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Workplace Safety Grant Contractual Documents and Forms

Prospect DIA Workplace Safety Grant applicants must download the forms below, and upload the completed documents upon submitting their application. Please email candpgms@mass.gov if you have questions about the state procurement process.

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Contractual Documents

Open PDF file, 244.03 KB,  FY25 Contract Document Checklist (English, PDF 244.03 KB)
Open PDF file, 97.67 KB,  FY25 Form W9 (English, PDF 97.67 KB)
Open PDF file, 149.79 KB,  FY25 Standard Contract (English, PDF 149.79 KB)
Open PDF file, 274.48 KB,  Workplace Safety Grant FY25 Electronic Funds Transfer Form (English, PDF 274.48 KB)
Open PDF file, 216.48 KB,  Workplace Safety Grant FY25 Contractor Authorized Signatory Listing Form (English, PDF 216.48 KB)
Open PDF file, 194.54 KB,  FY25 CASL Form Contractor Authorized Signatory Listing for Sole Proprietors (English, PDF 194.54 KB)
Open PDF file, 363.94 KB,  DOR Sample Certificate of Good Standing and/or Tax Compliance (English, PDF 363.94 KB)

Other Workplace Safety Grant Resources

Open PDF file, 906.31 KB,  Workplace Safety Grant Application Instruction Guide (English, PDF 906.31 KB)
Open PDF file, 351.96 KB,  Workplace Safety Grant Training Providers (English, PDF 351.96 KB)
Open PDF file, 149.1 KB,  Workplace Safety Grant Training Topics (English, PDF 149.1 KB)

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