Time of Sale (TOS)
License Application
City Clerk
Business Licensing
1800 W. Old Shakopee Road
Bloomington MN 55431-3027
PH 952-563-8728
MN RELAY 711
BloomingtonMN.gov
53_133 TOS License Application pg1 of 2 (08/19)
Continue to page 2
(Office Use Only)
Date Application received __________________ Payment entered ________________________
Date Mailed ____________________________
Renewal Application Number: LCCL______________________
To renew your Time of Sale (TOS} license, complete and sign this application.
Return with payment of $ ___________________ to the City of Bloomington.
You may email the 2 page application to businesslicensing@bloomingtonmn.gov and call in a credit card; or pay by
check thru the mail; or pay in person with cash, check or credit card.
APPLICANT
Identication
Evaluator Name ________________________________________________ Phone (____) _____ - ________
Business Name ________________________________________________ Phone (____) _____ - ________
Address _______________________________________ City _______________ State ___ Zip __________
E-mail Address ___________________________________________________________________________
Minnesota Business Tax ID Number ___________________________ or,
Federal Business Tax ID Number _____________________________ or,
Applicant Social Security Number _____________________________
REQUIRED per
Minnesota Statute 270C.72
Proof of Workers Compensation Insurance Coverage:
Insurance company name____________________________________ Dates of coverage _______________________
Policy number/Self-insurance permit number (Per Minnesota Statute Section 176. 182) __________________________
Or,
I am not required to have workers compensation liability coverage because:
I have no employees. (See Minn. Stat.§ 176.011, subd. 9 for the denition of an employee.)
I am self-insured for workers compensation (include a copy of authorization to self-insure from the Minnesota
Department of Commerce).
I have employees but they are not covered by the workers compensation law. (See Minn. Stat. § 176.041 for a list of
excluded employees.) Explain why your employees are not covered:
____________________________________________________________________________________________
Other: ______________________________________________________________________________________
businesslicensing@bloomingtonmn.gov
53_133 TOS License Application pg2 of 2 (08/19)
Time of Sale (TOS) Licence Application
Acknowledgement of Continuing Education Credits
Independent Time of Sale Evaluators
I, ________________________________________ (please print name) hereby swear that I have completed 18 hours
of approved continuing education credits in ________________. The burden of demonstrating that courses impart
appropriate and related knowledge in the regulated industry is upon the person seeking approval or credit. Continuing
education credits MUST be completed before renewing your license. You may be subject to enforcement action including
license suspension or revocation and/or a civil penalty.
The City of Bloomington requires verication by the building official of your 18 continuing education credits each year to
maintain your license. Proof of continuing education credits from the previous year may be requested at any time.
Signature ___________________________________________________________________ Date ________________
CODE OF ETHICS FOR TIME-OF-SALE HOUSING EVALUATORS
1. The Evaluator will be responsible at all times to execute his/her duties with due care and in good faith, in compliance
with the Laws and Regulations of the City of Bloomington and the Evaluator’s Code of Ethics.
2. The Evaluator will not discriminate in providing services and establishing fees on the basis of sex, marital status,
national origin, sexual orientation, race, disability, or religious preference.
3. The Evaluator shall not act as an Evaluator during any time he/she may be under the inuence of alcoholic beverages
or using any form of drug or narcotic not specically prescribed by a Doctor of Medicine.
4. The Evaluator shall not knowingly re-evaluate any premises within the time period for which the original evaluation
remains valid without the prior approval of the City’s Review Evaluator, or use the forms supplied by the City for any
use other than evaluations required by Chapter 14.418.
5. The Evaluator, while acting as such, shall not engage in conduct that in any way is in violation of any law or ordinance
or is in contravention of good order and decorum.
6. The Evaluator will be responsible to notify the City of Bloomington Review Evaluator of all complaints led regarding
the Evaluators services.
7. The Evaluator shall not prepare or submit to a homeowner or to the Building and Inspection Division any completed
form knowing it or any entry therein to be false. All evaluations made shall be completed upon the forms authorized by
the City and shall be submitted to the City within seven (7) calendar days of the evaluation.
8. An Evaluator summoned in writing to appear before the City Council shall respond to such summons on the date and
at the time and place indicated.
9. An Evaluator shall not evaluate any property in which the Evaluator has an interest.
10. An Evaluator who is also licensed by the State of Minnesota to sell real estate shall not ;valuate any property required
to be evaluated by Chapter 14.413, which said Evaluator has listed or is showing or attempting to sell. An Evaluator
shall not be in the employ of a real estate sales person or broker and evaluate any property for which such employer
has a listing agreement. An Evaluator shall not engage in business practices with any person in the real estate eld
when such a practice could be construed to be collusion.
11. An Evaluator shall not solicit for sale or solicit or perform repair work for any person, rm or organization on any
property the Evaluator has evaluated.
A VIOLATION OF ANY OF THE GUIDELINES MAY RESULT IN SUSPENSION OR REVOCATION OF AN EVALUATOR’S
LICENSE OR DENIAL OF A RENEWAL OF SUCH LICENSE.
I, THE UNDERSIGNED, HAVE READ AND UNDERSTAND THE TIME-OF-SALE ORDINANCE AND THE CODE OF
ETHICS FOR TIME-OF-SALE HOUSING EVALUATORS.
Signature ___________________________________________________________________ Date ________________
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