Rockland County Office of Consumer Protection/Weights & Measures (NY)

Home Improvement Contractor License Application

$325

• Experience Record – (original, no copies) must be signed in front of a notary public
• • Partnerships – Each partner must fill in an experience record
  • Corporations – Applicant of record and each additional corporate officer upon whom process may be served must fill out an experience record and attach photo ID
• Child Support Certification – (original, no copies) must be completed by applicant and signed in front of notary public
  • Partnerships - Both parties must fill out child support certification
• Copy of driver’s license with clear image of photograph
• One of the following documents:
  • Certified Copy of Rockland County Business Certificate
  • Copy of Corporate Filing Receipt (if NY State Corp.)
  • Copy of Filing Receipt for Authority to Do Business in NY (if outside NY State Corp.)
  • If lost filing receipt, request and submit a copy of certificate of good standing (518-473-2492)
• If you are a corporation that also does business under an assumed name:
  • Copy of Filing Receipt for Assumed Name Certificate. Assumed name must be registered with Rockland County
• Proof of insurance in Licensed Name exactly with a current issue date:
  • Liability – per classification (see back of law book Appendix A)
    • Send Certificate of Insurance (ACORD Form accepted). Must be an “occur” type policy
  • Workers Compensation
    • Send Certificate of Insurance (Form C105.2 or SI-12) or
    • Form U26.3 if through NYSIF or
    • Form CE-200 in license name - file electronically at http://www.wcb.ny.gov/ then print, sign and date
  • Disability
    • Send Certificate of Insurance (Form DB120.1) or (Form DB155)
    • Form CE-200 in license name – file electronically at http://www.wcb.ny.gov/ then print, sign and date
  • Certificate Holder on certificates of insurance must be written as follows:
  • Rockland County Consumer Protection
    50 Sanatorium Road, Building A, 8th Floor
    Pomona, NY 10970
  • Insurance papers may be faxed to (845) 364-3902 or emailed to: CPLCAL@CO.ROCKLAND.NY.US
• Proof of Completion of Approved Pool Course
  • Mandatory for Applicants of Classification 25, 26
  • Proof of Course Completion or Affirmation for Applicants of Classification A6, B6
• Proof of Completion of Approved Turf Management Course
  • Mandatory for Applicants of Classification 18
  • Proof of Course Completion or Affirmation for Applicants of Classification 15, A6 or B6
• Letters of Reference
  • Two (2) or more regarding applicant’s experience. Signed letters must be in applicant’s name, not company’s, showing type of work performed and time frame
• Copy of current DMV Registrations for each vehicle used in business. Signed authorization letter from vehicle owner if
  registration is not in your name or company’s name

$225

Annually by the end of the month prior to the registration anniversary month.

Renewal forms are sent to licensees.