Level 2 Electric Vehicle Charging Grant
To access and download our Level 2 Electric Vehicle Charging Grant Guidelines, click the link provided below. Please read ALL eligibility requirements and grantee qualifications.
https://docs.google.com/document/d/1-VpboN3ChVjlmis_V5-R2Mgszn7MjQEg/edit?usp=sharing&ouid=117638006935813551375&rtpof=true&sd=true
Grant program materials can be made available in additional languages upon request of the applicant. Please contact the Economic Development Department by email at bizsupport@southportland.org for more information on translation services.
Date
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Month
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Day
Year
Date
Legal Business Name:
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DBA (Doing Business As) if different from legal name:
Principal Place of Business (in South Portland, ME)
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
*If your Principal Place of Business is not in South Portland, ME, please list your Principal address below.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Owner/Applicant Name:
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First Name
Last Name
Business Phone Number
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Area Code
Phone Number
Mobile Phone
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Area Code
Phone Number
Email
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example@example.com
Business Structure NOTE: Non-Profit/Not for Profit businesses are NOT eligible for this grant program.
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Sole Proprietorship
General Partnership
Limited Partnership
Limited Liability Company (LLC)
Corporation
Central Maine Power (CMP) Account #: (Optional)
Funding Requested
Please read ALL Standards and Performance Requirements for EV Chargers (Appendix 1 of Grant Program Guidelines), as these requirements must be met during installation and during the first years of operation. Please visit the following link to view Appendix 1: https://drive.google.com/file/d/1HvXHDlGzBqKm6U0yWySCORoBtOI6u4WW/view?usp=sharing
Proposed Number of Level 2 EV Charger Plugs for Funding (# must be between 2 & 6 plugs):
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NOTE: This program will fund Level 2 EV charger projects with between 2 and 6 charger plugs at eligible businesses or workplaces.
Total Amount Being Requested ($):
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NOTE: Chargers are eligible for up to $5,000 per plug or 50% of the allowable project costs (whichever is less).
Please describe the degree to which your proposed EV Charging Stations will be visible and accessible to the public. South Portland seeks to use this program to build out a network of chargers that are used frequently and influences a culture around electric vehicles.
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Please Attach: Description of EV Charging Station Project and Use of Funds. Please include technical specifications of chargers, as required in Appendix 1: Standards and Performance Requirements for EV Chargers.
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Please Attach: Map, Sketch, or Plan of EV Charging Stations on Business Property.
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Please Attach: EV Charging Station Project Budget.
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Tax Payer ID (EIN):
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Please Attach: Completed IRS W-9 Tax Form of the Applicant.
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To access a copy of the W-9 tax form: https://drive.google.com/file/d/1YHpORQWYyjmf7YwjGWsjkj1HeBKQy5fW/view?usp=sharing
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Please Attach: Copy of last two years Business Tax Return of the Applicant (typically 1120,1120S, or Schedule C).
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Please Attach: Copy of last two years Business Tax Return of the Applicant (typically 1120,1120S, or Schedule C).
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Certification
Signature of Authorized Representative
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Date:
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Print Name:
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All statements contained in the Application are truthful and accurate. If statements are subsequently determined to be false or inaccurate, the Applicant may forfeit any Grant award and be required to repay the City any funds that have been received. For questions and/or program clarifications, please contact: William Mann, Economic Development Director, at: wmann@southportland.org.
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