DOE F 540.8 E&I Form - Grant File

Weatherization Assistance Program Sub-programs

DOE F 540.8 E&I Form - Grant File- Final

Weatherization Assistance Program Sub-programs - State, Local or Tribal Government

OMB: 1910-5157

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DOE F 540.8 OMB Control No. 1910-5157

Expiration date: XX/XX/2023


U.S. Department of Energy

WEATHERIZATION ASSISTANCE PROGRAM ENHANCEMENT AND INNOVATION (E&I)

GRANT FILE WORKSHEET



Grant #: __________ Grantee: ___________


Budget Period: / / - / /

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IV.1 Subgrantees and Contractors


Organization Name


City

Tentative

Funding*

Units*













Totals



* Funding can include non-DOE sources if included in DOE budget. Units can include those completed with non-DOE funding if included in the DOE budget.



IV.2 E&I Topic Area (select one)

Place-based Initiative

Multifamily

Single Family and Manufactured Homes

Workforce Development

Other



IV.3 E&I Planned Activities (select all that apply)

Make Homes Weatherization-Ready

Deploy Renewable Energy and New Technologies

Enhance Indoor Environments

Hire and Retain Workforce

Disseminate New Methods and Best Practices

Other



IV.4 Production Schedule

Unit Metrics

Planned # of Units

Total Units


Units in Underserved Communities


Units Rehabilitated to be Weatherization-Ready





IV.5 Workforce Development Goals

Workforce Metrics

Planned # of Full Time Equivalent (FTE) Workers

Number of Workers Hired


Number of Workers Retained




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IV.6 Miscellaneous

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OMB Burden Disclosure Statement


Public reporting burden for this collection of information is estimated to average 3 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0043), Washington, DC 20503.


PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.


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U.S. Department of Energy

WEATHERIZATION ASSISTANCE PROGRAM ENHANCEMENT AND INNOVATION (E&I)

GRANT FILE WORKSHEET

INSTRUCTIONS


The Annual File Worksheet is designed to gather specific detail related to the expenditures of the Weatherization grant.






Item


Explanation

IV.1

Subgrantees and Contractors


  • Organization Name


  • City


  • Funding


  • Units



Identify each intended subgrantee or contractor by name


Identify the city in which the organization is located


Identify the tentative funding each organization will receive


Identify the tentative total of completed units anticipated by the organization with this funding, if applicable



IV.2

E&I Topic Area

Select one topic area based on E&I award and SOPO


IV.3

E&I Planned Activities

Select all activities that apply based on E&I award and SOPO


IV.4

Production Schedule


  • Total Units



  • Units in Underserved Communities



  • Units Rehabilitated to be Weatherization-Ready




Enter the total units expected to receive E&I services during the Budget Period.


Enter the number of units in underserved communities expected to receive E&I services during the Budget Period. This should be at least 40% of the Total Units.


Enter the number of units expected to be made Weatherization-Ready. This must be less than or equal to the Total Units.



IV.5

Workforce Development Goals


  • Number of Workers Hired




  • Number of Workers Retained





Enter the total number of full-time equivalent weatherization workers (employees or contractors) that are expected to be hired during the budget period.


Enter the total number of full-time equivalent weatherization workers (employees or contractors) that are expected to be retained during the budget period. This should be less than or equal to Number of Workers Hired.


IV.6

Miscellaneous

Identify any anticipated activities that are not routinely administered as part of the Enhancement and Innovation program.





PAPERWORK REDUCTION ACT BURDEN DISCLOSURE STATEMENT



PAPERWORK REDUCTION ACT BURDEN DISCLOSURE STATEMENT



This data is being collected to be used by program staff to track Community Scale recipients’ activities, their progress in achieving scheduled milestones, and funds expended. The data you supply will be used to enable program staff to provide required or requested information on program activities to OMB, Congress, and the public.


Public reporting burden for this collection of information is estimated to average 3 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Office of the Chief Information Officer, Enterprise Policy Development & Implementation Office, IM-22, Paperwork Reduction Project 1910-5157, U.S. Department of Energy, 1000 Independence Ave SW, Washington, DC, 20585-1290; and to the Office of Management and Budget (OMB), OIRA, Paperwork Reduction Project 1910-5157, Washington, DC  20503.


Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB control number.


Submission of this data is required.







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