Equipment Rebate Voucher Applicants
4-Statement of Work for Energy Efficiency and Conservation Block Grant (EECBG) Equipment Rebate Voucher Applicants (including tribal and non-tribal applicants) withOUT a Historic Preservation Programmatic Agreement1 (PA) Requesting Expedited Reviews for Projects with No Ground Disturbing Activities Check applicable boxes.
☐ I represent a tribal government.
☐ I represent a non-tribal organization located in Guam. ☐ I understand all activities would be restricted to homes/buildings less than forty-five (45) years old and without ground disturbance. My organization would contact the DOE Project Officer for a Historic Preservation Worksheet to request a review of activities that are listed below on tribal homes/buildings forty-five (45) years and older, are located in a historic district, and/or propose ground disturbing activities. I understand the DOE must review the Historic Preservation Worksheet and approval from my DOE Project Officer is required before I may begin initiating activities reviewed on the Historic Preservation Worksheet.
☐ My organization is proposing no ground disturbing activities. ☐ I understand I am required to review the NEPA and Historic Preservation training website:
www.energy.gov/node/4816816 and contact my DOE Project Officer with any questions before initiating project activities.
☐ I understand I am required to review my NEPA determination (the DOE form that documents DOE’s environmental review of project activities) once I have an approved award from the DOE Contracting Officer. I will contact my DOE Project Officer with questions on my award documents.
☐ I understand I am required to submit an annual Historic Preservation Report at https://forms.office.com/g/kAFs0N7CZH.
☐ I understand if I propose activities not listed below, I must contact my DOE Project Officer who will review the proposal for program eligibility. Additional NEPA review will be required including the possible submission of an Environmental Questionnaire 1 form (EQ1). I will not initiate any activities without approval from the DOE Contracting Officer.
By signing below, ______________________________________ (enter Applicant organization) provides assurance that it shall only fund projects (including subgrants) that fall within the Blueprints and Additional Activities listed below and will follow all restrictions defined below. 1 Determine if your project is located in a jurisdiction with a Historic Preservation Programmatic Agreement by checking this website: https://www.energy.gov/node/812599 .
City of Modesto
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Blueprints and Additional Activities:
All proposed project activities and equipment funded from Administrative and Legal Requirements Documents (ALRD), and all proposed project activities and equipment funded under Financial Incentive Programs, must be listed below. Activities and equipment not listed below would require submission of an Environmental Questionnaire 1 form (EQ1).
This Statement of Work is organized around EECBG Program Blueprints. Applicants that plan to use a Blueprint should identify their selected Blueprint number and ensure that their proposed activities align with this Statement of Work. Applicants that do not plan to use a Blueprint may find that their proposed activities are covered under of one of the Blueprint headers or the “Additional Activities” section. Please review each item carefully to determine if proposed activities are included in this Statement of Work.
Blueprints:
1. Blueprint #2A: Funding commercially available, energy efficient, grid-interactivity, electrification and renewable energy upgrades; provided that projects are installed in or on existing buildings less than 45 years old (or within the boundaries of a facility less than 45 years old, defined as an already disturbed area due to regular ground maintenance), are not within a historic district, do not require ground disturbance, tree removal or tree trimming, and are limited to:
a. Installation of insulation.
b. Installation of energy efficient lighting.
c. HVAC upgrades to existing systems.
d. Weather sealing and duct sealing.
e. Purchase and installation of energy/water-efficient residential and commercial appliances and equipment (including, but not limited to, grid-interactive building technologies, energy or water monitoring and control systems, thermostats, heat pumps, air conditioners, and related software).
f. Retrofit of energy efficient pumps and motors (for such uses as, but not limited to, wastewater treatment plants) where it would not alter the capacity, use, mission, or operation of an existing facility.
g. Retrofit and replacement of windows and doors.
h. Installation of electric appliances (including replacement of appliances that utilize fossil fuels with electric appliances) such as heat pumps for water heating, air heating/cooling, electric dryers, and stoves.
i. Retrofit and installation of energy-efficient commercial kitchen equipment, such as efficient refrigerators, freezers, dishwashers.
j. Electrical system upgrades limited to electric panel upgrades, updated wiring and conduit, grounding, and arc-fault circuit interrupter (AFCI) and ground-fault circuit interrupter (GFCI) breakers.
