Sacramento City Council
August 8, 2023

City of Sacramento
City Council - 5PM Report
915 I Street Sacramento, CA 95814
www.cityofsacramento.org
File ID: 2023-00893 8/8/2023 Consent Item 10.

Budgetary Adjustments for the California Energy Commission Electric Vehicle Ready Communities Phase II Blueprint Implementation Grant (C15210000) File ID: 2023-00893
Location: Citywide
Recommendation: Pass a Resolution to authorize the City Manager or the City Manager’s designee to increase revenue and expense budgets by $595,404 (Fund 3702, CIP Reimbursable) in the Sacramento EV Blueprint Phase 2 Project (C15210000) with funds from the Sacramento Metropolitan Air Quality Management District for the installation of electric vehicle system equipment.

Contact: Fedolia “Sparky” Harris, Principal Planner (916) 808-2996, [email protected], Department of Public Works; Lucinda Willcox, Assistant Director, (916) 808-5052, [email protected], Department of Public Works Presenter: None
Attachments:
1-Description/Analysis
2-Resolution
3-Agreement
Description/Analysis
Issue Detail: This item is an administrative action to allow for implementation of a competitive Electric Vehicle (EV) grant from the California Energy Commission (CEC) to adjust the project budget to account for matching funds dedicated by a partner agency.

The grant supports high-impact EV programs, outreach, and evaluation, including public charging infrastructure at community facing facilities; highly localized outreach, education, and engagement activities around zero-emissions transportation access; increasing equity and addressing frontline community needs with zero emission technologies; and identification and testing of technologies, partnership models, programs, and processes that can serve as templates for other entities to approach similar mobility issues.

In 2018, the CEC awarded the City $198,218 for a Phase 1 EV Blueprint planning grant that staff successfully completed in 2019. As a grant recipient for Phase 1, the City was eligible to compete for Phase 2 implementation funding. In March 2020 the CEC approved the City’s full funding request of

File ID: 2023-00893 8/8/2023 Consent Item 10.
$1,825,418, for a project cost of $2,908,375 including City and partner match. Per Resolution 2020- 0314, the City Manager or City Manager’s designee accepted and executed the grant agreement with the CEC on September 22, 2020. The Sacramento EV Blueprint Phase II Capital Improvement Project was established on June 15, 2021, by Resolution 2021-0187 and $1,825,418 in CEC grant funding under agreement 2021-0574 was loaded to the CIP revenue and expense budget. Additional City Council action is required to load the $595,404 match contribution from the Sacramento Metropolitan Air Quality Management District (SMAQMD) specifically for the installation of electric vehicle system equipment (EVSE).

Policy Considerations: The City Council, passed by Motion 2017-0374, the EV Strategy on December 12, 2017. Goals and policies in the EV Strategy are consistent with this recommended motion, calling for the City to increase and accelerate EV use and adoption levels, increase the visibility and awareness of EVs, and achieve equitable access to (Zero Emission Vehicle) ZEV technologies. Receipt of grant funds will equip the City to accelerate EV Strategy implementation.

Economic Impacts: None.

Environmental Considerations:

California Environmental Quality Act (CEQA): Under the California Environmental Quality Act (CEQA) guidelines, administrative activities are exempt from review. Applicable environmental review will occur for project tasks prior to award of any construction contract.

Individual construction activities under this grant will undergo any appropriate environmental review.

Sustainability: The transportation sector accounted for 57% of community-wide greenhouse gas emissions in 2016, the largest single sector in the community. Electrification of the transportation sector leads to reductions in petroleum use, both reducing greenhouse gas emissions and improving local air quality.

Commission/Committee Action: Not applicable.

Rationale for Recommendation: Despite momentum towards goals established in the City of Sacramento’s EV Strategy, continued investment is critical to achieve transformative progress in EV equity, access, and infrastructure. Public investment is key to address the gaps in geographic and programmatic implementation and advance equitable investments. Phase 1 planning, analysis, and outreach confirmed the opportunity to expand beyond the existing approach and services. Further investment is needed to serve the City’s diverse businesses and residents more equitably, placing special focus on disadvantaged and low-income communities and neighborhoods that have had a history of underinvestment in clean mobility options. Phase 2 funds will help address market gaps in the zero-emission ecosystem and provide funding for the City to implement the City Council’s transformative EV mobility goals.

File ID: 2023-00893 8/8/2023 Consent Item 10.

Financial Considerations: Grant funding for the project includes $1,825,418 from the CEC and required an additional $1,082,957 in match funds for an approximate three-year project period.

Projects selected for this grant were required to include a minimum 25% local match share, which was secured through partnership with the SMAQMD, the Sacramento Municipal Utilities District (SMUD), and City staff time. This proposed action will budget the $595,404 (Fund 3702, CIP Reimbursable) match share contribution from the SMAQMD into the Sacramento EV Blueprint Phase 2 Project (C15210000) which will allow the City to proceed with grant reimbursements. .

Upon approval of the requested budget adjustment there will be sufficient funding within Sacramento EV Blueprint Phase 2 Project (C15210000) to complete the project.

After the in-kind contributions from SMAQMD ($160,000) and SMUD ($99,000) are completed the minimum match requirement of $1,082,957 will be met.

CEC Agreement CIP Budget
Measure U 228,553 386,014* SMAQMD (2023-0135) 595,404 595,404 SMUD Inkind** 99,000
SMAQMD Inkind** 160,000
1,082,957 981,418
Local Match 1,825,418 1,825,418 CEC Agreement (2021-0574) 2,908,375 2,806,836 *Includes non-participating costs.
**Inkind match towards CEC Agreement, will not be loaded into the city project budget.

Sacramento EV Blueprint Phase II Funding
Local Business Enterprise (LBE): Not applicable.

Background:

Specific project activities supported by the grant and matching funds includes the following:
· Installation of at least 34 EV chargers (66 EV connectors) across 13 public libraries and community centers, with at least two thirds of connectors located in disadvantaged communities.
· Procurement of 30 e-bikes for a pilot lending program operated by the Library · Expansion of the Air District’s ‘Our Community CarShare’ program in project neighborhoods for a minimum of 18 months.
· The California Conservation Corp (CCC) will engage members consisting of local youth for job training and installation support.
· An equity-based evaluation will yield further metrics to evaluate the project’s impact on equity,

File ID: 2023-00893 8/8/2023 Consent Item 10.

EV adoption, and other community indicators to be developed throughout tasks. UC Davis ITS will evaluate performance and present findings on the impact of the project strategies on EV adoption and equity.

The grant tasks will also focus on building meaningful relationships with community members and groups to increase education, awareness, and community input. New information will be available regarding the success of E-mobility hub and EV ecosystem elements such as E-bike lending, car share, connection to transit and active transportation, and workforce training.

The City will serve as the lead grant manager, but work in close collaboration with local stakeholders and agencies. Outreach will build on existing work underway, including General Plan outreach and the Environmental Justice Collaborative Governance Committee. Key partners include members of the Sacramento Plug-in EV Collaborative, such as the SMUD, the SMAQMD, the UC Davis Institute of Transportation Studies, and other stakeholders.
..End

RESOLUTION NO.

Adopted by the Sacramento City Council

Budgetary Adjustments for the EV Blueprint Phase II Project (C15210000)

BACKGROUND
A. Assembly Bill (AB) 118 (Nùñez, Chapter 750, Statutes of 2007), created the Clean Transportation Program, formerly known as the Alternative and Renewable Fuel and Vehicle Technology Program (ARFVTP). The statute authorizes the California Energy Commission (CEC) to develop and deploy alternative and renewable fuels and advanced transportation technologies to help attain the state’s climate change, clean air, and alternative energy policies. AB 8 (Perea, Chapter 401, Statutes of 2013) re-authorized the Clean Transportation Program through January 1, 2024.

