5900-646 Close-out Form

Clean School Bus Rebates Program Application and Close-out Form

5900-646 CSB Close out Form User Guide pdf

OMB: 2060-0686

Document [pdf]

Download: pdf | pdf

2022 EPA Clean School Bus Rebate Forms:
Close Out Form User Guide
September 2023

EPA-420-B-23-038

Table of Contents
1. Sign In/Register................................................................................... 5
2. Application Information...................................................................... 5
2.1
2.2
2.3
2.4
2.5
2.6
2.7
2.8
2.9
2.10
2.11
2.12
2.13
2.14
2.15
2.16
2.17
2.18
2.19
2.20
2.21
2.22
2.23
2.24
2.25
2.26
2.27

Start a New Close Out Form...................................................................... 5
Welcome Screen........................................................................................ 6
Information Icons ...................................................................................... 7
Application Information ............................................................................. 8
Save and Next Buttons............................................................................... 9
Add Organizations ..................................................................................... 9
Organizations Information ....................................................................... 10
Complete Organizations........................................................................... 11
Saving and Editing Your Information ........................................................ 11
Add Documents ...................................................................................... 12
Add Document Information...................................................................... 13
Complete Documents ............................................................................. 14
Complete Bus Information ...................................................................... 15
New Bus Information .............................................................................. 16
Excluding a Bus ....................................................................................... 23
Swapping Out an Old Bus........................................................................ 24
Bus Funding Information .......................................................................... 25
Complete Bus Information ...................................................................... 26
Infrastructure and Funding Information .................................................... 27
Add Infrastructure – Level 2 / DC Fast Chargers ..................................... 28
Add Infrastructure – Other Eligible Infrastructure Costs ......................... 31
Funding Information ................................................................................ 33
Complete Infrastructure and Funding ...................................................... 35
Telematics Information ............................................................................ 35
Telematics Contact Information ............................................................... 36
Signature ................................................................................................. 37
Missing Document and/or Organization Information ............................... 38

3. Next Steps ......................................................................................... 39
Appendix A. Glossary ............................................................................ 40
Appendix B. Printable List of Fields ..................................................... 53

Before You Begin
This guide will walk you through the steps needed to create, edit, submit, and view the Close Out Form for
your Clean School Bus rebate application online. This guide also includes detailed defnitions of key felds found
in the online form and a printable list of all felds required in the form. Plan to spend 4 or more hours to
complete the Close Out Form. However, you don’t need to complete it in one session. You may save the form
and come back at any time.
Follow these steps to prepare for completing the Close Out Form:
1.

Review the glossary of terms (see Appendix A).

2. Compile all required data. Appendix B provides a printable list of all necessary data felds.
3. Confrm the Point of Contact. Confrm the email of the person completing the Close Out Form is
registered as a designated Point of Contact in your entity’s SAM.gov account by logging on to
SAM.gov. Otherwise, the person will not be able to log into the Close Out Form from the system.
Additionally, please verify that the SAM.gov account associated with your CSB Rebate has an active
registration.
4. Check your browser version. Before flling out the Close Out Form, make sure the web browser
version meets or exceeds the following versions:
— Chrome 38
— Safari 7.1
— Internet Explorer 11
— Firefox 13
Note: The heading numbers on the following pages correspond to the Close Out Form screen sequence.

1. Sign In/Register
Use your existing SAM.gov credentials to log in to your account. If you are unable to sign in, please click
here to refer to the instructions in the application form User Guide.

2. Application Information
2.1

Start a New Close Out Form

After signing in using your Login.gov account, you see the Clean School Bus Rebate Forms screen.

Select the “New Close Out” button to begin.
Note: We recommend clicking “Save” prior to exiting the form and before a system time out would occur.
Your connection to the Close Out Form system will time out unless you interact with the screen at least once
every 15 minutes. “Interacting” can mean entering or deleting information, or even moving your cursor on the
screen. If your connection times out, you risk losing data entered since the last save.

2.2

Welcome Screen

Review the text on the “Welcome” screen to determine what information you will need and how to complete
the Close Out Form and select “Next” to proceed.
Note: Use of the browser back, forward, or refresh buttons while in the Close Out Form will result in loss of
work. Please navigate using the “Next”, “Previous”, and “Save” buttons on the screen.

2.3

Information Icons

Hover your mouse over the information icons, found throughout the Close Out Form screens, for additional
information regarding specifc felds that may not be covered in this user guide.

2.4

Application Information

High level application information, and the Primary and Alternate Contact information felds will prepopulate
with information from the associated Payment Request Form. Double-check that your Primary and Alternate
Contact information is correct. The information can be edited if necessary. Select “Next” to continue.

2.5

Save and Next Buttons

When you press the save or next buttons, a box will pop up in the top right corner of your screen confrming
your information has been saved.
Note: The save and next buttons are the only buttons that save entered information. The “Previous”,
“Complete”, and “Return to...” navigation buttons do not save entered information.

2.6

Add Organizations

Review the information on this screen to understand the types of organizations for which you will need
to provide information, then select “+ Add Organization” to proceed. Required organizations include the
entity(ies) that took control of the old bus(es), the owner(s) of the new bus(es) and/or electric bus charging
infrastructure, and the infrastructure supplier(s).

2.7

Organizations Information

Select an organization type by checking the appropriate box. Each organization only needs to be entered once,
even if the organization is associated with multiple buses or infrastructure purchases, or multiple organization
types. If the old or new bus owner is the applicant, the school district that the new buses will serve, or the
old bus private feet identifed in your application, then you do not have to enter owner information as it’s
already included within the form. Once you select an organization type, enter the organization’s name, contact
information and address. When all felds have been entered for the organization select the “Complete” button.
Note this button does not save your form, and you must select the “Save” or “Next” button to save
your information.
Add another organization by selecting “+ Add Organization” at the bottom of the screen. You may add as many
organizations as needed and delete or edit them at any time. Deleting an organization is permanent, so do
not do so unless you are sure it is necessary. You must select the “Complete” button at the bottom of the
Organizations screen before moving on.

2.8

Complete Organizations

Once you have added all your organizations, select “Next” to continue.

2.9

Saving and Editing Your Information

You can save your work while flling out the Close Out Form and return to it later to fnish and submit. Data
entered on each screen will be saved automatically when the “Next” button is selected. In addition, you can
use the “Save” buttons to save information before proceeding to the next page.
Note: When editing an organization or providing bus information, you must select the “Complete” button prior
to “Save” or the data will be lost.

2.10 Add Documents
Select “+ Add Document” to add the required fles, including a fnal invoice and proof of delivery for each bus.
Note: Infrastructure documentation is only required for charging infrastructure purchased for electric buses
under this funding opportunity.

2.11 Add Document Information
Select a document type, either fnal invoice or proof of delivery, using the drop-down menu. Next, select the
document purpose by checking the box(es) that apply. Then enter the document name which will be used to
reference this document within the form. Please make the names unique to each document. If you would like,
you may enter a description of the document. Lastly, attach a PDF or image of the document. The image fle
size must be between 1KB and 5MB. Accepted fle types include .pdf, .png, .jpeg, and .jpg. When all felds
have been entered, select the “Complete” button for the document. Note this button does not save your
form, and you must select the “Save” or “Next” button to save your information.
You may add another document by selecting “+ Add Document” at the bottom of the screen. You may add
as many documents as needed and delete or edit them at any time. Deleting a document is permanent, so
please do not do so unless you are sure it is necessary. You must select the “Complete” button at the bottom
of the screen before moving on.
Note: Scrappage documentation will be uploaded in the Buses section of the form.

2.12 Complete Documents
Once you have added all your documents, select “Next” to continue.

2.13 Complete Bus Information
Enter the total number of school buses in your feet as well as the total number of electric school buses. The
list of buses under “Bus Information” are the Old Buses that were entered on your application form. Edit
information for each old bus and corresponding replacement bus by completing the mandatory felds and as
needed the non-mandatory felds. If the bus information is incomplete, you will see a message in red next to
the bus number.

2.14 New Bus Information
The data felds associated with old and new buses are presented below, with required data felds marked with
an asterisk. Enter the required information then select “Complete.” See Sections 2.15 and 2.16 of this user
guide for information on Swapping or Excluding a Bus.

The Old Bus VIN is prepopulated from the information in the Payment Request Form and is not
editable.

2. Old Bus Fuel Type is prepopulated from the information in the Payment Request Form and is not
editable.
3. Estimated Remaining Life (years) is prepopulated from the information in the Payment Request Form
and is not editable.
4. Old Bus Model Year is prepopulated from the information in the Payment Request Form and is not
editable.
5. The Old Bus NCES District ID feld is prepopulated with the School District ID from the Payment
Request Form and is not editable.
6. The Old Bus Owner* feld requires you to choose the organization who owned the bus before
replacement from the drop-down menu. If you don’t see the owner, select “Back to Organization
Entry” to add them.
7.

