bcap0021-150804v01.pdf

This form is available electronically. Form Approved – OMB No. 0560-0082

BCAP-21 U.S. DEPARTMENT OF AGRICULTURE

(08-04-15) Commodity Credit Corporation

BIOMASS CROP ASSISTANCE PROGRAM (BCAP)

PROJECT AREA PROPOSAL ESTIMATES

For CCC Use Only 1A. Approved Project

Area ID Number 1B. Date Assigned

(MM-DD-YYYY)

NOTE: The following statement is made in accordance with the Privacy Act of 1974 (5 USC 552a as amended). The authority for requesting the information identified on this form is 7 CFR Part 1450, the Commodity Credit Corporation Charter Act (15 U.S.C. 714 et seq.), and the Agricultural Act of 2014 (Pub. L. 113-79). The information will be used to determine eligibility to participate in and receive benefits under the Biomass Crop Assistance Program through documentation of the project sponsor’s project area proposal estimates. The information collected on this form may be disclosed to other Federal, State, Local government agencies, Tribal agencies, and nongovernmental entities that have been authorized access to the information by statute or regulation and/or as described in applicable Routine Uses identified in the System of Records Notice for USDA/FSA-2, Farm Records File (Automated). Providing the requested information is voluntary. However, failure to furnish the requested information will result in a determination of ineligibility to participate in and receive benefits under the Biomass Crop Assistance Program.

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0560-0082. The time required to complete this information collection is estimated to average 10 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The provisions of appropriate criminal and civil fraud, privacy, and other statutes may be applicable to the information provided. RETURN THIS COMPLETED FORM WITH YOUR PROJECT AREA PROPOSAL.

This form is to be submitted to the State office where the majority of the proposed project area is located.

PART A – ANNUAL PAYMENTS (TO BE COMPLETED BY CCC)

2. Project Proposal Cost Estimate -- Annual Payments

Annual Contracts Payments

A.

Total

Acreage

B.

Weighted Average

Contract Payment Rate for Project Area

X C.

Estimated Total Annual Contract

Payments

(1) Total Cropland Enrollment Goal (BCAP-20, Item 9A) X $/Acre 5 Years = $

(2) Total Cropland Enrollment Goal (BCAP-20, Item 9A) X $/Acre 15 Years = $

(3) Total Non-Crop Agland Enrollment Goal (BCAP-20, Item 9B ) X $/Acre 5 Years = $

(4) Total Non-Crop Agland Enrollment Goal (BCAP-20, Item 9B ) X $/Acre 15 Years = $

(5) Total Non-Industrial Private Forest Land (NIPF) Enrollment Goal (BCAP-20, Item 9C) X $/Acre 5 Years = $

(6) Total Non-Industrial Private Forest Land (NIPF) Enrollment Goal (BCAP-20, Item 9C) X $/Acre 15 Years = $

(7) TOTALS $

PART B – ESTABLISHMENT PAYMENTS (TO BE COMPLETED BY CCC) (If more space is needed, see Page 4)

3. Project Proposal Cost Estimate -- Establishment Payments (Summarize the Acreage for each Unique Energy Crops to be Planted)

A.

Energy Crops

B.

Summarize Total

Acreage

C.

50% Or Not To Exceed

$500/Acre Establishment Rate/Acre (Estimate)

D.

Total Estimated

Establishment Payment

Perennial Crops:

(1) Designated Perennial Energy Crop 1.

(List Common Name)

X $/Acre = $

(2) Designated Perennial Energy Crop 2.

(List Common Name)

X $/Acre = $

(3) Designated Perennial Energy Crop 3.

(List Common Name)

X $/Acre = $

(4) Designated Perennial Energy Crop 4.

(List Common Name)

X $/Acre = $

(5) TOTALS $

NOTE: Exclude all Annual Crops (These are not eligible for Establishment Payment) The U.S. Department of Agriculture (USDA) prohibits discrimination against its customers, employees, and applicants for employment on the basis of race, color, national origin, age, disability, sex, gender identity, religion, reprisal, and where applicable, political beliefs, marital status, familial or parental status, sexual orientation, or all or part of an individual’s income is derived from any public assistance program, or protected genetic information in employment or in any program or activity conducted or funded by the Department. (Not all prohibited bases will apply to all programs and/or employment activities.) Persons with disabilities, who wish to file a program complaint, write to the address below or if you require alternative means of communication for program information (e.g., Braille, large print, audiotape, etc.) please contact USDA’s TARGET Center at (202) 720-2600 (voice and TDD). Individuals who are deaf, hard of hearing, or have speech disabilities and wish to file either an EEO or program complaint, please contact USDA through the Federal Relay Service at (800) 877-8339 or (800) 845-6136 (in Spanish).

