Fillable PERMIT PROCEDURES ALARM DEALERS The City of Columbus (City of Columbus)

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PERMIT PROCEDURES ALARM DEALERS The City of Columbus (City of Columbus)

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DEPARTMENT OF PUBLIC SAFETY LICENSE SECTION
PERMIT PROCEDURES
ALARM DEALERS
•
Application Completed in its entirely and notarized.
•
Certificate of Insurance in an amount no less than
$1,000,000 (one million)
and
must contain an endorsement providing for 10 day notice of cancellation or change
to the City of Columbus – License Section, 4252 Groves Rd, Columbus,
Ohio 43232
•
•
•
A “Letter of Good Standing” is required from the City of Columbus Department
of Income Tax. Questions on how to obtain this should be directed to
614-645-7370
BCI Background Check: The Company Representative is required to complete a
statewide background check from their state of residence. The License Section can
complete the background at our location for local applicants; at a cost of $32.00.
If you live in a closed record state, where you cannot receive a copy of your
background check, please contact License Officer Glenn Rutter at 614-645-6854.
The City of Columbus has revised Columbus City Code 597, that governs the Alarm Industry.
Please review the code at:
https://www.columbus.gov/public-safety/License-Section/
APPLICATION PROCEDURES
Proof of Identity of Company Representative.
(examples: Copy of Driver’s License or State issued ID).
For new applicants $400.00. For renewals $250.00
Include a Late Renewal Fee of $50.00, if renewing past your expiration date.
Permit Fees
Make checks payable to the City Treasurer - License Section
SUBMIT THE ABOVE REQUIRED INFORMATION TO:
Department of Public Safety
License Section – AlarmUnit
4252 Groves Rd
Columbus, OH 43232
Phone: 614-645-7960
2
LICENSE SECTION
ALARM DEALER
APPLICATION
NEW_________
RENEWAL________
OFFICE USE ONLY
Permit No_________________________
BCI: NH MA OOS
Company Representative
Full Name __________________________________________________________ Date of Birth: ________/_______/__________
Ho
me
Address__________________________________________________________________________________________________
Drivers License #:___________________
Place of Birth: _______________________________
Phone # ____________________
E-mail Address: ___________________________________________________________
List any theft or felony convictions, anywhere in the United States, within the past ten (10) years; if none write "none":
Business Information
Corporate Name_______________________________________________________ Federal I.D. #__________________________
Mailing
Address___________________________________________________________________________________________________
Address City State Zip Code
Corporate Telephone ____________________________________
Business Name (DBA) (If different from above): __________________________________________________
List the company owner's name, date of birth, home address and title.
1._________________________________________________________________________________________________________
Name
Date of Birth
Title
State
Zip Code
ATTACH ADDITIONAL SHEET IF NEEDED
Number
Street Name
City
Home Address
City
State
Zip
Male: ___ Female: ___ Race: ______ Ht: _____Ft ____ In Weight _______ Hair: _______ Eyes: ________
Are you on felony probation or parole? _____________ If Yes date Began: _______ /______ /_________
Have you or your company had a Columbus license/permit revoked, suspended, or refused within the last three (3) year? _________
Business e-mail: __________________________________________________________________
3
ALARM DEALERS
List all companies that you contract to sell, lease, monitor, maintain, service,
repair, alter, replace, move or install any alarm system in or on any building,
structure or facility within the jurisdiction of the City of Columbus.
Select Company Type
Mailing Address City, State
Zip Code
Phone #
Certain information in this application is subject to disclosure as a matter of public record. Any false statement made or given in this
application shall result in denial or future revocation of this permit, as well as criminal prosecution under
Chapter 2321.13 (A-3) (A-5) , Columbus City Codes.
STATE OF ________________, COUNTY OF __________________:
________________________________________________________, being duly sworn, deposes and
(Applicant Name - Print)
says he or she is the individual making the foregoing application; that he or she is knowledgeable with respect to that which is to be
licensed; that the answers to the foregoing questions and other statements contained herein are true of his or her own knowledge and
belief.
____________________________________________________________________
Applicant Signature
Sworn to before me and subscribed in my presence this ______day of ________________, __________.
______________________________________________________
Notary or Agent of Director of Public Safety
My Commission expires: _________________ ___________, 20_______
(Month) (Day) (Year)
Company Name
Authorized Reseller
Installation Company
Monitoring Company
Sales Company
Service / Repair Company
IF NONE WRITE "NONE"
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PERMIT PROCEDURES ALARM DEALERS The City of Columbus (City of Columbus)

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Completed 21 January 2021

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