### BOARD MEETING DATE: M arch 4, 2016 AGENDA NO. 7

PROPOSAL: Adopt Resolution Reco gnizing Funds and Accepting Term s and

Conditions for FY 2015-16 C arl Moyer Program Award, Issue

Program Announcements for C arl Moyer Program and SOON

Provision, Execute and Ame nd Contracts, and Amend SOON

Provision Implementation Guidelines

SYNOPSIS: These actions are to a dopt a resolution recognizing u p to $26

million in Carl Moyer Program g rant awards from CARB under SB

1107 with its terms a nd conditions for FY 2015-16 and to approv e the release of Prog ram Announcements for the FY 2015-16 “Year

18” Carl Moyer Program and SOON P rovision to provide incentive

funding for low-emitting on- and off-road vehicles and equipmen t.

Additionally, these actions are to execute and amend contracts in

the amount of $570,799, compris ed of $542,300 from the Air

Quality Investment Fund, Rule 2202 Program (27), and $28,499

from the Carl Moyer Program SB 1107 Fund (32). Finally, this

action is to approve amendmen ts to the SOON Provision

Implementation Guidelines.

COMMITTEE: Technology, February 19, 2016; Recommended for Appro val

RECOMMENDED ACTIONS:

1. Adopt the attached resolution recognizing upon receipt up to $2 6 million from

CARB into the Carl Moyer Program SB 1107 Fund (32) and acceptin g terms and

conditions of the FY 2015- 16 Carl Moyer grant award.

2. Approve issuance of Program Ann ouncement #PA2016-05 to solicit projects for the

FY 2015-16 “Year 18” Carl Moyer Me morial Air Quality Standards Attainment

Program.

3. Approve issuance of Program Ann ouncement #PA2016-06 to solicit projects for the

SOON Provision.

4. Authorize the Chairman to execute the following contracts in an amount not to

exceed $542,300, from the Air Qua lity Investment Fund, Rule 220 2 Program (27):

a. Philip Huynh for the rep ower of 2 main engines of a marine vess el in an amount

not to exceed $181,900;

### -2- 

### b. James Simmerman for the repower o f 2 main engines of a marine v essel in an

amount not to exceed $145,350; and

c. Khiet Nguyen for the repower of 2 main and 1 auxiliary engines of a marine

vessel in an amount not to exceed $215,050.

5. Authorize the Chairman to amend a contract with West Coast Equi pment, LLC for

the replacement of 7 o ld for 3 new o ff-road equipment with lowe r-emitting CARBcertified Interim Tier 4 engines with an increase in the fundin g amount by $28,499

from the Carl Moyer Program SB 1 107 Fund (32), for a new total amount of

$132,509.

6. Approve amendments to the SOON Pr ovision Implementation Guideli nes as provided in Attachment 4.

Barry R. Wallerstein, D.Env.

Executive Officer

MMM:FM



### Background

The Carl Moyer Memorial Air Quality Standards Attainment Progra m (CMP) and the

Surplus Off-Road Opt-in for NOx (SOON) Provision provide fundin g on an incentive

basis for the incremental cost of purchasing cleaner than requi red engines and

equipment. Both programs are f unded with the Carl Moyer Progra m SB 1107 and AB

923 funds. This is the 18 th 

### year of the CMP and the 12 th 

### year of the program with

funding from SB 1107 and AB 923.

SOON Provision Implementation Guidelines

On July 11, 2014, the Board ame nded Rule 2449 - Control of Oxid es of Nitrogen

Emissions from Off-Road Diesel Veh icles, to revise the referenc e from Section 2449.3

to Section 2449.2 of Title 13 of t he California Code of Regulat ion. On August 14,

2014, the amended Rule 2449 was submitted to CARB for approval. CARB approved

Rule 2449 and forwarded it on to U.S. EPA as a revision to the State Implementation

Plan. As part of reviewing the approvability of Rule 2449, U.S . EPA indicated that the

SOON Implementation Guidelines (Guidelines) should be amended t o reference the

appropriate section of the State Regulation. In addition, ther e is a desire to align the

funding levels for the SOON Provis ion to be the same as the fun ding levels provided in

the Carl Moyer Program.

### -3- 

### Proposal

Carl Moyer Program

This action is to adopt the att ached resolution recognizing upo n receipt up to $26

million from CARB into the Carl Mo yer Program SB 1107 Fund (32) for

implementation of the FY 2015-1 6 “Year 18” CMP and accepting th e terms and

conditions of the FY 2015-16 Ca rl Moyer Grant award. CARB has tentatively allocated

$25,495,135 to the SCAQMD. Of t his amount, $23,901,689 is desi gnated for projects

funding and $1,593,446 for admin istrative and outreach efforts. In addition, $3,824,270

is required from the SCAQMD as the local match, which will be p rovided from AB 923

funds.

This action is to also approve th e issuance of Program Announce ments #PA2016-05 and

#PA2016-06 for the Carl Moyer Prog ram and the SOON Provision, r espectively. The

approximate amounts of available funding are $23 million for th e Carl Moyer Program

and $5 million for the SOON Prov ision. Additional funds may be come available by the

time of award approval, upon whic h more projects will be awarde d up to the total

amount of funds available. A det ailed account of available fun ds from the Carl Moyer

Program Fund, including earned in terest and the split between t he SB 1107 and the AB

923 funds, will be outlined at the time of award recommendation s.

The PAs are issued based on th e current program guidelines and the revisions approved

by CARB on Decembe r 18, 2015. The Carl M oyer PA solicits proje cts for on-road

vehicles, off-road vehicles of sma ll and medium size fleets, lo comotives, marine and

port applications and other vehic les and equipment. The SOON P rovision PA solicits

projects for off-road vehicles in large fleets. As in previous years, SCAQMD will only

fund diesel-to-diesel applications when alternative fuel engine s/vehicles are not

commercially available or certif ied by CARB exce pt for emergenc y vehicles. Approval

of emergency vehicle applicatio ns will be on a case-by-case bas is. Proposals for all

categories will be due by 1:00 p m on Wednesday, June 1, 2016. Staff expects to

finalize the review and evalua tion of the proposals and recomme nd awards for Board

approval at the October 2016 Boa rd meeting. The Carl Moyer Pro gram and the SOON

Provision PAs are attached.

Execute and Amend Contracts

Rule 2202 Air Quality Investment P rogram requires the SCAQMD to achieve emissions

reductions credits with funds su bmitted by employers in lieu of having rideshare

programs. To generate the requi red NOx emissions credits, propo sals were evaluated

from the latest oversubscribed Carl Moyer Program solicitation that closed on June 3,

2015. This action is to fund t he repower of three marine vesse l projects operating in

disproportionately impacted are as in an amount not to exceed $5 42,300, from the Air

Quality Investment Fund, Rule 22 02 Program (27). Total annual NOx and PM

emissions reductions from the reco mmended projects are 2.8 tons and 0.1 ton,

respectively.

### -4- 

### Furthermore, this action is to am end a contract with West Coast Equipment, LLC for the

replacement of 7 old fo r 3 new off-road equip ment with lower-em itting CARB-certified

Interim Tier 4 engines with an increase in the funding amount b y $28,499, and for a

new total amount of $132,509 from the Carl Moyer Program SB 110 7 Fund (32).

Amend SOON Provision Im plementation Guidelines

Per discussions with the U.S. EPA on the SIP a pprovability of R ule 2449, staff is

proposing amendments to the refe rence of the appropriate sectio n under state law,

Section 2449.2, Title 13 of the California Code of Regulations. In addition, staff is

proposing that that the maximum funding amount for eligible rep lacement projects be

the same as the funding level pr ovided in the Carl Moyer Guidel ines for off-road

equipment replacement projects. The provisions referred to in the proposed amendment

are already in effect and repres ent no change to existing requi rements on affected fleets.

This action is to approve the ame ndments provided in Attachment 4.

Outreach

In accordance with SCAQMD’s Proc urement Policy and Procedure, a public notice

advertising the PAs and inviti ng bids will be published in the Los Angeles Times, the

Orange County Registe r, the San Bernardino Sun, and Riverside C ounty’s Press

Enterprise newspapers to leverage the most c ost-effective metho d of outreach to the

South Coast Basin.

Additionally, potential bidders may be notifie d utilizing SCAQM D’s own electronic

listing of certified minority ven dors. Notice of the PAs will b e emailed to the Black and

Latino Legislative Caucuses and various minority chambers of co mmerce and business

associations, and placed on the Internet at SCAQMD’s website ( http://www.aqmd.gov

where it can be viewed by making the selection “Grants & Bids.”

Amend SOON Provision Im plementation Guidelines

No public workshops were held b y SCAQMD staff since the propose d amendments are

administrative in nature and woul d only reference the appropria te section in the

California Code of Regulation per discussions with the U.S. EPA . This will provide

greater funding flexibility to e ligible projects consistent wit h the Carl Moyer Guidelines

for off-road equipment repl acement projects.

Program Guideline

At its July 8, 2005 meeting, the SCAQMD Board approved a long-t erm Program

Guideline for the implementation of the Carl Moyer Program in t he South Coast Air

Basin. The proposed funding dist ribution for different equipme nt categories is made in

this Board letter according to t he criteria outlined in that Gu ideline with emphasis on the

following priorities in order to achieve the highest emission r eductions:

- Goods Movement (40 percent allocation)

- Environmental Justice (50 percent allocation)

### -5- 

### - Cost-Effectiveness

- Low Emission Engine / Vehicle Preference

- Early Commercialization of Advanced Technologies/Fuels

- Fleet Rules

- School Buses

Funding Distribution

The CMP Guideline includes the re quirement that at least 50% of the program funds

must be spent in disproportionate ly impacted areas. At least h alf the funding allocated

under SB 1107 and collected und er AB 923 will be awarded to pro jects located in

disproportionately impacted are as. It has been the policy of t he SCAQMD to allocate at

least 50% of all funding availabl e in the CMP and the SOON Prov ision, including rollover funding from previous years and turnback funds, to disprop ortionately impacted

areas.

Disproportionately Impac ted Areas Point Ranking

The requirements of the CMP and the SOON Provision will be impl emented according

to the following criteria.

1) All projects must qualify by mee ting the cost-effectiveness lim its established in the

Program Announcement.

2) All projects will be evaluated according to t he following crite ria to qualify for

funding as a disproporti onately impacted area:

a) Poverty Level: Detailed socioeco nomic information is not includ ed in the 2010

Census. Such data is collected y early from a small percentage of the population

on a rotating basis by the Americ an Community S urvey (ACS). Al l projects in

areas where at least 10 percent of the population falls below t he federal poverty

level based on the 2008-2012 ACS data are eligible to be includ ed in this

category, and

b) PM2.5 Exposure: All projects in areas with the highest 15 perce nt of PM2.5

concentration measured within a 2 km grid will be eligible to b e ranked in this

category. The highest 15 percent of PM2.5 concentration is 11.1 0 micrograms

per cubic meter and above, on an annual average, or

c) Air Toxics Exposure: All project s in areas with a cancer risk o f 894 in a million

and above (based on MATES IV e stimates) will be eligible to be ranked in this

category.

The maximum score will be compris ed of 40 percent for poverty l evel and 30 percent

each for PM and toxic exposures. S pecial circumstances exist i n some areas, such as

the Ports of Long Beach and Los A ngeles. Since there are no re sidents within the ports,

poverty ranking could not be es tablished. In this case, the po verty ranking from the

adjacent on-shore areas was exte nded to the ports since these p opulated areas are

directly impacted by port activities.

### -6- 

### Benefits to SCAQMD

The SCAQMD has supported a num ber of activities directed to the advancement of new

technologies and commercializati on of low-emission alternative fuel technologies. The

successful implementation of the Carl Moyer Program and the SOO N Provision are

direct results of these techno logy advancement activities. The vehicles and equipment

funded under these Program Ann ouncements will operate many year s, providing longterm emission reductions.

Resource Impacts

CARB has tentatively allocated $ 25,495,135 to the SCAQMD under SB 1107 for

implementation of the FY 2015-1 6 “Year 18” CMP. Of this amount , $23,901,689 is

designated for project funding a nd $1,593,446 for administrativ e and outreach efforts.

These funds shall be recognized i nto the Carl Moyer Program SB 1107 Fund (32). In

addition, $3,824,270 is required as the local match from the SC AQMD, which will be

provided from AB 923 funds.

The total funding for the new c ontracts under the Rule 2202 Pro gram shall not exceed

$542,300 from the Air Quality Inve stment Fund, Rule 2202 Progra m (27).

The total funding increase for t he contract amendment shall not exceed $28,499 from

the Carl Moyer Program SB 1107 Fund (32).

The proposed amendments to the SOON Provision Implementation Gu idelines are

administrative in nature and have minimal administrative resour ce impacts. Existing

SCAQMD resources are sufficient for continued implementation an d enforcement of the

rule and the Guidelines.

Attachments

1. A Resolution of the South Coast Air Quality Management District Board

Recognizing Funds and Accepting the Terms and Conditions of the FY 2015-16 Carl

Moyer Grant Award

2. Carl Moyer Program An nouncement #PA2016-05

3. SOON Provision Program Announcement #PA2016-06

4. SOON Provision Implem entation Guidelines

### -7- 

### RESOLUTION NO. 16-___

A Resolution of the South Coast Ai r Quality Management District Board

Recognizing Funds and Accepting the Terms and Conditions of the

FY 2015-16 Carl Moy er Grant Award

WHEREAS, under Health & Safety Code §40400 et seq., the South Coast

Air Quality Management District (SCAQMD) is the local agency wi th the primary

responsibility for the developmen t, implementation, monitoring and enforcement of air

pollution control strategies, clean fuels programs and motor ve hicle use reduction

measures; and

WHEREAS, the SCAQMD is authorized by Health & Safety Code

§§40402, 40440, and 40 448.5 to implement programs to reduce tra nsportation emissions,

including programs to encourage the use of alternative fuels an d low-emission vehicles;

to develop and implement other strategies and measures to reduc e air contaminants and

achieve the state and federa l air quality standards; and

WHEREAS, the Board has adopted s everal programs to reduce emis sions

from on-road and off-road vehicle s, as well as emissions from o ther equipment, including

the School Bus Incentive Progra m and the Carl Moyer Program; an d

WHEREAS, the SCAQMD is designated as an extreme non-attainment

area for ozone and as such is required to utilize all feasible means to meet national ambient

air quality standards.

THEREFORE, BE IT RESOLVED that the Board of the SCAQMD, State

of California, in regular session assembled on March 4, 2016, d oes hereby accept the

terms and conditions of the FY 2015-16 (Year 18) Carl Moyer Pro gram grant award and

recognizes up to $26 m illion in SB 1107 funds.

BE IT FURTHER RESOLVED that the Executive Officer is authorize d and

directed to take all steps necessary to carry out this Resoluti on.

___________________ _____ __________ ________________ Date Clerk of the Board1 

### 201 6

CARL MOYER MEMORIAL

AIR QUALITY STANDARDS ATTAINMENT PROGRAM

PROGRAM ANNOUNCEMENT

“Year 1 8 ”

SCAQMD PROGRAM ANNOUNCEMENT

# PA 201 6

- 05

The South Coast Air Quality Management District ( SCAQMD ) is seeking project applications

for the following purpose according to terms and conditions attached. In the preparation of this

Program Announcement (PA) the words “Proposer,” “Applicant,” “Contractor,” and

“Consultant” are used interch angeably.

SECTION I

– OVERVIEW

PURPOSE

The SCAQMD is seeking applications for the 2016 Carl Moyer Memorial Air Quality Standards

Attainment Program (CMP), referred to as “ Year 18 ”.

Funding for this PA will be approximately $ 23 million, from the CMP Fund.

The purpose of the CMP is to achieve near

- term emission reductions of Nitrogen Oxides (NOx),

Particulate M atter (PM10) and Reactive Organic Gases (ROG) from heavy

- and medium

- duty

vehicles and equipment operating in Californi a as early and as cost

- effectively as possible. The

CMP provides financial incentives to assist in the purchase of low

- emission heavy

- and medium

duty engine technologies to achieve emission reductions that are real, surplus and quantifiable.

This Progr am Announcement (PA) was prepared based on the Approved Revision of the Carl

Moyer Program (CMP) Guidelines dated December 18, 2015

, which is available online at

http:// www.arb.ca.gov/msprog/moyer/guidelines/current.htm , as well as CMP mail

- out #MSC

15

- 25, also available online at http://www.arb.ca.gov/msprog/mailouts/msc1525/msc1525.pdf

.

All appli cations will be evaluated based on criteria set forth in this PA

, the CMP Guidelines, and

all subsequent updates and modifications /advisories ; up to date C MP information may be

obtained at C arl Moyer Program Web page at http:// www.arb.ca.gov/msprog/moyer/moyer.htm

.

INTRODUCTION

CMP funding is provided via two legislative bills, SB 1107 and AB 923. SB 1107 provides

approximately $61 million a year in statewide funding, and AB 923 permits air districts in

designated non

- attainment areas to collect an additional two dollars in vehicle registration fees to

expend on programs to reduce emissions from vehicular sources and off

- road equipment . A

resolution approving such fees was adopted by the SCAQ MD Board on December 3, 2004.2



### FUNDING CATEGORIES

The specific project categories identified for funding under the SCAQMD ’s 2016 CMP

solicitation are:

On

- Road Heavy

- Duty Vehicles

 On

- Road Heavy

- Duty Vehicle projects must generate surplus emission re ductions.

Therefore, all vehicles subject to California Air Resources Board’s ( CARB’s ) Fleet

Rules, including but not limited to the Statewide Truck & Bus Regulation, Solid Waste

Collection Vehicle Rule, Public Agencies & Utilities Fleet Rule and Drayage Truck

Regulation, significantly reduce if not eliminate funding opportunities. The remaining

funding opportunities apply exclusively to emergency vehicles and to fleets of three

( 3 ) or fewer vehicles

. Eligible Emergency Ve hicle projects are those in which a new or

used replacement vehicle with an engine meeting the current model year California

emission standard replaces an older, more polluting fire apparatus.

 A larger fleet ( four or more vehicles) may be eligible for a small percentage of funding if

the fleet is currently in compliance with the applicable CARB Fleet Regulation. The

percentage of funding will be determined by the amount of surplus emission reductions

that are generated a minimum of one year prior to regul atory requirements.

Off

- Road Heavy

- Duty Equipment/Engines

 Off

- Road Heavy

- Duty Equipment/Engines, including but not limited to construction

equipment, marine engines, shore power, locomotives, agricultural tractors

, zero

emission rubber

- tire d gantry ( RTG ) crane and other cargo handling equipment.

 Large fleets subject to CARB’s In

- Use Off

- Road Equipment regulation 1 

### are not eligible

for funding from the SCAQMD

.

Refer to C ARB’s fleet rule websites that provide detailed information on compliance with these

regulations . These are listed below in Section VI.

GENERAL PROGRAM INFORMATION

A ll project awards shall not exceed the project’s incremental cost or the maximum cost

effectiveness limit of $ 18,26 0 per ton of weighted emissions reduced

, unless revised by CARB

prior to SCAQMD awards. All projects must meet the criteria stated in this PA , Appendix A and

the CMP Guidelines. C ost

- effectiveness is based on NOx

, ROG and PM reductions

. Project cost

effectiveness is calculated according to the following formula:

Annualized Cost ($/year)

[ NOx reduction + 20(combustion PM10 reduction) + ROG reduction ] ( Tons/year )

All projects must be operational within eighteen (18) months of contract execution or by May 20

, 201 8 , whichever is earlier. Some projects may have earlier in

- service operation date

requirements, if they are subject to CARB regulations.

1 http://www.arb.ca.gov/msprog/ordiesel/ordiesel.htm3



### I t is the applica nt’s responsibility to ensure that the most current information and requirements

are reflected in a submitted application. Applicants should check the CARB website for updates

and advisories to the guidelines ( www.arb.ca.gov/msprog/moyer/moyer.htm )

.

In case s of conflict between CARB guidelines and SCAQMD criteria, the more stringent criteria

will prevail

. SCAQMD will post any new information and requ irements on its CMP W eb page at

www.aqmd.gov/Moyer

.

Projects subject to CARB regulations must submit a copy of the most recent CARB compliance

report(s) or other documentation that provides SCAQMD with clear understanding of the

applicant’s fleet rule compliance status.

All emission reductions resulting from funded projects will be retired by the SCAQMD

. Public financial incentives will be deducted from the total incremental costs that can be fun ded

with Carl Moyer Program funds e xcept for tax credits, tax deductions, public rebates, public

loans, or local air district penalty funds . L ocal air district mitigation fees and other state and

local air district incentives must be part of the cost

- effe ctiveness evaluation

.

Federal funding for programs to reduce greenhouse gas (GHG) emissions, funding provided by

the Alternative and Renewable Fuel and Vehicle Technology Program, Air Quality Improvement

Program, or C ARB’s Low Carbon Transportation Inve stment funds to reduce GHG emissions

are eligible for use provided the grantee pays at least 15 percent of the project cost from non

public sources.

ELIGIBILITY INFORMATION

Emission reductions obtained through Carl Moyer Program projects must not be required by any

federal, state or local regulation, memorandum of agreement/understanding, settlement

agreement, mitigation requirement or other legal mandate.

Engines operating under a regulatory compliance extension granted by C ARB, an air district or

t he United States Environmental Protection Agency (U.S. EPA) are not eligible for funding.

A grant recipient subject to an in

- use regulation may be eligible to receive CMP funding if the

applicant has met all compliance requirements of applicable regulatio ns. Documentation of

regulatory compliance must be provided by applicants to air districts at the time of application

.

Key program requirements for on

- and off

- road equipment categories are highlighted below ;

however

, applicants are responsible for consulting the CMP guideline s for additional program

limitations/requirements

.

ON

- ROAD VEHICLES

All on

- road projects must generate surplus emission reductions. Therefore, all vehicles subject to

CARB’s Fleet Rules, includin g but not limited to the Statewide Truck & Bus Regulation, Solid

Waste Collection Vehicle Rule, Public Agencies & Utilities Fleet Rule, and Drayage Truck

Regulation, significantly reduce if not eliminate CMP funding opportunities. The remaining

funding op portunities discussed below apply exclusively to emergency vehicles and fleets of

three ( 3 ) or fewer heavy

- duty trucks

.

The proposed engine for each on

- road project must be consistent with the “Intended Service

Class” per the CARB Executive Order [ medium

- heavy duty (MHD) Intended Service Class4



### engines cannot be used for projects which have the heavy

- heavy duty (HHD) vehicle

classifications ]

. Executive Orders for on

- road vehicles may be downloaded at:

http://www.arb.ca.gov/msprog/onroad/cert/cert.php

.

Emergency Vehicles

Eligible emergency vehicle projects are those in which a new or used replacement vehicle with

an engine meeting the current model year California emission standard rep laces an older, more

polluting emergency vehicle . The older, replaced vehicle must be destroyed.

A fire truck reuse option is also available on a case

- by

- case basis. The fire truck reuse option

allows fire departments to give away the existing old vehicl e and destroy another older vehicle in

its place. Additional requirements should be reviewed and understood at

http://www.arb.ca.gov/msprog/moyer/guidelines/2011g l/2011cmp_ch6_07_11_14.pdf

New Purchase

On

- road new purchase project opportunities are currently very limited and include, (1) engines

that are at least 30% cleaner than current standards for NOx (0.14 g/bhp

- hr or less) or (2) zero

emission technologies. Both opportunities would generate minimal surplus emission reductions,

resulting in very nominal funding amounts.

Repowers

A replacement engine for a repower project must be a C ARB

- certified engine meeting emissions

levels of 0.50 g/bhp

- hr NOx and 0.0 1 g/bhp

- hr PM or lower. Repowers with replacement family

emission limit ( FEL ) engines that meet these emissions levels must be based on emission factors

for model year 2007

- 2009 engines.

Due to technological constraints presented with the limited feasib ility of newer engines with

advanced emissions control equipment fitting into an older vehicle chassis, single vehicle

repower projects are not eligible for Moyer funding

. However, t he economics of repower

projects involving a large quantity of the same c hassis and engine combination may allow

compliance with the engine manufacturer quality assurance process that is equivalent to an

Original Equipment Manufacturer ( OEM ) package. In these cases, a prototype vehicle is

thoroughly reviewed and tested to ensur e that the installation meets OEM requirements, and the

successful prototype installation is then replicated in other vehicles with the same chassis and

engine combination. While the prototype evaluation (with documented OEM approval) is not

eligible for C MP funding, projects to replicate the identical chassis and engine combination will

be considered on a case

- by

- case basis

.

Retrofit/Replacement

Please refer to the On

- Road Voucher Incentive Program (VIP) to explore funding opportunities

for rep lacement and retrofit funding at : www.aqmd.gov/VIP

.

OFF

- ROAD COMPRESSION

- IGNITION EQUIPMENT

Propulsion engines greater than 25 horsepower on mobile off

- road equipment are eligible for

CMP funding, with limitations. Off

- road heavy

- duty equipment/engines include, but are not

limited to, construction equipment, agricultural tractors, marine engines, shore power and

locomotive equipment. Portable equipment is not eligible for CMP funding.5



### Construction

Fleets must be in compliance with CARB’s In

- Use Off

- Road Diesel Vehicle Regulation (Off

Road Regulation) in order to be eligible for funding. Large f leets subject to CARB’s In

- Use Off

Road Equipment regulation 2 

### are no longer eligible for funding from the CMP.

Applicants must submit information regarding fleet size and compliance status. This must

include the Diesel Off

- Road On

- line Reporting System (D OORS) ID of the fleet, the

DOORS Compliance Snapshot, the DOORS equipment list, and the DOORS Equipment

Identification Number (EIN) of the funded equipment. All documentation submitted must be

signed and dated by the applicant and include language certifyi ng that the fleet list provided is

accurate and complete. Off

- road projects fall into three distinct categories: 1) repower with an

emission

- certified engine, 2) retrofit with a verified

- diesel emission control strategy (VDECS),

and 3) replacement by a ve hicle with an engine certified as meeting the current off

- road emission

standards.

Engine Repower

Engine repowers are commonly diesel

- to

- diesel repowers and significant NOx and PM benefits

are achieved due to the higher emission levels of the engine being replaced. Funding is not

available for projects where a spark

- ignition engine (i.e., natural gas, gasoline, etc.) is replaced

with a diesel engine. Off

- road repower projects must install C ARB

- verified retrofit equipment

subject to the “Retrofit Purchase” discussion below.

Retrofit Purchase

Retrofit is the installation of a C ARB

- verified diesel emission control devic e on an existing

engine. Examples include, but are not limited to, particulate filters and diesel oxidation catalysts.

Retrofit projects that control PM must use the highest level

, technically feasible technology

available for the equipment being retrofi tted , which is defined as a device that achieves the

highest level of PM reductions (Level 3

- 85 percent) and the highest level of NOx reductions

.

Replacement

Fleets may apply for replacement in lieu of repowering their vehicle, where new or used

repla cement equipment with an engine certified to the current emission standard or Tier is

purchased to replace the existing equip ment (which will be scrapped)

.

Cargo Handling Equipment (CHE) Electrification

Cargo handling equipment fleets must be fully compliant with C ARB’s Regulation for Cargo

Handling Equipment at Ports and Intermodal Rail Yards in order to be eligible for CMP funding.

Applicants must provide a copy of their most recent C ARB Compliance Plan to document

compliance with the regulation

.

Existing diesel

- powered RTG cranes or diesel

- powered CHE (i.e., yard trucks, etc.) operating at

a seaport or intermodal railyard in a trade corridor are eligible for CMP funding to offset costs to

electrify th is equipment. Projects utilizing regulatory extensions are not eligible for funding.

CHE Electrification

– RTG Cranes

The CMP allows funding to converting existing diesel

- powered RTG cranes with a zero

emission power system. Eligible costs may include th e purchase of a new crane or installation of

a zero

- emission engine, necessary parts for an existing RTG crane including directly related

2 http://www.arb.ca.gov/msprog/ordiesel/ordiesel.htm6



### vehicle modifications, and infrastructure to supply electrical power, utility construction, and

costs associated with increasing the capacity of electrical power to the crane. Ineligible costs

include design, engineering, consulting, environmental review, legal fees, permits, licenses and

associated fees, taxes, metered costs, insurance, operation, maintenance and repair. Projects are

evaluated on a case

- by

- case basis.

CHE Electrification

– Other

The CMP allows partial funding of up to 50 percent of the eligible cost or $50,000/unit,

whichever is less, to replace an existing CHE with a zero

- emission propulsion system

. Eligible

costs may include the purchase of a zero

- emission yard truck. Ineligible costs include license,

registration, taxes (other than federal excise and sales tax), insurance, operation, maintenance

and repair. Projects are evaluated on a case

- by

- case b asis.

MARINE VESSEL PROJECTS

Marine vessel project types include e ngine repower and shore power. Each category is

summarized below.

Marine Engine Repower

Limited CMP funding opportunities remain for vessel engines subject to the in

- use compliance

requirements of C ARB’s Commercial Harbor Craft (CHC) regulation, since the repower must be

completed at least three (3) years prior to the vessel’s regulatory in

- use compliance date. Based

on the vessel’s operation, the newer engine’s emissions must be surplus to the currently required

U.S. EPA marine engine emission standard (i.e., Tier 3, Tier 4, etc.). Remanufacture k it s, which

are comprised of engine component parts that, when inst alled, reduce the engine’s emissions , are

subject to the same requirements as engine repower projects

.

Shore Power Projects

Shore power projects are eligible only if applicants submit their C ARB

- approved Initial

T erminal P lan with their application to document compliance with C ARB’s Shore Power

regulation and that the proposed project provides emissions reductions that are surplus to

regulatory requirements. Projects not subject to the Shore Power regulation are also eligible

.

All subsequent proje ct reports to air districts must include any new or updated Terminal Plans in

order to evaluate compliance with the project contract.

For shore power projects that demonstrate eligibility, up to 50 percent of the total cost of a shore

side transformer an d other equipment between the vessel and shore

- side transformer at the port

or terminal is eligible for CMP funding. Any costs directly related and necessary to the

installation of the eligible equipment may reasonably be included in the total cost, such a s labor

for installation, and costs of site preparation. Design and engineering costs associated with the

transformer and other eligible equipment between the vessel and transformer are considered

professional labor costs required to complete the installat ion and are eligible for funding.

Up to 100 percent of necessary vessel (non

- transformer) retrofit costs, specifically required to

allow the vessel to plug into shore

- side power, are eligible for CMP funding. Up to 50 percent of

any necessary transforme r costs on board the vessel are eligible for CMP funding.

Ineligible costs include modifications or enhancements made to the shore

- side electrical

infrastructure needed to bring power to the terminal. Other in eligible shore power costs consist7



### of barge o r other acquisitions and modification for a portable system, design, construction or

metered costs, insurance, operation, maintenance and repair.

LOCOMOTIVES

In the SCAQMD , all new locomotives and replacement engines must be certified to Tier 4

standards to be eligible for CMP funding.

Class 1 freight railroads may be eligible for Carl Moyer funding if Proposition 1B Goods

Movement Program funding is not available . Such a project is subject to a case

- by

- case approval

by C ARB. Class 3 f

reight r ailroads and p assenger r ailroads a re not subject to any C ARB fleet

regulations and are therefore eligible for CMP funding. There are f ive types of locomotive

projects that are eligible for Carl Moyer Program funding:

1. Alternative technology switcher (or other cleaner

- than

- required new locomotive)

2. Idle limiting device (ILD)

3. U.S. EPA

- certified engine remanufactu re kit or repower/refurbishment

4. C ARB

- verified retrofit

5. Head

- end powe r (HEP) unit (apply as an off

- road engine project)

Locomotive project activity must be based upon fuel consumption.

All locomotive projects receiving more than $50,000 per locomotive in Carl Moyer Program

funds must include the purchase and installation of an ILD if the locomotive is not already

equipped with such a device and installation is technically feasib le.

Refer to the CMP guidelines for additional information regarding these project types:

http://www.arb.ca.gov/msprog/moyer/guidelines/2011gl/2011cmp_ch11_07_11_14.pdf

DEFINITIONS

Alternative Fuel

Alternative fuels include compressed natural gas (CNG), liquefied natural gas (LNG), hydrogen

(H 2 ), met hanol, ethanol, propane (LPG) and electric technologies

. Experimental technologies

and fuels will be referred to CARB for evaluation and possible eligibility in the program.

E quipment R eplacement

Equipment replacement means the replacement of an older ve hicle or piece of e quipment that

still has remaining useful life with a newer, cleaner vehicle or piece of equipment. For this

project type, applicant must have owned and operated the old equipment in California for the

previous two years.

Repower

Vehicle repower means the replacement of an in

- use engine with another, cleaner engine (more

than 15 percent cleaner)

.

Retrofit

An emission control system employed exclusively with an in

- use engine, vehicle or piece of

equipment. CARB guidance requires the applicant to select the highest level technology

certified for that engine that provides the most emission reductions. For many projects, this

includes a diesel emission control device that reduces both PM and NOx emissions. In order to8



### be eligible fo r CMP funding, the retrofit device must be verified for the specific engine family

found on the equipment and achieve the highest level emission reductions when compared to

other verified retrofit devices. If a specific device reduces both NOx and PM but t he PM

reduction from a retrofit is required by a regulation, only the NOx reduction may be eligible for

funding

.

SCAQMD Jurisdiction

The SCAQMD is the air pollution control agency for all of Orange County and the urban

portions of Los Angeles, Riverside and San Bernardino counties. This area of 10,743 square

miles is home to over 16.8 million people

– about half the population of the whol e state of

California. It is the second most populated urban area in the United States and one of the

smoggiest. Visit www.aqmd.gov/home/about/jurisdiction for more information.

IMPORTANT PROGRAM INFORMATION

 Applicants must provide vendor quotes with their application to document the cost of the

low

- emission vehicle/equipment project

. Applicants may be awarded up to the designated

percentage of total cost for the specified type of project (new p urchase, repower and/ or

retrofit ) . Eligible costs include installation labor and sales tax; however, the total award

may not exceed the maximum cost

- effectiveness for the equipment/vehicle category

. All

quotes must have been obtained within 90 days prior to the closing date of the

Program Announcement

.

 A number of the CARB fleet rules and air quality regulations have reduce d or eliminate d

CMP eligibility. Compliance with existing air quality regulations is a pre

- requisite for

CMP funding. Only emissions reductions in excess of regulatory requirement s can be

considered for CMP funding . If applicants are applying for CMP funds to reduce

emissions before the required compliance date ( i.e., early reductions) , the equipment

must demonst rate sufficient years of operation before the regulatory compliance deadline

. Applicants are responsible for ensuring that they are in full compliance with all

applicable regulations and that vehicles/equipment requests under the CMP provide

surplus emissi ons reductions. As noted earlier, applicants must provide documentation of

their regulatory compliance status.

 Any tax obligation associated with the award is the responsibility of the grantee.

 All projects must be operational within eighteen (1 8 ) months of contract execution or

May 20

, 201 8 , whichever is earlier , with the exception of large off

- road fleet projects, in

which case all equipment must be in operation no later than October 31, 201 8

.

 All project invoices must be submitted for payment no later than May 20

, 201 8

. Projects

which have not invoiced by the applicable date may forfeit their funding.

 The highest level verified diesel emissions control system (VDECS) available is required

.

 Repower projects must also include a VDECS, if available for the project engine. The

cost of the VDECS equipment and installation may be included in the CMP grant request.

It is the responsibility of the applicant to determine the applicability of this requirement,

and

, if required, to include quotes f or this equipment in their application. Projects that9



### require the additional VDECS that do not have cost and system specification information

may not be evaluated by SCAQMD staff.

 No third

- party contracts will be executed.

 Pre

- and post

- inspection of al l vehicles/engines/equipment approved for funding will be

conducted, as required

. Applicants must make all equipment available locally (i.e. within

the SCAQMD boundaries) for inspections unless specified during contract preparation.

Documentation of compliance with existing regulatory requirements is required at the

time of pre

- inspection.

 Local d estruction of the engine and/or equipment being replaced is require d for repower

or replacement projects

.

 Emissions reduction calculations will be based on annual hour s of operation for off

- road

equipment projects and annual mileage for on

- road vehicle projects

.

 For projects that involve extended idling, including but not limited to street sweepers and

solid waste collection v ehicles

, annual fuel consumption may be used as the basis for the

emissions reduction evaluation. For projects based on fuel consumption , usage must be

based on two years of historical fuel consumption documentation submitted with the

application and speci fic to the equipment for which funding is requested . Documentation

may include fuel logs, purchase receipts , business logs, ledger entries , etc

. Annual fuel

consumption may be used for the emissions reduction evaluation if documentation of

previous fuel us age and mileage records demonstrates at least 30% better cost

effectiveness 3 

### , as compared to using hours (for off

- road) or mileage (for on

- road).

PROGRAM ADMINISTRATION

The CMP will be administered locally by the SCAQMD through the Science and Technology

Advancement office.

F unding category allocations are provided below in Table 1 . The SCAQMD reserves the right to

reallocate the funds to another category or subcategory. Additionally, the SCAQMD reserves the

right to partially fund a project.

All qualified applications submitted for each category/subcategory will be evaluated for

disproportional impacts (discussed in Section IV) and ranked by emission reduction cost

effectiveness.

Proposals for fuel and engine tech nologies not yet certified by CARB, or falling outside the

categories specifically discussed in this PA, will be referred to CARB for determination of CMP

eligibility. Please discuss these projects with SCAQMD staff prior to application submittal.

3 This requirement does not apply to projects in the Emergency Vehicle category.10 

### Table 1: Proposed Categories and Cost

- Effectiveness Limits

Category Cost

- Effectiveness $/ton

ON

- ROAD

(A) Vehicles 1 

### (including

Emergency Vehicles) 18,260

OFF

- ROAD

(A) Marine/Shore Power 18,260

(B) Construction 2 

### (small and

medium fleets only) 18,260

(C) Locomotives 18,260

(D) Cargo Handling Equipment

(electrification only) 18,260

1 On

- road new purchase project opportunities are currently very limited and include, (1)

engines that are at least 30% cleaner than current standards for NOx (0.14 g/bhp

- hr or

less) or (2) zero

- emission technologies. Both opportunities would generate minimal

surplus emission reductions, resulting in very nominal funding amounts.

2 Large fleets subject to CARB’s In

- Use Off

- Road Equipment regulation are not eligible for

funding from the SCAQMD

.



### SCHEDULE OF EVENTS

Issue # PA 20 16

- 05 March 4

, 2016

Workshop s April

– May 2016

All Applications Due by 1:00 pm Wednesday

, June 1

, 2016

Awards Consideration by the Board September

– October 2016

Contract Execution January 201 7

ALL PROPOSALS MUST BE RECEIVED AT THE SCAQMD HEADQUARTERS

NO LATER THAN 1:00 P.M. ON WEDNES DAY

, JUNE 1

, 2016

Postmarks will not be accepted. Fax or email proposals will not be accepted. Proposers may

hand deliver proposals to the SCAQMD by submitting the proposal to the SCAQMD

reception desk. The proposal will be date and time

- stamped and the person delivering the

proposal will be given a receipt.11



### S CHEDULE OF 

### CMP G ENERAL 

### W ORKSHOPS 

### :

 Wednesday April 20, 2016

- 10 a.m. to Noon

SCAQMD Headquarters, Room CC2

21865 Copley Drive

Diamond Bar, CA 91765

 Wednesday May 4, 2016

- 10 a.m. to Noon

SCAQMD Headquarters, Room CC2

21865 Copley Drive

Diamond Bar, CA 91765

M ARINE 

### V ESSEL 

### /S HORE 

### P OWER 

### /CH E E LECTRIFICATION 

### W ORKSHOP



###  Wednesday, April 27, 2016

– 10 a.m. to Noo n

Port of Los Angeles Board Room

425 South Palos Verdes Street

San Pedro, CA 90731

STATEMENT OF COMPLIANCE

Government Code Section 12990 and California Administrative Code, Title II, Division 4,

Chapter 5, require employers to agree not to unlawfully discriminate against any employee or

applicant because of race, religion, color, national origin, ancestry, phys ical handicap, medical

condition, marital status, sex, or age. A statement of compliance with this clause is included in

all SCAQMD contracts.

CONTACT FOR ADDITIONAL INFORMATION

Questions regarding the content or intent of this PA , procedural matters, or locations of

workshops should be addressed to:

Lani Montojo

Science and Technology Advancement

South Coast Air Quality Management District

21865 Copley Drive, Diamond Bar, CA 91765

(909) 396

- 2231/3252 FAX

SECTION II

- WORK STATEMENT/SCHEDULE OF DELIVERA BLES

A pplicants must sign the Application form indicating their understanding of the requirements for

submittal of additional project information to finalize a contract and that all vehicles, engines or

equipment must be in operation within eighteen (18) months of contract execution or by May 20

, 201 8

, whichever is earlier

. Unsigned applications will be deemed ineligible and may NOT be

considered for funding.

WORK STATEMENT

The scope of work involves a series of tasks and deliverables that demonstrate compliance with

the requirements of the CMP as administered by CARB and the SCAQMD . The project

applicant is responsib le for developing detailed project plans that address the p rogram criteria. In

addition, alternative fuel project applicants must discuss their plan for refueling the proposed

vehicles/equipment, and if appropriate, should provide a letter of agreement from their fuel

provider (see Application forms).

At a mini mum, any contract for funding the proposed project must meet the following criteria:12



###  Provide emission reductions that are real, quantifiable, enforceable and surplus in

accordance with CARB and SCAQMD guidelines.

 Meet the cost

- effectiveness limits, as des cribed in Table 1 of this PA

.

 Provide at least 30 percent NOx emission reduction for new engine/vehicle purchases

and 15 percent for repowers and retrofits, compared to baseline NOx emissions, if NO

x 

### emission reductions are to be considered in the cost

- eff ectiveness calculations.

 Commit that project engines or equipment operate in

- service for the full project life

, a

minimum of three years

, and at least 75 percent of annual operation must occur within

the SCAQMD . Project life is the number of years used to determine the cost

effectiveness and is equal to the contract term.

 Commit that all vehicles/engines/equipment are in operation within 18 months of

contract execution or by May 20

, 201 8

, whichever is earlier

.

 Provide for appropriate record

- keeping during the project life (i.e., annual mileage, fuel

consumption and/or hours of operation).

 Ensure that the project complies with other local, state and federal programs, and

resulting emission reductions from a specific project are not required as a mitig ation

measure to reduce adverse environmental impacts that are identified in an

environmental document prepared in accordance with the California Environmental

Quality Act or the National Environmental Policy Act.

 If requested, contractor must provide a fi nancial statement and bank reference, or other

evidence of financial ability to fulfill contract requirements.

 If requested, contractor must make all equipment and records available to the

SCAQMD or CARB for audit and inspections.

DELIVERABLES

The contra ct will describe how the project will be monitored and what type of information will

be included in project progress reports. At a minimum, the SCAQMD expects to receive the

following reports:

1. Quarterly status reports until the vehicle or equipment purchase, repower or retrofit has

been accomplished and in operation . These reports shall include a discussion of any

problems encountered and how they were resolved, any changes in the schedule, and

recommendations for com pletion of the project. These progress reports are required

before payment for the purchase, repower or retrofit will be made.

2. An annual report for each year during the full contract term, or project life, which

provides the annual miles or hours of o peration, where the vehicle or equipment was

operated (75 percent required in

- Basin), annual fuel consumption, and operational and

maintenance issues encountered and how they were resolved. SCAQMD reserves the

right to verify the information provided.

Re porting forms are available online at: www.aqmd.gov/Moyer13



### SECTION III

- PROPOSAL SUBMITTAL REQUIREMENTS

Proposers must complete the appropriate application forms, which are included in Appendix A

. In addition, Conflict of Interest and Project Cost information, as described below, must also be

submitted with the application. It is the responsibility of the applicant to ensure that all

information submitted is accurate and complete.

CONFLICT OF IN TEREST

Applicant must address any potential conflicts of interest with other clients affected by actions

performed by the firm on behalf of the SCAQMD . Although the proposer will not be

automatically disqualified by reason of work performed for such firms, the SCAQMD reserves

the right to consider the nature and extent of such work in evaluating the proposal. Conflicts of

interest will be screened on a case

- by

- case basis by the SCAQMD General Counsel’s Office.

Conflict of interest provisions of the state la w, including the Political Reform Act, may apply to

work performed pursuant to this contract. Please discuss potential conflicts of interest on the

Application Statement Form

.

PROJECT COST

Applicants must provide cost information that specifies the amount of funding requested and the

basis for that request by attaching vendor quotes to the application. Applicants need to inform

vendors of the time frame of the award process so that they can estimate prices to the

future/ projected order/purchase date.

P urchase orders must not be placed for projects until after the date of award approval by

the SCAQMD Governing Board. P urchase orders may be placed after SCAQMD

Governing Board approval and in advance of a fully executed contract , but these orders

are placed at the applicant’s risk 4



### .

The CMP funds only a percentage of the cost of the low

- emission technology based on the type

of project

. The proposed low

- emission technology must be CARB

- certified in most cases 5 

### . No

fueling infrastructure, administrative or operational costs will be funded.

All project costs must be clearly indicated in the application. In addition, applicants should be

s ure to include any sources of cofunding and the amount of each cofunding source in the

application. Proposers are cautioned that the project life period used in calculating

emissions reductions will be used to determine the length of their annual reporting

obligation. In other words, a project applicant using a ten

- year life for the emissions reduction

calculations will be required to operate

, track and report activity for the project vehicle for the

full ten years. The contract term will also be ten years.

P roposers are not required to calculate a project’s cost

- effectiveness , although it is helpful to

understand your project’s cost

- effectiveness in order to anticipate the maximum possible grant

award that might be recommended. Methodologies for calculating cost

- effectiveness are

provided in the CARB Moyer Guidelines at

http://www.arb.ca.gov/msprog/moyer/guidelines/2011gl/2011cmp_appc_0 7_11_14.pdf

4 All orders placed in advance of a fully executed contract are at the purchaser’s own risk.

5 Note that an experimental permit from CARB may be considered, but the project will require special CARB

approval.14



### APPLICATION SUBMISSION

All applications must be submitted according to specifications set forth herein. Failure to adhere

to these specifications may be cause for rejection of the proposal without evaluation

.

Staff Contact Information : SCAQMD staff contacts for each program category are listed in

Table 2 below

. Applicants are strongly encouraged to contact SCAQMD staff experts to discuss

their project prior to submitting an application to ensure program eligibility.

Application Forms : P rogram application forms are provided in Appendix A . These must be

completed and submitted with other required documents (i.e. Business Information Request

forms , activity documentation, project quotes, etc. ) discussed in the application and below

.

A separate Form A

- 1 is required for each category (i.e., marine, off

- road, locomotive, etc.) . For

example, if an applicant is requesting funding for marine engine repowers and off

- road

construction equipment, then two (2) separate Form A

- 1 ’s must be submi tted

– one for each

category. In addition to each Form A

- 1, the applicable category Form is required for each piece

of equipment for which grant funding is requested (i.e., B

- 1, C

- 1, etc.)

. For example:

E xample Application Package :

Applicant X plans to submit a request for CMP funding to repower three marine vessels and

two locomotive projects . The forms required are:

 Form A

- 1 for the marine vessel project s , which includes:

 Application Checklist

 Application Statement

 Business Infor mation Forms

 Form D

- 1 for the first marine vessel repower

 Form D

- 1 for the second marine vessel repower

 Form D

- 1 for the third marine vessel repower

 Form A

- 1 for the locomotive projects, which includes:

 Application Checklist

 Application Statement

 Busines s Information Forms

 Form D

- 1 for the first locomotive project

 Form D

- 1 for the second locomotive project

Business Information Forms : Consists of business information request forms that must be

completed and submitted with the Application. Please note, if recommended for an award

, you

will be required to submit an updated Campaign Contribution Disclosure form at a later date.

Due Date

- The proposer shall submit four ( 4) complete signed copies of the application , as

well as a n electronic copy of the application and its supporting documents on a CD or flash

drive

, in a sealed envelope, plainly marked in the upper left

- hand corner with the name and

address of the proposer and the words " Program Announcement # PA 2016

- 05

. All

proposals/applications shall b e submitted in an environmentally friendly format: stapled, not

bound, black and white print; no three

- ring, spiral or plastic binders, and no card stock or colored

paper

.15



### All proposals must be received , either electronically or on paper, no later than 1:00 p.m., on

June 1

, 2016

. Postmarks are not accepted as proof of deadline compliance. Faxed or emailed

proposals will not be accepted . Proposals must be directed to:

Procurement Unit

South Coast Air Quality Management District

21865 East Copley Drive

Di amond Bar, CA 91765

Any correction or resubmission done by the proposer will not extend the submittal due

date.

Grounds for Rejection

- A proposal may be immediately rejected if:

 It is not prepared in the format described

 It is not signed by an individu al authorized to represent the firm

 Does not include current cost quotes, Contractor Statement Forms and other forms

required in this PA

.

Missing Information

– Within thirty (30) business days of the proposal due date, SCAQMD

will send letters to applicants regarding missing information. Applicants will have seven ( 7 ) days

to provide any missing information requested in this letter. Any additional information requests

will also have a seven ( 7 ) day response deadline.

Disposition of Proposals

- The SCAQMD reserves the right to reject any or all proposals. All

responses become the prop erty of the SCAQMD . One copy of proposal s not selected for funding

shall be retained for one year. Additional copies and materials will be returned only if requested

and at the proposer's expense.

SECTION IV

- PROPOSAL EVALUATION/CONTRACTOR SELECTION CRITERIA

SCAQMD staff will evaluate all submitted proposals and make recommendations to the

Governing Board for final selection of project(s) to be funded. Proposals will be evaluated on the

cost

- effectiveness of NOx, PM10 and ROG reduced, as well as a project’s dispropo rtional

impact evaluation (discussed below). Be aware that there is a possibility that due to program

priorities, cost

- effectiveness and/or funding limitations, project applicants may be offered only

partial funding, and not all proposals that meet cost

- ef fectiveness criteria may be funded.

A t least 50 percent of the SCAQMD ’s CMP funds must be spent in areas that are most

disproportionally impacted by air pollution

. SCAQMD use s the following method to meet these

requirements :

1. All projects must qualify for the Carl Moyer Program by meeting the cost

- effectiveness

limits established in the Program Announcement.

2. All projects will be evaluated according to the following criteria to qualify for funding as

a disproportionately impacted area:

a) Poverty Level: Deta iled socioeconomic information is not included in the 2010 Census.

Such data is collected yearly from a small percentage of the population on a rotating16 

### basis by the American Community Survey (ACS). All projects in areas where at least

10 percent of the po pulation falls below the Federal poverty level based on the 2008

- 2012 ACS data are eligible to be included in this category, and

b) PM2.5 Exposure: All projects in areas with the highest 15 percent of PM2.5

concentration measured within a 2 km grid will be e ligible to be ranked in this category.

The highest 15 percent of PM2.5 concentration is 11.10 micrograms per cubic meter

and above, on an annual average, or

c) Air Toxics Exposure: All projects in areas with a cancer risk of 865 in a million and

above (based on MATES III estimates) will be eligible to be ranked in this category.

The maximum score is comprised of 40 percent for poverty level and 30 percent each for PM and

toxic exposures. Special circumstances exist in some areas, such as the Ports of Long Be ach and

Los Angeles. Since there are no residents within the ports, poverty ranking could not be

established. In this case, the poverty ranking from the adjacent on

- shore areas was extended to the

port since these populated areas are directly impacted by p ort activities.

SECTION V

- PAYMENT TERMS

For all projects, except shore power projects , full payment will be made upon installation and

commencement of operation of the funded equipment. For shore power projects, a progress

payment schedule will be established that allows payment upon completion of key milestones, as

delineated in the contract.

S ECTION VI: S CAQMD STAFF CONTACTS AND ADDITIONAL RESOURCES

The SCAQMD staff contact s are li sted in Table 2 by project categor y. Copies of the Program

Announcement, Application Forms and a sample SCAQMD CMP contract may be accessed at :

www.aqmd.gov/Moyer

.

Table 2: CMP Staff Contacts

Project Category Staff Contact Phone Number Email

On

- Road Heavy

- Duty Vehicles Ashkaan Nikravan (909) 396

- 3260 anikravan@aqmd.gov

Off

- Road Equipment Richard Carlson (909) 396

- 3996 rcarlson@aqmd.gov

Cargo Handling Equipment

Electrification Greg Ushijima (909) 396

- 3301 gushijima@aqmd.gov

Marine Vessels Mark Coleman

Von Loveland (909) 396

- 3074

(909) 396

- 3063 mcoleman@aqmd.gov

vloveland@aqmd.gov

Shore Power Greg Ushijima (909) 396

- 3301 gushijima@aqmd.gov

Locomotives Connie Day (909) 396

- 3055 cday@aqmd.gov17



### WEBSITE LINKS TO CAR B RULES THAT AFFECT CMP ELIGIBILITY

On

- Road Private (truck and bus) @ http://www.arb.ca.gov/msprog/onrdiesel/onrdiesel.htm

Public/Utility Fleets @ http://www.arb.ca.gov/msprog/publicfleets/publicfleets.htm

In

- Use Off

- Road (CI) @ http://www.arb.ca.gov/msprog/ordiesel/ordiesel.htm

Harbor Craft @ http://www.arb.ca.gov/ports/marinevess/harborcraft.htm

Cargo Handling Equipment @ http://www.arb.ca.gov/ports/cargo/cargo.htm

Shore Power @ http://www.arb.ca.gov/ports/shorepower/shorepower.htm18 

### APPENDIX A

Table of Contents

Each document listed below is linked to SCAQMD’s CMP website for efficient download.

1. Application Checklist

– one per applicant.

2. Form A

- 1: General Application (includes Checklist, Application Statement and Business

Information Forms) . Provide a complete set of Form A

- 1 documents for each equipment

category (i.e., locomotive, marine, off

- road, etc.).

3. Category Application Form specific to your project category (one per unit, or use excel

templates referenced in the f orm for multiple unit projects )

a) Form B

- 1: On

- Road Heavy

- Duty Vehicles, New Purchase

b) Form B

- 2: On

- Road Heavy

- Duty Vehicles, Repower

c) Form B

- 3: Emergency Vehicles (Fire Apparatus)

d) Form C

- 1: Off

- Road Equipment R eplacement

e) Form C

- 2: Off

- Road Equipment (Repower, Repower with Retrofit)

f) Form C

- 3 : Off

- Road Equipment Retrofit

g) Form C

- 4 : Cargo Handling Equipment ( CHE ) Electrification

h) Form D

- 1: Marine Vessels, Repower

i) Form D

- 2: Marine Vessels, Shore Power

j) Form E

- 1: Locomotives19 

### APPLICATION CHECK L IST

Use this checklist to organize your application. Each of the following application sections is

required to be submitted :

A cover letter stating your grant request, how many pieces of equipment and/or

engines included in the proposed project , and the funding amount being requested

(per engine and for the total projec t). For applications covering more than one

category, organize this information into project category (i.e., marine, locomotive,

on

- road, etc.)

