Spill Response & Cleanup Subcontractor Prequalification Questionnaire
Company Information
Company Name
Address
City
State/Province
ZIP/Postal Code
Contact Name
Contact Phone
Contact Email
Emergency Response & Coverage
24/7 Emergency Contact Number
Regions/Coverage Area
Response Time Commitment (e.g., within x hours)
Experience & Capabilities
Years in Spill Response Business
List of Spill Response Services Provided
Types of Spills Experienced (oil, hazmat, etc.)
Equipment Available for Spill Response
Personnel & Training
Number of Trained Spill Responders
List Certifications/Training (e.g., HAZWOPER)
Health, Safety & Environment
Do you have a written Health & Safety Program?
Yes
No
Attach HSE Statistics (e.g., TRIR, EMR)
Describe your spill waste management capabilities
Insurance
General Liability Coverage Amount
Pollution Liability Coverage Amount
Workers’ Compensation Coverage
References
Provide 2-3 Recent Clients as References
Additional Information
Other Relevant Information