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Overview of the Limited Certification Programs The Bureau administers four Limited Certification Categories to certify Governmental or Private applicators, Commercial Landscape Maintenance applicators, Limited Urban Commercial Fertilizer applicators, and Limited Commercial Wildlife Management applicators. None of these certifications allows the operation of a commercial pest control business. Limited Governmental or Private Applicator Certification Chapter 482.155, Florida Statutes Limited Certification for Governmental and Private Applicators was designed for individuals and employees of private or government entities. Examples of pesticide applicators that are impacted by this regulation would include individuals who apply pesticides to their own or their employer’s buildings or lawn and ornamental plants associated with government or commercial structures such as schools, municipal/agency offices, banks, grocery stores, apartments, condominium common areas, hotels, restaurants, etc. (Persons making application to their own personal residential property OR persons using retail general-use, ready-to-use, pre-mixed, over the counter products are exempt.) Certification obtained under this section does not authorize a person to operate a pest control business. There are two categories within this certification program: “Structural Pest Control” for applications in, on, around or under structures, and “Lawn and Ornamental” for pesticide applications to exterior property areas. Depending on the applicator’s job duties, one (or both) of the categories may be required. Limited Gov’t/Private Certification allows the use of both general and restricted use materials. For smaller municipalities and/or companies, each applicator must be individually certified. (For larger operations, the program has provisions for an employer to hire a Florida Pest Control Operator to be in charge of the pest control program and they are responsible for providing training and guidance to any applicator(s) in lieu of individual applicator certification). Application for examination is made to the Bureau with current photo and fee and an admission slip is issued to the exam candidate. The candidate then makes arrangements with their local County Extension Service office who administers the exam. The exams are then returned to the Bureau for grading and issuance of the credential to passing candidates. The certificate is valid for four years. When renewing, the certified applicator must provide proof of having obtained four hours of acceptable continuing education.

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Page 1: Home - Florida Department of Agriculture & Consumer …...Ornamental Pest Control and Structural Pest Control. Each is treated individually and some persons will need both categories

          

    

Overview of the Limited Certification Programs

The Bureau administers four Limited Certification Categories to certify Governmental or Private applicators, Commercial Landscape Maintenance applicators, Limited Urban Commercial Fertilizer applicators, and Limited Commercial Wildlife Management applicators. None of these certifications allows the operation of a commercial pest control business.

Limited Governmental or Private Applicator Certification

Chapter 482.155, Florida Statutes

Limited Certification for Governmental and Private Applicators was designed for individuals and employees of private or government entities. Examples of pesticide applicators that are impacted by this regulation would include individuals who apply pesticides to their own or their employer’s buildings or lawn and ornamental plants associated with government or commercial structures such as schools, municipal/agency offices, banks, grocery stores, apartments, condominium common areas, hotels, restaurants, etc. (Persons making application to their own personal residential property OR persons using retail general-use, ready-to-use, pre-mixed, over the counter products are exempt.) Certification obtained under this section does not authorize a person to operate a pest control business. There are two categories within this certification program: “Structural Pest Control” for applications in, on, around or under structures, and “Lawn and Ornamental” for pesticide applications to exterior property areas. Depending on the applicator’s job duties, one (or both) of the categories may be required. Limited Gov’t/Private Certification allows the use of both general and restricted use materials. For smaller municipalities and/or companies, each applicator must be individually certified. (For larger operations, the program has provisions for an employer to hire a Florida Pest Control Operator to be in charge of the pest control program and they are responsible for providing training and guidance to any applicator(s) in lieu of individual applicator certification). Application for examination is made to the Bureau with current photo and fee and an admission slip is issued to the exam candidate. The candidate then makes arrangements with their local County Extension Service office who administers the exam. The exams are then returned to the Bureau for grading and issuance of the credential to passing candidates. The certificate is valid for four years. When renewing, the certified applicator must provide proof of having obtained four hours of acceptable continuing education.

