EOD > Construction Compliance

Certificate of Compliance Application

Instructions

The following instructions are provided for users electronically completing and submitting the Certificate of Compliance Application.

PART A

Check appropriate box if the company is presently a low bidder expecting award for any state or state assisted construction contract. If yes to question, e nter the appropriate information for the following categories: project number, project name, award amount, awarding agency, and bid date.

PART B

Check box in Part B if the company’s FTID #, name, address, phone number has been changed since your last application submittal.

FTID# : enter the company’s federal tax identification number

Company Name : enter the company’s registered name

Owner/President : enter the owner’s or president’s name

Title : enter the title of the person listed as owner or president

Address, City, State, Zip Code & County: enter the company’s mailing address

Phone number: enter the company’s phone number. Example: (614) 466-8380

Fax number : enter the company’s fax number

Email address : enter the email address of the person listed as owner/president or other designate employee

Owner’s Race & Sex : check the appropriate boxes for the race and sex of the individual listed as the owner/president

 PART C

• Indicate if the company has employed 50 or more field employees ( construction trades only) at any time during the past 12 months.
• Enter the number of employees currently working in your company’s construction trades on both private and public projects. This does not include office personnel or superintendents.
• Indicate by selecting the appropriate box if the company is currently submitting the Ohio Construction Contract Information Report – Input Form 29 (I-29) to the Department of Administrative Services, Equal Opportunity Division.
• Indicate by selecting the appropriate boxes the construction trades employed by the company. If the trade “Other “ is checked, please specify the specific trade name in text box.

 PART D

• Indicate by selecting the appropriate box the type of applicant:

First Time Applicant

If your company is a first time applicant, list allpublic construction contracts (township, county, city, state, or federal government) exceeding $50,000 or more regardless of location for the past 12 months in the project information section.

Indicate if the company has been found in violation of any affirmative action program within the past 5 years. If yes, provide the following information in the text box: agency name, address, telephone number and fax or mail a copy of notification of violation to the Equal Opportunity Division.

Renewal Applicant

If your company is submitting for a renewal application, list allpublic construction contracts (township, county, city, state, or federal government) exceeding $50,000 or more regardless of location and issuedsince the date of your last certificate of compliance application in the project information section.

Check box if company does not have any new publicly funded projects since your last submittal application for certificate of compliance.

Project Information ONLY section

State or state assisted funded project: indicate if the public project listed is a state or state assisted funded project

Project #: enter the project number issued for the public project

Project Name: enter the name of the public project

County: Enter the county name in which the public project is located

Contract Information ONLY section

Prime/Sub: indicate if the company is a prime contractor or subcontractor for each public project

Contract $ Amount: enter the company’s contract amount for each public project listed

Start Date: enter the month and year the company started their portion of the public project. Example: 3/02

Complete Date: enter the month and year the company completed each public contract. If the project is not completed, enter the approximate month and year the project is projected to be completed

% of Contract Complete: enter the approximate percentage of completion for each public contract

Awarding Agency: enter the name of the governmental entity that awarded the public contract. Example: Ohio State University, ODOT, City of Cleveland, West Virginia Dept. of Transportation…

Part E

Check box if there has been changes in Part E since the submittal of previous application.

Questions 6 : check appropriate box

Question 7 : provide the name of the company’s designated EEO Officer

Question 8 : indicate by selecting the appropriate box if the company has had their affirmative action program (EEO policies, hiring practices, affirmative action plan…) reviewed by any government agency within the past 12 months.

If yes , provide the following information in the text boxes:

Reviewing Agency’s Name : enter the name the agency that conducted the review

Reviewing Agency’s Address : enter the address of the agency that conducted the review

Results of the Review *: indicate the final result of the review

*Fax or mail results of your company’s review to the DAS/Equal Opportunity Division

Question 9 : check appropriate box. If yes to question, provide the name of agency in text box

Questions 10-14 : check appropriate boxes

Question 15 : provide in the text box the name(s) of organization(s) the company utilizes for the hiring of trades employed by the company

Question 16 : check appropriate box. If yes to question, provide the name(s) of MBE/DBEs and the projects they were utilized on in the text box

Part F

• Enter the name of the person who completed, submitted and certifies the information provided on the form is accurate.
• Enter the title of the person who completed and submitted the application.
• Enter the date the application was completed and submitted. Example: 03/02/02

NOTE: THE CERTIFICATE OF COMPLIANCE APPLICATION MUST BE COMPLETED IN ITS ENTIRETY. IF NOT, THE APPLICATION WILL BE RETURNED TO SENDER.

Please utilize the staff roster on our website to contact a compliance officer for questions regarding the Certificate of Compliance Application and the status of your certification.

STAFF ROSTER

Please fax or mail requested documentation to:

DAS/Equal Opportunity Division,

30 E. Broad Street , 18 th Floor

Columbus , OH 43215

Fax: (614) 728-5628

(DAS/EOD/COC ONLINE INSTRUC REV 10/05)