This Application Checklist (signed below)

.

General Application Form A

- 1 . Provide a separate Form A

- 1 for each category (i.e.,

marine, locomotive, etc.) for which grant funding is requested. Form A

- 1 also

includes the following documents:

Application Statement (signed and initialed as applicable)

Completed and signed Business Informat ion Request Forms

Category Application F orm specific to your project category (i.e., locomotive, off

road, marine, etc.) , along with the following attachments/enclosures :

Excel Worksheet associated with applicable application form/category ( you

may us e this form for multiple unit projects , if desired )

Vendor quotes dated no earlier than 90 days prior to the closing date of the

Program Announcement

C ARB Executive Order s for each engine . Download at:

On

- road: http://www.arb.ca.gov/msprog/onroad/cert/cert.php

Off

- road: http://www.arb.ca.gov/diesel/cv.htm

Previous two years of historical data documenting usage

Once completed

, please submit one electronic and four paper copies of the assembled package

, in accordance with the Application Submittal Instructions

.

I understand that all documents, as listed above, are required in order to have a complete

application package in order to be considered for funding under the Carl Moyer Program

.

Signature DatePage 1 of 1 8



### FORM A

- 1: GENERAL APPLICATION FORM

– Submit a separate Form A

- 1 for each

category type (i.e., locomotive, off

- road, marine, etc.)

.

The SCAQMD is accepting applications for projects throughout its jurisdiction. All proposals will be

evaluated based on their cost

- effectiveness and their disproportionate impact score as discussed in

Section IV “Proposal Evaluation/Contract Selection Criteria” contained in Program Announcement

# PA 2016

- 05

. For additional information about SCAQMD’s policies and application information

, visit : www.aqmd.gov/Moyer

. In general, this program will follow CARB Carl Moyer Program

guidelines , which are available at: http://www.arb.ca.gov/msprog/moyer/moyer.htm

.

The submittal of an application does not guarantee approval for funding, but will be used to determine

the potential emission reductions and eligible grant fund ing amount for the proposed project. Any

equipment purchased prior to project approval by the SCAQMD Governing Board will not be eligible

for funding. Applicant may, at their own risk, issue a purchase order for approved equipment prior to

contract executi on. Other than a purchase order, no other work shall proceed until a fully executed

contract, i.e. signed by the applicant and SCAQMD Board Chairman and a p re

- inspection, is

completed.

APPLICANT INFORMATION

Total Number of Vehicles/Equipment

included in this application:

Legal Name of Equipment Owner:

Mailing Address:

Street Address/P.O. Box:

State:

County:

City and zip code :

Em ail Phone Number Fax Number

Primary Contact Name:

Person Authorized to Sign Application and

Execute Grant Agreement:

Name of Person who Completed Application:

What is your position?

How much are you being paid to complete

this application for the owner or to assist in

the proposed project?

What is the source of funds being used to pay

you?

Signature :

Date :Page 2 of 1 8 

### Application Statement

– Please Read and Sign /Initial as Applicable

All information provided in this application will be used by SCAQMD staff to evaluate the eligibility of this

application to receive program funds. SCAQMD staff reserves the right to request additional information and can

deny the application if such requested information is not provided by the requested deadline. Incom plete or illegible

applications will be returned to applicant or vendor, without evaluation. An incomplete application is an application

that is missing information critical to the evaluation of the project.

I nitial to indicate acceptance or note “NA” if not applicable (NA) to your project

.

I certify to the best of my knowledge that the information contained in this application is true and accurate.

I understand that all vehicles/equipment, both existing and new, must be made available within the SCAQMD

boundaries for inspection, unless otherwise approved by SCAQMD’s Project Officer.

The vehicle/engine will be used within the SCAQMD boundaries (with the emission reduction system

operating) for at least the projected usage shown in this application, and no less than 75 percent of the time.

I understand that it is my responsibility to ensure that all technologies are either verified or certified by the

California Air Resources Board (CARB) to reduce NOx and/or PM pollutants . CARB Verification Letters

and/or Executive Orders are attached, as applicable.

I understand that for repower projects, I am required to install the highest level available verified diesel

emission control device (VDECS), and that the costs of this device and associated installation are a CMP

eligible expense. These costs may be included in the project grant request up to the maximum cost

effectiveness limit.

I understand that there may be conditions placed upon receiving a grant and agree to refund the grant (or pro

rated portion thereof) if it is found that at any time I do not meet those conditions and if directed by the

SCAQMD in accordance with the contract agreement.

I understand that, for this equipment, I will be prohibited from apply ing for any other form of emission

reduction credits for Moyer

- funded vehicles/engines, including: Emission Reduction Credit (ERC); Mobile

Source Emission Reduction Credit (MSERC) and/or Certificate of Advanced Placement (CAP), for all time,

from the SCAQM D, CARB or any other Air Quality Management or Air Pollution Control District.

The proposed project has not been funded and is not being considered for Carl Moyer Program funds by

another air district, CARB, or any other public agency.

In the event that the vehicle(s)/equipment do not complete the minimum term of any agreement eventually

reached from this application, I agree to ensure the equivalent project emissions reductions, or to return grant

funds to the SCAQMD as required by the contract.

I have the legal authority to apply for grant funding for the entity described in this application.

I understand that all on

- road engines in my fleet that are eligible for a low

- NOx software upgrade (reflash)

must be reflashed within 60 days of receipt of contract execution

. I may self

- certify that the reflash has been

performed by submitting a receipt of the completed reflash or a picture of the “Low NOx Reflash Label ” from

the reflashed engine to SCAQMD

. Disclosure of the value of any current financial incentive that directly reduces the project price, including tax

credits or deductions, grants, or other public financial assistance for the same engine is required. To avoid

double counting of incentives, a ll tax credits or deductions, grants, or other public financial assistance must be

deducted from the CMP request.

I understand that third party contracts are not permitted. A third party may, however complete an application

on an owner’s behalf. Third parties are required to list how much compensation, if any, they are receiving to

prepare the application(s), and to certify that no CMP funds are being used for this compensation.

I u nderstand that off

- road equipment applicants subject to CARB’s I n

- Use Off

- Road Diesel Vehicle

Regulation (Off

- Road Regulation must submit information regarding fleet size and compliance status. This

must include the Diesel Off

- Road On

- line Reporting System (DOORS) ID of the fleet and the DOORS

Equipment Identification Number (EIN) of the funded equipment. All documentation submitted must be

signed and dated by the applicant and include language certifying that the fleet list provi ded is accurate and

complete.Page 3 of 1 8

I understand that additional project information may be requested during project review and must be submitted

prior to contract award

. I understand that all vehicles, engines or equipment funded by this program must be operational within

eighteen (18) months of contract execution, or by May 20

, 201 8 , whichever is earlier

. All project applicants must submit documentation that supports the activity claimed in the application (i.e.,

fuel receipts, mileage logs and/or hour

- meter readings covering the last two years). This documentation is

attache d.

The grant contract language cannot be modified without the written consent of all parties. I have reviewed and

accepted the sample contact language.

I understand that an IRS Form 1099 may be issued to me for incentive funds received under the Moyer

Program. I understand that it is my responsibility to determine the tax liability associated with participating in

the Moyer Program.

I understand that an SCAQMD

- funded Global Positioning System (GPS) unit will be installed on

vehicles/equipment not operating within SCAQMD boundaries full time. I will submit data as requested and

otherwise cooperate with all data reporting requirements. I also understand that the additional cost of the GPS

unit will be added to the project cost when calculating cost

- effectiveness, though the SCAQMD will pay for

this system directly.

I understand that the SCAQMD has the right to conduct unannounced in spections for the full project life to

ensure the project equipment is fully operational at the activity level committed to by the contract.

I understand that all emission reductions resulting from funded projects will be retired. To avoid double

counting of emission reductions, project vehicles and/or equipment may not receive funding from any other

government grant program that is designed t o reduce mobile source emissions.

I understand that a tamper proof, non

- resettable digital hour meter/odometer must be installed on all

vehicles/equipment and that the digital hour meter/odometer will record the hours/miles accumulated within

the SCAQM D boundaries. This cost is my responsibility.

I understand that any tax credits claimed must be deducted from the CMP request.

Please check one:

I do not plan to claim a tax credit or deduction for costs funded by the CMP.

I do plan to claim a tax credit or deduction for costs funded by the CMP.

If so, please indicate amount here: $______________

I plan to claim a tax credit or deduction only for the portion of incremental costs not funded by the CMP.

If so, please indicate amount here: $______________

Conflict of Interest

I initialed below to indicate that there are no potential conflicts of interest with other clients affected by actions

performed by the firm on behalf of the SCAQMD

. If this bullet is not initialed, I have attached a description

to this application of the potential conflict of intere st , which will be screened on a case

- by

- case basis by the

SCAQMD General Counsel’s Office. There is no potential conflict of interest: ___________ _ ( Please i nitial if

applicable, else attach separate sheet describing the potential conflict

. )

____________________________________ _____________________ Applicant’s Signature Date

____________________________________ _____________________ Applicant’s Name (please print) TitlePage 4 of 1 8



# South Coast

Air Quality Management District

21865 Copley Drive, Diamond Bar, CA 91765

- 4178

(909) 396

- 2000 • www.aqmd.gov



### Business Information Request

Dear SCAQMD Contractor/Supplier:

South Coast Air Quality Management District (SCAQMD) is committed to ensuring that our

contractor/supplier records are current and accurate. If your firm is selected for award of a

purchase order or contract, it is imperative that the information requeste d herein be supplied in a

timely manner to facilitate payment of invoices. In order to process your payments, we need the

enclosed information regarding your account. Please review and complete the information

identified on the following pages, remember to sign all documents for our files, and return

them as soon as possible to the address below:

Attention: Accounts Payable, Accounting Department

South Coast Air Quality Management District

21865 Copley Drive

Diamond Bar, CA 91765

- 4178

If you do not return this information, we will not be able to establish you as a vendor. This will

delay any payments and would still necessitate your submittal of the enclosed information to our

Accounting department before payment could be initiated. C ompletion of this document and

enclosed forms would ensure that your payments are processed timely and accurately.

If you have any questions or need assistance in completing this information, please contact

Accounting at (909) 396

- 3777. We appreciate you r cooperation in completing this necessary

information.

Sincerely,

Michael B. O’Kelly

Chief Financial Officer

DH:tm

Enclosures: Business Information Request

Disadvantaged Business Certification

W

- 9

Form 590 Withholding Exemption Certificate

Fe deral Contract Debarment Certification

Campaign Contributions Disclosure

Direct Deposit Authorization

REV 9/15Page 5 of 1 8



# South Coast

Air Quality Management District

21865 Copley Drive, Diamond Bar, CA 91765

- 4178

(909) 396

- 2000 • www.aqmd.gov



## BUSINESS INFORMATION REQUEST

Business Name

Division of

Subsidiary of

Website Address

Type of Business

Check One:  Individual

 DBA, Name _______________, County Filed in _______________

 Corporation, ID No. ________________

 LLC/LLP, ID No. _______________

 Other _______________



### REMITTING ADDRESS INFORMATION

Address

City/Town

State/Province Zip

Phone ( )

- Ext Fax ( )

-

Contact Title

E mail Address

Payment Name if

Different



### All invoices must reference the corresponding Purchase Order Number(s)/Contract Number(s) if

applicable and mailed to:

Attention: Accounts Payable, Accounting Department

South Coast Air Quality Management District

21865 Copley Drive

Diamond Bar, CA 917 65

- 4178Page 6 of 1 8 BUSINESS STATUS CERTIFICATIONS

Federal guidance for utilization of disadvantaged business enterprises allows a vendor to be deemed a small business enterpri se (SBE),

minority business enterprise (MBE) or women business enterprise (WBE) if it meets the criteria below.

 is certified by the Small Business Administration or

 is certified by a state or federal agency or

 is an independent MBE(s) or WBE(s) business concern which is at least 51 percent owned and controlled by minority group member(s)

who are citizens of the United States.

Statements of certification:

As a prime contractor to SCAQMD, (name of business) will engage in good faith efforts to achieve the fair share in ac cordance with

40 CFR Section 33.301, and will follow the six affirmative steps listed below for contracts or purchase orders funded in whole

or in part by federal grants and contracts.

1. Place qualified SBEs, MBEs, and WBEs on solicitation lists.

2. Assure tha t SBEs, MBEs, and WBEs are solicited whenever possible.

3. When economically feasible, divide total requirements into small tasks or quantities to permit greater participation by

SBEs, MBEs, and WBEs.

4. Establish delivery schedules, if possible, to encourage pa rticipation by SBEs, MBEs, and WBEs.

5. Use services of Small Business Administration, Minority Business Development Agency of the Department of

Commerce, and/or any agency authorized as a clearinghouse for SBEs, MBEs, and WBEs.

6. If subcontracts are to be let, take the above affirmative steps.

Self

- Certification Verification: Also for use in awarding additional points, as applicable, in accordance with

SCAQMD Procurement Policy and Procedure:

Check all that apply:

Small Business Enterprise/Small Business Joint Venture Women

- owned Business Enterprise

Local business Disabled Veteran

- owned Business Enterprise/DVBE Joint Venture

Minority

- owned Business Enterprise Most Favored Customer Pricing Certification

Percent of ownership: %

Name of Qualifying Owner(s):

State of California Public Works Contractor Registration No.

______________________. MUST BE

INCLUDED IF BID PROPOSAL IS FOR PUBLIC WORKS PROJECT.

I, the undersigned, hereby declare that to the best of my knowledge the above information is accurate. Upon penalty of perju ry, I certify

information submitted is factual.

NAME TITLE

TELEPHONE NUMBER DATEPage 7 of 1 8 

### Definitions

Disabled Veteran

- Owned Business Enterprise means a business that meets all of the following criteria:

 is a sole proprietorship or partnership of which is at least 51 percent owned by one or more disabled veterans,

or in the case of any business whose stock is publicly held, at least 51 percent of the stock is owned by one or

more disabled veterans; a subsidiary which is wholly owned by a parent corporation but only if at least 51

percent o f the voting stock of the parent corporation is owned by one or more disabled veterans; or a joint

venture in which at least 51 percent of the joint venture’s management and control and earnings are held by

one or more disabled veterans.

 the management and control of the daily business operations are by one or more disabled veterans. The

disabled veterans who exercise management and control are not required to be the same disabled veterans as

the owners of the business.

 is a sole proprietorship, corporatio n, partnership, or joint venture with its primary headquarters office located

in the United States and which is not a branch or subsidiary of a foreign corporation, firm, or other foreign

based business.

Joint Venture means that one party to the joint ven ture is a DVBE and owns at least 51 percent of the joint venture. In the case

of a joint venture formed for a single project this means that DVBE will receive at least 51 percent of the project dollars.

Local Business means a business that meets all of t he following criteria:

 has an ongoing business within the boundary of SCAQMD at the time of bid application.

 performs 90 percent of the work within SCAQMD’s jurisdiction.

Minority

- Owned Business Enterprise means a business that meets all of the following criteria:

 is at least 51 percent owned by one or more minority persons or in the case of any business whose stock is

publicly held, at least 51 percent of the stock is owned by one or more minority persons.

 is a business whose management and daily busin ess operations are controlled or owned by one or more

minority person.

 is a business which is a sole proprietorship, corporation, partnership, joint venture, an association, or a

cooperative with its primary headquarters office located in the United States , which is not a branch or

subsidiary of a foreign corporation, foreign firm, or other foreign business.

“Minority” person means a Black American, Hispanic American, Native American (including American Indian, Eskimo, Aleut,

and Native Hawaiian), Asian

- Indian American (including a person whose origins are from India, Pakistan, or Bangladesh),

Asian

- Pacific American (including a person whose origins are from Japan, China, the Philippines, Vietnam, Korea, Samoa,

Guam, the United States Trust Territories of the Pacific, Northern Marianas, Laos, Cambodia, or Taiwan).

Small Business Enterprise means a business that meets the following criteria:

a. 1) an independently owned and operated business; 2) not dominant in its field of operation; 3) together with affiliates

is either:

 A service, construction, or non

- manufacturer with 100 or fewer employees, and average annual

gross receipts of ten million dollars ($10,000,000) or less over the previous three years, or

 A manufacturer with 100 or fewer employees.

b. Manufacturer means a business that is both of the following:

1) Primarily engaged in the chemical or mechanical transformation of raw materials or processed substances into

new products.

2) Classified between Codes 311000 to 339000, inclusive, of the North Ame rican Industrial Classification System

(NAICS) Manual published by the United States Office of Management and Budget, 2007 edition.Page 8 of 1 8

Small Business Joint Venture means that one party to the joint venture is a Small Business and owns at least 51 percent of the

joint venture. In the case of a joint venture formed for a single project this means that the Small Business will receive at least 51

percent of the project dollars.

Women

- Owned Business Enterprise means a business that meets all of the following criteria:

 is at least 51 percent owned by one or more women or in the case of any business whose stock is publicly held,

at least 51 percent of the stock is owned by one or more women.

 is a business whose management and daily business operations are controlled or owned by one or more

women.

 is a business which is a sole proprietorship, corporation, partnership, or a joint venture, with its primary

headquarters off

ice located in the United States, which is not a branch or subsidiary of a foreign corporation,

foreign firm, or other foreign business.

Most Favored Customer as used in this policy means that the SCAQMD will receive at least as favorable pricing, warran ties,

conditions, benefits and terms as other customers or clients making similar purchases or receiving similar services.Page 9 of 1 8Page 10 of 1 8Page 11 of 1 8Page 12 of 1 8Page 13 of 1 8



### [Page 14 of 1 8Page 15 of 1 8Page 16 of 1 8 

### CAMPAIGN CONTRIBUTIONS DISCLOSURE

In accordance with California law, bidders and contracting parties are required to disclose, at the time the application

is filed, information relating to any campaign contributions made to South Coast Air Quality Management District

(SCAQMD) Board Member s or members/alternates of the MSRC, including: the name of the party making the

contribution (which includes any parent, subsidiary or otherwise related business entity, as defined below), the amount

of the contribution, and the date the contribution was made. 2 C.C.R. §18438.8(b).

California law prohibits a party, or an agent, from making campaign contributions to SCAQMD Governing Board

Members or members/alternates of the Mobile Source Air Pollution Reduction Review Committee (MSRC) of more

than $250 w hile their contract or permit is pending before SCAQMD; and further prohibits a campaign contribution

from being made for three (3) months following the date of the final decision by the Governing Board or the MSRC

on a donor’s contract or permit. Gov’t C ode §84308(d). For purposes of reaching the $250 limit, the campaign

contributions of the bidder or contractor plus contributions by its parents, affiliates, and related companies of the

contractor or bidder are added together. 2 C.C.R. §18438.5.

In addition, SCAQMD Board Members or members/alternates of the MSRC must abstain from voting on a contract

or permit if they have received a campaign contribution from a party or participant to the proceeding, or agent, totaling

more than $250 in the 12

- mo nth period prior to the consideration of the item by the Governing Board or the MSRC.

Gov’t Code §84308(c).

The list of current SCAQMD Governing Board Members can be found at SCAQMD website ( www.aqmd.gov ). The

list of current MSRC members/alternates can be found at the MSRC website

( http://www.cleantransportationfunding.org ).



### SECTION I

.

Contractor (Legal Name):

List any parent, subsidiaries, or otherwise affiliated business entities of Contractor :

(See definition below).

SECTION II

.

Has Contractor and/or any parent, subsidiary, or affiliated company, or agent thereof, made a

campaign contribution(s) totaling $250 or more in the aggregate to a current member of the South

Coast Air Quality Management Governing Board or member/alternate of the MSRC in the 12

months preceding the date of execution of this disclosure?

Yes No If YES, complete Section II below and then sign and date the form.

If NO, sign and date below. Include this form with your submittal. DBA, Name

, County Filed in

Corporation, ID No

.

LLC/LLP, ID No

.Page 17 of 1 8

Campaign Contributions Disclosure, c ontinued:



### Name of Contri butor

Governing Board Member or MSRC Member/Alternate Amount of Contribution Date of Contribution



### Name of Contributor

Governing Board Member or MSRC Member/Alternate Amount of Contribution Date of Contribution



### Name of Contributor

Governing Board Member or MSRC Member/Alternate Amount of Contribution Date of Contribution



### Name of Contributor

Governing Board Member or MSRC Member/Alternate Amount of Contribution Date of Contribution



### I declare the foregoing disclosures to be true and correct.

By:

Title:

Date:

DEFINITIONS

Parent, Subsidiary, or Otherwise Related Business Entity (2 Cal. Code of Regs., §18703.1(d).)

(1) Parent subsidiary. A parent subsidiary relationship exists when one corporation directly or indirectly owns shares possessing

more than 50 percent of the voting power of another corporation.

(2) Otherwise related business entity. Business entities, including corporations, partnerships, joint ventures and any other

organizations and enterprises operated for profit, which do not have a parent subsidiary relationship are otherwise related i f

any one of the following three tests is met:

(A) One business entity has a controlling ownership interest in the other business entity.

(B) There is shared management and control between the entities. In determining whether there is shared management

and control, consideration should be given to the following factors:

(i) The same person or substantially the same person owns a nd manages the two entities;

(ii) There are common or commingled funds or assets;

(iii) The business entities share the use of the same offices or employees, or otherwise share activities, resources or

personnel on a regular basis;

(iv) There is otherwise a regular and close working relationship between the entities; or

(C) A controlling owner (50% or greater interest as a shareholder or as a general partner) in one entity also is a controlling

owner in the other entity.Page 18 of 1 8 Direct Deposit Authorization

STEP 1 : Please check all the appropriate boxes

Individual (Employee, Governing Board Member) New Request

Vendor/Contractor Cancel Direct Deposit

Changed Information

STEP 2 : Payee Inform ation

Last Name First Name Middle Initial Title

Vendor/Contractor Business Name (if applicable)

Address Apartment or P.O. Box Number

City State Zip Country

Taxpayer ID Number Telephone Number Email Address

Authorization

1. I authorize South Coast Air Quality Management District (SCAQMD) to direct deposit funds to my account in the financial institution

as indicated below. I understand that the authorization may be rejected or discontinued by SCAQMD at any time. If any of th e

above in formation changes, I will promptly complete a new authorization agreement. If the direct deposit is not stopped before

closing an account, funds payable to me will be returned to SCAQMD for distribution. This will delay my payment.

2. This authorization rem ains in effect until SCAQMD receives written notification of changes or cancellation from you.

3. I hereby release and hold harmless SCAQMD for any claims or liability to pay for any losses or costs related to insufficient fund

transactions that result from f ailure within the Automated Clearing House network to correctly and timely deposit monies into my

account.

STEP 3 :

You must verify that your bank is a member of an Automated Clearing House (ACH). Failure to do so could delay the processing of your

paymen t. You must attach a voided check or have your bank complete the bank information and the account holder must sign below.

To be Completed by your Bank Staple Voided Check Here Name of Bank/Institution

Account Holder Name(s)

Saving Checking Account Number Routing Number

Bank Representative Printed Name Bank Representative Signature Date

Date

ACCOUNT HOLDER SIGNATURE:

For SCAQMD Use Only Input By Date 

# South Coast

Air Quality Management District

21865 Copley Drive, Diamond Bar, CA 91765

- 4178

(909) 396

- 2000 • www.aqmd.govValid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

On

- Road Heavy

- Duty Vehicles New Purchase Application Form B

– 1

Page 1 of 3 

### FORM B

- 1: ON

- ROAD HEAVY

- DUTY VEHICLE

- NEW PURCHASE

If you have any questions regarding this program or the application process, please contact

Ashkaan Nikravan by phone at (909) 396

- 3260 or by e mail at: anikravan@aqmd.gov

.

For o n

- r oad heavy

- duty vehicle new purchase project s , only vehicles with technologies that are

certified at least 30 percent below the 0.20 NOx standard , such as electric vehicles or engines

certified to the low

- NOx emission standard (0.02 g/bh p

- hr) , are eligible for CMP funding.

Please complete one Form B

- 1 for each piece of equipment. For multiple unit requests, you may

down load the Form B

- 1 multiple

- unit spreadsheet from www.aqmd.gov/Moyer in lieu of filling out

multiple B

- 1 forms

.



## Part 1: Existing Vehicle Information

Company name/ Organization name/ Individual name:

Equipment Identifier (Company ID or Unit #):

Is the vehicle location address the same as the applicant address? Yes NO ( If not, please provide

vehicle address below)

Street Address:

City:

Zip Code:

Vehicle type (Solid Waste Collection Vehicle, Stop

- and

- Go Street Sweeper, Urban Transit Bus, School

Bus, Other Medium

- Heavy Duty Vehicle (GVWR 14,001

- 33,000 lbs), Other Heavy

- Heavy Duty Vehicle

( GVWR >33,000 lbs), Other Transit Vehicle):

Project Life (in years): ________

Equipment must operate for this full life; this life is equivalent to the contract and the reporting term.

Vehicle Make: Vehicle GVWR:

Vehicle Model: Is this a public fleet vehicle? Yes No

Vehicle Model Year: Registered Owner:

Department of Transportation Number (if interstate):

California Highway Patrol CA Number (if applicable):

Projected Year of New Vehicle Purchase:Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

On

- Road Heavy

- Duty Vehicles New Purchase Application Form B

– 1

Page 2 of 3 

## Part 2. Fleet Rule Status

CARB rules and regulations listed below severely limit, and in some cases eliminate, funding

opportunities for certain vehicle types. In order to ensure eligibility, please confirm your project provides

emission reductions that are surplus to CARB regulat ory requirements by contacting SCAQMD’s Project

Officer for this category, Ashkaan Nikravan by phone at (909) 396

- 3260 or by e mail at:

anikravan@aqmd.gov

.

ARB Rule Applicability (Check One):

Fleet Rule for Transit Agencies (Urban Buses & Transit Fleet Vehicles)

SWCV Rule (Solid Waste Collection Vehicles, Excludi ng Transfer Trucks)

Fleet Rule for Public Agencies & Utilities (Municipal & Utility Vehicles)

Por t Truck Regulation (Port & Drayage Trucks)

On

- Road Private Truck and Bus Regulation (All diesel or alternative diesel

– fueled vehicles with

a GVWR > 14,000 lbs operating in CA) IF CHECKED PLEASE COMPLETE SECTION 3.

None . P roject is exempt from CARB Rules (supporting documentation validating exemption

from any CARB rule is attached)

.

Is supporting documentation demonstrating compliance with the applicable CARB rule included in this

application? Yes No

(Applications submitted without supporting documentation that demonstrates an applicant’s

current fleet compli ance status will be deemed incomplete).



## Part 3

. Existing Vehicle Compliance Applicability

– Private Fleets Only

What is the GVWR for this vehicle?

8,501 to 14,000*

14,001 to 26,000

26,001 or greater

What is your current fleet size? (Should reflect all diesel fuel vehicles with a GVWR greater than

14,000 lbs.) ___________________________________

If applicable did you register your fleet through ARB’s TRUCRS Database by January 31, 2 016 ?

Yes, please provide a copy of the Compliance Certificate from the TRUCRS Database.

No

*Note: On

- road heavy

- duty diesel vehicles with this GVWR range will be considered for CMP funding

on a case

- by

- case basis.Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

On

- Road Heavy

- Duty Vehicles New Purchase Application Form B

– 1

Page 3 of 3 

## Part 4

. Activity I nformation

Please provide projected annual usage for the new equipment over the proposed life of the project.

This projection should be based on actual usage data for the baseline, or existing, equipment.