If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at http://www.ascr.usda.gov/complaint_filing_cust.html , or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter by mail to U.S. Department of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, by fax (202) 690-7442 or email at program.intake@usda.gov. USDA is an equal opportunity provider and employer.

BCAP-21 (08-04-15) Page 2 of 4

PART C – PROJECT CRITERIA

4. Project Impacts - The Project Sponsor Submits the Following Estimates. Please attach additional supporting documentation if estimates are not supported by material attached to the BCAP-20. (Check Only One that Applies):

A. Criteria 1 The volume of the eligible crops proposed to be produced in the proposed project area and the probability that such crops will be used for BCAP purposes.

This factor is to be scored based on the expected likelihood that the designated crops are suitable to be produced within the project area AND the proposed annual tonnage that will be utilized by the Biomass Conversion Facility (BCF) for BCAP purposes when the project is fully operational.

% of BCF expected annual biomass needs fulfilled by BCAP contract crops.

B. Criteria 2 The volume of renewable biomass projected to be available from sources other than the eligible crops grown on contract acres.

This volume is based on the expected tonnage volume from non-BCAP contract sources of biomass for the BCF’s use in relationship to the BCF’s total annual biomass needs located within an economically viable distance of the BCF.

% of BCAP expected annual biomass needs fulfilled by material from non-BCAP contract lands.

NOTE: “Expected annual biomass needs” includes current and future biomass harvesting and collection from plants already or routinely established when the project proposal is submitted. This also includes biomass that also qualifies only for BCAP matching payments.

C. Criteria 3 The anticipated economic impact in the proposed project area.

This volume is the number of new full-time permanent jobs the facility and project area is expected to create when fully implemented.

% new jobs

D. Criteria 4 The opportunity for producers and local investors to participate in the ownership of the biomass conversion facility in the proposed project area.

Enter percent ownership of the biomass conversion facility by local investors in the project area.

% owned locally

E. Criteria 5 The participation rate by beginning or socially disadvantaged farmers or ranchers (as defined in program regulations).

This percentage is based on the expected participation rates by socially disadvantaged and beginning farmers and ranchers combined.

% of participation

F. Criteria 6 The impact on soil, water, and related resources.

These factors characterize the expected impact the proposed project will have on soil, water, air, plant, and animal resources with the project area when compared to current land use.

(1) Soil Erosion Will overall soil erosion decrease?

YES

NO

(2) Soil Quality Will overall soil quality improve?

YES

NO

(3) Water Quality Will overall water quality improve?

YES

NO

(4) Water Quantity Will overall water quantity increase?

YES

NO

(5) Air Quality Will overall air quality improve?

YES

NO

(6) T&E Plant and Animal Species

Will the project area have a positive impact on any threatened or endangered plant or animal species?

YES

NO

BCAP-21 (08-04-15) Page 3 of 4 F. Criteria 6 The impact on soil, water, and related resources (Continuation).

(7) Wildlife Will overall wildlife habitat improve?

YES

NO

G. Criteria 7 The variety in biomass production approaches within a project area, including, as appropriate, agronomic conditions, harvest and postharvest practices, and monoculture and polyculture crop mixes.

(1) Variety of Agronomic Conditions

Project area suitability of agronomic conditions.

Is the proposed project area suitable?

YES

NO

(2) Variety of Harvest and Post Harvest Practices

Project area suitability to support, (or potential ability and economical adaptability to support), a variety of harvest and post harvest practices for biomass processing and handling.

Is the proposed project area suitable?

YES

NO

(3) Variety of Crop Mixes

Project area variety of energy crops or plant varieties.

Please enter the number of eligible crops included in the proposed project area:

PART D- CERTIFICATION

I certify that: 1) I am the project sponsor for this project proposal, 2) the above information and supporting documents are true and complete to my knowledge and comply with 7 CFR Part 1450, 3) I have provided this form for the purpose of proposing the geographic project area delineated in the proposal. This document is part of a series of documents related to the BCAP project area program. The BCAP matching payments program has its own separate documentation that must be completed before any participation in that part of BCAP. Project areas are subject to CCC approval and the availability of funds.

I am aware that approval of a proposal will only quality certain producers for contracting acreage for establishment and annual payments.