B. On September 22, 2020, the City Council adopted Resolution No. 2020-0314 which authorized staff to apply for the grant and authorized the City Manager or City Manager's designee to accept and execute the grant agreement with the CEC.

C. The City submitted a grant application to the CEC on October 22, 2020, and on March 17, 2020, the CEC selected the City’s grant for award.

D. The grant will provide funding for the City to implement the City’s transformative electric vehicle (EV) mobility goals. A key focus of the grant proposal is increasing access in underserved areas, and to learn the best methods to address transportation needs.

E. The grant requires $1,825,418 in CEC funding and $1,082,957 in local funding from several agencies. Local funding commitments were made by the Sacramento Metropolitan Air Quality Management District (SMAQMD), Sacramento Municipal Utilities District and the City of Sacramento. Agreements with SMAQMD and SMUD are being established. The remainder of the match requirements will be met with Measure U (Fund 2401).

F. The Sacramento EV Blueprint Phase II Capital Improvement Project (C15210000) was established by Resolution 2021-0187 on June 15, 2021.

G. $60,000 was transferred from (Measure U, Fund 2401) from the expenditure budget of the FY2020/21 Public Works Measure U Program (I80150900) to the expenditure budget of the Sacramento EV Blueprint Phase II Project (C15210000) by Resolution 2021-0187 on June 15, 2021.

H. The expenditure budget for the Sacramento EV Blueprint Phase II Project (C15210000) was increased by $106,000 to cover local match costs from Measure U, Fund 2401 by Resolution 2022-0062 for a total of $166,000.

I. Public Works Measure U Program (I80150900) was replaced with the Public Works Sustainability Program (I15220300)
J. The original estimated budget for the Sacramento EV Blueprint Phase II Project required $272,952 in local funding as CEC match share. Subsequently, staff changes, permitting costs, and ineligible expenses have increased the amount of local funding needed to $386,014.

K. The expenditure budget for the Sacramento EV Blueprint Phase II Project (C15210000) was increased by $220,014 to cover local match costs from Measure U, Fund 2401 by Resolution 2023-0006.

L. The City and the Sacramento Metropolitan Air Quality Management District (SMAQMD) executed Agreement C2023-0135 on February 1, 2023, for SMAQMD’s contribution of $595,404 towards match for the Sacramento EV Blueprint Phase II Project (C15210000).

M. This resolution is necessary to increase the revenue and expense budgets by $595,404 (Fund 3702, CIP Reimbursable) in the Sacramento EV Blueprint Phase 2 Project (C15210000).

BASED ON THE FACTS SET FORTH IN THE BACKGROUND, THE CITY COUNCIL RESOLVES AS FOLLOWS:

Section 1. The City Manager or the City Manager’s designee is authorized to increase revenue and expense budgets by $595,404 (Fund 3702, CIP Reimbursable) in the Sacramento EV Blueprint Phase 2 Project (C15210000) with funds from the Sacramento Metropolitan Air Quality Management District (SMAQMD) received through Agreement C2023- 0135 for the installation of electric vehicle system equipment.

SACRAMENTO
Office of the City Clerk

CONTRACT

ROUTING SHEET
Contract Cover/Routing Form: Must Accompany ALL Contracts; however, it is NOT part of the contract.

General Information (Required)
Original Contract # (supplements only):

Assessor's Parcel Number(s):

Supplement/Addendum #:

Contract Effective Date: 2/1/2023

Contract Expiration Date (if applicable):

$ Amount (Not to Exceed): $595,404 Adjusted $ Amount (+/-):

Other Party: Sacramento Metropolitan Air Quality Management District Project Title:Sacramento EV Blueprint Phase II SMAQMD EVSE Contribution Project #: C15210000
City Council Approval: NO
Contract Processing Contacts
Department: Public Works
Contract Coordinator: Julie Lim
Bid/RFQ/RFP #:
if YES, Council File ID#: 2020-0107d
Project Manager: Fedolia Harris
Email: [email protected]
Department Review and Routing
Contracts: Julie Lim Digitally signed by Julie Lim
Date: 2023.02.02 09:15:23 -0800'
Project Manager: Fedolia Harris Digitally signed by Fedolia Harris Date: 2023.02.01 10:21:15 -0800'
Supervisor:
,oz7 Division Manager:

Dept Review:

Construction Related ACM Signature Needed
Special Instruction/Comments (i.e. recording requested, other agency signatures required, etc.) Fully executed agreement attached. Requesting filing in CARA.

FOR CLERK & IT DEPARTMENTS ONLY DO NOT vvRiTek I THIS LINE CC Rev. 12.19.2018
3c0Ektreldqte4t20a3804a5)BF-4293-9D9C-11C956012243
Agreement Number VET-22-0009

SACRAMENTO METROPOLITAN AIR QUALITY MANAGEMENT DISTRICT LOWER EMISSION VEHICLE INCENTIVE PROGRAM AGREEMENT — FUELING & ENERGY

INFRASTRUCTURE
This Agreement (Agreement) is between the Sacramento Metropolitan Air Quality Management District (SMAQMD), a California local public agency and City of Sacramento (Participant).

1.0 Recitals

1.1 SMAQMD is the local agency within the boundaries of Sacramento County with the primary responsibility for the development, implementation, monitoring, and enforcement of air pollution control strategies, clean fuel programs, and motor vehicle use reduction measures under Health and Safety Code Section 4096'1.

1.2 SMAQMD is authorized by Health and Safety Code Sections 41062(a) and 41082 to implement programs to reduce transportation emissions, including programs to encourage the use of alternative fuels and low- emission vehicles.

1.3 The mission of the SMAQMD is to achieve state and federal clean air goals. These goals include attainment and maintenance of ozone standards as part of the Sacramento Federal Nonattainment Area (SFNA) which is described in Exhibit A of this Agreement. The SMAQMD is also responsible for reducing exposure to other air pollutants and toxic air contaminants on a community level. The majority of these emissions are generated by mobile sources, including heavy-duty vehicles, off-road engines, and other equipment.

1.4 The California Air Resources Board (CARB) has developed Carl Moyer Program Guidelines, and SMAQMD has developed Guidelines that incorporate and implement these CARB guidelines. These documents are collectively referred to as the Moyer Guidelines. These Guidelines, and any subsequent amendments, will be automatically specifically incorporated into the Agreement as though fully set forth herein.

1.5 On April 28, 2016, SMAQMD approved Resolution No. 2016-019, establishing the Lower Emission Vehicle Incentive Program (LEVIP), which provides incentives to fleet operators and individuals for the purchase, repower and/or retrofit of low-emission on-road motor vehicles, off-road mobile equipment, agricultural water pumps, infrastructure, and other engines.

1.6 This agreement may be funded using incentive funds received from sources other than the Carl Moyer Program. These funds may have requirements similar to those in Moyer Guidelines and other guidelines as adopted into the LEVIP as directed by the applicable funding source. These sources may include, but are not limited to, the Greenhouse Gas Reduction Fund and the Air Quality Improvement Fund.

1.7 Participant has reviewed and is familiar with the Moyer Guidelines or other guidelines applicable to the funding source used to fund New Equipment under this agreement.

1.8 Participant understands that the purpose of the Program, and this Agreement, is to help SMAQMD achieve clean air standards as required by state and federal law and to reduce exposure in communities most impacted by air pollution.

