DAQ-2024-007666

Request For Payment from
VW EVSE
Division of Air Quality
Department of Environmental Quality
State of Utah
195 North 1950 West
Salt Lake City, UT 84116
PAYABLE TO:
SLC, UT 84114
TAX ID:
CHARGE TO: Fund Agency Approp Unit Function Prog Object or BS
2158 480 2158 2113 2VWUDOT 7512
DATE DESCRIPTION TOTAL
1/5/2023 $146,006.09
$146,006.09
Reviewed and Approved By: Date:
Mat Carlile
Andrea Riddle
Project completed: April 1, 2020
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.
Payment to UDOT for reimbursement for purchase, installation, warranty, and
networking costs for two DC Fast Chargers ($146,006.09) at 216 S Main St.
Monticello, UT 84535. As per the State Cooperative Agreement with Verdek
shipping costs will not be reimbursed on this payment. This payment comes
from the Contract 201217 for UDOT through the VW Settlement funds.
Transaction Id:______________________
UDOT #VC0000179400
4501 South 2700 West
Awardee Name: _UDOT-Monticello___

Award Amount (verify that the requested amount does not exceed total amount reimbursed to UDOT
pursuant to the Volkswagen Eligible Mitigation Action Agreement Between State of Utah, Department of
Transportation and State of Utah, Department of Environmental Quality, #201217, effective December
18, 2019, as amended March 23, 2022): $_1,047,6231

Project Summary
Proposed number of EVSEs (type and quantity of each) Two DC Fast Chargers
Actual number of EVSEs (type and quantity of each) Two DC Fast Chargers
Proposed address of EVSE location(s): 701 E, Highway 491, Monticello Utah
Actual address of EVSE location(s): 216 S Main St. Monticello, Utah
Bid amount: $137,802.52. That amount was made up of $18,061 in power upgrades and
$119,741.52 in Verdek install costs.
Invoice amount $128,791.71, The actual costs to install the EV Chargers at this location was
$146,006.09 for an increase in cost of $8,203.09. Savings associated with the power
upgrades accounted for $2,261.43. Additional costs associated with Verdek installation
accounted for $12,065. Verdek indicated that these additional costs above their bid price
were due to multiple trips to the project location by their installers in separate vehicles due
to the COVID-19 Pandemic & a change order to move the charger location that was more
accessible.

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 October 1, 2020 (See Monticello Session Data) ;
The date the EVSE was placed into April 1, 2020 (See Monticello Session Data)
A photo of the EVSE funded by this funding assistance and placed into service;
The estimated hours per day and days per year the EVSE funded by this funding assistance
will be used: 1.6 hours a day 292 days a year (See Monticello Session Data).
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? The original bid
amount for the install at this location was $137,802.52. That amount was made up of
$18,061 in power upgrades and $119,741.52 in Verdek install costs. The actual costs to
install the EV Chargers at this location was $146,006.09 for an increase in cost of $8,203.09.
Savings associated with the power upgrades accounted for $2,261.43. Additional costs
associated with Verdek installation accounted for $12,065. Verdek indicated that these
additional costs above their bid price were due to multiple trips to the project location by

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.
their installers in separate vehicles due to the COVID-19 Pandemic & a change order to
move the charger location that was more accessible.
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? Yes, however, VW funds will not reimburse for
shipping costs because UDOT used the Verdek State Cooperative Agreements where
shipping costs are not allowed.

Amount authorized for reimbursement: =$146,006.09
With this authorized amount, the total amount reimbursed to UDOT to date = $739,148.33

