State Certified Contractor Repository Registration

Please complete the form below and provide the following:

Business name must match as it appears on the qualifying license.

  • Copy of State Certified License (actual certificate, not a summary from the state website)
  • Copy of Valid Driver’s License for the License Holder
  • Copy of Business Tax Receipt from the County/Municipality where your business is located. If located in Brevard County, you must have a Brevard County Business Tax Receipt, call 321-264-6969 for more information.
  • Certificate of General Liability Insurance
  • Certificate of Workers Compensation Insurance (Required if you have employees)
  • Certificate of Workers Compensation Exemption

Certificates of Insurance must be sent directly from insurance agency with the Certificate Holder as follows:
Brevard County Licensing Regulation & Enforcement
2725 Judge Fran Jamieson Way, A-114
Viera, FL. 32940

This form and requested documents are to be emailed to: