DAQ-2024-007648

Request For Payment form
VW EVSE
Division of Air Quality
Department of Environmental Quality
State of Utah
195 North 1950 West
Salt Lake City, UT 84116
PAYABLE TO:
TAX ID:
CHARGE TO: Fund Agency Approp Unit Function Prog
Object or BS
2158 480 2158 2113 2VWPROVO 7512
DATE DESCRIPTION TOTAL
10/20/2022 $222,030.00
$222,030.00
Reviewed and Approved By: Date:
Mat Carlile
Andrea Riddle
NOTE:Please note that this payment was part of a larger project and that
request is for a portion of the overall cost of the project. The included invoices
came in at $267,718, which includes the costs of purchasing and installing all
20 EVSE units plus the warranty, and network costs for the 20 EVSE units;
however, only 16 of the EVSE units have been installed and activated. Provo is
requesting reimbursement for these 16 units. The reimbursable amount for
these 16 EVSE units comes to $222,030, which includes costs for buying and
installing 16 dual-port level 2 EVSE units, plus the warranty and network for
these units. The remaining costs, which include the cost of electrical
infrastructure updates, will be reimbursed when the remaining four EVSE units
are installed and activated.
Project complete dates: Rock Canyon Park January 15, 2021; Provo Power
Complex January 26, 2021; Provo City Academy Library December 16,
2020; Provo Recreation Center February 12, 2021; Public Works Complex
February 26, 2021; Spring Creek Park March 5, 2021; and Pioneer Park
March 19, 2021
351 West Center St
Payment to Provo City for reimbursement of the purchase and installation of 16
dual port level 2 Electric Vehicle Supply Equipment (EVSE) units ($222,030).
This payment comes from Contract 200969 for Provo City through the VW
Settlement funds.
Transaction Id:______________________
Provo City
Provo City, UT 84061
Awardee Name: _Provo City ___

Award Amount (verify that the requested amount does not exceed this amount): $_752,5001

Project Summary
Proposed number of EVSEs (type and quantity of each) 20 Dual-Port Level 2 EVSE units
Actual number of EVSEs (type and quantity of each) 16 Dual-Port Level 2 EVSE units
Proposed address of EVSE location(s): Provo City Center 351 W. Center St. Provo, UT 84601; Provo
Recreation Center 300 West 500 North Provo, Utah 84601; Provo City Academy Library 550 North
University Ave. Provo, Utah 84601; Provo Power Complex 251 West 800 North Provo, Utah 84601;
Public Works Complex 1377 South 350 East Provo, Utah 84601; Rock Canyon Park 500 East 2320
North Provo, Utah 84601; North Park 500 North 500 West Provo, Utah 84601; Spring Creek
Park 1700 South State St. Provo, Utah 84601; and Pioneer Park 550 West 100 South Provo,
Utah 84601
Actual address of EVSE location(s): Rock Canyon Park 500 East 2320 North Provo, Utah 84601;
Provo Power Complex 251 West 800 North Provo, Utah 84601; Provo City Academy Library 550 North
University Ave. Provo, Utah 84601; Provo Recreation Center 300 West 500 North Provo, Utah 84601;
Public Works Complex 1377 South 350 East Provo, Utah 84601; Spring Creek Park 1700 South State
St. Provo, Utah 84601; and Pioneer Park 100 North 400 West Provo, Utah 84601.

Bid amount: $302,155.11 this includes costs for buying, installation, warranty, and network of 20
dual-port level 2, warranty and network ($267,718), and electrical system infrastructure upgrades
($34,437.11).
Invoice amount: The invoices came in at $267,718, which includes the costs of purchasing and
installing all 20 EVSE units plus the warranty, and network costs for the 20 EVSE units; however, only 16
of the EVSE units have been installed and activated. Provo is requesting reimbursement for these 16
units. The reimbursable amount for these 16 EVSE units comes to $222,030, which includes costs for
buying and installing 16 dual-port level 2 EVSE units, plus the warranty and network for these units. The
remaining costs, which include the cost of electrical infrastructure updates, will be reimbursed when the
remaining four EVSE units are installed and activated.