2. Blueprint #2B: Energy Savings Performance Contracts for Efficiency and Electrification in Buildings, activities limited to:
a. Building energy efficiency project implementation and acceptance. Funding commercially available energy efficiency or renewable energy upgrades; provided that projects are installed in or on existing buildings less than 45 years old (or within the boundaries of a facility less than 45 years old, defined as an already disturbed area due to #3..
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regular ground maintenance), are not within a historic district, do not require ground disturbance, tree removal or tree trimming, and are limited to:
i. Installation of insulation.
ii. Installation of energy efficient lighting.
iii. HVAC upgrades (to existing systems).
iv. Weather sealing and duct sealing.
v. Purchase and installation of energy/water-efficient residential and commercial appliances and equipment (including, but not limited to, grid-interactive building technologies, energy or water monitoring and control systems, thermostats, heat pumps, air conditioners, and related software).
vi. Retrofit of energy efficient pumps and motors (for such uses as, but not limited to, wastewater treatment plants) where it would not alter the capacity, use, mission, or operation of an existing facility.
vii. Retrofit and replacement of windows and doors.
viii. Installation of electric appliances (including replacement of appliances that utilize fossil fuels with electric appliances) such as heat pumps for water heating, air heating/cooling, electric dryers, and stoves.
ix. Retrofit and installation of energy-efficient commercial kitchen equipment, such as efficient refrigerators, freezers, dishwashers.
x. Electrical system upgrades limited to electric panel upgrades, updated wiring and conduit, grounding, and arc-fault circuit interrupter (AFCI) and ground-fault circuit interrupter (GFCI) breakers.
b. Post-implementation measurement & verification limited to data analysis (e.g.:
metering/usage/temperature), which may include monitoring devices installed on equipment, but not on buildings.
3. Blueprint #2C: Building Efficiency & Electrification Campaign, activities limited to:
a. Building Energy Efficiency: Funding commercially available energy efficiency or renewable energy upgrades; provided that projects are installed in or on existing buildings less than 45 years old (or within the boundaries of a facility less than 45 years old, defined as an already disturbed area due to regular ground maintenance), are not within a historic district, do not require ground disturbance, tree removal or tree trimming, and are limited to:
i. Installation of insulation.
ii. Installation of energy efficient lighting.
iii. HVAC upgrades to existing systems.
iv. Weather sealing and duct sealing.
v. Purchase and installation of energy/water-efficient residential and commercial appliances and equipment (including, but not limited to, grid-interactive building technologies, energy or water monitoring and control systems, thermostats, heat pumps, air conditioners, and related software).
vi. Retrofit of energy efficient pumps and motors (for such uses as, but not limited to, wastewater treatment plants) where it would not alter the capacity, use, mission, or operation of an existing facility.
vii. Retrofit and replacement of windows and doors.
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viii. Installation of electric appliances (including replacement of appliances that utilize fossil fuels with electric appliances) such as heat pumps for water heating, air heating/cooling, electric dryers, and stoves.
ix. Retrofit and installation of energy-efficient commercial kitchen equipment, such as efficient refrigerators, freezers, dishwashers.
x. Electrical system upgrades limited to electric panel upgrades, updated wiring and conduit, grounding, and arc-fault circuit interrupter (AFCI) and ground-fault circuit interrupter (GFCI) breakers.
4. Blueprint #3A: Solar and Battery Storage - Power Purchase Agreements and Direct Ownership, activities limited to:
a. Installation of solar electricity/photovoltaic (PV) systems , provided that projects are installed in or on existing buildings less than 45 years old (or within the boundaries of a facility less than 45 years old, defined as an already disturbed area due to regular ground maintenance), are not within a historic district, do not require ground disturbance, tree removal or tree trimming, and are not to exceed 60 kW DC. b. Installation of energy storage systems, including electrochemical and thermal storage systems, provided that projects are installed in or on existing buildings less than 45 years old (or within the boundaries of a facility less than 45 years old, defined as an already disturbed area due to regular ground maintenance), are not within a historic district, do not require ground disturbance, tree removal or tree trimming, and are appropriately sized not to exceed 1,000 kWh.
5. Blueprint #3B: Community Solar, activities limited to:
a. Installation of solar electricity/photovoltaic (PV) systems , provided that projects are installed in or on existing buildings less than 45 years old (or within the boundaries of a facility less than 45 years old, defined as an already disturbed area due to regular ground maintenance), are not within a historic district, do not require ground disturbance, tree removal or tree trimming, and are not to exceed 60 kW DC. b. Installation of energy storage systems, including electrochemical and thermal storage systems, provided that projects are installed in or on existing buildings less than 45 years old (or within the boundaries of a facility less than 45 years old, defined as an already disturbed area due to regular ground maintenance), are not within a historic district, do not require ground disturbance, tree removal or tree trimming, and are appropriately sized not to exceed 1,000 kWh.
