National Clean Diesel Rebate Program
2012 School Bus Replacement Funding
Opportunity (Pilot)
Program Guide
&EPA
United States
Environmental Protection
Agency
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National Clean Diesel Rebate Program
2012 School Bus Replacement Funding
Opportunity (Pilot)
Program Guide
Transportation and Climate Division
Office of Transportation and Air Quality
U.S. Environmental Protection Agency
United States
Environmental Protection
Agency
EPA-420-R-12-029
November 2012
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Table of Contents
1. Introduction 1
1.1 Rebate Program History 1
1.2 Scope of Work 1
2. Rebate Program Structure 2
2.1 Eligible Applicants 2
2.2 Eligible Vehicles 2
2.2.1 Vehicles Eligible for Replacement 2
2.2.2 Eligible Replacement Vehicles 2
2.3 Available Funding 3
2.4 Amount of Rebate 3
2.5 Maximum Number of Vehicles per Applicant 3
3. Rebate Process 3
3.1 Step 1 - Application 5
3.2 Step 2 - Selection 6
3.3 Step 3 -Notification and Obligation 6
3.4 Step 4 - Purchase Order Submittal 6
3.5 Step 5 - Vehicle Delivery and Scrappage 7
3.5.1 - New Vehicle Delivery 7
3.5.2 Scrappage/Disposal of Old Vehicle 7
3.6 Step 6 - Request for Payment 8
3.7 Step 7 - Payment 8
3.8 Cancellation of Rebate Application 8
4. Rebate Program Administration 8
4.1 Terms and Conditions 8
4.1.1 Use of Replacement School Bus 8
4.1.2 Scrappage of Old School Bus 9
4.1.3 Ownership of Replacement School Bus 9
4.1.4 Restriction for Mandated Measures 9
4.1.5 Documentation Requirement 9
ii
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4.2 EPA Responsibilities 9
4.3 Disbursement of Funds 9
4.4 Emission Reductions Reporting 9
4.5 Program Audit 9
4.6 Record Retention Requirements 10
Appendices
A. Sample Rebate Applications
B. Gross Vehicle Weight Rating (GVWR) Classes and School Bus Types
C. Rebate Application Checklist
D. How to Find Your Vehicle's VEST, Engine Model Year, and Engine Family Name
in
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1. Introduction
The Diesel Emission Reduction Act program (DERA) was originally authorized by Title VII,
Subtitle G (Sections 791 to 797) of the Energy Policy Act of 2005 (Public Law 109-58). DERA
was amended by the Diesel Emissions Reduction Act of 2010 (Public Law 111-364), codified at
42 U.S.C. 16131 et seq, adding, among other provisions, a rebate program option. These
provisions provide the Environmental Protection Agency (EPA) with the authority to award
grants, rebates or low-cost revolving loans on a competitive basis to eligible entities to fund the
costs of a clean diesel strategy that significantly reduces diesel emissions from mobile sources
through implementation of a certified engine configuration or verified technology. The objective
of this program is to achieve significant reductions in diesel emissions in terms of tons of
pollution produced and reductions in diesel emissions exposure, particularly from fleets
operating in areas designated by the Administrator as poor air quality areas.
1.1 Rebate Program History
The National Clean Diesel Rebate Program was authorized by the Diesel Emissions Reduction
Act of 2010. Prior to the issuance of this document, no previous EPA direct rebate program has
existed. Through the National Clean Diesel Rebate Program, EPA will offer financial support to
eligible applicants to reduce diesel emissions from a variety of mobile sources.
This initial round of rebate funding, known as the 2012 School Bus Replacement Funding
Opportunity, will provide financial assistance to public and private fleet owners for the
replacement of older school buses with new, cleaner school buses. EPA anticipates offering
additional rebate opportunities in future years to retrofit, repower or replace other types of diesel
engines in various sectors. Future rebate funding opportunities will be based on program goals
and available funding, among other factors.
1.2 Scope of Work
The 2012 School Bus Replacement Funding Opportunity will provide rebate incentives to
selected eligible applicants to replace school buses powered by model year engines ranging from
1994 to 2003 with new buses powered by a certified 2012 or newer model year engine, or
operate solely on electricity. Eligible replacement school buses may operate on conventional
diesel (ULSD), battery or hybrid drivetrains, or alternative fuels. See Section 2.2 for specific
information on eligible vehicles.
The project parameters for the 2012 School Bus Replacement Funding Opportunity ensure that
all projects that receive funding meet the DERA national priorities. The eligible projects will
maximize public health benefits, are the most cost-effective, serve areas that receive a
disproportionate quantity of air pollution from diesel fleets (schools), include a certified engine
configuration, maximize the useful life of the certified engine configuration, and conserve diesel
fuel.
In addition, the 2012 School Bus Replacement Funding Opportunity supports EPA's 2011 -
2015 Strategic Plan that defines goals, objectives, and sub-objectives for protecting human health
and the environment. Specifically, it supports Goal 1 (Take Action on Climate Change and
Improve Air Quality) and Objective 1.2 (Improve Air Quality). Activities funded will reduce
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diesel emissions from the existing fleet of school buses, thereby reducing local and regional air
pollution.
This document describes the minimum criteria and requirements of the 2012 School Bus
Replacement Funding Opportunity.
2. Rebate Program Structure
2.1 Eligible Applicants
Eligible applicants include regional, state, local or tribal agencies with jurisdiction over
transportation or air quality, including school districts and municipalities. Private entities that
operate school buses under a contract with an entity listed above are also eligible. If the applicant
is a private entity, the applicant must certify on the Rebate Application that it has an existing and
executed contract to provide transportation services to a specific public school district at the time
of the rebate application. Private schools and other organizations that operate school buses are
not eligible to apply for this rebate, unless they operate those school buses under a contract with
an entity listed above.
The applicant must own and operate the school bus, for which funds are being requested, at the
time of application. Ownership must be documented by providing a copy of the current vehicle
title and vehicle registration if registration is required by law in the state where the vehicle
operates. If vehicle registration is not included in the application package, the applicant must
submit documentation that registration is not required in its jurisdiction. If the existing vehicle
title is not available at the time of application, a copy of the current and valid vehicle registration
may be used as alternative ownership documentation until a duplicate title is obtained.
2.2 Eligible Vehicles
2.2.7 Vehicles Eligible for Replacement
Diesel-powered Class 3 through Class 8 school buses powered by an engine with model year
1994 to 2003 are eligible for replacement. A school bus, for the purpose of the 2012 School Bus
Replacement Funding Opportunity, is defined as a vehicle used for the purpose of transporting
10 or more preprimary, primary or secondary school students to schools or homes. See
Appendix B for assistance with determining the class of the proposed school bus to be replaced.
The existing school bus must currently operate on diesel fuel, be in regular use and in operational
condition to qualify for funding. In order to be considered operational, the bus must be able to
start, move in all directions, and have all operational parts. School buses to be replaced must
have accumulated at least 10,000 or more miles over the most recent calendar year, or been in
use for at least three days per week during the most recent school year. Applicants are required to
certify in the Rebate Application that the school bus or buses to be replaced meet these
operational requirements.
2.2.2 Eligible Replacement Vehicles
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All replacement buses must be powered by a certified 2012 or newer model year engine, or
operate solely on electricity. Eligible replacement school buses may operate on conventional
diesel (ULSD), battery or hybrid drivetrains, or alternative fuels. All replacement school buses
must be of the same or smaller vehicle class as the original school bus and operate in the same
manner and over similar routes as the original school bus. All replacement buses must meet
Federal safety standards and required warranties. The applicant takes sole responsibility for
ensuring the replacement bus is in operational condition.
2.3 Available Funding
For the initial 2012 School Bus Replacement Funding Opportunity, EPA anticipates having up to
$2,000,000 available for rebates, subject to availability of funds. Funding will not be provided
for administration expenses.
EPA reserves the right to partially fund applications, reject all applications and make no
selections under this program, or to make fewer selections than anticipated.
2.4 Amount of Rebate
EPA will provide rebate amounts for Class 3 - Class 8 school buses as specified in Table 1.
Table 1: School Bus Rebate Program
Rebate Amount per Bus Class
Bus Class
Class 3 - 5
Class 6 - 7
Class 8
Rebate Amount
$20,000
$25,000
$30,000
2.5 Maximum Number of Vehicles per Applicant
Applicants may submit only one Rebate Application, that includes up to five eligible
replacement school buses.
3. Rebate Process
The 2012 School Bus Replacement Funding Opportunity consists of the following seven steps,
as illustrated in Figure 1. Details of the requirements for each step are described in Sections 3.1
- 3.7 below.
Step 1 - Application Submission
Step 2 - Selection of Participants
Step 3 - Notification of Selectees
Step 4 - Purchase Order Submittal
Step 5 - Delivery and Scrappage
Step 6 - Payment Request
Step 7 - Payment
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Figure 1 - Rebate Program Flow Chart
Step 1 Application
Eligible Fleet owners submit
applications to EPA from November 13,
2012 through December 14, 2012.
Step 2 Selection
EPA randomly selects from eligible
applicant pool. All other eligible
applicants will be placed on the waiting
list in random order.
Step 4 Purchase Order Submittal
Selectees have 90 days from date of
selection letter to submit to EPA a copy
of the purchase order for the new bus.
Step 3 Notification and Obligation
EPA sends selection letter to Selectees
notifying them of selection status.
Funds are obligated and held at EPA.
Step 5 Delivery and Scrappage
New buses are delivered and old
buses scrapped.
Step 6 Payment Request
Selectee submits proof of receipt of
new bus and compliance with all other
Terms and Conditions (invoices,
pictures of scrapped old bus, etc.)
within 9 months from selection letter
date.
Step? Payment
EPA liquidates the obligation (sends
the rebate amount to Selectee)
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3.1 Step 1 - Application
All applicants must submit a Rebate Application (EPA Form 5600-260) and required supporting
documentation to EPA by Friday, December 14, 2012, 4:00 pm EST. The application may be
downloaded from www.epa.gov/cleandiesel/documents/2012-clean-diesel-rebate-application.pdf
as a fillable Portable Document File (PDF). See Appendix A for a sample Rebate Application.
You must have Adobe Reader to open and fill in the fields of this form. For more information
about PDFs, please see www.epa.gov/epahome/pdf.html.
Email the completed Rebate Application, along with a scanned copy of the vehicle(s)' titles and
registration, to: CleanDieselRebate@epa.gov. Include the subject line: DERA School Bus
Rebate Application: [your organization's name] If the applicant does not have access to
email, please call 734-214-4442 for assistance.
The Rebate Application includes identifying information such as organization name, address,
Dun and Bradstreet (DUNS) number, Employer ID Number (EIN), and the name of the
organization's Authorized Representative, who is able to sign on behalf of the applicant
organization. If an applicant does not have a DUNS or EIN, they must obtain one prior to
applying for a rebate. An organizational Dun and Bradstreet (D&B) Data Universal Number
System (DUNS) number must be included on the rebate form. Organizations may obtain a
DUNS number at no cost by calling the toll-free DUNS number request line at 1-866-705-5711,
or visiting the D&B website at: www.dnb.com.
Applicants must also be registered in the System for Award Management (SAM), prior to
submitting an application (previously known as the Central Contractor Registration). Information
can be found at www.sam.gov.
The Rebate Application requires applicants to supply the following information related to the
school bus to be replaced.
1) Vehicle Identification Number (VIN)
2) Engine Model Year
3) Vehicle Class
4) Engine Manufacturer
5) Engine Family Name
6) Annual Miles Traveled
7) Annual Fuel Consumption
8) Annual Hours Idling
9) Location of operation of the school bus (County and State)
10) Rebate Amount (See Section 2.4 for eligible rebate amounts)
The model year of the existing vehicle's engine must be between 1994 and 2003, as described in
Section 2.2.1. See Appendix D for additional assistance with determining the VIN, engine
model year, or engine family name.
A copy of the vehicle title and registration must be submitted with the application package. The
applicant must be listed on the title as the sole owner of the vehicle. A school bus with an active
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A copy of the vehicle title and registration must be submitted with the application package. The
applicant must be listed on the title as the sole owner of the vehicle. A school bus with an active
lien-holder does not qualify to participate in this program. See Section 2.1 for additional
information.
Annual miles traveled and fuel usage should be obtained from driver or maintenance logs. Hours
idling may be based on actual hours idling or estimated based on known usage. By signing the
Rebate Application, applicants are certifying that the VIN, engine model year, family name,
miles traveled, fuel usage, and idling hours reported are true to the best of their knowledge. EPA
reserves the right to request copies of documentation, such as activity logs, to verify the above
information.
EPA may contact an applicant to clarify any information provided by that applicant.
3.2 Step 2 - Selection
All applications that are submitted to EPA by Friday, December 14, 2012, 4:00 pm EST, will
be assigned a unique identification number, and applicants will be selected through a random
number generator. EPA reserves the right to adjust final selections based on geographic
diversity.
