Revised January 2011. You must submit with the application the following documentation:



Similar documents
Building Division. Engineering, Planning and Building Department 540 Laird Avenue S.E. Warren, Ohio Office: (330) Fax: (330)

BLAKE PETERSON HVAC INSPECTOR. TRUMBULL COUNTY BUILDING INSPECTION DEPT Wean Building. Warren, Ohio 44481

CONTRACTOR REGISTRATION

CITY OF BUFFALO PERMIT & INSPECTION SERVICES CITY OF BUFFALO - COLLECTION AGENCY LICENSE

INSTRUCTIONS for COMPLETING COLLECTION AGENCY BOND APPLICATIONS

Proper Procedures to Make Business Permit Changes

INSTRUCTIONS FOR MAKING APPLICATION UNDER PROVISIONS OF THE ILLINOIS ROOFING INDUSTRY LICENSING ACT

General Contractor Registration Application Please read and follow these instructions.

State of Oklahoma COUNCIL ON LAW ENFORCEMENT EDUCATION AND TRAINING Private Security Licensing Division

ALL LOAN BROKERS AND ORIGINATORS DOING BUSINESS IN INDIANA FROM: OFFICE OF SECRETARY OF STATE TODD ROKITA, SECURITIES DIVISION

COMMONWEALTH OF VIRGINIA STANDARD PERFORMANCE BOND

APPLICATION FOR PERMIT TO HOLD AMATEUR BOXING EVENT INSTRUCTION SHEET

PAYMENT/PERFORMANCE BOND. This is the front page of the payment/performance bond issued in compliance with Florida Statutes

THIS RENEWAL IS DUE ON OR BEFORE DECEMBER 1, 2015 DEBT MANAGEMENT ACT 2016 LICENSE RENEWAL CHECKLIST

This page left blank intentionally

Instructions Application for a Business License

DEVELOPMENT INFRASTRUCTURE COMPLETION BOND. Name of Approved Construction Drawings ( Required Infrastructure ):

MAINTENANCE AND PERFORMANCE BONDS

CALIFORNIA TRANSPORTATION COMMISSION DESIGN-BUILD DEMONSTRATION PROGRAM STANDARD FORM OF PAYMENT AND PERFORMANCE BOND

Year 2015 Contractor License Packet

OFFICE OF THE ATTORNEY GENERAL SDCL BUYING CLUB BOND INSTRUCTIONS

DEBT MANAGEMENT COMPANY LICENSE APPLICATION

DUSTIN McDANIEL ATTORNEY GENERAL OFFICE OF THE ATTORNEY GENERAL 323 CENTER STREET, Suite 200 LITTLE ROCK, AR (501)

SOUTH CAROLINA STATE BOARD OF COSMETOLOGY

KNOW ALL MEN BY THESE PRESENTS, that we, the undersigned,

Performance Bond. as Principal, (Legal title of the Contractor) (Street, City, State, Zip Code) and as Surety, (Legal title of the Surety)

HOW TO OBTAIN A NEW CONTRACTOR LICENSE

NEW JERSEY BOARD OF PUBLIC UTILITIES. ELECTRIC POWER and/or GAS SUPPLIER INITIAL APPLICATION INSTRUCTIONS

(Affix Principal s corporate seal.)

BID BOND CITY OF EAST POINT, GEORGIA

CITY OF FAIRFAX TELECOMMUNICATION FACILITY BONDING PACKAGE

OFFICE OF THE ATTORNEY GENERAL SDCL DEBT ADJUSTING BOND INSTRUCTIONS

Sewage Sludge Utilization Performance Bond

Construction Trades Qualifying Board APPLICATION FOR BUSINESS CERTIFICATION OR ADDING D/B/A TO EXISTING BUSINESS LICENSE

COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC WORKS FAITHFUL PERFORMANCE BOND. For Tract/Parcel Map No.

SURETY BOND (CORPORATION) (Public Resources Code )

PERFORMANCE BOND. Surety Bond No. STATE OF TEXAS KNOW ALL MEN BY THESE PRESENTS: COUNTY OF

#5 Independent Contractor Form - With Insurance With Bonds

RONALD WASTEWATER DISTRICT LINDEN AVENUE NORTH - P.O. BOX SHORELINE WA (206)

PERMIT HOURS: 8:30 A.M :00 A.M. & 1:00 P.M :00 P.M.

