Get Poc Prime Requalification Form - Connect Ncdot - North Carolina ...

Filling out the POC Prime Requalification Form is an essential step for firms seeking to be requalified as prime contractors with the North Carolina Department of Transportation. This guide provides detailed instructions to help users complete the form accurately and efficiently online.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to obtain the form and open it in the online editor.
2. Fill in the company's legal name and Federal Tax ID in the designated fields. Ensure that these details are without abbreviations.
3. Complete the contact information section, including the contact person's name, phone number, fax number, and email address.
4. List the owners of the company along with their percentage of ownership, race, and gender (optional).
5. Review the checklist for requalifying as a POC Prime Contractor and ensure that all items have been addressed correctly.
6. Fill out Parts 1 and 2 of the Safety Index, including your firm’s Experience Modification Rate (EMR) and Incident Rate. If applicable, check the box regarding worker’s compensation insurance.
7. Complete the work location sheet by selecting only the counties or divisions where your firm typically works.
8. Sign and complete the affidavit on the last page of the application, ensuring the certifying officer's signature and details are accurately filled.
9. Submit the completed package as directed, either by mailing to the specified address or via fax. Ensure all documents are submitted in their entirety.
10. Once submitted, retain a copy of the form for your records. You may have the option to save changes, download, print, or share the form before final submission.

Take the next step and complete your documents online today!