Application for Contractor's License
Code Enforcement Department
Pursuant to Ordinance #925 hereby apply for Contractor's License in the Township of Springfield and I submit the following statement.
Employer Identification Numbers
Public Liability Insurance
Workman's Compensation Insurance
Worker's Compensation Information
Complete this section if the applicant is a contractor claiming exemption from providing worker's compensation insurance.
The undersigned swears or affirms that he/she is not required to provide worker's compensation insurance under the provisions of Pennsylvania's Worker's Compensation Law for one of the following reasons, as indicated:
List here the Names of Owners, Partners, Directors and Officers of the Business
I hereby certify that the statements contained herein are true and correct to the best of my knowledge and belief. I understand that if I knowingly make any false statement herein I am subject to such penalties as may be prescribed by law or ordinance.
We authorize you to obtain any information that you require concerning statements in this application, which shall remain the property of Springfield Township.
Payment of fees for this application will be requested via email once your submission has been reviewed. Please verify that emails from firstname.lastname@example.org are not sent to your spam/junk mail folder. The email will contain a link to this form allowing you to make a secure payment by credit card.