LICENSE APPLICATION FOR CONSTRUCTION TRADES (INSTRUCTIONS)

INSTRUCTIONS FOR APPLICATION FOR NEW DEALERSHIP

ARKANSAS APPRAISAL MANAGEMENT COMPANY APPLICATION FOR REGISTRATION

INFORMATION FOR OCILB CONTRACTOR APPLICATION:

PERMIT BOND ONE LOCATION LIABILITY. KNOW ALL PERSONS BY THESE PRESENTS, that we,

Initial Application for Debt Management License Attachments and Instructions

Upon receipt of a letter of intent to award a contract, Bidder shall provide Performance and Payment Bonds as outlined below.

Public Health - Dayton & Montgomery County

DIVISION OF BANKING 1511 Pontiac Avenue, Bldg Cranston, Rhode Island UNIFORM DEBT-MANAGEMENT SERVICES ACT BOND

West Virginia State Tax Department Nonresident Contractors Sales And Use Tax Requirements

BY THIS BOND,, whose principal address is, business phone number is as Principal,hereinafter Contractor, and, whose principal address is

PROJECT NO. 2733, RFP NO /02. Peralta Community College District. 333 East 8th Street, Oakland, CA Questions

INDEMNITIES. Guaranty Agreement and Bond Information

(For Department Use Only) TYPE OF APPLICATION

PERFORMANCE BOND. KNOW ALL MEN BY THESE PRESENTS that we,, as. Principal (the Principal ), and, a corporation

FORM H PERFORMANCE SECURED BY A SURETY COMPANY., 20 Dunstable, Massachusetts

(contractor s name) (hereinafter called the Contractor ) located at: (contractor s address) and (surety s name)

Plumbing Contractor or Restricted Plumbing Contractor

SECTION AWARD AND EXECUTION OF CONTRACT

PAYMENT BOND. KNOW ALL MEN BY THESE PRESENTS that we,, as Principal (the Principal ), and, a corporation organized

Ohio Department of Transportation

Contractor s License & Endorsements

FIGURE 20 BOND FORMS

HOMER TOWNSHIP HIGHWAY DEPARTMENT ADDENDUM #1. June 13, 2014 VARIOUS (2014 ROAD PROGRAM) SECTION NO.: GM

WEST VIRGINIA CONTRACTOR LICENSING BOARD

Exhibit D CONTRACT DOCUMENTS

GUARANTY BOND SAMPLE. correspondence school seeks from the State Board of Community Colleges licensure to

Expedited Dispute Resolution Bond (P3 Form)

CONSTRUCTION AGREEMENT FOR

EXHIBIT S - BOND SURETY FORMS

THE CORPORATION OF THE CITY OF BURLINGTON D1 - AGREEMENT

SUBCONTRACTOR LABOR AND MATERIAL PAYMENT BOND ("Bond") SURETY Address

Secretary of State Lincoln, NE DEBT MANAGEMENT LICENSE APPLICATION Initial Fee: $ Investigation Fee: $200.00

Retaining Wall Replacement at the Currituck County Veterans Memorial Park

STATE OF NORTH CAROLINA AGREEMENT COUNTY OF WAKE

PERFORMANCE BOND INSTRUCTIONS (FEB 2015)

SECTION PERFORMANCE BOND., hereinafter called PRINCIPAL, and

CONTRACTOR ENCROACHMENT PERMIT (OFF-SITE) REQUIREMENTS Municipal Code Section 14.08/General Information: (530)

Rock Island County Raffle License Application Packet

CITY OF SIKESTON INVITATION FOR BID GENERAL REQUIREMENTS

INSTRUCTION SHEET COLLECTION AGENCY

INVITATION TO BID EOE

State of Utah Department of Commerce Division of Consumer Protection

PROFESSIONAL ENGINEERING SERVICES FOR HURRICANE IRENE HAZARD MITIGATION GRANT PROGRAM (HMGP) FOR ELEVATION

G U A R A N T Y B O N D

Who Can Apply (A or B)

Transcription:

Charlie A. Dooley County Executive Sheryl L. Hodges, D.E., P.E., L.P.G. Director MECHANICAL LICENSING Guidelines for completing the Application for Contractor License Contractor License Categories: Mechanical, Sheet Metal, Sprinklerfitter and HVAC Servicer-Installer Revised January 2011 Requirements to Obtaining your Contractor License: You must submit with the application the following documentation: Documentation must be issued during the preceding ten (10) years, submitting three (3) copies per year, for a three (3) year period, of mechanical permits obtained, invoices/receipts to customers, and material/supply orders, verifying that your company has actually been engaged in the mechanical industry, accordingly. 1. Mechanical permit obtained; if the permit does not specify the entity or person performing the mechanical work, then additional documentation will be required to verify that the applicant actually performed the mechanical work and operated as a business at the time of each job. 2. Invoice to customer, evidence for each job shall include, but not be limited to, the applicant s (company) name listed on the invoice, proof of payment by the owner or general contractor. 3. Material / Supply Order, evidence that the applicant (company) purchased sufficient mechanical materials and supplies for the work performed. 4. Affidavit; that your company performed the mechanical work within at least a four year period. 5. Licensed Mechanical Contractors Bond; must use the appropriate bond form attached with the application. 6. General Liability Insurance Form; applicant must carry a minimum of five hundred thousand dollars liability insurance for bodily injury and property damage. 7. A Local Business License 8. State and/or Federal Tax Identification 9. Certificate of Good Standing from the Secretary of State

MECHANICAL LICENSING Guidelines for completing the Application for Contractor License Instructions to complete the application for Contractor License: 1. Select only one license category and check the appropriate box. 2. Provide company/corporation name, location, and telephone number. 3. Provide name, birth date, Social Security number, address, and telephone number of the designated director-supervisor. 4. I. If you have a license for at least three (3) years under the St. Louis County Plumbing Code as a Master Pipefitter, Master Plumber, or Master Sprinklerfitter: Check the box next to Option I. Submit the required documentation, listed in Option I, with the Contractor License application. II. If you have a degree in civil or mechanical engineering from an accredited college: Check the box next to Option II. Submit the required documentation, listed in Option II, with the Contractor License application. III. If you have a minimum of three (3) years experience directing and supervising at least one (1) journeyman: Check the box next to Option III. Submit the required documentation, listed in Option III, with the Contractor License application. Note: For a Residential HVAC sole proprietor, documentation should be three (3) years of contracts and bills to your customers, invoices and/or bills of material from your suppliers and mechanical permits obtained. 5. Submit proof of liability insurance and a current surety bond with the Contractor License application. (Refer to the insurance and bond information attached to the Contractor License application) 6. Sign and date the Contractor License application. 7. Mail application with a $100 check payable to St. Louis County Treasurer to the Clayton central office: St. Louis County Department of Public Works Attention: Mechanical Licensing 41 South Central Avenue 6 th Floor Clayton, MO 63105 or Deliver to the above address Monday through Friday 8:00AM 4:30PM For assistance with mechanical licensing please call the Mechanical Licensing Clerk (314) 615-7096

ST. LOUIS COUNTY DEPARTMENT OF PUBLIC WORKS Rev: Jan 2011 BOARD OF EXAMINERS FOR MECHANICAL LICENSING 41. So. Central, 6 th Floor Clayton, Missouri 63105 ST. LOUIS COUNTY, MISSOURI APPLICATION FOR CONTRACTOR LICENSE FEE $100.00 (make check payable to: St. Louis County Treasurer) PLEASE CHECK ONE LICENSE CATEGORY FOR WHICH YOU ARE APPLYING: (see reverse side for definitions) Mechanical Contractor Sheet Metal Contractor Sprinklerfitter Contractor HVAC Servicer-Installer Contractor Company Name: Phone#( ) Address City State Zip Complete name and supplemental information below on owner, if sole proprietor, or individual employed by the company who is experienced in directing and supervising at least one (1) journeyman working in the category of license requested as further described below: Name Birth Date - - Social Security No. / / Res Phone #( ) Residence Address City State Zip Please check one: (If HVAC sole proprietor, check box III and see HVAC definition) I) An individual licensed under the St. Louis County Plumbing Code as a Master Pipefitter, Master Plumber, or Master Sprinklerfitter for at least three(3) years and a minimum of one(1) year of verifiable training or experience directing and supervising at least one (1) journeyman. My License # is: Staff Verification Required documentation for this option also includes: a notarized letter from an officer of the company confirming at least one(1) year directing and supervising journeyman level work associated with the specific category of license requested; OR II) An individual with a degree in civil or mechanical engineering from an accredited college and a minimum of one(1) year of verifiable training or experience directing and supervising at least one (1) journeyman. Required documentation for this option includes: a notarized letter from an officer of the company confirming at least one(1) year of directing and supervising journeyman level work associated with the specific category of license requested; and a copy of the diploma in civil or mechanical engineering from an accredited college; OR III) An individual with a minimum of three (3) years of verifiable training or experience directing and supervising at least one (1) journeyman. Required documentation for this option includes: a notarized letter from an officer of the company confirming at least three(3) years of directing and supervising journeyman level work associated with the specific category of license requested. SEE REVERSE SIDE FOR COMPLETION OF APPLICATION FORM Page 1 of 2

St. Louis County, Missouri Application for Contractor License Note: Proof of general liability insurance and a current surety bond must be submitted with this application. I understand that as the Contractor I must notify the Department of Public Works within ten (10) days if I no longer actively employ the above named director-supervisor. I hereby affirm the information provided on this application and all attachments to be true to the best of my knowledge and I hereby make application for the License indicated above. Officer of the Company Director-Supervisor (If Required) Printed Name: Signature: Title: Date: Printed Name: Signature: Title: Date: 1. Any misstatement or misrepresentation in said application will disqualify the applicant. 2. The applicant will be notified in writing of the action of the board following review of the application. 3. In the event an applicant fails to qualify for a license, the application fee deposited will not be refunded. If a new application is submitted, it must be accompanied by the fee specified by law. Definitions A Contractor is an individual or Entity who is licensed under this Section to engage in contracts and perform work on any or all of the following: Process Piping Systems, HVAC Duct Systems, Fire Suppression Systems, HVAC Piping Systems or HVAC Systems. (A) A Mechanical Contractor is an individual or Entity licensed to perform work under this Section who employs at least one Pipefitter Journeyman. (B) A Sheet Metal Contractor is an individual or Entity licensed to perform work under this Section who employs at least one Sheet Metal Journeyman. (C) A Sprinkler fitter Contractor is an individual or Entity licensed to perform work under this Section who employs at least one Sprinkler fitter Journeyman. (D) A HVAC Servicer-Installer Contractor is an individual or Entity licensed to perform work under this Section who employs at least one HVAC Servicer-Installer Journeyman. In the case of a sole proprietor, the journeyman may be himself. Also, an individual having a minimum of three (3)years verifiable experience as the owner, operator or supervisor of a company that performed residential work exempted from licensing by previous ordinances. A Contractor licensed under this Section who performs work under any of the foregoing categories may take out permits for and perform work that falls under one of the other categories provided such Contractor uses a Journeyman (or an Apprentice under the required supervision and inspection of such Journeyman) who is licensed to perform the specific work involved pursuant to the applicable provisions of this Section. Page 2 of 2

ST. LOUIS COUNTY DEPARTMENT OF PUBLIC WORKS MECHANICAL LICENSING CONTRACTOR BOND REQUIREMENTS FOLLOW THESE INSTRUCTIONS OR THE BOND WILL NOT BE APPROVED 1. Be sure the appropriate bond conforms to that of the St. Louis County Dept. of Public Works. 2. Include the registrant name, dba company name, address with zip code, on page 1. 3. St. Louis County, Mechanical Licensing Department has four (4) license categories. Please list the correct license category on the bond. Mechanical Contractor Sprinklerfitter Contractor Sheet Metal Contractor HVAC Servicer-Installer Contractor 4. Bond must be signed by principal (mechanical contractor s responsible officer) a. If applicant is a corporation, the corporate seal should be impressed; (Or if there is none, so stated) b. If other than individual s own name is used, state if corporation or sole proprietorship 5. Underneath all signatures, type or legibly print the names, and their job titles. 6. The signature of the principal of the company/corporation/partnership must be notarized. 7. Bond must be signed by the surety company s attorney-in-fact and the signature notarized. 8. The surety company s Power of Attorney letter must be attached to the bond. 9. An original Bond Continuation Certificate must be provided annually to ensure bond is continued. 10. The date of the Acknowledgement of Surety, and the date of the Power of Attorney must be the same date as the effective date of the bond. This is the obligee information and the mailing address: ST. LOUIS COUNTY DEPT OF PUBLIC WORKS (CERTIFICATE HOLDER) ATTENTION: MECHANICAL LICENSING 41 S. CENTRAL AVE. ST. LOUIS MO 63105 Certificate of Insurance must conform to the following: Owners or operators of amusement devices must carry a minimum of one million dollars per occurrence general liability insurance. All other registrants must carry a minimum of five hundred thousand dollars liability insurance for bodily injury and property damage. Certificate must name St. Louis County as the certificate holder. Certificate must include the company s registered name, dba company name, address with zip code. Questions? Call the Mechanical Licensing Clerk @ (314) 615-7096 2-page bond form follows

