AB863 Grant Reimbursement Form Page

AB863 Grant Reimbursement Form – Union apprentice and journey-level carpet installer training

The Grant Program for Union apprentice and journey-level carpet installer training is administered through Carpet America Recovery Effort (CARE) for the California Carpet Stewardship Program in accordance with CA AB-863. Funds are made available for grants to apprenticeship programs for training apprentices and journey-level carpet installers in proper carpet recycling techniques, including installation and removal techniques that maximize the recyclability of carpet. All funds must be utilized in the same fiscal year they are awarded unless specifically noted in each solicitation.

Step 1 of 4 – AB863 Grant Reimbursement Form

Notice to Applicants
All applicants are required to complete and submit this form within the space provided. Please refer to grant solicitation for criteria and other requirements.
Grant Cycle*
Eligibility Declaration*
As of today, is the applicant a registered and active member of an Apprenticeship program approved by the Chief of the Division of Apprenticeship Standards for training apprentice and journey-level carpet installers?
- No
- Yes
Declaration:*
Furthermore, I attest that by submitting this application, all expenses and reimbursable funds were used to provide training to apprentice and journey-level carpet installers in proper carpet installation, reuse, and recycling practices to maximize the chances of achieving the goals of the Carpet Stewardship Program.
I do declare.
Thank you for your interest in CARE’s Union Grant Program. You must meet the eligibility requirements to proceed. Please refer to the Solicitation for eligibility requirements. If you are not a Union Representative of a California Apprenticeship program and you would like to apply for our standard grants, please visit https://carpetrecovery.org/california/ca-grants/ for more information.
Section I. Applicant Information
IUPAT Branch*
Applicant Name*
Must be a verified Union representative for a California Joint Apprenticeship Program approved by the Division of Apprenticeship Standards.
First Last
Applicant Telephone*
Applicant Email*

Section III. Project Information
All grant expenditures must be for activities, products and costs specifically related to Union apprentice and journey-level carpet installer training. Eligible costs must be incurred, services provided, training completed, and goods received during the current fiscal year or before the end of the Grant Term. Eligible costs are limited to activities that promote apprentice or journey – level training activities. Certain equipment / infrastructure, program education and outreach materials, or minor improvements to existing collections or reuse facilities (if a CARE public drop-off site) may be considered.
Project Title*
In a brief, one-sentence project objective, please describe how the funds are used. (255 Max Characters)
Training Reimbursement
The following section relates to expenses incurred for providing training to apprentice and journey-level carpet installers in proper carpet installation, reuse, and recycling practices. A copy of the Grant Reimbursement Form – Class Roster is required for each reimbursement application.
Training Completion Date**
*Please check the eligibility dates for the grant cycle you are applying for. Training must take place during the fiscal year in which the grant was awarded.
Number of Enrolled Students
Enter the total number of Enrolled students listed in the Installer Training Class Roster template.
Upload Class Roster(s)*
Please upload a completed copy of the course attendee list template provided in the solicitation documents.
Accepted file types: xlsx, xltx, pdf, Max. file size: 256 MB.
Tuition Rate per Apprentice member*
Please enter a number from 1 to 1000.
Number of Apprentice Graduates*
Graduates must receive a passing grade of 80 percent or higher on the CARE quiz.
Tuition Rate per Journey-level member*
Please enter a number from 1 to 2000.
Number of Journey-level Graduates*
Graduates must receive a passing grade of 80 percent or higher on the CARE quiz.
Total Combined Additional Expenses
Enter the total amount from the CARE AB863 Union Grant Expenditure Itemization Summary form: “Additional Expenses Total”.
Eligible expenses aid in best practices training that support collection activities which increase the volume of PCC collected for reuse and/or recycling at end of life. Examples may include training materials or equipment such as carpet tile wrapping machines, etc. Fund disbursements will be issued for reasonable actual costs that are in line with industry standards. Receipts are required.
Equipment purchases above $1000.00 require pre-authorization from CARE to be eligible for reimbursement. Vehicles are not eligible.
Additional Expenses Receipts / Invoices*
Drop files here or
Max. file size: 256 MB.
Are you requesting Equipment Reimbursement?*
Note: Any equipment costing $1000.00 or more must have CARE pre-authorization to be eligible for reimbursement.
- Yes
- No
Total Equipment Costs*
Enter the combined total for all equipment for which you are requesting reimbursement .
Pre-Approved Equipment Invoice*
Please attach equipment purchase invoice(s). Invoices should include the name of the Selling Company, Contact information, Make & Model number, Description of Equipment, Serial Number (if applicable), unit cost, and any additional fees such as service, warranty or taxes. Only equipment that costs over $1000.00 must be pre-authorized before procurement.
Drop files here or
Accepted file types: pdf, docx, Max. file size: 256 MB.
Total Grant Funds Requested
If the total amount requested exceeds the fiscal year’s available allocated grant funds, your request may be adjusted or denied.
Section IV. Project Contacts
Please provide contact information for the course Instructor (required) with phone number, address and email information. Trainers should be persons familiar with the project scope of work and/or technical requirements outlined in the CARE developed training plan.
Name*
First Last
Title*
Agency / Business / Organization*
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Applicant/Team Qualifications and Experience*
Please describe the qualifications and experience of the trainer with regard to managing, implementing or providing technical expertise to the project.