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Commercial Landscape Maintenance Applicator Certification Chapter 482.156, Florida Statutes

The Limited Commercial Landscape Maintenance Certification Program was designed to allow commercial landscape maintenance personnel to make pesticide applications (using materials, with a signal word of Caution) to ornamental plants and plant beds only. It does not allow landscape maintenance workers to make any kind of pesticide applications (including weed control) to any turf areas. There are also restrictions on application equipment. Examples of pesticide applicators that are impacted by this regulation would include commercial (for-hire) lawn maintenance or landscape maintenance individuals who apply pesticides to lawn and ornamental plants in plant beds associated with residential, governmental or commercial structures such as homes, schools, municipal/agency offices, banks, grocery stores, apartments, condominium common areas, hotels, restaurants, etc. This certification does not allow or authorize the fertilizing/maintenance company or the applicator to operate a pest control business. Application is made to the Bureau and, upon approval, an admission slip is provided to the applicant. The applicant makes arrangements with the local County Extension Service office to take the Limited Commercial Landscape Maintenance examination. The exam is then graded and certificates issued to applicants who successfully pass the examination and provide proof of minimum liability insurance (see below). Qualifying for the Limited Commercial Landscape Maintenance examination requires the applicant to complete an application and to submit documentation showing completion of six (6) classroom hours of plant bed and ornamental training approved by the Department, current photo and required fee (check or money order in the amount of $150 made payable to the Department of Agriculture and Consumer Services). Also, prior to the issuance of the Limited Commercial Landscape certification, an applicant will have to provide proof of insurance which indicates that their employer meets the minimum financial responsibility requirements for bodily injury and property damage. Presently, these amounts are set at: Bodily injury: $250,000 each person and $500,000 each occurrence; and property damage $250,000 each occurrence and $500,000 in the aggregate; or combined single limit coverage of $500,000 in the aggregate.

Limited Urban Commercial Fertilizer Applicator Certification Chapter 482.1562, Florida Statutes

The Limited Urban Commercial Fertilizer Certification Program was designed to allow commercial (for hire) fertilizer applicators to make fertilizer applications to urban properties. It does not allow any other kind of pesticide applications (including weed-n-feed fertilizers) to any turf or ornamental areas. Examples of applicators that are impacted by this regulation would include commercial (for-hire) lawn maintenance or landscape maintenance individuals who apply fertilizers to lawn and ornamental plants in turf and plant bed areas associated with residential, governmental or commercial structures such as homes, schools, municipal/agency offices, banks, grocery stores, apartments, condominium common areas, hotels, restaurants, etc.

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This certification does not allow or authorize the maintenance company or the applicator to operate a pest control business. It also does not allow the application of pesticides to turf or ornamentals, including pesticide/fertilizer mixtures and it does not allow supervision of non-certified fertilizer applicators. Application is made directly to the Bureau and the applicant must submit proof of training under Chapter 403.9338, F.S., with the required fee (check or money order in the amount of $25.00 made payable to the Department of Agriculture and Consumer Services).

Limited Commercial Wildlife Management Certification Chapter 482.157, Florida Statutes

The Limited Commercial Wildlife Management Certification Program was designed to allow commercial wildlife trappers to exclude and trap (including glue boards) commensal rodents in, on or under structures. It does not allow wildlife management workers to make any kind of pesticide applications. Examples of persons that are impacted by this regulation would include any commercial (for-hire) wildlife trapper wanting to control commensal rodents (rats/mice) in, on, or under structures. These structures can be residential, governmental or commercial structures such as homes, schools, municipal/agency offices, banks, grocery stores, apartments, condominium common areas, hotels, restaurants, etc. This certification does not allow or authorize the wildlife company or the applicator to operate a pest control business. Application is made to the Bureau with the required fee (check or money order in the amount of $150 made payable to the Department of Agriculture and Consumer Services) and, upon approval, an admission slip is provided to the applicant. The applicant makes arrangements with the local County Extension Service office to take the Limited Commercial Wildlife Management certification examination. The exam is then graded and certificates issued to applicants who successfully pass the examination and provide proof of minimum liability insurance (see below). Also, prior to the issuance of the Limited Wildlife Management certification, an applicant will have to provide proof of insurance which indicates that their employer meets the minimum financial responsibility requirements for bodily injury and property damage. Presently, these amounts are set at: Bodily injury: $250,000 each person and $500,000 each occurrence; and property damage $250,000 each occurrence and $500,000 in the aggregate; or combined single limit coverage of $500,000 in the aggregate. Rev. 07/14

