Certificate of Workers' Compensation Insurance (Form 61A) - ONLINE


The Contractor’s Certificate of Workers’ Compensation Insurance (Form 61A) is a form issued by Commissioners of Revenue all over the Commonwealth in conjunction with Contractor’s business license filings. Pursuant to § 58.1-3714, the governing body of each county, city or town must require every contractor to provide written certification at the time of any application for issuance or reissuance of a business license that such contractor is in compliance with workers’ compensation requirements and will remain in compliance during the effective period of the business license. The form has been developed by the Workers’ Compensation Commission. Contractors are asked to provide business, contact and workers’ compensation insurance information. Contractors that do not list insurance coverage are asked to provide a reason. The completed form assists the Commission in following up with uninsured contractors that may be required to insure under the Act.