Fill - Free fillable IDAHO CONTRACTORS BOARD Idaho Division of Occupational and (State of Idaho) PDF form

IDOPL-09/20 CONA/RCT/01-50

IDAHO CONTRACTORS BOARD

Idaho Division of Occupational and Professional Licenses

11351 W. Chinden Blvd., Bldg. #6, Boise ID 83714 or

PO Box 83720, Boise Idaho 83720-0063

Phone: (208)-334-3233 Website: https://dopl.idaho.gov

E-mail: con@dopl.idaho.gov

INSTRUCTIONS FOR

APPLICATION FOR AN INDIVIDUAL CONTRACTOR REGISTRATION

USE THIS APPLICATION ONLY IF YOU ARE AN INDIVIDUAL OPERATING AS A SOLE PROPRIETOR OR WITH AN

ASSUMED BUSINESS NAME (ABN or DBA) WHICH MUST BE REGISTERED WITH THE SECRETARY OF STATE’s

OFFICE. Use the business entity application if you are a business entity including but not limited to general or limited

partnerships, LLPs, LLCs, and corporations.

Application Checklist for an Individual Registration (NOTE: Incomplete applications that do not include all the items listed below will

not be processed and will be returned, which will delay registration):

___ Complete the application. Per Idaho Code § 54-5210(a) every applicant MUST have a Social Security Number. Processing will be

delayed for applications that do not include a social security number or other documentation required under Idaho Code § 73-122.

___ Attach a copy of the certificate of Assumed Business Name (ABN or DBA) from the Secretary of State’s Office if applicable.

___ Enclose the application fee of $50.00

or a copy of your Public Works License. Checks should be made payable to the Idaho Division

of Occupational and Professional Licenses (IDOPL). There is a $20.00 fee for returned checks.

___ Proof of identification – a clear and readable color copy of a government-issued photo ID such as a passport, military ID, or valid

driver’s license for each listed owner must be received with this application.

___ Attach either: (1) a current, effective certificate of worker’s compensation insurance in the name of the individual applying for

registration, or (2) a written

statement

explaining why you are exempt per Idaho Code § 72-212. For information or questions

about workers compensation exemptions, please contact the Industrial Commission on the web

https://iic.idaho.gov/employer-

compliance-division/, by email at suretyrequest@iic.idaho.gov or by phone at the Employer Compliance General Phone Number:

208-334-6060.

Attach a current, effective certificate of general liability insurance including products and completed operations coverage in the

name of the individual applying for registration with a minimum coverage amount of $300,000.00.

___ If you answer Yes to question 12, 13, or 14 regarding prior licensure/registration discipline or previous criminal charges, you must

provide additional information. The additional paperwork should be submitted with the original application or, if necessary, mailed,

faxed or e-mailed to the Division of Occupational and Professional Licenses. Question 14 requires the Disclosure form at the end

of the application to be completed.

___ Mail or deliver the original notarized application, fee, and the attachments to the address listed above. Faxed or e-mailed copies of

an application cannot be processed; originals are required.

TO AVOID DELAYS IN PROCESSING, INCLUDE A COPY OF YOUR CURRENT, EFFECTIVE CERTIFICATE(S) OF

INSURANCE WITH THIS APPLICATION. THE INDIVIDUAL NAME LISTED ON THE APPLICATION AND THE

INSURED NAME ON THE CERTIFICATE(S) SHOULD MATCH.

OTHER INSTRUCTIONS:

•

There may be other requirements for doing business in the State of Idaho. Please consider contacting the Secretary of State’s

Office as part of your Contractor Registration process at www.sos.idaho.gov

or (208) 334-2300.

•

Laws and Rules governing Contractor Registration can be viewed at https://dopl.idaho.gov under the Contractors link.

•

Please be sure to keep a copy of this application for your records. Registrations are non-transferable.

ATTENTION MEMBERS AND SPOUSES OF MEMBERS OF THE ARMED SERVICES

If you are a member of the armed forces, an honorably discharged veteran or the spouse of an active member or veteran of the military, you are entitled

to certain benefits because of your service. Those benefits may include expedited processing of your application and credit for military training that is

relevant to the occupational license/registration for which you are applying, For a full explanation of eligibility and a comprehensive description of

benefits available, see Idaho Code §§ 67-9401-9407

. Additionally, active members of the military may be eligible for a waiver of renewal fees and

other renewal requirements, see Idaho Code § 67-2602A.

Note: The applicant’s signature must be notarized. The applicants must declare the answers provided are true in front of a

notary (jurat). The language “subscribed and sworn” must appear before the applicant’s signature. An “acknowledgement”

where the notary only verifies the identity of the applicant is not acceptable.

IDOPL-09/20 CONA/RCT/01-50

LIST OF IDAHO CONTRACTING TYPES

The code you choose does not limit you to the work you perform.

REF # TYPE

GENERAL CONTRACTOR TYPES:

001 GENERAL COMMERCIAL BUILDER

002 GENERAL RESIDENTIAL BUILDER

003 GENERAL REMODEL BUILDER

004 SUPPLIER

SUBCONTRACTOR TYPES:

010 DEMOLITION / ABATEMENT / MITIGATION

020 EXCAVATION / TRENCHING / SITE PREP

030 SEPTIC SYSTEMS

040 WATER WELL SYSTEMS

050 ROADS / DRIVEWAYS

060 FOOTINGS / FOUNDATION

070 WATERPROOFING

080 CONCRETE FLATWORK

090 FRAMING LABOR & ROUGH CARPENTRY

100 STRUCTURAL STEEL / METAL STUDS

110 ROOFING

120 HVAC**

130 PLUMBING**

140 ALARM / AV / DATA SYSTEMS

150 ELECTRICAL**

160 INSULATION

170 DOORS / WINDOWS

180 DRYWALL / PLASTER

190 PAINTING / WALL COVERINGS

200 WALLPAPERING

210 CABINETS / COUNTERTOPS

220 FINISH LABOR

230 FINISH HARDWARE / MIRRORS / ENCLOSURES

240 STAIRWAY SYSTEMS

250 CLOSET SYSTEMS

260 ACOUSTICAL CEILINGS

270 FINISH FLOORING INSTALLATION

280 FIREPLACES / WOODSTOVES

290 ELEVATORS / DUMB WAITERS

300 FIRE PROTECTION SYSTEMS

310 APPLIANCE INSTALLATION

315 CLEANING SERVICES

320 SIDING / SOFFITS / FACIAS

330 GUTTERS

340 STUCCO / MASONRY / TILE

350 DECKS

360 ORNAMENTAL IRON / RAILINGS

370 CARPORTS

380 ASPHALT PAVING

390 FENCING / GATES / BARRIERS / ENCLOSURES

400 LANDSCAPING / SPRINKLERS / IRRIGATION/TREE

SERVICE

410 POOLS / SPAS

420 TANKS / CONTAINERS

430 SIGNAGE

440 LOG STRUCTURES

450 PRE-ENGINEERED STRUCTURES

460 WELDING

470 HEAVY EQUIPMENT

500 HANDYMAN

**Public Works, HVAC, Plumbing, Construction Manager and Electrical contractors are required to be licensed with the Division of

Building Safety and need only register with the Idaho State Contractors Board if doing work outside of that license.

**Fire Protection Sprinkler contractors are required to be licensed with the Department of Insurance State Fire Marshal and need only

** Pursuant to the Idaho Contractor Registration Act all individuals and entities registered with the Idaho Contractors Board are

registered as “contractors. A contractor’s self-characterization as a “general contractor type” or “subcontractor type” does not mean it

is a general contractor or subcontractor for purposes of the Residential Real Property Lien Disclosure Law (Idaho Code §

45-525).

That

determination depends on the nature of the individual contract between the contractor and the homeowner, prospective real

property purchaser or another contractor. A contractor may be a subcontractor in some instances and at the same time a general

contractor in others. See the following example:

Example: John the concrete contractor is contacted by Phil the homeowner who requests John to provide a quote to construct a

concrete sidewalk and patio for Phil’s house. John quotes Phil a price of $3,000 and Phil accepts the quote. John and Phil enter into a

contract for John’s concrete crew to construct a concrete sidewalk and patio for Phil’s house for $3,000. On the same day John

is also

approached by Chuck the contractor who has a contract to build a house for Ned the prospective residential real property

urchaser. Chuck asks John to provide a quote to construct concrete footings, foundation, sidewalks and driveway pursuant to the

plan for a house Chuck has a contract to build for Ned. John quotes Chuck a price of $25,000 and Chuck accepts the quote. John and

Chuck enter into a contract for John’s concrete crew to construct concrete footings, foundation, sidewalks and driveway for Ned’s

house pursuant to the plan and schedule Chuck provides to John.

