Fillable Btfr 20contractor 20license 20application BENSALEM TOWNSHIP

Fill Online, Printable, Fillable, Blank Btfr 20contractor 20license 20application BENSALEM TOWNSHIP Form

Use Fill to complete blank online BENSALEM TOWNSHIP (PA) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Btfr 20contractor 20license 20application BENSALEM TOWNSHIP

On average this form takes 5 minutes to complete

The Btfr 20contractor 20license 20application BENSALEM TOWNSHIP form is 2 pages long and contains:

  • 0 signatures
  • 46 check-boxes
  • 0 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Bensalem Township

BROWSE BENSALEM TOWNSHIP (PA) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
DEPARTMENT OF PUBLIC SAFETY
BENSALEM FIRE RESCUE
CONTRACTOR LICENSE APPLICATION
Page 1 of 3 BTFR 08/2018
Total fee due with this application: $100.00 (check or money order, made payable to Bensalem Township)
TO SUBMIT YOUR APPLICATION AND/OR CONTACT US FOR INFORMATION:
BENSALEM FIRE RESCUE Phone: 215-633-3617 FAX: 215-633-3662
2400 Byberry Road Website: www.bensalempa.gov
Bensalem, PA 19020
All personal & employment information is strictly confidential and is not shared with any organization outside of Bensalem Township.
License #
BUSINESS INFORMATION
Business Name:
Address:
City:
State:
ZIP:
Phone #:
Fax #:
State Tax #:
Federal Tax #:
E-Mail Address:
APPLICANT INFORMATION
Name:
Address:
City
State
ZIP
Phone #:
Position/Title:
Check all services that apply:
Specific Services
Inspection
Installation
Design
Fire Alarm Systems*
Sprinkler Systems**
Alternative Extinguishing Systems***
Cooking Hood Suppression Systems
Underground Fire Main
Fire Hydrants
Fireplaces/Chimneys
Fire Extinguishers
General Services
Cooking Hood Cleaning
Tanks (Installation/Removal)
Environmental Remediation
Tents
Hot Works/Welding
Other
Please list service
See next page for requirements
DEPARTMENT OF PUBLIC SAFETY
BENSALEM FIRE RESCUE
CONTRACTOR LICENSE APPLICATION
Page 2 of 3 BTFR 08/2018
QUALIFICATIONS (ATTACH SUPPORTING DOCUMENTATION)
REQUIRED SUPPORTING DOCUMENTS FOR ALL CONTRACTORS
A Certificate of Insurance in the amount of $1,000,000.00 each occurrence naming Bensalem Township as
the certificate holder, proof of workman’s compensation insurance, an insurance declaration page and a list
of all employees. Insurance certificate must contain a clause stating the policy will not be cancelled until the
Township of Bensalem is provided a 30 day notice prior to cancellation.
*FIRE ALARM CONTRACTORS*
All fire alarm contractors shall provide a copy of NICET II certification or higher, or submit a certificate of
training from the alarm manufacturer to inspect and install systems.
All plans submitted for fire alarm systems shall be signed and sealed by a P.E. Licensed in PA or NICET III
or higher.
**SPRINKLER CONTRACTORS**
All sprinkler contractors shall provide a copy of NICET II certification or higher to inspect systems.
All sprinkler contractors shall provide a copy of NICET III certification or higher to install systems.
All plans submitted for sprinkler systems shall be signed and sealed by a P.E. Licensed in PA or NICET III.
**SPECIAL HAZARD SUPPRESSION SYSTEMS**
All special hazard suppression contractors shall provide a copy of NICET III certification or higher to install
systems.
All plans submitted for special hazard suppression systems shall be signed and sealed by a P.E. Licensed
in PA or NICET III.
Name:
NICET II
NICET III
NICET IV
PE
(Check One)
Name:
NICET II
NICET III
NICET IV
PE
(Check One)
Name:
NICET II
NICET III
NICET IV
PE
(Check One)
Name:
NICET II
NICET III
NICET IV
PE
(Check One)
Name:
NICET II
NICET III
NICET IV
PE
(Check One)
15
DEPARTMENT OF PUBLIC SAFETY
BENSALEM FIRE RESCUE
CONTRACTOR LICENSE APPLICATION
Page 3 of 3 BTFR 08/2018
INFORMATION OF RECORD
1. Names of Owners, Partners, etc. & Business Trade Name:
2. Statements regarding any other municipalities having refused to issue a license within the last two years:
3. If licensed in other municipalities, please list at least three along with license number:
4. List all convictions within last two years:
5. List all unsatisfied civil judgments in any jurisdiction against the applicant:
6. List contractor jobs completed or accepted within the last two years. At least five are required. Jobs are
not required to have been performed in Bensalem Township.
7. Provide separate list of all employees as required by Bensalem Township Code.
Pursuant to the code of the Township of Bensalem Section 65-46,
I hereby apply for a license with Bensalem Township.
Applicant
Date
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Btfr 20contractor 20license 20application BENSALEM TOWNSHIP

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 11 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document