1.9 Participant wishes to participate in the Program by purchasing and operating the New Equipment (as defined in Paragraph 2.1.3).

1.10 The parties specifically recognize that the CARB is a third-party beneficiary to this Agreement and has the right to audit compliance with the Agreement, including conducting inspections, and has the right to enforce Participant's compliance with the terms of the Agreement.

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009

DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

2.0 Special Terms and Conditions
The parties agree to the terms and conditions listed below.

2.1 Definitions: As used in this Agreement, the following terms have the following meanings:

2.1.1 "Applicable emission standards" means the emission standards for NOx, particulate matter (PM), hydrocarbons, carbon monoxide, and carbon dioxide established by the California Air Resources Board (CARB) or the United States Environmental Protection Agency (USEPA) for the model year of the vehicle or engine.

2.1.2 "Dealership" means a business that has entered into an agreement with SMAQMD to assist in the implementation of the Program and that specializes in the sale of New Equipment.

2.1.3 "New Equipment" means the fueling or energy infrastructure that is identified in Exhibit B.

2.1.4 "Participant Agreement" means the LEVIP Agreement between SMAQMD and a Program Participant, under which SMAQMD agrees to pay the Program Participant a specific amount to help offset the cost of purchasing New Equipment from Dealership.

2.1.5 "Project Completion" means the project post-inspection has confirmed that the new equipment is operational. Project Completion cannot occur before the date of execution of the Participant Agreement.

2.1.6 "Project Implementation" means the period following Project Completion, during which period the participant must meet the performance obligation in Exhibit C.

2.1.7 "Program" means the SMAQMD's LEVIP, the CARB Carl Moyer Program, their respective guidelines and other applicable funding source guidelines adopted into the LEVIP (as mentioned in Section 1.6), all of which are incorporated into this Agreement as if fully set forth. Any subsequent amendments to the Program Guidelines, are specifically incorporated into the Agreement as though fully set forth herein.

2.1.8 "Program Participant" means the individual, agency, or business entity that is receiving funds to aid in the purchase of the New Equipment.

2.1.9 "Reimbursement Formula" is the following calculation for determining the level of funds to be returned to SMAQMD if Participant fails to meet the operational requirements of the Agreement:

For Projects That Do Not Have Minimum Annual Operational Requirement A=I—[I*(T/L)]
A = Amount Owed to SMAQMD
I = Total Incentive Award
L = Length of the Agreement in Months
T = Elapsed New Equipment Project Life in Months

2.1.10 "Verified" means a device, fuel, or system that is verified by CARB or the USEPA to reduce emissions from a mobile source by a verified amount.

2.2 Payment:

2.2.1 Payment: SMAQMD will pay up to $595,404 to Participant to aid in the purchase of the New Equipment. No payment is required until: (i) the Participant commences operation, as required under Paragraph 2.3.1 (Time), (ii) the Participant submits a Payee Data Record form, as required under Paragraph 2.2.2, (iii) Participant satisfies the requirements in Paragraph 2.5 (Inspections and Audits) and 2.6 (Invoice Requirements), and (iv) Exhibit Z has been signed by all parties. If LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009

DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243 Participant purchases the New Equipment before this Agreement is signed by all parties, then Participant will NOT receive any grant funds.

2.2.2 Taxation: Payments made under this Agreement may be subject to taxation. Participants are encouraged to consult with a tax professional regarding the taxability of payments from this program. Participant is not entitled to payment until it submits a completed Payee Data Record form to SMAQMD prior to payment. SMAQMD will report the payment to both the State of California and the United States Treasury and will issue an IRS Form 1099 to the Participant.

2.2.3. Prevailing Wages: If applicable, the Participant and any subcontractors agree to be bound by all provisions of State Labor Code Section 1771 regarding prevailing wages. If applicable, any subcontractors must be registered with the Department of industrial Relations (DIR) pursuant to State Labor Code Section 1725.5 and comply with prevailing wages requirements as published by DIR. Refer to https://www.dirca.clov/Public-Works/PublicWorks.html for more information.

Participant must ensure that any and all subcontractors are registered, pay prevailing wages and submit records as applicable.

2.3 Participant Obligations: Participant must:

2.3.1 Time: Purchase and begin operating the New Equipment described in Exhibit B within the timeframe indicated on Exhibit B. Participant may submit a written request to extend this time frame if it is unable to comply with the deadline due to circumstances outside Participant's reasonable control. No extension will be granted, regardless of the circumstances, if the new deadline would conflict with deadlines under the Program. Participant must notify SMAQMD if it fails to meet the project completion milestones.

2.3.2 Operation: Meet the operational requirements of Exhibit C for each item of New Equipment described in Exhibit B, and operate the New Equipment in a manner that is consistent with the Program eligibility requirements, the goals and objectives of the Program, the terms of this Agreement, and all local, state, and federal rules, laws, and regulations.

2.3.3 Equipment Warranties: Secure New Equipment Warranties and operate the New Equipment within the manufacturer's specifications, including all maintenance and fueling requirements.

2.3.4 Additional Devices Requirements:
(i)
Usage Meter: Install an operational hour meter, electric meter, or other SMAQMD- approved or required usage measuring device on the New Equipment.

2.3.5 Decals: Display two decals approved by SMAQMD on the New Equipment. SMAQMD must approve the location of the decals.

2.3.6 Program Guidelines: Comply with all other requirements detailed in this Agreement and the Program.

2.3.7 Disclosures: Complete Exhibit F and, if this Agreement requires approval by the Board of Directors, Exhibit G.

2.4 Participant's Warranties: The Participant warrants that:
(i) It has completed a LEVIP Application Form and all of the information presented in the Form is complete and accurate. Participant's Application for the LEVIP is incorporated by reference in this Agreement.
(ii) The New Equipment meet all of the criteria established in the Program Guidelines in effect at the time this Agreement is signed, as well as the goals and objectives of the Program.

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009

DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243 (i-) The purchase of the New Equipment described in Exhibit B is not required by any law or regulation with the exception of certain agricultural projects described in Health and Safety Code §41081(d)(2)(ii). If the Participant is a public agency, Participant further warrants that its board policies do not require the purchase.
(iv) It will not make any modifications to, or tamper with the New Equipment or any recording devices on the New Equipment.
(v) It has read and agrees to all requirements of the Program application and guidelines, including the applicable Program Guidelines. The Participant also agrees to read and meet all subsequent revisions to and advisories regarding the Program Guidelines.

2.5 Inspections and Audits: The New Equipment funded under this Agreement is subject to inspection by SMAQMD, CARB, or their designee at any time with 24-hour notification. Any inspection will be conducted at a reasonable time and with reasonable notice to Participant. Inspections will include the post- and audit inspections identified in Paragraphs 2.5.1 to 2.5.2.

2.5.1 Post-inspection: SMAQMD will conduct an inspection after the New Equipment is purchased and (if necessary) installed to verify that the New Equipment meets the Program requirements.

For Electric Vehicle Supply Equipment (EVSE)/Battery Charging Stations, the Participant must provide a print out of the current usage from each smart meter or other SMAQMD-approved usage meter installed on each EVSE charger.

2.5.2 Audit Inspection: SMAQMD, CARB, or their designees will conduct audit inspections as necessary to verify the New Equipment is operating pursuant to program guidelines and meeting contractual requirements. SMAQMD, CARB, or their designees may perform a fiscal audit of the project at any time during the Project Implementation period.

