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MEDIA INQUIRIES

Environmental Justice: What’s the Buzz?

March 2, 2023

ECT Supports Domestic Violence Nonprofit Fundraiser

October 14, 2022

Amber Ballman joins ECT as Texas Operations Director for firm’s Natural Resources division

September 16, 2022

ECT announces Sri Vedachalam joins as Director of Water Equity & Climate Resilience

June 30, 2022

Derrick Lewis Joins ECT as Southeast Operations Director for Firm’s Water Resources Division

May 25, 2022

Alabama Rural Electric Association Conference

March 30, 2022

Ellen Graap Loth Joins ECT as Federal Services Market Leader

February 10, 2022

ECT Bolsters Transmission Capabilities in the Midwest with Strategic Hire

November 24, 2021

Dean Harwood joins ECT as Chief Financial Officer

February 9, 2021

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Terms & Conditions

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ECT Subcontractor H&S Prequalification - Renewal Application

Section 1: Subcontractor Information

Company Legal Name:

Company legal name as it appears on the W-9:

Primary Mailing Address:

Street Address:

Address Line 2:

City:

State:

Zip Code:

Website:

H&S Manager Information:

H&S Manager Name and Title (if you don't have one, please write "Not Applicable"):

H&S Manager Phone:

H&S Manager Email:

Current Date:

Date:

Recent Service:

Primary ECT contact(s) and office(s) most recently serviced:

NAICS Code(s):

Please list relevant NAICS Code(s):

Business Certifications:

If you possess any of the following Business Certifications, please check all that apply:

Small Business Non-profit Organization Woman Owned Disability Owned Veteran Owned Service‐Disabled Vet owned Black American owned Hispanic American owned Native American owned Asian‐Pacific American owned Subcontinent Asian American owned HUBZone Certified Other - Explain Not applicable

If you selected "other," please specify below:

Please characterize the work you provided for ECT over the past 12 months.

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.

OSHA 2022 300/300A logs:

2023 EMR verification on insurance company letterhead:

Sample of completed Job Safety Analysis (similar for work to be performed with ECT):

Certificate of Insurance (COI) – Scroll to the bottom of the page to view our COI requirements

Business Certifications – If you answered yes to one or more of the Business Certifications in Section 1, please provide documentation:

Context and Explanation – Should any of the requested information not be available or need explanation, please provide an explanation here:

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

Name

Title

Date

KP Test Form

Name:

Company:

Phone:

Email:

Please briefly explain your inquiry:

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.

File Upload 1:

File Upload 2:

File Upload 3:

File Upload 4:

File Upload 5:

File Upload 6:

File Upload 7:

File Upload 8:

ECT Inquiry

Name:

Company:

Phone:

Email:

Please briefly explain your inquiry:

ECT Subcontractor H&S Prequalification - New Application

Section 1: Subcontractor Information

Company Legal Name:

Company legal name as it appears on the W-9:

Primary Mailing Address:

Street Address:

Address Line 2:

City:

State:

Zip Code:

Website:

H&S Manager Information:

H&S Manager Name and Title (if you don't have one, please write "Not Applicable"):

H&S Manager Phone:

H&S Manager Email:

Current Date:

Date:

Recent Service:

Primary ECT contact(s) and office(s) most recently serviced:

NAICS Code(s):

Please list relevant NAICS Code(s):

Business Certifications:

If you possess any of the following Business Certifications, please check all that apply:

If you selected "other," please specify below:

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:

TRIR 2022

TRIR 2021

TRIR 2020

DART – Days Away, Restricted, or Transferred:

DART 2022

DART 2021

DART 2020

EMR – Experience Modification Rate:

EMR 2023

EMR 2022

EMR 2021

Citations/Safety

Has your company received a citation from OSHA or state equivalent, or other agency regarding an injury or environmental incident within the past 5 years?

Yes No

If yes, please provide a brief summary:

Has your company experienced a work-related, OSHA defined severe injury including hospitalization, amputation, or death in the past 5 years?

Yes No

If yes, please provide a brief summary:

H&S Program Information

Do you have H&S program information available about your company?

Yes No Not applicable

If you said yes, please check all that apply for your company.

We have a written H&S Program. We hold Tailgate/Job Site Safety Meetings. We have an Injury Management & Reporting Procedure. We have a written Hazard Communication (HazComm) policy/program. We have written H&S procedures for the work we may perform for ECT. We prepare job-specific health & safety plans and job safety and hazard assessments. We have a “Stop Work Authority” policy.

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.

H&S Program Table of Contents:

OSHA 300 and 300A logs for 2022, 2021, and 2020:

Explanation of any severe injuries, hospitalizations, deaths or citations in last 5 years:

On Insurance carrier letterhead, EMR verification for years 2023, 2022, and 2021:

Sample of completed Job Safety Analysis (similar for work to be performed with ECT):

Certificate of Insurance (COI) – Scroll to the bottom of the page to view our COI requirements

Current W-9 form (Signed) – A link to a fillable W-9 form is provided below.

Business Certifications – If you answered yes to one or more of the Business Certifications in Section 1, please provide documentation:

Context and Explanation – Should any of the requested information not be available or need explanation, please provide an explanation here:

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.

Signature

Name

Title

Date

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