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Regular Post Delivery Texas Commission on Environmental
Quality
Air Grants Division ERIG, MC-204 P.O. Box 13087
Austin, Texas 78711-3087
Express Delivery Texas Commission on Environmental Quality
Air Grants Division ERIG, MC-204
12100 Park 35 Circle Building F, 1st Floor, Room 1301
Austin, Texas 78753
Emissions Reduction Incentive Grants (ERIG) Replacement Project
Application Form
TCEQ-10430b Solicitation No. 582-21-10608
Eligible Counties:
Austin Area: Bastrop, Caldwell, Hays, Travis, and Williamson
Counties
Beaumont-Port Arthur Area: Hardin, Jefferson, and Orange
Counties
Corpus Christi Area: Nueces and San Patricio Counties
Dallas-Fort Worth Area: Collin, Dallas, Denton, Ellis, Henderson,
Hood, Hunt, Johnson, Kaufman, Parker, Rockwall, Tarrant, and Wise
Counties
El Paso Area: El Paso County Houston-Galveston-Brazoria Area:
Brazoria, Chambers, Fort Bend, Galveston, Harris, Liberty,
Montgomery, and Waller Counties
San Antonio Area: Bexar, Comal, Guadalupe, and Wilson
Counties
Tyler-Longview Area: Gregg, Harrison, Rusk, Smith, and Upshur
Counties
Eligible Applicants: Eligible applicants include individuals,
corporations, organizations, governments or governmental
subdivisions or agencies, business trusts, partnerships,
associations, or any other legal entity. This may include a
corporation headquartered outside of the state of Texas, but which
operates equipment primarily in an eligible county in Texas.
Eligible Activities: Eligible projects include the replacement
of older on-road heavy-duty vehicles and non-road heavy-duty
equipment with newer and cleaner models. Note: The term "equipment"
refers to one of the eligible emission sources: on-road heavy-duty
vehicles, non-road equipment, stationary equipment, marine vessels
and locomotives. Equipment being replaced must be in good operating
condition. On-Road replacement vehicles and non-road replacement
engines must not be more than three years older than the calendar
year in which the purchase is made. Refer to the RFGA for a
complete list of replacement requirements.
Application Deadline: Applications will be accepted on a
competitive basis until 5:00 p.m. CT on January 11 2021.
Applications may be submitted via electronic mail to
[email protected] or by mail to one of the addresses below.
mailto:[email protected]
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FY21 Emissions Reduction Incentive Grants Program TCEQ-10430b
(Version 20.01)
Form 1: Applicant Information
1. Applicant Legal Name
2. Business Information
Ownership Code (Business Type):
Payee Identification Number (FEI or SSN):
Does the Applicant meet the TERP Small Business definition? (see
RFGA)
3. Authorized OfficialThe applicant or an employee who has legal
authority to sign for and speak on behalf of the entity.
Prefix First MI Last Suffix
Title
Primary Phone Secondary Phone
Mailing Address
City State Zip Code
Check here if the physical address is the same as the mailing
address.
Physical Address
City State Zip Code
4. Designated Project RepresentativeThe applicant or an employee
who will serve as the point of contact for this application.
Check here if the Designated Project Representative is the same
as the Authorized Official
Prefix First MI Last Suffix
Title
Primary Phone Secondary Phone
E-mail Address
Mailing Address
City State Zip Code
Check here if the physical address is the same as the mailing
address.
Physical Address
City State Zip Code
5. Designated Location for Records Access and Review by the TCEQ
or its RepresentativePlease provide the physical address where
records relating to this project may be accessed and reviewed.
Physical Address
City State Zip Code
E-mail Address
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FY21 Emissions Reduction Incentive Grants Program TCEQ-10430b
(Version 20.01)
Form 2: Third Party Preparer Signature Page 1. Was this
application prepared by a third-party? Yes No
A third-party preparer is someone who is assisting in the
preparation of the grant application, but who is not related toor a
current employee of the applicant.
2. Third-Party Preparer Certification.I hereby certify that, to
the best of my knowledge and belief, all information provided in
this application and anyattachments is true and correct, as
represented to me by the applicant. I understand that failure to
sign the applicationor signing it with a false statement may make
the submitted offer or any resulting contracts voidable.
Third-Party Preparer Information.
Printed Name:
Title:
Company Name:
Street Address:
City, State, Zip Code:
Phone Number:
Email Address:
Signature*:
Date of Signature:
*Please fill out the entire application before completing the
electronic signature. The ability to edit, add, orremove
information will be removed after the application is electronically
signed.
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FY21 Emissions Reduction Incentive Grants Program
Form 3: Program Certifications
This section serves to assure the TCEQ that you understand and
agree to the statements below. These provisions relate to the basic
contract document which will be in force between the applicant and
the TCEQ upon award of a grant. TCEQ urges applicants to download a
copy of the example grant contract from www.terpgrants.org and
review it so that any questions can be discussed early in the
application review process.
By signing this application, you understand and certify
compliance with all the statements below, as well as with any state
statutes, regulations, policies, guidelines, and requirements as
they relate to the application, acceptance, and use of funds for
this project. If any of these certifications change between
submittal of the application and award of a contract or
cancellation of the solicitation, you will promptly notify
TCEQ.
Equipment and Activity Certifications
1. Ownership. The equipment has been continuously owned by the
applicant for the two years immediately preceding theapplication
signature date. For on-road vehicles, the applicant has been listed
on the front of the title document for the twoyears immediately
preceding the application signature date.
2. Operation & Registration. The equipment has been
continuously located and used in Texas for the two yearsimmediately
preceding the application signature date. In addition, on-road
vehicles have been continuously registered foroperation in Texas
for the two years immediately preceding the application signature
date. Applicants with apportionedvehicles must submit quarterly
usage summaries that include accurate dates and miles driven in
each registered state.
