Fillable General Contractor Certificate of Competency Application Information and (Broward County)

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General Contractor Certificate of Competency Application Information and (Broward County)

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General Contractor
Certificate of Competency Application Information and Instructions
You must submit your application package in the following order:
1. Fully completed application
2. Affidavits
3. Credit references
4. Credit report
5. Corporate documents
Experience
In order to apply, you must have the following practical construction experience:
• Class A General Building Contractor ................. 6 years
• Class B General Building Contractor ................. 4 years
• Class C Residential Building Contractor ............ 3 years
Class A General Building Contractor
Unlimited as to height, area and complexity of the construction.
Class B General Building Contractor
Limited to construction of commercial buildings and single or multiple dwelling residential buildings not
exceeding three stories in height and accessory use structures in connection therewith; or those whose
services are limited to remodeling, repair or improvement of any size building if the services do not
affect the structural members of the building.
Class C Residential Building Contractor
Limited to construction, remodeling, repair or improvement of one, two or three family unit residences
not exceeding two stories in height and accessory use structures in connection therewith.
Appearing Before the Board
The Board has set a high threshold for approval when considering an application for a General
Contractor’s Certificate of Competency. When submitting your application, we recommend you request
to appear before the Board so you may answer any questions about your application. This will help
expedite your application. The Board highly recommends that, if possible, you ask a county or state
certified General Contractor to accompany you to the meeting in order to speak to your prior practical
construction experience and how it qualifies you to take the exam.
Environmental Protection and Growth Management Department
BUILDING CODE SERVICES DIVISION
1 North University Drive, Box #302 • Plantation, Florida 33324
954-954-765-4400 • Broward.org/building
Print
2
Affidavits
Please advise anyone preparing an affidavit that they may be contacted by Broward County to verify
information provided. Affidavits must be submitted to substantiate the aforementioned required
experience. Affidavits must be completed by your present or former licensed contractor employer.
Types of affidavits accepted:
• One notarized affidavit from a State of Florida or Broward County licensed contractor of equal or
higher category of license than the one for which you are applying for; or
• One notarized letter from a licensed architect or engineer verifying required experience for the
specific type of work performed; or
• Three notarized affidavits from out-of-state licensed contractors, with license numbers included,
verifying the required experience for the specific type of work performed.
References
Please provide at least three credit references as follows:
• At least one from a local financial institution stating your accounts are in good standing.
• Two letters from supply houses or other similar business entities you have done business
with.
All letters of reference should be notarized, include a contact number and, if applicable, a certificate of
competency number. Providing more than the minimum number of required letters of reference will only
enhance your application. The Board may or may not consider, at its discretion, letters of reference
from homeowners you have performed work for.
Personal Credit Report
The Board highly recommends that you pull your credit report just prior to submitting your application.
This will ensure the Board is presented with the most current information pertaining to your credit
history. However, reports dated within 12 months or less may be used. If your report is over 90 days
old, it must be accompanied by a notarized affidavit stating no material change has occurred since its
preparation and that is substantially represents your current financial condition.
Your personal credit report must include your credit score. If the credit score is less than 550, you
will have to appear before the Board to explain any area(s) of concern.
Business Credit Report
If you already have an active corporation, you should also provide a credit report for your business –
also including the credit score.
3
Personal Financial Statement
If you have a personal financial statement, please include it with your application. If you do not, please
include copies of your most recent bank statements.
Corporate Financial Statement
If you already have an active corporation, please provide a comprehensive financial statement –
notarized by your accountant. The financial statement should not be over 180 days old. If over 90 days
old, it needs to be accompanied by a notarized affidavit stating that no material change has occurred
since its preparation and that is substantially represents your current financial condition and the
business organization.
Project List
The Board highly recommends inclusion of a project list for those applying for a Class “A” or Class “B”
contractor license. The project list should include construction projects worked on during the required
period of experience.