Eligible applicants who are selected (Selectees) will move on to Step 3 in the Rebate Process.
All other applicants will remain in random number order on the wait list. If a Selectee does not
complete the remaining required steps in the rebate process within the required timeframe
(described in Steps 3-7 below), that Selectee will be removed from the program and the next
applicant on the wait list will be selected for participation.
Both the Selectee List and the Applicant Wait List will be posted at
www.epa.gov/cleandiesel/dera-rebate.
3.3 Step 3 - Notification and Obligation
EPA will notify Selectees and those applicants that are on the wait list within 30 days of the
application submittal deadline. Once Selectees receive the selection letter from EPA, they may
purchase the eligible replacement school bus and complete Steps 4-7 below.
3.4 Step 4 - Purchase Order Submittal
A copy of the purchase order for the new school bus is required to be submitted to EPA within
90 days of date of the selection letter. The date of the purchase order cannot pre-date the date of
the Selection Letter. The proof of purchase may be a procurement request, purchase order, or any
other document that clearly shows a transaction being initiated between the applicant and a
school bus vendor for the purchase of an eligible school bus. Proof of purchase must be on
official school bus vendor or purchaser letterhead and include the following information for each
bus: (1) purchaser name, address, and phone number; (2) vendor name, address, and phone
number; (3) vehicle make, model, engine model year, and purchase price; (4) vehicle purchase
date; (5) vehicle delivery date, predetermined and agreed upon by both vendor and purchaser.
Selectees that submit false or misleading information may be barred from future participation in
DERA and other federal funding programs or may face other penalties.
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The proof of purchase document should be scanned and saved in PDF format and emailed to:
CleanDieselRebate@epa.gov. Include the subject line: DERA School Bus Proof of Purchase:
[your organization's name]
3.5 Step 5 - Vehicle Delivery and Scrappage
3.5.1 -New Vehicle Delivery
Selectees must take delivery of the new vehicle prior to submitting the Payment Request to EPA.
New vehicles must meet the requirements described in Section 2.2.2.
3.5.2 Scrappage/Disposal of Old Vehicle
Each bus being replaced must be scrapped or rendered permanently disabled prior to Selectee
submitting the Payment Request to EPA. The older bus being replaced must be scrapped and
permanently disabled by:
1. Drilling a minimum V? diameter hole completely through the engine block and manifold,
and;
2. Cutting the chassis in half.
Proof of scrappage must be provided with the Payment Request. Scrappage documentation
includes photos of:
1. Side profile of the bus
2. Vehicle Identification Number (VIN)
3. The engine tag that includes:
a. Engine serial number
b. Engine family identifier
4. Chassis cut in half
5. Engine block, prior to hole being drilled
6. Engine block, after hole has been drilled
The Selectee must also provide a letter confirming the scrappage requirements have been met.
The letter must be signed by the authorized representative listed on the rebate application forms.
The letter should include:
1. The date the buses were scrapped.
2. A listing of the buses with model year, engine serial number, and VIN.
3. The name and contact information for the entity that scrapped the buses, if other than the
applicant.
All scrappage documentation should be submitted, with the Payment Request, in PDF format or
as JPEG image files.
Scrappage may be completed by the Selectee or by a salvage yard, or similar service, provided
all scrappage requirements have been met and all necessary documentation is provided.
Equipment and vehicle components that are not part of the engine or chassis may be salvaged
from the bus being replaced (e.g., seats, tires, etc). The engine and chassis may be sold for scrap
metal, provided that the bus is disposed of in accordance with federal and state requirements for
vehicle disposal.
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3.6 Step 6 - Request for Payment
Selectees may request reimbursement from EPA by submitting a Payment Request, proof of
scrappage (see Section 3.5.2), a copy of the school bus invoice, and a copy of the bill of lading
(proof of delivery) for the new bus. The Payment Request requires Selectees to provide detailed
information on the new vehicle, such as the Vehicle Identification Number, Engine Model Year,
Vehicle Class, Engine Manufacturer, Engine Family Name, and vehicle cost. The Payment
Request must be submitted to EPA no later than 9 months after the date of the Selection Letter
(see Section 3.3 for information about the Selection Letter).