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LIMITED CERTIFICATION APPLICATION INSTRUCTIONS FOR GOVERNMENTAL AND PRIVATE APPLICATORS

Chapter 482.155, Florida Statutes, requires that individuals applying both general use and restricted use pesticides as a governmental employee or as a private property owner or employee thereof must qualify to do such pesticide application by taking and passing a limited certification exam or be trained and supervised by a certified pest control operator certified by the State of Florida, Department of Agriculture and Consumer Services (DACS). Examples of pesticide applicators that come under this measure would include individuals who apply pesticides to buildings or lawn and ornamentals associated with these buildings: government buildings (schools, agency offices, etc.), commercial buildings (banks, groceries, apartments, condominium common areas, hotels, restaurants, etc.). There will be two categories of Limited Certification under this measure. They are Lawn and Ornamental Pest Control and Structural Pest Control. Each is treated individually and some persons will need both categories depending on where they will make pesticide applications. Those individuals performing pest control upon their own individual residential property are exempted from these requirements. Applicants must complete and submit form DACS 13610 with the examination fee of $150. The Bureau will process and send an examination admission letter/receipt to your address that you will need to take to your local County Extension office for them to administer and proctor your exam. The examination will be given at least quarterly, or as necessary, at most County Extension offices. Once issued, you will receive a renewal notice 45 days prior to your anniversary date (expiration date). You must complete and submit form, DACS 13683, with the recertification fee of $25 and proof of having obtained four hours of acceptable continuing education, submitted on the attendance verification form, DACS 13325. CERTIFICATION OBTAINED UNDER THIS SECTION DOES NOT AUTHORIZE A PERSON TO OPERATE A PEST CONTROL BUSINESS. (Rev 07/14)

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LIMITED CERTIFICATION APPLICATION INSTRUCTIONS

FOR COMMERCIAL LANDSCAPE MAINTENANCE Persons seeking certification in this category must pass an examination given by the department. The examination fee is set at $150. Those individuals performing pest control upon their own individual residential property are exempted from these requirements. The Annual Recertification must be accompanied by a fee of $75 and proof of having obtained four hours of acceptable continuing education submitted on DACS Form 13325 and proof of insurance in accordance with Section 482.071(4). The examination will be given at least quarterly, or as necessary, at most County Extension offices.

CERTIFICATION OBTAINED UNDER THIS SECTION DOES NOT AUTHORIZE A PERSON TO OPERATE A PEST CONTROL BUSINESS.

Also, certification, under this section, does not authorize application of pesticides to turf or the supervision of non-certified personnel. All persons making applications must be certified. Section 482.156, Florida Statutes, also requires that each applicant for examination must submit the following: 1. A completed application, on DACS Form 13604, with a current photo and the required fee ($150.00), check or money order made out to the Department of Agriculture and Consumer Services. 2. Documentation, on DACS Form 13325, showing completion of six (6) classroom hours of plant bed and ornamental continuing education training approved by the Department. Approved providers include many of the county offices of the Florida Cooperative Extension Service, pesticide distributors and pesticide consulting service companies. You may contact those in your area for further information.

(Continued next page)

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LIMITED CERTIFICATION APPLICATION INSTRUCTIONS

FOR COMMERCIAL LANDSCAPE MAINTENANCE (CONTINUED)

3. Prior to issuance of the Limited Commercial Landscape certificate, proof of insurance is required. This is documented using a Certificate of Insurance (DACS Form 13654) that indicates that the employer meets the requirements for minimum financial responsibility for bodily injury and property damage consisting of:

(a) Bodily injury: $250,000 each person and $500,000 each occurrence; and property damage $250,000 each occurrence and $500,000 in the aggregate; or (b) Combined single limit coverage: $500,000 in the aggregate.

