DHS 163.12(3)(a)1.e.e. The name of an individual who meets one of the certification requirements under sub. (2) (d) or the completed regulatory worksheet under sub. (2) (d) 2. DHS 163.12 NoteNote: The regulatory worksheet under DHS 163.12 (2) (d) 2. was repealed by CR 19-110. The language referring to the regulatory worksheet will be repealed in future rulemaking by the department. DHS 163.12(3)(a)1.f.f. A statement signed by an owner or officer of the company attesting that the company will employ or contract with only appropriately certified persons when certification is required under this chapter. DHS 163.12(3)(a)1.g.g. A statement signed by an owner or officer of the company attesting that the company, its employees and subcontractors will comply with the requirements of this chapter when conducting activities regulated under this chapter. DHS 163.12(3)(a)2.b.b. Any other fee imposed by the department as necessary to cover costs of administering this chapter. DHS 163.12(3)(b)(b) Application for a governmental agency. A company that is a governmental agency shall submit a fully and accurately completed application on a form obtained from the department. The application shall include all of the following information: DHS 163.12(3)(b)1.1. Name, mailing address, physical address and telephone number for the agency and physical address of records required under s. DHS 163.13 (3) if different from the agency’s physical address. DHS 163.12(3)(b)2.2. A statement signed by an authorized representative of the agency attesting that the agency will employ or contract with only appropriately certified persons when certification is required under this chapter. DHS 163.12(3)(b)3.3. A statement signed by an authorized representative of the agency attesting that the agency, its employees and subcontractors will follow the work practice standards in s. DHS 163.14 when conducting activities covered by the work practice standards. DHS 163.12 NoteNote: Applications are available on the department website at http://dhs.wi.gov/lead. To request forms by mail, call 608-261-6876 or write to the Lead and Asbestos Section, 1 W. Wilson Street, Room 137, Madison, WI 53703-3445. DHS 163.12 NoteNote: Submit application and fee according to form instructions. To pay by credit or debit card, or electronic check, apply online at http://dhs.wi.gov/lead. DHS 163.12(4)(a)(a) Time limit. Within 15 working days after receipt of a fully and accurately completed certification application, the department shall grant or deny a lead company’s request for certification. DHS 163.12(4)(b)(b) Grant certification. If the department grants company certification, the department shall issue a certificate of approval. DHS 163.12(4)(c)(c) Deny certification. If the department denies company certification, the department shall give the company a written explanation for the denial and shall notify the company of the right to appeal that decision under s. DHS 163.33. DHS 163.12(5)(5) Expiration of company certification. A company’s certification shall expire 2 years after the certification issue date. DHS 163.12(6)(a)(a) Requirement. No person may perform, supervise, advertise, claim to provide or offer to perform or supervise an activity for which company certification is required under this subchapter after the expiration date of that company’s certification. A company shall submit all of the following to the department to apply for recertification before certification expires or within 12 months after certification expires: DHS 163.12(6)(a)1.1. A completed application for renewal of company certification indicating changes to company information since the previous application. DHS 163.12(6)(a)2.2. A nonrefundable fee of $125, except that a state or local government agency is exempt from paying the fee. DHS 163.12 NoteNote: Applications are available on the department website at http://dhs.wi.gov/lead. To request forms by mail, call 608-261-6876 or write to the Lead and Asbestos Section, 1 W. Wilson Street, Room 137, Madison, WI 53703-3445. DHS 163.12 NoteNote: Submit application and fee according to form instructions. To pay by credit or debit card, or electronic check, apply online at http://dhs.wi.gov/lead. DHS 163.12(6)(b)1.1. ‘Time limit.’ Within 15 working days after receipt of a fully and accurately completed application, the department shall grant or deny a company’s request for renewal of certification. DHS 163.12(6)(b)2.2. ‘Grant renewal of certification.’ If the department grants a company renewal of certification, the department shall issue a certificate of approval. DHS 163.12(6)(b)3.3. ‘Deny renewal of certification.’ If the department denies a company renewal of certification, the department shall give the company a written explanation for the denial and shall notify the company of the right to appeal that decision under s. DHS 163.33.