Below is an outline of the steps in the project process:

1. Apply: Complete and submit this Rebate Reservation Form

2. If you are NOT the site owner/legal representative, complete and submit the Designated Applicant Form

3. Review application: MCE Clean Energy reviews your application and emails you the Fund Reservation notification

4. Install ports: Upon installation of your charging ports, complete and submit the Installation Verification Form

5. Project Verification & Payment: MCE Clean Energy reviews your form and approves your project for payment. You will receive an email notification indicating your project is approved for payment

Required:

Project Installation Information Reference # (If provided by MCE EV Charging program staff) Customer Organization Name Primary PG&E Account # Property Type Customer's Available Budget for EV Charging Project

Installation Address Property Name Address 1 Address 2

City

State

ZIP Code

Total Number of Ports Desired # Networked L1 Ports # Networked L2 Ports # of Networked DCFC Ports

Customer Contact Information First Name Last Name Title Phone Email

Your Relationship to the Project

I would like an EV charging expert to contact me to discuss my options.

Electric Vehicle Service Equipment Project Components

Project is triggered by compliance through building or reach codes.

(If yes, please also state which component of the Project is going above these codes.)

Customer has their own electrician and has already completed a load study.

Project will pursue or has obtained additional external funding. (If confirmed, please also list the amount and source(s) of additional external funding.)

Other Funding Source Name Other Funding Source Amount

EV charging will be available to the public.

Key Tasks for Electric Vehicle Service Equipment Project Estimated Approval of EVSE Project by Applicable Customer Decision Maker Estimated Load Study Completion Estimated Permit Application Submitted to City/Town: Estimated Installation

Optional Enrollments If you are a Designated Applicant, please make sure your selections below match the selections included in the Designated Applicant Form uploaded at the bottom of this page. EVs are only as clean as the electricity that powers them. Earn a Deep Green Bonus of $500/Level 2 port and $125/Level 1 port. OPT UP to Deep Green!

Power your charging stations MCE Deep Green 100% renewable energy service. By selecting "OPT UP to Deep Green!", I, as the authorized account holder/representative of the Primary PG&E Account Number listed above, authorize MCE to enroll my accounts associated with the aforementioned Project in Deep Green service upon charger activation and agree to the Terms & Conditions of Deep Green service.

MCE offers additional programs and funding partnerships to help you reduce the Project cost and maximize EV charging utilization.

Apply for MCE's free EV 101 education program for your employees and/or multi-family tenants.

Most Californians aren't informed about EVs, charging, and incentives despite EVs becoming more common. Help the desired users of your charging stations get the most out of this new asset. Receive free, tailored engagement (virtual or in-person) for your workplace and multi-family property around the basics of EVs, charging (including your stations), and how to maximize their incentives. By checking this box, MCE will follow-up with you on this service once you have an installation date scheduled and you - or someone on your team - would only be responsible for helping us select a day/time to maximize attendance and marketing this workshop to the desired attendees.

Apply for Additional Rebate Through Transportation Authority of Marin ('TAM')

Marin County's government entities and public districts, including school districts and other special districts, are eligible for additional funding provided by TAM. The TAM rebate amount reimburses the installation and/or hardware costs of level 2 charging stations owned and/or operated by a Marin County government entity as described here. By checking this box, I certify that I am a government entity or public district (including federal, state of local school districts and other special districts) located in Marin County, agree to the terms and conditions for TAM's Electric Vehicle Supply Equipment Grant Program as described here, consent to MCE sharing this Rebate Reservation form with TAM, and would like the additional funding provided by TAM.

MCE bears no responsibility or liability for the TAM Electric Vehicle Supply Equipment Grant Program.

Apply for Additional Rebate Through Contra Costa Transportation Authority ('CCTA')

Please enter in your initials confirming you have read and agree to the CCTA rebate terms & conditions described below:

Contra Costa County offers a rebate to property owners installing EVSE. The CCTA rebate amount reimburses the hardware costs of Level 1 and/or Level 2 (high) charging stations at workplaces, long-dwell sites, and multi-family properties. By checking this box, I certify that I am a property owner located in Contra Costa County, agree to the terms and conditions for CCTA�s Charge Up Contra Costa EV Supply Equipment Rebate Program as described here consent to MCE sharing this Rebate Reservation form with CCTA, and would like the additional funding provided by CCTA. MCE bears no responsibility or liability for the CCTA Electric Vehicle Supply Equipment Rebate Program. Note that CCTA requires the payment of prevailing wage, which means that the property owner must comply with and be bound by the provisions of Labor Code Sections 1774 and 1775 concerning the payment of prevailing rates of wages to workers and the penalties for failure to pay prevailing wages. Property owner must comply with and be bound by the provisions of Labor Code Section 1776, which requires the property owner and each subcontractor to: keep accurate payroll records and verify such records in writing under penalty of perjury, as specified in Section 1776; certify and make such payroll records available for inspection as provided by Section 1776; and inform MCE of the location of the records. The property owner is required to take all actions necessary to ensure the compliance of every subcontractor who will perform work on the project, including without limitation, conducting a periodic review of the certified payroll records of the subcontractor and, upon becoming aware of the failure of the subcontractor to pay his or her workers the specified prevailing rate of wages, property owner mu must diligently take corrective action to halt or rectify any failure. To the maximum extent permitted by law, property owner must agree to indemnify, hold harmless and defend (at the property owner's expense with counsel reasonably acceptable to MCE) MCE, its officials, officers, employees, agents and independent contractors serving in the role of MCE officials, and volunteers from and against any demand or claim for damages, compensation, fines, penalties or other amounts arising out of or incidental to any acts or omissions listed above by any person or entity (including property owner, its subcontractors, and each of their officials, officers, employees and agents) in connection with any work undertaken or in connection with this rebate, including without limitation the payment of all consequential damages, attorneys� fees, and other related costs and expenses.

Rebate Amount Requested Additional Rebate through TAM Requested Additional Rebate through CCTA Requested

MCE Rebate Requested: $0.00

Total Rebate Requested: $0.00

The Customer must accept the Terms and Conditions established and provided by MCE

Due to the high demand for EVSE rebates, a customer must be able to display the Project's continuous progress toward completion. A customer who is not able to display the Project's continuous progress toward completion (including, but not limited to: permit application submission; securing contractor proposals; or Project inactivity for 30+ days) may lose their rebate reservation position unless an exception is granted in writing by MCE. If a customer loses their rebate reservation position for this reason, the customer may rejoin the reservation queue once progress toward completion continues. If complexities arise such that the Project requires more time for completion, please notify MCE in writing as soon as possible with a proposed completion schedule and a request for an exception. Before allocating the reserved rebate, MCE requires Project verification documents, including, but not limited to: (1) proof of purchase or invoice of qualified EVSE hardware, software, and installation; (2) proof that the EVSE is operational; and (3) proof that the EVSE is metered through an MCE account number.

If you are NOT the site owner, complete and submit the Designated Applicant Form here.

Is there anything else you would like to tell the team?

How did you hear about EV Charging Rebate?

I, the owner, legal representative, or designated applicant, agree to use best efforts to implement my EVSE charging infrastructure Project as described in the components above. By submitting this application, I am confirming that I accept the Terms & Conditions of the MCE EV Charging Program.

MCE EV Charging Rebate Reservation Form

The Customer must accept the Terms and Conditions established and provided by MCE