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Certificate of Authorization Sopplemental

CA Supplemental Form.pdf

Form Instructions

INSTRUCTIONS: ALABAMA CERTIFICATE OF AUTHORIZATION SUPPLEMENTAL FORM

An Alabama professional engineer or land surveyor may serve as the principal or responsible charge at more than one building site by filing the form discussed in this article. You must be able to detail how you will be able to supervise multiple sites. This document can be obtained from the website of the Alabama State Board for Licensure for Professional Engineers & Land Surveyors.

Alabama Certificate Of Authorization Supplemental Form Step 1: On line 1, enter the name of the licensee and their license number.

Alabama Certificate Of Authorization Supplemental Form Step 2: Lines 2 through 5 document the primary employer responsible for the project for which you are already licensed. Enter their name and CA number on line 2.

Alabama Certificate Of Authorization Supplemental Form Step 3: On line 3, enter the primary address of the employer.

Alabama Certificate Of Authorization Supplemental Form Step 4: Line 4 asks whether you are the resident designated principal or responsible charge for this employer.

Alabama Certificate Of Authorization Supplemental Form Step 5: Line 5 asks how many hours a week you are physically present at the site of the primary employer.

Alabama Certificate Of Authorization Supplemental Form Step 6: Lines 6 through 12 concern your proposed secondary employer. Enter their name and CA number on line 6.

Alabama Certificate Of Authorization Supplemental Form Step 7: Enter the secondary firm's address on line 7.

Alabama Certificate Of Authorization Supplemental Form Step 8: Line 8 asks whether you are this secondary firm's resident designated principal or responsible charge. Check "Yes" or "No."

Alabama Certificate Of Authorization Supplemental Form Step 9: Line 9 asks how many hours a week you are physically present at the second firm. Line 10 asks how many miles separate the two employers.

Alabama Certificate Of Authorization Supplemental Form Step 10: Line 11 asks how many people are employed by the secondary firm. Line 12 asks if services are performed or offered by the secondary firm during your absence.

Alabama Certificate Of Authorization Supplemental Form Step 11: Line 13 asks you to detail the hours of operation for both firms.

Alabama Certificate Of Authorization Supplemental Form Step 12: Sign and date the bottom of the form. Also provide your email address and phone number.

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