3. Condition. The equipment is currently in good operating
condition and capable of performing its primary function in
theroutine operations of the applicant at the time of signature. To
the best of the applicant’s knowledge, the equipment iscapable of
continuing to perform its primary function for the duration of the
Activity Life, taking into account normalmaintenance, repairs, and
upkeep.
4. Continued Operation and Use. If the grant funds were not
available, the applicant expects to otherwise continue tooperate
the equipment in Texas for at least the duration of the Activity
Life and the applicant otherwise would not haveplanned to replace
the equipment.
5. Destruction. The applicant has the legal authority to
complete the approved method of destruction (disposition) of
theequipment or engine being replaced. In general, the old
equipment, including the engine, must be rendered
permanentlyinoperable within 90 days of receiving financial
reimbursement.
6. Not Otherwise Required. To the best of the applicant’s
knowledge, the proposed activities are not required by anystate or
federal law, rule or regulation, memorandum of agreement, or other
legally binding contract.
7. No Emissions Reductions Credits. Activities funded under this
program are not eligible to generate marketablecredits under state
or federal emissions reduction credit averaging, banking, or
trading programs. If the project is funded,the applicant waives,
for all time, its right to claim or apply for any emissions
reduction credits from the use of the low-emission technology
funded under this program.
8. Not to Exceed 100% of Equipment Cost. The amount of the grant
award plus any other public financial assistance,tax credits or
deductions, or other grants may not exceed the total capital cost
of the equipment.
9. Failure to achieve the NOX emissions reductions projected in
the designated eligible counties for this projectand comply with
certain contractual terms may require the grantee to return all or
a share of the grant funds.Emission reductions will be based on the
grant equipment being used for the percentage of annual hours,
miles, or fueluse that occurs in the eligible counties, as
designated in the application for that activity. Failure to operate
the grantequipment for the percentage of annual use in the eligible
counties as designated in the application may result in theTCEQ
requiring the return of all or a share of the grant funds.
Additionally, the applicant will notify the TCEQ of anytermination
of use, change in use, sale, transfer, or destruction of
grant-funded equipment, during the Activity Life. Theapplicant
further agrees that, during the Activity Life, the TCEQ may be
entitled to the return of all or a share of the grantfunds for any
loss of emissions reductions compared with the emissions reductions
projected in awarding the grant.
10. Requirement to Monitor. The applicant will monitor the use
of the grant-funded equipment over the designatedActivity Life. The
applicant agrees to provide information on the use of the equipment
upon request of the TCEQ.
11. Insurance Coverage. The applicant will maintain, for the
term of the Activity Life for each activity, property lossinsurance
or self-insurance coverage on any equipment acquired, leased,
repowered, retrofitted, or constructed usingthese funds, sufficient
to cover the costs of reimbursing the state for its pro-rata share
of the activity costs.
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TCEQ-10430b (Version 20.01)
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FY21 Emissions Reduction Incentive Grants Program TCEQ-10430b
(Version 20.01)
12. Legal Authority. The applicant has the legal authority in
the State of Texas to apply for the grant. The applicant'sgoverning
body has authorized the filing of the application, understands
these requirements and certifications, and hasauthorized the person
identified as the Authorized Official to act in connection with the
application and to provide suchadditional information as may be
required.
Administrative and State Contracting Certifications
1. Uniform Grant Management Standards. The applicant will comply
with the Uniform Grant Management Standards(UGMS), adopted June
2004 by the Texas Comptroller of Public Accounts in accordance with
Texas Government CodeChapter 783. This document is available at:
http://www.comptroller.texas.gov/purchasing/docs/ugms.pdf.
2. Procurement of Goods and Services. In procuring goods and
services, the applicant will comply with UGMS Part III.State
Uniform Administrative Requirements for Grants, _.36 Procurement.
All procurement transactions will be conductedin a manner providing
full and open competition.
3. Historically Underutilized Businesses (HUBs). Qualified HUBs,
as defined and designated under state law, shallhave the maximum
practicable opportunity to participate in the performance of the
work arising out of this project.
4.Nondiscrimination. The applicant will comply with all State
and Federal statutes relating to nondiscrimination.
5.Grant Administration. The applicant will maintain an
appropriate grant administration system to ensure that all
terms,conditions, and specifications of the grant, including these
certifications and assurances, are met.
6.Audit. Acceptance of funds under this program acts as
acceptance of the authority of the State Auditor’s Office, or
anysuccessor agency, to conduct an audit or investigation in
connection with those funds. The applicant or other entity thatmay
receive funds directly or indirectly from TCEQ must provide the
state auditor with access to any information the stateauditor
considers relevant to the investigation or audit. Applicant will
include this clause concerning the authority to auditfunds received
indirectly and the requirement to cooperate in any subcontract it
awards.
7.Debt to the State. The applicant is not indebted to the state
or has an outstanding tax delinquency. The applicant mustcomply
with all State and Federal tax laws and fee requirements and is
solely responsible for filing all State and Federaltax and fee
forms.
8.Debarment. The applicant certifies that the applying entity
and its principals are eligible to participate in this
transactionand have not been subjected to suspension, debarment, or
similar ineligibility determined by any federal, state or
localgovernmental entity.
9.Conflict of Interest. The applicant has not given, offered to
give, nor intends to give any economic opportunity,
futureemployment, gift, loan, gratuity, special discount, trip,
favor, or service to a public servant in connection with the
submittedapplication. Under Texas Government Code Section 2155.004,
no person involved in the preparation of the Request forGrant
Applications may have financial interest in this application. If
applicant is not eligible, then any contract resultingfrom this
application shall be immediately terminated. Furthermore, under
Texas Government Code Section 2155.004, theapplicant certifies that
the individual or business entity named in this application or
contract is not ineligible to receive thespecified contract and
acknowledges that the contract may be terminated and payment
withheld if this certification isinaccurate. All purchase decisions
must be based on sound business decisions and arm’s length
bargaining.
