National Clean Diesel Rebate Program 2015 School Bus Replacement and Retrofit Funding Opportunity Program Guide &EPA United States Environmental Protection Agency ------- National Clean Diesel Rebate Program 2015 School Bus Replacement and Retrofit Funding Opportunity Program Guide Transportation and Climate Division Office of Transportation and Air Quality U.S. Environmental Protection Agency &EPA United States Environmental Protection Agency EPA-420-B-15-086 September 2015 ------- Table of Contents Contents Section 1: Background 2 Section 2: Eligible Applicants 2 Section 3: Eligible Vehicles 3 Section 4: Funding Amounts 6 Section 5: Application 6 Section 6: Selection 9 Section 7: Notification 9 Section 8: Purchase Order Submittal 9 Section 9: Vehicle Delivery or DOC plus CCV Installation 10 Section 10: Scrappage 11 Section 11: Request for Payment 11 Section 12: Payment 12 Section 13: Cancellation of Rebate Application 12 Appendix A: Sample Application for a Public Entity 13 Appendix B: Sample Application for a Private Entity 14 Appendix C: Letter Tern plate for State-Owned Buses 15 Appendix D: Rebate Application Checklist 16 Appendix E: Sample Scrappage Photos 17 Appendix F: Sample Scrappage Certification Letter 23 Appendix G: Terms and Conditions 24 ------- Section 1: Background The Diesel Emissions Reduction Act program (DERA) was originally authorized by Title VII, Subtitle G (Section 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. EPA designed this rebate program to encourage school bus fleet turnover so more children can ride buses with the cleanest emissions standards or buses that have been retrofitted to reduce emissions. The 2015 School Bus Replacement and Retrofit Funding Opportunity will provide financial assistance to public and private fleet owners for the replacement or retrofit of older school buses. See Section 3 for specific information on eligible vehicles and the replacement and retrofit options This rebate program will provide rebate incentives to selected eligible applicants to replace school buses powered by model year 2006 or older engines with new buses powered by a certified 2015 or newer model year engine, or operate solely on electricity. Eligible replacement school buses may operate on ultra-low sulfur diesel fuel (ULSD), battery or hybrid drive trains, or alternative fuels. This rebate program will also allow fleet owners the option to retrofit buses powered by model year 1994 to 2006 engines with Diesel Oxidation Catalysts (DOCs) plus Closed Crankcase Ventilation (CCVs). DOCs are exhaust after-treatment devices that reduce toxic emissions from diesel vehicles and equipment. DOCs are widely used as a retrofit technology because of their simplicity and limited maintenance requirements. CCV systems redirect emissions back to the intake systems for combustion instead of emitting them into the air and are often used in combination with a DOC. EPA will fully fund the cost of these retrofit technologies up to $3,000. This document describes the criteria and requirements for the 2015 School Bus Replacement and Retrofit Funding Opportunity. Section 2: Eligible Applicants Eligible applicants include: • Regional, state, local, or Tribal agencies with jurisdiction over transportation or air quality, including school districts and municipalities. o A Tribal agency is a Federally recognized Indian tribal government, which is any Indian tribe, band, nation, or other recognized group or community (including Native villages) certified by the Secretary of the Interior as eligible for special programs and services provided by her through the Bureau of Indian Affairs or other organizations. • Private entities that operate school buses under a contract with an entity listed above. o 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. ------- Ownership At the time of application, the applicant must own and operate the school bus for which funds are being requested. The applicant must submit 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. State-Owned Buses Public school districts that operate state-owned school buses meeting the 2015 School Bus Replacement and Retrofit Funding Opportunity requirements may submit an application to replace up to 10 buses per district and retrofit up to 10 buses per district. Each public school district applicant must submit the required ownership documents as stated above in the Program Guide that show state ownership. The buses targeted for replacement or retrofit must meet the requirements for eligibility as stated in Section 3 of the Program Guide. The district must submit a signed letter from the state agency that owns the buses authorizing the district to participate in the rebate program and, if the district is selected, to proceed with the required scrappage of the replaced bus. The letter must be signed by the authorizing official and must be submitted on the official letterhead of the state agency that owns the buses. A template of the letter may be found in Appendix C. Section 3: Eligible Vehicles For the purpose of the 2015 School Bus Replacement and Retrofit Funding Opportunity, a school bus is defined as a vehicle used for the purpose of transporting 10 or more preprimary, primary, or secondary school students to schools or homes. Fleet size is determined by how many buses are in current operation and meet the above definition of a school bus. Current operation is defined having accumulated at least 10,000 or more miles over the most recent 12 months, or having been in use at least three days per week during the current school year. Public and private applicants with school bus fleet sizes between 1-100 buses may submit only one rebate application that includes up to ten eligible replacements and/or up to ten eligible retrofits. Public and private applicants with school bus fleet sizes with 101 or more buses may submit two rebate applications that include up to 10 eligible replacements and/or up to ten eligible retrofits per application. In order to submit two applications, at least one of the applications has to list 10 buses for replacement and/or retrofit. Applicants submitting two applications must list different buses on each application. Applicants must sign both applications. EPA will verify fleet size once an application has been selected. ------- Fleet Size 1-100 101 and over Number of Applications Permitted One Two Replacements and Retrofits Per Application Up to 10 replacements and/or 10 retrofits Total Replacements and/or Retrofits Per Applicant Up to 10 replacements 10 retrofits Up to 20 replacements 20 retrofits Vehicles for Replacement Vehicles listed for replacement must be: • Diesel-powered school buses powered by a 2006 or older engine model year; • Above Gross Vehicle Weight Rating (GVWR) of 10,001 Ibs; • Able to start, move in all directions, and have all operational parts; and • Have accumulated at least 10,000 or more miles over the most recent 12 months, or been in use for at least three days per week during the current school year. Applicants are required to certify on the rebate application that the school bus or buses to be replaced meet these operational requirements. Replacement Vehicles Replacement school buses may not be ordered under this funding opportunity until the applicant has been selected and has received the selection letter from EPA. All replacement buses must meet the following criteria: • Powered by a certified 2015 or newer model year engine, or operate solely on electricity. Eligible replacement school buses may operate on conventional diesel (ULSD), battery or hybrid drive trains, or alternative fuels; • The same or smaller vehicle class, as determined by GVWR, as the original school bus and operate in the same manner and over similar routes as the original school bus; and • Meet Federal safety standards and required warranties. The selected applicant [selectee] takes sole responsibility for ensuring the replacement bus remains in operational condition. In addition, selectees must agree to: • Register the replacement bus as required by state law (if applicable); • Maintain insurance as required by law; • Not make modifications to the emission control system on the replacement school bus or engine; and • Be available for follow-up inspection of the school bus and related documents for three years after receipt of the rebate, if requested by EPA or its designee. ------- Selectees must maintain ownership of the replacement school bus for three years after receipt of the rebate, 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. Retrofitted Vehicles Engines eligible for DOC plus CCV option include: • School buses equipped with 1994 to 2006 model year engines; • Must be powered by ultra-low sulfur diesel fuel (ULSD); • The engine must be well maintained and not consume lubricating oil at a rate greater than that specified by the engine manufacturer; • The engine must not have been originally certified or equipped with a DOC or diesel particulate filter; • Must be compatible with the selected DOC plus CCV from EPA's verified technology list or CARB's verified technology list. Applicants should list $3,000 per DOC plus CCV on the application. This is the maximum EPA will pay. Typically, DOC plus CCV installation should not exceed $3,000 per engine. Applicants should work with dealers to make sure the parts and installation will not exceed $3,000. EPA will pay the exact amount for the parts and installation as determined by receipts submitted later in the rebate process. The selectee takes sole responsibility for ensuring the DOC plus CCV is compatible with their engine and remains in operational condition. The selectees should work with manufacturers and suppliers to ensure the engine type and model year are compatible with the technology and should negotiate a warranty with product suppliers prior to purchase. In addition, selectees must agree to: • Perform regular engine maintenance to ensure DOC performance; • Not make modifications to the retrofit technologies or engine after installation; • Follow the CCV maintenance schedule for filter cartridge replacement; • Be available for follow-up inspection of the school bus and related documents for three years after the receipt of the rebate, if requested by EPA or its designees. Selectees must maintain ownership of the retrofitted school bus for three years after receipt of the rebate, 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 retrofitted 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. For more information about DOC plus CCV installation, please visit: www3.epa.gov/cleandiesel/documents/420fl0030.pdfwww3.epa.gov/otaq/diesel/documents/420flOO 30.pdf ------- Section 4: Funding Amounts Vehicles for Replacement For the 2015 School Bus Replacement Funding Opportunity, EPA anticipates having up to $7,000,000 available for rebates, subject to the 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 the program, or to make fewer selections than anticipated. Table 1: Bus Size and Rebate Amount for Replacements 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. Rebate Amount $15,000 $15,000 $15,000 $20,000 $20,000 $25,000 Retrofitted Vehicles EPA will pay up to $3,000 per bus for the DOC plus CCV option. This includes parts and installation. Section 5: Application EPA must receive all rebate applications (EPA Form 5600-260) and required supporting documentation by Friday, October 30, 2015, 4:00 pm Eastern Time. The application should be downloaded as a fillable Portable Document File (PDF): 2015 Rebate Application See Appendices A and B for sample rebate applications. You must have Adobe Reader to open and fill in the fields of this form. For more information about PDFs, please see www2.epa.gov/home/pdf-files. The rebate application includes identifying information such as organization name, 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. 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. An EIN may be obtained by visiting the IRS website at: www.irs.gov/Businesses/Small-Businesses-&-Self-Employed/Apply-for-an-Employer-ldentification- Number-%28EIN%29-Online The rebate application requires the applicant to supply all of the following information related to the school bus to be replaced: 1) Vehicle Information Number (VIN) ------- The VIN 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 VIN is 17 letters and numbers and does not use the letters "I" or "O" so as to avoid confusion with the numbers 1 and 0. 2) Engine Model Year The engine model year can be found on the plate attached to the engine itself, usually on the nameplate that is permanently affixed to the engine. The engine model year can differ from the vehicle model year. 3) Gross Vehicle Weight Table 2: Vehicle Class and Gross Vehicle Weight 4) 5) Class Class 3 Class 4 Class 5 Class 6 Class 7 Class 8 Gross Vehicle Weight 10,0001-14,000 Ibs. 14,001-16,000 Ibs. 16,001-19,500 Ibs. 19,501-26,000 Ibs. 26,001-33,000 Ibs. 33,001 lbs+ The applicant does not need to indicate class size on the application, only the Gross Vehicle Weight. However, the new bus cannot exceed the class size of the bus being replaced. Applicants should refer to the table above to make sure their new buses fit the weight requirements. Engine Manufacturer The engine manufacturer is the manufacturer of the original engine. This information can usually be found on the engine nameplate. Engine Family Name 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. The EPA engine family name is usually 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 EPA engine family name does not appear on the engine or it is difficult to read, the manufacturer of your engine may be able to assist you in determining the engine family name. Some manufacturers also have online tools where their customers can enter engine serial numbers and determine the engine family name. 6) Annual Miles Annual miles traveled should be obtained from driver or maintenance logs. 7) Annual Fuel Use Annual fuel consumption should be obtained from driver or maintenance logs. ------- 8) Annual Idling Hours Hours idling may be based on actual hours idling or estimated based on known usage. 