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from its web site at www.dir.ca.gov. These regulations are for the
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Chapter 6. Division of Labor Standards Enforcement
Subchapter 9. Labor Commissioner's Farm Labor Contractor Fund
To apply for a Farm Labor Contractor license pursuant to Labor Code section 1684, the applicant shall complete, sign, and submit an online application along with required items and documents at DLSE's website (https://permits.dir.ca.gov/FLC_External/) for any initial or new license or license renewal. Alternatively, an applicant may submit to DLSE a complete and signed physical application for a new or initial license (DLSE 401-N), a regular license renewal (DLSE 401-R), or a short-form license renewal (DLSE 401-S) and provide the items and documents pursuant to the respective application requirements as specified in this article. The applicant shall certify under penalty of perjury that the information provided on the application form, any supplementary documents, and any other information submitted by the applicant in support of the application is true and correct and executed by signature. If the place of execution is outside California, the certification must be sworn before a notary public or other officer authorized to take oaths and affirmations.
(a) The application for an initial or new license (online form or DLSE 401-N) shall contain the following information to be provided by the applicant:
(1) If the applicant is an individual (sole proprietor), that individual's name, date of birth, driver's license number, and Social Security number. If applicant is a corporation, the date of incorporation. If applicant is a partnership, the date the partnership was created and the name, date of birth, driver's license number, and Social Security number of each partner. If applicant is a limited liability company (LLC) the date of filing the articles of organization.
(2) All names under which the applicant is doing business as or has done business as within the previous three years;
(3) Current physical business address (number, street, city or town, county, state, zip code) and preferred mailing address if different than physical business address, preferred email address, and home physical address of the applicant (if a sole proprietor), for each partner in a partnership, each member of an LLC, or each corporate officer of a corporation. If the current address information subsequently changes, the applicant must immediately, but no later than five (5) days thereafter, advise the Labor Commissioner of the change;
(4) Main business telephone number and mobile telephone number used in conducting business;
(5) A copy of the Migrant and Seasonal Worker Protection Act (29 U.S.C. section 1811) certificate of registration that has been issued to applicant, if the applicant is required to register as a farm labor contractor under federal law;
(6) Identity of the legal form or type of ownership of the farm labor contractor business (individual/sole proprietor, partnership, corporation, limited liability company, or other business entity).
(A) If individual or sole proprietor ownership, the full name of the owner, physical home address, mailing address, if different, business telephone and mobile telephone number of owner, and designation of an agent for service of process, if applicable, including physical address and business telephone number and mobile telephone number of the designated agent for service of process;
(B) If partnership, the full name, physical home address, mailing address, if different, and business telephone number and mobile telephone number of each partner used in conducting business;
(C) If corporation or LLC, the full name, titles, physical home address, mailing address, if different, business telephone number and mobile telephone number of each corporate officer, managing agent and LLC member, and indicate whether the corporation or LLC is in good standing with the Secretary of State;
(D) If a foreign corporation incorporated or organized outside of California, in addition to the information required under (C), provide the date a Statement and Designation by Foreign Corporation (form S&DC-STK/NP) was filed with the Secretary of State.
(7) For all persons, except bona fide salaried employees, or entities with a financial interest in the applicant's business, including but not limited to partnerships, corporations, LLCs or other business entities, the name and address of the person or entity and a statement of the person or entity's percentage of financial or profit-sharing interest in the applicant's business.
(8) Indicate whether the applicant will utilize the services of any other individual or entity to recruit, solicit, hire, furnish, employ, or transport agricultural workers, which includes but is not limited to, foremen and crew bosses.
(A) If yes, state for each individual or entity who will perform any of these activities (i) the person or other entity's name, current physical address and telephone number, Social Security number, and farm labor contractor license number, if applicable, (ii) whether each individual or entity identified has at any time within the last 10 years held a farm labor contractor license, and (iii) provide federal certificate of registration issued by the U.S. Department of Labor if the individual or entity is required to register under federal law.
(B) If no, state who will perform these activities.
(9) The names and physical addresses, mailing address, if different, and email address of all growers with whom the applicant plans to contract in the near future and, if applicable, with whom the applicant has contracted during the past three years;
(10) The name and title of the person who will take the written examination for the applicant and whether the person prefers to take the examination in English or Spanish;
(11) State whether the applicant intends to maintain a labor camp, lodging house, or other housing for workers. If yes, state the physical address of the location of the housing, the local agency which issued a license or permit to house workers, and the effective dates of such license or permit;
(12) Indicate that applicant will not sell or propose to sell intoxicating liquors, including wine or beer, on the premises where the applicant operates;
(13) Indicate whether the applicant has submitted to the Internal Revenue Service a tax information authorization form (IRS Form 8821);
(14) Indicate whether the applicant intends to provide transportation to employees, and:
(A) For each vehicle to be used for this purpose, identify the owner, make, model and year, body type and capacity, license plate number, vehicle identification number (VIN), and name, address, and telephone number of the automobile liability insurance carrier;
(B) Identify the name, address, and driver's license number of each individual who will operate any vehicle to provide transportation;
(C) For any additional vehicle which is subsequently sought to be used for the transportation of employees which is not identified on the application, the additional vehicle must be registered with DLSE not later than 7 days prior to use of the vehicle for transportation of workers. For vehicles which are subsequently registered, applicant or licensee must provide a copy of the liability insurance coverage, and DMV certification, if applicable, for operators, as required under subdivision (b)(10) and (11).