Fictitious Corporate Name
If the firm is not incorporated but is operating under a trade name – other than your proper name – the
company must conform to Florida Statute 865.09 and must be properly registered with the Florida
Division of Corporations.
Business Organization
If you are qualifying a corporation, you are required to provide:
• A
copy of the front page of your Article of Incorporation
• A copy of the page listing the corporate officers
• A written statement from the Secretary of State certifying the corporation is current
Certificates of Insurance
After you have passed your exam, you will be required to submit certificates of insurance. Reciprocity
applicants will be required to submit insurance at the time of application. The minimum liability
insurance amounts are:
• Bodily Injury ..........................$300,000
• Property Damage* .................$50,000
*for any one accident, including damage to rights-of-way and/or shrubbery
4
Worker’s Compensation Insurance
In addition to the certificates of insurance previously listed, you will need to submit proof of worker’s
compensation insurance or a waiver stating exemption from Florida’s Worker’s Compensation law.
Each certificate must list as a certificate holder:
Broward County Building Code Services Division
1 North University Drive, Mailbox 302
Plantation, Florida 33324
All Certificates must provide at least 30 days advance notice of cancellation
Photographs
You must include two passport-sized photos of yourself taken within the last three months.
Processing Fee
• $200
Please make checks payable to: Broward County Board of County Commissioners
All fees are non-refundable
Notification
After the Board reviews your application, you will be advised of their decision by letter – or if you
choose to appear before the board, at the meeting.
Testing
Once approved, your contact information will be sent to Gainesville Independent Testing Service, LLC
(GITS). They will contact you to schedule your exams.
Applicants are required to pass a Trade and Business Exam with a minimum passing score of 70%
Answer all questions in full, please type or print clearly with sufficient detail to determine if you are
qualified to take the examination. If not applicable indicate N/A. Attach additional sheets if necessary.
5
Environmental Protection and Growth Management Department
BUILDING CODE SERVICES DIVISION
1 North University Drive, Box #302 • Plantation, Flor
ida 33324 • 954-765-4400 • broward.org/building
General Contractor
Application for Certificate of Competency
New License License by Reciprocity
Contractor Classification:
Class A
General Building Contractor
Class B
General Building Contractor
Class C
Residential Building Contractor
Notice of Collection of Social Security Numbers for Government Purposes
Under the Federal Privacy Act, disclosure of social security numbers is voluntary unless specifically required by federal statute.
In this instance, social security numbers are mandatory pursuant to Title 42 United States Code, Sections 653 and 654: and
Sections 409.2577 and 409.2598, Florida Statutes, to allow efficient screening of applicants and licenses by a Title IV-D child
support agency to assure compliance with child support obligations. Social security numbers must also be recorded on all
professional and occupational license applications and will be used for licensee identification pursuant to the Personal
Responsibility and Work Opportunity Reconciliation Act of 1996 (Welfare Reform Act).
Personal Information
Last Name First Name Middle Initial Suffix
Home Address
City
State
Zip
Home Phone Mobile Phone
Email
Place of Birth
Date of Birth
Height Weight Hair Color Eye Color
Business Organization Information
I am qualifying as a:
Sole Proprietor
Partnership
Corporation
Business Name
Business Address City State Zip
Business Phone Business Mobile Phone Business FAX
Email
ATTACH
TWO
1
½”
x 1
½”
PHOTOS
HERE
6
Have you ever:
Yes No
Been convicted, adjudication withheld, and/or you plead nolo contendere (no contest) to a felony or first degree misdemeanor,
including but not limited to the following crimes, dishonesty, fraud, deceit, or lack of integrity in the operation or conduct of the
applicant’s business, occupation, or trade. Please provide official disposition documents from the court of law for any
adjudication, conviction, withheld adjudication or nolo contendere.
Date Location Charges Disposition
Yes No
Contracted or done work outside the scope of operation, as set out in the definition of the particular type of contractor for which
y
ou are qualifying?
