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HomeMy WebLinkAboutAgenda Report - May 5, 2021 C-17AGENDA ITEM .► 17 d CITY OF LODI COUNCIL COMMUNICATION TM AGENDA TITLE: Adopt Resolution Authorizing City Manager to Accept California Electric Vehicle Infrastructure Project (CALeVIP) Grant Funding and Appropriating Funds ($70,000) MEETING DATE: May 5, 2021 PREPARED BY: Business Development Manager RECOMMENDED ACTION: Adopt a resolution authorizing the City Manager to accept California Electric Vehicle Infrastructure Project (CALeVIP) grant funding and appropriating funds in the amount of $70,000. BACKGROUND INFORMATION: Funded by the California Energy Commission (CEC) and implemented by the Center for Sustainable Energy (CSE), CALeVIP is providing incentives for electric vehicle (EV) charging installations. The CEC is working with cities on projects that promote EV use and support regional EV needs. Examples of eligible costs include charging equipment, installation labor, utility upgrades, trenching and conduits. On April 1, 2021, Lodi Electric Utility (LEU) issued a Request for Proposals for a turnkey project to furnish, install, operate and maintain Level II EV public charging stations and ensure that these EV public charging stations are accessible and safe to use at all times by users. The project includes not only the replacement of existing equipment which has reached the end of its useful life but also the installation of new charging stations through the City. All newly installed charging stations will be equipped with two ports to allow for additional charging opportunities. Below is a summary of the proposed project: 1) Hutchins Street Square: One replacement and two new chargers 2) Downtown Parking Garage: One replacement and one new charger 3) City Hall: Two replacement chargers 4) Finance Department: One replacement charger 5) Library: One replacement charger 6) Kofu Park: One new charger It is worth noting that the existing Level II EV charging station located at Animal Services will be removed to accommodate parking needs. The installation proposed at Kofu Park will serve as the "replacement' for this facility. There is no matching fund requirement and grant funds will be provided on a reimbursement basis to LEU. LEU will fund all costs up front and be reimbursed from the California Electric Vehicle Infrastructure APPROVED: S ephen Schw , City Manager AdoptResolution Authorizing City Manager to Accept California Electric Vehicle Infrastructure Project (CALeVIP) Grant Funding and Appropriating Funds ($70,000) May 5, 2021 Page 2 Project. Should costs exceed the total grant funds awarded, LEU has available funding budgeted in its Low Carbon Fuel Standard Fund 503. It is anticipated the project will be completed by Fall 2020. FISCAL IMPACT: The CALeVIP Grant will provide $70,000 in funds. FUNDING AVAILABLE: CALeVIP Grant with funds to be appropriated as provided below. Any additional funds, if needed, will be available from the Low Carbon Fuel Standard Fund 503: Revenue: 50100000.56005 - $70,000 Expenditures: 50199000.77030 - $70,000 Andrew Keys Andrew Keys Deputy City Manager/Internal Services Director Astrida Trupovnieks Astrida Trupovnieks Business Development Manager Signature: 9A7HpvnrelrJ Signature: Ofl"J� Email: atrupovnieks@lodi.gov Email: akeys@lodi.gov San Joaquin Valley Incentive Project Application Form APWCAL e.IP BUILDING EV INFRASTRUCTURE San Joaquin Valley Incentive Project Requirements At the time an applicant submits an online incentive application the most current San Joaquin Valley Incentive Project (Project) Implementation MaIlLial available, as well as the incentive requirements agreed to by the applicant, will apply. Applications are processed on a first-come, first- served basis for both Level 2 (L2) and DC fast charging (DCFC) projects. First-come basis for an owner -submitted application is determined on the date of application submittal. For applicants submitting on behalf of a property owner, first-come basis is determined by the submittal date of the Site Verification Form (SVF) following application submittal. If the SVF is not submitted within five (5) calendar days of initial application, the application will be canceled. Qualified applicants featuring L2 projects will receive a single payment up to 270 days from the Funds Reserved date. Qualified applicants featuring DCFC or combined projects (projects featuring a combination of DCFC and L2 chargers within the same application) can receive up to two payments — a milestone payment can be requested up to 240 calendar days (8 months) and a final payment up to 450 days from the Funds Reserved date. Delays beyond normal processing times may occur. The maximum amount of active application incentives an applicant may reserve at any time is limited to $360,000 for applications on sites in Fresno, Kern, and San Joaquin counties. To apply for an incentive an Applicant must: 1. Submit an online application. 2. Complete an Installation Form online within 270 days from the Funds Reserved date for Level 2 only applications and within 450 days for DCFC or combined applications. 3. Submit supporting documentation within 270 days from the Funds Reserved date for Level 2 only applications and within 450 days for DCFC or combined applications. The supporting documentation must be scanned and submitted through the CALeVIP website. Required supporting documentation will include, at a minimum, the following: a. For applicants who request applications by phone, a complete application with signature and date. For online applicants, a scanned copy of the submitted application signed by the site owner or authorized representative. b. For applicants who are not site owners, a completed Site Verification Form providing confirmation that the site owner authorizes the applicant to install the equipment at the site. c. Copy of paid equipment receipt/invoice. wrn urrnr �,r.w CALIFORNIA ENERGY COMMISSION Center for .� ,Sustainable Energy° C S E -CA Le V I P-102019 San Joaquin Valley Incentive Project Application Form e IP BUILDING EV INFRASTRUCTURE i. Receipt/Invoice must include, at a minimum, purchase date, retailer name, business address, phone number, equipment make and model number(s), equipment serial number(s), and payment terms (paid in full — cash, check, credit card, etc.). d. Copy of installation receipt/invoice(s). i. Receipt/Invoice must include contractor name, contractor license number, business address, phone number, itemized costs, and payment terms (paid in full — cash, check, credit card, etc.). e. Copy of network service agreement (for a minimum of two years for Level 2 chargers or five years for DC fast chargers). f. Copy of building or other local agency permit(s) approving installation. g. Copy of design/engineering invoice(s). i. Invoice must include contractor/engineer name, contractor/engineer license number, business address, phone number, itemized costs, and payment terms (paid in full — cash, check, credit card, etc.). h. Copy of final inspection card, permit or other local agency document showing installation has been completed. i. Photograph(s) of installed and operational charger(s) at the site address provided in the application. Photographs must clearly show required San Joaquin Valley Incentive Project labeling. j. Photograph(s) of all installed charger serial number(s). k. (If installation required utility service) Copy of utility service order(s) needed for the installation. If new service is not required, a copy of the utility bill is needed for existing accounts, along with meter number EV chargers are to be tied into. 1. (If installation required utility service) Copy of utility receipt/invoice(s). i. Receipt/Invoice must include utility name, address, phone number, itemized costs, and payment terms (paid in full — cash, check, credit card, etc.). Center for Sustainable Energy (CSE) may request additional documentation to verify that the applicant meets required eligibility criteria. If the installation is a DCFC or combined installation, applicants may request a milestone payment to be calculated based on project costs submitted to that point if all the following conditions are met: • The application is in Funds Reserved status. • At least a copy of the building permit, design/engineering receipt/invoice, and signed application form have been submitted. • Less than 240 calendar days (8 months) have passed since funds reserved date. Important: If an applicant fails to submit the required supporting documentation within 270/450 days (L2/DCFC and combined projects) of the incentive funds reserved date, the application may be terminated, and the reserved incentive funds released back to the Project. CSE has the discretion to complete additional review beyond the allotted time on a case by case basis. CALIFORNIA ENERGY . COMMISSION Center for Sustainable Energy - C SE -CA Le V I P-102019 San Joaquin Valley Incentive Project Application Form a CA L .VIP BUILDING EV INFRASTRUCTURE Incentive checks must be cashed within six (6) months of the date on the check. Checks not cashed within this timeframe will be cancelled, and the incentive amount will be returned to the Project. Applicant, Site and Equipment Requirements As a condition for receiving CALeVIP (from State of California and California Energy Commission) incentive funds, the applicant must comply with the requirements below. Eligible applicants must meet requirements that include, but are not limited to, the following: • Submit a Project application prior to purchasing and installing equipment and before funds run out. Design, engineering, and utility service request costs may be incurred after October 10, 2019 but are incurred at applicant's own risk prior to the funds reserved date (e.g. application may be determined ineligible, or funds may be unavailable at time of application). All other eligible costs must be incurred after funds are reserved to be eligible. • Be an authorized representative of a qualified commercial or public facility installation site. An authorized representative is defined as a site owner or an individual that has received permission from the site owner to apply on behalf of a qualified site. • Be a business or government entity that is based in California or has a California-based affiliate or be a California Native American Tribe listed with the Native American Heritage Commission at the time of application. a. California business entities and non -California business entities that conduct intrastate business in California and are required to register with the California Secretary of State must do so and be in good standing in order to receive an incentive. If not currently registered with the California Secretary of State, applicants should contact the Secretary of State's Office as soon as possible. For more information, visit the Secretary of State's website at: www,sos.ca.gov. b. Sole proprietorships and DBA's (Doing Business As; also, called fictitious business name, assumed business name, or trade name) cannot apply as a business and must instead apply as a sole proprietorship. • Have the new charger(s) installed by a qualified and licensed contractor in accordance with all local, state, and federal codes, permitting, and inspection requirements. • Obtain any required permits and comply with all applicable federal, state, and municipal laws, rules, codes, and regulations for work performed for the incentive. • Grant Center for Sustainable Energy and Energy Commission direct access to EV charger utilization data (for up to 2 years (L2) or 5 years (DCFC) depending on charger type) through applicant's selected network provider, through acceptance of these requirements. • Ensure the charger(s) shall remain in service at the project site address for a minimum of sixty (60) months. • Submit information to the Alternative Fuels Data Center station locator tool for all charging stations incentivized through the Project. CALIFORMIA _ ENERGY + '� COMMISSION CSE-CALeVIP-102019 San Joaquin Valley Incentive Project Application Form MOWIP BUILDING EV INFRASTRUCTURE • Submit two (2) years (for Level 2) or five (5) years (for DCFC) of utilization data, in increments not exceeding 1 -year, to CSE. • Apply CALeVIP labeling to all incentivized chargers. • Be available for follow-up inspection if requested by CSE or Energy Commission. • Energy Commission reserves the right to request voluntary participation from incentive recipients in ongoing research efforts that support CALeVIP Project goals. Eligible project sites must: • Be located at a physical site address in Fresno, Kern, and San Joaquin counties. • Be well -lit, secure and in compliance with all federal, state and municipal laws, ordinances, rules, codes, standards and regulations. • For L2 Projects containing 1-10 connectors, be one of the following site types: a. Commercial — any non-residential property used solely for business purposes including private office buildings, warehouses, and retail buildings. b. Workplace — A workplace is a non-residential site location, where business is conducted or where services or industrial operations are performed. Residential properties are ineligible as a workplace regardless of their use as a place of business. c. Multi -unit dwelling — Classification of housing where multiple separate housing units for residential inhabitants are contained within one building or several buildings within one complex. MUDs must contain at least three (3) units for this program. Chargers may be public or private and must be shared use (accessible to more than one resident of the MUD complex). d. Light-duty Fleet — Groups of motor vehicles owned or leased by a business, government agency or other organization rather than by an individual or family. Chargers may be public or private and must be shared use. e. Public facility — can be any facility, including, but not limited to, buildings, property, recreation areas, and roads, which are owned, leased, or otherwise operated, or funded by a governmental body or public entity. f. Curbside — On -street in public right-of-way along the street frontage of any of the above listed uses. • For DCFC Projects, be one of the following site types: a. Urban/suburban retail core — a retail store within a business district in which merchandise is sold primarily to consumers. Standalone retail stores are ineligible. b. Retail shopping center — a group of retail and other commercial establishments that is planned, developed, owned and managed as a single property. Standalone retail stores do not qualify as a retail shopping center. c. Grocery store — a store that sells food and household supplies. d. Restaurant a business where people pay to sit