in Table 2a. will be completed. For state, other municipality, and nonprofit school transportation association applicants, please provide information for each school district that will be served by the new buses in Table 2a. and all non-school-bus grantees in Table 2b. Please refer to the Data Dictionary (tab 12) for additional guidance on each field.

Table 2a: School Bus Sub-Program Grantee Summary

Proposed Fleet + Infrastructure

School District Name

NCES #

State

County

City

Zip Code

School District is located within a county listed in Section IV.C.2, Section 4 of the NOFO

Proposed Number of Zero-Emission Vehicles

Proposed Number of AC Level 2 Chargers

Proposed Number of DC Level 3 Chargers

Total Number of Chargers

Proposed Number of On Site Power Generation Systems

Proposed Number of Battery Energy Storage Systems (BESS)

Example: School District A

Example: 1234567

Example: AZ

Example: Maricopa

Example: Phoenix

Example: 85308

Example: Yes

Example: 20

Example: 10

Example: 5

Example: 15

Example: 5

Example: 5

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

◄ Access additional rows to Table 2b by selecting the "+" button here.

Table 2b: Vocational Vehicles Sub-Program Grantee Summary

Proposed Fleet + Infrastructure

non-School-Bus Recipient Organization

N/A

State

County

City

Zip Code

Project is taking place within a county listed in Section IV.C.2, Section 4 of the NOFO

Proposed Number of Zero-Emission Vehicles

Proposed Number of AC Level 2 Chargers

Proposed Number of DC Level 3 Chargers

Total Number of Chargers

Proposed Number of On Site Power Generation Systems

Proposed Number of Battery Energy Storage Systems

Proposed Number of H2 Fueling Infrastructure Units

Example: Recipient Organization 1

Example: AZ

Example: Maricopa

Example: Phoenix

Example: 85308

Example: Yes

Example: 20

Example: 10

Example: 5

Example: 15

Example: 5

Example: 2

Example: 1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

◄ Access additional rows to Table 2b by selecting the "+" button here.

Table 3. CHDV Priorities

CHDV Priority

Question

Answer 1

Answer 2

A. Community Engagement

Does the workplan demonstrate actions and/or commitments to engage communities? If no, please jump to the next section, "Project Sustainability." If yes, please complete the rest of this section.

(Y or N or N/A)

A. Community Engagement

1. How does the workplan demonstrate engagement with the communities identified above, especially local residents, to ensure their meaningful participation with respect to the design, planning, and performance of the project?

B. Project Sustainability

Does the workplan demonstrate actions and/or commitments to promote sustainable project results and benefits? If no, please jump to the next section, "Workforce Development." If yes, please complete the rest of this section.

(Y or N or N/A)

B. Project Sustainability

1. How does the workplan demonstrate that project results and benefits will be sustainable and that the applicant and project partners have the ability to promote and continue efforts to reduce emissions from vehicles after EPA funding for the project has ended?

C. Workforce Development

Does the workplan demonstrate actions and/or commitments to promote workforce development? If no, please jump to the next section, "Project Resilience to Extreme Weather." If yes, please complete the rest of this section.

(Y or N or N/A)

C. Workforce Development

1. How does the workplan demonstrate a plan to prepare the workforce for the project?

D. Project Resilience

Does the workplan demonstrate actions and/or commitments to promote project resilience to extreme weather? If no, please jump to the next section, "Leveraging of Additional External Funds". If yes, please complete the rest of this section.

(Y or N or N/A)

D. Project Resilience

1. How does the workplan demonstrate planning or action taken towards building project resilience and reducing vulnerabilities to extreme weather?

E. Leveraging of Additional External Funds

Does the workplan demonstrate that the recipient has leveraged or plans to leverage additional external funds in order to support proposed project activities? If no, please jump to the next table, "Timeline and Milestones". If yes, please complete the rest of this section.

(Y or N or N/A)

E. Leveraging of Additional External Funds

1. How does the workplan demonstrate that the recipient has leveraged or plans to leverage additional external funds in order to support proposed project activities, as well as how these funds will be used to contribute to the performance and success of the project?

Table 4. Timeline and Milestones

Please use the rows below to indicate key project milestones and activities, the timeline for each, and the responsible party for each milestone and activity. Timeline can be represented either as the expected month(s) each activity/milestone will take place (ex., September 2024, September 2024 - December 2024, etc.), or, if applicable, can be represented with descriptors such as "continuous," "ongoing," or otherwise described in relation to other activities and milestones (ex., 1 month after activity X). Note: Additional rows may be accessed by selecting the "+" at the bottom of the table.

Timeline

Responsible Party

Milestone/Activity

◄ Access additional rows to Table 4 by selecting the "+" button here.

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Sheet 3: 3. Amendments

U. S. Environmental Protection Agency
Clean Heavy-Duty Vehicles (CHDV) Grant Program
Amendments
Instructions
Recipients must agree to carry out the project in accordance with the final approved workplan. Recipients are required to request prior written approval from EPA for any budget or program plan revisions, as defined in 2 CFR §200.308. Proposed modifications to the approved workplan, including additions, deletions, or changes in the schedule, shall be submitted in a timely manner to the EPA project officer for approval. Depending on the type of changes, a formal amendment to the award may be necessary. If the EPA project officer approves modifications to the approved workplan, any changes must be captured in the this tab. Fill out this tab at the end of each year of project performance and select the relevant year of the update. The Amendments tab does not supersede or replace written approval from the EPA project officer. The Amendments tab does not need to be completed if the project is carried out in accordance with the final approved workplan.
Table 5a. Post-Award Amendments
Update Year	Type of Amendment	Grantee Name	NCES ID (If applicable)	Original Vehicle or Eligible Infrastructure Component Type	Updated Vehicle or Eligible Infrastructure Component Type	Original Quantity of Vehicle or Eligible Infrastructure Component	Updated Quantity of Vehicle or Eligible Infrastructure Type	If 'Other Activity in Approved Workplan' selected as Type of Amendment, please describe here	Original Funding Request Amount	Updated Funding Request Amount	Change in Funding Amount
(Select Year)	(Select Amendment Type)										$-
(Select Year)	(Select Amendment Type)										$-
(Select Year)	(Select Amendment Type)										$-
(Select Year)	(Select Amendment Type)										$-
(Select Year)	(Select Amendment Type)										$-
(Select Year)	(Select Amendment Type)										$-
(Select Year)	(Select Amendment Type)										$-
(Select Year)	(Select Amendment Type)										$-
(Select Year)	(Select Amendment Type)										$-
(Select Year)	(Select Amendment Type)										$-
(Select Year)	(Select Amendment Type)										$-
(Select Year)	(Select Amendment Type)										$-
(Select Year)	(Select Amendment Type)										$-
(Select Year)	(Select Amendment Type)										$-
(Select Year)	(Select Amendment Type)										$-
(Select Year)	(Select Amendment Type)										$-
(Select Year)	(Select Amendment Type)										$-
(Select Year)	(Select Amendment Type)										$-
Table 5b. Change in funding by project year (Values will auto-populate based on data entered in table 5a)
Project Year	Number of Amendments By Year	Change in Funding Amount by Year
Project Year One	0	0
Project Year Two	0	0
Project Year Three	0	0

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Sheet 4: 4. Financial Summary

U. S. Environmental Protection Agency

Clean Heavy-Duty Vehicles (CHDV) Grant Program

Financial Summary - Project Lifetime

Instructions

Financial summary for the entire grant period of performance. Please complete shaded cells highlighted blue that contain grantee and original project budget information. Yellow cells on this worksheet will automatically populate based on information entered in tabs 5-7 (Year 1-Year 3). If a modification to the grant is approved, please update the financial tabs accordingly.

Table 6. Summary Rate of Expenditure

Record project budget funds ONLY from approved final workplan. All other numbers will reflect automatically from subsequent tabs.

Project Budget

Total Expenses to Date

Remaining Balance

Financial Summary

EPA Funds Project Budget

Mandatory Cost Share Project Budget

Voluntary Cost Share Project Budget

Total Project Cost Project Budget

EPA Funds Expenses to Date

Mandatory Cost Share Expenses to Date

Voluntary Cost Share Expenses to Date

Total Project Cost Expenses to Date

EPA Funds Remaining Balance

Mandatory Cost Share Remaining Balance

Voluntary Cost Share Remaining Balance

Total Project Cost Remaining Balance

Personnel

$-

$-

$-

$-

$-

$-

$-

$-

$-

Fringe Benefits

$-

$-

$-

$-

$-

$-

$-

$-

$-

Travel

$-

$-

$-

$-

$-

$-

$-

$-

$-

Equipment

$-

$-

$-

$-

$-

$-

$-

$-

$-

Supplies

$-

$-

$-

$-

$-

$-

$-

$-

$-

Contractual

$-

$-

$-

$-

$-

$-

$-

$-

$-

Construction

$-

$-

$-

$-

$-

$-

$-

$-

$-

Other

$-

$-

$-

$-

$-

$-

$-

$-

$-

Direct Cost Total

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Indirect Charges

$-

$-

$-

$-

$-

$-

$-

$-

$-

TOTALS

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Table 6a. Summary Rate of Expenditure of Other Leveraged Funds

_

Project Budget

_9

_2

Column3

Total Expenses to Date

_3

_4

_5

Remaining Balance

_6

_7

_8

Other Leveraged Funds

Table 7. Annual Rate of Expenditure

No Entry Needed - ALL numbers will reflect automatically from subsequent tabs.

Year 1

Year 2

Year 3 (if applicable)

Financial Summary

EPA Funds Year 1

Mandatory Cost Share Year 1

Additional Leveraged Funds Year 1

Total Project Cost Year 1

EPA Funds Year 2

Mandatory Cost Share Year 2

Additional Leveraged Funds Year 2

Total Project Cost Year 2

EPA Funds Year 3

Mandatory Cost Share Year 3

Additional Leveraged Funds Year 3

Total Project Cost Year 3

Personnel

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Fringe Benefits

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Travel

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Equipment

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Supplies

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Contractual

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Construction

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Other

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Direct Cost Total

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Indirect Charges

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

TOTALS

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Table 7a. Annual Rate of Expenditure of Other Leveraged Funds

_

Year 1

_10

_2

_3

Year 2

_4

_5

_6

Year 3

_7

_8

_9

Other Leveraged Funds

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Sheet 5: 5. Year 1

U. S. Environmental Protection Agency

Clean Heavy-Duty Vehicles (CHDV) Grant Program

Financial and Narrative Summary - Year 1

Instructions

Financial summary for the first year of the project period. For each quarterly report, please complete all financial and narrative descriptive cells highlighted blue for each quarter the report is submitted. Cells highlighted yellow are automatically populated based on previous responses in this spreadsheet. Below the financial information, please ensure to complete the programmatic questions regarding the grant.

Table 8. Year 1 Annual Rate of Expenditure

Record and update project expenses at each interval according to the reporting cadence determined by your Project Officer. Previous fields should remain and edits should be made to the whenever interannual reports are submitted.

Reporting Period

Jan-June of Year 1

July-Sept of Year 1

Oct-Dec of Year 1

Enter Dates For this Reporting Period in the blue cells

_

EPA Funds Reporting Period 1

Mandatory Cost Share Reporting Period 1

Voluntary Cost Share Reporting Period 1

Total Project Cost Reporting Period 1

EPA Funds Reporting Period 2

Mandatory Cost Share Reporting Period 2

Voluntary Cost Share Reporting Period 2

Total Project Cost Reporting Period 2

EPA Funds Reporting Period 3

Mandatory Cost Share Reporting Period 3

Voluntary Cost Share Reporting Period 3

Total Project Cost9 Reporting Period 3

Personnel

$-

$-

$-

Fringe Benefits

$-

$-

$-

Travel

$-

$-

$-

Equipment

$-

$-

$-

Supplies

$-

$-

$-

Contractual

$-

$-

$-

Construction

$-

$-

$-

Other

$-

$-

$-

Direct Cost Total

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Indirect Charges

$-

$-

$-

TOTALS

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Table 8a. Year 1 Other Leveraged Funds

Reporting Period

Jan-June of Year 1

_

_2

_3

July-Sept of Year 1

_4

_5

_6

July-Sept of Year 2

_7

_8

_9

Other Leveraged Funds

Table 9. Project Updates - Narrative Responses

Record and update project updates below.

Please paste the planned activities, outputs, and outcome from the submitted workplan information. Provide updates and if any changes occurred, please provide that information accordingly. In the 'Progress to Date' column, please use the dropdown to indicate if the activity is 1) Not yet started, 2) In progress, or 3) Completed.

Activities

Anticipated Outputs

Anticipated Outcomes

Progress to Date

_

_2

Progress Notes

Jan-June of Year 1

July-Sept of Year 1

Oct-Dec of Year 1

Write below, as appropriate.

Table 10. Project Questions

Please provide programmatic and narrative financial updates on the project. As quarterly reports are submitted, indicate updates or changes for each quarter. For each quarter, please indicate if there was a change from the previous quarter. If yes, please provide an explanation in the subsequent cell.

Question

Jan-June of Year 1 Update

July-Sept of Year 1 Update

Oct-Dec of Year 1 Update

1. Provide a comparison of actual accomplishments to the objectives established for the reporting period.

2. If anticipated outputs/outcomes and/or timelines/milestones are not met, why not? Did you encounter any problems during the reporting period which may interfere with meeting project objectives?