Enter the estimated annual idling hours for the old bus in the Old Bus Annual Idling Hours* feld.

8. The Old Bus Odometer (miles)* feld needs to be populated with the odometer reading of the old bus
at the time of scrappage, donation, or sale. If the exact reading is unknown, provide an estimate.
9. The Replacement Process* feld requires you to specify how the old bus was replaced (scrapped,
sold, or donated). 2010 and older buses can only be scrapped. 2011 and newer buses can be scrapped,
sold, or donated. If you enter an invalid replacement process, a warning message will appear that says
the disposal method is not valid. You can proceed with completing the form, but this will need to be
addressed during the review process.

*Please note that felds 10-12 will show depending on what is selected in the Replacement
Process drop-down.

10. Select the Scrap Yard Organization from the drop-down. If the organization does not appear in the
drop-down, frst complete the remainder of the Old Bus and New Bus felds, select the complete and
save buttons, return to the Organizations screen by selecting “Back to Organization Entry”, and enter
the required information.
11. Upload the Old Bus Proof of Scrappage by attaching photos and letter. Attach photos of the old bus
destroyed engine and chassis that shows or indicates what the last 4 digits of the bus VIN are as proof
of old bus scrappage. Attach a letter signed by a representative of the scrap yard/entity that performed
the scrappage.

12. The Old Bus Sold To/Donated To* feld requires you to select the organization that the old bus was
sold/donated to. If the organization does not appear in the drop-down, frst complete the remainder of
the Old Bus and New Bus felds, select the complete and save buttons, return to the Organizations
screen by selecting “Back to Organization Entry”, and enter the required information.

13
14

13. New Bus Dealer is prepopulated from the information in the Payment Request Form and is not
editable.
14. The options for New Bus Owner* are generated from the entries in the Organization page with an
Organization Type of “New Bus Owner”. If the organization does not appear in the drop-down, frst
complete the remainder of the Old Bus and New Bus felds, select the complete and save buttons,
return to the Organizations screen by selecting “Back to Organization Entry”, and enter the required
information.
15. The options for Final Invoice* are generated from the entries in the Documents page with a
Document Type of “Final Invoice” and a Document Purpose of “Bus”. If the document does not appear
in the drop-down menu, frst complete the remainder of the Old Bus and New Bus felds, select the
complete and save buttons, return to the Documents screen by selecting “Back to Document Entry”,
and enter the required information.
16. The options for Proof of Delivery* are generated from the entries in the Documents page with a
Document Type of “Proof of Delivery” and a Document Purpose of “Bus”. If the document does not
appear in the drop-down menu, frst complete the remainder of the Old Bus and New Bus felds, select
the complete and save buttons, return to the Documents screen by selecting “Back to Document
Entry”, and enter the required information.

17. Enter the 17-digit Vehicle Identifcation Numbers (VINs) for the bus(es) delivered for New Bus VIN*.
18. New Bus EPA Vehicle Family feld requires you to enter the 12 character alphanumeric EPA Vehicle
Family. The EPA Vehicle Family can be found on the Vehicle Emission Control Information (VECI) label.
The VECI label is usually on/near a door pillar or on the engine compartment sheet metal. If the bus is
not an EPA certifed vehicle, please enter the CARB Executive Order ID. If the vehicle does not have
EPA or CARB certifcation, then please contact the CSB helpdesk.
19. New Bus Manufacturer* is prepopulated from the information in the Payment Request Form and
is editable. If the new bus make has changed, update the name of the manufacturer. The drop-down
menu provides a list of bus manufacturers to choose from. Manufacturers in the drop-down list are:
All American, Blue Bird Corporation, BYD, Collins Bus Corporation, Greenpower Motor Company, IC
Bus (Navistar), Lion Electric Company, Micro Bird (Girardin), Roush Cleantech, Starcraft Bus, Thomas
Built Buses, Titan Bus, Trans Tech, and Van-Con, Inc. If the manufacturer of your new bus is not shown,
choose the “Other” option and an additional feld will appear allowing you to enter the make of your
new bus. If the new bus has changed, the feld is editable.
20. New Bus Purchase Price* is the purchase price of the ordered replacement bus including tax and
any eligible training/consulting/warranty line-item expenses associated with the individual bus in the
purchase order. Do not include charging infrastructure costs here.
21. New Bus Fuel Type* is prepopulated from the information in the Payment Request Form.
22. New Bus Model* is prepopulated from the information in the Payment Request Form. If the new bus
has changed, the feld is editable.
23. The Eligible Funding from Close Out feld is read-only. If the actual bus cost from the fnal invoice
(New Bus Purchase Price), is greater than or equal to the rebate amount from the Payment Request,
then this feld will display the rebate amount from the Payment Request. If the actual bus cost is less
than the rebate amount from the Payment Request, this will display the actual bus cost.
24. New Bus Model Year* is prepopulated from the information in the Payment Request Form. If the new
bus has changed, the feld is editable.
25. The New Bus GVWR* is prepopulated from the information in the Payment Request Form. If the new
bus has changed, the feld is editable.

26. The Applicant Bus Cost Responsibility feld is read-only and displays the amount that the applicant is
responsible for paying, based on the difference between the New Bus Purchase Price and the Eligible
Funding from Close Out felds.

27
28

27. The New Bus Delivery Date* feld is the date the bus was actually delivered.
28. Reason For Change of Bus Information feld is required if at least one of the new bus felds has
changed from the new bus information entered in the Payment Request. Please provide an explanation
for the change(s) in this feld.

29. The New Bus Estimated Annual Mileage* feld requires you to enter the estimated annual miles the
new bus will travel.
30. The Estimated EV Bus Range* feld requires you to enter the manufacturer’s estimated range in miles
for the new bus. This feld is only visible if the New Bus Fuel Type is electric.
The New Bus estimated fuel consumption (gallons) feld requires you to enter the estimated annual
fuel consumption for new propane (gallons) or CNG (lbs) buses. This feld is only visible if the New Bus
Fuel Type is CNG or propane.
31. The Capable of Bidirectional Charging* feld appears with the New Bus Fuel Type is electric and
prompts you to select yes or no from the drop-down menu. Select “yes” if the charger is capable of
bidirectional charging (i.e., the EVSE can both receive energy and provide energy to an external load,
such as vehicle-to-grid charging, which supplies energy back to the electrical grid).
32. EV Battery Capacity (kWh) is only visible if the New Bus Fuel Type is electric. Enter the rated battery
capacity of the bus in kWhs.
33. The Equipped with Auxiliary Heater?* feld prompts you to select yes or no from the drop-down
menu. Select “yes” if the New Bus is equipped with an auxiliary heater. This feld is only visible if the
New Bus Fuel Type is electric.

34. Auxiliary Heater Fuel Type is only visible if the bus is equipped with an auxiliary heater. Select the
auxiliary heater fuel type from the drop-down menu.

35. Auxiliary Heater Fuel Type (Other) is only visible if the auxiliary heater fuel type is “other”.
36. The Photo of New Bus and VIN Documentation* feld requires you to attach an image of the new
bus with the VIN number displayed. The image fle size must be between 1KB and 5MB. Accepted fle
types include .pdf, .png, .jpeg, and .jpg.

37
38

37. Battery Warranty Included? Select “Yes” from the drop-down menu if the New Bus has a battery
warranty.
38. The Number of Years Covered feld allows you to enter the length of the battery warranty in years.
This feld is only visible if Battery Warranty Included? Is “Yes”. Leave this feld blank if it does not apply
to your bus warranty.
39. The Miles Covered feld allows you to enter the miles covered by the battery warranty. This feld is only
visible if the Battery Warranty Included selection is “Yes”. Leave this feld blank if it does not apply to
your bus warranty.
40. kWh of Gross Discharge Throughput feld allows you to enter the total kWh of throughput covered by

the battery warranty. This feld is only visible if the Battery Warranty Included selection is “Yes.” Leave
this feld blank if it does not apply to your bus warranty.
41. The Battery Warranty Documents feld allows you to attach a fle or scan of the battery warranty for
the bus. The image fle size must be between 1KB and 5MB. Accepted fle types include .pdf, .png,
.jpeg, and .jpg. This feld is only visible if the Battery Warranty Included selection is “Yes”. Leave this
feld blank if it does not apply to your bus warranty.