and eat meals that are cooked and served on the premises. CAa..LIF4RHIAAF ENERGY COMMISSION 106 Center for Sustainable Energy- CSE-CALeVIP-102019 San Joaquin Valley Incentive Project Application Form + C14 e�Ilp BUILDING EV INFRASTRUCTURE e. Gas station — any new or existing facility that, as its primary use, serves as a motor vehicle fueling service station retailing petroleum-based automotive fuels (e.g. gasoline, diesel, E10/E15) to the general public and has additional complementary customer store(s) or services(s) located onsite. f. Hospital — a facility providing medical, psychiatric or surgical services for sick or injured persons primarily on an in-patient basis, including ancillary facilities for outpatient and emergency treatment, diagnostic services and training. g. Sheriff/police station — Includes storefront police or sheriff substations that serve surrounding communities and adjacent areas. h. Airport — parking facilities at airports that serve the public are eligible. Long-term parking uses are ineligible. i. Hotels - an establishment providing accommodations, meals, and other services for travelers and tourists. j. City/County/Privately owned parking lot or garage - an area or structure where the primary use is to leave cars temporarily. City/County office buildings are ineligible. k. Library — a building or room containing collections of books, periodicals, and sometimes films and recorded music for people to read, borrow, or refer to. 1. Casino — a building where gambling games of chance against the house/casino are played. Standalone poker rooms or card halls are ineligible. in. Public transit hub - a place where passengers and cargo are exchanged between vehicles and/or between transport modes. Public transport hubs include train stations, rapid transit stations, bus stations, and tram stops. n. Curbside — On -street in public right-of-way along the street frontage of any of the above listed uses. • DCFC Projects must also be publicly accessible and available 24 hours per day, year-round. DCFCs cannot be located behind a fence or in a gated parking lot closed to the public after-hours. All L2 charger(s) must: • Be new equipment installed for the first time. Resale units, rebuilt, rented, received from warranty insurance claims, or new parts installed in existing units are not eligible. • Meet the international standard connector for Level 2 EV chargers. This connector is known as the SAE J1772 connector. • Be networked, which is defined as a charger connected to a backend network operations center, enabling remote diagnostics, remote start and usage data collection at a minimum. • Be capable of delivering electricity to a plug-in electric vehicle at a minimum rate of 6.2 kilowatts. • Use an open standard protocol as a basic framework for purposes of network interoperability. Any proprietary protocol may be superimposed on the system, provided the owner is able to revert to the open standard protocol. • Accept some form of credit card payment, if payment is required. • Accept more than one form of payment, if payment is required. n m. CALIFORNIA ENERGY COMMISSION �. Center for Sustainable Energy- CSE-CALeVIP-102019 San Joaquin Valley Incentive Project Application Form c.� �alip BUILDING EV INFRASTRUCTURE ■ Be approved by a Nationally Recognized Testing Laboratory (NRTL) program for EVSE testing and certification. • Be ENERGY STARO Certified, listed on the ENERGY STARO product finder page (littpsm//..www.energystar.gov/12r.o-dit.ctfindei-/). All DC fast charger(s) must: • Be new equipment installed for the first time. Resale units, rebuilt, rented, received from warranty insurance claims, or new parts installed in existing units are not eligible. • Be a dual standard, CHAdeMO and Combined Charging System (CCS) DC fast charger. • Be networked, which is defined as a charger connected to a backend network operations center, enabling remote diagnostics, remote start and usage data collection, at a minimum. • Be capable of delivering electricity to a plug-in electric vehicle at a minimum rate of 50 kilowatts. • Use an open standard protocol as a basic framework for purposes of network interoperability. Any proprietary protocol may be superimposed on the system, provided the owner is able to revert to the open standard protocol. • Accept some form of credit card payment, if payment is required. • Accept more than one form of payment, if payment is required. • Be approved by a Nationally Recognized Testing Laboratory (NRTL) program for EVSE testing and certification. Detailed information about these requirements and the processes associated with them can be found in the Project Itnplennentation Manual. Applicants that have questions about Project Requirements should contact CSE at san -joaquin-valley-caleyipLa)energycenter.org,. Declarations Please review each statement below. By clicking Accept and Continue you are indicating that you agree with the following statements and that information provided in your application is accurate and truthful. 1. I am the owner of the installation site or have the authority to file this application on behalf of the owner. 2. I have read and agree to the requirements of the San Joaquin Valley Incentive Project. 3. I choose to voluntarily submit personally -identifying information for the purposes of processing my incentive and enforcing the San Joaquin Valley Incentive Project Requirements. 4. I have read and agree to the terms of the San Joaquin ValleyIncentive PrQiect Priwtcy Polic . CALIFORNIA r' ENERGY COMMISSION = Center for Sustainable Energy- CSE-CALeVIP-102019 San Joaquin Valley Incentive Project Application Form �aCA ILP BUILDING EV INFRASTRUCTURE If any of the information below is incorrect, please contact CALeVIP staff at sari j�aS�uin-valley-caleyi energycenfer.ora. Project application number: F-00360 Applicant name : Astrida Trupovnieks Applicant email : atrupovnieks@lodi.gov Organization name : City of Lodi, California Applicant type : Public Entity Installation street address : 201 W Locust St City : Lodi State : CA Zip :95240 County : San Joaquin County r` Mailing address: 221 W Pine Street, Lodi, CA, 95241 Site use: City, County or Privately Owned Parking Lot or Garage Please review all charger equipment on the last page. By signing this form, the applicant agrees to the following: 1. 1 understand that the Energy Commission reserves all rights and remedies available under the law to enforce the San Joaquin Valley Incentive Project Requirements. 2. I acknowledge that I have read, understand, and agree to be bound by the San Joaquin Valley Incentive Project Requirements as outlined within this Rebate Application Form. I certify, under the penalty of perjury, that the information provided herein and all supporting documentation is true, accurate, and complete. Name of applicant or authorized representative: Astrida Trupovnieks Signature: CALIFORNIA ENERGY COMMISSION Center for Sustainable Energy - Total reserved rebate amount: $7,000.00 Date: 04/03/21 CSE -CA Le V I P-102019 San Joaquin Valley Incentive Project Application Form �24w/p BUILDING EV INFRASTRUCTURE CALIFORNIA �� �� • ENERGY COMMISSION CSE -CA LeV I P-102019 San Joaquin Valley Incentive Project Application Form � 2 IP BUILDING EV INFRASTRUCTURE San Joaquin Valley Incentive Project Requirements At the time an applicant submits an online incentive application the most current San Joaquin Valley Incentive Project (Project) Implementation Manual available, as well as the incentive requirements agreed to by the applicant, will apply. Applications are processed on a first-come, first-served basis for both Level 2 (L2) and DC fast charging (DCFC) projects. First-come basis for an owner -submitted application is determined on the date of application submittal. For applicants submitting on behalf of a property owner, first-come basis is determined by the submittal date of the Site Verification Form (SVF) following application submittal. If the SVF is not submitted within five (5) calendar days of initial application, the application will be canceled. Qualified applicants featuring L2 projects will receive a single payment up to 270 days from the Funds Reserved date. Qualified applicants featuring DCFC or combined projects (projects featuring a combination of DCFC and L2 chargers within the same application) can receive up to two payments — a milestone payment can be requested up to 240 calendar days (8 months) and a final payment up to 450 days from the Funds Reserved date. Delays beyond normal processing times may occur. The maximum amount of active application incentives an applicant may reserve at any time is limited to $360,000 for applications on sites in Fresno, Kern, and San Joaquin counties. To apply for an incentive an Applicant must: 1. Submit an online application. 2. Complete an Installation Form online within 270 days from the Funds Reserved date for Level 2 only applications and within 450 days for DCFC or combined applications. 3. Submit supporting documentation within 270 days from the Funds Reserved date for Level 2 only applications and within 450 days for DCFC or combined applications. The supporting documentation must be scanned and submitted through the CALeVIP website. Required supporting documentation will include, at a minimum, the following: a. For applicants who request applications by phone, a complete application with signature and date. For online applicants, a scanned copy of the submitted application signed by the site owner or authorized representative. b. For applicants who are not site owners, a completed Site Verification Form providing confirmation that the site owner authorizes the applicant to install the equipment at the site. c. Copy of paid equipment receipt/invoice. HI U'.� CALIFORNIAENERGY COMMISSION A6Center for . Sustainable Energy~ C S E -CA Le V I P-102019 San Joaquin Valley Incentive Project Application Form �2010 BUILDING EV INFRASTRUCTURE i. Receipt/Invoice must include, at a minimum, purchase date, retailer name, business address, phone number, equipment make and model number(s), equipment serial number(s), and payment terms (paid in full — cash, check, credit card, etc.). d. Copy of installation receipt/invoice(s). i. Receipt/Invoice must include contractor name, contractor license number, business address, phone number, itemized costs, and payment terms (paid in full — cash, check, credit card, etc.). e. Copy of network service agreement (for a minimum of two years for Level 2 chargers or five years for DC fast chargers). f. Copy of building or other local agency permit(s) approving installation. g. Copy of design/engineering invoice(s). i. Invoice must include contractor/engineer name, contractor/engineer license number, business address, phone number, itemized costs, and payment terms (paid in full — cash, check, credit card, etc.). h. Copy of final inspection card, permit or other local agency document showing installation has been completed. i. Photograph(s) of installed and operational charger(s) at the site address provided in the application. Photographs must clearly show required San Joaquin Valley Incentive Project labeling. j. Photograph(s) of all installed charger serial number(s). k. (If installation required utility service) Copy of utility service order(s) needed for the installation. If new service is not required, a copy of the utility bill is needed for existing accounts, along with meter number EV chargers are to be tied into. 1. (If installation required utility service) Copy of utility receipt/invoice(s). i. Receipt/Invoice must include utility name, address, phone number, itemized costs, and payment terms (paid in full — cash, check, credit card, etc.). Center for Sustainable Energy (CSE) may request additional documentation to verify that the applicant meets required eligibility criteria. If the installation is a DCFC or combined installation, applicants may request a milestone payment to be calculated based on project costs submitted to that point if all the following conditions are met: • The application is in Funds Reserved status. • At least a copy of the building permit, design/engineering receipt/invoice, and signed application form have been submitted. • Less than 240 calendar days (8 months) have passed since funds reserved date. Important: If an applicant fails to submit the required supporting documentation within 270/450 days (L2/DCFC and combined projects) of the incentive funds reserved date, the application may be terminated, and the reserved incentive funds released back to the Project. CSE has the discretion to complete additional review beyond the allotted time on a case by case basis. CALIFORNIA ENERGY COMMISSION = Center for A Sustainable Energy - C S E -CA Le V I P-102019 San Joaquin Valley Incentive Project Application Form IIP BUILDING EV INFRASTRUCTURE Incentive checks must be cashed within six (6) months of the date on the check. Checks not cashed within this timeframe will be cancelled, and the incentive amount will be returned to the Project. Applicant, Site and Equipment Requirements As a condition for receiving CALeVIP (from State of California and California Energy Commission) incentive funds, the applicant must comply with the requirements below. Eligible applicants must meet requirements that include, but are not limited to, the following: • Submit a Project application prior to purchasing and installing equipment and before funds run out. Design, engineering, and utility service request costs may be incurred after October 10, 2019 but are incurred at applicant's own risk prior to the funds reserved date (e.g. application may be determined ineligible, or funds may be unavailable at time of application). All other eligible costs must be incurred after funds are reserved to be eligible. • Be an authorized representative of a qualified commercial or public facility installation site. An authorized representative is defined as a site owner or an individual that has received permission from the site owner to apply on behalf of a qualified site. • Be a business or government entity that is based in California or has a California-based affiliate or be a California Native American Tribe listed with the Native American Heritage Commission at the time of application. a. California business entities and non -California business entities that conduct intrastate business in California and are required to register with the California Secretary of State must do so and be in good standing in order to receive an incentive. If not currently registered with the California Secretary of State, applicants should contact the Secretary of State's Office as soon as possible. For more information, visit the Secretary of State's website at: www.sos.ca.gov. b. Sole proprietorships and DBA's (Doing Business As; also, called fictitious business name, assumed business name, or trade name) cannot apply as a business and must instead apply as a sole proprietorship. • Have the new charger(s) installed by a qualified and licensed contractor in accordance with all local, state, and federal codes, permitting, and inspection requirements. • Obtain any required permits and comply with all applicable federal, state, and municipal laws, rules, codes, and regulations for work performed for the incentive. • Grant Center for Sustainable Energy and Energy Commission direct access to EV charger utilization data (for up to 2 years (L2) or 5 years (DCFC) depending on charger type) through applicant's selected network provider, through acceptance of these requirements. • Ensure the charger(s) shall remain in service at the project site address for a minimum of sixty (60) months. • Submit information to the Alternative Fuels Data Center station locator tool for all charging stations incentivized through the Project. UL,irpRNIA g, ENERGY CCMMISSIQN Center for Sustainable Energy - C S E -CA Le V I P-102019 San Joaquin Valley Incentive Project Application Form 4 1P BUILDING EV INFRASTRUCTURE • Submit two (2) years (for Level 2) or five (5) years (for DCFC) of utilization data, in increments not exceeding 1 -year, to CSE. • Apply CALeVIP labeling to all incentivized chargers. • Be available for follow-up inspection if requested by CSE or Energy Commission. • Energy Commission reserves the right to request voluntary participation from incentive recipients in ongoing research efforts that support CALeVIP Project goals. Eligible project sites must: • Be located at a physical site address in Fresno, Kern, and San Joaquin counties. • Be well -lit, secure and in compliance with all federal, state and municipal laws, ordinances, rules, codes, standards and regulations. • For L2 Projects containing 1-10 connectors, be one of the following site types: a. Commercial — any non-residential property used solely for business purposes including private office buildings, warehouses, and retail buildings. b. Workplace — A workplace is a non-residential site location, where business is conducted or where services or industrial operations are performed. Residential properties are ineligible as a workplace regardless of their use as a place of business. c. Multi -unit dwelling — Classification of housing where multiple separate housing units for residential inhabitants are contained within one building or several buildings within one complex. MUDs must contain at least three (3) units for this program. Chargers may be public or private and must be shared use (accessible to more than one resident of the MUD complex). d. Light-duty Fleet — Groups of motor vehicles owned or leased by a business, government agency or other organization rather than by an individual or family. Chargers may be public or private and must be shared use. e. Public facility — can be any facility, including, but not limited to, buildings, property, recreation areas, and roads, which are owned, leased, or otherwise operated, or funded by a governmental body or public entity. f. Curbside — On -street in public right-of-way along the street frontage of any of the above listed uses. • For DCFC Projects, be one of the following site types: a. Urban/suburban retail core — a retail store within a business district in which merchandise is sold primarily to consumers. Standalone retail stores are ineligible. b. Retail shopping center — a group of retail and other commercial establishments that is planned, developed, owned and managed as a single property. Standalone retail stores do not qualify as a retail shopping center. c. Grocery store — a store that sells food and household supplies. d. Restaurant — a business where people pay to sit and eat meals that are cooked and served on the premises. n�+nm onnrminrne �- CALIFORNIA ' ENERGY COMMISSION Center for Sustainable Energy- CSE-CALeVIP-102019 nergy- CSE-CALeVIP-102019 San Joaquin Valley Incentive Project Application Form e IP BUILDING EV INFRASTRUCTURE e. Gas station — any new or existing facility that, as its primary use, serves as a motor vehicle fueling service station retailing petroleum-based automotive fuels (e.g. gasoline, diesel, E10/E15) to the general public and has additional complementary customer store(s) or services(s) located onsite. f. Hospital — a facility providing medical, psychiatric or surgical services for sick or injured persons primarily on an in-patient basis, including ancillary facilities for outpatient and emergency treatment, diagnostic services and training. g. Sheriff/police station — Includes storefront police or sheriff substations that serve surrounding communities and adjacent areas. h. Airport — parking facilities at airports that serve the public are eligible. Long-term parking uses are ineligible. i. Hotels - an establishment providing accommodations, meals, and other services for travelers and tourists. j. City/County/Privately owned parking lot or garage - an area or structure where the primary use is to leave cars temporarily. City/County office buildings are ineligible. k. Library — a building or room containing collections of books, periodicals, and sometimes films and recorded music for people to read, borrow, or refer to. 1. Casino — a building where gambling games of chance against the house/casino are played. Standalone poker rooms or card halls are ineligible. in. Public transit hub - a place where passengers and cargo are exchanged between vehicles and/or between transport modes. Public transport hubs include train stations, rapid transit stations, bus stations, and tram stops. n. Curbside — On -street in public right-of-way along the street frontage of any of the above listed uses. • DCFC Projects must also be publicly accessible and available 24 hours per day, year-round. DCFCs cannot be located behind a fence or in a gated parking lot closed to the public after-hours. All L2 charger(s) must: • Be new equipment installed for the first time. Resale units, rebuilt, rented, received from warranty insurance claims, or new parts installed in existing units are not eligible. • Meet the international standard connector for Level 2 EV chargers. This connector is known as the SAE J1772 connector. • Be networked, which is defined as a charger connected to a backend network operations center, enabling remote diagnostics, remote start and usage data collection at a minimum. • Be capable of delivering electricity to a plug-in electric vehicle at a minimum rate of 6.2 kilowatts. • Use an open standard protocol as a basic framework for purposes of network interoperability. Any proprietary protocol may be superimposed on the system, provided the owner is able to revert to the open standard protocol. • Accept some form of credit card payment, if payment is required. 18 Accept more than one form of payment, if payment is required. CALIFORNIA ENERGY ., COMMISSION Center for Sustainable Energy- CSE-CALeVIP-102019 San Joaquin Valley Incentive Project Application Form �2011_p BUILDING EV INFRASTRUCTURE • Be approved by a Nationally Recognized Testing Laboratory (NRTL) program for EVSE testing and certification. • Be ENERGY STAR® Certified, listed on the ENERGY STAR® product finder page (https://www.ellergystar.90V/pl-OdLictfitidqr/). All DC fast charger(s) must: • Be new equipment installed for the first time. Resale units, rebuilt, rented, received from warranty insurance claims, or new parts installed in existing units are not eligible. • Be a dual standard, CHAdeMO and Combined Charging System (CCS) DC fast charger. • Be networked, which is defined as a charger connected to a backend network operations center, enabling remote diagnostics, remote start and usage data collection, at a minimum. • Be capable of delivering electricity to a plug-in electric vehicle at a minimum rate of 50 kilowatts. • Use an open standard protocol as a basic framework for purposes of network interoperability. Any proprietary protocol may be superimposed on the system, provided the owner is able to revert to the open standard protocol. • Accept some form of credit card payment, if payment is required. • Accept more than one form of payment, if payment is required. • Be approved by a Nationally Recognized Testing Laboratory (NRTL) program for EVSE testing and certification. Detailed information about these requirements and the processes associated with them can be found in the Project IniplemetugfiQn Manual. Applicants that have questions about Project Requirements should contact CSE at saii-joaquin-va[ley-calevipiracenter.org. Declarations Please review each statement below. By clicking Accept and Continue you are indicating that you agree with the following statements and that information provided in your application is accurate and truthful. 1. I am the owner of the installation site or have the authority to file this application on behalf of the owner. 2. I have read and agree to the requirements of the San Joaquin Valley Incentive Project. 3. I choose to voluntarily submit personally -identifying information for the purposes of processing my incentive and enforcing the San Joaquin Valley Incentive Project Requirements. 4. I have read and agree to the terms of the San Joaquin Valley Incentive Project Privacy Policy. CALIFORNIA UPOF-0 ENERGY COMMISSION Center for Sustainable Energy - C S E -CA Le V I P-102019 San Joaquin Valley Incentive Project Application Form �2 /1-P BUILDING EV INFRASTRUCTURE If any of the information below is incorrect, please contact CALeVIP staff at san-jooa uin-valley pal yj energysgnter.org. Project application number : F-00361 Applicant name : Astrida Trupovnieks Applicant email : atrupovnieks@lodi.gov Organization name : City of Lodi, CA Applicant type : Public Entity Installation street address : 310 W Elm St City : Lodi State : CA Zip : 95240 County : San Joaquin County Mailing address: 221 W Pine Street, Lodi, CA, 95241 Site use: City, County or Privately Owned Parking Lot or Garage Please review all charger equipment on the last page. By signing this form, the applicant agrees to the following: 1. 1 understand that the Energy Commission reserves all rights and remedies available under the law to enforce the San Joaquin Valley Incentive Project Requirements. 2. 1 acknowledge that I have read, understand, and agree to be bound by the San Joaquin Valley Incentive Project Requirements as outlined within this Rebate Application Form. I certify, under the penalty of perjury, that the information provided herein and all supporting documentation is true, accurate, and complete. Name of applicant or authorized representative: Total reserved rebate amount: Astrida Trupovnieks 1 $7,000.00 Signature: !j4 I Date: 04/03/2021 CALIFORNIAC ENERGY COMMISSION Center for Sustainable EnergyrM C S E -CA Le V I P-102019 San Joaquin Valley Incentive Project Application Form MOWIP BUILDING EV INFRASTRUCTURE CALIFdRNIA ENERGY COMMISSION Center for Sustainable Energy, CSE-CALeVIP-102019 San Joaquin Valley Incentive Project Application Form �2 /1P BUILDING EV INFRASTRUCTURE San Joaquin Valley Incentive Project Requirements At the time an applicant submits an online incentive application the most current San Joaquin Valley Incentive Project (Project) Implementation Manual available, as well as the incentive requirements agreed to by the applicant, will apply. Applications are processed on a first-come, first-served basis for both Level 2 (L2) and DC fast charging (DCFC) projects. First-come basis for an owner -submitted application is determined on the date of application submittal. For applicants submitting on behalf of a property owner, first-come basis is determined by the submittal date of the Site Verification Form (SVF) following application submittal. If the SVF is not submitted within five (5) calendar days of initial application, the application will be canceled. Qualified applicants featuring L2 projects will receive a single payment up to 270 days from the Funds Reserved date. Qualified applicants featuring DCFC or combined projects (projects featuring a combination of DCFC and L2 chargers within the same application) can receive up to two payments — a milestone payment can be requested up to 240 calendar days (8 months) and a final payment up to 450 days from the Funds Reserved date. Delays beyond normal processing times may occur. The maximum amount of active application incentives an applicant may reserve at any time is limited to $360,000 for applications on sites in Fresno, Kern, and San Joaquin counties. To apply for an incentive an Applicant must: 1. Submit an online application. 2. Complete an Installation Form online within 270 days from the Funds Reserved date for Level 2 only applications and within 450 days for DCFC or combined applications. 