(Rev 07/14)

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LIMITED URBAN FERTILIZER APPLICATOR

APPLICATION INSTRUCTIONS Persons seeking certification in this category must complete the application and submit proof of training that has been approved by the Florida Department of Environmental Protection, under Chapter 403.9338, F.S., commonly known as the Green Industries Best Management Practices (GIBMP) training. Most of this training is being provided by the University of Florida, Institute of Food and Agricultural Sciences (UF/IFAS). Available training programs and classes can be found at this website: https://gibmp.ifas.ufl.edu/ You will be awarded a certificate upon completion of this training. A copy of this certificate MUST be included with your application. Application is made directly to the Bureau by submitting a completed application form (DACS 13677) with the required fee (check or money order) in the amount of $25.00, made payable to the Department of Agriculture and Consumer Services, and a copy of the GIBMP training certificate.

CERTIFICATION OBTAINED UNDER THIS SECTION DOES NOT AUTHORIZE A PERSON TO OPERATE A PEST CONTROL BUSINESS.

(Rev 07/14)

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LIMITED CERTIFICATION APPLICATION INSTRUCTIONS

FOR COMMERCIAL WILDLIFE MANAGEMENT Persons seeking certification in this category must pass an examination given by the department. The examination fee is set at $150. Those individuals performing nuisance wildlife control upon their own individual residential property are exempted from these requirements. The Annual Recertification must be accompanied by a fee of $75 and proof of having obtained four hours of acceptable continuing education submitted on DACS Form 13325 and proof of insurance in accordance with Section 482.071(4). The examination will be given at least quarterly, or as necessary, at the Apopka, Florida, UF/IFAS Mid Florida Research and Education Center located at 2725 South Binion Road, Apopka, Florida, 32703.

CERTIFICATION OBTAINED UNDER THIS SECTION DOES NOT

AUTHORIZE A PERSON TO OPERATE A PEST CONTROL BUSINESS.

Also, certification, under this section, does not authorize the use of pesticides or chemical substances, other than adhesive materials, to control rodents or other nuisance wildlife in, on, or under structures or the supervision of non-certified personnel. All persons using nonchemical methods to control rodents must be certified.   Section 482.157, Florida Statutes, also requires that each applicant for examination must submit the following: 1. A completed application, on DACS Form 13685, with a current photo and the required fee ($150.00), check or money order made out to the Department of Agriculture and Consumer Services. 2. Prior to issuance of the Limited Commercial Wildlife Management certificate, proof of insurance is required. This is documented using a Certificate of Insurance

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(DACS Form 13688) that indicates that the employer meets the requirements for minimum financial responsibility for bodily injury and property damage consisting of:

(a) Bodily injury: $250,000 each person and $500,000 each occurrence; and property damage $250,000 each occurrence and $500,000 in the aggregate; or (b) Combined single limit coverage: $500,000 in the aggregate.

(Rev 07/14)

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REFERENCE MATERIAL SUGGESTED FOR STUDY IN PREPARATION FOR THE LIMITED CERTIFICATION EXAMINATIONS

The source and price of each reference are provided at the end of this list as indicated by the numbers in parentheses ( ). REFERENCES FOR ALL LIMITED CERTIFICATION EXAMINATIONS: The Structural Pest Control Act, Chapter 482, Florida Statutes (1) Rules of the Department of Agriculture and Consumer Services, Chapter 5E-14, Florida Administrative Code (1) Applying Pesticides Correctly - A Guide for Pesticide Applicators (Revised 2010)-SM-1 (2a) For Questions concerning labels, a label will be included for reference during examination. ADDITIONAL REFERENCES IN EACH CATEGORY:

LIMITED STRUCTURAL PEST CONTROL General Household Pest Control Applicator Training Manual – SM-47 Edited by Philip G. Koehler & William H. Kern, Jr. (2b)

LIMITED LAWN & ORNAMENTAL Lawn and Ornamental Pest Management – SM-81 (2e) Identification Guide to Common Florida Lawn and Ornamental Weeds, SP-499 - $12.00 (2d)

Best Management Practices for Protection of Water Resources in Florida, June 2002, Florida Green Industries. Available free of charge at your local County extension office or it can be downloaded directly from: http://ffl.ifas.ufl.edu/professionals/BMP_manual.htm.

LIMITED COMMERCIAL LANDSCAPE MAINTENANCE PERSONNEL

Limited Commercial Landscape Maintenance – SM-82 (2c)

Best Management Practices for Protection of Water Resources in Florida, June 2002, Florida Green Industries. Available free of charge at your local County extension office or it can be downloaded directly from: http://ffl.ifas.ufl.edu/professionals/BMP_manual.htm.

