EPA Form Number 5900-679_Clean Ports Supplemental Application Template.xlsx
XLSX spreadsheet 772 KB Posted
- Opportunity number
- EPA-R-OAR-CPP-24-05
- Issued by
-
Environmental Protection Agency
About this file
This document is an optional supplemental application template for the U.S. Environmental Protection Agency (EPA) Clean Ports Program, which consists of two funding opportunities: the Climate and Air Quality Planning (CAQP) Competition and the Zero-Emission Technology Deployment Competition.
The CAQP Competition invites applicants to complete Tab 2 of the template, which covers applicant and project details, project partners, project locations, and proposed climate and air quality planning activities. The Zero-Emission Technology Deployment Competition invites applicants to complete Tabs 3-5, which include a cover sheet, a new fleet description, scrappage information, and infrastructure details. The template provides instructions and data dictionaries to assist applicants in completing the relevant sections. Key details include project period lengths of up to 3 years for CAQP projects and up to 4 years for zero-emission technology projects, with funding requests between $200,000 and $3,000,000. The grant program is authorized under the Clean Air Act Section 133 and funded through the Inflation Reduction Act of 2022.
EPA Form Number 5900-679_Clean Ports Supplemental Application Template
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Other files
| File | Type | Posted |
|---|---|---|
| FY24 Clean Ports CAQP Sample Proj Narrative.docx | DOCX document | |
| EPA Form Number 5900-685_TCD Utility Partnership Agreement.pdf | ||
| EPA-R-OAR-CPP-24-05 Revised 2024 04 10.pdf | ||
| EPA-R-OAR-CPP-24-05.pdf |
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1. Instructions
| U. S. Environmental Protection Agency |
| Clean Ports Program |
| Supplemental Application Template |
| Burden Statement for EPA Form 5900-679 |
| This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2060-0754). Responses to this collection of information are voluntary (2 CFR 200 at 2 CFR 1500). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The public reporting and recordkeeping burden for this collection of information is estimated to range from 2.2-6.1 hours per response. Send comments on the Agency’s need for this information, the accuracy of the provided burden estimates and any suggested methods for minimizing respondent burden to the Regulatory Support Division Director, U.S. Environmental Protection Agency (2821T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address. |
| Instructions |
| This optional supplemental application template may be submitted at the time of award application to summarize the overview of the proposed project. Please work with relevant parties (i.e., transportation contractor, port authority, etc.) to ensure information submitted is accurate if available. To complete this template, applicants may fill out shaded cells highlighted blue with a diagonal pattern (///). Cells highlighted yellow are simply for informative purposes and/or automated from other tabs in this spreadsheet. Additional fields may autopopulate with bold diagonal patterns (///), indicating that a response to those fields is not necessary, based on prior responses entered. Please complete tabs in this workbook according to the instructions below. |
Applicants applying to the Climate and Air Quality Planning Competition are invited to complete Tab 2. Applicants applying to the Zero-Emission Technology Deployment Competition are invited to complete Tabs 3, 4a., 4b. (if scrapping vehicles or equipment), and Tab 5.
| Excel Workbook Tab | Definition |
| 1. Instructions | Basic instructions for all worksheets in this reporting workbook. |
| 2. CAQP Supplemental Application | For applicants of the Clean Ports Program Climate and Air Quality Planning (CAQP) Competition, this is the only tab that should be completed. This tab provides an overview of the Participant Details, list of Project Partners, Project Location Information, and Proposed Climate and Air Quality Planning Project Activities. Please refer to the definitions on Tab 6 (Data Dictionary) for additional guidance on each field in this tab. |
| 3. Cover Sheet for Application_ZE | For applicants of the Clean Ports Program Zero-Emission Technology Deployment Competition, this tab serves as a cover sheet, with space to provide an overview of the Participant Details, list of Project Partners, Project Location Information, and other key project details. Several fields and Table 4 of this tab will auto-populate based on responses entered into subsequent tabs. Please refer to the Cover Sheet for Application_ZE data definitions on Tab 6 (Data Dictionary) for additional guidance on each field. |
| 4a. New Fleet Description | For applicants of the Clean Ports Program Zero-Emission Technology Deployment Competition, the New Fleet Description tab captures all new vehicles and mobile source equipment proposed under the project. Please only fill out shaded cells highlighted blue with a diagonal pattern (///). The sheet has capacity for 100 vehicles. Please refer to the New Fleet Description data definitions on Tab 6 (Data Dictionary) for additional guidance on each field. |
| 4b. Scrappage Information | For applicants of the Clean Ports Program Zero-Emission Technology Deployment Competition, the Scrappage Information provides space for applicants whose proposed project includes plans to scrap vehicles and/or equipment. This data sheet is linked to the 'New Fleet Description' data table (Tab 4a.) to autopopulate the corresponding 'new' vehicle or equipment that is to be replaced. The sheet has capacity for 100 vehicles. Please refer to the Scrappage Information data definitions on Tab 6 (Data Dictionary) for additional guidance on each field. |
| 5. Infrastructure | For applicants of the Clean Ports Program Zero-Emission Technology Deployment Competition, the Infrastructure Description should detail all electric vehicle supply equipment (EVSE), shore power, and other eligible zero emission supporting infrastructure proposed in the project. Please only fill out shaded cells highlighted blue with a diagonal pattern (///). Each table on this sheet has capacity for 50 units of infrastructure, however many of these additional rows have been hidden; to access these additional rows, right-click the left hand column and select 'Unhide'. Additional rows may also be added as needed to capture all supporting infrastructure. Please refer to the Infrastructure data definitions on Tab 6 (Data Dictionary) for data field definitions. |
Key Reminders:
►All Level 2 EVSEs and DC Fast Chargers must be ENERGY STAR certified.
►All zero emission supporting infrastructure must comply with Build America, Buy America (BABA) requirements.
6. Data Dictionary Please refer to the dictionary on this tab for support in completing the following tabs: CAQP Supplemental App. (Tab 2), Cover Sheet for Application_ZE (Tab 3), New Fleet Description (Tab 4a), Scrappage Information (Tab 4b), and Infrastructure (Tab 5).
OMB Control Number: 2060-0754 Expiration Date: 04/30/2027 U.S. EPA Office of Transportation and Air Quality Transportation and Climate Division
OMB Control Number: 2060-NEW Expiration Date: MM/DD/YYYY Office of Transportation and Air Quality Transportation and Climate Division
EPA Form Number: 5900-679
2. CAQP Supplemental App.
| U. S. Environmental Protection Agency | |||||
| Clean Ports Program | Climate and Air Quality Planning Competition | |||||
| Supplemental Application | |||||
| Instructions | |||||
| For applicants of the Climate and Air Quality Planning Competition: Complete this supplemental project application by entering in the requested information in the blue shaded cells for Tables 1, 2, 3a, 3b, and 4. This sheet details an overview of the Applicant and Project Details, the complete list of Project Partners, Project Location Information, and Climate and Air Quality Planning Project Details. Please refer to the definitions on Tab 6 (Data Dictionary) for additional guidance on each field in this tab. | |||||
| Table 1: Applicant & Project Details | |||||
| Applicant Name/Organization | Proposed Project Title | One descriptive sentence only | |||
| Applicant Address | Street | Project Period | |||
| For Climate & Air Quality Planning projects, project periods may be up to three years. | Project Start Date | ||||
| City | Project End Date | ||||
| State | |||||
| (Select from dropdown) | Short Project Description |
Briefly describe your project in one to three sentences only, especially noting the expected outputs and outcomes.
| Zip Code | ||||
| Primary Contact Information | Name | |||
| Title/Role | Project includes planning activities related to emissions inventory and accounting exercises? | Select Yes or No from Dropdown | ||
| Phone | Total EPA Funding Requested | |||
| Use the definitions provided in Section IV.C., Section 7 “Budget” to fill out this budget summary. The amount listed in this summary should match the amounts listed in the budget table in Section 7. As noted in Section II.B. of the NOFO, each application can request between $200,000 and $3,000,000. | ||||
| Other Federal Funding Sources | If the applicant has applied or plans to apply for funding for this project (or portions of this project) from another federal funding source, the applicant should list the potential funding source(s). Otherwise, enter N/A | |||
| Applicant Type | ||||
| (See NOFO Section III.A for details) | Select from Dropdown | |||
| Affiliate Port Authority |
(if applicable)
| SAM.gov Unique Entity ID (UEI) | ||
| Small Water Port Project? | ||
| (See NOFO Section II.B for specifications) | Select Yes or No from Dropdown | |
| Dry Port Project? | ||
| (See NOFO Section I.B. for specifications) | Select Yes or No from Dropdown | |
| Does the applicant use LOGINK or any other prohibited logistics platform as described in NOFO Section III.D.? | Select Yes or No from Dropdown |
| Table 2: Project Partners | |||||||||
| Project Partner Organization Name | Primary Contact Information for Project Partner(s) | Type of Organization | Nature of Partnership with Applicant | Role in Project | |||||
| Name | Title/Role | Phone | Select from Dropdown | If Other, describe | Select from Dropdown | Select from Dropdown | If Other, describe | ||
| Example Partner Organization | Ali Raymond | Director of Advancement | Other | Non-governmental Organization | Collaborating Entity (non-statutory) | Other | Site Manager |
| Table 3: Project Location(s) | |||||||||||||||
| Table 3a: Port/Port Facility Location(s) | |||||||||||||||
| Port/Port Facility Name | |||||||||||||||
| If a port or port facility spans more than 1 county, please enter a new line for each unique county. | Project Site ID | Port Authority Name (if applicable) | State | ||||||||||||
| (Select from dropdown) | County | ||||||||||||||
| (Select from dropdown) | City | Description of Project Activity at Port/Port Facility | |||||||||||||
| (if known) | Estimate of the Share of Overall Project Activity at this site | ||||||||||||||
| (Enter a value between 0-1, where 1 is 100%) | County FIPS Code | EPA Region | Does this county contains a PM2.5 or Ozone Nonattainment Area? | Does this county contains a Severe or Extreme Ozone Nonattainment Area? | Does this county contains a PM2.5 or Ozone Maintenance Area? | Does this county contain an area with High Ambient Diesel PM Concentration? | Does this county meet the Disadvantaged Community Definition in Section IV.C.2 of the NOFO? | ||||||||
| Port of Miami | Example Project ID | FL | Miami-Dade County | Miami | Mobile Source Emissions Inventory | 100% | 12086 | EPA Region 4 | No | No | No | Yes | Yes | ||
| Primary Place of Performance | please provide state first | ||||||||||||||
| 2 | please provide state first | ||||||||||||||
| 3 | please provide state first | ||||||||||||||
| 4 | please provide state first | ||||||||||||||
| 5 | please provide state first | ||||||||||||||
| 6 | please provide state first | ||||||||||||||
| 7 | please provide state first | ||||||||||||||
| 8 | please provide state first | ||||||||||||||
| 9 | please provide state first | ||||||||||||||
| 10 | please provide state first | ||||||||||||||
| Table 3b: Additional Project Locations |
Use this table to identify additional project locations found outside of the ports and port facilities listed in Table 3a above.