(15) Indicate whether applicant's farm labor contractor operation will be conducted in connection with any other business and, if so, the type of business and name, address, and telephone number of the other business;
(16)(A) Indicate whether any person identified under subdivisions (a)(6) and (a)(7) of this section, within the last 10 years:
(i) owes any delinquent unpaid wages;
(ii) has any unpaid judgments outstanding;
(iii) owes payroll taxes, personal, partnership or corporate income taxes, Social Security taxes, or disability insurance taxes;
(iv) has plead guilty or nolo contendere to or been convicted of a crime substantially related to working conditions or workers' health or safety, either misdemeanor or felony. The term convicted includes instances in which there was a suspension of sentence and probation granted, and where judicial dismissal proceedings under Penal Code section 1203.4 et seq. were undertaken;
(v) has had any license or permit issued pursuant to the Labor Code or Business and Professions Code, or both, that was suspended, revoked, or denied, or has had any disciplinary action of any nature whatsoever imposed upon him, her, or it in connection with the holding of a license or permit;
(vi) has violated or willfully aided or abetted any person in the violation of any law in the State of California regulating employment in agriculture, the payment of wages to farm employees, or the conditions, terms or places of employment affecting the health and safety of farm employees which are applicable to business activities or operations of the licensee in his or her capacity as a farm labor contractor.
(B) If any person or entity identified in subdivision (A) above falls within subdivisions (i) through (vi), the applicant shall submit an explanation regarding the incident and documentation supporting the explanation, including but not limited to, description of the violation or charge, date of incident, court or agency name (federal, state or local), and the disposition, if any, of the matter.
(17) Applicant shall submit a list including the name and addresses of any of the following relatives who the applicant knows has previously applied for or held a farm labor contractor license and whether the license was denied or revoked within the last 10 years: spouse, domestic partner, brother, brother-in law, sister, sister-in-law, cousin, cousin-in-law, father, father-in-law, mother, mother-in law, son, son-in-law, daughter, or daughter-in-law, aunt, or uncle of the applicant if the applicant is an individual, of a partner if applicant is a partnership, and of an officer or shareholder if applicant is a corporation, LLC, or other business entity.
(18) Indicate the total number of employees the applicant will employ, and provide his or her state and federal tax employer identification numbers.
(19) Total gross annual revenue for the applicant.
(20) The name and address of an agent or representative designated by the applicant to speak on behalf of the applicant for purposes of communicating with DLSE personnel.
(21) Attest to express certification statements regarding obligations which are acknowledged and made when submitting an application that the applicant:
(A) Agrees to comply with the provisions of Labor Code section 3700 which require every employer to be insured against liability for workers compensation.
(B) Is aware of and agrees to comply with the provisions of Labor Code section 1684(a)(3) to deposit with the Labor Commissioner and maintain a current surety bond.
(C) Agrees, in the event the transportation is provided for employees, to carry public liability insurance on each vehicle used, as required by subdivision (b)(10) and to ascertain that all individuals providing transportation are legally licensed and competent to transport employees.
(D) Agrees, as a condition of being licensed as a farm labor contractor by the Labor Commissioner, to keep the Commissioner informed of any change in the licensee's address and other contact information.
(E) Consents, pursuant to Labor Code section 1684(a)(1)(C), to the designation of the Labor Commissioner by an appropriate civil court as the licensee's agent to accept service of summons in any action against a licensee relating to their activities as a farm labor contractor in the event that applicant has left the jurisdiction in which the action is commenced or otherwise become unavailable to accept service.
(F) Is aware of the responsibilities as licensee and agrees to operate as a farm labor contractor in compliance with the provisions of the California Labor Code and applicable regulations, including provision of adequate safeguards for health and safety of workers and proper payment to workers; and specifically:
(i) is aware of all applicable worker safety requirements related to agricultural working conditions, including heat illness injury prevention and pesticide use and exposure, and will comply with all applicable requirements; and
(ii) will provide all protective measures, materials and equipment necessary to comply with heat illness injury prevention requirements (see Title 8, California Code of Regulations, section 3395) at each work site where work is to be performed.
(G) Certifies that applicant has provided all facts required by the Labor Commissioner to make its determination to issue a license to operate as a farm labor contractor as to the applicant's character, competency, responsibility, and the manner in which the applicant proposes to conduct operations.
(H) Is aware of the provisions of the Labor Code and applicable regulations regarding grounds for revocation, suspension, refusal to renew, or issue a license to operate as a farm labor contractor, and that a violation or failure to comply with all licensing requirements applicable to farm labor contractors, including regulations in Title 8 of the California Code of Regulations sections 13660 through 13667.4, inclusive, will subject a licensee to denial of an application, revocation, suspension, or failure to renew a license.
