Emissions Reduction Incentive Grant (ERIG) · Refer to the RFGA for a complete list of replacement requirements. Application Deadline: Applications will be accepted on a competitive

Regular Post Delivery Texas Commission on Environmental Quality

Air Grants Division ERIG, MC-204 P.O. Box 13087

Austin, Texas 78711-3087

Express Delivery Texas Commission on Environmental Quality

Air Grants Division ERIG, MC-204

12100 Park 35 Circle Building F, 1st Floor, Room 1301

Austin, Texas 78753

Emissions Reduction Incentive Grants (ERIG) Replacement Project Application Form

TCEQ-10430b Solicitation No. 582-21-10608

Eligible Counties:

Austin Area: Bastrop, Caldwell, Hays, Travis, and Williamson Counties

Beaumont-Port Arthur Area: Hardin, Jefferson, and Orange Counties

Corpus Christi Area: Nueces and San Patricio Counties Dallas-Fort Worth Area: Collin, Dallas, Denton, Ellis, Henderson, Hood, Hunt, Johnson, Kaufman, Parker, Rockwall, Tarrant, and Wise Counties

El Paso Area: El Paso County Houston-Galveston-Brazoria Area: Brazoria, Chambers, Fort Bend, Galveston, Harris, Liberty, Montgomery, and Waller Counties

San Antonio Area: Bexar, Comal, Guadalupe, and Wilson Counties

Tyler-Longview Area: Gregg, Harrison, Rusk, Smith, and Upshur Counties

Eligible Applicants: Eligible applicants include individuals, corporations, organizations, governments or governmental subdivisions or agencies, business trusts, partnerships, associations, or any other legal entity. This may include a corporation headquartered outside of the state of Texas, but which operates equipment primarily in an eligible county in Texas.

Eligible Activities: Eligible projects include the replacement of older on-road heavy-duty vehicles and non-road heavy-duty equipment with newer and cleaner models. Note: The term "equipment" refers to one of the eligible emission sources: on-road heavy-duty vehicles, non-road equipment, stationary equipment, marine vessels and locomotives. Equipment being replaced must be in good operating condition. On-Road replacement vehicles and non-road replacement engines must not be more than three years older than the calendar year in which the purchase is made. Refer to the RFGA for a complete list of replacement requirements.

Application Deadline: Applications will be accepted on a competitive basis until 5:00 p.m. CT on January 11 2021. Applications may be submitted via electronic mail to [email protected] or by mail to one of the addresses below.

mailto:[email protected]

FY21 Emissions Reduction Incentive Grants Program TCEQ-10430b (Version 20.01)

Form 1: Applicant Information

1. Applicant Legal Name

2. Business Information

Ownership Code (Business Type):

Payee Identification Number (FEI or SSN):

Does the Applicant meet the TERP Small Business definition? (see RFGA)

3. Authorized OfficialThe applicant or an employee who has legal authority to sign for and speak on behalf of the entity.

Prefix First MI Last Suffix

Title

Primary Phone Secondary Phone

Mailing Address

City State Zip Code

Check here if the physical address is the same as the mailing address.

Physical Address

City State Zip Code

4. Designated Project RepresentativeThe applicant or an employee who will serve as the point of contact for this application.

Check here if the Designated Project Representative is the same as the Authorized Official


Title

Primary Phone Secondary Phone

E-mail Address

Mailing Address

City State Zip Code

Check here if the physical address is the same as the mailing address.

Physical Address

City State Zip Code

5. Designated Location for Records Access and Review by the TCEQ or its RepresentativePlease provide the physical address where records relating to this project may be accessed and reviewed.

Physical Address

City State Zip Code

E-mail Address


Form 2: Third Party Preparer Signature Page 1. Was this application prepared by a third-party? Yes No

A third-party preparer is someone who is assisting in the preparation of the grant application, but who is not related toor a current employee of the applicant.

2. Third-Party Preparer Certification.I hereby certify that, to the best of my knowledge and belief, all information provided in this application and anyattachments is true and correct, as represented to me by the applicant. I understand that failure to sign the applicationor signing it with a false statement may make the submitted offer or any resulting contracts voidable.

Third-Party Preparer Information.

Printed Name:

Title:

Company Name:

Street Address:

City, State, Zip Code:

Phone Number:

Email Address:

Signature*:

Date of Signature:

*Please fill out the entire application before completing the electronic signature. The ability to edit, add, orremove information will be removed after the application is electronically signed.

FY21 Emissions Reduction Incentive Grants Program

Form 3: Program Certifications

This section serves to assure the TCEQ that you understand and agree to the statements below. These provisions relate to the basic contract document which will be in force between the applicant and the TCEQ upon award of a grant. TCEQ urges applicants to download a copy of the example grant contract from www.terpgrants.org and review it so that any questions can be discussed early in the application review process.

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 change between submittal of the application and award of a contract or cancellation of the solicitation, you will promptly notify TCEQ.

Equipment and Activity Certifications

1. Ownership. The equipment has been continuously owned by the applicant for the two years immediately preceding theapplication signature date. For on-road vehicles, the applicant has been listed on the front of the title document for the twoyears immediately preceding the application signature date.

2. Operation & Registration. The equipment has been continuously located and used in Texas for the two yearsimmediately preceding the application signature date. In addition, on-road vehicles have been continuously registered foroperation in Texas for the two years immediately preceding the application signature date. Applicants with apportionedvehicles must submit quarterly usage summaries that include accurate dates and miles driven in each registered state.

3. Condition. The equipment is currently in good operating condition and capable of performing its primary function in theroutine operations of the applicant at the time of signature. To the best of the applicant’s knowledge, the equipment iscapable of continuing to perform its primary function for the duration of the Activity Life, taking into account normalmaintenance, repairs, and upkeep.

4. Continued Operation and Use. If the grant funds were not available, the applicant expects to otherwise continue tooperate the equipment in Texas for at least the duration of the Activity Life and the applicant otherwise would not haveplanned to replace the equipment.

5. Destruction. The applicant has the legal authority to complete the approved method of destruction (disposition) of theequipment or engine being replaced. In general, the old equipment, including the engine, must be rendered permanentlyinoperable within 90 days of receiving financial reimbursement.

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

7. No Emissions Reductions Credits. Activities funded under this program are not eligible to generate marketablecredits 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.

8. Not to Exceed 100% of Equipment Cost. The amount of the grant award plus any other public financial assistance,tax credits or deductions, or other grants may not exceed the total capital cost of the equipment.

9. Failure to achieve the NOX emissions reductions projected in the designated eligible counties for this projectand comply with certain contractual terms may require the grantee to return all or a share of the grant funds.Emission reductions will be based on the grant equipment being used for the percentage of annual hours, miles, or fueluse that occurs in the eligible counties, as designated in the application for that activity. Failure to operate the grantequipment for the percentage of annual use in the eligible counties as designated in the application may result in theTCEQ requiring the return of all or a share of the grant funds. Additionally, the applicant will notify the TCEQ of anytermination of use, change in use, sale, transfer, or destruction of grant-funded equipment, during the Activity Life. Theapplicant further agrees that, during the Activity Life, the TCEQ may be entitled to the return of all or a share of the grantfunds for any loss of emissions reductions compared with the emissions reductions projected in awarding the grant.

10. Requirement to Monitor. The applicant will monitor the use of the grant-funded equipment over the designatedActivity Life. The applicant agrees to provide information on the use of the equipment upon request of the TCEQ.

11. Insurance Coverage. The applicant will maintain, for the term of the Activity Life for each activity, property lossinsurance or self-insurance coverage on any equipment acquired, leased, repowered, retrofitted, or constructed usingthese funds, sufficient to cover the costs of reimbursing the state for its pro-rata share of the activity costs.

Continued on next page

TCEQ-10430b (Version 20.01)


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

Administrative and State Contracting Certifications

1. Uniform Grant Management Standards. The applicant will comply with the Uniform Grant Management Standards(UGMS), adopted June 2004 by the Texas Comptroller of Public Accounts in accordance with Texas Government CodeChapter 783. This document is available at: http://www.comptroller.texas.gov/purchasing/docs/ugms.pdf.

2. Procurement of Goods and Services. In procuring goods and services, the applicant will comply with UGMS Part III.State Uniform Administrative Requirements for Grants, _.36 Procurement. All procurement transactions will be conductedin a manner providing full and open competition.

3. Historically Underutilized Businesses (HUBs). Qualified HUBs, as defined and designated under state law, shallhave the maximum practicable opportunity to participate in the performance of the work arising out of this project.

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

5.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 and assurances, are met.

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

7.Debt to the State. The applicant is not indebted to the state or has an outstanding tax delinquency. The applicant mustcomply with all State and Federal tax laws and fee requirements and is solely responsible for filing all State and Federaltax and fee forms.

8.Debarment. The applicant certifies that the applying entity and its principals are eligible to participate in this transactionand have not been subjected to suspension, debarment, or similar ineligibility determined by any federal, state or localgovernmental entity.

9.Conflict of Interest. The applicant has not given, offered to give, nor intends to give any economic opportunity, futureemployment, gift, loan, gratuity, special discount, trip, favor, or service to a public servant in connection with the submittedapplication. Under Texas Government Code Section 2155.004, no person involved in the preparation of the Request forGrant Applications may have financial interest in this application. If applicant is not eligible, then any contract resultingfrom this application shall be immediately terminated. Furthermore, under Texas Government Code Section 2155.004, theapplicant certifies that the individual or business entity named in this application or contract is not ineligible to receive thespecified contract and acknowledges that the contract may be terminated and payment withheld if this certification isinaccurate. All purchase decisions must be based on sound business decisions and arm’s length bargaining.

10. Contracting with an Executive of a State Agency. Under Texas Government Code Section 669.003, relating tocontracting with an executive head of a state agency, applicant represents that no person who, in the past four years,served as an executive of the TCEQ or any other state agency, was involved with or has any interest in this application. Ifapplicant employs or has used the services of a former executive head of TCEQ or other state agency, the applicant shallprovide 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.

11. Under Texas Government Code Section 2155.006, the applicant certifies that the individual or business entitynamed in this application is not ineligible to receive the specified contract and acknowledges that any contract resultingfrom this application may be terminated and payment withheld if this certification is inaccurate.

12. The applicant has not been adjudicated during the three-year period immediately preceding the application signaturedate to have committed substantive, non-clerical violations resulting in an actual release of hazardous waste thatpresented an imminent and substantial danger to the public health and safety or the environment.

Continued on next page


13. The applicant’s facilities that shall be utilized in the accomplishment of the activities are not listed on the EPA’s list ofViolating Facilities nor is it under consideration for such listing.

14. The applicant complies with applicable environmental standards, regulations, and laws.

15. The applicant, nor any of its officers, have been adjudicated by a court of law to have violated the Texas DeceptiveTrade Practices Act.

16. Abortion Funding Limitation. The applicant represents and warrants that any payments made by TCEQ withappropriated funds, should a contract be awarded, are not prohibited by Article IX, Section 6.25 of the GeneralAppropriations Act, 86th Legislative Session (2019), nor by Texas Government Code Chapter 2272 ProhibitedTransactions [Senate Bill 22, 86th Legislative Session (2019)].

17. Excluded Parties. Applicant represents and warrants that it is not listed in the prohibited vendors lists authorized byExecutive Order No. 13224, “Blocking Property and Prohibiting Transactions with Persons Who Commit, Threaten toCommit, or Support Terrorism,” published by the United States Department of the Treasury, Office of Foreign AssetsControl. Applicant will notify TCEQ if it can no longer make this representation.


Form 4: Certification of Eligibility to Receive a State-Funded Grant All applicants must complete this form to certify eligibility to receive a grant under this program, regardless if child support obligations apply to the applicant. Failure to submit this form 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% 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)(2) 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), Texas Family Code.

Please Check One of the Following Applicant Options:

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

I certify that to the best of my knowledge and belief that the individual or business entity submitting this application is eligible to receive a grant. I acknowledge that the grant contract may be terminated, and any payments withheld if this certification is inaccurate.

1. Individual or sole proprietorship

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

Name: Social Security Number (SSN):





Initial*: Date:

*Please fill out the entire application before completing the electronic signature. The ability to edit, add, or remove information will be removed after the application is electronically signed.


Form 5: Equipment Information 1. Old Equipment Information.

Equipment Type: (i.e. haul truck, excavator, etc.)

Identification Number: Equipment ID or last four digits of VIN #

Equipment Model Year:

Equipment Make:

Equipment Model: Gross Vehicle Weight Rating:

On-road equipment only Engine Model Year:

Engine Make:

Engine Identification/Serial Number:

Engine Model: Engine Horsepower Rating (bhp/hr):

Non-road equipment only Fuel Type:

Engine Family Code: 12-digit emissions code for engines 2003 and newer

Federal NOX Emissions Standard (g/bhp-hr): Historical Annual Usage:

List average annual use for the last two years immediately preceding the application signature date and select a unit from the dropdown list.

2. New Equipment Information.Equipment Type:

(i.e. haul truck, excavator, etc.) Equipment Model Year:

Engine Model Year: GVWR:

(On-road projects) Horsepower:

(Non-road projects) Fuel Type:

Federal NOX Emissions Standard (g/bhp-hr):

3. Annual UsageUsage Type:

Standard or Non-Standard (only one usage type per application)

Usage Unit: Select from the drop-down list

Activity Annual Usage Rate:

4. Requested Grant Amount. Please indicate the requested grant amount and cost per ton.

Requested Grant Amount: Cost Per Ton of NOX Reduced:

Use the grant estimator to determine Cost Per Ton

Activity Number: ________ Click here for additional pages


Form 6: New Equipment Usage Information Check here if percent annual usage is the same for all activities.

Identify one or more of the following eligible areas where the grant-funded equipment will be operated and indicate the percentage of total annual use in that area for the equipment. Refer to the list of counties within each area on the cover page of this application.

1. Percentage in Area

2. Project Activity LifeCheck here if the activity life is the same for all activities.

3. Business DescriptionProvide a description of your business and how the equipment will be used in your routine operations. For on-road equipment, include your typical driving route (including the cities traveled to and highways/roadways traveled on). If the equipment is primarily being used for natural gas recovery purposes, please indicate this below.

