Laserfiche WebLink
WEATHERIZATION SUBCONTRACTOR PROFILE AND CERTIFICATION <br />This page must be filled out and returned with your application. Failure to do so may subject your application to rejection. <br />------------------------------------------------------------------------------------- - - - - -- <br />SOL # 2011 WXSSP CONTRACT PERIOD: January 1, 2011 — March 31, 2012 <br />BUSINESS NAME: <br />OWNER'S NAME: <br />ADDRESS: <br />CITY: <br />TELEPHONE: <br />EMAIL: <br />STATE: ZIP +4: <br />FACSIMILE: <br />BUSINESS STRUCTURE (CHECK THE APPROPRIATE BOX): <br />❑Individual /Sole Proprietor ❑Corporation ❑Partnership ❑Other <br />FEDERAL EMPLOYER IDENTIFICATION NUMBER: <br />YEARS IN BUSINESS: <br />YEARS WEATHERIZATION EXPERIENCE: <br />TYPE OF WORK TO BE PERFORMED (CHECK ALL THAT APPLY): <br />❑ Blower door directed air sealing of plumbing, electrical and HVAC penetrations through attic, wall and floor surfaces with <br />appropriate materials <br />❑ General heat waste measures (i.e., weather - stripping, caulking, glass patching, etc.) <br />❑ Insulation (Check appropriate areas) <br />❑ Duct sealing and insulation <br />❑ Water heater and pipe insulation <br />❑ Crawlspace vapor barrier installation <br />❑ Other: <br />❑ Attic ❑ Floor ❑ Sidewall <br />AREAS TO BE SERVED (CHECK ALL THAT APPLY) <br />❑ Entire State <br />❑ Alamance <br />❑ Chowan <br />❑ Guilford <br />❑ Mitchell <br />❑ Rutherford <br />❑ Alexander <br />❑ Clay <br />❑ Halifax <br />❑ Montgomery <br />❑ Sampson <br />❑ Alleghany <br />❑ Cleveland <br />❑ Harnett <br />❑ Moore <br />❑ Scotland <br />❑ Anson <br />❑ Columbus <br />❑ Haywood <br />❑ Nash <br />❑ Stanly <br />❑ Ashe <br />❑ Craven <br />❑ Henderson <br />❑ New Hanover <br />❑ Stokes <br />❑ Avery <br />❑ Cumberland <br />❑ Hertford <br />❑ Northampton <br />❑ Surry <br />❑ Beaufort <br />❑ Currituck <br />❑ Hoke <br />❑ Onslow <br />❑ Swain <br />❑ Bertie <br />❑ Dare <br />❑ Hyde <br />❑ Orange <br />❑ Transylvania <br />❑ Bladen <br />❑ Davidson <br />❑ Iredell <br />❑ Pamlico <br />❑ Tyrrell <br />❑ Brunswick <br />❑ Davie <br />❑ Jackson <br />❑ Pasquotank <br />❑ Union <br />❑ Buncombe <br />❑ Duplin <br />❑ Johnston <br />❑ Pender <br />❑ Vance <br />❑ Burke <br />❑ Durham <br />❑ Jones <br />❑ Perquimans <br />❑ Wake <br />❑ Cabarrus <br />❑ Edgecombe <br />❑ Lee <br />❑ Person <br />❑ Warren <br />❑ Caldwell <br />❑ Forsyth <br />❑ Lenoir <br />❑ Pitt <br />❑ Washington <br />❑ Camden <br />❑ Franklin <br />❑ Lincoln <br />❑ Polk <br />❑ Watauga <br />❑ Carteret <br />❑ Gaston <br />❑ McDowell <br />❑ Randolph <br />❑ Wayne <br />❑ Caswell <br />❑ Gates <br />❑ Macon <br />❑ Richmond <br />❑ Wilkes <br />❑ Catawba <br />❑ Graham <br />❑ Madison <br />❑ Robeson <br />❑ Wilson <br />❑ Chatham <br />❑ Granville <br />❑ Martin <br />❑ Rockingham <br />❑ Yadkin <br />❑ Cherokee <br />❑ Greene <br />❑ Mecklenburg <br />❑ Rowan <br />❑ Yancey <br />Solicitation No. 2011WXSSP <br />F -4 <br />Page 22 of 53 <br />Attachment number 1 <br />Page 134 <br />