2.6 Invoice Requirements: The Participant must submit a final invoice packet to SMAQMD. This requirement may be met by submission of the documents by a Dealership on Participant's behalf. The packet must include the New Equipment's identification number, engine serial number, and the date the New Equipment was purchased and installed. The invoice must also include copies of:

2.6.1 UCC-1 Form: A copy of an UCC-1 Form, filed with the California Secretary of State, giving SMAQMD a security interest in the New Equipment for the full amount of the funds to be paid to the Participant under a Participant Agreement.

2.6.2 Purchase Documentation: A copy of (i) the New Equipment invoice, and (ii) copies of all invoice documents associated with the purchase and installation of New Equipment described in Exhibit B, detailing costs associated with parts, labor, and miscellaneous charges, including a copy of the Program Participant final itemized paid invoice, invoices for work performed to meet Program eligibility requirements, and the finance agreement for any portion of the New Equipment purchase price to be privately financed. The documentation must include the usage meter reading on the date the New Equipment is financed.

2.6.3 New Equipment Warranty: A copy of the new equipment warranty.

2.6.4 Usage Meter Installation: Copy of an invoice documenting that an hour meter, electric meter, or other SMAQMD-approved tracking device has been purchased and installed on the New Equipment, and a written confirmation by Dealership that the meter is operational.

2.6.5 Proof of Insurance: A copy of proof of insurance demonstrating compliance with Section 3.6 and Exhibit D.

2.7 Termination:

2.7.1 General: SMAQMD may immediately suspend or terminate this Agreement, in whole or in part, if it determines that there is: (i) an illegal or improper use of funds; (ii) a failure to comply with any term of this Agreement; or (iii) a failure to submit a correct and complete report. In no event will LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009

DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243 any payment by SMAQMD constitute a waiver by SMAQMD of any breach of this Agreement or any default that may then exist on the part of Participant. Neither will such payment impair or prejudice any remedy available to SMAQMD with respect to the breach or default. The SMAQMD will have the right to demand the repayment to SMAQMD of any funds disbursed to Participant under this Agreement that it determines were not expended in accordance with the terms of this Agreement. Participant must promptly refund the moneys upon demand. In addition to immediate suspension or termination, SMAQMD may impose any other remedies available by law, in equity, or otherwise specified in this Agreement.

2.7.2 Limitation: Notwithstanding the provisions of this Paragraph, the Participant is subject to the reimbursement requirements of Section 2.8 (Reimbursements), which are in addition to, and do not offset or displace, any other recovery rights that SMAQMD may have in the event the contract is breached.

2.7.3 Funding: The parties acknowledge that this Agreement will be funded by incentive fund revenues from other agencies; however, SMAQMD may terminate this Agreement if: (i) it does not receive all or a portion of the revenues, or (ii) funds are not specifically appropriated for this Agreement in SMAQMD's final budget prior to the expiration of the Agreement and any Agreement extensions.

If SMAQMD terminates this Agreement under this paragraph, it will serve notice of the action on the Participant within 10 working days.

2.8 Reimbursements: Notwithstanding the provisions in Section 2.7 (Termination), the Participant is subject to the reimbursement requirements of this Paragraph, which are in addition to, and do not offset or displace, any other recovery rights that SMAQMD may have in the event the contract is terminated or breached. If the Participant fails to fulfill the minimum operational requirements by the termination date in Paragraph 2.12 (Term), it must refund a pro rata portion of the $595,404 to SMAQMD.

2.8.1 Reimbursement Determination: SMAQMD will determine whether a reimbursement is required after reviewing the annual reports required under Section 2.9 (Recordkeeping and Reporting Requirements). If the Participant has failed to submit a report for any year, SMAQMD may assume that none of the operational requirements were met for that year.

2.8.2 Reimbursement Amount: The reimbursement amount is the difference between the required level of operation and the actual level of operation during a given contract year, according to the Reimbursement Formula. The termination date of the contract will be automatically extended until payment is complete.

2.8.3 Early-Termination Reimbursements: If the contract is terminated prior to the termination date in Paragraph 2.12 (Term), SMAQMD may:

Demand full repayment of the Section 2.2 (Payment) funds, or (ii) Apply the Reimbursement Formula and demand repayment of the prorated amount.

2.8.4 Inoperable New Equipment Reimbursements: If the New Equipment is stolen or rendered inoperable prior to the end of the Agreement term (as determined by Participant's insurance company), Participant may either: (i) replace the inoperable New Equipment with new equipment certified to equal or lower emission levels than the inoperable New Equipment (if applicable) and complete performance of this Agreement or (ii) terminate the Agreement and a return a prorated portion of the $595,404, based on the Reimbursement Formula.

2.8.5 Full or Partial Waiver: The APCO of the SMAQMD may, at his or her sole discretion, relieve the obligation to reimburse funds after considering the circumstances leading to the failure to fulfill the minimum performance requirements.

2.8.6 Statute of Limitations: Because underperforming participants can reduce the pro rata amount owed by performing through the entire contract period, the statute of limitations period will not begin until the last day of the Agreement term.

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009

DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

2.9 Recordkeeping and Reporting Requirements:

2.9.1 Record Requirements: Participant must maintain adequate records to document compliance with this Agreement. Records include the documents specified below. Participant must maintain the records for the term of the contract and the four years following the end date listed in Paragraph 2.12 (Term). SMAQMD may inspect or request copies of these records at any time during the term of this Agreement. This paragraph will survive the termination of this Agreement. (i)
Infrastructure: Required records include the fuel or power dispensed by the infrastructure, qualitative description of public and private uses, and summary of any unscheduled downtime.

2.9.2 Report Requirements: The Participant must submit a report stating the fuel or power dispensed in the preceding year, the type and cost of maintenance or repair work performed over the course of the year, and the amount of time the New Equipment was inoperable due to the maintenance and repair activities.
(i) Reporting requirements include the items in Section 2.9.1(i). EVSE must have smart meters or other SMAQMD-approved usage meters installed. EVSE must report annual usage per charger (e.g. kilowatt-hour) and the number of plug-in events. Alternative Fueling Stations must report annual usage per dispenser (e.g. kilograms or standard cubic feet).
(ii) Battery Charging Station: Participant must report all battery charging station installations to the Department of Energy Alternative Fuel Data Center located at http://www.afdc.energy.gov/locator/stations/.
(iii) Alternative Fueling Station: For hydrogen fueling stations, Participant must register and report to the Station Online Status System (SOSS) maintained by the California Fuel Cell Partnership (www.cafcp.org ). In addition, grantee must abide by the requirements of the reporting system.

2.9.3 Report Submission Deadlines: Participant must submit use reports at least once annually or as requested by SMAQMD, CARB staff, or their representatives. Annual reports are due not later than January 31 of each year. Additional reports are due on the date specified in the request, or within 30 days if no date is specified. SMAQMD, CARB or their representatives may also request additional performance or other documentation at their discretion and Participant must provide the requested information on the date specified in the request, or within 30 days if no date is specified.

2.9.4 Failure to Comply: If Participant fails to comply with the reporting requirements, SMAQMD may require repayment in accordance with Section 2.8 (Reimbursements), or, at its sole election, institute on-site monitoring and inspection measures.

2.9.5 Report if New Equipment Becomes Non-operational: Participant must notify SMAQMD within seven days if the New Equipment funded under this Agreement becomes non-operational.

2.10 Sale of New Equipment: Participant acknowledges and agrees that it may not sell or encumber the New Equipment without the prior written consent of SMAQMD. SMAQMD will not approve the sale, transfer, licensing, or subcontracting, unless either 2.12.1 or 2.12.2 are satisfied:

2.12.1 Performance Completed: If performance is complete, SMAQMD will approve the sale or encumbrance after confirming that Participant has met the performance obligations.

