Corporate Entity Information
The information provided in this section must be the same as that provided to the Internal Revenue Service, Federal Trade
Commission, or other government entity.
FULL AND LEGAL NAME OF CORPORATE ENTITY
ADDRESS
LEGAL STATE OF INCORPORATION IF DOMESTIC,
OR COUNTRY IF INTERNATIONAL
PARENT COMPANY NAME
(business enterprise that owns the company, if applicable)
Certification Contact Information
The Certification Contact is AHRI’s point of contact for all issues relating to his/her company’s participation in the AHRI
Certification Program, such as certification agreements, test selections and reports, certified directory listings, certification sales
volume inquiries, any questions of a technical nature, and compliance with the rules of the certification program. The Certification
Contact will also receive courtesy copies of all certification invoices.
CERTIFICATION CONTACT’S NAME
TITLE
CERTIFICATION CONTACT’S ADDRESS, INCLUDING COUNTRY (if different than corporate entity address)
BUSINESS PHONE
EMAIL ADDRESS
Billing Contact Information
The Billing Contact will receive all invoices related to AHRI certification and liaison with the Certification Contact for invoice
approval.
BILLING CONTACT NAME
TITLE
BILLING CONTACT’S ADDRESS, INCLUDING COUNTRY (if different than corporate entity address)
BUSINESS PHONE
EMAIL ADDRESS
Chief Executive Officer/President Information
The CEO/President will receive a report each year regarding his/her company’s performance in the AHRI Certification Program.
CEO/PRESIDENT NAME
TITLE
CEO/PRESIDENT’S ADDRESS, INCLUDING COUNTRY (if different than corporate entity address)
BUSINESS PHONE
EMAIL ADDRESS
Certification Program Information
(a separate application must be filed for each certification program)
AHRI CERTIFICATION PROGRAM BEING APPLIED FOR
Active Chilled Beams
Air-Cooled Water-Chilling Packages
Air-to-Air Energy Recovery Ventilators
(Component)
Air-to-Air Energy Recovery Ventilators
(Packager)
Automatic Commercial Ice-Makers and Ice
Storage Bins
Central Station Air-Handling Unit Supply Fans
Central Station Air-Handling Units Casings
Commercial Boiler
Commercial Finned Tube Radiation
Commercial Furnaces
Commercial Refrigerated Display
Merchandisers and Storage Cabinets
Commercial Water Heaters
Datacom Cooling
Direct Heating
DX-Dedicated Outdoor Air System Units
Forced Circulation Air-Cooling and Air-Heating
Coils
Geothermal - Direct Geoexchange Heat
Pumps
Geothermal - Water Source Heat Pumps
Heat Pump Pool Heaters
Indirect Water Heaters
Indoor Pool Dehumidifiers
Liquid to Liquid Brazed & Fusion Bonded Plate
Heat Exchangers
Liquid to Liquid Heat Exchangers
Non-Condensable Gas Purge Equipment for Use With Low
Pressure Centrifugal Liquid Chiller
Packaged Terminal Air-Conditioners
Packaged Terminal Heat Pumps
Reclaimed Refrigerants
Refrigerant Recovery/Recycling Equipment
Refrigerant Testing Laboratory
Residential Baseboard Radiation
Residential Boilers
Residential Furnaces
Residential Water Heaters
Room Fan-Coil Air-Conditioners
Single Package Vertical Heat Air-Conditioners
Single Package Vertical Heat Pumps
Transport Refrigeration
Unit Coolers
Unit Ventilators
Unitary Large Equipment
Unitary Small Air-Conditioner Equipment
(includes Mixed-Match Coils)
Unitary Small Heat Pump Equipment
(includes Mixed-Match Coils)
Variable Air Volume Terminals
Variable Frequency Drive
Variable Refrigerant Flow
Water-Cooled Water-Chilling and Heat Pump Water-Heating
Packages
(other, not listed)
PUBLISHED NAMES
List all names (under which the product is commercially known) to be affiliated with this corporate entity’s participation in the noted
certification program. The corporate entity shall be able to provide proof of legal ownership of the trade and brand names listed.
Note: The full and legal name of the corporate entity does not need to be displayed, and model series names should not be
included as a brand name.
TRADE NAMES:
(published as ‘Manufacturer Name’ on the AHRI Directory)
ASSOCIATED BRAND NAMES:
(one trade name can have multiple brand names; separate by commas)
Company Type
(please select only one)
COMPANIES APPLYING TO BE AN OEM MUST COMPLETE THE FOLLOWING SECTION
Original Equipment Manufacturer (OEM):
A corporate entity that manufactures equipment that falls within the scope of a certification program.
Please provide the City and State, or City and County of all Manufacturing Facilities for the certified product
CITY
STATE (if domestic) OR COUNTRY (if international)
COMPANIES APPLYING TO BE A PBM MUST COMPLETE THE FOLLOWING SECTION
Private Brand Marketer (PBM):
A corporate entity (capable of bearing legal rights and obligations) that markets equipment manufactured by a
different corporate entity (an OEM) under one or more brand/trade names.
CORRESPONDING AHRI OEM PARTICIPANT NAME
COMPANY ADDRESS, COUNTRY
OEM CONTACT NAME
TITLE
BUSINESS PHONE
EMAIL
CORRESPONDING OEM CORPORATION NAME
This application is being submitted by:
NAME
DATE
BUSINESS PHONE
EMAIL ADDRESS
Marketing Information:
Marketing Contact Information
The Marketing Contact is AHRI’s point of contact for all issues relating to promotions, advertising, and marketing.
MARKETING CONTACT NAME
TITLE
MARKETING CONTACT’S ADDRESS (if different from company address)
BUSINESS PHONE
EMAIL ADDRESS
Other Information
MARKETS WHERE THE CERTIFIED PRODUCTS ARE USED
Residential
Commercial & Industrial
THE AHRI CERTIFICATION PROGRAM IS SEPARATE FROM THE
MEMBERSHIP ORGANIZATION. ARE YOU AN AHRI MEMBER?
Yes
WHY OR WHY NOT?
No
ARE YOU AWARE OF THE BENEFITS OFFERED BY MEMBERSHIP IN AHRI? CHECK ALL THAT APPLY.
Industry statistical data
Networking
Pre-competitive research
Legislative and regulatory news and guidance
Standards and certification program voting rights
Certification discounts
DO YOU SHIP THE PRODUCT YOU PLAN TO CERTIFY IN THE U.S. AND/OR CANADA? IF SO, WHAT PERCENTAGE?
0 – 20%
21% – 40%
41% – 60%
61% – 80%
REASON FOR SEEKING CERTIFICATION:
Minimum efficiency requirements
Client requested
Requirement for project
Competitive edge
Marketing purposes
Other (please specify):
81% – 100%