/

The Commonwealth of Massachusetts

Executive Office for Administration and Finance

Division of Capital Asset Management and Maintenance

One Ashburton Place, 15th Floor
Boston, Massachusetts 02108
CHARLES d. bAKER / Tel: (617) 727-4050 / kRISTEN LEPORE
Governor / Fax: (617) 727-8284
/ Secretary,
Administration & Finance
KARYN POLITO / carol w. GLADSTONE
LT. GOVERNOR / Commissioner

APPLICATION FOR SUB-BIDDER CERTIFICATE

OF ELIGIBILITY

NOTE: This Application is meant to be completed on a computer by clicking on or filing in the shaded areas. Upon completion of this Application and the two corresponding Excel Spreadsheets, you must:

(1)Save and email them to .

(2)Print the Application and the two Excel Spreadsheets, sign the Application in the presence of a Notary Public, and mail the signed Application (with any required attachments), the two Excel Spreadsheets, and the necessary application filing fee to:

If you have any questions or need assistance in completing any of the required documents, please contact the Contractor Certification Office at 617-727-4050.

I.Requirements and Information
A.Introductionp. 2
B.Requirements for Consideration of Sub-Bidder Certificationp. 2

C.Fee Schedulep. 3

D.Categories of Workp. 4

II.Application p. 6

Company Information and Category Request Sheetp. 7

  1. Historical Data/Organizationp. 8
  1. Personnelp. 9
  1. Organizational Experiencep. 9
  1. Bonding, Financial Data, and Workers’ Compensationp. 9
  1. Projects in Progressp. 10
  1. Completed Projectsp. 10
  1. General Performancep. 11
  1. Legal or Administrative Proceedings; Compliance with Lawsp. 12
  1. Certificationp. 14

I.Requirements and Information

  1. Introduction

In order to bid on any project put out to bid under Massachusetts General Laws, Chapter 149, §44A and Chapter 149A, Filed Sub-Bidders are required to submit a valid DCAM Sub-Bidder Certificate of Eligibility. This Application is only to be completed by contractors that wish to become certified by DCAMM as filed sub-bidder contractors.

Contractors wishing to bid as prime/general contractors must complete DCAMM’s Application for Prime/General Contractor Certificate of Eligibility.

A contractor who files an application for, and who is awarded, prime certification in the following categories of work and who also qualifies for sub-bidder certification in these categories shall also be awarded sub-bidder certification in these categories without the necessity of filing a separate application for sub-bidder certification: Electrical, Elevators, Fire Protection Sprinkler Systems, HVAC, Masonry, Painting, Plumbing, Roofing and Waterproofing.

Once a Sub-Bidder Certificate of Eligibility has been issued, it is generally valid for a period of one year.

A sub-bidder contract is subject to M.G.L. C. 149 §44A and C. 149A if:

  • it is put out to bid by a public agency (including state agencies, authorities, counties, cities and towns); and
  • it is for the construction, reconstruction, demolition, maintenance, or repair of a building; and
  • the entire project is estimated to cost over $100,000; and
  • the sub-bid category of work is estimated to cost over $20,000.

A DCAMM Certificate of Eligibility is not required for:

  • Highway, bridge, tunnel, sewer, site work, or other horizontal projects that do not involve buildings
  • Ordinary (non-filed) sub-bids
  1. Requirements for Consideration of Sub-Bidder Certification
  1. Your firm must have been in business for at least one year in the category of work for which certification is sought.
  1. Your firm must have successfully completed a minimum of three (3) projects, each with a minimum value of $20,000, within the past three years in each category of work in which you’re seeking certification.
  1. Your firm must have Workers’ Compensation Insurance Coverage

C.Fee Schedule

In order for your application to be processed, it must include a certified check or money order (personal and business checks are not acceptable) payable to the Commonwealth of Massachusetts in the amount of $200.

Please understand that once the evaluation of your application commences, there can be no refunds. DCAMM greatly appreciates your cooperation in this matter.

Please contact the Contractor Certification Office at (617) 727-4050 if you have any questions.

D.Categories of Work

  1. Acoustical Tile. Installation of tile-shaped blocks of sound-absorbent material used for ceilings or as wall facing within a building.

