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ECT Subcontractor H&S Prequalification - Renewal Application

Section 1: Subcontractor Information


Company Legal Name:
Primary Mailing Address:
H&S Manager Information:
Current Date:
Recent Service:
NAICS Code(s):
Business Certifications:

Section 2: Document Uploads


Please provide your most current copy of the following items.
You may upload up to a total of 10 MB for all of your files; if you need to upload more or are experiencing difficulty uploading, please let us know and we will contact you directly. You may include up to 3 files per upload button. Hold down the command key to select multiple files from the same folder.

Next Steps

Once your renewal application is received, the information will be reviewed and you will be contacted either to confirm approval and active status in our system or to request additional or supplementary information such as HAZWOPER training certifications, procedural documentation, or other related information. To complete the application process, please complete the required signatures below.

"By signing below, I acknowledge the information provided is current and true and I have provided the support information requested or provided explanations why the information was not provided. Additionally, the submitting subcontractor agrees to follow ECT health & safety requirements and applicable state or Federal health & safety regulations."
Signature

KP Test Form

File Upload Section
You may upload up to a total of 10 MB for all of your files; if you need to upload more, please let us know and we will contact you directly.
You may include up to 3 files per upload button. Hold down the command key to select multiple files from the same folder.

ECT Inquiry

ECT Subcontractor H&S Prequalification - New Application

Section 1: Subcontractor Information


Company Legal Name:
Primary Mailing Address:
H&S Manager Information:
Current Date:
Recent Service:
NAICS Code(s):
Business Certifications:

Section 2: Subcontractor Health & Safety Information


Please provide the following data for the last three years below. If not applicable, please mark "NA" in the fields.
TRIR – Total Recordable Incident Rate:
DART – Days Away, Restricted, or Transferred:
EMR – Experience Modification Rate:
Citations/Safety
H&S Program Information

Section 3: Document Uploads


Please upload the following supporting documents.
You may upload up to a total of 10 MB for all of your files; if you need to upload more or are experiencing difficulty uploading, please let us know and we will contact you directly. You may include up to 3 files per upload button. Hold down the command key to select multiple files from the same folder.

Next Steps

Once your application is received, the information will be reviewed and you will be contacted either to confirm approval and active status in our system or to request additional or supplementary information such as HAZWOPER training certifications, procedural documentation, or other related information. To complete the application process, please complete the required signatures below.

"By signing below, I acknowledge the information provided is current and true and I have provided the support information requested or provided explanations why the information was not provided. Additionally, the submitting subcontractor agrees to follow ECT health & safety requirements and applicable state or federal health & safety regulations."
Signature
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