6. Blueprint #3C: Solarize Campaign, activities limited to:
a. Installation of solar electricity/photovoltaic (PV) systems , provided that projects are installed in or on existing buildings less than 45 years old (or within the boundaries of a facility less than 45 years old, defined as an already disturbed area due to regular ground maintenance), are not within a historic district, do not require ground disturbance, tree removal or tree trimming, and are not to exceed 60 kW DC. b. Installation of energy storage systems, including electrochemical and thermal storage systems, provided that projects are installed in or on existing buildings less than 45 years old (or within the boundaries of a facility less than 45 years old, defined as an already disturbed area due to regular ground maintenance), are not within a historic district, do #3..
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not require ground disturbance, tree removal or tree trimming, and are appropriately sized not to exceed 1,000 kWh.
7. Blueprint #3D: Renewable Resource Planning, activities limited to:
a. Installation of solar electricity/photovoltaic (PV) systems , provided that projects are installed in or on existing buildings less than 45 years old (or within the boundaries of a facility less than 45 years old, defined as an already disturbed area due to regular ground maintenance), are not within a historic district, do not require ground disturbance, tree removal or tree trimming, and are not to exceed 60 kW DC. b. Installation of energy storage systems, including electrochemical and thermal storage systems, provided that projects are installed in or on existing buildings less than 45 years old (or within the boundaries of a facility less than 45 years old, defined as an already disturbed area due to regular ground maintenance), are not within a historic district, do not require ground disturbance, tree removal or tree trimming, and are appropriately sized not to exceed 1,000 kWh.
8. Blueprint #4A: Electric Vehicles for Fleets and Fleet Electrification, activities limited to:
a. Purchase of alternative fuel vehicles, including electric vehicles and plug-in hybrid vehicles.
b. Installation of electric vehicle supply equipment (EVSE), including testing measurements to assess the safety and functionality of the EVSE (restricted to existing footprints within an existing parking facility, defined as any building, structure, land, right-of-way, facility, or area used for parking of motor vehicles which would not require any ground disturbance). All activities must use reversible, non-permanent techniques for installation, and where appropriate, use the lowest profile EVSE reasonably available that provides the necessary charging capacity. EVSE shall be placed in minimally visibly intrusive area; use colors complementary to surrounding environment, where possible, and be limited to the current electrical capacity. This applies to Level 1, Level 2, and Level 3 (also known as Direct Current (DC) Fast Charging) EVSE for community and municipal fleets.
9. Blueprint #4B: Electric Vehicle Charging Infrastructure, activities limited to:
a. Installation of electric vehicle supply equipment (EVSE), including testing measurements to assess the safety and functionality of the EVSE (restricted to existing footprints within an existing parking facility, defined as any building, structure, land, right-of-way, facility, or area used for parking of motor vehicles which would not require any ground disturbance). All activities must use reversible, non-permanent techniques for installation, and where appropriate, use the lowest profile EVSE reasonably available that provides the necessary charging capacity. EVSE shall be placed in minimally visibly intrusive area; use colors complementary to surrounding environment, where possible, and be limited to the current electrical capacity. This applies to Level 1, Level 2, and Level 3 (also known as Direct Current (DC) Fast Charging) EVSE for community and municipal fleets.
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Additional Activities:
10. Building Energy Efficiency: Funding commercially available energy efficiency or renewable energy upgrades, provided that projects are installed in or on existing buildings less than 45 years old (or within the boundaries of a facility less than 45 years old, defined as an already disturbed area due to regular ground maintenance), are not within a historic district, do not require ground disturbance, tree removal or tree trimming, and are limited to:
a. Installation of insulation.
b. Installation of energy efficient lighting.
c. HVAC upgrades to existing systems.
d. Weather sealing and duct sealing.
e. Purchase and installation of energy/water-efficient residential and commercial appliances and equipment (including, but not limited to, grid-interactive building technologies, energy or water monitoring and control systems, thermostats, heat pumps, air conditioners, and related software).
