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HomeMy WebLinkAboutEECBG Project Application G Fr Y CoeY PROPOSAL Minnesota Department of Commerce S Office of Energy Security Energy Efficiency and Conservation Ifs Block Grant Program-ARRA rM•+ ,'. 4r - REF. NUMBER: OES-12142009-EECBG01-AMENDMENT 1 •>�ti I''�RI•. Ili II•tt 4 f 1 II %I I • Direct Energy Efficiency PROJECT Proposal Presented to: Natalie Buys Department of Commerce 85 Seventh Place East, Suite 500 Saint Paul, MN 55101 By: • City of Oak Park Heights 14168 Oak Park Boulevard North P.O. Box 2007 Oak Park Heights, MN 55082-2007 www.cityofoakparkheights.com Contact Person: Eric A. Johnson City Administrator Phone: (651) 439-4439 Email: eajohnson @cityofoakparkheights.com January 25, 2010 • Page 1 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010 • Background Oak Park Heights is a community of 4,700 citizens, located on the west bank of the St. Croix River, roughly 15 miles north north-east of St. Paul.The City has taken a proactive stance in managing its energy use and environmental impact. This is evidenced by the significant investment it is making to install geothermal heat pump technology in its new City Hall Facility (Figure 1) and its adoption of the U.S. Mayors Climate Protection Agreement(Attachment A). Figure 1. New Oak Park Heights City Hall, Featuring Geothermal Heating/Cooling System Eta R R Iii w M r, -- r- wahr Nom m_— ■ ■ iii The City of Oak Park Heights plans to use funds made available under the Energy efficiency and Conservation Block Grant(EECBG) Program to implement direct energy and cost saving projects—projects that will also effectively reduce the community's"carbon footprint". The City has also submitted an EECBG proposal to implement a program to indirectly improve the community's energy efficiency. Some of the activities that would be performed under that program would support the direct energy efficiency projects that would be performed under this proposal. While the success of the proposed direct energy efficiency projects under this proposal is not dependent on the"Program"proposal, its effectiveness would certainly be enhanced if both efforts are funded. • Page 2 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010 • Section 1.Application Form Energy Efficiency and Conservation Block Grant Proposal Summary Applications must be submitted using this document Additional pages must be within the limits specified below. APPLICANT INFORMATION Entity Name: City of Oak Park Heights Project Contact: Eric A.Johnson Title: City Administrator Email: eajohnson @cityofoakparkheights.com Phone number: (651)439-4439 Address: 14168 Oak Park Boulevard North City/County/Township: Oak Park Heights/Washington/ State fjja Zip Code: 55082 Applicant FEIDtf: 41-0941681 Legislative District: MN 56th,US 6th Population: 4,700 Applicant Type: •✓,City County jTownship PROJECT SUMMARY Activity Title: Oak Park Heights Direct Energy Efficiency Improvement Project Activity Location: City of Oak Park Heights Activity Type: ✓ Direct Energy Savings Project Indirect Energy Savings Program Total Project Cost- S 114.820 %of Total: 100% Requested EECBG Funds: S 98.320 %of Total: 86% Applicant Funds: S 11,700 %of Total: 12% 4,800 4% DOE Renew Energy Grant(30% Other Outside Funding(specify): 5 %of Total: of PV system) Protect start date: April 15.2010 Project end date: March 31,2011 Labor Hours' 120 Fuel Type(Electricity,Gas,Oil,etc.) Fuel 1: Electricity Fuel 2: Gasoline Fuel 3: Annual Fuel Ene Savings Electric(kW-h)- 156273 Oil(Gallons): ri/a Natural Gas(MCF): n/a Propane(Gallons): n/a Gasoline 1 591 Other: (gal.) Annual Energy Use- n/a MMRTU Annual Energy Savings: 730 MMBTU office of Annual Energy Cost Savings: s 23.648 tqrgY Cnr Simple Payback: 4.2 Years Page 3 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010 • Certifying Official 7 / - Certifying Official's Signature v Oil Certifying Official's Name(print): is A. Jo son Date: January . 2010 Title: City Ad inistrator Organization: City o Oak Park Heights Please provide a brief description of you proposed activity in the space provided. The City of Oak Park proposes using EECBG01 funding to perform the following activities: •Replace existing gasoline-fueled utility pick-up truck(Ford F-550)with an energy-efficient hybrid/flex fuel vehicle of somewhat smaller cargo capacity but approximately twice the city mode fuel mileage (Chevrolet Silverado or equivalent). If available, a plug-in hybrid electric truck will be considered— promising even greater fuel economy. •Distribution of approximately 1.000 dual-flush toilet retrofit kits and 1.000 low-flow shower heads to City residents. These easily-installed devices will be provided at a steeply discounted price in order to encourage water conservation and indirectly. reduces City electricity consumption by reducing water utility pumping demand. •Distribution of approximately 1,000 compact fluorescent light(CFL)bulbs to City residents. By replacing incandescent light bulbs,the CFLs will reduce the community's electricity use and therefore.energy costs. 4111/ •Solar lighting retrofit for one City park shelter. This demonstration project will provide information on reliability and performance of an integrated solar PV/LED lighting system,while reducing electric demand and cost. Installation will consist of shelter interior.external flood,and external street lighting. •Purchase Advanced Energy Star Appliances for new City Hall Facility(refrigerator&dishwasher). office of ___. n ! Y Page 4 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010 • • Section 2. Project Narrative and Scope of Work Oak Park Heights has developed a portfolio of five activities to be enabled by EECBG01 funding. These activities address important, cost-effective efforts to improve the energy efficiency of City- owned and private facilities. Emphasis has been placed on those activities that will provide local "green"employment opportunities and have long-lasting impact on energy use and the energy habits of our citizens. Each proposed activity is described below, and a detailed estimate provided for all anticipated equipment, material, and labor expenditures. For the building retrofit activities, we have provided information on baseline energy use and our estimated efficiency performance enhancement. Exhibit F is provided in support of the proposed solar energy system installation. Activity Descriptions.The City of Oak Park proposes using EECBG01 funding to perform the following activities: • Replace existing gasoline-fueled utility pick-up truck(Ford F-550)with an energy-efficient hybrid/flex fuel vehicle of somewhat smaller cargo capacity but approximately twice the city mode fuel mileage (Chevrolet Silverado or equivalent). If available, a plug-in hybrid electric truck will be considered—promising even greater fuel economy. ULL ELECTRIC LAUNCH ' '„41 1. powrIrri-Ce fN( ICS 1,.\i I1.k1 1'\l/. • Distribution of approximately 1,000 dual-flush toilet retrofit kits and 1,000 low-flow shower heads to City residents. These easily-installed devices will be provided at a steeply discounted price in order to encourage water conservation and, indirectly, reduces City electricity consumption by reducing water utility pumping demand. ootif.. II • Page 5 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010 • • Distribution of approximately 1,000 compact fluorescent light(CFL) bulbs to City residents. By replacing incandescent light bulbs, the CFLs will reduce the community's electricity use and therefore, energy costs. • Solar lighting retrofit for one City park shelter. This demonstration project will provide information on reliability and performance of an integrated solar PV/LED lighting system, while reducing electric demand and cost. Installation will consist of shelter interior, external flood, and 3 pole-mounted external street lights. Exhibit F provides additional detail on the proposed installation. ,.. t4;„ . `' „- � ' 4 fill • Purchase Advanced Energy Star Appliances for new City Hall Facility(refrigerator& dishwasher). These units will replace the pre-1996 appliances currently used in City Hall. Estimate.The proposed activities will require investment in capital equipment, material, and labor. These are summarized below and detailed in the budget provided in Section 3. Activity Purchase Compact Advanced Water Fluorescent PV/LED Energy Star Projects Cost Category Hybrid Vehicle_Conservation Lights Demonstration Appliances Total City Labor(hours) 2 2 2 12 2 20 City Labor(dollars) 170 170 170 1,020 170 1,700 Consultant Labor(hours) 7 14 5 24 6 56 Consultant Labor(dollars) 665 1,330_ 475 2,280 570 5,320 Contractor Labor(hours) - - - 44 - 44 Contractor Labor(dollars) - - - 4,400 - 4,400 Capital Equipment(dollars) 45,000 26,000 3,000 21,000 2,400 97,400 Supplies(dollars) - _ - - 6,000 - 6,000 Total Labor(hours)!114 9 16 7 80 8! 120 Total Cost dollars 45,835 27,500 3,645 34,700 3,140 114,820 Ill Page 6 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010 P • Section 3. Budget The City of Oak Park Heights plans to finance the proposed project with a combination of EECBG01 grant funds, City disbursements($11,700—up to$10,000 matching funds, and in-kind staff support), and federal renewable energy grants($4,800).The Microsoft Excel®spreadsheet (hardcopy in Attachment B), is provided in native format as an attachment to the electronic submittal. After netting out the City's matching funds and renewable energy grant, the simple payback period is 4.2 years.This exceptional performance actually understates both the projects energy and environmental value because it only considers water supply electrical demand on the low flow showerhead retrofit and Energy Star dishwasher elements. Considering the water heating energy demand would make the payback period even shorter. Aside from reduction in direct energy use(and consequent environmental insults)water conservation is of growing