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Fill the answers in this section
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I.Total Project Cost 80,000$ or less
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A. Applicant Legal Name
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B.What is Applicant’s race (check all that apply)?
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C. What is Applicant's Gender
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D. What is Applicant's Etnicity?
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E. Is Applicant a Veteran?
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F. Is Applicant a member of a Socially Disadvantaged group?
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II.Project Title (Block 15 of SF 424)
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III.System for Awards Management (SAM) Registration: Provide a Unique Entity Identifier (UEI) number upon successful SAM registration. UEI:
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IV.Provide the name(s) for the Executive Director and person(s) who will be accepting or distributing Federal funds
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V.Type of Applicant:
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Applicant must certify to meeting the definition of either an Agricultural Producer or Rural Small Business, per 7 C.F.R. 4280.103.
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A. Applicant is applying as and hereby certifies to meeting the definition of:
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B. Provide primary North American Industry Classification System (NAICS) code for operation:
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NAICS Code:
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Corresponding NAICS size limitation:
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VI.Applicant Description: Describe the ownership of the applicant, including:
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A. The project’s relationship to the applicant’s operations. Describe how the proposed project fits into or operates separately from the applicant’s overall business or agricultural production operation:
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B. Describe how the applicant, at the time of application, award, and through the useful life, owns the project and owns or controls the site for the project:
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C. For each entity(ies) the applicant controls or entity(ies) it is controlled by, provide a list of the owners with their contact information.
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Describe the relationship between the applicant and the other entity(ies), including percent of ownership and control, management, passive investor ownership and any products exchanged. Organizational charts should be submitted when available:
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D. Advise if the applicant is a Tribal entity, describe the location of the project and whether it will be located on Tribal Lands
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VII.Project Information:
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1. The REAP Federal grant share is up to a maximum of 25% unless the project meets one of the following criteria: a) is located in a designated energy community;
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b) is proposed by a Tribal entity; c) is an energy efficiency improvement project; or d) is a renewable energy system or retrofit of a renewable energy system that produces
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 zero greenhouse gas emissions (GHGE) at the project level.
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Identify the type of energy project to be funded, supported by attached energy assessment or audit, technical report or vendor certification, or feasibility study as applicable.
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Select one type
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If selected B.
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Select the one that apply (or leave in blank.)
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Please indicate applicable renewable energy technology: (or leave in blank.)
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If selected C.
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Select the one that apply (or leave in blank.)
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Please indicate applicable renewable energy technology: (or leave in blank.)
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If selected D.
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Select technologies above and describe how they work together to support a single system:
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E. Project Description. Provide a detailed description of the technology and its intended purpose (energy replacement, netmetered, sold, self-use energy), the project location (address) and the specific site of the project at the project location.
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Describe utility relationships (interconnection, net metering, power purchase agreements, etc.) and attach agreements to document established rates to be paid for energy being sold or replaced.
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F. Project Economic Assessment:
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a. Construction Item: (Break down total project costs by providing a list of major equipment, labor costs, fees, and other costs associated with the project. Provide useful life information on
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major system components. Detailed bids may be attached to support total project costs.):Useful LifeCost (in dollars)
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b. Total Project Costs: (Total Project Costs should be the same as in Form SF-424C, “Budget InformationConstruction Programs.”)
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Total cost
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c. Eligible Project Costs: (See Instructions to determine eligible project costs.)
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Elegible project costs
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d. In-Eligible Project Costs: Provide details for any known in-eligible project costs, including but not limited to, down payments made prior to date of application or the prorated portion of residential related renewable energy system costs.
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2. Estimated Project Energy Generation or Savings and Cost of Energy. The Agency may request additional information to substantiate energy quantity, units, and rates if necessary.
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a. For Renewable Energy Systems:
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i. Annual amount of renewable energy to be generated and unit of energy:
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-Attach Vendor/Installer certified projections, renewable energy site assessment, or other documentation to validate the totalamount of energy to be generated, including the quality and availability of the renewable resource to the project.
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a.Total Estimated Generation
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b. Unit (select one that applies)
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Or write the unit
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ii. Documented use (renewable energy sold, metered/credited, or for direct-use, unit of measurement, price per unit, dollar value and name of utility/offtaker, as applicable.
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-Attach power purchase agreement to document quantity of energy sales and price/unit to be paid for energy.
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a. Energy Sold:
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b. Unit (select one that applies)
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Or write the unit
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c. Price/Unit in dollars
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d. Value (a x c) in dollars
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e. Name of Utility/Offtaker
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- Attach utility net metering, virtual net metering, energy crediting policies or agreements, or letter from utility which shows rate to be paid for excess energy.
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a. Energy Metered/Credited:
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b. Unit (select one that applies)
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c. Price/Unit in dollars
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