Changes to the proposed project area geographic boundaries require approval by CCC and a new or amended environmental screening and/or assessment. I am aware that all information provided and activities conducted are subject to compliance review and to remedies under program regulations for misinformation and such remedies are in addition to any liability which may be incurred under various criminal and civil fraud statutes, including, but not limited to, 18 U.S.C. 1001 and 15 U.S.C. 714m. Payments will be subject to all program regulations and authorities.

5A. Signature (By) 5B. Title/Relationship of the Individual if Signing in a

Representative Capacity 5C. Date (MM-DD-YYYY)

PART E- TO BE COMPLETED BY CCC

6A. CCC Signature 6B. Date (MM-DD-YYYY)

BCAP-21 (08-04-15) Page 4 of 4

CONTINUATION OF ITEM 3

PART B – ESTABLISHED PAYMENTS (TO BE COMPLETED BY CCC)

3. Project Proposal Cost Estimate -- Establishment Payments (Summarize the Acreage for each Unique Energy Crops to be Planted

A.

Energy Crops

B.

Summarize Total

Acreage

C.

50% Or Not To Exceed

$500/Acre Establishment Rate/Acre (Estimate)

D.

Total Estimated

Establishment Payment

Perennial Crops:

(1) Designated Perennial Energy Crop 1.

(List Common Name) X $/Acre = $

(2) Designated Perennial Energy Crop 2.

(List Common Name)

X $/Acre = $

(3) Designated Perennial Energy Crop 3.

(List Common Name)

X $/Acre = $

(4) Designated Perennial Energy Crop 4.

(List Common Name)

X $/Acre = $

(5) Designated Perennial Energy Crop 5.

(List Common Name)

X $/Acre = $

(6) Designated Perennial Energy Crop 6.

(List Common Name)

X $/Acre = $

(7) Designated Perennial Energy Crop 7.

(List Common Name)

X $/Acre = $

(8) Designated Perennial Energy Crop 8.

(List Common Name)

X $/Acre = $

(9) Designated Perennial Energy Crop 9.

(List Common Name and Scientific Name)

X $/Acre = $

(10) Designated Perennial Energy Crop 10.

(List Common Name)

X $/Acre = $

(11) Designated Perennial Energy Crop 11.

(List Common Name)

X $/Acre = $

(12) Designated Perennial Energy Crop 12.

(List Common Name)

X $/Acre = $

(13) Designated Perennial Energy Crop 13.

(List Common Name)

X $/Acre = $

BCAP0021_xxxxxxV01 proposal 5 usda 9.0.0.2.20120627.2.874785 This form is available electronically.

Form Approved – OMB No. 0560-0082

BCAP

U.S. DEPARTMENT OF AGRICULTURE

(08-04-15) Commodity Credit Corporation

BIOMASS CROP ASSISTANCE PROGRAM (BCAP)

PROJECT AREA PROPOSAL ESTIMATES

For CCC Use Only 1A . Approved Project Area ID Number 1B. Date Assigned

(MM

DD

YYYY)

NOTE:

The following statement is made in accordance with the Privacy Act of 1974 (5 USC 552a as amended). The authority for requesting the information identified on this form is 7 CFR Part 1450, the Commodity Credit Corporation Charter Act (15 U.S.C. 714 et seq.), and the Agricultural Act of 2014 (Pub. L. 113-79). The information will be used to determine eligibility to participate in and receive benefits under the Biomass Crop Assistance Program through documentation of the project sponsor’s project area proposal estimates. The information collected on this form may be disclosed to other Federal, State, Local government agencies, Tribal agencies, and nongovernmental entities that have been authorized access to the information by statute or regulation and/or as described in applicable Routine Uses identified in the System of Records Notice for USDA/FSA-2, Farm Records File (Automated). Providing the requested information is voluntary. However, failure to furnish the requested information will result in a determination of ineligibility to participate in and receive benefits under the Biomass Crop Assistance Program.

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0560-0082. The time required to complete this information collection is estimated to average 10 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The provisions of appropriate criminal and civil fraud, privacy, and other statutes may be applicable to the information provided. RETURN THIS COMPLETED FORM WITH YOUR PROJECT AREA PROPOSAL.

This form is to be submitted to the State office where the majority of the proposed project area is located.

PART A

ANNUAL

PAYMENTS

TO BE COMPLETED BY

CCC

2. Project Proposal Cost Estimate -- Annual Payments Annual Contracts Payments A.

Total Acreage B.

Weighted Average Contract Payment Rate f or Project Area X C.

