City:		State: AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinois IndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontana NebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvania Rhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming		Zip Code:
Phone:		Fax:		Email:		Website:
Additional Branch Locations:
Other Legal Company or Trade Names:

Type of Business

Type of Business:		Sole ProprietorshipCorporationPartnership
	Tax ID# (mandatory):			Date of Corporation/Regsitration:

Name and Addresses of all Principals and Directors

Name	Address

Type of Air Barriers Applied

	Air Barrier Type			# Years of Experience
		Fluid Membrane
		Self-Adhered Membrane
		Sprayed Polyurethane Foam
		Boardstock
	Other:

Main Suppliers (Minimum of 3)

Name	Address	Phone

Subcontractors Utilized

Name	Address	Phone

Financial Information

Financial Institution (Primary):
	Branch Address:
	Contact:			Position:
	Phone:			Fax:

Legal Information

	Legal Firm:
	Address:
	Contact:			Position:
	Phone:			Fax:

Insurance Information

	Insurance Information:
	Address:
	Contact:			Position:
	Phone:			Fax:

A copy of your Insurance Certificate with a minimum coverage of $2,000,000.00 for general liability must be attached to this application.

Bonding Information

	Bonding Company:
	Address:
	Contact:			Position:
	Phone:			Fax:
Has your company ever been bonded?		yesno
If yes, please indicate why:
Bonding Amount:
Has the Company ever been refused bonding?		yesno
If yes, please indicate why:

A copy of a letter from your Bonding Company indicating that you are Bondable up to a minimum of $300,000.00 must be attached to this application.

Market Information

Number of Air/Vapor Barrier projects completed in a year:
Air/Vapor Barriers installed (Check all that apply to your company):				RoofWallsSubgrade
Approximate annual square footage of Air Barrier materials applied:
Number of projects completed in the previous year by product:
	Self Adhered Membrane:			Sprayed Polyurethane Foam:
	Fluid Membrane:			Boardstock:
Percentage of projects you are required to tie into:
	Roofs		Foundations		Wall Components
Annual value of Air/Vapor Barrier Work:
Percentage of projects by value:
Under $50,000		$50,000-$100,000		$100,000-$200,000		Over $200,000
Other Business Interests:
Indicate States served/willing to accept jobs in Air/Vapor Barrier Work:

Installer Information

Certified Installer Name	Certification Number

Agreement
I hereby certify that to the best of my knowledge, the foregoing statements are true and correct, and they have been made to facilitate an agreement with ABAA. I hereby authorize Building Professionals, on ABAA’s behalf to contact and obtain credit and other information as necessary from the references listed on this application, as well as to conduct any other personal or company investigation necessary for the purpose of qualifying as an ABAA licensed contractor.
I hereby agree to abide by the code of ethics.
I Accept