Green Ship Incentive Program

Registration Form

Qualifying vessel operators calling at the Port of Long Beach (Port) may be eligible for an incentive under the Green Ship Incentive Program. The vessel operator must comply with Port Tariff No. 4, Item 1060 in order to to be eligible. This registration form must be completed in order to receive incentive payments. Please make sure to also register with the The Environmental Ship Index (refer to Tariff No. 4, Item 1060) in order to verify eligibility for incentives. You can begin the registration process by visiting their website, here: ESI Portal (environmentalshipindex.org)

Company Name

Street Address

City

State/Province/Territory

Zip/Country Code

Country

Name

Phone Number

Email

Please indicate the address and contact person to whom you would like payments mailed:

If the address and contact is the same as above please select here

Name

Department

Street Address

City

State/Province/Territory

Zip/Country Code

Country

Upload Tax I.D. Form: W-9 (U.S. entities), or W-8BEN (non-U.S. entities) and, if applicable, any licenses or permits which may be required by the City of Long Beach. 🛈

Additional copies of tax forms are available below:

W-9 (U.S. Entities) http://www.irs.gov/pub/irs-pdf/fw9.pdf

W-8BEN (non-U.S. entities) http://www.irs.gov/pub/irs-pdf/fw8ben.pdf

Certification and Disclaimer

By checking this box I am acknowledging that my information submitted to the Port is true and correct. My firm is solely responsible for the operation of all vessels participating in the program and I am the eligible party to receive the incentive payment. I further acknowledge that this program will be governed by the terms of Port Tariff No. 4, Item 1060 for the Green Ship Incentive Program as adopted by the Long Beach Board of Harbor Commissioners on May 24, 2021. The only obligation of the Port of Long Beach under this program is to make incentive payments under the Green Ship Incentive Program after verification of compliance in accordance with the terms in Tariff No. 4, Item 1060.

Once your quarterly invoice and supporting data have been received by Port personnel, please allow a minimum of 30 days to process reimbursement incentives.