f. Retrofit of energy efficient pumps and motors (for such uses as, but not limited to, wastewater treatment plants) where it would not alter the capacity, use, mission, or operation of an existing facility.
g. Retrofit and replacement of windows and doors.
h. Installation of electric appliances (including replacement of appliances that utilize fossil fuels with electric appliances) such as heat pumps for water heating, air heating/cooling, electric dryers, and stoves.
i. Retrofit and installation of energy-efficient commercial kitchen equipment, such as efficient refrigerators, freezers, dishwashers.
j. Electrical system upgrades required to enable energy efficient/clean energy. Measures limited to electric panel upgrades, updated wiring and conduit, grounding, and arc-fault circuit interrupter (AFCI) and ground-fault circuit interrupter (GFCI) breakers.
11. Installation of renewable energy technology, provided that projects are installed in or on existing buildings less than 45 years old (or within the boundaries of a facility less than 45 years old, defined as an already disturbed area due to regular ground maintenance), are not within a historic district, do not require ground disturbance, tree removal or tree trimming, and are limited to:
a. Solar Electricity/Photovoltaic—appropriately sized systems not to exceed 60kW (including community solar projects)
b. Wind Turbines 20 kW or smaller
c. Solar thermal systems (including solar thermal hot water) limited to 200,000 BTU per hour or smaller.
12. Biomass thermal systems, provided that projects are installed in or on existing buildings less than 45 years old (or within the boundaries of a facility less than 45 years old, defined as an already disturbed area due to regular ground maintenance), are not within a historic district, do not require ground disturbance, tree removal or tree trimming, are appropriately sized, and limited to 3 MMBTUs per hour or smaller, with appropriate regulatory permits obtained and Best Available Control Technologies (BACT) installed and operated.
13. Purchase of alternative fuel vehicles, hybrids, and electric vehicles. #3..
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14. Installation of fueling pumps and systems (but not storage tanks) for fuels such as compressed natural gas, hydrogen, ethanol, and other commercially available biofuels, provided that projects are installed on a current fueling station site (less than 45 years old), are not within a historic district, do not require ground disturbance, tree removal or tree trimming, are appropriately sized, and obtain the appropriate permits, and comply with regulatory requirements.
15. Development and installation of energy storage systems, including electrochemical and thermal storage systems, provided that projects are installed in or on existing buildings less than 45 years old (or within the boundaries of a facility less than 45 years old, defined as an already disturbed area due to regular ground maintenance), are not within a historic district, do not require ground disturbance, tree removal or tree trimming, are appropriately sized not to exceed 1,000 kWh, obtain the appropriate permits, and comply with regulatory requirements.
The Applicant is responsible for informing DOE of any extraordinary circumstances, cumulative impacts, or connected actions that may lead to significant impacts on the environment or any inconsistency with the “integral elements” from a particular project. See 10 C.F.R. Part 1021 Appendix B, and the DOE’s online NEPA and historic preservation training at www.energy.gov/node/4816816 to reviews these concepts.
Expedited NEPA review based on this NEPA Statement of Work and supporting documents does not preclude DOE from conducting stewardship activities, including audits, and site visits, or from exercising any other rights under the EECBG program.
By signing below, the Applicant, agrees to follow all the statements and restrictions in this document; review and comply with the NEPA Determination (included in their Applicant award documents); review the DOE’s NEPA and Historic Preservation training website. DOE has developed a NEPA and Historic Preservation training website which contains PowerPoint presentations, sample template documents (including a project scope of work and a project layout), a Word template of the Environmental Questionnaire1 (EQ1), and an EQ1 Submission Guide at www.energy.gov/node/4816816. Applicants are responsible for reviewing these trainings and reviewing the sample documents prior to initiating projects.
