5900-451 NR Small SI Small Volume Bond Worksheet

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Overview

Bonding-Warranty worksheet
Population and altitude

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Sheet 1: Bonding-Warranty worksheet

Bond worksheet for small-volume manufacturers of Small SI engines only (rev3). Please save this file with the title "Bond worksheet XXXXXXXX20MY.xls" where XXXXXXXX is your company's name and 20MY is actually the Model Year that this Bond Worksheet represents

THIS WORKSHEET CONTAINS CBI!

Paperwork Reduction Act Notice

Entry required

Field automatically filled in

CBI Indicator

The public reporting and recordkeeping burden for this collection of information is estimated to average 453.79 hours per respondent. Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number 2060-0338 in any correspondence. Do not send the completed form to this address.

Certificate Holder's Name:

Yes

Do you meet the small business requirements as defined by the Small Business Administration at 13 CFR 121.201)?

No

Are you a small-volume manufacturer per the requirements in 40 CFR 1054.801?

Are you a certificate holder in each of the previous 5 model years without failing an EPA-conducted emission test or being found non-compliant in any way by EPA?

Bond

-- See §1054.690 at:

1.0

http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&sid=7b71abf4441bd775ff07e96fe5b58c11&rgn=div8&view=text&node=40:31.0.1.3.16.7.1.15&idno=40

1.2

Test 1 -- Repair network (§1054.120(f))

Projected Sales

We have more than 100 authorized repair facilities (Yes or No) - If yes, please go to Test 2

Historical Sales

CBI =>

Identify the total number of Small SI engines sold in the United States from your most recent end-of-year sales reports. New manufacturers may use sales projections until actual numbers are available.

Certificate Holder

CBI =>

Number of required repair facilities for this level of production

Importer

Please enter in the total number of Small SI engines produced in cell C16

Not enough data entered, You must first enter value(s) in C17 or Cells C18 and C21

Test 2 -- Long-term assets

This test is based on the value of buildings, land, and fixed equipment from your most recent balance sheet, minus depreciation and long-term liabilities (such as a mortgage). The value of fixed assets are for the whole company, including any parent or subsidiary companies.

Identify the threshold that applies to your company.

CBI =>

$10 million

CBI =>

For secondary engine manufacturers ($6 million). Note that companies outside the United States cannot be secondary engine manufacturers (see §1068.30).

Identify the company that supplies your engines:

CBI =>

For manufacturers that have held a certificate for each of the last 10 years with no finding of noncompliance ($3 million).

Identify your level of fixed assets in the United States minus depreciation and related long-term liabilities.

CBI =>

Less than

$3 million

CBI =>

At least

$3 million

but less than

$6 million

CBI =>

At least

$6 million

but less than

$10 million

CBI =>

$ $10 million or more

Not enough data entered, You must first chose an asset threshold from Cells C29, C30, or C33

Certificate Holder's Name:

Identify the addresses where you have at least that much value of fixed assets (with corresponding photographs), as described below.

If you need to add additional locations, please use a second file. Name the file, "Bond worksheet XXXXXXXX-Y.xls where XXXXXXXX is your companies name, and Y is the next sequential letter. For example, the second file is -A, the third file is -B

Identify all the addresses where your fixed assets are located.

Address 1

Address 2

Address 3

Include a photograph of each facility identified above. (Please embed files)

Address 1

Address 2

Address 3

Include the following information:

Please enter the following data from the most recent balance sheet. Please include all Capital Leases

Address 1

Address 2

Address 3

CBI =>

Net PPE

- or -

CBI =>

Total fixed assets

CBI =>

Mortgages on above assets

CBI =>

Accumulated depreciation on above assets

CBI =>

Net Assets

$-

$-

$-

Certificate Holder's Name:

Bond amounts

If you need to post bond under §1054.690, use the following worksheet to calculate the value of the bond.

Report production volumes based on one of the following:

Most recent production reports for all engines produced from certified Small SI engine families.

Projected sales figures from all certified Small SI engine families from the previous model year.