10. Contracting with an Executive of a State Agency. Under Texas
Government Code Section 669.003, relating tocontracting with an
executive head of a state agency, applicant represents that no
person who, in the past four years,served as an executive of the
TCEQ or any other state agency, was involved with or has any
interest in this application. Ifapplicant employs or has used the
services of a former executive head of TCEQ or other state agency,
the applicant shallprovide the following information: name of
former executive, name of state agency, date of separation from
state agency,position with applicant, and date of employment with
applicant.
11. Under Texas Government Code Section 2155.006, the applicant
certifies that the individual or business entitynamed in this
application is not ineligible to receive the specified contract and
acknowledges that any contract resultingfrom this application may
be terminated and payment withheld if this certification is
inaccurate.
12. The applicant has not been adjudicated during the three-year
period immediately preceding the application signaturedate to have
committed substantive, non-clerical violations resulting in an
actual release of hazardous waste thatpresented an imminent and
substantial danger to the public health and safety or the
environment.
Continued on next page
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FY21 Emissions Reduction Incentive Grants Program TCEQ-10430b
(Version 20.01)
13. The applicant’s facilities that shall be utilized in the
accomplishment of the activities are not listed on the EPA’s list
ofViolating Facilities nor is it under consideration for such
listing.
14. The applicant complies with applicable environmental
standards, regulations, and laws.
15. The applicant, nor any of its officers, have been
adjudicated by a court of law to have violated the Texas
DeceptiveTrade Practices Act.
16. Abortion Funding Limitation. The applicant represents and
warrants that any payments made by TCEQ withappropriated funds,
should a contract be awarded, are not prohibited by Article IX,
Section 6.25 of the GeneralAppropriations Act, 86th Legislative
Session (2019), nor by Texas Government Code Chapter 2272
ProhibitedTransactions [Senate Bill 22, 86th Legislative Session
(2019)].
17. Excluded Parties. Applicant represents and warrants that it
is not listed in the prohibited vendors lists authorized
byExecutive Order No. 13224, “Blocking Property and Prohibiting
Transactions with Persons Who Commit, Threaten toCommit, or Support
Terrorism,” published by the United States Department of the
Treasury, Office of Foreign AssetsControl. Applicant will notify
TCEQ if it can no longer make this representation.
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FY21 Emissions Reduction Incentive Grants Program TCEQ-10430b
(Version 20.01)
Form 4: Certification of Eligibility to Receive a State-Funded
Grant All applicants must complete this form to certify eligibility
to receive a grant under this program, regardless if child support
obligations apply to the applicant. Failure to submit this form may
result in rejection of the application.
Certification Regarding Child Support Obligations. Under Section
231.006, Texas Family Code, a child support obligor who is more
than 30 days delinquent in paying child support and a business
entity in which the obligor is a sole proprietor, partner,
shareholder, or owner with an ownership interest of at least 25%,
is not eligible to receive a state-funded grant or loan. All
applicants must include in the application the name and social
security number of the individual or sole proprietor and each
partner, shareholder, or owner with an ownership interest of 25% of
the business entity submitting the application.
FEDERAL PRIVACY ACT NOTICE: This notice is given pursuant to the
Federal Privacy Act. Disclosure of your Social Security Number
(SSN) is required under Section 231.006(c) and Section
231.302(c)(2) of the Texas Family Code. The SSN will be used to
identify persons that may owe child support. The SSN will be kept
confidential to the fullest extent allowed under Section
231.302(e), Texas Family Code.
Please Check One of the Following Applicant Options:
If Option 1 or 2 is checked, list the name(s) and social
security number(s) (SSN) below.
I certify that to the best of my knowledge and belief that the
individual or business entity submitting this application is
eligible to receive a grant. I acknowledge that the grant contract
may be terminated, and any payments withheld if this certification
is inaccurate.
1. Individual or sole proprietorship
2. One or more individuals own 25% or more of the business
entity
3. No individual owns 25% or more of the business entity
4. Governmental entity
Name: Social Security Number (SSN):
Name: Social Security Number (SSN):
Name: Social Security Number (SSN):
Name: Social Security Number (SSN):
Name: Social Security Number (SSN):
Initial*: Date:
*Please fill out the entire application before completing the
electronic signature. The ability to edit, add, or remove
information will be removed after the application is electronically
signed.
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FY21 Emissions Reduction Incentive Grants Program TCEQ-10430b
(Version 20.01)
Form 5: Equipment Information 1. Old Equipment Information.
Equipment Type: (i.e. haul truck, excavator, etc.)
Identification Number: Equipment ID or last four digits of VIN
#
Equipment Model Year:
Equipment Make:
Equipment Model: Gross Vehicle Weight Rating:
On-road equipment only Engine Model Year:
Engine Make:
Engine Identification/Serial Number:
Engine Model: Engine Horsepower Rating (bhp/hr):
Non-road equipment only Fuel Type:
Engine Family Code: 12-digit emissions code for engines 2003 and
newer
Federal NOX Emissions Standard (g/bhp-hr): Historical Annual
Usage:
List average annual use for the last two years immediately
preceding the application signature date and select a unit from the
dropdown list.
