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If you are a new potential subconsultant to ECT or have been inactive for more than a year, please complete the form below. If you are unsure, contact Sheldon Nozik for this or any other questions related to this process.

Please note the following:

  • Asterisks indicate required fields.
  • If you were an approved, active subconsultant to ECT in the previous 12 months, please complete this renewal process.
  • Section 1: Subcontractor Information

  • Company legal name as it appears on the W-9.
  • If you don't have one, please write not applicable.
  • MM slash DD slash YYYY
    If you possess any of the following Business Certifications, please check all that apply:
  • Section Two: Subcontractor Health & Safety Information

  • Please provide the following data for the last three years below:

    Total Recordable Incident Rate (TRIR)
    Days Away, Restricted, or Transferred (DART)
    Experience Modification Rate (EMR)
    If not applicable, please mark NA in the fields below.
  • 202020192018
  • 202020192018
  • 202120202019
  • Your response is limited to 400 characters.
  • Your response is limited to 400 characters.
  • If you said yes, please check all that apply for your company.
  • Section 3: Document Uploads

    Upload the following supporting documents:
  • Drop files here or
    Max. file size: 128 MB.
    • Drop files here or
      Max. file size: 128 MB.
      • Drop files here or
        Max. file size: 128 MB.
        • Drop files here or
          Max. file size: 128 MB.
          • Drop files here or
            Max. file size: 128 MB.
            • Scroll to the bottom of the page to view our COI requirements.
              Drop files here or
              Max. file size: 128 MB.
              • A link to a fillable W-9 form is provided below.
                Drop files here or
                Max. file size: 128 MB.
                • If you answered yes to one or more of the Business Certifications in section one, please provide documentation.
                  Drop files here or
                  Max. file size: 128 MB.
                  • 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. 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.
                  • This field is for validation purposes and should be left unchanged.

                  ECT will contact approved consultants after January 1, 2022, with information on how to access a simplified renewal process.

                  CLICK HERE TO VIEW THE REQUIREMENTS FOR THE SUBCONTRACTOR’S CERTIFICATE OF INSURANCE:

                  The certificate holder name/address shall be:
                  Environmental Consulting & Technology, Inc. and its Affiliates Attn: Risk Management Dept.
                  3701 NW 98th Street Gainesville, FL 32606-5004
                  RE: Approved Subcontractor Qualification List

                  General Liability with minimum limits of:

                  • $1,000,000 – Each Occurrence
                  • $2,000,000 – Products and Completed Operations
                  • $2,000,000 – General Aggregate
                  • Automobile Liability with minimum combined single limit of $1,000,000
                  • Worker’s Compensation – statutory; Employers Liability – $1,000,000
                  • Professional Liability (if required) with minimum limit of $1,000,000
                  • Pollution Liability (if required) with minimum limit of $1,000,000

                  The certificate holder needs to be listed as an additional insured, as their interest appears, on the General Liability and Auto Liability policies. Workers Compensation needs to have a waiver of subrogation in favor of the certificate holder.

                  The NAIC number for each insurer needs to be shown.

                  If Worker’s Compensation is obtained through a Professional Employer Organization (aka PEO or employee/staff leasing company), the PEO must provide a certificate of insurance showing a “master list” of the employees being leased to the subcontractor and the specific period of time each employee is being leased.