Estimated Total Annual Contract Payments

(1) Total Cropland Enrollment Goal (BCAP-20, Item 9A) X $/Acre 5 Years

(2) Total Cropland Enrollment Goal (BCAP-20, Item 9A) X $/Acre 15 Years

(3) Total Non-Crop Agland Enrollment Goal (BCAP-20, Item 9B ) X $/Acre 5 Years

(4) Total Non-Crop Agland Enrollment Goal (BCAP-20, Item 9B ) X $/Acre 15 Years

(5) Total Non-Industrial Private Forest Land (NIPF) Enrollment Goal (BCAP-20, Item 9C) X $/Acre 5 Years (6) Total Non Industrial Private Forest Land (NIPF) Enrollment Goal (BCAP-20, Item 9C) X $/Acre 15 Years (7)

TOTALS

PART B

ESTABLISH

MENT

PAYMENTS

TO BE COMPLETED BY

CCC

(If more space is needed, see Page 4)

3. Project Proposal Cost Estimate -- Establishment Payments (Summarize the Acreage for each Unique Energy Crops to be Planted) A.

Energy Crops B.

Summarize Total Acreage C 50% Or Not To Exceed $500/Acre Establishment Rate/Acre Est imate) D.

Total Estimated Establishment Payment Perennial Crops:

) Designated Perennial Energy Crop 1.

(List Common Name) X $/Acre ) Designated Perennial Energy Crop 2.

(List Common Name) X $/Acre ) Designated Perennial Energy Crop 3.

(List Common Name) X $/Acre ) Designated Perennial Energy Crop 4.

(List Common Name) X $/Acre (5)

TOTALS

NOTE:

Exclude all Annual Crops (These are not eligible for Establishment Payment) The U.S. Department of Agriculture (USDA) prohibits discrimination against its customers, employees, and applicants for employment on the basis of race, color, national origin, age, disability, sex, gender identity, religion, reprisal, and where applicable, political beliefs, marital status, familial or parental status, sexual orientation, or all or part of an individual’s income is derived from any public assistance program, or protected genetic information in employment or in any program or activity conducted or funded by the Department. (Not all prohibited bases will apply to all programs and/or employment activities.) Persons with disabilities, who wish to file a program complaint, write to the address below or if you require alternative means of communication for program information (e.g., Braille, large print, audiotape, etc.) please contact USDA’s TARGET Center at (202) 720-2600 (voice and TDD). Individuals who are deaf, hard of hearing, or have speech disabilities and wish to file either an EEO or program complaint, please contact USDA through the Federal Relay Service at (800) 877-8339 or (800) 845-6136 (in Spanish).

If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at http://www.ascr.usda.gov/complaint_filing_cust.html , or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter by mail to U.S. Department of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, by fax (202) 690-7442 or email at program.intake@usda.gov. USDA is an equal opportunity provider and employer.

BCAP-21

(08-04-15)

PART C – PROJECT CRITERIA

. Project Impacts The Project Sponsor Submits the Following Estimates Please attach additional supporting documentation if estimates are not supported by material attached to the BCAP 20.

(Check Only One that Applies A.

Criteria 1 The volume of the eligible crops proposed to be produced in the proposed project area and the probability that such crops will be used for BCAP purposes.

This factor is to be scored based on the expected likelihood that the designated crops are suitable to be produced within the project area

AND

the proposed annual tonnage that will be utilized by the Biomass Conversion Facility (BCF) for BCAP purposes when the project is fully operational.

% of BCF expected annual biomass needs fulfilled by BCAP contract crops.

B.

Criteria 2 The volume of renewable biomass projected to be available from sources other than the eligible crops grown on contract acres.

This volume is based on the expected tonnage volume from non-BCAP contract sources of biomass for the BCF’s use in relationship to the BCF’s total annual biomass needs located within an economically viable distance of the BCF.

% of BCAP expected annual biomass needs fulfilled by material from non-BCAP contract lands.

NOTE:

“Expected annual biomass needs” includes current and future biomass harvesting and collection from plants already or routinely established when the project proposal is submitted. This also includes biomass that also qualifies only for BCAP matching payments.

C.

Criteria 3 The anticipated economic impact in the proposed project area.

This volume is the number of new full-time permanent jobs the facility and project area is expected to create when fully implemented.

% new jobs D.

Criteria 4 The opportunity for producers and local investors to participate in the ownership of the biomass conversion facility in the proposed project area.

Enter percent ownership of the biomass conversion facility by local investors in the project area.

