Third Party Inspector Application Package Submission Requirements A completed application form* A statement of qualifications of the contractor's/agency's inspection staff on company letterhead. The statement shall list all staff to be engaged in the performance of inspection services and attest that they possess the minimum qualifications, and that all inspection work will be performed under the direct supervision of the person identified as the agency representative or professional in charge. Copy of current relevant license(s) and certifications, including: Basic Business License Professional Licenses Local, Small, Disadvantaged Business Enterprise (LSDBE) certification (not required) Copy of current insurance policy for errors and omissions, stating amount of insurance coverage. Insurance coverage must be a minimum of $1,000,000, with the District of Columbia government, its officers, officials, and employees to be covered as additional insured Statement of Independence: A notarized sworn affidavit to the Administrator, signed by an authorized representative of the Inspection Agency, attesting that the Inspection Agency, its inspectors, and the Professional(s)-in-charge of the third-party inspection or inspection duties will remain independent of conflict of interest that may arise at any time, between the Inspection Agency and the Project or parties connected to the Project. Mail or deliver the application package to: Third Party Inspection Coordinator Building and Land Regulation Administration Suite 2000 941 North Capitol Street, NE Washington, DC 20002 Phone: (202) 442-4455 Fax: (202) 442-4863 * This document is presented in Portable Document Format (PDF) and a PDF reader is required for viewing. Download a PDF reader or learn more about PDF's