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Contractor's Certificate of Workers' Compensation Insurance - City of ... - harrisonburgva

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The document is a Contractor’s Certificate of Workers’ Compensation Insurance (Form 61-A) required for contractors applying for or renewing a business license in Virginia. It outlines the necessary information to be provided by the applicant, including business details, insurance coverage, and compliance with the Virginia Workers’ Compensation Act. The form must be completed fully and returned to the local licensing authority.

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Click ‘Get Form’ to open it in the editor.
Begin by selecting the locality issuing the business license. Fill in the name and number of the locality accurately.
Enter your business or trade name, along with your business license number. Ensure all information is complete and legible.
Provide your full name as the applicant, including your mailing address, city, state, and zip code.
Indicate your business structure (e.g., LLC, Sole Proprietor) and provide your FEIN or Tax ID number.
Select the method of workers’ compensation insurance applicable to you. Fill in details such as the insurance carrier's name and policy number if applicable.
If workers' compensation is not required, check the appropriate box and provide a reason. Answer whether you hire independent contractors or subcontractors.
Sign and date the form at the bottom, ensuring that you print your name clearly for verification purposes.

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Is workers compensation insurance required in Virginia?

A: Virginia law requires Virginia workers compensation coverage for work performed or subcontracted in Virginia, even if it is temporary work. Virginia does not have reciprocity with any other state.

How does workers comp work in Virginia?

Virginia law requires that most employers carry workers compensation insurance in order to cover their workers in the event of a work injury. Workers compensation provides a tradeoff for both employers and employees. For the employer, it provides an exclusive remedy, shielding the employer from civil suit.

How much does workers comp pay in Virginia?

If your doctor says you cannot work because of your work-related injury or illness, you may be entitled to compensation equaling 66 2/3% of your regular wages based upon earnings for the 52 weeks prior to your injury. This amount is subject to a statewide maximum reimbursement amount.

How long does it take to get paid by workers comp Virginia?

If your claim progresses relatively smoothly and your employer promptly approves it, you may start receiving benefits within a few weeks. You have two years from the injury date to file your workers compensation claim.

Can independent contractors get workers compensation in Virginia?

The Virginia Workers Compensation Act requires employers with at least three employees to provide insurance that covers work-related injuries and illnesses for all employees. However, independent contractors are not eligible for coverage under the workers compensation policy for the company they are working for.

How long can you get workers comp in Virginia?

Virginia Workers Compensation Benefits Limits. For most workers compensation cases, there is an overall limit of 500 weeks on how long you can receive benefits. There are exceptions to this limit in the case of some especially severe injuries such as spinal cord injuries, brain injuries, or the loss of multiple limbs

How is workers comp calculated in Virginia?

After calculating your average weekly wage, you would be eligible for two-thirds of that wage (or the maximum rate, whichever is lower). For example, if your pre-injury average weekly wage was $900, then you are entitled to $600 in benefits, which is two-thirds of your average weekly wage.

How to calculate average weekly wage Virginia Workers Compensation?

Calculate Your Earnings Calculate your total gross earnings (not your take-home pay) over that 52 week period and divide the total gross earnings figure by 52. The resulting amount is your average weekly wage as defined under the Virginia Workers Compensation Act.

Contractor's Certificate of Workers' Compensation Insurance - City of ... - harrisonburgva 2025

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Got questions?

How can I eSign my Contractor's Certificate of Workers' Compensation Insurance - City of ... - harrisonburgva in Word?

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Is workers compensation insurance required in Virginia?

How does workers comp work in Virginia?

How much does workers comp pay in Virginia?

People also ask

How long does it take to get paid by workers comp Virginia?

Can independent contractors get workers compensation in Virginia?

How long can you get workers comp in Virginia?

How is workers comp calculated in Virginia?

How to calculate average weekly wage Virginia Workers Compensation?

Related links

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Contractor's Certificate of Workers' Compensation Insurance - City of ... - harrisonburgva 2025

Here's how it works

How to use or fill out Contractor's Certificate of Workers' Compensation Insurance - City of Harrisonburg with our platform

See more Contractor's Certificate of Workers' Compensation Insurance - City of ... - harrisonburgva versions

Complete this form in 5 minutes or less

Got questions?

How can I eSign my Contractor's Certificate of Workers' Compensation Insurance - City of ... - harrisonburgva in Word?

How do you edit Contractor's Certificate of Workers' Compensation Insurance - City of ... - harrisonburgva on Android?

Is workers compensation insurance required in Virginia?

How does workers comp work in Virginia?

How much does workers comp pay in Virginia?

Related Searches

People also ask

How long does it take to get paid by workers comp Virginia?

Can independent contractors get workers compensation in Virginia?

How long can you get workers comp in Virginia?

How is workers comp calculated in Virginia?

How to calculate average weekly wage Virginia Workers Compensation?

Related links

Try more PDF tools