To request reimbursement, email the completed Payment Request, proof of scrappage, a copy of
the school bus invoice, and a copy of the bill of lading (in PDF format) as attachments to:
CleanDieselRebate@epa.gov. Include the subject line: DERA School Bus Payment Request:
[your organization's name].
3.7 Step 7 - Payment
Once EPA has received and approved the Selectee's Payment Request and supporting
documentation, EPA will issue the rebate funds electronically to the Selectee. EPA anticipates
that payment will be issued to the Selectee within approximately 10 business days from when
complete documentation is received by EPA.
3.8 Cancellation of Rebate Application
If a Selectee fails to submit all of the required forms and other documents by the deadlines
established in Section 4.1, the rebate application will be cancelled and any reserved funds will be
offered to the next eligible applicant on the waiting list. EPA will notify the Selectee prior to
cancelling any reserved funds.
4. Rebate Program Administration
4.1 Terms and Conditions
Applicants are required to comply with the following terms and conditions. By signing the
Rebate Application (see Appendix A for example), applicants certify that they have read and
agree to the requirements of this document and the program terms and conditions.
4.1.1 Use of Replacement School Bus
The replacement bus must be of the same or smaller Vehicle Class (3 - 8) and operate in a
similar manner and over similar routes as the school bus it replaces. In addition, the Selectee
agrees that they will:
1. Register the replacement school bus as required by state law (if applicable);
2. Maintain insurance as required by law;
3. Not make modifications to the emission control system on the replacement school bus or
engine; and,
4. Be available for follow-up inspection of the school bus for three years after receipt of the
rebate, if requested by EPA or its designee.
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4.1.2 Scrappage of Old School Bus
Selectees must scrap the school bus being replaced in accordance with Section 3.5.2 (Disposal of
Old Vehicle).
4.1.3 Ownership of Replacement School Bus
Selectees must maintain ownership of the replacement school bus for three years from the date of
purchase, and the bus must be used for the purpose of transporting 10 or more preprimary,
primary or secondary school students to schools or homes during that three-year period. If the
replacement school bus is sold before the end of the three-year period or used for purposes other
than described above, the Selectee may be required to return up to the full amount of the rebate
to EPA. The amount required to be returned is at the discretion of EPA, and will be determined
on a case-by-case basis.
4.1.4 Restriction for Mandated Measures
Pursuant to 42 U.S.C. 16132(d)(2), no funds awarded under the 2012 School Bus Replacement
Funding Opportunity shall be used to fund the costs of emission reductions that are mandated
under federal law. In addition, federal funds for school bus replacements must not be used in
combination with any other federal funding.
4.1.5 Documentation Requirement
If an applicant is selected, that Selectee is responsible for providing the Payment Request and
required supporting documentation to EPA. Selectees are responsible for maintaining copies of
all submitted forms and documents, and EPA responses, for a period of 3 years from the date of
payment.
4.2 EPA Responsibilities
EPA will review rebate applications for eligibility within the timelines established in Section 3.
EPA will promptly notify applicants by email of the status of an initial application within 30
days of the close of the open application period.
4.3 Disbursement of Funds
EPA will issue rebate funds within 10 business days of determining that a Selectee has submitted
a completed Payment Request and all supporting documents, including proof of scrappage of the
old vehicle and proof of the new vehicle delivery. If necessary, EPA may request additional
documentation from a Selectee prior to issuing funds if EPA determines that any required
information is missing or incomplete. In such a case, EPA will provide the Selectee with a
reasonable amount of time to submit additional information.
4.4 Emission Reductions Reporting
EPA will use the vehicle information supplied by applicants to calculate emissions reductions
attributable to the 2012 School Bus Replacement Funding Opportunity for the purposes of
program evaluation and reporting to Congress on the effectiveness of the program.
4.5 Program Audit
EPA will conduct random reviews of Selectees' documentation to protect against waste, fraud,
and abuse. As part of this process, EPA may request copies of rebate documents from prior
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Selectees who have received rebates, or may request documentation from current Selectees to
verify statements made on the application and payment forms. Selectees are expected to comply
with recordkeeping requirements (see Section 4.1.5), and must supply EPA with any requested
documents for three years from date of rebate issuance, or risk cancellation of an active rebate
application or other enforcement action.
4.6 Record Retention Requirements
Selectees must retain all financial records, supporting documents, accounting books and other
evidence of Rebate Program activities for three years. The retention period starts on the day the
Applicant is notified that their application has been selected for funding. If any litigation, claim,
or audit is started before the expiration of the three year period, the recipient must maintain all
appropriate records until these actions are completed and all issues resolved.
