Account#

Electrical Contractor (EC) BP# Office Use

Licence Application Licence# Only
Billing doc#

Email: [email protected] Phone: 1-877-372-7233

400 Sheldon Dr, Unit 1, Cambridge, ON N1T 2H9 www.esasafe.com/licensing
Part 1: Applicant Information
Legal Company Name:
Operating Name:
Business Address:

Street City Prov Postal Code

Address for Service in Ontario (if different than above):

Street City Prov Postal Code

Business Phone: Cell Phone:
Email: Website:
Preferred method of correspondence: Email Mail
Residential Commercial & Industrial Pole Line HVAC
Work Type:
Street Lighting High Voltage / Sub Station Utility Other
Business Type: Corporation Partnership Proprietorship
Business Registration Number/Corporate Tax Number:
Business Start Date: Number of Trade Employees:
WSIB Employer Account Number: Tax Compliance Verification Number:
You may not need a WSIB or a TCV number depending on the type of work you do.
Part 2: Principal Owner(s), Partner(s), Officer(s) or Director(s) Information
Attach a separate sheet if more space is required
Name: Position:
Residence Address:
Phone: Date of Birth:
Name: Position:
Residence Address:
Phone: Date of Birth:
Part 3: Professional Qualifications - submit a copy of valid qualification(s) with application
Qualification - select at least one Original Date of Issuance:
Journeyperson Electrician STO Account (OCOT Membership) Number:
309A, 309D 309C 442A 434A
Professional Engineer PEO Number:
Certified Engineering Technician or Technologist OACETT Number:
Designated Master Electrician Name:
Designated Master Electrician Number:
The Designated Master Electrician must complete the Acknowledgement of Responsibility form.

EC Application Page 1 of 6 Form 1294K October 2024

Part 4: Licence Fee Payment Method - $487.03 ($431 + $56.03 HST)
Credit Card (Visa, MasterCard or Amex) - ESA will call you between 8:30 and 4:30 (M-F) to process
Cheque or Money Order made payable to: Electrical Safety Authority
Part 5: Statement of Fact
I/we make the following statements of fact:
1. Have you ever had an ECRA/ESA licence refused, suspended,
Yes No
revoked or voluntarily terminated?
2. Are you currently in default of filing a return with the Canada
Revenue Agency or of paying any tax, penalty or interest assessed Yes No
under the Retail Sales Tax Act or the Corporations Tax Act?
3. Do you presently owe ESA any money for which payment
Yes No
arrangements have not been made?
If you answered Yes to any of these questions, attach the particulars with your application.
Part 6: Declaration, Notice and Consent
The applicant declares that:
I/we, do solemnly declare:
name(s)
1. I/we am/are the Applicant.
2. I/we acknowledge to being at least 18 years of age.
3. All information and any statement contained in this application, to the best of my/our knowledge, is
true and correct.
4. If a Licence is granted, I/we will carry on my/our business/trade in compliance with the
requirements of Ontario Regulation 570/05 made under the Electricity Act, 1998.
5. I am the Designated Master Electrician or will employ at all times at least one Designated Master
Electrician in order to maintain this Licence.
6. As a licence holder, I/we will carry out the activities granted by this licence safely and in accordance
with the law.
7. As a licence holder, I/we will ensure I/we have the resources necessary to carry out the activities
granted by this licence.
8. As a licence holder, I/we will conduct my/our self with honesty and integrity and in accordance with
the principle of protecting consumers.
9. As a licence holder, I/we will ensure I/we have the required training, experience, qualifications and
skills required to carry out the activities granted by this licence.
10. As a licence holder, I/we will not permit unauthorized persons under my/our supervision to carry
out activities granted by this licence.
11. I/we hold a valid certificate of qualification, or employ at least one individual with the appropriate
trade qualification(s) as required for the electrical work carried out by the electrical contracting
business.
I/we have included a completed Designated Master Electrician Acknowledgement of
Responsibilities Form that has been signed by the appropriate parties.
I/we have included a completed Application For Customer Account that has been signed by the
appropriate parties.

EC Application Page 2 of 6 Form 1294K October 2024

NOTICE AND CONSENT
NOTE: PLEASE ENSURE THAT YOU HAVE READ THIS SECTION IN FULL BEFORE SIGNING BELOW.

