Checklist for Submitting Your Pesticide Applicator's Business License (PABL) Application Form

Required Documents

1. Pesticide Applicator's Business License - Application Form (PI-079)
2. Incorporation, partnership, or assumed name documents (where applicable).
3. Proof of Insurance
4. Notarized Statement of Experience (PI-217), if adding a new category.
    

A. LICENSE APPLICATION

1. Is the current and full legal name of the business on the application?
    
2. Have you filled in the emergency phone number, fax number, and E-mail address?
    
3. Are all the applicators full names and certification/registration numbers listed? Attach an additional sheet if necessary. It is the responsibility of the license applicant to provide updates to MDARD regarding any changes in status of any of the firm’s applicators. Certified applicators must be certified in categories they're applying for before submitting business license application.  If you or your employees have recently taken certification exams, please attach copies of your receipt(s) that show the exam scores and dates.
    
4. Have you selected all the license categories that your firm intends to provide application services for? Does your listing of certified applicators cover all those categories?
    
5. Is the application signed? We cannot process an application that is not signed.
    
6. Have you enclosed a check or money order for $100.00, payable to State of Michigan?
   
   Please allow 4 to 6 weeks to process your business license.
    

B. CORPORATION/PARTNERSHIP/ASSUMED NAME DOCUMENTS

1. Have you enclosed necessary documentation that shows your business name is registered?

For sole proprietorships or partnerships, submit a copy of each DBA Certificate issued from county clerk offices. A DBA Certificate is required in each county where the firm operates.

For corporations and limited liability companies, submit a Corporation ID number and any associated Certificates of Assumed Names filed with LARA.  Contact LARA, Corporations Division, Phone: 517-241-6470, Fax: 517-334-8329.For more information, visit LARA’s website at Michigan.gov/Corporations.

For out-of-state firms (also known as “foreign corporations”), submit Certificate of Authority to do business in the State of Michigan.  Apply for this authorization at LARA, Corporations Division, Phone: 517-241-6470, Fax: 517-334-8329. For more information, visit LARA’s website at Michigan.gov/Corporations.

      2.  Are the certificates current and active (i.e. have not expired)?

C. PROOF OF INSURANCE

1. Does the Certificate of liability insurance form include:

• Exact street address for the business as provided on the application?
• Exact legal name of the business as provided on the application?
• It is the responsibility of the license applicant to provide a current certificate of insurance to MDARD, not the insurance agent’s duty. You must fax (517-284-0458) or mail any updated insurance information to the MDARD Central Licensing Unit, P.O. Box 30017, Lansing, MI 48909.

2. Verify insurance coverage amounts to cover bodily injury and property damages that arise from pesticide application. All license categories require a minimum of $100,000 for bodily injury and $25,000  property damage minimum coverage, with the exception of categories 6, AE, and FUM, which are required to have a minimum coverage of $300,000 combined single limit bodily injury and property damage.

D. NOTARIZED STATEMENT OF EXPERIENCE

1. Have you enclosed the Notarized Statement of Experience (PI-217) document for the pesticide applicator who is the qualifier of any new category, or categories, being requested on the license?
2. Does the experience statement include the required timeframe and the contact persons along with their phone numbers?