For NORA approved trade associations to request payment to contractors or other service providers for approved projects that benefit the industry, please completely fill out and submit this form.

NOTE…you can now include up to three projects with each submitted request as long as the payment is to one party (vendor or association).

Please note: no single document upload can exceed 3 MB.
File formats accepted: jpg, jpeg, png, gif, xls, xlsx, pdf, tif, tiff, csv

Date: *
 /  / 
Association name *
Pin *
Name: *
E-mail: a copy of this submission will be sent to this email *
Phone:
-
You may enter up to three projects as long as the payment
will 
be made to a single recipient (either the vendor or Association).

First Project

Project Type 1: CE=Consumer Education, EE=Energy Efficiency, ET=Education & Training, RD&D=Research Development & Demonstration *
First Project description *
First Project Amount in $ *
Upload Vendor receipt for $ amount. (First Project)

Second Project

Project Type 2: CE=Consumer Education, EE=Energy Efficiency, ET=Education & Training, RD&D=Research Development & Demonstration
Second project description
Second project Amount in $
Upload Vendor receipt for $ amount. (Second Project)

Third Project

Project Type 3: Project Type: CE=Consumer Education, EE=Energy Efficiency, ET=Education & Training, RD&D=Research Development & Demonstration
Third project description
Third project Amount in $
Upload Vendor receipt for $ amount. (Third Project)



Total

Total amount of request in $ *
Payment to *
Vendor *
Vendor Contact
Vendor address: *

Accepted file formats: jpg, jpeg, png, gif, doc, docx, xls, xlsx, pdf, tif, tiff, csv

Upload Vendor W-9

All vendors will be verified.


This is for an oil efficiency and upgrade program
and I certify that to the maximum extent practicable,
I have coordinated, developed and implemented
this project with the state energy efficiency administrator.

Certify *
I hereby declare the the funds were used in accordance with the act. *