2.12.2 Performance Incomplete: If performance is not complete, SMAQMD will approve the sale or encumbrance after both of the following occur:

The Participant notifies the prospective buyer of the New Equipment, in writing, of the terms of this Agreement and any unperformed requirements.

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009

DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243 (ii) The buyer executes a Program Agreement with SMAQMD.

2.11 Multiple Funding Source & Incentive Funding Limits: Participant warrants that it fully disclosed all funds received under any other incentive agreement for the New Equipment described in Exhibit B and that the total combined funding amount does not exceed the maximum funding limits identified in any Program. Exhibit E lists the multiple incentive agreements, the entities involved, and the incentive funds provided by each entity, as disclosed in the application, and Participant warrants that the information is accurate and complete.

2.12 Term: This Agreement will begin upon execution by all parties and terminate on 12/31/2025, and the parties agree that the statute of limitations period for demanding reimbursement does not begin to run until the Agreement termination date. The Project Completion period is 180 days or the timeframe indicated in Exhibit B, whichever period is longer, beginning with the execution of the Agreement by all parties and ending with the initial operation of the New Equipment as verified by the post-inspection. See Paragraph 2.3.1 (Time) regarding extensions of this period. The Project Implementation period is the period immediately following the Project Completion period. Notwithstanding the expiration or early termination of this Agreement, SMAQMD's security interest in the New Equipment will continue in full force and effect until Participant fully satisfies its obligations under this Agreement.

2.13 Notice of Contact Information Change: It is the Participant's responsibility to ensure that its contact and address information in Section 3.29 (Communications) is current at all times. If SMAQMD is forced to pursue legal action and is unable to complete personal or substitute service on Participant, it will request court permission to serve notice by publication in the Sacramento Bee and The Daily Recorder, and will seek a default judgment if the Participant fails to timely respond to legal actions filed by SMAQMD.

2.14 Electric Vehicle Infrastructure Training Program Certification Requirements — Applies to California Air Resources Board (CARB) funded or authorized electric vehicle charging infrastructure and equipment under Assembly Bill (AB) 841; Stats. 2020, ch. 372, Section 4 added Section 740.20 to the Public Utilities Code.

2.14.1 Provisions: For any work performed after January 1, 2022, the following requirements apply:
( )

All Electric Vehicle (EV) infrastructure and equipment on the customer side of the electrical meter that is funded or authorized, in whole or in part by CARB must meet specified labor certification requirements (i.e. installed by contractors with the appropriate license classification as determined by the Contractors State License Board).

Specifically, at least one electrician on each crew, at any given time, must hold an Electric Vehicle Infrastructure Training Program (EVITP) certification; and (ii) Projects funded or authorized, in whole or in part, by CARB that install a charging port supplying 25 kilowatts (kW) or more, must have at least 25 percent of the total electricians working on the crew for the project, at any given time, hold an Electric Vehicle Infrastructure Training Program (EVITP) certification; and One member of each crew may be both the contractor and an EVITP certified electrician.

2.14.2 The requirements stated in Section 2.14.1(i) do not apply to any of the following:
(i) Electric vehicle charging infrastructure installed by employees of an electrical corporation or local publicly owned electric utility.
(ii) Electric vehicle charging infrastructure funded by moneys derived from credits generated from the Low Carbon Fuel Standard Program (Subarticle 7 (commencing with Section 95480) of Article 4 of Subchapter 10 of Chapter 1 of Division 3 of Title 17 of the California Code of Regulations).
(iii) Single-family home residential electric vehicle chargers that can use an existing 208/240- volt outlet.

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009

DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

3.0 General Terms and Conditions

3.1 Term: Not Applicable, see Paragraph 2.12 (Term).

3.2 Inspections: Not Applicable, see Section 2.5 (Inspections and Audits).

3.3 Prohibition on Emission Reduction Credits: Not Applicable.

3.4 Prohibition on Vocation Change: Not Applicable.

3.5 Voluntary Act: The Participant's purchase of the New Equipment is a completely voluntary act and SMAQMD has not made representations or guarantees to the Participant regarding the New Equipment.

3.6 Insurance: The Participant must maintain the insurance coverage described in Exhibit D for the entire term of this Agreement and any extensions to the Agreement. The Participant must name SMAQMD as an additional insured and loss payee. The Participant must obtain and transmit to SMAQMD a yearly Certificate of Insurance from the Insurance Company(ies) listing SMAQMD as additional insureds and loss payees, and obligating the Company(ies) to provide at least 30 days notice to the Participant and SMAQMD in the event of a change in, cancellation of, non-renewal of, reduction in coverage under, or termination of any policy listed on the certificate for any reason whatsoever. If the Participant fails to obtain the required certificate of insurance, or if the required insurance lapses, this Agreement may be terminated by SMAQMD immediately.

3.7 Notice of Significant Events: Partic pant will provide to SMAQMD prompt written notice of any of the following events:
(i) Any pending litigation or governmental action that may have a material adverse effect on Participant's ability to operate its business in the ordinary course, or Participant's ability to perform this Agreement.
(ii) Any change in its name, adoption of a fictitious business name, change in the location of its principal place of business, change in its business structure (such as from a sole proprietorship to a corporation), any proposed sale or transfer of substantially all its operating assets, or any proposed sale or transfer of 20.0% of its equity ownership or control. (iii) The filing of any petition in bankruptcy by or against Partic pant. (iv) The occurrence of any catastrophic loss to Participant, Participant's principal place of business, or Participant's operating assets.
(v) Damage to the New Equipment greater than 10% of its fair market value at the time of damage. (vi) Repossession of the New Equipment.

3.8 Ability to Perform: If either of the events listed in this paragraph occur, the Participant must notify SMAQMD within 30 days of the date Participant knows, or should have known, that the event has occurred or is likely to occur:

The Participant suffers catastrophic loss.
(ii) Any other event has occurred or is likely to occur that could impair the Participant's ability to perform the conditions of this Agreement.

3.9 Amendment: No amendment, alteration or variation of the terms of this Agreement is valid unless made in writing and signed by all parties.

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009

DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

3.10 Assignments: No performance rendered or payment due under this Agreement may be delegated or assigned without the written consent of Participant, CARB and SMAQMD. If Participant assigns any of its rights or obligations under this contract, all of the terms and conditions of this contract will apply to the Participant's assignee.

3.11 Non-Discrimination: Not Applicable.

3.12 Subcontracts: If the Participant submitted the name of a subcontractor in the proposal or application for this Agreement, SMAQMD's approval of the Agreement is also an approval of the use of the named subcontractor. In the event that any part of this Agreement is subcontracted, Participant agrees to document the following affirmative steps for utilizing Minority Business Enterprises (MBE) or Women Owned Business Enterprises (WBE) as required by the Environmental Protection Agency:

Include MBEs and WBEs on solicitation lists.
(ii) Assure MBEs and WBEs are solicited once they are identified. (iii) Divide total requirements into smaller tasks to permit maximum MBE/WBE participation, where feasible.
(iv) Establish delivery schedules which will encourage MBE and WBE participation, where feasible. (v) Encourage use of the services of the U.S. Department of Commerce's Minority Business Development Agency (MBDA) and the U.S, Small Business Administration to identify MBEs and WBEs.

3.13 Successors: This Agreement will bind the successors of SMAQMD and Participant in the same manner as if they were expressly named.