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oEPA
Appendix A
Sample Rebate Application - Public School District
United States Environmental Protection Agency
National Clean Diesel Rebate Program
Rebate Application
OMB Number: 2060-0686
Expiration Date: 10/31/2015
Applicant Information
Funding Year [2012 ) Target Fleet [School Bus j Rebate Type [Replacement
Organization Name [Anytown Public School District
! Address 1234 Main St.
City [Anytown
County/Parish
Johnson
State
MS
ZIP
12345
J Employer/Taxpayer No. (EIN/TIN) [012345678
Organizational DUNS Code
111111111
Eligible Entity Information (Private Fleet Owner Applicants Only]
Private fleet owners are able to apply for funding from the National Clean Diesel Rebate Program if the vehicle(s) or equipment, for which funding is being
requested, are currently contracted or leased to an eligible entity An eligible entity is a federal, regional, State, local, or tribal agency or port authority with
jurisdiction over transportation or air quality. For additional information regarding private fleet applicants and eligible entities, please refer to the program guide.
Eligible Entity Type
j Eligible Entity Name
'Eligible Entity Location (City. State) j
I certify the fleet of vehicle(s) or equipment, for which rebate funds are being requested, meet the requirements
for private fleets as described above and in the rebate program's terms and conditions.
Original Vehicle/Equipment/Engine
Vehicle Identification
Number
Engine
Model
Year
1 9A9AAA9AXAA999999 1999
_L
2
3
4
5
„
Vehicle
Class
6
Engine
Manufacturer
input MFR
|
Engine Family
Name
1XXXXOO.OOOO
Annual
Miles
12,500
i
! :
Annual Fuel
Consumption
Annual
Idling
Hours
1 ,400 270
i
i
Location of
Operation
County State
Johnson MS
Rebate
Amount*
25.000
I
I
FT/I I certify that the vehicle(s) listed for replacement are operational and "1
L_jJ meet the eligibility requirements defined in the program guide. i
Total Funds Requested [ 25,QOoJ
I certify that the vehicle(s) listed for replacement will be properly
disposed of according to the requirements defined in the program guide.
'Please see the program guide
for eligible rebate amounts
Applicant Signature
By signing, I certify the statements and information provided in this application are true and accurate to the best of my
knowledge. If selected for funding, I agree to provide the required documentation and assurances necessary for
funding.
Funding for the National Clean Diesel Rebate Program is subject to continuing federal appropriations Please see the
program guide for additional funding information.
i Authorized Representative Name
; Title
Jane Smith
Superintendent
j Email smith.jane@aps.org
Phone
(555) 555-5555
j Authorized Representative Signature
Date
Nov 19,
EPA Form 5600-260 (9-12)
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Sample Rebate Application - Private Fleet Owner
v>EPA
United States Environmental Protection Agency
National Clean Diesel Rebate Program
Rebate Application
OMB Number: 2060-0686
Expiration Date: 10/31/2015
Funding Year
Applicant Information
2012
Target Fleet [School Bus
-• • '
Organization Name
Add re
City
ss
A School Bus Operating Company
5678 Main St.
Anytown
Employer/Taxpayer No. (EIN/TIN) 0123
County/Parish Johnson State MS j ZIP 12345
45678 Organizational DUNS Code 111111111
I
j
i
I
Eligible Entity Information (Private Fleet OwnerApplicants Only)
Private fleet owners are able to apply for funding from the National Clean Diesel Rebate Program if the vehide(s) or equipment, for which funding is being
requested, are currently contracted or leased to an eligible entity. An eligible entity is a federal, regional. State, local, or tribal agency or port authority with
jurisdiction over transportation or air quality. For additional information regarding private fleet applicants and eligible entities, please refer to the program guide.
i Eligible Entity Type
i Eligible Entity Name
State Govt/Agency
Anytown Public School District
Eligible Entity Location (City, State)
Anytown, MS
I certify the fleet of vehicle(s) or equipment, for which rebate funds are being requested, meet the requirements
for private fleets as described above and in the rebate program's terms and conditions.
Original Vehicle/Equipment/Engine
Vehicle Identification
Number
1 i 9A9AAA9AXAA999999
Engine
Model
Year
1999
2!
3
4!
