Revised 2.6.18

Residential Subcontract Labor Only

Louisiana State Licensing Board for Contractors

LSLBC

Important Information Regarding

Residential Subcontract Labor Only

Classifications

Subcontract Labor Only: Subcontractor does not purchase materials used and provides only labor under a prime contractor for any Subcontract Labor only classifications.

Subcontract Labor Only Classifications

Residential Roofing (Subcontract Labor only) Residential Framing (Subcontract Labor only) Residential Foundations (Subcontract Labor only) Residential Masonry/Stucco (Subcontract Labor only) Residential Pile Driving (Subcontract Labor only)

Revised 2.6.18

Instructions on Applying

for these Specialty

Classifications

The following classifications are intended for subcontractors who provide labor only, but whose portion of the project (based on the combined cost of labor, materials, rentals, and all direct and indirect expenses) would require a license:

Residential Roofing (Subcontract Labor only)

Residential Framing (Subcontract Labor only)

Residential Foundations (Subcontract Labor only)

Residential Masonry/Stucco (Subcontract Labor only)

Residential Pile Driving (Subcontract Labor only)

In addition to the regular application, the subcontractor should submit the attached form, which includes the subcontractor’s work experience, a signed affidavit by a general contractor for whom the subcontractor is working, attesting to the subcontractor’s quality of work and trustworthiness, and a signed affidavit by the subcontractor. With these classifications, the subcontractor is allowed to perform labor on subcontracts, but is not allowed to supply materials or to enter into contracts with anyone other than a licensed contractor. The subcontractor may perform work for any contractor within the scope of his Subcontract Labor Only classification.

Contents

Table of Contents 1

Classification Descriptions 2

Request for Classification(s) 3

Applicant Resume 3

Contractor Affidavit 4

Subcontractor Affidavit 4

Residential Application 5

Subcontract Labor Only

Revised 2.6.18

Classification Descriptions

Residential Roofing (Subcontract Labor only): Refers to the construction, installation or repair of roofs for new homes Residential Framing (Subcontract Labor only): Refers to the construction, installation or repair of frames and concrete formwork for homes Residential Foundations (Subcontract Labor only): Refers to the construction, installation or repair of concrete, forms and reinforcing steel, and to the pouring and finishing of concrete slabs for homes Residential Masonry/Stucco (Subcontract Labor only): Refers to the construction, installation or repair of masonry or stucco facades or interiors for homes Residential Pile Driving (Subcontract Labor only): Refers to the construction, installation or repair of piles for homes

Revised 2.6.18

State of Louisiana

State Licensing Board for Contractors 2525 Quail Drive, Baton Rouge, LA 70808 1-800-256-1392 Fax (225) 765-2362

REQUEST FOR SPECIALTY RESIDENTIAL SUBCONTRACT LABOR ONLY CLASSIFICATION(S) BASED ON EXPERIENCE

AND CONTRACTOR REFERENCE

Name (as it appears on the license/license application):

Subcontract Labor Only Classification(s) Being Requested:

RESUME FOR QUALIFYING PARTY CANDIDATE FOR APPLICATION USE ADDITIONAL PAGES AS NECESSARY

Current Employment of Qualifying Party Candidate (name of Business or Employer):

Address: City: State: Zip Code:

Job Title: Dates Employed

From: To: Present

Description of Duties Performed Under this Job Title (Please print or type):

Previous Employer:

Address: City: State: Zip Code:

Job Title: Dates Employed

From: To:

Description of Duties Performed Under this Job Title (Please print or type):

Please list and/or describe all relevant education or training of the Qualifying Party Candidate

Instructions to Applicant: Please fill out the information below and submit this form with your residential application. Use a

separate form for each additional Qualifying Party for which examination exemption is requested.