3.14 Recordkeeping: Not Applicable. See Section 2.9 (Recordkeeping and Reporting Requirements).

3.15 Termination Notice Requirements:

3.15.1 30-day Notice Termination: Either SMAQMD or Participant may terminate this Agreement for any reason by giving the other party 30-days written notice.

3.15.2 5-day Notice Termination: SMAQMD, through its APCO, may terminate this Agreement with 5 days written notice if Participant fails to perform any of the terms and conditions of this Agreement in the time and manner specified.

3.15.3 Immediate Termination: SMAQMD, through its APCO, may terminate this Agreement immediately if informed that moneys to fund the contract are not available. If SMAQMD terminates this Agreement under this paragraph, it will serve notice of the action on the Participant within 10 working days.

3.16 Waiver of Claims: Participant waives any claims against SMAQMD, CARB, its officers, agents, employees, delegates or volunteers from damage or loss caused by:
(i) Any suit or proceeding directly or indirectly attacking the validity of this Agreement, or any part of this Agreement.
(ii) Any judgment or award declaring this Agreement either void or voidable, or delaying the performance of any part of this Agreement.

3.17 Waiver of Agreement Provisions: No waiver or modification of this Agreement will be binding upon either party unless made in writing and signed by a duly authorized representative of that party and no failure or delay in enforcing any right will be deemed a waiver. A waiver of a particular breach, or default, will not be deemed to be a waiver of any other subsequent breach or default.

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009

DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

3.18 Time: Time is of the essence with respect to the timely performance of each provision of this Agreement.

3.19 Severability: If any provision of this Agreement is held invalid or unenforceable, its invalidity or unenforceability will not affect any other provisions of this Agreement, and this Agreement will be construed and enforced as if such provision had not been included.

3.20 Venue and Choice of Law: This Agreement is executed in Sacramento County, California and will be governed by the laws of the State of California. Any action arising out of this Agreement must be filed in a state court or federal court located in Sacramento, California.

3.21 Compliance with Laws and Regulations: Participant must observe and comply with all applicable laws and regulations. In addition to all other applicable laws, this Agreement is subject to the provisions and limitations of Health & Safety Code. Notwithstanding the terms of this Agreement, the Parties are not permitted to undertake any actions that contravene the Health & Safety Code or any other law or regulation.

3.22 Payments that Contravene the Law: SMAQMD and CARB have no liability for payments that are found to contravene the law. Participant will reimburse SMAQMD for any payments made by SMAQMD to Participant and later determined to contravene federal, state or local laws and regulations.

3.23 Status of Participant: This Agreement is only for the payment of incentive funds to offset the cost of the items identified in Exhibit C. Accordingly, Participant, its employees, consultants and subcontractors do not have any of the entitlements of a CARB or SMAQMD employee. Participant is an independent contractor.

3.23.1 Direction of Third Parties: If the Participant employs any third persons, these persons will be under the exclusive control of Participant. All terms of employment, including but not limited to hours, wages, working conditions, discipline, hiring, and discharging will be determined by Participant.

3.23.2 Right to Bind: Neither the Participant nor its employees, subcontractors or consultants have the right to act on behalf of CARB or SMAQMD in any capacity, or to bind CARB or SMAQMD to any obligation.

3.23.3 Taxes: Neither CARB nor SMAQMD will make any deductions or withholdings from the compensation paid to Participant. Participant must issue all forms required by federal and state laws for income and employment tax purposes for all of Participant's assigned personnel.

3.24 Conflict of Interest: No officer or employee of CARB or SMAQMD has any pecuniary interest, direct or indirect, in this Agreement or the proceeds of the Agreement. No officer or employee of Participant may serve on CARB or SMAQMD's governing body or hold any CARB or SMAQMD position which by rule, practice, or action nominates, recommends, supervises or authorizes the development or execution of this Agreement, or any payment to Participant.

3.25 Indemnity: The Participant must indemnify and defend SMAQMD, CARB, their officers, agents, employees, delegates and volunteers, from any and all losses, costs, damages, fines or expenses (including attorneys fees, court costs and expert fees) or liability of any kind or character to any person or property that:
(i) Arises from, or are alleged to arise from, any breach of the responsibilities required of Participant by this Agreement, or
(ii) Are related in any way to the New Equipment described in Exhibit C, including any and all liability for general, special, consequential, or other damages arising from the use of the New Equipment by Participant, for which financial assistance or other incentives are received from SMAQMD by Participant.

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009

DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

3.26 Force Majeure: If performance by CARB, SMAQMD, or the Participant of any of its obligations or undertakings under this Agreement is interrupted or delayed by any occurrence not occasioned by the conduct of either party to this Agreement, whether that occurrence is an act of God or public enemy, or whether that occurrence is caused by war, riot, storm, earthquake, or other natural forces, or by the acts of anyone not a party to this Agreement, then CARB, SMAQMD or the Participant may be either excused from any further performance or excused from any further performance for whatever period of time after the occurrence is reasonably necessary to remedy the effects of that occurrence at the election of CARB and SMAQMD.

3.27 Two Originals: This Agreement and any modification to this Agreement will be executed in two originals, one to be kept by SMAQMD and one to be kept by the Participant. Either of the originals is enforceable without the presentation of the other original.

3.28 Entire Agreement: This Agreement constitutes the entire Agreement between SMAQMD and Participant.

All parties revoke all prior or contemporaneous oral or written Agreements between them that are inconsistent with this Agreement. In the event of a dispute between the parties regarding the Agreement, this Agreement will be deemed to have been drafted by the parties in equal parts so that no presumptions or inferences concerning its terms or interpretation may be construed against any party to this Agreement.

This Agreement consists of the following parts:
(I) This Agreement
(ii) Exhibit A — Map of Federal Sacramento Ozone Nonattainment Area (iii) Exhibit B — New Equipment Information Form
(iv) Exhibit C — Performance Requirements
(v) Exhibit D — Insurance Requirements
(vi) Exhibit E — Joint Funding Information (if applicable) (vii) Exhibit F — Debarment Certification
(viii) Exhibit G — Levine Act Disclosure Statement
(ix) Exhibits H to Y intentionally left blank
(x) Exhibit Z — Verified Information of New Equipment & (if applicable) New Termination Date for Agreement

3.29 Communications: Correspondence between SMAQMD and Participant should be addressed to the following:

To SMAQMD To Participant
Steffani Charkiewicz
Sacramento Metropolitan AQMD
777 12th Street, Third Floor
Sacramento, CA 95814-1908
Phone: (916) 201-8488
Fax (916) 874-4899
Fedolia Harris
City of Sacramento
5730 24th Street, Bldg 4
Sacramento, CA 95822
Phone: (916) 808-7118
Fax:

The address and/or contacts may be changed by written notice to the other party. Such written notice may be given by mail, using the U.S. Postal Service, or personal service.

3.30 Authority to Bind and Acknowledgement of Terms: The undersigned representative of Participant has read and agrees to comply with all terms and conditions in this Agreement and also affirmatively states that he or she has legal authority to bind Participant to the terms and conditions of this Agreement; including the following Disclosure Agreement:

DISCLOSURE AGREEMENT
The undersigned representative of Participant affirmatively states that neither they nor any other representative of Participant will submit another application or sign another contract for the same New Equipment described in Exhibit B with any other source of LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009

DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243 funds, including but not limited to other air districts or multidistrict funding under the Carl Moyer Program.

Any owner or owner's designee who is found to have submitted multiple applications or signed multiple contracts for the same New Equipment will, at a minimum, be disqualified from funding for that New Equipment from all sources, may be required to reimburse the public agencies for any monies received, and may also be banned from submitting future applications to any and all Program solicitations. In addition, if noncompliance or nonperformance under this agreement also constitutes a violation of the Health and Safety Code, including but not limited to the Program and it's implementing Guidelines, CARB and SMAQMD may levee fines and refer the violations for criminal enforcement.