Checklist of required documents (Provide a description of any modifications from the original, proposed
project).
A site map showing the location of the EVSE funded by this funding assistance;
Installation start date of the EVSE project March 6, 2020 (see EVSE Reimbursement Request
#1 5/31/2022 submission);
The date the EVSE was placed into: Rock Canyon Park January 15, 2021; Provo Power
Complex January 26, 2021; Provo City Academy Library December 16, 2020; Provo Recreation
Center February 12, 2021; Public Works Complex February 26, 2021; Spring Creek Park March 5,
2021; and Pioneer Park March 19, 2021 (see EVSE Reimbursement Request #1 5/31/2022
submission)
A photo of the EVSE funded by this funding assistance and placed into service;

1 Please note that this payment was part of a larger project and that request is for a portion of the overall cost of the
project
The estimated hours per day and days per year the EVSE funded by this funding assistance
will be used:
A final purchase invoice for each EVSE, installation, maintenance, and other itemized actual
costs from the Funding Assistance Application. The invoice shall include:
a. the invoice date;
b. the itemized purchase cost for each item or service listed in the competitive bid; and
c. the applicant as the purchaser;
If costs are higher than the original bid, are the increased costs reasonable? N/A
If items purchased are different from competitive bid did entity document that they meet
procurement rules for changed items (see Terms and Conditions section II B.); and
Proof of payment.
Did the applicant use the State Cooperative Agreement? Yes
o If yes, did the invoice include shipping? No
o If yes Were the shipping and EVSE cost below State Contract list price (See price
breakdown)? N/A

Reviewed by
Mat Carlile _______________
Becky Close________________
Andrea Riddle_______________
Locations
Item
Application/B Qty Cost per item total cost Grant $Provo $Locations
Item on Final
Invoice Qty
Cost Per
Item Cost Grant $Provo $Invoice #
Chargers
gateway
Model # iL2-20 $4,995.00 $99,900.00 $99,900.00 $0.00
All Locations Chargers gateway
Model # iL2-eSta-
sm 20 $4,995.00 $99,900.00 $79,920.00 $0.00
110619-
BTCP L2
Warranty for
five (5) year -
first year 20 $2,500.00 $50,000.00 $50,000.00 $0.00
Warranty for five
(5) year - first
year FREE. Total 6 20 $2,500.00 $50,000.00 $40,000.00 $0.00
0506202N
WEXS
components
(such as
cloud service) 20 $1,790.00 $35,800.00 $35,800.00 $0.00
components
(such as cloud
service) and 20 $1,790.00 $35,800.00 $28,640.00 $0.00
0506202N
WEXS
Rock Canyon
Park
Materials,
Engineering,
and 1 $10,672.00 $10,672.00 $10,672.00 $0.00
Rock Canyon
Park
Labor, Materials,
Engineering, and
Permitting 1 $10,672.00 $10,672.00 $10,672.00 $0.00
20L2 &
041420-
20L2P2
Provo Power
Complex
Labor,
Materials,
Engineering,
and 1 $7,224.00 $7,224.00 $7,224.00 $0.00
Provo Power
Complex Labor, Materials,
Engineering, and
Permitting 1 $7,224.00 $7,224.00 $7,224.00 $0.00
02202020-
20L2 &
041420-
20L2P2
Academy Libray Labor,
Materials, 1 $15,002.00 $15,002.00 $15,002.00 $0.00
Academy
Libray
Labor, Materials,
Engineering, and 1 $15,002.00 $15,002.00 $15,002.00 $0.00
02202020-
20L2 &
City
Center/Pioneer
Labor,
Materials, 1 $15,308.00 $15,308.00 $15,308.00 $0.00
City
Center/Pionee
Labor, Materials,
Engineering, and 1 $15,308.00 $15,308.00 $6,760.00 $0.00
02202020-
20L2 &
Rec
Center/North
Labor,
Materials, 1 $13,728.00 $13,728.00 $13,728.00 $0.00
Rec
Center/North
Labor, Materials,
Engineering, and 1 $13,728.00 $13,728.00 $13,728.00 $0.00
02202020-
20L2 &
Public Works
Complex
Labor,
Materials, 1 $9,482.00 $9,482.00 $9,482.00 $0.00
Public Works
Complex
Labor, Materials,
Engineering, and 1 $9,482.00 $9,482.00 $9,482.00 $0.00
02202020-
20L2 &
Spring Creek
Park
Labor,
Materials, 1 $10,602.00 $10,602.00 $10,602.00 $0.00
Spring Creek
Park
Labor, Materials,
Engineering, and 1 $10,602.00 $10,602.00 $10,602.00 $0.00
02202020-
20L2 &
$267,718.00 $267,718.00 $0.00 $267,718.00 $222,030.00 $0.00
All Locations
1 $34,437.11 $34,437.11 $34,437.11 $0.00
All Locations
1 $34,437.11 $34,437.11 $0.00 $0.00
$34,437.11 $34,437.11 $0.00 $34,437.11 $0.00 $0.00
$302,155.11 $302,155.11 $0.00 Grant Total $302,155.11 $222,030.00 $80,125.11
Sub Totals
Sub Totals
Upgrade Costs
Grand Total
Sub Totals
Orignal BIDS FINAL INVOICE
Upgrade Costs
All Locations
Sub Totals
Electric Highway LLC INVOICE
63 E 11400 S #196
Sandy, UT 84070
808.256.5660
INVOICE #FINAL
DATE 10/14/2022
TO
Dick Blackham
Provo City Facilities Services Manager
351 W Center St
Provo, UT 84601
FOR Provo City EV charger infrastructure
P.O. #
Description Amount
Itemized costs are the same as the bid provided to Provo City on Oct 10, 2019
Total 267,718
Make all checks payable to Electric Highway LLC
Payment is due within 30 days.
If you have any questions concerning this invoice, contact Rob Slater | 808.256.5660 |
[e-mail]
THANK YOU FOR YOUR BUSINESS!
October 10, 2019
41420 2P2
April 13 0
QUANTITY DESCRIPTION Total
40 ports