| Site Name | |||||||||||||||
| If an Additional Site spans more than 1 county, please enter a new line for each unique county. | Project Site ID | Port(s)/Port Facilities Served by Location | |||||||||||||
| (separate additional ports by semicolon) | State | ||||||||||||||
| (Select from dropdown) | County | ||||||||||||||
| (Select from dropdown) | City | Description of Project Activity at Site | |||||||||||||
| (if known) | Estimate of the Share of Project Activity at this site | ||||||||||||||
| (Enter a value between 0-1, where 1 is 100%) | County FIPS Code | EPA Region | Does this county contains a PM2.5 or Ozone Nonattainment Area? | Does this county contains a Severe or Extreme Ozone Nonattainment Area? | Does this county contains a PM2.5 or Ozone Maintenance Area? | Does this county contain an area with High Ambient Diesel PM Concentration? | Does this county meet the Disadvantaged Community Definition in Section IV.C.2 of the NOFO? | ||||||||
| Hialeah Fueling Depot | Example Additional Site A | Port of Miami; Port Everglades | FL | Miami-Dade County | Miami | EV Infrastructure Planning | 100% | 12086 | EPA Region 4 | No | No | No | Yes | Yes | |
| Additional Site 1 | please provide state first | ||||||||||||||
| Additional Site 2 | please provide state first | ||||||||||||||
| Additional Site 3 | please provide state first | ||||||||||||||
| Additional Site 4 | please provide state first | ||||||||||||||
| Additional Site 5 | please provide state first | ||||||||||||||
| Additional Site 6 | please provide state first | ||||||||||||||
| Additional Site 7 | please provide state first | ||||||||||||||
| Additional Site 8 | please provide state first | ||||||||||||||
| Additional Site 9 | please provide state first | ||||||||||||||
| Additional Site 10 | please provide state first | ||||||||||||||
| Table 4: Climate and Air Quality Planning Project Overview | |||||||||||||||
| Planning Activity Type | Project includes this activity | ||||||||||||||
| Select from Dropdown | Requested EPA Funds for this Activity | Is it the intent that this Activity will be fully funded by EPA? (select from dropdown) | |||||||||||||
| Emissions Inventory and/or Accounting Practice | |||||||||||||||
| Emissions Reduction Strategy Analysis | |||||||||||||||
| Development of Emissions Reduction Target | |||||||||||||||
| Plan for Reducing Future Port Emissions | |||||||||||||||
| Port Resiliency Assessment | |||||||||||||||
| Plan to Increase Resilience of Port | |||||||||||||||
| Formal Stakeholder Engagement | |||||||||||||||
| Workforce Planning Analysis | |||||||||||||||
| Other Activities |
If project features other Planning Activities not listed, please provide here; additional rows hidden if needed.
Expiration Date: 04/30/2027 U.S. EPA Office of Transportation and Air Quality Transportation and Climate Division
OMB Control Number: 2060-NEW Expiration Date: MM/DD/YYYY Office of Transportation and Air Quality
3. Cover Sheet for App_ZE
| U. S. Environmental Protection Agency | |||||
| Clean Ports Program | Zero-Emission Technology Deployment Competition | |||||
| Supplemental Application Cover Sheet | |||||
| Instructions | |||||
| For applicants of the Clean Ports Program Zero-Emission Technology Deployment Competition: Please complete this cover sheet by entering in the requested information in the blue shaded cells for Tables 1, 2, 3a, and 3b. This sheet details an overview of the Applicant and Project Details, the complete list of Project Partners, Project Location Information, and will autopopulate key project details based on information supplied in other tabs. | |||||
| Table 1: Applicant & Project Details | |||||
| Applicant Name/Organization | Proposed Project Title | One descriptive sentence only | |||
| Applicant Address | Street | Project Period | |||
| For Zero Emissions Technology projects, project periods may be up to 4 years. | Project Start Date | ||||
| City | Project End Date | ||||
| State | |||||
| (Select from dropdown) | Short Project Description |
Briefly describe your project in one to three sentences only, especially noting the expected outputs and outcomes.
