ESBD_381848_1730396605748_582-25-70001-NG-NTIG Application Form-Acc.pdf

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New Technology Implementation Grant Program (NTIG)
Solicitation number
582-25-70001-NG
Issued by
Texas

About this file

This document is a Project Application Form for the New Technology Implementation Grant (NTIG) Program, a solicitation issued by the Texas Commission on Environmental Quality (TCEQ) under the Texas Emissions Reduction Plan (TERP). The NTIG Program provides grants to implement new technologies that improve air quality. Eligible activities include equipment, supplies and materials, construction, contract services, and operation and maintenance. Applications must be received by 5:00 p.m. Central Time on January 7, 2025.

The application requires detailed project budgets, including proposed grant reimbursement costs and matching costs. The total grant amount requested cannot exceed 50% of the total eligible project costs. Applicants must certify compliance with various program requirements, such as maintaining the new technology for 5 years, obtaining necessary permits, and not generating emissions reduction credits. Governmental entities and businesses must meet child support obligations to be eligible. The application also includes provisions related to procurement, conflict of interest, nondiscrimination, and other grant administration requirements.

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Project Application Form New Technology Implementation Grant Program (NTIG)

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

Solicitation No. 582-25-70001-NG

Este documento es la Solicitud de Aplicaciones de Subvenciones para Programa de Subvenciones para la Implementación de Nuevas Tecnologías (NTIG). La información en este documento lo ayudará a determinar si califica para una subvención. Comuníquese al 800-919-TERP (8377) para obtener ayuda con esta información.

Eligible Activities Project eligibility criteria and types of purchases eligible under this program are explained in TCEQ’s NTIG Request for Grant Applications (RFGA). The RFGA can be found at the NTIG homepage. Applicants should review the RFGA before completing this application.

Application Completeness TCEQ will review applications and project proposals for completeness. If an application or project proposal is found to be incomplete, TCEQ will notify the applicant in writing and provide details about what is missing from the application or project proposal. Applicants will be provided a deadline of three full business days to submit the missing information to TCEQ.

Submission Instructions Applications will be accepted for consideration during this grant period only if received by TCEQ via upload to TCEQ’s file transfer protocol secure (FTPS) server or via mail at one of TCEQ’s addresses no later than 5:00 p.m. Central Time, Jan. 7, 2025. Only one project per application may be submitted.

Any information submitted as part of the application forms is considered public information and may be subject to disclosure pursuant to the Texas Public Information Act, even if you have marked it confidential.

See Appendix C of the RFGA for more detail.

Important Dates Date

Program Opening Date Oct. 31, 2024

Application Submission Deadline Jan. 7, 2025

TCEQ-20686 (Revised October 2024) Page 1 of 17 https://www.tceq.texas.gov/airquality/terp/ntig.html

Section 1: Applicant Information

1. Legal Name of Entity Applying for the Grant If selected for a grant, the legal name of the applicant will be used for contracting purposes.

Applicant Legal Name (Must Match W-9 Form)

2. Business Information All business entities such as corporations or partnerships must have an active registration with the Texas Secretary of State by 5:00 p.m. CT on the opening date on the cover page of this document. Businesses must maintain an active registration throughout the contract period.

Ownership / Business Type

Employer Identification Number (EIN)

3. Authorized Official (AO) The applicant or an employee who has legal authority to sign for and speak on behalf of the entity.

AO First Name

AO Middle Initial

AO Last Name

AO Suffix (If applicable)

AO Title

AO Primary Phone Number

AO Secondary Phone Number

AO Email Address

AO Mailing Address (Street or PO Box)

AO City, State, and Zip Code

4. Designated Project Representative (DPR) The applicant or an employee who will serve as the point of contact for this application.

Is the DPR the same person as the AO?

(If yes, select Yes and continue to Section 2.

If no, select No and enter DPR information.)

DPR First Name

DPR Middle Initial

DPR Last Name

DPR Suffix (If applicable)

DPR Title

DPR Primary Phone Number

DPR Secondary Phone Number

DPR Email Address

DPR Mailing Address (Street or PO Box)

DPR City, State, and Zip Code

TCEQ-20686 (Revised October 2024) Page 2 of 17 https://www.irs.gov/pub/irs-pdf/fw9.pdf

Section 2: Third-Party Preparer Signature Page

1. Third-Party Preparer (TPP) A third-party preparer is someone other than the applicant or an employee of the applicant. If a third-party preparer was not used in the preparation of an application, select “No” from the dropdown list and proceed to Section 3.

Was this application prepared by a third-party?

2. Third-Party Preparer Certification I hereby certify to the best of my knowledge and belief that all information provided in this application, including any attachments, is true and correct, as represented to me by the applicant. I understand that failure to sign the application will make this application ineligible. I understand that making a false statement may cause the submitted application to be ineligible, may make any resulting contracts voidable, and may subject me to criminal and civil penalties.

TPP Printed Name (First Last)

TPP Title

TPP Company Name

TPP Mailing Address (Street or PO Box)

City

State

Zip Code

TPP Primary Phone Number

TPP Secondary Phone Number

TPP Email Address

TPP Signature*

TPP Signature Date

*If using an electronic signature instead of a typed signature, please complete the entire application before signing electronically. The ability to edit, add, or remove information will not be available after the application is electronically signed.

TCEQ-20686 (Revised October 2024) Page 3 of 17

Section 3: Certification of Eligibility to Receive a State-Funded Grant All applicants must complete this section to certify eligibility to receive a grant under this program, even if child support obligations do not apply to the applicant. Failure to complete this section may result in rejection of the application.

Certification Regarding Child Support Obligations Under Texas Family Code, Section 231.006, a child support obligor who is more than 30 days delinquent in paying child support and a business entity in which the obligor is a sole proprietor, partner, shareholder, or owner with an ownership interest of at least 25%, is not eligible to receive a state-funded grant or loan. All applicants must include in the application the name and social security number of the individual or sole proprietor and each partner, shareholder, or owner with an ownership interest of 25% or more of the business entity submitting the application.