2. New Equipment Information.Equipment Type:
(i.e. haul truck, excavator, etc.) Equipment Model Year:
Engine Model Year: GVWR:
(On-road projects) Horsepower:
(Non-road projects) Fuel Type:
Federal NOX Emissions Standard (g/bhp-hr):
3. Annual UsageUsage Type:
Standard or Non-Standard (only one usage type per
application)
Usage Unit: Select from the drop-down list
Activity Annual Usage Rate:
4. Requested Grant Amount. Please indicate the requested grant
amount and cost per ton.
Requested Grant Amount: Cost Per Ton of NOX Reduced:
Use the grant estimator to determine Cost Per Ton
Activity Number: ________ Click here for additional pages
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TCEQ-10430b (Version 20.01)
Form 6: New Equipment Usage Information Check here if percent
annual usage is the same for all activities.
Identify one or more of the following eligible areas where the
grant-funded equipment will be operated and indicate the percentage
of total annual use in that area for the equipment. Refer to the
list of counties within each area on the cover page of this
application.
1. Percentage in Area
2. Project Activity LifeCheck here if the activity life is the
same for all activities.
3. Business DescriptionProvide a description of your business
and how the equipment will be used in your routine operations. For
on-road equipment, include your typical driving route (including
the cities traveled to and highways/roadways traveled on). If the
equipment is primarily being used for natural gas recovery
purposes, please indicate this below.
. FY21 Emissions Reduction Incentive Grants Program
Description Percent Usage
% of Annual Usage Austin Area:
% of Annual Usage Beaumont-Port Arthur Area:
% of Annual Usage Corpus Christi Area:
% of Annual Usage Dallas-Fort Worth Area:
% of Annual Usage El Paso Area:
% of Annual Usage Houston-Galveston-Brazoria Area:
% of Annual Usage San Antonio Area:
% of Annual Usage Tyler-Longview Area:
% Total Annual Usage:
% on Designated Highways (if applicable):
Activity Life: Select an activity life from the drop-down
list.
Business Description and/or Daily Route Description:
Activity Number: ________
Click here for additional pages
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FY21 Emissions Reduction Incentive Grants Program TCEQ-10430b
(Version 20.01)
Form 7: Summary Page Applicant Information.
Authorized Official. The applicant or an employee of the
applicant who has the legal authority to sign on behalf of the
entity.
I hereby certify that to the best of my knowledge and belief,
all information provided in this application and any attachments is
true and correct. I certify that I have read the complete
application after all forms and information were completed, I agree
with the information provided, and the date provided below is the
date I signed the form. I further understand that prior to
incorporating these forms and information into a grant contract the
data and information may be revised by the TCEQ for accuracy, and
the acceptance of a grant contract will constitute agreement with
those revisions. My signature also constitutes acceptance of the
certifications in Form 3, the terms of this grant, and any changes
posted through addenda on the Electronic State Business Daily.
Failure to sign the application or signing it with an incorrect
statement may make the submitted offer or any resulting contracts
voidable.
Applicant Legal Name:
Applicant Type:
FEI or SSN:
Primary Project Area: Emission Source:
Total Requested Grant Amount:
Total Number of Activities: Activity Type:
Usage Rate: Standard or Non-Standard
Is the applicant a TERP Small Business?
Mailing Address:
City: State: Zip Code:
How did you hear about this grant program?
Other (please specify):
Printed Name of Authorized Official:
Authorized Official Title:
Signature of Authorized Official*:
Date of Signature:
The application, signed by the Authorized Official, must be
received by the application deadline or the application will not be
accepted.
Intentional falsification of these forms will be prosecuted to
the extent allowed under the law and may be used as an adverse
factor in future grant selection decisions. Upon submission, all
proposals become the property of the State of Texas and as such
become subject to the Texas Public Information Act, Texas
Government Code Chapter 552.
Personal Information Policy: Individuals are entitled to request
and review their personal information that the agency gathers on
its forms. Individuals may also have any errors in their
information corrected.
To review such information, contact the TCEQ TERP program at
[email protected] or 1-800-919-TERP (8377).
mailto:[email protected]
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FY21 Emissions Reduction Incentive Grants Program TCEQ-10430b
(Version 20.01)
Required Attachments – Part 1 W-9 Form – Applicable to All
ApplicationsSignature Required. A W-9 Form can be obtained from the
IRS, link: https://www.irs.gov/pub/irs-pdf/fw9.pdf Please use the
"Attach Documents" button below to upload your W-9 Form to this
document.
State or Federal Identification Card - Only applicable if
applicant is an Individual or Sole Proprietor. Please insert a copy
of your State or Federal Identification Card in the provided box
below. Picture or attachment must be clear and easily readable.
New Equipment Prior Purchase Documents – Only applicable if
applicant has already purchased the new equipment. If the equipment
has already been purchased, provide the purchase, lease or
financing agreement showing the price paid. Please use this upload
feature to attach purchase, lease, or finance agreements for each
activity purchased prior to your application submission.
New equipment purchases made before the opening of the grant
application period may not be eligible.
https://www.irs.gov/pub/irs-pdf/fw9.pdf
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FY21 Emissions Reduction Incentive Grants Program TCEQ-10430b
(Version 20.01)
Required Attachments – Part 2a: Color Photographs of Old
Equipment
Exterior Equipment Photographs Please upload color photographs
into the boxes provided below of the front, right side, left side,
and rear. The equipment photographs should be clear and
readable.
Activity ___________ Front -Select camera icon to upload your
photograph
Activity ___________ Rear -Select camera icon to upload your
photograph
Click here for additional pages
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FY21 Emissions Reduction Incentive Grants Program TCEQ-10430b
(Version 20.01)
Required Attachments – Part 2b: Color Photographs of Old
Equipment
Exterior Equipment Photographs Please upload color photographs
into the boxes provided below of the front, right side, left side,
and rear. The equipment photographs should be clear and
readable.