2.Electrical Work. Installation, renovation, repair and maintenance of electrical wiring, circuits, panel boards, fixtures and equipment within a building, including such incidental or related work as is customarily performed by those in the electricians' trade. For firms that are incorporated, certification in this category requires possession of a Massachusetts Corporate Master Electrician’s License.

3.Elevators. The installation, maintenance and repair of elevators, handicapped accessible chair lifts, moving stairs, or dumbwaiters within a building.

4.Fire Protection Sprinkler Systems. Installation, renovation, repair and maintenance of fire protection sprinklers in buildings including such incidental or related work as is customarily performed by those in the Fire Protection Sprinkler Systems' trade

5.Glass and Glazing. Installation and securing of glass in prepared openings in windows, door panels, screens, partitions, etc. that are not part of a correlated window system.

  1. HVAC. Installation, renovation repair and maintenance of the systems and apparatus required, collectively or individually, to provide comfort heating, ventilation and/or cooling within or associated with a building, including such incidental or related work as is customarily performed by those in the HVAC trade. This category does not include sheet metal work by itself.
  1. Lathing and Plastering. The application of, but not limited to, plaster, Keene cement plaster, furring, metal and gypsum lathing, scratch coat and lathing for ceramic tile walls, and plaster ceiling suspension systems to a building.
  1. Marble. Installation/application of marble, including but not limited to, toilet and shower compartments, counters, cladding, fixed furnishings including fountains, thin skin exterior and interior, granite, and limestone walls and facings, marble and pre-cast terrazzo treads and risers, blue stone and slate walls and floors, and stone window stools and thresholds to a building.
  1. Masonry Work. Installation, renovation, repair and maintenance of masonry units composed of concrete, stone, or brick which are part of a building, including such incidental or related work as is customarily performed by those in the masons' trade.
  1. Metal Windows. Installation to a building of steel windows, aluminum windows, detention windows and screens, window walls, curtain walls and entrance and sidelight systems if a part of a correlated window system.

D.Categories of Work (continued)

  1. Miscellaneous and Ornamental Iron. Installation of miscellaneous and ornamental iron including, but not limited to, steel chairs, handrails and railings, ornamental metal, elevator ladders, ladders, balconies, catwalks, fire escapes, decorative grilles and screens, and any other non-standard metal items requiring custom fabrication and installation to a building.
  1. Painting. Application of paint to interior and exterior surfaces of buildings and preparation of such surfaces for the purpose of receiving a finish coat of paint, including such incidental or related work as is customarily performed by those in the painting trade.
  1. Plumbing. Installation, renovation repair and maintenance of pipes, fixtures and other apparatus in buildings for bringing in and distributing the water supply and removing liquid and water-borne wastes, including such incidental or related work as is customarily performed by those in the plumbers' trade. For firms that are incorporated, certification in this category requires possession of a Massachusetts Corporate Master Plumber’s License.
  1. Resilient Floors. Installation of, but not limited to, vinyl tile, asphalt tile, rubber and other resilient tile, resilient sheet flooring, linoleum, resilient vinyl or rubber bases, resilient stair treads and adhesives to a building.
  1. Roofing and Flashing. The installation of various types of roofing materials to a building, including shingles, slate, rubber, PVC and related flashing and drainage systems.
  1. Terrazzo. Installation of terrazzo to a building including, but not limited to, sand cushion terrazzo floors, bond to concrete terrazzo floors, thin set terrazzo, conductive terrazzo floors, pre-cast terrazzo, and plastic-matrix terrazzo.
  1. Tile. Installation of tile which includes, but is not limited to, ceramic floor and wall tile, quarry tile, glass mosaic tile, special shapes, setting materials and accessories to a building.
  1. Waterproofing, Damp-proofing, and Caulking. Installation, renovation, repair or maintenance of materials required to make foundations, walls and other surfaces of a building damp-proof or impervious to water, including such incidental or related work as is customarily performed by those in the waterproofing and damp-proofing trade. This category does not include roofing by itself.

Please Detach the Previous Section and Retain it for Your Records

II.Application

In filling out this application, be sure to answer all questions and include all required information. Failure to answer any question or comply with any directive contained in these forms may result in denial of certification.