9) Replacement or retrofit Use the drop down menu to select the replacement or retrofit option. 10) Rebate Amount See Section 4 to find the corresponding rebate amount for the size of the buses listed on the application for the replacement option. Applicants choosing the DOC plus CCV option should list $3,000 per bus. After selection, the applicant will need to provide an exact cost including parts and installation. 11) Idle Reduction Policy Check the appropriate box to indicate if the school transportation provider has an idle reduction policy for the buses listed on the application. This is not a requirement for eligibility, it is for inventory purposes only. For more information about idle reduction, please visit www3.epa.gov/cleandiesel/sector-programs/antiidling.htm. Please note that the Original Vehicle table has space to list only five buses. Applicants may list additional buses on page two of the application. By signing the rebate application, applicants are certifying that the information provided is 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 the applicant. See Appendix A for a sample rebate application for a public school district, and see Appendix B for a sample rebate application for a private fleet owner. Submitting the Application Applicants may submit the application via email, which is an option on the bottom of page one of the application. A copy of the vehicle title and registration for each bus must be submitted with the application package, and can be attached the email. The applicant must be listed on the title as the sole owner of the vehicle unless applying to replace state-owned buses. Public school districts applying with state-owned buses must also submit a signed letter (see Appendix C) on the official letterhead of the state agency that owns the buses at the time of application. See Section 2 for additional information. Email the completed rebate application, along with a scanned copy of each vehicle's title and registration, and if applicable, a letter from the state agency that owns the buses to: Cleandieselrebate@epa.gov. Emailed applications must include the subject line: DERA SCHOOL BUS REBATE APPLICATION and the name of your organization. If the applicant does not have access to email, please call the help line at 877-623-2322 for assistance. ------- Section 6: Selection All applications that are submitted to EPA by the deadline will be assigned a unique identification number, and applications will be selected through a random number generator. EPA will select at least one applicant from each EPA Region, provided each Region has an eligible applicant. If additional resources are available in EPA Regions, more projects in those Regions may be funded. EPA will also select at least one Tribal applicant, provided at least one eligible Tribal entity applies. To view a map of EPA Regions, please visit: www2.epa.gov/aboutepa#pane-4. Each selectee will be assigned an EPA contact to work with throughout the process. Applicants not selected by lottery will remain in random number order on the wait list. If a selectee does not complete the remaining required steps in the rebate process, that selectee will be removed from the program and the next applicant on the wait list will be selected for participation. Both the selectee and applicant waitlist will be posted on the 2015 School Bus Rebate page. Section 7: Notification EPA will notify selectees and those applicants that are on the wait list within 45 days of the application submittal deadline. Selectees must register in the System for Award Management (SAM). EPA will direct selectees to register in SAM prior to receiving their official selection letter. Information can be found at www.sam.gov. Once the selectee receives the selection letter from EPA, they may purchase the eligible replacement school bus or DOC plus CCV. Section 8: Purchase Order Submittal Replacement Buses A copy of the purchase order for the new school bus is required to be submitted to EPA within 90 days of the 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 selectee