ESBD_File_350635_582-24-85016-CB-retrofit-app-FINAL-acc.pdf

Retrofit Project Application Form Texas Clean School Bus Program (TCSB)

Texas Commission on Environmental Quality (TCEQ) Texas Emissions Reduction Plan (TERP)

Solicitation No. 582-24-85016-CB

Este documento es la Solicitud de Aplicaciones de Subvenciones para Programa de Autobuses Escolares Limpios de Texas [(TCSB) por sus siglas en inglés]. 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 Eligible projects include the purchase and installation of eligible retrofit systems on eligible school buses.

The applicant must have continuously owned and registered the school bus for a minimum of two years immediately preceding the application signature date. A school bus proposed for retrofit must be operating on a regular daily route to and from a school in Texas during the regular school year and have at least five years of useful life remaining, unless the applicant agrees to remove the retrofit device at the end of the life of the bus and reinstall it on another bus.

Application Submission Limitations Applicants are limited to applying for a maximum of 5 retrofit activities. If funding is available, TCEQ may publish an addendum to this solicitation and increase this maximum number. Applicants would then be allowed to submit additional application(s) and exceed the original maximum number of five (5) activities.

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

Submission Instructions Submit a completed and signed application form and the required attachments by emailing to TCSB- Apply@tceq.texas.gov, uploading to TCEQ’s File Transfer Protocol Secure (FTPS) site, or submitting the application and associated documents by mail. All applications must be received by TCEQ no later than 5:00 p.m. Central Time, on the application submission deadline listed in the table below. Refer to Section

4.0 of the Request for Grant Applications (RFGA) for detailed instructions for submitting an application.

Please note: submission via standard email may not be secure. Use TCEQ’s FTPS site to submit your application securely (FTPS: A Step-by-Step Video Guide).

Important Dates Date

Program Opening Date Feb. 14, 2024

Application Submission Deadline Oct. 14, 2024

TCEQ-20804b (Rev. Feb. 2024) Page 1 of 13 mailto:TCSB-Apply@tceq.texas.gov mailto:TCSB-Apply@tceq.texas.gov https://ftps.tceq.texas.gov/ https://www.youtube.com/watch?v=GW4eEe_uUwc

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. Entity Information

Entities required to register with the Secretary of State must have an active registration by Feb. 14, 2024, 5:00 p.m. CT and must maintain an active registration throughout the contract period.

Ownership / Business Type

Federal Employer Identification Number (FEI)

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-20804b (Rev. Feb. 2024) Page 2 of 13 https://www.irs.gov/pub/irs-pdf/fw9.pdf

Section 2: Third-Party Preparer Signature Page

1. Third-Party Preparer

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.

Third-Party Preparer Printed Name (First Last)

Title

Company Name

Mailing Address (Street or PO Box)

City

State

Zip Code

Primary Phone Number

Secondary Phone Number

Email Address

Third-Party Preparer Signature*

Third Party 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-20804b (Rev. Feb. 2024) Page 3 of 13

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 Section 231.006, Texas Family Code, 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 Section 231.006(c) and Section 231.302(c)(3) of the Texas Family Code. 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 Section 231.302(e) of the Texas Family Code.

Please Check 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 9: Project Summary Page, under Section 231.006 of the Texas Family Code, 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-20804b (Rev. Feb. 2024) Page 4 of 13 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#231.302 https://statutes.capitol.texas.gov/Docs/FA/htm/FA.231.htm#231.302

Section 4: General Certifications This section includes specific requirements and statements for funding under TCSB. These terms apply to any contract awarded by TCEQ from this application. The TCSB RFGA and the draft contract, located on the TCSB 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 notification to TCEQ within three business days of becoming aware of the change. Failure to notify TCEQ and/or any changes to your certifications may make the application ineligible and may make any resulting contracts voidable.

Equipment and Activity Certifications

1. Ownership. The school bus has been continuously owned for the two years immediately preceding the application signature date. In addition, the applicant has been listed on the front of the title document for the preceding two years.

2. Operation and Registration. The school bus has been continuously located and used in Texas for the two years immediately preceding the application signature date. In addition, the school bus has been continuously registered for operation in Texas for the two years immediately preceding the application signature date.

3. Condition. The school bus is currently in good operating condition and capable of performing its primary function in the routine operations of the applicant at the time of application signature. To the best of the applicant’s knowledge, the bus is capable of performing its primary function for at least five years from the application signature date, 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 school bus in Texas for at least five years from the application signature date.

5. Not Otherwise Required. To the best of the applicant’s knowledge, the proposed activities are not required by any state or federal law, rule or regulation, memorandum of agreement, or other legally binding contract.

6. 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 bus or low-emission technology funded under TCSB.