Any person completing and/or signing this form and any attachments or accompanying answers,
schedules, documents, or records, is hereby notified that the Electrical Safety Authority (ESA) may
collect additional information from or disclose information contained herein to third parties. The ESA
is committed to maintaining the security and confidentiality of your business and personal information
and as such, information collected will only be used in accordance with applicable legislation and ESA’s
Privacy Policy. If you provide information on behalf of another individual, you represent that you have
all necessary authority and/or have obtained all necessary consents from such individual to enable ESA
to collect, use and disclose such personal information for the purpose set forth in our Privacy Policy. A
copy of our policy is located on our website at www.esasafe.com.
By completing or signing this form and any accompanying documents, I consent to ESA collecting,
using and/or disclosing such information in accordance with applicable privacy legislation and ESA’s
Privacy Policy.

I/we consent to Canada Revenue Agency releasing information and records as necessary to verify
compliance with the representations made in Part 5: Statements of Fact.
I acknowledge and understand the declarations made in Part 6 of this form and agree to conduct my
activities in accordance to those statements.
Warning- it is an offence under section 113.20 of the Electricity Act, 1998 to knowingly provide false
information on this application and any attachments.

By signing the application, you are confirming the information contained in this document is correct.

This application must be signed by all Owners, Partners, Officers, and Directors of the Company
Name: Name:
Signature: Signature:
Date: Date:

Part 7: Application Checklist

The following must be provided with this application (incomplete applications will be returned):
A copy of Ontario business registration (i.e. Limited Partnership Declaration, Articles of Incorp.,
Business Name Registration, Master Business Licence)
A Certificate of Insurance for Public Liability and Property Damage Insurance coverage of at least
$2,000,000 (Binders will not be accepted)
Employer Account number issued by the Workplace Safety & Insurance Board (as applicable)
A signed Acknowledgement of Responsibility by your Designated Master Electrician(s)
A copy of your Certificate of Qualifications: Active STO account (formerly OCOT) number, P. Eng.,
C.E.T. (as applicable)
An explanation if a “Yes” answer is given to any statement in Part 5 Statements of Fact
A completed ESA Application For Customer Account (available at www.esasafe.com)

EC Application Page 3 of 6 Form 1294K October 2024

Schedule A
Designated Master Electrician
Acknowledgement of Responsibility

I, , ESA Master Electrician

(Name)

Licence Number, , DO HEREBY DECLARE that I

(ME Licence Number)

am a employee director/officer/owner/partner of
(Business Name)

By signing this document, I affirm that I am actively employed with the above named Electrical
Contracting Business, and I assume responsibility for the personal planning and direct supervision of
all electrical work carried out on behalf of the electrical contractor. I further agree to ensure that the
electrical work is carried out in accordance with applicable law, including the Electrical Safety Code
and the laws relating to health and safety and consumer protection, on behalf of the electrical
contractor.
I state that the information contained on this form is true and correct to the best of my knowledge. I
understand that providing false information is a chargeable offence and is also grounds for denial,
suspension, or revocation of an Electrical Contractor and Master Electrician Licence.

Signature of Master Electrician Date

Statutory Authority:
Ontario Regulation 570/05 Section 7 (1), (2) and Section 28 A master electrician shall not accept the
master electrician designation on behalf of more than one electrical contractor at a time, and the
designated master electrician must be actively employed by the designating electrical contracting
business. A master electrician shall notify the Director within five business days of their change in
designation for an electrical contracting business. Failure to comply with the above may lead to
suspension or revocation of the electrical contractor and master electrician licence.

BY SUBMITTING PERSONAL INFORMATION TO THE ELECTRICAL SAFETY AUTHORITY, OR ITS AGENTS AND
SERVICE PROVIDERS, YOU AGREE THAT ESA MAY COLLECT, USE AND DISCLOSE SUCH PERSONAL INFORMATION
IN ACCORDANCE WITH ITS PRIVACY POLICY, APPLICABLE LAWS OR PURSUANT TO OUR ADMINISTRATIVE
AGREEMENT WITH THE PROVINCE OF ONTARIO.
If you provide us with the personal information on behalf of another individual, you represent that you have all
necessary authority and/or have obtained all necessary consents from such individual to enable us to collect,
use and disclose such personal information for the purposes set forth in our Privacy Policy. A copy of our policy
is located on our website at www.esasafe.com

EC Application Page 4 of 6 Form 1294K October 2024

How to Complete the Application for an Electrical Contractor Licence
Ontario Regulation 570/05 made under the Electricity Act, 1998