. FY21 Emissions Reduction Incentive Grants Program

Description Percent Usage

% of Annual Usage Austin Area:

% of Annual Usage Beaumont-Port Arthur Area:

% of Annual Usage Corpus Christi Area:

% of Annual Usage Dallas-Fort Worth Area:

% of Annual Usage El Paso Area:

% of Annual Usage Houston-Galveston-Brazoria Area:

% of Annual Usage San Antonio Area:

% of Annual Usage Tyler-Longview Area:

% Total Annual Usage:

% on Designated Highways (if applicable):

Activity Life: Select an activity life from the drop-down list.

Business Description and/or Daily Route Description:

Activity Number: ________

Click here for additional pages


Form 7: Summary Page Applicant Information.

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 that to the best of my knowledge and belief, all information provided in this application and any attachments is true and correct. I certify that I have read the complete application after all forms and information were completed, I agree with the information provided, and the date provided below is the date I signed the form. I further understand that prior to incorporating these forms and information into a grant contract the data and information may be revised by the TCEQ for accuracy, and the acceptance of a grant contract will constitute agreement with those revisions. My signature also constitutes acceptance of the certifications in Form 3, the terms of this grant, and any changes posted through addenda on the Electronic State Business Daily. Failure to sign the application or signing it with an incorrect statement may make the submitted offer or any resulting contracts voidable.

Applicant Legal Name:

Applicant Type:

FEI or SSN:

Primary Project Area: Emission Source:

Total Requested Grant Amount:

Total Number of Activities: Activity Type:

Usage Rate: Standard or Non-Standard

Is the applicant a TERP Small Business?

Mailing Address:

City: State: Zip Code:

How did you hear about this grant program?

Other (please specify):

Printed Name of Authorized Official:

Authorized Official Title:

Signature of Authorized Official*:

Date of Signature:

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

Intentional falsification of these forms will be prosecuted to the extent allowed under the law and may be used as an adverse factor in future grant selection decisions. 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 also have any errors in their information corrected.

To review such information, contact the TCEQ TERP program at [email protected] or 1-800-919-TERP (8377).

mailto:[email protected]


Required Attachments – Part 1 W-9 Form – Applicable to All ApplicationsSignature Required. A W-9 Form can be obtained from the IRS, link: https://www.irs.gov/pub/irs-pdf/fw9.pdf Please use the "Attach Documents" button below to upload your W-9 Form to this document.

State or Federal Identification Card - Only applicable if applicant is an Individual or Sole Proprietor. Please insert a copy of your State or Federal Identification Card in the provided box below. Picture or attachment must be clear and easily readable.

New Equipment Prior Purchase Documents – Only applicable if applicant has already purchased the new equipment. If the equipment has already been purchased, provide the purchase, lease or financing agreement showing the price paid. Please use this upload feature to attach purchase, lease, or finance agreements for each activity purchased prior to your application submission.

New equipment purchases made before the opening of the grant application period may not be eligible.

https://www.irs.gov/pub/irs-pdf/fw9.pdf


Required Attachments – Part 2a: Color Photographs of Old Equipment

Exterior Equipment Photographs Please upload color photographs into the boxes provided below of the front, right side, left side, and rear. The equipment photographs should be clear and readable.

Activity ___________ Front -Select camera icon to upload your photograph

Activity ___________ Rear -Select camera icon to upload your photograph



Required Attachments – Part 2b: Color Photographs of Old Equipment

Exterior Equipment Photographs Please upload color photographs into the boxes provided below of the front, right side, left side, and rear. The equipment photographs should be clear and readable.

Activity ___________ Right Side -Select camera icon to upload your photograph

Activity ___________ Left Side -Select camera icon to upload your photograph



Required Attachments – Part 2c: Color Photographs of Old Equipment

Engine Photographs Please upload color photographs into the boxes provided below of the engine and engine plate of the old equipment. The engine plate should include the engine family code, engine model, engine serial number and be clear and readable.

Activity ___________ Engine Top -Select camera icon to upload your photograph

Activity ___________ Engine Right -Select camera icon to upload your photograph



Required Attachments – Part 2d: Color Photographs of Old Equipment

Engine Photographs Please upload color photographs into the boxes provided below of the engine and engine plate of the old equipment. The engine plate should include the engine family code, engine model, engine serial number and be clear and readable.

Activity ___________ Engine Left -Select camera icon to upload your photograph

Activity ___________ Engine Plate -Select camera icon to upload your photograph


FY21 Emissions Reduction Incentive Grants Program

Required Attachments – Part 3

On-Road Equipment Applications Only Copy of Current Title or Lease Agreement for Old Equipment Please use the "Attach Documents" button below to upload the old equipment title or lease agreement for each activity.

Copy of Registration Documents for Old Equipment Please include documentation of continuous registration for the 12 months immediately preceding the application signature date. NOTE: This may require 2 years of registration documents depending on your annual registration date. Please use the "Attach Documents" button below to upload registration documents for each activity.

Note: To view all attachments, go to View>Show/Hide>Navigation Pane>Attachments.


Form 8: Application Checklist and Submission All applications require the documents listed below. Please ensure that you have read and attached all the required documents. All pages that must be signed or initialed are indicated below. If a signature page is missing or has been altered, the application will not be considered.

Application Form Checklist (All Applications):

Form 1: Applicant Information I have filled out this ERIG application entirely.

Form 2: Third-Party Preparer Certification If a Third-Party Preparer was used, Signature Required.

Form 3: Program Certifications I have read and understand Form 3 within this application.

Form 4: Certification of Eligibility Initials Required.

Form 5: Equipment Information I have filled out entirely and created additional pages as needed.

Form 6: New Equipment Usage Information

I have filled out entirely and created additional pages as needed.

Form 7: Summary Page I have filled out entirely. Signature Required.

Form 8: Application Checklist and Submission

I have filled out entirely.

Required Attachment Checklist (All Applications):

W-9 Form Signature Required. https://www.irs.gov/pub/irs-pdf/fw9.pdf

Copy of State or Federal Identification Card

Only applicable if applicant is an individual or sole proprietor.

Color Photographs of Old Equipment Please upload color photographs of the front, right side, left side, rear, engine and engine plate of the old equipment.

If the Equipment has already been purchased, provide the purchase, lease or financing agreement showing the price paid.

The purchase may not have been made before the opening of the grant application period.

Required Attachments (On-Road Equipment):

Copy of Current Title or Lease Agreement for Old Equipment

Please document ownership for the 2 years immediately preceding the application signature date.

Copy of Registration Documents for Old Equipment

Please include documentation of current registration for 1 year (12 months) immediately preceding the application signature date.

Supplemental Forms (if applicable):

Waiver Request (if applicable) Please fill out entirely if applicable. Signature Required.

Quarterly Summaries (On-Road Equipment - Apportioned Tags Only) Quarterly Summary Form provided at the end of this document.

If apportioned registration was submitted, mileage logs are required for 2 years immediately preceding the application signature date. Please include quarterly summaries that include miles driven in each registered state.

Locomotive Projects Applicants applying for Locomotive projects must complete this form and attach it to the application form being submitted.

Stationary Equipment Applicants applying for Stationary Equipment projects must complete this form and attach it to the application form being submitted.

Heavy-Duty Non-Road Equipment Natural Gas Recovery

Submit this form if you are applying for heavy-duty non-road equipment that is used for Natural Gas Recovery Purposes.


Alternative Disposition Request (Locomotive Projects Only): Form provided.

Permanent Removal from the State of Texas

If an applicant is requesting an alternative method of disposition that results in the old locomotive and engine being permanently removed from the State of Texas, the request must be submitted prior to or with the application submission.

Alternative Destruction Request: Form provided.

Requesting Alternative Destruction If an applicant is requesting an alternative method of destruction other than the listed method in the RFGA, the request must be submitted prior to or with the application submission.

Waiver for Ownership, Registration, Use, or Condition Requirement: Form provided.

Ownership:

Registration (On-Road Vehicles):

Operation in Texas:

Condition:

Continued Operation and Use:

Application Submission Please confirm that you have completed all requirements for your Emissions Reduction Incentive Grants (ERIG) application. To submit your application, including uploaded attachments, supplemental forms, and photographs, please do the following:

Step 1 - Press the Save My Application Button to compile and compress your application in preparation for email. Choose Reduced File Size and save your file with 'FY21 ERIG' and your legal name as your file name.

Step 2 - Email your saved application to [email protected]. Please include 'FY21 ERIG' and your legal name in the subject line. Submit one (1) email including your FY21 ERIG application and any attachments.

Helpful Tips and Tools:

Is your file too large to email?

Need help to view, delete, or upload additional attachments? In Adobe Acrobat reader or Pro, choose View, then Show/Hide, then Navigation Pane, then Attachments.

Please contact [email protected] if you have questions or need help with your application.


Adobe Acrobat Pro Users: Choose File, then Save As Other, then Optimized PDF instead of Reduced File Size asstated in Step 1 above. Remember, if you choose to optimize your application, your attachments will not beincluded with your application and will need to be included with your email instead. To avoid a large ERIGapplication file, confirm that your submitted documents and pictures are no larger than 500 KB each.

Free Adobe PDF Compress tool: Browse to free tool located at https://www.adobe.com/acrobat/online/compress-pdf.html website, press the blue ‘Select a file’ button to upload your ERIG application and follow the directions.Download your final compressed ERIG application file, save your file with the program year and program acronymand your legal name as your file name. Example: FY21 ERIG Your Legal Name. Email your saved application [email protected]


Supplemental Form: Waiver Request Applicants requesting a waiver to one or more of the program requirements must complete this form and include it with the application during submission.

Please choose the waiver request(s) that apply to the activity. Waiver for the Ownership Requirement: Equipment has not been continuously owned for the two years immediately preceding the application signature date. For on-road equipment, the applicant has not been listed on the front of the title document for the two years immediately preceding the application signature date.

Waiver for the Registration Requirement: Equipment has not been continuously located and used in Texas for the two years immediately preceding the application signature date. In addition, on-road equipment has not been continuously registered for operation in Texas for the two years immediately preceding the application signature date.

Waiver for the Usage Requirement: Equipment is not currently in good operating condition and is incapable of performing its primary function in the routine operations of the applicant at the time of application signature. Equipment cannot continue to perform its primary function for the duration of the activity life of the project.

Please provide a detailed explanation for the waiver request(s) below. Attach any supporting documentation for your request(s) to this application for review by the TCEQ.

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

Printed Name of Authorized Official:

Signature of Authorized Official*:

Date of Signature Provided:

*Please fill out the entire application before completing the electronic signature. The ability to edit, add, orremove information will be removed after the application is electronically signed.

Year:

Quarter 1 (Jan / Feb / Mar) Texas: Outside Texas: Quarter 1 Total:

Miles:

Quarter 2 (April / Mar / June) Texas: Outside Texas: Quarter 2 Total:

Miles:

Quarter 3 (July / Aug / Sept)

Texas: Outside Texas: Quarter 3 Total:

Miles:

Quarter 4 (Oct / Nov / Dec) Texas: Outside Texas: Quarter 4 Total:

Miles:

Year Total Miles:

Year:

Quarter 1 Texas: Outside Texas: Quarter 1 Total:

Miles:


Miles:


Miles:


Miles:

Year Total Miles:

(Jan / Feb / Mar)

(April / Mar / June)

(July / Aug / Sept)

(Oct / Nov / Dec)


Supplemental Form: Quarterly Usage Summary If an applicant is operating with Apportioned Tags, please indicate the mileage driven inside Texas and outside Texas during each quarter for two years preceding the application signature date. Please use the "Attach Documents" button below to upload IFTA logs.

Please use this "Attach Documents" button to upload IFTA logs.


Supplemental Form: Locomotive Projects – Complete if Needed Applicants applying for Locomotive projects must complete this form and attach it to the Project Application Form being submitted.

Locomotive Only 1. What will be the primary use of the locomotive? Please check the appropriate box. Refer to the locomotive technicalsupplement for details on the options.

Switchyard, Short Haul, Etc. Industrial Rail – Limited use by an industrial or commercial entity

2. The new locomotive will be what type? Please select the appropriate box.Genset/Hybrid Regular One Engine Switcher

3. Use DescriptionBriefly explain the use of the locomotive below to verify the category marked in Item 2 above.

.


Supplemental Form: Stationary Equipment – Complete if Needed 1. List the physical address and/or other description of the equipment location below:

Equipment Physical Address

City State Zip Code

Description of the equipment location:

2. Is this facility covered by a TCEQ permit or registration?Please select the appropriate boxYes No

If you answered Yes to question 2 above, complete information below.

3. Permit Information

Name of Permit Holder


Title

TCEQ Permit / Registration / Account Number (if applicable)

4. General Permit or Permit by Rule (if applicable):List permit or rule number and provide a summary of equipment regulated below.

5. TCEQ Customer Reference Number (CN)

6. TCEQ Regulated Entity Reference Number (RN)

7. TCEQ Facility Identification Number (FIN)

8. TCEQ Emission Point Number (EPN)

Emissions Reduction Requirements, Credits, and Allowances

By signing the Project Application Form 10430b, the applicant certifies that the NOx emissions achieved by this activity are not already required under the conditions of a permit or rule for this site or facility or to ensure that the site or facility remains under an emissions limit.

The applicant also understands that any emissions reduction measure that would otherwise generate a marketable credit under a state or federal emissions averaging, banking, or trading program is not eligible unless the credits are transferred to the TCEQ for the state implementation plan and permanently retired. This includes emissions allowances assigned to the applicant under the Mass Emission Cap and Trade Program in the Houston-Galveston-Brazoria Area established under TCEQ rules (30 TAC Chapter 101, Subchapter H, Division 3). If a grant is awarded, the applicant must transfer and permanently retire any applicable credits or allowances.


Supplemental Form: Non-Road Heavy-Duty Equipment Used for Gas Recovery Purposes – Complete if Needed For non-road equipment used primarily for natural gas recovery purposes, the TCEQ may exempt the applicant from the requirement that 75% of the annual operation of the grant-funded equipment must occur in the eligible counties listed in the application and contract documents.

Note: If the applicant is exempt from using the equipment less than 75% of the annual use in the designated areas, the applicant must agree to install a GPS tracking device through a designated TGMS Contractor to track and report usage and location of the use of the non-road equipment. Refer to section 2.7(c of the RFGA for an explanation of the percent of use commitment.