3. Submit supporting documentation within 270 days from the Funds Reserved date for Level 2 only applications and within 450 days for DCFC or combined applications. The supporting documentation must be scanned and submitted through the CALeVIP website. Required supporting documentation will include, at a minimum, the following: a. For applicants who request applications by phone, a complete application with signature and date. For online applicants, a scanned copy of the submitted application signed by the site owner or authorized representative. b. For applicants who are not site owners, a completed Site Verification Form providing confirmation that the site owner authorizes the applicant to install the equipment at the site. c. Copy of paid equipment receipt/invoice. CALIFORNIA ENERGY COMMISSION Center for Sustainable Energy - C S E -CA Le V I P-102019 San Joaquin Valley Incentive Project Application Form �U wip BUILDING EV INFRASTRUCTURE i. Receipt/Invoice must include, at a minimum, purchase date, retailer name, business address, phone number, equipment make and model number(s), equipment serial number(s), and payment terms (paid in full — cash, check, credit card, etc.). d. Copy of installation receipt/invoice(s). i. Receipt/Invoice must include contractor name, contractor license number, business address, phone number, itemized costs, and payment terms (paid in full — cash, check, credit card, etc.). e. Copy of network service agreement (for a minimum of two years for Level 2 chargers or five years for DC fast chargers). f. Copy of building or other local agency permit(s) approving installation. g. Copy of design/engineering invoice(s). i. Invoice must include contractor/engineer name, contractor/engineer license number, business address, phone number, itemized costs, and payment terms (paid in full — cash, check, credit card, etc.). h. Copy of final inspection card, permit or other local agency document showing installation has been completed. i. Photograph(s) of installed and operational charger(s) at the site address provided in the application. Photographs must clearly show required San Joaquin Valley Incentive Project labeling. j. Photograph(s) of all installed charger serial number(s). k. (If installation required utility service) Copy of utility service order(s) needed for the installation. If new service is not required, a copy of the utility bill is needed for existing accounts, along with meter number EV chargers are to be tied into. 1. (If installation required utility service) Copy of utility receipt/invoice(s). i. Receipt/Invoice must include utility name, address, phone number, itemized costs, and payment terms (paid in full — cash, check, credit card, etc.). Center for Sustainable Energy (CSE) may request additional documentation to verify that the applicant meets required eligibility criteria. If the installation is a DCFC or combined installation, applicants may request a milestone payment to be calculated based on project costs submitted to that point if all the following conditions are met: • The application is in Funds Reserved status. • At least a copy of the building permit, design/engineering receipt/invoice, and signed application form have been submitted. • Less than 240 calendar days (8 months) have passed since funds reserved date. Important: If an applicant fails to submit the required supporting documentation within 270/450 days (L2/DCFC and combined projects) of the incentive funds reserved date, the application may be terminated, and the reserved incentive funds released back to the Project. CSE has the discretion to complete additional review beyond the allotted time on a case by case basis. CALIFORNIA ENERGY COMMISSION Center for Sustainable Energy", C S E -CA Le V I P-102019 San Joaquin Valley Incentive Project Application Form Q. �2/lp BUILDING EV INFRASTRUCTURE Incentive checks must be cashed within six (6) months of the date on the check. Checks not cashed within this timeframe will be cancelled, and the incentive amount will be returned to the Project. Applicant, Site and Equipment Requirements As a condition for receiving CALeVIP (from State of California and California Energy Commission) incentive funds, the applicant must comply with the requirements below. Eligible applicants must meet requirements that include, but are not limited to, the following: • Submit a Project application prior to purchasing and installing equipment and before funds run out. Design, engineering, and utility service request costs may be incurred after October 10, 2019 but are incurred at applicant's own risk prior to the funds reserved date (e.g. application may be determined ineligible, or funds may be unavailable at time of application). All other eligible costs must be incurred after funds are reserved to be eligible. • Be an authorized representative of a qualified commercial or public facility installation site. An authorized representative is defined as a site owner or an individual that has received permission from the site owner to apply on behalf of a qualified site. • Be a business or government entity that is based in California or has a California-based affiliate or be a California Native American Tribe listed with the Native American Heritage Commission at the time of application. a. California business entities and non -California business entities that conduct intrastate business in California and are required to register with the California Secretary of State must do so and be in good standing in order to receive an incentive. If not currently registered with the California Secretary of State, applicants should contact the Secretary of State's Office as soon as possible. For more information, visit the Secretary of State's website at: www.sos.ca.gov. b. Sole proprietorships and DBA's (Doing Business As; also, called fictitious business name, assumed business name, or trade name) cannot apply as a business and must instead apply as a sole proprietorship. • Have the new charger(s) installed by a qualified and licensed contractor in accordance with all local, state, and federal codes, permitting, and inspection requirements. • Obtain any required permits and comply with all applicable federal, state, and municipal laws, rules, codes, and regulations for work performed for the incentive. • Grant Center for Sustainable Energy and Energy Commission direct access to EV charger utilization data (for up to 2 years (L2) or 5 years (DCFC) depending on charger type) through applicant's selected network provider, through acceptance of these requirements. • Ensure the charger(s) shall remain in service at the project site address for a minimum of sixty (60) months. • Submit information to the Alternative Fuels Data Center station locator tool for all charging stations incentivized through the Project. CALIFORNIA ENERGY COMMISSION = Center for Sustainable Energy - CSE-CALeVIP-102019 San Joaquin Valley Incentive Project Application Form �Uwlp BUILDING EV INFRASTRUCTURE • Submit two (2) years (for Level 2) or five (5) years (for DCFC) of utilization data, in increments not exceeding 1 -year, to CSE. • Apply CALeVIP labeling to all incentivized chargers. • Be available for follow-up inspection if requested by CSE or Energy Commission. • Energy Commission reserves the right to request voluntary participation from incentive recipients in ongoing research efforts that support CALeVIP Project goals. Eligible project sites must: • Be located at a physical site address in Fresno, Kern, and San Joaquin counties. • Be well -lit, secure and in compliance with all federal, state and municipal laws, ordinances, rules, codes, standards and regulations. • For L2 Projects containing 1-10 connectors, be one of the following site types: a. Commercial — any non-residential property used solely for business purposes including private office buildings, warehouses, and retail buildings. b. Workplace — A workplace is a non-residential site location, where business is conducted or where services or industrial operations are performed. Residential properties are ineligible as a workplace regardless of their use as a place of business. c. Multi -unit dwelling — Classification of housing where multiple separate housing units for residential inhabitants are contained within one building or several buildings within one complex. MUDs must contain at least three (3) units for this program. Chargers may be public or private and must be shared use (accessible to more than one resident of the MUD complex). d. Light-duty Fleet — Groups of motor vehicles owned or leased by a business, government agency or other organization rather than by an individual or family. Chargers may be public or private and must be shared use. e. Public facility — can be any facility, including, but not limited to, buildings, property, recreation areas, and roads, which are owned, leased, or otherwise operated, or funded by a governmental body or public entity. f. Curbside — On -street in public right-of-way along the street frontage of any of the above listed uses. • For DCFC Projects, be one of the following site types: a. Urban/suburban retail core — a retail store within a business district in which merchandise is sold primarily to consumers. Standalone retail stores are ineligible. b. Retail shopping center — a group of retail and other commercial establishments that is planned, developed, owned and managed as a single property. Standalone retail stores do not qualify as a retail shopping center. c. Grocery store — a store that sells food and household supplies. d. Restaurant — a business where people pay to sit and eat meals that are cooked and served on the premises. CALIFORNIA ENERGY COMMISSION 106 Center for . Sustainable Energy- CSE-CALeVIP-102019 nergy- CSE-CALeVIP-102019 San Joaquin Valley Incentive Project Application Form 2ca� /IP BUILDING EV INFRASTRUCTURE e. Gas station — any new or existing facility that, as its primary use, serves as a motor vehicle fueling service station retailing petroleum-based automotive fuels (e.g. gasoline, diesel, E10/E15) to the general public and has additional complementary customer store(s) or services(s) located onsite. f. Hospital — a facility providing medical, psychiatric or surgical services for sick or injured persons primarily on an in-patient basis, including ancillary facilities for outpatient and emergency treatment, diagnostic services and training. g. Sheriff/police station — Includes storefront police or sheriff substations that serve surrounding communities and adjacent areas. h. Airport — parking facilities at airports that serve the public are eligible. Long-term parking uses are ineligible. i. Hotels - an establishment providing accommodations, meals, and other services for travelers and tourists. j. City/County/Privately owned parking lot or garage - an area or structure where the primary use is to leave cars temporarily. City/County office buildings are ineligible. k. Library — a building or room containing collections of books, periodicals, and sometimes films and recorded music for people to read, borrow, or refer to. 1. Casino — a building where gambling games of chance against the house/casino are played. Standalone poker rooms or card halls are ineligible. in. Public transit hub - a place where passengers and cargo are exchanged between vehicles and/or between transport modes. Public transport hubs include train stations, rapid transit stations, bus stations, and tram stops. n. Curbside — On -street in public right-of-way along the street frontage of any of the above listed uses. • DCFC Projects must also be publicly accessible and available 24 hours per day, year-round. DCFCs cannot be located behind a fence or in a gated parking lot closed to the public after-hours. All L2 charger(s) must: • Be new equipment installed for the first time. Resale units, rebuilt, rented, received from warranty insurance claims, or new parts installed in existing units are not eligible. • Meet the international standard connector for Level 2 EV chargers. This connector is known as the SAE J1772 connector. • Be networked, which is defined as a charger connected to a backend network operations center, enabling remote diagnostics, remote start and usage data collection at a minimum. • Be capable of delivering electricity to a plug-in electric vehicle at a minimum rate of 6.2 kilowatts. • Use an open standard protocol as a basic framework for purposes of network interoperability. Any proprietary protocol may be superimposed on the system, provided the owner is able to revert to the open standard protocol. • Accept some form of credit card payment, if payment is required. • Accept more than one form of payment, if payment is required. Hw aP _. 0, 11.g CALIFORNIA ENERGY COMMISSION _ Center for Sustainable Energy- CSE-CALeVIP-102019 San Joaquin Valley Incentive Project Application Form �2wip BUILDING EV INFRASTRUCTURE ' Be approved by a Nationally Recognized Testing Laboratory (NRTL) program for EVSE testing and certification. • Be ENERGY STAR® Certified, listed on the ENERGY STAR® product finder page (httpsLLww.enerUstar,gov/Mod�iGttinder/). All DC fast charger(s) must: • Be new equipment installed for the first time. Resale units, rebuilt, rented, received from warranty insurance claims, or new parts installed in existing units are not eligible. • Be a dual standard, CHAdeMO and Combined Charging System (CCS) DC fast charger. • Be networked, which is defined as a charger connected to a backend network operations center, enabling remote diagnostics, remote start and usage data collection, at a minimum. • Be capable of delivering electricity to a plug-in electric vehicle at a minimum rate of 50 kilowatts. • Use an open standard protocol as a basic framework for purposes of network interoperability. Any proprietary protocol may be superimposed on the system, provided the owner is able to revert to the open standard protocol. ' Accept some form of credit card payment, if payment is required. • Accept more than one form of payment, if payment is required. • Be approved by a Nationally Recognized Testing Laboratory (NRTL) program for EVSE testing and certification. Detailed information about these requirements and the processes associated with them can be found in the Project Implementation Manual. Applicants that have questions about Project Requirements should contact CSE at san-jQaquin-valtey-calevii2a=rgycenter.org. Declarations Please review each statement below. By clicking Accept and Continue you are indicating that you agree with the following statements and that information provided in your application is accurate and truthful. 1. I am the owner of the installation site or have the authority to file this application on behalf of the owner. 2. 1 have read and agree to the requirements of the San Joaquin Valley Incentive Project. 3. 1 choose to voluntarily submit personally -identifying information for the purposes of processing my incentive and enforcing the San Joaquin Valley Incentive Project Requirements. 4. 1 have read and agree to the terms of the San Joaquin Valley Incentive Project Privacy Policy. CAf.IF�RNIA ENERGY COMMISSION 100�Center for 1 Sustainable Energy - C S E -CA Le V I P-102019 San Joaquin Valley Incentive Project Application Form IP BUILDING EV INFRASTRUCTURE If any of the information below is incorrect, please contact CALeVIP staff at - r . Project application number : F-00600 -T101111W Applicant name : Astrida Trupovnieks Applicant email : atrupovnieks@lodi.gov Organization name : City of Lodi Applicant type : Public Entity Installation street address : 1145 S Ham Lane City : Lodi State : CA Zip : 95242 FCounty : San Joaquin County Mailing address: 221 West Pine Street, Lodi, CA 95241, Lodi, CA, 95241 Site use: Public Transit Hub Please review all charger equipment on the last page. By signing this form, the applicant agrees to the following: 1. 1 understand that the Energy Commission reserves all rights and remedies available under the law to enforce the San Joaquin Valley Incentive Project Requirements. 2. 1 acknowledge that I have read, understand, and agree to be bound by the San Joaquin Valley Incentive Project Requirements as outlined within this Rebate Application Form. I certify, under the penalty of perjury, that the information provided herein and all supporting documentation is true, accurate, and complete. Name of applicant or authorized representative: Astrida Trupovnieks Signature: F4 CALIFORNIA ENERGY COMMISSION Center for Sustainable Energy - Total reserved rebate amount: $7,000.00 Date: 04/03/21 CSE-CALeVIP-102019 San Joaquin Valley Incentive Project Application Form i1P BUILDING EV INFRASTRUCTURE n,p ruovkv-o ev me ��.