A pplicants requesting evaluation based on fuel consumption M UST provide both mileage and fuel

records from the past 24 months. Supporting documentation may be in the form of maintenance

records, fuel receipts, logs, or other paperwork for each piece of baseline equipment covering at least

the past 24 months. No s uch documentation is required for project evaluations based solely on

mileage.

Total Annual Miles Traveled: or Gallons of Fuel Used:

Percent Operation within CA: % Percent Operation within District: %



## Part 5

. N ew Vehicle’s Engine Information

Part 6. Funding Information

New Vehicle Cost (including tax): $

Note: You MUST attach a written estimate from the equipment vendor documenting the cost of the new

vehicle; this quote must be obtained within 90 days prior to the closing date of the Program

Announcement

.

Applicant Grant Request per unit : $

New Equipment Vendor (name, address and phone) : ARB Certification Executive Order (EO) Number:

NOTE: The proposed engine for the project must be consistent with the Intended Service Class per the

EO (MHD Intended Service Class engines cannot be used for projects which have the HHD vehicle

classifications). Applicant must ATTACH a copy of the referenced Executive Order with the

application. Download the EO at: http://www.arb .ca.gov/msprog/onroad/cert/cert.php

Propulsion System Engine Make: Propulsion System Engine Model Year:

Propulsion System Engine Model: Fuel Type (Fuel Cell, Battery, etc.) :

Engine Family:Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

On

- Road Heavy

- Duty Vehicle

- Repower Application Form B

- 2

Page 1 of 3 

### FORM B

- 2: ON

- ROAD HEAVY

- DUTY VEHICLE

- REPOWER

If you have any questions regarding this program or the application process, please contact

Ashkaan Nikravan by phone at (909) 396

- 3260 or by e mail at: anikravan@aqmd.gov

.

For On

- Road vehicle repower projects, only alternative fuel engines that provide at least a 15

percent NOx reduction are eligible for funding, with the single exception of emergency vehicles and

equipment (use Form B

- 3).

Please comple te one Form B

- 2 for each piece of equipment. For multiple unit requests, you may

download the Form B

- 2 multiple

- unit spreadsheet from www.aqmd.gov/Moyer in lieu of filling out

multiple B

- 2 forms.



## Part 1: Existi ng Vehicle Information

Company name/ Organization name/ Individual name:

Equipment Identifier (Company ID or Unit #):

Is the vehicle location address the same as the applicant address? Yes No, (please provide

vehicle address below)

Street Address:

City:

Zip Code:

Vehicle type (Solid Waste Collection Vehicle, Stop

- and

- Go Street Sweeper, School Bus, Other

Medium

- Heavy Duty Vehicle (GVWR 14,001

- 25,999 lbs), Other Heavy

- Heavy Duty Vehicle):

Project Life: years. Equipment must operate for this full life; this life is equivalent to the contract

and the reporting term.

Vehicle Identification Number (VIN):

Vehicle License Plate:

Vehicle Make: Vehicle GVWR:

Vehicle Model: Is this a public fleet vehicle? Yes No

Vehicle Model Year: Registered Owner:

Department of Transportation Number (if interstate):

California Highway Patrol CA Number (if applicable):

Projected Year of Repower Completion:Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

On

- Road Heavy

- Duty Vehicle Repower Application Form B

- 2

Page 2 of 3 

## Part 2. Fleet Rule Status

ARB Rule Applicability (Check One):

NOTE: The CARB rules listed below severely limit, and in some cases eliminate, funding opportunities

for certain vehicle types. In order to ensure eligibility, Please confirm your project provides emission

reductions that are surplus to CARB regulatory re quirements by contacting SCAQMD staff as indicated

in P rogram A nnouncement # PA 2016

- 05

.

Fleet Rule for Transit Agencies (Urban Buses & Transit Fleet Vehicles)

SWCV Rule (Solid Waste Collection Vehicles, Excluding Transfer Trucks)

Fleet Rule for Public Agencies & Utilities (Mu nicipal & Utility Vehicles)

Port Truck Regulation (Port & Drayage Trucks)

On

- Road Private Truck and Bus Regulation (All diesel or alternative diesel

– fueled vehicles

with a GVWR > 14,000 lbs operating in CA) IF CHECKED PLEASE COMPLETE

SECTION 3.

None . Project is exempt from CARB Rules/Regulations (supporting docu m entation validating

exemption from any CARB rule is attached)

Is supporting documentation demonstrating compliance with the applicable CARB rule included in this

application? 

### Yes N o

(Applications submitted without supporting documentation that demonstrates an applicant’s

curren t fleet compliance status will be deemed incomplete).



## Part 3. Existing Vehicle Compliance Applicability

– Private Fleets Only

What is the GVWR for this vehicle? 8,501 to 14,000*

14,001 to 26,000

26,001 or greater

*Note: On

- road heavy

- duty diesel vehicles with this GVWR range will be considered for CMP funding

on a case

- by

- case basis.

What is your current fleet size? (Should reflect all diesel fuel vehicles with a GVWR greater than

14,000 lbs.) ___________________________________

If applicable did you register your fleet through ARB’s TRUCRS Database by January 31, 2016 ?

Yes, please provide a copy of the Compliance Certificate from the TRUCRS Database. No



## Part 4. Activity Information

Please provide projected annual usage for the new engine over the proposed life of the project. This

projection should be based on actual usage data for the baseline, or existing, vehicle/engine. Applicants

requesting evaluation based on fuel consumption MUST provide both mileage and fuel records from the

past 24 months. Supporting documentation may be in the form of maintenance records, fuel receipts,

logs, or other paperwork for each piece of baseline equipment covering at least the past 24 months. No

such documentation is required for project evaluations based solely on mileage.

Total Annual Miles Traveled: or Gallons of Fuel Used:

Percent Operation within CA: % Percent Operation within District: %Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

On

- Road Heavy

- Duty Vehicle Repower Application Form B

- 2

Page 3 of 3 

## Part 5. Baseline Engine Information

Fuel Type: Engine Year:

Engine Make: Engine Serial No.:

Engine Model: Engine Family:

ARB Certification Executive Order (EO) Number:

Download the EO at: http://www.arb.ca.gov/msprog/onroad/cert/cert.php



## Part 6. New Reduced

- Emission Engine Information

Fuel Type: Engine Year:

Engine Make: Engine Family:

Engine Model: Engine Horse Power:

ARB Certification Executive Order (EO) Number:

NOTE: The proposed engine for the project must be consistent with the Intended Service Class per the

EO (MHD Intended Service Class engines cannot be used for projects which have the HHD vehicl e

classifications). Applicant must ATTACH a copy of the referenced Executive Order with the

application. Download the EO at: http://www.arb.ca.gov/msprog/onroad/cert/cert.php



## Part 7. Funding Information

Note: You MUST attach a written estimate from the equipment vendor documenting the cost of the new

equipment; this quote must be obtained within 90 days prior to the closing date of the Program

Announcement.

New Engine Cost:

New Engine Installation Cost:

Engine Core Charge (optional):

Grant Request: $

New Engine Vendor:

New Engine Installer:Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Emergency Vehicles (Fire Apparatus) Application Form B

- 3

Page 1 of 4 

### FORM B

- 3: EMERGENCY VEHICLES ( FIRE APPARATUS)

Eligible Emergency Vehicle (Fire Apparatus) projects are those in which a new or used

replacement vehicle with an engine meeting the current model year California emission standard

replaces an older, more polluting fire apparatus. The older, replaced vehicle must be destroyed.

A fire tru ck reuse option is also available, which is also known as a “2 for 1 replacement”. The

fire truck reuse option allows fire departments to give away the existing old vehicle and destroy

another older vehicle in its place.

If you have any questions regardi ng this program or the application process, please contact

Ashkaan Nikravan by phone at (909) 396

- 3260 or by e mail at: anikravan@aqmd.gov

.

Please complete one Form B

- 3 for each piece of equipment. For multiple un it requests, you may

download the Form B

- 3 multiple

- unit spreadsheet from www.aqmd.gov/Moyer in lieu of filling out

multiple B

- 3 forms.



## Part 1 a : Existing Vehicle Information

Company name/ Organization name/ Individual name:

Equipment Identifier (Company ID or Unit #):

Is the vehicle location address the same as the applicant address? Yes No, (please provide

vehicle address below)

Street Address:

City: Zip Code:

Vehicle type (Solid Waste Collection Vehicle, Stop

- and

- Go Street Sweeper, School Bus, Other

Medium

- Heavy Duty Vehicle (GVWR 14,001

- 25,999 lbs), Other Heavy

- Heavy Duty Vehicle):

Project Life: years. Equipment must operate for this full life; this life is equivalent to the contract

and the reporting term.

Vehicle Identification Number (VIN):

Vehicle License Plate:

Vehicle Make: Vehicle GVWR:

Vehicle Model: Is this a public fleet vehicle? Yes No

Vehicle Model Year: Registered Owner:

Department of Transportation Number (if interstate):

California Highway Patrol CA Number (if applicable):

I have attached proof of California registration for the past 24

- months and a copy of the Title, proving

ownership (without lien holder ) for each project vehicle

. YES NO (circle one)

(if not, why not?_______________________________________________________________ _____)Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Emergency Vehicles (Fire Apparatus) Application Form B

- 3

Page 2 of 4 

## P art 1b: 2 nd 

## Existing Vehicle Information (only required if proposing a “2 for

1” Replacement Project)

Company name/ Organization name/ Individual name:

Equipment Identifier (Company ID or Unit #):

Is the vehicle location address the same as the applicant address? Yes No, (please provide

vehicle address below)

Street Address:

City:

Zip Code:

Vehicle type (Solid Waste Collection Vehicle, Stop

- and

- Go Street Sweeper, School Bus, Other

Medium

- Heavy Duty Vehicle (GVWR 14,001

- 25,999 lbs), Other Heavy

- Heavy Duty Vehicle):

Project Life: years. Equipment must operate for this full life; this life is equivalent to the contract

and the reporting term.

Vehicle Identification Number (VIN):

Vehicle License Plate:

Vehicle Make: Vehicle GVWR:

Vehicle Model: Is this a public fleet vehicle? Yes No

Vehicle Model Year: Registered Owner:

Department of Transportation Number (if interstate):

California Highway Patrol CA Number (if applicable):

Projected Year of Repower Completion:



## Part 2. CARB Fleet Rule Self

- Certification Statement

This is to certify that the project vehicle(s) being submitted for funding under this category

are exempt from ARB Regulations based on the fact that they are classified as authorized

emergency vehicle as described under California Vehicle Code Sections 27 156.2 and 165.

Signature: _______________________ Date: __________________________Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Emergency Vehicles (Fire Apparatus) Application Form B

- 3

Page 3 of 4 

## Part 3 . Activity Information

Please provide projected annual usage for the new equipment over the proposed life of the project.

This projection should be based on ac tual usage data for the baseline, or existing, equipment.

Applicants requesting evaluation based on fuel consumption MUST provide both mileage and fuel

records from the past 24 months. Supporting documentation may be in the form of maintenance

records, fuel receipts, logs, or other paperwork for each piece of baseline equipment covering at least

the past 24 months. No such documentatio n is required for project evaluations based solely on

mileage.

Total Annual Miles Traveled: or Gallons of Fuel Used:

Percent Operation within CA: % Percent Operation within District: %



## Part 4 . Baseline Engine Information

Fuel Type: Engine Year:

Engine Make: Engine Serial No.:

Engine Model: Engine Family:

ARB Certification Executive Order (EO) Number:

Download the EO at: http://www.arb.ca.gov/msprog/onroad/cert/cert.php



## Part 5 . New Reduced

- Emission Engine Information

Fuel Type: Engine Year:

Engine Make: Engine Family:

Engine Model: Engine Horse Power:

ARB Certification Executive Order (EO) Number:

The proposed engine for the project must be consistent with the Intended Service Class per the

EO (MHD Intended Service Class engines cannot be used for projects which have the HHD

vehicle class ifications). Applicant must ATTACH a copy of the referenced Executive Order with

the application. Download the EO at: http://www.arb.ca.gov/msprog/onroad/cert/cert.phpValid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Emergency Vehicles (Fire Apparatus) Application Form B

- 3

Page 4 of 4 

## Part 6

. Funding Information

Note: You MUST attach a written estimate from the equipment vendor documenting the cost of the new

equipment; this quote must be obtained within 90 days prior to the closing date of the Program

Announcement

.

New Engine Cost:

New Engine Installation Cost:

Engine Core Charge (optional):

Grant Request: $

New Engine Vendor:

New Engine Installer:Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Off

- Road Equipment Replacement Application Form C

- 1

Page 1 of 4 

### FORM C

- 1: OFF

- ROAD EQUIPMENT REPLA CEMENT

If you have any questions regarding this program or the application process, please contact

Richard Carlson by phone at (909) 396

- 3996 or by e mail at: rcarlson@aqmd.gov

.

Large fleets subject to CARB’s In

- Use Off

- Road Equipment regulation are no longer eligible for funding

from the SCAQMD

.

Please complete one Form C

- 1 for each piece of equipment. For multiple unit requests, you may

download the Form C

- 1 multiple

- unit spreadsheet from www.aqmd.gov/Moyer in lieu of filling out

multiple C

- 1 forms.



## Part 1: Existing Equipment Information (Baseline)

Company name/ Organization name/ Individual name:

Is equipment currently subject to CARB’s Off

- Road Regulation? Yes No

Off

- road equipment applicants subject to CARB’s In

- Use Off

- Road Diesel Vehicle Regulation must

submit the ir DOORS fleet compliance snapshot and vehicle list. You may contact the DOORS hotline

at (877) 593

- 6677 for assistance.

Baseline Equipment Identifier (Company ID or Unit #):

What is the primary function of this equipment?

Has this equipment received Carl Moyer Program funds in the past? Yes No

Is the vehicle location address the same as the applicant address? Yes No

If “No”, p lease provide vehicle address here:

Is existing equipment in operable condition?

How long has a pplicant owned the existing piece of equipment?

Baseline Equipment Type ( e.g. tractor, scraper, roller, loader, etc

. ):

Number of Main /Front Engines on this Unit?

Number of Auxiliary /Rear Engines on this Unit?

Baseline Equipment Serial Number:

Baseline Equipment Make & Model : Make: Model:

Baseline Equipment Model Year:

Is 2 for 1 Replacement Applied? YES or NO (circle one)

Is this vehicle used in Agricultural operation? YES or NO (circle one)

If Yes, What percent of the time of the equipment used in Agricultural operations? _______%

Does the existing equipment have a functioning, non

- resettable hour meter?

Proposed Project Life (same as contract term /how long you must operate equipment ): yearsValid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Off

- Road Equipment Replacement Application Form C

- 1

Page 2 of 4 

## Part 2: Existing (b aseline ) Engine Information ( one section for each engine)

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

Annual activity in units of hour per year:__________ (hr/yr)

Note: Annual gallons may not be used to document activity unless the fuel tank is dedicated for the use of this single unit.

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

Annual activity in units of hour per year:__________ (hr/yr)

Note: Annual gallons may not be used to document activity unless the fuel tank is dedicated for the use of this single unit.

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

Annual activity in units of hour per year:__________ (hr/yr)

Note: Annual gallons may not be used to document activity unless the fuel tank is dedicated for the use of this single unit.

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

Annual activity in units of hour per year:__________ (hr/yr)

Note: Annual gallons may not be used to document activity unless the fuel tank is dedicated for the use of this single unit.Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Off

- Road Equipment Replacement Application Form C

- 1

Page 3 of 4 

## Part 3: New Equipment Information

New Equipment Type ( e.g. tractor, scraper, roller, loader, etc

. ):

New Equipment Make:

New Equipment Model: Equipment

New Equipment Model Year:

# of Main /Front Engines :

# of Auxiliary /Rear Engines :

Percent Operation in California:

Percent Operation with in the South Coast Air Quality Management District (%):



## Part 4 : New Equipment Vendor Information

Name and location of dealership assisting with this equipment:

Equipment Vendor Contact:

Equipment Vendor Phone:



## Part 5: New Engine Information (one section for each engine)

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Fuel Type: New Engine Make:

New Engine Model: New Engine Year:

Engine Serial No.: New Engine Horsepower:

New Engine Tier: New Engine Family:

Annual activity in units of hour per year:__________ (hr/yr)

Note: Annual gallons may not be used to document activity unless the fuel tank is dedicated for the use of this single unit.

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Fuel Type: New Engine Make:

New Engine Model: New Engine Year:

Engine Serial No.: New Engine Horsepower:

New Engine Tier: New Engine Family:

Annual activity in units of hour per year:__________ (hr/yr)

Note: Annual gallons may not be us ed to document activity unless the fuel tank is dedicated for the use of this single unit.Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Off

- Road Equipment Replacement Application Form C

- 1

Page 4 of 4 

## Part 5: New Engine Information ( 1 section for each engine ), cont’d.

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Fuel Type: New Engine Make:

New Engine Model: New Engine Year:

Engine Serial No.: New Engine Horsepower:

New Engine Tier: New Engine Family:

Annual activity in units of hour per year:__________ (hr/yr)

Note: Annual gallons may not be us ed to document activity unless the fuel tank is dedicated for the use of this single unit.

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Fuel Type: New Engine Make:

New Engine Model: New Engine Year:

Engine Serial No.: New Engine Horsepower:

New Engine Tier: New Engine Family:

Annual activity in units of hour per year:__________ (hr/yr)

Note: Annual gallons may not be used to document activity unless the fuel tank is dedicated for the use of this single unit.



## Part 6: Funding/Cost Information for this Rep ower Project

You MUST attach a written estimate from the equipment vendor documenting the cost of the device; this

quote must be obtained within 90 days prior to the closing date of the Program Announcement.

Number of engines for this Unit? Main (Front) Engine (s) : Auxiliary (Rear) Engine (s):

New Replacement Unit C ost : $

Tax: $

Total C ost: $

Applicant Co

- Funding Amount (if any): $

Applicant Grant Request Amount: $Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Off

- Road Equipment Repower & Retrofit Application Form C

- 2

Page 1 of 6 

### FORM C

- 2 : OFF

- ROAD EQUIPMENT REPOWER & RETROFI T

(use form C

- 3 for Retrofit

- Only projects)

All off

- road repower projects must include installation of the highest level CARB

- verified retrofit

device if one is available. Repower projects are not disqualified from participation in the Carl Moyer

Program if retrofit devices are not available, technically infeasible or unsafe. If installat ion of a retrofit

device is infeasible or unsafe you MUST attach documentation in accordance with CARB requirements,

as summarized at: http://www.arb.ca.gov/msprog/ordiesel/vdecssafety.h tm

.

If you have any questions regarding this program or the application process, please contact

Richard Carlson by phone at (909) 396

- 3996 or by e mail at: rcarlson@aqmd.gov

.

Note that Large Off

- Road Fleets are no longer eligible for SCAQMD funding

. Please complete one Form

C

- 2 for each piece of equipment. For multiple unit requests, you may download the Form C

- 2 multiple

unit spreadsheet from www.aqmd.gov/Moyer in lieu of filling out multiple C

- 2 forms.



## Part 1: Equipment Information

Company name/ Organization name/ Individual name:

Is equipment currently subject to CARB’s Off

- Road Regulation? Yes No

Off

- road equipment applicants subject to CARB’s In

- Use Off

- Road Diesel Vehicle Regulation must

submit their DOORS fleet compliance snapshot and vehicle list. You may contact the DOORS hotline

at (877) 593

- 6677 for assistance.

Baseline Equipment Identif ier (Company ID or Unit #):

What is the primary function of this equipment?

Has this equipment received Carl Moyer Program funds in the past? Yes No

Is the vehicle location address the same as the applicant address? Yes No. If “No”, provide

vehicle address here:

Is existing equipment in operable condition?

How long has applicant owned the existing piece of equipment?

Equipment Type ( e.g. tractor, scraper, roller, loader, etc

. ):

Number of Main Engines on this Unit?

Number of Auxiliary Engines on this Unit?

Equipment Serial Number or VIN :

Baseline Equipment Make & Model: Make: Model:

Equipment Model Year:

Is this vehicle used in Agricultural operation? Yes No

If Yes, What percent of the time of the equipment used in Agricultural operations? _______%

Does the existing equipment have a functioning, non

- resettable hour meter? Yes No

Proposed Project Life (same as contract term/how long you must operate equipment): yearsValid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Off

- Road Equipment Repower & Retrofit Application Form C

- 2

Page 2 of 6 

## Part 2: Existing Engine Information (one section for each engine)

Method proposed for rendering the baseline engine(s) inoperable:

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

Annual activity in units of hour per year:__________ (hr/yr)

Note: Annual gallons may not be used to document activity unless the fuel tank is dedicated for the use of this single unit.

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

Annual activity in units of hour per year:__________ (hr/yr)

Note: Annual gallons may not be used to document activity unless the fuel tank is dedicated for the use of this single unit.

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

Annual activity in units of hour per year:__________ (hr/yr)

Note: Annual gallons may not be used to document activity unless the fuel tank is dedicated for the use of this single unit.

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

Annual activity in units of hour per year:__________ (hr/yr)

Note: Annual gallons may not be used to document activity unless the fuel tank is dedicated for the use of this single unit.Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Off

- Road Equipment Repower & Retrofit Application Form C

- 2

Page 3 of 6 

## Part 3 : New Engine Information (one section for each e ngine)

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

Annual activity in units of hour per year:__________ (hr/yr)

Note: Annual gallons may not be used to document activity unless the fuel tank is dedicated for the use of this single unit.

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

Annual activity in units of hour per year:__________ (hr/yr)

Note: Annual gallons may not be used to document activity unless the fuel tank is dedicated for the use of this single unit.

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

Annual activity in units of hour per year:__________ (hr/yr)

Note: Annual gallons may not be used to document activity unless the fuel tank is dedicated for the use of this single unit.

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

Annual activity in units of hour per year:__________ (hr/yr)

Note: Annual gallons may not be used to document activity unless the fuel tank is dedicated for the use of this single unit.Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Off

- Road Equipment Repower & Retrofit Application Form C

- 2

Page 4 of 6 

## Part 4 : New Engine Vendor Information

Name and location of dealership assisting with this equipment:

Equipment Vendor Contact:

Equipment Vendor Phone:



## Part 5 : Retrofit Information ( applicable to Repower project s )

You MUST attach a copy of the CARB Executive Order for the retrofit device and indicate (circle) on the

Executive Order Attachment the engine family name for the engine on which the device will be installed.

Download the EO at: http://www.arb.ca.gov/diesel/cv.htm

NOTE: O ff

- road retrofit s must include installation of the highest level CARB

- verified retrofit device.

On which repowered engine will this device be installed? Main (Front) # of

Auxiliary (Rear) # of

Retrofit Device CARB Executive Order Number:

Retrofit Device Make: Verified NOx Reduction: %

Retrofit Device Model: Verified PM Reduction: %

Retrofit Family Name: Verified ROG Reduction: %

Verification Level: Retrofit Device Serial No.

On which repowered engine will this device be installed? Main (Front) # of

Auxiliary (Rear) # of

Retrofit Device CARB Executive Order Number:

Retrofit Device Make: Verified NOx Reduction: %

Retrofit Device Model: Verified PM Reduction: %

Retrofit Family Name: Verified ROG Reduction: %

Verification Level: Retrofit Device Serial No.Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Off

- Road Equipment Repower & Retrofit Application Form C

- 2

Page 5 of 6 

## Part 6 a : Funding/Cost Information for Engine Repower

You MUST attach a written estimate from the equipment vendor documenting the cost of the device; this

quote must be obtained within 90 days prior to the closing date of the Program Announcement.

Engine Type? Main (Front) Engine(s): Auxiliary (Rear) Engine(s):

New Engine Unit Cost: $ (Quantity of this Engine Type:______________)

Tax: $

Installation Cost: $

Total Repower Cost: $

Applicant Co

- Funding Amount (if any): $

Grant Request Amount for this Repower : $

Engine Type? Main (Front) Engine(s): Auxiliary (Rear) Engine(s):

New Engine Unit Cost: $ (Quantity of this Engine Type:______________)

Tax: $

Installation Cost: $

Total Repower Cost: $

Applicant Co

- Funding Amount (if any): $

Grant Request Amount for Repower: $Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Off

- Road Equipment Repower & Retrofit Application Form C

- 2

Page 6 of 6 

## Part 6 b: Funding/Cost Information for Engine Retrofit s

You MUST attach a written estimate from the equipment vendor documenting the cost of the device; this

quote must be obtained within 90 days prior to the closing date of the Program Announcement. The data

logging cost of a retrofit project cannot be included in the eligible project cost.

On which repowered engine will this device be installed? Main (Front) # of

Auxiliary (Rear) # of

Retrofit Device Unit Cost: $

Tax: $

Installation Cost: $

Maintenance Cost: $ (if grant funding assistance is requested)

Total Retrofit Cost: $

Retrofit Device Vendor and Installer:

Grant Request for Retrofit : $

On which repowered engine will this device be installed? Main (Front) # of

Auxiliary (Rear) # of

Retrofit Device Unit Cost: $

Tax: $

Installation Cost: $

Maintenance Cost: $ (if grant funding assistance is requested)

Total Retrofit Cost: $

Retrofit Device Vendor and Installer:

Grant Request for Retrofit: $



## Part 6 c: Total Project Costs and Grant Request for full Project

Total Project Cost (Repower(s) + Retrofit(s)):

Total Grant Request (Repower(s) + Retrofit(s)):Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Off

- Road Equipment Retrofit Application Form C

- 3

Page 1 of 4 

### FORM C

- 3: OFF

- ROAD EQUIPMENT RETRO FIT

If you have any questions regarding this program or the application process, please contact

Richard Carlson by phone at (909) 396

- 3996 or by e mail at: rcarlson@aqmd.gov

.

Please complete one Form C

- 3 for each piece of equipment. For multiple unit req uests, you may

download the Form C

- 3 multiple

- unit spreadsheet from www.aqmd.gov/Moyer in lieu of filling out

multiple C

- 3 forms.



## Part 1: Equipment Information

Company name/ Organization name/ Individual name:

Is equipment currently subject to CARB’s Off

- Road Regulation? Yes No

Off

- road equipment applicants subject to CARB’s In

- Use Off

- Road Diesel Vehicle Regulation must

submit their DOO RS fleet compliance snapshot and vehicle list. You may contact the DOORS hotline

at (877) 593

- 6677 for assistance.

Baseline Equipment Identifier (Company ID or Unit #):

What is the primary function of this equipment?

Has this equipment received Carl Moyer Program funds in the past? Yes No

Is the vehicle location address the same as the applicant address? Yes No If “No”, p rovide

vehicle address here:

Is existing equipment in operable condition?

How long has applicant owned the existing piece of equipment?

Equipment Type ( e.g. tractor, scraper, roller, loader, etc

. ):

Number of Main Engines on this Unit?

Number of Auxiliary Engines on this Unit?

Equipment Serial Number or VIN:

Baseline Equipment Make & Model: Make: Model:

Equipment Model Year:

Is this vehicle used in Agricultural operation? Yes No

If Yes, What percent of the time of the equipment used in Agricultural operations? _______%

Does the existing equipment have a functioning, non

- resettable hour meter?

Proposed Project Life (same as contract term/how long you must operate equipment): yearsValid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Off

- Road Equipment Retrofit Application Form C

- 3

Page 2 of 4 

## Part 2: Existing Engine Information (one section for each engine)

Method proposed for rendering the baseline engine(s) inoperable:

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

Annual activity in units of hour per year:__________ (hr/yr)

Note: Annual gallons may not be used to document activity unless the fuel tank is dedicated for the use of this single unit.