and a school bus vendor on 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, GVWR, engine model year, and purchase price; 4) Vehicle purchase date; and 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. The proof of purchase document should be scanned and saved in PDF format titled "Proof of Purchase" and should be emailed to your assigned EPA contact. The subject line should include the name of your organization and DERA School Bus Proof of Purchase. Retrofitted Buses A copy of the purchase order for the DOC plus CCV is required to be submitted to EPA within 90 days of the 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 selectee and a DOC plus CCV vendor on purchaser letterhead and include the following information for each DOC plus CCV: 1) Purchaser name, address, and phone number; 2) Vendor name, address, and phone number; 3) DOC plus CCV product name; 4) Vehicle purchase date; and 5) Installation 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. The proof of purchase document should be scanned and saved in PDF format titled "Proof of Purchase" and should be emailed to your assigned EPA contact. The subject line should include the name of your organization and DERA School Bus Proof of Purchase. Section 9: Vehicle Delivery or DOC plus CCV Installation Replacement Buses Selectees must take delivery of the new vehicle within nine months from the date of the selection letter and prior to submitting the payment request to EPA. New vehicles must meet the requirements described in Section 3. Selectees should receive a bill of lading, or proof of delivery, to send in with the payment request form. Retrofitted Buses Selectees must select a certified dealer to install the DOC plus CCV within nine months from the date of the selection letter and prior to submitting the payment request to EPA. A selectee must use a certified dealer to complete essential installation checks to ensure the CCV works properly. The DOC plus CCV must meet the requirements described in Section 3. Selectees must submit an installation receipt. ------- Section 10: Scrappage Replacement Buses This only applies to buses that have been replaced. Each bus being replaced must be scrapped or rendered permanently disabled prior to the selectee submitting the payment request to EPA. The bus being replaced must be scrapped and permanently disabled by: 1) Drilling a three inch by three inch hole completely through the engine block; and 2) Cutting the chassis rail in half. Proof of scrappage must be provided with the payment request. Scrappage documentation must include JPEG images of the following with corresponding file names: 1) Side profile of the bus 2) Vehicle Identification Number (VIN) 3) Engine plate 4) Chassis rail cut in half 5) Engine block, prior to hole being drilled 6) Engine block, after hole has been drilled Please see Appendix E for example photos of required scrappage documentation. The selectee must also provide a letter on their letterhead or the letterhead of the salvage yard that performed the service confirming the scrappage requirements have been met. The letter must be signed by salvage yard that performed the service, if applicable, and the authorized representative listed on the rebate application form. A template of the letter may be found in Appendix F. The letter must include: 1) The date the buses were scrapped 2) A listing of the buses with engine model year and VIN 3) The name and contact information for the entity that scrapped the buses The letter confirming scrappage should be scanned and saved in PDF format titled "Scrappage Letter" and emailed to your rebate contact. This letter should be sent with the JPEG scrappage photos along with the Request for Payment Form (Section 11). 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 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. Section 11: Request for Payment Replacement Buses ------- Selectees must submit the following documentation to request reimbursement from EPA: • Payment Request Form (EPA Form 5600-261)) including detailed information on the new vehicle • Scrappage photos and letter for buses being replaced (see Section 10) • A copy of the invoice for the new bus • A copy of the bill of lading (proof of delivery) for the new bus To request reimbursement, email the completed payment request, proof of scrappage for replaced buses, a copy of the invoice for the new bus and a copy of the bill of lading for new buses in PDF format as attachments to your assigned EPA contact. These documents must be sent no later than nine months