Contractors Certification Of Workers Compensation Insurance {61A}

FORM 61A - CONTRACTOR’S CERTIFICATE OF WORKERS’ COMPENSATION INSURANCE. This form is used to verify a contractor’s compliance with Virginia’s Workers’ Compensation insurance requirements. Contractors must complete this form when applying for or renewing a business license with their local Commissioner of the Revenue or other designated local official. The form requires contractors to provide their business details, including the name, address, trade name, Federal Employer Identification Number (FEIN), and business structure. Contractors must indicate whether they have workers’ compensation insurance and, if so, list their insurance carrier, policy number, and coverage dates. The form requires contractors to declare whether they have employees or subcontractors, as this affects their obligation to carry workers’ compensation insurance under Virginia law (Virginia Code § 65.2-805). If a contractor has more than two employees—including part-time workers, corporate officers, or subcontractors’ employees—they are generally required to maintain workers’ compensation coverage. The form also warns that failure to obtain proper insurance when required can result in civil penalties of up to $50,000. Finally, the contractor must certify under penalty of perjury that the information provided is accurate and that they are in compliance with the Virginia Workers’ Compensation Act. www.FormsWorkflow.com