7. Not to Exceed 100% of Retrofit Equipment Cost. The amount of the TCSB grant award plus any other public financial assistance, tax credits or deductions, or other grants may not exceed the total eligible costs of the retrofit equipment.

8. Requirement to Monitor. The applicant will monitor the use of the grant-funded bus or retrofit equipment over the designated Activity Life. The applicant agrees to provide information on the use of the bus or equipment upon request of TCEQ.

9. Insurance Coverage. The applicant will maintain, for the term of the Activity Life, property loss insurance or self-insurance coverage on any bus or equipment acquired, leased, repowered, retrofitted, or constructed using these funds, in an amount enough to reimburse the grant.

10. Legal Authority. The applicant has legal authority in the State of Texas to apply for the grant and perform any required retrofit installation activities on the proposed bus(es). 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.

Administrative and State Contracting Certifications

11. 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

TCEQ-20804b (Rev. Feb. 2024) Page 5 of 13 https://www.tceq.texas.gov/airquality/terp/school-buses.html servant in connection with the submitted application. All purchase decisions must be based on sound business decisions and arm’s length bargaining.

12. Nondiscrimination. The applicant will comply with all State and Federal statutes relating to nondiscrimination.

13. Risk Review. The applicant’s prior performance under other TCEQ contracts; its overall compliance history; and any federal, state, or local enforcement action for violation of environmental laws or permit conditions may be considered in determining eligibility.

14. Texas Public Information Act. Information, documentation, and other material in connection with this solicitation or any resulting contract or grant may be subject to public disclosure pursuant to Chapter 552 of the Texas Government Code. In accordance with Section 2252.907 of the Texas Government Code, applicant is required to make any information created or exchanged with the State pursuant to the contract and grant, and not otherwise excepted from disclosure under the Texas Public Information Act, available in a format that is accessible by the public at no additional charge to the State.

15. 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.

16. Contract. The applicant understands that a PDF of the draft contract may be viewed and downloaded from the TCSB 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 TCSB webpage and the Electronic State Business Daily.

a. Emission Reductions. 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 vehicles 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.

b. Texas Grant Management Standards. In accordance with Chapter 783, Texas Government Code, if the applicant is a local government, federal or state entity, or political subdivision, it will comply fully with the Texas Grant Management Standards (TxGMS). This includes compliance with 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: comptroller.texas.gov/purchasing/grant-management.

c. 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 purchases 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.

d. Grant Administration. The applicant will maintain an appropriate grant administration system to ensure that all terms, conditions, and specifications of the grant, including these certifications, are met.

e. Audit. Acceptance of funds under this program acts as acceptance of the authority of the State Auditor’s Office (SAO), 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 SAO with access to any information the SAO considers relevant to the investigation or audit. Applicant will include this clause concerning the authority to audit funds received indirectly and the requirement to cooperate in any subcontract it awards.

17. Contracting with an Executive of a State Agency. Under Government Code Section 669.003, 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

TCEQ-20804b (Rev. Feb. 2024) Page 6 of 13 https://statutes.capitol.texas.gov/Docs/GV/htm/GV.552.htm https://statutes.capitol.texas.gov/Docs/GV/htm/GV.2252.htm#2252.907 https://statutes.capitol.texas.gov/Docs/GV/htm/GV.2252.htm#2252.907 https://www.tceq.texas.gov/airquality/terp/school-buses.html https://www.tceq.texas.gov/airquality/terp/school-buses.html https://statutes.capitol.texas.gov/Docs/GV/htm/GV.783.htm https://statutes.capitol.texas.gov/Docs/GV/htm/GV.783.htm https://comptroller.texas.gov/purchasing/grant-management/ https://statutes.capitol.texas.gov/Docs/GV/htm/GV.669.htm#669.003 with or has any interest in this application. If applicant employs or has used the services of a former executive head of TCEQ or other state agency, then applicant shall provide the following information:

name of former executive, name of state agency, date of separation from state agency, position with applicant, and date of employment with applicant.

18. Debarment and Excluded Parties. 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 in the State of Texas Debarred Vendor List maintained by the Texas Comptroller of Public Accounts, or Sam.gov 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.

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

20. 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.

21. 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.