Federal Privacy Act Notice: This notice is given pursuant to the Federal Privacy Act. Disclosure of your Social Security Number (SSN) is required under Texas Family Code, Section 231.006(c) and Section 231.302(c)(3). The SSN will be used to identify persons that may owe child support. The SSN will be kept confidential to the fullest extent allowed under Texas Family Code, Section 231.302(e).

Please Check ONLY One of the Following Applicant Options.

1. Individual or Sole Proprietor

2. One or more individuals own 25% or more of the business entity

3. No individual owns 25% or more of the business entity

4. Governmental Entity

If Option 1 or 2 is checked above, list the name(s) and social security number(s) below.

Name Social Security Number

Name Social Security Number

Name Social Security Number

Name Social Security Number

Applicant Certification

By signing this application in Section 7, under Texas Family Code, Section 231.006, the applicant certifies that the individual or business entity named in this application is not ineligible to receive the specified grant and acknowledges that any contract may be terminated, and any payments may be withheld if this certification is inaccurate.

TCEQ-20686 (Revised October 2024) Page 4 of 17 https://statutes.capitol.texas.gov/Docs/FA/htm/FA.231.htm#231.006 https://www.justice.gov/opcl/privacy-act-1974 https://statutes.capitol.texas.gov/Docs/FA/htm/FA.231.htm#231.006 https://statutes.capitol.texas.gov/Docs/FA/htm/FA.231.htm#231.302 https://statutes.capitol.texas.gov/Docs/FA/htm/FA.231.htm#231.302 https://statutes.capitol.texas.gov/Docs/FA/htm/FA.231.htm#231.302 https://statutes.capitol.texas.gov/Docs/FA/htm/FA.231.htm#231.006

Section 4: Health/Safety and Environmental Impact Certification

The applicant confirms that it has made a reasonable effort to identify safety and health issues that might arise from the implementation, testing, or use of the proposed technology. (Please mark one box below with an X.)

1. The applicant is not aware of any safety and health issues that might arise from the implementation, testing, or use of the proposed technology.

2. The applicant is aware of one or more safety and health issue that might arise from the implementation, testing, or use of the proposed technology and has identified those issues in the Project Proposal.

The applicant confirms that it has made a reasonable effort to identify adverse environmental impacts, such as increased emissions of pollutants or the creation of a hazardous waste that might arise from the implementation, testing, or use of the proposed technology. (Please mark one box below with an X.)

1. The applicant is not aware of any adverse environmental impacts, such as increased emissions of pollutants or the creation of a hazardous waste, that might arise from the implementation, testing, or use of the proposed technology.

2. The applicant is aware of one or more adverse environmental impacts, such as increased emissions of pollutants or the creation of a hazardous waste, that might arise from the implementation, testing, or use of the proposed technology and has identified those issues in the Project Proposal.

TCEQ-20686 (Revised October 2024) Page 5 of 17

Section 5: Project Budget Summary Refer to Section 3.0 of the NTIG RFGA for a detailed description of each eligible budget category. Complete the relevant Project Budgets Sections 5.1 through 5.5 as needed. List all expenses by budget category, including a description of each line item and its purpose in the project. For Electricity Storage projects, clearly distinguish between costs related to the storage project and costs related to the renewable energy source in Sections 5.1 through 5.5. Costs related to the renewable energy source are not reimbursable but may be submitted for matching costs.

The sum of the Proposed Matching Cost Totals must meet or exceed the sum of the Proposed Grant Reimbursement Cost Totals. Individual budget categories do not need to be split 50/50 between those two columns.

The project budget is subject to disclosure under the Public Information Act (PIA). Applicants must supply supporting documentation for the budget category costs that provides sufficient detail to demonstrate the underlying expenses and allow for clear connections to the project.

A supplemental budget for major subcontractors should also be included with the application. This is particularly recommended for projects in which the subcontractor will be completing a major portion of the proposed grant-funded work.

1. Eligible Budget Categories

Budget Category Proposed Grant Reimbursement

Cost Totals

Proposed Matching Cost

Totals

Total (Reimbursement

+ Matching Costs)

Equipment Use the columns to the right to list the Proposed

Equipment Cost Totals from Section 5.1 Supplies and Materials

Use the columns to the right to list the Proposed Supplies and Materials Cost Totals from Section 5.2

Construction Use the columns to the right to list the Proposed

Construction Cost Totals from Section 5.3 Contract Services

Use the columns to the right to list the Proposed Contract Services Cost Totals from Section 5.4

Operation and Maintenance Use the columns to the right to list the Proposed

Operations and Maintenance Cost Totals from Section 5.5

Sum of Costs Number in Total column should match Project Totals in Section 7: Project Summary Requested Grant Amount

Cannot exceed 50% of Sum of Costs: Total above

2. Additional Funding Sources (Refer to the RFGA, Section 3.0 Available Funding and Cost)

In determining the amount of a grant, TCEQ shall reduce the incremental cost of a proposed project by the value of any existing financial incentive that directly reduces the cost of the proposed project, including tax credits or deductions, other grants, or any other public financial assistance. If the applicant has received, or anticipates receiving, any additional financial incentives, indicate the dollar amount: ___________________

TCEQ-20686 (Revised October 2024) Page 6 of 17

Section 5.1: Equipment Project Budget

Click here for additional pages +

Include detailed information in the columns indicated for both Costs Proposed for Grant Reimbursement and the Proposed Matching Costs.

Expenses that are ineligible for reimbursement are not allowable as matching expenses, unless the expense is related to the renewable energy source for an Electricity Storage project. Refer to Section 3.3 of the NTIG RFGA for information regarding ineligible costs. Costs incurred prior to the opening of the grant round are not eligible for reimbursement.

Description and Purpose Costs Proposed for Grant Reimbursement

Proposed Matching Costs

Subtotal

Total Eligible Costs

TCEQ-20686 (Revised October 2024) Page 7 of 17

Section 5.2: Supplies and Materials Project Budget

Include detailed information in the columns indicated for both Costs Proposed for Grant Reimbursement and the Proposed Matching Costs.

Expenses that are ineligible for reimbursement are not allowable as matching expenses. Refer to Section 3.3 of the NTIG RFGA for information regarding ineligible costs. Costs incurred prior to the opening of the grant round are not eligible for reimbursement.

