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NYSERDA
CONTRACTOR APPLICATION
Real Time Energy Management
Step 1
Company Information
Complete
Step 2
Contact Information
Complete
Step 3
Qualifications Survey
Complete
Step 4
Certification
Complete
Step 5
References
Complete
Step 6
Submission Confirmation
Complete
Company Information
(Step 1 of 6)
Legal Business Name
*
(Required)
An organization should enter the name shown on its charter, articles of incorporation, or other legal documents that created the organization. Do not abbreviate names.
Business Name / Disregarded Entity Name
If different from legal business name, enter the name you normally do business as (DBA) or another name your entity is known by.
Business Website
Enter your business website. Use full URL format, e.g. "https://www.example.com".
Street Address 1
*
(Required)
Enter your company's primary mailing address.
Street Address 2
If “Street Address 1” is a P.O. Box, enter the physical street address here.
City
*
(Required)
State/Province
*
(Required)
--None--
Alabama
Alaska
Alberta
Arizona
Arkansas
British Columbia
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Maryland
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
Newfoundland and Labrador
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northwest Territories
Nova Scotia
Nunavut
Ohio
Oklahoma
Ontario
Oregon
Pennsylvania
Prince Edward Island
Quebec
Rhode Island
Saskatchewan
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon
Massachusetts
Zip/Postal Code
*
(Required)
What kind of business do you have? (select all that apply)
*
(Required)
Select the entity type doing business with New York State.
Corporation
Disregarded Entity
Federal, State or Local Government
Individual / Sole Proprietor
Limited Liability Co.
Not For Profit
Partnership
Public Authority
Trust / Estates
Please Select if Applicable (check all that apply)
New York State registered or New York City certified Minority Owned Business Enterprise (MBE)
New York State registered or New York City certified Women Owned Business Enterprise (WBE)
New York State Service-Disabled Veteran-Owned Business Enterprise (SDVOBE)
NYS M/WBE or SDVOBE Certification number(s)
*
(Required)
Please provide your NYS M/WBE or SDVOBE number.
Please provide your NYS M/WBE or SDVOBE number. For more information, please refer to the
NY State Division of Minority and Women's Business Development.
Exempt Payee Code
If you are exempt from backup witholding and/or FATCA reporting, provide any EPC that may apply to you. For EPC and additional instructions, please refer to the instructions located on IRS form W-9, which can be found here http://www.irs.gov/forms-instructions
If you are exempt from backup withholding and/or FATCA reporting, provide any EPC that may apply to you. For EPC and additional instructions, please refer to the
Instructions located on IRS form W-9 (PDF)
Tax identification type:
*
(Required)
Employer Identification Number (EIN)
Social Security Number (SSN)
Employer Identification Number (EIN)
Your Employer Identification Number (EIN) is not your Social Security Number.
See the IRS Form W-9 instructions for more information.
IRS Form W-9 Instructions
Do not submit a Social Security Number to NYSERDA on this form.
If, in accordance with the rules on IRS Form-W9, your taxpayer identification number is a Social Security Number, complete all other information on this form and leave Employer Identification Number blank. In addition, mail a printed and signed copy of IRS Form W-9 to NYSERDA, attention to NYSERDA Finance, 17 Columbia Circle, Albany, NY 12203. Include your auto-generated Application Number on this and any forms submitted by mail to NYSERDA. You will receive your Application Number upon submission of your application.
Click to view or print the
IRS Form W-9
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