Get Idph Lead Contractor Application Form

Filling out the Idph Lead Contractor Application Form online can be a straightforward process with the right guidance. This guide will walk you through each section of the form, ensuring you provide all necessary information accurately.

Follow the steps to complete the application efficiently.

1. Click ‘Get Form’ button to obtain the application form and open it in your preferred online platform.
2. Begin by entering your business name in the designated field. Ensure the name is exact as registered with relevant authorities.
3. Provide the contact person's name, which should be an individual who can address inquiries related to the application.
4. Fill in your business address, including the street, city, county, state, and ZIP code. Ensure all details are accurate to avoid any delays.
5. Enter a working business telephone number where representatives can be reached, along with a fax number if available.
6. Select your type of ownership by checking the appropriate box: Sole Proprietorship, Corporation, Trust, Partnership, Association, or specify another type.
7. List the names of any officers in the business, including their titles and addresses, where required.
8. Designate a supervisor for your operations alongside their license number or Social Security number, and their address.
9. Review the certification statement affirming that the information provided is accurate. This is crucial as false claims may lead to the denial of your application.
10. Ensure to complete and return the accompanying Public Information Disclosure form, as this is necessary for contact data release.
11. Attach a current certificate of insurance issued by an authorized insurer in Illinois. This document must be kept on file to maintain compliance.
12. Submit any Notices of Commencement for Lead Abatement/Mitigation projects at least 10 working days prior to the project start date.
13. Finally, print or save the completed application for your records. You may also want to download or share the form as needed.

Complete your Idph Lead Contractor Application Form online today to ensure a smooth application process.