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

Annual activity in units of hour per year:__________ (hr/yr)

Note: Annual gallons may not be used to document activity unless the fuel tank is dedicated for the use of this single unit.

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

Annual activity in units of hour per year:__________ (hr/yr)

Note: Annual gallons may not be used to document activity unless the fuel tank is dedicated for the use of this single unit.

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

Annual activity in units of hour per year:__________ (hr/yr)

Note: Annual gallons may not be used to document activity unless the fuel tank is dedicated for the use of this single unit.Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Off

- Road Equipment Retrofit Application Form C

- 3

Page 3 of 4 

## Par t 3: Retrofit Information

You MUST attach a copy of the CARB Executive Order for the retrofit device and indicate (circle) on the

Executive Order Attachment the engine family name for the engine on which the device will be installed.

Download the EO at: http://www.arb.ca.gov/diesel/cv.htm

NOTE: Off

- road retrofits must include installation of the highest level CARB

- verified retrofit device.

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Retrofit Device Make: Verified NOx Reduction: %

Retrofit Device Model: Verified PM Reduction: %

Retrofit Family Name: Verified ROG Reduction: %

Verification Level: Retrofit Device Serial No.

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Retrofit Device Make: Verified NOx Reduction: %

Retrofit Device Model: Verified PM Reduction: %

Retrofit Family Name: Verified ROG Reduction: %

Verification Level: Retrofit Device Serial No.

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Retrofit Device Make: Verified NOx Reduction: %

Retrofit Device Model: Verified PM Reduction: %

Retrofit Family Name: Verified ROG Reduction: %

Verification Level: Retrofit Device Serial No.

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Retrofit Device Make: Verified NOx Reduction: %

Retrofit Device Model: Verified PM Reduction: %

Retrofit Family Name: Verified ROG Reduction: %

Verification Level: Retrofit Device Serial No.Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Off

- Road Equipment Retrofit Application Form C

- 3

Page 4 of 4 

## Part 4 : Funding/Cost Information for Engine Retrofit (s)

You MUST attach a written estimate from the equipment vendor documenting the cost of the device; this

quote must be obtained within 90 days prior to the closing date of the Program Announcement. The data

logging cost of a retrofit project cannot be included in th e eligible project cost.

On which repowered engine will this device be installed? Main (Front) # of

Auxiliary (Rear) # of

Retrofit Device Unit Cost: $

Tax: $

Installation Cost: $

Maintenance Cost: $ (if grant funding assistance is requested)

Total Retrofit Cost: $

Retrofit Device Vendor and Installer :

Grant Request for Retrofit: $

On which repowered engine will this device be installed? Main (Front) # of

Auxiliary (Rear) # of

Retrofit Device Unit Cost: $

Tax: $

Installation Cost: $

Maintenance Cost: $ (if grant funding assistance is requested)

Total Retrofit Cost: $

Retrofit Device Vendor and Installer:

Grant Request for Retrofit: $Valid until June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Cargo Handling Equipment (CHE) Electrification Application Form C

– 4

Page 1 of 4 

### FORM C

- 4 : CARGO HANDLING EQUIPMENT ELECTRIFICATION

If you have any questions regarding this program or the application process, please contact Greg

Ushijima by phone at (909) 396

- 3301 or by e mail at: gushijima@aqmd.gov

.

Please complete one Form C

- 4 for each piece of equipment. For multiple unit requests, you may

download the Form C

- 4 multiple

- unit spreadsheet from www.aqmd.gov/Moyer in lieu of filling out

multiple C

- 4 forms.



### Please Check One: Rubber

- Tire Gantry Crane Electrification

Other Cargo Handling Equipment (CHE) Electrification



## Part 1: Existing Equi pment Information

Company name/ Organization name/ Individual name:

Is equipment currently subject to CARB’s Cargo Handling Equipment r egulation? Yes No

If YES, attach evidence that your fleet is in full compliance of this regulation.

If NO, and the applicant is not able to document that project equipment is not subject to the CARB

regulation, then the project is ineligible.

Baseline Equipment Identifier (Company ID or Unit #):

What is the primary function of this equipment?

Has this equipment received Carl Moyer Program funds in the past? Yes No

Is the vehicle location address the same as the applicant address? Yes No If “No”, p lease

provide vehicle address here:

Is existing equipment in operable condition?

How long has a pplicant owned the existing piece of equipment?

Baseline Equipment Type (e.g. yard trucks, top handlers, side handlers, reach stackers, forklifts,

loaders, aerial lifts, excavators, dozers, etc.):

Number of Main Engines on this Unit?

Number of Auxiliary Engines on this Unit?

Baseline Equipment Serial Number:

Baseline Equipment Make & Model: Make: Model:

Baseline Equipment Model Year:

Does the existing equipment have a functioning, non

- resettab le hour meter?

Proposed Project Life (same as contract term/how long you must operate equipment): yearsValid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Cargo Handling Equipment (CHE) Electrification Application Form C

– 4

Page 2 of 4 

## Part 2a: Existing (baseline) Engine Information (one section for each engine)

Method proposed for rendering the baseline engine(s) inoperable:

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

Engine Type: Main (Front)

- OR

- Auxiliary (Rear) # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:



## Part 2b: Existing (baseline) Engine Activity Information

Annual Operation Hours (hours/year):

Annual Fuel Usage (gallons per year):

Fuel Type:Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Cargo Handling Equipment (CHE) Electrification Application Form C

– 4

Page 3 of 4 

## Part 3: Project Description

Please provide a full description of the proposed project . Include specifications for the

equipment electrification and associated infrastructure.

(Attach additional sheets if more space is needed.)



## Part 4: Electrification Vendor Information

Equipment Vendor/Contractor Company:

Equipment Vendor

/Contractor Contact Name :

Equipment Vendor

/Contractor Phone Number :

Equipment Vendor/Contractor Email:



## Part 5: Projected New Equipment Activity Information

Estimated Future Annual Operation Hours (hours/year):

Annual Fuel Usage (gallons per year):

Fuel Type:Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Cargo Handling Equipment (CHE) Electrification Application Form C

– 4

Page 4 of 4 

## Part 6: Funding/Cost Information for this Electrification Project

You MUST attach a written estimate from the equipment vendor /contractor documenting the cost of the

device; this quote must be obtained within 90 days prior to the closing date of the Program

Announcement. Quote must itemize material costs and labor costs separately and must provide

explanatory details on each line item.

To tal Project Materials Cost (incl. tax): $

Total Project Labor Cost: $

Total Project Cost: $

Applicant Co

- Funding Amount (if any): $

Applicant Grant Request Amount: $Valid until June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Marine Vessels

, Repower Application Form D

– 1

Page 1 of 6 

### FORM D

- 1: MARINE VESSELS

- REPOWER

If you have any questions regarding this program or the application process, please contact:

 Mark Coleman at (909) 396

- 3074 or mcoleman@aqmd.gov

 Von Loveland at (909) 396

- 3063 or vloveland@aqmd.gov

Please complete one form for each marine vessel

.



## Part 1: Existi ng Equipment Information

Company name/ Organization name :

All Commercial Harbor Craft are currently subject to CARB’s Commercial Harbor Craft regulation.

A ttach a copy of your most recent CARB Commercial Harbor Craft Initial Report , and all updates.

Vessel Name :

Has this equipment received Carl Moyer Program funds in the past? Yes No

Port/Harbor:

Terminal: Pier:

Vessel berth / slip number:

Primary Vessel Use: (Commercial Fishing, Charter Fishing, Crew & Supply, Pilot, Work, Ferry/

Excursion, Tow, Tug, Barge, Other):

Annual Hours of operation for Primary Vessel Use:______________hr/yr

Secondary Vessel Use (If Applicable):

Annual Hours of operation for Secondary Vessel Use:______________hr/yr

Vessel Make:

Vessel Model:

Vessel Model Year:

U.S. Coast Guard Documentation Number (IMO Lloyd’s Number if oceangoing vessel, or CF# AND

CA Department of Fish & Game license for fishing vessels manufactured out of the United States or

less than five net tons displacement):

Does the project vessel utilize a wet exhaust system: Yes No

Total Number of Main Engines on this Vessel ?

Total Number of Auxiliary Engines on this Vessel ?Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Marine Vessels

, Repower Application Form D

– 1

Page 2 of 6 

## Part 2. U sage/Activity Information

Provide projected annual usage for the vessel/engines over the proposed life of the project. This

projection should be based on actual usage for the marine vessel. You MUST attach

documentation supporting the projected annual usage and operation within Dis trict and

California waters. Supporting hours of operation documentation may be in the form of

maintenance records, hour

- meter reports, logs, or other paperwork for each piece of baseline

equipment covering at least the past 24 months.

The vessel is required to have a functioning non

- resettable hour meter for the full project life.

Initial here to indicate understanding of this requirement:

_________________

Project Life _______ years. Project Life is equivalent to the contract reporting term. (Project

life may be adjusted by SCAQMD)

Number of Propulsion Engines to be rep owered : _________

Number of Auxiliary Engines to be rep owered :_________

For each Propulsion engine: Hours of Operation (per year , per engine ):_________

For each Auxiliary engine: Hours of Operation (per year , per engine ):________

Percent of Operation within California waters:_________%

Percent of Operation within District waters: _________%

Justification for purchasing new transmission (if applicable):

Electronic Monitoring Unit

I understand that a new Electronic Monitoring Unity (EMU) will be installed as part of this

Project. (This is a program requirement

. ) Initial:________________



## □ YesValid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Marine Vessels

, Repower Application Form D

– 1

Page 3 of 6 

## Part 3. Engine I nformation



##  Main Engine____ of ____ 

##  Auxiliary Engine ____ of ____

Baseline (Existing) Engine Information

Fuel Type: Engine Make:

Engine Model: Engine Year:

Engine Serial No.: Horsepower:

Engine Displacement: Liters (ltr):________

Cylinder (cyl):______ Engine Family:

Method proposed for rendering the replaced engine inoperable:

New Reduced

- Emission Engine Information

Fuel Type: Engine Make:

Engine Model: Engine Year:

Engine Serial No.: Horsepower:

Engine Displacement: ltr:

___ cyl:______ Engine Family:

New Engine Cost (incl. tax) : $ New Eng

. Installation/Labor Cost: $



##  Main Engine____ of ____ 

##  Auxiliary Engine ____ of ____

Baseline (Existing) Engine Information

Fuel Type: Engine Make:

Engine Model: Engine Year:

Engine Serial No.: Horsepower:

Engine Displacement: ltr: ___ cyl:______ Engine Family:

Method proposed for rendering the replaced engine inoperable:

New Reduced

- Emission Engine Information

Fuel Type: Engine Make:

Engine Model: Engine Year:

Engine Serial No.: Horsepower:

Engine Displacement: ltr: ___ cyl:______ Engine Family:

New Engine Cost (incl. tax) : $ New Eng . Installation/Labor Cost: $Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Marine Vessels

, Repower Application Form D

– 1

Page 4 of 6 

## Part 3. Engine Information, cont’d.



##  Main Engine____ of ____ 

##  Auxiliary Engine ____ of ____

Baseline (Existing) Engine Information

Fuel Type: Engine Make:

Engine Model: Engine Year:

Engine Serial No.: Horsepower:

Engine Displacement: Liters (ltr):________

Cylinder (cyl):______ Engine Family:

Method proposed for rendering the replaced engine inoperable:

New Reduced

- Emission Engine Information

Fuel Type: Engine Make:

Engine Model: Engine Year:

Engine Serial No.: Horsepower:

Engine Displacement: ltr: ___ cyl:______ Engine Family:

New Engine Cost (incl. tax): $ New Eng. Installation/Labor Cost: $



##  Main Engine____ of ____ 

##  Auxiliary Engine ____ of ____

Baseline (Existing) Engine Information

Fuel Type: Engine Make:

Engine Model: Engine Year:

Engine Serial No.: Horsepower:

Engine Displacement: ltr: ___ cyl:______ Engine Family:

Method proposed for rendering the replaced engine inoperable:

New Reduced

- Emission Engine Information

Fuel Type: Engine Make:

Engine Model: Engine Year:

Engine Serial No.: Horsepower:

Engine Displacement: ltr: ___ cyl:______ Engine Family:

New Engine Cost (incl. tax): $ New Eng. Installation/Labor Cost:$Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Marine Vessels

, Repower Application Form D

– 1

Page 5 of 6 

## Part 3. Engine Information, cont’d.



##  Main Engine____ of ____ 

##  Auxiliary Engine ____ of ____

Baseline (Existing) Engine Information

Fuel Type: Engine Make:

Engine Model: Engine Year:

Engine Serial No.: Horsepower:

Engine Displacement: ltr: ___ cyl:______ Engine Family:

Method proposed for rendering the replaced engine inoperable:

New Reduced

- Emission Engine Information

Fuel Type: Engine Make:

Engine Model: Engine Year:

Engine Serial No.: Horsepower:

Engine Displacement: ltr: ___ cyl:______ Engine Family:

New Engine Cost (incl. tax): $ New Eng. Installation/Labor Cost:$



##  Main Engine____ of ____ 

##  Auxiliary Engine ____ of ____

Baseline (Existing) Engine Information

Fuel Type: Engine Make:

Engine Model: Engine Year:

Engine Serial No.: Horsepower:

Engine Displacement: ltr: ___ cyl:______ Engine Family:

Method proposed for rendering the replaced engine inoperable:

New Reduced

- Emission Engine Information

Fuel Type: Engine Make:

Engine Model: Engine Year:

Engine Serial No.: Horsepower:

Engine Displacement: ltr: ___ cyl:______ Engine Family:

New Engine Cost (incl. tax): $ New Eng. Installation/Labor Cost:$Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Marine Vessels

, Repower Application Form D

– 1

Page 6 of 6 

## Part 4. Funding Information

Total Project Cost of All New Engines (incl. tax and labor): $

NOTE : You MUST attach a written estimate or quotation from the equipment vendor

documenting the cost of the new equipment. This quot e must be obtained within 90 days prior

to the closing date of the Program Announcement. The quote must indicate the certification

level of the new, replacement engine ( i.e., T ier 3 or cleaner).

Applicant Co

- Funding Amount (if any): $

Total Funding Req uested (all engines): $

New Engine Vendor/Installer Contact Information:Valid until June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Marine Vessels

, Shore Power Application Form D

– 2

Page 1 of 4 

### FORM D

- 2: MARINE VESSELS

– SHORE POWER

If you have any questions regarding this program or the application process, please contact Greg

Ushijima by phone at (909) 396

- 3301 or by e mail at: gushijima@aqmd.gov

.

Please complete one form for each Shore Power project.



## Part 1. Project Information

Company name/ Organization name/ Individual name:

Type of project (check all that apply):

Vessel retrofit to accept

electrical power (“ship

- side”) Purchase of transformer and associated

infrastructure (“shore

- side”)

Type of applicant:

Terminal Operator Vessel Owner Port Authority Other

Other potential project partners (if applicable):

Power supplier:

Where does the electrical power infrastructure begin and end?

Project Location: (Please include port, terminal, pier and berthing slip)

If you are leasing the terminal, identify time left on the current lease:

Total number of vessels expected to use shore power at this location (per year):

Total number of annual vessel visits expected to use shore power:

Total number of annual hours of usage for vessels expecting to use shore power:Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Marine Vessels

, Shore Power Application Form D

– 2

Page 2 of 4 

## Part 2: Vessel Information

Complete Part 2 for each vessel to be retrofitted. For transformer only projects please provide a

detailed description of the vessels that typically use this terminal.

If your vessel type is a refrigerated cargo ship, container

- ship or passenger ship, please attach

your Vessel Plan as required by the ARB shore power regulation:

http://www.arb.ca.gov/ports/shorepower/shorepower .htm

Vessel Type:

Vessel Name: Vessel Make:

Vessel Model: Vessel Ye ar:

US Coast Guard Documentation Number:

Lloyds Register/IMO Ship ID Number:

Vehicle Registration (CF) Number:

Total Number of main and auxiliary engines on vessel:

Main engine(s) Auxiliary engine(s)

Total number of annual visits to the terminal:

Average berthing time (hours) of the vessel, per visit (include time needed to connect and disconnect

the vessel to shore power):

Vessel power (kW) requirements while at berth :

Average Power Requirement:

Maximum Power Requirement:



## Part 3. C urrent Berth Activity (Cumulative)

Nu m ber of annual ship visits to the berth (attach the log of vessel visits for each of the specified years) :

2012_______________

2013_______________

2014_______________Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Marine Vessels

, Shore Power Application Form D

– 2

Page 3 of 4 

## Part 4. Predicted (Future)Berth Activity

Estimated annual ship visits using electrical power:

2014

- 2016____________________

2017

- 2019____________________

2020 and beyond_______________

Estimated monthly hours of operation:

2014

- 2016____________________

2017

- 2019____________________

2020 and beyond_______________

Estimated monthly megawatt (MW) usage:

2014

- 2016____________________

2017

- 2019____________________

2020 and beyond_______________



## Part 5 : Vessel Activity Information

Attach a detailed description of the vessels that will be using the shore power equipment. Title this

attachment “Part 5

– Vessel Activity Information”. This description should include:

 Vessel type

 Ship size (in 20

- foot equivalent units (TEU) capacity)

 Number and type of engines

 Power demand (total auxiliary power (kW)

– not hotelling load)

 This number of auxiliary engines typically operating while at berth per vessel

 Number of annual visits

 Average berthing time (hours) of the vessel, per visit (include time needed to connect and

disconnect the vessel to shore power). Be sure to consider the maximum time the auxiliary

engines are in use.Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District

Marine Vessels

, Shore Power Application Form D

– 2

Page 4 of 4 

## Part 6 : Funding Information

You MUST attach a written estimate or quotation from the equipment vendor documenting the

cost of the new equipment and associated labor. This quote must be obtained within 90 days

prior to the closing date of the Program Announcement.

Transformer Project Cost : $ Associated Infrastructure: $

Retrofit Equip. Cost (incl. tax): $ Retrofit Equip. Installation Cost : $

Total Project Cost:

Total Amount Requested for this Project:

You MUST attach a detailed written estimate/quote from the equipment vendor for the cost of the equipment and labor.

Maximum allowable Shore Power Transformer (“shore

- side”): 50% of tra nsformer & other

equipment between the vessel and transformer

Shore Power Vessel Retrofit (“ship

- side”): 100% of retrofit cost &

50% of transformer cost

Other: $ You may request less than the maximum allowable funding amount to improve

cost

- effectiveness of your project

.

Anticipated Project Completion Date:

Please attach a proposed project schedule. Title this attachment “Part 8

– Project Schedule

. ”Valid until June 1, 2016 at 1:00 PM

South Coast Air Quality Management District



### Locomotives Application Form E

– 1

Page 1 of 5 

### FORM E

- 1: LOCOMOTIVES

I f you have any questions regarding this program or the application process, please contact

Connie Day by phone at (909) 396

- 3055 or by e mail at: cday@aqmd.gov

.

Please complete one Form E

- 1 for each piece of equipment. For multiple unit requests, you may

download the Form E

- 1 multiple

- unit spreadsheet from www.aqmd.gov/Moyer in lieu of filling

out multiple E

- 1 forms.

W hich type of locomotive project is proposed with this application? (Check one)

 Locomotive Replacement (includes Tier 4 locomotives (or cleaner), GenSet locomotives

(multi

- engine switcher) and electric

- hybrid locomotives. U.S.EPA considers a refurbished

locomotive a new locomotive if it includes at least 75 % (by value) new parts.

 Idle limiting device (ILD)

 U.S. EPA certified engine remanufacture kit or repower/refurbishment

 ARB verified retrofit

 Head end power unit (HEP)



## Part 1: Locomotive Information

Locomotive Type (Line Haul, Traditional Switcher, Alternative Technology Switcher, Passenger):

Railroad Class:

Proposed Project Life (same as contract term/how long you must operate equipment): years

Percent Operation in California (%): _____ Percent Operation in District (%): ______

Has this equipment received previous CMP Funding? Yes No

Unit Number or Other Identifier: Equipment Location Address:

Locomotive Make: Locomotive Serial Number:

Locomotive Model: Locomotive Model Year:

Does the locomotive already have a functioning

idle limit device ( ILD ) installed? Yes NoValid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District



### Locomotives Application Form E

– 1

Page 2 of 5 

## Part 2: Existing (Baseline) Engine(s) Information

Engine Type: MAIN

- OR

- AUXILIARY # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

US EPA Certificate of Conformity No :

(attached) CARB Executive Order No:

(attached)

Engine Type: MAIN

- OR

- AUXILIARY # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

US EPA Certificate of Conformity No:

(attached) CARB Executive Order No:

(attached)

Engine Type: MAIN

- OR

- AUXILIARY # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

US EPA Certificate of Conformity No:

(attached) CARB Executive Order No:

(attached)

Engine Type: MAIN

- OR

- AUXILIARY # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

US EPA Certificate of Conformity No:

(attached) CARB Executive Order No:

(attached)Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District



### Locomotives Application Form E

– 1

Page 3 of 5 

## Part 3: Existing Locomotive Activity Information

Annual Fuel Usage (gallons per year): 2012: _______

2013: _______

2014: _______

Attach documentation to support the reported gallons per year.



## Complete each section(s) below that pertains to your Locomotive project type:

Part 4 : New (Replacement) Locomotive Information

Locomotive Type :



###  Tier 4 locomotive (or cleaner)

 Gen S et locomotive (multi

- engine switcher)

 Electric

- hybrid locomotive

NOTE: A refurbished locomotive is considered to be a new locomotive if it includes at least

75 percent (by value) new parts.

Locomotive Serial Number (If available) :

Locomotive Make:

Locomotive Model:

Locomotive Model Year:

Will the locomotive have a functioning idle limit

device (ILD) installed? Yes NoValid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District



### Locomotives Application Form E

– 1

Page 4 of 5 

## Part 5 : New/Replacement Engine(s) Information

Engine Type: MAIN

- OR

- AUXILIARY # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

US EPA Certificate of Conformity No:

(attached) CARB Executive Order No:

(attached)

US EPA Certified Emissions (g/bhp

- hr): NOx:_______ HC:____ ___ PM: __________

Engine Type: MAIN

- OR

- AUXILIARY # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

US EPA Certificate of Conformity No:

(attached) CARB Executive Order No:

(attached)

US EPA Certified Emissions (g/bhp

- hr): NOx:_______ HC:_______ PM: __________

Engine Type: MAIN

- OR

- AUXILIARY # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

US EPA Certificate of Conformity No:

(attached) CARB Executive Order No:

(attached)

US EPA Certified Emissions (g/bhp

- hr): NOx:_______ HC:_______ PM: __________

Engine Type: MAIN

- OR

- AUXILIARY # of

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No.: Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

US EPA Certificate of Conformity No:

(attached) CARB Executive Order No:

(attached)

US EPA Certified Emissions (g/bhp

- hr): NOx:_______ HC:____ ___ PM: __________Valid unt il June 1, 2016 at 1:00 PM

South Coast Air Quality Management District



### Locomotives Application Form E

– 1

Page 5 of 5 

## Part 6 : Future/Projected Locomotive Activity Information

Annual Fuel Usage (gallons per year):

______________

Contact the SCAQMD Staff Lead to discuss your project and appropriate assumptions for

this projection.



## Part 7: Engine and/or Locomotive Cost

All cost estimates must be based on quotes that have been obtained within 90 days prior to the

closing date of the Program Application. Attach all quotes to the application.

New Locomotive Cost: $

Engine Unit Cost: $

Tax: $

Engine Installation Cost: $

Total Project Cost: $

Project Grant Request: $



## Part 8: Additional Project Information

Please provide a full description of the proposed project. Include an explanation of any

project elements that are not adequately covered in the above Parts.

(Attach additional sheets if more space is needed.)Valid until June 1 , 201 6 , at 1:00 P.M. #PA 2016

- 06

1 

### Surplus Off

- Road Opt

- In for NOx (SOON)

SC AQMD PROGRAM ANNOUNCEMENT

# PA 2016

- 06

The South Coast Air Quality Management District ( SC AQMD) is soliciting project proposals

for the following purpose according to terms and conditions attached. In this Progra m

Announcement (PA) the words “Proposer,” “Applicant,” “Contractor,” and “Consultant” are

used interchangeably.

SECTION I

– OVERVIEW

PURPOSE

The SC AQMD is seeking proposals for the Surplus Off

- Road Opt

- In for NOx (SOON)

Provision of the California Air R esources Board’s (CARB’s) In

- Use Off

- Road Diesel

Vehicle Regulation. The primary purpose of this program is to provide financial incentives

to assist in the purchase of low

- emission heavy

- duty engine technologies to achieve near

term nitrogen oxides (NOx) emission reductions from in

- use off

- road equipment. Since

funding for the SOON P rogram is from the Carl Moyer Program (CMP), all CMP

requirements apply to this P rogram, except where specifically noted, or where the

SC AQMD implements more stringent program criteria as described in the Rule 2449

SOON Implementation Guidelines.

INTRODUCTION

The SOON P rogram is designed to achieve additional NOx reductions above those that

would be obtained from the State In

- Use Off

- Road Vehicle Regulation. These reductions

ar e critical to meeting the PM 2.5 and ozone ambient air quality standard s in the South

Coast Air Basin

.

Funding for Program Announcement # PA 2016

- 06 is from state SB 1107 and AB 923

funds. Project awards are contingent upon receiving these funds from CARB. A dditional

sources of funding may become available and added to this P rogram.

Desirable projects must strive to meet a maximum cost

- effectiveness limit of $ 18,260 per

ton of emissions reduced and any additional SC AQMD criteria as stated in this PA ( t he

co st

- effectiveness limit may be changed depending on the demand for program funds).

Projects exceeding the cost

- effectiveness limit may receive partial funding. Except where

otherwise stated, projects must meet the requirements of the CMP program guidelines.

The current Program Announcement was prepared using the Approved Revision of the

CMP Guidelines released on December 18, 2015 . It is the applicant’s responsibility to

ensure that the most current information and requirements are reflected in a submitte d

application. Applicants should check the CARB website for updates and advisories to the

guidelines ( http://www.arb.ca.gov/msprog/moyer/moyer.htm ).Valid until June 1 , 201 6 , at 1:00 P.M. #PA 2016

- 06

2 

### SC AQMD SOON requirements may sometimes be more stringent tha n CARB guidelines.

For example, SC AQMD may have a lower cost

- effectiveness ceiling for a particular

category. In case there are any conflicts between CARB guidelines and SC AQMD criteria,

the more stringent criteria will prevail. SC AQMD w ill post any new information and

requirements on its SOON web page at www.aqmd.gov/soon

. It is the responsibility of the

applicant to ensure that the most current information and requirements are reflected in a

sub mitted application.

DEFINITION S

1. Alternative Fuel

Alternative fuels include compressed natural gas (CNG), liquefied natural gas (LNG),

methanol, ethanol, propane (LPG) and electric technologies.

2. Base Rule

Base rule is defined as CARB’s In

- Use Off

- Road Diesel regulation without the SOON

provisions. Compliance with the Base Rule is required and is demonstrated by the

DOORS Compliance Snapshot.

3. Compliance Plan

Compliance plan is the future forecast of fleet average emissions using current fleet

informatio n and planned future repower, replacement, retirement and retrofit projects

. An Excel spreadsheet template is available on the SCAQMD SOON W eb page.

4. Contract Term

Contract term is the duration for which the contract is valid. It encompasses both the

proje ct completion and project implementation period s.

i. Project completion period is the first part of the Contract term starting from the date

of Contract execution by both parties to the date the project post

- inspection

confirms that the project has become ope rational.

ii. Project implementation period is the second part of the Contract term and equals

the project life.