Activity ___________ Right Side -Select camera icon to upload
your photograph
Activity ___________ Left Side -Select camera icon to upload
your photograph
Click here for additional pages
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FY21 Emissions Reduction Incentive Grants Program TCEQ-10430b
(Version 20.01)
Required Attachments – Part 2c: Color Photographs of Old
Equipment
Engine Photographs Please upload color photographs into the
boxes provided below of the engine and engine plate of the old
equipment. The engine plate should include the engine family code,
engine model, engine serial number and be clear and readable.
Activity ___________ Engine Top -Select camera icon to upload
your photograph
Activity ___________ Engine Right -Select camera icon to upload
your photograph
Click here for additional pages
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FY21 Emissions Reduction Incentive Grants Program TCEQ-10430b
(Version 20.01)
Required Attachments – Part 2d: Color Photographs of Old
Equipment
Engine Photographs Please upload color photographs into the
boxes provided below of the engine and engine plate of the old
equipment. The engine plate should include the engine family code,
engine model, engine serial number and be clear and readable.
Activity ___________ Engine Left -Select camera icon to upload
your photograph
Activity ___________ Engine Plate -Select camera icon to upload
your photograph
Click here for additional pages
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FY21 Emissions Reduction Incentive Grants Program
Required Attachments – Part 3
On-Road Equipment Applications Only Copy of Current Title or
Lease Agreement for Old Equipment Please use the "Attach Documents"
button below to upload the old equipment title or lease agreement
for each activity.
Copy of Registration Documents for Old Equipment Please include
documentation of continuous registration for the 12 months
immediately preceding the application signature date. NOTE: This
may require 2 years of registration documents depending on your
annual registration date. Please use the "Attach Documents" button
below to upload registration documents for each activity.
Note: To view all attachments, go to
View>Show/Hide>Navigation Pane>Attachments.
TCEQ-10430b (Version 20.01)
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Form 8: Application Checklist and Submission All applications
require the documents listed below. Please ensure that you have
read and attached all the required documents. All pages that must
be signed or initialed are indicated below. If a signature page is
missing or has been altered, the application will not be
considered.
Application Form Checklist (All Applications):
Form 1: Applicant Information I have filled out this ERIG
application entirely.
Form 2: Third-Party Preparer Certification If a Third-Party
Preparer was used, Signature Required.
Form 3: Program Certifications I have read and understand Form 3
within this application.
Form 4: Certification of Eligibility Initials Required.
Form 5: Equipment Information I have filled out entirely and
created additional pages as needed.
Form 6: New Equipment Usage Information
I have filled out entirely and created additional pages as
needed.
Form 7: Summary Page I have filled out entirely. Signature
Required.
Form 8: Application Checklist and Submission
I have filled out entirely.
Required Attachment Checklist (All Applications):
W-9 Form Signature Required.
https://www.irs.gov/pub/irs-pdf/fw9.pdf
Copy of State or Federal Identification Card
Only applicable if applicant is an individual or sole
proprietor.
Color Photographs of Old Equipment Please upload color
photographs of the front, right side, left side, rear, engine and
engine plate of the old equipment.
If the Equipment has already been purchased, provide the
purchase, lease or financing agreement showing the price paid.
The purchase may not have been made before the opening of the
grant application period.
Required Attachments (On-Road Equipment):
Copy of Current Title or Lease Agreement for Old Equipment
Please document ownership for the 2 years immediately preceding
the application signature date.
Copy of Registration Documents for Old Equipment
Please include documentation of current registration for 1 year
(12 months) immediately preceding the application signature
date.
Supplemental Forms (if applicable):
Waiver Request (if applicable) Please fill out entirely if
applicable. Signature Required.
Quarterly Summaries (On-Road Equipment - Apportioned Tags Only)
Quarterly Summary Form provided at the end of this document.
If apportioned registration was submitted, mileage logs are
required for 2 years immediately preceding the application
signature date. Please include quarterly summaries that include
miles driven in each registered state.
Locomotive Projects Applicants applying for Locomotive projects
must complete this form and attach it to the application form being
submitted.
Stationary Equipment Applicants applying for Stationary
Equipment projects must complete this form and attach it to the
application form being submitted.
Heavy-Duty Non-Road Equipment Natural Gas Recovery
Submit this form if you are applying for heavy-duty non-road
equipment that is used for Natural Gas Recovery Purposes.
FY21 Emissions Reduction Incentive Grants Program TCEQ-10430b
(Version 20.01)
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Alternative Disposition Request (Locomotive Projects Only): Form
provided.
Permanent Removal from the State of Texas
If an applicant is requesting an alternative method of
disposition that results in the old locomotive and engine being
permanently removed from the State of Texas, the request must be
submitted prior to or with the application submission.
Alternative Destruction Request: Form provided.
Requesting Alternative Destruction If an applicant is requesting
an alternative method of destruction other than the listed method
in the RFGA, the request must be submitted prior to or with the
application submission.
Waiver for Ownership, Registration, Use, or Condition
Requirement: Form provided.
Ownership:
Registration (On-Road Vehicles):
Operation in Texas:
Condition:
Continued Operation and Use:
Application Submission Please confirm that you have completed
all requirements for your Emissions Reduction Incentive Grants
(ERIG) application. To submit your application, including uploaded
attachments, supplemental forms, and photographs, please do the
following:
Step 1 - Press the Save My Application Button to compile and
compress your application in preparation for email. Choose Reduced
File Size and save your file with 'FY21 ERIG' and your legal name
as your file name.
Step 2 - Email your saved application to
[email protected]. Please include 'FY21 ERIG' and your legal
name in the subject line. Submit one (1) email including your FY21
ERIG application and any attachments.
