BEMC Energy Efficiency Loan Application

Do you own or rent your home?

You must own your home to be eligible for an Energy Efficiency loan.

How long have you been a member of BEMC?

You must be a member for more than 1 year to be eligible for an Energy Efficiency loan.

Have you been disconnected for non-payment in the last 12 months?

You must not have been disconnected for non-payment in the last 12 months to be eligible for an Energy Efficiency loan.

Do you receive a monthly bill or are you on Prepay Billing?

You must receive a monthly bill to be eligible for an Energy Efficiency loan.

If approved you will be required to receive a monthly bill.

I agree to transition to a monthly bill.

Applicant Information

Enter your BEMC Account #

Commercial or Residential

Company Name

Tax ID

Business Type

Date Business Started

First Name

Last Name

BEMC Service Address Street

City

State

Zip Code

Is your mailing address different from your service address?

Mailing Address Street (If different)

City

State

Zip Code

Phone

Driver's License #

Date of Birth

SSN

Contractor Information

Contractor Company Name

Contract Address Street

City

State

Zip Code

Phone

Loan Amount and Purpose

Amount

Enter values without commas.

Please enter an amount equal to or less than $10,000

Loan proceeds may not exceed $10,000. The member shall be solely responsible for all costs or obligations above this amount.

Loan Purpose

The above information is correct and is given for the purpose of obtaining credit. You are authorized to verify this information and to obtain additional information in reviewing this credit request. BEMC reserves the right to make a credit decision based upon the findings of this credit request. BEMC also reserves the right to make a credit decision based on current and past payment history with BEMC.

BEMC Energy Efficiency loans will not be used to refinance existing obligations or to finance the costs of work to be done in structures being planned or under construction. Only approved work will be covered by the terms of this loan, if approved.

BEMC reserves the right to inspect the approved project(s) at any time.

BEMC reserves the right to file UCC filings (lien) against the applicant's property securing the project materials as collateral for the purpose of repayment in the event of default.

By checking this box, I confirm that I have had the opportunity to review BEMC's Energy Efficiency Loan Privacy Policy and that I agree to be bound by its terms.

I acknowledge and agree that for loans greater than $3,000, a UCC financing statement will be filed against my property.

I acknowledge and agree that the costs of filing the UCC financing statement ($38) will be included on my first monthly bill after project completion, and that I am responsible for additional costs of terminating the UCC filing ($38) at loan payoff.

Attach Estimate Here

When submitting pictures of multi-page documents, please upload pages separately. Be sure to include all pages before submitting.

Estimate - Page 1

Do you have additional pages/documents to upload?

Estimate - Page 2

Estimate - Page 3

Estimate - Page 4

Estimate - Page 5

Attach Drivers License Here

How did you hear about this loan program?

Contractor Name

BEMC Employee Name

Any additional comments or questions related to your application?

Please allow up to 3 business days for loan status notification.

NOTE: Work must be completed within 90 days of the loan approval date.

Record Type

Record Type Name

Application Type

Contact Information