New Project Intake Form

Company name

Person Submitting Project

Email of Person Submitting Project

Position of Person Submitting Project

Phone Number of Person Submitting Project

Project Name

Internal Project Number (if applicable)

Project Address

Multi-line address

Country/Region

Address

City

Zip / Postal code

Project County

Type of Project

New Construction (the creation of a new building/project)

Remodel (remodel includes projects that involve changing the interior or exterior space of an already existing building/project.)

Repair (repair includes fixing existing structures and/or components of an existing building/project without changing the interior/exterior look and/or function.)

Maintenance (includes general/regular check-up on the building/site after construction. Maintenance may or may not lead to a repair or remodel decision)

Role on Project

Prime Contractor

Subcontractor

Prime Contractor means you were hired directly by the Awarding Body/Project Owner. Subcontractor means you were hired by another contractor or subcontractor.

Prime Contractor Name (If you are the Prime, list SELF)

Prime Contractor means you were hired directly by the Awarding Body/Project Owner. Subcontractor means you were hired by another contractor or subcontractor.

Awarding Body Name (this is not the Prime Contractor - this is the overall project Owner)

Project DIR #

Required on all California Public Works project if: The total project cost is $15k+ for (maintenance contracts), $25+ (construction contracts). The Awarding Body is responsible for registering the project with the DIR.

Chose One

Project DIR # IS KNOWN (provided below)

Project DIR # NOT KNOWN (will reach out to Prime or Awarding Body and will provide to CCM)

Project DIR # IS PENDING (will provide to CCM as soon as available)

Project DIR # NOT APPLICABLE (will provide explanation below)

Other: (explanation listed below)

DIR Project # Information

Provide DIR Project # (if applicable). If not applicable, explain why.

Compliance Requirements

Total Project Cost (amount the awarding body/project owner is paying to have the project completed) 30k or more?

Yes - 30k or more

No - Under 30k

Unsure - (will find out and let CCM know)

Current Status of Project

Project has not started.

Project has started, but not ended.

Project has started and ended.

This information is specific to your companies status on the project.

Project Start Date

If you do not have an actual start date, list the estimated start date.

Project End Date

If you do not have an actual start date, list the estimated start date.

Your Companies Contract Award Amount

If you do not have the actual amount, list the estimated amount. This information is required on certain compliance documents.

Project Support Requested

Full Project Compliance Management ( CCM will complete the compliance items for the project on behalf of your company.)

Subcontractor Management (CCM will review subcontractor compliance paperwork and report to your company. CCM will NOT complete the compliance paperwork on behalf the subcontractor unless they establishe their own account with CCM.)

Consulting Only (CCM will not process any compliance paperwork on your behalf. CCM will only review requested compliance documents and report back to you as well as provide consulting calls and emails with client regarding project.)

Scope Classifications

You are able to add 5 total scopes by using the "addition check box". If you need more than 5, please reach out to CCM.

Project scope(s) of Work (Choose ALL known scopes that your company will self-perform on the project site.)

Describe work to be completed.

Estimated number of man-hours for this scope?

Man-hours are the total number of hours that it takes to get the job done. A 2-man crew working 8-hours for one day, would equal 16-man hours total.

Estimated number of employees that will work in this scope?

Estimated Scope Start Date

Check box to add additional scopes.

Will SHIFT work be required on this project?

Yes

PROJECT DOCUMENT SUBMISSIONS

Please include any contract or bid documents relevant to ensuring this project’s compliance as well as informative emails from project administrators that relate to the project’s requirements, decisions, or compliance obligations.

Statements of Understanding

Any missing project information will be followed up on by Clarity Compliance. We appreciate your patience and understanding with our team members. Our goal is to support you, and all requests for additional information are made with your best interests in mind, as well as to ensure appropriate liability protection on our part.
If the start and/or end date you selected falls in the past, Clarity Compliance will make every effort to ensure full compliance and minimize exposure to potential penalties. Please be aware that certain compliance requirements are time‑sensitive and may not be able to be corrected retroactively.
Clarity Compliance will complete the DAS 140 using the information provided in this form. The client is responsible for completing the DAS 142 Dispatch Request Form in order for us to perform that task.
Failure to submit the DAS 142 Dispatch Request Form releases Clarity Compliance from any responsibility or liability related to compliance for those documents.
Clarity Compliance makes every effort to ensure that all compliance documentation is completed in a timely manner. Our ability to do so depends on the client providing current project information and submitting payroll data promptly. We do not manage project operations and rely on the client to supply the information necessary for us to perform our work effectively.

I have read the about statements and understand.