5 years Network and Extended Service for the following locations:
Rock Canyon Park
Provo Power Complex
Academy Library

City Center/ Pioneer Park

Rec center/ North Park

Public Works Complex

Spring Creek Park
$ 85,800.00

63.E 11400 S #196
Sandy UT 84070
UTAH Office Invoice Number 0506202NWEXS
Invoice Date May 06,2020
To: Due upon Receipt.
Provo City (Dick Blackmen)
Provo City Facilities Services Manager
351 West Center Street
Provo, Utah 84601 ATTN: Accounts Payable

TOTAL
PAY THIS AMOUNT

MAKE ALL CHECKS PAYABLE TO:
The Electric Highway Company LLC

THANK YOU FOR YOUR BUSINESS!
OCPP
Network $ 35,800.00
Extended
EVSE
Service
$50,000.00
Complete
d EVSE
Type
Quantity Location Name EVSE Cost
EVSE
Installation
Costs
EVSE Maintenance Costs Total Project
Amount
1 -
Invoice
2 - Proof
of
Payment
3 - Photo 4 - Map
5 - Date
Installation
Started
6 - Date Placed Into
Service
7 - Hours Per Day and Days
Per Year EVSE will be used 8 - Address
Level 2
Dual
chargers
2 Rock Canyon Park $9,990.00 $10,672.00 $8,580.00 $29,242.00 Yes Yes Yes Yes 3/6/2020 1/15/2021 4-8 Hours a day 365
days/year
Rock Canyon Park - 500 East
2320 North Provo, Utah 2019-11-06 - Electric Highway Company 110619-BTCP L2 - $99,900
Level 2
Dual
chargers
2 Provo Power
complex $9,990.00 $7,224.00 $8,580.00 $25,794.00 Yes Yes Yes Yes 3/6/2020 1/26/2021 4-8 Hours a day 365
days/year
Provo Power complex - 251 West
800 North Provo, Utah
Level 2
Dual
chargers
2 Academy Library $9,990.00 $15,002.00 $8,580.00 $33,572.00 Yes Yes Yes Yes 3/6/2020 12/16/2020 4-8 Hours a day 365
days/year
Academy Library - 550 North
University Avenue Provo, Utah 2020-05-06 - Electric Highway Company 0506202NWEXS -$85,800
Level 2
Dual
chargers
4 Provo City
Recreation Center $19,980.00 $13,728.00 $17,160.00 $50,868.00 Yes Yes Yes Yes 3/6/2020 2/12/2021 4-8 Hours a day 365
days/year
Provo City Recreation Center -
300 West 500 North Provo, Utah
Level 2
Dual
chargers
2 Provo City Public
Works complex $9,990.00 $9,482.00 $8,580.00 $28,052.00 Yes Yes Yes Yes 3/6/2020 2/26/2021 4-8 Hours a day 365
days/year
Provo City Public Works complex -
1377 South 350 East Provo, Utah
Level 2
Dual
chargers
2 Spring Creek Park $9,990.00 $10,602.00 $8,580.00 $29,172.00 Yes Yes Yes Yes 3/6/2020 3/5/2021 4-8 Hours a day 365
days/year
Spring Creek Park - 1700 South
State Street Provo, Utah
Level 2
Dual
chargers
2 Pioneer Park $9,990.00 $6,760.00 $8,580.00 $25,330.00 Yes Yes Yes Yes 3/6/2020 3/19/2021 4-8 Hours a day 365
days/year
Pioneer Park - 100 North 400
West Provo, Utah
Totals 16 $79,920.00 $73,470.00 $68,640.00 $222,030.00
Level 2
Dual
chargers
4 Provo City Center $19,980.00 $8,548.00 $17,160.00 $45,688.00 Yes Yes
Still waiting
for
installation
Yes
Still waiting
for
installation
Installation will be
scheduled as soon as
the site is designed
and construction
begins. The completion
date has been
extended to November
2023
Public access to all units 24
hours/day ; 365 days/year