In this example as to the contract for a sidewalk and patio for Phil’s house, John is a “general contractor” for purposes of the

Residential Real Property Lien Disclosure Law and must provide disclosures to Phil the homeowner pursuant to its requirements.

the contract for footings, foundation, sidewalks and driveway for Ned’s house, John does not have a disclosure obligation

because

is a subcontractor whose contract is with Chuck, the general contractor. Chuck’s contract is with Ned the prospective real property

purchaser and Chuck must provide disclosures to Ned as required by the Residential Real Property Lien Disclosure Law, including the

requirement to disclose the business name, address and telephone number of John as a subcontractor.

IDOPL-09/20 CONA/RCT/01-50

IDAHO CONTRACTORS BOARD

Idaho Division of Occupational and Professional Licenses

11351 W. Chinden Blvd., Bldg. #6, Boise ID 83714 or

PO Box 83720, Boise Idaho 83720-0063

Phone: (208)-334-3233 Website: https://dopl.idaho.gov

E-mail: con@ibol.idaho.gov

APPLICATION FOR AN INDIVIDUAL CONTRACTOR REGISTRATION

USE THIS APPLICATION ONLY IF YOU ARE AN INDIVIDUAL OPERATING AS A SOLE

PROPRIETOR OR WITH AN ASSUMED BUSINESS NAME (DBA)

I hereby make application for registration as a Contractor in Idaho under the provisions of Title 54, Chapter 52, Idaho Code:

1. Name of Individual:_________________________________________________________________________________

First Middle Last

THE APPLICANT NAME (above) AND THE INSURED NAME (on the certificate of insurance) SHOULD MATCH.

2. Registered ABN/DBA name (if applicable): ______________________________________________________________

An ABN/DBA cannot contain an LLC, INC, or other initials that indicate a legal business entity. Use the

business entity application if you are a business entity including but not limited to general or limited

partnerships, LLPs, LLCs, and corporations

2. Business Address:___________________________________________________________________________________

(This is your Address of Record and is a public record.) Street City State Zip

3. Mailing Address:____________________________________________________________________________________

(Will be a public record if no Business Address above.) Street/PO Box City State Zip

4. Business Phone: (_____) ____________________ Cell or Other Phone: (_____) ______________________

(The above phone number is a public record.) (The above phone number is not a public record.)

5. E-mail: _________________________________________________________________________________

(This is not a public record; required by I.C. § 67-2609.)

6. Date of Birth: _______________ Social Security Number: ____________-________-____________

mm/dd/yyyy This is not a public record; required by I.C. § 73-122.

(Proof of identification – a clear and readable color copy of a government-issued photo ID such as a passport, military ID, or valid driver’s license must be attached.)

7. Are you or your spouse an active member or honorably discharged veteran of the United States Armed Services?

( ) Yes ( ) No

8. Do you have a current Public Works or Construction Manager license in Idaho issued by the Division of Building Safety?

( ) Yes ( ) No

If Yes, you are not required to pay the $50.00 registration fee for this application. Please attach a copy of your Idaho Public Works or

Construction Manager license and enter your license number here: _______________________.

The public works license must be signed.

9. What is your primary type of construction (Ref #) ___________ (Use the attached list and choose only one category that best

describes your business.)

10. You must hold a current, effective general liability insurance policy including products and completed operations

coverage

of not less than $300,000.00 single limit. Do you hold current liability insurance? If yes, please attach the certificate of

liability insurance. If no, your application cannot be processed until this information is received. ( ) Yes ( ) No

THE APPLICANT NAME (above) AND THE INSURED NAME (on your certificate) SHOULD MATCH.

11. Do you hold a current, effective worker’s compensation insurance policy? ( ) Yes ( ) No

If Yes, you must attach the certificate. If No, explain below as to why such coverage is not required under the laws governing

worker’s compensation (Idaho Code §§ 72-101 – 72-230). If you do not know the reason for the exemption, you may contact the

Industrial Commission on the web https://iic.idaho.gov/employer-compliance-division/, by email at suretyrequest@iic.idaho.gov

or by phone at

the Employer Compliance General Phone Number: 208-334-6060.

THE APPLICANT NAME (above) AND THE INSURED NAME (on your certificate) SHOULD MATCH.

