Form COM5021 "Application for Fire Protection Company Certification" - Ohio

What Is Form COM5021?

This is a legal form that was released by the Ohio Department of Commerce - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2019;
  • The latest edition provided by the Ohio Department of Commerce;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form COM5021 by clicking the link below or browse more documents and templates provided by the Ohio Department of Commerce.

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Download Form COM5021 "Application for Fire Protection Company Certification" - Ohio

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Application for Fire Protection Company Certification
Please choose company type:
Main Company
Sole Proprietor
Branch office
Branch office must provide existing company number _____ - _____ - ________
Filing Instructions
A.
Application fee:
Main Company (partnership, limited liability company (LLC), association or corporation) - $200
Sole Proprietor
(a business in which one person owns all the assets, owes all the liability and operates in his/her capacity) - $50
Branch office
(a separate but dependent office of a main certified Fire Protection company that operates at a different address
from the main company
) - $10
B.
Submit check or money order payable to: Treasurer, State of Ohio. Fees are non- refundable.
C.
Branch offices must provide a copy of main company license in good standing with their certification.
D.
All categories must submit proof of liability insurance or bond in amount of a minimum of $50,000.00.
E.
List all persons responsible for the normal operations of the company (e.g. officers of the corporation, partners, etc.).
F.
Companies not based in the state of Ohio must complete an irrevocable consent to legal service.
Company Information
Legal Name of Company
Address
City, State, and Zip
County
Phone
Fax
Email
Cell
Officers of the Corporation
Name
Title
Email
Cell
Name
Title
Email
Cell
Name
Title
Email
Cell
Sole Proprietor
Name
Individual License Number
.
.
Address _______________________________________________________________________________________________
City, State, and Zip ______________________________________________________________________________________
County ________________________________Phone____________________________Fax____________________________
Email _________________________________________________________________________________________________
Signature:
Date:
Bureau of Testing & Registration
614-752-7126
8895 East Main Street
Fax 614-995-4206
Reynoldsburg, Ohio 43068
1-877-264-0023
COM 5021
webfmtr@com.state.oh.us
4/2019
An Equal Opportunity Employer and Service Provider
Application for Fire Protection Company Certification
Please choose company type:
Main Company
Sole Proprietor
Branch office
Branch office must provide existing company number _____ - _____ - ________
Filing Instructions
A.
Application fee:
Main Company (partnership, limited liability company (LLC), association or corporation) - $200
Sole Proprietor
(a business in which one person owns all the assets, owes all the liability and operates in his/her capacity) - $50
Branch office
(a separate but dependent office of a main certified Fire Protection company that operates at a different address
from the main company
) - $10
B.
Submit check or money order payable to: Treasurer, State of Ohio. Fees are non- refundable.
C.
Branch offices must provide a copy of main company license in good standing with their certification.
D.
All categories must submit proof of liability insurance or bond in amount of a minimum of $50,000.00.
E.
List all persons responsible for the normal operations of the company (e.g. officers of the corporation, partners, etc.).
F.
Companies not based in the state of Ohio must complete an irrevocable consent to legal service.
Company Information
Legal Name of Company
Address
City, State, and Zip
County
Phone
Fax
Email
Cell
Officers of the Corporation
Name
Title
Email
Cell
Name
Title
Email
Cell
Name
Title
Email
Cell
Sole Proprietor
Name
Individual License Number
.
.
Address _______________________________________________________________________________________________
City, State, and Zip ______________________________________________________________________________________
County ________________________________Phone____________________________Fax____________________________
Email _________________________________________________________________________________________________
Signature:
Date:
Bureau of Testing & Registration
614-752-7126
8895 East Main Street
Fax 614-995-4206
Reynoldsburg, Ohio 43068
1-877-264-0023
COM 5021
webfmtr@com.state.oh.us
4/2019
An Equal Opportunity Employer and Service Provider