42
43

42. Powertrain Warranty Included? Select “Yes” from the drop-down menu if the New Bus has a
powertrain warranty. Leave this feld blank if it does not apply to your bus warranty.
43. The Years Covered feld allows you to enter the length of powertrain warranty in years. This feld is
only visible if the Powertrain Warranty Included selection is “Yes”. Leave this feld blank if it does not
apply to your bus warranty.
44. The Miles Covered feld allows you to enter the miles covered by powertrain warranty. This feld is only
visible if the Powertrain Warranty Included selection is “Yes”. Leave this feld blank if it does not apply
to your bus warranty.
Note: Once you have completed the felds above you must select the “Complete” button at the bottom of the
screen before moving on. You must fll out all required information for every bus in your feet.

2.15 Excluding a Bus

At this point, you can swap out old buses or exclude buses from your feet. If you choose to exclude a bus,
EPA must be reimbursed for the amount you received for that bus. A warning will pop up with the amount of
money you owe to EPA. The Bus Rebate Owed Back to EPA feld is the amount by which your rebate exceeded
your cost for the bus. You must refund this amount back to EPA.
Note: If you accidentally select “Swap Old Bus” or “Exclude Bus”, select “Cancel” and your data will be
restored.
Note: When EPA completes the review of your Close Out Form, you will receive confrmation that a rebate is
needed and EPA RTP Finance Center will provide you with a direct link to pay your bill.

2.16 Swapping Out an Old Bus
If you choose to swap out an old bus for a different old bus, you will need to choose the Old Bus Owner
from the drop-down list. If you don’t see the owner, select “Back to Organization Entry” to add them. Then,
you need to select a reason for swapping the old bus from the drop-down menu. If you select “other” you
will need to provide a reason for swapping out the old bus. Then, you will need to complete the New Bus
information and Old Bus information presented in Section 2.13.

2.17 Bus Funding Information
Once you have completed the Bus Information section, you will need to provide the funding information
for non-EPA sources. Select the funding type from the drop-down menu, then add the funding source and
amount. The drop-down menu will give you the following options for funding type: Federal Funding, State
Funding, City Funding, Non-Proft Assistance, and Other. The funding source is the organization that provided
the funding.
Note: See Program Guide regarding restrictions on the use of Federal funds.

A warning will pop up if you do not list enough funds or if you list more funds than needed to cover your cost
responsibility, but you can still continue with the form.

2.18 Complete Bus Information
1

7
8
9

Please review the prepopulated Bus Cost Totals felds listed below before moving on.
1.

The Number of Buses Requested (Application) is prepopulated from the information in your rebate
application.

2. Number of Buses Ordered (Payment Request) is prepopulated from the information in your Payment
Request Form.
3. Number of Buses Received (Close Out) is the sum of the number of new buses entered on this
Close Out Form.
4. Total Bus Costs from Payment Request is the New Bus Purchase Price for all the replacement buses
ordered on the Payment Request Form.
5. Total Bus Rebate Received is the total rebate amount received for all the buses ordered in the
Payment Request Form. This does not include the infrastructure portion of the rebate (if applicable).
6. Total Bus Cost (Actual) is the sum of the actual costs of all buses ordered and received.
7.

Total Bus Rebate Amount Used is the Eligible Rebate Funding based on the Close Out Form for all
the replacement buses received.

8. Total Applicant Bus Cost Responsibility is the amount by which the total bus cost exceeds the total
eligible rebate funding amount for the new replacement buses.
9. Total Non-Program Funding Acquired is the sum of all non-EPA funding amounts.
Total Bus Rebate Owed Back to EPA is the amount of excess rebate funds from all buses that you
must pay back to EPA. This feld does not appear if there are no excess rebate funds that are due to
EPA.
Once you have added all the bus information, select “Next” to continue

2.19 Infrastructure and Funding Information
Select “+ Add Infrastructure” to add information for EVSE (electric vehicle supply equipment) or other eligible
infrastructure costs purchased. Select “+ Add Funding” to add non-EPA funding sources.

2.20 Add Infrastructure – Level 2 / DC Fast Chargers

8
9

Note: You only have to complete the Infrastructure Information section for electric buses. Select the
infrastructure type by using the drop-down menu. The data felds associated with Level 2 and DC fast chargers
are described below, with required felds marked with an asterisk.
1.

The Infrastructure Type* feld requires you to select a charging infrastructure type from the drop-down
menu. You must specify all infrastructure items purchased with rebate funds. The options are Level 2
Charger, DC Fast Charger, and Other Eligible Infrastructure Costs.

2. The Infrastructure Quantity* feld needs to be populated with the number of chargers purchased.
If multiple types of chargers were purchased, each type must be entered separately. Also, if the
purchase price varied for the same type of charger, then the chargers should be entered separately.
3. The EVSE Maximum Output Power (kW)* feld requires you to enter the rated maximum output
power of the charger (in kilowatts)
4. Enter the price per charger in the Infrastructure Cost Per Charger (Actual)* feld.
5. Select the EVSE Manufacturer* from the dropdown list. If the manufacturer is not listed, select
“Other” and enter the manufacturer in the EVSE Manufacturer (Other) feld below.
6. The Infrastructure Subtotal feld is read only and displays the subtotal for each infrastructure line
item.
7.

The EVSE Model* is the model of the infrastructure hardware purchased.

8. The Cost Includes Installation box should be selected if the Infrastructure Cost includes installation.
9. Select the Infrastructure Supplier* from the drop-down menu. If the name doesn’t appear on the
list, complete the Infrastructure Information for this infrastructure type, the Installation/Construction
Address felds, select the Complete and Save buttons, and select the “Back to Organization Entry”
button to enter the supplier’s information.

10
11
12
10. Enter the EVSE Manufacture Year.* The year must not be before 2005 or after 2031.
11. Enter the number of plugs per charger for the Number of Plugs on EVSE* feld.
12. EVSE Capable of Bidirectional Charging? Check this box if the charger is capable of bidirectional
charging (i.e., the EVSE can both receive energy and provide energy to an external load, such as
vehicle-to-grid charging, which supplies energy back to the electrical grid).
The Bus and EVSE to be Used for V2G feld is visible if both the charging equipment and bus are
capable of bidirectional charging (EVSE Capable of Bidirectional Charging? checkbox is selected).
Please enter whether or not this equipment will be used in a vehicle to grid application.

Next, add a fnal invoice and proof of delivery using the drop-down menus. If you don’t see the documents
required, select the Complete and Save buttons, and then the “Back to Document Entry” button to add them.
Finally, add an image of the charging equipment after installation. The image fle size must be between 1KB
and 5MB. Accepted fle types include .pdf, .png, .jpeg, and .jpg.
Once the required information is entered, select “Complete.”
Note: If a fnal invoice lists all the equipment on one invoice with different prices, and the total tax (if included)
is listed for all the equipment, you need to apportion the total tax for each piece of equipment.

2.21 Add Infrastructure – Other Eligible Infrastructure Costs

Note: You only have to complete the Infrastructure Information section for electric buses.
Select the infrastructure type using the drop-down menu. The data felds associated with “Other Eligible
Infrastructure Costs” are shown below, with required felds marked with an asterisk. Other Eligible
Infrastructure Costs include construction, electrical work, site preparation, etc.
1.

The Infrastructure Type* feld requires you to select a charging infrastructure type from the drop-down
menu. In this case select Other Eligible Infrastructure Costs. Do not enter other eligible infrastructure
costs that were included in the purchase price of the EVSE as that should already be accounted for
when you entered EVSE costs.

2. The Other Infrastructure Organization Cost (Actual)* feld must be populated with the total of all
Other Eligible Infrastructure Costs, including construction, electrical work, site preparation, etc.
3. Indicate the Infrastructure Type (Other)* that you are referring to (e.g., construction, electrical work,
site preparation, etc.).
4. Select the Other Infrastructure Organization* from the drop-down menu. If the name doesn’t
appear on the list complete the Infrastructure Information for this infrastructure type, the Installation/
Construction Address felds, and select the Complete and Save buttons and then the “Back to
Organization Entry” button to enter the supplier’s information.
5. Provide a detailed description of the infrastructure-related work entered in the “Other Eligible
Infrastructure Costs” feld for the Description of Work.

Next, select the infrastructure owner from the drop-down menu. If you don’t see the owner, complete
the Installation/Construction Address felds, select the Complete and Save buttons, and select “Back to
Organization Entry” to add them. Then, add the address where the charger is installed.
Then, add a fnal invoice for the associated cost using the drop-down menu. If you don’t see the document
required, select the Complete and Save buttons, and then the “Back to Document Entry” button to add them.
Once the required information is entered, select “Complete.”
Continue to add infrastructure until you have added all items that were purchased.

2.22 Funding Information

Select the funding type, and add the source and amount for each non-EPA funding source. Once the required
information is entered for each source, select “Complete.” Repeat the process until all funding sources have
been added. The felds associated with funding information are listed below:
1.

Select a Funding Type* from the drop-down menu. The options are Federal Funding, State Funding,
City Funding, Utility Make-Ready Funding, Non-Proft Assistance, and Other.

