Application for HVAC Contractor License

Application for HVAC Contractor License
Please note: you may save your progress and continue your application at a later time by clicking the "Save" button at the bottom of the page
Is this a new registration or a renewal?
Has the license holder changed companies since last renewal?
Because the license holder is switching to a different company, a new registration is required.

Work History
Employer 1 - Company Name
Employer 1 - Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employer 1 - Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Employer 1 - Duties
Employer 1 - Years of Service
Employer 2 - Company Name
Employer 2 - Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employer 2 - Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Employer 2 - Duties
Employer 2 - Years of Service
Total Years of Experience - Journeyman
Total Years of Experience — HVAC Contractor
Education Information
If less than 4 years of applicable experience, provide information regarding your education

New Registration Documents & Uploads
Upload a copy of your photo ID - must be at least 21 years of age.

Cancelof
Upload a police background statement. A police background statement is a statement from the Police Department of your local municipality indicating whether or not you have been convicted of a misdemeanor or felony. If convicted, include the crimes, dates, and places.

Cancelof
Upload proof of scoring at least 70% on the National Standard Master Mechanical exam (F29-N) through Pearson Vue or Prometric, or a comparable nationally recognized exam approved by the Board of Examiners.

Cancelof
Upload a letter of reference from each employer listed verifying apprenticeship. If you are the business owner, provide Articles of Incorporation, W-2 forms, Schedule K-1, or other tax documents from the last 4 years.

Cancelof

Documents & Uploads

Optional for new registrations (will be completed after board approval) and required for renewals
Bond Requirements Summary
- Trade label must be "HVAC CONTRACTOR".
- Amount of bond must be $5,000.
- Bond must name the City of South Bend/St. Joseph County as the obligee.
- Principal's name on bond must match name used on registration.
- Principal's name must follow the format of [Your Name] DBA [Company Name].
- Bond must have a bond number.
- Term of bond must be for a one (1) year period with a beginning date and ending date.
- Original bond is required and must be signed.
Surety Bond

New registrations and renewals where company was switched: upload Original Surety Bond. Renewals where company stayed the same: upload Continuation Certificate
Cancelof
Has your registration been expired for more than 1 year?
All Previous Continuation Certificates

Upload all previous continuation certificates — we cannot have a lapse in bond coverage
Cancelof
You will also be required to pay all missed annual registration fees ($125 per year).
Contractors are responsible for having applicable Workers' Compensation throughout Registration/License term.
Workers' Compensation Coverage Type
Please print, complete, and notarize a Worker's Compensation Clearance Application, and upload the completed document to the Worker's Compensation field below
Worker's Compensation Documentation

Upload your certificate, exemption, or affidavit documentation
Cancelof

Certification & Submission
By typing my name in the boxes below, I agree that I'm electronically signing this form. I affirm that the information that I've provided is accurate and true to the best of my knowledge. I understand that my electronic signature is legally binding and equivalent to my handwritten signature.
Name

First NameLast Name
Date

MonthDayYear
Hour MinutesAM/PM Option
Should be Empty:

Applicant Info