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Esco) Retail Access Application Form

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Esco) Retail Access Application Form DEBM, LLC rciNEW YORK STATE OF Department of OPPORTUNITY. Public Service ENERGY SERVICE COMPANY (ESCO) RETAIL ACCESS APPLICATION FORM 1. Business Information Business Name: Direct Energy Business Marketing, LLC Address: 194 Wood Avenue South 08830 City: Iselin State: NJ Zip: Telephone: 732-516-7500 Fax: If you intend to market your services under a DBA list name(s) here: (Copy of your certificate of assumed name is required) N/A Do you currently have any energy affiliates (including subsidiaries) located or operating within New York State? Yes X No If yes, provide the contact information for any entity with an ownership interest of 10 percent or more in the company listed above: Business Name: Direct Energy Business, LLC Contact Name: John Schultz, President Address: 194 Wood Avenue South City: Iselin State: N J 08 830 Telephone: 732-516-2600 Fax: Email Address: [email protected] Page I 1 DEBM, LLC During the previous 36 months, have any criminal or regulatory sanctions been imposed for any senior officer of the ESCO applicant, its subsidiaries or its energy affiliates listed above? Yes No X If yes, provide the following information: Name: Title: Name: Title: 2. Contact Information Executive Contact Christopher Kallaher, Senior Director, Gov't Regulator Affairs Name and Title: Address: 162 Cypress Street City: Boston State: MAZip: 05445 Telephone: 617-879-0668 Fax: Email Address: [email protected] Regulatory Contact Angela Schorr, Manager, gov't Regulatory Affairs Name and Title: Address: 574 Derby South City: Oceanside State: NY Zip: 11572 Telephone: 516-536-6180 Fax: Email Address: [email protected] Page 12 DEBM, LLC Marketing Contact Name and Title: David Roe, VP, Mrkts Customer Exper, NA Business Address: 194 Wood Avenue South City: Iselin State: NJ Zip: 08830 Telephone: 732-516-3050 Fax: Email Address: [email protected] Power to Choose Website Information http://www.directenergybusiness.com Website Address: [email protected] Customer Service Email Address: Toll Free Number: 888-925-9115 Vendor Contact (e.g. EDI Vendor) Vendor Name: Address: City: State: Zip: Contact Name: Telephone: Fax: Email Address: Page 1 3 DEBM, LLC 3. Additional Requirements (Required for New ESCO Applications and Triennial Filings) • Copy and proof of acceptance of your registration with the NYS Dept of State and a copy of your certificate of assumed name (if applicable); • Comprehensive copy of your standard sales agreement(s), including presentation of the customer disclosure statement; • Marketing representative ID badge; • Marketing standards quality assurance plan; • Third party verification (TPV) script; • Sample forms of notices for assignment, discontinuance and transfer of 5000 or more customers to other providers; • Sample(s) of your billing format(s); • Procedures you will use to obtain customer's authorization for historic usage and credit information; • Copies of information and promotional materials used for mass marketing purposes; • HEFPA documents, if providing energy supply to residential customers; • Internal procedures for the prevention of slamming or cramming; • A list of entities, including contractors and sub-contractors, that will market on behalf of your ESCO; • Attestation that you will comply with the requirements of the New York State's Environmental Disclosure Program, if you intend to serve electric customers; • NYS DPS Office of Consumer Services Service Provider Form. • Letter from a utility that you have successfully completed EDI Phase I Testing. Page I 4 DEBM, LLC 4. Identify the Types and Locations of Markets For Eligible ESCOs that have completed Phase III Testing, place an "J" in the applicable cells of the table below to 1) designate the individual utility retail access programs in which you participate, and the customer market(s) in each program you serve; 2) indicate the commodities you offer in each service territory, and 3) indicate the billing options you offer in each territory. If you are a new ESCO applying for eligibility, please leave this section blank. If you are an ESCO that has eligibility but are not serving, leave this section blank. Utility Customer Commodity Billing Options Markets Res Non Nat Electric Utility Rate Utility Bill *Single Dual Res Gas Ready Ready Retailer Bill n/a n/a n/a Central Hudson X X x n/a n/a nia Con Edison X X X X X n /a n/a n/a n/a n/a Corning Natural Gas n/a n/a n/a n/a n/a LIPA X X National Grid n/a n/a n/a (KEDNY, KEDLI) X X X X National Grid n/a n/a n/a (Upstate) X X X X n/a n/a National Fuel Gas X X X n/a n/a n/a NYSEG X X X X n/a n/a Orange & Rockland X X X X Rochester Gas & n/a n/a n/a Electric X X X n/a n/a n/a n/a n/a St. Lawrence The designation "N/A" indicates that either a commodity or billing option is