Revised 2.6.18

Affidavit of Contractor for whom Subcontractor is Currently Performing Work

State of Louisiana, Parish of __________________________________________________________ personally

appears _____________________________________________________ who being duly sworn, deposes and

saith that _____________________________________________, a qualifying party candidate for the license

application under the name _____________________________ has done the following type(s) of work for me:

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

I hereby testify that this candidate and/or his firm is currently working as a subcontractor under contracts

that I hold, that this candidate’s work is acceptable and according to industry standards, and that I find

him/her to be a trustworthy individual.

I affirm that the forgoing statements of experience of the above-named application and all statements

therein contained on this form are true and correct and the answers of the foregoing are true to the best of

my knowledge under penalties of perjury.

Sworn or affirmed before me this ____________ date of _________________________________,_____________.

Name of Contractor’s Firm:______________________________________ Contractor’s License Number:_________

Signature of Contractor: __________________________________________________________________________

Address of Contractor’s Firm ______________________________City________________ State_____ Zip________

Print Name and Address of Notary Public

_________________________________

_________________________________

Signature of Notary Public

Revised 2.6.18

Affidavit of Subcontractor Applying for Subcontract Labor Only Classification(s)

State of Louisiana, Parish of __________________________________________________________ personally

appears ______________________________________________ who being duly sworn, deposes and saith that:

I understand that approval for the subcontract labor only license classification(s) that I have requested on

this form neither permits me to enter into contracts directly with a project owner or awarding authority, nor

to buy materials for contracts for which this subcontractor labor only classification has been used and

required. I further understand and agree that my license may be immediately suspended or revoked if it is

determined by the compliance section of the Louisiana State Licensing Board for Contractors that I have used

the subcontractor labor only license classification(s) requested on this form to contract directly with anyone

other than a licensed contractor, or if I have purchased materials for contracts signed using the subcontractor

labor only license classification(s) requested herein, where a state contractors license is required by law for

such contracts.

I affirm that the forgoing statements and all statements contained on this form are true and correct and the

answers of the foregoing are true to the best of my knowledge under penalties of perjury.

Sworn or affirmed before me this ____________ date of _________________________________,______________.

Name of Subcontractor’s Firm:_____________________________________________________________________

Signature of Subcontractor: _______________________________________________________________________

Address of Subcontractor’s Firm ____________________________City________________ State_____ Zip________

Print Name and Address of Notary Public

_________________________________

_________________________________

Signature of Notary Public

APPLICATION FOR ORIGINAL CONTRACTOR’S LICENSE

STATE OF LOUISIANA

STATE LICENSING BOARD FOR CONTRACTORS 2525 QUAIL DRIVE

BATON ROUGE, LOUISIANA 70808 PHONE (225) 765-2301-- FAX (888) 510-0127

www.lslbc.louisiana.gov

Save this application to your computer before you begin to complete it. Every question must be answered. * If a question is not applicable, indicate.* If a space provided is not sufficient, attach separate sheet(s).

Submit separate application for EACH license type. All signatures must be notarized. Social Security Number/Tax ID: Failure to provide your Social Security Number (SSN) or Taxpayer ID where requested may result in denial of your licensure application. Your SSN/Taxpayer ID will not be released for any other purpose not provided by law.Misrepresentation of information supplied by an applicant shall be deemed sufficient cause for denial of application or revocation of license and/or subject to criminal prosecution for making false official statements, in accordance with LA R. S. 14:133.Do NOT use this application for Home Improvement Registration. The Home Improvement application may be downloaded by clicking HERE. Fees are NONREFUNDABLE. Click HERE for more information about fees.

Section 1: IDENTIFYING INFORMATION

Enter full legal name of company or sole proprietor:

C rporaGeneral Partnership Limited Liability Company (LLC)* Limited Liability Partnership (LLP)* Sole Proprietor

Mailing Address of Principal Place of Business: P.O. Box or Street Address

City State Zip Code Physical Address of Principal Place of Business

Street Name and Number City, State, Zip Code Phone Cell FAX Email Website

o tion* Limited Partnership* Joint Venture*

ALL applicable fees MUST BE INCLUDED with this application!