Please click next to each item and ensure that the following are included:

Application for Sub-Bidder Certificate of Eligibility (Section II).

Fee payment in the form of Certified Check or Money Order for $200 made payable to the Commonwealth of Massachusetts (Section I (C)).

Copy of Current Supplier Diversity Office (SDO) Certificate, if applicable (Section II (A)(4).

Most recent Massachusetts Corporation Annual Report or Massachusetts Foreign Corporation Annual Report if an out of state firm (Section II (A)(8)) or LLC Annual Report if an LLC (Section II (A)(8)), and, for new applicants, please include Articles of Organization or Massachusetts Foreign Corporation Certificate if an out of state firm (Section II (A)(8)) or Certificate of Organization if a Limited Liability Company (LLC) (Section II (A)(8)).

Resumes of all Principal and Supervisory Personnel (Section II (B)).

Most Recent Year-Ending CPA-Compiled, Reviewed or Audited Financial Statement (Section II (D)(2)).

Workers Compensation Insurance Binder or Policy and verification of your firm’s Experience Modification Rating (EMR) (Section II (D)(3)).

Division of Unemployment Assistance (DUA) Certificate of Compliance dated within thirty (30) days of application submission. Employer log in at:

Authorized Signatory listing. If your company does not have one, a sample form may be found at

DO NOT SUBMIT BINDERS OR INCLUDE SUPERFLUOUS MATERIALS

Application for Sub-Bidder Certificate of Eligibility

Company Information and Category Request Sheet

Fill in Shaded Areas:

Company Name:

Street Address:

City, State, Zip:

Telephone:

Fax:

E-Mail Address:

Submitted by:

Date:

Check all categories of work from the list at the right for which you wish to receive certification.

To be considered for certification in any category, contractors must perform work in those categories using their own workforce. Certification will not be granted in categories where the work was subcontracted.

Current or most recent

DCAMM certificate number:

Categories of Work (click using your cursor):

Acoustical Tile

Electrical Work

Elevators

Fire Protection Sprinkler Systems

Glass and Glazing

HVAC

Lathing and Plastering

Marble

Masonry Work

Metal Windows

Miscellaneous and Ornamental Iron

Painting

Plumbing

Resilient Floors

Roofing and Flashing

Terrazzo

Tile

Waterproofing, Damp-proofing and

Caulking

Special (for DCAMM pre-approved projects only)

Date received: ______

A.Historical Data/Organization

1.Indicate the exact name by which your firm is known:

2.How many years has your firm been in business under its present business name?

3.Indicate all other names by which your firm has been known and the length of time known by each name:

  1. Is your firm currently certified by the Supplier Diversity Office (SDO) as an MBE, WBE or MWBE? yes no

If yes, please provide a copy of your firm’s current SDO certificate.

5.My firm is a: (click one)

Corporation Limited Liability Company

Sole Proprietorship Partnership Business Trust

If a corporation or LLC, list or enclose the following:

6.State of Incorporation:

7.Date of Incorporation:

8. Enclose your firm’s most recent Massachusetts Corporation Annual Report or Massachusetts Foreign Corporation Annual Report if an out of state firm or LLC Annual Report if a Limited Liability Company (LLC). For new applicants, please include Articles of Organization or Massachusetts Foreign Corporation Certificate if an out of state firm or Certificate of Organization if an LLC.

If a sole proprietorship, partnership, or business trust list or enclose the following:

9.Name of proprietor, principal partners or principal officers:

10.State in which organized:

11.Date business was initiated/organized:

12.Type of partnership (e.g. 50/50, etc.):

13.If a sole proprietorship, include a copy of business certificate as filed with town clerk of town where business is located.

  1. If a partnership, include a copy of business certificate as filed with the clerk of the city or town where partnership is located. Also, attach a copy of the partnership’s articles of formation or partnership agreement.

  1. If a business trust, include a copy of declaration of business as filed with the secretary of the commonwealth.

B.Personnel

Enclose resumes of all officers, partners, principal individuals and other key personnel in your firm. Information must include:

i.educational background

ii.construction experience

iii.number of years with this firm

iv.names of all other firms in which the individual now has or has in the past had a financial interest or decision-making responsibility.

v.licenses held - individual and corporate (attach copies)

C.Organizational Experience

  1. How many individuals are directly employed (not contracted or temporarily employed) by your firm?

2.List all trades that your firm customarily performs with its own employees:

3.What percentage of work does your firm customarily perform with its own employees?

