Ohop Mutual State HEAR Program Contractor Application

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8.1.1. Business Information

Legal Business Name(Required)

DBA (if applicable)

UBI Number(Required)

Washington Contractor Registration Number

Website

Federal Tax ID / EIN (Optional)

8.1.2. Primary Contact Information

Primary Contact(Required)

First Last

Phone(Required)

Email(Required)

Mailing Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

8.1.3. Service Information

Service Availability(Required)

Is your company willing to perform eligible work throughout OMLC’s service territory?

Yes

Other

If no, please describe limitations:

Typical Scheduling Lead Time

Less than 2 weeks

2-4 weeks

1-2 months

More than 2 months

Other

Which services does your company perform?

HVAC Services

Ductless Heat Pumps

Ducted Heat Pumps

Package Systems

Heat Pump Water Heaters

Heat Pump Dryers

Electrical Services

Panel Upgrades

Service Upgrades

Branch Circuit Installation

Wiring Upgrades

Other

Manufactured Home Work

Adult Family Home Projects

Small Commercial Projects

8.1.4. Experience

Years in Business(Required)

Approximate Number Heat Pump Installs (last 12 months)

Approximate Number of Panel Upgrades (last 12 months)

Do you currently perform work in manufactured homes?(Required)

Yes

Do you currently perform work in occupied residential homes?(Required)

Yes

Do you currently perform work in Adult Family Homes?(Required)

Yes

8.1.5. Licensing & Insurance

The contractor certifies:(Required)

Contractor registration is active and in good standing.

All required licenses are current.

General liability insurance is maintained.

The contractor agrees to provide updated licensing or insurance documentation upon request.

8.1.6. Program Participation

The contractor understands and acknowledges:(Required)

Customers select their own contractor.

OMLC does not guarantee project volume or referrals.

OMLC determines customer eligibility.

OMLC determines rebate eligibility and funding availability.

Participation does not guarantee project approval.

OMLC may request project documentation necessary for compliance and reporting.

Participation may be suspended or terminated for failure to comply with program requirements.

8.1.7. Documentation Capability

The contractor confirms the ability to provide:(Required)

Equipment proposals and quotations

Manufacturer and model information

Final invoices

Permit information

Installation completion information

Additional project documentation upon request

8.1.8. Optional Contractor Profile

This information may be included in OMLC’s contractor directory.

Company Description

(50 words or less)

Preferred Contact Method

Phone

Website

Other

8.1.9. Certification

Certification(Required)

Authorized Representative

I certify that the information provided in this application is true and correct to the best of my knowledge.
I understand that submission of this application does not guarantee participation in the OMLC State HEAR Program.
I agree to comply with OMLC program requirements if accepted as a Participating Contractor.

Name(Required)

First Last

Type your name to sign this application

Title(Required)

Additional Comments/Questions

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