Section V. Project Information
This project will increase: (Check all that apply)*
- Select All
- Captured Post Consumer Carpet (PCC)
- Captured Reuse Opportunities
- End-of-Life Carpet Recyclability
Project Impact/Program Efficiency*
Describe how the project results benefit union members while increasing the amount of PCC collection as a result of receiving grant funds.
In the box below, enter the number of additional square yards (YD2) of post-consumer carpet collected for reuse or recycling during the last quarter; or estimated to be captured during the next quarter, as a result of the training received. Note: Additional material is that which was previously destined for landfill or sent to Waste-to-Energy prior to members being trained in best practices.
Square Yards actually collected during reporting period or the estimated amount to be collected in the next quarter.*
Include any material sent to a recycler or reuse outlet.
Reimbursement Summary & Payment
AB863 Union Grant Expenditure Itemization Summary*
Please upload a completed Union Grant Expenditure Worksheet. The worksheet can be found on CARE’s website at https://carpetrecovery.org/ca-unions.
Accepted file types: pdf, xlsx, Max. file size: 256 MB.
Total Grant Funds Requested*
Payment Type*
If Direct Deposit is selected, please be prepared to provide CARE with your Union’s banking information. ACH Payments (direct deposit) will be made to a Union held commercial bank account only, provided the account is eligible for receiving direct deposits. Please provide CARE with a copy of an account deposit slip or voided check, and a completed ACH Form which can be provided upon request.”
- Mailed Check
- Direct Deposit (ACH)
(IRS) form W-9
If this is the first submission for this branch, please upload a completed copy of a Department of the Treasury / Internal Revenue Service (IRS) form W-9. The form and instructions can be found on the IRS website https://www.irs.gov/forms-pubs/about-form-w-9. Must be in pdf format.
Accepted file types: pdf, Max. file size: 256 MB.
Payment Mailing Address*
Please list where any payments should be mailed.
Street Address Address Line 2 City State ZIP Code
Acknowledgement
I understand that CARE may conduct Agreed-upon-procedures (AUPs) for up to three (3) years after the close of the grant project. I further understand that submitting this application does not guarantee an automatic reimbursement of all funds requested, and that CARE may, at its discretion, reduce (partial) or deny (whole) any reimbursement amounts that fall outside of legislated eligibility.
Signature*
By signing below, I certify that I am authorized by my Organization to provide the included information to CARE for the sole purpose of soliciting Grant funds.
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AB863 Grant Reimbursement Form – Union apprentice and journey-level carpet installer training

Step 1 of 4 – AB863 Grant Reimbursement Form

Notice to Applicants

Section I. Applicant Information

Section II. Training Facility Information

Section III. Project Information

Training Reimbursement

Section IV. Project Contacts

Section V. Project Information

Reimbursement Summary & Payment

Acknowledgement

2025 Annual Report Public Workshop Announced

Find carpet reclamation partners in your area

Products Made with Recycled Carpet

AB863 Grant Reimbursement Form – Union apprentice and journey-level carpet installer training

Step 1 of 4 – AB863 Grant Reimbursement Form

Notice to Applicants

Section I. Applicant Information

Section II. Training Facility Information

Section III. Project Information

Training Reimbursement

Section IV. Project Contacts

Section V. Project Information

Reimbursement Summary & Payment

Acknowledgement

Find carpet reclamation partners in your area

Products Made with Recycled Carpet

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