5. Cost

- Effectiveness Limit

T he cost

- effectiveness limit is the maximum funding that can be provided to an

individual vehicle repower, replacement or retrofit project for each ton of covered

emission reduc ed.

6. Current NOx Standard

For all engine horsepower categories, the current NOx standard in 2015 is Tier 4 Final.

7. Dual

- F uel Technology

Dual

- fuel technolog y include s electric hybrids and technologie s that utilize a

combination of either CNG and diesel fuel or LNG and diesel fuel, provided they are

certified by CARB. Experimental technologies and fuels will be referred to CA R B for

evaluation and possible eligibility in the program

.

8. Incremental Cost

Incremental cost is the percent of actual cost that is eligible for SOON funding. ForValid until June 1 , 201 6 , at 1:00 P.M. #PA 2016

- 06

3 

### repower projects

, it is 85% ; for replacement projects, it is 80% ; and for retrofit projects,

it is 100%.

9. Project Life

Project life is the period of the contract term du ring which the repowered, replacement

or retrofitted vehicle is operated and the contractor must report annual usage. It is used

to calculate the cost

- effectiveness and funding amount for a particular project.

10. Replacement Project

R eplacement project is t he purchase of a new or used vehicle to replace an existing

vehicle

.

11. Repower Project

R epower project is the replacement of an old engine of a n existing vehicle with a newer

engine certified to lower emission standards.

12. Retrofit Project

Retrofit project is a modification made to an engine exhaust and/or fuel system such

that the specifications of the retrofitted engine are different from the original engine.

GENERAL PROGRAM INFORMATION

The primary focus of the SOON Program is to achieve emission reducti ons from heavy

duty vehicles and equipment operating in California as early and as cost effectively as

possible. The SOON Program is intended to achieve additional NOx reductions which are

needed to meet the PM 2.5 and ozone ambient air quality standard s in the South Coast Air

Basin. The emission reductions expected through the deployment of low

- emission engines

or retrofit technologies under this P rogram must be real, surplus and quantifiable. To avoid

double counting of emission redu ctions, project vehicle s and/or equipment may not receive

funding from any other government grant program that is designed to reduce mobile

source emissions. Specifically, these programs include, but are not limited to:

 All Mobile Source Air Pollution Reduction Review Committee (MSRC) Programs

 All CARB Emission Reduction Credit Programs

 SC AQMD Rule 2202 Air Quality Investment Program

 SC AQMD RECLAIM Air Quality Investment Program for NOx

 Emission Credit Programs e ncompassed in the SC AQMD Rule 1600

- series and

1309.1

 1B Bond Program

 AB 118 Funding Program

Replacement and repower p rojects are limited to only those involving d iesel

- to

- alternative

fuel , diesel

- to

- dual fuel technology

, and diesel

- to

- diesel fuel engines or vehicles

. All

projects must meet the program’s cost

- effectiveness limits and be operational no

later than May 31, 2018

. No administrative or vehicle operational costs are eligible.

It is expected that multiple awards will be granted under this PA, subject to the approval of

the SC AQMD Governing Board.Valid until June 1 , 201 6 , at 1:00 P.M. #PA 2016

- 06

4 

### All proposal s will be evaluated based on criteria set forth in this PA. The SC AQMD will

evaluate and/or verify information submitted by the applicant. At SC AQMD's discretion,

consultants to the SC AQMD may conduct all or part of such evaluation and/or verification.

Dat a verification during the evaluation and contracting process may cause initial cost

effectiveness rankings, and associated awards, to change. Furthermore, the SC AQMD

reserves the right to make adjustments to awards based on the subsequent verification of

i nformation as well as changes in cost

- effectiveness.

IMPORTANT PROGRAM INFORMATION

 Fleets with a total statewide equipment horsepower over 20,000 hp and with 40

percent or more of their vehicles at Tier 0 and Tier 1 emission levels as of

January 1, 200 8

, are subject to the SOON Program and are required to apply for

funding . Fleets not meeting both of the above criteria on January 1, 2008

, may

voluntarily participate in this program and apply for funding

.

 For this program cycle, all project s will be elig ible for a maximum seven (7) year

operational requirement within the South Coast Air District

. Shorter project life will

be considered on a case

- by

- case basis and may be required by the CMP

Guidelines . However, a shorter project life may affect the project ’s ranking relative

to other project applicants and the amount of funding that can be provided

.

 The annual hours used to calculate cost

- effectiveness will be included in the

contract. An extension of the contract or partial payback of funds may be required if

the proposed annual hours are not achieved.

 For all repower projects, fleets are

U 

### not

U 

### required to but may install the highest level

verified diesel emission control system (VDECS) at their own cost.

 Retrofit project s which can achieve NOx reduction s may be funded on a case

- by

case basis.

 Replacement, r epowers or NOx retrofits projects funded under SOON are in eligible

for compliance with the base rule until the end of the contract period.

 Applicants

U 

### must

U 

### provide vendor quotes with their applicati on to document the cost

of implementing the proposed technology. All quotes must have been obtained

within 90 days of application submittal. Applicants may be required to submit

quotes from more than one technology provider.

 Applicants must demonstrate tha t they are in full compliance with all CARB

applicable regulations and that vehicle/equipment funding requests under this

P rogram provide surplus emissions reductions. Applicants are required to submit

a compliance plan showing how they will comply with th e targets of CARB’s

In

- Use Off

- Road Vehicle regulation throughout the c ontract term , as well as

how the new projects under this PA will meet SOON NOx targets in 201 7 and

20 20

.

 Applicants must ensure that the vehicle/equipment to be purchased or installed is in

compliance with all applicable federal, state and local air quality rules and

regulations and that it will maintain compliance for the full c ontract term.

 Any associated tax obligation with the award is the responsibility of the grantee.

 No third

- p arty contracts will be executed.Valid until June 1 , 201 6 , at 1:00 P.M. #PA 2016

- 06

5 

###  Pre

- and post

- inspection of all vehicles/engines/equipment approved for funding will

be conducted by SC AQMD

.

 Destruction of the engine /equipment being replaced is required.

 To avoid double dipping, applicants shall not appl y for funding of the same

equipment in any other air district.

POTENTIAL PROJECTS

All eligible projects must use certified technology or technology that has been verified by

C ARB for real and quantifiable emission reductions that go beyond any regulatory

requirement. The following projects are eligible for SOON funding:

Repower Project

For a repower project, the new engine must be certified for sale in California to the current

NOx emission standard (Tier 4 Final)

. If an engine meeting the current emiss ion standard

is not available or cannot be installed :

 A Tier 3 Replacement Engine rated at 175 hp or higher can be used for the

repower project

.

 A Tier 3 Replacement rated at 175 horsepower or less can be used for repower

projects provided it complies with U

. S

. Environmental Protection Agency ( EPA )

requirements related to replacing in

- use engines contained in the Code of Federal

Regulations, Title 40, Section 1068.240.

 For off

- road equipment with similar modes of operation to on

- road vehicles, other

p ossible options include the replacement of an older diesel off

- road engine with a

new on

- road engine certified to an emission standard equal to or cleaner than the

Tier 4 Final off

- road emission standard or a newer emission certified alternative

fuel engin e.

Retrofit Project

For a retrofit project, the retrofit technology must be :

 V erified by CARB to reduce NOx or NOx plus PM for the specific engine for which

funding is requested

.

 In compliance with established durability and warranty requirements and cos t

effectiveness criteria

.

Diesel Particulate Filters (DPFs) and other devices that are not verified to reduce NOx are

not eligible for SOON funding. T he applicant will find more information on VDECS,

including a list of currently verified DECS at

http://www.arb.ca.gov/diesel/verdev/verdev.htm

.

Replacement Project

For replacement projects, the replacement vehicle/ equipment must be powered by a Tier 4

Final engine

. If a vehicle/ equipment with a Tier 4 Final engine will not be available within 6

months of the application submittal, vehicle/ equipment with a n I nterim Tier 4 or Tier 3

engine may be purchased.Valid until June 1 , 201 6 , at 1:00 P.M. #PA 2016

- 06

6 

### PROJECT CRITERIA

The SC AQMD retain s the authority to impose more stringent additional requirements in

order to address local concerns.

 Off

- road CI equipment eligible for SOO N Program funding includes equipment 25

hp (19 kilowatt) or greater. The complete definition can be found in CARB’s In

- U se

Off

- R oad Diesel regulation at http://www.arb.ca.gov/msprog/ordiesel/ordiesel.htm

.

 SOON Program grants can be no greater than a project’s incremental cost (85% of

quotation for repower projects , 80% of quotation for replacement proj ects ) . The

incremental cost shall be reduced by the value of any current financial incentive that

reduces the project price, including but not limited to tax credits or deductions,

grants, or other public financial assistance.

 Applicants must ensure that the vehicle/equipment to be purchased or installed is in

compliance with all applicable federal, state and local air quality rules and

regulations and that it will maintain compliance for the full c ontract term.

 The certification emission standard and Tie r designation for the engine must be

determined from the CARB’s Executive Order issued for that engine, not by the

engine model year. Executive orders for off

- road engines may be found at

h ttp://www.arb.ca.gov/msprog/offroad/cert/cert.php

.

 Reduced

- emission engines or retrofits must be certified/verified for sale in California

and must comply with durability and warranty requirements. These may include new

CARB

- certified engines and verified diesel emission control strategies.

 New vehicles equipped with Tier 4 family emission limits ( FEL ) engines certified to

Tier 3 or Interim Tier 4 standard s are eligible for SOON Program funding

. However,

those engines will have their cost

- effectiveness ca lculated as though they

were Tier 3 engines

.

 Equipment manufactured under the “Flexibility Provisions for Equipment

Manufacturers”, as detailed in Title 13, CCR, section 2423(d), are eligible for SOON

Program funding provided their engines are certifie d to Tier 3 or Interim Tier 4

standards

.

 Class 7 diesel forklifts are the only diesel forklifts eligible for SOON Program

funding and are subject to all off

- road project criteria. The SC AQMD must obtain

and verify documentation of the classification of th e forklift prior to funding.

 If repower with an engine meeting the current applicable standard is technically

infeasible, unsafe or cost prohibitive, the replacement engine must meet the most

current practicable previously applicable emission standard and cost

- effectiveness

criteria and

, if rated at less than 175 hp, must comply with the requirements related

to replacing in

- use engines contained in Title 40, Code of Federal Regulations,

Section 1068.240

.

 Replacement of an uncontrolled diesel off

- road eng ine with a new on

- road engine

certified to an emission standard equal to or lower than the Tier 4 Final off

- road

emission standard or a newer emission

- certified alternative

- fuel engine may be

eligible for funding as off

- road equipment with similar modes of operation as on

road vehicles on a case

- by

- case basis. Other equipment may be eligible for funding

on a case

- by

- case basis. These repowers must meet all other applicable project

criteria.Valid until June 1 , 201 6 , at 1:00 P.M. #PA 2016

- 06

7 

###  Applicants must provide their DOORS Fleet Compliance S napshot

.

 Ap plicants must provide the DOORS EIN for each vehicle for which funding is

requested.

 Applicants must provide proof they have owned each vehicle for which funding is

requested for a replacement vehicle for at least two years

.

 Applicants must provide a curr ent Compliance Plan using the SCAQMD fleet

calculator or the DOORS calculator demonstrating compliance with the Off

- Road

regulation throughout the anticipated contract period

.

 Applicants must provide at least the most recent two ( 2 ) years of hour

- meter

rea dings.

Potential projects that fall outside of these criteria may be considered on a case

- by

- case

basis if evidence provided to the air district suggests potential surplus, real, quantifiable

and enforceable emission reduction benefits.

MAXIMUM ELIGIBLE FUNDING

The maximum eligible funding amount and project life for each SOON project type is

summarized below.

Project Maximum Funding Maximum Project Life

Replacement 80% of

vehicle/equipment cost Five years, except:

 Three years for excavators, skid stee r

loaders, and rough terrain forklifts

 Seven years crawler tractors, off

- road

tractors, rubber tired dozers, and workover

rigs.

 Ten years for all off

- road farm equipment

Repower 85% of engine cost

plus parts and labor

necessary for

installation Seven year s

Retrofit 100% of retrofit device

cost plus parts and

labor for installation,

plus estimated cost for

maintenance during

project life. Five years

COST

- EFFECTIVENESS EVALUA TION DISCUSSION

The SOON Program is required to meet the requirements of the CMP by using the c ost

effectiveness calculations methodology found in Appendix C of t he CMP Guidelines (see

http://www.arb.ca.gov/msprog/moyer/guidelines/current.htm ).

REPORTING AND MONITORING

All participants in the SOON Program are required to keep appropriate records during the

full contract period. Project life is the number of years used to determine the cost

-Valid until June 1 , 201 6 , at 1:00 P.M. #PA 2016

- 06

8 

### effectiveness and is equivalent to the contract life. All equipment mu st operate in the

SC AQMD for this full project life. The SC AQMD shall conduct periodic reviews of each

project’s operating records to ensure that the engine is operated as stated in the program

application. Annual records must contain the following , at a m inimum:

 Total Hours of Operation

 Total Hours of Operation in the South Coast Air District

 Annual Maintenance and Repair Information

Records must be retained and updated throughout the project life and made available for

SC AQMD inspection. The SC AQMD may c onduct periodic reviews of each

vehicle/equipment project’s operating records to ensure that the vehicle is operated as

required by the project requirements.

PROGRAM ADMINISTRATION

The SOON Program will be administered locally by the SC AQMD through the Science and

Technology Advancement O ffice.

FUNDING CATEGORIES

Only equipment identified in the CARB In

- U se Off

- Road Diesel Vehicle regulation is

eligible for this P rogram.

PROJECT EVALUATION/AWARDS

SC AQMD staff will evaluate all submitted proposals and make recommendations to the

SCAQMD Governing Board for final selection of project(s) to be funded. Proposals will be

evaluated on the cost

- effectiveness of emissions reduced on a vehicle/equipment

- by

vehicle/equipment basis, as well as a project’s disprop ortional impact evaluation

. (This is

discussed further in Section IV).

SCHEDULE OF EVENTS

Release of # PA 2016

- 06 March 4 , 201 6

All Applications d ue by 1:00 p

. m

. Wednesday

, June 1, 2016

Anticipated Award Consideration by SCAQMD Board October 7

, 2016

ALL PROPOSALS MUST BE RECEIVED AT THE SC AQMD HEADQUARTERS

NO LATER THAN 1:00 P.M. ON WEDNESDAY

, JUNE 1, 2016

Postmarks will not be accepted. Faxed or email proposals will not be accepted.

Proposers may hand

- deliver proposals to the SC AQMD by submitting the proposal

to the SC AQMD Public Information Center . The proposal will be date and time

stamped and the person delivering the proposal will be given a receipt.

SC AQMD may issue subsequent solicitations if insufficient applications are

received in the ini tial solicitation.Valid until June 1 , 201 6 , at 1:00 P.M. #PA 2016

- 06

9 

### STATEMENT OF COMPLIANCE

Government Code Section 12990 and California Administrative Code, Title II, Division 4,

Chapter 5, require employers to agree not to unlawfully discriminate against any employee

or applicant because of race, reli gion, color, national origin, ancestry, physical handicap,

medical condition, marital status, sex, or age. A statement of compliance with this clause is

included in all SC AQMD contracts.

SECTION II: WORK STATEMENT/SCHEDULE OF DELIVERABLES

All applicant s that are selected for funding awards must complete the Work Statement and

Schedule of Deliverables described below as part of the contracting process. Development

of these materials for the initial application is NOT required; however, applicants must si gn

the a pplication form indicating their understanding of the requirements for submittal of

additional project information to finalize a contract and that all vehicles, engines or

equipment must be in operation no later than May 31, 2018

.

WORK STATEMENT

The scope of work involves a series of tasks and deliverables that demonstrate

compliance with the requirements of the SOON Program as administered by CARB and

the SC AQMD. The project applicant is responsible for developing detailed project plans

that add ress the program criteria. In addition, alternative fuel project applicants must

discuss their plan for refueling the proposed vehicles/equipment, and if appropriate, should

provide a letter of agreement from their fuel provider.

At a minimum, any contr act for funding the proposed project must meet the following

criteria:

 E mission reductions must be real, quantifiable, enforceable and surplus in

accordance with CARB and SC AQMD guidelines.

 C ost

- effectiveness of the project must meet the minimum requiremen t of the Carl

Moyer guidelines

.

 P roject engines or equipment must operate in

- service for the full project life.

 A ll vehicles/engines/equipment must be in operation no later than May 31, 2018

.

 A ppropriate annual usage record s must be kep t and reported to SCAQMD during

the project life (i.e., annual hours of operation )

.

 A compliance plan that demonstrates compliance with the off

- road regulation

throughout the c ontract period must be provided

.

 Ensure that the project complies with other local, state and fede ral programs, and

resulting emission reductions from a specific project are not required as a mitigation

measure to reduce adverse environmental impacts that are identified in an

environmental document prepared in accordance with the California Environment al

Quality Act or the National Environmental Policy Act.

 If requested, a contractor must provide a financial statement and bank reference, or

other evidence of financial ability to fulfill contract requirements.Valid until June 1 , 201 6 , at 1:00 P.M. #PA 2016

- 06

10 

### DELIVERABLES

The contract will describe ho w the project will be monitored and what type of information

will be included in project progress reports. At a minimum, the SC AQMD expects to

receive the following reports:

1. Quarterly status reports until the vehicle (s) or equipment purchase (s) , repower (s)

, or retrofit (s) has been completed and the vehicle (s) is operational. These reports

shall include a discussion of any problems encountered and how they were

resolved, any changes in the schedule, and recommendations for completion of the

project. These progress reports are required before payment for the purchase,

repower or retrofit will be made.

2. An annual report, throughout the project life, which provides the annual hours of

operation, where the vehicle (s) or equipment (s) was operated, annual fuel

consumption, and operational and maintenance issues encountered and how they

were resolved. SC AQMD reserves the right to verify the information provided.

SECTION III: PROPOSAL SUBMITTAL REQUIREMENTS

Proposers must complete the appropriate application forms committing that the

information requested in Section II, Work Statement/Schedule of Deliverables will be

submitted if the Proposer’s project is selected for funding.

In addition, Conflict of Interest and Project Cost information, as described belo w, must also

be submitted with the applica tion. It is the responsibility of the proposer to ensure that all

information submitted is accurate and complete.

CONFLICT OF INTEREST

Applicant must address any potential conflicts of interest with other client s affected by

actions performed by the firm on behalf of the SC AQMD. Although the proposer will not be

automatically disqualified by reason of work performed for such firms, the SC AQMD

reserves the right to consider the nature and extent of such work in ev aluating the

proposal. Conflicts of interest will be screened on a case

- by

- case basis by the SC AQMD

General Counsel’s Office. Conflict of interest provisions of the state law, including the

Political Reform Act, may apply to work performed pursuant to this contract. Please

discuss potential conflicts of interest on the a pplication form entitled “ Campaign

Contributions Disclosure ”.

PROJECT COST

Applicants must provide cost information that specifies the amount of funding requested

and the basis for that re quest by attaching vendor quotes to the application. Applicants

need to inform vendors of the time frame of the award process so that they can accurately

quote costs based on the anticipated order/purchase date. Note that no purchase orders

may be placed o r work performed for projects awarded under this PA until after the

date of award approval by the SC AQMD Governing Board. A ny orders placed or

payments made in advance of an executed contract with the SC AQMD are done atValid until June 1 , 201 6 , at 1:00 P.M. #PA 2016

- 06

11 

### the risk of the applicant. The SC AQM D has no obligation to fund the project until a

contract is fully executed by both parties.

The SOON Program funds only the differential cost between existing technology

and low

- emission technology . The proposed low

- emission technology must be CARB

cert ified in most cases

. 1 

### Proposals will be ranked by cost

- effectiveness on a

vehicle/equipment

- by

- vehicle/equipment basis. The c ost

- effectiveness limit has been

established at $ 18,260 /ton of emissions reduced. The cost

- effectiveness may be changed

depending o n the demand for program funds. No fueling infrastructure, administrative or

operational costs will be funded.

All project costs must be clearly indicated in the application. In addition, applicants must

include any sources of cofunding and the amount of each cofunding source in the

application. Applicants are cautioned that the project life period used in calculating

emissions reductions will be used to determine the length of their data reporting

obligation and the length of their contract . In other word s, a project applicant using

a seven year life for the emissions reduction calculations will be required to operate

and track activity for the project vehicle for the full seven years. A seven

- year life

( shorter project life will be considered on a case

- by

- case basis and may be required for

replacement projects ) will be used for all projects subject to # PA 2016

- 06

.

PROPOSAL SUBMISSION

All proposals must be submitted according to specifications set forth herein

.

U 

### Application Forms

Program application fo rms are provided after this document. These must be completed

and submitted with other required documents (i.e., Certifications and Representations and

vendor quotations ) discussed in the application and below.

Certifications and Representations

Contain ed in Form A

- 1 of this PA are five forms

U 

### which must also be completed and

submitted with the application.

Compliance Plan

Projects funded by SOON monies must result in emission reductions that are surplus to

those that would be realized by fleets compl ying with the base rule. Fleets are required to

submit a compliance plan in electronic format to demonstrate how they comply with both

the base rule as well as the SOON provision of the rule. Fleet owners, at a minimum, must

provide the following informati on for each year

, 2010 through 202 2 inclusive:

 A vehicle list which includes, but is not limited to, vehicle type, manufacturer, model,

model year, and whether the equipment is included in the base or SOON fleet for

each piece of equipment in the fleet.

 In formation including, but not limited to, calculations, fleet information, etc., showing

compliance with the base rule fleet target levels or compliance with the BACT

turnover and retrofit requirements. Either the CARB DOORS calculator ( individual

1 Not e that non

- CARB certified engines/devices requiring an experimental permit from CARB may be

considered, but the project will require special CARB approval.Valid until June 1 , 201 6 , at 1:00 P.M. #PA 2016

- 06

12 

### tabs for each future year) or the Excel SOON fleet calculator spreadsheet may be

used.

 Information including, but not limited to, calculations, fleet information, etc., showing

whether the vehicles funde d by the SOON program are in compliance with the

SOON NOx fle et average target levels.

SOON Compliance Plan documents and the Microsoft Excel SOON fleet calculator can be

downloaded at the SCAQMD SOON website : www.aqmd.gov/soon

Due Date

The proposer shall submit four (4) c omplete paper copies of the application and an

electronic copy (CD or flash drive) of the compliance plan and completed

application in a sealed envelope, plainly marked in the upper left

- hand corner with the

name and address of the proposer and the words " Program Announcement # PA 2016

-

06 ”

. P aper applications shall be submitted in an eco

- friendly format: stapled, not bound,

black and white print; no three

- ring, spiral or plastic binders, and no card stock or colored

paper. All proposals must be received no la ter than

U 

### 1:00 p.m., on Wednesday

, June 1,

2016 . Postmarks are not accepted as proof of deadline compliance. Faxed or emailed

proposals will not be accepted . Proposals must be directed to:

Procurement Unit

South Coast Air Quality Management District

2186 5 Copley Drive

Diamond Bar, CA 91765

Any correction or resubmission done by the proposer will not extend the submittal

due date.

Grounds for Rejection

A proposal may be immediately rejected if:

1. It is not prepared in the format described

.

2. It is not signed by an individual authorized to represent the firm

.

3. Does not include current cost quotes, Contractor Statement Forms

, and other

forms required in this PA

.

Disposition of Proposals

The SC AQMD reserves the right to reject any or all proposals. All responses become the

property of the SC AQMD. One copy of the proposal shall be retained for SC AQMD files.

Additional copies and materials will be returned only if requested and at the proposer's

expense.

Modification or Withdrawal

Once submitted, proposals cannot be altered without the prior written consent of

SC AQMD. All proposals shall constitute firm offers and may not be withdrawn for a period

of ninety (90) days following the last day to accept proposals.Valid until June 1 , 201 6 , at 1:00 P.M. #PA 2016

- 06

13 

### SECTION IV: PROPOSAL EVALUATION/CONTRACTOR SELECTION CRITERIA

SC AQMD staff will evaluate all submitted proposals and make recommendations to the

SCAQMD Governing Board for final selection of project(s) to be funded. Proposals will be

evaluated based on the cost

- effectiveness of emissions reduced on a vehic le/equipment

by

- vehicle/equipment basis. Be aware that there is a possibility that due to program

priorities, cost

- effectiveness and/or funding limitations, project applicants may be offered

only partial funding, and not all proposals that meet minimum cos t

- effectiveness criteria

may be funded.

Funding will be awarded based on the cost

- effectiveness of each piece of equipment.

Distribution will be as follows:

1. 75% of total project funding will be awarded to the most cost

- effective projects. No

individual co mpany shall receive more than 10% of this portion of the funding.

2. The remaining 25% of funding will be distributed so that at least one piece of

equipment per applicant is funded, until funding is expended. If funds are still

remaining after this distribut ion, they will be distributed according to cost

effectiveness

.

In addition, at least 50 percent of the CMP funds must be spent in areas that are most

significantly impacted by air pollution and are low income or communities of color, or both

(i.e., receiv e a disproportionate impact from these factors). CARB issued broad goals and

left the details of how to implement this requirement to each air agency. SC AQMD uses

the following method to meet these requirements.

1. All projects must qualify for the CMP by mee ting the cost

- effectiveness limit of

$ 17, 72 0 per ton of emissions controlled.

2. All projects will be evaluated according to the following criteria to qualify for

disproportionate impact funding :

a. Poverty Level: All projects in areas where at least 10 percent of the population

falls below the Federal poverty level, based on the year 2000 census data, will

be eligible to be included in this category

b. PM Exposure: All projects in areas with the highest 15 percent of PM

concentration will be eligible to be ranked in this category. The highest 15

percent of PM concentration is 46 micrograms per cubic meter and above, on an

annual average

c. Toxic Exposure: All projects in areas with a cancer risk of 1,000 in a million and

above (based on MATES II estimates) will be e ligible to be ranked in this

category.

3. Fifty percent of the available funding from this PA will be allocated among proposals

located in disproportionately impacted areas. If available funding is not exhausted

with the outlined methodology, then staff will return to the SCAQMD Governing

Board for direction. If

, on the other hand, funding requests exceed the available

funding levels, then all qualified projects will be ranked for poverty level, PM and

toxic exposures. The maximum score will be comprised of 40 percent for poverty

level and 30 percent each for PM and toxic exposuresValid until June 1 , 201 6 , at 1:00 P.M. #PA 2016

- 06

14 

### 4. All the proposals not awarded under the 50 percent disproportional impact funding

will then be ranked according to cost

- effectiveness, with the most cost

- effective

project funded fi rst and then in descending order for each funding category until the

remainder of the CMP funds are exhausted.

SECTION V: PAYMENT TERMS

For all projects, payment will be made upon installation and commencement of operation

of the funded equipment for 8 5% of the submitted repower invoice (80% of the submitted

replacement invoice) or the contract maximum amount, whichever is less

.

CONTACT FOR ADDITIONAL INFORMATION

Questions regarding the content or intent of this PA, procedural matters, sample contract,

the compliance plan worksheet, or locations of workshops can be found at the SOON

website ( http://www.aqmd.gov/home/pro grams/business/business

- detail?title=off

- road

diesel

- engines&parent=vehicle

- engine

- upgrades ), or can be addressed to:

Adewale Oshinuga

Science and Technology Advancement

South Coast Air Quality Management District

21865 Copley Drive

Diamond Bar, CA 91765

Phone: (909) 396

- 2599 / Fax: (909) 396

- 3 324Valid until June 1 , 201 6 , at 1:00 P.M. #PA 2016

- 06

15 

# Appl ication FormsGene ral Application Information Page 1 of 2 2 Form A

- 1



## FORM A

- 1

-

U 

## GENERAL PROJECT INFORMATION

APPLICATION

All Sections of Form A

- 1 must be submitted for an application to be deemed complete.

