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: firstname.lastname@example.org