CERTIFICATE OF DISPOSAL

CERTIFICATE OF DISPOSAL The Certificate of Disposal is required to be signed by the school district’s authorized agent or superintendent and by the scrapping company/dismantler or dealer (if bus being replaced is traded in) and returned along with the request for reimbursement. Any successful grant recipient may use a school bus as a trade-in, provided the dealer can provide proof that the requirements will be followed and applied to the school bus that is being traded in by the school district. The EPA requires that the engine being replaced must be scrapped, remanufactured by an original engine manufacturer to meet 2007 EPA emission standards or rendered permanently disabled. Drilling a hole in the engine block and manifold while retaining possession of the engine is an acceptable scrapping method. Please identify the bus/bus engine being disposed. Please identify if the bus/bus engine is being scrapped, the remanufacture method or other method of disposal. Bus Manufacturer Bus Model Bus Year Engine Year Bus VIN Engine Manufacturer Engine Model Engine Serial Number *Disposal Method *Please provide a “specific” description of the disposal method for the bus listed above. If scrapped or salvaged engines/vehicles are to be sold, program income requirements apply. If this applies, what is the amount of program income? $_________________ Signatures below certify that that the scrappage/remanufacture/disposal methods meet the EPA requirements. This form must be returned with the request for reimbursement form. Name of School District _______________________________________________________________ ____________________________________ Superintendent/Authorized Agent - Signature Date _______________________________ _________________________________________ Scrapping Company/Dismantler/Dealer – Signature Date _____________________________________

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