after the date of the selection letter (see Section 7). Retrofitted Buses Selectees must submit the following documentation to request reimbursement from EPA: • Payment Request Form (EPA Form 5600-261) including detailed information on the DOC plus CCV technology • A copy of the invoice for the DOC plus CCV • A copy of the installation receipt for the DOC plus CCV To request reimbursement, email the completed payment request, a copy of the invoice for the DOC plus CCV, and a copy of the installation receipt for the DOC plus CCV in PDF format as attachments to your assigned EPA contact. These documents must be sent no later than nine months after the date of the selection letter (see Section 7). Section 12: 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 the payment will be issued to the selectee within a month from when complete documentation is received by EPA. Section 13: Cancellation of Rebate Application If a selectee fails to submit all of the required forms and other documents by the deadline, the rebate application will be canceled and any reserved funds will be offered to the next eligible applicant on the waiting list. EPA will notify the selectee prior to canceling any reserved funds. ------- Appendix A: Sample Application for a Public Entity 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|2015 | Target Fleet [School Bus Rebate Type | Replacement/Retrofit Organization Name Anytown Public School District Address 11234 Main St. City Anytown County/Parish [Anywhere -I ZIP 60000 Employer/Taxpayer No. favrm, |p1 -2345678 J DUNS Code 101-234-5678 D Organization is a federally recognized tribal government 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 etigtble entity. An eligible entity \i 3 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 Eligible Entity Name Eligible Entity Location (County, State) 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 terms and conditions wrthin the Program Guide. Original Vehicle Vehicle Identification ?J?ln Number ., Year 1 9A9AAA9AXA999999 2001 2 8A8AAA8AXA688888 2002 3 4 5 v/ , ." Engine Engine Family Annual c . «S-!j Manufacturer Name ' Miles ,,uel ™'n9 Weight Use Hours 30.000 Engine Co. 1XXXXOO.OOOO 15,000 1.400 270 30,000 Engine Co 2XXXXOQ.OOOO 12.000 1.300 2CO Replacement or Rebate Retrofit Amount" Replacement 0 $20,000 Retrofit [»| $3.000 a I a *To list additional vehicles for retrofit or replacement, please use table below |Yes »| Does your school transportation provider have an idle reduction policy? I certify that the vehicle(s) listed for replacement are operational and meet the eligibility requirements defined in the Program Guide. I certify that the vehicle(s) listed for replacement will be properly disposed of according to the requirements defined in the Program Guide. Total Funds Requested 123,000 Applicant Signature "Please see the Program Guide for eligible rebate amounts \/ By signing, I certify the statements and information provided in this application are true and accurate to the best of my l/\l 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 Jane Smith Title [Superintendent Email [jsmit h@anytownschool.edu Phone | (123)456-7890 Date 10/8/2015 Authorized Representative Signature If signing »l«clrt.n»:fl1ly. dick "Suhmt by FmaC twlow and attach vehicl* titla arrf «gistrali«i dOhTurmintii Fnr papw signaturss. plaase scan the flgnsd reb«* application an.: : t '.•|*.-ar-4'ir'L.vlrvL'jKjij>.^.'i) gwy wtUi v#*iicle liHa art(J rwgi'dra&on docum«nl5 as ctescntwd this lundmg o&pcwltrnti/s fasatgiLSMfite. EPA Form 5600-260 (9-14) Submit by Email Print Form ------- Appendix B: Sample Application for a Private Entity 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|2015 | Target Fleet [School Bus Rebate Type | Replacement/Retrofit Organization Name Anytown Transit Co. Address J4321 Main St City Anytown I County/Parish |Anywhere | State | IL Q ZIP 60000 Employer/Taxpayer No. favrm, |p1 -2345679 J DUNS Code 101-234-5679 D recognized tribal government Eligible Entity Information (Private Fleet Owner Applicants Only) Private fleet owners are able to apply fur funding from the National Clean Diesel Rebate Program if the vehicle^} or equipment, for which funding is being requested, are currently contracted or leased to an elig'ble entity. An eligible entity 1-3 a federal regional, state, local, or bibal 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. Eiioible Entity Type Eligible Entity Name Eligible Entity Location (County, State) ptate Govt/Agency [J [Anytown Public School District J I Anytown, IL 