Unified Certification Program
Be advised that your request to add NAICS codes is subject to review.
Copies of the documents listed below are required and must be submitted with the Request Form. If
you do not have any of the necessary information, provide a written statement explaining why.
If additional NAICS codes are being sought, the applicant owner of the firm must complete and sign
the Request Form and submit it with the following documents. The applicant owner must also
demonstrate control with respect to the code(s) being requested.
If a state or federal license is required to sell a product or perform a service, provide a current copy of
the required license held by the applicant owner.
Required Document Checklist for All Requests
Brief explanation of how the firm qualifies for each requested code,
List of equipment used to perform the requested service(s), including specialized software,
Copies of contracts, purchase orders, bids, proposals, or invoices verifying the performance of
the requested service(s),
Copies of special license(s) pertaining to the requested service(s).
If you are requesting codes in the following categories, additional required documents are:
Supplier Firms:
Current list of inventories,
Proof and description of warehouse/storage facilities,
Vendor agreements or copies of invoices from vendors for products that are retailed.
Wholesale/Broker Firms:
Wholesale/Distributor agreements,
Copies of invoices from vendors for products being wholesale.
Trucking Firms:
Kansas permit for each truck owned and/or operated by the firm,
Commercial Driver’s License (CDL) for all drivers,
Insurance Agreements for each truck owned and/or operated by the firm,
Title(s) and registration certificate(s) for each truck owned and/or operated by the firm.
Include the documentation with a completed NAICS Code Modification Request Form and email
the information to KDC_MWBD@ks.gov.
Unified Certification Program
Firm’s Name:
Applicant Owner’s Name:
Address (Street/City/State/Zip):
Phone Number:
Fax Number:
3yr. Average of Annual Gross Receipts:
Number of Employees:
The 2017 North American Industry Classification System (NAICS) Manual can be found at
Please ADD the following NAICS code(s) to our certification. Our firm is providing the services and/or products
covered by these codes, as demonstrated by the provided documentation. (Attach additional sheets if needed.)
NAICS Code #1:
NAICS Code #2:
NAICS Code #4:
Please REMOVE the following NAICS code(s) from our certification.
NAICS Code #1:
NAICS Code #2:
NAICS Code #4:
I hereby make the above request and affirm the information I am providing is true and correct. I understand
Requests for NAICS Code Modifications are subject to review by the Kansas Department of Commerce.
Applicant’s Signature/Title Date
click to sign
click to edit