Estimated total annual U.S.-directed production of Small SI engines:

CBI =>

Disp. < 225 cc

CBI =>

225 ≤ Disp. < 740 cc

CBI =>

740 ≤ Disp. ≤ 1,000 cc

CBI =>

Disp. > 1,000 cc

1.0

CHANGE to 1.2 IF YOU PARTICIPATE IN DELEGATED ASSEMBLY, PER 1068.261

CBI =>

This is your minimum bond value for this year.

This must be at least

$25,000

You must increase the value of your bond if your actual U.S.-directed production volumes for the current calendar year cause this calculated value to increase.

Warranty assurance

Provide the following information related to fulfilling warranty claims:

Toll-free number in the United States for information about warranty claims and arranging for authorized repairs.

E-mail address (or qualifying website) for information about warranty claims and arranging for authorized repairs.

Address of at least one location in the United States from which you can supply replacement parts (for imported and domestic parts).

You must select one of the following three methods to show that you will generally be able to honor warranty claims:

1.

We have authorized service centers in all 251 of the population centers identified in the "Population and altitude" sheet.

2.

We will offer warranty service to owners located within 100 miles of an authorized service center in the continental United States.

Note that this does not apply for states with high-altitude areas (see "Population and altitude" sheet).

If owners are more than 100 miles from an authorized service center, which of the following methods will you use to honor warranty claims (select all that apply):

Free shipping

Send service technician

Pay for repairs at non-authorized service centers.

3.

We will use Option #1 for some states and Option #2 for other states.

Identify the states where you do not have authorized service centers in all the identified population centers.

Option #2 Additional Information - for states in which you do not have the requisite number of service centers

If owners are more than 100 miles from an authorized service center, which of the following methods will you use to honor warranty claims (select all that apply):

Free shipping

Send service technician

Pay for repairs at non-authorized service centers.

Certificate Holder's Name:

Bond and Importation Information

Please detail the following information for all engine families that you will be certifying this year that include any engines introduced into commerce in the United States. Note one family may be on multiple lines because it has multiple importers.

EPA Family Name

Does the certificate holder meet the bond exemption criteria?

Importer(s) Name, Address, Phone number, Email, contact person (if certificate holder is the importer put "certificate holder") See §1054.205(aa)(2)

Volume of engines Importer will Import into U.S. (This column is CBI)

Is this volume projected sales or based on historical sales?

Does the importer meet the bond exemption criteria? (answer only if the certificate holder does not)

Who will post the bond - certificate holder or the importer? (answer only if the exemption criteria are not met by the importer or the certificate holder)

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Sheet 2: Population and altitude

