HomeMy WebLinkAbout2-Formula_Nontribal EECBG Statement of Work With PA No Ground Disturbance_Final_0
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2-Statement of Work for Non-tribal Energy Efficiency and Conservation Block Grant
(EECBG) Applicants with a Historic Preservation Programmatic Agreement1 (PA)
Requesting Expedited Reviews for Projects with No Ground Disturbing Activities
Check applicable boxes. Note-All boxes must be checked to use this statement of work.
☐I represent a non-tribal organization.☐If my organization funds any activities on tribal lands or tribal properties, I understand
those activities would be restricted to homes/buildings less than forty-five (45) years old
and without ground disturbance. My organization would contact the DOE Project Officer
for a Historic Preservation Worksheet to request a review of activities that are listed below
on tribal homes/buildings forty-five (45) years and older and/or ground disturbing
activities. I understand the DOE NEPA team must review the Historic Preservation
Worksheet and notify my DOE Project Officer before I may begin initiating activities
reviewed on the Historic Preservation Worksheet.
☐ ☐ DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MP, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX,
☐ www.energy.gov/node/4816816 and contact my DOE Project Officer with any questions
☐ NEPA determinationdocuments DOE’s environmental review of project activities) once I have an approved
award from the DOE Contracting Officer. I will contact my DOE Project Officer with
☐
I understand I am required to review and comply with the requirements and restrictions of my Historic Preservation Programmatic Agreement found at:
https://www.energy.gov/node/812599 once I have an approved award from the DOE Contracting Officer. I will contact my DOE Project Officer with questions on my award
☐ I understand I am required to submit an annual Historic Preservation Report in the Performance and Accountability for Grants in Energy system (PAGE). ☐
I understand if I propose activities not listed below, I must contact my DOE Project Officer who will review the proposal for program eligibility. Additional NEPA review will be required including the possible submission of an Environmental Questionnaire 1 form (EQ1). I will not initiate any activities without approval from the DOE Contracting
1 Determine if your project is located in a jurisdiction with a Historic Preservation Programmatic Agreement by checking this website: https://www.energy.gov/node/812599 .
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By signing below, ______________________________________ (enter Applicant organization)
provides assurance that it shall only fund projects (including subgrants) that fall within the Blueprints and
Additional Activities listed below and will follow all restrictions defined below.
Blueprints and Additional Activities:
All proposed project activities and equipment funded from Administrative and Legal Requirements
Documents (ALRD), and all proposed project activities and equipment funded under Financial Incentive
Programs, must be listed below. Activities and equipment not listed below would require submission of
an Environmental Questionnaire 1 form (EQ1).
This Statement of Work is organized around EECBG Program Blueprints. Applicants that plan to use a
Blueprint should identify their selected Blueprint number and ensure that their proposed activities align
with this Statement of Work. Applicants that do not plan to use a Blueprint may find that their proposed
activities are covered under of one of the Blueprint headers or the “Additional Activities” section. Please
review each item carefully to determine if proposed activities are included in this Statement of Work.
Blueprints:
1.Blueprint #1: Energy Planning, activities limited to:
a.Stakeholder engagement, education, and outreach.
b.Energy data collection to assist in reducing fossil fuel emissions, reducing total energy
use, or improving energy efficiency, including to establish a baseline.
c.Development of an energy vision, goals, and strategies.
d.Writing, adopting, and/or publicizing an energy plan.
e. Development of energy efficiency and conservation strategies, project-specific plans that
may require feasibility studies, preparation of preliminary project design, outreach, and
technical support to state agencies, local governments, and affected stakeholders.
f.Development and implementation of programs and strategies to encourage energy
efficiency and renewable energy such as policy development and stakeholder
engagement.
2.Blueprint #2A: Funding commercially available, energy efficient, grid-interactivity,
electrification and renewable energy upgrades; provided that projects adhere to the
requirements of the respective applicant’s DOE executed Historic Preservation
Programmatic Agreement (PA), are installed in or on existing buildings, do not require
ground disturbance, tree removal or tree trimming, do not require structural reinforcement,
and are limited to:
a.Building energy assessments.
b.Energy audits.
c.Installation of insulation.
d.Installation of energy efficient lighting and light poles (may be installed within a
maintained utility easement if no trees are removed and no ground disturbed).
e.HVAC upgrades to existing systems.
f.Weather sealing and duct sealing.
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g. Purchase and installation of energy/water-efficient residential and commercial appliances
and equipment (including, but not limited to, grid-interactive building technologies,
energy or water monitoring and control systems, thermostats, heat pumps, air
conditioners, and related software).
h. Retrofit of energy efficient pumps and motors (for such uses as, but not limited to,
wastewater treatment plants) where it would not alter the capacity, use, mission, or
operation of an existing facility.
i. Retrofit and replacement of windows and doors.
j. Installation of electric appliances (including replacement of appliances that utilize fossil
fuels with electric appliances) such as heat pumps for water heating, air heating/cooling,
electric dryers, and stoves.
k. Retrofit and installation of energy-efficient commercial kitchen equipment, such as
efficient refrigerators, freezers, dishwashers.
l. Electrical system upgrades limited to electric panel upgrades, updated wiring and
conduit, grounding, and arc-fault circuit interrupter (AFCI) and ground-fault circuit
interrupter (GFCI) breakers.
3. Blueprint #2B: Energy Savings Performance Contracts for Efficiency and Electrification in
Buildings, activities limited to:
a. Exploring potential future financing options.
b. Procurement of energy savings performance contractor and legal support/technical
assistance.
c. Building energy efficiency project implementation and acceptance. Funding
commercially available energy efficiency or renewable energy upgrades; provided that
projects adhere to the requirements of the respective applicant’s DOE executed Historic
Preservation Programmatic Agreement (PA), are installed in or on existing buildings, do
not require ground disturbance, tree removal or tree trimming, do not require structural
reinforcement, and are limited to:
i. Installation of insulation.
ii. Installation of energy efficient lighting and light poles (may be installed within a
maintained utility easement if no trees are removed and no ground disturbed).
iii. HVAC upgrades (to existing systems).
iv. Weather sealing and duct sealing.
v. Purchase and installation of energy/water-efficient residential and commercial
appliances and equipment (including, but not limited to, grid-interactive building
technologies, energy or water monitoring and control systems, thermostats, heat
pumps, air conditioners, and related software).
vi. Retrofit of energy efficient pumps and motors (for such uses as, but not limited
to, wastewater treatment plants) where it would not alter the capacity, use,
mission, or operation of an existing facility.
vii. Retrofit and replacement of windows and doors.
viii. Installation of electric appliances (including replacement of appliances that
utilize fossil fuels with electric appliances) such as heat pumps for water heating,
air heating/cooling, electric dryers, and stoves.
ix. Retrofit and installation of energy-efficient commercial kitchen equipment, such
as efficient refrigerators, freezers, dishwashers.
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x.Electrical system upgrades limited to electric panel upgrades, updated wiring and
conduit, grounding, and arc-fault circuit interrupter (AFCI) and ground-fault
circuit interrupter (GFCI) breakers.
d.Post-implementation measurement & verification limited to data analysis (e.g.:
metering/usage/temperature), which may include monitoring devices installed on
equipment, but not on buildings.
4.Blueprint #2C: Building Efficiency & Electrification Campaign, activities limited to:
a.Design of an electrification campaign, including assessing the market, defining campaign
goals, and engaging stakeholders.
b. Design and execution of financial incentives, including rebates, grants, or financing
mechanisms, to support building energy efficiency and electrification upgrades. All
project activities funded under a financial incentive program must be listed within this
statement of work.
c. Research and procurement of campaign partner, including necessary legal and technical
support and assistance.
d.Development and implementation of communications plan and materials, including
website development.
e.Program education, outreach, and advertising.
f.Building Energy Efficiency: Funding commercially available energy efficiency or
renewable energy upgrades; provided that projects adhere to the requirements of the
respective applicant’s DOE executed Historic Preservation Programmatic Agreement
(PA), are installed in or on existing buildings, do not require ground disturbance, tree
removal or tree trimming, do not require structural reinforcement, and are limited to:
i.Installation of insulation.
ii.Installation of energy efficient lighting and light poles (may be installed within a
maintained utility easement if no trees are removed and no ground disturbed).
iii.HVAC upgrades to existing systems.
iv. Weather sealing and duct sealing.
v. Purchase and installation of energy/water-efficient residential and commercial
appliances and equipment (including, but not limited to, grid-interactive building
technologies, energy or water monitoring and control systems, thermostats, heat
pumps, air conditioners, and related software).
vi.Retrofit of energy efficient pumps and motors (for such uses as, but not limited
to, wastewater treatment plants) where it would not alter the capacity, use,
mission, or operation of an existing facility.
vii.Retrofit and replacement of windows and doors.
viii.Installation of electric appliances (including replacement of appliances that
utilize fossil fuels with electric appliances) such as heat pumps for water heating,
air heating/cooling, electric dryers, and stoves.
ix.Retrofit and installation of energy-efficient commercial kitchen equipment, such
as efficient refrigerators, freezers, dishwashers.
x.Electrical system upgrades limited to electric panel upgrades, updated wiring and
conduit, grounding, and arc-fault circuit interrupter (AFCI) and ground-fault
circuit interrupter (GFCI) breakers.
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5.Blueprint #2D: Building Performance Standards and Stretch Codes, activities limited to:
a.Stakeholder Engagement, education, and outreach.
b. Data collection and benchmarking.
c. Metric selection and target setting.
d.Determination of compliance and enforcement approach.
e.Development and implementation of building codes, including inspection services, and
associated activities to support code compliance and promote building energy efficiency.
6.Blueprint #3A: Solar and Battery Storage - Power Purchase Agreements and Direct
Ownership, activities limited to:
a.Site assessment.
b.Project savings assessment.
c.Procurement & legal support.
d.Development, implementation, and installation of solar electricity/photovoltaic (PV)
systems, provided that projects adhere to the requirements of the respective applicant’s
DOE executed Historic Preservation Programmatic Agreement (PA), are installed in or
on existing buildings, do not require ground disturbance, tree removal or tree trimming,
do not require structural reinforcement, and are not to exceed 60 kW DC.
e.Development and installation of energy storage systems, including electrochemical and
thermal storage systems, provided that projects adhere to the requirements of the
respective applicant’s DOE executed Historic Preservation Programmatic Agreement
(PA), are installed in or on existing buildings, do not require ground disturbance, tree
removal or tree trimming, do not require structural reinforcement, and are appropriately
sized not to exceed 1,000 kWh.
7.Blueprint #3B: Community Solar, activities limited to:
a.Communications, program education, and promotion
b.Development, implementation, and installation of solar electricity/photovoltaic (PV)
systems, provided that projects adhere to the requirements of the respective applicant’s
DOE executed Historic Preservation Programmatic Agreement (PA), are installed in or
on existing buildings, do not require ground disturbance, tree removal or tree trimming,
do not require structural reinforcement, and are not to exceed 60 kW DC.
c.Development and installation of energy storage systems, including electrochemical and
thermal storage systems, provided that projects adhere to the requirements of the
respective applicant’s DOE executed Historic Preservation Programmatic Agreement
(PA), are installed in or on existing buildings, do not require ground disturbance, tree
removal or tree trimming, do not require structural reinforcement, and are appropriately
sized not to exceed 1,000 kWh.
d. Implementation of financial incentive programs including rebates; energy savings
performance contracts, renewable energy sharing, or energy savings agreements for
existing facilities; community solar credit sharing arrangements; grants and loans to
support energy efficiency, renewable energy and energy saving projects. All project
activities funded under a financial incentive program must be listed within this statement
of work.
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8.Blueprint #3C: Solarize Campaign, activities limited to:
a.Design of Solarize Campaign program details.
b.Stakeholder engagement through education and outreach.
c.Procurement of solar installer/developer, legal, and technical support.
d. Solarize program education, outreach, and advertising.
e.Development, implementation, and installation of solar electricity/photovoltaic (PV)
systems, provided that projects adhere to the requirements of the respective applicant’s
DOE executed Historic Preservation Programmatic Agreement (PA), are installed in or
on existing buildings, do not require ground disturbance, tree removal or tree trimming,
do not require structural reinforcement, and are not to exceed 60 kW DC.
f.Development and installation of energy storage systems, including electrochemical and
thermal storage systems, provided that projects adhere to the requirements of the
respective applicant’s DOE executed Historic Preservation Programmatic Agreement
(PA), are installed in or on existing buildings, do not require ground disturbance, tree
removal or tree trimming, do not require structural reinforcement, and are appropriately
sized not to exceed 1,000 kWh.
g. Implementation of financial incentive programs including rebates; energy savings
performance contracts, renewable energy sharing, or energy savings agreements for
existing facilities; community solar credit sharing arrangements; grants and loans to
support energy efficiency, renewable energy and energy saving projects. All project
activities funded under a financial incentive program must be listed within this statement
of work.
