"New Pesticide Business License Application" - Ohio

New Pesticide Business License Application is a legal document that was released by the Ohio Department of Agriculture - a government authority operating within Ohio.

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OHIO DEPARTMENT OF AGRICULTURE
Plant Health Division - Pesticide & Fertilizer Regulation Section
8995 East Main Street, Reynoldsburg, OH 43068-3399
Phone: 614-728-6987 - Fax: 614-728-4235
Email:
pesticides@agri.ohio.gov
Web:
www.agri.ohio.gov
20
21
A Certificate of Insurance (COI) MUST be submitted with this application, except for Solicitation and RUP Dealer Licenses
PART A - PESTICIDE BUSINESS LICENSE TYPES AND FEES (check license type(s) you are applying for)
PESTICIDE APPLICATION BUSINESS LICENSE
($35.00)
PESTICIDE REGISTERED LOCATION LICENSE
($35.00)
(must employ at least one licensed Commercial Applicator)
Pesticide Application Business License ID#: _______________
Applicator License ID# __________________________________
PESTICIDE SOLICITATION BUSINESS LICENSE
($35.00)
Applicator's Name: _____________________________________
RESTRICTED-USE PESTICIDE DEALER LICENSE
($35.00)
Email Address
Company Name:
s
Other
Sole Proprietorship
Partnership
Corporation
Limited Liability Company (LLC)
PART C - ADDRESS AND SIGNATURE (Please Print)
State
Payment by check or money order
must be mailed or hand delivered.
. This application may be faxed provided it is a credit card payment ONLY. License payments
-
Payment may be made with one check when submitting multiple applications. This application can be duplicated.
Number of licenses_______________________ X $35.00 each =
Payment method: Check or Money Order # ____________________________
Visa
MasterCard
The following information is required before a credit card payment can be processed.
Cardholder Name
Credit Card Number
CVV (3 digits on back)
Expiration Date
(MM)
(YYYY)
Valid CC Signature _______________________________________
OHIO DEPARTMENT OF AGRICULTURE
Plant Health Division - Pesticide & Fertilizer Regulation Section
8995 East Main Street, Reynoldsburg, OH 43068-3399
Phone: 614-728-6987 - Fax: 614-728-4235
Email:
pesticides@agri.ohio.gov
Web:
www.agri.ohio.gov
20
21
A Certificate of Insurance (COI) MUST be submitted with this application, except for Solicitation and RUP Dealer Licenses
PART A - PESTICIDE BUSINESS LICENSE TYPES AND FEES (check license type(s) you are applying for)
PESTICIDE APPLICATION BUSINESS LICENSE
($35.00)
PESTICIDE REGISTERED LOCATION LICENSE
($35.00)
(must employ at least one licensed Commercial Applicator)
Pesticide Application Business License ID#: _______________
Applicator License ID# __________________________________
PESTICIDE SOLICITATION BUSINESS LICENSE
($35.00)
Applicator's Name: _____________________________________
RESTRICTED-USE PESTICIDE DEALER LICENSE
($35.00)
Email Address
Company Name:
s
Other
Sole Proprietorship
Partnership
Corporation
Limited Liability Company (LLC)
PART C - ADDRESS AND SIGNATURE (Please Print)
State
Payment by check or money order
must be mailed or hand delivered.
. This application may be faxed provided it is a credit card payment ONLY. License payments
-
Payment may be made with one check when submitting multiple applications. This application can be duplicated.
Number of licenses_______________________ X $35.00 each =
Payment method: Check or Money Order # ____________________________
Visa
MasterCard
The following information is required before a credit card payment can be processed.
Cardholder Name
Credit Card Number
CVV (3 digits on back)
Expiration Date
(MM)
(YYYY)
Valid CC Signature _______________________________________
3
Applicants for a Pesticide Business License of Pesticide Registered Location License in Ohio must provide proof of financial
responsibility before a license can be issued. Provisions of Ohio’s Administrative code 901:5-11-07 specifying the insurance
requirements are detailed below and include ONE of the statements verifying coverage for Section (E)(6) below:
(B) Every pesticide business shall have in force a commercial general liability insurance policy and, either a separate professional
liability insurance policy or an endorsement covering the properties under the care, custody, and control of the pesticide application
business as it relates to the application of pesticides, including but not limited to the damage to the actual properties the pesticide
business is treating or working on in each of the pesticide use categories in which the commercial applicators employed by the
business are licensed. The policies and endorsements shall:
(1) Provide coverage for each registered location associated with the pesticide business;
(2) Provide coverage for bodily injury, property damage, products, and completed operations due to the application of
pesticides at the location applied and for third party claims; and
(3) Contain the following minimum limits of insurance:
(a) Three hundred thousand dollars policy general aggregate;
(b) Three hundred thousand dollars per occurrence limit; and
(c) Three hundred thousand dollars products and completed operations aggregate.
Example of acceptable statement for Section (E)(6):
For most Pesticide Businesses: This policy provides the coverage required in Ohio Administrative Code 901:5-11-07 (B)
(C) Every pesticide business which is also licensed in the pesticide use category of wood-destroying insect diagnostic inspection shall
obtain either a specific liability policy or an endorsement on an existing commercial general liability policy covering claims which arise
from errors or omissions in the performance of wood-destroying insect diagnostic inspections. The policy and endorsements shall
contain the following minimum limits of insurance:
(1) One hundred thousand dollars policy general aggregate; and (2) Fifty thousand dollars per occurrence limit.
Example of acceptable statements for Section (E)(6):
WDI inspections only:
This policy provides the coverage required in Ohio Administrative Code 901:5-11-07 (C)
WDI and Pesticide applications: This policy provides the coverage required in Ohio Administrative Code 901:5-11-07(B) & (C)
(D) Every pesticide business that conducts aerial pest control applications shall have in force a comprehensive chemical liability
insurance policy for the properties under the care, custody, and control of the pesticide application business as it relates to the
application of pesticides from, including but not limited to the damage to the actual properties the pesticide business is treating or
working on. The policy and endorsements shall
(1) Provide coverage for bodily injury, property damage, products, and completed operations due to the application of
pesticides at the location applied and for third party claims; and
(2) Contain the following minimum limits of insurance:
(a) One hundred thousand dollars property damage coverage per occurrence; and
(b) One hundred thousand dollars bodily injury (excluding passengers) coverage for each person; and
(c) Three hundred thousand dollars bodily injury (excluding passengers) coverage per occurrence.
Example of acceptable statement for Section (E)(6):
Aerial Pesticide Businesses: This policy provides the coverage required in Ohio Administrative Code 901:5-11-07 (D)
(E) Every person applying for a pesticide business license shall submit with their license application either a certificate of insurance or
a binder verifying that they meet the requirements of this rule. The certificate of insurance or binder shall contain:
(1) The name and address of the issuing company;
(2) The name and address of the insured pesticide business;
(3) The name and address of each registered location associated with the insured pesticide business;
(4) The effective date and expiration date of the insurance policy;
(5) The policy number;
(6) A statement verifying that the policy provides the coverage required in paragraphs (B), (C), and/or (D) of this rule;
(7) The limits of insurance; and
(8) A clause which states in the same or similar language: "In the event of cancellation for non-payment, the insurer agrees to
advise the Ohio Department of Agriculture, Pesticide Regulation Section, 8995 East Main Street, Reynoldsburg, Ohio 43068, by
written notice ten days prior to the effective date of cancellation. If the policy is, for any other reason, canceled, not renewed,
or there is a material change the insurer agrees to give the Ohio Department of Agriculture thirty days written notice.”
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