| Zip Code | ||||||
| Primary Contact Information | Name | |||||
| Title/Role | ||||||
| Phone | Total EPA Funding Requested | |||||
| Use the definitions provided in Section IV.C., Section 7 “Budget” to fill out this budget summary. The amount listed in this summary should match the amounts listed in the budget table in Section 7. As noted in Section II.B. of the NOFO, each application can request between $200,000 and $3,000,000. | ||||||
| Total Applicant Costs | Use the definition provided in Section IV.C., Section 8 “Budget” to fill out this field. The amount listed in this summary should match the amounts listed in the budget table in Section | |||||
| Applicant Type | Select from Dropdown | Total Project Costs | Sum of the EPA Funding Requested and Total Applicant Costs | $ - 0 | ||
| Affiliate Port Authority | ||||||
| (if applicable) | Other Federal Funding Sources | If the applicant has applied or plans to apply for funding for this project (or portions of this project) from another federal funding source, the applicant should list the potential funding source(s). Otherwise, enter N/A | ||||
| SAM.gov Unique Entity ID (UEI) | Total Funding for ZE Equipment | |||||
| This field will auto-populate upon completing 'Fleet Description' tab. | $ - 0 | |||||
| Small Water Port Project? | ||||||
| (See NOFO Section II.B for specifications) | Select from Dropdown | Total Funding for Charging and/or Fueling Infrastructure | ||||
| This field will auto-populate upon completing 'Infrastructure' tab | $ - 0 | |||||
| Dry Port Project? | ||||||
| (See NOFO section I.B. for specifications) | Select from Dropdown | |||||
| Does the applicant use LOGINK or any other prohibited logistics platform as described in NOFO Section III.D.? | Select from Dropdown |
| Table 2: Project Partners | |||||||||
| Project Partner Organization Name | Primary Contact Information for Project Partner(s) | Type of Organization | Nature of Partnership with Applicant | Role in Project | |||||
| Name | Title/Role | Phone | Select from Dropdown | If Other, describe | Select from Dropdown | Select from Dropdown | If Other, describe | ||
| Example Partner Organization | Ali Raymond | Director of Advancement | Other | Non-governmental Organization | Collaborating Entity (non-statutory) | Other | Site Manager |
| Table 3: Project Location(s) | |||||||||||||||
| Table 3a: Port/ Port Facility Location(s) | |||||||||||||||
| Port/ Port Facility Name | |||||||||||||||
| If a port or port facility spans more than 1 county, please enter a new line for each unique county. | Project Site ID | Port Authority Name (if applicable) | State | ||||||||||||
| (Select from dropdown) | County | ||||||||||||||
| (Select from dropdown) | City | Description of Project Activity at Port/ Port Facility | |||||||||||||
| (if known) | Estimate of the Share of Project Activity at this site | ||||||||||||||
| (Enter a value between 0-1, where 1 is 100%) | County FIPS Code | EPA Region | County Contains PM2.5 or Ozone Nonattainment Area? | County Contains Severe or Extreme Ozone Nonattainment Area? | County Contains PM2.5 or Ozone Maintenance Area? | County Contains High Ambient Diesel PM Concentration? | County Meets Disadvantaged Community Definition in Section IV.C.2, Section 4 in the NOFO? | ||||||||
| Port of Miami | 1 | FL | Miami-Dade County | Miami | Mobile Source Emissions Inventory | 100% | 12086 | EPA Region 4 | No | No | No | Yes | Yes | ||
| Primary Place of Performance | please provide state first | ||||||||||||||
| 2 | please provide state first | ||||||||||||||
| 3 | please provide state first | ||||||||||||||
| 4 | please provide state first | ||||||||||||||
| 5 | please provide state first | ||||||||||||||
| 6 | please provide state first | ||||||||||||||
| 7 | please provide state first | ||||||||||||||
| 8 | please provide state first | ||||||||||||||
| 9 | please provide state first | ||||||||||||||
| 10 | please provide state first | ||||||||||||||
| Table 3b: Additional Project Locations |
Use this table to identify additional project locations found outside of the ports listed in Table 3a above.