importance globally—even in the Land of 10,000 Lakes. • Page 7 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010 Section 4.Attachments • Attachment A: City of Oak Park Heights Adoption of U.S. Mayors Climate Protection Agreement • Attachment B: Detailed Budget • Attachment C: Exhibits A, B,C, F(Solar electric System Assessment),G,and H • Attachment D: Documentation of City Commitment of Matching Funds • Page 8 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010 Attachment A: City of Oak Park Heights Adoption of U.S. Mayors Climate Protection Agreement korf . ti The U.S.Mayors Climate Protection Agreement (As endorsed by the 73i°Annual US.Conference of Mayors meeting,Chicago,2005) Adopted by Oak Park A. We urge the federal government and state governments to enact policies and programs Heights City/ to meet or beat the target of reducing global warming pollution levels to 7 percent below 1990 levels by 2012,including efforts to:reduce the United States'dependence Council on on fossil fuels and accelerate the development of clean,economical energy resources 3-25-08. and fuel-efficient technologies such as conservation,methane recovery for energy Cotmcihnember generation,waste to energy,wind and solar energy,fuel cells,efficient motor vehicles, McComber, and biofuels; seconded by 8. We urge the U.S.Congress to pass bipartisan greenhouse gas reduction legislation that Co uneilmember 1)includes clear timetables and emissions limits and 2)a flexible,market-based system Swenson, of tradable allowances among emitting industries;and C We will strive to meet or exceed Kyoto Protocol targets for reducing global warming moved that the pollution by taking actions in our own operations and communities such as: City participate in the U.S. 1. Inventory global warming emissions In City operations and in the community, Mayors Climate set reduction targets and create an action plan. Protection 2. Adopt and enforce land-use policies that reduce sprawl,preserve open space, Agreement. and create compact,walkable urban communities; Carved 5-0- 3. Promote transportation options such as bicycle trails,commute trip reduction • programs,Incentives for car pooling and public transit; 4. Increase the use of clean,alternative energy by,for example,investing in "green tags",advocating for the development of renewable energy resources, recovering landfill methane for energy production,and supporting the use of waste to energy technology; 5. Make energy efficiency a priority through building code improvements, retrofitting city facilities with energy efficient lighting and urging employees to conserve energy and save money; 6. Purchase only Energy Star equipment and appliances for City use; 7. Practice and promote sustainable building practices using the U.S.Green Building Council's LEED program or a similar system; 8. Increase the average fuel efficiency of municipal fleet vehicles;reduce the number of vehicles;launch an employee education program Including anti- idling messages;convert diesel vehicles to bio-diesel; 9. Evaluate opportunities to increase pump efficiency in water and wastewater systems;recover wastewater treatment methane for energy production; 10.Increase recycling rates in City operations and in the community; 11.Maintain healthy urban forests;promote tree planting to increase shading and to absorb CO2;and 12.Help educate the public,schools,other jurisdictions,professional associations, business and industry about reducing global warming pollution. Page 102 of 112 Page 9 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010 • Attachment B: Detailed Budget[native format(MS Excel°) provided with electronic submittal] waist Cory o aaf n=Deronstokiott pour fowshowllthH s a (Warm,corntoller•batted*LED Purchase Advanced EnMryy star H , 13 Vehicle curl flush toilet retrofits' Com. Pluorasoent Li.hes f. , .lances • Cosh Cate•o WWII* !BpeeHks. EpecNle's Wane Specifics Value Specifics ® Specifics Eillhil Cit Labor tot. hours -© MMM ® © 1 Develop specifications,solic' 1 10 bids,issue• chase orris Publid •administratie ttttttttl111l=11■111■ttt1111=-MIIM -© •11•3 1M110_:..`._r:,j Ch Labor tot.dollars Ott!!!!!ltfI711■111=11Mt!!!!!!!! eL,1MII■IilEECI !IMI Develop specifications,sof',MI 85 850 1,190 bids,issue• rchase orders®_�— ®_ Publicity,administratio i ' — Elie—li117 ii11E1 _MILLI Consultant Labor tot. 111•11113111MMIMI■Ittttttttttm11111=1=1=©fit ? Assist in developing©— 10_ 2_ 20 III specifications,administenne +k •rocuremen ham,: E .©.11111MIIi©—I—© =Ilil iii Develops baseline greenhous 1_ 1 © ' as emission enhou _ Consultant Labor dollars• , © ttttttt ©� Assist in develo in r 950 190 1900 3,610 specifications,admiurem ne III• •. • • l�-its-i��i� i� '11=1:13 s Develops esmeliinsse invent°,= —®_ 95— 95— E ;® Illiflaiiiiiilig Eli MI 95 Eliii1 111 ..11111 Contractor Labor hours MIKIIIMIMMIEMMEIIIMMIIMIIMMICIMIIIMIIIMMIIMIEBEIIIIMIIMMIIIMIEMEIMMIMEMEMIIIIIIME6 Mobilize,foundation work, •h ical installatio ----_—® Eleckicnmmll siunoq- ---- 12 ® < .r wmmissionin•, Ill Contractor Labor dollars tthl�-���- thl� '. '.' Mobilize,foundation installatio -- 3,200 3200 iti ical Electrical mmisslation---_-- 1,200 1,200 . . commissioning 46 000�26 000� 3 000� 21 000 ©� � Hybrid pickup ern 40,000 Chev•Silverado or equiv.