Application for Company Membership

September 6, 2020ACG

Application for Company Membership
Please submit complete Company Membership Application with at least one (1) CxA Application to be considered for approval.
Company Name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Telephone Number*
Fax
Date of Incorporation*
MM slash DD slash YYYY
Website Address*
Number of Employees*
Primary Contact*

(must be an applying/current CxA)
Primary Contact Email Address*
Enter Email Confirm Email
Parent Company*
Company Subsidiary(ies)*

(if applicable)
1. Please list the full scope of services provided by the company:*
2. Please describe all configurations under which your firm delivers commissioning (Cx) services:*
If approved for ACG membership, our company agrees:*
- 1. To provide professional, independent commissioning services on behalf of the owner.
- 2. To uphold professional and ethical standards of conduct.
- 3. To keep at least one (1) ACG Certified Commissioning Authority (CxA) employed at all times in order to maintain membership. (Should the only CxA leave, the company would have a 3-month grace period to have a new CxA certified.)
- 4. To abide by the ACG Bylaws and Policies and Procedures.
- 5. That our membership will only remain valid while our membership dues status remains current. Dues are currently $2,000 per year, and include discounted certification fees, and one CxEnergy registration.
Application Submitted by (print name)*
Title*
Signature*
Date*
MM slash DD slash YYYY

Membership & Certification