| Business Information  | 
               
              
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                  Business/Firm Name*  | 
                Stay Safe   Enterprises  | 
               
              
                | Enter Business   Name*  | 
                Stay Safe   Enterprises  | 
               
              
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                | Web Address  | 
                http://www.staysafe.net  | 
               
              
                | Federal ID  | 
                65-0802680  | 
               
              
                | Fax  | 
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                | Business Location   Address*  | 
                1721   Farmington Circle  | 
               
              
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                | City*  | 
                Wellington  | 
               
              
                | State*  | 
                Florida  | 
               
              
                | Zip   Code*  | 
                33414  | 
               
              
                | County*  | 
                Palm   Beach  | 
               
              
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          | Evaluation Process Flowchart of Processes/Timelines | 
        
        
          | Describe how you   intend to evaluate courses to ensure 100% compliance with the most current   edition of the Florida Building Code and its latest   amendments* | 
        
        
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          | Training provider Verification | 
        
        
          | Is applicant   approved as a provider by any board within DBPR to provide continuing   education?* | 
        
        
          
            
              
                |  Yes No | 
                       DBPR Provider Number 0001394  | 
               
            
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          | Background Information | 
        
        
          | Has any license,   registration or permit to practice any regulated profession, occupation,   vocation or business been revoked, annulled, suspended, relinquished,   surrendered, or withdrawn in Florida or in any other jurisdiction, or is any   such proceeding or investigation now pending?* | 
        
        
          |  Yes No | 
        
        
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          |   If Yes,   Describe: | 
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          | Certification Statements | 
        
        
          
            
              
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                I agree that payment for accreditation   services will be rendered by the Training Provider requesting services directly   to the Accreditor offline.  | 
               
              
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                I agree to comply with the Florida   Building Commission requirement that this course update take no more than 30   days for courses up to 8 credit hours, and 45 days for courses in excess of 8   credit hours.  | 
               
              
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                I hereby certify that all statements   made on this application are true and correct. I agree and understand that any   misrepresentations of material facts will result in revocation of this   approval.  | 
               
            
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          | History | 
        
        
          | Date   Submitted | 
          5/16/2012 | 
        
        
          | Date   Approved | 
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          | Date Last   Updated | 
          5/16/2012 | 
        
        
          | Date   Expires | 
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