� CALIFORNIA ,ti ENERGY COMMISSION Center for Sustainable Energy- C S E -CA LeV I P-102019 San Joaquin Valley Incentive Project Application Form �aILP BUILDING EV INFRASTRUCTURE San Joaquin Valley Incentive Project Requirements At the time an applicant submits an online incentive application the most current San Joaquin Valley Incentive Project (Project) Implempitation MatlLial available, as well as the incentive requirements agreed to by the applicant, will apply. Applications are processed on a first-come, first-served basis for both Level 2 (L2) and DC fast charging (DCFC) projects. First-come basis for an owner -submitted application is determined on the date of application submittal. For applicants submitting on behalf of a property owner, first-come basis is determined by the submittal date of the Site Verification Form (SVF) following application submittal. If the SVF is not submitted within five (5) calendar days of initial application, the application will be canceled. Qualified applicants featuring L2 projects will receive a single payment up to 270 days from the Funds Reserved date. Qualified applicants featuring DCFC or combined projects (projects featuring a combination of DCFC and L2 chargers within the same application) can receive up to two payments — a milestone payment can be requested up to 240 calendar days (8 months) and a final payment up to 450 days from the Funds Reserved date. Delays beyond normal processing times may occur. The maximum amount of active application incentives an applicant may reserve at any time is limited to $360,000 for applications on sites in Fresno, Kern, and San Joaquin counties. To apply for an incentive an Applicant must: 1. Submit an online application. 2. Complete an Installation Form online within 270 days from the Funds Reserved date for Level 2 only applications and within 450 days for DCFC or combined applications. 3. Submit supporting documentation within 270 days from the Funds Reserved date for Level 2 only applications and within 450 days for DCFC or combined applications. The supporting documentation must be scanned and submitted through the CALeVIP website. Required supporting documentation will include, at a minimum, the following: a. For applicants who request applications by phone, a complete application with signature and date. For online applicants, a scanned copy of the submitted application signed by the site owner or authorized representative. b. For applicants who are not site owners, a completed Site Verification Form providing confirmation that the site owner authorizes the applicant to install the equipment at the site. c. Copy of paid equipment receipt/invoice. CALIFORNIA ENERGY y COMMISSION - Center for ;� .Sustainable Energy - CSE-CALeVIP-102019 San Joaquin Valley Incentive Project Application Form GAL ';Wlev/p BUILDING EV INFRASTRUCTURE i. Receipt/Invoice must include, at a minimum, purchase date, retailer name, business address, phone number, equipment make and model number(s), equipment serial number(s), and payment terms (paid in full — cash, check, credit card, etc.). d. Copy of installation receipt/invoice(s). i. Receipt/Invoice must include contractor name, contractor license number, business address, phone number, itemized costs, and payment terms (paid in full — cash, check, credit card, etc.). e. Copy of network service agreement (for a minimum of two years for Level 2 chargers or five years for DC fast chargers). f. Copy of building or other local agency permit(s) approving installation. g. Copy of design/engineering invoice(s). i. Invoice must include contractor/engineer name, contractor/engineer license number, business address, phone number, itemized costs, and payment terms (paid in full — cash, check, credit card, etc.). h. Copy of final inspection card, permit or other local agency document showing installation has been completed. i. Photograph(s) of installed and operational charger(s) at the site address provided in the application. Photographs must clearly show required San Joaquin Valley Incentive Project labeling. j. Photograph(s) of all installed charger serial number(s). k. (If installation required utility service) Copy of utility service order(s) needed for the installation. If new service is not required, a copy of the utility bill is needed for existing accounts, along with meter number EV chargers are to be tied into. 1. (If installation required utility service) Copy of utility receipt/invoice(s). i. Receipt/Invoice must include utility name, address, phone number, itemized costs, and payment terms (paid in full — cash, check, credit card, etc.). Center for Sustainable Energy (CSE) may request additional documentation to verify that the applicant meets required eligibility criteria. If the installation is a DCFC or combined installation, applicants may request a milestone payment to be calculated based on project costs submitted to that point if all the following conditions are met: • The application is in Funds Reserved status. • At least a copy of the building permit, design/engineering receipt/invoice, and signed application form have been submitted. • Less than 240 calendar days (8 months) have passed since funds reserved date. Important: If an applicant fails to submit the required supporting documentation within 270/450 days (L2/DCFC and combined projects) of the incentive funds reserved date, the application may be terminated, and the reserved incentive funds released back to the Project. CSE has the discretion to complete additional review beyond the allotted time on a case by case basis. ryrnpw Pr�'�`+n qy iri CALIFORNIA ENERGY COMMISSION Center for Sustainable Energy - C S E -CA Le V I P-102019 San Joaquin Valley Incentive Project Application Form �awlp BUILDING EV INFRASTRUCTURE Incentive checks must be cashed within six (6) months of the date on the check. Checks not cashed within this timeframe will be cancelled, and the incentive amount will be returned to the Project. Applicant, Site and Equipment Requirements As a condition for receiving CALeVIP (from State of California and California Energy Commission) incentive funds, the applicant must comply with the requirements below. Eligible applicants must meet requirements that include, but are not limited to, the following: • Submit a Project application prior to purchasing and installing equipment and before funds run out. Design, engineering, and utility service request costs may be incurred after October 10, 2019 but are incurred at applicant's own risk prior to the funds reserved date (e.g. application may be determined ineligible, or funds may be unavailable at time of application). All other eligible costs must be incurred after funds are reserved to be eligible. • Be an authorized representative of a qualified commercial or public facility installation site. An authorized representative is defined as a site owner or an individual that has received permission from the site owner to apply on behalf of a qualified site. • Be a business or government entity that is based in California or has a California-based affiliate or be a California Native American Tribe listed with the Native American Heritage Commission at the time of application. a. California business entities and non -California business entities that conduct intrastate business in California and are required to register with the California Secretary of State must do so and be in good standing in order to receive an incentive. If not currently registered with the California Secretary of State, applicants should contact the Secretary of State's Office as soon as possible. For more information, visit the Secretary of State's website at: www.sos.ca.gov. b. Sole proprietorships and DBA's (Doing Business As; also, called fictitious business name, assumed business name, or trade name) cannot apply as a business and must instead apply as a sole proprietorship. • Have the new charger(s) installed by a qualified and licensed contractor in accordance with all local, state, and federal codes, permitting, and inspection requirements. • Obtain any required permits and comply with all applicable federal, state, and municipal laws, rules, codes, and regulations for work performed for the incentive. • Grant Center for Sustainable Energy and Energy Commission direct access to EV charger utilization data (for up to 2 years (L2) or 5 years (DCFC) depending on charger type) through applicant's selected network provider, through acceptance of these requirements. • Ensure the charger(s) shall remain in service at the project site address for a minimum of sixty (60) months. • Submit information to the Alternative Fuels Data Center station locator tool for all charging stations incentivized through the Project. CALIFORNIA ENERGY COMMISSION Center for Sustainable Energy - C S E -CA Le V I P-102019 San Joaquin Valley Incentive Project Application Form �2 II -P BUILDING EV INFRASTRUCTURE • Submit two (2) years (for Level 2) or five (5) years (for DCFC) of utilization data, in increments not exceeding 1 -year, to CSE. • Apply CALeVIP labeling to all incentivized chargers. • Be available for follow-up inspection if requested by CSE or Energy Commission. • Energy Commission reserves the right to request voluntary participation from incentive recipients in ongoing research efforts that support CALeVIP Project goals. Eligible project sites must: • Be located at a physical site address in Fresno, Kern, and San Joaquin counties. • Be well -lit, secure and in compliance with all federal, state and municipal laws, ordinances, rules, codes, standards and regulations. • For L2 Projects containing 1-10 connectors, be one of the following site types: a. Commercial — any non-residential property used solely for business purposes including private office buildings, warehouses, and retail buildings. b. Workplace — A workplace is a non-residential site location, where business is conducted or where services or industrial operations are performed. Residential properties are ineligible as a workplace regardless of their use as a place of business. c. Multi -unit dwelling — Classification of housing where multiple separate housing units for residential inhabitants are contained within one building or several buildings within one complex. MUDS must contain at least three (3) units for this program. Chargers may be public or private and must be shared use (accessible to more than one resident of the MUD complex). d. Light-duty Fleet — Groups of motor vehicles owned or leased by a business, government agency or other organization rather than by an individual or family. Chargers may be public or private and must be shared use. e. Public facility — can be any facility, including, but not limited to, buildings, property, recreation areas, and roads, which are owned, leased, or otherwise operated, or funded by a governmental body or public entity. f. Curbside — On -street in public right-of-way along the street frontage of any of the above listed uses. • For DCFC Projects, be one of the following site types: a. Urban/suburban retail core — a retail store within a business district in which merchandise is sold primarily to consumers. Standalone retail stores are ineligible. b. Retail shopping center — a group of retail and other commercial establishments that is planned, developed, owned and managed as a single property. Standalone retail stores do not qualify as a retail shopping center. c. Grocery store — a store that sells food and household supplies. d. Restaurant — a business where people pay to sit and eat meals that are cooked and served on the premises. ,CALIFORNIA�, ENERGY COMMISSION Center for Sustainable Energy - CS E -CA Le V I P-102019 San Joaquin Valley Incentive Project Application Form �2w/p BUILDING EV INFRASTRUCTURE e. Gas station — any new or existing facility that, as its primary use, serves as a motor vehicle fueling service station retailing petroleum-based automotive fuels (e.g. gasoline, diesel, E10/E15) to the general public and has additional complementary customer store(s) or services(s) located onsite. f. Hospital — a facility providing medical, psychiatric or surgical services for sick or injured persons primarily on an in-patient basis, including ancillary facilities for outpatient and emergency treatment, diagnostic services and training. g. Sheriff/police station — Includes storefront police or sheriff substations that serve surrounding communities and adjacent areas. h. Airport — parking facilities at airports that serve the public are eligible. Long-term parking uses are ineligible. i. Hotels - an establishment providing accommodations, meals, and other services for travelers and tourists. j. City/County/Privately owned parking lot or garage - an area or structure where the primary use is to leave cars temporarily. City/County office buildings are ineligible. k. Library — a building or room containing collections of books, periodicals, and sometimes films and recorded music for people to read, borrow, or refer to. 1. Casino — a building where gambling games of chance against the house/casino are played. Standalone poker rooms or card halls are ineligible. m. Public transit hub - a place where passengers and cargo are exchanged between vehicles and/or between transport modes. Public transport hubs include train stations, rapid transit stations, bus stations, and tram stops. n. Curbside — On -street in public right-of-way along the street frontage of any of the above listed uses. • DCFC Projects must also be publicly accessible and available 24 hours per day, year-round. DCFCs cannot be located behind a fence or in a gated parking lot closed to the public after-hours. All L2 charger(s) must: • Be new equipment installed for the first time. Resale units, rebuilt, rented, received from warranty insurance claims, or new parts installed in existing units are not eligible. • Meet the international standard connector for Level 2 EV chargers. This connector is known as the SAE J1772 connector. • Be networked, which is defined as a charger connected to a backend network operations center, enabling remote diagnostics, remote start and usage data collection at a minimum. • Be capable of delivering electricity to a plug-in electric vehicle at a minimum rate of 6.2 kilowatts. • Use an open standard protocol as a basic framework for purposes of network interoperability. Any proprietary protocol may be superimposed on the system, provided the owner is able to revert to the open standard protocol. • Accept some form of credit card payment, if payment is required. • Accept more than one form of payment, if payment is required. a wa w.aimin n+xn CALIFORNIA ENERGY COMMISSION Center for Sustainable Energy- CSE-CALeVIP-102019 San Joaquin Valley Incentive Project Application Form LIP BUILDING EV INFRASTRUCTURE • Be approved by a Nationally Recognized Testing Laboratory (NRTL) program for EVSE testing and certification. • Be ENERGY STAR® Certified, listed on the ENERGY STAR® product finder page (https://www.etiergysta:-.gov/productfitider/). All DC fast charger(s) must: • Be new equipment installed for the first time. Resale units, rebuilt, rented, received from warranty insurance claims, or new parts installed in existing units are not eligible. • Be a dual standard, CHAdeMO and Combined Charging System (CCS) DC fast charger. • Be networked, which is defined as a charger connected to a backend network operations center, enabling remote diagnostics, remote start and usage data collection, at a minimum. • Be capable of delivering electricity to a plug-in electric vehicle at a minimum rate of 50 kilowatts. • Use an open standard protocol as a basic framework for purposes of network interoperability. Any proprietary protocol may be superimposed on the system, provided the owner is able to revert to the open standard protocol. • Accept some form of credit card payment, if payment is required. • Accept more than one form of payment, if payment is required. • Be approved by a Nationally Recognized Testing Laboratory (NRTL) program for EVSE testing and certification. Detailed information about these requirements and the processes associated with them can be found in the Project Implementation Manual. Applicants that have questions about Project Requirements should contact CSE at sail-ioaquin-valley-caleyi c�energycesiter.org. Declarations Please review each statement below. By clicking Accept and Continue you are indicating that you agree with the following statements and that information provided in your application is accurate and truthful. 