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 terms and conditions wrthin the Program Guide. Original Vehicle Vehicle Identification ?J?ln Number ., Year 1 9ASAM9AXA999999 2001 2 8A8AAA8AXA688888 2002 3 4 5 v/ , ." Engine Engine Family Annual c . «S-!j Manufacturer Name ' Miles ,,uel ™'n9 Weight Use Hours 30.000 Engine Co. 1XXXXOO.OOOO 15,000 1.400 270 30.000 Engine Co 2XXXXOO.OOOO 12.000 1.300 2CO Replacement or Rebate Retrofit Amount" Replacement 0 $20,000 Retrofit [»| $3.000 a B a *To list additional vehicles for retrofit or replacement, please use table below |Yes »| Does your school transportation provider have an idle reduction policy? I certify that the vehicle(s) listed for replacement are operational and meet the eligibility requirements defined in the Program Guide. I certify that the vehicle(s) listed for replacement will be properly disposed of according to the requirements defined in the Program Guide. Total Funds Requested 123,000 Applicant Signature "Please see the Program Guide for eligible rebate amounts \/ By signing, I certify the statements and information provided in this application are true and accurate to the best of my l/\l 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 Ellen Smith Title President Email esmith@arty1ownsohool.edu Authorized Representative Signature Phone | (123)456-7891 Date 10/8/2015 If signing »l«dron.:aiy. did. -Subnrt by Fmal' Mom and attach vehid« Ml* and i»»itratioi documents Ft* ftftr signatures, ptoni* 10*1 Iho iiSKWd ivbat* appluat ':k--jr".li......,..i--..i,Iik-:jl..~..li n r. . . i ..•!., -Ml i. 'ni;oi-|.j LI L,lj,.. i!u'ill V''., ^V...J!.rn ''3 mat' 1-1 .'ir:,-. =.: -i- i I tr. EPA Form 5600-260 (9-14) Submit by Email Print Form ------- Appendix C: Letter Template for State-Owned Buses [MUST BE PRINTED ON OFFICIAL LETTERHEAD OF THE STATE AGENCY THAT OWNS THE BUS LISTED ON THE APPLICATION] The [NAME OF STATE AGENCY THAT OWNS THE BUSES] owns the buses operated by [SCHOOL DISTRICT NAME]. The [NAME OF STATE AGENCY THAT OWNS THE BUSES] authorizes [AUTHORIZED APPLICANT REPRESENTATIVE NAME] to submit an application on behalf of [SCHOOL DISTRICT NAME] to the U.S. Environmental Protection Agency for the 2015 School Bus Replacement and Retrofit Funding Opportunity to replace or retrofit the buses listed on the application. [SCHOOL DISTRICT NAME] may apply to replace up to 10 buses and retrofit up to 10 buses owned by the state and operated by the [NAME OF SCHOOL DISTRICT]. [SCHOOL DISTRICT NAME] must submit the signed rebate application, the required documents as stated in the Program Guide, and this signed letter in order to be eligible for participation in the 2015 School Bus Replacement and Retrofit Funding Opportunity. If selected to participate, [SCHOOL DISTRICT NAME] is authorized by the [NAME OF THE STATE AGENCY THAT OWNS THE BUSES] to proceed with all scrappage requirements or DOC plus CCV installation as set out in the Program Guide. All other eligibility restrictions for the applicant, vehicles, and program requirements must be met as specified in the Program Guide (EPA FORM NUMBER). All eligible applications will be selected by a lottery system. Signed by the Authorized Representative of the State Agency that owns the buses Phone number of the Authorized Representative ------- Appendix D: 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 2015 School Bus Replacement and Retrofit Funding Opportunity. EPA must receive the rebate application by Friday, October 30, 2015, 4:00 pm Eastern Time. S Review eligibility of applicant to apply (Section 2) S Review fleet and determine the vehicle eligibility (Section 3) including: o School bus engine model year requirements o Operation specifications S Certify eligible entity information (private fleet owner applicants only) (Section 2) S Complete the rebate application (EPA Form 5600-260). Download 2015 Rebate Application Form o Complete vehicle information required on the rebate application for each school bus to be replaced or retrofitted o Include Dun and Bradstreet (DUNS) and Employer ID Number (EIN) o Provide name, title, contact information and signature of the applicant's authorized representative S 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 S For public school districts applying with state-owned buses, attach a signed letter of official state agency letterhead (Appendix C) ------- Appendix E: Sample Scrappage Photos 1) Side profile of the bus ------- 2) Vehicle Identification Number (VIN) -^••Hf- 821280 MANUFACTURED BY AMERICAN TRANSPORTATION CORPORATION DA"E OF MANUFACTURE 05 MO. 01 YR