2. The Funding Source* feld requires you to enter the name of the organization that provided funding.
3. The Funding Amount* feld must be populated with the amount of funding received.
Once you have added all infrastructure and funding source information, you will see the total costs for
your infrastructure at the bottom of the page. Please review the prepopulated Infrastructure Cost Totals
felds listed below before moving on.
If your rebate does not cover the full cost of infrastructure, you will see how much you will need to pay
to cover the costs under “Applicant Infrastructure Cost Responsibility (Actual)”. If you owe money back
to EPA, a warning will pop up letting you know the amount to be reimbursed.

10
11
12
13

Level 2 Charger Costs from Payment Request are the costs listed on the Payment Request Form
that were itemized on an infrastructure Purchase Order and is not editable.

2. DC Fast Charger Costs from Payment Request are the costs listed on the Payment Request Form
that were itemized on an infrastructure Purchase Order and is not editable.
3. Other Infrastructure Costs from Payment Request are the costs listed on the Payment Request
Form that were itemized on an infrastructure Purchase Order and is not editable.
4. Level 2 Charger Costs (Actual) is based on the sum of all Level 2 charger costs and is not editable.
5. DC Fast Charger Costs (Actual) is based on the sum of all DC fast charger costs and is not editable.
6. Other Infrastructure Costs (Actual) is based on the sum of all other eligible infrastructure costs and is
not editable.
7.

Total Infrastructure Costs from Payment Request is prepopulated with the sum of the infrastructure
costs entered on the Payment Request Form and is not editable.

8. Total Infrastructure Rebate Received is prepopulated with the total infrastructure rebate you received
based on your Payment Request Form and is not editable.
9. Total Infrastructure Costs (Actual) is based on the sum of the actual Level 2, DC fast charger and
other eligible infrastructure costs and is not editable.
10. Total Eligible Rebate (Actual) is prepopulated with the total infrastructure funding you are eligible for
based on the number of replacement electric school bus(es) received and the prioritization level of the
school district that the buses will serve and is not editable.
11. The Total Infrastructure Rebate Used (Actual) value is the amount of the actual total eligible funding
that you used for all the charging infrastructure received and installed as well as any other eligible
infrastructure costs and is not editable.
12. Applicant Infrastructure Cost Responsibility (Actual) shows the amount of money that the applicant
will be responsible to pay after the rebate based on the costs provided in this form and is not editable.
13. Total Non-Program Funding Acquired is prepopulated with the sum of all non-EPA funding received
and associated infrastructure for your new buses and is not editable.

Infrastructure Rebate Owed Back to EPA shows the amount of excess rebate funds from all
infrastructure that you must pay back to EPA and is not editable. This feld does not appear if there are
no excess rebate funds that are due to EPA.

2.23 Complete Infrastructure and Funding

Once you have added all infrastructure and funding source information, you will see the total costs for your
infrastructure at the bottom of the page. If your rebate does not cover the full cost of infrastructure, you will
see how much you owe under “Applicant Infrastructure Cost Responsibility (Actual)”. If you owe money back to
EPA, a warning will pop up letting you know the amount to be reimbursed.
Select “Next” when you are fnished.
Note: You will be able to continue with the form even if you need to reimburse EPA.

2.24 Telematics Information
If you are willing to share your telematics-related information with EPA, select the Telematics Data check box.
Next, select the appropriate contact information.

2.25 Telematics Contact Information
If you would like to provide separate contact information from your primary or alternate contact, select
“Provide Separate Telematic Contact” and fll in the required information. Select “Next” to proceed.

2.26 Signature

Please review the summary cost information provided at the top of the screen before you sign the Close
Out Form. Summary information includes Total Bus and Infrastructure Rebate Amount Paid, the Total Bus and
Infrastructure Eligible Rebate Amount, the Total Bus and Infrastructure Costs (actual), and the Total Non-EPA
Funding Acquired. If you owe any money back to EPA, a warning will pop up letting you know the total amount.
To complete your Close Out Form, you must read and certify to the items listed in the Signature and
Certifcation section, sign, confrm signature, and select “Submit Form”. The “Name” and “Title” felds on this
page are prepopulated based on who is logged into this form. If you are the authorized representative, confrm
your title in the ‘Title’ feld, update if needed. If you do not have the authority to sign this Close Out Form, then
notify the authorized representative so they can sign and submit the Close Out Form.
If you sign and confrm signature, but then return to a previous screen to make edits, you will need to repeat
the signature and confrmation steps to submit your form.
If a different user needs to sign and submit the form, they must also be a SAM.gov point of contact for your
organization and will need to use Login.gov to enter the Clean School Bus Rebate Forms site to complete the
Close Out Form (saved as a draft). In this case, they must edit the “Name” and “Title” felds on this screen to
show their full name and title before signing and submitting.

2.27 Missing Document and/or Organization Information

If there is any missing information, a warning will pop up indicating what is lacking. Select “Back to Bus
Information Entry” if you have any bus information missing, and “Back to Infrastructure Information Entry” if
you have any missing infrastructure information. Once you add all missing information, return to the signature
page to sign and submit the Close Out Form.

3. Next Steps
EPA will review submissions for completeness and accuracy and follow up with questions as needed.

Appendix A. Glossary
The following provides defnitions of terms and feld labels used throughout the Close Out Form and system
screens.

Your Rebate Applications Forms Screen: Defnitions
■

Form Type –Application, Payment Request, or Close Out Form

■

UEI – Unique Entity ID from SAM.gov

■

EFT Indicator – Electronic Funds Transfer Indicator for the associated bank account from SAM.gov

■

Applicant – Legal Business Name from SAM.gov for this UEI

■

School District – School District represented by the applicant

■

Updated by – Last person to update the form

■

Date Updated – Last date this form was updated

■

Status – submitted or draft

Close Out Form Screens: Defnitions

■

Alternate Contact Business Email – Please verify that the alternate contact business email for your
organization is correct. If not, update it with the current alternate contact business email. If this feld is
blank, enter an alternate contact business email if you have one.

■

Alternate Contact Business Phone Number – Please verify that the alternate contact business phone
number for your organization is correct. If not, update it with the current alternate contact business
phone number. If this feld is blank, enter an alternate contact business phone number if you have one.

■

Alternate Contact First Name – Please verify that the alternate contact frst name for your organization
is correct. If not, update it with the current alternate contact frst name. If this feld is blank, enter an
alternate organization contact frst name if you have one.

■

Alternate Contact Last Name – Please verify that the alternate contact last name for your organization
is correct. If not, update it with the current alternate contact last name. If this feld is blank, enter an
alternate organization contact last name if you have one.

■

Alternate Contact Title – Please verify that the alternate contact title for your organization is correct. If
not, update it with the current alternate contact title. If this feld is blank, enter an alternate contact title
if you have one.

■

Applicant Bus Cost Responsibility –This calculated value is the portion of the bus cost that exceeds the
rebate amount.

■

Applicant Infrastructure Cost Responsibility (Actual) –This calculated value is the amount that is the
responsibility of the applicant to pay for infrastructure. It is the sum of the Level 2 Charger Costs
(Actual), the DC Fast Charger Costs (Actual) and Other Eligible Infrastructure Cost (Actual) feld
amounts that exceeds the total rebate amount received for infrastructure.

■

Auxiliary Heater Fuel Type – Select the auxiliary heater fuel type from the dropdown menu. If the
auxiliary heater fuel type is not listed, select “Other” and enter the type in the Auxiliary Heater Fuel
Type (Other) feld.

■

Auxiliary Heater Fuel Type (Other) – Enter the auxiliary heater fuel type.

■

Battery Warranty Documents –Attach a fle or scan of the battery warranty for the bus.
Allowed fle types: *.pdf, *.png, *.jpeg, *.jpg
Minimum fle size: 1KB
Maximum fle size: 5MB

■

Battery Warranty Included? – Select “Yes” from the dropdown menu if the New Bus has a battery
warranty, or “No” if there is no battery warranty.

■

Bus # –This value is imported from your Payment Request.

■

Bus and EVSE to be Used for V2G? – Select from the dropdown list to indicate if the bus and EVSE are
going to be used for Vehicle to Grid charging.

■

Bus Rebate Received –The is the rebate you received for this new bus and is preflled from your
Payment Request.

■

Bus Reimbursement Owed to EPA –This is the amount by which your rebate exceeded your cost for
this bus. You must refund this amount back to EPA.

■

Capable of Bidirectional Charging – Select “yes” if the charger is capable of two-way charging (e.g.,
grid-to-vehicle and vehicle-to-grid). Select “no” if the charger can only charge grid-to-vehicle.

■

City – Enter the city where the infrastructure (charger and other eligible infrastructure) was installed.