Recipients must contact their DOE Project Officer with any questions. Subgrantees should also review the NEPA and Historic Preservation training website prior to initiating projects. ________________________________________________________________ Authorized Signature Date
Name (Printed or typed):___________________________________________ Title (Printed or typed):_____________________________________________ Organization (Printed or typed):______________________________________ Crowley, Patrick
Senior Public Works Manager
City of Modesto
10/1/2024
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KINGSBURG TRUCK CENTER
11652 E Kamm Ave
Kingsburg, CA 93631
559-891-7077
Quote/Purchase Order
ADDRESS
City of Modesto
1010 10th Street
Modesto, Ca 95353
SHIP TO
City of Modesto
1010 10th Street
Modesto, Ca 95353
QUOTE/PURCH
ASE ORDER
COM 3 trucks
DATE 12/03/2024
DATE ACTIVITY DESCRIPTION QTY RATE AMOUNT
Workhorse W4 CC Workhorse W4CC Cab and Chassis
Vehicle Class 4
GVWR 14,330
Curb Weight 7,330
Payload 7,000
Axle Load Rating - Front 4,409
Axle Load Rating - Rear 9,920
Battery: kWh 118
Voltage 576
Chemistry LiFrPo4
Range (nominal) 150 Miles
Wheelbase 170
Cab-to-Axle Distance 110
Sourcewell Contract (#032824-WKH)
3 156,000.00 468,000.00T
CTEC 144-43-
VFT-95
CTEC 144-43-VFT-95 (Workhorse W4 CC)
Utility Bed
Body is 144" long
Body is 43" tall
Body is 95" wide
Body config: Vertical config with flip top
lids - CS&SS
Painted White
LED stop tail turn lights
Step bumper painted silver
Hardware; stainless steel t-handles
3 point door locking
Barrel locks with 4 keys
Gas shocks on all compartments
Interior work lighting in all utility bed
compartments
Stand alone isolated 12 volt battery to
operate all work lights and emergency
flashers
Overhead HD ladder rack
3 0.00 0.00T
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Diamond plate lids and gravel guards
4 Cornerstrobes & amber lights
Doc fee 3 33.00 99.00
Document
Processing Fee
3 85.00 255.00T
HVIP Class 4 CAHVIP VoucherAmount
Discount Grant EECGB Funding 3 -80,333.33 -240,999.99
Sourcewell Sourcewell contract 032824-WKH 1 0.00 0.00T
Disclaimer Please note, the above vouchers are based
on current availability and the companies
ability to qualify forsaid vouchers.
*Quote valid for 60 days*
3 0.00 0.00
Disclaimer Please note, this quote is only valid if both the EECGB funding comes through at the
above mentioned amounts. Neither
Modesto or Kingsburg Truck Center are
liable to follow through with this order if
the above grants are not met at their above
stated amounts.
1 0.00 0.00
SUBTOTAL 227,354.01
TAX 41,557.63
TOTAL $268,911.64
Accepted By
Accepted Date
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From: EECBG Vouchers
Sent: Tue, 12 Nov 2024 14:59:14 +0000
To: Patrick Crowley; Maria Garnica; [email protected]
Subject: Department of Energy EECBG Voucher Preapproval – Modesto Attachments: FARC 6.17.24.pdf, Post-Installation User Guide.pdf External Email: Please use caution when clicking links and/or opening attachments.
Congratulations! The U.S. Department of Energy has approved your Energy Efficiency and Conservation Block Grant (EECBG) Program Equipment Rebate Voucher application. This email serves as the official notice that you may now proceed with equipment purchase and installation.
Next steps:
Start your project! For information, please refer to the EECBG Voucher Handbook and the EECBG Program website.
We recommend that all entities review their state’s executed historic preservation programmatic agreement (PA) by visiting DOE’s website that lists out each state’s executed PA. If your application includes activities that require consultation with your state historic preservation office, you are responsible for reaching out to your state’s SHPO contact to complete any required reviews.
Please review the attached Federal Assistance Reporting Checklist (FARC) for details on required reporting. (Note: The highlighted reports may or may not apply to your project.)
o For more information, please see DOE’s Equipment Voucher Reporting webinar recording and slides.
Per the Handbook: “Following application approval, eligible entities have up to two years to use their EECBG Program voucher funds with the option to request a no-cost extension.”
Once your entire project is complete and all costs paid, see the attached PostInstallation User Guide for instructions on requesting voucher reimbursement. You are invited to join an EECBG Program Blueprint Cohort to meet monthly with other EECBG governments across 13 clean energy topic areas and learn from experts, discuss challenges/best practices, and answer questions. Sign up here to join a cohort relevant to your EECBG Program project or your community’s broader clean energy goals. Have a question about the cohorts? Reach out to [email protected].
If you need additional assistance or have any questions, please get in touch with us at this email address ([email protected]) and reference your application number below:
Application Number: IA-0000001172
Thank you,
EECBG Rebate & Portal Administrator
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ICF – Supporting DOE’s Energy Efficiency and Conservation Block Grant (EECBG) Program Email: [email protected]
Portal: https://doerebates.my.site.com/eecbgvouchers
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