Fillable City of Pompano Beach Contractor Record Maintenance (City of Pompano Beach)

Fill Online, Printable, Fillable, Blank City of Pompano Beach Contractor Record Maintenance (City of Pompano Beach) Form

Use Fill to complete blank online CITY OF POMPANO BEACH (FL) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

City of Pompano Beach Contractor Record Maintenance (City of Pompano Beach)

On average this form takes 3 minutes to complete

The City of Pompano Beach Contractor Record Maintenance (City of Pompano Beach) form is 1 page long and contains:

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

Country of origin: US
File type: PDF

U.S.A. forms for City of Pompano Beach

BROWSE CITY OF POMPANO BEACH (FL) 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
 
City of Pompano Beach
Department of Development Services
Business Tax Receipt Division
100 W. Atlantic Blvd Pompano Beach, FL 33060
Contractor Record Maintenance
Phone: 954.786.4668 / 954.786.4633 Fax: 954.786.4666
NO PERMIT WILL BE ISSUED WITHOUT THE COMPLETION AND APPROVAL OF
THIS APPLICATION.
Business
name___________________________________________________________________________
Business address_________________________________________________________________
City_______________________________________________ Zip____________________
Email_____________________________________________________________________
Business phone____________________________Number of Employees ____________________
Qualifier’s name__________________________________________________________________
Home address____________________________________________________________________
City_______________________________________________ Zip____________________
Email_____________________________________________________________________
Home phone_______________________________
If you hold a Broward County Competency Card, the following items must be submitted:
• Broward County Certificate of Competency and State Registration (if applicable) (FS
489.115)
• Liability and Worker’s Comp Insurance, the City of Pompano Beach must be the
certificate holder (City of Pompano Beach, P.O. Drawer 1300, Pompano Beach, FL
33061) (FS 489.114 and FS 489.115)
• Worker’s Comp Exemption (if applicable) (FS 440.10)
If you hold a State Certification, the following items must be submitted:
• State Certification (FS 489.115)
• Liability and Worker’s Comp Insurance, the City of Pompano Beach must be the
certificate holder (City of Pompano Beach, P.O. Drawer 1300, Pompano Beach, FL
33061) (FS 489.114 and FS 489.115)
• Worker’s Comp Exemption (if applicable) (FS 440.10)
NOTE: For more than one qualifier, please complete one form for each qualifier. Same business
name must be indicated on each document.
G:\Zoning 2009\Forms \Website\BTR\PDF\contractor_registration.pdf Modified: 7.22.2016
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

City of Pompano Beach Contractor Record Maintenance (City of Pompano Beach)

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 14 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document