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LIMITED COMMERCIAL WILDLIFE MANAGEMENT

Dealing with Unwanted Wildlife in an Urban Environment, Publication #WEC20 Available free of charge by downloading it directly from: http://edis.ifas.ufl.edu/uw070 Non-Chemical Rodent Control, Publication #ENY-243 Available free of charge by downloading it directly from:

https://www.freshfromflorida.com/content/download/76591/2214164/file/ratmousenonchemMG21800.pdf 

Rat and Mouse Control, Publication #ENY-224 Available free of charge by downloading it directly from: http://edis.ifas.ufl.edu/dh044 The Florida Mouse, Publication #WEC362 Available free of charge by downloading it directly from: http://edis.ifas.ufl.edu/uw307

SOURCE OF REFERENCE MATERIAL (1) The Structural Pest Control Act, Chapter 482, Florida Statutes; the Rules of the Department of Agriculture and Consumer Services, Chapter 5E-14, Florida Administrative Code, are available at this link http://www.freshfromflorida.com/Divisions-Offices/Agricultural-Environmental-Services in the “Laws and Regulations” box on the right hand side of the page; OR upon request from the Bureau of Licensing and Enforcement, 3125 Conner Blvd, Bldg 8, Tallahassee, Florida 32399-1650, telephone (850) 617-7997. (2) IFAS Manuals a. Applying Pesticides Correctly - A Guide for Pesticide Applicators, 7th Edition SM 1 - $20.00 b. General Household Pest Control Applicator Training Manual, SM 47 - $30.00 c. Limited Commercial Landscape Maintenance, SM 82 - $25.00 d. Identification Guide to Common Florida Lawn and Ornamental Weeds, SP-499 - $12.00 e. Lawn and Ornamental Pest Management, SM-81 - $25.00 All of the above under (2) are available from IFAS Publications, Building 664, Gainesville, Florida, 32611, telephone (800) 226-1764. Make Checks payable to University of Florida. Florida residents add the appropriate sales tax for the county in which you reside and the postage/handling costs as indicated below.

Schedule of Postage and Handling

Amount of Sale Add $ 0 - 4.99 .............................. $4 $ 5 - 24.99 .............................. $6 $ 25 - 49.99 ...............................$7 $ 50 - 129.99 ...............................$8

(Revised 07/15)

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Remit Fee Online at: www.FreshFromFlorida.com

- or -Check or Money Order Payable to

FDACS:

FDACS Revenue Processing Section P.O. Box 6710 Tallahassee, FL 32314-671

Florida Department of Agriculture and Consumer Services Division of Agricultural Environmental Services

LIMITED CERTIFICATION FOR GOVERNMENT PESTICIDE APPLICATORS OR PRIVATE APPLICATORS

Rule 5E-14.117, F.A.C. Telephone: (850) 617-7997

REMIT SEPARATE CHECKS FOR EACH APPLICATION

IMPORTANT - DIRECTIONS:

(1) Applicant must be 18 years of age or older to apply.

(2) Enclose a check or money order payable to FDACS in the amount of $150.00. DO NOT SEND CASH. PLEASE REMIT SEPARATE CHECKS FOR EACH APPLICATION.

I hereby make application for Limited Certification in the categories checked.

STRUCTURAL PEST CONTROL – 001367 $ 150.00

LAWN AND ORNAMENTAL PEST CONTROL – 001366 $ 150.00

TOTAL FEES ENCLOSED $

All questions MUST be answered. PLEASE PRINT.

