Residential Energy Audit Program

Participation Agreement Signature Form

Before starting and completing this form, please review the terms and conditions of your participation in the Residential Energy Audit Program Participation Agreement.

Please note: Partially completed information cannot be saved, be sure to have all details with you before beginning the form. For the best form completion experience, use the Google Chrome browser.

To complete this Agreement you will need to upload the following documents:

• Projects List:
Description of at least three audits or energy efficiency projects your organization has completed within the last six-months. Please include the customer addresses, phone numbers, and details describing if the project was an audit only or if it resulted in the installation of any energy efficiency measures.

• Doing Business As  (DBA) Certificate (if applicable):
Organizations  that conduct business under a name other than their legal name need a Certificate of Assumed Name. This certificate is also called the "doing business as” (DBA) certificate. 

• Completed IRS Form W-9:
Your Employer Identification Number (EIN) is not your Social Security Number. Do not upload an IRS Form W-9 with a Social Security Number to this Agreement. 
- If your Taxpayer Identification Number is a Social Security Number, complete all other information on this form and leave the W-9 Form blank. You will then need to submit a printed and signed copy of IRS Form W-9 to NYSERDA Finance via mail. Be sure to include your auto-generated Tracking ID Number (displayed on-screen after you submit this Agreement) on any forms submitted by mail to NYSERDA. 
- View and print the IRS Form W-9  
- Review the IRS Form W-9 instructions 
 
• Certified Staff Information List:
Provide a document listing each individual performing audits and their certifications (see Section 2.01of the Participation Agreement  for a list of eligible certifications).
 
• Proof(s) of Certification:
For each certified individual listed on the above “Certified Staff Information List” you must upload a proof of the individual’s certification including a credential from the eligible certifying organization.
 
• Proof(s) of Insurance:
Provide in accordance with Section 2.06 of the Participation Agreement copies of insurance policies, each of which shall: (1) reference this Agreement; name or be endorsed to cover the Participating Auditor as the insured, and NYSERDA and the State of New York as additional insured; and reference all work to be performed under the Program; (2) provide that such policy may not be cancelled or modified until at least 30 days after receipt by NYSERDA of written notice thereof; and be reasonably satisfactory to NYSERDA in all other respects.
 
• Workers’ Compensation Form CE-200 (if applicable):
If you are a Sole Proprietor complete and upload form CE-200.  
 
After you submit the Agreement you will receive an auto-generated Tracking ID Number. You should print or save this tracking number and refer to it when checking on the status of your application.

For full program details and eligibility, visit nyserda.ny.gov/All-Programs/Programs/Become-a-Contractor/Become-a-Participating-Auditor

If you have any questions, feel free to contact homeaudits@nyserda.ny.gov or call toll free 1-877-NYSMART.

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By electronically signing this form, I attest that I have legal signatory rights to enter into a contractual agreement on behalf of my company.

I have read, understand, and agree to comply with all participation commitments in NYSERDA's Residential Energy Audit Participation Agreement, including all supporting policies described or referenced therein. I understand that my participation in the Program is not approved until NYSERDA has reviewed and approved this Agreement. I understand the provisions of this Agreement are effective from the date of approval by NYSERDA. NYSERDA reserves the right to modify, at any time during this Agreement term, the provision of this Agreement. I certify under the penalties of law that the statements made in the Agreement and in supporting documentation provided along with this Agreement, have been examined by me and are true and complete. I understand that by signing this Agreement, I consent to any other inquiry to verify or confirm the information I have given.