Reviewed by
Mat Carlile _______________
Becky Close________________
Andrea Riddle_______________
Locations Vendors Attachment B-
Bid Item
Application Bid
$
VW $ UDOT $ Finial Invoice Items Contract List
Price
Final Invoice $ VW $ UDOT $ Invoice #
216 S Main St.
Monticello, UT
84535,
San Juan County
CPE250-
ChargePoint
Express 250
$60,850.00 $60,850.00 $0.00 CPE250C-625-CCS1-CDH $74,256.00 $60,850.00 $60,850.00 $0.00 84709
Shipping $1,600.00 $1,600.00 Shipping $1,600.00 $1,600.00 84709
5 Year Warranty
(Assure Plan)/
Network Plan
$34,710.00 $34,710.00 $0.00 CPCLD-ENTERPRISE-DC-5 5yr
Prepaid Enterprise Cloud Plan
$7,424.00 $6,810.00 $6,810.00 $0.00 84709
EXPRESS-ASSURE5 Express
CPE 250 5-yr Prepaid Assure
Plan (per module - 2 modules
per station)
$29,140.00 $27,900.00 $27,900.00 $0.00 84709
Mobilzation $3,875.00 $3,875.00 $0.00 MOBILIZATION $4,654.96 $4,654.96 $0.00 84709
Design/
Equipment
$3,050.00 $3,050.00 $0.00 DESIGN EQUIPMENT $3,050.00 $3,050.00 $0.00 84709
Related
Improvements/R
epairs
$6,356.00 $6,356.00 $0.00 RELATED
IMPROVEMENTS/REPAIRS
$6,356.00 $6,356.00 $0.00 84709
Electrical
Materials
$4,646.00 $4,646.00 $0.00 ELECTRICAL MATERIALS $4,646.00 $4,646.00 $0.00 84709
Commissioning
System
$432.00 $432.00 $0.00 COMMISSIONING SYSTEM $432.00 $432.00 $0.00 84709
Overhead $3,304.61 $3,304.61 $0.00 OVERHEAD $3,304.61 $3,304.61 $0.00 84709
Profit $917.95 $917.95 $0.00 PROFIT $917.95 $917.95 $0.00 84709
Change Order Move
Installation
$11,285.00 $11,285.00 $0.00 84709
Subtotal (Verdek) $119,741.56 $119,741.56 $0.00 Subtotal (Verdek) $131,806.52 $130,206.52 $1,600.00
Empire Elctric
Association, Inc
Provide 3 phase
power 277/480
to EV charging
station for
udot at 216 S
i
$18,061.00 $18,061.00 $0.00 Provide 3 phase power
277/480 to EV charging
station for
udot at 216 S Main St.
Monticello, UT 84535,
$14,899.57 $14,899.57 $0.00 228032
Deposit $900.00 $900.00 $0.00 53394C
Subtotal Upgrades $18,061.00 $18,061.00 $0.00 Subtotal Upgrades $15,799.57 $15,799.57 $0.00
Estimated Grand
Total
$137,802.56 $137,802.56 $0.00 Estimated Grand Total $147,606.09 $146,006.09 $0.00
$146,006.09Grand Total Payment amount for Project
Original Bid Final Invoice Amount
Verdek
UPGRADES UPGRADES
STATEMENT
Utah Department of Transportation
4501 S. 2700 W./ BOX 141510
801-965-2494 (for Accts. Receivables)
DATE:
STATEMENT # 201217-
Department of Environmental Quality
195 N 1950 W
Salt Lake City UT 84116
Customer ID: DEQ-VWGRANT
COMMENTS:Per VW Eligible Mitigation
Action Grant Agreement #
201217 - $ is to be
reimbursed for
DATE DESCRIPTION AMOUNT BALANCE
//20
CURRENT 1-30 DAYS
PAST DUE
31-60 DAYS
PAST DUE
61-90 DAYS
PAST DUE
OVER 90 DAYS
PAST DUE AMOUNT DUE

REMITTANCE
Statement #201217-
Date
Amount Due
Amount Enclosed
Make all checks payable to Utah Department of
Transportation. Please include the UDOT coding
block:
Unit
Appr XE
Program 73261
Phase
Page:of1 1
STATE OF UTAH PAYMENT REQUEST -
COMMODITY BASED
DOCUMENT TOTAL:
FY:BFY:
DOCUMENT DESCRIPTION:
ENTERED BY:
LAST USER:
CREATION DATE:PERIOD:
PRINT DATE:
2021 4 10-29-2020
lbarker October 29, 2020
lbarker
$120,521.52
DISB TYPE:
VNDR LN:VENDOR NUMBER:
LEGAL NAME:
ADDRESS:
AMOUNT:
HDLG CD:
ALIAS/DBA:
PYMT DT:
SNGL CHK FL:
1
123 Rolling Meadow Rd
Check
true
10/29/20VC219254
Verdek LLC $120,521.52
Madison, CT 06443 US
VNDR INV #:
QTY:
COMM LN: COMM#:
DESCRIPTION:
UNIT: UNIT PRICE: TOTAL: F/A:
VNDR INV LN: VNDR INV DT:
WHSE#:
AGREEMENT REF:MA 100 AR2842
1 25170
Vehicle components & systems including safety & security
1.00000 EA $120,521.52
84709 1 10-05-2020
$120,521.52 1
REF TYP:REF ACTG LN:
ACCT LN:
REF COMM LN:
BFY:
REF VNDR LN:
PERIOD:FY:
REF DOC:
LINE AMOUNT:EVENT TYPE:
PRG PRDPHASEPROGMFUND DEPT SOBJUNIT DPT REVAPPR OBJ ACTY FUNCREV BSA
LINE DESC:
1
Partial00
2800 6816810 7203 XED 73261 10U UDOT
AR2842 - MONTICELLO VISITOR CENTER
AP01 $120,521.52
Page:of1 1
STATE OF UTAH PAYMENT REQUEST -
COMMODITY BASED
DOCUMENT TOTAL:
FY:BFY:
DOCUMENT DESCRIPTION:
ENTERED BY:
LAST USER:
CREATION DATE:PERIOD:
PRINT DATE:
2021 4 10-28-2020
lbarker October 28, 2020
lbarker
$11,285.00
Roll Document from 2020 to 2021
DISB TYPE:
VNDR LN:VENDOR NUMBER:
LEGAL NAME:
ADDRESS:
AMOUNT:
HDLG CD:
ALIAS/DBA:
PYMT DT:
SNGL CHK FL:
1
123 Rolling Meadow Rd
Check
true
10/28/20VC219254
Verdek LLC $11,285.00
Madison, CT 06443 US
VNDR INV #:
QTY:
COMM LN: COMM#:
DESCRIPTION:
UNIT: UNIT PRICE: TOTAL: F/A:
VNDR INV LN: VNDR INV DT:
WHSE#:
AGREEMENT REF:
2 25170
Vehicle components & systems including safety & security
11285.00000 EA $11,285.00
84646 1 08-05-2020
$1.00 1
REF TYP:REF ACTG LN:
ACCT LN:
REF COMM LN:
BFY:
REF VNDR LN:
PERIOD:FY:
REF DOC:
LINE AMOUNT:EVENT TYPE:
PRG PRDPHASEPROGMFUND DEPT SOBJUNIT DPT REVAPPR OBJ ACTY FUNCREV BSA
LINE DESC:
1 2021
PartialDO 2002209759810 1 2 1
2800 6816810 7203 XED 73261 10U UDOT
AR2842 - MONTICELLO-CHANGE ORDER
AP01 $11,285.00
Page:of1 1
CREATION DATE:
STATE OF UTAH GENERAL ACCOUNTING EXPENDITURE
DOCUMENT TOTAL:
PRINT DATE: FY:
DOCUMENT DESCRIPTION:
VENDOR LINES:
ENTERED BY:
LAST USER:
BFY:
DOCUMENT NAME:
PERIOD:
05-29-2020
2020 11 1 May 29, 2020
lbarker
lbarker
$900.00
ALIAS/DBA:
VNDR LN: VENDOR NUMBER:
LEGAL NAME:
ADDRESS:
SNGL CHK FL:
PYMT DT:
DISB TYPE:
AMOUNT:
HDLG CD:
1
PO Box K
true
05/29/20
Check
53394C
Cortez, CO 81321-0676 US
$900.00EMPIRE ELECTRIC
ACCT LINE DESC:
ACCT LN:
VNDR INV LN:VNDR INV DT:
REF ACTG LN:
BFY:
REF VNDR LN:
PERIOD:FY:
VNDR INV #:
LINE AMOUNT:EVENT TYPE:
PRG PRDPHASEPROGMFUND SOBJUNIT DPT REVAPPR OBJ ACTY FUNCREV BSADEPT
REF DOC:
1 $900.00
2800 6816810 7203 XED 73261 10U UDOT
UDOT MONTICELLO ELECTRIC VEHICLE CHARGING DEPOSIT
AP01
53394C 04/28/20 1 04-21-2020
Monticello Station – Welcome West 2
Monticello Station – Welcome East 1