Approved by City of Sacramento
(pitAA, (Last6IA,
Assistant City Manager
Date: 1/26/2023

Approved by the Sacramento Metropolitan Air Quality Management District au/fa ayabk, Date: 2/1/2023
)., M.S.E.

Executive Director/ Air Pollution Control Officer
Reviewed By:

Kathrine Pittard
District Counsel
LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009

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DocuSign Envelope lD: 248389A4-CDBF-4293-9D9C-11C956012243 r

FEDERAL AIR QUALITY

PLANNING BOUNDARIES
Sutter

OZONE AREAS
CO MAINTENANCE AREA (Sacrartrenti, Urbanized Areal

COUNTY BOUNDARIES
- URBAN AREA BOUNDARIES

FEDERAL AND STATE HIGHWAYS
Sacramento Courty Is a 5M-10 rionattarnreert Area
Number, under doulty names are. 1998 Popuratior estimates

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SACRAMENTO OZONE

NONATTAINMENT AREA
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008939
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B1 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: SMQV008940
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B2 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: SMQV008941
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B3 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008942
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B4 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008943
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B5 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008944
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B6 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008945
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B7 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008946
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B8 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008947
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B9 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008948
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B10 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008949
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B11 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: SMQV008950
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B12 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: SMQV008951
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B13 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008952
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B14 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008953
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B15 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008954
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B16 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008955
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B17 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008956
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B18 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008957
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B19 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008958
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B20 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008959
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B21 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: SMQV008960
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B22 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: SMQV008961
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B23 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008962
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B24 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008963
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B25 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008964
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B26 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008965
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B27 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008966
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B28 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008967
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B29 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008968
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B30 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008969
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B31 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: SMQV008970
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B32 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: SMQV008971
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B33 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008972
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B34 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008973
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B35 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008974
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B36 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008975
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B37 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008976
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B38 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008977
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B39 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008978
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B40 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008979
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B41 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: SMQV008980
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B42 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: SMQV008981
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B43 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008982
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B44 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008983
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B45 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008984
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B46 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008985
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B47 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008986
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B48 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT B

LOWER EMISSION VEHICLE INCENTIVE PROGRAM

NEW EQUIPMENT INFORMATION FORM
Participant must purchase and begin operation within 180 days upon Agreement execution SMAQMD Vehicle ID #: 5MQV008987
Vocation(s) (Please list all equipment uses):

Equipment: INFRASTRUCTURE Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelinci or Enerciv Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page B49 of B49
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT C

PERFORMANCE REQUIREMENTS
The below listed New Equipment must meet the minimum performance requirements shown to avoid reimbursement according to Paragraph

2.8 (Reimbursements) of this Agreement
SMAQMD Vehicle
ID #,
New Equipment
Information*
Equipment
Serial Numbers*
Minimum Annual
Usage
Total Usage Anticipated Annual NOx
Reduction (tons)
Description of
Additional
Performance
Requirements (if
applicable)
Maximum
Incentive
Amount
SMAQMD Vehicle ID #:

SMQV008939
Must Report
Annual Usage
Must Report
Annual Usage
EVSE / Alternative
Fueling Station does not
generate any emissions
reductions
See Note 1 $6,300
SMAQMD Vehicle ID #:

SMQV008940
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:

SMQV008941
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:
5MQV008942
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:
5MQV008943
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $29,160
SMAQMD Vehicle ID #:
5MQV008944
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:
5MQV008945
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $26,820
SMAQMD Vehicle ID #:
5MQV008946
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:
5MQV008947
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:
5M0V008948
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:

SMQV008949
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:
5MQV008950
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $22,860
LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page C1 of C4
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243 SMAQMD Vehicle ID #:

SMQV008951
Must Report
Annual Usage
Must Report
Annual Usage
EVSE / Alternative
Fueling Station does not
generate any emissions
reductions
See Note 1 $5,100
SMAQMD Vehicle ID #:
5MQV008952
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $22,284
SMAQMD Vehicle ID #:
5MQV008953
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:

SMQV008954
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $31,620
SMAQMD Vehicle ID #:
5MQV008955
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:
5M0V008956
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:
5MQV008957
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $36,480
SMAQMD Vehicle ID #:
5MQV008958
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:
5MQV008959
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $16,620
SMAQMD Vehicle ID #:
5MQV008960
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:

SMQV008961
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:
5MQV008962
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:
5M0V008963
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $19,530
SMAQMD Vehicle ID #:
5M0V008964
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:

SM0V008965
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:
5MQV008966
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:

SM0V008967
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:
5MQV008968
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page C2 of C4
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243 SMAQMD Vehicle ID #:

SMQV008969
Must Report
Annual Usage
Must Report
Annual Usage
EVSE / Alternative
Fueling Station does not
generate any emissions
reductions
See Note 1 $37,020
SMAQMD Vehicle ID #:
5MQV008970
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:

SMQV008971
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:

SMQV008972
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $19,140
SMAQMD Vehicle ID #:
5MQV008973
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:
5MQV008974
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:
5M0V008975
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $25,680
SMAQMD Vehicle ID #:
5MQV008976
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:
5M0V008977
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:
5MQV008978
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $40,140
SMAQMD Vehicle ID #:
5M0V008979
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:
5MQV008980
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:

SMQV008981
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $18,690
SMAQMD Vehicle ID #:
5MQV008982
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:

SM0V008983
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:
5MQV008984
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:

SM0V008985
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $6,300
SMAQMD Vehicle ID #:
5MQV008986
Must Report
Annual Usage
Must Report
Annual Usage See Note 1 $36,360
LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page C3 of C4
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243 Total CMP: 0.00 $595,404
* SMAQMD will fill in information upon verification of project completion.

Note 1: Participant must annually provide the SMAQMD with the following data for the entire term of this Agreement:
(A) Qualitative description of public and private uses. (B) Annual usage per EVSE charger (e.g. kilowatt-hour) and the number of plug-in events. EVSE must have smart meters or other SMAQMD- approved usage meters installed.
(C) Annual usage per Alternative Fueling Station dispenser (e.g. kilograms or standard cubic feet). (D) Any unscheduled downtime, including duration of downtime and causes of downtime.

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page C4 of C4
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT D

INSURANCE REQUIREMENTS
Verification of Coverage
Participant must furnish SMAQMD with certificates evidencing the coverage required below. Certified copies of required endorsements must be attached to provided certificates. All certificates are to be received and approved by SMAQMD before work commences. SMAQMD reserves the right to require Participant to provide complete, certified copies of any policy of insurance offered in compliance with these specifications. As an alternative to insurance certificates, Participant's insurer may voluntarily provide complete, certified copies of all required insurance policies, including endorsements, affecting the coverage required by these specifications.

SMAQMD will be named as additional insured and loss payee on all required insurance policies for the New Equipment funded by this Agreement.

Minimum Scope of Insurance
During the term of this Agreement, Participant must, at its sole expense, obtain and maintain in full force and affect the type and limits of liability requirements as follows:

Coverage must be at least as broad as:

1. Insurance Services Office Commercial General Liability coverage (occurrence form CG 0001, most recent edition).

2. Worker's Compensation insurance as required by the State of California.

3. Verification of insurance coverage equal to the replacement costs of the New Equipment included in this project.

Minimum Limits of Insurance
Participant must maintain limits no less than:

1. General Liability: $1,000,000 per occurrence for bodily injury, personal injury and property damage. If Commercial General Liability Insurance or other form with a general aggregate limit is used, either the general aggregate limit must apply separately to this project/location or the general aggregate limit must be twice the required occurrence limit.

