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1 of 19State of FloridaDepartment of Business and Professional RegulationElectrical Contractors’ Licensing BoardApplication for Initial Certification by ExaminationForm # DBPR ECLB 1APPLICATION CHECKLIST – IMPORTANT – Submit all items on the checklist below with yourapplication to ensure faster processing.APPLICATION REQUIREMENTSALL License Applicants must submit: Fees: If applying for Inactive status- 55. If applying for Active status- 300. Make check payable to the Florida Department of Business and Professional Regulation. W-2 forms for each year of experience required for employment verification. Credit report on the applicant from a nationally recognized credit reporting agency, which includes a publicrecords statement that records have been checked at local, state, and federal levels. For a list of acceptableagencies visit ments/cilb credit reporting agencies.pdf. School transcripts, if using education as part of experience requirement. Supporting legal documentation, if necessary. See Sections 2(m-n) of Instructions. Proof of satisfaction of liens, judgments, and discharge of bankruptcy, if applicable. Copy of professional engineering license and transcripts if applying under qualification as professional engineer. Optional if applying for Alarm Contractor I - you may submit a copy of your NICET Level III or highercertifications in lieu of job lists.ACTIVE License Applicants must also submit: If qualifying a business- Credit report on the business to be qualified from a nationally recognized credit reporting agency, whichincludes a public records statement that records have been checked at local, state, and federal levels. Fora list of acceptable agencies /documents/cilb credit reporting agencies.pdf.Please mail your completed application, documentation and required fee(s) to:Department of Business and Professional Regulation2601 Blair Stone RoadTallahassee, FL 32399-0783INSTRUCTIONSIf you have any questions or need assistance in completing this application, please contact theDepartment of Business and Professional Regulation, Customer Contact Center, at 850.487.1395.1. General Requirements for Certificationa. Applicants must be at least 18 years of age, be of good moral character, meet theeducation/experience requirements, and pay all applicable fees.b. This form is required if you are applying to become a certified electrical, alarm or electricalspecialty contractor based on having taken and passed the State of Florida Examination.c. Passing exam scores must be less than 2 years old.2. Application Instructions (by section)a. Section I- Application Typei.Select the transaction you wish to conduct. An active license will allow you to performwork as an electrical/alarm or specialty contractor, an inactive license cannot be used forcontracting.ii.If you hold a registered electrical/alarm or specialty license please list the license numberon the application in the space provided. When your certified license is issued yourregistered license will be cancelled if it is in the same category.b. Section II - Applicant Personal Informationi.Fill out each section completely. A Social Security number is required to apply for anyindividual license within the Department of Business and Professional Regulation.ii.In the Full Legal Name section provide your full legal name as it appears on your SocialSecurity card. Do not use any nicknames or initials. Please list any aliases or prior namesin the prior name information section.DBPR ECLB 1 Initial Certification by Examination Eff. date: April 2021Incorporated by Rule: 61-35.012
2 of 19iii.Provide your mailing address. This will be used for sending correspondence regardingyour application and license.iv.Contact information is often used to quickly resolve questions with applications bytelephone call or email. If contact information is not provided, questions regardingapplications will be mailed to the applicant’s mailing address and may take longer toresolve.v.Additional contact information is optional and will be used when the applicant cannot bereached using their primary contact information.vi.Applicants must provide information on current or prior licenses held in Florida or anyother state, territory, or jurisdiction of the United States or in any foreign nationaljurisdiction.vii.Applicants must provide information on any prior names or aliases used by applicant. Ifthe name on supporting documentation does not match the applicant’s legal name, thealias used in the supporting documentation must be provided in this section. Failure to doso will result in a deficient application.c. Section III – Statement of Financial Condition(1)Please indicate the type of business organization you are applying to qualify.d. Section IV– Business to be Qualified Informationi.Complete this section entirely.ii.Provide the name of the business to be qualified as it is registered with the FloridaDivision of Corporations.iii.The “Doing Business