2020-2021 Energy Efficient Builder Registration Form

2020-2021 Energy Efficient Builder Registration Form
Company Information
Company Name (As you wish it to appear in the Registry) *
Name of Person Making the Application *

First Name Last Name
Email (As you wish it to appear in the Registry) *
example@example.com
Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number (As you with it to appear in the Registry) *

Area Code Phone Number
Other Phone Number (Not to appear in the Registry)

Area Code Phone Number
What year did your company begin? *
Are you incorporated? *

Yes No
Do we have your permission to advertise your company on the Registry? *

Yes No
Approximately how many homes do you build per year? *
What is the highest level of Energy Efficiency your company has achieved thus far? *
FaceBook URL
Website
New Home Warranty
New Home Warranty Member Number (If you strictly only perform renovations please write "renovator") *
Warranty Company *
I confirm that all new homes built by the company noted above that fall under Part 9 of the National Building Code of Canada are enrolled with a 3rd party warranty company and we are registered with the warranty company under the name of the company listed as this Company; *
WorkSafeNB Compliance
WorkSafeNB Number: *
I confirm that my company will respect and abide by the rules, laws and regulations of WorkSafe NB and adhere to all Workplace Health and Safety Requirements on my job sites. My policy number is indicated below. *
Liability Insurance
Liability Insurance Coverage in an amount not less than $2,000,000 – Attach Copy of Proof of Insurance on the next screen.I confirm that my company will maintain liability insurance coverage in amount not less than two million throughout my time being listed as a Registered Energy Efficient Builder. *
Please upload proof of insurance. *

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No Cash Deals
As a Registered Energy Efficient Builder, I recognize that I am not permitted in 'cash deals" (to participate with an intention to not collect and remit the required HST) whatsoever and that I will provide my customers with receipts for all work undertaken by my company. I further commit that I will not pay my employees cash and will adhere to laws set forth by the Government of Canada and the Province of New Brunswick with respect to the collection of HST and Payroll Remittances. *
Please enter your Business Number
Energy Efficiency Training & House Certification
There are different levels that at which each company will be placed when registering as an Energy Efficient Builder. Please help us assign you to the correct category by uploading copies of your energy efficient training certificates as well as energy efficient labels on homes that you have built & certified under the ENERGY STAR, R-2000, Passive House, NetZero Ready or NetZero Programs.
Please upload your training here

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Upload the labels of your certified homes that you have built

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Declaration for all Registered Companies
I hereby make application as a Registered Energy Efficient Builder.

I certify that none of the principals of this company has been refused registration or had registration revoked previously.

I state that all information contained on this application to be true and accurate and I authorize the Association* to undertake investigative procedures to confirm the accuracy of such information including but not limited to a verification of the credit worthiness. The Association* reserves the right to reject any application for registration, or to defer consideration of an application. Should my application for renewal be rejected, I agree to fully indemnify and save harmless the Association*, it's members, its directors and staff from any and all loss, cost, claims or damage of whatever kind and however arising as a result of such refusal of this application.
Do you agree to the full declaration above? *
Information Disclosure Consent
It is the mandate of the Association* to provide information, promote registration and foster communication, i.e. catalogues of registered builders, internet information, new products and services, etc. The applicant hereby consents to the use of the information in this application for such purposes (banking and credit card information exempted) by all levels of the Association*. *
By signing below, you are confirming you agree to the information previously entered on behalf of the company indicated above.
* For the purposes of this agreement, the term Association* refers to the Canadian Home Builders' Association New Brunswick on behalf of the New Brunswick Environmental Trust Fund.
Signature *

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2020-2021 Energy Efficient Builder Registration Form

Company Information

New Home Warranty

WorkSafeNB Compliance

Liability Insurance

No Cash Deals

Energy Efficiency Training & House Certification

Declaration for all Registered Companies

Information Disclosure Consent