Type of Business (choose one)

*Tax ID:SS#:

SAVE to your computer BEFORE completingSAVE to your computer BEFORE completing 1

Section 2: LEGAL INFORMATION

As used on this Application, the terms “you” and “your” shall mean the applicant, whether an individual or a corporation, partnership, firm, joint venture, limited liability company or any other business or legal entity with which the applicant is or has been affiliated, or principals of the applicant’s firm.

1.

Yes No Are you currently/previously licensed as a contractor with the Louisiana StateLicensing Board?

If YES, provide the following: Name of Firm/Company License

2.

Yes No Are you requesting reciprocity with a state with which Louisiana has a reciprocal agreement? (click HERE to view Reciprocity information)

If YES, provide the following: Name of Firm/Company License/State

3.

Yes No Have you ever taken an examination given by the Louisiana State Licensing Board for Contractors?

If YES, provide the following Name of Examinee(s) Name of Firm Classification

4.

Yes No Have you ever had a contractor’s license/registration denied, suspended, or revoked by this agency or any other state, parish/county, or municipality?

If YES, identify the person(s) or entity, regulatory agency, month and year, and explain circumstances.

Name of Licensee(s) Name of Regulatory Agency Month/Year Circumstances

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5.

Yes No Have you ever been given notice that an administrative hearing is scheduled with this Board or ever been issued a fine?

If YES, provide the name of the individual or entity which was scheduled for a hearing and the date of the hearing.

Name of Person(s) or Entity(ies) Date of Board Hearing

6.

Yes No Has any bonding or surety company ever completed or made financial settlements upon any contract in which you had interest or have you ever failed to complete a contract?

If YES, please explain below:

7.

Yes No Have you ever filed bankruptcy as an individual or under any firm name whatsoever in Louisiana or in any other state?

If YES, send copies of records showing the chapter filed, the initial debts submitted (including all creditors and the amount remaining owed each), and a discharge summary. For bankruptcies discharged over ten years ago, send only a copy of the discharge summary.

8. Yes No

Are there now any liens, judgments, garnishments or attachments pending or recorded against you, or against any firm in which you had interest at the time such indebtedness was created, or against any property involved under any of your contracts arising out of your previous operations in ANY state?

If YES, please send a certificate of release or a payment plan, along with a statement from the legal agency showing that the plan is current.

9.

Yes No Have you or principals in your firm been convicted of a felony or a misdemeanor other than violation of traffic laws?

If YES, please explain below:

SAVE to your computer BEFORE completingSAVE to your computer BEFORE completing 3

The following information MUST be provided for your company before a license will be issued:

Either Articles of Incorporation (Corporations), Articles of Organization (LLC) or Partnership Agreement.

Operating Agreement (if one is in effect)

Officers,

Members or

Partners Social Security #

President

Vice President

Secretary/Treasurer

Partner(s)

Member(s)

I am applying for: (submit separate application for EACH license type)

Commercial*

Mold Remediation (click HERE for specific requirements for this license)

*If applying for Commercial, enter at least one classification(s) below. Click HERE for the list.C

lassifica

tion

s

Click HERE for study reference lists and testing information.

Note: ALL COMMERCIAL APPLICANTS MUST HAVE AT LEAST ONE CLASSIFICATION.

If you cannot find a classification that adequately describes the type of work you perform, provide a detailed

description of your work below:

Section 4: CLASSIFICATION INFORMATION

Section 3: BUSINESS INFORMATION

Residential*If applying for Residential, enter at least one classification(s) below. Click HERE for the list.

SAVE to your computer BEFORE completingSAVE to your computer BEFORE completing

Section 5: COMPANY AFFIDAVIT

I certify under penalty of perjury under the laws of the State of Louisiana that all statements, answers and representations in this application, including all supplementary statements attached thereto, are true and accurate and acknowledge that any purposeful false information submitted on behalf of myself and/or this applicant and verified by this signature is cause to have license denied or revoked by the State Licensing Board for Contractors.