(I) Is aware that any material misrepresentation made in connection with the information provided on the application or other documents submitted relating to the application is grounds for denial or subsequent revocation of a license.
(b) The applicant for a farm labor contractor license shall provide to the Labor Commissioner the following items and documents along with the application for a license:
(A) License fee of $500 and a filing fee of $10, pursuant to Labor Code section 1684(a)(4);
(B) Examination fee pursuant to Labor Code section 1684(b)(1). The applicant shall pay a one hundred dollar ($100) fee for three attempts to pass the examination in a calendar year. Failure to pass after three attempts shall result in rejection of the application, forfeiture of the examination and applications fees, and inability to re-apply and retake the test until the beginning of the next calendar year after rejection.
All fees may be paid online by accessing http://www.dir.ca.gov/dlse/Online Payment, or by submission of a certified check, cashier's check, or money order to the Division of Labor Standards Enforcement;
(2) If applicant is a corporation, a copy of the Articles of Incorporation and the most recent Statement of Information (form SI-200) filed with the Secretary of State. If the applicant is an LLC, a copy of the Articles of Organization and most recent Statement of Information (form LLC-12); and if a partnership, a copy of the written partnership agreement, if any;
(3) Two (2) current passport photos for an individual who is a sole proprietor, each partner, and a representative of a corporation, LLC, or other business entity, as applicable for the type of business entity. If the identity of a representative changes during the period of the license, the corporation or business entity shall submit two passport photographs of the new representative so that the division can issue a new license. The name of the person in the photo must be written on the back of the each photo.
(4) A copy (for online applications) or an original (for submitting a physical application) of a Farm Labor Contractor Bond (DLSE 402 or on a form issued by the surety) which complies with the requirements of Labor Code Section 1684(a)(3).
(5) Certificate of Workers' Compensation Insurance coverage or certificate of self-insurance issued to the applicant or valid contract with a third party to provide workers' compensation insurance. This certificate and documentation shall contain the name of the insured, fictitious business name ( “dba”), if any, and current physical business address of the insured, effective and expiration date, amount of coverage and a policy number, if applicable. If the applicant provides a contract with a third party to provide workers' compensation insurance, the applicant shall also provide a Certificate of Workers' Compensation Insurance or certificate of self-insurance issued to that third party demonstrating workers' compensation coverage for employees of the applicant.
(6) Evidence of completion of eight hours of approved educational classes during the previous year in accordance with section 13665.5.
(7) Pursuant to Labor Code section 273 subdivision (b), a statement that applicant has satisfied all current requirements imposed in a final court judgment, Labor Commissioner order, or an accord (e.g. settlement agreement) involving an issue which relates to unpaid wages.
(8) Live scan fingerprint images for a sole proprietor, all partners of a partnership, all corporate officers of a corporation, each member of a limited liability company, as applicable.
(9) A copy of driver's license for:
(A) A sole proprietor, each partner of a partnership, each corporate officer of a corporation, each member of a limited liability company, as applicable
(B) Each person who will operate a farm labor vehicle for transportation of workers, including drivers of vehicles who transport farm laborers who are not the applicant's employees.
(C) The person taking the examination required under Labor Code section 1684(a)(5). For purposes of this subdivision (b)(9)(C), other photo identification on a legally authorized document is acceptable.
(10) Proof of applicant's vehicle liability insurance coverage in the amount set below, for each vehicle identified under section 13660(a)(14)(A) which includes the name of the insured, the name and address of coverage carrier, policy number, coverage limits, including medical coverage, the policy's effective dates for each vehicle applicant intends to utilize.
(A) For vehicles carrying 15 or fewer passengers: $15,000/$30,000 minimum coverage for personal injury, and $50,000 for property damage.
(B) For vehicles carrying more than 15 passengers: $30,000/$60,000 minimum coverage for personal injury, and $50,000 for property damage.
(C) For day haulers who only provide transportation: $1,500,000 minimum coverage for personal injury for a vehicle carrying 15 or fewer passengers; $5,000,000 minimum coverage for personal injury for a vehicle carrying more than 15 passengers.
(11) Certificate from Department of Motor Vehicles (DMV) permitting operation of farm labor vehicle if the vehicle is subject to Vehicle Code sections 322 and 12519 and where the applicant will transport farm workers who are his or her own employees or are employed by another.
(12) Evidence of clean driving license record from the Department of Motor Vehicles (DMV Form INF 1125) for any person operating a vehicle which will transport the applicant's own employees or workers who are not his or her employees.
(13) Personal record information (included in online and physical application (DLSE 401-N) which provides the following information for each sole proprietorship, each partner of a partnership, each corporate officer of a corporation, each member and managing agent (if any) of an LLC, and certified under penalty of perjury:
(A) the full name (first, middle, and last name) of the individual, title in the business, social security number, percentage of ownership interest (if any), date of birth, driver's license number (include a copy of driver's license), spouse's name, spouse's capacity in business (if any), physical home address (post office or other mail box number not allowed), business telephone number, mobile telephone number, email address, and mailing address if different from home address.
(B) the occupation history of the person for the last two years including commencing and ending dates, name of employer (if self-employed, indicate name and type of business), description of occupation, and business location address.