TCEQ-20804b (Rev. Feb. 2024) Page 7 of 13 https://comptroller.texas.gov/purchasing/programs/vendor-performance-tracking/debarred-vendors.php https://sam.gov/content/home https://www.govinfo.gov/content/pkg/FR-2001-09-25/pdf/01-24205.pdf https://statutes.capitol.texas.gov/Docs/GV/htm/GV.2273.htm https://statutes.capitol.texas.gov/Docs/HS/htm/HS.161.htm#161.0085 https://statutes.capitol.texas.gov/Docs/HS/htm/HS.161.htm#161.0085 https://statutes.capitol.texas.gov/Docs/GV/htm/GV.2252.htm#2252.906 https://statutes.capitol.texas.gov/Docs/GV/htm/GV.2252.htm#2252.906

Section 5: Bus Information

1. Activity Number

Activity 001 002 003 004 005

2. Bus Information

Bus Description (Type A, B, C, or D)

Retrofit Type (DOC, CCFS, DPF)

Bus Make

Bus Model Year

Last 4 Digits of Vehicle ID Number

(VIN)

Gross Vehicle Weight Rating

(GVWR)

Engine Make

Engine Model

Engine Model Year

Engine ID Number

Fuel Type Diesel Diesel Diesel Diesel Diesel

Engine Family Code (12-digit emissions code for engines

2003 and newer)

3. Requested Grant Amount

Total Retrofit Equipment and Installation Cost for this Activity

TCEQ-20804b (Rev. Feb. 2024) Page 8 of 13

Section 6: Retrofit Equipment Information

1. Equipment Information

For each of the buses listed in Section 5, provide additional information on the retrofit equipment.

Diesel Particulate Filter (DPF)

Activity Number(s)

Vendor

Manufacturer(s)

Part No.

Diesel Oxidation Catalysts (DOC)

Activity Number(s)

Vendor

Manufacturer(s)

Part No.

Closed Crankcase Filtration Systems (CCFS)

Activity Number(s)

Vendor

Manufacturer(s)

Part No.

TCEQ-20804b (Rev. Feb. 2024) Page 9 of 13

Section 7: Leasing Company Certification

1. Information of Authorized Bus Leasing Company

Is the bus being retrofitted currently being leased?

If the applicant is leasing the buses, the leased buses are eligible for retrofits if the company that owns the leased buses consents to be a party to the grant agreement between TCEQ and the applicant. This form is to be completed by the leasing company that owns the school buses in order to certify that the company is willing to be a party with the applicant in the contract with TCEQ.

If you selected Yes in subsection 1 above, the leasing company must complete and sign subsection 2 below. If you marked No in subsection 1, you may continue to Section 8: Retrofit Budget Plan.

2. Information of Authorized Bus Leasing Company

Applicant Name

Name of Authorized Bus Leasing Company

Printed Name of Authorized Bus Leasing Company Representative

Signature of Authorized Bus Leasing Company Representative

Date of Signature

TCEQ-20804b (Rev. Feb. 2024) Page 10 of 13

Section 8: Retrofit Budget Plan

Activity Number Device Type Budget

Category Unit Price Number of Units Total

Total Retrofit Equipment Cost

TCEQ-20804b (Rev. Feb. 2024) Page 11 of 13

Section 9: Project Summary Page

1. Applicant Information

Applicant Legal Name

Applicant Type

Applicant Mailing Address (Street or PO Box)

Applicant City, State, and Zip Code

2. Location/Facility Description Describe the current, daily route that the school bus takes to and from school, including the cities and counties travelled between.

Activity 001

Activity 002

Activity 003

Activity 004

Activity 005

3. Project Information

Primary Project Area

Emission Source On-Road

Project Type Retrofit

Total Number of Activities in this Application (This number should match the number from Section 5)

Total Requested Grant Amount (Total requested grant amount of all activities from Section 5)

4. 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 Sections 3 & 4 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. Upon submission, all proposals become the property of the State of Texas and as such become subject to the Texas Public Information Act, Texas Government Code Chapter 552.

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 800-919-TERP (8377).

TCEQ-20804b (Rev. Feb. 2024) Page 12 of 13 https://statutes.capitol.texas.gov/Docs/GV/htm/GV.552.htm mailto:TERP@tceq.texas.gov

Section 10: 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

(only required if application was prepared by a third party) Signature Required.

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

Section 4: General Certifications Read and include with the application.

Section 5: Bus Information

Section 6: Retrofit Equipment Information

Section 7: Leasing Company Certification

(only required if buses being retrofitted are currently leased) Signature Required.

Section 8: Retrofit Budget Plan

Section 9: Project Summary Page Signature Required.

Section 10: Application Checklist Read and include with the application.

Required Attachments Checklist (All Applications)

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

Color Photographs of Bus

Attach color photographs of the front, right side, left side, rear, engine, and engine plate of the old bus. Label each photo with the associated activity number.

Copy of Current Title or Lease Agreement for Bus

Include documentation of ownership for the 2 years immediately preceding the application signature date.

Copy of Registration Documents for Bus

Include documentation of continuous registration for the 12 months immediately preceding the application signature date.

TCEQ-20804b (Rev. Feb. 2024) Page 13 of 13 https://www.irs.gov/pub/irs-pdf/fw9.pdf