----- > 45,000 Low flow shower heads-- 10,000 1 000 at$10 ea. --- E 10,000 MEE— 16,000 1,000 at$16 ea. —INNIMI 16,000 13 Wad compact flr r ht buen---- 3,000 1,000 at$3 ea 3.000 I'a r bulbs 150 W PV array,controller,------ 18 000 System, Power Ready ,� q d 18,000 ontrolie System,or equiv. LED Lights and controls------ 5,000 interior I r hiss,2 area lights,4- 5,000 Refregerstor,Energy Sta■—■_._._. 1.400 ecaomerete duty r compliant, ? 1,400 8 Dishwasher,Energy Sta■_■_._■ 1.000 light Energy duty compliant,¢ #;' 1.000 light commercial duty ' 3 ������ 6000 .z..v= 6 000 ������ 1000 - 1 000 Con,mounts r hardware, conduit, 5,000 5,000 conductor,mounti r haroware, Total Labor hours,MEME ':•` .,. x" "x 1MIMEI i..; 11MIWIT r ,- .:r tMOT 1® ''a Total Cost dollars Iw....,:"' ..,..........,�,,.....,:=1r - ..... ME1131?" ,s;:°..r<`�i.,.. 1112111:1 te a,:,.............."...43111. ' . . .... w,...... .......,�. 10111ECI Avg.City Labor Rate 85($/hr;assumes mostly summer intem,includes benefits) Avg.Consultant Labor Rate 95($/hr,assumes mix of senior and junior staff, fully loaded fee rate) Avg.Contractor Labor Rate 100($/hr,licensed electrician,foundation work,etc.,fully loaded fee rate) • Page 10 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010 Attachment C: Exhibits A, B,C, F(Solar electric System Assessment),G,and H • Page 11 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010 Exhibit A NEiL F 451.1-EECBG (32009)OPI=320 U.S,DEPARTMENT OF ENERGY (Previous Editions Obsolete) ENVIRONMENTAL QUESTIONNAIRE 1. BACKGROUND The Department of Energy(DOE)National Environmental Policy Act(NEPA)Implementing Procedures(10 CFR 1021)require careful consideration of the potential environmental consequences of all proposed actions during the early planning stages of a project or activity. DOE must determine at the earliest possible time whether such actions will require either an Environmental Assessment or an Environmental Impact Statement,or whether they qualify for a Categorical Exclusion. To comply with these requirements,an Environmental Questionnaire must be completed for each proposed action to provide DOE with the information necessary to determine the appropriate level of NEPA review. 11. Bingiii Separate copies of the Environmental Questionnaire should be completed by the principal proposer and appropriate proposers subcontractor. In addition,If the proposed project includes activities at different locations,an independent questionnaire should be prepared for each location. Supporting information can be provided as attachments. In completing this Questionnaire,the proposer is requested to provide specific information and quantities,when applicable, regarding air emissions,wastewater discharges,solid wastes,etc.,to facilitate the necessary review. The proposer should identify the location of the project and specifically describe the activities that would occur at that location. In addition,the proposer will be required to submit an official copy of the project's statement of work(SOW)or statement of project objective(SOPO)that will be used in the contract/agreement between the proposer and DOE. 111. QUESTIONNARtE A. PROJECT SUMMARY L Solicitation/Project Number: DES-12142009-EECBG01-Amendment 1 2. Proposer: City of Oak Park Heights,MN 3. Principal investigator: Eric A.Johnson Telephone Number: (651)439-4439 4. Project Title: MN Department of Commerce(Ace of Energy Security Energy Efficiency and Conservation Block Grant Program-Atom Kth.NUMt3tt(:C7t.-12141VUU-ttt.tSUU 1-AMtNUMtN I 1 5. Duration: 17 rrnnths 6. Location(s)of Performance(City/Township,County,State): Oak Park Heights,VVashington Cty,MN 14168 Oak Park Boulevard North 7. Identify and select checkbox with the predominant project work activities under Group A-lb or A-7c. Group A-7b ® Work or project activities does NOT involve new building/facilities construction and site preparation activities. This work typically involves routine operation,modification,and retrofit of existing utility and transportation infrastructure, laboratories,commercial buildings/properties,offices and homes,test facilities,factories/power plants,vehicles test stands and components,refueling facilities,greenspace infrastructure,or other existing facilities. Department of Commerce-OES-12142009.EECSGOI 18 • Page 12 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010. 