WGL ENERGY CHANNEL PARTNER APPLICATION

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Winfred Higgins
8 years ago
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1 Cmpany Infrmatin Applicatin Date: Legal Business Name: Street Address: City State Zip State f Incrpratin: Fax #: ( ) Website: # Years in Business: # Emplyees: DUNS # Business Type: Prprietrship Crpratin Partnership Limited Partnership Limited Liability Cmpany Limited Liability Partnership Other: Has the cmpany r any principal filed bankruptcy? Yes N Has the cmpany r any principal been terminated by a funding surce? Yes N Prvide a cncise descriptin f the cmpany histry and principal business interests WGL Hldings, Inc. All rights reserved.

Liability Partnership Other: Has the cmpany r any principal filed bankruptcy?

2 Cntact Infrmatin Cntact #1 Name: Title: Telephne #: ( ) Fax #: ( ) Cntact #2 Name: Title: Telephne #: ( ) Fax #: ( ) Channel Designatin Our cmpany is interested in being a WGL Energy Brker (Cmmissin fees paid by WGL Energy) Our cmpany als prvides Energy Cnsulting Services (Cmmissin fees paid by end-user custmer) Please list any energy services yur cmpany prvides t end-user custmers: Natural Gas Supply Services Electricity Supply Services Renewable Energy Energy Management (please explain) Billing Services (please explain) Other 2015 WGL Hldings, Inc. All rights reserved.

(Cmmissin fees paid by end-user custmer) Please list any energy services yur cmpany prvides t end-user custmers: Natural Gas Supply Services

3 Cmpany Experience Average Size f Custmers Electricity (Annual MWhs): Gas (Therms): # Cmmercial Custmers: # Residential Custmers: Aggregated Annual Revenue f End User Supply Cntracts: Key cmpanies/rganizatins that yur cmpany is currently prviding services t: Service Territry Utility service territries that yur cmpany is ding business in r is interested in serving: Natural Gas Utility Area f Operatin and Custmer Type Utility Washingtn Gas MD Washingtn Gas VA Washingtn Gas DC Baltimre Gas & Electric Clumbia Gas f Virginia Clumbia Gas f Maryland Clumbia Gas f Pennsylvania Chesapeake Gas DE / MD Currently Active in this Market? # Ptential Custmers Type f Custmers Where required, d yu have a license? Yes N Gas Cmmercial? Industrial? Residential? Yes/N 2015 WGL Hldings, Inc. All rights reserved.

Service Territry Utility service territries that yur cmpany is ding business in r is interested in serving: Natural Gas Utility Area f Operatin and Custmer Type Utility Washingtn Gas MD Washingtn Gas

4 Delmarva Gas DE / MD Frederick Gas PECO Shenandah Gas UGI Penn Natural UGI Utilities Virginia Natural Gas Other Electricity Utility Area f Operatin and Custmer type Utility Pepc Maryland Pepc District f Clumbia Currently Active in this Market? # Ptential Custmers Type f Custmers Where required, d yu have a license? Yes N Electricity Cmmercial? Industrial? Residential? Yes/N Baltimre Gas & Electric Delmarva Pwer DE/MD Allegheny Pwer MD Allegheny Pwer PA Pennsylvania Pwer and Light Duquesne - PA PECO - PA MetEd Penelec Other 2015 WGL Hldings, Inc. All rights reserved.

# Ptential Custmers Type f Custmers Where required, d yu have a license? Yes N Electricity Cmmercial? Industrial? Residential?

5 Required Dcumentatin f Financial Integrity: T the extent available, please prvide the mst recent versins f at least ne f the fllwing dcuments. Check each that is attached: Balance sheet and incme statement fr the tw mst recent 12 mnth perids fr which infrmatin is available. Balance sheets and incme statements must be fr the Applicant, and nt a parent crpratin in the event it exists. Audited financial statements must be prvided if they exist. If the applicant has nt been in existence fr at least tw 12 mnth perids, it must prvide balance sheets and incme statements fr the life f the business. Audited financial statements must be prvided if they exist. Credit reprts f ratings prepared by established credit bureaus r agencies regarding the Applicant s payment and credit histry. Other evidence f financial integrity (please attach additinal infrmatin t applicatin Required Dcumentatin f Business Registratin: Please prvide a cpy f the business registratin yu received frm the Secretary f State f the state in which yur rganizatin is incrprated and, if applicable, frm each state in which yu maintain a registered ffice. Cmments r Cncerns 2015 WGL Hldings, Inc. All rights reserved.

Balance sheets and incme statements must be fr the Applicant, and nt a parent crpratin in the event it exists. Audited financial statements must be prvided if they exist.

VENDOR REGISTRATION AND DISCLOSURE STATEMENT AND SMALL, WOMEN-, AND MINORITY-OWNED BUSINESS CERTIFICATION APPLICATION

WV-1A New Update REV. 09/18/15 STATE OF WEST VIRGINIA - PURCHASING DIVISION VENDOR REGISTRATION AND DISCLOSURE STATEMENT AND SMALL, WOMEN-, AND MINORITY-OWNED BUSINESS CERTIFICATION APPLICATION Befre a