Fillable Clb Application (Warren County Kentucky)

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Clb Application (Warren County Kentucky)

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U.S.A. forms for Warren County Kentucky

BROWSE WARREN COUNTY KENTUCKY (KY) FORMS

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Bob Appling, Executive Director
1141 State Street, Suite 200 – PO Box 1268 – Bowling Green, KY 42102-1268
Office: (270) 781-3530 / Fax: (270) 781-3481
CONTRACTORS LICENSE APPLICATION
General Contractor ($250)
• Pulls permits for building or Remodeling
• Construction Management
• Has two subcontractors or more per project
Specialty Contractor ($100)
• Specializes in a particular trade
• Maximum of one subcontractor per project
License Requirements
• Complete Contractors License Application Form
• Provide Certificate of Insurance listing the Contractors Licensing Board, PO Box 1268, Bowling
Green, KY 42102 as Certificate Holder showing proof of a minimum of $100,000 General
Liability and Workers Comp coverage (if there are no employees ask for an Affidavit of
Exemption form)
• Pay the required fee by check, cash, money order or credit card. Checks or money orders should
be made payable to Contractors Licensing Board.
• Please Note if working within the Bowling Green city limits, you are required to obtain a Bowling
Green Occupational License. This may be obtained by contacting the Finance Department at the
Bowling Green City Hall Annex or by phoning (270) 393-3000.
ATTENTION
The fees for a Bowling Green/Warren County Contractors License are NON-REFUNDABLE. Should you
be unable to perform work as a General or Specialty Contractor in Bowling Green/Warren County as
anticipated or otherwise cease doing business, you will not be entitled to a refund any portion of your
license fee. In addition to the Bowling Green/Warren County Contractors License, there may be other local,
state, or federal regulations governing your trade or specialty. The Contractors Licensing Board does not
warrant that you are otherwise qualified to perform your trade or specialty by the issuance of a license. Any
change in ownership nullifies previous licenses and shall require a new application to be submitted.
GENERAL CONTRACTOR SPECIALTY CONTRACTOR
COMPANY NAME _____________________________________________________________________
SOLE PROPRIETORSHIP PARTNERSHIP LLC CORPORATION
OWNER/PARTNER/CORP OFFICER ___________________________________
OWNER/PARTNER/CORP OFFICER ___________________________________
OWNER/PARTNER/CORP OFFICER ___________________________________
OWNER/PARTNER/CORP OFFICER ___________________________________
MAILING ADDRESS
________________________________________________________________________________________________________
STREET CITY STATE ZIP
STREET ADDRESS
_________________________________________________________________________________________________________
STREET CITY STATE ZIP
PHONE __________________________________ SOCIAL SECURITY # ______________________
CELL __________________________________ FEDERAL TAX ID # ______________________
FAX __________________________________ B.G. OCCUPATIONAL # ______________________
E-MAIL __________________________________ W.C. OCCUPATIONAL # ______________________
STATE LICENSE NUMBERS (IF APPLICABLE):
KY ELEC MASTER # __________________ EXPIRATION DATE __________________
KY ELEC CONTRACTOR # __________________ EXPIRATION DATE __________________
KY PLUMBING MASTER # __________________ EXPIRATION DATE __________________
KY HVAC MASTER # __________________ EXPIRATION DATE __________________
KY FIRE PROTECTION # __________________ EXPIRATION DATE __________________
A CERTIFICATE OF GENERAL LIABILITY INSURANCE LISTING THE BG/WC CONTRACTORS
LICENSING BOARD AS CERTIFICATE HOLDER MUST ACCOMPANY THE COMPLETED
APPLICATION. WORKERS COMPENSATION INSURANCE MUST BE LISTED ON THE
CERTIFICATE COVERING ANY AND ALL EMPLOYEES.
❏ ACOUSTICAL TREATMENTS
❏ CARPENTRY
❏ CARPETING