3. If any additional voluntary leveraged funds are reported for this Reporting Period in Table 8 above, identify the source of the funds.

4. Have there been any major personnel changes during this reporting period?

5. Did any public relations events regarding this grant take place during the reporting period?

6. Are you using websites or other tools used to relay information about this grant to the public?

7. What project activities are planned for the next reporting period?

8. Was any program income generated during the reporting period? Identify amount of program income, how it was generated, and how the program income was/will be used.

9. Have any vehicles or activities changed from those included in the final workplan?

10. Do you have any other comments or feedback?

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Sheet 6: 6. Year 2

U. S. Environmental Protection Agency

Clean Heavy-Duty Vehicles (CHDV) Grant Program

Financial and Narrative Summary - Year 2

Instructions

Financial summary for the second year of the project period if grant period of performance is longer than one year. For each quarterly report, please complete all shaded financial and narrative descriptive cells highlighted blue for each quarter the report is submitted. Cells highlighted yellow are automatically populated based on previous responses in this spreadsheet. Below the financial information, please ensure to complete the programmatic questions regarding the grant.

Table 11. Year 2 Annual Rate of Expenditure

Record and update project expenses at each interval according to the reporting cadence determined by your Project Officer. Previous fields should remain and edits should be made to the whenever interannual reports are submitted.

Reporting Period

Jan-March of Year 2

April-June of Year 2

July-Sept of Year 2

Oct-Dec of Year 2

Enter Dates For this Reporting Period in the blue cells

_

EPA Funds Reporting Period 1

Mandatory Cost Share Reporting Period 1

Voluntary Cost Share Reporting Period 1

Total Project Cost Reporting Period 1

EPA Funds Reporting Period 2

Mandatory Cost Share Reporting Period 2

Voluntary Cost Share Reporting Period 2

Total Project Cost Reporting Period 2

EPA Funds Reporting Period 3

Mandatory Cost Share Reporting Period 3

Voluntary Cost Share Reporting Period 3

Total Project Cost9 Reporting Period 3

EPA Funds Reporting Period 4

Mandatory Cost Share Reporting Period 4

Voluntary Cost Share Reporting Period 4

Total Project Cost Reporting Period 4

Personnel

$-

$-

$-

$-

Fringe Benefits

$-

$-

$-

$-

Travel

$-

$-

$-

$-

Equipment

$-

$-

$-

$-

Supplies

$-

$-

$-

$-

Contractual

$-

$-

$-

$-

Construction

$-

$-

$-

$-

Other

$-

$-

$-

$-

Direct Cost Total

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Indirect Charges

$-

$-

$-

$-

TOTALS

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Table 11a. Year 2 Other Leveraged Funds

Reporting Period

Jan-March of Year 2

_

_2

_3

April-June of Year 2

_4

_5

_6

July-Sept of Year 2

_7

_8

_9

Oct-Dec of Year 2

_10

_11

_12

Other Leveraged Funds

Table 12. Project Updates - Narrative Responses

Record and update project updates below.

Please paste the planned activities, outputs, and outcome from the submitted workplan information. Provide updates and if any changes occurred, please provide that information accordingly. In the 'Progress to Date' column, please use the dropdown to indicate if the activity is 1) Not yet started, 2) In progress, or 3) Completed.

Activities

Anticipated Outputs

Anticipated Outcomes

Progress to Date

_

_3

_2

Progress Notes

Jan-March of Year 2

April-June of Year 2

July-Sept of Year 2

Oct-Dec of Year 2

Write below, as appropriate.

Table 13. Project Questions

Please provide programmatic and narrative financial updates on the project. As quarterly reports are submitted, indicate updates or changes for each quarter. For each quarter, please indicate if there was a change from the previous quarter. If yes, please provide an explanation in the subsequent cell.

Question

Jan-March of Year 2 Update

April-June of Year 2 Update

July-Sept of Year 2 Update

Oct-Dec of Year 2 Update

1. Provide a comparison of actual accomplishments to the objectives established for the reporting period.

2. If anticipated outputs/outcomes and/or timelines/milestones are not met, why not? Did you encounter any problems during the reporting period which may interfere with meeting project objectives?

3. If any additional voluntary leveraged funds are reported for this Reporting Period in Table 8 above, identify the source of the funds.

4. Have there been any major personnel changes during this reporting period?

5. Did any public relations events regarding this grant take place during the reporting period?

6. Are you using websites or other tools used to relay information about this grant to the public?

7. What project activities are planned for the next reporting period?

8. Was any program income generated during the reporting period? Identify amount of program income, how it was generated, and how the program income was/will be used.

9. Have any vehicles or activities changed from those included in the final workplan?

10. Do you have any other comments or feedback?

---

Sheet 7: 7. Year 3

U. S. Environmental Protection Agency

Clean Heavy-Duty Vehicles (CHDV) Grant Program

Financial and Narrative Summary - Year 3

Instructions

Financial summary for the third year of the project period if grant period of performance is longer than two years. For each quarterly report, please complete all shaded financial and narrative descriptive cells highlighted blue for each quarter the report is submitted. Cells highlighted yellow are automatically populated based on previous responses in this spreadsheet. Below the financial information, please ensure to complete the programmatic questions regarding the grant.

Table 14. Year 3 Annual Rate of Expenditure

Record and update project expenses at each interval according to the reporting cadence determined by your Project Officer. Previous fields should remain and edits should be made to the whenever interannual reports are submitted.

Reporting Period

Jan-March of Year 3

April-June of Year 3

July-Sept of Year 3

Oct-Dec of Year 3

Enter Dates For this Reporting Period in the blue cells

Column1

EPA Funds Reporting Period 1

Mandatory Cost Share Reporting Period 1

Voluntary Cost Share Reporting Period 1

Total Project Cost Reporting Period 1

EPA Funds Reporting Period 2

Mandatory Cost Share Reporting Period 2

Voluntary Cost Share Reporting Period 2

Total Project Cost Reporting Period 2

EPA Funds Reporting Period 3

Mandatory Cost Share Reporting Period 3

Voluntary Cost Share Reporting Period 3

Total Project Cost9 Reporting Period 3

EPA Funds Reporting Period 4

Mandatory Cost Share Reporting Period 4

Voluntary Cost Share Reporting Period 4

Total Project Cost Reporting Period 4

Personnel

$-

$-

$-

$-

Fringe Benefits

$-

$-

$-

$-

Travel

$-

$-

$-

$-

Equipment

$-

$-

$-

$-

Supplies

$-

$-

$-

$-

Contractual

$-

$-

$-

$-

Construction

$-

$-

$-

$-

Other

$-

$-

$-

$-

Direct Cost Total

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Indirect Charges

$-

$-

$-

$-

TOTALS

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

$-

Table 14a. Year 2 Other Leveraged Funds

Reporting Period

Jan-March of Year 3

_

_2

_3

April-June of Year 3

_4

_5

_6

July-Sept of Year 3

_7

_8

_9

Oct-Dec of Year 3

_10

_11

_12

Other Leveraged Funds

Table 15. Project Updates - Narrative Responses

Record and update project updates below.

Please paste the planned activities, outputs, and outcome from the submitted workplan information. Provide updates and if any changes occurred, please provide that information accordingly. In the 'Progress to Date' column, please use the dropdown to indicate if the activity is 1) Not yet started, 2) In progress, or 3) Completed.

Activities

Anticipated Outputs

Anticipated Outcomes

Progress to Date

_

_3

_2

Progress Notes

Jan-March of Year 3

April-June of Year 3

July-Sept of Year 3

Oct-Dec of Year 3

Write below, as appropriate.

Table 16. Project Questions

Please provide programmatic and narrative financial updates on the project. As quarterly reports are submitted, indicate updates or changes for each quarter. For each quarter, please indicate if there was a change from the previous quarter. If yes, please provide an explanation in the subsequent cell.

Question

Jan-March of Year 3 Update

April-June of Year 3 Update

July-Sept of Year 3 Update

Oct-Dec of Year 3 Update

1. Provide a comparison of actual accomplishments to the objectives established for the reporting period.

2. If anticipated outputs/outcomes and/or timelines/milestones are not met, why not? Did you encounter any problems during the reporting period which may interfere with meeting project objectives?

3. If any additional voluntary leveraged funds are reported for this Reporting Period in Table 8 above, identify the source of the funds.

4. Have there been any major personnel changes during this reporting period?

5. Did any public relations events regarding this grant take place during the reporting period?

6. Are you using websites or other tools used to relay information about this grant to the public?

7. What project activities are planned for the next reporting period?

8. Was any program income generated during the reporting period? Identify amount of program income, how it was generated, and how the program income was/will be used.