9.Blueprint #3D: Renewable Resource Planning, activities limited to:
a. Market assessment.
b.Stakeholder engagement.
c.Action Plan development and implementation, which may include resource planning and
preliminary siting assessments, identification of financial options, and streamlining of
permitting processes.
d.Development, implementation, and installation of solar electricity/photovoltaic (PV)
systems, provided that projects adhere to the requirements of the respective applicant’s
DOE executed Historic Preservation Programmatic Agreement (PA), are installed in or
on existing buildings, do not require ground disturbance, tree removal or tree trimming,
do not require structural reinforcement, and are not to exceed 60 kW DC.
e.Development and installation of energy storage systems, including electrochemical and
thermal storage systems, provided that projects adhere to the requirements of the
respective applicant’s DOE executed Historic Preservation Programmatic Agreement
(PA), are installed in or on existing buildings, do not require ground disturbance, tree
removal or tree trimming, do not require structural reinforcement, and are appropriately
sized not to exceed 1,000 kWh.
f.Implementation of financial incentive programs including rebates; energy savings
performance contracts, renewable energy sharing, or energy savings agreements for
existing facilities; community solar credit sharing arrangements; grants and loans to
support energy efficiency, renewable energy and energy saving projects. All project
activities funded under a financial incentive program must be listed within this statement
of work.
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10.Blueprint #4A: Electric Vehicles for Fleets and Fleet Electrification, activities limited to:
a.Development of fleet replacement plan, including stakeholder engagement and input.
b.Siting planning and preliminary assessments.
c.Development of utility data sharing agreement.
d.Development of charging plan including cost assessment of electric bill.
e.Procurement, legal, and technical support to purchase and install EVs and EVSE.
f.Purchase of alternative fuel vehicles, including electric vehicles and plug-in hybrid
vehicles.
g.Installation of electric vehicle supply equipment (EVSE), including testing measurements
to assess the safety and functionality of the EVSE (restricted to existing footprints within
an existing parking facility, defined as any building, structure, land, right-of-way, facility,
or area used for parking of motor vehicles which would not require any ground
disturbance). All activities must use reversible, non-permanent techniques for
installation, and where appropriate, use the lowest profile EVSE reasonably available that
provides the necessary charging capacity. EVSE shall be placed in minimally visibly
intrusive area; use colors complementary to surrounding environment, where possible,
and be limited to the current electrical capacity. This applies to Level 1, Level 2, and
Level 3 (also known as Direct Current (DC) Fast Charging) EVSE for community and
municipal fleets.
11.Blueprint #4B: Electric Vehicle Charging Infrastructure, activities limited to:
a.Procurement, legal, and technical support to purchase and install EVs and EVSE.
b.Stakeholder engagement.
c. Siting planning, assessments, and site selection.
d.Installation of electric vehicle supply equipment (EVSE), including testing measurements
to assess the safety and functionality of the EVSE (restricted to existing footprints within
an existing parking facility, defined as any building, structure, land, right-of-way, facility,
or area used for parking of motor vehicles which would not require any ground
disturbance). All activities must use reversible, non-permanent techniques for
installation, and where appropriate, use the lowest profile EVSE reasonably available that
provides the necessary charging capacity. EVSE shall be placed in minimally visibly
intrusive area; use colors complementary to surrounding environment, where possible,
and be limited to the current electrical capacity. This applies to Level 1, Level 2, and
Level 3 (also known as Direct Current (DC) Fast Charging) EVSE for community and
municipal fleets.
12.Blueprint #5: Unlocking Sustainable Financing Solutions for Energy Projects and Programs
including Revolving Loan Funds, activities limited to:
a.Market analysis, programmatic research, and design.
b.Stakeholder engagement, education, and outreach.
c.Legal and technical support.
d.Communications, program education, and promotion.
e.Program evaluation.
f.Implementation of financial incentive programs, including rebates and energy savings
performance contracts for existing facilities; grants and loans to support energy
efficiency, renewable energy, and sustainable transportation projects; loan loss reserves;
interest-rate buy down programs; PACE programs; and loan guarantees. All project
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activities funded under a financial incentive program must be listed within this statement
of work.
13.Blueprint #6: Workforce Development, activities limited to:
a. Workforce assessment and market analysis.
b.Program design and curriculum development.
c. Stakeholder engagement, including program promotion and outreach.
d.Implementation of classroom or virtual training programs.
e.Paying trainers and trainees, including supplemental services.
Additional Activities:
14. Building Energy Efficiency: Funding commercially available energy efficiency or renewable
energy upgrades, provided that projects adhere to the requirements of the respective
applicant’s DOE executed Historic Preservation Programmatic Agreement (PA), are
installed in or on existing buildings, do not require ground disturbance, tree removal or tree
trimming, do not require structural reinforcement, are appropriately sized, and are limited to:
a.Installation of insulation.
b. Installation of energy efficient lighting and light poles (may be installed within a
maintained utility easement if no trees are removed and no ground disturbed).
c.HVAC upgrades to existing systems.
d. Weather sealing and duct sealing.
e.Purchase and installation of energy/water-efficient residential and commercial appliances
and equipment (including, but not limited to, grid-interactive building technologies,
energy or water monitoring and control systems, thermostats, heat pumps, air
conditioners, and related software).
f. Retrofit of energy efficient pumps and motors (for such uses as, but not limited to,
wastewater treatment plants) where it would not alter the capacity, use, mission, or
operation of an existing facility.
g. Retrofit and replacement of windows and doors.
h.Installation of electric appliances (including replacement of appliances that utilize fossil
fuels with electric appliances) such as heat pumps for water heating, air heating/cooling,
electric dryers, and stoves.
i.Retrofit and installation of energy-efficient commercial kitchen equipment, such as
efficient refrigerators, freezers, dishwashers.
j.Electrical system upgrades required to enable energy efficient/clean energy. Measures
limited to electric panel upgrades, updated wiring and conduit, grounding, and arc-fault
circuit interrupter (AFCI) and ground-fault circuit interrupter (GFCI) breakers.
15. Development, implementation, and installation of renewable energy technology, provided
that projects adhere to the requirements of the respective applicant’s DOE executed Historic
Preservation Programmatic Agreement (PA), are installed in or on existing buildings, do not
require ground disturbance, tree removal or tree trimming, do not require structural
reinforcement, are appropriately sized, and are limited to:
a.Solar Electricity/Photovoltaic—appropriately sized systems not to exceed
60kW (including community solar projects)
b. Wind Turbines 20 kW or smaller
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c.Solar thermal systems (including solar thermal hot water) limited to 200,000 BTU
per hour or smaller.
16.Biomass thermal systems, provided that projects adhere to the requirements of the respective
applicant’s DOE executed Historic Preservation Programmatic Agreement (PA), are
installed in existing buildings, do not require structural reinforcement, do not require ground
disturbance, are appropriately sized, and limited to 3 MMBTUs per hour or smaller, with
appropriate regulatory permits obtained and Best Available Control Technologies (BACT)
installed and operated.
17. Purchase of alternative fuel vehicles, hybrids, and electric vehicles.
18. Installation of fueling pumps and systems for fuels such as compressed natural gas, hydrogen,
ethanol, and other commercially available biofuels, (but not storage tanks) provided that
projects adhere to the requirements of the respective applicant’s DOE executed Historic
Preservation Programmatic Agreement (PA), are installed on a current fueling station site, do
not require ground disturbance, tree removal or tree trimming, are appropriately sized, and
obtain the appropriate permits, and comply with regulatory requirements.
19. Implementation of financial incentive programs including rebates and energy savings
performance contracts for existing facilities; grants, loans, and revolving loans to support
energy efficiency, renewable energy and energy saving projects. All project activities funded
under a financial incentive program must be listed within this NEPA statement of work.
20. Development and installation of energy storage systems, including electrochemical and
thermal storage systems, provided that projects adhere to the requirements of the respective
applicant’s DOE executed Historic Preservation Programmatic Agreement (PA), are
installed in or on existing buildings, do not require ground disturbance, tree removal or tree
trimming, do not require structural reinforcement, are appropriately sized not to exceed 1,000
kWh, obtain the appropriate permits, and comply with regulatory requirements.
The Applicant is responsible for informing DOE of any extraordinary circumstances, cumulative impacts,
or connected actions that may lead to significant impacts on the environment or any inconsistency with
the “integral elements” from a particular project. See 10 C.F.R. Part 1021 Appendix B, and the DOE’s
online NEPA and historic preservation training at www.energy.gov/node/4816816 to reviews these
concepts.
Expedited NEPA review based on this NEPA Statement of Work and supporting documents does not
preclude DOE from conducting stewardship activities, including audits, and site visits, or from exercising
any other rights under the EECBG program.
By signing below, the Applicant, agrees to follow all the statements and restrictions in this document;
review and comply with the NEPA Determination (included in their Applicant award documents); review
the DOE’s NEPA and Historic Preservation training website. DOE has developed a NEPA and Historic
Preservation training website which contains PowerPoint presentations, sample template documents
(including a project scope of work and a project layout), a Word template of the Environmental
Questionnaire1 (EQ1), and an EQ1 Submission Guide at www.energy.gov/node/4816816. Applicants are
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responsible for reviewing these trainings and reviewing the sample documents prior to initiating projects.
Recipients must contact their DOE Project Officer with any questions. Subgrantees should also review the
NEPA and Historic Preservation training website prior to initiating projects.
________________________________________________________________
Authorized Signature Date
Name (Printed or typed):___________________________________________
Title (Printed or typed):_____________________________________________
Organization (Printed or typed):______________________________________