■

Cost Includes Installation – Check this box if the cost listed in the Infrastructure Cost Per Charger feld
includes installation.

■

County – Enter the county where the infrastructure (charger and other eligible infrastructure) was
installed.

■

DC Fast Charger Costs (Actual) –This is the sum of all DC fast charger costs entered on this Close Out
Form.

■

DC Fast Charger Costs from Payment Request –These are the costs listed on the Payment Request
Form that were itemized on an infrastructure Purchase Order.

■

Description of Work – Provide a detailed description of the infrastructure-related work entered in the
“Other Eligible Infrastructure Cost” feld.

■

Document Description –This optional feld can be used to enter any additional information about the
document and is limited to 250 characters.

■

Document Name – Enter a name for the document (may be different than the flename). Used to
reference this document within the form. Please keep these names unique to each document.

■

Document Purpose – Indicate the purpose for this Document (bus, electric charging infrastructure, or
both). Note: Documents for any propane and CNG infrastructure are not needed as this infrastructure
was not eligible to receive rebate funding.

■

Document Type – Select the document type from dropdown menu. Both a fnal invoice and proof of
delivery must be entered for each new bus receiving funding; however you may combine multiple
buses or infrastructure elements, if clearly delineated, on a single invoice and a single proof of delivery
document if desired.

■

Document Upload – Final Invoices and Proof of Delivery – Attach a fle or scan of the relevant
document.
Allowed fle types: *.pdf, *.png, *.jpeg, *.jpg
Minimum fle size: 1KB
Maximum fle size: 5MB

■

Eligible Funding From Close Out –This calculated value is the eligible funding for this bus based on the
new bus information entered in the Close Out. This amount can be the same (if no changes from the
Payment Request), or less than the Bus Rebate Received (if New Bus Purchase Price is less than the
Bus Rebate Received). The amount cannot be more than the Bus Rebate Received even if the New
Bus Purchase Price is greater than the Bus Rebate Received.

■

EPA Vehicle Family – Please enter the 12-character alphanumeric EPA Vehicle Family. The EPA Vehicle
Family can be found on the Vehicle Emission Control Information (VECI) label. The VECI label is usually
on/near a door pillar or on the engine compartment sheet metal. If the bus is not an EPA certifed
vehicle, please enter the CARB Executive Order ID. If the vehicle does not have EPA or CARB
certifcation, then please contact the CSB helpdesk.

■

Equipped with Auxiliary Heater? – Select “Yes” from the dropdown menu if the New Bus is equipped
with an auxiliary heater. Select “No” if the bus is not equipped with an auxiliary heater.

■

Estimated Annual Idling Hours – Enter the estimated annual idling hours for the new bus.

■

Estimated EV Bus Range (mi) – Enter the manufacturer’s estimated range in miles for the new bus.

■

Estimated Remaining Life (years) –This value is imported from your Payment Request. If “Swap Old
Bus” is checked, estimate the remaining service life (in years) of the different Old Bus that was
replaced.

■

EV Battery Capacity (kWh) – Enter the rated battery capacity of the bus in kilowatt-hours (kWh).

■

EVSE Capable of Bidirectional Charging? – Check this box if the charger is capable of bidirectional
charging (i.e., the EVSE can both receive energy and provide energy to an external load, such as
vehicle-to-grid charging, which supplies energy back to the electrical grid).

■

EVSE Manufacture Year –The manufacturer year must not be before 2005 or after 2031.

■

EVSE Manufacturer – Select the EVSE manufacturer from the dropdown list. If the manufacturer is
not listed, select “Other” at the bottom of the list, and then enter the manufacturer in the EVSE
Manufacturer (Other) feld below this feld.

■

EVSE Manufacturer (Other) – Enter the EVSE manufacturer that was not listed in the dropdown in the
EVSE Manufacturer feld.

■

EVSE Maximum Output Power (kW) – Enter the rated maximum output power of the charger (in
kilowatts).

■

EVSE Model –The model of the infrastructure hardware purchased.

■

Exclude Bus – Exclude this bus and its replacement bus rebate from this rebate request. If you want
to replace a different old bus rather than excluding this bus and its replacement, select the “Swap
Bus” checkbox instead. If you want to replace a different old bus rather than excluding this bus and its
replacement, select the “Swap Bus” checkbox instead.

■

Final Invoice – Select the fnal invoice for the bus listed in the New Bus felds below. If the fnal invoice
does not appear in the dropdown, complete the following steps:
1.

Complete the remainder of the Old Bus and New Bus felds

2. Click the “Complete” button
3. Click “Save” button at the bottom right of the screen
4. Click “Back to Document Entry” to enter the Final Invoice for this bus
5. Click “Return to Bus Information Page”
6. Select “Edit” for this bus
7.

Select the document from the dropdown

■

Infrastructure Cost Per Charger (Actual) – Enter the unit cost for each charger (plus installation costs if
not reported separately). If you have multiple chargers at different costs, a separate Infrastructure Item
needs to be entered for each (click the blue “Add Infrastructure” box).

■

Infrastructure Owner – Select the infrastructure owner or organization that did other eligible
infrastructure work from the dropdown list. If you don’t see the organization in the dropdown do the
following:
1.

Complete the Installation/Construction Address felds

2. Click the “Complete” button
3. Click the “Save” button at the bottom right of the screen
4. Click “Return to Organization Entry” to enter the organization information
5. Click “Return to Infrastructure Page”
6. Select “Edit” for this Infrastructure Type
7.

Select the organization from the dropdown

■

Infrastructure Quantity – Enter the number of chargers purchased at the same price. If multiple types
of chargers were purchased, each type must be entered individually. Additionally, if multiple chargers
of the same type were purchased at different costs, then the chargers need to be entered as separate
infrastructure items.

■

Infrastructure Reimbursement Owed to EPA – Amount of excess rebate funds received for all
infrastructure, that you may need to pay back to EPA based on this Close Out Form.

■

Infrastructure Supplier – Select the supplier from the dropdown list. If you don’t see the organization in
the dropdown do the following:
1.

Complete the Infrastructure Information for this infrastructure type, and the Installation/
Construction Address felds

Select the organization from the dropdown

■

Infrastructure Type – Select the charging infrastructure type from the dropdown menu. Add all that were
purchased with rebate funds. Level 2 Charger and DC Fast Charger refer to the actual chargers and
pedestals. Other Eligible Infrastructure Costs include construction, electrical work, site preparation,
design and engineering, labor and permitting etc.

■

Infrastructure Type (Other) – Enter the type of other eligible infrastructure costs. Other Eligible
Infrastructure Costs include construction, electrical work, site preparation, design and engineering,
labor and permitting etc.

■

Level 2 Charger Costs from Payment Request –The costs listed on the Payment Request Form that
were itemized on an infrastructure Purchase Order.

■

Level 2 Charger Costs (Actual) –This is the sum of all Level 2 charger costs entered on this Close Out
Form.

■

Miles Covered [battery] – Enter total miles covered by battery warranty.

■

Miles Covered [powertrain] – Enter total miles covered by powertrain warranty.

■

Name [signature] –The authorized representative’s name is automatically flled from SAM.
gov information in this feld, based on who is logged-in to this form. If you are the authorized
representative, confrm your title in the ‘Title’ feld, update if needed and sign the form below. If you do
not have the authority to sign this Close Out Form, then notify the authorized representative so they
can sign and submit the Close Out Form.

■

National Center for Education Statistics (NCES) District ID –This is the NCES District ID that was
entered on your application form for the school district listed above that new buses will serve for at
least fve years. You may have updated this ID on the Payment Request Form for specifc buses.

■

New Bus Dealer –This is the bus seller from the Purchase Order that was entered into the Payment
Request Form.

■

New Bus Delivery Date – Enter date in the format MM/DD/YYYY.

■

New Bus Estimated Annual Mileage – Enter the estimated annual miles the new bus will travel.

■

New Bus Estimated Fuel Consumption (gallons) – Enter the estimated annual fuel consumption for the
new propane (gallons) or CNG (lbs) bus.

■

New Bus Fuel Type –This is preflled from what you entered in your Application form. If the new bus
fuel type has changed, update it from the dropdown menu and provide a reason why the bus fuel type
has changed in the Reason For Change of Bus Information feld.

■

New Bus GVWR –This is preflled from what you entered in your Payment Request Form. If the new
bus Gross Vehicle Weight Rating (GVWR) has changed, update it and provide a reason why the GVWR
of the bus has changed in the Reason For Change of Bus Information feld.

■

New Bus Manufacturer –This is preflled from what you entered in your Payment Request Form. If the
new bus make has changed, update name of manufacturer and provide a reason why the make of the
bus has changed in the Reason For Change of Bus Information feld.

