Hazardous Waste Handling Subcontractor Prequalification Form
1. Company Information
Company Name
Address
City
State / Province
ZIP / Postal Code
Country
Phone
Email
Website
2. Contact Person
Name
Title
Phone
Email
3. Licensing & Certification
List all current licenses relevant to hazardous waste handling (with license numbers)
Do you have a valid hazardous waste transporter permit?
Yes
No
Provide details of any other certifications/accreditations
4. Insurance
Insurance Company
Policy Number
Coverage Types & Limits
5. Experience
How many years of experience does your company have in hazardous waste handling?
List recent hazardous waste projects (include client, location, description, and date)
6. Safety History
OSHA Recordable Incidents (last 3 years)
Has your company been cited for environmental violations in the last 5 years?
Yes
No
If yes, please explain
7. References
Reference 1 (Name, Company, Contact Info)
Reference 2 (Name, Company, Contact Info)
8. Additional Information or Comments