Description and Purpose Costs Proposed for Grant Reimbursement

Proposed Matching Costs

Subtotal

TCEQ-20686 (Revised October 2024) Page 8 of 17

Section 5.3: Construction Project Budget

Include detailed information in the columns indicated for both Costs Proposed for Grant Reimbursement and the Proposed Matching Costs.

Expenses that are ineligible for reimbursement are not allowable as matching expenses. Refer to Section 3.3 of the NTIG RFGA for information regarding ineligible costs. Costs incurred prior to the opening of the grant round are not eligible for reimbursement.

Description and Purpose Costs Proposed for Grant Reimbursement

Proposed Matching Costs

Subtotal

TCEQ-20686 (Revised October 2024) Page 9 of 17

Section 5.4: Contract Services (Consultants and Subcontracts) Project Budget

Include detailed information in the columns indicated for both Costs Proposed for Grant Reimbursement and the Proposed Matching Costs.

Expenses that are ineligible for reimbursement are not allowable as matching expenses. Refer to Section 3.3 of the NTIG RFGA for information regarding ineligible costs. Costs incurred prior to the opening of the grant round are not eligible for reimbursement.

Description and Purpose Costs Proposed for Grant Reimbursement

Proposed Matching Costs

Subtotal

TCEQ-20686 (Revised October 2024) Page 10 of 17

Section 5.5: Operation and Maintenance Project Budget

Include detailed information in the columns indicated for both Costs Proposed for Grant Reimbursement and the Proposed Matching Costs.

Expenses that are ineligible for reimbursement are not allowable as matching expenses. Refer to Section 3.3 of the NTIG RFGA for information regarding ineligible costs. Costs incurred prior to the opening of the grant round are not eligible for reimbursement.

Description and Purpose Costs Proposed for Grant Reimbursement

Proposed Matching Costs

Subtotal

TCEQ-20686 (Revised October 2024) Page 11 of 17

Section 6: P rogram Certifications This section includes specific requirements and statements for funding under the New Technology Implementation Grant Program. These terms apply to any contract awarded by TCEQ from this application. The New Technology Implementation Grant Program RFGA and the draft contract, located on the New Technology Implementation Grant Program webpage, contain additional terms and conditions that the applicant should review before submitting an application.

By signing this application, you understand and certify compliance with all the statements below, as well as with any state statutes, regulations, policies, guidelines, and requirements as they relate to the application, acceptance, and use of funds for this project. If any of these certifications materially change after submittal of the application, you will provide prompt written notification to TCEQ within three business days of becoming aware of the change. Failure to notify TCEQ of any changes to your certifications may make the application ineligible and may make any resulting contracts voidable.

New Technology Implementation Grant Project Provisions

1. If selected for award, the applicant agrees to maintain and operate the proposed technology for five years after the final reimbursement is paid by TCEQ.

2. The applicant has informed TCEQ of all permits, including but not limited to permits with TCEQ, the Public Utility Commission of Texas (PUCT), and the Railroad Commission of Texas (RRC), and certifies that applicant is in compliance with all permits.

3. The proposed activities are not required by any state or federal law, rule, or regulation, memorandum of agreement, or other legally binding document.

4. No Emissions Reductions Credits. Activities funded under this program are not eligible to generate marketable credits under state or federal emissions reduction credit averaging, banking, or trading programs. If the project is funded, the applicant waives, for all time, its right to claim or apply for any emissions reduction credits from the use of the low-emission technology funded under this program.

5. Not to exceed 50% of the implementation cost. The amount of the grant award plus any other public financial assistance, tax credits or deductions, or other grants may not exceed 50% of the implementation cost of the proposed project.

6. Requirement to Monitor. The applicant will monitor the use of the grant-funded activities over the designated Contract Period. The applicant agrees to provide information on the use of the equipment upon request of TCEQ.

7. Insurance Coverage. The applicant will maintain, for the term of the Contract Period, insurance levels in accordance with the contract requirements.

8. The applicant will notify TCEQ of any termination of use, change in use, sale, transfer, or destruction of grant-funded new technology or the facilities in which it will be installed, during the Contract Period.

TCEQ may be entitled to the return of all or a share of the grant funds for any non-compliance with these Assurances, any Contract terms, or misuse of grant funds during the Contract Period.

New Technology Stationary Compressor Project Provisions

1. Ownership. The equipment has been continuously owned for the two years immediately preceding the application signature date. A waiver may be submitted for this requirement.

2. Operation. The equipment has been continuously located and used in Texas for the two years prior to the application signature date. A waiver may be submitted for this requirement.

3. Condition. On the application signature date, the equipment is currently in good operating condition and capable of performing its primary function in the routine operations of the applicant. To the best of the applicant’s knowledge, the equipment is capable of continuing to perform its primary function for the duration of the Contract Period, taking into account normal maintenance, repairs, and upkeep.

4. Continued Operation and Use. If the grant funds were not available, the applicant expects to otherwise continue to operate the equipment in Texas for at least the duration of the Contract Period and the applicant otherwise would not have planned to replace the equipment.

TCEQ-20686 (Revised October 2024) Page 12 of 17

General Provisions

1. Legal Authority. The applicant has the legal authority in the State of Texas to apply for the grant. The applicant's governing body has authorized the filing of the application, understands these requirements and certifications, and has authorized the person identified as the Authorized Official to act in connection with the application and to provide such additional information as may be required.

2. If awarded a grant, the applicant certifies that it will provide written notification to TCEQ within 30 calendar days of any termination of use, change in use, sale, transfer, or accidental or intentional destruction of grant-funded equipment during the activity life. The applicant further agrees that TCEQ may be entitled to the return of all or a prorated share of the grant funds for any loss of emissions reductions compared with the emissions reductions projected in awarding the grant.

3. Texas Grant Management Standards. In accordance with Chapter 783 of the Texas Government Code, if the applicant is a local government, state entity, or political subdivision, it will comply fully with the Texas Grant Management Standards (TxGMS). This includes compliance with the relevant sections of TxGMS when procuring goods and services under a resulting contract. For all other applicants, the selected items of cost of TxGMS apply to any resulting contract. These documents are available at:

https://www.comptroller.texas.gov/purchasing/grant-management/.

