Badge #10580
Badges Form (#37)
This Application is currently Approved
Current user: Anonymous......your Role: (Submitter / 12)

Application Controlling Account ⟶ (Company POC: Invalid) click here to go to your Business Account Homepage...
a.10580^
Verl Dyer Co dba DreamMaker B&K
03-17-2022 03:05 PM
tbd
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New/Initial Applicant
Business Entity
DC22-0580
8
Main

TYPE OF APPLICATION....100% Application Type info...
_____________________________________________________________________________________________________________________________________________________
APPLICATION FOR LEAD-BASED PAINT CERTIFICATION - INDIVIDUAL DISCIPLINES AND BUSINESS ENTITY
Business Entity Complete
New/Initial Applicant Complete

FEES PAYMENT NOTICE
_________________________________________________________________________________________________________________________________
Please continue to process your application.
Upon clicking save your badge number and invoice amount will be populated.
Your new Badge Number is DC22-0580

If you would like to process your payment for your application prior
to receiving an invoice Please pay the amount of $300
...upon finishing the application and saving (use the SAVE Tab above)
Company/Employment Info

COMPANY INFORMATION....33% Company/Employment Info ...
_________________________________________________________________________________________________________________________________
Verl Dyer Co dba DreamMaker B&K Complete
7418 Leighton Drive Complete
Falls Church Complete
VA Complete
22043 Complete
(202) 920-1180 Complete
(703) 573-8034 Complete
info@dreammakernwdc.com
DreamMaker-Remodel.com/NWDC DreamMaker-Remodel.com/NWDC

OTHER INFORMATION REQUIRED
_________________________________________________________________________________________________________________________________
* Upload Evidence of Personal or Company Liability Insurance including environmental liability in an amount sufficient to cover the lead-based paint activity.

(business entity applicants only)
- If you plan to conduct lead abatement activities, attach a copy of a Certificate of Liability Insurance, proving the applicant s current policy coverage for at least one million dollars ($1,000,000) for individual environmental,
lead claims or pollution insurance, which the applicant shall maintain throughout the entire period that the lead abatement permit is in effect.
- If you plan to conduct abatement or demolition activities, attach a copy of a Certificate of Liability Insurance, proving the applicant s current policy coverage for at least two hundred fifty thousand dollars ($250,000) for individual
environmental or lead claims, which the applicant shall maintain throughout the entire period that the renovation permit is in effect.

Please upload your Evidence of Personal or Company Liability Insurance ----->
Complete-has previous system file uploaded
CURRENT COI 8.1.21-8.1.22.pdf
* The District of Columbia is not an agreement jurisdiction with the Nuclear Regulatory Commission (NRC). Contact NRC before conducting work in the District of Columbia.
 
* The District of Columbia is not an agreement jurisdiction with the Nuclear Regulatory Commission (NRC). Contact NRC before conducting work in the District of Columbia.*

Please upload your Evidence of radioactive material license ----->
Incomplete
* Stopped requiring this license on July 26, 2013
Business Entity Info

BUSINESS ENTITY....83% Buisness Entity Info ...
_________________________________________________________________________________________________________________________________
* COMPANY INFORMATION - COMPLETE ONLY FOR BUSINESS ENTITY CERTIFICATION
51-0509048 Complete
* District of Columbia Basic Business License or Exemption Information
Yes   TBD
* Do you have a current District Department of Consumer and Regulatory Affairs (DCRA) Basic Business License or Exemption?*

  • EACH business must be registered with DCRA s Corporations Division, registered with the Office of Tax Revenue and licensed under the Basic Business License program with DCRA.
  • Contact DCRA at (202)442-4400 or visit the website here: for more information. Proof of the DCRA Basic Business License or exemption must be attached to this application.
    		•

    Please upload your evidence of DCRA Basic Business License or Exemption ----->
    Add/View/Edit my Document
    Incomplete
    Corporation Complete
    * Types of Lead-Based Paint and Related Activities Conducted by your Company/Business - Check all that Apply Complete
     
     
     
     
     
    Yes  
     
     
    * Types of Properties your Company/Business Conduct Lead-Based Paint Activities - Check all that Apply Complete
    Yes  
     
     
    * Company Type of Business: Consultant, Abatement or Both Complete
     
    Yes  
    Verl Dyer, President Complete
    * Upload District of Columbia training certificates and certifications for employees who will be conducting lead-based paint activities.

    Please upload your Lead-Based Paint Credentials ----->

    		 Incomplete
    Affidavits

    AFFIDAVITS AND SHARING INFO CONSENT....100% Affidavids Info ...
    _________________________________________________________________________________________________________________________________
    FOR INDIVIDUAL DISCIPLINE APPLICANTS ONLY

  • The information that I have provided in this “DOEE Application for Lead-Based Paint Certification Form” is true, accurate, and complete to the best of my knowledge.
  • I understand that my application is subject to verification, and I agree to provide any additional documentation required to review that application.
  • I also understand that outside sources may be contacted for purposes of verifying the information contained in this application, and I hereby give permission for the disclosure
    of any information that may be needed to determine the validity of the information that I have provided and/or to determine eligibility for the certification sought.
  • I understand that failure to provide full disclosure of any requested information that may be needed to determine the validity of this application or eligibility for certification may result
    in the rejection of this application.
  • I also understand that completion of this application does not guarantee lead-based paint certification in the District of Columbia.
  • Further, I understand that if the Department finds that I have made a false statement or misrepresentation material to the issuance, modification, or renewal of a certification,
    the Department may, after notice and opportunity for hearing, suspend, revoke, modify, or refuse to issue, renew, or restore the certification. The Department may also seek to
    impose administrative, civil, or criminal penalties under D.C. Official Code § 8-231.01 et seq.
  • Finally, I understand that under D.C. Official Code § 22-2405, any person convicted of making false statements shall be fined not more than $1,000, or imprisoned for not
    more than 180 days, or both. A person commits the offense of making false statements if that person willfully makes a false statement that is in fact material, in writing directly or
    indirectly to any instrumentality of the District of Columbia Government, under circumstances in which the statement could reasonably be expected to be relied upon as true.
    		•
      Incomplete
    Application Compliance (Individual): I understand THAT IN ORDER TO BE CERTIFIED, I MUST COMPLY WITH THE SPECIFIC discipline requirements of this application
    THAT WOULD APPLY TO THE TYPE OF CERTIFICATION FOR WHICH I AM APPLYING and required under 20 DCMR §§ 3307 & 3322.
      Incomplete
    For Business Entity Applicants