Explain below in detail how the equipment being upgraded has been used and how the upgraded equipment will be used in natural gas recovery. For example, a generator used on a natural gas drill rig may qualify, but a tracked dozer used to build a road to a drill would not.


Alternative Disposition/Destruction Request - Locomotives Only Alternative Disposition Request:

Permanent Removal from the State of Texas If an applicant is requesting an alternative method of disposition that results in the old locomotive and engine being permanently removed from the State of Texas, the request must be submitted prior to or with the application submission.

Please describe the alternative method of disposition proposed below.

Alternative Destruction Request:

Requesting Alternative Destruction If an applicant is requesting an alternative method of destruction other than the listed method in the RFGA, the request must be submitted prior to or with the application submission.

Please describe the alternative method of destruction proposed below.

Form 1: Applicant Information1. Applicant Legal Name2. Business Information3. Authorized Official4. Designated Project Representative5. Designated Location for Records Access and Review by the TCEQ or its Representative

Form 2: Third Party Preparer Signature Page1. Was this application prepared by a third-party? Yes No2. Third-Party Preparer Certification.Third-Party Preparer Information.

Form 4: Certification of Eligibility to Receive a State-Funded GrantCertification Regarding Child Support Obligations.Please Check One of the Following Applicant Options.If Option 1 or 2 is checked, list the name(s) and social security number(s) (SSN) below.

Form 5: Equipment InformationForm 6: New Equipment Usage InformationForm 7: Summary PageApplicant Information.Authorized Official.

Required Attachments – Part 1W-9 Form – Applicable to All ApplicationsState or Federal Identification Card - Only applicable if applicant is an individual or sole proprietor.New Equipment Prior Purchase Documents – Only applicable if applicant has already purchased the new equipment.New equipment purchases made before the opening of the grant application period may not be eligible.

Required Attachments – Part 2: Color Photographs of Old EquipmentEngine PhotographsRequired Attachments – Part 3On-Road Equipment Applications OnlyCopy of Current Title or Lease Agreement for Old EquipmentCopy of Registration Documents for Old EquipmentQuarterly Summaries – Applicable to applicants with apportioned Tags Only

FY20ERIG-CHECKLIST-DRAFT-UPDATED-SW.pdfApplication Submission

Title: Social Security Number SSN: Social Security Number SSN_2: Social Security Number SSN_3: Social Security Number SSN_4: Social Security Number SSN_5: Equipment Type ie haul truck excavator etc: Identification Number Equipment ID or last four digits of VIN: Equipment Make: Equipment Model: Equipment Model Year: Gross Vehicle Weight Rating Onroad equipment only: Engine Make: Engine Model: Engine IdentificationSerial Number: Engine Model Year: Engine Horsepower Rating bhphr Nonroad equipment only: Engine Family Code 12digit emissions code: Federal NOX Emissions Standard gbhphr: Historical Annual Usage List average annual use for the last two years immediately preceding the application signature date and select a unit from the dropdown list: Equipment Type ie haul truck excavator etc_2: Equipment Model Year_2: Engine Model Year_2: GVWR Onroad Projects: Horsepower Nonroad projects: Select OneFederal NOX Emissions Standard gbhphr: Cost Per Ton of NOX Reduced Use the grant estimator to determine Cost Per Ton: Percent Usage of Annual Usage Austin Area: Percent Usage of Annual Usage BeaumontPort Arthur Area: Percent Usage of Annual Usage Corpus Christi Area: Percent Usage of Annual Usage DallasFort Worth Area: Percent Usage of Annual Usage El Paso Area: Percent Usage of Annual Usage HoustonGalvestonBrazoria Area: Percent Usage of Annual Usage San Antonio Area: Percent Usage of Annual Usage TylerLongview Area: Percent Usage Total Annual Usage: Percent Usage on Designated Highways if applicable: Other please specify: Printed Name of Authorized Official: Printed Name of Authorized Official_2: Activity: Activity_2: Equipment Physical Address: City_2: State_7: Zip Code_7: First_5: MI_3: Last_3: Suffix_3: Title_2: TCEQ Permit Registration Account Number if applicable: 5 TCEQ Customer Reference Number CN 6 TCEQ Regulated Entity Reference Number RN 7 TCEQ Facility Identification Number FIN 8 TCEQ Emission Point Number EPN: 5 TCEQ Customer Reference Number CN 6 TCEQ Regulated Entity Reference Number RN 7 TCEQ Facility Identification Number FIN 8 TCEQ Emission Point Number EPN_2: 5 TCEQ Customer Reference Number CN 6 TCEQ Regulated Entity Reference Number RN 7 TCEQ Facility Identification Number FIN 8 TCEQ Emission Point Number EPN_3: 5 TCEQ Customer Reference Number CN 6 TCEQ Regulated Entity Reference Number RN 7 TCEQ Facility Identification Number FIN 8 TCEQ Emission Point Number EPN_4: Form4 One or more 25%: OffForm4 Individual: OffForm4 No 25%: OffForm4 Government: OffForm4 Date_af_date: Form 7 Date of AO Signature: Form 8 Date of AO Signature: Name of Permit Holder: Please describe the alternative method of disposition proposed: Please describe the alternative method of destruction proposed: ReqAttPt2Ext: Click here for additional pages:

Upload Photograph of State or Federal ID: Check Box6: OffCheck Box7: OffCheck Box8: OffCheck Box9: OffCheck Box10: OffCheck Box11: OffCheck Box12: OffCheck Box13: OffDescription of the equipment location: Prefix P18: [-Select-]List permit or rule number and provide a summary of equipment regulated below: Briefly explain the use of the locomotive below to verify the category marked in Item 2 above: Check Box16: OffCheck Box17: OffCheck Box18: OffCheck Box19: OffActivity Number_2: Form 2 No Check Box: OffForm 2 Yes Check Box: OffForm5: Click here for additional pages:

Form 6 Check Box: OffWaiver Check Box - Ownership: OffWaiver Check Box - Registration: OffWaiver Check Box - Usage: OffForm2Date_af_date: Form2Email: Form2Number: Form2 City State Zip Code: Form2 Street Address: Form2 Company Name: Form2 Printed Name: Form4Name: Form4Name_2: Form4Name_3: Form4Name_4: Form4Name_5: Authorized Official Title: CheckSame: OffAuthorized Official Physical City: Authorized Official Physical State: Authorized Official Physical Zip Code: Authorized Official Physical Address: CheckSame2: OffDPR First Name: DPR Middle Initial: DPR Last Name: DPR Suffix: DPR Title: DPR Cell Number: DPR Phone Number: DPR Mailing Address: DPR Mailing City: DPR Mailing State: DPR CheckSame: OffDPR Physical Address: DPR Physical State: DPR Physical Zip Code: DPR Physical City: DPR Mailing Zip Code: AO Prefix: [-Select-]AO First Name: AO Middle Initial: AO Last Name: AO Suffix: AO Title: AO Number: AO Cell Number: DPR Prefix: [-Select-]Records City: Records Address: Records State: Records Zip Code: Form 5 Historical Annual Usage: [-Select-]Form 5 New Usage: [-Select One-]Form 5 Usage Rate: Form 6 Check Box 2: OffProject Activity Life: [-Select One-]Form 1 Applicant Information: Ownership Code (Business Type): [-Select One-]Select OnePayee Identification Number FEI or SSN: Requested Grant Amount: Form 5 Fuel Type Old: [-Select One-]Authorized Official Mailing Address: Form 7 Number of Activities: Authorized Official Mailing City: Authorized Official Mailing State: Authorized Official Mailing Zip Code: Form 5 Usage: [-Select One-]Does the Applicant meet the TERP Small Business definition?: [-Select One-]Form 5 Fuel Type New: [-Select One-]Form 7 Primary Area: [-Select One-]Form 7 Outreach: [-Select One-]RA-P1 W-9 Upload: RA-P1 Prior Purchase Documents: Detailed Explanation Alternative Disposition: Price Comparison Upload: F7ActivityType: [-Select-]Requested Granted Amount: SF Gas Recovery: Business Description andor Daily Route Description: Pt2EngPicL2: Pt2engPicPlate: Pt2EngPicPlate: Pt2EngPicLeftUpload: Pt2EngRightPic: Pt2EngTopPic: Pt2EngPicTopAct: Pt2EngPicRtAct: Pt2Eng2AddPg: WaiverSignature: Form2 Signature: RAPT2F: RAPT2R_af_image: Pt2LRAddPg: P2RightSideExt: Pt2PicRightSide: Pt2LeftSideExt_af_image: Pt2LeftRightAddPg: F4 Signature: Save My Application: Reset Photo: Camera: Camera2: Camera3: RESET BUTTON: Camera4: RESET PHOTO: AO Email Address: DPR Email Address: RA-Pt3 Upload Title or Lease: RA-Pt3 Upload Registration: Year: Miles: Miles_2: Miles_3: Miles_4: Year Total Miles: Year_2: Miles_5: Miles_6: Miles_7: Miles_8: Year Total Miles_2: Q1Miles2: Q1Miles3: Q2Miles2: Q2Miles3: Q3Miles3: Q3Miles2: Q4Miles2: Q4Miles3: Q1Miles4: Q1Miles5: Q2Miles4: Q2Miles5: Q3Miles4: Q3Miles5: Q4Miles4: Q4Miles5: Please provide a detailed explanation for the waiver request(s): Summary Attachments: Form5 NewFuel Type: [-Select One-]