1. Name of Applicant(Last) (First) (Middle)

Mailing Address (Street or Post Office Box)

(City) (County) (State) (Zip Code)

Telephone Number ( ) Email Address (Area Code)

FL Driver’s License Number (or State ID)

2. Name of Employer (if applicable)

Street Address (Street) (City) (County) (State) (Zip Code)

Employer Phone No. ( ) (Area Code)

3. Have you previously been examined and failed in the category(s) now applied for? YES NO If yes, give month and year FIRST examined in category:

Structural Lawn and Ornamental ___________________________________ (Month) (Year) (Month) (Year)

Date of Birth: (Month) (Day) (Year)

_________________________________________ (Applicant’s Signature)

County to be examined in

FDACS-13610 Rev. 10/15

Org. Code: 42 13 08 02 060 EO B7 Object Code: 001367 $ 150.00

001366 $ 150.00

NICOLE "NIKKI" FRIED

COMMISSIONER

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Remit Fee Online at: www.FreshFromFlorida.com

- or -

Check or Money Order Payable to FDACS:

FDACS Revenue Processing Section P.O. Box 6710 Tallahassee, FL 32314-6710

Florida Department of Agriculture and Consumer Services Division of Agricultural Environmental Services

LIMITED CERTIFICATION FOR COMMERCIAL LANDSCAPE MAINTENANCE PERSONNEL

Section 482.156, F.S. and Rule 5E-14.117, F.A.C.

Telephone: (850) 617-7997

IMPORTANT - DIRECTIONS:

(1) Applicant must be 18 years of age or older to apply.

(3) Enclose a check or money order payable to FDACS in the amount of $150.00. DO NOT SEND CASH. PLEASE REMIT SEPARATE CHECKS FOR EACH APPLICATION.

I hereby make application for the Limited Certification for Commercial Landscape Maintenance Personnel examination. (Proof of insurance is required prior to issuance of the credential.)

Limited Certification for Commercial

Landscape Maintenance Personnel - 001365 $ 150.00

TOTAL FEES ENCLOSED $

All questions MUST be answered. PLEASE PRINT.

1. Name of Applicant(Last) (First) (Middle)

Mailing Address (Street or Post Office Box)

(City) (County) (State) (Zip Code)

Telephone Number ( ) Email Address (Area Code)

FL Driver’s License No. (or State ID)

2. Name of Employer (if applicable)

Street Address (Street) (City) (County) (State) (Zip Code)

Employer Phone No. ( ) (Area Code)

3. Have you previously been examined and failed in the category now applied for? YES NO

If yes, give month and year FIRST examined in category: (Month) (Year)

Date of Birth: (Month) (Day) (Year)

(Applicant’s Signature)

County to be examined in:

FDACS-13604 Rev. 10/15

Org. Code: 42 13 08 02 060

EO B7

Object Code: 001365 $ 150.00

NICOLE "NIKKI" FRIED

COMMISSIONER

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NICOLE "NIKKI" FRIED COMMISSIONER

Florida Department of Agriculture and Consumer Services Division of Agricultural Environmental Services

CERTIFICATE OF INSURANCE

Rule 5E-14.117, F.A.C.

Telephone: (850) 617-7997; Fax (850) 617-7967

Please check the type of business your insurance is applicable to:

Commercial Landscape Maintenance Commercial Wildlife Management

Policy Number Policy effective date Policy expiration date

Section(s) 482.071(4), 482.156(2)(a), and 482.157(2)(c), Florida Statutes, states, in part, “Each person making application for certification under this section must furnish proof of having a certificate of insurance, as required by Section 482.071(4), Florida Statutes”, which states that the employer or individual meets the requirements for minimum financial responsibility for bodily injury and property damage consisting of:

(A) Bodily injury: $250,000 each person and $500,000 each occurrence; andProperty damage: $250,000 each occurrence and $500,000 in the aggregate; or

(B) Combined single-limit coverage: $500,000 in the aggregate.

The insured’s coverage meets or exceeds the minimum statutory requirement as stated above:

Authorized Insurance Representative

CERTIFICATE HOLDER

Florida Department of Agriculture and Consumer Services Bureau of Licensing and Enforcement 3125 Conner Blvd, Bldg 8, Tallahassee, Florida 32399-1650

FDACS-13654 Rev. 07/14

Respond to:

Bureau of Licensing and Enforcement 3125 Conner Blvd, Bldg 8, Tallahassee, FL 32399-1650

Insured:

Company Name

Company Business Location Address

City, State, Zip Code

______________________________________________ Individual’s Name (for Landscape and Wildlife applicants)

PRODUCER:(Insurance Agent)

Company Name

Company Business Location Address

City, State, Zip Code

Insured Company Affording Coverage:

Company Name

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NICOLE "NIKKI" FRIED COMMISSIONER

Remit Fee Online at: www.FreshFromFlorida.com

- or -Check or Money Order Payable to

FDACS:

FDACS Revenue Processing Section P.O. Box 6710 Tallahassee, FL 32314-6710

Florida Department of Agriculture and Consumer Services Division of Agricultural Environmental Services

APPLICATION FOR LIMITED CERTIFICATION FOR URBAN LANDSCAPE COMMERCIAL FERTILIZER

Rule 5E-14.117, F.A.C.Telephone: (850) 617-7997

IMPORTANT – DIRECTIONS: (1) Applicants must be 18 years of age or older to apply.(2) Enclose a check or money order made payable to FDACS in the amount of $25.00. Please remit separate checks for each

application. DO NOT SEND CASH.

(3) You must enclose a certificate of completion of training issued by the University of Florida (IFAS) and/or Department ofEnvironmental Protection (DEP) with this application.

Issuance fee for a Limited Certificate for Commercial Fertilizer Application - 002258: $ 25.00 each

Total Fees Enclosed: $ __________

ALL INFORMATION MUST BE LEGIBLE AND COMPLETELY FILLED IN. PLEASE PRINT.

1. Full Legal Name of Applicant: _________________________________________________________________________(Last) (First) (Middle)

2. Mailing Address: ___________________________________________________________________________________(Complete Street or Post Office Box Number)

(City) (State) (Zip Code)

3. Email Address: ___________________________________________________________________________________

4. FL Driver’s License No. (or State ID):

5. Telephone Number: ( ) (Area Code) (Phone Number)

6. Applicant’s Date of Birth: __________________________________________(Month) (Day) (Year)

7. Employed By: _____________________________________________________________________________________(Name of Company)

8. Employer’s Address: ________________________________________________________________________________(Complete Street Address) (City) (State) (Zip Code)

9. Employer’s Telephone Number: ______(________)_______________________________________________________ (Area Code) (Phone Number)

I hereby make application for the issuance of a Limited Certification for Urban Landscape Commercial Fertilizer.

Applicant Signature: _________________________________________

Date: _____________________________________________________

FDACS-13677 Rev. 10/15

Org. Code: 42 13 08 02 060 EO B7 Object Code: 002258 $ 25.00

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NICOLE "NIKKI" FRIED

COMMISSIONER

Remit Fee Online at: www.FreshFromFlorida.com

- or -

Check or Money Order Payable to FDACS:

FDACS

Revenue Processing Section

P.O. Box 6710

Tallahassee, FL 32314-6710

Florida Department of Agriculture and Consumer Services Division of Agricultural Environmental Services

LIMITED CERTIFICATION FOR COMMERCIAL WILDLIFE MANAGEMENT

Rule 5E-14.117, F.A.C. Telephone: (850) 617-7997

IMPORTANT - DIRECTIONS:

(1) Applicant must be 18 years of age or older to apply.

(2) Enclose a check or money order payable to FDACS in the amount of $150.00. DO NOT SEND CASH.

PLEASE REMIT SEPARATE CHECKS FOR EACH APPLICATION.

I hereby make application for the Limited Commercial Wildlife Management examination.

Limited Certification for Commercial Wildlife Management - 001137 $ 150.00

TOTAL FEES ENCLOSED $ .

All questions MUST be answered. PLEASE PRINT.

1. Name of Applicant(Last) (First) (Middle)

Mailing Address (Street or Post Office Box)

(City) (County) (State) (Zip Code)

Telephone Number ( ) Email Address (Area Code)

FL Driver’s License No. (or State ID)

2. Name of Employer

Address(Street) (City) (County) (State) (Zip Code)

Employer Phone No. ( ) (Area Code)

3. Have you previously been examined and failed in the category now applied for? YES NO

If yes, give month and year FIRST examined in category: (Month) (Year)

Date of Birth: (Month) (Day) (Year)

_____

(Applicant’s Signature)

County to be examined in: ________________________ ________

FDACS-13685 Rev. 10/15

Org. Code: 42 13 08 02 060 EO B7 Object Code: 001137 $ 150.00