1. I am the owner of the installation site or have the authority to file this application on behalf of the owner. 2. I have read and agree to the requirements of the San Joaquin Valley Incentive Project. 3. I choose to voluntarily submit personally -identifying information for the purposes of processing my incentive and enforcing the San Joaquin Valley Incentive Project Requirements. 4. I have read and agree to the terms of the San Joaquin Valley IncentiveProject Privacy Policy. , rueur Twc CALIFORNIA,���'� ENERGY COMMISSION Center for Sustainable Energy - C SE -CA Le V I P-102019 San Joaquin Valley Incentive Project Application Form If any of the information below is incorrect, please contact CALeVIP staff at - Project application number : F-00607 �2ILP BUILDING EV INFRASTRUCTURE Applicant name : Astrida Trupovnieks Applicant email : atrupovnieks@lodi.gov Organization name : City of Lodi Applicant type : Public Entity Installation street address : 125 S Hutchins St City : Lodi I State : CA Zip :95240 County : San Joaquin County Mailing address: City Hall; 221 W Pine Street, Lodi, CA, 95241 Site use: City, County or Privately Owned Parking Lot or Garage Please review all charger equipment on the last page. By signing this form, the applicant agrees to the following: 1. 1 understand that the Energy Commission reserves all rights and remedies available under the law to enforce the San Joaquin Valley Incentive Project Requirements. 2. 1 acknowledge that I have read, understand, and agree to be bound by the San Joaquin Valley Incentive Project Requirements as outlined within this Rebate Application Form. I certify, under the penalty of perjury, that the information provided herein and all supporting documentation is true, accurate, and complete. Name of applicant or authorized representative: Total reserved rebate amount: Astrida Trupovnieks $21,000.00 Signature: 6,4 /2�� Date: 04/03/21 CALIFORNIA ENERGY COMMISSION Center for Sustainable Energy - C SE -CA Le V I P-102019 San Joaquin Valley Incentive Project Application Form •- A• Replacement/make-ready lex P I.., CALIFORNIA ENERGY COMMISSION CAL ,;de.v1P BUILDING EV INFRASTRUCTURE Center for Sustainable Energy - C SE -CA Le V I P-102019 San Joaquin Valley Incentive Project Application Form W rAI �I►P BUILDING EV INFRASTRUCTURE San Joaquin Valley Incentive Project Requirements At the time an applicant submits an online incentive application the most current San Joaquin Valley Incentive Project (Project) Implementation Manual available, as well as the incentive requirements agreed to by the applicant, will apply. Applications are processed on a first-come, first-served basis for both Level 2 (L2) and DC fast charging (DCFC) projects. First-come basis for an owner -submitted application is determined on the date of application submittal. For applicants submitting on behalf of a property owner, first-come basis is determined by the submittal date of the Site Verification Form (SVF) following application submittal. If the SVF is not submitted within five (5) calendar days of initial application, the application will be canceled. Qualified applicants featuring L2 projects will receive a single payment up to 270 days from the Funds Reserved date. Qualified applicants featuring DCFC or combined projects (projects featuring a combination of DCFC and L2 chargers within the same application) can receive up to two payments — a milestone payment can be requested up to 240 calendar days (8 months) and a final payment up to 450 days from the Funds Reserved date. Delays beyond normal processing times may occur. The maximum amount of active application incentives an applicant may reserve at any time is limited to $360,000 for applications on sites in Fresno, Kern, and San Joaquin counties. To apply for an incentive an Applicant must: 1. Submit an online application. 2. Complete an Installation Form online within 270 days from the Funds Reserved date for Level 2 only applications and within 450 days for DCFC or combined applications. 3. Submit supporting documentation within 270 days from the Funds Reserved date for Level 2 only applications and within 450 days for DCFC or combined applications. The supporting documentation must be scanned and submitted through the CALeVIP website. Required supporting documentation will include, at a minimum, the following: a. For applicants who request applications by phone, a complete application with signature and date. For online applicants, a scanned copy of the submitted application signed by the site owner or authorized representative. b. For applicants who are not site owners, a completed Site Verification Form providing confirmation that the site owner authorizes the applicant to install the equipment at the site. c. Copy of paid equipment receipt/invoice. .nw.r�wm¢nerne - CALIFORNIA ENERGY COMMISSION Center for . Sustainable Energy - CSE -CA Le V I P-102019 San Joaquin Valley Incentive Project Application Form r CA e�1�IP BUILDING EV INFRASTRUCTURE i. Receipt/Invoice must include, at a minimum, purchase date, retailer name, business address, phone number, equipment make and model number(s), equipment serial number(s), and payment terms (paid in full — cash, check, credit card, etc.). d. Copy of installation receipt/invoice(s). i. Receipt/Invoice must include contractor name, contractor license number, business address, phone number, itemized costs, and payment terms (paid in full — cash, check, credit card, etc.). e. Copy of network service agreement (for a minimum of two years for Level 2 chargers or five years for DC fast chargers). f. Copy of building or other local agency permit(s) approving installation. g. Copy of design/engineering invoice(s). i. Invoice must include contractor/engineer name, contractor/engineer license number, business address, phone number, itemized costs, and payment terms (paid in full — cash, check, credit card, etc.). h. Copy of final inspection card, permit or other local agency document showing installation has been completed. i. Photograph(s) of installed and operational charger(s) at the site address provided in the application. Photographs must clearly show required San Joaquin Valley Incentive Project labeling. j. Photograph(s) of all installed charger serial number(s). k. (If installation required utility service) Copy of utility service order(s) needed for the installation. If new service is not required, a copy of the utility bill is needed for existing accounts, along with meter number EV chargers are to be tied into. 1. (If installation required utility service) Copy of utility receipt/invoice(s). i. Receipt/Invoice must include utility name, address, phone number, itemized costs, and payment terms (paid in full — cash, check, credit card, etc.). Center for Sustainable Energy (CSE) may request additional documentation to verify that the applicant meets required eligibility criteria. If the installation is a DCFC or combined installation, applicants may request a milestone payment to be calculated based on project costs submitted to that point if all the following conditions are met: • The application is in Funds Reserved status. • At least a copy of the building permit, design/engineering receipt/invoice, and signed application form have been submitted. • Less than 240 calendar days (8 months) have passed since funds reserved date. Important: If an applicant fails to submit the required supporting documentation within 270/450 days (L2/DCFC and combined projects) of the incentive funds reserved date, the application may be terminated, and the reserved incentive funds released back to the Project. CSE has the discretion to complete additional review beyond the allotted time on a case by case basis. CALIFORNIA ENERGY .� COMMISSION Center for Sustainable Energy- CSE-CALeVIP-102019 San Joaquin Valley Incentive Project Application Form � 2e.VIP BUILDING EV INFRASTRUCTURE Incentive checks must be cashed within six (6) months of the date on the check. Checks not cashed within this timeframe will be cancelled, and the incentive amount will be returned to the Project. Applicant, Site and Equipment Requirements As a condition for receiving CALeVIP (from State of California and California Energy Commission) incentive funds, the applicant must comply with the requirements below. Eligible applicants must meet requirements that include, but are not limited to, the following: • Submit a Project application prior to purchasing and installing equipment and before funds run out. Design, engineering, and utility service request costs may be incurred after October 10, 2019 but are incurred at applicant's own risk prior to the funds reserved date (e.g. application may be determined ineligible, or funds may be unavailable at time of application). All other eligible costs must be incurred after funds are reserved to be eligible. • Be an authorized representative of a qualified commercial or public facility installation site. An authorized representative is defined as a site owner or an individual that has received permission from the site owner to apply on behalf of a qualified site. • Be a business or government entity that is based in California or has a California-based affiliate or be a California Native American Tribe listed with the Native American Heritage Commission at the time of application. a. California business entities and non -California business entities that conduct intrastate business in California and are required to register with the California Secretary of State must do so and be in good standing in order to receive an incentive. If not currently registered with the California Secretary of State, applicants should contact the Secretary of State's Office as soon as possible. For more information, visit the Secretary of State's website at: www.sos.ca.gov. b. Sole proprietorships and DBA's (Doing Business As; also, called fictitious business name, assumed business name, or trade name) cannot apply as a business and must instead apply as a sole proprietorship. • Have the new charger(s) installed by a qualified and licensed contractor in accordance with all local, state, and federal codes, permitting, and inspection requirements. • Obtain any required permits and comply with all applicable federal, state, and municipal laws, rules, codes, and regulations for work performed for the incentive. • Grant Center for Sustainable Energy and Energy Commission direct access to EV charger utilization data (for up to 2 years (L2) or 5 years (DCFC) depending on charger type) through applicant's selected network provider, through acceptance of these requirements. • Ensure the charger(s) shall remain in service at the project site address for a minimum of sixty (60) months. • Submit information to the Alternative Fuels Data Center station locator tool for all charging stations incentivized through the Project. R• T„e CALIFORNIA ENERGY COMMISSION _ 1404 Center for Sustainable Energy - C S E -CA Le V I P-102019 San Joaquin Valley Incentive Project Application Form �gwlp BUILDING EV INFRASTRUCTURE • Submit two (2) years (for Level 2) or five (5) years (for DCFC) of utilization data, in increments not exceeding 1 -year, to CSE. • Apply CALeVIP labeling to all incentivized chargers. • Be available for follow-up inspection if requested by CSE or Energy Commission. • Energy Commission reserves the right to request voluntary participation from incentive recipients in ongoing research efforts that support CALeVIP Project goals. Eligible project sites must: • Be located at a physical site address in Fresno, Kern, and San Joaquin counties. • Be well -lit, secure and in compliance with all federal, state and municipal laws, ordinances, rules, codes, standards and regulations. • For L2 Projects containing 1-10 connectors, be one of the following site types: a. Commercial — any non-residential property used solely for business purposes including private office buildings, warehouses, and retail buildings. b. Workplace — A workplace is a non-residential site location, where business is conducted or where services or industrial operations are performed. Residential properties are ineligible as a workplace regardless of their use as a place of business. c. Multi -unit dwelling — Classification of housing where multiple separate housing units for residential inhabitants are contained within one building or several buildings within one complex. MUDs must contain at least three (3) units for this program. Chargers may be public or private and must be shared use (accessible to more than one resident of the MUD complex). d. Light-duty Fleet — Groups of motor vehicles owned or leased by a business-, government agency or other organization rather than by an individual or family. Chargers may be public or private and must be shared use. e. Public facility — can be any facility, including, but not limited to, buildings, property, recreation areas, and roads, which are owned, leased, or otherwise operated, or funded by a governmental body or public entity. f. Curbside — On -street in public right-of-way along the street frontage of any of the above listed uses. • For DCFC Projects, be one of the following site types: a. Urban/suburban retail core — a retail store within a business district in which merchandise is sold primarily to consumers. Standalone retail stores are ineligible. b. Retail shopping center — a group of retail and other commercial establishments that is planned, developed, owned and managed as a single property. Standalone retail stores do not qualify as a retail shopping center. c. Grocery store — a store that sells food and household supplies. d. Restaurant — a business where people pay to sit and eat meals that are cooked and served on the premises. CALIFORNIA/ _ ENERGY;' • COMMISSION Energy- CSE-CALeVIP-102019 San Joaquin Valley Incentive Project Application Form �gwlp BUILDING EV INFRASTRUCTURE e. Gas station — any new or existing facility that, as its primary use, serves as a motor vehicle fueling service station retailing petroleum-based automotive fuels (e.g. gasoline, diesel, E10/E15) to the general public and has additional complementary customer store(s) or services(s) located onsite. f. Hospital — a facility providing medical, psychiatric or surgical services for sick or injured persons primarily on an in-patient basis, including ancillary facilities for outpatient and emergency treatment, diagnostic services and training. g. Sheriff/police station — Includes storefront police or sheriff substations that serve surrounding communities and adjacent areas. h. Airport — parking facilities at airports that serve the public are eligible. Long-term parking uses are ineligible. i. Hotels - an establishment providing accommodations, meals, and other services for travelers and tourists. j. City/County/Privately owned parking lot or garage - an area or structure where the primary use is to leave cars temporarily. City/County office buildings are ineligible. k. Library — a building or room containing collections of books, periodicals, and sometimes Elms and recorded music for people to read, borrow, or refer to. 1. Casino — a building where gambling games of chance against the house/casino are played. Standalone poker rooms or card halls are ineligible. m. Public transit hub - a place where passengers and cargo are exchanged between vehicles and/or between transport modes. Public transport hubs include train stations, rapid transit stations, bus stations, and tram stops. n. Curbside — On -street in public right-of-way along the street frontage of any of the above listed uses. • DCFC Projects must also be publicly accessible and available 24 hours per day, year-round. DCFCs cannot be located behind a fence or in a gated parking lot closed to the public after-hours. All L2 charger(s) must: 11 Be new equipment installed for the first time. Resale units, rebuilt, rented, received from warranty insurance claims, or new parts installed in existing units are not eligible. • Meet the international standard connector for Level 2 EV chargers. This connector is known as the SAE J1772 connector. • Be networked, which is defined as a charger connected to a backend network operations center, enabling remote diagnostics, remote start and usage data collection at a minimum. • Be capable of delivering electricity to a plug-in electric vehicle at a minimum rate of 6.2 kilowatts. • Use an open standard protocol as a basic framework for purposes of network interoperability. Any proprietary protocol may be superimposed on the system, provided the owner is able to revert to the open standard protocol. • Accept some form of credit card payment, if payment is required. • Accept more than one form of payment, if payment is required. w•frNen nr..n� �- ` CALIFORNIA s: ENERGY i• fj 1.+ COMMISSION Center for Sustainable Energy - C SE -CA Le V I P-102019 San Joaquin Valley Incentive Project Application Form �gwlp BUILDING EV INFRASTRUCTURE • Be approved by a Nationally Recognized Testing Laboratory (NRTL) program for EVSE testing and certification. • Be ENERGY STAR® Certified, listed on the ENERGY STAR® product finder page (Litips://www.energystar.gov/12rodiietfinder/). All DC fast charger(s) must: • Be new equipment installed for the first time. Resale units, rebuilt, rented, received from warranty insurance claims, or new parts installed in existing units are not eligible. • Be a dual standard, CHAdeMO and Combined Charging System (CCS) DC fast charger. • Be networked, which is defined as a charger connected to a backend network operations center, enabling remote diagnostics, remote start and usage data collection, at a minimum. • Be capable of delivering electricity to a plug-in electric vehicle at a minimum rate of 50 kilowatts. • Use an open standard protocol as a basic framework for purposes of network interoperability. Any proprietary protocol may be superimposed on the system, provided the owner is able to revert to the open standard protocol. • Accept some form of credit card payment, if payment is required. • Accept more than one form of payment, if payment is required. • Be approved by a Nationally Recognized Testing Laboratory (NRTL) program for EVSE testing and certification. Detailed information about these requirements and the processes associated with them can be found in the Project Implementation Manual. Applicants that have questions about Project Requirements should contact CSE at sail-Joaquin-valley-ca.levip(a eiiergycenter.org. Declarations Please review each statement below. By clicking Accept and Continue you are indicating that you agree with the following statements and that information provided in your application is accurate and truthful. 1. I am the owner of the installation site or have the authority to file this application on behalf of the owner. 2. I have read and agree to the requirements of the San Joaquin Valley Incentive Project. 3. 1 choose to voluntarily submit personally -identifying information for the purposes of processing my incentive and enforcing the San Joaquin Valley Incentive Project Requirements. 4. 1 have read and agree to the terms of the Sai�uiii Valley Incentive Project Privacy Policy. yn emx"-A•IMF CALIFORNIA ENERGY COMMISSION A.6Center for '. Sustainable Energy - CSE-CALeVIP-102019 San Joaquin Application Valley Incentive Project Form M, CAlip BUILDING EV INFRASTRUCTURE If any of the information below is incorrect, please contact CALeVIP staff at sari-joaquin-valley-calevip(a)onprgyont-er.orn. Project application number : F-00608 Applicant name : Astrida Trupovnieks Applicant email : atrupovnieks@lodi.gov Organization name : City of Lodi Applicant type : Public Entity Installation street address : 221 W Pine St City : Lodi State : CA Zip: 95240 County : San Joaquin County Mailing address: City Hall; 221 W Pine Street, Lodi, CA, 95241 Site use: City, County or Privately Owned Parking Lot or Garage Please review all charger equipment on the last page. Bysigning this form, the applicant agrees to the following: 1. 1 understand that the Energy Commission reserves all rights and remedies available under the law to enforce the San Joaquin Valley Incentive Project Requirements. 2. 1 acknowledge that I have read, understand, and agree to be bound by the San Joaquin Valley Incentive Project Requirements as outlined within this Rebate Application Form. I certify, under the penalty of perjury, that the information provided herein and all supporting documentation is true, accurate, and complete. Name of applicant or authorized representative: Astrida Trupovnieks Signature. CAL1iFORNIA ENERGY COMMISSION Center for • Sustainable Energy - Total reserved rebate amount: $14,000.00 Date: 04/03/21 C SE -CA Le V I P-102019 San Joaquin Valley Incentive Project Application Form alp BUILDING EV INFRASTRUCTURE CALIFORNIA ENERGY COMMISSION Center for Sustainable Energy - CS E -CA Le V I P-102019 San Joaquin Valley Incentive Project Application Form ,ram car_ IP BUILDING EV INFRASTRUCTURE San Joaquin Valley Incentive Project Requirements At the time an applicant submits an online incentive application the most current San Joaquin Valley Incentive Project (Project) Implementation Manual available, as well as the incentive requirements agreed to by the applicant, will apply. Applications are processed on a first-come, first-served basis for both Level 2 (L2) and DC fast charging (DCFC) projects. First-come basis for an owner -submitted application is determined on the date of application submittal. For applicants submitting on behalf of a property owner, first-come basis is determined by the submittal date of the Site Verification Form (SVF) following application submittal. If the SVF is not submitted within five (5) calendar days of initial application, the application will be canceled. Qualified applicants featuring L2 projects will receive a single payment up to 270 days from the Funds Reserved date. Qualified applicants featuring DCFC or combined projects (projects featuring a combination of DCFC and L2 chargers within the same application) can receive up to two payments — a milestone payment can be requested up to 240 calendar days (8 months) and a final payment up to 450 days from the Funds Reserved date. Delays beyond normal processing times may occur. The maximum amount of active application incentives an applicant may reserve at any time is limited to $360,000 for applications on sites in Fresno, Kern, and San Joaquin counties. To apply for an incentive an Applicant must: 1. Submit an online application. 2. Complete an Installation Form online within 270 days from the Funds Reserved date for Level 2 only applications and within 450 days for DCFC or combined applications. 3. Submit supporting documentation within 270 days from the Funds Reserved date for Level 2 only applications and within 450 days for DCFC or combined applications. The supporting documentation must be scanned and submitted through the CALeVIP website. Required supporting documentation will include, at a minimum, the following: a. For applicants who request applications by phone, a complete application with signature and date. For online applicants, a scanned copy of the submitted application signed by the site owner or authorized representative. b. For applicants who are not site owners, a completed Site Verification Form providing confirmation that the site owner authorizes the applicant to install the equipment at the site. c. Copy of paid equipment receipt/invoice. CALIFORNIA ENERGY f", .. , ! COMMISSION Center for Sustainable Energy CSE-CALeVIP-102019 San Joaquin Valley Incentive Project Application Form �Uw/p BUILDING EV INFRASTRUCTURE i. Receipt/Invoice must include, at a minimum, purchase date, retailer name, business address, phone number, equipment make and model number(s), equipment serial number(s), and payment terms (paid in full — cash, check, credit card, etc.). d. Copy of installation receipt/invoice(s). i. Receipt/Invoice must include contractor name, contractor license number, business address, phone number, itemized costs, and payment terms (paid in full — cash, check, credit card, etc.). e. Copy of network service agreement (for a minimum of two years for Level 2 chargers or five years for DC fast chargers). f. Copy of building or other local agency permit(s) approving installation. g. Copy of design/engineering invoice(s). i. Invoice must include contractor/engineer name, contractor/engineer license number, business address, phone number, itemized costs, and payment terms (paid in full — cash, check, credit card, etc.). h. Copy of final inspection card, permit or other local agency document showing installation has been completed. i. Photograph(s) of installed and operational charger(s) at the site address provided in the application. Photographs must clearly show required San Joaquin Valley Incentive Project labeling. j. Photograph(s) of all installed charger serial number(s). k. (If installation required utility service) Copy of utility service order(s) needed for the installation. If new service is not required, a copy of the utility bill is needed for existing accounts, along with meter number EV chargers are to be tied into. 1. (If installation required utility service) Copy of utility receipt/invoice(s). i. Receipt/Invoice must include utility name, address, phone number, itemized costs, and payment terms (paid in full — cash, check, credit card, etc.). Center for Sustainable Energy (CSE) may request additional documentation to verify that the applicant meets required eligibility criteria. If the installation is a DCFC or combined installation, applicants may request a milestone payment to be calculated based on project costs submitted to that point if all the following conditions are met: • The application is in Funds Reserved status. • At least a copy of the building permit, design/engineering receipt/invoice, and signed application form have been submitted. • Less than 240 calendar days (8 months) have passed since funds reserved date. Important: If an applicant fails to submit the required supporting documentation within 270/450 days (L2/DCFC and combined projects) of the incentive funds reserved date, the application may be terminated, and the reserved incentive funds released back to the Project. CSE has the discretion to complete additional review beyond the allotted time on a case by case basis. V� PPrtwpee eP'i�i� CALIFORNIA�'r ENERGY COMMISSION Center for Sustainable Energy- CSE-CALeVIP-102019 San Joaquin Valley Incentive Project �aL Application Form IP BUILDING EV INFRASTRUCTURE Incentive checks must be cashed within six (6) months of the date on the check. Checks not cashed within this timeframe will be cancelled, and the incentive amount will be returned to the Project. Applicant, Site and Equipment Requirements As a condition for receiving CALeVIP (from State of California and California Energy Commission) incentive funds, the applicant must comply with the requirements below. Eligible applicants must meet requirements that include, but are not limited to, the following: • Submit a Project application prior to purchasing and installing equipment and before funds run out. Design, engineering, and utility service request costs may be incurred after October 10, 2019 but are incurred at applicant's own risk prior to the funds reserved date (e.g. application may be determined ineligible, or funds may be unavailable at time of application). All other eligible costs must be incurred after funds are reserved to be eligible. • Be an authorized representative