Abandoned without legal excuse, a construction project or in which you were engaged or under contract as a contractor or
subcontractor?
Diverted Funds or property received for execution or completion of specific construction project or operation, or for a specific
purpose, to any other use whatsoever?
Departed from or disregarded in any material respect, the plans of the owner or his duly authorized representative?
Disregarded or violated in the performance of your contracting business, any of the building, safety, health insurance, or
workmen’s compensation laws of the State of Florida, or the regulations of Broward County?
Misrepresented any material fact in your application and supporting papers in obtaining a license?
Failed to fulfill your contractual obligation through inability to pay all creditors for material furnished, work or services
performed, in the operation of your business for which you are licensed?
Aided or abetted an unlicensed person to evade the licensing requirements of Broward County, or allowed your license to be
used by an unlicensed person or acted as an agent, partner, or associate of an unlicensed person with the intent to evade the
licensing requirements of Broward County?
Been guilty of any fraudulent act as a contractor or sub-contractor, by which another is substantially injured?
Filed bankruptcy in business?
If you answered yes to any of the above questions, please explain on a separate sheet of paper
7
Employment History
List your record of employment, beginning with your most recent employer, to demonstrate your practical and required
experience in the construction field. Include any and all businesses that you have owned, operated, managed or you have had
an active part in. Please explain any gaps in employment on a separate sheet. If your employment history exceeds the space
provided, please provide on an additional sheet and attach to this application.
Employer 1
Date Hired
End Date
Business Name
Business Address City State Zip
Business Phone Business Mobile Phone
Business Email
Last Position Held
Reason for Leaving
Specify Type of Work
Employer 2
Date Hired
End Date
Business Name
Business Address City State Zip
Business Phone Business Mobile Phone
Business Email
Last Position Held
Reason for Leaving
Specify Type of Work
8
Education History
College
Name
Address City State Zip
Degree
Trade School
Name
Address City State Zip
Degree/Certification
High School
Name
Address City State Zip
Degree
Certificates of Competency
Certificate Type
Certificate Number
Date Issued
Date Expires
Place Issued
By Exam
Yes No*
Yes No*
Yes No*
*If not issued by exam, please explain:
Are you aware that all answers made on this application constitute a sworn statement by you?
Yes No
I certify that the above information and any attachments to this application are true and correct under penalty of law.
I further understand that the Broward County Building Code Services Division may deny this application based on
my history, failure to disclose information, and/or information that is false or misleading.
Signature Date
NOTARY PUBLIC
State of Florida )
) SS
County of )
The foregoing instrument was acknowledged before me this ____ day of __________________, 20___, by _______________________
who is personally known to me, or who has produced ___________________________________________________________________
as identification, and who did take an oath.
__________________
____________________
(Seal) Notary Public in and for the State of Florida
9
Affidavit of Experience
Provided by:
Employer Self Employed Employer No Longer in Business
This is to certify that:
Is/was employed by
Business Address City State Zip
From To Total Length of Time
The specific type of work performed consisted of the following:
Remarks (if any)
I am the qualifier for the above mentioned firm or corporation and hold a current Certificate of Competency
Card Number
Issued By
Type of Contractor
Contact Phone Number
By signing this affidavit, I understand that if I am found to be providing false statements related to the applicant’s
experience and competency, then as a contractor licensed by Broward County I face penalties up to and including
licenses suspension and revocation. If I am licensed by another county, state, or professional agency other than
Broward County, then I understand a letter from the Contracting Licensing Board for the General Construction and
Specialty Trades will be sent to my licensing authority making them aware of any false or misleading statements I
may have made in this affidavit.
Signature
Date
NOTARY PUBLIC
State of Florida )
) SS
County of )
The foregoing instrument was acknowledged before me this ____ day of __________________, 20___, by _______________________
who is personally known to me, or who has produced ___________________________________________________________________
as identification, and who did take an oath.
__________________
____________________
(Seal) Notary Public in and for the State of Florida
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Completed 27 August 2020

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