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Energy Cost Savings Program

Certificate of Continuing Business Activity

     

This form must be filed with the Department of Small Business Services Energy Cost Savings Program, 110 William Street, 7th Floor, NY, NY 10038. Information from this form may be used to adjust ECSP credits, and a survey of energy use can be requested at any time by SBS to verify information. Failure to submit this form within 30 days may result in termination of benefits.

Please provide your contact information.
 
Company Name:*   
Company Name is a required value.
 
First Name:* Last Name:*
First Name is required field. Last Name is required field.
 
Business Address:*  
Please enter a valid contact address.
 
City:* State:* Zip Code:*
   
Please enter valid city. Please select a valid state. Please enter valid zip code.
 
Telephone #:*
(Telephone # x Extension)
Email:* Fax #:*
 
Please enter valid phone #. Please enter valid email address. Please enter valid Fax #.
 
Have there been any changes in your business activity? * Yes   No
Please select appropriate value.
 
Indicate current business activity: *  
Please select appropriate value.
 
Is any space used for retail activity? * Yes   No
Please select appropriate value.
 
 
Are you a landlord or tenant?  
Please select an appropriate value.
 
Please select an appropriate value.
Please select an appropriate value.
 
 
Does your utility bill indicate that you are still receiving ECSP benefits?* Yes   No
Please select appropriate value.
 
Is your business directly metered or sub-metered?* Directly Metered
Sub-metered
Please select appropriate value.
 
Is electricity or natural gas used for space heating?* Yes   No
Please select appropriate value.
 
 
Are you interested in additional programs and services?  
 
How many employees do you currently have?*
Please input appropriate value.
 
Do you plan on hiring additional employees within the next 12 months?* YesNo
Please select appropriate value.
 
Is your Business IBZ or Empire Zone Certified?* YesNo
Please select appropriate value.
 
Additional Information:
Please enter valid details.
 
  I confirm that the above information is accurate.
Please confirm that you have entered valid details.