U.S. Population Centers over 100,000 – U.S. Census, 2000
Birmingham, AL					States in the continental U.S. with high-altitude areas
Huntsville, AL					Arizona
Mobile, AL					Colorado
Montgomery, AL					Idaho
Anchorage, AK					Montana
Chandler, AZ					Nebraska
Gilbert, AZ					Nevada
Glendale, AZ					New Mexico
Mesa, AZ					Oregon
Peoria, AZ					Texas
Phoenix, AZ					Utah
Scottsdale, AZ					Wyoming
Tempe, AZ
Tucson, AZ
Little Rock, AR
Anaheim, CA
Antioch, CA
Bakersfield, CA
Berkeley, CA
Burbank, CA
Chula Vista, CA
Concord, CA
Corona, CA
Costa Mesa, CA
Daly City, CA
Downey, CA
El Monte, CA
Elk Grove, CA
Escondido, CA
Fairfield, CA
Fontana, CA
Fremont, CA
Fresno, CA
Fullerton, CA
Garden Grove, CA
Glendale, CA
Hayward, CA
Huntington Beach, CA
Inglewood, CA
Irvine, CA
Lancaster, CA
Long Beach, CA
Los Angeles, CA
Modesto, CA
Moreno Valley, CA
Norwalk, CA
Oakland, CA
Oceanside, CA
Ontario, CA
Orange, CA
Oxnard, CA
Palmdale, CA
Pasadena, CA
Pomona, CA
Rancho Cucamonga, CA
Richmond, CA
Riverside, CA
Roseville, CA
Sacramento, CA
Salinas, CA
San Bernardino, CA
San Buenaventura (Ventura), CA
San Diego, CA
San Francisco, CA
San Jose, CA
Santa Ana, CA
Santa Clara, CA
Santa Clarita, CA
Santa Rosa, CA
Simi Valley, CA
Stockton, CA
Sunnyvale, CA
Thousand Oaks, CA
Torrance, CA
Vallejo, CA
Visalia, CA
West Covina, CA
Arvada, CO
Aurora, CO
Colorado Springs, CO
Denver, CO
Fort Collins, CO
Lakewood, CO
Pueblo, CO
Thornton, CO
Westminster, CO
Bridgeport, CT
Hartford, CT
New Haven, CT
Stamford, CT
Waterbury, CT
Washington, DC
Cape Coral, FL
Clearwater, FL
Coral Springs, FL
Fort Lauderdale, FL
Gainesville, FL
Hialeah, FL
Hollywood, FL
Jacksonville, FL
Miami, FL
Miami Gardens, FL
Miramar, FL
Orlando, FL
Pembroke Pines, FL
Port St. Lucie, FL
St. Petersburg, FL
Tallahassee, FL
Tampa, FL
Athens-Clarke County, GA
Atlanta, GA
Augusta-Richmond County, GA
Columbus, GA
Savannah, GA
Honolulu, HI
Boise City, ID
Aurora, IL
Chicago, IL
Joliet, IL
Naperville, IL
Peoria, IL
Rockford, IL
Springfield, IL
Evansville, IN
Fort Wayne, IN
Indianapolis, IN
South Bend, IN
Cedar Rapids, IA
Des Moines, IA
Kansas City, KS
Olathe, KS
Overland Park, KS
Topeka, KS
Wichita, KS
Lexington-Fayette, KY
Louisville-Jefferson County, KY
Baton Rouge, LA
Lafayette, LA
New Orleans, LA
Shreveport, LA
Baltimore, MD
Boston, MA
Cambridge, MA
Lowell, MA
Springfield, MA
Worcester, MA
Ann Arbor, MI
Detroit, MI
Flint, MI
Grand Rapids, MI
Lansing, MI
Sterling Heights, MI
Warren, MI
Minneapolis, MN
St. Paul, MN
Jackson, MS
Independence, MO
Kansas City, MO
Springfield, MO
St. Louis, MO
Lincoln, NE
Omaha, NE
Henderson, NV
Las Vegas, NV
North Las Vegas, NV
Reno, NV
Manchester, NH
Elizabeth, NJ
Jersey City, NJ
Newark, NJ
Paterson, NJ
Albuquerque, NM
Buffalo, NY
New York, NY
Rochester, NY
Syracuse, NY
Yonkers, NY
Cary, NC
Charlotte, NC
Durham, NC
Fayetteville, NC
Greensboro, NC
Raleigh, NC
Winston-Salem, NC
Akron, OH
Cincinnati, OH
Cleveland, OH
Columbus, OH
Dayton, OH
Toledo, OH
Norman, OK
Oklahoma City, OK
Tulsa, OK
Eugene, OR
Portland, OR
Salem, OR
Allentown, PA
Erie, PA
Philadelphia, PA
Pittsburgh, PA
Providence, RI
Charleston, SC
Columbia, SC
Sioux Falls, SD
Chattanooga, TN
Clarksville, TN
Knoxville, TN
Memphis, TN
Nashville-Davidson, TN
Abilene, TX
Amarillo, TX
Arlington, TX
Austin, TX
Beaumont, TX
Brownsville, TX
Carrollton, TX
Corpus Christi, TX
Dallas, TX
El Paso, TX
Fort Worth, TX
Garland, TX
Grand Prairie, TX
Houston, TX
Irving, TX
Laredo, TX
Lubbock, TX
McAllen, TX
Mesquite, TX
Pasadena, TX
Plano, TX
San Antonio, TX
Waco, TX
Wichita Falls, TX
Salt Lake City, UT
West Valley City, UT
Alexandria, VA
Arlington CDP
Chesapeake, VA
Hampton, VA
Newport News, VA
Norfolk, VA
Richmond, VA
Virginia Beach, VA
Bellevue, WA
Seattle, WA
Spokane, WA
Tacoma, WA
Vancouver, WA
Green Bay, WI
Madison, WI
Milwaukee, WI