411 Group A-7e ❑ Work or project activities typically involves major building or facility construction,site preparation;the installation, replacement,or major modifications of energy system prototypes and infrastructure,access right-of-ways and roads;utility, greenspace,and transportation infrastructure,vehicle test facilities;commercial buildings/properties,fuel refinery/mixing facilities,factories/power plants;and other types of energy effidency/conservation related systems,structures,and facilities. This work can require new or modified regulatory permits,environmental sampling and monitoring requirements,master planning,public involvement,and environmental impact review. ❑ Other types of work or project activities not listed.(please describe): 8. Summarize the objectives of the proposed work. Ust activities planned at the location as covered by this Environmental Questionnaire. See accompanying proposal. 9. List all other locations where proposed work or project would be performed by project's proposer and subcontractors. See accompanying proposal. 10. Identify major project operation related materials and waste that would be used,consumed,and produced by this project or activity. None. 11. Provide a brief description of the prqect location(physical location,surrounding area adjacent structures). Oak Park Heights City Hall,Brekke Park 12. Attach a site plan or topographic map of the project work area. nla S. ENVIRONMENTAL IMPACTS This section is designed to obtain information for objectively assessing the environmental impacts of a proposed project. NEPA procedures require evaluations of possible effects(induding land use,energy resource use,natural,historic and cultural resources, and pollutants)from proposed projects on the envkonment. 1. Land Use • a. Characterize present land use where the proposed project would be located. CsjUrban Industrial Commercial ❑ Agricultural Suburban Rural 0 Residential ❑ Research Facilities ❑ Forest ❑ University Campus ❑ Other b. Describe how land use would be affected by planned construction and project activities. ®No construction would be anticipated for this project. c. Describe any plans to reclaim/replant areas that would be affected by the proposed project. in No land areas would be affected. d. Would the proposed project affect arty unique or unusual landforms(e.g..cliffs,waterfalls.etc.)? Ei No ❑ Yes(describe) e. Would the proposed project be located in or near a national park or wilderness area ® No ❑Yes(describe) If project work activities fails under item A-70;then proceed directy to question 8.6(Atmospheric Conditions/Air Quality)and continue to fill out questionnaire. If project work foils under item A-7c;then proceed dhectly below to question 82(Construction Activities and/or Operations)and continue to fill out questionnaire. Department of Commerce—OES-12142009.EECsG01 19 • Page 13 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010 • For all proposed project work activities Identified under item A-7b,respond to Item 86 directly below and continue filling out environmental questionnaire. 6. Atmospheric Condkl.nsfAir Quality a. Identify air quality Y conditions in the Immediate vicinity H of the proposed project rof ect with regard to attainment of National Ambient Air Quality Standards(NAAQS). This information is available under the NAAQS tables from the U.S.EPA Air and Radiation Division. Attainment Non-Attainment O, ® ❑ s . ® ❑ PM10 ® ❑ co ® ❑ NOT ® ❑ Lead ® ❑ b. Would proposed project require issuance of new or modified major source air quality permits? ® No ❑ Yes(describe) c. Would the proposed project be in compliance with the National Emissions Standards for Hazardous Air Pollutants? ® No(explain) 3] Yes d. Would the proposed project be classified as either a New Source or a major modification to an existing source? ® No ❑ Yes(describe) e. Would the proposed project be in compliance with the New Source Performance Standards? ® Not Applicable ❑ No(explain) ❑ Yes • f. Would the proposed project be subject to prevention of significant deterioration sir quality review? ® Not applicable 0 No(explain) ❑Yes(describe) What types of air emissions,including fugitive emissions,would be anticipated from the p project? g. tYP n8 � proposed h. Would any types of emission control or particulate collection devices be used? ®No ❑Yes(describe,Including collection efficiencies) I. If no control devices are used,how would emissions be vented? Na-no emissions 7. Hydrologic Conditions/W ater Quality a. What is the closest body of water to the proposed project area and what Is its distance from the project site? St.Croix River,1 mile b. What sources would supply potable and process water for the proposed project? rhea c. Quantify the daily or annual amount of wastewater that would be generated by the proposed project. mone d. Identify the local treatment facility that would receive wastewater from the proposed project. ® No discharges to local treatment facility Department of Commerce-OES12142009•EECBGra 21 • Page 14 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010 e. Describe how wastewater would be collected and treated. N/A--no wastewater will be generated f. Would any run-off or leachates be produced from storage piles or waste disposal sites? ®No ❑ Yes(describe source) g. Would project