❏ CERAMIC TILE
❏ COMMUNICATIONS
❏ CONCRETE
❏ CONVEYING SYSTEMS
❏ DEMOLITION
❏ DOORS AND WINDOWS
❏ DRYWALLING
❏ EARTHWORK
❏ ELECTRICIAN
❏ EXCAVATION
❏ FENCING
❏ FIRE PROTECTION
❏ FLOORING
❏ FRAMING
❏ GRADING
❏ HANDYMAN
❏ HVAC
❏ INSULATION
❏ LANDSCAPING
❏ LIGHTING
❏ LIQUID HEAT TRANSFER
❏ MASONRY
❏ METAL FABRICATIONS
❏ ORNAMENTAL METALS
❏ PAINTER
❏ PAVING AND SURFACING
❏ PLUMBER
❏ REFRIGERATION
❏ RESILIENT FLOORING
❏ ROOFING
❏ SIDING
❏ SIGNS
❏ SITE IMPROVEMENTS
❏ SOIL TREATMENT
❏ STEEL
❏ SUBSURFACE EXPLORATION
❏ THERMAL AND MOISTURE PROTECTION
❏ UTILITY CONTRACTOR
❏ WALL COVERINGS
❏ WASTE WATER DISPOSAL AND TREATMENT
❏ WINDOW REPLACEMENT
❏ WOOD FLOORING
❏ OTHER _______________________________________
CHECK ALL WHICH DESCRIBE BUSINESS
❏
GENERAL CONTRACTOR
❏
CONSTRUCTION MANAGER
❏
HOME BUILDER
❏
REMODELER
❏
SPECIALTY CONTRACTOR
The undersigned does hereby certify the accuracy of the submitted information.
Signature: X _____________________________________________ Company Name: _________________________________________
Date: __________________________________________________________
NOTICE
No person shall undertake any work as a general contractor or as a specialty contractor without first obtaining a license from the Contractor’s
Licensing Board. The Board is also authorized to bring necessary legal action, including cease and desist orders, against unlicensed contractors
in order to protect the public health, safety and welfare. BG 6-15.09.
In addition to any other penalties provided in this Ordinance, any person found violating this Ordinance may be fined in an amount not to
exceed five hundred dollars ($500.00). In addition, no contract for the performance of any act for which a license is required by this Ordinance
shall be enforceable by the general contractor or specialty contractor unless the contractor was properly licensed at the time the work was
performed. BG 6-15.10. ALL LICENSE FEES ARE NON-REFUNDABLE.
LICENSE NUMBER: ____________________________________________________ VALID FROM _______________TO ________________
APPROVED: ___________________________________________________________ FEE COLLECTED: ______________________________
DATE RECEIVED: ______________________________________________________ CHECK NO.: ___________________________________
1141 State Street, Suite 200 – PO Box 1268 – Bowling Green, KY 42102-1268
Bowling Green – Warren County
CONTRACTORS LICENSING BOARD
Bob Appling Office: (270)781-3530 / Fax:(270)781-3481 Holly Warren
Executive Director www.bgky.org/contractorslicensing Office Manager
CREDIT CARD AUTHORIZATION FORM
Please circle the appropriate card: Mastercard Visa Discover American Express
Company name: _____________________________________________________
Cardholder Name: _____________________________________________________
Billing Address: _____________________________________________________
City, State, Zip: _____________________________________________________
Phone: _____________________________________________________
Fax: _____________________________________________________
Cell: _____________________________________________________
Credit Card number: ____________________________________________________
Expiration Date: _____________________________________________________
CVV2 Code (3 digit code on back of card):__________________________________
License Fee: __________________________________
Handling Fee: (add $4.00 for Specialty)
or
(add $10.00 for General ) __________________________________
Total: __________________________________
I AGREE TO PAY THE ABOVE TOTAL AMOUNT ACCORDING TO THE CARD
ISSUER AGREEMENT (MERCHANT AGREEMENT IF CREDIT VOUCHER).
__________________________________________ ________________________
CARDHOLDERS SIGNATURE DATE
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Clb Application (Warren County Kentucky)

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Completed 25 July 2020

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