GVWR 16,034 KGS ( 35,350 IBS ) 5AWR FRONT 5,601 KGS ( 12,350 IBS ) WITH 295/75R22.5G TIRES 14 PLY AT 758 KPa (110 PSI)COLD RIMS 225X900 AXLE SINGLE 5AWRREAR 10.432KGS (23,000 IBS) WITH 11R22.5H TIRES 14 PLY AT 758 KPa (110 PSI)COLD RIMS 22.5X8.25 AXLE DUAL THIS VEHICLE CONFORMS TO ALL APPLICABLE FEDERAL MOTOR VEHICLE SAFETY STANDARDS IN EFFECT ON THE DATE OF MANUFACTURE SHOWN ABOVE. VEHICLE IDENTIFICATION NO. 1HVBGAAR01A917002 VEHICLE TYPE SCHOOL BUS BODY# 917002 ------- 3) Engine plate INTERNATIONAL* 2001 .NE MANUFACTURED BY: CYLINDREE : '•«> L EMISSION 1NVXH0466ANB FAMILY "OREL CH230 . I r^^^^r^o^^oo I PUSSJOUt IH^N I IB-FI TOHO. • HFM I ggQ g, 14Q I CMIE UWI X TR/MM I EMISSIONS CONTROL SYSTEMS Dl. TC. ECM, CAC lllllllllllllllllllllllllllll'll IMS mtt (US A PRWtftY MENDED SERVICE «w*n« ^ A raw HEAvr-Dun DIESEL gat AM) CdfOflMS TO OS. EPA. CALIFORNIA, AUS1RAIIAN AHD. AND CANADIAN HEAVY-DUTY DIESEL BEGULATK1NS AFFUCABtE FOR THE MPliD MODEL TEAR. AM) B CEBTIFED TO (ffiMTE (WDIESEL FUEL. 1 - Ct NOIEIR A I T CONCU EN TANT WIN ND1BJR DESa BOBUSTE DE GAMME MOTENNE El ESI COKOf. AIR flEOEMENlS T '"" «K til Ef DU CANADA, APPLICABLE1)! L'ANNEE DE NOtElE IPIIOIEE ET EST CERTIFIE POUR FOCTUie) All CARBURANT DtSEL. LE. FUEL'RATE 0 ADV. POWER AND ^TION TIMING ARE NON-ADJUSTABLE &/N 470HM2U1305324 I ------- 4) Chassis rail cut in half ------- 5) Engine block, prior to hole being drilled ------- 6) Engine block, after hole has been drilled ------- Appendix F: Sample Scrappage Certification Letter [MUST BE PRINTED ON THE APPLICANT'S OR SALVAGE YARD'S LETTERHEAD] [DATE] The following bus(es) was/were disposed of according to Section 10 of the National Clean Diesel Rebate Program 2015 School Bus Replacement and Retrofit Funding Opportunity Program Guide. I confirm that the EPA scrappage requirements have been made. [NAME OF ENTITY THAT SCRAPPED THE BUS] performed the bus scrappage on [DATE]. The phone number of the organization is [PHONE NUMBER]. [BusVIN] [Engine Model Year] Signed by the authorized representative of selectee ------- Appendix G: 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. Use of Replaced or Retrofitted School Bus The replaced or retrofitted bus must be of the same or smaller Vehicle Class (3 - 8) and operate in a similar manner and over similar routes as the original bus. In addition, the selectee agrees that they will: • Register the replacement school bus as required by state law (if applicable); • Maintain insurance as required by law; • Not make modifications to the emission control system on the replaced or retrofitted school bus or engine; and, • 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. Ownership of Replaced or Retrofitted School Bus Selectees must maintain ownership of the replaced or retrofitted school bus for three years after receipt of the rebate 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 replaced or retrofitted 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. Restriction for Mandated Measures [seems like this should be mentioned earlier too] Pursuant to 42 U.S.C. 16132(d)(2), no funds awarded under the 2015 School Bus Replacement and Retrofit 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 or retrofits must not be used in combination with any other federal funding. 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 three years after receipt of the rebate. EPA Responsibilities EPA will review rebate applications for eligibility within the timelines established in Section 7. EPA will promptly notify applicants by email of the status of an initial application within 45 days of the close of the open application period. Disbursement of Funds EPA will issue rebate funds within a month 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 or technology installation. 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. Emission Reductions Reporting EPA will use the vehicle information supplied by applicants to calculate emissions reductions attributable to the 2015 School Bus Replacement and Retrofit Funding Opportunity for the purposes of program evaluation and reporting to Congress on the effectiveness of the program. 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 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 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. Record Retention Requirements Selectees must retain all financial records, supporting documents, accounting books and other evidence of Rebate Program activities for three years after receipt of the rebate. 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. ------- |