Fillable DCAMM - Applicant Checklist for DCAMM Online Contractor Certification Small Prime Contractor Certification

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DCAMM - Applicant Checklist for DCAMM Online Contractor Certification Small Prime Contractor Certification

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U.S.A. forms for Commonwealth of Massachusetts

BROWSE COMMONWEALTH OF MASSACHUSETTS (MA) FORMS

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☐ Supplier Diversity Office (SDO) Certificate, if applicable
☐ Primary Contact information for your company and your company’s business address. Include a
separate mailing address, if applicable
☐ Federal Employer Identification Number (FEIN)
☐ For corporations and LLCs, your company’s most recent annual report filed with the Secretary of
State Corporations Division Click this link to access the Secretary of State's Corporation Division
☐ For unincorporated businesses, a business certificate filed with the applicable city or town
☐ For Corporations or LLCs applying for DCAMM certification online for the first time, your
company’s Articles of Incorporation or Articles of Organization
☐ Resumes of Principals, Management and Supervisory Personnel
☐ Copies of all applicable Licenses in the Category(s) of Work for which your company is seeking
Certification
☐ Information for up to twenty (20) of your company’s most recent construction projects of at least
$50,000 completed within the past five (5) years. Also required for projects in progress
☐ Bonding commitment letter addressed to DCAMM containing single project and aggregate work
limits for your company
☐ Most recent annual CPA-audited, CPA-reviewed or CPA-compiled Financial Statement, including
balance sheet, income statement, statement of cash flows, notes
☐ Workers’ Compensation Policy Information Page showing coverage in Massachusetts and your
Experience Modification Rating (EMR)
☐ If your Policy Information Page does not include your EMR, or if your company does not qualify
(DNQ) for an EMR, a verification document from your insurance agent is required
☐ Division of Unemployment Assistance (DUA) Certificate of Compliance dated within thirty (30) days
of application submission. Certificates may be obtained at Click this link to access DUA Quest
☐ Authorized Signatory listing. If your company does not maintain a list of authorized signers, you
may use the Authorized Signatory Listing
form on the Contractor Certification Applications page
APPLICANT CHECKLIST FOR DCAMM ONLINE CONTRACTOR CERTIFICATION
SMALL PRIME CONTRACTOR CERTIFICATION
DCAMM Contractor Certification Office
Phone: 617-727-4050 x31305
Fax: 617-727-8284
Email:
Certification.DCAMM@state.ma.us
Website: www.mass.gov/dcamm/certification
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DCAMM - Applicant Checklist for DCAMM Online Contractor Certification Small Prime Contractor Certification

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Completed 15 May 2020

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