As” (D/B/A) name must be provided as it is registered with theFlorida Division of Corporations, if the business uses a fictitious name to conductbusiness.iv.Applicants must provide the Federal Employer Identification Number (FEID) for thebusiness to be qualified. Please be aware that as an individual or sole proprietorship youmay not be eligible for the workers’ compensation exemption – please contact theDepartment of Financial Services, Division of Workers’ Compensation and determinehow you need to be licensed in order to qualify for the exemption.v.Applicants must provide the business location address of the business to be qualified.e. Section V– Liability Insurance and Workers’ Compensationi.Applicant must answer questions 1 and 2 in this section. Applicant is required to obtainthe required insurance as listed on the application and workers’ compensation coverage.Information regarding workers compensation insurance and exemptions is available bycontacting contact the Department of Financial Services, Division of Workers’Compensation. If applying for Inactive Status this section does not need to becompleted.f. Section VI– Qualifier Informationi.If the applicant is a primary qualifier he/she is required to have financial and supervisoryauthority for the business. Without this authority an applicant will not be approved.ii.Applicants must state whether the business to be qualified is already qualified by anothercontractor. If so, provide the qualifying contractor’s name and license number in thespaces provided.iii.If the applicant is a secondary qualifier he/she must have supervisory authority over allsites where their license is used to pull the permit. An applicant cannot apply to be asecondary qualifier unless there is a licensed electrical/alarm or electrical specialtycontractor already designated as a primary qualifier for the business.iv.Secondary qualifiers will automatically become primary qualifiers if the primary qualifierceases qualifying the business and a new primary qualifier is not designated within 60days.g. Section VII– Qualification for Licensurei.Indicate which qualification you are applying under. In order to qualify for licensure youmust meet one of the following experience requirements. The applicant will have toprovide documentation to prove experience.(1)Must have three (3) years of management experience in the trade ofelectrical/alarm/specialty contracting within the last six (6) years immediatelypreceding the filing of the application; orDBPR ECLB 1 Initial Certification by Examination Eff. date: April 2021Incorporated by Rule: 61-35.012
3 of 19(2)Must have four (4) years of experience as a foreman, supervisor or contractor in thetrade within the last eight (8) years immediately preceding the filing of the application;or(3)Must have six (6) years of comprehensive training, technical education or supervisoryexperience associated with an electrical or alarm contracting business within the last12 years immediately preceding the filing of the application; or must have at least six(6) years technical experience in electrical or alarm system work with the ArmedForces or a governmental entity within the last 12 years immediately preceding thefiling of the application; or have a combination of these qualifications totaling six (6)years of experience; or(4)Must be licensed as an electrical professional engineer for three (3) years within thelast 12 years. Provide a copy of current electrical professional engineer license andtranscripts showing electrical engineering work; or(5)Must have a combination of experience listed in 1-3 above totaling 6 years within thelast 12 years.ii.In addition, if you are applying for the following categories these specific experiencerequirements will apply:EC – Certified Electrical Contractor - The required experience must include at least40% of work that is in 3-phase services.EF – Certified Alarm System Contractor I (All Alarm Systems) - The requiredexperience must include at least 40% of work that is in fire alarm systems.*Note: you may submit a copy of your NICET Level III or higher certifications in lieu of joblists for Alarm Contractor I.EG – Certified Alarm System Contractor II (Excluding Fire) - The required experiencemust include at least 40% of work that is in alarm systems other than fire alarm systems.h. Section VIII– PART A1: Employment Verificationi.This section is to be completed by the applicant’s employer if the applicant’s experiencehas been gained through employment with a Florida licensed contractor. The qualifyingFlorida licensed electrical/alarm or electrical specialty contractor should complete theformii.Applicants are required to submit copies of W2’s to verify employment with the qualifiedbusiness.iii.If the applicant was employed by a Florida electrical/alarm or electrical specialtycontractor that employer should complete section VIII A for all required experience. Theapplicant is not required to complete the job lists in section VIII B.iv.Note to verifiers – as a licensed electrical/alarm or electrical specialty contractor you areproviding verification of the applicant’s experience and may be subject to discipline forproviding any false or misleading information to the Department under 489.531(1)(f), F.S.v.Note: 40 percent of experience in a required area is considered to be 40 percent of fulltime employment for each year of experience the applicant is applying under.