Contractor Name *

First Name

Last Name

Company Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

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PLEASE RESPOND WITH A CHECK TO EACH ITEM *

Do you have a track record of residential renovation work

Do you carry general liability, auto, and workers compensation insurance?

Have you done projects in Evanston?

I understand that this is the first step of registering to participate in the Evanston Green Home Pilot Program. I recognize that participation in this program depends on my submission and the acceptance of a full application by the Evanston Green Homes Pilot Program joint Evaluation Committee

To move forward with the application , I plan to call and schedule an appointment at their office.