2. Worker's Compensation: Statutory.

3. Property Loss or Damage: Equal to the full replacement cost.

Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M. Best's rating of no less than A:VII. SMAQMD Liability and Property Insurance Manager may waive or alter this requirement, or accept self-insurance in lieu of any required policy of insurance if, in the opinion of the Risk Manager, the interests of SMAQMD and the general public are adequately protected.

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page D1 of D1
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT E

JOINT FUNDING INFORMATION (IF APPLICABLE)
The funding entity names and funding amounts provided by each entity are shown below.

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page El of El
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT F

DEBARMENT CERTIFICATION FORM
The Participant certifies that, neither the Participant nor any owner, partner, director, officer, or principal of the Participant, nor any person in a position with management responsibility or responsibility for the administration of federal funds:
(a) Is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal or state department/agency; (b) Has within a three-year period preceding this certification been convicted of or had a civil judgment rendered against it for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public transaction or contract (federal, state, or local); violation of federal or state antitrust statutes; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;
(c) Is presently indicted for or otherwise criminally or civilly charged by a governmental entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (b) above; or (d) Has within a three-year period preceding this certification had one or more public transactions or contracts (federal, state, or local) terminated for cause or default.

The Participant further certifies that it shall not knowingly enter into any transaction with any subcontractor, material supplier, or vendor who is debarred, suspended, declared ineligible, or voluntarily excluded from covered transactions by any federal or state department/agency.

Dated this 26 day of January , 20 23
By_ (,LbitA,G
e for Participant
Leyne Milstein, Assistant City Manager
Printed Name and Title
City of Sacramento
Participant and Type of Entity (Corp., Partnership, Sole Proprietor) 5730 24th Street, Bldg 4
Address
Sacramento, CA 95822
City/State/Zip Code
(916) 808-7118, [email protected]
Area Code/Telephone Number and E-Mail Address
LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page F1 of F1
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT G

LEVINE ACT DISCLOSURE STATEMENT
California Government Code § 84308, commonly referred to as the "Levine Act," precludes an Officer of a local government agency from participating in the award of a contract if they received political contributions totaling more than $250 in the 12 months preceding the contract award, and for three months following the final decision, from the contract recipient. This prohibition applies to contributions to the Officer, or received by the Officer on behalf of any other Officer, or on behalf of any candidate for office or on behalf of any committee. The Levine Act also requires disclosure of such contributions by a party to be awarded a specified contract.

Current members of the SMAQMD Board of Directors are: (as of 1/28/2021; check for current list) Eric Guerra
Patrick Kennedy
Mai Vang
Kevin Papineau
Sarah Aquino
Sean Loloee
Jeff Harris
Bobbie Singh-Allen
Sue Frost
Bret Daniels
Donald Terry
Don Nottoli
Rich Desmond
Phil Serna

1. Have you or your company, or any agent on behalf of you or your company, made any political contributions of more than $250 to any SMAQMD Director(s) in the 12 months preceding the date of the issuance of this request for proposal or request for qualifications? YES x NO
If yes, please identify the Director(s):

2. Do you or your company, or any agency on behalf of you or your company, anticipate or plan to make any political contributions of more than $250 to any SMAQMD Director(s) in the three months following the award of the contract?
YES )( NO
If yes, please identify the Director(s):

Answering yes to either of the two questions above does not preclude SMAQMD from awarding a contract to your firm. It does, however, preclude the identified Director(s) from participating in the contract award process for this contract.

1/26/2023 (pitAA,

DATE JATURE OF AUTHORIZED OFFICIAL)
Leyne Milstein, Assistant City Manager
(TYPE OR WRITE APPROPRIATE NAME, TITLE)
City of Sacramento
(TYPE OR WRITE NAME OF COMPANY)
LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page G1 of G1
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT Z
Section (i)
Verified Information of New Equipment & (if applicable) New Termination Date for Agreement Exhibit Z will be added to Agreement # VET-22-0009 after the Agreement is executed and the Post-inspection identified in Paragraph 2.5.1 (Post-inspection) for each New Equipment has been completed. All information in Exhibit Z will supersede the New Equipment information in Exhibit B and the performance requirements in Exhibit C.

Exhibit Z will also supersede the funding allocation for each New Equipment in Exhibit C, provided that the total contract amount does not exceed: (a) the original Total Maximum Incentive Amount identified in Exhibit C and Paragraph 2.2.1 (Payment) of the Agreement and (b) the funding for each New Equipment does not exceed the Program Guideline allowances.

If the project implementation timeframe is less than the project credit life due to the date of the last New Equipment Post-inspection, then the new Agreement termination date is: . The new Agreement termination date in Exhibit Z will supersede the original Agreement termination date identified in Paragraph 2.12 (Term).

Approved by City of Sacramento
(SAMPLE — DO NOT SIGN)
Date:

Leyne Milstein
Assistant City Manager
Approved by the Sacramento Metropolitan Air Quality Management District (SAMPLE — DO NOT SIGN)
Date:

Raef Porter
Program Manager, Transportation & Climate Change Division LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page Z1 of Z3
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT Z
Section (ii)

NEW EQUIPMENT INFORMATION FORM
SMAQMD Vehicle ID #:

Vocation(s) (Please list all equipment uses):

Equipment: Project Type:

Equipment Location Address:

Infrastructure Category (select one):
▪ Electric Vehicle Supply Equipment (EVSE) / Battery Charging Station ▪ Alternative Fueling Station, such as Hydrogen or Natural Gas ▪ Other:

Fuelina or Enerav Infrastructure
Manufacturer: Model: Date of Manufacturer:

Serial Number: Fleet Identification Number: Meter Reading:

Amperage/Voltage (if applicable): Equipment Recharge Rate (if applicable): Number of Ports / Dispensers:

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page Z2 of Z3
DocuSign Envelope ID: 248389A4-CDBF-4293-9D9C-11C956012243

EXHIBIT Z
Section (iii)

PERFORMANCE REQUIREMENTS
The below listed New Equipment must meet the minimum performance requirements shown to avoid reimbursement according to Paragraph

2.8 (Reimbursements) of this Agreement
SMAQMD Vehicle ID #,
New Equipment Information*
Equipment
Serial Numbers*
Minimum
Annual Usage
Total Usage
Anticipated
Annual NOx
Reduction
(tons)
Description of
Additional
Performance
Requirements (If
applicable)
Maximum
Incentive
Amount
SMAQMD Vehicle ID #: Must Report
Annual Usage
Must Report
Annual Usage
EVSE /
Alternative
Fueling
Station does
not generate
any
emissions
reductions
See Note 1
Total CMP:
* SMAQMD will fill in information upon verification of project completion.

Note 1: Participant must annually provide the SMAQMD with the following data for the entire term of this Agreement:
(A) Qualitative description of public and private uses. (B) Annual usage per EVSE charger (e.g. kilowatt-hour) and the number of plug-in events. EVSE must have smart meters or other SMAQMD- approved usage meters installed.
(C) Annual usage per Alternative Fueling Station dispenser (e.g. kilograms or standard cubic feet). (D) Any unscheduled downtime, including duration of downtime and causes of downtime.

LEVIP Participant Agreement — Fueling & Energy Infrastructure v.1.5 1/25/2023 Rev. 04-27-2021
Agreement Number: VET-22-0009
Page Z3 of Z3