9. Have any vehicles or activities changed from those included in the final workplan?

10. Do you have any other comments or feedback?

---

Sheet 8: 8. CHDV Priorities

U. S. Environmental Protection Agency
Clean Heavy-Duty Vehicles (CHDV) Grant Program
CHDV Priorities
Instructions
Please complete this tab if your organization committed to ANY community engagement, project sustainability, workforce development, extreme weather resiliency, or leveraging of additional external funds actions or commitments in your application, as referred to in the evaluation metrics defined in section V.A. Evaluation Criteria in the NOFO. Only cells shaded in blue need to be filled out; cells shaded in yellow will automatically populate based on information entered in earlier tabs. Please use the drop downs for columns to indicate any updates that occurred during the reporting period indicating continued progress towards commitments. At the end of each of the sections below, there is a cell to provide additional narrative responses, as appropriate. Please take care to ensure all questions are answered; the final question is on row 127 of this sheet.
Table 17. Community Engagement
Question	Answer 1	Status Update	Quarter Completed
Did the workplan demonstrate actions and/or commitments to engage communities? If no, please jump to Table 18. If yes, please complete the rest of this section.	Please complete Tab 2 before completing this Tab
1. How did the workplan demonstrate engagement with the communities identified above, especially local residents, to ensure their meaningful participation with respect to the design, planning, and performance of the project?	Please complete Tab 2 before completing this Tab
2. Did the workplan for this project demonstrate that the recipient and/or project partner(s) has an existing clear point of contact in a public platform (e.g., newsletter, website) for community issues and complaints (specific to air quality or broader) and a publicly documented policy or process to engage communities and get their input on operations and projects that impact air quality? The process could be a meeting in the past year and/or a policy or process to have a meeting or otherwise get input (e.g., a standing citizens advisory committee). Please include any narrative details in question 3.	(Y or N or N/A)
2.a. If no, did the workplan for this project demonstrate that the recipient and/or project partner(s) commit to completing one before the end of the project period?	(Y or N or N/A)
2.b. To date, has the recipient and/or project partner(s) completed this commitment?		Select Status	Select Quarter
3. Please provide any additional details and/or a status update to be provided for this category, including but not limited to the URL(s) where the public can find the clear point of contact and policy or process; a description of the point of contact and policy or process; and any other relevant information. Please use the drop downs under 'Please Select One' to indicate which quarter.
Community Engagement Update 1			Select Quarter
Community Engagement Update 2			Select Quarter
Community Engagement Update 3			Select Quarter
Community Engagement Update 4			Select Quarter
Community Engagement Update 5			Select Quarter
Community Engagement Update 6			Select Quarter
Community Engagement Update 7			Select Quarter
Community Engagement Update 8			Select Quarter
Community Engagement Update 9			Select Quarter
Community Engagement Update 10			Select Quarter
Please provide any additional details or comments regarding community engagement
Table 18. Project Sustainability
Question	Answer 1	Status Update	Quarter Completed
Did the workplan demonstrate actions and/or commitments to promote sustainable project results and benefits? If no, please jump to Table 19. If yes, please complete the rest of this section.	Please complete Tab 2 before completing this Tab
1. How did the workplan demonstrate that project results and benefits will be sustainable and that the applicant and project partners have the ability to promote and continue efforts to reduce emissions from vehicles after EPA funding for the project has ended?	Please complete Tab 2 before completing this Tab
2. Zero-Emission Projects
2a. Did the workplan for this project demonstrate coordination and/or consultation with utilities or refueling partners on the feasibility of the project? This could include, but is not limited to, discussion with utilities or refueling partners on project charging needs, project upgrade needs, project costs, rates for future service, and/or the timeframe for necessary upgrades. Please include any narrative details in question 4.	(Y or N or N/A)
2b. If no, did the workplan for this project demonstrate that the recipient and/or project partner(s) commit to such coordination before the end of the project period?	(Y or N or N/A)
3. To date, has the recipient and/or project partner(s) completed this commitment?		Select Status	Select Quarter
4. Please provide additional details and any relevant status updates for this section, including but not limited to describing the extent of coordination with utilities, noting the timing and frequency of discussions with utilities, and any project decisions impacted by these discussions. Please use the drop downs under 'Please Select One' to indicate which quarter.
Project Sustainability Update 1			Select Quarter
Project Sustainability Update 2			Select Quarter
Project Sustainability Update 3			Select Quarter
Project Sustainability Update 4			Select Quarter
Project Sustainability Update 5			Select Quarter
Project Sustainability Update 6			Select Quarter
Project Sustainability Update 7			Select Quarter
Project Sustainability Update 8			Select Quarter
Project Sustainability Update 9			Select Quarter
Project Sustainability Update 10			Select Quarter
Please provide any additional details or comments regarding project sustainability
Table 19. Workforce Development
Question	Answer 1	Status Update	Quarter Completed
Did the workplan demonstrate actions and/or commitments to promote workforce development? If no, please jump to Table 20. If yes, please complete the rest of this section.	Please complete Tab 2 before completing this Tab
1. How did the workplan demonstrate a plan to prepare the workforce for the project?	Please complete Tab 2 before completing this Tab
2. Did the workplan for this project demonstrate that current drivers, mechanics, electricians, and other essential personnel have received training to safely operate and maintain the new vehicles and infrastructure? This could include the establishment of workforce training programs for zero emission vehicles and charging infrastructure. Please include any narrative details in question 6.	(Y or N or N/A)
2.a. If no, did the workplan for this project demonstrate that the recipient and/or project partner(s) commit to ensuring current drivers, mechanics, electricians, and other essential personnel receive training to safely operate and maintain the new vehicles and infrastructure before the end of the project period?	(Y or N or N/A)
2.b. To date, has the recipient and/or project partner(s) completed this commitment?		Select Status	Select Quarter
3. Did the workplan for this project demonstrate that the recipient and/or project partner(s) have clarified protections to ensure existing workers are not replaced or displaced because of new technologies? Please include any narrative details in question 6.	(Y or N or N/A)
3.a. If no, did the workplan for this project demonstrate that the recipient and/or project partner(s) commit to clarifying protections to ensure existing workers are not replaced for displaced because of new technologies before the end of the project period?	(Y or N or N/A)
3.b. To date, has the recipient and/or project partner(s) completed this commitment?		Select Status	Select Quarter
4. Did the workplan for this project demonstrate that the recipient and/or project partner(s) have increased the availability of domestic manufacturing and workforce for zero-emission vehicles, engines, and other key components (e.g., batteries)? Please include any narrative details in question 6.	(Y or N or N/A)
4.a. If no, did the workplan for this project demonstrate that the recipient and/or project partner(s) commit to increasing the availability of domestic manufacturing and workforce for zero- and near-zero emission vehicles, engines, and other key components (e.g., batteries) before the end of the project period?	(Y or N or N/A)
4.b. To date, has the recipient and/or project partner(s) completed this commitment?		Select Status	Select Quarter
5. Did the workplan for this project demonstrate that the recipient and/or project partner(s) have other measures and/or policies in place to promote workforce development? If yes, please describe the other measures and/or policies in more detail below. Please include any narrative details in question 6.	(Y or N or N/A)
5.a. If no, did the workplan for this project demonstrate that the recipient and/or project partner(s) commit establishing measures and/or policies to promote workforce development before the end of the project period?	(Y or N or N/A)
5.b. To date, has the recipient and/or project partner(s) completed this commitment?		Select Status	Select Quarter
6. Please provide additional details and any relevant status updates for this section, including but not limited to details on training programs, protections for existing workers, measures taken to increase the availability of domestic manufacturing and workforce, and/or descriptions of any additional policies and measures to promote workforce development, as well as any changes made to these throughout the project period.Please use the drop downs under 'Please Select One' to indicate which quarter.
Workforce Development Update 1			Select Quarter
Workforce Development Update 2			Select Quarter
Workforce Development Update 3			Select Quarter
Workforce Development Update 4			Select Quarter
Workforce Development Update 5			Select Quarter
Workforce Development Update 6			Select Quarter
Workforce Development Update 7			Select Quarter
Workforce Development Update 8			Select Quarter
Workforce Development Update 9			Select Quarter
Workforce Development Update 10			Select Quarter
Please provide any additional details or comments regarding workforce development.
Table 20. Project Resilience
Question	Answer 1	Status Update	Quarter Completed
Did the workplan demonstrate actions and/or commitments to promote project resilience to extreme weather? If no, please jump to Table 21. If yes, please complete the rest of this section.	Please complete Tab 2 before completing this Tab
1. How did the workplan demonstrate planning or action taken towards building project resilience and reducing vulnerabilities to extreme weather?	Please complete Tab 2 before completing this Tab
2. Did the workplan for this project demonstrate that the recipient and/or project partner(s) have assessed and implemented extreme weather adaptation considerations to help ensure that the project achieves its expected outcomes even in the face of extreme weather? This could include assessing project vulnerability to local extreme weather when making siting decision and operational plans, ensuring fleets and equipment are protected from extreme weather and/or protecting infrastructure from storm damage and/or extreme weather. Please include any narrative details in question 4.	(Y or N or N/A)
2.a. If no, did the workplan for this project demonstrate that the recipient and/or project partner(s) commit to assessing and implementing extreme weather adaptation considerations before the end of the project period?	(Y or N or N/A)
2.b. To date, has the recipient and/or project partner(s) completed this commitment?		Select Status	Select Quarter
3. Did the workplan for this project demonstrate that the recipient and/or project partner(s) have other measures and/or policies in place to promote project resilience to extreme weather? If yes, please describe the other measures and/or policies in more detail below. Please include any narrative details in question 4.	(Y or N or N/A)
3.a. If no, did the workplan for this project demonstrate that the recipient and/or project partner(s) commit establishing measures and/or policies to promote project resilience to extreme weather before the end of the project period?	(Y or N or N/A)
3.b. To date, has the recipient and/or project partner(s) completed this commitment?		Select Status	Select Quarter
4. Please provide additional details and any relevant status updates for this section, including but not limited to details on extreme weather impact assessments, descriptions of project decisions impacted by these assessments, and/or descriptions of any additional policies and measures to promote project resilience to extreme weather, as well as any changes made to these throughout the project period. Please use the drop downs under 'Please Select One' to indicate which quarter.
Project Resilience Update 1			Select Quarter
Project Resilience Update 2			Select Quarter
Project Resilience Update 3			Select Quarter
Project Resilience Update 4			Select Quarter
Project Resilience Update 5			Select Quarter
Project Resilience Update 6			Select Quarter
Project Resilience Update 7			Select Quarter
Project Resilience Update 8			Select Quarter
Project Resilience Update 9			Select Quarter
Project Resilience Update 10			Select Quarter
Please provide any additional details or comments regarding resiliency to extreme weather impacts.
Table 21. Leveraging of Additional External Funds
Leveraged funds refers to additional, external funds where an applicant or grantee is providing additional resources to support or complement the project above and beyond the EPA grant funds.
Question	Answer 1	Status Update	Quarter Completed	Amount (S)
Did the workplan demonstrate that the recipient has leveraged or plans to leverage additional external funds in order to support proposed project activities? If yes, please complete the rest of this section.	Please complete Tab 2 before completing this Tab
1. How did the workplan demonstrate that the recipient has leveraged or plans to leverage additional external funds in order to support proposed project activities, as well as how these funds will be used to contribute to the performance and success of the project?	Please complete Tab 2 before completing this Tab
2. Please provide updates on proposed or secured additional external funds using the rows below. This should include additional external leveraged funds, but should not include applicant funds. Place the Source Name in the 'Answer 1' field and refer to the following definitions when selecting Status: "Not Yet Started:" Funding is proposed but the application process has not yet begun "In Progress:" The funding application or selection process is underway, but funds have not been awarded "Awarded:" Funding has been officially awarded "Not Awarded:" Funding that had been applied for was not awarded
Exernal leveraged funds source 1		Select Status	Select Quarter
Exernal leveraged funds source 2		Select Status	Select Quarter
Exernal leveraged funds source 3		Select Status	Select Quarter
Exernal leveraged funds source 4		Select Status	Select Quarter
Exernal leveraged funds source 5		Select Status	Select Quarter
Exernal leveraged funds source 6		Select Status	Select Quarter
Exernal leveraged funds source 7		Select Status	Select Quarter
Exernal leveraged funds source 8		Select Status	Select Quarter
Exernal leveraged funds source 9		Select Status	Select Quarter
Exernal leveraged funds source 10		Select Status	Select Quarter
3. Are there any updates to be provided or additional information for any proposed or secured additional external funds? If yes, please provide additional details and a status update below, including a description of how any secured funds are being used to support proposed project activities and how they are contributing to the performance and success of the project. If any proposed funding was not awarded, use the space provided to indicate your plans to make up for these funds. Please use the drop downs under 'Please Select One' to indicate which quarter.
Leveraging of Additional External Funds Update 1			Select Quarter
Leveraging of Additional External Funds Update 2			Select Quarter
Leveraging of Additional External Funds Update 3			Select Quarter
Leveraging of Additional External Funds Update 4			Select Quarter
Leveraging of Additional External Funds Update 5			Select Quarter
Leveraging of Additional External Funds Update 6			Select Quarter
Leveraging of Additional External Funds Update 7			Select Quarter
Leveraging of Additional External Funds Update 8			Select Quarter
Leveraging of Additional External Funds Update 9			Select Quarter
Leveraging of Additional External Funds Update 10			Select Quarter
Please provide any additional details or comments regarding leveraged additional external funds of the project.

---

Sheet 9: 9a. Current Fleet Description

U. S. Environmental Protection Agency

Clean Heavy-Duty Vehicles (CHDV) Grant Program

Current Fleet Description

Instructions

The Current Fleet Description table should detail all vehicles that will be scrapped, sold, or donated under this project. The Current Fleet Description tab should be updated quarterly with any new information that becomes available during the quarter. Please fill out all shaded cells highlighted blue with a diagonal pattern (///). The Current Vehicle needs to be paired with the replacement vehicle listed on the New Fleet Description tab by selecting the 'New Vehicle' from the dropdown in column C. For the vocational vehicle sub-group, if two or more vehicles will be replaced by a single ZE vehicle, list each vehicle on a separate line and then select the corresponding New Vehicle in column C. For example, if Current Vehicles 1-3 were going to replace New Vehicle 1, New Vehicle 1 would be selected multiple times from the dropdown in column C. The sheet has capacity for 300 vehicles. Please refer to the Current Fleet Description data definitions in the Data Dictionary (Tab 12) for additional guidance on each field. Note: the Current Vehicle Activity Data data should be included in the reporting template during the first reporting period in which the data become available and are only reported once during the project. If you do not have data available, please contact your PO for further guidance.

Table 22. CURRENT VEHICLE INFORMATION

22a. Basic Fleet Information

22b. Current Vehicle Information

22c. Current Vehicle Activity Information

22d. Vehicle Disposition Process

22e. Current Vehicle Place(s) of Performance: Populate the location details for the county in which each vehicle primarily operates.

Primary Place of Performance

Secondary Place of Performance (if applicable)

Additional Location Details (if applicable)

Vehicle

Is this vehicle a part of a group of vehicles that will be replaced by a single ZE vehicle? (vocational vehicles sub-program only)

Corresponding New Vehicle (select 'New Vehicle XX' from 'New Fleet Description' table, provided in dropdown)

Group Name

Current Fleet Owner

Publicly or Privately Owned (select from dropdown)

Vehicle Type (select from dropdown)

Vehicle Class (select from dropdown)

Vehicle Vocation (select from dropdown)

Vehicle Group Sector (select from dropdown)

Vehicle Identification Number (VIN)

Vehicle Manufacturer

Vehicle Model

Current Vehicle Model Year

Current Engine Fuel Type (select from dropdown)

If "Other", please describe here

Engine Family Name (if unregulated, then NA)

GVWR

Annual Miles Traveled (miles per vehicle)

Annual Idling Hours (hours per engine)

Current Odometer (in miles)

Annual Amount of Fuel Used (gallons/year per engine)

Remaining Life of Baseline Engine/Vehicle

Provide evidence that the replacement activity is an “early replacement”

Vehicle Disposition/Replacement Process

If sold or donated, provide the state in which the vehicle is expected to primarily operate (For Vehicles Model Year 2011 and newer; if known, select from dropdown)

If sold or donated, provide the county in which the vehicle is expected to primarily operate (For Vehicles Model Year 2011 and newer; if known, select from dropdown)

Provide evidence of appropriate scrappage, sale, or vehicle donation (if applicable).

School District Name (if applicable)

NCES ID (if applicable)

State (select from dropdown)

County (select from dropdown)

Percentage of Time operated in County

Place of Performance: City

Zip Code

School District Name (if applicable)_2

NCES ID (if applicable)_2

State_2

County_3

Percentage of Time operated in County_2

Place of Performance: City_3

Zip Code_2

Additional Counties where Vehicle Operates

Percentage of time operated in each Additional County

Example Vehicle

Example: No

Example: New Vehicle 67

Example: ESBs for District A

Example: Sarah Smith

Example: Publicly Owned

Example: Refuse Hauler

Example: Class 6

Example: Refuse Hauler

Example: Municipal

Example: 12345678910ABCDEFG

Example: Manufacturer Name

Example: Model Name or #

Example: 1995

Example: Diesel

Example: Hybrid

Example: N/A

Example: 20150

Example: 140000

Example: 12000

Example: 1500

Example: 6000

Example: 3

Example: Based on average turnover rate, this vehicle would have been used for three more years.

Example: Scrapped

Example: CA

Example: Alameda County

Example: Engine seral number 12345678 and VIN 12345678910ABCDEFG was scrapped on 11/1/2025. See associated Eligibility and Scrappage statement.

