Form Cc-008 - Certificate Of Competency Application Page 4
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26CERTIFICATE OF COMPETENCY APPLICATION
3.2.Business Questionnaire
a. I am qualifying for a (check one): Sole Proprietorship
Partnership Corporation or LLC
b. Will you, as the qualifying agent have any ownership in the firm? (check one): Yes No
c. If yes please describe ownership type and percentage; be sure to include proof of ownership.
d. Will you be supervising employees of this company (check one): Yes No
e. If yes, please provide the number of employees and their duties.
f. Please describe your Supervision duty under your trade:
g. Do you hold any current Construction/Trade licenses?: Yes No
h. If yes, please list (include copies).
3.3.Complete this section if you are qualifying a Corporation or an LLC:
Title
Officer or Member Name
Home Address, City, State, Zip, & Contact
number
Page 3 of 8
Form CC-008
Certificate of Competency Application
Rev. 12/9/16
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