Active Expired Suspended Revoked

General Contractor Carpenter Electrician Plumber Heating and Ductwork Roofing Drywaller Painter Architect Designer Utility Other Contractor

Yes No

Yes No

Have you previously held this type of registration?

If Other

Name on License

Cell #

Is this a continuous bond?

Bond Date

Primary Contact Information (Certificate Holder)

First Name

Address

Additional Documents Required

Board Decision

A completed application will include the following:

• $50 Contractor Registration Fee, payable by phone, mail or in person. Make checks payable to City of Pontiac.
• A copy of professional license for plumbing or roofing contractors.
• $5,000 Permit Bond.
• Certificate of Insurance for at least $500,000 in liability insurance, with City of Pontiac as the Certificate Holder.

Provide a description of the work being done.

To attach a document, click "Upload New Files" button, select the file to be attached, and click open.

I hereby certify that, to the best of my knowledge and belief, all statements made herein or attached are complete and accurate. I understand that any false statements later disclosed may cause loss of my right of registration, and may subject me to prosecution under IL Revised Code Section 2921.13

Hearing Date

Certification

If YES, which board?

If YES, provide the Previous License #

Email

Liability Date

Last Name

Contractor Registration Application

Phone #

Signature

Contractor Name

Contractor Type

Fee Schedule

Contractor Information

Previous License Date Expiration

City, State, ZIP

Have you ever been summoned before any Contractor Board of Review for any type of violation hearing?

The fee for a Contractor's License.