Example: Warren 01

Example: 123456

Example: SC

Example: Warren

Example: 100%

Example: Springhill

Example: 123456

Example: Warren 01

Example: 123456

Example: SC

Example: Warren

Example: 100%

Example: Springhill

Example: 123456

Example: Pima County, AZ; La Paz County, AZ

Example: 5% in Pima; 5% in La Paz

Current Vehicle 1

Current Vehicle 2

Current Vehicle 3

Current Vehicle 4

Current Vehicle 5

Current Vehicle 6

Current Vehicle 7

Current Vehicle 8

Current Vehicle 9

Current Vehicle 10

Current Vehicle 11

Current Vehicle 12

Current Vehicle 13

Current Vehicle 14

Current Vehicle 15

Current Vehicle 16

Current Vehicle 17

Current Vehicle 18

Current Vehicle 19

Current Vehicle 20

Current Vehicle 21

Current Vehicle 22

Current Vehicle 23

Current Vehicle 24

Current Vehicle 25

Current Vehicle 26

Current Vehicle 27

Current Vehicle 28

Current Vehicle 29

Current Vehicle 30

Current Vehicle 31

Current Vehicle 32

Current Vehicle 33

Current Vehicle 34

Current Vehicle 35

Current Vehicle 36

Current Vehicle 37

Current Vehicle 38

Current Vehicle 39

Current Vehicle 40

Current Vehicle 41

Current Vehicle 42

Current Vehicle 43

Current Vehicle 44

Current Vehicle 45

Current Vehicle 46

Current Vehicle 47

Current Vehicle 48

Current Vehicle 49

Current Vehicle 50

Current Vehicle 51

Current Vehicle 52

Current Vehicle 53

Current Vehicle 54

Current Vehicle 55

Current Vehicle 56

Current Vehicle 57

Current Vehicle 58

Current Vehicle 59

Current Vehicle 60

Current Vehicle 61

Current Vehicle 62

Current Vehicle 63

Current Vehicle 64

Current Vehicle 65

Current Vehicle 66

Current Vehicle 67

Current Vehicle 68

Current Vehicle 69

Current Vehicle 70

Current Vehicle 71

Current Vehicle 72

Current Vehicle 73

Current Vehicle 74

Current Vehicle 75

Current Vehicle 76

Current Vehicle 77

Current Vehicle 78

Current Vehicle 79

Current Vehicle 80

Current Vehicle 81

Current Vehicle 82

Current Vehicle 83

Current Vehicle 84

Current Vehicle 85

Current Vehicle 86

Current Vehicle 87

Current Vehicle 88

Current Vehicle 89

Current Vehicle 90

Current Vehicle 91

Current Vehicle 92

Current Vehicle 93

Current Vehicle 94

Current Vehicle 95

Current Vehicle 96

Current Vehicle 97

Current Vehicle 98

Current Vehicle 99

Current Vehicle 300

← Click + to access additional rows. Please do not insert or delete rows.

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Sheet 10: 9b. New Fleet Description

U. S. Environmental Protection Agency

Clean Heavy-Duty Vehicles (CHDV) Grant Program

New Fleet Description

Instructions

The New Fleet Description should detail all vehicles that will be purchased under the project. The New Fleet Description should be updated quarterly with all vehicle upgrades completed. Please fill out all shaded cells highlighted blue with a diagonal pattern (///). The sheet has capacity for 250 vehicles. Please refer to the Fleet Description data definitions on tab 12 (Data Dictionary) for additional guidance on each field. Note: the New Vehicle Activity Data data should be included in the reporting template during the first reporting period in which the data become available and are only reported once during the project. If you do not have data available, please contact your PO for further guidance.

Table 23. NEW REPLACEMENT VEHICLE INFORMATION

23a. Upgrade Vehicle Information

23b. Upgrade Cost

23c. New Vehicle Activity Information

23d. New Vehicle Battery Information (for Battery Electric Vehicles Only)

23e. New Vehicle Fuel Cell Information (for Fuel Cell EVs Only)

23f. Warranty Information

23g. New Vehicle Place(s) of Performance

23h. Optional Participation in Future of Transportation Research

23i. Vehicle Ownership and BABA Compliance

Primary Place of Performance

Secondary Place of Performance (if applicable)

Additional Location Details (if applicable)

Vehicle

Group Name (optional)

Year of Upgrade Action

New Vehicle Fleet Owner

New Vehicle Class (select from dropdown)

Vehicle Vocation (select from dropdown)

Vehicle Group Sector (select from dropdown)

VIN for New Vehicle(s)

New Vehicle Manufacturer

New Vehicle Model

New Vehicle Model Year

New Vehicle Fuel Type

New Vehicle GVWR

Upgrade Cost per Vehicle

Total Federal Funds Expended Per Vehicle ($ of Total Cost per Unit)

New Vehicle Annual Miles Traveled (miles per vehicle)

New Vehicle Equipped with Auxiliary Heater? (Yes/No)

Auxiliary Heater Type (if not applicable, then N/A)

Capable of Bidirectional Charging? (Yes/No/N/A)

Manufacturer of Battery Pack

Number of Battery Packs

Battery Capacity per Battery Pack (kWh)

Vehicle Total Battery Capacity (kWh)

Rated Charging Power (kW)

Estimated Range in Miles

Manufacturer of Fuel Cell System (if known)

Fuel Cell Stack Capacity (kW)

Hydrogen Fuel Tank Capacity (kg)

Does the Battery or Fuel Cell Have a Warranty? (Yes/No)

Number of Years Covered by Battery or Fuel Cell System Warranty

Number of Miles Covered by Battery or Fuel Cell System Warranty

Total kWh of Battery or Fuel Cell System Discharge Covered by Warranty

Powertrain Warranty Included? (Yes/No)

Number of Years Covered by Powertrain Warranty

Number of Miles Covered by Powertrain Warranty

School District Name (if applicable)

NCES ID (if applicable)

State (select from dropdown)

County (select from dropdown)

Percentage of Time operated in County

Place of Performance: City_2

Zip Code_3

School District Name (if applicable)_2

NCES ID (if applicable)_2

State (select from dropdown)_2

County (select from dropdown)_2

Percentage of Time operated in County_2

Place of Performance: City_2

Zip Code_2

Additional Counties where Vehicle Operates_3

Percentage of Time operated in each Additional County_3

Is the vehicle/equipment equipped with Telematics? (Yes/No/Not Sure)

If Yes, Fleet Primary Point of Contact (name and email)

Can EPA or its partners contact this fleet about participating in research opportunities to provide vehicle or infrastructure data that could inform future transportation work? (Yes/No)

Publicly or Privately Owned (select from dropdown)

Does the vehicle serve a public function?

Is the vehicle subject to BABA?

Is the vehicle BABA Compliant?

Is a waiver being used to fulfill BABA compliance for the vehicle?

If ''Yes - Other EPA Waiver', explain

Example Vehicle

Example: ESB for District A

Example: 2025

Example: Walton School District

Example: Class 6

Example: Refuse Hauler

Example: Municipal

Example: 1234567890ABCDE

Example: Manufacturer Name

Example: Model Name or #

Example: 2023

Example: Battery Electric

Example: 12000

Example: $375,000

Example: $325,000

Example: 12000

Example: Yes

Example: N/A

Example: Yes

Example: Battery & Co.

Example: 6

Example: 90

Example: 540

Example: 360

Example: 200

Example: Fuel Cell Co.

Example: 140

Example: 800

Example: Yes

Example: 8

Example: 160,000

Example: 200,000

Example: Yes

Example: 4

Example: 100,000

Example: Warren 01

Example: 123456

Example: SC

Example: Warren

Example: 100%

Example: Springhill

Example: 123456

Example: Warren 01

Example: 123456

Example: SC

Example: Warren

Example: 100%

Example: Springhill

Example: 123456

Example: Pima County, AZ; La Paz County, AZ

Example: 5% in Pima; 5% in La Paz

Example: Yes

Example: Sarah Smith, smith.sarah@HSD.edu

Example: Yes

Example: Publicly Owned

Example: Yes

Example: Yes

Example: Yes - This vehicle is BABA compliant

Example: No - Vehicle meets all BABA requirements

Please describe

New Vehicle 1

New Vehicle 2

New Vehicle 3

New Vehicle 4

New Vehicle 5

New Vehicle 6

New Vehicle 7

New Vehicle 8

New Vehicle 9

New Vehicle 10

New Vehicle 11

New Vehicle 12

New Vehicle 13

New Vehicle 14

New Vehicle 15

New Vehicle 16

New Vehicle 17

New Vehicle 18

New Vehicle 19

New Vehicle 20

New Vehicle 21

New Vehicle 22

New Vehicle 23

New Vehicle 24

New Vehicle 25

New Vehicle 26

New Vehicle 27

New Vehicle 28

New Vehicle 29

New Vehicle 30

New Vehicle 31

New Vehicle 32

New Vehicle 33

New Vehicle 34

New Vehicle 35

New Vehicle 36

New Vehicle 37

New Vehicle 38

New Vehicle 39

New Vehicle 40

New Vehicle 41

New Vehicle 42

New Vehicle 43

New Vehicle 44

New Vehicle 45

New Vehicle 46

New Vehicle 47

New Vehicle 48

New Vehicle 49

New Vehicle 50

New Vehicle 51

New Vehicle 52

New Vehicle 53

New Vehicle 54

New Vehicle 55

New Vehicle 56

New Vehicle 57

New Vehicle 58

New Vehicle 59

New Vehicle 60

New Vehicle 61

New Vehicle 62

New Vehicle 63

New Vehicle 64

New Vehicle 65

New Vehicle 66

New Vehicle 67

New Vehicle 68

New Vehicle 69

New Vehicle 70

New Vehicle 71

New Vehicle 72

New Vehicle 73

New Vehicle 74

New Vehicle 75

New Vehicle 76

New Vehicle 77

New Vehicle 78

New Vehicle 79

New Vehicle 80

New Vehicle 81

New Vehicle 82

New Vehicle 83

New Vehicle 84

New Vehicle 85

New Vehicle 86

New Vehicle 87

New Vehicle 88

New Vehicle 89

New Vehicle 90

New Vehicle 91

New Vehicle 92

New Vehicle 93

New Vehicle 94

New Vehicle 95

New Vehicle 96

New Vehicle 97

New Vehicle 98

New Vehicle 99

New Vehicle 300

← Click + to access additional rows. Please do not insert or delete rows.

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Sheet 11: 10. Infrastructure

U. S. Environmental Protection Agency

Clean Heavy-Duty Vehicles (CHDV) Grant Program

Infrastructure Description

Instructions

The tables on this tab capture aspects of eligible infrastructure included in this project. The EVSE Equipment Information (Table 24) should detail all electric vehicle supply equipment (EVSE) and supporting infrastructure purchased under the project that uses any source of funding. Details on attribute and activity of other infrastructure should be captured in the following tables: On-site Power Generation Equipment (Table 25); Battery Energy Storage System (BESS) Equipment Information (Table 26); and Hydrogen Fueling Station Information (Table 27). Other infrastructure components included in the project, that uses any source of funding, but not otherwhere captured should be included in the free response field at the bottom of the tab. For tables 24-27, third-party and large school districts awardees, 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. The EV Infrastructure worksheet should be updated semi-annually as EVSEs and supporting infrastructure are procured and installed. Please only fill out shaded cells highlighted blue with a diagonal pattern (///); however, additional rows may be add as needed to capture all equipment. Please refer to the EV Infrastructure data definitions on Tab 12 (Data Dictionary) for data field definitions. Reminder: All Level 2 EVSEs must be ENERGY STAR certified.

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 a federally-funded infrastructure project are produced in the United States. If the EPA award funds part of a project that includes the installation, upgrading, or replacement of infrastructure, then BABA applies to the entire infrastructure project. For more information, please visit https://www.epa.gov/ports-initiative/cleanports#otaq-baba.

Table 24: Electric Vehicle Supply Equipment Information

Table 24a. EVSE Information Overview and Funding Source

Table 24b. Location of EV Infrastructure

Table 24c. Owners & Anticipated Users of EVSE

Table 24d. Charge Management Service

Table 24e. Infrastructure Installation Information, funding source, and BABA compliance

Table 24f. EVSE Cost Summary

Table 24g. Optional Participation in the Future of Transportation Research

Table 24H: EVSE Unit Serial Number (Applies to EVSE units purchased with EPA funds)

To add more EVSE Serial Numbers, click on the (+) at the top of column KU1 ↑

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 per EVSE unit

Is the EVSE Capable of Bidirectional Charging?

Will the Vehicle and EVSE be Used for Vehicle to Grid (V2G)?

Number of EVSE Units

EVSE Equipment Cost only Per Unit

Are Applicant Funds being used to purchase EVSE equipment? (Yes/No)

If yes, list the amount in dollars of Applicant Funds used to purchase EVSE equipment

Total EPA Funds Expended Per EVSE Unit

Total EPA Funds Expended for EVSE

Date of EVSE Manufacture (mm/dd/yyyy)

Date of EVSE Installation (mm/dd/yyyy)

Date EVSE Operational (mm/dd/yyyy)

State (Select from dropdown)

County (Select from dropdown)

City

Zip Code

Street Address

Who owns the charger?

Anticipated User(s) of the Charger

If serving school districts, does the EVSE serve multiple school districts within this project?

Name of the School District(s) the EVSE will serve (if applicable; use a colon between school districts)

NCES ID of School District that the EVSE will serve (if applicable; use a colon between school districts)

Name of Charge Management Service Provider (if not applicable, enter "N/A")

Does the Infrastructure Equipment Cost Include Charge Management Service? (Yes/No)

If Charge Management Service not included in cost, but is acquired, what is the cost and frequency of charges?

Total Funds Expended for EVSE Installation

Are Applicant Funds being used for EVSE installation costs (Yes/No)

If yes, list the amount in dollars of Applicant Funds used for EVSE installation costs

Total EPA Funds Expended for EVSE Installation Costs

Does the Infrastructure Equipment Cost Include Installation?

Description of Installation Work

Installation Work Performed By

Installation was conducted by an individual who meets the infrastructure electrician requirements as outlined in the program guidance?

Is the infrastructure subject to BABA?

Is this infrastructure BABA Compliant? (Select Options)

Is a waiver being used to fulfill BABA compliance for the Infrastructure Project

If 'Yes - Other EPA Waiver' selected, explain

Total EPA Funds Expended on EVSE Equipment and Installation

Can EPA or its partners contact this fleet about participating in research opportunities to provide EVSE data that could inform future transportation work? (Yes/No)

If Yes, Charge Management Service Primary Point of contact (name and email)

Serial Number: Unit 1

Serial Number: Unit 2

Serial Number: Unit 3

Serial Number: Unit 4

Serial Number: Unit 5

Serial Number: Unit 6

Serial Number: Unit 7

Serial Number: Unit 8

Serial Number: Unit 9

Serial Number: Unit 10

Serial Number: Unit 11

Serial Number: Unit 12

Serial Number: Unit 13

Serial Number: Unit 14

Serial Number: Unit 15

Serial Number: Unit 16

Example EV Infrastructure

Example: AC Level 2

Example: Yes

Example: Manufacturer Name

Example: Model Name

Example: 2023

Example: 24

Example: 2

Example: No

Example: No

Example: 2

Example: $16,000

Example: Yes

Example: No

Example: $12,000

Example: $24,000

Example: 5/27/2024

Example: 6/29/2024

Example: 8/28/2024

Example: VA

Example: Arlington County

Example: Alexandria

Example: 22305

Example: 400 1st Street

Example: Walton School District

Example: Electric school buses serving Walton School District

Example: Yes

Example: Walton School District: Franklin School District

Example: 1234567: 7654321

Example: Charge Manage & Co.

Example: Yes

Example: $250 per charger per month

Example: $12,000

Example: No

Example: $2,000

Example: $7,000.00

Example: No

Example: Upgrades to the electrical panel, wiring, and installation for two DCFC

Example: XYZ Electric Co.

Example: Yes - Certification from EVITP

Example: Yes

Example: Yes - This infrastructure is BABA compliant

Example: No - Infrastructure meets all BABA requirements

Please describe

Example: $31,000

Example: Yes

Example:  Sarah Smith, Smith.Sarah@hsd.edu

Example: L1-0357-ISO-3240-049390

Example: VX-1263-11C1-2-2310-05642

Example: 0170182509830170

Example: 9124-1GT05-09830170

Example: VX-1265-11C1-2-2635-07842

Example: VX-1264-11C1-2-2502-05872

Example: VX-1266-11C1-2-2502-05642

Example: VX-1266-11C1-2-2502-05643

Example: VX-1266-11C1-2-2502-05644

Example: 9125-1GT27-0983253

Example: VX-1263-11C1-2-2310-05643

Example: 0170182509830170

Example: 9124-1GT05-09830171

Example: VX-1265-11C1-2-2635-07843

Example: VX-1264-11C1-2-2502-05873

Example: VX-1266-11C1-2-2502-05643

EVSE Group 1

$-

No

$-

EVSE Group 2

$-

No

$-

EVSE Group 3

$-

No

$-

EVSE Group 4

$-

No

$-

EVSE Group 5

$-

No

$-

EVSE Group 6

$-

No

$-

EVSE Group 7

$-

No

$-

EVSE Group 8

$-

No

$-

EVSE Group 9

$-

No

$-

EVSE Group 10

$-

No

$-

EVSE Group 11

$-

No

$-

EVSE Group 12

$-

No

$-

EVSE Group 13

$-

No

$-

EVSE Group 14

$-

No

$-

EVSE Group 15

$-

No

$-

EVSE Group 16

$-

No

$-

EVSE Group 17

$-

No

$-

EVSE Group 18

$-

No

$-

EVSE Group 19

$-

No

$-

EVSE Group 20

$-

No

$-

EVSE Group 21

$-

No

$-

EVSE Group 22

$-

No

$-

EVSE Group 23

$-

No

$-

EVSE Group 24

$-

No

$-

EVSE Group 25

$-

No

$-

EVSE Group 26

$-

No

$-

EVSE Group 27

$-

No

$-

EVSE Group 28

$-

No

$-

EVSE Group 29

$-

No

$-

EVSE Group 30

$-

No

$-

Table 25. On-Site Power Generation Equipment Information

Note: If the on-site power generation includes an energy storage system, information for such system needs to be documented in the table below this one.

Table 25a. On-Site Power Generation Equipment Overview, Cost, and Installation

Table 25b. Location of On-site Power Generation Infrastructure

Table 25c. Ownership and Anticipated Users of On-Site Power Generation Infrastructure

Table 25d. BABA Compliance

Totals

Type of energy generation

Manufacturer of On-site Power Generation

Model of On-site Power Generation

Manufacture Year of On-site Power Generation

Generation Capacity of the system (please indicate kW or MW)

Equipment Cost only Per Power Generation System

Are Applicant funds being used to purchase on-site power generation equipment? (Yes/No)

If yes, list the amount in dollars of Applicant Funds used to purchase on-site power generation equipment

Total EPA Funds Expended Per on-site power generation equipment

Total Funds Expended Installation Cost

Are Applicant funds being used for Installation Cost? (Yes/No)

If yes, list the amount in dollars of Applicant Funds used for Installation Cost

Total EPA Funds Expended Installation Cost

Date(s) On-Site Power Generation Equipment was Manufactured

Date the On-site Power Generation was Installation (mm/dd/yyyy)

Date the On-site Power Generation was Operational (mm/dd/yyyy)

State

County

City

Zip Code

Street Address

Who owns the equipment?

Anticipated Users of On-Site Power Generation Infrastructure

If serving school districts, Name of the School District(s) the On-site Power Generation will serve

If serving school districts, NCES ID of School District that the On-site Power Generation will serve

Is the on-site Power Generator subject to BABA?

Is the on-site Power Generator BABA Compliant? (Select Options)

Is a waiver being used to fulfill BABA compliance for the On-site Power Generation?

If 'Yes - Other EPA Waiver' selected, explain

Total EPA Funds Expended - Equipment and Installation

Example On-site Power Generation

Example: Solar

Example: Manufacturer Name

Example: Model Name

Example: 2023

Example: 15 kW

Example: $45,000

Example: No

Example: No

Example: $45,000

Example: $7,000

Example: No

Example: No

Example: $5,000

Example: equipment: 3/2024; housing: 6/2023

Example: 6/28/2024

Example: 7/31/2024

Example: VA

Example: Arlington County

Example: Alexandria

Example: 22305

Example: 400 1st Street

Example: Walton School District

Example: Walton School District & NoVA Community College

Example: Walton School District

Example: 1234567

Example: Yes

Example: Yes - This infrastructure is BABA compliant

Example: No - Infrastructure meets all BABA requirements

Please describe

Example: $50,000

On-site Power Generation 1

No

$-

On-site Power Generation 2

No

$-

On-site Power Generation 3

No

$-

On-site Power Generation 4

No

$-

On-site Power Generation 5

No

$-

On-site Power Generation 6

No

$-

On-site Power Generation 7

No

$-

On-site Power Generation 8

No

$-

On-site Power Generation 9

No

$-

On-site Power Generation 10

No

$-

Table 26. Battery Energy Storage System (BESS) Equipment Information

Table 26a. Battery Energy Storage System (BESS) Equipment Overview, Cost, and Installation

Table 26b. Location of BESS Infrastructure

Table 26c. Ownership and Anticipated Users of BESS Infrastructure

Table 26d. BABA Compliance

Totals

Type of Battery

Manufacturer of BESS

Model of BESS

Manufacture Year of BESS

Energy Capacity (please indicate kWh or MWh)

Equipment Cost only Per Unit:

Are Applicant funds being used to purchase BESS equipment? (Yes/No)

If yes, list the amount in dollars of Applicant Funds used to purchase BESS equipment

Total EPA Funds Expended Per Unit

Total Funds Expended Installation Cost

Are Applicant funds being used for Installation Cost? (Yes/No)

If yes, list the amount in dollars of Applicant Funds used for Istallation Cost

Total EPA Funds Expended Installation Cost:

Date(s) BESS and related Equipment was Manufactured

Date of BESS Installation (mm/dd/yyyy)

Date BESS Operational (mm/dd/yyyy)

State

County

City

Zip Code

Street Address

Who owns the equipment?

Anticipated Users of BESS

If serving school districts, Name of the School District the BESS will serve

If serving school districts, NCES ID of School District that the BESS will serve

Is the BESS subject to BABA?

Is the BESS BABA Compliant?

Is a waiver being used to fulfill BABA compliance for the BESS?

If 'Yes - Other EPA Waiver' selected, explain

Total EPA Funds Expended - Equipment and Installation

BESS Example

Example: Lithium-Ion

Example: Manufacturer Name

Example: Model Name

Example: 2023

Example: 36kWh

Example: $45,000

Example: No

Example: No

Example: $20,000

Example: $12,000

Example: No

Example: No

Example: $10,000

Example: battery: 3/2024; housing: 6/2023

Example: 6/29/2024

Example: 7/31/2024

Example: VA

Example: Arlington County

Example: Alexandria

Example: 22305

Example: 400 1st Street

Example: Walton School District

Example: Walton School District & NoVA Community College

Example: Walton School District

Example: 1234567

Example: Yes

Example: Yes - This infrastructure is BABA compliant

Example: No - Infrastructure meets all BABA requirements

Please describe

Example: $30,000

BESS Group 1

No

$-

BESS Group 2

No

$-

BESS Group 3

No

$-

BESS Group 4

No

$-

BESS Group 5

No

$-

BESS Group 6

No

$-

BESS Group 7

No

$-

BESS Group 8

No

$-

BESS Group 9

No

$-

BESS Group 10

No

$-

Table 27. Hydrogen Fueling Station Information

Table 27a. Hydrogen Fueling Station Information Overview

Table 27b. H2 Dispenser Pedestal Details

Table 27c. H2 Storage Tank

Table 27d. H2 Compressor

Table 27e. H2 Cooling System (refrigeration and heat exchanger)

Table 27f. Service Details

Table 27g. Location of H2 Station

Table 27h. Installation Details

Table 27i. Funding Details

Table 27j. H2 Fueling Infrastructure BABA Compliance

Table 27k. H2 Fueling Infrastructure Cost Summary

Column1

Type of Station (select from dropdown)

Type of Hydrogen Storage (select from dropdown)

Refilling Pressure (select from dropdown)

Refilling Pressure: If Other, specify below

Total Hydrogen Storage Tank Capacity (kg)

Total Number of Dispensers

Maximum Dispensing Flow Rate per Hose (kg/day)

Total Dispensing Capacity of the Station (kg/day)

Total Number of Cooling Systems

Total Number of Compressors

Number of Storage Tanks

Number of Dispenser Pedestals

Number of Hoses per Pedestal

H2 Dispenser Pedestal Manufacturer

H2 Dispenser Pedestal Model

H2 Dispenser Pedestal Manufacture Year

H2 Storage Tank Manufacturer

H2 Storage Tank Model

H2 Storage Tank Manufacture Year

H2 Compressor Manufacturer

H2 Compressor Model

H2 Compressor Manufacture Year

H2 Cooling System Manufacturer

H2 Cooling System Model

H2 Cooling System Manufacture Year

Annual Total H2 Dispensed (kg)

Who owns the H2 Fueling Station?

State (select from dropdown)

County (select from dropdown)

City

Zip Code

Street Address

Description of H2 Fueling Station Installation Work Performed

H2 Fueling Station Installation Performed by:

Date of H2 Fueling Station Installation (mm/dd/yyyy)

Date H2 Fueling Station Operational (mm/dd/yyyy)

H2 Fueling Infrastructure equipment Cost

Are Applicant funds being used to purchase H2 Fueling Infrastructure equipment? (Yes/No)

If yes, list the amount in dollars of Applicant Funds used to purchase H2 Fueling Infrastructure equipment

Total EPA Funds Expended for H2 Fueling Infrastructure Equipment

Total Funds Expended for H2 Fueling Infrastructure Installation

Does the H2 Fueling Infrastructure Equipment Cost Include Installation?

Are Applicant Funds being used for H2 Fueling Infrastructure Installation costs? (Yes/No)

If yes, list the amount in dollars of Applicant Funds used for H2 Fueling Infrastructure costs

Total EPA Funds Expended for H2 Fueling Infrastructure Installation Costs

Is the Hydrogen Fueling Infrastructure subject to BABA?