■

New Bus Manufacturer (Other) –This is preflled from what you entered in your Payment Request Form.
If the new bus manufacturer has changed, update name of manufacturer and provide a reason why the
make of the bus has changed in the Reason For Change of Bus Information feld.

■

New Bus Model –This is preflled from what you entered in your Payment Request Form. If the new
bus model has changed, update it and provide a reason why the model of the bus has changed in the
Reason For Change of Bus Information feld.

■

New Bus Model Year –This is preflled from what you entered in your Payment Request Form. If the
new bus model year has changed, update it and provide a reason why the model year of the bus has
changed in the Reason For Change of Bus Information feld.

■

New Bus Owner – Select the name of the Organization that owns the new bus listed in the New Bus
felds below. If the organization does not appear in the dropdown, complete the following steps:
1.

Complete the remainder of the Old Bus and New Bus felds

2. Click the “Complete” button
3. Click the “Save” button at the bottom right of the screen
4. Click “Back to Organization Entry” to enter the New Bus Owner for this bus
5. Click “Return to Bus Information Page”
6. Select “Edit” for this bus
7.

Select the organization from the dropdown

■

New Bus Purchase Price – Enter the purchase price of the new replacement school bus received
including tax and any eligible training/consulting/warranty line-item expenses associated with the
individual bus in the purchase order. Do not include charging infrastructure costs here.

■

New Bus VIN – Enter the 17-digit Vehicle Identifcation Number (VIN) for the new bus delivered.

■

Non-EPA Funding Amount [bus] – Enter the amount of bus funding received from this source.

■

Non-EPA Funding Amount [infrastructure] – Enter the amount of infrastructure funding received from
this source.

■

Non-EPA Funding Source [infrastructure] – Enter the name of the organization that provided
infrastructure funding.

■

Non-EPA Funding Source [bus] – Enter the name of the organization that provided bus funding.

■

Non-EPA Funding Type [bus] – Select non-EPA new bus funding source type from the dropdown menu.

■

Non-EPA Funding Type [infrastructure] – Select the non-EPA infrastructure funding source type from
dropdown menu.

■

Non-EPA Infrastructure Funding Not Accounted For –This calculated number shows the amount of nonEPA funding that is the applicant’s responsibility which is not yet accounted for in the list of funding
source amounts you entered above. When all funding source amounts are accounted for, this number
will be ‘$0.00. If too much is accounted for, this number will be negative, and if not all funding source
amounts have been accounted for, this number will be positive.

■

Number of Buses Ordered (Payment Request) –This feld is autoflled from your Payment Request
Form.

■

Number of Buses Received (Close Out) –This value is the sum of the number of new buses entered
on this form. If this number is less than the Number of Buses Ordered (Payment Request) feld, you
excluded a replacement bus from this Close Out.

■

Number of Buses Requested (Application) –This feld is autoflled from your Application form.

■

Number of Electric School Buses in Current Fleet – Enter the total number of electric buses in your
current feet.

■

Number of Plugs on EVSE – Enter the number of plugs on each charger.

■

Number of School Buses in Current Fleet – Enter the total number of buses in your current feet.

■

Number of Years Covered [battery] – Enter the length of the battery warranty in years.

■

Number of Years Covered [powertrain] – Enter the length of the powertrain warranty in years.

■

Old Bus Annual Idling Hours – Enter the estimated annual idling hours for the old bus.

■

Old Bus Average Annual Fuel Consumption (gallons) – If the Swap Old Bus box is checked, enter the
estimated annual fuel consumption of the different old bus that was replaced.

■

Old Bus Average Annual Mileage – If the Swap Old Bus box is checked, enter the estimated average
annual mileage for the different old bus that was replaced.

■

Old Bus Donated To – Select the organization that the old bus was donated to. If the organization does
not appear in the dropdown, complete the following steps:
1.

Complete the remainder of the Old Bus and New Bus felds

2. Click the “Complete” button
3. Click the “Save” button at the bottom right of the screen
4. Click “Back to Organization Entry” to enter the Donee for this bus
5. Click “Return to Bus Information Page”
6. Select “Edit” for this bus
7.

Select the organization from the dropdown

■

Old Bus Fuel Type –This value is imported from your Payment Request. If the Swap Old Bus box is
checked, enter the fuel type of the different old bus that was replaced.

■

Old Bus GVWR – If the Swap Old Bus box is checked, enter the Gross Vehicle Weight Rating of the
different old bus that was replaced.

■

Old Bus Manufacturer – If the Swap Old Bus box is checked, select the manufacturer’s name of the
different old bus that was replaced.

■

Old Bus Manufacturer (Other) – If the Swap Old Bus box is checked, enter the manufacturer name of
the different old bus that was replaced if it doesn’t appear in the selection.

■

Old Bus Model – If the Swap Old Bus box is checked, enter the manufacturer name of the different old
bus that was replaced.

■

Old Bus Model Year –This value is imported from your Payment Request. If the Swap Old Bus box is
checked, enter the model year of the different old bus that was replaced.

■

Old Bus NCES District ID –This value is imported from your Payment Request. If the Swap Old Bus box
is checked, enter the 7-character NCES District ID for the school district the different old bus primarily
served during the 2021-2022 school year.

■

Old Bus Odometer (miles) – Enter odometer reading of the old bus at time of scrappage, donation or
sale. If exact reading is unknown, provide an estimate.

■

Old Bus Owner – Select the old bus owner from the dropdown. If the old bus owner is not listed in the
dropdown, you need to go back to the Organizations screen to enter the old bus owner organization,
so complete the following steps:
1.

Click “Back to Organization Entry”

2. Enter the old bus owner organization information,
3. Select the “Return to Bus Information Page”

4. Select “Edit” for this bus
5. Select the organization from the dropdown
■

Old Bus Proof of Scrappage –Attach photos of the old bus destroyed engine and chassis that shows or
indicates what the last 4 digits of the bus VIN are as proof of old bus scrappage. Attach a letter signed
by a representative of the scrap yard/entity the performed the scrappage. Allowed fle types: *.pdf,
*.png, *.jpeg, *.jpg. Minimum fle size: 1KB. Maximum fle size: 5MB

■

Old Bus Sold To – Select the organization that the old bus was sold to. If the organization does not
appear in the dropdown, complete the following steps:
1.

Complete the remainder of the Old Bus and New Bus felds

2. Click the “Complete” button
3. Click the “Save” button at the bottom right of the screen
4. Click “Back to Organization Entry” to enter the Purchaser for this bus
5. Click “Return to Bus Information Page”
6. Select “Edit” for this bus
7.

Select the organization from the dropdown

■

Old Bus Title and Registration –Attach a fle or scan of the Title and Registration for the different old
bus. Allowed fle types: *.pdf, *.png, *.jpeg, *.jpg. Minimum fle size: 1KB. Maximum fle size: 5MB.

■

Old Bus VIN –This value is imported from your Payment Request and is the Vehicle Identifcation
Number (VIN). If the Swap Old Bus box is checked, enter the 17-digit Vehicle Identifcation Number
(VIN) of the different old bus that was replaced.

■

Organization Address – Enter the street address of the organization.

■

Organization City – Enter the city where the organization is located.

■

Organization Contact Business Email – Enter the business email of the contact person entered for this
organization.

■

Organization Contact Business Phone Number – Enter the business phone number of the contact
person entered for this organization.

■

Organization Contact First Name – Enter the frst name of the contact person for the organization.

■

Organization Contact Last Name – Enter the last name of the contact person for the organization.

■

Organization County – Enter the county where the organization is located.

■

Organization Name – Enter the name of the organization.

■

Organization State or Territory – Search for or select the state or territory where the organization is
located from the dropdown list.

■

Organization Type – For the organization you are adding, select the appropriate checkboxes for this
organization’s type(s). See text at top of the page explaining the different organization types.

■

Organization Zip – Enter the 5 digit zip code, or the 5 digit zip plus 4 (e.g. NNNNN-NNNN) for the
organization.

■

Other Eligible Infrastructure Cost (Actual) – Enter the total of Other Eligible Infrastructure Costs for this
infrastructure type (other). The costs for this infrastructure type (for example, design and engineering)
are refected on the fnal invoice that you received for this work.

■

Other Infrastructure Organization – Select the organization from the dropdown that performed the other
eligble infrastructure installation or services (construction, electrical work, site preparation, design
and engineering, labor and permitting, charger installation) if not included in fnal invoice for charger
purchase etc. If you don’t see the organization in the dropdown do the following:
1.

Complete the Infrastructure Information for this infrastructure type, and the Installation/
Construction Address felds

Select the organization from the dropdown

Other Eligible Infrastructure Organization Supplier – Select the organization from the dropdown that
performed the other eligble infrastructure installation or services (construction, electrical work, site
preparation, design and engineering, labor and permitting, charger installation) if not included in fnal
invoice for charger purchase etc. If you don’t see the organization in the dropdown do the following:
1.

