Non-refundable $300.00 registration fee. If paying by check, make check payable to Columbus City Treasurer.

Application may be submitted to:

[email protected] (you will receive an email containing a link to pay the fee online)

-OR-

City of Columbus - Department of Building & Zoning Services

111 N Front Street

Columbus, Ohio 43215

For additional information, contact the Customer Service Center at [email protected] or (614) 645-7433 or

visit us online at www.columbus.gov/bzs.

State of Ohio, with the limits of liability no less than three hundred thousand dollars ($300,000) for damages to a single

person, and ve hundred thousand dollars ($500,000) for one (1) occurrence.

Individual name, and company name if applicable, must be listed identically on all documents. Please review all

information and have your application notarized before ling for a license. If the application is not notarized, all

documents will be returned without being processed.

NOTE:

ba 1/24

REGISTRATION FEE

INFORMATION FOR GENERAL CONTRACTOR APPLICATION:

Section 4114 of the Columbus Code requires the following be presented in order to secure a contractor registration.

Signature of Applicant

Print/Type Name Date

Full Name Date of Birth

Home Address City/State/Zip Home Phone Number

Email Address for notication of permits issued under applicant’s registration:

Email Address for communication related to issuance of applicant’s registration:

Have you previously held this type of registration with the City of Columbus? Yes No

If YES, provide the following if known: Registration Number: Expiration Date:

Have you ever been summoned before any City of Columbus Contractor Board of Review for any type of violation hearing? Yes No

PART I: QUALIFICATION CERTIFICATE HOLDER INFORMATION

By completing this section, the applicant conrms his/her association with the business concern as a legal full-time ocer, proprietor,

partner, or employee. The applicant will be actively engaged in and perform work only for the business concern listed below.

PART II: ASSIGNMENT OF REGISTRATION TO BUSINESS CONCERN

Incomplete information will result in the rejection of this submittal.

PART III: STATEMENT BY APPLICANT

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 Ohio Revised Code Section 2921.13.

NOTICE TO CONTRACTOR: Please give these instructions to your bonding company or agent to ensure that all the

information is correctly provided on the bond.

NOTICE TO BONDING COMPANY AND AGENT: Please follow the instructions below when completing this

‘Contractor License / Registration Bond’ form. Guidelines showing the correct way to complete the bond form have been

provided for your convenience. Please refer to the Guidelines for any questions you may have with regard to completing

the bond form. Please also note the following:

       submitted for the rst time. In the case of a renewal for an existing License / Registration and corresponding bond, we will 

       accept a Continuation Certicate.

2. Bond Number and Effective Date: Please enter the Bond Number and the Effective Date of the bond on the lines provided.

line can be left blank.

6. Name of Bonding Company: Please insert the complete name of the bonding company. Also, please note that the name of this

Surety must also appear on the Power of Attorney which is to be attached.

7. Date and Signing of Bond: Please enter the date in which the bond is being executed. It is important that this date be on or

       after the effective date in which the Power of Attorney is dated. If the Power of Attorney is dated after the date in which the 

       bond is executed, then the bond will be considered invalid. Please print or type the name of the Individual (not the name of the

       business) who holds the License or Certicate, as indicated in No. 4 above. The Individual also needs to provide an original 

       signature. Please print or type the name of the Surety, as indicated in No. 6 above. The bond must be signed by the 

       Attorney-in-Fact. An electronic or facsimile signature of the Attorney-in-Fact is acceptable. Lastly, please provide the telephone 

       number of the Attorney-in-Fact who can be contacted with any questions.

CONTRACTOR LICENSE / REGISTRATION BOND FORM 1

Bond #: _________2__________ Effective Date: __________2__________

Amount: $25,000.00 3

as Surety, are held and rmly bound unto the City of Columbus, c/o City Treasurer, City Hall, 90 West Broad Street, Columbus, Ohio 43215, as Obli-

gee, in the sum of Twenty Five Thousand and no/100 Dollars ($25,000.00) to be paid to said Obligee, its successors and assigns, and for the payment 

thereof well and truly to be made, we, the Principal and Surety, jointly and severally bind ourselves, our heirs, executors, administrators, successors, 

and assigns rmly by these presents. The conditions of the above obligation are such that:

WHEREAS, the above Principal has or is about to apply to said Obligee for a License / Registration as a Contractor effective upon approval and 

expiring at the end of the twelfth month from the date of issuance, pursuant to Chapter 33 or 41 of the Columbus City Codes, as applicable.

WHEREAS, the expiration date of this bond shall coincide with the expiration date of said License/Registration.

WHEREAS, the Principal, its agents and employees shall save the City of Columbus harmless from all loss and damage to persons or property which 

may be occasioned in any way, by accident or the want of care or skill on the applicant’s part, in the prosecution of the work contracted, performed, 

cancellation notice, the Surety is relieved of any further liability. The Surety will be liable for loss accruing up to the effective date of said cancella-

tion; but, in no event will the liability to the Surety exceed $25,000.00

Signed this _____7_____ day of __________7__________, in the year _____7_____.

LICENSEE / REGISTRANT:   _________________4_________________ By: _________________7_________________

            (PRINT OR TYPE NAME)           (SIGNATURE)

SURETY:       _________________6_________________ By: _________________7_________________

          (PRINT OR TYPE NAME)           (SIGNATURE OF ATTORNEY-IN-FACT)

        Telephone No. of Attorney-in-Fact for Surety   _________________7_________________

Place Surety Seal Here

8

That     (Insert Name of Individual Licensee / Registrant)

of (Insert Company Name)

as Principal, and (Insert Name of Bonding Company)

as Surety, are held and rmly bound unto the City of Columbus, c/o City Treasurer, City Hall, 90 West Broad Street, Columbus, Ohio 

43215, as Obligee, in the sum of Twenty Five Thousand and no/100 Dollars ($25,000.00) to be paid to said Obligee, its successors and 

assigns, and for the payment thereof well and truly to be made, we, the Principal and Surety, jointly and severally bind ourselves, our 

heirs, executors, administrators, successors, and assigns rmly by these presents. The conditions of the above obligation are such that: