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NCEF Contractor Application

Thank you for your interest in joining the Nevada Clean Energy Fund (NCEF) Contractor Network!

NCEF has partnered with the Solar and Energy Loan Fund (SELF) to vet, approve, and pay contractors. By applying for the NCEF Contractor Network, you acknowledge that SELF has sole discretion to vet, approve and pay you for work performed for NCEF clients.

Eligibility
Requirements:

* Current General Liability Insurance certificate

* If available, Workers Compensation Insurance certificate

* Signed W-9

* Current State Construction Specialty License, or current local Construction License, if required

· As the authorized agent for this business, please be prepared to
submit required credentials and to acknowledge the Terms and Conditions for the
completion of the application.

Page 1 of 3

Company & Contact Information

Company Information

Company Name

Website

Street

State Please select...
NV

City

Zip

County Please select...
NV - Carson City
NV - Churchill County
NV - Clark County
NV - Confederated Tribes of Goshute
NV - Douglas County
NV - Duck Valley Shoshone-Paiute Tribe
NV - Duckwater Shoshone Tribe
NV - Elko County
NV - Ely Shoshone Tribe
NV - Esmeralda County
NV - Eureka County
NV - Fallon Paiute Shoshone Tribe
NV - Fort McDermitt Paiute-Shoshone Tribe
NV - Humboldt County
NV - Lander County
NV - Las Vegas Paiute Tribe
NV - Lincoln County
NV - Lovelock Paiute Tribe
NV - Lyon County
NV - Mineral County
NV - Moapa Band of Paiutes
NV - Nye County
NV - Pershing County
NV - Pyramid Lake Paiute Tribe
NV - Reno-Sparks Indian Colony
NV - Storey County
NV - Summit Lake Paiute Tribe
NV - Te-Moak Shoshone Tribe - Battle Mountain Band
NV - Te-Moak Shoshone Tribe - Elko Band
NV - Te-Moak Shoshone Tribe - South Fork Band
NV - Te-Moak Shoshone Tribe - Wells Band
NV - Timbisha Shoshone Tribe
NV - Walker River Paiute Tribe
NV - Washoe County
NV - Washoe Tribe of Nevada & California - Carson Colony Community
NV - Washoe Tribe of Nevada & California - Dresslerville Community
NV - Washoe Tribe of Nevada & California - Stewart Community
NV - Washoe Tribe of Nevada & California - Woodfords Community
NV - White Pine County
NV - Winnemucca Colony Council
NV - Yerington Paiute Tribe
NV - Yomba Shoshone Tribe
Other

Company mailing address is different than above

Mailing Street

Mailing State Please select...
NV

Mailing City

Mailing Zip

Contact Information

First Name

Last Name

Title

Add a second contact person

Phone (incl. ext)

Mobile

Email

Contact Information

First Name

Last Name

Title

Mobile

Phone (incl. ext)

Email

Service Areas

What counties are you readily able to serve?
Please select...
NV - Carson City
NV - Churchill County
NV - Clark County
NV - Confederated Tribes of Goshute
NV - Douglas County
NV - Duck Valley Shoshone-Paiute Tribe
NV - Duckwater Shoshone Tribe
NV - Elko County
NV - Ely Shoshone Tribe
NV - Esmeralda County
NV - Eureka County
NV - Fallon Paiute Shoshone Tribe
NV - Fort McDermitt Paiute-Shoshone Tribe
NV - Humboldt County
NV - Lander County
NV - Las Vegas Paiute Tribe
NV - Lincoln County
NV - Lovelock Paiute Tribe
NV - Lyon County
NV - Mineral County
NV - Moapa Band of Paiutes
NV - Nye County
NV - Pershing County
NV - Pyramid Lake Paiute Tribe
NV - Reno-Sparks Indian Colony
NV - Storey County
NV - Summit Lake Paiute Tribe
NV - Te-Moak Shoshone Tribe - Battle Mountain Band
NV - Te-Moak Shoshone Tribe - Elko Band
NV - Te-Moak Shoshone Tribe - South Fork Band
NV - Te-Moak Shoshone Tribe - Wells Band
NV - Timbisha Shoshone Tribe
NV - Walker River Paiute Tribe
NV - Washoe County
NV - Washoe Tribe of Nevada & California - Carson Colony Community
NV - Washoe Tribe of Nevada & California - Dresslerville Community
NV - Washoe Tribe of Nevada & California - Stewart Community
NV - Washoe Tribe of Nevada & California - Woodfords Community
NV - White Pine County
NV - Winnemucca Colony Council
NV - Yerington Paiute Tribe
NV - Yomba Shoshone Tribe
Other

