Tes Ceri Phase2

General Eligibility Criteria

Type of Applicant?

Business

Non-profit organization

Date / Time

Is your business in any of these commercial activities? Indicate which one.

Is your community organization engaged in any of these business activities? Please indicate which one.

Health

Hospitals and community health clinics

Care centers for the elderly

Physical therapy and rehabilitation centers

Dialysis or cancer treatment centers

Community pharmacies

Centers offering ambulance, paramedic and other rescue services

Dental clinics

Centers for mental health services

Controlled substance abuse treatment centers

Social Services

Homeless shelters

Shelters for victims of domestic violence

Day care centers for infants, toddlers and children

Shelters for people displaced from their homes due to natural phenomena

Community centers

Child and adolescent care centers (foster care)

Adoption centers

Community call centers for emergency situations

Medicine cooling center

Infrastructure Services

Community aqueducts

Community wastewater treatment plants

Hardware stores and hardware equipment suppliers

Contractors' offices

Communications

Television and radio stations

Wireless communication facilities (internet and cellular)

Food Services

Supermarkets

Bakeries

Restaurants and cafeterias

Food banks

Transportation

Public trolley terminals

Charging centers for electric cars

Gas stations and refueling

Another

A business or nonprofit organization that provides essential life-saving, emergency or economic services; supports vulnerable or dependent populations; and/or ensures continuity of health and safety during a disaster, while assisting in recovery efforts and the continuity of government, business and other services after a disaster.

Provide your NAIC code, as it appears on the SURI certificate:

Business Eligibility Criteria:

Eligibility Criteria for Non-Profit Organizations:

Have you been operating for more than five (5) years?

Yes

¿Su volumen de ingresos brutos es menor a $5,000,000?

Yes

*Financial statements will be required as evidence

Is there a solar energy system for the structure (property) for which you wish to apply for participation in the CERI Program?

Yes

Do you own the structure (property) where you want to install a solar energy system?

Yes

*Evidence will be requested

*Please note that if you do not own the structure (critical facility) where you intend to apply for the CERI Program, you will not normally qualify to participate. However, this requirement will be evaluated when you submit your loan application and the bank, at its sole discretion.

¿Necesitaría construir un “carport” u otra estructura independiente para ubicar los paneles solares?-1

Yes

¿Necesitaría construir un “carport” u otra estructura independiente para ubicar los paneles solares?-2

Yes

¿Necesitaría construir un “carport” u otra estructura independiente para ubicar los paneles solares?-3

Yes

¿Está en cumplimiento con las obligaciones fiscales y permisos gubernamentales requeridos para operar su negocio? -1

Yes

¿Está en cumplimiento con las obligaciones fiscales y permisos gubernamentales requeridos para operar su negocio? -2

Yes

¿Está en cumplimiento con las obligaciones fiscales y permisos gubernamentales requeridos para operar su negocio? -3

Yes

*This information will be corroborated for CERI participants.

Initial Profile

Requesting Entity Information:

Business/Organization Name

Date of Incorporation (MM/DD/YYYYYY)

Date / Time

Years in operation

Contact Information for CERI Program:

Full Name

Phone

E-mail address

Position (Title):

Location of the facility:

Physical Address

Address 1

City

Zip Code

Mailing Address

Address Line 1

City

Zip Code

Brief Description of Services Provided:

Financial Information:

Annual Business/Organization Income

Revenue Sources

Estimated monthly amount of debts (loans), this includes principal and interest

General Eligibility Criteria

Business Eligibility Criteria:

Eligibility Criteria for Non-Profit Organizations:

Initial Profile

Requesting Entity Information:

Contact Information for CERI Program:

Location of the facility:

Brief Description of Services Provided:

Financial Information:

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