% owned locally E.

Criteria 5 The participation rate by beginning or socially disadvantaged farmers or ranchers (as defined in program regulations).

This percentage is based on the expected participation rates by socially disadvantaged and beginning farmers and ranchers combined.

% of participation F.

Criteria 6 The impact on soil, water, and related resources.

These factors characterize the expected impact the proposed project will have on soil, water, air, plant, and animal resources with the project area when compared to current land use.

(1) Soil Erosion Will overall soil erosion decrease?

YES

NO

(2) Soil Quality Will overall soil quality improve?

YES

NO

(3) Water Quality Will overall water quality improve?

YES

NO

(4) Water Quantity Will overall water quantity increase?

YES

NO

(5) Air Quality Will overall air quality improve?

YES

NO

(6) T&E Plant and Animal Species Will the project area have a positive impact on any threatened or endangered plant or animal species?

YES

NO

BCAP-21

(08-04-15) F.

Criteria 6 The impact on soil, water, and related resources (Continuation)

(7) Wildlife Will overall wildlife habitat improve?

YES

NO

G.

Criteria 7 The variety in biomass production approaches within a project area, including, as appropriate, agronomic conditions, harvest and postharvest practices, and monoculture and polyculture crop mixes.

(1) Variety of Agronomic Conditions Project area suitability of agronomic conditions.

Is the proposed project area suitable?

YES

NO

(2) Variety of Harvest and Post Harvest Practices Project area suitability to support, (or potential ability and economical adaptability to support), a variety of harvest and post harvest practices for biomass processing and handling.

Is the proposed project area suitable?

YES

NO

(3) Variety of Crop Mixes Project area variety of energy crops or plant varieties.

Please enter the number of eligible crops included in the proposed project area:

PART D

CERTIFICATION

I certify that: 1) I am the project sponsor for this project proposal, 2) the above information and supporting documents are true and complete to my knowledge and comply with 7 CFR Part 1450, 3) I have provided this form for the purpose of proposing the geographic project area delineated in the proposal. This document is part of a series of documents related to the BCAP project area program. The BCAP matching payments program has its own separate documentation that must be completed before any participation in that part of BCAP. Project areas are subject to CCC approval and the availability of funds.

I am aware that approval of a proposal will only quality certain producers for contracting acreage for establishment and annual payments. Changes to the proposed project area geographic boundaries require approval by CCC and a new or amended environmental screening and/or assessment. I am aware that all information provided and activities conducted are subject to compliance review and to remedies under program regulations for misinformation and such remedies are in addition to any liability which may be incurred under various criminal and civil fraud statutes, including, but not limited to, 18 U.S.C. 1001 and 15 U.S.C. 714m. Payments will be subject to all program regulations and authorities.

A. Signature (By) B. Title/Relationship of the Individual if Signing in a Representative Capacity C. Date

(MM

DD

YYYY)

PART

E

TO BE COMPLETED BY

CCC

A. CCC Signature B. Date

(MM

DD

YYYY)

BCAP-21

(08-04-15)

CONTINUATION OF ITEM 3

PART B

ESTABLISHED PAYMENTS

(TO BE COMPLETED BY CCC)

3. Project Proposal Cost Estimate -- Establishment Payments (Summarize the Acreage for each Unique Energy Crops to be Planted A.

Energy Crops B.

Summarize Total Acreage C 50% Or Not To Exceed $500/Acre Establishment Rate/Acre (Estimate) D.

Total Estimated Establishment Payment Perennial Crops:

) Designated Perennial Energy Crop 1.

(List Common Name) X $/Acre ) Designated Perennial Energy Crop 2.

(List Common Name) X $/Acre ) Designated Perennial Energy Crop 3.

(List Common Name) X $/Acre ) Designated Perennial Energy Crop 4.

(List Common Name) X $/Acre ) Designated Perennial Energy Crop (List Common Name) X $/Acre ) Designated Perennial Energy Crop (List Common Name) X $/Acre ) Designated Perennial Energy Crop (List Common Name) X $/Acre ) Designated Perennial Energy Crop (List Common Name) X $/Acre ) Designated Perennial Energy Crop (List Common Name and Scientific Name) X $/Acre ) Designated Perennial Energy Crop (List Common Name) X $/Acre ) Designated Perennial Energy Crop (List Common Name) X $/Acre ) Designated Perennial Energy Crop (List Common Name) X $/Acre ) Designated Perennial Energy Crop 13 (List Common Name) X $/Acre