Company Information Continued

Page 2 of 3

Principal Sector
Residential Only Commercial Both

Company Organizational Structure
Sole Proprietor C-Corp S-Corp LLC Corporation Other

Are you certified/licensed to install Disability retrofits? (Copy Required on Page 3)
Yes No

Are you a Universal Design Certified Professional (UDCP)?
(Copy Required on Page 3)
Yes No

Davis-Bacon Qualified Not qualified Interested in becoming qualified

Is your company Women, Minority, Hispanic, or Veteran owned? Please select...
Women Owned
Minority Owned
Hispanic Owned
Veteran Owned
Not Applicable

Please indicate all product(s) that your business is licensed to offer and install.

Sealing Weatherization Attic Floor Insulation Roof Insulation Wall Insulation Floor Foundation Insulation Insulation & Duct Repair Other

Other - Sealing

Storm Resilience Window Repair Window Replacement Doors Garage Doors Hurricane Shutters & Fasteners Window Shutters Hail Protection Exterior Siding Other

Other - Storm Resilience

Pool/Plumbing Pool Pump Plumbing Low Flow: Toilet Low Flow: Shower Head Low Flow: Aerator Septic to Sewer Conversion Irrigation Package Rain Water Barrel Cistern Sprinkler Heads Drip Irrigation Electric Water Heater Gas Water Heater Other

Other - Pool/Plumbing

Solar Products/Window Film Solar Pool Heater Solar Pool Pump Solar Water Heater Photovoltaic Solar Attic Fan Window Films & Solar Screens Other

Nevada statute—specifically, NRS 624.860 (as amended by SB 293 in the 2023 legislative session) in conjunction with NRS 624.020(6) —prohibits licensed solar contractors in Nevada from using non-W2 employees or employees with dual compensation structures (i.e., W2 and 1099 compensation) to directly or indirectly perform or offer to perform any work concerning a residential photovoltaic system. Are your employment practices in compliance with these Nevada statutes?"

Please select...
Yes
No
I don't know, please contact me

Other - Solar/Window

Heating Ventilation Air Conditioning HVAC Duct Testing & Repair Ductwork Programmable Thermostat Ceiling Fans Kitchen & Bathroom Exhaust Fans Whole House Attic Fan Other

Other - Heating / AC

Roofing Roof Replacement Roof Repair & Reinforcement Roof Soffit Vent Sealing/Flashing Reflective Roof Reflective Paint Coating Soffit Baffles Flashing Hurricane Clips/Straps/Roof Anchors Other

Other - Roofing

Lighting Interior & Exterior Light Bulbs Skylight or Solar Tube Other

Other - Lighting

Health & Safety Drywall Repair Electric Miscellaneous Fixtures DHW Timer Other

Other - Health & Safety

Disability Installations Wheelchair Ramps Stair Lifts Showers Walk-in Tubs Grab Bars/Rails Doorway Widening Hallway Widening Other

Other - Disability Installations

Page 3 of 3

Please upload the following attachments.

Workers Compensation Insurance (If exempt, please provide a copy)

Workman's Comp expiration date

General Liability Insurance

General Liability expiration date

State Specialty License and/or Local Construction/Occupational License

License expiration date

Signed W-9

Disability Installations

Universal Design Certified Professional (UDCP)

Copy of Bond

Copies of any additional certifications (i.e. BPI, RESNET, NATE, ASHRAE, AEE, Disability installations, UDCP)
Only one document may be uploaded at a time. Click "Add another response" to upload an additional document.

By signing this Acknowledgment, I represent and warrant that (i) I am duly authorized to submit this Acknowledgment on behalf of the Contractor; (ii) the information provided in this Application and any related documents are true, accurate, and complete; (iii) I understand and accept the terms and conditions provided herein (including any updates thereto). I further understand and accept that the approval or rejection of the Application is at the sole discretion of SELF.

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