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NYSERDA

info@nyserda.ny.gov

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Thank you for your interest in participating as a contractor in the NYS Clean Heat Program. The authorized company contact must electronically sign this participation agreement.

Please note: Partially completed information cannot be saved, be sure to have all details (i.e. required Certificate of Insurance and a DBA Certificate if applicable) with you before beginning the form. Upon submission, you will receive a confirmation and a tracking number on your screen to print or save. Refer to this tracking number to check on the status of your request.

For complete NYS Clean Heat Program details and eligibility, visit SaveEnergyNY.ny.gov/NYScleanheat.

If you have any questions, please email NYSCleanHeatProgram@nyserda.ny.gov.

Contractor Information

Is your Legal Business Name different from your Business Name/Disregarded Entity Name?

Counties Served (Select all that apply)

Utilities Served (Select all that apply)

Select the type of contractor you are applying for (Select all that apply)

Company Address

Company Mailing Address

Primary Contact Information

Primary Contact Name

Your company information will be publicly displayed so end-use consumers can contact you. Should the information provided in the "Primary Contact Information" section be used?

Public-Facing Contact Information

Full Name

Uploads

Be certain that NYSERDA and the State of New York are listed on the certificate as additional insured, using the NYSERDA address of 17 Columbia Circle, Albany, NY 12203-6399.

DBA Certificate

Completed Certificate of Insurance naming NYSERDA and NYS as Additional Insured

Sign Here

Choose how to sign

Tracking ID

You will be provided with a Tracking ID upon submission.