EXHIBIT G - REPORTING REQUIREMENTS AND FORMS_V4.PDF

Exhibit G: Quarterly, Annual, and Station Profile,
Charging Port, and Contact Information Report Forms
G.1 Reporting Requirements and Schedule

Reporting Requirements and Schedule
Quarterly Program Progress Reports
Submission Requirement
Submit the completed Program Progress Report via email to:
- Milly Chandler at Milly.Chandler@Maricopa.gov; and
- Maricopa County CFI Funded EV Infrastructure Program at EVChargers@Maricopa.gov
Report Due Date
Calendar Quarter 1 April 12
Calendar Quarter 2 July 12
Calendar Quarter 3 October 12
Calendar Quarter 4 January 12
Station Profile, Charging Port, and Contact Information
Submission Requirement
Submit the completed Station Profile, Charging Port, and Contact Information via email to:
- Milly Chandler at Milly.Chandler@Maricopa.gov; and
- Maricopa County CFI Funded EV Infrastructure Program at EVChargers@Maricopa.gov
Report Due Date
No later than 10-business days prior to each charging port becoming operational.
One-Time Operational Reports
Submission Requirement
Submit the completed required data modules for Station Operator Identity, DER Information,
and Capital & Installation Costs via Electric Vehicle Charging Analytics and Reporting Tool (EV-
ChART).
Submission will be reviewed by MCAQD for accuracy and completeness.
Report Due Date
No later than 10-business days following the initial date of operation for each charging port.
Annual Operational Reports
Submission Requirement
Submit the completed required data modules for Maintenance Costs and Station Operator
Program via EV-ChART.
Submission will be reviewed by MCAQD for accuracy and completeness.

Report Due Date
Annually February 14
Quarterly Program Progress Reports
Submission Requirement
Submit the completed required data modules for Charging Sessions, Uptime, and Outages via
EV-ChART.
Submission will be reviewed by MCAQD for accuracy and completeness.
Report Due Date
Calendar Quarter 1 April 12
Calendar Quarter 2 July 12
Calendar Quarter 3 October 12
Calendar Quarter 4 January 12

G.2 Quarterly Project Progress Report Form

#NAME?
Enter Organization Name
Enter Street Address
Suite/Unit
City, State ZIP1
Quarterly Project Progress Report
Quarter #
Report Prepared For: Due on:
Maricopa County Calendar Quarter 1 April 12
Air Quality Department Calendar Quarter 2 July 12
Division of Planning & Analysis Calendar Quarter 3 October 12
CFI Funded EV Infrastructure Program Calendar Quarter 4 January 12
Quarter Start Date: Project Start Date:
Quarter End Date: Project End Date:
Federal Award Identification Number: 693JJ32540008
Project Title:
Project Manager:
Project Budget Table
Category Approved Budget Budget Percentage
MCAQD Share:
Project Cost Share:
Total Budget:
Baseline Measurement: Zero operational EV charging port and/or hydrogen dispensers.
Performance Measurement Table
Measure Type Number
Number of CFI grant-funded EV
charging ports and/or Hydrogen
dispenser (operational)
Total Operational:

Section A
Project Overall Status
Final project overall status should include the following:
- Comparison of the project's accomplishments to the baselines, goals, and objectives
- Description of the project's outcomes and impact
- Highlighted success stories when the project met or exceeded the goals and objectives
- Explanation of why goals and objectives were not met, if applicable
- Identification of cost-effective practices and innovative strategies
- Discussion of the potential to continue the project without federal funding

Section B
Project Significant Activities, Issues, and Schedule
This section should reflect highlights of key activities, accomplishments, and issues that have
occurred throughout the project duration. The final master project schedule should reflect a
completion of all activities that have been reported on throughout the duration of this project.
If the project has received a prior approved written extension, the cause of delay and the
anticipated completion date with additional details should be included in this section.
Current Overall Project Completion:
Current Overall Project
Latest Plan Percentage:
Meetings with MCAQD, contractors, etc.
Not Started Planning In Progress Complete N/A
Completion Percentage:
Schedule Status:
Progress Description:
Community Engagement and Outreach
Not Started Planning In Progress Complete N/A
Completion Percentage:
Schedule Status:
Progress Description:

Request For Proposal (RFP)
Not Started Planning In Progress Complete N/A
Completion Percentage:
Schedule Status:
Progress Description:
Preliminary Design Plans
Not Started Planning In Progress Complete N/A
Completion Percentage:
Schedule Status:
Progress Description:
National Environmental Policy Act (NEPA) Review
Not Started Planning In Progress Complete N/A
Completion Percentage:
Schedule Status:
Progress Description:

Construction and Installation Permits
Not Started Planning In Progress Complete N/A
Completion Percentage:
Schedule Status:
Progress Description:
Equipment Procurement
Not Started Planning In Progress Complete N/A
Completion Percentage:
Schedule Status:
Progress Description:
Electric Vehicle Charging Station Construction and Installation
Not Started Planning In Progress Complete N/A
Completion Percentage:
Schedule Status:
Progress Description:

EVCS Operation Announcement
Not Started Planning In Progress Complete N/A
Completion Percentage:
Schedule Status:
Progress Description:
Other Activities of Significance
Not Started Planning In Progress Complete N/A
Completion Percentage:
Schedule Status:
Progress Description:

Section C
Action Items/Outstanding Issues
For the Final Poject Data Report, this section should not have any remaining Actions
Items/Outstanding Issues. If there are outstanding action items or outstanding issues, please
contact Maricopa County's CFI Funded EV Infrastructure Program prior to submitting this
Item/Issue 1: Due Date:
Responsible Person(s):
Status:
Item/Issue 2: Due Date:
Responsible Person(s):
Status:
Item/Issue 3: Due Date:
Responsible Person(s):
Status:

Section D
Project Scope Overview
Final project scope overview should include the following:
- Comparison of the project's initial intended scope and final project outcomes scope
- Explanation of changes in scope and its effect on project costs, if applicable

Section E
Project Cost
Final project costs should match the budget approved in the subaward agreement. Any
changes in this budget must include:
- Details of the specific change in cost
- Explanation of change in cost
- Explanation for how this change in cost affects the overall budget
- Description of the change in cost share
- Documentation of written prior approval of cost changes from the County
Program Expenditures Cost Share Expenditures
Cost Classifications Current Billing Cumulative Current Cumulative
Administrative Expenses $ 0.00 $ 0.00 $ 0.00 $ 0.00
Personnel
Benefits
Travel
Supplies
Community Outreach
Indirect Costs
Preliminary Expenses
Land, Structures, Right of Way
Architectural/Engineering Basic Fees
Other Arch./Eng. Fees
Project Inspection Fees
Land Development
Relocation Expenses
Demolition and Removal
Construction/Improvement Costs
Equipment
Miscellaneous
Contingencies
Total Project Costs $ 0.00 $ 0.00 $ 0.00 $ 0.00
Project Cost Narrative

Project Cost Narrative Continued

Section F
Certifications
By signing this report, I certify to the best of my knowledge and belief that _________________ is
in compliance with 2 C.F.R. 200.303 (Internal Controls) and 2 C.F.R. Part 200, Subpart F (Audit
Requirements).
Certification required under 2 C.F.R. 200.415(a) is included in the SF-425 report attached.
Name of Certifying Official:
Title of Certifying Official:
Telephone:
Email Address:
SIGN
Signature of Authorized Certifying Official: Date of Signature:

G.3 STATION PROFILE, CHARGING PORT, AND CONTACT
INFORMATION FORM

#NAME?
Enter Organization Name
Enter Street Address
Suite/Unit
City, State ZIP1
Station Profile, Charging Port, and Contact Information
Due no later than 10-business days prior to the operational date of each charging station.
Report Prepared For:
Maricopa County
Air Quality Department
Division of Planning & Analysis
CFI Funded EV Infrastructure Program
Federal Award Identification Number: 693JJ32540008
Project Title:
Project Manager:
Project Manager Email:
STATION PROFILE
Station Nickname:
Station ID:
Station Address:
Station Geographic
Coordinates:
Network Provider:
Operational Date:
Located on AFC?
Number of Federally Funded Ports Number of Federally Funded Ports
Federally Funded Port IDs and Charging Level Non-Federally Funded Port IDs and Charging Level