If inf ormation does not pertain to your project, please write “NA” on the form and sign it.

In addition, supplemental forms are required for each piece of requested equipment.



### I. APPLICANT INFORM ATION

Company name/ Organization name/ Individual name:

Business address (Mailing address): Street:

City: State: Zip code:

Contact name and title:

Email:

Phone: ( ) Fax: ( )

Person with contract signing authority (if different from above):

I hereby certify that all information provided in this application and any

attachments are true and co rrect.

Printed Name of Responsible Party: Title:

Signature of Responsible Party: Date:

U Complete this section if application was prepared by another person

I have completed the application, in whole or in part, on behalf of the applicant.

Printed Name: Title:

Signature: Date:

Amount Being Paid for Application Completion

in Whole or Part: Source of funding to 3rd party:

II. FUNDING INFORMATION

Total Number of Equipment Included in Project:

Total Number of Engines Included in Project:

Total Amount of Funding Reques ted:

$ Total Applicant Co f unding Amount (if any):

$Gene ral Application Information Page 2 of 2 2 Form A

- 1

III. 

### GENERAL PROJECT INFO RMATION

There are three types of emission reduction projects:

New Purchase

- Purchasing a new vehicle or piece of equipment with an engine that is

cleaner than the current year standard.

Repower

- Replacing an existing engine with a new reduced

- emission engine.

Retrofit

– Installing an ARB

- verified emission control system on an in

- use engine.

IMPORTANT REMINDER : Only projects that are demonstrate d to be surplus to

California Air Resources Board ( C ARB) regulations are eligible for CMP (CMP) funding.

Please ensure your proposed project is eligible prior to submitting an application.

Check the appropriate box(es) below for each type of project and i ndicate the total

number of equipment/engines included in your project.

U B. Off

- Road Diesel

- SOON

U (Please Circle Fleet Size)

Diesel Fleet Size (Total hp): Small < 2,500 Medium 2,501

- 5,000 Large > 5,000

Equipment Replacement

– Total pieces of equipment:

A supplemental application (Form B

- 1) must be completed for each piece of new equipment

Repower Only

– Total engines to be repowered:

A supplemental application (Form B

- 2) must be completed for each engine repower

Repower with NOx Retrofit

– Total engines to be repowered/retrofit:

A supplemental application (Form B

- 2) must be completed for each engine repower

NOx Retrofit Only

– Total engines to be retrofit:

A supplemental application (Form B

- 3) must be completed for each retrofitGene ral Application Information Page 3 of 2 2 Form A

- 1

IV 

### . FUNDING DISCLOSURE

Have any engines or vehicles listed in this application been awarded funding from the Air

Resources Board or another p ublic agency or are any being considered for funding?

Yes

No

If “yes”, complete the following for each engine or vehicle:

Agency applied to:

Date/Number of Agency Solicitation:

Total Funding Amount Requested or Awarded:

$

Amount per Unit Requested or Awarded:

$

Status:

Do you plan to claim a tax credit or deduction for the project vehicle?

Yes

No

If “yes”, please indicate the estimated tax credit amount to be claimed per vehicle:

________.Gene ral Application Information Page 4 of 2 2 Form A

- 1 U 

### Application Statement

– Please Read and Sign

All information provided in this application will be used by SCAQMD staff to evaluate t he eligibility of

this application to receive program funds. SCAQMD staff reserves the right to request additional

information and can deny the application if such requested information is not provided by the

requested deadline. Incomplete or illegible a pplications will be returned to applicant or vendor, without

evaluation. An incomplete application is an application that is missing information critical to the

evaluation of the project.

 I certify to the best of my knowledge that the information conta ined in this application is true

and accurate.

 I understand that all vehicles/equipment, both existing and new, must be made available

within the SCAQMD boundaries for inspection, unless otherwise approved by SCAQMD’s

Project Officer.

 I understand that, if awarded funding under the CMP, development and submittal of a

detailed work statement, with deliverables and schedule is a requirement of the contracting

process.

 I understand that it is my responsibility to ensure that all technologies are either veri fied or

certified by the CARB to reduce NOx and/or PM pollutants. CARB Verification Letters and/or

Executive Orders are attached, as applicable.

 I understand that it is my responsibility to ensure that the vehicle/equipment to be purchased

or installed i s in compliance with all applicable federal, state, and local air quality rules and

regulations and that it will maintain compliance for the full Contract term.

 I understand that off

- road equipment applicants subject to CARB’s In

- Use Off

- Road Diesel

Vehi cle Regulation (Off

- Road Regulation must submit information regarding fleet size and

compliance status. This must include the Diesel Off

- Road On

- line Reporting System

(DOORS) ID of the fleet and the DOORS Equipment Identification Number (EIN) of the

funde d equipment. All documentation submitted must be signed and dated by the applicant

and include language certifying that the fleet list provided is accurate and complete.

 I understand that for SOON repower projects, I am not required to install the highes t level

available verified diesel emission control device (VDECS)

.

 I understand that there may be conditions placed upon receiving a grant and agree to refund

the grant (or pro

- rated portion thereof) if it is found that at any time I do not meet those

con ditions and if directed by the SCAQMD in accordance with the contract agreement.

 I understand that, for this equipment, I will be prohibited from applying for any other form of

emission reduction credits for Moyer

- funded vehicles/engines, including: Emiss ion Reduction

Credit (ERC); Mobile Source Emission Reduction Credit (MSERC) and/or Certificate of

Advanced Placement (CAP), for all time, from the SCAQMD , CARB or any other Air Quality

Management or Air Pollution Control District.

 The proposed project has not been funded and is not being considered for CMP funds by

another air district, CARB or any other public agency.Gene ral Application Information Page 5 of 2 2 Form A

- 1

 In the event that the vehicle(s)/equipment do not complete the minimum term of any

agreement eventually reached from this application, I agree to ensure the equivalent project

emissions reductions, or to return grant funds to the SCAQMD as required by the contract.

 I have the legal authority to apply for grant funding for the entity described in this application.

 Disclosure of that val ue of any current financial incentive that directly reduces the project

price, including tax credits or deductions, grants, or other public financial assistance for the

same engine is required. To avoid double counting of incentives, all tax credits or ded uctions,

grants, or other public financial assistance must be deducted from the CMP request. I

understand that third party contracts are not permitted. A third party may, however complete

an application on an owner’s behalf. Third parties are required to list how much

compensation, if any, they are receiving to prepare the application(s), and to certify that no

CMP funds are being used for this compensation. (see below)

 I understand that additional project information must be submitted to finalize a con tract. This

information may be found under Section II: Work Statements/Schedule of Deliverables in the

PA.

 I unders tand that all vehicles, engines or equipment funded by this program must be

operational within eighteen (18) months of contract execution, or by May 31, 2018 , whichever

is earlier.

 I have initialed this bullet to indicate that there are no potential conflicts of interest with

other clients affected by actions performed by the firm on behalf of the SCAQMD

. If this

bullet is not initialed, I have attached a description to this application of the potential

conflict of interest, which will be screened on a case

- by

- case basis by the SCAQMD

General Counsel’s Office. There is no potential conflict of interest: ____________ (Please

i nitial if appl icable, otherwise attach separate sheet describing the potential conflict

. )

____________________________________ _____________________ Applicant’s Signature Date

____________________________________ _____________________ Applicant’s Name (p lease print) TitleGene ral Application Information Page 6 of 2 2 Form A

- 1 

### Please initial each section.

(See # PA 2016

- 06 for additional information and requirements

. ):

The purchase of this low

- emission technology is NOT required by any other local, state,

and/or federal rule or regulation

. The definition s of qualifying projects are described in # PA 2016

- 06

. These definitions

have been reviewed and this application is consistent with those definitions.

The vehicle/engine will be used within the SCAQMD boundaries (with the emission

reduction system operat ing) for at least the projected usage shown in this application,

and no less than 75 percent of the time.

All project applicants must submit documentation that supports the activity claimed in the

application (i.e., fuel receipts, mileage logs and/or hou r

- meter readings covering the last

two years). This documentation is attached.

The grant contract language cannot be modified without the written consent of all parties.

I have reviewed and accepted the sample contact language.

I understand that a n IRS Form 1099 may be issued to me for incentive funds received

under the Moyer Program. I understand that it is my responsibility to determine the tax

liability associated with participating in the Moyer Program.

I understand that a SCAQMD

- funded Glob al Positioning System (GPS) unit may be

installed on vehicles/equipment not operating within SCAQMD boundaries full time. I will

submit data as requested and otherwise cooperate with all data reporting requirements. I

also understand that the additional cost of the GPS unit will be added to the project cost

when calculating cost

- effectiveness, though the SCAQMD will pay for this system

directly.

I understand that the SCAQMD has the right to conduct unannounced inspections for the

full project life to e nsure the project equipment is fully operational at the activity level

committed to by the contract.

I understand that all emission reductions resulting from funded projects will be retired.

To avoid double counting of emission reductions, project vehic les and/or equipment may

not receive funding from any other government grant program that is designed to reduce

mobile source emissions.

I understand that a tamper proof, non

- resettable digital hour meter/odometer must be

installed on all vehicles/equi pment and that the digital hour meter/odometer will record

the hours/miles accumulated within the SCAQMD boundaries. This cost is my

responsibility.

I understand that any tax credits claimed must be deducted from the CMP request.

Please check one:

I do not plan to claim a tax credit or deduction for costs funded by the CMP.

I do plan to claim a tax credit or deduction for costs funded by the CMP.

If so, please indicate amount here: $______________

I plan to claim a tax credit or deduction only for the portion of incremental costs not

funded by the CMP. If so, please indicate amount here: $______________Gene ral Application Information Page 7 of 2 2 Form A

- 1



# South Coast

Air Quality Management District

21865 Copley Drive, Diamond Bar, CA 91765

- 4178

(909) 396

- 2000 • www.aqmd.gov



### Business Information Request

Dear SCAQMD Contractor/Supplier:

South Coast Air Quality Management District (SCAQMD) is committed to ensuring that our

contractor/supplier records are current and accurat e. If your firm is selected for award of a

purchase order or contract, it is imperative that the information requested herein be supplied in a

timely manner to facilitate payment of invoices. In order to process your payments, we need the

enclosed inform ation regarding your account. Please review and complete the information

identified on the following pages, remember to sign all documents for our files, and return

them as soon as possible to the address below:

Attention: Accounts Payable, Accounting Department

South Coast Air Quality Management District

21865 Copley Drive

Diamond Bar, CA 91765

- 4178

If you do not return this information, we will not be able to establish you as a vendor. This will

delay any payments and would still necessitate your submittal of the enclosed information to our

Accounting department before payment could be initiated. Completion of this document and

enclosed forms would ensure that your payments are processed timely and accurately.

If you have any questions or need a ssistance in completing this information, please contact

Accounting at (909) 396

- 3777. We appreciate your cooperation in completing this necessary

information.

Sincerely,

Michael B. O’Kelly

Chief Financial Officer

DH:tm

Enclosures: Business Informa tion Request

Disadvantaged Business Certification

W

- 9

Form 590 Withholding Exemption Certificate

Federal Contract Debarment Certification

Campaign Contributions Disclosure

Direct Deposit Authorization REV 9/15Gene ral Application Information Page 8 of 2 2 Form A

- 1



# South Coast

Air Quali ty Management District

21865 Copley Drive, Diamond Bar, CA 91765

- 4178

(909) 396

- 2000 • www.aqmd.gov



## BUSINESS INFORMATION REQUEST

Business Name

Division of

Subsidiary of

Website Address

Type of Business

Check One:  Individual

 DBA, Name _______________, County Filed in _______________

 Corporation, ID No. ________________

 LLC/LLP, ID No. _______________

 Other _______________



### REMITTING ADDRESS INFORMATION

Address

City/Town

State/Province Zip

Phone ( )

- Ext Fax ( )

-

Contact Title

Email Address

Payment Name if

Different



### All invoices must reference the corresponding Purchase Order Number(s)/Contract Number(s) if

applicable and mailed to:

Attention: Accounts Payable, Accounting Department

South Coast Air Quality Management District

21865 Copley Drive

Diamond Bar, CA 91765

- 4178Gene ral Application Information Page 9 of 2 2 Form A

- 1 BUSINESS STATUS CERTIFICATIONS

Fed eral guidance for utilization of disadvantaged business enterprises allows a vendor to be deemed a small business enterprise (SBE),

minority business enterprise (MBE) or women business enterprise (WBE) if it meets the criteria below.

 is certified by the Small Business Administration or

 is certified by a state or federal agency or

 is an independent MBE(s) or WBE(s) business concern which is at least 51 percent owned and controlled by minority group

member(s) who are citizens of the United States.

Statemen ts of certification:

As a prime contractor to SCAQMD, (name of business) will engage in good faith efforts to achieve the fair share in accordance with

40 CFR Section 33.301, and will follow the six affirmative steps listed below for contracts or purcha se orders funded in whole

or in part by federal grants and contracts.

1. Place qualified SBEs, MBEs, and WBEs on solicitation lists.

2. Assure that SBEs, MBEs, and WBEs are solicited whenever possible.

3. When economically feasible, divide total requirements into small tasks or quantities to permit greater participation by

SBEs, MBEs, and WBEs.

4. Establish delivery schedules, if possible, to encourage participation by SBEs, MBEs, and WBEs.

5. Use services of Small Business Administration, Minority Business Development A gency of the Department of

Commerce, and/or any agency authorized as a clearinghouse for SBEs, MBEs, and WBEs.

6. If subcontracts are to be let, take the above affirmative steps.

Self

- Certification Verification: Also for use in awarding additional points, as applicable, in accordance with

SCAQMD Procurement Policy and Procedure:

Check all that apply:

Small Business Enterprise/Small Business Joint Venture Women

- owned Business Enterprise

Local business Disabled Veteran

- owned Business Enterprise/DVBE Joint Venture

Minority

- owned Business Enterprise Most Favored Customer Pricing Certification

Percent of ownership: %

Name of Qualifying Owner (s):

State of California Public Works Contractor Registration No.

______________________. MUST BE

INCLUDED IF BID PROPOSAL IS FOR PUBLIC WORKS PROJECT.

I, the undersigned, hereby declare that to the best of my knowledge the above information i s accurate. Upon

penalty of perjury, I certify information submitted is factual.

NAME TITLE

TELEPHONE NUMBER DATEGene ral Application Information Page 10 of 2 2 Form A

- 1 

### Definitions

Disabled Veteran

- Owned Business Enterprise means a business that meets all of the following criteria:

 is a so le proprietorship or partnership of which is at least 51 percent owned by one or more disabled veterans,

or in the case of any business whose stock is publicly held, at least 51 percent of the stock is owned by one or

more disabled veterans; a subsidiary w hich is wholly owned by a parent corporation but only if at least 51

percent of the voting stock of the parent corporation is owned by one or more disabled veterans; or a joint

venture in which at least 51 percent of the joint venture’s management and cont rol and earnings are held by

one or more disabled veterans.

 the management and control of the daily business operations are by one or more disabled veterans. The

disabled veterans who exercise management and control are not required to be the same disable d veterans as

the owners of the business.

 is a sole proprietorship, corporation, partnership, or joint venture with its primary headquarters office located

in the United States and which is not a branch or subsidiary of a foreign corporation, firm, or othe r foreign

based business.

Joint Venture means that one party to the joint venture is a DVBE and owns at least 51 percent of the joint venture. In the case

of a joint venture formed for a single project this means that DVBE will receive at least 51 percen t of the project dollars.

Local Business means a business that meets all of the following criteria:

 has an ongoing business within the boundary of SCAQMD at the time of bid application.

 performs 90 percent of the work within SCAQMD’s jurisdiction.

Minor ity

- Owned Business Enterprise means a business that meets all of the following criteria:

 is at least 51 percent owned by one or more minority persons or in the case of any business whose stock is

publicly held, at least 51 percent of the stock is owned by one or more minority persons.

 is a business whose management and daily business operations are controlled or owned by one or more

minority person.

 is a business which is a sole proprietorship, corporation, partnership, joint venture, an association, or a

cooperative with its primary headquarters office located in the United States, which is not a branch or

subsidiary of a foreign corporation, foreign firm, or other foreign business.

“Minority” person means a Black American, Hispanic American, Native Am erican (including American Indian, Eskimo, Aleut,

and Native Hawaiian), Asian

- Indian American (including a person whose origins are from India, Pakistan, or Bangladesh),

Asian

- Pacific American (including a person whose origins are from Japan, China, the Ph ilippines, Vietnam, Korea, Samoa,

Guam, the United States Trust Territories of the Pacific, Northern Marianas, Laos, Cambodia, or Taiwan).

Small Business Enterprise means a business that meets the following criteria:

a. 1) an independently owned and operate d business; 2) not dominant in its field of operation; 3) together with

affiliates is either:

 A service, construction, or non

- manufacturer with 100 or fewer employees, and average annual gross

receipts of ten million dollars ($10,000,000) or less over the previous three years, or

 A manufacturer with 100 or fewer employees.

b. Manufacturer means a business that is both of the following:

1) Primarily engaged in the chemical or mechanical transformation of raw materials or processed substances

into new products.

2) Classified between Codes 311000 to 339000, inclusive, of the North American Industrial Classification

System (NAICS) Manual published by the United States Office of Management and Budget, 2007 edition.Gene ral Application Information Page 11 of 2 2 Form A

- 1

Small Business Joint Venture means that one part y to the joint venture is a Small Business and owns at least 51 percent of the

joint venture. In the case of a joint venture formed for a single project this means that the Small Business will receive at least 51

percent of the project dollars.

Women

- Ow ned Business Enterprise means a business that meets all of the following criteria:

 is at least 51 percent owned by one or more women or in the case of any business whose stock is publicly held,

at least 51 percent of the stock is owned by one or more wome n.

 is a business whose management and daily business operations are controlled or owned by one or more

women.

 is a business which is a sole proprietorship, corporation, partnership, or a joint venture, with its primary

headquarters office located in the U nited States, which is not a branch or subsidiary of a foreign corporation,

foreign firm, or other foreign business.

Most Favored Customer as used in this policy means that the SCAQMD will receive at least as favorable pricing, warranties,

conditions, be nefits and terms as other customers or clients making similar purchases or receiving similar services.Gene ral Application Information Page 12 of 2 2 Form A

- 1Gene ral Application Information Page 13 of 2 2 Form A

- 1Gene ral Application Information Page 14 of 2 2 Form A

- 1Gene ral Application Information Page 15 of 2 2 Form A

- 1Gene ral Application Information Page 16 of 2 2 Form A

- 1



### [Gene ral Application Information Page 17 of 2 2 Form A

- 1Gene ral Application Information Page 18 of 2 2 Form A

- 1Gene ral Application Information Page 19 of 2 2 Form A

- 1 

### CAMPAIGN CONTRIBUTIONS DISCLOSURE

In accordance with California law, bidders and contracting parties are required to disclose, at t he time the

application is filed, information relating to any campaign contributions made to South Coast Air Quality

Management District (SCAQMD) Board Members or members/alternates of the MSRC, including: the name of the

party making the contribution (whi ch includes any parent, subsidiary or otherwise related business entity, as defined

below), the amount of the contribution, and the date the contribution was made. 2 C.C.R. §18438.8(b).

California law prohibits a party, or an agent, from making campaign contributions to SCAQMD Governing Board

Members or members/alternates of the Mobile Source Air Pollution Reduction Review Committee (MSRC) of more

than $250 while their contract or permit is pending before SCAQMD; and further prohibits a campaign contribut ion

from being made for three (3) months following the date of the final decision by the Governing Board or the MSRC

on a donor’s contract or permit. Gov’t Code §84308(d). For purposes of reaching the $250 limit, the campaign

contributions of the bidder or contractor plus contributions by its parents, affiliates, and related companies of the

contractor or bidder are added together. 2 C.C.R. §18438.5.

In addition, SCAQMD Board Members or members/alternates of the MSRC must abstain from voting on a cont ract

or permit if they have received a campaign contribution from a party or participant to the proceeding, or agent,

totaling more than $250 in the 12

- month period prior to the consideration of the item by the Governing Board or the

MSRC. Gov’t Code §843 08(c).

The list of current SCAQMD Governing Board Members can be found at SCAQMD website ( www.aqmd.gov ). The

list of current MSRC members/alternates can be found at the MSRC website

( http://www.cleantransportationfunding.org ).



### SECTION I

.

Contractor (Legal Name):

List any parent, subsidiaries, or otherwise affiliated business entities of Contractor :

(See definition below).

SECTION II

.

Has Contractor and/or any parent, subsidiary, or affiliated company, or agent thereof, made a

campaign contribution(s ) totaling $250 or more in the aggregate to a current member of the

South Coast Air Quality Management Governing Board or member/alternate of the MSRC in the

12 months preceding the date of execution of this disclosure?

Yes No If YES, complete Section II below and then sign and date the form.

If NO, sign and date below. Include this form with your submittal. DBA, Name , County Filed in

Corporation, ID No.

LLC/LLP, ID No.Gene ral Application Information Page 20 of 2 2 Form A

- 1



### Campaign Contributions Disclosure, c ontinued:

Name of Contributor

Governing Board Member or MSRC Member/Alternate Amount of Contribution Date of Contribution



### Name of Contributor

Governing Board Member or MSRC Member/Alternate Amount of Contribution Date of Contribution



### Name of Contributor

Governing Board Member or MSRC Member/Alternate Amount of Contribution Date of Contribution



### Name of Contributor

Governing Board Member or MSRC Member/Alternate Amount of Contribution Date of Contribution



### I declare the foregoing disclosures to be true and cor rect.

By:

Title:

Date:

DEFINITIONS

Parent, Subsidiary, or Otherwise Related Business Entity (2 Cal. Code of Regs., §18703.1(d).)

(1) Parent subsidiary. A parent subsidiary relationship exists when one corporation directly or indirectly owns shares

possessing more than 50 percent of the voting power of another corporation.

(2) Otherwise related business entity. Business entities, including corporations, partnerships, joint ventures and any other

organizations and enterprises operated for profi t, which do not have a parent subsidiary relationship are otherwise related

if any one of the following three tests is met:

(A) One business entity has a controlling ownership interest in the other business entity.

(B) There is shared management and contro l between the entities. In determining whether there is shared management

and control, consideration should be given to the following factors:

(i) The same person or substantially the same person owns and manages the two entities;

(ii) There are common or commingle d funds or assets;

(iii) The business entities share the use of the same offices or employees, or otherwise share activities, resources

or personnel on a regular basis;

(iv) There is otherwise a regular and close working relationship between the entities; or

(C) A co ntrolling owner (50% or greater interest as a shareholder or as a general partner) in one entity also

is a controlling owner in the other entity.Gene ral Application Information Page 21 of 2 2 Form A

- 1 Direct Deposit Authorization

STEP 1 : Please check all the appropriate boxes

Individ ual (Employee, Governing Board Member) New Request

Vendor /Contractor Cancel Direct Deposit

Changed Information

STEP 2 : Payee Information

Last Name First Name Middle Initial Title

Vendor/Contractor Business Name (if applicable)

Address Apartment or P.O. Box Number

City State Zip Country

Taxpayer ID Number Telephone Number Email Address

Authorization

1. I authorize South Coast Air Quality Management District ( S C AQMD) to direct deposit funds to my account in the financial

institution as indicated below. I understand that the authorization may be rejected or discontinued by SC AQMD at any time.

If any of the above information changes, I will promptly complete a n ew authorization agreement. If the direct deposit is not

stopped before closing an account, funds payable to me will be returned to SC AQMD for distribution. This will delay my

payment.

2. This authorization remains in effect until SC AQMD receives written no tification of changes or cancellation from you.

3. I hereby release and hold harmless SC AQMD for any claims or liability to pay for any losses or costs related to insufficient

fund transactions that result from failure within the Automated Clearing House netw ork to correctly and timely deposit monies

into my account.

STEP 3 :

You must verify that your bank is a member of an Automated Clearing House (ACH). Failure to do so could delay the processing of

your payment . You must attach a voided check or have your bank complete the bank information and the account holder must sign

below.

To be Completed b y your Bank Staple Voided Check Here Name of Bank/Institution

Account Holder Name(s)

Saving Checking Account Number Routing Number

Bank Representative Printed Name Bank Representative Signature Date

Date

ACCOUNT HOLDER SIGNATURE :

For SCAQMD Use Only Input By Date 

# South Coast

Air Quality Management District

21865 Copley Drive, Diamond Bar, CA 91765

- 4178

(909) 396

- 2000 • www.aqmd.govPage 22 of 22



### SOUTH COAST AIR QUAL ITY MANAGEMENT DISTR ICT FORM 2449

- CP

21865 Copley Drive, Dia mond Bar, CA 91765 Revised 02/06/09

Off

- Road Mobile Source (909) 396

- 2903

http://www.aqmd.gov/tao/implementation/soonprogram.htm



### RULE 2449 FLEET COMP LIANCE PLAN

1. COMPANY NAME:

2. MAILING ADDRESS:

3. CONTACT PERSON, TITL E, TELEPHONE, EMAIL:

4. ALTERNATE CONTACT, T ITLE, TELEPHONE, EMA IL:

5. FLEET SUMMARY

PLEASE PROVIDE DESCR IPTION OF YOUR FLEET AND TYPE OF BUSINESS IT IS IN.

FLEET DESCRIPTION:

# OF VEHICLES: # OF ENGINES:

___ DOORS FLEET # _____

___________

TOTAL HORSEPOWER OF FLEET:

______

6. SIGNATURE OF PERSON RESPONSIBLE FOR RULE 2449 COMPLIANCE

I HEREBY CERTIFY, UN DER PENALTY OF PERJU RY UNDER THE LAWS OF THE STATE OF CALIFOR NIA, THAT ALL

INFORMATION CONTAINE D HEREIN AND INFORMA TION SUBMITTED WITH THIS COM PLIANCE PLAN IS TRUE AND

CORRECT. I ALSO ACK NOWLEDGE THAT THIS P LAN IS BEING PROVIDE D TO THE SCAQMD EXECUTIVE OFFICER IN

COMPLIANCE WITH THE SCAQMD RULE 2449. APPROVAL OF THIS COMPLIANCE P LAN IS SUBJECT TO

VERIFICATION OF INFO RMATION SUBMITTED. I UNDERS TAND THAT SCAQMD STAFF MAY REQUIRE AD DITIONAL

INFORMATION TO PROCE SS THIS COMPLIANCE P LAN, AND AGREE TO PR OVIDE SUCH INFORMATI ON.



### SIGNATURE:

NAME:

TITLE:

SIGNED THIS DAY OF

IN , CALIFORNIA

If you need assistance in preparing the complia nce plan,

please call the Off

- Road Mobile Source Section at (909) 396

- 2903.

### SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT

SOON PROGRAM (FY 15/16 )

Off

- Road HD

– Replacement Page 1 of 3 Form B

- 1 SCAQMD Use Only : App. #

______________ Project

Type:_________________



## FORM B

- 1

-

U 

## OFF

- ROAD HEAVY

- DUTY

U 

## EQUIPMENT REPLACEMEN T

Please complete one form for each piece of equipment. For multiple unit requests, you may submit a

spreadsheet that provide s all requested information below, in the order presented below.

