Do not attach a copy of a license with an expiration of 2020. Only 2023 licenses are accepted.
PLEASE READ BEFORE CLICKING YES>: Application will be rejected if you attached an unsigned license.
PLEASE READ BEFORE CLICKING YES>: This application will be rejected if you attach an unsigned license.
Unlicensed contractors are not allowed to pull permits on behalf of a licensed contractor.
Coverage shall include General Liability Insurance in the amount of six hundred thousand ($600,000)- general aggregate and three hundred thousand ($300,000) for each occurrence. The City of Wheat Ridge must be listed as the Certificate holder.
Coverage shall include workers compensation and employer’s liability in the amount of five hundred thousand dollars ($500,000); The City of Wheat Ridge must be listed as the Certificate holder.
Workers Comp Insurance Certificate must have the following listed as CERTIFICATE HOLDER:
City of Wheat Ridge, 7500 W 29th Avenue, Wheat Ridge, CO 80033
Please provide proof of one of the following:
1. Colorado driver’s license or identification card
2. United States military identification or dependent’s identification card
3. United States coast guard merchant mariner card
4. Native American tribal document
I understand that this sworn statement is required by law because I have applied for a public benefit. I understand that state law requires me to provide proof that I am lawfully present in the United States prior to receipt of this public benefit. I further acknowledge that making a false, fictitious, or fraudulent statement or representation in this sworn affidavit is punishable under the criminal laws of Colorado as perjury in the second degree under Colorado Revised Statute 18-8-503 and it shall constitute a separate criminal offense each time a public benefit is fraudulently received.
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