Full Legal Name of Applicant:

Current Address of Applicant:

State of

Parish or County of

Personally appears being duly sworn deposes and saith: That the foregoing statements of experience of the above-named applicant and all statements therein contained are true and correct and the answers of the foregoing are true to the best of my knowledge under penalties of perjury.

Signature must be notarized.

Signature of Applicant, Officer or Authorized Representative

Sworn before me this day of 20

Signature of Notary Public

Print Name and Address of Notary Public

Tax ID:

SAVE to your computer BEFORE completingSAVE to your computer BEFORE completing 5

Section 6: APPLICATION FOR QUALIFYING PARTY

The qualifying party is the person designated by the applicant to take the exams or to hold the classifications, if previously tested or requesting reciprocity. Click HERE for eligibility requirements for Qualifying Party.

The applicant may have more than one qualifier. You must submit a Qualifying Party Application for each qualifying party. Click HERE for additional Qualifying Party applications.

Qualifying Party must meet one of the following (Please check box that applies.) Sole Proprietor (Individual) Spouse of Sole Proprietor (Individual) Partner Original Member of LLC Original Incorporator or Original Stockholder in the original Articles of Incorporation Employee

PRINT FULL LEGAL NAME OF QUALIFIER

(First) (Middle) (Last) (Jr/Sr, etc)

(Name of Company)

Mailing Address: (Street or P.O. Box)

(Work Number) (Fax Number) (Cell or Home Number)

(Email address of Qualifying Party)

1A. For which classification(s) will you be representing your company as a qualifying party? List Below:

1B. Yes No Have you previously taken the Business and Law Exam? (NOTE: Each Company must have at least one qualifying party for Business and Law)

1C.

Yes No Have you ever passed a trade examination with the Louisiana State Licensing Board for Contractors?

If YES, complete the following: Licensee Name Exam

City State ZIP

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2.

Yes No Have you been affiliated with or employed by any company who has previously held (within the past 5 years) or currently holds a Louisiana contractor's license?

If YES, complete the following: Company Name Address License Number

THE FOLLOWING QUESTIONS MUST BE ANSWERED YES OR NO.

3A. Yes No Do you or any firm in which you have had financial decision making authority have any current outstanding liens or judgments or any current or previous bankruptcies (within the last ten years)?

3B. Yes No Do you have any outstanding garnishments or child support payments against you?

3C. Yes No Have you or any firm in which you were a principal been debarred or disqualified by any public entity?

If you answer YES to any of the above questions, click HERE.

AFFIDAVIT

I certify under penalty of perjury under the laws of the State of Louisiana that all statements, answers and representations on this form are true and accurate, and I acknowledge that any purposeful false information submitted on behalf of myself and verified by this signature is cause to have license denied or revoked by the Louisiana State Licensing Board for Contractors.

THIS FORM MUST BE SIGNED BY BOTH THE QUALIFYING PARTY AND A NOTARY PUBLIC

Signature of Qualifying Party (Required) Social Security Number of Qualifier (Required)

Sworn before me this day of 20

(Notary Seal)

_ Signature of Notary Public

_ Print Name and Address of Notary Public

QP# :_____________________________________________________________________Date accepted :____________________________________________________________________Approved by :____________________________________________________________________Eligibility Status:____________________________________________________________________

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Section 7: FINANCIAL STATEMENT

It is mandatory that your financial statement be submitted accurately and with the provisions of R.S. 37-2156.1(c) printed below. An unaudited financial statement should be inclusive within the last twelve (12) months and must be signed by applicant and notarized.

R.S. 37:2156.1(c) Furnish the board with a financial statement, prepared by an independent auditor and signed by the applicant and auditor before a notary public, stating the assets of the person, firm, partnership, co- partnership, or corporation, such statement to be used by the board to determine the financial responsibility of the applicant to perform work in the amount of fifty thousand dollars or more, such assets shall include a net worth of at least ten thousand dollars. The financial statement and any information contained therein, as well as any other financial information required to be submitted by a contractor, shall be confidential and not subject to the provisions of R.S. 44:1 through R.S. 44:37, inclusive.

Checklist for this section: • A financial statement indicating net worth of at least $10,000, such as a balance sheet, statement of financial position, or statement of net worth. • Signed by an independent auditor• Signed by the applicant• Notarized

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Application Fee Schedule 

Classification Fees: 

*Number of Classifications requested

1 classification: $100.00 

2 classifications: $195.00 

3 classifications: $290.00 

4 classifications: $385.00 

5 or more classifications: $400.00 

Total Classification Fees: _______ 

Examination Administrative/Research/Transaction Fee: 

*This fee is charged for EACH classification and for EACH person. This fee is charged whether or not there is

an exam or if a company/entity is requesting reciprocity. 

Price per classification per person: $120.00   Quantity: ____         Total Exam Fees: _____ 

Business and Law Price: $120.00  Quantity: ____          Total Business and Law Fees: _____ 

Business and Law Study Guide Price: $60.00  Quantity: ____         Total Study Guide Book Fees: _____ 

Mold Remediation Unfair Trade Practice Seminar Fee: 

*Only required for Mold Remediation applications

Price per person: $120.00 Quantity: ____    Total Seminar Fees: _____ 

Background Financial Investigations Fee: 

Price: $60.00       Total Investigation Fee: $60.00 

Out‐of‐State Contractors Fee: 

*This fee is for out‐of‐state companies or entities applying for a license.

Price: $400.00         Total Out‐of‐State Contractors Fees: $400.00 

      TOTAL APPLICATION FEES: _________ 

Please remit this amount by check, money order, or provide credit card information with the application. There is a $7.00 credit card swipe fee for credit card transactions.  

Checks or money orders made out to Louisiana State Licensing Board for Contractors or LSLBC. SAVE to your computer BEFORE completingSAVE to your computer BEFORE completing 9

APPLICATION CHECKLIST

Sole Proprietor: An individual who is contracting, bidding, and/or performing work under their personal name and information given on the application should be about the individual. If operating as a D/B/A you will need to complete the application as a sole proprietor.

General Partnership: An unincorporated business that is created by an agreement with two or more co-owners called general partners. The information given on the application should be about the general partnership.

Sole Proprietor or General Partnership Checklist ☐ Application: completed, signed, and notarized

☐ Application for Qualifying Party: completed, signed, and notarized

☐ Financial Statement, signed and notarized

☐ All required fees; see attached Application Fee Schedule

☐ Certificate of General Liability and Workers’ Compensation Insurance (both types of insurance are required)

**only required for Residential and Mold Remediation applications **emailed from agent to insurance@lacontractor.org AFTER the application is submitted

**see specific insurance requirements on LSLBC website on the “Frequently Asked Questions” page

☐ A copy of the Partnership Agreement (for General Partnership only)

☐ Any required copies of certifications for the requested classification(s). Examples: Plumbing certificate, Asbestos certificate, Landscaping certificate

☐ On page 1 of this application, provide the email and fax for your company if applicable.

Limited Liability Company, Limited Partnership or Corporation: The company or corporation who will be contracting, bidding, and/or performing the work is the applicant and information given on the application should be about the company.

LLC, LP, or INC Checklist ☐ Application: completed, signed, and notarized

☐ Application for Qualifying Party: completed, signed, and notarized

☐ Financial Statement, signed and notarized

☐ All required fees; see attached Application Fee Schedule

☐ Certificate of General Liability and Workers’ Compensation Insurance; both types of insurance are required

**only required for Residential and Mold Remediation applications **emailed from agent to insurance@lacontractor.org AFTER the application is submitted

**see specific insurance requirements on LSLBC website on the FAQ page

☐ A copy of the company’s Articles of Organization/Incorporation or Partnership Agreement.

☐ Any required copies of certifications for the requested classification(s). Examples: Plumbing certificate, Asbestos certificate, Landscaping certificate

☐ Registered and “In Good Standing” with the Louisiana Secretary of State’s office. This is required of ALL companies, including out-of-state companies.

☐ On page 1 of this application, provide the email and fax for your company if applicable.