Complete the Infrastructure Information for this infrastructure type, and the Installation/
Construction Address felds

Select the organization from the dropdown

■

Other Infrastructure Costs (Actual) –This is the sum of all other eligible infrastructure costs entered on
this Close Out Form.

■

Other Infrastructure Costs from Payment Request –The costs listed on the Payment Request Form that
were itemized on an infrastructure Purchase Order.

■

Photo of Charging Equipment –Attach a photo of the installed EVSE. Allowed fle types: *.pdf, *.png,
*.jpeg, *.jpg. Minimum fle size: 1KB. Maximum fle size: 5MB.

■

Photo of New Bus and VIN Documentation – Attach a photo of the new bus that includes or indicates
the VIN number. Allowed fle types: *.pdf, *.png, *.jpeg, *.jpg. Minimum fle size: 1KB. Maximum fle
size: 5MB.

■

Powertrain Warranty Included? – Select “Yes” from the dropdown menu if the New Bus has a
powertrain warranty, or “No” if it doesn’t.

■

Powertrain Warranty Documents –Attach a fle or scan of the powertrain warranty for the bus if
applicable. Allowed fle types: *.pdf, *.png, *.jpeg, *.jpg. Minimum fle size: 1KB. Maximum fle size:
5MB.

■

Primary Contact Business Email [your organization] – Please verify that the primary contact business
email for your organization is correct. If not, update it with the current primary contact business email.

■

Primary Contact Business Email [telematics organization] – Please verify that the primary contact
business email for the telematics organization is correct. If not, update it with the current primary
contact business email.

■

Primary Contact Business Phone Number [your organization contact] – Please verify that the primary
contact business phone number for your organization is correct. If not, update it with the current
primary contact business phone number.

■

Primary Contact Business Phone Number [telematics organization] – Please verify that the primary
contact business phone number for the telematics organization is correct. If not, update it with the
current primary contact business phone number.

■

Primary Contact First Name [your organization] – Please verify that the primary contact frst name for
your organization is correct. If not, update it with the current primary contact frst name.

■

Primary Contact First Name [telematics organization] – Please verify that the primary contact frst name
for the telematics organization is correct. If not, update it with the current primary contact frst name.

■

Primary Contact Last Name [your organization] – Please verify that the primary contact last name for
your organization is correct. If not, update it with the current primary contact last name.

■

Primary Contact Last Name [telematics organization] – Please verify that the primary contact last name
for the telematics organization is correct. If not, update it with the current primary contact last name.

■

Primary Contact Title [your organization] – Please verify that the primary contact title for your
organization is correct. If not, update it with the current primary contact title.

■

Primary Contact Title [telematics organization] – Please verify that the primary contact title for the
telematics organization is correct. If not, update it with the current primary contact title.

■

Private Fleet Name –This is the private feet that was listed on your application form. If the private feet
supplying buses or service to the school district has changed, enter new private feet information on
the Organizations page of this form.

■

Proof of Delivery [new bus] – Select the proof of delivery (e.g. bill of lading) for the bus listed in the
New Bus felds. If the proof of delivery does not appear in the dropdown, complete the following
steps:
1.

Complete the remainder of the Old Bus and New Bus felds

2. Click the “Complete” button
3. Click the “Save” button at the bottom right of the screen
4. Click “Back to Document Entry” to enter the Proof of delivery for this bus
5. Click “Return to Bus Information Page”
6. Select “Edit” for this bus
7.
■

Select the document from the dropdown

Proof of Delivery [infrastructure] – Select the proof of delivery document for this infrastructure type
item from the dropdown. If the proof of delivery does not appear in the dropdown, complete the
following steps:
1.

Click the “Complete” button

2. Click the “Save” button at the bottom right of the screen
3. Click ‘Back to Document Entry’ to enter the Proof of Delivery document for this infrastructure

4. Click “Return to Infrastructure Page”
5. Select “Edit” for this infrastructure type item
6. Select the document from the dropdown
■

Reason for Change of Bus Information –This feld displays if at least one of the new bus felds has
changed from the new bus information entered in the Payment Request or Application. Explain the
change(s) in this feld.

■

Reason for Swapping Old Bus – Select the reason for swapping the old bus from the dropdown menu.

■

Reason for Swapping Old Bus (Other) – If you have a reason that isn’t listed for swapping an old bus,
provide the reason here.

■

Replacement Process – Select how the different old bus was replaced. 2010 and older buses can only
be scrapped. 2011 and newer buses can be scrapped, sold, or donated.

■

School District Name –This is the school district name that corresponds to the NCES District ID that
was submitted on the application form.

■

Scrap Yard Organization – Select the scrap yard where the old bus was scrapped from the dropdown
list. If the organization does not appear in the dropdown, complete the following steps:
1.

Complete the remainder of the Old Bus and New Bus felds

2. Click the “Complete” button
3. Click the “Save” button at the bottom right of the screen
4. Click “Back to Organization Entry” to enter the Scrap Yard for this bus
5. Click “Return to Bus Information Page”
6. Select “Edit” for this bus
7.

Select the organization from the dropdown

■

State or Territory – Select the state or territory from the dropdown list.

■

Street Address – Enter the street address where the charger is installed, or where the other eligble
infrastructure work was done.

■

Swap Old Bus – Check this box if you want to scrap, donate or sell a different Old Bus from what was
entered in your Application and complete the felds for the different old bus.

■

Telematic Contact Selection – Select the type of contact for the telematics organization using the
dropdown menu.

■

Telematic Contact First Name – If you selected a “Separate Telematic Contact” in the Telematic Contact
Selection dropdown, provide the frst name of the separate contact.

■

Telematic Contact Last Name – If you selected a “Separate Telematic Contact” in the Telematic Contact
Selection dropdown, provide the last name of the separate contact.

■

Telematic Contact Title – If you selected a “Separate Telematic Contact” in the Telematic Contact
Selection dropdown, provide the title of the separate contact.

■

Telematic Contact Business Phone Number – If you selected a “Separate Telematic Contact” in the
Telematic Contact Selection dropdown, provide the business phone number of the separate contact.

■

Telematic Contact Business Email – If you selected a “Separate Telematic Contact” in the Telematic
Contact Selection dropdown, provide the email of the separate contact.

■

Title –The authorized representative’s title is automatically flled from SAM.gov information in this feld,
based on who is logged-in to this form. If you are the authorized representative, confrm your title,
update if needed, and sign the form below. If you do not have the authority to sign this Close Out
Form, then notify the authorized representative so they can sign and submit the Close Out Form.

■

Total Applicant Bus Cost Responsibility –This calculated value is the amount that is the responsibility of
the applicant to pay. It is the difference between the New Bus Purchase Price for all the replacement
buses and the total eligible rebate funding amount for the new replacement buses.

■

Total Bus and Infrastructure Costs (Actual) –This is the sum of bus and infrastructure costs entered on
this form.

■

Total Bus and Infrastructure Eligible Rebate Amount – This is the sum of the ‘Total Bus Rebate Amount
Used’ and ‘Total Infrastructure Rebate Used (Actual)’ felds.

■

Total Bus Cost (Actual) –This calculated value is the New Bus Purchase Price for all the replacement
buses received and included in the Close Out.

■

Total Bus Costs from Payment Request –This calculated value from the Payment Request Form is the
New Bus Purchase Price for all the replacement buses ordered.

■

Total Bus Rebate Amount Used –This calculated value is the Eligible Funding from this Close Out Form
for all the replacement buses received and included in the Close Out.

■

Total Bus Rebate Received –This calculated value is the total rebate amount received for all the buses
ordered in the Payment Request Form. This does not include the infrastructure portion of the rebate (if
applicable).

■

Total Bus Reimbursement Owed to EPA – Amount of excess rebate funds received for all buses that
you need to pay back to EPA based on this Close Out Form.

■

Total Infrastructure Costs (Actual) –This is the total costs entered on this Close Out Form for Level 2
and DC Fast Chargers as well as any other eligible infrastructure costs.

■

Total Infrastructure Costs from Payment Request –This is the sum of the infrastructure costs entered
on your Payment Request.

■

Total Infrastructure Rebate Received –This is the total infrastructure rebate you received based on your
Payment Request.

■

Total Infrastructure Rebate Used (Actual) –This calculated value is the amount of the actual eligible
funding from this Close Out Form that you used for all the charging infrastructure received and installed
as well as any other eligible infrastructure costs.

■

Total Non-EPA Program Funding Acquired –This is the sum of all non-EPA funding received for new
replacement buses and associated infrastructure.

■

Total Non-Program Funding Acquired [bus] –The sum of all non-EPA funding amounts entered in the
Non-EPA Clean School Bus Funding Information section of the page.