(1)40 percent of 3 years full time experience is approximately 15 months on 3 phaseelectrical systems, commercial fire alarm or alarm systems other than fire.(2)40 percent of 4 years of full time experience is approximately 20 months on 3 phaseelectrical systems, commercial fire alarm or alarm systems other than fire.(3)40 percent of 6 years of full time experience is approximately 29 months on 3 phaseelectrical systems, commercial fire alarm or alarm systems other than fire.i. Section VIII– PART A2: Employment Verificationi.This section is to be completed by the applicant’s employer if the applicant’s experiencehas been gained through employment with a non-Florida licensed contractor.ii.Applicants are required to submit copies of W2’s to verify employment with the qualifiedbusiness.j. Section VIII– PART B: Employment Verification Job Listi.This section is to be completed by an applicant whose experience has been gainedthrough self-employment, under a licensed contractor outside of the state of Florida or ifDBPR ECLB 1 Initial Certification by Examination Eff. date: April 2021Incorporated by Rule: 61-35.012
4 of 19you are unable to get your Florida Licensed Employer to verify your experience. Applicantmust provide details of 5 jobs/projects per year for each year of experience he/she isapplying under. If there are less than 5 jobs for a given year provide an explanation ofthis on that year’s job list.*Note: Alarm Contractor I applicants may submit a copy of your NICET Level III or highercertifications in lieu of job lists.ii.Job lists should list as much detail of the work performed as possible. Applicant shouldfocus on jobs that include the required type of experience such as 3 phase electricalsystems, commercial fire alarms or alarms other than fire as required for the categorybeing applied for.iii.Job lists should be in chronological order, duplicate pages as needed. Please limit eachpage to 1 year.iv.Note: 40 percent of experience in a required area is considered to be 40 percent of fulltime employment for each year of experience the applicant is applying under.(1)40 percent of 3 years full time experience is approximately 15 months on 3 phaseelectrical systems, commercial fire alarm or alarm systems other than fire.(2)40 percent of 4 years of full time experience is approximately 20 months on 3 phaseelectrical systems, commercial fire alarm or alarm systems other than fire.(3)40 percent of 6 years of full time experience is approximately 29 months on 3 phaseelectrical systems, commercial fire alarm or alarm systems other than fire.v.On the job lists indicate the name of the licensed contractor you were employed by whileworking on that job, dates the job began and ended, location of job, specific details of thework performed and mark 3 phase, commercial fire alarm or alarm systems other thanfire if applicable.k. Section IX– Business Financial Statementi.The business financial statement must be prepared within twelve (12) months precedingof the filing this application and must show a total net worth of:(1) 10,000 for Certified Electrical, Certified Alarm I and Certified Alarm II Contractors(2) 5,000 for Certified Specialty Contractorsii.All vehicles and real property listed as assets of the business must be titled to thebusiness to be considered assets of the business. DO NOT include personal vehiclesand property as assets of the business.iii.Applicant should list all of the business’ assets and liabilities on the form.iv.Total value of assets listed should be listed in Box 12.v.Total value of liabilities listed should be listed in Box 19.vi.To determine net worth (Box 12 - Box 19 Net Worth)vii.List net worth in Box 20. The business’ net worth should be at least 10,000 for CertifiedElectrical, Certified Alarm I and Certified Alarm II Contractors or 5,000 for CertifiedSpecialty Contractors. A business net worth that does not meet minimum requirementsis considered grounds for denial.l. Section X– Background Questionsi.The applicant and the authorized representative(s), as specified in the section, mustsubmit answers to each of the background questions.ii.For each “Yes” answer the person must provide an explanation in Section XI or XII, asapplicable.iii.The number of “Yes” boxes checked must equal the number of explanation boxescompleted.iv.If you answered “YES” to any question, please provide full explanations as requiredbelow. If you have more than two offenses to document in Section XI or more than two inSection XII, attach additional copies as necessary.m. Section XI – Explanations for “Yes” answers to Question 1i.For this section, provide as much detail as possible.ii.Each explanation can only relate to one person and one question.iii.Question 1:(1)If you answer “yes” to this question, you must complete Section XII [make additionalcopies as necessary] of the application. Please provide the full details of the criminalcharges including dates, outcomes, sentences, and/or conditions imposed; the dates,name and location of the court and/or jurisdiction in which any proceedings were heldor are pending. If you answer NO to this question because you believe that previousincidents have been dismissed, no action taken, nolle prossed, or expunged, youDBPR ECLB 1 Initial Certification by Examination Eff. date: April 2021Incorporated by Rule: 61-35.012
5 of 19must supply documentation as proof of the disposition or showing sanctions weresatisfied.n. Section XII – Explanations for “Yes” answers to Questions 2-6i.Question 2:(1)If you answer “yes” to this question, you must complete Section XIII [make additionalcopies as necessary] of the application and you must also supply documentationproving the bankruptcy has been discharged or the judgment or lien has beensatisfied, or if not, stating the current status of the bankruptcy, judgment or lien.ii.Question 3:(1)If you answer “yes” to this question provide the full details in Section XIII explainingthe denial or pending administrative action including the nature of any charges,dates, outcomes, sentences, and/or conditions imposed; the dates, name andlocation of the court and/or jurisdiction in which any proceedings were held or arepending; and the designation and/or license number for any actions against a licenseor licensure application.iii.Question 4:(1)If you answer “yes” to this question provide the full details explaining the situation inSection XIII including the nature of any charges, dates, outcomes, sentences, and/orconditions imposed; the dates, name and location of the court and/or jurisdiction inwhich any proceedings were held or are pendingiv.Question 5:(1)If you answer “yes” to this question provide the full details in Section XIII explainingthe situation and provide copies of any relevant documentation.v.Question 6:(1)If you answer “yes” to this question provide the full details in Section XIII explainingthe situation and provide copies of any relevant documentation.o. Section XIII- Affirmation by Written Declarationi.Please read and sign the affirmation by written declaration.ii.If the applicant fails to sign the affirmation statement, the Department will not process theapplication.3. Additional Supporting Documentation Requiredi.W-2 FORMS: Copies of W-2 forms must be provided for each year of experience aslisted on the applicant job list. If you are self employed you can provide 1099’s, ScheduleC or K-1 forms from your tax returns in lieu of W-2 forms.(1)If your W2’s do not have your employer listed on them because they used a payroll oremployee leasing company, please indicate that information on the forms.ii.APPLICANT CREDIT REPORT: A credit report on the qualifying agent from anyrecognized credit bureau that includes, but is not limited to, liens, judgments, suits, andbankruptcy obtained from county, state and federal records. The credit report must bedated within twelve (12) months of filing this application and must include the followingstatement: “PUBLIC RECORDS HAVE BEEN SEARCHED AT THE COUNTY, STATEAND FEDERAL LEVELS.” Go cuments/cilb credit reporting agencies.pdf for a list of acceptable agencies.(1)If there are negative items on the credit report such as open collections, past dueaccounts, foreclosures or bankruptcy please provide a written explanation of theissue and the current status of those items.iii.BUSINESS CREDIT REPORT: A credit report on the business to be qualified from anyrecognized credit bureau that includes, but is not limited to, liens, judgments, suits, andbankruptcy obtained from county, state and federal records. The credit report must bedated within twelve (12) months of filing this application and must include the followingstatement: “PUBLIC RECORDS HAVE BEEN SEARCHED AT THE COUNTY, STATEAND FEDERAL LEVELS”. Go cuments/cilb credit reporting agencies.pdf for a list of acceptable agencies.(1)If there are negative items on the credit report such as open collections, past dueaccounts, foreclosures or bankruptcy please provide a written explanation of theissue and the current status of those items.DBPR ECLB 1 Initial Certification by Examination Eff. date: April 2021Incorporated by Rule: 61-35.012
6 of 19Letters Verifying Experience: If you were self employed you must submit at least three(3) letters verifying required experience from building officials, local licensing agenciesand licensed contrac
Department of Business and Professional Regulation, Customer Contact Center, at : 850.487.1395. 1. General Requirements for Certification : a. Applicants must be at least 18 years of age, be of good moral character, meet the educat