Helpful Tips and Tools:
Is your file too large to email?
Need help to view, delete, or upload additional attachments? In
Adobe Acrobat reader or Pro, choose View, then Show/Hide, then
Navigation Pane, then Attachments.
Please contact [email protected] if you have questions or
need help with your application.
FY21 Emissions Reduction Incentive Grants Program TCEQ-10430b
(Version 20.01)
Adobe Acrobat Pro Users: Choose File, then Save As Other, then
Optimized PDF instead of Reduced File Size asstated in Step 1
above. Remember, if you choose to optimize your application, your
attachments will not beincluded with your application and will need
to be included with your email instead. To avoid a large
ERIGapplication file, confirm that your submitted documents and
pictures are no larger than 500 KB each.
Free Adobe PDF Compress tool: Browse to free tool located at
https://www.adobe.com/acrobat/online/compress-pdf.html website,
press the blue ‘Select a file’ button to upload your ERIG
application and follow the directions.Download your final
compressed ERIG application file, save your file with the program
year and program acronymand your legal name as your file name.
Example: FY21 ERIG Your Legal Name. Email your saved application
[email protected]
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FY21 Emissions Reduction Incentive Grants Program TCEQ-10430b
(Version 20.01)
Supplemental Form: Waiver Request Applicants requesting a waiver
to one or more of the program requirements must complete this form
and include it with the application during submission.
Please choose the waiver request(s) that apply to the activity.
Waiver for the Ownership Requirement: Equipment has not been
continuously owned for the two years immediately preceding the
application signature date. For on-road equipment, the applicant
has not been listed on the front of the title document for the two
years immediately preceding the application signature date.
Waiver for the Registration Requirement: Equipment has not been
continuously located and used in Texas for the two years
immediately preceding the application signature date. In addition,
on-road equipment has not been continuously registered for
operation in Texas for the two years immediately preceding the
application signature date.
Waiver for the Usage Requirement: Equipment is not currently in
good operating condition and is incapable of performing its primary
function in the routine operations of the applicant at the time of
application signature. Equipment cannot continue to perform its
primary function for the duration of the activity life of the
project.
Please provide a detailed explanation for the waiver request(s)
below. Attach any supporting documentation for your request(s) to
this application for review by the TCEQ.
By signing this document, the applicant is certifying that all
information provided is complete and accurate.
Printed Name of Authorized Official:
Signature of Authorized Official*:
Date of Signature Provided:
*Please fill out the entire application before completing the
electronic signature. The ability to edit, add, orremove
information will be removed after the application is electronically
signed.
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Year:
Quarter 1 (Jan / Feb / Mar) Texas: Outside Texas: Quarter 1
Total:
Miles:
Quarter 2 (April / Mar / June) Texas: Outside Texas: Quarter 2
Total:
Miles:
Quarter 3 (July / Aug / Sept)
Texas: Outside Texas: Quarter 3 Total:
Miles:
Quarter 4 (Oct / Nov / Dec) Texas: Outside Texas: Quarter 4
Total:
Miles:
Year Total Miles:
Year:
Quarter 1 Texas: Outside Texas: Quarter 1 Total:
Miles:
Quarter 2 Texas: Outside Texas: Quarter 2 Total:
Miles:
Quarter 3 Texas: Outside Texas: Quarter 3 Total:
Miles:
Quarter 4 Texas: Outside Texas: Quarter 4 Total:
Miles:
Year Total Miles:
(Jan / Feb / Mar)
(April / Mar / June)
(July / Aug / Sept)
(Oct / Nov / Dec)
FY21 Emissions Reduction Incentive Grants Program TCEQ-10430b
(Version 20.01)
Supplemental Form: Quarterly Usage Summary If an applicant is
operating with Apportioned Tags, please indicate the mileage driven
inside Texas and outside Texas during each quarter for two years
preceding the application signature date. Please use the "Attach
Documents" button below to upload IFTA logs.
Please use this "Attach Documents" button to upload IFTA
logs.
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FY21 Emissions Reduction Incentive Grants Program TCEQ-10430b
(Version 20.01)
Supplemental Form: Locomotive Projects – Complete if Needed
Applicants applying for Locomotive projects must complete this form
and attach it to the Project Application Form being submitted.
Locomotive Only 1. What will be the primary use of the
locomotive? Please check the appropriate box. Refer to the
locomotive technicalsupplement for details on the options.
Switchyard, Short Haul, Etc. Industrial Rail – Limited use by an
industrial or commercial entity
2. The new locomotive will be what type? Please select the
appropriate box.Genset/Hybrid Regular One Engine Switcher
3. Use DescriptionBriefly explain the use of the locomotive
below to verify the category marked in Item 2 above.
.
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FY21 Emissions Reduction Incentive Grants Program TCEQ-10430b
(Version 20.01)
Supplemental Form: Stationary Equipment – Complete if Needed 1.
List the physical address and/or other description of the equipment
location below:
Equipment Physical Address
City State Zip Code
Description of the equipment location:
2. Is this facility covered by a TCEQ permit or
registration?Please select the appropriate boxYes No
If you answered Yes to question 2 above, complete information
below.
3. Permit Information
Name of Permit Holder
Prefix First MI Last Suffix
Title
TCEQ Permit / Registration / Account Number (if applicable)
4. General Permit or Permit by Rule (if applicable):List permit
or rule number and provide a summary of equipment regulated
below.
5. TCEQ Customer Reference Number (CN)
6. TCEQ Regulated Entity Reference Number (RN)
7. TCEQ Facility Identification Number (FIN)
8. TCEQ Emission Point Number (EPN)
Emissions Reduction Requirements, Credits, and Allowances
By signing the Project Application Form 10430b, the applicant
certifies that the NOx emissions achieved by this activity are not
already required under the conditions of a permit or rule for this
site or facility or to ensure that the site or facility remains
under an emissions limit.