Is the Hydrogen Fueling Infrastructure BABA Compliant? (select from dropdown)

Is a waiver being used to fulfill BABA compliance for the H2 Fueling Infrastructure? (select from dropdown)

If 'Yes - Other EPA Waiver' selected, explain

Total EPA Funds Expended on H2 Fueling Infrastructure Equipment and Installation

Example: Hydrogen Fueling Station

Example: Gas

Example: Above Ground

Example: H35

Example: 1,200

Example: 6

Example: 2

Example: 12

Example: 2

Example: 2

Example: 3

Example: 3

Example: 2

Example: H2 Hoses & Co.

Example: Magic Hose 1

Example: 2023

Example: H2 Super Tank

Example: ST001

Example: 2023

Example: Cool Engineering Co.

Example: H2+HD

Example: 2023

Example: Cool and Beyond

Example: Cool H2+ Mark I

Example: 2023

Example: 200,000

Example: Port of Houston

Example: VA

Example: Arlington County

Example: Alexandria

Example: 22305

Example: 400 1st Street

Please describe

Example: XYZ H2 Solutions

Example: 6/28/2024

Example: 8/28/2024

Example: $16,000

Example: No

Example: $2,000

Example: $24,000

Example: $12,000

Example: No

Example: No

Example: $2,000

Example: $7,000.00

Example: Yes

Example: Yes - This Infrastructure is BABA Compliant

Example: No - Infrastructure meets all BABA requirements

Please describe

Example: $31,000

Hydrogen fueling station 1

No

$-

Hydrogen fueling station 2

No

$-

Hydrogen fueling station 3

No

$-

Hydrogen fueling station 4

No

$-

Hydrogen fueling station 5

No

$-

Hydrogen fueling station 6

No

$-

Hydrogen fueling station 7

No

$-

Hydrogen fueling station 8

No

$-

Hydrogen fueling station 9

No

$-

Hydrogen fueling station 10

No

$-

Are there any other infrastructure projects associated with this grant that are not listed above?

Select Yes or No

If no, please leave the following section blank. If yes, please provide details in the box below on the infrastructure project, EPA funds used for this infrastructure, and describe how BABA compliance was determined.

Other Infrastructure Description:

EPA Funds for Other Eligible Infrastructure not listed in tables above:

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Sheet 12: 11. Final Report

U. S. Environmental Protection Agency
Clean Heavy-Duty Vehicles (CHDV) Grant Program
Final Report: Financial and Narrative Summary
Table 28. Project Updates - Narrative Responses
Record final project information.
Please paste the planned activities, outputs, and outcome from the last quarterly report. Please indicate the final results below.
Activities	Anticipated Outputs	Anticipated Outcomes	ACTUAL Results
Table 29: Additional Questions
Please provide programmatic and narrative financial results on the project.
Question	Answer
1. Provide a narrative description of the project.
2. Explain the reason for any differences in proposed versus actual outputs/outcomes identified in Table 25 above.
3. Provide a narrative discussion of the actual project results (outputs and outcomes) and how the results are quantified. These may include, but are not limited to: • Number of replaced vehicles; • Dissemination of the project information and increased knowledge via list serves, websites, journals, and press/outreach events (provide web links where applicable); • Widespread adoption of the implemented technology; • Increased public awareness of project and results • Other
4. Provide information on subrecipients and vendors: • Sub-recipient information (name, award amount, project description); • Vendor information (name, payment amount, good/services provided);
5. Provide a narrative discussion of the successes and lessons learned for the entire project.
6. If any cost-share or additional External funds are reported, identify the source of the funds.
7. Was any program income generated during the project period? Identify amount of program income, how it was generated, and how the program income was used.
8. For projects that take place in an area affected by, or that include affected vehicles affected by, Federal, State or local law mandating emissions reductions, provide evidence that emission reductions funded with EPA funds were implemented prior to the effective date of the mandate and/or are in excess of (above and beyond) those required by the applicable mandate. *Include Attachments as Necessary
9. Did you include at least one photo of successful, new vehicle(s) employed? If yes, please indicate if you approve of permission for EPA's future use of the photo(s) in future internal and external documents including, but not limited to Reports to Congress and case studies highlighting CHDV success stories.
10. Do you have any other comments or feedback?

