How to Apply For A New Service Contract Provider Certificate 

These instructions are designed to assist with the preparation of the Service Contract Provider New Application form. They do not replace or supersede what is in Nevada law. As the applicant, you are responsible for understanding and complying with Nevada law. A PDF of these instructions is available here.

The Nevada Division of Insurance (Division) has provided the Service Contract Provider Application Checklist form to summarize all required parts of the application.

Additional forms and instructions are available on the Division’s website at Forms for Service Contract Providers

These include:

• Service Contract Provider Application Checklist– For reference only.
  Do not submit with application.
• Service Contract Provider New Application form
• Service Contract Provider Bond Form
• NAIC Biographical Affidavit
• Affidavit of Executive Officer form

Required Documents for Application Filing

The application for a Certificate of Registration as a service contract provider must include the items summarized below. Please refer to the statutes and regulations for further information.

Section A: Complete all fields. The dba fields must be completed. If no dba name will be used, mark the field N/A

1.Application Fee - $4,600.00 NRS 690C.160(1)(e), NRS 680C.110. This fee is due at the time of filing the application, payable through Sircon’s online portal at www.sircon.com.

2.Completed Service Contract Provider New Application form per NRS 690C.160(1)(a).The application form is not optional and must be completed.

If the applicant uses a dba, a copy of the approval of the dba filing at the county level for each county in which the applicant will do business is required and should be attached to the application form.  Information regarding filing for a dba is available at www.nvsos.gov.

Section B: Identify the contact person and contact information for communication during the application process and after the completion of the registration.

Section C: If the applicant uses an Administrator, identify the name and contact information. If no Administrator will be used, mark the field N/A.

Section D: Identify the type(s) of products covered by the service contracts.

Section E:  If the applicant is owned by other companies, complete section E. If the applicant is only owned by individuals, identify the owners in Section F.

• 100% of ownership should be identified.

Section F:  This section is for information regarding individuals who control or own the applicant. 

• List all controlling persons and officers of the applicant. Names and titles are required for all individuals.  List individuals who are owners, including each sole proprietor, partner, or individual(s) who own the applicant. Percentage of ownership should be completed for each owner. 
• 100% of ownership should be identified.
• An NAIC biographical affidavit is required for each person listed. The affidavits must have been signed and notarized within the last 6 months.

Section G: Identify the type of Financial Security the applicant will use pursuant to NRS 690C.170. Complete all fields.

• If the applicant uses a contractual liability insurance policy, a copy of the policy should be attached to the application form. Policies older than 1 year require a letter from the insurance company stating the policy is active and in effect.  
• If the applicant uses a Funded Reserve Account and Security Deposit, a copy of the Nevada bank statement clearly identified as “(Provider’s Name) Nevada Service Contracts Funded Reserve Account” should be attached to the application form, along with the $25,000 security deposit. If the provider chooses to deposit cash for the $25,000 security deposit, it must complete the Incoming Funds Deposit Notification form. Please contact ifn@doi.nv.gov for this form.
• If the applicant maintains or is a subsidiary of a parent company that maintains a net worth or stockholders’ equity of at least $100,000,000, a copy of the most recent Form 10-K, 20-F, or audited financial statements should be attached.  

Section H: The form must be signed and dated by an executive officer or controlling person of the applicant.

• Electronic signatures that are verifiable are permitted.

Mail the original bond with power of attorney to:

Division of Insurance – Service Contracts

1818 East College Parkway, Suite 103

Carson City, NV 89706

3. Biographical Affidavits

• Submit an NAIC Biographical Affidavit for each controlling person and officer of the applicant who is listed in Section F of the application form. Affidavits must have been signed and notarized within 6 months of the application date.

4. Business License

• Submit a copy of applicant’s registration with the Nevada Secretary of State.

5. Service Contract Form Filing

• Submit a copy of the proposed form(s) to be used via SERFF (System for Electronic Rate and Form Filing). See the Filing Information page for SERFF filing fees.

6. Affidavit

• Submit a signed affidavit by an executive officer or controlling person of the applicant.

Application Process

Submit applications for a service contract provider Certificate of Registration online at www.sircon.com. The $4,600 application fee will be due at the time of application and must be paid via Sircon as part of the application process. (Additional fees may apply.)

It will be necessary to prepare the supporting documentation before applying online as the documentation identified in the Service Contract Provider Application Checklist must be attached to the electronic application. All required documents must be in electronic form and attached to the Sircon application. Each attachment should named to match the requirement on the Service Contract Provider Application Checklist.

In addition, please mail the original bond and power of attorney to the Division in accordance with Section G, above.

Certificate

A certificate of registration to act as a service contract provider must be obtained prior to offering, selling or issuing a service contract. This certificate is only available to business entities. Each certificate is valid for two years after the date of issuance and must be renewed prior to expiration. Once the certificate has been issued or renewed, it will be available on the Division’s website under Verify a License. First ensure that the registration has been approved, and then print your certificate through Sircon’s website. Click the Print a License button and follow the directions on the webpage. A fee to print the certificate may apply.

Name Restriction

The name of the provider may not contain words “insurance,” “casualty,” “surety,” “mutual” or any other word or term that implies that the provider is engaged in the business of insurance or is a surety company; however, the name may include the word “guaranty.” Likewise, a provider may not have a name that is deceptively similar to the name or description of an insurer or surety company or the name of another provider.

Exceptions

The following are not subject to the requirements for service contract providers:

• Contracts in which a provider is obligated for a specified period to a holder to repair or replace any physical component of the manufactured home;
• Contracts for motor club;
• Contracts of Insurance issued by an insurer;
• Warranties provided by a manufacturer, importer, or seller of goods that is not separate from the sale of goods;
• Maintenance agreements that provide for limited, scheduled maintenance;
• Service contracts regulated by the Public Utilities Commission of Nevada;
• Service contracts sold or offered for sale to a person who is not a consumer;
• Service contracts for goods if the purchase price of the goods is less than $250; or
• Service contracts issued, sold or offered for sale by a vehicle dealer obligated to provide all services under the service contract.

FAQs

Who can I contact if I have questions?

Send questions regarding service contract applications to ServiceContracts@doi.nv.gov.  Ensure that the name of the applicant is included in the subject line. e.g. Subject line:  Applicant Name Service Contract Application

How do I file for a dba in Nevada?

A dba is filed at the county level in Nevada. Please see https://www.nvsos.gov/sos/businesses/resources/county-clerk-information-for-filing-a-fictitious-firm-name-or-dba-doing-business-as.

Should fingerprints and supporting background investigation reports be submitted with each biographical affidavit?

Fingerprints and supporting background investigation reports are not required with service contract provider application. 

Can an initial application for a service contract provider be submitted through NIPR?

At this time, applications for service contract providers cannot be submitted through NIPR.

What can I do to expedite the application process?

• Ensure that all supporting documentation is submitted with the initial application. Missing documentation causes most of the delays.
• Number and name the supporting documents to correspond to the Service Contract Provider Application Checklist. Do not use file names that are unrelated to the Service Contract Provider Application Checklist.
• Include the name of the applicant in the subject line of every email.
• Put information in the appropriate section of the application, not a cover letter. (A cover letter that addresses unusual conditions may be submitted, but this should not include information required in other sections of the application.)

How do I do submit revised documentation?

Send documentation to ServiceContracts@doi.nv.gov.  Ensure that the name of the applicant is included in the subject line. Do not submit additional documentation through Sircon after the application has been submitted.

May I redact information?

Information that is required for the application may not be redacted.