The applicant also understands that any emissions reduction
measure that would otherwise generate a marketable credit under a
state or federal emissions averaging, banking, or trading program
is not eligible unless the credits are transferred to the TCEQ for
the state implementation plan and permanently retired. This
includes emissions allowances assigned to the applicant under the
Mass Emission Cap and Trade Program in the
Houston-Galveston-Brazoria Area established under TCEQ rules (30
TAC Chapter 101, Subchapter H, Division 3). If a grant is awarded,
the applicant must transfer and permanently retire any applicable
credits or allowances.
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FY21 Emissions Reduction Incentive Grants Program TCEQ-10430b
(Version 20.01)
Supplemental Form: Non-Road Heavy-Duty Equipment Used for Gas
Recovery Purposes – Complete if Needed For non-road equipment used
primarily for natural gas recovery purposes, the TCEQ may exempt
the applicant from the requirement that 75% of the annual operation
of the grant-funded equipment must occur in the eligible counties
listed in the application and contract documents.
Note: If the applicant is exempt from using the equipment less
than 75% of the annual use in the designated areas, the applicant
must agree to install a GPS tracking device through a designated
TGMS Contractor to track and report usage and location of the use
of the non-road equipment. Refer to section 2.7(c of the RFGA for
an explanation of the percent of use commitment.
Explain below in detail how the equipment being upgraded has
been used and how the upgraded equipment will be used in natural
gas recovery. For example, a generator used on a natural gas drill
rig may qualify, but a tracked dozer used to build a road to a
drill would not.
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FY21 Emissions Reduction Incentive Grants Program TCEQ-10430b
(Version 20.01)
Alternative Disposition/Destruction Request - Locomotives Only
Alternative Disposition Request:
Permanent Removal from the State of Texas If an applicant is
requesting an alternative method of disposition that results in the
old locomotive and engine being permanently removed from the State
of Texas, the request must be submitted prior to or with the
application submission.
Please describe the alternative method of disposition proposed
below.
Alternative Destruction Request:
Requesting Alternative Destruction If an applicant is requesting
an alternative method of destruction other than the listed method
in the RFGA, the request must be submitted prior to or with the
application submission.
Please describe the alternative method of destruction proposed
below.
Form 1: Applicant Information1. Applicant Legal Name2. Business
Information3. Authorized Official4. Designated Project
Representative5. Designated Location for Records Access and Review
by the TCEQ or its Representative
Form 2: Third Party Preparer Signature Page1. Was this
application prepared by a third-party? Yes No2. Third-Party
Preparer Certification.Third-Party Preparer Information.
Form 4: Certification of Eligibility to Receive a State-Funded
GrantCertification Regarding Child Support Obligations.Please Check
One of the Following Applicant Options.If Option 1 or 2 is checked,
list the name(s) and social security number(s) (SSN) below.
Form 5: Equipment InformationForm 6: New Equipment Usage
InformationForm 7: Summary PageApplicant Information.Authorized
Official.
Required Attachments – Part 1W-9 Form – Applicable to All
ApplicationsState or Federal Identification Card - Only applicable
if applicant is an individual or sole proprietor.New Equipment
Prior Purchase Documents – Only applicable if applicant has already
purchased the new equipment.New equipment purchases made before the
opening of the grant application period may not be eligible.
Required Attachments – Part 2: Color Photographs of Old
EquipmentEngine PhotographsRequired Attachments – Part 3On-Road
Equipment Applications OnlyCopy of Current Title or Lease Agreement
for Old EquipmentCopy of Registration Documents for Old
EquipmentQuarterly Summaries – Applicable to applicants with
apportioned Tags Only
FY20ERIG-CHECKLIST-DRAFT-UPDATED-SW.pdfApplication
Submission
Title: Social Security Number SSN: Social Security Number SSN_2:
Social Security Number SSN_3: Social Security Number SSN_4: Social
Security Number SSN_5: Equipment Type ie haul truck excavator etc:
Identification Number Equipment ID or last four digits of VIN:
Equipment Make: Equipment Model: Equipment Model Year: Gross
Vehicle Weight Rating Onroad equipment only: Engine Make: Engine
Model: Engine IdentificationSerial Number: Engine Model Year:
Engine Horsepower Rating bhphr Nonroad equipment only: Engine
Family Code 12digit emissions code: Federal NOX Emissions Standard
gbhphr: Historical Annual Usage List average annual use for the
last two years immediately preceding the application signature date
and select a unit from the dropdown list: Equipment Type ie haul
truck excavator etc_2: Equipment Model Year_2: Engine Model Year_2:
GVWR Onroad Projects: Horsepower Nonroad projects: Select
OneFederal NOX Emissions Standard gbhphr: Cost Per Ton of NOX