---

Sheet 13: 12. Data Dictionary

Fleet Description Data Fields: Please refer to the following data field dictionary for support in completing tabs 2, 9a, 9b and 10
Tab 2. Work Plan
School Bus Grantee Summary
Prioritized	Select yes if the school district listed on the 2024 CHDV Prioritized School District List.
Self-Certified as Prioritized	If the school district self-certifies as Prioritized, indicate which of the three criteria the school district is using to self-certify.
Non-Attainment or Maintenance Area	Select yes if grantee's vehicles operate in a non-attainment or Maintenance area.
Tab 4. Financial Summary
Funding Information
EPA Funds	Federal project award amount approved from final work plan.
Other Leveraged Funds	Non-EPA funds that support the proposed project activities such as public private-partnerships, grants from other entities, or the issuance of school bounds.
Tab 9a. Current Fleet Description
Table 22. Current Vehicle Information
Basic Vehicle Information
Is this vehicle a part of a group of vehicles that will be replaced by a single ZE vehicle? (vocational vehicles sub-program only)	For vocational vehicles sub-program only, select yes or no from dropdown menu based if the vehicle described in the row will be replaced by a single zero-emissions vehicle
Corresponding New Vehicle (select 'New Vehicle XX' from 'New Fleet Description' table, provided in dropdown)	Use the dropdown menu to identify which new vehicle will be used to replace the current vehicle in this project
Group Name	Enter the name of the vehicle group to which this vehicle belongs
Current Fleet Owner	Enter the first and last name and email address of the individual or organization that owns the fleet.
Publicly or Privately Owned (select from dropdown)	Use the dropdown menu to select if the vehicle is publicly or privately owned.
Current Vehicle Information
Vehicle Type (select from dropdown)	Use the dropdown menu to select the vehicle type
Vehicle Class (select from dropdown)	Select the class size from the dropdown menu. Note, class size is based on the vehicle's GVWR.
Vehicle Vocation (select from dropdown)	Use the dropdown menu to select the vehicle vocation
Vehicle Group Sector (select from dropdown)	Use the dropdown menu to select the vehicle sector.
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.
Current Vehicle Model Year	Enter the model year of the existing vehicle.
Current Engine Fuel Type	Select the type of fuel that is currently being used (prior to upgrade).
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 "N/A."
GVWR	Enter the gross vehicle weight rating (GVWR) of the existing vehicle.
Current Vehicle Activity Information
Annual Miles Traveled	Enter the average number of vehicle miles traveled per year per vehicle in the past two years.
Annual Idling Hours	Enter the average number of hours the vehicle idles in the past two years.
Current Odometer	Enter the existing vehicle's current odometer reading, in miles.
Annual Amount of Fuel Used	Enter the amount of fuel used in gallons/year in the last two years.
Remaining Life of Baseline Vehicle	Enter the remaining life of baseline engine/vehicle in years at the time of the upgrade action.
Evidence of Early Replacement	Evidence that the replacement activity is an “early replacement,” and would not have occurred during the project period through normal attrition (i.e. without the financial assistance provided by EPA) can include verification that the vehicles replaced had useful life left and fleet characterization showing fleet age ranges and average turnover rates per the vehicle or fleet owner’s budget plan, operating plan, standard procedures, or retirement schedule.
Vehicle Disposition Process
Vehicle Disposition/Replacement Process	Select a vehicle disposition option. Please see Section III.D of the Notice of Funding Opportunity for disposition requirements by existing bus model year.
If sold or donated, provide the state in which the vehicle is expected to primarily operate (For Vehicles Model Year 2011 and newer; if known, select from dropdown)	If vehicle is sold or donated, enter the state in which the vehicle is expected to primarily operate in
If sold or donated, provide the county in which the vehicle is expected to primarily operate (For Vehicles Model Year 2011 and newer; if known, select from dropdown)	If vehicle is sold or donated, enter the county in which the vehicle is expected to primarily operate in
Provide evidence of appropriate scrappage, sale, or vehicle donation	Evidence includes the engine serial numbers and/or the vehicle identification numbers (VIN). *Include Attachments as Necessary; refer to the CHDV Eligibiligy and Scrappage Statement for details.
Current Vehicle Place(s) of Performance
School District Name (if applicable)	Enter the name of the school district in which the current bus in which the bus to be scrapped, sold, or donated has operated in primarily.
NCES ID (if applicable)	Enter the name of the National Center for Education Statistics (NCES) ID associated with the school district in which the current bus to be scrapped, sold, or donated has operated in primarily.
State (select from dropdown)	Select the two letter postal code for the state in which the bus to be scrapped, sold, or donated has primarily operated in.
County (select from dropdown)	Enter the county in which the bus to be scrapped, sold, or donated has primarily operated in.
Percentage of Time operated in County	Enter the percent of time the bus to be scrapped, sold, or donated has operated in each county.
Place of Performance: City	Enter the city in which the bus to be scrapped, sold, or donated has primarily operated in.
Zip Code	Enter the zip code in which the bus to be scrapped, sold, or donated primarily operated in. If there is more than one, separate using a colon.
School District Name (if applicable)_2	Enter the name of the school district in which the current bus in which the bus to be scrapped, sold, or donated has operated in secondarily.
NCES ID (if applicable)_2	Enter the name of the National Center for Education Statistics (NCES) ID associated with the school district in which the current bus to be scrapped, sold, or donated has operated in secondarily.
State_2	Select the two letter postal code for the state in which the bus to be scrapped, sold, or donated has secondarily operated in.
County_3	Enter the county in which the bus to be scrapped, sold, or donated has secondarily operated in.
Percentage of Time operated in County_2	Enter the percent of time the bus to be scrapped, sold, or donated has operated in each county.
Place of Performance: City_3	Enter the city in which the bus to be scrapped, sold, or donated has secondarily operated in.
Zip Code_2	Enter the zip code in which the bus to be scrapped, sold, or donated secondarily operated in. If there is more than one, separate using a colon.
Additional Counties where Vehicle Operates	Enter in the additional counties in which the vehicle has operated in. If it has operated in multiple counties beyond those previously listed, record all and separate using a colon (e.g., Polk: Butler).
Percentage of time operated in each Additional County	Enter in the additional time operated in each additional county. If it has operated in multiple counties beyond those previously listed, record all and separate using a colon (Polk - 80%: Butler 20%).
Tab 9b. New Fleet Description
Table 23. New Replacement Vehicle Information
Upgrade Vehicle Information
Group Name (optional)	Enter the name of the vehicle group to which this vehicle belongs
Year of Upgrade Action	Enter the year the upgrade happened.
New Vehicle Fleet Owner	Enter the first and last name and email address of the individual or organization that owns the fleet.
New Vehicle Class (select from dropdown)	Select the class size from the dropdown menu. Note, class size is based on the vehicle's GVWR.
VIN for New Vehicle(s)	Enter the vehicle identification numbers (VIN) of the new vehicle.
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 Fuel Type	Select the fuel type of the new vehicle.
New Vehicle GVWR	Enter the gross vehicle weight rating (GVWR) of the new vehicle.
Upgrade Cost
Upgrade Cost per Vehicle	Enter the cost of vehicle in dollars per unit.
Total Federal Funds Expended Per Vehicle ($ of Total Cost per Unit)	Enter the federal funds expended per vehicle in dollars per unit.
New Vehicle Activity Information
New Vehicle Annual Miles Traveled (miles per vehicle)	Enter the average number of vehicle miles traveled per year per new vehicle.
New Vehicle Equipped with Auxiliary Heater? (Yes/No)	Select yes or no to specify whether the vehicle is equipped with an auxiliary heater.
Auxiliary Heater Type (if not applicable, then N/A)	If bus has an auxiliary heater, enter the type.
New Vehicle Battery Information (Battery Electric Vehicles only)
Capable of Bidirectional Charging? (Yes/No/N/A)	Select yes or no into the cell to specify whether the vehicle is capable of bidirectional charging.
Manufacturer of Battery Pack	For battery electric vehicles, enter the manufacturer of the battery pack
Number of Battery Packs	For battery electric vehicles, enter the number of battery packs
Battery Capacity per Battery Pack (kWh)	For battery electric vehicles, enter the battery capacity per battery pack
Vehicle Total Battery Capacity (kWh)	For battery electric vehicles, enter the vehicle's total battery capacity
Rated Charging Power (kW)	For battery electric vehicles, enter the rated charging power in kW
Estimated Range in Miles	For battery electric vehicles, enter the estimated range in miles
New Vehicle Fuel Cell Information (for Fuel Cell EVs only)
Manufacturer of Fuel Cell System (if known)	For hydrogen fuel cell electric vehicles, enter the manufacturer of the hydrogen fuel cell system
Fuel Cell Stack Capacity (kW)	for hydrogen fuel cell electric vehicles, enter the hydrogen fuel cell stack capacity in kW
Hydrogen Fuel Tank Capacity (kg)	For hydrogen fuel cell electric vehicles, enter the hydrogen fuel tank capacity in kg
Warranty Information
Is the Battery or Fuel Cell System Warranty Included? (Yes/No)	Select yes or no into the cell to specify whether the vehicle battery or hydrogen fuel cell system warranty is included.
Number of Years Covered by Battery or Fuel Cell System Warranty	If the battery or fuel cell system includes a warranty, indicate the number of years the coverage is valid for
Number of Miles Covered by Battery or Fuel Cell System Warranty	If the battery or fuel cell system includes a warranty, indicate the number of miles the coverage is valid for
Total kWh of Battery or Fuel Cell System Discharge Covered by Warranty	Enter the total kWh of battery discharge
Powertrain Warranty Included? (Yes/No)	Select yes or no into the cell to specify whether a powertrain battery warranty is included.
Number of Years Covered by Powertrain Warranty	If the powertrain includes a warranty, indicate the number of years the coverage is valid for
Number of Miles Covered by Powertrain Warranty	If the powertrain includes a warranty, indicate the number of miles the coverage is valid for
New Vehicle Place(s) of Performance
School District Name (if applicable)	Enter the name of the school district in which the new vehicle will operate in primarily.
NCES ID (if applicable)	Enter the name of the National Center for Education Statistics (NCES) ID associated with the school district in which the current new vehicle has operated in primarily.
State (select from dropdown)	Select the two letter postal code for the state in which the new vehicle will primarily operate in.
County (select from dropdown)	Enter the county in which the new vehicle will primarily operate in.
Percentage of Time operated in County	Enter the percent of time the new vehicle has operated in each county.
Place of Performance: City_2	Enter the city in which the new vehicle will primarily operate in.
Zip Code_3	Enter the zip code in which the new vehicle will primarily operate in. If there is more than one, separate using a colon.
School District Name (if applicable)_2	Enter the name of the school district in which the current vehicle in which the new vehicle will operate in secondarily.
NCES ID (if applicable)_2	Enter the name of the National Center for Education Statistics (NCES) ID associated with the school district in which the current new vehicle will operate in secondarily.
State (select from dropdown)_2	Select the two letter postal code for the state in which the new vehicle will secondarily operate in
County (select from dropdown)_2	Enter the county in which the new vehicle will secondarily operate in
Percentage of Time operated in County_2	Enter the percent of time the new vehicle will operate in each county.
Place of Performance: City_2	Enter the city in which the new vehicle will secondarily operated in.
Zip Code_2	Enter the zip code in which the new vehicle will secondarily operated in. If there is more than one, separate using a colon.
Additional Counties where Vehicle Operates_3	Enter in the additional counties in which the new vehicle is expected to operate in. If it will operate in multiple counties beyond those two previously listed, record all here and separate using a colon (e.g., Polk: Butler).
Percentage of Time operated in each Additional County_3	Enter in the additional time operated in each additional county. If it will operate in multiple counties beyond those two previously listed, record all and separate using a colon (Polk - 80%: Butler 20%).
Optional Participation in the Future of Transportation Research
Is the vehicle/equipment equipped with Telematics? (Yes/No/Not Sure)	Select yes or no into the cells it specify whether the vehicle is equipped with telematics.
If Yes, Telematics Primary Point of Contact (name and email)	Select yes or no.
Can EPA or its partners contact me about participating in research opportunities to provide vehicle or infrastructure data that could inform future transportation work? (Yes/No)	Enter First and Last name and email address.
Vehicle Ownership and BABA Compliance
Publicly or Privately Owned (select from dropdown)	Use the dropdown menu to select if the vehicle is publicly or privately owned.
Does the vehicle serve a public function?	Use the dropdown menu to select if the vehicle serves a public function
Is the vehicle subject to BABA?	Use the dropdown menu to select if the vehicle is subject to BABA
Is the vehicle BABA Compliant?	Use the dropdown menu to select if the vehicle is BABA Compliant
Is a waiver being used to fulfill BABA compliance for the vehicle?	If a waiver is being used to meet BABA compliance requirements, select the waiver type
If ''Yes - Other EPA Waiver', explain	Enter which waiver is being used to meet BABA requirements.
Tab 10. Infrastructure
Table 24. Electric Vehicle Supply Equipment Information
EVSE Equipment Information
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 per EVSE unit	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 Vehicle and EVSE be Used for Vehicle to Grid (V2G)?	Select yes or no into the cell to specify whether the buses and charging equipment will be used for vehicle-to-grid (V2G) services.
EVSE Number of Units	Enter the quantity of charging equipment unit
EVSE Equipment Cost only Per Unit	Enter the cost of the charging equipment per unit.
Are Federal funds being used to purchase EVSE equipment?	Enter yes or no for whether federal funds are being used to purchase EVSE equipment.
Are applicant funds being used to purchase EVSE equipment?	Enter yes or no for whether applicant funds are being used to purchase EVSE equipment.
Are state funds being used to purchase EVSE equipment?	Enter yes or no for whether state funds are being used to purchase EVSE equipment.
Are local funds being used to purchase EVSE equipment?	Enter yes or no for whether local funds are being used to purchase EVSE equipment.
Are other funds being used to purchase EVSE equipment?	Enter yes or no for whether other funds are being used to purchase EVSE equipment.
Is Program Income being used to purchase EVSE equipment?	Enter yes or no for whether program income is being used to purchase EVSE equipment.
Total EPA Funds Expended Per EVSE Unit	Enter the total EPA funds expended for charging equipment per unit.
Total EPA Funds Expended for EVSE	No action - autopopulated
Total Other Leveraged Funds Expended for EVSE	No action - autopopulated
Date of EVSE Manufacture (mm/dd/yyyy)	Enter the date on which the EVSE was manufactured.
Date of EVSE Installation (mm/dd/yyyy)	Enter the date on which the EVSE is permanently affixed.
Date EVSE Operational (mm/dd/yyyy)	Enter the date when the EVSE became operational.
Location of EV Infrastructure
State	Select the two letter postal code for the state in which the charging equipment will be located.
County	Select the county in which the charging equipment will be located.
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.
Who owns the charger?	Enter the name of the school district or organization that owns the charging equipment.
Anticipated user(s) of the charger.	Enter the types of users expected to utilize the charger.
If serving school districts, does the EVSE serve multiple school districts within this application?	Select yes, no, or "N/A" if not serving school districts.
Name of the School District(s) the EVSE will serve (use a colon between school districts)	Enter the name of the school district in which the EVSE will serve. If it will serve multiple school districts, list all and separate with a colon (e.g., Hampton School District: Edgewood School District).
NCES ID of School District that the EVSE will serve (use a colon between school districts)	Enter the name of the National Center for Education Statistics (NCES) ID associated with the school district in which the EVSE will serve. If it will serve multiple school districts, list all NCES IDs and separate with a colon (e.g., 1234567: 7654321).
Charging Management Service
Name of Charging Management Service Provider	Enter the name of the charging management service provider.
Does the Infrastructure Equipment Cost Include Charging Management Service?	Please enter yes or no into the cell to specify whether the indicated cost of the charging equipment above includes any charging management expenses.
If charging management service is not included in cost, but is acquired, what is the cost and frequency of charges?	Please enter the cost of any charging management services and how frequently they are billed.
Infrastructure Installation Information, funding source, and BABA compliance
Total Funds Expended for EVSE Installation	Enter the total installation costs for the EVSE.
Are Federal funds being used for EVSE Installation costs?	Enter yes or no for whether federal funds are being used for EVSE installation.
Are applicant funds being used for EVSE Installation Costs?	Enter yes or no for whether applicant funds are being used for EVSE installation.
Are state funds being used for EVSE installation costs?	Enter yes or no for whether state funds are being used for EVSE Installation.
Are local funds being used for EVSE installation costs?	Enter yes or no for whether local funds are being used for EVSE Installation.
Are other funds being used for EVSE Installation costs?	Enter yes or no for whether other funds are being used for EVSE Installation.
Is Program Income being used for EVSE installation costs	Enter yes or no for whether program income is being used for EVSE Installation.
Total EPA Funds Expended for EVSE Installation Costs	Enter the total amount of EPA funds expended for EVSE installation costs.
Total Other Leveraged Funds Expended for EVSE Installation Costs	No action - autopopulated
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.
Description of Installation Work	Enter a description of the work performed to install the charging equipment, such as design and engineering, trenching, wiring and electrical upgrades, labor, and permitting.
Installation Work Performed By	Enter the name(s) of the organization(s) that performed the installation work described above.
Installation was conducted by an individual who meets the infrastructure electrician requirements as outlined in the program guidance?	Select electrician category
Is this infrastructure BABA Compliant?	Select an option. EVSE manufactured on or after July 1, 2024 must be meet BABA requirements.
Is a waiver being used to fulfill BABA compliance for the Infrastructure Project	If a waiver is being used to meet BABA compliance requirements, select the waiver type
If 'yes -other EPA waiver' selected, explain	Enter which waiver is being used to meet BABA requirements.
EVSE Cost Summary
Total Federal Funds Expended Equipment and Installation	Automated cell that will calculate the total Federal Funds expended for the charging equipment and installation for an EV Infrastructure Group.