require Issuance of new or modified water permits to perform project work or site development? ® No ❑Yes(describe) h. Where would wastewater effluents from the proposed project be discharged? ®No wastewater produced L Would the proposed project be permitted to discharge effluents into an existing body of water? ®No ❑Yes(describe water use and effluent impact) j. Would a new or modified National Pollutant Discharge Elimination System(NPDES)permit be required? ®No ❑ yes(describe) k. Would the proposed project adversely affect the quality or movement of groundwater? ® No ❑ Yes(describe) & Solid and Hazardous Wastes a. Describe and estimate major nonhazardous solid wastes that would be generated from the project Solid wastes are defined as any solid,liquid,semi-solid,or contained gaseous material that Is discarded or has served its intended purpose.or is a manufacturing or mining by-product(40 CFR 260,Appendix 1). None. b. Would project require issuance of new or modified solid waste and/or hazardous waste related permits to perform project work activities? ® No ❑ Yes(explain) • c. How and where would solid waste disposal be accomplished? ❑On-site(identify and describe location) ❑Off-site(identify location and describe facility and treatment) N/A-No waste generated d. How would wastes for disposal be transported? N/A e. Describe and estimate the euentityof hazardous wastes(40 CFR 261.31)that would be generated,used,or stored under this project ® None 1. How would hazardous or toxic waste be collected and stored? ® None used or produced g. If hazardous wastes would require off-site disposal,have arrangements been made with a certified TSD(Treatment,Storage, and Disposal)facility? ® Not required ❑ Arrangements not yet made ❑ Arrangements made with a certified TSD facility (identify): C. DESCRIBE ANY ISSUESTHAT WOULD GENERATE PUBUC CONTROVERSY REGARDING THE PROPOSED PROJECT. ® None Department of Commerce-OES-12142009-EECBG01 22 • Page 15 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010 N. Iial i':�i� hereby certify tha gon pTa ided herein is current,accurate,and complete as of the date shown immediately below. SIGNATURE: ! ' DATE: 1 / 25/ 2010 month day year TYPED NAME: A Johnson TITLE: Ci Atkninistrator ORGANIZATION: City of Oak Park Heights(MN) V. REVIEW AND APPROVAL BY DO( I hereby certify that I have reviewed the information provided in this questionnaire,have determined that all questions have been appropriately answered,and Judge the responses to be consistent with the efforts proposed. PROJECT MANAGER: SIGNATURE: DATE:_/ month day year TYPED NAME: S Department of Commerce—OES-12142009-EECBGO1 23 • Page 16 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010 • Exhibit B STATE OF MINNESOTA AFFIDAVIT OF NONCOIWSION I swear(or affirm)under the penalty of perjury: 1. That I am the Responder(if the Responder is an individual),a partner in the company(if the Responder is a partnership),or an officer or employee of the responding corporation having authority to sign on its behalf(if the Responder is a corporation); 2. That the attached proposal submitted in response to the Request for Proposals has been arrived at by the Responder independently and has been submitted without collusion with and without any agreement, understanding or planned common course of action with,any other Responder of materials,supplies,equipment or services described in the Request for Proposal,designed to limit fair and open competition; 3. That the contents of the proposal have not been communicated by the Responder or its employees or agents to any person not an employee or agent of the Responder and will not be communicated to any such persons prior to the official opening of the proposals;and 4. That 1 am fully informed regarding the accuracy of the statements made in this affidavit. City of Oak4 Heights Responder; Fir Name Eric 'Jo�r•n Aut •ize• • .-sentot' tease Print) (J,�° 1125/2010 Autho iced='gnature Date Subslrri ed and sworn to me this _day of J[IV Rail , o Notary Public Stamp: cal l�J....flf./llffllll./�J!.l✓J!1-IIY✓-,-\ ti «�;�., JENNIFER M PINSKI �: NOTARY PUBLIC-MINNESOTA My Commission Expires Jan 31,2012 ✓��_/!J!!J!!I!J'"dam/'....c_._/!../.W✓' '... Department of Commerce—OES-12142009-EECBG01 24 • Page 17 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010 Exhibit C STATE OF MINNESOTA LOCATION OF SERVICE DISCLOSURE AND CERTIFICATION LOCATION OF SERVICE DISCLOSURE Check all that apply: el The services to be performed under the anticipated grant as specified in our proposal will be performed ENTIRELY within the State of Minnesota. O The services to be performed under the anticipated grant as specified in our proposal entail work ENTIRELY within another state within the United States. ❑ The services to be performed under the anticipated grant as specified in our proposal will be performed in part within Minnesota and in part within another state within the United States. O The services to be performed under the