ESBD_376987_1726675202940_582-25~2.PDF

Supplemental Form 1 – Waiver Request for Project Application Form Texas Natural Gas Vehicle Grant Program (TNGVGP)

Texas Commission on Environmental Quality (T CEQ) Texas Emissions Reduction Plan (TERP)

Under Texas Health and Safety Code (THSC), Subsection 394.005(i), TCEQ may consider a request to waive one or more of the program requirements based on a finding of good cause.

• This may include short lapses in registration or operation due to economic conditions, seasonal work, or other circumstances.

• The burden is on the applicant to demonstrate why there is good cause to grant the waiver request.

Refer to Appendix B of the TNGVGP Request for Grant Applications for TCEQ’s basis for determining good cause.

Applicants requesting a waiver to one or more of the program requirements must complete Part A of this form. Applicants who have purchased fleet vehicles, or who plan to purchase fleet vehicles from another entity (third-party fleet vehicles) for the purpose of replacing and disposing of those vehicles under the TNGVGP must complete Parts A and B of this form.

Please complete a separate Supplemental Form 1 for each activity that includes a request to waive one or more of the program requirements and submit the completed form with the Project Application Form

(TCEQ-20625).

TCEQ-20625-a (Revised September 2024) Page 1 of 3

Activity Number ____

An activity represents the individual replacement of a vehicle.

Part A: Good Cause Waiver of Ownership, Registration, and Use Requirements Please choose the waiver(s) that apply to the activity.

Waiver for the Ownership Requirement: The applicant has not continuously owned the vehicle for the two years immediately preceding the application signature date.

Waiver for the Registration Requirement: The vehicle being replaced has not been continuously registered in Texas for the two years immediately preceding the application signature date.

Waiver for the Usage Requirement: The vehicle being replaced has not been operated in Texas for the two years immediately preceding the application signature date.

In the space below, please provide a detailed explanation of good cause (see above) for the following:

• Why the vehicle being replaced does not meet the ownership, registration, and/or operation requirements.

• How the replacement of the vehicle will result in the projected NOx emissions reductions.

Please confirm that the vehicle being replaced will continue to be operated in Texas if a grant is not awarded by selecting yes or no from the dropdown menu.

By signing this document, the applicant certifies that all information provided is complete and accurate.

Printed Name of Authorized Official:

Signature of Authorized Official*:

Date of Signature:

*Please complete the entire form before signing electronically. The ability to add, edit, or remove information will not be available after the application is electronically signed.

TCEQ-20625-a (Revised September 2024) Page 2 of 3

Part B: Special Ownership Preapproval for the Purchase of a Fleet Vehicle Registered in the Clean Transportation Zone (CTZ) to be Used as the Vehicle Being Replaced.

Applicants who have purchased fleet vehicles, or who plan to purchase fleet vehicles, from another entity (third-party fleet vehicles) for the purpose of replacing and disposing of those vehicles under the TNGVGP must complete this section.

1. Required Information & Documentation The applicant must provide the vehicle information requested in Section 6 of TNGVGP application (TCEQ- 20625) and attach documentation and photographs of the third-party fleet vehicle to the application including:

• Color photographs of the vehicle and engine.

• A copy of the vehicle title or lease agreement for the two years immediately preceding the application signature date.

• Registration receipts for the 12 months immediately preceding the application signature date. An apportioned registration for operation in multiple states including Texas may be considered as proof of continuous registration and operation in Texas.

2. Third-Party Fleet Vehicle Certifications By signing below, the applicant and current vehicle owner (if applicable) certifies that the vehicle meets the following requirements:

a. Registration. The vehicle has been continuously registered in a county in the Clean Transportation Zone (CTZ) for at least the two years immediately preceding the submission of this form.

b. Operation. The vehicle has been continuously operated at least 75% of the vehicle’s total annual miles of operation in Texas for the two years immediately preceding the application signature date.

c. Condition. The vehicle is currently in operating condition and has a remaining useful life of two or more years.

d. Qualifying Vehicle. The vehicle will be replaced with a qualifying vehicle of the same weight classification and used in the same application or vocation.

3. Current Vehicle Owner Signature The information below must be completed and signed by the current vehicle owner, or a company representative of the vehicle owner, to establish permission to include the vehicles in the application.

“I, the undersigned vehicle owner/company representative, consent to the applicant including the vehicle currently owned by me in this application. I understand that if awarded a grant, the applicant is obligated to own and destroy the vehicle being replaced.”

Printed Name of the Vehicle Owner:

Name of Company Representative:

If the owner of the vehicle is a company, please provide the name of a company representative with signature authority.

Signature of Vehicle Owner/Company Representative*:

Date of Signature:

4. Applicant Signature

Printed Name of Authorized Official:

Signature of Authorized Official*:

Date of Signature:

*Please complete the entire form before signing electronically. The ability to add, edit, or remove information will not be available after the application is electronically signed.

TCEQ-20625-a (Revised September 2024) Page 3 of 3