Reduced Use the grant estimator to determine Cost Per Ton: Percent
Usage of Annual Usage Austin Area: Percent Usage of Annual Usage
BeaumontPort Arthur Area: Percent Usage of Annual Usage Corpus
Christi Area: Percent Usage of Annual Usage DallasFort Worth Area:
Percent Usage of Annual Usage El Paso Area: Percent Usage of Annual
Usage HoustonGalvestonBrazoria Area: Percent Usage of Annual Usage
San Antonio Area: Percent Usage of Annual Usage TylerLongview Area:
Percent Usage Total Annual Usage: Percent Usage on Designated
Highways if applicable: Other please specify: Printed Name of
Authorized Official: Printed Name of Authorized Official_2:
Activity: Activity_2: Equipment Physical Address: City_2: State_7:
Zip Code_7: First_5: MI_3: Last_3: Suffix_3: Title_2: TCEQ Permit
Registration Account Number if applicable: 5 TCEQ Customer
Reference Number CN 6 TCEQ Regulated Entity Reference Number RN 7
TCEQ Facility Identification Number FIN 8 TCEQ Emission Point
Number EPN: 5 TCEQ Customer Reference Number CN 6 TCEQ Regulated
Entity Reference Number RN 7 TCEQ Facility Identification Number
FIN 8 TCEQ Emission Point Number EPN_2: 5 TCEQ Customer Reference
Number CN 6 TCEQ Regulated Entity Reference Number RN 7 TCEQ
Facility Identification Number FIN 8 TCEQ Emission Point Number
EPN_3: 5 TCEQ Customer Reference Number CN 6 TCEQ Regulated Entity
Reference Number RN 7 TCEQ Facility Identification Number FIN 8
TCEQ Emission Point Number EPN_4: Form4 One or more 25%: OffForm4
Individual: OffForm4 No 25%: OffForm4 Government: OffForm4
Date_af_date: Form 7 Date of AO Signature: Form 8 Date of AO
Signature: Name of Permit Holder: Please describe the alternative
method of disposition proposed: Please describe the alternative
method of destruction proposed: ReqAttPt2Ext: Click here for
additional pages:
Upload Photograph of State or Federal ID: Check Box6: OffCheck
Box7: OffCheck Box8: OffCheck Box9: OffCheck Box10: OffCheck Box11:
OffCheck Box12: OffCheck Box13: OffDescription of the equipment
location: Prefix P18: [-Select-]List permit or rule number and
provide a summary of equipment regulated below: Briefly explain the
use of the locomotive below to verify the category marked in Item 2
above: Check Box16: OffCheck Box17: OffCheck Box18: OffCheck Box19:
OffActivity Number_2: Form 2 No Check Box: OffForm 2 Yes Check Box:
OffForm5: Click here for additional pages:
Form 6 Check Box: OffWaiver Check Box - Ownership: OffWaiver
Check Box - Registration: OffWaiver Check Box - Usage:
OffForm2Date_af_date: Form2Email: Form2Number: Form2 City State Zip
Code: Form2 Street Address: Form2 Company Name: Form2 Printed Name:
Form4Name: Form4Name_2: Form4Name_3: Form4Name_4: Form4Name_5:
Authorized Official Title: CheckSame: OffAuthorized Official
Physical City: Authorized Official Physical State: Authorized
Official Physical Zip Code: Authorized Official Physical Address:
CheckSame2: OffDPR First Name: DPR Middle Initial: DPR Last Name:
DPR Suffix: DPR Title: DPR Cell Number: DPR Phone Number: DPR
Mailing Address: DPR Mailing City: DPR Mailing State: DPR
CheckSame: OffDPR Physical Address: DPR Physical State: DPR
Physical Zip Code: DPR Physical City: DPR Mailing Zip Code: AO
Prefix: [-Select-]AO First Name: AO Middle Initial: AO Last Name:
AO Suffix: AO Title: AO Number: AO Cell Number: DPR Prefix:
[-Select-]Records City: Records Address: Records State: Records Zip
Code: Form 5 Historical Annual Usage: [-Select-]Form 5 New Usage:
[-Select One-]Form 5 Usage Rate: Form 6 Check Box 2: OffProject
Activity Life: [-Select One-]Form 1 Applicant Information:
Ownership Code (Business Type): [-Select One-]Select OnePayee
Identification Number FEI or SSN: Requested Grant Amount: Form 5
Fuel Type Old: [-Select One-]Authorized Official Mailing Address:
Form 7 Number of Activities: Authorized Official Mailing City:
Authorized Official Mailing State: Authorized Official Mailing Zip
Code: Form 5 Usage: [-Select One-]Does the Applicant meet the TERP
Small Business definition?: [-Select One-]Form 5 Fuel Type New:
[-Select One-]Form 7 Primary Area: [-Select One-]Form 7 Outreach:
[-Select One-]RA-P1 W-9 Upload: RA-P1 Prior Purchase Documents:
Detailed Explanation Alternative Disposition: Price Comparison
Upload: F7ActivityType: [-Select-]Requested Granted Amount: SF Gas
Recovery: Business Description andor Daily Route Description:
Pt2EngPicL2: Pt2engPicPlate: Pt2EngPicPlate: Pt2EngPicLeftUpload:
Pt2EngRightPic: Pt2EngTopPic: Pt2EngPicTopAct: Pt2EngPicRtAct:
Pt2Eng2AddPg: WaiverSignature: Form2 Signature: RAPT2F:
RAPT2R_af_image: Pt2LRAddPg: P2RightSideExt: Pt2PicRightSide:
Pt2LeftSideExt_af_image: Pt2LeftRightAddPg: F4 Signature: Save My
Application: Reset Photo: Camera: Camera2: Camera3: RESET BUTTON:
Camera4: RESET PHOTO: AO Email Address: DPR Email Address: RA-Pt3
Upload Title or Lease: RA-Pt3 Upload Registration: Year: Miles:
Miles_2: Miles_3: Miles_4: Year Total Miles: Year_2: Miles_5:
Miles_6: Miles_7: Miles_8: Year Total Miles_2: Q1Miles2: Q1Miles3:
Q2Miles2: Q2Miles3: Q3Miles3: Q3Miles2: Q4Miles2: Q4Miles3:
Q1Miles4: Q1Miles5: Q2Miles4: Q2Miles5: Q3Miles4: Q3Miles5:
Q4Miles4: Q4Miles5: Please provide a detailed explanation for the
waiver request(s): Summary Attachments: Form5 NewFuel Type:
[-Select One-]