5i
Vehicle
Class
6
Engine
Manufacturer
input MFR
Engine Family
Name
1XXXXOO.OOOO
1=
i
Annual Annual Fuel
Miles Consumption
12,500 1,400
i
i
,
X
X
1 certify that the ve
meet the eligibility
iicle(s) listed for replacement are operational and
requirements defined in the program guide.
1 certify that the vehicle(s) listed for replacement will be properly
disposed of accordinq to the requirements defined in the Droqram quide. i
Annual
Idling
Hours
270
Location of
Operation
County State
Rebate
Amount*
Johnson IMS 125,000 j
Total Funds Requested
25,000
*Please see the program guide
for eligible rebate amounts
Applicant Signature
X
By signing, I certify the statements and information provided in this application are true and accurate to the best of my
knowledge. If selected for funding, I agree to provide the required documentation and assurances necessary for
funding.
Funding for the National Clean Diesel Rebate Program is subject to continuing federal appropriations. Please see the
program guide for additional funding information.
Authorized Representative Name
Title
Director
Jane Smith
Email smith.jane@ABu
Authorized Representative Signature |
_ J
ses.com Phone (555) 555-5555
—— — : • • -,T ' | 1
(Date|Nov19, 2
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Appendix B
Gross Vehicle Weight Rating (GVWR) Classes & School Bus Types
CLASS
Class 3
Class 4
Class 5
Class 6
Class 7
Class 8
GROSS VEHICLE WEIGHT RATING
10,001 - 14,000 Ibs.
14,001 - 16,000 Ibs.
16,001 -19,500 Ibs.
19,501 -26,000 Ibs.
26,001 -33,000 Ibs.
33,001 Ibs. +
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Appendix C
Rebate Application Checklist
The following information is required in order for an application to be considered eligible and
therefore entered into the random selection pool to potentially receive funds through the 2012
School Bus Replacement Funding Opportunity.
EPA must receive the Rebate Application by Friday, December 14, 2012, 4:00 pm EST.
1) Review eligibility to apply (Section 2.1).
2) Review fleet and determine vehicle eligibility including (section 2.2):
a. School bus engine model year requirement
b. Operation specifications
3) Certify Eligible Entity Information (Private Fleet Owner Applicants only).
4) Complete Rebate Application (EPA Form 5600-260) available for download at
www.epa.gov/cleandiesel/dera-rebate.
a. Complete Vehicle Information required on the rebate application for each school
bus to be replaced (up to five).
b. Include Dun and Bradstreet (DIMS ) and Employer ID Number (EIN).
c. Provide name, title, contact information, and obtain the signature of the
applicant's Authorized Representative.
5) Attach a scanned copy of the vehicle title and registration for each bus to be replaced.
Note: A school bus with an active lien-holder does not qualify to participate in this
program.
6) Email the completed Rebate Application with a scanned copy of the vehicle(s) title and
registration for the vehicles to be replaced to: CleanDieselRebate@epa.gov Include in
the subject line: DERA School Bus Rebate Application: [your organization's name].
7) Selected applicants must be registered in the System for Award Management (SAM),
(previously known as the Central Contractor Registration) prior to submitting an
application. Information can be found at www.sam.gov.
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Appendix D
How to Find Your Vehicle's VIN, Engine Model Year, and Engine Family Name
D.I How to find the VIN Number
The VEST, or vehicle identification number is most frequently located on the driver's side dash
and is visible through the windshield. The VIN can also be located on the Vehicle Title. The
vehicle identification number or VIN is 17 letters and numbers and there are no letters "F or "O"
so there is no confusion with the numbers 1 and 0.
D.2 How to find the Engine Model Year and Engine Family Name
The engine model year can be found on the label which is affixed to the engine itself. Do not be
confused with the Vehicle Model year that can be found on the Title. The engine model year can
differ from the vehicle model year. The EPA engine family name is an 11 or 12 character
number/letter designation included on the engine nameplate for all heavy-duty truck engines sold
in the United States.
In general, both the family name and model year can be found on the nameplate that is
permanently affixed to the engine. The exact location and appearance of the nameplate varies by
engine manufacturer.
If the engine label does not list the EPA-issued engine family name or is difficult to read, the
manufacturer of your engine may be able to assist you in determining the engine family name if
you are able to supply information on the model year and make of the engine, or the engine serial
number. Some manufacturers also have online tools where their customer can enter engine serial
numbers and determine the engine family name.
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