Preliminary Information You must be a contractor member of ABAA to apply for accreditation. Representative Given Name(s) (Primary Contact): Surname(s): Company Legal Name: Company Trade Name: Street Address: 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 All information received on this form is held in strictest confidence. The purpose of this form is strictly to facilitate the process of becoming a licensed contractor under the ABAA rules and regulations and to facilitate a way to track industry market information. The information is kept on file at the Building Professionals office. Under no circumstances is any one to have access to any information on this form other than the Building Professionals office. Payment Annual Membership and Accreditation: January 1st - December 31st. Fees are not pro-rated and are subject to change without notice. Contractor Membership Fee: $1000 Licensing Fee: $700 [authorize_net amount=100 custom_amount=true] Payment × Payment