LICENSE CATEGORY: ST. LOUIS COUNTY, MISSOURI LICENSED MECHANICAL CONTRACTORS BOND BOND NUMBER KNOW ALL MEN BY THESE PRESENTS, that we, of, State of (a corporation duly organized under the laws of the State of Missouri), hereinafter referred to as PRINCIPAL, and, a corporation duly organized under the laws of the State of, hereinafter referred to as SURETY, are held and firmly bound unto St. Louis County, Missouri, in the sum of TEN THOUSAND DOLLARS ($10,000.00) for the payment of which the PRINCIPAL binds itself, its heirs, executors, administrators, successors and assigns, and the SURETY binds itself, its successors and assigns, jointly and severally by these presents. WHEREAS, the Mechanical Code of St. Louis County, Missouri, Chapter 1108 SLCRO, 1974, as amended, requires an applicant for a mechanical permit to file with the Department of Public Works an indemnifying bond with good and sufficient sureties to St. Louis County, Missouri; and WHEREAS, the PRINCIPAL has made application to St. Louis County for registration of financial responsibility in accordance with the Mechanical Code of St. Louis County, Chapter 1108 SLCRO, 1974, as amended. NOW, THEREFORE, the condition of the foregoing obligation is such that if the PRINCIPAL is granted a registration of financial responsibility pursuant to the Mechanical Code of St. Louis County, Chapter 1108 SLCRO, 1974, as amended, and if PRINCIPAL shall faithfully: A) observe all ordinances, rules and regulations adopted for the public health and safety pertaining to mechanical work performed within St. Louis County, Missouri; and B) indemnify St. Louis County, Missouri, or any other governmental agency, or any person, firm or corporation for any damage or injury sustained through the negligence of such PRINCIPAL, its servants, agents or employees in performing mechanical work or for any damages or injury sustained due to such PRINCIPAL s failure to perform mechanical work in a careful and workmanlike manner in conformity with Chapter 1108 SLCRO, 1974, as amended; and C) pay to St. Louis County, Missouri, all fees due St. Louis County, Missouri, within thirty (30) days from due date; and D) indemnify any person, firm or corporation with whom said PRINCIPAL contracts to do work for damages sustained due to failure of PRINCIPAL to do the work contracted, then this obligation shall be void. Otherwise, this obligation shall remain in full force and effect and the same may be sued upon by St. Louis County, Missouri, or by any person, firm or corporation with whom the PRINCIPAL may hereafter contract to perform mechanical work for any damage sustained by St. Louis County or by any such person, firm or corporation on account of the failure of the PRINCIPAL to observe, perform or satisfy conditions A through D of the preceding paragraph. PRINCIPAL and SURETY are aware that ordinances, laws, rules, regulations and/or fees pertaining to mechanical work are subject to change. PRINCIPAL and SURETY agree to be bound by any such changes and hereby expressly waive notice of any such change. This bond shall take effect on, 20, and shall remain in full force and effect until conditions A through D of this bond have been fully and faithfully observed, performed, or satisfied, provided however that PRINCIPAL or SURETY may terminate this bond upon thirty (30) days written notice to the St. Louis County Director of Public Works as to obligations arising from mechanical work for which no permit has yet been issued by St. Louis County and for which the PRINCIPAL has not begun any mechanical work. This bond cannot be canceled or terminated as to any obligation arising from mechanical work once St. Louis County has issued a permit for such work. (page 1 of 2)

INSURANCE/BONDING COMPANY NAME BOND # (page 2 of 2) ACKNOWLEDGMENT OF PRINCIPAL (Firm / Corporation / Individual) PRINCIPAL: By: Registrant: (Name of Company/Contractor) (signature of company's responsible officer) (name and title typed or printed below) (signature of license holder) (name and title typed or printed below) STATE OF ) COUNTY OF ) SS On this day of, 20, before me personally appeared (name of company officer) the above signed officer who acknowledged himself/herself to be the (title) of (name of company) and that he/she as such officer being authorized to do so, executed the foregoing instrument for the purposes therein contained by signing the name of the (name of company) a (company/corporation/partnership) by himself/herself as such officer. In witness whereof, I hereunto set my hand and official seal. Notary Public My commission expires: ACKNOWLEDGMENT OF SURETY SURETY: STATE OF ) COUNTY OF ) SS By: (Attorney-in-Fact) On this day of, 20 before me personally appeared, who being sworn, stated that he/she is attorney-in-fact for surety,, and that he/she signed this instrument as attorney-in-fact for the foregoing surety. My commission expires: Notary Public APPROVED AS TO LEGAL FORM: St. Louis County Counselor