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City of Oldsmar Application for Registration of Contractor Certification

  1. Please select one of the following options for receiving access to the online portal:

  2. By typing your name here, you are signing this form electronically. You agree you are submitting this application for processing and is the legal equivalent of your manual signature on this form. You must be the legal qualifier which match our registration records. Note: A notarized Letter of Authorization is required for an agent to sign the application or any other correspondence that calls for an agent signature.

  3. RETURN THIS APPLICATION WITH COPIES OF THE FOLLOWING DOCUMENTS:

  4. Qualifier to authorize agents for permit drop-off/pickup, must be notarized

  5. Pinellas County Certificate of Competency

  6. General Liability ($100,00/$500,000 each occurrence)

  7. Workers Compensation or State-approved Exemption Certificate

  8. *COI(s) with the City of Oldsmar listed as a certificate holder and addressed to 100 State St W, Oldsmar, FL 34677

  9. Leave This Blank:

  10. This field is not part of the form submission.