anticipated grant as specified in our proposal DO involve work outside the United States. Below(or attached)is a description of (1)the identity of the company(identify if subcontractor)performing services outside the United States; (2)the location where services under the grant will be performed;and • (3)the percentage of work(in dollars)as compared to the whole that will be conducted in each identified foreign location. CERTIFICATION By signing this statement,I certify that the information provided above is accurate and that the location where services have been indicated to be pe armed will not change during the course of the grant without prior,written approval from the State of Minnesota. Name of Company: C park is Authorized Signatur Printed Name: Eric A.Jo Title: City Administrator Date: 1/25/2010 Telephone Number: (651)439-4439 Department of Commerce—OES•12142009-EEC8601 25 I Page 18 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010 • Exhibit F EECBG Solar Photovoltaic System Application APPLICATION FORM:Complete all fields below. APPLICANT Contact Name: Eric A Johnson City/County/Township: Oak Park HeightsNVashington/Baytown Installation Address: Brekke Park;Omar Avenue south of the St.Croix Mall INSTALLER Installer Name: DAWN EIMERS Business Name: Hunt Electric Corporation 2300 West Territorial Road Installer Address: St Paul,MN 55114-1638 Installer Phone: (_) 651.643.6520 Is lead installer NABCEP Solar PV certified? a Yes 0 No All electrical work must be performed by a licensed electrician working for a licensed electrical contractor:Electrician License U: TBD • Does the solar installer have prior experience installing PV? In Yes ❑No Please briefly describe lead installer's PV experience/training: Hunt Electric is one of the most experienced PV installers in the country. Solar module manufacturer SunWise or equiv. Are modules Underwriters Laboratory Standard 1703 certified? El Yes 0 No Model Number TBD Rating 150 W(peak) Number of modules 4-6 System rating 150 W(peak) Performance warranty 10 years Expected annual energy production TBD kWh Inverter manufacturer n/a Department of Commerce—OES-12142009-EEC8G01 32 110 Page 19 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010 411 Model Number Rating n/a kW Number of inverters n/a Warranty n/a years Are inverters Underwriters Laboratory Standard 1741 certified? Yes 0 No n/a 0 Grid connected ®Off grid 0 Pole Mount 0 Ground Mount Eg Roof Mount ®Fixed 'Single Axis Tracking 'Dual Axis Tracking Tilt Angle if fixed(from horizontal) 30 0 180 Azimuth Angle if fixed(180°15 due south) What energy efficiency measures are being taken as part of this project? Lighting will be re-lamped with high efficiency LED luminaires o Shading analysis attached-A site assessment using a shading analysis tool,such as the Solar Pathfinder,the Solmetric SunEye or the ASSET by Wiley Electronics,helps determine if a solar photovoltaic system is suitable for your • location and budget.Please document that there will be sufficient solar resource available to ensure performance using one of these or a similar tool. The shading analysis should demonstrate that the collectors will be at least 90%unshaded on an annual basis as calculated from the middle of the lowest edge of the panels. Schematic attached showing system design and all major components,including panels,inverter(s),and external disconnect(s). o Photos included for the proposed installation site: • A panoramic photo or series of 5(five)photos from 90'to 270'through south showing horizon • A photo of the proposed installation site 0 Site Diagram complete with heights of array and surrounding objects and distances between array and objects N/a:Southern exposure is unencumbered. Department of Commerce-OES-12142009-EECBG01 33 Page 20 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010 • Exhibit G CERTIFICATION REGARDING LOBBYING For State of Minnesota Contracts and Grants over$100,000 The undersigned certifies,to the best of his or her knowledge and belief that: (1)No Federal appropriated funds have been paid or will be paid,by or on behalf of the undersigned,to any person for influencing or attempting to influence an officer or employee of any agency,a member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any Federal grant,the making of any Federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal,amendment,or modification of any Federal contract,grant,loan, or cooperative agreement. (2)If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency,A Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with this Federal contract,grant,loan,or cooperative agreement,the undersigned shall complete and submit Standard Form-ILL,Disclosure Form to Report Lobbying in accordance with its instructions. (3)The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers(including subcontracts,subgrants,and contracts under grants,loans and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31 U.S.C.1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than 111 $10,000 and not more than$100,000 for each such failure. City of Oa,.rk Heights Orga f ion ame • 'GA( n City Administrator Na, ,ial Signing for• :aniza on Title ! 