Construction Business License Application

CONSTRUCTION BUSINESS LICENSE APPLICATION

WHEREAS

WHEREAS, the Applicant seeks authorization to engage in construction activities within the municipality and requests issuance of a Construction Business License for the business identified below; and

WHEREAS, issuance of the License is subject to compliance with applicable building codes, local ordinances, insurance and bonding requirements, payment of fees, and verification of qualifications of the Applicant and its principals;

WHEREAS, by submitting this Application the Applicant warrants the truthfulness of the information provided and agrees to the terms, conditions and certifications set forth herein.

APPLICANT INFORMATION

Sole Proprietorship Partnership Corporation LLC Other:

CONTRACTOR CLASSIFICATION & CAPACITY

Classifications (check all that apply):

General Contractor Residential Commercial Electrical Plumbing HVAC Other:

PRINCIPALS / OFFICERS

Provide names and titles of all principals and officers. Attach additional sheets if necessary.

SCOPE OF WORK

INSURANCE, BONDING & COMPLIANCE

Applicant must maintain insurance and bonding in accordance with municipal requirements. Provide current insurance and bonding information below.

PAYMENT TERMS (APPLICATION FEES)

Application Fee Amount: $   Payment Method:

Payment Schedule:

Late Fee: — Fees not paid when due may result in suspension or denial.

TERM AND TERMINATION

Proposed License Term Start Date:   End Date:

Either party may terminate the license or application process for cause upon days' written notice. Grounds for revocation include material misrepresentation, failure to maintain required insurance/bonds, or violation of applicable codes.

CONFIDENTIALITY

All information submitted with this Application will be treated in accordance with applicable public records law. Confidential business information clearly designated by the Applicant may be withheld from disclosure to the extent permitted by law. The Applicant acknowledges that the municipality may disclose application data when required by law.

GOVERNING LAW; ENTIRE AGREEMENT

This Application, and any license issued pursuant to it, shall be governed by the laws and ordinances of the jurisdiction in which the license is issued. This Application and any attachments constitute the entire agreement between the parties with respect to the matters contained herein and supersede any prior oral or written statements or agreements.

CERTIFICATIONS AND ACKNOWLEDGMENTS

The Applicant certifies under penalty of perjury that the information provided in this Application and any attachments is true, correct and complete to the best of the Applicant's knowledge. The Applicant authorizes verification of any information supplied and understands that false statements may result in denial, revocation, or penalties.

Has the Applicant or any principal been convicted of a felony or any offense related to construction in the past 10 years?    Yes    No

ADDITIONAL DOCUMENTS ATTACHED

Check all documents included with this Application:

Certificate of Insurance Surety Bond Resumes/Qualifications of Key Personnel Copies of Prior Licenses

AUTHORIZATION

By signing below the Applicant acknowledges receipt of and agreement to the terms set forth in this Application and authorizes representatives of the issuing authority to conduct inspections and inquiries necessary to evaluate the Application.

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