of a qualified commercial or public facility installation site. An authorized representative is defined as a site owner or an individual that has received permission from the site owner to apply on behalf of a qualified site. • Be a business or government entity that is based in California or has a California-based affiliate or be a California Native American Tribe listed with the Native American Heritage Commission at the time of application. a. California business entities and non -California business entities that conduct intrastate business in California and are required.to register with the California Secretary of State must do so and be in good standing in order to receive an incentive. If not currently registered with the California Secretary of State, applicants should contact the Secretary of State's Office as soon as possible. For more information, visit the Secretary of State's website at: www.sos.ca.gov. b. Sole proprietorships and DBA's (Doing Business As; also, called fictitious business name, assumed business name, or trade name) cannot apply as a business and must instead apply as a sole proprietorship. • Have the new charger(s) installed by a qualified and licensed contractor in accordance with all local, state, and federal codes, permitting, and inspection requirements. • Obtain any required permits and comply with all applicable federal, state, and municipal laws, rules, codes, and regulations for work performed for the incentive. • Grant Center for Sustainable Energy and Energy Commission direct access to EV charger utilization data (for up to 2 years (L2) or 5 years (DCFC) depending on charger type) through applicant's selected network provider, through acceptance of these requirements. • Ensure the charger(s) shall remain in service at the project site address for a minimum of sixty (60) months. • Submit information to the Alternative Fuels Data Center station locator tool for all charging stations incentivized through the Project. nniNr, �iipro or rare - - CALIFORNIA ENERGY` COMMISSION =— '� Center for Sustainable Energy CSE-CALeVIP-102019 San Joaquin Valley Incentive Project Application Form � a LIP BUILDING EV INFRASTRUCTURE • Submit two (2) years (for Level 2) or five (5) years (for DCFC) of utilization data, in increments not exceeding 1 -year, to CSE. * Apply CALeVIP labeling to all incentivized chargers. • Be available for follow-up inspection if requested by CSE or Energy Commission. • Energy Commission reserves the right to request voluntary participation from incentive recipients in ongoing research efforts that support CALeVIP Project goals. Eligible project sites must: • Be located at a physical site address in Fresno, Kern, and San Joaquin counties. • Be well -lit, secure and in compliance with all federal, state and municipal laws, ordinances, rules, codes, standards and regulations. • For L2 Projects containing 1-10 connectors, be one of the following site types: a. Commercial — any non-residential property used solely for business purposes including private office buildings, warehouses, and retail buildings. b. Workplace — A workplace is a non-residential site location, where business is conducted or where services or industrial operations are performed. Residential properties are ineligible as a workplace regardless of their use as a place of business. c. Multi -unit dwelling — Classification of housing where multiple separate housing units for residential inhabitants are contained within one building or several buildings within one complex. MUDs must contain at least three (3) units for this program. Chargers may be public or private and must be shared use (accessible to more than one resident of the MUD complex). d. Light-duty Fleet — Groups of motor vehicles owned or leased by a business, government agency or other organization rather than by an individual or family. Chargers may be public or private and must be shared use. e. Public facility — can be any facility, including, but not limited to, buildings, property, recreation areas, and roads, which are owned, leased, or otherwise operated, or funded by a governmental body or public entity. f. Curbside — On -street in public right-of-way along the street frontage of any of the above listed uses. • For DCFC Projects, be one of the following site types: a. Urban/suburban retail core — a retail store within a business district in which merchandise is sold primarily to consumers. Standalone retail stores are ineligible. b. Retail shopping center — a group of retail and other commercial establishments that is planned, developed, owned and managed as a single property. Standalone retail stores do not qualify as a retail shopping center. c. Grocery store — a store that sells food and household supplies. d. Restaurant — a business where people pay to sit and eat meals that are cooked and served on the premises. CALIFORNIA ENERGY COMMISSION Center for . Sustainable Energy - CSE -CA Le V I P-102019 San Joaquin Valley Incentive Project Application Form 2ca /1-P BUILDING EV INFRASTRUCTURE e. Gas station — any new or existing facility that, as its primary use, serves as a motor vehicle fueling service station retailing petroleum-based automotive fuels (e.g. gasoline, diesel, EIO/E15) to the general public and has additional complementary customer store(s) or services(s) located onsite. f. Hospital — a facility providing medical, psychiatric or surgical services for sick or injured persons primarily on an in-patient basis, including ancillary facilities for outpatient and emergency treatment, diagnostic services and training. g. Sheriff/police station — Includes storefront police or sheriff substations that serve surrounding communities and adjacent areas. h. Airport — parking facilities at airports that serve the public are eligible. Long-term parking uses are ineligible. i. Hotels - an establishment providing accommodations, meals, and other services for travelers and tourists. j. City/County/Privately owned parking lot or garage - an area or structure where the primary use is to leave cars temporarily. City/County office buildings are ineligible. k. Library — a building or room containing collections of books, periodicals, and sometimes films and recorded music for people to read, borrow, or refer to. 1. Casino — a building where gambling games of chance against the house/casino are played. Standalone poker rooms or card halls are ineligible. in. Public transit hub - a place where passengers and cargo are exchanged between vehicles and/or between transport modes. Public transport hubs include train stations, rapid transit stations, bus stations, and tram stops. n. Curbside — On -street in public right-of-way along the street frontage of any of the above listed uses. • DCFC Projects must also be publicly accessible and available 24 hours per day, year-round. DCFCs cannot be located behind a fence or in a gated parking lot closed to the public after-hours. All L2 charger(s) must: • Be new equipment installed for the first time. Resale units, rebuilt, rented, received from warranty insurance claims, or new parts installed in existing units are not eligible. • Meet the international standard connector for Level 2 EV chargers. This connector is known as the SAE J1772 connector. • Be networked, which is defined as a charger connected to a backend network operations center, enabling remote diagnostics, remote start and usage data collection at a minimum. • Be capable of delivering electricity to a plug-in electric vehicle at a minimum rate of 6.2 kilowatts. • Use an open standard protocol as a basic framework for purposes of network interoperability. Any proprietary protocol may be superimposed on the system, provided the owner is able to revert to the open standard protocol. • Accept some form of credit card payment, if payment is required. • Accept more than one form of payment, if payment is required. VNu[wvxiF..1CALIFORNIA ENERGY GCMMISSI4N ;=_ ,6Center for - Sustainable Energy - CS E -CA LeV I P-102019 San Joaquin Valley Incentive Project Application Form mo/lp BUILDING EV INFRASTRUCTURE • Be approved by a Nationally Recognized Testing Laboratory (NRTL) program for EVSE testing and certification. • Be ENERGY STAR® Certified, listed on the ENERGY STAR® product finder page (littps://www.energystai-.gov/pi-odtictfitidej�/). All DC fast charger(s) must: • Be new equipment installed for the first time. Resale units, rebuilt, rented, received from warranty insurance claims, or new parts installed in existing units are not eligible. • Be a dual standard, CHAdeMO and Combined Charging System (CCS) DC fast charger. • Be networked, which is defined as a charger connected to a backend network operations center, enabling remote diagnostics, remote start and usage data collection, at a minimum. • Be capable of delivering electricity to a plug-in electric vehicle at a minimum rate of 50 kilowatts. • Use an open standard protocol as a basic framework for purposes of network interoperability. Any proprietary protocol may be superimposed on the system, provided the owner is able to revert to the open standard protocol. • Accept some form of credit card payment, if payment is required. • Accept more than one form of payment, if payment is required. • Be approved by a Nationally Recognized Testing Laboratory (NRTL) program for EVSE testing and certification. Detailed information about these requirements and the processes associated with them can be found in the Project linplementation Manual. Applicants that have questions about Project Requirements should contact CSE at san--joaqtiiii-valley-caleyip@energycetiter.org. Declarations Please review each statement below. By clicking Accept and Continue you are indicating that you agree with the following statements and that information provided in your application is accurate and truthful. 1. I am the owner of the installation site or have the authority to file this application on behalf of the owner. 2. I have read and agree to the requirements of the San Joaquin Valley Incentive Project. 3. I choose to voluntarily submit personally -identifying information for the purposes of processing my incentive and enforcing the San Joaquin Valley Incentive Project Requirements. 4. I have read and agree to the terms of the San Joaquin Valley Incei.)tive Pt'oject Privacy Policy. ., K,.. � CALIFORNIA ENERGY COMMISSION Center for Sustainable Energy - C S E -CA Le V I P-102019 San Joaquin Valley Incentive Project �2wlp Application Form BUILDING EV INFRASTRUCTURE If any of the information below is incorrect, please contact CALeVIP staff at-m2jgaguin7valley-calevi energycenter.oro. [Project application number : F-00623 Applicant name : Astrida Trupovnieks Applicant email : atrupovnieks@lodi.gov Organization name : City of Lodi Applicant type : Public Entity Installation street address : 2 N Sacramento St City : Lodi State : CA Zip : 95240 County : San Joaquin County Mailing address: 221 West Pine Street, Lodi, CA, 95241 I Site use: City, County or Privately Owned Parking Lot or Garage I I Please review a// charger equipment on the last page. I By signing this form, the applicant agrees to the following: 1. 1 understand that the Energy Commission reserves all rights and remedies available under the law to enforce the San Joaquin Valley Incentive Project Requirements. 2. 1 acknowledge that I have read, understand, and agree to be bound by the San Joaquin Valley Incentive Project Requirements as outlined within this Rebate Application Form. I certify, under the penalty of perjury, that the information provided herein and all supporting documentation is true, accurate, and complete. Name of applicant or authorized representative: Astrida Trupovnieks Signature:gw CALIFORNIA ENERGY ICOMMISMON Center for Sustainable Energy - Total reserved rebate amount: $14,000.00 Date: 04/03/21 CSE -CA Le V I P-102019 San Joaquin valley Incentive Project Application Form New CALIFORNIA ENERGY COMMISSIONAC ChargePoint CT4000 Series, 2 Connectors r - Center for Sustainable Energy - CA L +�I1P BUILDING EV INFRASTRUCTURE C S E -CA Le V I P-102019 RESOLUTION NO. 2021-124 A RESOLUTION OF THE LODI CITY COUNCIL AUTHORIZING THE CITY MANAGER TO ACCEPT CALIFORNIA ELECTRIC VEHICLE INFRASTRUCTURE PROJECT (CALeVIP) GRANT FUNDING; AND FURTHER APPROPRIATING FUNDS WHEREAS, funded by the California Energy Commission (CEC) and implemented by the Center for Sustainable Energy (CSE), CALeVIP is providing incentives for electric vehicle (EV) charging installations; and WHEREAS, the CEC is working with cities on projects that promote EV use and support regional EV needs, and the CALeVIP grant funding will reimburse eligible costs such as charging equipment, installation labor, utility upgrades, trenching, and conduits; and WHEREAS, on April 1, 2021, Lodi Electric Utility (LEU) issued a Request for Proposals for a turnkey project to furnish, install, operate, and maintain Level II EV public charging stations; and WHEREAS, the project includes not only the replacement of existing equipment which has reached the end of its useful life, but also the installation of new charging stations through the City at locations including Hutchins Street Square, the Downtown Parking Garage, City Hall, the Finance Department, the Library, and Kofu Park; and WHEREAS, there is no matching fund requirement and grant funds will be provided on a reimbursement basis to LEU; and WHEREAS, should total project costs exceed total grant funds awarded, LEU has available funding budgeted in its Low Carbon Fuel Standard Fund 503; and WHEREAS, staff recommends the City Council accept the CALeVIP grant funding and appropriate funds as follows: Revenue: 50100000.56005 - $70,000 Expenditures: 50199000.77030 - $70,000 NOW, THEREFORE, BE IT RESOLVED that the Lodi City Council does hereby authorize the City Manager to accept California Electric Vehicle Infrastructure Project grant funding in the amount of $70,000; and BE IT FURTHER RESOLVED that funds be appropriated in the amount of $70,000 as set forth above; and BE IT FURTHER RESOLVED, pursuant to Section 6.3q of the City Council Protocol Manual (adopted 11/6/19, Resolution No. 2019-223), the City Attorney is hereby authorized to make minor revisions to the above -referenced document(s) that do not alter the compensation or term, and to make clerical corrections as necessary. Dated: May 5, 2021 I hereby certify that Resolution No. 2021-124 was passed and adopted by the City Council of the City of Lodi in a regular meeting held May 5, 2021 by the following votes: AYES: COUNCIL MEMBERS — Chandler, Hothi, Khan, Kuehne, and Mayor Nakanishi NOES- COUNCIL MEMBERS — None ABSENT: COUNCIL MEMBERS — None ABSTAINS COUNCIL MEMBERS — None I A--;� ENNIFE USMIR City Clerk 2021-124