not available in a specific service territory. *Single Retailer is also known as "ESCO Consolidated Billing" Page I 5 5. Signature The person signing this application attests to the following: that she or he is an owner, partner, or officer of the business named on this application, the answers and materials contained in this application package are true and the application package submitted is complete and accurate. An ESCO that knowingly makes false statements in this application package is subject to denial or revocation of eligibility. Signature: Print Name: _Erica Steele Title: _Assistant Secretary Date: -c----141--/ Company Name: Direct Energy Business Marketing, LLC DEBM, LLC Exhibit A Proof of Registration DEBM, LLC Exhibit A (1) Direct Energy Business Marketing, LLC Current Status New York Department of Public Service Entity Information Page 1 of 2 NYS Department of State Division of Corporations Entity Information The information contained in this database is current through April 29, 2019. Selected Entity Name: DIRECT ENERGY BUSINESS MARKETING, LLC Selected Entity Status Information Current Entity Name: DIRECT ENERGY BUSINESS MARKETING, LLC DOS ID #: 4383564 1 nitial DOS Filing Date: APRIL 04, 2013 County: NEW YORK Jurisdiction: DELAWARE Entity Type: FOREIGN LIMITED LIABILITY COMPANY Current Entity Status: ACTIVE Selected Entity Address Information DOS Process (Address to which DOS will mail process if accepted on behalf of the entity) C/O CORPORATE CREATIONS NETWORK, INC. 15 NORTH MILL STREET NYACK, NEW YORK, 10960 Registered Agent CORPORATE CREATIONS NETWORK INC. 15 NORTH MILL STREET NYACK, NEW YORK, 10960 This office does not require or maintain information regarding the names and addresses of members or managers of nonprofessional limited liability companies. Professional limited liability companies must include the name(s) and address https://appext20.dos.ny.gov/corp_public/CORPSEARCH.ENTITY_INFORMATION?p_to... 4/30/2019 Entity Information Page 2 of 2 (es) of the original members, however this information is not recorded and only available by viewing the certificate. *Stock Information # of Shares Type of Stock $ Value per Share No Information Available *Stock information is applicable to domestic business corporations. Name History Filing Date Name Type Entity Name MAY 30, 2014 Actual DIRECT ENERGY BUSINESS MARKETING, LLC APR 04, 2013 Actual HESS ENERGY MARKETING, LLC A Fictitious name must be used when the Actual name of a foreign entity is unavailable for use in New York State. The entity must use the fictitious name when conducting its activities or business in New York State. NOTE: New York State does not issue organizational identification numbers. Search Results New Search Services/Programs I Privacy Policy I Accessibility Policy I Disclaimer I Return to DOS Homepage I Contact Us https://appext20.dos.ny.gov/corp_public/CORPSEARCH.ENTITY_INFORMATION?p_to... 4/30/2019 DEBM, LLC Exhibit A (2) Certification of Incorporation of Hess Energy Marketing, LLC And Certificate of Amendment for Name Change to Direct Energy Business Marketing, LLC 13 0 40 4000 Aqi APPLICATION FOR AUTHORITY OF HESS ENERGY MARKETING, LLC Under Section 802 of the Limited Liability Company Law CT)CZ) • Ecr STATE OF NEW YORK U.1 DEPARTMENT OF STATE a. FILED APR 0 4 2013 ----- az; ---4--- FIltd by: Hess Corporation BY: 1185 Avenue of the Americas New York, NY 10036 NY102 - 03/11/02 C T System Online 1 3 0 4 0 4 0 0 0 M APPLICATION FOR AUTHORITY OF HESS ENERGY MARKETING, LLC Under Section 802 of the Limited Liability Company Law FIRST: The name of the limited liability company Is: HESS ENERGY MARKETING, LLC If the name does not contain a required word or abbreviation pursuant to Section 204 of the Limited Liability Company Law, the following word or abbreviation is added to the name for use in this state: If the name of the limited liability company is unavailable, the fictitious name under which it will do business in New York is: SECOND: The jurisdiction of organization of the limited liability company is: Delaware The date of its organization is: March 20, 2013 THIRD: The county Within this state In which the office, or if more than one office, the principal office of the limited liability company is to be located is: New York FOURTH: The secretary of state is designated as agent of the limited liability company upon whom process against it may be served. The post office address within this state to which the secretary of state shall mail a copy of any process against him or her is: do CT Corporation System, 111 Eighth Avenue, New York, New York 10011. FIFTH: The name and street address within this state of the registered agent of the limited liability company upon whom and at which process against the limited liability company can be served is: C T Corporation System, 111 Eighth Avenue, New York, New York 10011.
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