    The District Government shall not issue or reissue any license or permit if the applicant owes it more than $100 in outstanding debt. A false statement on this certification requires that the District Department of Energy and Environment (DOEE), proceed immediately to revoke the certification, accreditation and/or permit or renewal for which you are now applying and fine you $1,000. This certification form is required to be completed and submitted with any application for a certification, accreditation and/or permit or renewal by the Clean Hands Before Receiving a License or Permit Act of 1996, effective May 11, 1996 (DC Law 11-118, DC Official Code Sec. 47-2861 et seq.) as amended, effective October 21, 2000 (DC Law 13-183, sec. 2(b), DC Code sec. 47-2861 et. seq.). As of the date, does not owe more than more than one hundred dollars ($100) in outstanding debt to the District of Columbia Government as a result of: 1. Fines, penalties, or interest assessed pursuant to the Lead–Hazard Prevention and Elimination Act of 2008, effective March 31, 2009 as amended (DC Law 17-381; D.C. Official Code § 8-231.01 et seq (2013 Supp.)); or 2. Fines, penalties, or interest assessed pursuant to the Litter Control Administration Action of 1985, effective March 25, 1986, (DC Law 6-100; DC Code Sec. 8-801 (et seq.) (2001 ed.); or 3. Fines, penalties, or interest assessed pursuant to the Illegal Dumping Enforcement Act of 1994, effective May 20, 1994 (DC Law 10-117; DC Code Sec. 8-901 (et seq.) (2001 ed.); or 4. Fines, penalties, or interest assessed pursuant to the Department of Consumer and Regulatory Affair (DCRA) Civil Infraction Act of 1985, effective October 5, 1985 (DC Law 6-42; DC Code Sec. 2-1801.01 (et. seq.) (2001 ed.); or 5. Past Due Taxes owed to the Office of Tax and Revenue pursuant to Title 47 of the DC Code; or 6. Past due District of Columbia Water and Sewer Authority service fees pursuant to Title 34 Chapter 22 and 24 of the DC Code (2001 ed.); or 7. Fines, penalties or interest assessed pursuant to Traffic Adjudication Act, Title 50, Chapter 23, of the DC Code (2001 ed.) I understand that a signed and dated Clean Hands Self-Certification Form is required as documentation to accompany my application for a certification, accreditation and/or permit or renewal. I understand that by completing and submitting this form, I am not guaranteed that my certification, accreditation and/or permit or renewal will be approved. I understand that the District Department of Energy and Environment (DOEE) and/or the Department of Consumer and Regulatory Affairs (DCRA) may conduct an investigation to ascertain the veracity of the information contained in this Clean Hands Self-Certification Form. I understand that if I knowingly provide false information on this Clean Hands Self-Certification Form, DOEE will proceed immediately to revoke each certification, accreditation and/or permit or renewal for which I am applying, and to fine me one thousand dollars ($1,000).
    Yes   Complete
    Application Compliance (Business): I understand THAT IN ORDER TO BE CERTIFIED, I MUST COMPLY WITH THE SPECIFIC requirements listed above and on page 3 of this
    application THAT WOULD APPLY TO THE TYPE OF CERTIFICATION FOR WHICH I AM APPLYING and required under 20 DCMR §§ 3311 & 3322.
    Yes  
    Complete

    Please Upload your Clean Hands Certificate ----->
    from https://mytax.dc.gov/_/
    Complete-has previous system file uploaded
    CLEAN HANDS CERTIFICATE.pdf
    For Individual Applicants: Has any federal, state or local jurisdiction ever revoked, suspended, modified, or proposed to revoke or suspend, or modified any permit, license, certification, or
    approval you have held or currently hold, or has any penalty action or fine been assessed against you for failure to comply with the laws and regulations pertaining to lead-based paint?
    For Business Entity Applicants: Has any federal, state or local jurisdiction ever revoked, suspended, modified, or proposed to revoke, suspend, or modify any permit, license, certification or approval your company has held or currently holds, or has any penalty or fine been assessed against your company or business for failure to comply with the laws and regulations governing lead-based paint activities?
    No Complete
    Info Sharing Consent

    INFO SHARING CONSENT....0% Info Sharing Info ...
    *** The email and website addresses are used to contact companies with compliance and enforcement updates.  DDOE is not responsible for incorrect email and website addresses.
    * FOR BUSINESS ENTITIES:

    CAN DOEE LIST YOUR BUSINESS NAME, CITY, STATE, CERTIFICATION NUMBER, EXPIRATION DATE AND CERTIFICATION TYPE ON OUR WEBSITE AS CERTIFIED AND WORKING IN D.C.?
    IF YES, INDICATE YOUR RESPONSE BELOW.

    I consent to give DOEE authorization to use the following personal information
    for DOEE Website as a Certified Professional working in Washington D.C
    YES
    Complete
             
    AI&EI Records
    Available Business Contacts
     
     
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