This form is only valid when completed by the Commercial Applicator's Insurance Agent.
Existing licenses: it must be submitted by the expiration date of the Commercial Applicator's insurance policy or that license is automatically suspended.
Law: Washington pesticide law (chapter 17.21 RCW) requires that all Commercial Applicators submit proof of financial responsibility.
Policy only: use this form if reporting a liability insurance policy; there is a separate form for reporting a surety bond.
WDO: a Commercial Applicator who conducts complete WDO inspections must meet the financial coverage requirements of both licenses.
| Question | Answer |
|---|---|
| Form Name | AGR-4279 |
| Form Length | 1 page |
| Fillable? | Yes |
| Fillable fields | 23 |
| Avg. time to fill out | 4 min |
| Edition | R/10/24 |
| Filing deadline | For new licenses, BEFORE the Commercial Applicator license can be issued; for existing licenses, by the expiration date of the Commercial Applicator's insurance policy |
| Other names | AGR-4279, AGR 4279, AGR4279, FRIC, Financial Responsibility Insurance Certificate |
| Official source | AGR-4279 (Rev R/10/24), |
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