_________________________________________________________________________________________________________

Explanation of why such coverage is not required Page 1 of 2

IDOPL-09/20 CONA/RCT/01-50

APPLICATION FOR AN INDIVIDUAL CONTRACTOR REGISTRATION

(continued)

In questions number 12, 13, and 14, “you” refers to the individual owner of a contracting business or a sole proprietor; “you”

also refers to any ownership or management interest you had or have in a contracting business engaged in by a firm,

partnership, limited liability company, limited liability partnership, corporation, trust, association or other entity or

organization capable of conducting business, or any combination thereof acting as a unit. See Idaho Code § 54-5203(6). Also,

please note that in questions number 12, 13, and 14, the phrase “any jurisdiction” refers to the federal government or any city,

county or state including Idaho

12. Have you ever been licensed or registered as a contractor in any state, including Idaho, or other jurisdiction?

( ) Yes ( ) No

(If Yes, list below the jurisdiction and license/registration numbers.)

________________________________________________________________________________________________________

13. Have you ever had a contractor license or registration denied, surrendered, suspended, revoked, or otherwise disciplined in

any state, including Idaho, or other jurisdiction? ( ) Yes ( ) No

(If Yes, a copy of the charges and final order must be received by the Board directly from each issuing authority; also attach a detailed statement

of explanation from the individual or entity involved which includes the jurisdiction, the license/registration number(s), the allegations if you are

aware of them, and any other relevant information.)

14. Have you ever received a conviction, finding of guilt, withheld judgment or suspended sentence for any felony in any state,

including Idaho, or other jurisdiction? ( ) Yes ( ) No

(If yes, the Criminal Conviction Disclosure Form on the following page, official court documents, and probation and parole documents along with

any other relevant information must be received with this application.)

AFFIDAVIT

Upon oath I certify each of the following: (1) the responses and information provided in this application and in the attached addendum(s)

and documentation are true and correct to the best of my knowledge; (2) I am the applicant named in and who has signed this application;

(3) I am a United States citizen or a legal permanent resident or I am otherwise lawfully present in the United States; (4) I have read and

will conform to the Laws and Rules governing the profession for which I am seeking a license or authority to practice; (5) I acknowledge

and agree the use of intentional misrepresentation or fraud in this application or violation of any Laws or Rules governing the profession

for which I am seeking a license or authority to practice shall constitute cause sufficient for denial, suspension, cancellation or revocation

of any license or authority applied for or granted to me; (6) I will provide additional or corrected information if material changes occur

which would cause responses or information provided in or with this application to be inaccurate or incomplete; (7) I authorize and direct

any person, agency, firm, or other entity to release, upon the request of the Idaho Division of Occupational and Professional Licenses or

its authorized representative, any information, communication, report, record, statement, disclosure, or recommendation that may have

bearing on my eligibility for or maintenance of the license or authority for which I am applying and hereby release and exonerate any of

them from any liability of any kind resulting from the release or collection thereof; and (8) I authorize the Division of Occupational and

Professional Licenses to release to any other regulatory entity in any jurisdiction any information requested about me that may otherwise

be protected or confidential that may have bearing on my eligibility for or maintenance of any license or authority issued or applied for in

this or any jurisdiction and hereby release and exonerate them from any liability of any kind resulting from the release thereof.

_______________________________________________ _________________________________________________

Print Applicant Name Signature of Applicant

Note: Please print and sign your full legal name

State of _______________, County of ___________________, ss

Subscribed and sworn before me this _____ day of ______________________________, 20 ___

(seal) Notary Public Official Signature

My Commission Expires

IDOPL-09/20 CONA/RCT/01-50

Disclosure Statement Regarding Criminal Conviction

Use this form only if you answered yes to Question 14

Please complete one form for each conviction, regardless of when the crime was committed or whether it was a withheld

judgement or suspended sentence. All fields must be completed. If the question does not apply, please write NA in the

box.

FAILURE TO REPORT A CONVICTION IS CONSIDERED FALSIFICATION OF THE APPLICATION AND MAY RESULT IN THE DENIAL

OF LICENSURE.

You will need to also submit copies of the official court documents and probation/parole documents.

Applicant Name:

Conviction Date:

Court Case or Docket

Number:

Court Name and Location:

Crime:

Sentence: (Please

describe any punishment

imposed by the court.)

Incarceration Date

Release Date:

Probation/Parole Date:

Release Date:

Fines (amount)

Paid?

Yes No

Restitution (amount)

Paid?

Yes No

Please provide a brief description

of the crime:(Provide additional

details on an attached additional

pages as needed.)

Rehabilitation Efforts: (What

positive changes have you made

in your life since this conviction?

Please attach documentation to

support the rehabilitation

efforts.)

For Official IDOPL Use Only

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