| Site Name | |||||||||||||||
| If an Additional Site spans more than 1 county, please enter a new line for each unique county. | Project Site ID | Port(s)/Port Facilities Served by Location | |||||||||||||
| (separate additional ports by semicolon) | State | ||||||||||||||
| (Select from dropdown) | County | ||||||||||||||
| (Select from dropdown) | City | Description of Project Activity at Site | |||||||||||||
| (if known) | Estimate of the Share of Project Activity at this site | ||||||||||||||
| (Enter a value between 0-1, where 1 is 100%) | County FIPS Code | EPA Region | County Contains PM2.5 or Ozone Nonattainment Area? | County Contains Severe or Extreme Ozone Nonattainment Area? | County Contains PM2.5 or Ozone Maintenance Area? | County Contains High Ambient Diesel PM Concentration? | County Meets Disadvantaged Community Definition in Section IV.C.2, Section 4 in the NOFO? | ||||||||
| Hialeah Fueling Depot | Example Site 1 | Port of Miami; Port Everglades | FL | Miami-Dade County | Miami | EV Infrastructure Planning | 100% | 12086 | EPA Region 4 | No | No | No | Yes | Yes | |
| Additional Site 1 | please provide state first | ||||||||||||||
| Additional Site 2 | please provide state first | ||||||||||||||
| Additional Site 3 | please provide state first | ||||||||||||||
| Additional Site 4 | please provide state first | ||||||||||||||
| Additional Site 5 | please provide state first | ||||||||||||||
| Additional Site 6 | please provide state first | ||||||||||||||
| Additional Site 7 | please provide state first | ||||||||||||||
| Additional Site 8 | please provide state first | ||||||||||||||
| Additional Site 9 | please provide state first | ||||||||||||||
| Additional Site 10 | please provide state first | ||||||||||||||
| Table 4: Zero-Emission Technology Deployment Project Overview | |||||||||||||||
| Port Sectors Affected |
These fields will auto-populate with ✔ upon completing 'Fleet Description' tab.
| Onroad Vehicles |
| Cargo Handling Equipment & Other Nonroad |
| Locomotive |
| Vessels |
| Project Features Scrappage of Equivalent Equipment? This field will auto-populate with ✔ upon completing 'Scrappage Information' tab. |
| Fueling Infrastructure Affected |
These fields will auto-populate with ✔ upon completing 'Infrastructure' tab.
| Electric Vehicle Supply Equipment (EVSE) |
| Shore Power Infrastructure |
| Hydrogen Fueling Infrastructure |
| Solar and Wind Power Generation |
| Battery Energy Storage System |
| Other Infrastructure |
OMB Control Number: 2060-0754 Expiration Date: 04/30/2027 U.S. EPA Office of Transportation and Air Quality Transportation and Climate Division
OMB Control Number: 2060-NEW Expiration Date: MM/DD/YYYY Office of Transportation and Air Quality
4a. New Fleet Description
| U. S. Environmental Protection Agency |
| Clean Ports Program | Zero-Emission Technology Deployment Competition |
| New Fleet Description |
| Instructions |
| The Fleet Description should detail all vehicles, vessels, and other mobile source equipment that will be purchased as part of the project. Please only fill out shaded cells highlighted blue with a diagonal pattern (///); field in yellow will be autopopulated, and some fields will be hashed out if they are not applicable based on the information entered. Please list ALL port and other locations where the project will take place in this worksheet. This Fleet Description is connected to the Scrappage Information table (Tab 4b). The sheet has capacity for 100 vehicles or equipment. Please refer to the Fleet Description data definitions on Tab 6 (Data Dictionary) for additional guidance on each field. |
| Table 5. New Vehicle, Equipment, or Engine Information | |||||||||||||||||||||||||||||||||||||||||
| Table 5a: Vehicle/Equipment Overview | Table 5b: Place(s) of Performance | Table 5c: Details of New Vehicle, Vessel, and/or Equipment | Table 5d. Engine Replacement Details (only to be completed if 'Technology Type' selected is "New Engine") | ||||||||||||||||||||||||||||||||||||||
| Primary Place of Performance | Secondary Place of Performance (if applicable) | Additional Location Details (if applicable) | |||||||||||||||||||||||||||||||||||||||
| Vehicle or Equipment | Vehicle or Equipment Type | ||||||||||||||||||||||||||||||||||||||||
| (select from dropdown) | Vehicle or Equipment Subtype | ||||||||||||||||||||||||||||||||||||||||
| (select from dropdown; must select a 'Vehicle or Equipment Type' first) | Vocation | ||||||||||||||||||||||||||||||||||||||||
| (select from dropdown; onroad & vessels only) | If 'Other' Subtype or Vocation selected, please describe | ||||||||||||||||||||||||||||||||||||||||
| (Onroad, Cargo Handling Equipment, and Vessels only) | Technology Type | ||||||||||||||||||||||||||||||||||||||||
| (select from dropdown) | If 'Other' selected for Technology Type, please describe | Vehicle or Equipment Total Battery Capacity, (kWh) | Fuel Cell Capacity (kW) | Fleet Owner | Vehicle or Equipment Operates in Multiple Performance Locations Within this project? (Yes/No) | Primary Port or Port Facility | |||||||||||||||||||||||||||||||||||
