To apply for the Category III LP Gas Cylinder Exchange Operator (0404) license, fill this form out completely and return it with all attachments.
Proof of insurance must be enclosed with application and fee. Pursuant to section 527 04 F S., a primary policy of bodily injury liability and property damage liability insurance covering the products and operations of the business for an amount of not less than $300,000 must be submitted along with this application. This policy must be issued by an insurer authorized to do business in the state of Florida. Proof of insurance may be provided on an insurance company certificate or by using FDACS-03520 (02/14). Liquefied Petroleum Gas Insurance Affidavit Category III LP Gas Cylinder Exchange Operator. A $300,000 surety bond may be submitted in lieu of the required proof of insurance made payable to the Governor, with the application and principal and a surety company authorized to do business in Florida as surety.
This license is required for any person, firm or corporation operating a liquefied petroleum gas cylinder exchange unit, pursuant to Chapter 527, F.S.
(0404) License Checklist:
- Complete the enclosed application.
- Submit application with $100.00 license fee.
- Attach proof of insurance coverage. ($300,000 minimum general liability including products and completed opearations) BINDERS ARE NOT ACCEPTABLE.
- Submit a Site Plan Showing all pertinent structures or sources of ignition. This is provided by your gas supplier.