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Business: Legal Name
Tax I.D Number
DBA if Applicable (list all names)
Years in Business
Address:
City:
ZIP:
St:
Phone:
Legal Form Under Which Business Operates ( Business Structure):
Proprietorship:
If Division/Subsidiary, Name of Parent Company:
Web Address:
Primary Owner Name:
Title:
Ownership %
Primary Owner Phone
Primary Owner Email
Additional Material Owner Information ( if Primary Owner <50%)
Primary Contact
Title
Phone
Email
Total number of Employees
Lead Generation Activities(Office| Sales)
Annual Sales Revenue $
Which panel brands does your company use?
What supplies do you use?
Geographic Sales Area ( Please list all states that apply)
CSLB Lic #
Lic Expiration Date
Lic Type
Number of Panel Upgrades ( Residential )
Offer dedicated POC ( Name of dedicated Partner Administrative contact. )
Procurement/Inventory Management System
List of Certifications (OEMs, NABCEP, etc. )
Equipment Distributors
Installation Backlog
General Liability Certificate ( add LA Solar Group as additionally Insured ( Liability + Workers Comp )
General Liability Limits ( $1M per occurrence, $2M aggregate )
Workers Comp Insurance Certificate
Contractor License
Business Licence
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