| (select options from dropdown, based on Table 3a of this template) | If Primary location of vehicle/equipment is not at a port or port facility listed in Table 3a, provide the Name of the Additional Project Location as listed in Table 3b (select from dropdown, based on Table 3b of this template) | Project Site ID | State | County | Percentage of Time operated in County | ||||||||||||||||||||||||||||||||||||
| (enter value 0-1, where 1= 100%) | City | Zip Code | Secondary Port or Port Facility | ||||||||||||||||||||||||||||||||||||||
| (select from dropdown, if applicable)_2 | If Secondary location of vehicle/equipment is not at a port or port facility, provide the Name of the Additional Project Location (select from dropdown)_2 | Project Site ID_2 | State_2 | County_2 | Percentage of Time operated in County | ||||||||||||||||||||||||||||||||||||
| (enter value 0-1, where 1= 100%)_2 | City_2 | Zip Code_2 | Additional Counties where Vehicle Operates | % of time operated in each Additional County | Vehicle Class | ||||||||||||||||||||||||||||||||||||
| (Onroad vehicles only) | Vehicle GVWR | ||||||||||||||||||||||||||||||||||||||||
| (Onroad Vehicle Only) | Vehicle or Equipment Manufacturer | Vehicle or Equipment Model | Vehicle or Equipment Model Year | Acquisition Cost per Vehicle or Equipment | |||||||||||||||||||||||||||||||||||||
| ($ of Cost per Unit) | Total EPA Funds Requested Per Vehicle or Equipment for Acquisition | ||||||||||||||||||||||||||||||||||||||||
| ($ of Total Cost per Unit) | New Engine Make | New Engine Model | New Engine Model Year | New Engine Horsepower | Number of New Propulsion Engines | ||||||||||||||||||||||||||||||||||||
| (Vessels Only) | Number of New Auxiliary Engines | ||||||||||||||||||||||||||||||||||||||||
| (Vessels Only) | Total Estimated Acquisition Cost per New Engine | ||||||||||||||||||||||||||||||||||||||||
| ($ of Cost per Unit) | EPA Funds Requested for New Engine Acquisition | ||||||||||||||||||||||||||||||||||||||||
| ($ of Cost per Unit) | Total Estimated Cost for Labor related to Engine Replacement | EPA Funds Requested for Labor Cost related to Engine Replacement | Total Combined Costs for New Engine Acquisition and Labor of Engine Replacement | Total EPA Funds Requested for New Engine Acquisition and Labor of Engine Replacement | |||||||||||||||||||||||||||||||||||||
| Example New Vehicle | Onroad | Short Haul - Combination | Drayage | New Vehicle - Battery Electric | 250 | NA | Sarah Smith | Yes | Port of Miami | Hialeah Fueling Depot | Example Site | FL | Miami-Dade County | 50% | Miami | 33032 | 45% | Broward County, FL; Monroe County, FL | 4% in Broward County; 1% in Monroe County | Class 7 | 12000 | Manufacturer Name | Model Name or # | 2023 | $ 150,000.00 | $ 112,000.00 | ZE Engine Co. | ZE 1000 | 2023 | 750 | 2 | 2 | $ 375,000.00 | $ 300,000.00 | $ 50,000.00 | $ 25,000.00 | $ 425,000.00 | $ 325,000.00 | |||
| Vehicle/ Equipment 1 | |||||||||||||||||||||||||||||||||||||||||
| Vehicle/ Equipment 2 | |||||||||||||||||||||||||||||||||||||||||
| Vehicle/ Equipment 3 | |||||||||||||||||||||||||||||||||||||||||
| Vehicle/ Equipment 4 | |||||||||||||||||||||||||||||||||||||||||
| Vehicle/ Equipment 5 | |||||||||||||||||||||||||||||||||||||||||
| Vehicle/ Equipment 6 | |||||||||||||||||||||||||||||||||||||||||
| Vehicle/ Equipment 7 | |||||||||||||||||||||||||||||||||||||||||
| Vehicle/ Equipment 8 | |||||||||||||||||||||||||||||||||||||||||
| Vehicle/ Equipment 9 | |||||||||||||||||||||||||||||||||||||||||
| Vehicle/ Equipment 10 | |||||||||||||||||||||||||||||||||||||||||
| Vehicle/ Equipment 11 | |||||||||||||||||||||||||||||||||||||||||
| Vehicle/ Equipment 12 | |||||||||||||||||||||||||||||||||||||||||
| Vehicle/ Equipment 13 | |||||||||||||||||||||||||||||||||||||||||
| Vehicle/ Equipment 14 | |||||||||||||||||||||||||||||||||||||||||
| Vehicle/ Equipment 15 | |||||||||||||||||||||||||||||||||||||||||
| Vehicle/ Equipment 16 | |||||||||||||||||||||||||||||||||||||||||
| Vehicle/ Equipment 17 | |||||||||||||||||||||||||||||||||||||||||
| Vehicle/ Equipment 18 | |||||||||||||||||||||||||||||||||||||||||
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Expiration Date: 04/30/2027 U.S. EPA Office of Transportation and Air Quality Transportation and Climate Division
OMB Control Number: 2060-NEW Expiration Date: MM/DD/YYYY Office of Transportation and Air Quality
4b. Scrappage Information
| U. S. Environmental Protection Agency |
| Clean Ports Program | Zero-Emission Technology Deployment Competition |
| Scrappage Information |
| Instructions |
| The Scrappage Information table should detail all vehicles and pieces of equipment that will be scrapped or otherwise replaced under the project. Please only fill out shaded cells highlighted blue with a diagonal pattern (///). This Scrappage and/or Disposal Information table is connected to the New Fleet Description table (Tab 4a), and fields in yellow will autopopulate with corresponding entries on previous page. The sheet has capacity for 100 vehicles or equipment. Please refer to the Data Dictionary (Tab 6) for additional guidance on each field. |