4. Procurement of Goods and Services. If this application results in a contract, all procurement transactions made with (or to be reimbursed by) grant funds must be conducted in a manner providing full and open competition. All purchase decisions must be based on sound business decisions and arm’s length bargaining, and purchases must be made without any real or apparent personal or organizational conflicts of interest as described in TxGMS.

5. Conflict of Interest. The applicant has not given, offered to give, nor intends to give any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to a public servant in connection with the submitted application.

6. Nondiscrimination. The applicant will comply with all state and federal statutes relating to nondiscrimination. If the applicant is an employer under the Texas Labor Code, it must not discriminate on the basis of race, color, disability, religion, sex, national origin, age, or genetic information in its employment decisions.

7. Grant Administration. The applicant will maintain an appropriate grant administration system to ensure that they meet all terms, conditions, and specifications of the grant, including these certifications and assurances.

8. Audit. Acceptance of funds under this program acts as acceptance of the authority of the State Auditor’s Office, or any successor agency, to conduct an audit or investigation in connection with those funds. The applicant or other entity that may receive funds directly or indirectly from TCEQ must provide the state auditor with access to any information the state auditor considers relevant to the investigation or audit. The applicant will include this clause concerning the authority to audit funds received indirectly and the requirement to cooperate in any subcontract it awards.

9. Debt to the State. The applicant is not indebted to the state nor has an outstanding tax delinquency. The applicant must comply with all state and federal tax laws and fee requirements and is solely responsible for filing all state and federal tax and fee forms.

10. Contract. The applicant understands that a PDF of the draft contract may be viewed and downloaded from the NTIG webpage. The draft contract is for reference only and contains terms and conditions which are standard provisions for grants awarded under this program. Any requested changes to the draft contract must be received by TCEQ no later than the date of the submission of this application. However, the applicant further understands that TCEQ will not normally change the contract language in response to individual requests from grant recipients and is under no obligation to do so. TCEQ reserves the right to modify the draft contract terms as necessary due to statutory rule, or policy changes. Modifications will be posted to the NTIG webpage and the Electronic State Business Daily.

11. Contracting with an Executive of a State Agency. Under Section 669.003 of the Texas Government Code, relating to contracting with an executive head of a state agency, applicant represents that no person who, in the past four years, served as an executive of TCEQ or any other state agency, was involved with or has any interest in this application. If the applicant employs or has used the services of a former executive head of TCEQ or other state agency, the applicant shall provide the following information: name of former

TCEQ-20686 (Revised October 2024) Page 13 of 17 https://www.comptroller.texas.gov/purchasing/grant-management/ executive, name of state agency, date of separation from state agency, position with applicant, and date of employment with applicant.

12. Debarment. The applicant certifies that the applying entity and its principals are eligible to participate in this transaction and have not been subjected to suspension, debarment, or similar ineligibility determined by any federal, state, or local governmental entity. The applicant also certifies that it and its principals are not listed on the State of Texas Debarred Vendor List maintained by the Texas Comptroller of Public Accounts, or the System for Award Management (SAM) maintained by the General Services Administration as authorized by Executive Order No. 13224, “Blocking Property and Prohibiting Transactions with Persons Who Commit, Threaten to Commit, or Support Terrorism,” published by the U.S. Department of Treasury, Office of Foreign Assets Control.

13. Abortion Funding Limitation. The applicant represents and warrants it is not an abortion provider or an affiliate of an abortion provider under Chapter 2273 of the Texas Government Code, Prohibited Transactions.

14. COVID-19 Vaccine Passport Prohibition. Under Section 161.0085 of the Texas Health and Safety Code, the applicant certifies that it is not ineligible to receive funds.

15. Disclosure Protections for Certain Charitable Organizations. If the applicant is a governmental entity, it represents and warrants that it will comply with Section 2252.906 of the Texas Government Code, relating to disclosure protections for certain charitable organizations, charitable trusts, and private foundations.

16. Public Camping Ban. If the applicant is a local entity, it certifies and affirms that it has not received a final judicial determination finding it intentionally adopted or enforced a policy that prohibited or discouraged the enforcement of a public camping ban in an action brought by the Attorney General under Local Government Code Section 364.003. If the applicant is currently being sued under this provision, it must disclose the lawsuit and its current posture to TCEQ.

17. The applicant has not been adjudicated during the preceding three-year period to have committed substantive, non-clerical violations resulting in an actual release of hazardous waste or any other environmental permit violations that presented an imminent and substantial danger to the public health and safety or the environment.

TCEQ-20686 (Revised October 2024) Page 14 of 17

Section 7: P roject Summary

1. Applicant Information

Applicant Legal Name (Must match Section 1)

Applicant Type

Applicant Mailing Address (Street or PO Box)

Applicant City, State, and Zip Code

2. Project Information

Project Location Street Address

Project Location City, State, Zip Code

Project Location County

Project Type DD (Electricity Storage, Stationary Sources, Oil and Gas)

Project Totals (This number should match Section 5: Project Budget

Summary) Total Requested Grant Amount

(This number should match Requested Grant Amount in Section 5: Project Budget Summary)

3. Authorized Official

The applicant or an employee of the applicant who has the legal authority to sign on behalf of the entity.

I hereby certify to the best of my knowledge and belief that all information provided in this application and any attachments is true and correct, including any representations made by a third-party preparer. My signature also constitutes acceptance of the certifications in Section 6 of this application, the terms of the RFGA, and any other changes posted through addenda on the Electronic State Business Daily. I understand that failure to sign the application will make this application ineligible. I understand that any false statement may cause the submitted application to be ineligible, may make any resulting contracts voidable, and may subject me to criminal or civil penalties.

Printed Name of Authorized Official

Authorized Official Title

Signature of Authorized Official*

Date of Signature

*If using an electronic signature instead of a typed signature, please complete the entire application before signing electronically. The ability to add, edit, or remove information will not be available after the application is electronically signed.

The application, signed by the Authorized Official, must be received by the application deadline or the application will not be accepted.

Personal Information Policy: Individuals are entitled to request and review their personal information that the agency gathers on its forms. Individuals may request to have their provided personal information updated.

