Pepco DPL Subcontractor Application v5

SUBCONTRACTOR FORM SUBMITTED BY TRADE ALLY

TRADE ALLY APPLICANT INFORMATION

Company Name (as shown on your last company W9 tax form)

Primary Contact

Title

Email

SUBCONTRACTOR INFORMATION

Company Name (as shown on your last company W9 tax form)

Primary Contact

Title

Tax ID or Social Security Number

Email

Mailing Address (will be used for Incentive Check Distribution)*

Office Telephone

Cell Phone

City

State

Zip

Fax

Website

Years in Business

Years under current ownership

Number of employees in MD

Minority Owned Business

Woman Owned Business

Veteran Owned Business

CUSTOMER REFERENCES (Projects must be related to energy efficiency improvements)

1

Company

Contact

Describe Project including total square feet and $ amount

Phone

2

Company

Contact

Describe Project including total square feet and $ amount

Phone

3

Company

Contact

Describe Project including total square feet and $ amount

Phone

CERTIFICATION INFORMATION

We accept certifications from the following 5 organizations: Certified Commissioning Professional (CCP): Building Commissioning Association (BCA), certification/index.htm Certified Commissioning Provider: Associated Air Balancing Council Commissioning Group (ACG), Accredited Commissioning Process Provider: University of Wisconsin at Madison (UWM), http:epdweb.engr.wisc.edu/courses/index.lasso (use link to Building

Systems and Construction to find certification training) Systems Commissioning Administrator: National Environmental Balancing Bureau (NEBB), Certified Building Commissioning Professional (CBCP?): Association of Energy Engineers (AEE), certification

Acceptable certifications for Trade Allys performing audits, electrical improvements or handling refrigerant: American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) - BEAP- Building Energy Assessment Professional Association of Energy Engineers (AEE) - CEA- Certified Energy Auditor Association of Energy Engineers (AEE) - CEM- Certified Energy Manager Northwest Water & Energy Education institute (NWEEI) EMC- Energy Management Certification USGBC- US Green Building Council - LEED-AP (O&M, BD+C) BOMI - HP- High Performance Sustainability

Name of Certification(s)

07/12/16 v2

Return Completed Form to: Pepco and Delmarva Power C&I Energy Savings Program email: Pepco.EnergySavings@ | phone: 1-866-353-5798 | web: business email: Delmarva.EnergySavings@ | phone: 1-866-353-5799 | web: business

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SUBCONTRACTOR FORM SUBMITTED BY TRADE ALLY

AGREEMENT AND SIGNATURE

We,

Contractor

, are formally submitting

Subcontractor

for approval to perform work in the Pepco and Delmarva Power C&I

Energy Savings Program. We confirm that our new subcontractor has been vetted by our staff according to the following:

The subcontractor is bound to the Pepco and Delmarva Power Trade Ally Network terms and conditions.

We have made an assessment that the subcontractor is qualified to perform the required work.

Our contract with subcontractor includes a provision requiring the subcontractor to strictly comply with all federal, state and local laws, rules or regulations and

executive orders applicable to the work.

We verify that the subcontractor is abiding by the provisions of the Trade Ally Network Terms and Conditions as required. We have included the following

information:

1. Insurance Coverage: Provide the subcontractor's Certificate of Insurance or proof the subcontractor is covered under the applicant's insurance policy.

2. Photographs: Provide photographs of the subcontractor vehicles, uniforms with logos, business cards and all other promotional materials. The vehicles must

include the company name (magnetic sign, painted or other) and must be readable in the photo.

3. Copies of certifications if appropriate

4. Copy of Maryland Business License

5. Maryland proof of good standing

6. W-9 if the subcontractor will receive any check through the Pepco or Delmarva Power Program.

Subcontractor name

to submit

provides the required

type of project(s)

Type of Certificate or License and issuing authority

Name on the certificate

certification or license type

projects.

required for

Applicant's Company Name

Phone Number

The subcontractor received an orientation and review, including insurance certificate before being considered for the program. The subcontractor will be consistently evaluated, both in the performance of their work (through an inspection process) and the way they are perceived by the end customers.

Contractor Name

Date

Contractor Signature

Date

07/12/16 v2

Return Completed Form to: Pepco and Delmarva Power C&I Energy Savings Program email: Pepco.EnergySavings@ | phone: 1-866-353-5798 | web: business email: Delmarva.EnergySavings@ | phone: 1-866-353-5799 | web: business

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