D.Bonding, Financial Data, and Workers’ Compensation

1.If your firm is bonded, please attach an original letter from your bonding agent addressed to DCAMM, Commonwealth of Massachusetts, confirming single and aggregate limits and providing name of Surety Company.

2.Attach the most recent, complete year-ending compiled,reviewed, or audited statement of financial condition prepared by a certified public accountant (CPA), including balance sheet, income statement, statement of cash flows, notes, and the most recent CPA-prepared mid-year financial statement. Applicants that have parent companies, affiliates, or subsidiaries must provide a stand-alone financial statement that pertains solely to the applicant; in such cases if no CPA-reviewed or CPA-audited financial statement is available, the applicant may provide an in-house generated report, provided it includes a balance sheet, statement of income, and reviewed or audited statement of the parent company.

3.Attach a copy of your firm’s Workers Compensation Insurance Policy Information Page and please ensure that it indicates your firm’s Experience Modification Rating (EMR).

**For Sections E and F below, please refer to the Excel Spreadsheets which are found below the link to this file.

E.Projects in Progress

Using the Excel Spreadsheet (“Sub-Bidder All Vertical Construction Projects Currently in Progress”), list all building construction projects your firm has in process on this date that are at least $20,000. Do not list projects with contract values of less than $20,000. If your firm has more than ten (10) projects in process on this date, please restrict your list to the ten (10) oldest contracts still in process. Information on randomly selected projects is not acceptable. Answer all questions. When listing Categories of Work, refer to categories requested on page 7 of this Application for Sub-Bidder Certificate of Eligibility and list all relevant Categories of Work which your firm performed with its own employees for each project. With respect to single contracts involving multiple categories of work, provide a dollar breakdown attributable to each category listed. Do not list highway, bridge, tunnel, sewer, site work, or other horizontal projects that do not involve buildings. Attach additional sheets, if necessary.

  1. Completed Projects

Using the Excel Spreadsheet (“Sub-Bidder All Vertical Construction Projects Completed within Past Three Years”), list all building construction projects of at least $20,000, which your firm has completed within the past three years or the ten (10) most recent projects completed within the past three years that are at least $20,000. Do not list projects with contract values less than $20,000. Information on randomly selected projects is not acceptable. Note: when listing Categories of Work, refer to the categories requested on page 7 of this Application for Sub-Bidder Certificate of Eligibility. List all relevant Categories of Work that your firm performed with its own employees for each project. With respect to single contracts involving multiple categories of work, provide a dollar breakdown attributable to each category listed. Do not list highway, bridge, tunnel, sewer, site work or other horizontal projects that do not involve buildings. Attach additional sheets, if necessary.

DCAMMM will request evaluations of your company’s performance from the “Evaluators” identified by you on the spreadsheet for “Sub-Bidder All Vertical Construction Projects Completed within Past Three Years”.

The proper individual to list as an “Evaluator” for a project depends on the type of project, as follows:

a)For a publicly owned project with a contract estimated to cost $1,500,000 or more, the Owner’s Project Manager must complete the Evaluation.

b)For a publicly owned project with a contract estimated to cost less than $1,500,000, an official from the Awarding Authority, architect/designer representing the Awarding Authority or any other party responsible for the oversight of the project must complete the Evaluation.

c)For a privately owned project, an individual responsible for the oversight of the project must complete the Evaluation.

NOTE: Per 810 CMR 8.09(2)(b), “An Awarding Authority or Owner’s Project Manager may seek input from the general contractor in evaluating a sub-bidder’s performance of a Building Project, however, the Awarding Authority or their representative must complete and sign the Standard Contractor Evaluation Form.”

Regarding the information you supplied in Sections E and F above:

is your firm or any individual who owns, manages or controls your firm affiliated with any owner, designer or general contractor named in Sections E and F either through a business or family relationship? yes no

are any of the contact persons named in Sections E and F affiliated with your firm or any individual who owns, manages or control your company, either through a business or family relationship? yes no