Chicago General License Application

Application for General Contractor License

1. Type or print legibly in black ink only.

2. Review the checklist attached.

3. Sign and date application.

4. Attach Proof of Insurance, A.M. Best rating, Affidavits and Payment.

5. Mail application, completed in its entirety to: City of Chicago, General Contractor License, P.O. Box 388249, Chicago, IL, 60638-8249.

Note: Failure to provide all requested supporting documents will delay the processing of your application. Separate sheets may be attached if additional space is needed to provide required information.

Description of work and services the applicant will provide:

Please check the appropriate License classification. (Only one):

Class A license: is subject to no limitation as to the value of any single contract project. License fee: $2,000

Class B license: is not entitled to engage in construction of any single contract project of value in excess of $10,000,000. License fee: $1,000

Class C license: is not entitled to engage in construction of any single contract project of value in excess of $5,000,000. License fee: $750

Class D license: is not entitled to engage in construction of any single contract project of value in excess of $2,000,000. License fee: $500

Class E license: is not entitled to engage in construction of any single contract project of value in excess of $500,000. License fee: $300

Check appropriate box for your type of business structure:

Individual/Sole Proprietor

Individual doing business under an assumed name

Partnership

Corporation

Limited Liability Company

(Section 1)

Applicant Information:

If the Applicant is a Corporation or Limited Liability Company:

Corporation Name:

Principal Office Address: City: St.: Zip:

Business Phone Number:

Emergency Phone Number: E-mail Address (required):

Local Office, if different than principal office: City: St.: Zip:

Taxpayer Identification Number:

State of Incorporation:

Date Incorporated:

*Attach additional sheet(s) listing the name, residence address, residence telephone number, social security number and date of birth of all corporate officers and registered agents; attach Certificate of Good Standing from Illinois Secretary of State; attach General Contractor’s License Affidavit for each (1) officer, director, manager, managing member or member of any entity seeking or holding a general contractor’s license; or (2) owns, directly or indirectly through one or more intermediate ownership entities, 25% or more of the interest in the licensee or applicant. (Attach a copy of the assumed name certificate issued by the County Clerk if applicable.) Proceed to Section 2.

If the Applicant is an Individual/Sole Proprietor or Individual doing business under an assumed name (DBA):

Business Name:

Business Address: City: St.: Zip:

Business Phone Number: E-mail Address (required):

*Attach completed General Contractor’s License Affidavit for each (1) officer, director, manager, or member of any entity seeking or holding a general contractor’s license; or (2) owns, directly or indirectly through one or more intermediate ownership, 25% or more of the interest in the licensee or applicant, listing the name, residence address, residence telephone number, social security number and date of birth. (Attach a copy of the assumed name certificate issued by the County Clerk if applicable.) Proceed to Section 2.

If the Applicant is a Partnership:

Business Name:

Principal Office Address:

Business Phone Number:

Emergency Phone Number: E-mail Address (required):

Local Office if different from principal office:

*Attach additional sheet(s) listing the name, residence address, residence telephone numbers, social security number and date of birth of all partners. Attach General Contractor’s License Affidavit for (1) partner, general partner, limited partner, managers, managing member or member of any entity seeking or holding a general contractor’s license; or (2) owns, directly or indirectly through one or more intermediate ownership, 25% or more of the interest in the licensee or applicant. (Attach a copy of the assumed name certificate issued by the County Clerk if applicable.) Proceed to Section 2.

(Section 2)

*In the area provided below please list individually the applicant and all required members of appropriate business structure. (See above.)

(Section 3)

Previous business addresses: List all past business addresses from which the applicant has engaged in general contracting in the last five years.

(Section 4)

Proof of insurance – (include certified copy of insurance certificate naming the City of Chicago as an additional insured, current A.M. Best Rating showing credit rating of B+ or higher and the following information)

Name of insurance company:

Address:

Phone number:

Insurance certificate number or policy number:

Date Issued: Expiration date:

SIGNATURE CERTIFICATION

Any change in any of the facts stated in this application shall be reported to the Commissioner of the Department of Buildings within 14 days of the effective date of such change. Failure to comply with this requirement is grounds for license revocation. Mail any changes to:

City of Chicago
General Contractor License
P.O. Box 388249
Chicago, IL 60638-8249

I, , as applicant (or otherwise as agent of the applicant) certify that the statements in this application are true. I understand that any false or inaccurate information contained in this license application may result in revocation of the license in addition to any other penalties provided by law. False statements made within this application also may violate federal, state and/or local law, and may subject any person making such a statement to a range of civil and criminal penalties, such as a period of incarceration, fines, and an award to the City of Chicago of up to three times any damages incurred. In addition, persons who submit false information are subject to denial of the requested City action.

GENERAL CONTRACTOR’S LICENSE AFFIDAVIT

This affidavit is required for all Contractor’s license applications.

Under the penalty of perjury, I, the Undersigned, warrant that:

(1) I am authorized to execute this affidavit on behalf of the applicant.

(2) Each controlling person of the applicant is at least 18 years of age.

(3) The applicant and each controlling person of the applicant are financially solvent.

(4) All information, certifications and statements contained in the attached license application are true, accurate and complete as of the date furnished to the City. Information pertaining to the qualifications of each controlling person has been obtained on an individual basis from each controlling person.

(5) (a) Neither the applicant nor any controlling person has ever been convicted, is in custody, is under parole or under any other non-custodial supervision resulting from a conviction in a court of any jurisdiction for the commission of a felony or criminal offense of whatever degree involving bribery; or

(b) If so, the details surrounding each conviction are provided in a separate attachment submitted with this affidavit.

(6) Neither the applicant nor any controlling person is currently under indictment or has been charged under any State or Federal law with the crime of bribery.

(7) I, , as applicant (or otherwise as agent of the applicant) certify that the statements in this application are true. I understand that any false or inaccurate information contained in this license application may result in revocation of the license in addition to any other penalties provided by law. False statements made within this application also may violate federal, state and/or local law, and may subject any person making such a statement to a range of civil and criminal penalties, such as a period of incarceration, fines, and an award to the City of Chicago of up to three times any damages incurred. In addition, persons who submit false information are subject to denial of the requested City action.