■

Total Non-Program Funding Acquired [infrastructure] –The sum of all non-EPA funding amounts entered
in the Non-EPA Clean School Bus Infrastructure Funding Information section of this screen.

■

Total Owed Back to EPA –This is the amount by which your Total Bus and infrastructure Rebate Amount
Paid exceeds your Total Bus and Infrastructure Eligible Rebate Amount. You must refund this amount
back to EPA.

■

Total Rebate Funds Received from Payment Request –This the total bus and insfrastructure rebate
payment you received based on your approved Payment Request Form.

■

Total Rebate Funds Requested In Application –This is the total bus and infrastructure (if applicable)
funding requested based on your application.

Appendix B. Printable List of Fields
The Close Out Form requires some or all of the following information. Fields with an asterisk are automatically
prepopulated based on Replacement Bus Fuel Type, Replacement Bus GVWR, and the prioritization status of
the school district per the 2022 CSB Rebates Program Guide.
SAM.gov credentials
Applicant Type
■

*Applicant Name

■

*School District Prioritized

■

*School District Name

■

*National Center for Education Statistics (NCES) District ID

■

*Total Rebate Funds Requested in the Application

Application Info (Screen 2)
__________________________________________

__________________________________________

*Applicant

*School District Prioritized?

__________________________________________

*School District Name

*NCES District ID

__________________________________________

*Total Rebate Funds Requested in the Application

*Total Rebate Funds Received from Payment Request

Applicant Primary Contact Information
__________________________________________

__________________________________________

*Primary Contact First Name

*Primary Contact Business Phone Number

__________________________________________

*Primary Contact Last Name

*Primary Contact Business email

__________________________________________
*Primary Contact Title

Applicant Alternate Contact Information
__________________________________________

__________________________________________

Alternate Contact First Name

Alternate Contact Business Phone Number

__________________________________________

Alternate Contact Last Name

Alternate Contact Business email

__________________________________________
Alternate Contact Title

Organizations (Screen 3)
General Information
*Organization Type

__________________________________________

__ Scrap Yard (old bus)

*Organization Name

__ Donee (old bus)
__ Purchaser (old bus)
__ Old Bus Owner
__ New Bus Owner
__ Infrastructure Owner (electric bus charging)
__ Infrastructure Supplier (charging equipment only)
__ Other Infrastructure Organization

Contact Information
__________________________________________

__________________________________________

*Organization Contact First Name

*Organization Contact Business Email

__________________________________________

*Organization Contact Last Name

*Organization Contact Business Phone Number

Address
__________________________________________

__________________________________________

*Organization Address

*Organization County

__________________________________________

*Organization City

*Organization State or Territory

__________________________________________
*Organization Zip

Documents (Screen 4)
Document Information
Make copies for additional documents
__________________________________________

__________________________________________

*Document Type

*Document Name

*Document Purpose

__________________________________________

__ Bus

*Document Description

__ Electric Bus Charging Infrastructure
*Document Upload – Final Invoices and Proof of Delivery. Allowed fle types: *.pdf, *.png, *.jpeg, *.jpg. Max fle size 1KN, min fle
size 5 MB

Buses (Screen 5)
General Information:
__________________________________________

__________________________________________

*Number of School Buses in Current Fleet

*Number of Electric School Buses in Current Fleet

Old Bus
__________________________________________
*Old Bus Owner

__________________________________________

*Old Bus Annual Idling Hours

*Old Bus Odometer (miles)

__________________________________________

*Replacement Process

*Scrap Yard Organization (if scrapped)

*Filet Upload – Old Bus Proof of Scrappage.
Allowed fle types: *.pdf, *.png, *.jpeg, *.jpg. Max fle size 1KN, min fle size 5 MB

__________________________________________
*Old Bus Sold To (if sold)

__________________________________________
*Old Bus Donated To (if donated)

Note: If you choose to swap out old buses designated in your payment request with different eligible old
buses you will need to complete additional felds including the reason for the swap and updates to the
following Old Bus felds: VIN, Manufacturer, Average Annual Mileage, Fuel Type, Model, Average Annual Fuel
Consumption, GVWR, Model Year, NCES District ID, and Estimated Remaining Life. You will also need to
upload proof of title and registration.

New Bus
__________________________________________
*New Bus Owner

__________________________________________
*Final Invoice

__________________________________________
*Proof of Delivery

_____________________________________________________________

__________________________

*New Bus VIN

*Bus Rebate Received

_____________________________

*New Bus EPA Vehicle Family

*New Bus Manufacturer

*New Bus Purchase Price

_____________________________

*New Bus Fuel Type

*New Bus Model

*Eligible Funding from Close Out

_____________________________

*New Bus Model Year

*New Bus GVWR

*Applicant Bus Cost Responsibility

_____________________________
*New Bus Delivery Date

_____________________________

*New Bus Estimated Annual Mileage

*Estimated EV Bus Range (mi)

*Capable of Bidirectional Charging?

_____________________________

*EV Battery Capacity (kWh)

*Equipped with Auxiliary Heater?

*Auxiliary Heater Fuel Type

__ *Heater installed in accordance with the Program Guide
*Filet Upload – Photo of New Bus and VIN Documentation.
Allowed fle types: *.pdf, *.png, *.jpeg, *.jpg. Max fle size 1KN, min fle size 5 MB

Battery Warranty:
Make copies for additional documents
_____________________________

_____________________________

Battery Warranty Included

Number of Years Covered

Miles Covered

__________________________________________
Total kW hours of Discharge
*Battery Warranty Document Upload. Allowed fle types: *.pdf, *.png, *.jpeg, *.jpg. Max fle size 1KN, min fle size 5 MB

Powertrain Warranty:
Only include if Powertrain Warranty Included
_____________________________

_____________________________

Powertrain Warranty Included

Number of Years Covered

__________________________
Miles Covered
*Powertrain Warranty Document Upload. Allowed fle types: *.pdf, *.png, *.jpeg, *.jpg. Max fle size 1KN, min fle size 5 MB

Non-EPA Clean School Bus Funding Information:
_____________________________

_____________________________

*Non-EPA Funding Type

*Non-EPA Funding Source

*Non-EPA Funding Amount

_____________________________

*Non-EPA Funding Type

*Non-EPA Funding Source

*Non-EPA Funding Amount

_____________________________

*Non-EPA Funding Type

*Non-EPA Funding Source

*Non-EPA Funding Amount

Infrastructure (Screen 6)
Infrastructure Information (if charger):
__________________________________________

________________________________________

*Infrastructure Type

*Infrastructure Quantity

__________________________________________

________________________________________

*EVSE Maximum Output Power (kW)

*Infrastructure Cost Per Charger (Actual)

__________________________________________

________________________________________

*EVSE Manufacturer

*Infrastructure Subtotal

__________________________________________

__ Cost includes Installation

* EVSE Model

__________________________________________

________________________________________

*EVSE Manufacture Year

*Infrastructure Supplier

__________________________________________
*Number of Plugs on EVSE

__ EVSE Capable of Bidirectional Charging?

__________________________________________
*Bus and EVSE to be Used for V2G?

_____________________________________________________________________________________
*Infrastructure Owner

Infrastructure Information (if other):
__________________________________________

________________________________________

*Infrastructure Type

*Other Eligible Infrastructure Cost (Actual)

__________________________________________

________________________________________

*Infrastructure Type (Other)

*Other Infrastructure Organization

_____________________________________________________________________________________
*Description of Work

_____________________________________________________________________________________
*Infrastructure Owner

Installation/Construction Address:
__________________________________________

________________________________________

Street Address

*State or Territory

__________________________________________

________________________________________

City

*County

__________________________________________
*Zip

Non-EPA Clean School Bus Infrastructure Funding Information:
________________________

___________________________________

__________________________

*Non-EPA Funding Type

*Source of Additional Non-EPA Funding

*Non-EPA Funding Amount

________________________

___________________________________

*Non-EPA Funding Type

*Source of Additional Non-EPA Funding

__________________________
*Non-EPA Funding Amount

________________________

___________________________________

__________________________

*Non-EPA Funding Type

*Source of Additional Non-EPA Funding

*Non-EPA Funding Amount

Telematics (Screen 7)
__________________________________________

________________________________________

Telematic Contact First Name*

Telematic Contact Title*

__________________________________________

________________________________________

Telematic Contact Last Name*

Telematic Contact Business Phone Number*

__________________________________________
Telematic Contact Email*

File Type	application/pdf
File Title	2022 EPA Clean School Bus Rebate Forms: Close Out Form User Guide (EPA-420-B-23-038, September 2023)
Subject	clean, school, bus, range, model, replacement, cost, rebate, register, online, application, user, guide, close, out, form, infra
Author	U.S. EPA
File Modified	2023-09-20
File Created	2023-09-19