1/25/2010 Si%na re of Official Date Department of Commerce—OES-12142009{ECBG01 35 • Page 21 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010 Exhibit H State Of Minnesota—Affirmative Action Certification If your response to this solicitation is or could be in excess of$100,000,complete the information requested below to determine whether you are subject to the Minnesota Human Rights Act(Minnesota Statutes 363A.36)certification requirement,and to provide documentation of compliance if necessary. It is your sole responsibility to provide this information and—If required—to apply for Human Rights certification prior to the due date and time of the bid or proposal and to obtain Human Rights certification prior to the execution of the contract. The State of Minnesota is under no obligation to delay proceeding with a contract until a company receives Human Rights certification. BOX A—For companies which have employed more than 40 full-time employees within Minnesota on any single working day during the previous 12 months. All other companies proceed to BOX B. Your response will be rejected unless your business: has a current Certificate of Compliance issued by the Minnesota Department of Human Rights(MDHR) -or- has submitted an affirmative action plan to the MDHR,which the Department received prior to the date and time the responses are due. Check one of the following statements if you have employed more than 40 full-time employees in Minnesota on any single working day during the previous 12 months: U We have a current Certificate of Compliance issued by the MDHR.Proceed to BOX C. Include a copy of your certificate with your response. U We do not have a current Certificate of Compliance. However,we submitted an Affirmative Action Plan to the MDHR for approval,which the Department received on (date). [If the date is the same as the response due date,indicate the time your plan was received: (time).Proceed to BOX C. O We do not have a Certificate of Compliance,nor has the MDHR received an Affirmative Action Plan from our company. We acknowledge that our response will be rejected. Proceed to BOX C. Contact the Minnesota Department of Human Rights for assistance. (See below for contact information.) S Please note: Certificates of Compliance must be issued by the Minnesota Deportment of Human Rights. Affirmative Action Plans approved by the Federal government,a county,or o municipality must still be received,reviewed,and approved by the Minnesota Department of Human Rights before a certificate can be issued. BOX B—For those companies not described in BOX A Check below. a We have not employed more than 40 full-time employees on any single working day in Minnesota within the previous 12 months. Proceed to BOX C. BOX C—For all companies By signing this statement,you certify that the information provided is accurate and that you are authorized to sign on behalf of the responder. You also certify that you are in compliance with federal affirmative action requirements that may apply to your compan se requirements are generally triggered only by participating as a prime or subcontractor on federal •roj or grants. Grantee's are alerted to these requirements by the federal government.) Name of Company: Ci of�'.r Park Heights Date: 1/25/2010 Authorized Signature: � 71'. Telephone number:(651)439-4439 Printed Name: Eric A.Jo -.n Title: City Administrator For assistance with this form,contact: Minnesota Department of Human Rights.Compliance Services Section Mail: 190 East 5t'St.,Suite 700 St.Paul,MN 55101 TC Metro: (651)296-5663 Toll Free: 800-657-3704 Web: www.humanrlghts.state.mn.us Fax: (651)296-9042 TTY: (651)296-1283 Email: employerinfo@therightsplace.net Department of Commerce—OES-12142009-EECBG01 36 S Page 22 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010 • Attachment D: Documentation of City Commitment of Matching Funds City of Oak Park Heights 14165 Oak Park Blvd. N•Box 2007•Oak Park Heights,MN 55052•Phone(6511439-4439•Fax(651)439-0574 ***LOCAL GRANT MATCH TO EECBG*** January 22,2010 TO: General issue Doc e, FROM: Eric Johnson,City Ad RE: Local Grant Match-Ener lency and Conservation Block Grant-Application On January I21',2010,the City Council for the City of Oak Park Heights did approve the submission of a grant application for various opportunities that may be available under the EECBG Program.The City Council did also commit to supplying a 510.000 grant match should grant funds be awarded. I Page 23 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010 M This Page Is Left Intentionally Blank. • I Page 24 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010 • This Page Is Left Intentionally Blank. iti - az ' • Page 25 of 25 EECBG Submittal Direct Energy Efficiency PROJECT Proposal Jan 25th,2010