Total Other Leveraged Funds Equipment and Installation	Automated cell that will calculate the total Leveraged Funds expended for the charging equipment and installation for an EV Infrastructure Group.
Optional Participation in the Future of Transportation Research
EPA or its partners may contact me about participating in research opportunities to provide bus or EVSE data that could inform future transportation work.	Enter yes or no if EPA may contact you regarding potential research opportunities.
If Yes, Charge Management Service Primary Point of contact (Name and email)	Enter the name and email of the primary charge management service POC.
EVSE Unit Serial Number (Applies to EVSE Units Purchased with EPA Funds)
Serial Number Unit 1 - 250	Enter the Serial Number for each EVSE unit purchased with EPA Funds in columns BG- KV
Table 25. On-Site Power Generation Equipment Information
On-Site Power Generation Equipment Overview, Cost, and Installation
Type of energy generation	Select a type of energy generation, solar or wind.
Manufacturer of On-site Power generation	Enter the manufacturer (s) of the system.
Model of on-site power generation	Enter the model name of the on-site generation system.
Manufacture year of on-site power generation	Enter the year the system was manufactured.
Generation Capacity of the system	Enter the generation capacity of the system as either kW or MW. Please indicate unit of measurement.
Equipment Cost only Per Power Generation System	Enter the equipment cost of the on-site power generation system.
Are Federal funds being used to purchase on-site power generation?	Enter yes or no for whether federal funds are being used to purchase on-site power generation equipment.
Are applicant funds being used to purchase on-site power generation?	Enter yes or no for whether applicant funds are being used to purchase on-site power generation equipment.
Are state funds being used to purchase on-site power generation?	Enter yes or no for whether state funds are being used to purchase on-site power generation equipment.
Are local funds being used to purchase on-site power generation?	Enter yes or no for whether local funds are being used to purchase on-site power generation equipment.
Are other funds being used to purchase on-site power generation?	Enter yes or no for whether other funds are being used to purchase on-site power generation equipment.
Is Program Income being used to purchase on-site power generation?	Enter yes or no for whether program income is being used to purchase on-site power generation equipment.
Total EPA funds expended per on-site power generation equipment	Enter the total EPA funds expended for the on-site power generation equipment.
Total Other Leveraged Funds Expended for EVSE	No action - autopopulated
Total Funds Expended cost Installation	Enter the total installation costs for the on-site power generation system.
Are federal funds being used for Installation costs?	Enter yes or no for whether federal funds are being used for on-site power generation installation.
Are applicant funds being used for EVSE Installation Costs?	Enter yes or no for whether applicant funds are being used for on-site power generation installation.
Are state funds being used for EVSE installation costs?	Enter yes or no for whether state funds are being used for on-site power generation Installation.
Are local funds being used for EVSE installation costs?	Enter yes or no for whether local funds are being used for on-site power generation Installation.
Are other funds being used for EVSE Installation costs?	Enter yes or no for whether other funds are being used for on-site power generation Installation.
Is Program Income being used for EVSE installation costs	Enter yes or no for whether program income is being used for on-site power generation Installation.
Total EPA Funds Expended for EVSE Installation Costs	Enter the total amount of EPA funds expended for on-site power generation installation costs.
Total Other Leveraged Funds Expended for EVSE Installation Costs	No action - autopopulated
Date(s) On-Site Power Generation Equipment was Manufactured	Enter the date the system was manufactured.
Date the On-site Power Generation was Installation (mm/dd/yyyy)	Enter the date the system was installed.
Date the On-site Power Generation was Operational (mm/dd/yyyy)	Enter the date the system became operational.
Location of On-site Power Generation Infrastructure
State	Select the two letter postal code for the state in which the on-site power generation will be located.
County	Select the county in which the on-site power generation will be located.
City	Enter the city in which the on-site power generation will be located.
Zip Code	Enter the zip code in which the on-site power generation will be located.
Street Address	Enter the street address in which the on-site power generation will be located.
Ownership and Anticipated Users of On-Site Power Generation Infrastructure
Who owns the equipment?	Enter the name of the organization that owns the on-site power generation system.
Anticipated user(s) of the on-site power generation infrastructure.	Enter the types of users expected to utilize the system.
If serving school districts, does the system serve multiple school districts within this application?	Select yes, no, or "N/A" if not serving school districts.
Name of the School District(s) the system will serve (use a colon between school districts)	Enter the name of the school district in which the system will serve. If it will serve multiple school districts, list all and separate with a colon (e.g., Hampton School District: Edgewood School District).
NCES ID of School District that the EVSE will serve (use a colon between school districts)	Enter the name of the National Center for Education Statistics (NCES) ID associated with the school district in which the system will serve. If it will serve multiple school districts, list all NCES IDs and separate with a colon (e.g., 1234567: 7654321).
BABA Compliance
Is this infrastructure BABA Compliant?	Select an option.
Is a waiver being used to fulfill BABA compliance for the Infrastructure Project	If a waiver is being used to meet BABA compliance requirements, select the waiver type
If 'yes -other EPA waiver' selected, explain	Enter which waiver is being used to meet BABA requirements.
Totals
Total Federal Funds Expended Equipment and Installation	Automated cell that will calculate the total Federal Funds expended for the on-site power generation system.
Total Other Leveraged Funds Equipment and Installation	Automated cell that will calculate the total Leveraged Funds expended for the on-site power generation system.
Table 26. Battery Energy Storage System (BESS) Equipment Information
BESS Equipment Overview, Cost, and Installation
Type of Battery	Select a type of battery from dropdown options.
Manufacturer of BESS	Enter the manufacturer (s) of the system.
Model of BESS	Enter the model name of the BESS.
Manufacture Year of BESS	Enter the year the system was manufactured.
Energy Capacity (please indicate kWh or MWh)	Enter the generation capacity of the system as either kWh or MWh. Please indicate unit of measurement.
Equipment Cost only Per Unit:	Enter the equipment cost of each BESS unit
Are Federal funds being used to purchase BESS equipment? (Yes/No)	Enter yes or no for whether federal funds are being used to purchase BESS equipment.
Are Applicant funds being used to purchase BESS equipment? (Yes/No)	Enter yes or no for whether applicant funds are being used to purchase BESS equipment.
Are State funds being used to purchase BESS equipment? (Yes/No)	Enter yes or no for whether state funds are being used to purchase BESS equipment.
Are Local funds being used to purchase BESS equipment? (Yes/No)	Enter yes or no for whether local funds are being used to purchase BESS equipment.
Are Other funds being used to purchase BESS equipment? (Yes/No)	Enter yes or no for whether other funds are being used to purchase BESS equipment.
Is Program Income being used to purchase BESS equipment? (Yes/No)	Enter yes or no for whether program income is being used to purchase BESS equipment.
Total EPA Funds Expended Per Unit	Enter the total EPA funds expended for the BESS equipment.
Total Other Leveraged Funds Expended Per Unit	No action - autopopulated
Total Funds Expended Installation Cost	Enter the total installation costs for the BESS system.
Are Federal funds being used for Installation Cost? (Yes/No)	Enter yes or no for whether federal funds are being used for BESS installation.
Are Applicant funds being used for Installation Cost? (Yes/No)	Enter yes or no for whether applicant funds are being used for BESS installation.
Are State funds being used for Installation Cost? (Yes/No)	Enter yes or no for whether state funds are being used for BESS installation.
Are Local funds being used for Installation Cost? (Yes/No)	Enter yes or no for whether local funds are being used for BESS installation.
Are Other funds being used for Installation Cost? (Yes/No)	Enter yes or no for whether other funds are being used for BESS installation.
Is Program Income being used for Installation Cost? (Yes/No)	Enter yes or no for whether program income is being used for BESS installation.
Total EPA Funds Expended Installation Cost:	Enter the total amount of EPA funds expended for BESS installation costs.
Total Other Leveraged Funds Expended - Installation Cost	No action - autopopulated
Date(s) BESS and related Equipment was Manufactured	Enter the date the system was manufactured.
Date of BESS Installation (mm/dd/yyyy)	Enter the date the system was installed.
Date BESS Operational (mm/dd/yyyy)	Enter the date the system became operational.
Location of BESS Infrastructure
State	Select the two letter postal code for the state in which the BESS will be located.
County	Select the county in which the BESS will be located.
City	Enter the city in which the BESS will be located.
Zip Code	Enter the zip code in which the BESS will be located.
Street Address	Enter the street address in which the BESS will be located.
Ownership and Anticipated Users of BESS Infrastructure
Who owns the equipment?	Enter the name of the organization that owns the BESS system.
Anticipated Users of BESS	Enter the types of users expected to utilize the system.
If serving school districts, Name of the School District the BESS will serve	Enter the name of the school district in which the system will serve. If it will serve multiple school districts, list all and separate with a colon (e.g., Hampton School District: Edgewood School District).
If serving school districts, NCES ID of School District that the BESS will serve	Enter the name of the National Center for Education Statistics (NCES) ID associated with the school district in which the system will serve. If it will serve multiple school districts, list all NCES IDs and separate with a colon (e.g., 1234567: 7654321).
BABA Compliance for BESS Infrastructure
Is the BESS subject to BABA?	Select from the dropdown menu if the equipment is subject to BABA
Is the BESS BABA Compliant?	Select from the dropdown menu how BABA compliance is met
Is a waiver being used to fulfill BABA compliance for the BESS?	If a waiver is being used to meet BABA compliance requirements, select the waiver type
If 'Yes - Other EPA Waiver' selected, explain	Enter which waiver is being used to meet BABA requirements, if 'Other EPA Waiver' selected in the prior field
Totals for BESS Infrastructure
Total EPA Funds Expended - Equipment and Installation	Automated cell that will calculate the total Federal Funds expended for the BESS system.
Total Other Leveraged Funds Expended - Equipment and Installation	Automated cell that will calculate the total Leveraged Funds expended for the BESS system.
Table 27. Hydrogen Fueling Station Information
Hydrogen Fueling Station Information Overview
Type of Station (Select from dropdown)	Select from the dropdown menu what type of hydrogen fueling station is installed under this project.
Type of Hydrogen Storage (select from dropdown)	Select from the dropdown menu what type of hydrogen storage is installed under this project.
Refilling Pressure (select from dropdown)	Select from the dropdown menu the refilling pressure level of supported by the hydrogen fueling equipment.
Refilling Pressure: If Other, specify below	If you selected "Other" for the previous column, please enter the refilling pressure information.
Total Hydrogen Storage Tank Capacity (kg)	Enter the capacity of the hydrogen storage tank in kilograms.
Total Number of Dispensers	Enter the total number of dispenser hoses installed on the hydrogen fueling station.
Maximum Dispensing Flow Rate per Hose (kg/day)	Enter the maximum hydrogen dispensing flow rate per dispenser hose in kilograms per day.
Total Dispensing Capacity of the Station (kg/day)	Enter the total capacity of hydrogen dispensing flow rate for the hydrogen fueling station in kilograms per day.
Total Number of Cooling Systems	Enter the total number of cooling systems installed on the hydrogen fueling station.
Total Number of Compressors	Enter the total number of compressors installed on the hydrogen fueling station.
Number of Storage Tanks	Enter the total number of hydrogen storage tanks installed on the hydrogen fueling station.
Number of Dispenser Pedestals	Enter the total number of hydrogen dispenser pedestals installed on the hydrogen fueling station.
H2 Dispenser Pedestal Details
Number of Hoses per Pedestal	Enter then umber of dispenser hoses installed on each pedestal of the hydrogen fueling station.
H2 Dispenser Pedestal Manufacturer	Enter the manufacturer of the hydrogen dispensing pedestal equipment.
H2 Dispenser Pedestal Model	Enter the model name of the hydrogen dispensing pedestal equipment.
H2 Dispenser Pedestal Manufacture Year	Enter the year the hydrogen dispensing pedestal equipment was manufactured.
H2 Storage Tank
H2 Compressor Manufacturer	Enter the manufacturer of the hydrogen storage tank.
H2 Compressor Model	Enter the model name of the hydrogen storage tank.
H2 Compressor Manufacture Year	Enter the year the hydrogen storage tank was manufactured.
H2 Compressor
H2 Compressor Manufacturer	Enter the manufacturer of the compressor.
H2 Compressor Model	Enter the model name of the compressor.
H2 Compressor Manufacture Year	Enter the year the compressor was manufactured.
H2 Cooling System (refrigeration and heat exchanger)
H2 Cooling System Manufacturer	Enter the manufacturer of the compressor.
H2 Cooling System Model	Enter the model name of the compressor.
H2 Cooling System Manufacture Year	Enter the year the compressor was manufactured.
Service Details
Annual Total H2 Dispensed (kg)	Enter the estimated amount of total annual hydrogen dispensed from the fueling station in kilograms.
Who owns the H2 Fueling Station?	Enter the name of the organization that owns the hydrogen fueling equipment.
Location of H2 Station
State (select from dropdown)	Select the two letter postal code for the state in which the hydrogen fueling station will be located.
County (select from dropdown)	Enter the county in which the hydrogen fueling station will be located.
City	Enter the city in which the hydrogen fueling station will be located.
Zip Code	Enter the zip code in which the hydrogen fueling station will be located.
Street Address	Enter the street address in which the hydrogen fueling station will be located.
Installation Details
Description of H2 Fueling Station Installation Work Performed	Describe the work done during installation, including all equipment that became part of the installed hydrogen fueling station.
H2 Fueling Station Installation Performed by:	List the name of the company (or companies) performing the installation of the hydrogen fueling station.
Date of H2 Fueling Station Installation (mm/dd/yyyy)	Enter the date (or date range) the hydrogen fueling station was installed.
Date H2 Fueling Station Operational (mm/dd/yyyy)	Enter the date by which the hydrogen fueling station became fully operational.
Funding Details
H2 Fueling Infrastructure Equipment Cost	Enter the cost of the H2 fueling infrastructure equipment, not including installation
Does the H2 Fueling Infrastructure Equipment cost include installation?	Please enter yes or no into the cell to specify whether the indicated cost of the H2 fueling infrastructure equipment includes any installation expenses.
Are Federal funds being used to purchase H2 fueling infrastructure equipment?	Enter yes or no for whether federal funds are being used to purchase H2 Fueling Infrastructure equipment.
Are applicant funds being used to purchase H2 Fueling infrastructure equipment?	Enter yes or no for whether applicant funds are being used to purchase H2 Fueling Infrastructure equipment.
Are state funds being used to purchase H2 Fueling infrastructure equipment?	Enter yes or no for whether state funds are being used to purchase H2 Fueling Infrastructure equipment.
Are local funds being used to purchase H2 Fueling infrastructure equipment?	Enter yes or no for whether local funds are being used to purchase H2 Fueling Infrastructure equipment.
Are other funds being used to purchase H2 Fueling infrastructure equipment?	Enter yes or no for whether other funds are being used to purchase H2 Fueling Infrastructure equipment.
Is Program Income being used to purchase H2 Fueling infrastructure equipment?	Enter yes or no for whether program income is being used to purchase H2 Fueling Infrastructure equipment.
Total EPA Funds Expended for H2 Fueling Infrastructure equipment.	Enter the total amount of EPA funds being used for H2 fueling infrastructure equipment.
Total Other Leveraged Funds Expended for H2 Fueling Infrastructure Equipment	Automated cell that will calculate the total Leveraged Funds expended for the H2 Fueling infrastructure equipment.
Total Funds expended for H2 Fueling Infrastructure Installation	Enter the cost of the H2 fueling infrastructure installation.
Are Federal funds being used for H2 fueling infrastructure installation costs?	Enter yes or no for whether federal funds are being used to purchase H2 Fueling Infrastructure installation.
Are Applicant funds being used for H2 fueling infrastructure installation costs?	Enter yes or no for whether applicant funds are being used to purchase H2 Fueling Infrastructure installation.
Are state funds being used for H2 fueling infrastructure installation costs?	Enter yes or no for whether state funds are being used to purchase H2 Fueling Infrastructure installation.
Are local funds being used for H2 fueling infrastructure installation costs?	Enter yes or no for whether local funds are being used to purchase H2 Fueling Infrastructure installation.
Are other funds being used for H2 fueling infrastructure installation costs?	Enter yes or no for whether other funds are being used to purchase H2 Fueling Infrastructure installation.
Is program income being used for H2 fueling infrastructure installation costs?	Enter yes or no for whether program income is being used to purchase H2 Fueling Infrastructure installation.
Total EPA Funds Expended for H2 Fueling Infrastructure installation.	Enter the total amount of EPA funds being used for H2 fueling infrastructure installation.
Total Other Leveraged Funds Expended for H2 Fueling Infrastructure installation	Automated cell that will calculate the total Leveraged Funds expended for the H2 Fueling infrastructure installation.
H2 Fueling Infrastructure BABA Compliance
Is the Hydrogen Fueling Infrastructure BABA Compliant? (select from dropdown)	Select from the dropdown menu which parts of the hydrogen fueling infrastructure project are BABA compliant.
Is a waiver being used to fulfill BABA compliance for the H2 Fueling Infrastructure? (select from dropdown)	Select from the dropdown menu how BABA requirements are being met for the hydrogen fueling infrastructure project.
If 'Yes-Other EPA waiver' selected, explain	Enter which waiver is being used to meet BABA requirements.
H2 Fueling Infrastructure Cost Summary
Total EPA Funds Expended for H2 Fueling Infrastructure equipment and installation.	Automated cell that will calculate the total EPA Funds expended for the H2 fueling infrastructure equipment and installation.
Total Other Leveraged Funds Expended for H2 Fueling Infrastructure Equipment and Installation	Automated cell that will calculate the total Leveraged Funds expended for the H2 fueling infrastructure equipment and installation.
For more information on BABA compliance please see the following link:	Build America, Buy America Act (BABA) Implementation Procedures for EPA Office of Transportation and Air Quality Federal Financial Assistance Programs (March 19, 2025)