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Municipal Application
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About Us
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Project Finance
Online Application
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New Dealer Form
Government
Municipal Application
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About Us
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Municipal Application
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Municipality Business Information :
Legal Name of Municipality/ Obligor:
*
Federal ID
Address
Address Line 1
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
County
Phone
Fax
Email
Email
Confirm Email
Gross Annual Revenue
State Organization ID
Contact Name
*
First
Last
Contact Title
Contact Phone
*
Contact Email
Email
Confirm Email
Alternate Contact
First
Last
Alternate Contact Title
Alternate Contact Phone
Alternate Contact Email
Email
Confirm Email
Type of Municipality
City
Township
State
School District
Town
County
Solid Waste District
Other
Population
Households
Department/Agency
Fiscal Officer Name
First
Last
Fiscal Officeer Title
Fiscal Officer Phone
Fiscal Officer Fax
Date Municipality Entity Was Established
Does the obligor self-insure for property & liability insurance?
Yes
No
Within the current calendar year, we or will not issue $10,000,000 or more total debt including all bonds, loans and leases.
We Will
We Will Not
Equipment Information (Attach separate sheet if necessary)
Equipment Description
Manufacturer
Model
Year
Quantity
Equipment Cost $
Total Cost $
Equipment Location
Address Line 1
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Equipment
Equipment is Additional
Equipment is Replacement
New
Used
Soft Costs Included?
Yes
No
Amount of soft costs included (shipping, software, and sales tax)
Buyout Included?
Yes
No
Amount of buyout included:
Describe the essential use of the equipment:
Is the project a building?
Yes
No
If yes, who owns the land?
What is the physical address of the new building/project?
Address Line 1
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Lease Terms Desired:
Length of Lease Term
3 Years
4 Years
5 Years
Other
Payment Mode
Monthly
4 Quarterly
Semi-Annual
Annual
First Payment Due
Upon Delivery
Other
Other Requests/ Requirements:
Vendor Information (Attach separate sheet if necessary)
Vendor Company
Vendor Contact email
Email
Confirm Email
Vendor Contact Name
First
Last
Vendor Contact Phone
Vendor City
State
Zip
Website
Submit