To review such information, contact TERP program staff at TERP@tceq.texas.gov or 1-800-919-TERP (8377).

TCEQ-20686 (Revised October 2024) Page 15 of 17 mailto:TERP@tceq.texas.gov

Section 8: Application Checklist All applications for funding must be submitted within the application submission period listed on the cover page of the RFGA. A complete application must include:

• all pages of the application

• all required attachments

• applicant’s contact information

• all required signatures

• any additional supporting documentation

Application Section Checklist (All Applications) All sections of the application must be completed entirely.

Mark each box below to certify that you have fully completed the indicated section and that you have signed all sections requiring a signature.

Section 1: Applicant Information

Section 2: Third-Party Preparer Signature Page Signature Required only if prepared by a third-party.

Section 3: Certification of Eligibility to Receive a State-Funded Grant

Section 4: Health/Safety and Environmental Impact Certification

Section 5: Project Budget Summary Signature Required.

Section 6: Program Certifications Read and include with the application.

Section 7: Project Summary Signature Required.

Section 8: Application Checklist Read and include with application.

Required Attachments Checklist (All Applications)

IRS Form W-9 Download, fill out entirely, and include with the application. Signature Required.

Copy of State or Federal Identification Card Include only if applying as an Individual or Sole Proprietor.

Project Proposal Submit a proposal using the instructions for your project type.

Supplemental Forms (if applicable)

Supplemental Form 1: Waiver Request Include with application. Signature Required.

TCEQ-20686 (Revised October 2024) Page 16 of 17 https://www.irs.gov/pub/irs-pdf/fw9.pdf

Section 9: Application Submission Instructions

Electronic Application Submissions Applications may be submitted electronically using the method listed below. It is preferable that the application and its attachments be submitted as a single PDF, but it is not required. If the attachments for an application will be submitted as separate files, each attachment must be grouped by activity and clearly labeled with the activity number at the top of each page.

Submitting Applications via TCEQ’s FTPS Server. Applications may be submitted securely by uploading the file to TCEQ's FTPS Server and selecting the share file(s) button. Enter NTIG-Apply@tceq.texas.gov as the email address. See detailed directions for using TCEQ’s FTPS site. Please note: Applications uploaded to TCEQ’s FTPS server without completing the share file(s) step will not be considered as submitted.

Learn how to create an account and submit your application via the FTPS site in this step-by-step video guide. It is preferable that the application and its attachments be submitted as a single PDF, but it is not required. If the attachments for an application are submitted as separate files, each attachment must be grouped by activity and clearly labeled with the activity number at the top of each page.

Physical Application Submissions

Applications may also be submitted by mailing a physical copy to one of these addresses:

Standard Mail:

Texas Commission on Environmental Quality Air Grants Division, MC-204 (NTIG) P.O. Box 13087 Austin, TX 78711-3087

Express Mail:

Texas Commission on Environmental Quality Air Grants Division, MC-204 (NTIG) 12100 Park 35 Circle, Building F, 1st Floor, Suite 1301 Austin, TX 78753

TCEQ-20686 (Revised October 2024) Page 17 of 17 https://ftps.tceq.texas.gov/ https://ftps.tceq.texas.gov/help/ https://www.youtube.com/watch?v=GW4eEe_uUwc&feature=youtu.be