| Table 6. Current Vehicle or Equipment Committed for Scrappage Information | |||||||||||||||||||||||||||||||||||||||||||||||
| Table 6a. Basic Vehicle Information and Place(s) of Performance | Note: Yellow fields for the Basic Fleet Information will Automatically Populate upon selecting the corresponding new equipment. | Table 6b. Current Vehicle or Equipment Specifications | Table 6c. Current Engine Information (Only to be completed for engine replacement projects) | |||||||||||||||||||||||||||||||||||||||||||||
| Primary Place of Performance | Secondary Place of Performance (if applicable) | Additional Location Details (if applicable) | |||||||||||||||||||||||||||||||||||||||||||||
| Current Vehicle or Equipment | Corresponding New Vehicle, Equipment, or Engine | ||||||||||||||||||||||||||||||||||||||||||||||
| (select from dropdown) | Vehicle or Equipment Type | Vehicle or Equipment Subtype | Vocation | If 'Other' Vocation selected, please describe | Technology Type | If 'Other' selected for Technology Type, please describe | Vehicle or Equipment Total Battery Capacity, (kWh) | Fuel Cell Capacity (kW) | Fleet Owner | Vehicle or Equipment Operates in Multiple Performance Locations Within this project? (Yes/No) | Primary Port or Port Facility | If Primary location of vehicle/equipment is not at a port or port facility listed in Table 3a, provide the Name of the Additional Project Location as listed in Table 3b | Project Site ID | State | County | Percentage of Time operated in County | City | Zip Code | Secondary Port or Port Facility | ||||||||||||||||||||||||||||
| (select from dropdown, if applicable)_2 | If Secondary location of vehicle/equipment is not at a port or port facility, provide the Name of the Additional Project Location_2 | Project Site ID_2 | State_2 | County_2 | Percentage of Time operated in County | ||||||||||||||||||||||||||||||||||||||||||
| (enter value 0-1, where 1= 100%)_2 | City_2 | Zip Code_2 | Additional Counties where Vehicle Operates | % of time operated in each Additional County | Current Vehicle Class | ||||||||||||||||||||||||||||||||||||||||||
| (Onroad Current Vehicles only) | Current Vehicle GVWR | ||||||||||||||||||||||||||||||||||||||||||||||
| (Onroad Current Vehicle Only) | Current Vehicle or Equipment Manufacturer | Current Vehicle or Equipment Model | Current Vehicle or Equipment Model Year | Current Fuel Type | |||||||||||||||||||||||||||||||||||||||||||
| (Select from Dropdown) | Estimated Remaining Life of Current Vehicle or Equipment (years): | Current Engine Make | Current Engine Model | Current Engine Model Year | Current Engine Tier (nonroad, locomotive, and marine only) | If Current Engine Tier is Tier 4, Provide Tier 4 Standards (Tier 4 only) | Current Engine After-Treatment Technology | ||||||||||||||||||||||||||||||||||||||||
| (Tier 4 nonroad only) | Current Engine Horsepower | Current Engine Cylinder Displacement | |||||||||||||||||||||||||||||||||||||||||||||
| (liters/cylinder; marine only) | Total # of Propulsion Engines (per vessel; marine only) | Total # of Auxiliary Engines (per vessel; marine only) | |||||||||||||||||||||||||||||||||||||||||||||
| Example Old Vehicle | Example New Vehicle | Onroad | Short Haul - Combination | Drayage | 0 | New Vehicle - Battery Electric | 0 | 250 | NA | Sarah Smith | Yes | Port of Miami | Hialeah Fueling Depot | Example Site | FL | Miami-Dade County | 50% | Miami | 33032 | 0 | 0 | 0 | 0 | 0 | 45% | 0 | 0 | Broward County, FL; Monroe County, FL | 4% in Broward County; 1% in Monroe County | Class 7 | 12000 | Manufacturer Name | Taurus | 1995 | ULSD (diesel) | 3 | ABC | ABC1000 | 1995 | Tier 2 | N/A | No DPF, Yes SCR | 660 | 5.0 <= size <15.0 | N/A | N/A | |
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| Current Vehicle or Equipment 100 |
OMB Control Number: 2060-0754 Expiration Date: 04/30/2027 U.S. EPA Office of Transportation and Air Quality Transportation and Climate Division
OMB Control Number: 2060-NEW Expiration Date: MM/DD/YYYY Office of Transportation and Air Quality
5. Infrastructure
| U. S. Environmental Protection Agency |
| Clean Ports Program | Zero-Emission Technology Deployment Competition |
| Infrastructure Description |
| Instructions |
| Below are 5 tables (7-11), and one text response. Please complete all applicable tables. The electric vehicle supply equipment (EVSE) & other electric charging information (Table 7) should detail all EVSE and other charging equipment and supporting infrastructure purchased under the project. Table 8 focuses on shore power systems, Table 9 covers hydrogen fueling stations, Table 10 captures solar and wind power generation systems, Table 11 covers battery energy storage systems (BESS), and the bottom text response focuses on any other eligible infrastructure activity funded by this grant. |
Please only fill out shaded cells highlighted blue with a diagonal pattern (///); additional rows for each table are hidden and may be unhidden and completed be added as needed to capture all infrastructure components of this project. Please refer to the Data Dictionary (Tab 6) for additional guidance on each field.
