Account Opening Documentation ( International Org)
Join Columbia Gas of Virginia's Trade Ally Program
1. 1
Trade Ally Program Enrollment Form
Join the Columbia Gas of Virginia Trade Ally Program for your opportunity to gain additional natural
gas equipment sales, installations and service work. Just fill out the front and back of this form along
with the Contractor or Vendor Agreement and return it with the necessary information to the address
at the bottom of the form.
To participate, please provide the following:
Signed Participating Contractor or Vendor Agreement
Copy of Certificate(s) of Insurance demonstrating required liability, auto, and workers’
compensation insurance (refer to Participating Contractor or Vendor Agreement,
Section 1, item g, for details)
Completed Insurance Data Request form (below)
Completed Territory Zip Code form (reverse)
Copy of valid gas fitter’s, plumber’s license or any other authorizations or license(s) required by
state or municipal authorities
Office phone: ( ) ________________ and Mobile phone: ( ) ________________
Primary contact email address:________________________________
Website address:____________________________________
Columbia Gas of Virginia
Trade Ally Enrollment Form
Columbia Gas of Virginia
Insurance Data Request Form
I hereby authorize my insurance agent(s) to disclose insurance information and provide certificates
to Columbia Gas of Virginia, Inc.
The offer shall continue to be valid until revoked.
Contractor or Company Name Fed ID# or SS#_____________________________________________________________
Signature____________________________________________________________________________________________
Print Name and Title___________________________________________________________________________________
Date_______________________
Return all required documents to:
Columbia Gas of Virginia, Inc.
Trade Ally Program
1809 Coyote Drive
Chester, VA 23836
Or scan and send to: tradeallies@columbiagasva.com