Company name/ Organization name/ Individual name:

Equipment Identifier (Unit # or Company ID): EIN

Is the vehicle l ocation address the same as the applicant address? Yes No, (please

provide vehicle address below)

Street Address:

City:

Zip Code:



### I. BASELINE (EXISTING) EQUIPMENT INFORMATION

Equipment Type/Functio n (Diesel):

(B ackhoe, baler, cargo container handling unit, combine, crane, crawler tractor, crushing/processing, excavator,

forklift, grader, ground suppor t equipment, hydro

- power unit, loader, mower, off

- highway tractor, off

- highway truck,

paver, paving equipment, roller, rubber

- tired dozer, rubber

- tired loader, scraper, signal board, skid steer loader,

sprayer, surfacing equipment, swather, tractor, tiller , trencher, or other. )

Equipment Make: Equipment Model:

Equipment Model Year: Equipment Serial Number or VIN :

Number of Engines on this Equipment:

Main (Front) Auxiliary

(Rear



### II

. USAGE/ ACTIVITY INFORMATION

Note : Please provide projected annual usage for the new equipment over the proposed life of the project. This

projection should be based on actual usage data for the baseline equipment. You

U MUST

U attach documentation

supporting the projected annual usage and operation within the District and within California. Supporting

documentation may be in the form of maintenance records, fuel receipts, hour

- meter reports, logs, or other

paperwork for each piece of baseline equip ment covering at least the past 24 months.

Total Annual Hours of Operation: or Gallons of Fuel Used:

If Hours, Does the Equipment Have a Functioning Hour Meter? Yes No

Percent Operation within CA: % Percent Operation within District: %

Project Life: years. Equipment must operate for this full life; this life is equivalent to

the contract and the reporting te rm.Off

- Road HD

– Replacement Page 2 of 3 Form B

- 1

III. BASELINE (EXISTING) ENGINE I NFORMATION ( for each engine)

Main (Front) Engine Auxiliary (Rear) Engine

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No. : Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Famil y:

Main (Front) Engine Auxiliary (Rear) Engine

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No. : Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

Method proposed for r endering the baseline engin e(s) inoperable:



### IV. NEW REPLACEMENT EQUIPMENT INFORMATION

Equipment Type/Function: Equipment Make:

Equipment Model: Equipment Model Year:

Equipment Serial Number or VIN (If

available) : Number of Engines on this Equipment:

Main (Front) Auxiliary (Rear)

V. NEW 

### REPLACEMENT EQUIPMENT E NGINE I NFORMATION ( for each engine)

Main (Front) Engine Auxiliary (Rear) Engine

Fuel Type: New Engine Make:

New Engine Model: New En gine Year:

Engine Serial No : New Engine Horsepower:

New Engine Tier: New Engine Family:

New Engine C ARB Executive Order Number (Attach a copy):

Main (Front) Engine Auxiliary (Rear) Engine

Fuel Type: New Engine Make:

New Engine Model: New E ngine Year:

Engine Serial No : New Engine Horsepower:

New Engine Tier: New Engine Family:

New Engine C ARB Executive Order Number (Attach a copy):Off

- Road HD

– Replacement Page 3 of 3 Form B

- 1



### VI. FUNDING INFORMATION

New Equipment Cost (incl. tax) : $

NOTE : You

U MUST

U attach a written estimate or quotation from the equipment vendor documenting the cost of the

new equipment. This quote must be obtained within 90 days of prior to the closing date of the Program

Announcement.

Applicant Co f unding Amount (if any): $

Funds Requested : $

New Equipment Vendor:

### SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT

SOON PROGRAM (FY 15/16 )

Off

- Road HD

– Repower Page 1 of 4 Form B

- 2 SCAQMD Use Only : App. #

______________ Project

Type:_________________



## FORM B

- 2

-

U 

## OFF

- ROAD HEAVY

- DUTY EQ UIPMENT

U 

## Repower Only or Repower/Retrofit

Please complete one form for each piece of equipment. For multiple unit requests, you may submit a

spreadsheet that provides all requested information below, in the order presented below.

Company name/ Organizatio n name/ Individual name:

Equipment Identifier (Unit # or Company ID): EIN

Is the vehicle location address the same as the applicant address? Yes No, (please

provide vehicle addre ss below)

Street Address:

City:

Zip Code:



### I. BASELINE (EXISTING) EQUIPMENT INFORMATION

Equipment Type/Functio n (Diesel):

(B ackhoe, baler, cargo container handling unit, combine, crane, crawler tractor, crushing/processing, excavator,

forklift, grader, ground support equipment, hydro

- power unit, loader, mower, off

- highway tractor, off

- highway truck,

paver, paving equipment, roller, rubber

- ti red dozer, rubber

- tired loader, scraper, signal board, skid steer loader,

sprayer, surfacing equipment, swather, tractor, tiller, trencher, or other. )

Equipment Make: Equipment Model:

Equipment Model Year: Equipment Serial Number or VIN :

Number of Engines on this Equipment:

Main (Front) Auxiliary

(Rear



### II

. USAGE/ ACTIVITY INFORMATION

Note : Please provide projected annual usage for the new equipment over the proposed life of the project. This

projection should be based on actual usage data for the baseline equipment. You

U MUST

U attach documentation

supporting the projected annual usage and operation within the District and within California. Supporting

documentation may be in the form of maintenance records, fuel receipts, hour

- meter reports, logs, or other

paperwork for each piece of baseline equip ment covering at least the past 24 months.

Total Annual Hours of Operation: or Gallons of Fuel Used:

If Hours, Does the Equipment Have a Functioning Hour Meter? Yes No

Percent Operation within CA: % Percent Operation within District: %

Project Life: years. Equipment must operate for this full life; this life is equivalent to the

contract and the repor ting term.Off

- Road HD

– Repower Page 2 of 4 Form B

- 2

III. BASELINE (EXISTING) ENGINE I NFORMATION ( for each engine)

Main (Front) Engine Auxiliary (Rear) Engine

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No. : Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engin e Family:

Main (Front) Engine Auxiliary (Rear) Engine

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No. : Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

Method propose d for rendering the baseline engin e(s) inoperable:

IV. NEW E NGINE I NFORMATION ( for each engine)

Main (Front) Engine Auxiliary (Rear) Engine

Fuel Type: New Engine Make:

New Engine Model: New Engine Year:

New Engine Tier: New Engine Horsepower:

New Engine C ARB Executive Order Numbe r (Attach a copy): New Engine Family:

Main (Front) Engine Auxiliary (Rear) Engine

Fuel Type: New Engine Make:

New Engine Model: New Engine Year:

New Engine Tier: New Engine Horsepower:

New Engine C ARB Executive Order Number

(Attach a copy): New Engine Family:Off

- Road HD

– Repower Page 3 of 4 Form B

- 2



### V. RETROFIT INFORMATION (If Applicable)

NOTE : You

U MUST

U attach a copy of the ARB Executive Order for the retrofit device and indicate (circle) on the

Executive Order Attachment the engine family name for the engine on which the device will be installed.

Main (Front) Engine Auxiliary (Rear) Engine

Retrofit Device Make: Verified NOx Reduction: %

Retrofit Device Model: Verified PM Reduction: %

Retrofit Family Name: Verified ROG Reduction: %

Verification Level:

Main (Fro nt) Engine Auxiliary (Rear) Engine

Retrofit Device Make: Verified NOx Reduction: %

Retrofit Device Model: Verified PM Reduction: %

Retrofit Family Name: Verified ROG Reduction: %

Verification Level:



### VI. FUNDING INFORMATION (ENGINE REPOWER)

Main (Front) Engine Auxiliary (Rear) Engine

New Engine Cost (incl. tax): $ Installation Cost: $

NOTE : You

U MUST

U attach a written estimate or quotation from the equipment vendor documenting the cost of the

new engine. This quote must be obtained within 90 days of prior to the closing date of the Program Announcement.

Applicant Co f unding Amount (if any): $

Applicant Grant Request Amount: $

New Equip ment Vendor:

Main (Front) Engine Auxiliary (Rear) Engine

New Engine Cost (incl. tax): $ Installation Cost: $

NOTE : You

U MUST

U attach a written estimate or quotation from the equipment vendor documenting the cost of the

new engine. This quote must be obtained within 90 days of prior to the closing date of the Program Announcement.

Applicant Co f unding Amount (i f any): $

Applicant Grant Request Amount: $

New Equipment Vendor:Off

- Road HD

– Repower Page 4 of 4 Form B

- 2



### VII. FUNDING INFORMATION (RETROFIT)

Main (Front) Engine

U U Auxiliary (Rear) Engine

U U

Retrofit Device Cost (including tax): $

NOTE : You MUST attach a written estimate from the equipment vendor documenting the cost of the device; this

quote must be obtained within 90 days prior to the closing date of the Program Announcement.

Retrofit Device Installation Cost:

Retrofit Device Maintenance Cost:

Applicant Grant Request: $

Retrofit Device Vendor and Installer:

Main (Front) Engine Auxiliary (Rear) Engine

Retrofit Device Cost (including tax): $

NOTE : You MUST attach a written estimate from the equipment vendor documenting the c ost of the device; this

quote must be obtained within 90 days prior to the closing date of the Program Announcement.

Retrofit Device Installation Cost:

Retrofit Device Maintenance Cost:

Applicant Grant Request: $

Retrofit Device Vendor and Installer:

### SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT

SOON PROGRAM (FY 15/16 )

Off

- Road HD

– Retrofit Page 1 of 3 Form B

- 3 SCAQMD Use Only : App. #

______________ Project

Type:_________________



## FORM B

- 3

-

U 

## OFF

- ROAD HEAVY

- DUTY EQUIPMENT

U 

## NOx Retrofit Only

Please complete one form for each piece of equipment. For multiple unit requests, you may submit a

spreadshe et that provides all requested information below, in the order presented below.

Company name/ Organization name/ Individual name:

Equipment Identifier (Unit # or Company ID): EIN

I s the vehicle location address the same as the applicant address? Yes No, (please

provide vehicle address below)

Street Address:

City:

Zip Co de:



### I. BASELINE (EXISTING) EQUIPMENT INFORMATION

Equipment Type/Functio n (Diesel):

(Backhoe , baler, cargo container handling unit, combine, crane, crawler tractor, crushing/processing, excavator,

forklift, grader , ground support equipment, hydro

- power unit, loader, mower, off

- highway tractor, off

- highway truck,

paver, paving equipment, roller, rubber

- tired dozer, rubber

- tired loader, scraper, signal board, skid steer loader,

sprayer, surfacing equipment, swather, tractor, tiller, trencher, or other. )

Equipment Make: Equipment Model:

Equipment Model Year: Equipment Serial Number or VIN :

Number of Engines on this Equipment:

Main (Front) Auxiliary

(Rear



### II

. USAGE/ ACTIVITY INFORMATION

Note : Please provide projected annual usage for the new equipment over the proposed life of the project. This

projection should be based on actual usage data for the baseline equipment. You

U MUST

U attach documentation

supporting the projected annual usage and operation within the District and within California. Supporting

documentation may be in the form of maintenance records, fuel receipts, hour

- meter reports, logs, or other

paperwork for each piece of baseline equip ment covering at least the past 24 months.

Total Annual Hours of Operation: or Gallons of Fuel Used:

If Hours, Does the Equipment Have a Functioning Hour Meter? Yes No

Percent Operation within CA: % Percent Operation within District: %

Project Life: years. Equipment must operate for this full life; this life is equivalent to the

contract and the repor ting term.Off

- Road HD

– Retrofit Page 2 of 3 Form B

- 3

III. 

### BASELINE (EXISTING) ENGINE INFORMATION (for each engine)

Main (Front) Engine Auxiliary (Rear) Engine

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No. : Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engin e Family:

Main (Front) Engine Auxiliary (Rear) Engine

Fuel Type: Baseline Engine Make:

Baseline Engine Model: Baseline Engine Year:

Engine Serial No. : Baseline Engine Horsepower:

Baseline Engine Tier: Baseline Engine Family:

Method propose d for rendering the baseline engin e(s) inoperable:



### IV. RETROFIT INFORMATION (for each engine)

NOTE : You

U MUST

U attach a copy of the ARB Executive Order for the retrofit device and indicate (circle) on the

Executive Order Attachme nt the engine family name for the engine on which the device will be installed.

Main (Front) Engine Auxiliary (Rear) Engine

Retrofit Device Make: Verified N Ox Reduction: %

Retrofit Device Model:

Retrofit Family Name:

Verification Level:

Retrofit Device Serial #:

Main (Front) Engine Auxiliary (Rear) Engine

Retrofit Device Make:

Retrofit Device Model:

Retrofit Family Name:

Verification Level:

Retrofit Device S erial #:Off

- Road HD

– Retrofit Page 3 of 3 Form B

- 3



### V. FUNDING INFORMATION

Main (Front) Engine Auxiliary (Rear) Engine

Retrofit Device Cost (including tax): $

NOTE : You MUST attach a written estimate from the equipment vendor documenting the cost of the device; this

quote must be obtained within 90 days prior to the closing date of the Program Announcement.

Retrofit Device Installation Cost:

Retrofit De vice Maintenance Cost:

Applicant Grant Request: $

Retrofit Device Vendor and Installer:

Main (Front) Engine Auxiliary (Rear) Engine

Retrofit Device Cost (including tax): $

NOTE : You MUST attach a written estimate from the equipment vendor documenting the cost of the device; this

quote must be obtained within 90 days prior to the closing date of the Program Announcement.

Retrofit Device Installation Cost:

Retrofit Device Maintenance Cost:

Applicant Grant Request: $

Retrofit Device Vendor and Installer:

### Administrative Guidelines Rule 2449

- SOON Program

SCAQMD

- 1

- February 2016 

## SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT

Rule 2449

- SOON Program Administrative Guidelines

February 2016

Deputy Executive Officer

Science and Technology Advancement

Matt Miyasato , Ph. D.

Assistant Deputy Executive Officer

Science and Technology Advancement

Mobile Source Division

Henry Hogo

Program Supervisor

Science and Technology Advancement

Mobile Source Division

– Off

- Road Section

Adewale Oshinuga

Air Quality Specialist

Science and Technology Advancement

Mobile Source Division

– Off

- Road Section

Richard Carlson

### Administrative Guidelines Rule 2449

- SOON Program

SCAQMD

- 2

- February 2016 

## R ULE 2449

– SOON PROGRAM ADMINISTRATIVE GUIDELINES

I NTRODUCTION



### Title 13, Section 2449 of the California Code of Regulation (CCR), “Emission Standards for

In

- Use Off

- Road Diesel

- Fueled Fleets,” was adopted by the California Air Resources Board

(CARB) in July 2007. The regulation requires off

- road diesel vehicle fleets to meet

increasingly more str ingent NOx and PM fleet average standards beginning in 2010 to achieve

NOx and PM2.5 reductions. A provision of this rule (Title 13, CCR, Section 2449. 2 ) allows

air districts to opt

- in and require the largest fleets to apply for funds to meet more stringent

NOx targets, thereby achieving additional NOx reductions earlier. Emission reductions

achieved must be surplus to those required from the statewide regulation (Title 13, CCR,

Section 2449.1 )

.

The opt

- in provision is also known as th e Surplus Off

- road Opt

- in for NOx (SOON) program.

If an air district formally opts

- in to the SOON program, it is required to develop administrative

and funding guidelines that outline additional provisions beyond existing guidelines such as

the Carl Moyer Memorial Air Quality Standards Attainment Program (Carl Moyer Program)

necessary to implement the SOON program. Pursuant to Section 2449. 2 (e)(7), any funding

awards must be consistent with the Carl Moyer Program. The South Coast Air Quality

Management District ( SC AQMD) has adopted specific policies and procedures to implement

the Carl Moyer Program. The policies and procedures for the implementation of the Carl

Moyer Program will serve as the basis for the SOON program. Additional administrative or

fu nding guidelines must be developed to implement the SOON Program. At a minimum, the

additional guidelines must include project selection criteria, co

- funding requirements, and

reporting and monitoring requirements.

Rule 2449

– Control of Oxides of Nitrogen Emissions from Off

- Road Diesel Vehicles,

incorporates by reference Title 13, CCR, Section 2449. 2 . The following sets forth additional

guidelines as required under Title 13, CCR, Section 2449. 2 (f)(2). These guidelines will be

reviewed , at a minimum, on an annual basis, and may be updated to reflect the most recent

applicable Carl Moyer guidelines or other administrative or funding guidelines approved by

the District Governing Board.



## G UIDELINES



### The guidelines described below are proposed to be in addition to the most current Policies and

Procedures for the Carl Moyer Program adopted by the S C AQMD Governing Board. Any

fleet that operates off

- road diesel vehicles in the SC AQMD that are subject to Title 13, CCR,

Section 2449. 2 (b) must, after April 2, 2009, apply for funding for those off

- road vehicles

operating a majority of the time in the SC AQMD, and the emission reductions must be surplus

to the provisions of Sections 2449.1 , Title 13, CCR.

### Administrative Guidelines Rule 2449

- SOON Program

SCAQMD

- 3

- February 2016 A. Vehicle Qualification / Eligibility in SOON Fleet

Pursuant to Title 13, CCR, Section 2449. 2 (b)(2), a fleet is subject to the SOON requirements

if it consists of more than 40 percent of Tier 0 and Tier 1 vehicles statewide as of January 1,

2008, and operates individual vehicles within the district.

1. Percentage of fleet that is Tier 0 and Tier 1 is based on vehicle number and not

horsepower. However, calculation of the SOON NOx index and SOON NOx targets

in section 2449. 2 (d)(1)(B) and 2449. 2 (d)(1)(C) will be based on each engine. For

example if a vehicle has two engines then the NOx Index a nd NOx target calculations

will be determined using each engine separately and not as the total horsepower

combined.

Operated within the district is defined [Title 13, CCR, Section 2449. 2 (c) (2)] as a vehicle

that currently operates in the district and for the three years immediately preceding the

SC AQMD SOON program announcement deadline

, operated more than 100 hours

annually, and operated more hours within the boundaries of the SC AQMD than a ny other

air distric t

2. t.

o Currently operates is defined as having operated or will operate in the

SC AQMD during the year immediately preceding the active SOON program

announcement deadline.

o Operated more hours within the SC AQMD’s boundaries than in any oth er

district means that the total number of hours operated in the AQMD’s

boundaries in the three years immediately preceding the active SOON

program announcement deadline are greater than the total hours operated over

the same timeframe within any other sin gle district’s boundaries.

3. Pursuant to Section 2449. 2 (d)(2) fleets with a statewide maximum horse power (hp)

less than or equal to 20,000 (hp) are not subject to the SOON provisions, but may

apply for SOON funding if they do not meet the SOO n NOx targets.

4. Pursuant to Section 2449. 2 (e)(8), fleets with vehicles that qualify for inclusion in the

SOON program but are planning to move vehicles out of the SC AQMD such that the

vehicles will not operate enough hours in the SC AQMD to qualify for S OON

funding, are not required to include such vehicles in meeting the NOx index

calculation in Section 2449. 2 (d)(1)(B), the NOx target rate calculation in Section

2449. 2 (d)(1)(C), and the application for funding requirements of the SOON program.

The vehicle must meet all requirements of Section 2449. 2 (e)(8) to qualify for this

provision.

5. If a fleet has a vehicle that has been retrofitted within the last six years with a Level 2

or 3 VDECS, which was the highest level VDECS at the time of retrofit, the fleet may

but is not required to apply for SOON funding for that vehicle.

### Administrative Guidelines Rule 2449

- SOON Program

SCAQMD

- 4

- February 2016 B. Compliance Plan Requirements

Title 13, CCR, Section 2449. 2 (e)(3), requires fleets applying for SOON funding to submit a

compliance plan in addition to their application. The c ompliance plan must describe actions

the fleet must take to meet the fleet average and BACT requirements of the statewide regulation

(Title 13, CCR, Section 2449.1 ) and actions to meet the more stringent SOON NOx fleet

targets. SC AQMD wo uld review and provide its initial approval within 45 days after a plan is

deemed complete. (CARB has a separate approval process, which the SC AQMD would work

with CARB to obtain CARB’s approval in a timely manner.) Information that must be

submitted as part of the compliance plan includes:

1. Fleet Information

–

a. Information required as part of Title 13, CCR, Section 2449(g)(1)(B), for each

vehicle and includes:

o Vehicle type;

o Vehicle manufacturer;

o Vehicle model;

o Vehicle model year;

o Vehicle serial number;

o If vehicle is permanent or year

- by

- year low use, specialty, dedicated

emergency, dedicated snow removal, or is used for agricultural operations for

over half of its annual operating hours;

o For each engine that propels the vehicle, the engine manufacturer, USEPA

certified engine family (if any), engine serial number, engine model year

and/or production year, engine maximum horse power ( net horsepower, or net

flywheel horsepower as certified by the Society of Automotive Engineers

(SAE), or if this is not readi ly available, a horsepower on the label of the

engine, or in the service literature for the engine can be used )



### , or estimate the

horsepower by multiplying the power take off by 120 percent, type of retrofit

emission control (if any), date installed, and it s verification level.

o Whether the vehicle has been retrofit, repowered, or replaced with SOON

funding, and if so, the start and end of dates of the contract period.

b. Information necessary to demonstrate eligibility for vehicles subject to SC AQMD

SOON provis ions:

o Percentage of Tier 0 and Tier 1 equipment as of January 1, 2008

o Total fleet horsepower subject to CARB regulation

o Vehicle operational time and location for past three (3) years

o Whether the vehicle is scheduled to leave the SC AQMD, and if so, the

app ropriate statement under penalty of perjury stating the fleet’s intent to

move the vehicle out of the SC AQMD.

c. If credit will be taken for early repowers, retirements, or retrofits for the purpose

of complying with the statewide rule, fleet information mus t be submitted from

the year of the earliest action to the current year for all vehicles used to generate

the early credits.

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- SOON Program

SCAQMD

- 5

- February 2016 2. Fleet Actions

– Sufficient information must be supplied in the compliance plan detailing actions

planned or taken on each piece of equipment in a fleet to meet the statewide

requirements as well as the actions necessary to meet the SOON NOx targets. As the

SOON NOx targe ts are set for every 3 years (2011, 2014, 2017, 2020, 2023),

additional actions taken each year from the current year to the next two f uture

applicable SOON NOx target date must be identified (e.g., if the compliance plan is

being prepared for the year 200 8, the plan must cover years through 2014). If credit

will be taken for early repowers, retirements, or retrofits, fleet actions taken before

the current year must be submitted for all vehicles used to generate the early credits.

Information must include for each year and each vehicle:

o Action taken

– retire, replace, repower, or retrofit

o For replacement, all information listed in Section 2449 (g)(1)(B) for the new

vehicle

o For repower, information about the new engine including engine

manufacturer, engine family (if any), engine serial number, engine model

year, engine maximum power, type of retrofit emission control equipment

installed (if any), date installed and its verification level.

o For retrofit, type of retrofit emission control equipment, and verifi cation level.

C. SOON Application Requirements

1. Application

-

Pursuant to Section 2449. 2 (d)(1)(D) a fleet must apply for sufficient funding to

repower, replace, or retrofit vehicles so that the SOON portion of the fleet (all

vehicles in the fleet that operated within the district) will meet or exceed the

applicable fleet NOx target if all projects were funded. The application and all

necessary information needed as part of the application are explained in the program

announcement. Information require d includes:

o Contact information

o Vehicle information (make, model, model year, etc.)

o Project life ( ranges 3 to 10 years)

o Project type

o Vehicle activity information (i.e. fuel usage, hours of operation)

o Cost information (including vendor quotes)

2. High Priority Request

- Pursuant to Title 13, CCR, Section 2449. 2 (d)(1)(D), fleets must designate for each

SOON program project application whether they wish the project to receive high

priority for funding.

3. Annual Hours of Operation

- A project’s a nnual hours of operation will be equal to the average of the operating

hours in the SCAQMD over the two years immediately preceding the active SOON

program announcement deadline. The hours the vehicle operated in the SCAQMD

### Administrative Guidelines Rule 2449

- SOON Program

SCAQMD

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- February 2016 will be used to calculate the p roject cost effectiveness as well as the subsequent

requirement of minimum operating time in the district should the project receive

funding. For example, should a vehicle operate on average for the past three years

400 hours each in two other air distri cts and 500 hours in the SCAQMD that vehicle

would qualify for the SC AQMD SOON program, but only for the 500 hours it

averages in the SC AQMD. The vehicles cost

- effectiveness would be evaluated on

the 500 hours, and should the vehicle receive funding, it would be required to operate

on the average, 70% of its 500 hours or 350 hours annually in the SC AQMD for the

life of the project.

D. Operational Requirements

1. Cont r act duration

– Minimum contract duration or project life ranges between three (3) to ten (10) years

unless otherwise noted in the program announcement.

E. Projec t Award

The first 75% of the available funding will be awarded strictly on cost

- effectiveness criteria.

A $5,000 per ton of NOx reduced cost

- effectiveness value will be used as the benchmark.

Most projects are expected to be below this benchmark (i.e. will be more cost

- effective).

However, projects at higher cost

- effectiveness values can still be funded as long as they are

below the cost

- effectiveness cap mandated by the applicable Moyer Guidelines. The

remaining 25% will be distributed to the most co st

- effective project presented by each fleet

with the goal of funding at least one project per fleet. The funding will be distributed beginning

with the most cost

- effective projects presented by a fleet not having received funding in the

first round and r equesting high priority for the projects until the 25% of the funding is all

awarded. If funding is still available after all fleets have at least one project funded, the

remaining funds will go to the next most cost

- effective projects available from all of the fleets.

At no time will a fleet receive more than 10% of the available SOON funding. All other

criteria being equal, projects greater than 250 horsepower will receive funding before projects

less than 250 horsepower.

F. Co

- funding

Most SOON p rojects are expected to be repowers to Tier 3 engines or cleaner. SOON repower

projects will be funded at the full incremental cost of the repower which will require the project

owner to co

- fund 15% of the cost of the repower with the SOON program providing 85% of

the repower costs. The exception to this requirement is where it could reasonably be

determined that the fleet would not have incurred the rebuild cost (e.g. the replaced engine was

re cently rebuilt). For the purpose of this provision, a rebuild refers to a rebuild of an engine

or engine system, including a major overhaul in which you replace the engine’s pistons or

### Administrative Guidelines Rule 2449

- SOON Program

SCAQMD

- 7

- February 2016 power assemblies or make other changes that significantly increase the service life of the

engine. It may also include replacing or rebuilding an engine’s turbocharger or after cooler or

the engine’s systems for fuel metering or electronic control so to significantly increase the

service life of the engine. The following m aintenance does not constitute a rebuild:

(1) Scheduled emission

- related maintenance during the useful life period (such as replacing

fuel injectors).

(2) Unscheduled maintenance that occurs commonly within the useful life period. For

example, replacing a water pump is not rebuilding an engine.

If the engine rebuild was completed in the 12 months prior to the contract date, the grantee

must provide the SC AQMD with documentation of the rebuild to qualify for this provision.

Rebuild documentation may incl ude, but is not be limited to, dated work orders, sale invoices

for parts, and/or maintenance records. For engine rebuilds completed in the 13 to 36 months

prior to the contract date, the grantee must provide the SC AQMD with documentation of the

rebuild a nd documentation that grantee’s normal business practice is to rebuild on an interval

equal to or greater than the contract project life plus the time since last rebuild to qualify for

this provision. Documentation for extended rebuild intervals includes, but is not limited to,

historical maintenance records for the equipment or fleet policy on rebuild intervals. Engine

rebuilds completed more than 36 months prior to contract date are not considered “recent” and

do not qualify for this provision.

G. Vehicle Replacement



### The maximum funding amount for eligible SOON replacement projects shall be the

same as the funding level provided in the most recent CARB approved version of the

Carl Moyer Guidelines for off

- road equipment replacement projects.