Provo City Center - 351 West
Center Street Provo, Utah
Totals 20 $19,980.00 $8,548.00 $17,160.00 $45,688.00
Total Reimbursement Requests 1 &2:$99,900.00 $82,018.00 $85,800.00 $267,718.00 14 kw/h per day
2020-02-20 - Electric Highway Company 02202020-20L2 -$41,009
2020-04-13 - Electric Highway Company 041420-20L2P2 -$41,009
EVSE Reimbursement Request #1- 05/31/2022 submission
Future Reimbursement Request #2 (Will be submitted after installation is complete)
300 S
500 N
100 N
100 S
800 N
400 N
700 N
400 S
1150 S
920 S
OAK VIEW
CIR
2230 N
2620 N
BULLDOG BLVD
640 S
1560 S
2320 N
2780 N
1320 S
460 S
900 N
580 S
900 S
2200 N
1325 S
150 N
1280 S
890 S
200 N
450 N
1020 S
940 N
1120 S
860 N
2100 N
1140 S
1020 N
1340 S
150 S
1990 N
950 S
1060 N
500 S
2600 N
2150 N
20 N
1400 S
1570 S 1600 S
1850 N
1800 N
770 S
930 N
1575 N
1440 S
1130 S
2680 N
B
1500 S
230 S
1280 N
2570 N
50 S
2500 N
1430 S
2120 N
70 N
1220 S
960 S
1975 N
650 N
1340 N
600 N
780 S
1200 N
1625 N
1925 N
890 N
680 S
420 N
1940 N
590 N
2170 N
690 S
1 3 00 N
1090 S
2050 N
1140 N
1100 S
1370 S
ST
1230 S
980 N
1225 N
1300 S
970 S
880 S
320 N
910 S
2270 N
1120 N
1060 S
730 S
1160 S
CAMB RIDGE CT
2280 N
2370 N
490 S
1040 S
1380 N
1000 S
1190 S
1050 S
1250 S
1400 S
560 N
880 N
1450 S
100 N
550 S
960 S
600 N
900 N
1950 N
1410 E
200 N
N
960 N
200 S
300 N
350 N
700 N
300 N
2000 N
1080 S
200 N
350 N
CAMBRIDGE
CIR
1400 N
500 N
700 N
300 N
600 S
1700 N
1500 N
STATE
HOSPITAL
900 N
1400 E
1200 S
1300 N
600 S
1500 S
1060 N
1150 S
1020 S
450 N
400 S
520 S
1020 S
700 S
500 S
N
1500 S
880 N
900 S
2550 N
560 S
1650 N
1060 N
50 S
1200 N
300 N
820 N
2680 N
520 S
1400 S
CE NTER ST
100 N
2060 N
1850 N
1460 N
1020 N
800 N
500 N
900 N
800 N
700 N700 N
80 N
100 N
200 N
400 N
CENTER ST
400 N
CENTER ST
500 N
620 N
300 N
CENTER ST
600 S
500 S
300 S
400 S
100 S
200 S
500 S
600 S
200 S
100 S
300 S
400 S
ER
NO
SEGO
LN
2050 N
2780 N
STADIUM CIR
2550 N
OAK
CREST
CIR
OAK
CLIFF
N DR
560 N
620 N
HILLSDALE
CIR
300 S
900 S
640 S
1230 S
1280 S
1270 S
1400 S
GREEN CANYON DR
CANYON VISTA DR
1280 S
1440 S
1500 S
1300 S
1610 S 1560 S
470 S
930 S
1350 S
1370 S
MCCLELLAN CT
ROCK
CANYON
CIR
Provost Park
Cottonwood
Greenway
Provo City
Cemetery
Powerline
Park #1
Franklin
Field
Franklin
Field
Wasatch
Field
Carterville Park
Sertoma
Park
Kiwanis
Park
Y-Mountain
Trailhead
Memorial
Park
Harmon
Park Neighborhood
Park
BYU
Botany
Pond
2230 N
Trailhead
Maeser
Park Roadside ParkPowerline
Park #3
Footprinters
Park
Bicentennial
Park
Slate Canyon
Trailhead
Fox
Field
Provost Field
Provo
Peaks
Field
Dixon
Field
Timpanogos
Field
Rock
Canyon
Field
Riverside
Country Club
Grandview
Field
Lions
Park
Exchange
Park
Riverside Park
Rock Canyon
Trailhead
Branbury Greenway
Joaquin
Park
Provo
River
Trail
Provo River
Trail
The
Peaks
Arena
Franklin
Park
City Center
Rec
Center
Library
Power Complex
Public Works
Rock
Canyon
Park
North Park
Spring
Creek
Park
Pioneer Park
Proposed Provo City Electric Vehicle Charging Stations