Project Application Form
Eligible Activities
Application Completeness
Submission Instructions
Section 1: Applicant Information
Section 2: Third-Party Preparer Signature Page
Section 3: Certification of Eligibility to Receive a State-Funded Grant
Certification Regarding Child Support Obligations
Applicant Certification
Section 4: Health/Safety and Environmental Impact Certification
Section 5: Project Budget Summary
Section 5.1: Equipment Project Budget
Section 5.2: Supplies and Materials Project Budget
Section 5.3: Construction Project Budget
Section 5.4: Contract Services (Consultants and Subcontracts) Project Budget
Section 5.5: Operation and Maintenance Project Budget
Section 6: Program Certifications
New Technology Implementation Grant Project Provisions
New Technology Stationary Compressor Project Provisions
General Provisions
Section 7: Project Summary
Section 8: Application Checklist
Application Section Checklist (All Applications)
Required Attachments Checklist (All Applications)
Supplemental Forms (if applicable)
Section 9: Application Submission Instructions
Electronic Application Submissions
Physical Application Submissions
Employer Identification Number EIN:
AO First Name:
AO Middle Initial:
AO Last Name:
AO Suffix If applicable:
AO Title:
AO Primary Phone Number:
AO Secondary Phone Number:
AO Email Address:
AO Mailing Address Street or PO Box:
AO City State and Zip Code:
DPR First Name:
DPR Middle Initial:
DPR Last Name:
DPR Suffix If applicable:
DPR Title:
DPR Primary Phone Number:
DPR Secondary Phone Number:
DPR Email Address:
DPR Mailing Address Street or PO Box:
DPR City State and Zip Code:
TPP Printed Name First Last:
TPP Title:
TPP Company Name:
TPP Mailing Address Street or PO Box:
City:
State:
Zip Code:
TPP Primary Phone Number:
TPP Secondary Phone Number:
TPP Email Address:
TPP Signature:
TPP Signature Date:
Name:
Social Security Number:
Name_2:
Social Security Number_2:
Name_3:
Social Security Number_3:
Name_4:
Social Security Number_4:
Proposed Grant Reimbursement Cost TotalsEquipment Use the columns to the right to list the Proposed Equipment Cost Totals from Section 51:
Proposed Matching Cost TotalsEquipment Use the columns to the right to list the Proposed Equipment Cost Totals from Section 51:
Total Reimbursement Matching CostsEquipment Use the columns to the right to list the Proposed Equipment Cost Totals from Section 51:
Proposed Grant Reimbursement Cost TotalsSupplies and Materials Use the columns to the right to list the Proposed Supplies and Materials Cost Totals from Section 52:
Proposed Matching Cost TotalsSupplies and Materials Use the columns to the right to list the Proposed Supplies and Materials Cost Totals from Section 52:
Total Reimbursement Matching CostsSupplies and Materials Use the columns to the right to list the Proposed Supplies and Materials Cost Totals from Section 52:
Proposed Grant Reimbursement Cost TotalsConstruction Use the columns to the right to list the Proposed Construction Cost Totals from Section 53:
Proposed Matching Cost TotalsConstruction Use the columns to the right to list the Proposed Construction Cost Totals from Section 53:
Total Reimbursement Matching CostsConstruction Use the columns to the right to list the Proposed Construction Cost Totals from Section 53:
Proposed Grant Reimbursement Cost TotalsContract Services Use the columns to the right to list the Proposed Contract Services Cost Totals from Section 54:
Proposed Matching Cost TotalsContract Services Use the columns to the right to list the Proposed Contract Services Cost Totals from Section 54:
Total Reimbursement Matching CostsContract Services Use the columns to the right to list the Proposed Contract Services Cost Totals from Section 54:
Proposed Grant Reimbursement Cost TotalsOperation and Maintenance Use the columns to the right to list the Proposed Operations and Maintenance Cost Totals from Section 55:
Proposed Matching Cost TotalsOperation and Maintenance Use the columns to the right to list the Proposed Operations and Maintenance Cost Totals from Section 55:
Total Reimbursement Matching CostsOperation and Maintenance Use the columns to the right to list the Proposed Operations and Maintenance Cost Totals from Section 55:
Proposed Grant Reimbursement Cost TotalsSum of Costs Number in Total column should match Project Totals in Section 7 Project Summary:
Total Reimbursement Matching CostsSum of Costs Number in Total column should match Project Totals in Section 7 Project Summary:
Total Reimbursement Matching Costs:
Description and PurposeRow1:
Costs Proposed for Grant ReimbursementRow1:
Proposed Matching CostsRow1:
Description and PurposeRow2:
Costs Proposed for Grant ReimbursementRow2:
Proposed Matching CostsRow2:
Description and PurposeRow3:
Costs Proposed for Grant ReimbursementRow3:
Proposed Matching CostsRow3:
Description and PurposeRow4:
Costs Proposed for Grant ReimbursementRow4:
Proposed Matching CostsRow4:
Description and PurposeRow5:
Costs Proposed for Grant ReimbursementRow5:
Proposed Matching CostsRow5:
Description and PurposeRow6:
Costs Proposed for Grant ReimbursementRow6:
Proposed Matching CostsRow6:
Description and PurposeRow7:
Costs Proposed for Grant ReimbursementRow7:
Proposed Matching CostsRow7:
Description and PurposeRow8:
Costs Proposed for Grant ReimbursementRow8:
Proposed Matching CostsRow8:
Description and PurposeRow9:
Costs Proposed for Grant ReimbursementRow9:
Proposed Matching CostsRow9:
Description and PurposeRow10:
Costs Proposed for Grant ReimbursementRow10:
Proposed Matching CostsRow10:
Description and PurposeRow11:
Costs Proposed for Grant ReimbursementRow11:
Proposed Matching CostsRow11:
Description and PurposeRow12:
Costs Proposed for Grant ReimbursementRow12:
Proposed Matching CostsRow12:
Description and PurposeRow13:
Costs Proposed for Grant ReimbursementRow13:
Proposed Matching CostsRow13:
Description and PurposeRow14:
Costs Proposed for Grant ReimbursementRow14:
Proposed Matching CostsRow14:
Description and PurposeRow15:
Costs Proposed for Grant ReimbursementRow15:
Proposed Matching CostsRow15:
Description and PurposeRow16:
Costs Proposed for Grant ReimbursementRow16:
Proposed Matching CostsRow16:
Description and PurposeRow17:
Costs Proposed for Grant ReimbursementRow17:
Proposed Matching CostsRow17:
Description and PurposeRow18:
Costs Proposed for Grant ReimbursementRow18:
Proposed Matching CostsRow18:
Description and PurposeRow19:
Costs Proposed for Grant ReimbursementRow19:
Proposed Matching CostsRow19:
Description and PurposeRow20:
Costs Proposed for Grant ReimbursementRow20:
Proposed Matching CostsRow20:
Description and PurposeRow21:
Costs Proposed for Grant ReimbursementRow21:
Proposed Matching CostsRow21:
Description and PurposeRow22:
Costs Proposed for Grant ReimbursementRow22:
Proposed Matching CostsRow22:
Description and PurposeRow23:
Costs Proposed for Grant ReimbursementRow23:
Proposed Matching CostsRow23:
Description and PurposeRow24:
Costs Proposed for Grant ReimbursementRow24:
Proposed Matching CostsRow24:
Costs Proposed for Grant ReimbursementSubtotal:
Proposed Matching CostsSubtotal:
Costs Proposed for Grant ReimbursementTotal Eligible Costs:
Proposed Matching CostsTotal Eligible Costs:
Description and PurposeRow1_2:
Costs Proposed for Grant ReimbursementRow1_2:
Proposed Matching CostsRow1_2:
Description and PurposeRow2_2:
Costs Proposed for Grant ReimbursementRow2_2:
Proposed Matching CostsRow2_2:
Description and PurposeRow3_2:
Costs Proposed for Grant ReimbursementRow3_2:
Proposed Matching CostsRow3_2:
Description and PurposeRow4_2:
Costs Proposed for Grant ReimbursementRow4_2:
Proposed Matching CostsRow4_2:
Description and PurposeRow5_2:
Costs Proposed for Grant ReimbursementRow5_2:
Proposed Matching CostsRow5_2:
Description and PurposeRow6_2:
Costs Proposed for Grant ReimbursementRow6_2:
Proposed Matching CostsRow6_2:
Description and PurposeRow7_2:
Costs Proposed for Grant ReimbursementRow7_2:
Proposed Matching CostsRow7_2:
Description and PurposeRow8_2:
Costs Proposed for Grant ReimbursementRow8_2:
Proposed Matching CostsRow8_2:
Description and PurposeRow9_2:
Costs Proposed for Grant ReimbursementRow9_2:
Proposed Matching CostsRow9_2:
Description and PurposeRow10_2:
Costs Proposed for Grant ReimbursementRow10_2:
Proposed Matching CostsRow10_2:
Description and PurposeRow11_2:
Costs Proposed for Grant ReimbursementRow11_2:
Proposed Matching CostsRow11_2:
Description and PurposeRow12_2:
Costs Proposed for Grant ReimbursementRow12_2:
Proposed Matching CostsRow12_2:
Description and PurposeRow13_2:
Costs Proposed for Grant ReimbursementRow13_2:
Proposed Matching CostsRow13_2:
Description and PurposeRow14_2:
Costs Proposed for Grant ReimbursementRow14_2:
Proposed Matching CostsRow14_2:
Description and PurposeRow15_2:
Costs Proposed for Grant ReimbursementRow15_2:
Proposed Matching CostsRow15_2:
Description and PurposeRow16_2:
Costs Proposed for Grant ReimbursementRow16_2:
Proposed Matching CostsRow16_2:
Description and PurposeRow17_2:
Costs Proposed for Grant ReimbursementRow17_2:
Proposed Matching CostsRow17_2:
Description and PurposeRow18_2:
Costs Proposed for Grant ReimbursementRow18_2:
Proposed Matching CostsRow18_2:
Description and PurposeRow19_2:
Costs Proposed for Grant ReimbursementRow19_2:
Proposed Matching CostsRow19_2:
Description and PurposeRow20_2:
Costs Proposed for Grant ReimbursementRow20_2:
Proposed Matching CostsRow20_2:
Description and PurposeRow21_2:
Costs Proposed for Grant ReimbursementRow21_2:
Proposed Matching CostsRow21_2:
Description and PurposeRow22_2:
Costs Proposed for Grant ReimbursementRow22_2:
Proposed Matching CostsRow22_2:
Description and PurposeRow23_2:
Costs Proposed for Grant ReimbursementRow23_2:
Proposed Matching CostsRow23_2:
Description and PurposeRow24_2:
Costs Proposed for Grant ReimbursementRow24_2:
Proposed Matching CostsRow24_2:
Costs Proposed for Grant ReimbursementSubtotal_2:
Proposed Matching CostsSubtotal_2:
Costs Proposed for Grant ReimbursementTotal Eligible Costs_2:
Proposed Matching CostsTotal Eligible Costs_2:
Description and PurposeRow1_3:
Costs Proposed for Grant ReimbursementRow1_3:
Proposed Matching CostsRow1_3:
Description and PurposeRow2_3:
Costs Proposed for Grant ReimbursementRow2_3:
Proposed Matching CostsRow2_3:
Description and PurposeRow3_3:
Costs Proposed for Grant ReimbursementRow3_3:
Proposed Matching CostsRow3_3:
Description and PurposeRow4_3:
Costs Proposed for Grant ReimbursementRow4_3:
Proposed Matching CostsRow4_3:
Description and PurposeRow5_3:
Costs Proposed for Grant ReimbursementRow5_3:
Proposed Matching CostsRow5_3:
Description and PurposeRow6_3:
Costs Proposed for Grant ReimbursementRow6_3:
Proposed Matching CostsRow6_3:
Description and PurposeRow7_3:
Costs Proposed for Grant ReimbursementRow7_3:
Proposed Matching CostsRow7_3:
Description and PurposeRow8_3:
Costs Proposed for Grant ReimbursementRow8_3:
Proposed Matching CostsRow8_3:
Description and PurposeRow9_3:
Costs Proposed for Grant ReimbursementRow9_3:
Proposed Matching CostsRow9_3:
Description and PurposeRow10_3:
Costs Proposed for Grant ReimbursementRow10_3:
Proposed Matching CostsRow10_3:
Description and PurposeRow11_3:
Costs Proposed for Grant ReimbursementRow11_3:
Proposed Matching CostsRow11_3:
Description and PurposeRow12_3:
Costs Proposed for Grant ReimbursementRow12_3:
Proposed Matching CostsRow12_3:
Description and PurposeRow13_3:
Costs Proposed for Grant ReimbursementRow13_3:
Proposed Matching CostsRow13_3:
Description and PurposeRow14_3:
Costs Proposed for Grant ReimbursementRow14_3:
Proposed Matching CostsRow14_3:
Description and PurposeRow15_3:
Costs Proposed for Grant ReimbursementRow15_3:
Proposed Matching CostsRow15_3:
Description and PurposeRow16_3:
Costs Proposed for Grant ReimbursementRow16_3:
Proposed Matching CostsRow16_3:
Description and PurposeRow17_3:
Costs Proposed for Grant ReimbursementRow17_3:
Proposed Matching CostsRow17_3:
Description and PurposeRow18_3:
Costs Proposed for Grant ReimbursementRow18_3:
Proposed Matching CostsRow18_3:
Description and PurposeRow19_3:
Costs Proposed for Grant ReimbursementRow19_3:
Proposed Matching CostsRow19_3:
Description and PurposeRow20_3:
Costs Proposed for Grant ReimbursementRow20_3:
Proposed Matching CostsRow20_3:
Description and PurposeRow21_3:
Costs Proposed for Grant ReimbursementRow21_3:
Proposed Matching CostsRow21_3:
Description and PurposeRow22_3:
Costs Proposed for Grant ReimbursementRow22_3:
Proposed Matching CostsRow22_3:
Description and PurposeRow23_3:
Costs Proposed for Grant ReimbursementRow23_3:
Proposed Matching CostsRow23_3:
Description and PurposeRow24_3:
Costs Proposed for Grant ReimbursementRow24_3:
Proposed Matching CostsRow24_3:
Costs Proposed for Grant ReimbursementSubtotal_3:
Proposed Matching CostsSubtotal_3:
Costs Proposed for Grant ReimbursementTotal Eligible Costs_3:
Proposed Matching CostsTotal Eligible Costs_3:
Description and PurposeRow1_4:
Costs Proposed for Grant ReimbursementRow1_4:
Proposed Matching CostsRow1_4:
Description and PurposeRow2_4:
Costs Proposed for Grant ReimbursementRow2_4:
Proposed Matching CostsRow2_4:
Description and PurposeRow3_4:
Costs Proposed for Grant ReimbursementRow3_4:
Proposed Matching CostsRow3_4:
Description and PurposeRow4_4:
Costs Proposed for Grant ReimbursementRow4_4:
Proposed Matching CostsRow4_4:
Description and PurposeRow5_4:
Costs Proposed for Grant ReimbursementRow5_4:
Proposed Matching CostsRow5_4:
Description and PurposeRow6_4:
Costs Proposed for Grant ReimbursementRow6_4:
Proposed Matching CostsRow6_4:
Description and PurposeRow7_4:
Costs Proposed for Grant ReimbursementRow7_4:
Proposed Matching CostsRow7_4:
Description and PurposeRow8_4:
Costs Proposed for Grant ReimbursementRow8_4:
Proposed Matching CostsRow8_4:
Description and PurposeRow9_4:
Costs Proposed for Grant ReimbursementRow9_4:
Proposed Matching CostsRow9_4:
Description and PurposeRow10_4:
Costs Proposed for Grant ReimbursementRow10_4:
Proposed Matching CostsRow10_4:
Description and PurposeRow11_4:
Costs Proposed for Grant ReimbursementRow11_4:
Proposed Matching CostsRow11_4:
Description and PurposeRow12_4:
Costs Proposed for Grant ReimbursementRow12_4:
Proposed Matching CostsRow12_4:
Description and PurposeRow13_4:
Costs Proposed for Grant ReimbursementRow13_4:
Proposed Matching CostsRow13_4:
Description and PurposeRow14_4:
Costs Proposed for Grant ReimbursementRow14_4:
Proposed Matching CostsRow14_4:
Description and PurposeRow15_4:
Costs Proposed for Grant ReimbursementRow15_4:
Proposed Matching CostsRow15_4:
Description and PurposeRow16_4:
Costs Proposed for Grant ReimbursementRow16_4:
Proposed Matching CostsRow16_4:
Description and PurposeRow17_4:
Costs Proposed for Grant ReimbursementRow17_4:
Proposed Matching CostsRow17_4:
Description and PurposeRow18_4:
Costs Proposed for Grant ReimbursementRow18_4:
Proposed Matching CostsRow18_4:
Description and PurposeRow19_4:
Costs Proposed for Grant ReimbursementRow19_4:
Proposed Matching CostsRow19_4:
Description and PurposeRow20_4:
Costs Proposed for Grant ReimbursementRow20_4:
Proposed Matching CostsRow20_4:
Description and PurposeRow21_4:
Costs Proposed for Grant ReimbursementRow21_4:
Proposed Matching CostsRow21_4:
Description and PurposeRow22_4:
Costs Proposed for Grant ReimbursementRow22_4:
Proposed Matching CostsRow22_4:
Description and PurposeRow23_4:
Costs Proposed for Grant ReimbursementRow23_4:
Proposed Matching CostsRow23_4:
Description and PurposeRow24_4:
Costs Proposed for Grant ReimbursementRow24_4:
Proposed Matching CostsRow24_4:
Costs Proposed for Grant ReimbursementSubtotal_4:
Proposed Matching CostsSubtotal_4:
Costs Proposed for Grant ReimbursementTotal Eligible Costs_4:
Proposed Matching CostsTotal Eligible Costs_4:
Description and PurposeRow1_5:
Costs Proposed for Grant ReimbursementRow1_5:
Proposed Matching CostsRow1_5:
Description and PurposeRow2_5:
Costs Proposed for Grant ReimbursementRow2_5:
Proposed Matching CostsRow2_5:
Description and PurposeRow3_5:
Costs Proposed for Grant ReimbursementRow3_5:
Proposed Matching CostsRow3_5:
Description and PurposeRow4_5:
Costs Proposed for Grant ReimbursementRow4_5:
Proposed Matching CostsRow4_5:
Description and PurposeRow5_5:
Costs Proposed for Grant ReimbursementRow5_5:
Proposed Matching CostsRow5_5:
Description and PurposeRow6_5:
Costs Proposed for Grant ReimbursementRow6_5:
Proposed Matching CostsRow6_5:
Description and PurposeRow7_5:
Costs Proposed for Grant ReimbursementRow7_5:
Proposed Matching CostsRow7_5:
Description and PurposeRow8_5:
Costs Proposed for Grant ReimbursementRow8_5:
Proposed Matching CostsRow8_5:
Description and PurposeRow9_5:
Costs Proposed for Grant ReimbursementRow9_5:
Proposed Matching CostsRow9_5:
Description and PurposeRow10_5:
Costs Proposed for Grant ReimbursementRow10_5:
Proposed Matching CostsRow10_5:
Description and PurposeRow11_5:
Costs Proposed for Grant ReimbursementRow11_5:
Proposed Matching CostsRow11_5:
Description and PurposeRow12_5:
Costs Proposed for Grant ReimbursementRow12_5:
Proposed Matching CostsRow12_5:
Description and PurposeRow13_5:
Costs Proposed for Grant ReimbursementRow13_5:
Proposed Matching CostsRow13_5:
Description and PurposeRow14_5:
Costs Proposed for Grant ReimbursementRow14_5:
Proposed Matching CostsRow14_5:
Description and PurposeRow15_5:
Costs Proposed for Grant ReimbursementRow15_5:
Proposed Matching CostsRow15_5:
Description and PurposeRow16_5:
Costs Proposed for Grant ReimbursementRow16_5:
Proposed Matching CostsRow16_5:
Description and PurposeRow17_5:
Costs Proposed for Grant ReimbursementRow17_5:
Proposed Matching CostsRow17_5:
Description and PurposeRow18_5:
Costs Proposed for Grant ReimbursementRow18_5:
Proposed Matching CostsRow18_5:
Description and PurposeRow19_5:
Costs Proposed for Grant ReimbursementRow19_5:
Proposed Matching CostsRow19_5:
Description and PurposeRow20_5:
Costs Proposed for Grant ReimbursementRow20_5:
Proposed Matching CostsRow20_5:
Description and PurposeRow21_5:
Costs Proposed for Grant ReimbursementRow21_5:
Proposed Matching CostsRow21_5:
Description and PurposeRow22_5:
Costs Proposed for Grant ReimbursementRow22_5:
Proposed Matching CostsRow22_5:

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