Key Reminders:
►All Level 2 EVSEs and DC Fast Chargers must be ENERGY STAR certified.
►All zero emission supporting infrastructure must comply with Build America, Buy America (BABA) requirements.
| Build America, Buy America (BABA) requirements |
| On August 16, 2022, the Inflation Reduction Act ("IRA"), Pub. L. No. 117-169, which includes the Build America, Buy America Act (BABA), Public Law 117-58, §§ 70901-52, was signed into law. BABA requires that on or after May 14, 2022, all of the iron, steel, manufactured products, and construction materials used in infrastructure project are produced in the United States. If award recipient will be installing, upgrading, or replacing “infrastructure,” then BABA requirements apply to the infrastructure project, regardless of whether or not the infrastructure project was the primary basis for the award. Additionally, BABA requirements apply even if the award recipient will be using another source of funding, whether in part or wholly, for the infrastructure project. For more information, please visit https://www.epa.gov/cwsrf/build-america-buy-america-baba. |
| Table 7. Electric Vehicle Supply Equipment (EVSE) & Other Electric Charging Equipment (not including vessel shore power) | |||||||||||||||||||||||||||||||
| Table 7a. EVSE & Charger Overview | Table 7b. Location of Charging Infrastructure | Table 7c. EVSE BABA Details | Table 7d. EVSE Cost Summary | ||||||||||||||||||||||||||||
| Type of Charger | If Level 2 or DC Fast Charging, is it ENERGY STAR certified? | EVSE or Other EV Charger Manufacturer | EVSE or Other EV Charger Model | EVSE or Other EV Charger Maximum Output Power (kW) | Number of EVSE or Other EV Charger Units | Port or Port Facility Where Infrastructure is Installed | |||||||||||||||||||||||||
| (select options from dropdown, based on Table 3a of this template) | If Infrastructure is not at a port or port facility listed in Table 3a, provide the Name of the Additional Project Location as listed in Table 3b (select from dropdown, based on Table 3b of this template) | Project Site ID | State | County | City | Zip Code | Does the EVSE or Other EV Charger serve multiple port areas within this application? | Primary Port or Port Facility Served by EVSE and/or EV Charger (select options from dropdown, based on Table 3a of this template) | Secondary Port or Port Facilities served by EVSE and/or EV Charger (use semicolon to separate between multiple port locations) | Is the EVSE or Other EV Charger and associated Equipment, Housing, and all Accessories BABA Compliant? | If No, Partly Compliant, or Unsure, explain | Is the plan to use a waiver to fulfill BABA compliance for this infrastructure? | |||||||||||||||||||
| (For more information on approved waivers, see Build America, Buy America (BABA) Approved Waivers US EPA) | Does the Infrastructure Equipment Cost Include Installation? | Total Estimated Acquisition Cost for each EVSE or Other EV Charger Equipment: | Total EPA Funds Requested for Acquisition of each EVSE or Other EV Charger Unit | Total Estimated Acquisition Cost for EVSE or Other EV Chargers | Total EPA Funds Requested for Acquisition of EVSE or Other EV Chargers | Total Estimated Cost for Installation of EVSE or Other EV Chargers | Total EPA Funds Requested for Installation Cost of EVSE or Other EV Chargers | Total Estimated Cost for All other Eligible EVSE or Other EV Charger Related Expenses (e.g., Shipping) | Total EPA Funds Requested for All other Eligible EVSE or Other EV Charger Related Expenses (e.g., Shipping) | Description of Other Eligible EVSE or Other EV Charger Administrative Expenses | Total Estimated Cost on EVSE or Other EV Charger Equipment, Installation, and Other Eligible EVSE or Other EV Charger Related Expenses | Total EPA Funds Requested for EVSE or Other EV Charger Equipment, Installation, and Other Eligible EVSE or Other EV Charger Related Expenses | |||||||||||||||||||
| Example EV Infrastructure | Level 2 | Yes | Manufacturer Name | Model Name | 24 | 2 | Port Facility A | Additional Site B | Example Site | VA | Arlington County | Alexandria | 22305 | Yes | Port Facility A | Port of Galveston; UP Englewood Yard | Yes - Equipment, Housing, Wiring, Cables, and All Accessories are BABA Compliant | No - Infrastructure meets all BABA requirements | No | $ 16,000.00 | $ 12,000.00 | $ 32,000.00 | $ 24,000.00 | $ 12,000.00 | $ 7,000.00 | $ 750.00 | $ 250.00 | shipping ($1000) | $ 44,750.00 | $ 31,250.00 | |
| EVSE Group 1 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||||||||||||||||
| EVSE Group 2 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||||||||||||||||
| EVSE Group 3 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||||||||||||||||
| EVSE Group 4 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||||||||||||||||
| EVSE Group 5 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||||||||||||||||
| EVSE Group 6 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |||||||||||||||||||||||||||
| EVSE Group 7 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
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