Part 1 Applicant Information Part 3 Professional Trade Qualifications

• Address for Service in Ontario: • As the applicant, if you hold a Trade C of Q,
Applicants must provide a valid address for the are a Professional Engineer, a Certified
purposes of serving registered legal documents. Engineering Technician or Technologist, please
Applicants that do not have a business address provide your qualification information. If you
in Ontario must provide a valid Ontario address do not hold a Trade C of Q, please indicate the
for the purposes of serving registered legal types of C of Qs held by your employees.
documents. It cannot be a Postal Box or Part 4 Licence Fee Payment Method
General Delivery address.
• Business Registration / Corporation Tax Number: • If paying by cheque or money order, payment
Provide the number issued to you by Service must be remitted at the time of application. If
Ontario, or Corporation Tax Number if your paying by credit card (MC, VISA or AMEX), we
business is incorporated or limited. You must will contact you via phone when processing the
be registered in the Province of Ontario. application (Mon-Fri, 8:30 am - 4:30 pm).
If you are incorporated Federally or do not • Electrical Contractor (EC) Licence: $487.03
know your Ontario Business Number, contact ($431 + $56.03 HST)
the Canada Revenue Agency at 1-800-959- • Licence Fees are non-refundable and are due
5525, www.cra.gc.ca. annually.
• Trade Employee Information: Part 5 Statements of Fact
Indicate the number of electrical trade's • If you answered "Yes" to any of the questions
personnel you regularly employ. in this section, attach additional sheets to
• WSIB Employer Account Number: provide full details of the situation.
Provide your Workplace Safety & Insurance Part 6 Declaration, Notice and Consent
Board (WSIB) Employer Account Number, if • Please read the declaration carefully before
your company is required to be registered signing your application.
under the Workplace Safety and Insurance Act,
• The application must be signed by all owners,
• Tax Compliance Verification Number: partners, officers and directors of the company.
If applicable, used for bidding on government Attach a separate sheet if the space provided is
contracts and to validate compliance with insufficient.
Provincial and Federal tax obligations. Designated Master Electrician Acknowledgement

https://www.doingbusiness.mgs.gov.on.ca/mbs of Responsibility
/psb/psb.nsf/EN/FAQ-TCTC-Program • Provide information for all individuals who
Part 2 Principal Owner(s), Partner(s), Officer(s) or you have designated as a Master Electrician for
Director(s) Information your company.
• Provide information for all Owners, Partners, • If you have more than one designated master
Officers, or Directors (Principals) of the Company. electrician, attach additional Designated
• Attach an additional sheet with applicable Master Electrician Acknowledge of
information if there are more than 2 Principals. Responsibility form(s).

EC Application Page 5 of 6 Form 1294K October 2024

Conditions of an Electrical Contractor Licence
Ontario Regulation 570/05 made under the Electricity Act, 1998

Business Name
An Electrical Contractor shall not carry on business in a name other than the name indicated in the
licence.
Posting of Licence
An Electrical Contractor must post the licence in a prominent location at the contractor’s principal
place of business in a manner that the public is likely to see it.
An Electrical Contractor must post a copy of the licence in a prominent location at any other place of
business at or from which the contractor carries on business.
Display of Licence Number
An Electrical Contractor must prominently display the licence number in all correspondence, contracts,
and advertisements, on business vehicles and, generally, in all situations where they are
communicating with the public.
Designations to be Recorded
An Electrical Contractor must keep a record of all designations of master electricians, irrespective of
the number of designations made.
The record shall include the name of the designated master electrician, the date on which the
designation is made, the period of time for which the designation is effective and the scope of the
designation.
An Electrical Contractor must notify ESA immediately of the loss of their designated master electrician.
Retention of Application Information
An Electrical Contractor must retain every document provided in the application for the licence or a
renewal of the licence until the expiry of the licence or renewal.
Notice of Change to Information
An Electrical Contractor must notify ESA of any change to the information provided on the application
or renewal of licence application form within 5 business days of the change.
The “Notice of Change to Information” form is available on our website at www.esasafe.com or by
calling our Customer Service Centre at 1-877-372-7233.
Annual Licence Fee and 5-year Renewal Form
Licence Fee must be received annually, prior to the deadline, in order to avoid late payment fees
and/or licence suspension. Licence Renewal Form is issued every 5 years and must be received prior
to the deadline to avoid late fees and/or licence expiry.
Notice of Failure to Meet Licence Requirements
An Electrical Contractor shall notify ESA immediately of any failure to continue to meet the
requirements for the relevant type of electrical contractor licence during the currency of the licence.
Note: ESA will make every effort to process all complete applications within 4 weeks from the date
they are received at our Customer Service Centre. Incomplete applications will be returned.

EC Application Page 6 of 6 Form 1294K October 2024