DUE
DILIGENCE PROTOCOL
REQUEST
FOR PRE-AUDIT INFORMATION
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Name of Legal Owner: |
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Address of Legal Owner: |
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Ownership Status of the Facility
and Number of Years at the Facility: |
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Permit/Generator
Status of Facility: |
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Address
of Main Facility (if different) and number of years at the facility: |
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Permit/Generator
Status of Main Facility: |
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Location(s)
of all other company owned/operated facilities and number of years at each
facility: |
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Permit/Generator
Status of all other company owned/operated facilities: |
Please describe the scope of services you provide,
service capabilities and response limitations relative to:
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Transporting
to a TSDF (authorized facility) |
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Use
of owned or leased storage or transfer facilities |
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Use
of contractor TSDF’s (Toxic Service Disposal Facility) |
Describe
your labor/management relations.
DOCUMENTS
WE WISH TO SEE SUBMITTED:
A List of 3 to 5 Customer References
(please include any healthcare references):
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Name: |
Address: |
Phone #: |
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VENDOR
CLIENT BASE/COMMUNITY RELATIONS:
Please tell us the percentage of revenues
a [COMPANYNAME] contract would represent:
Please
submit a listing of your major (or top 10) customers.
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Company
Name: |
Address: |
Contact: |
Phone: |
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OPERATIONS
AND CONTROLS:
Please
provide us with a general description of your operations.
DOCUMENTS WE WOULD LIKE TO SEE
SUBMITTED:
INSURANCE
AND FINANCIAL:
Please respond to the following questions
about your
company’s insurance coverage by completing the following table (we will also be asking for similar
information on subcontractors, in the Subcontractor’s section):
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Insurance: |
Yes/No: |
Carrier: |
Coverage: |
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Comprehensive General Liability |
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Workers Compensation |
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Automobile: |
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Pollution Liability |
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Other |
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Please
Provide your Dun & Bradstreet (D&B) Number: |
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Parent Organization: |
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Facility: |
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DOCUMENTS WE WOULD LIKE TO SEE SUBMITTED:
VENDOR
COMPLIANCE HISTORY:
Are you, or have you been in the past five
years, involved in any removal, remediation, or other environmental clean up
actions? (Yes / No) If yes, please identify the location of the
action and the nature of your activities at or with the site.
Are you, or have you been in the past five
years, involved in any lawsuit relating to the work you perform? (Yes /
No) If yes, describe the nature of the
lawsuits and, if settled, the outcome.
Are you, or have you been in the past five
years, involved in any lawsuit or government agency enforcement action relating
to the environmental contamination of real property? If yes, describe the nature of the enforcement action or lawsuits
and, if settled, the outcome.
In the last five years, have you been
cited for violations of any federal, state, or local environment laws or
regulations (including, but not limited to, any laws or regulations relating to
waste management or disposal, waste water, or air emissions)? (Yes / No)
If yes, identify the agency issuing the citation, the nature of the
violation(s), corrective action taken and current status.
In the last five years has your company
been cited for violations of the federal Occupational Safety and Health Act
(OSHA) or an equivalent state law? (Yes
/ No) If yes, indicate the nature of
the citations and provide copies of any serious, willful, or repeat citations.
Also provide a narrative of corrective action taken, and the current status of
citations.
In the last five years has your company
been cited for violations of any federal, state, or local hazardous materials
transportation laws or regulations?
(Yes / No) If yes, indicate the
nature of the citations and provide copies of any serious, willful, or repeat
citations. Also provide narrative corrective action taken, and the current
status of citations.
Are any environmental agency, OSHA, or
transportation agency investigations or citations currently pending or on
appeal? (Yes / No) If yes, please describe the nature of the
investigation or appealed violations?
VENDOR
SUBCONTRACTOR RELATIONSHIPS:
Do you subcontract for any of the services
that would be provided to [COMPANYNAME]? (e.g., waste disposal, waste
reclamation, transport, transfer stations, TSDF, spill response) (Yes / No)
If so, identify your subcontractors (including any alliances or
partnerships into which you would enter to handle any capacity contingencies),
frequency of use, and circumstances under which they would be used.
Subcontractors:
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Company: |
Service: |
Alliance / Partner: |
Frequency: |
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What due diligence, if any, have you done
on your subcontractors? Please describe
in detail and provide any supporting documentation. If none has been done,
please explain why.
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Subcontractor: |
Due Diligence performed: |
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Are any of your subcontractors involved in
any current or past (5 years) lawsuits relating to the work it performs? (Yes / No)
If yes, describe the nature of the lawsuits and, if settled, the
outcome.
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Subcontractor: |
History of Current, or Past, WORK
RELATED Law Suits: |
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Are any of your subcontractors involved in
any current or past (5 years) lawsuits or government agency enforcement actions
relating to the environmental contamination of real property? (Yes / No) If yes, describe the nature of the
enforcement action or lawsuits and, if settled, the outcome.
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Subcontractor: |
Current or Past CONTAMINATION Law Suits: |
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In the last five years, has your
subcontractor been cited for violations of any federal, state, or local environmental
laws or regulations (including, but not limited to, any laws or regulations
relating to waste management or disposal, waste water, or air emissions)? (Yes / No)
If yes, identify the agency issuing the citation and the nature of the
violation(s)?
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Subcontractor: |
Current or Past ENVIRONMENTAL Law
Violations: |
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In the last five years has your
subcontractor been cited for violations of the federal Occupational Safety and
Health Act (OSHA) or an equivalent state law?
(Yes / No) If yes, indicate the
nature of the citations and provide copies of any serious, willful, or repeat
citations.
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Subcontractor: |
Current or Past OSHA Law Violations: |
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In the last five years has your
subcontractor been cited for violations of any federal, state, or local
hazardous materials transportation laws or regulations? (Yes / No)
If yes, indicate the nature of the citations and provide copies of any
serious, willful, or repeat citations.
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Subcontractor: |
Past or Current HazMat Law Violations: |
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Are any environmental agency, OSHA, or
transportation agency investigations or citations involving your subcontractor
currently pending or on appeal? (Yes /
No) If yes, please describe the nature
of the investigation or appealed violations?
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Subcontractor: |
Past or Current OSHA Transportation Law
Violations: |
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Please indicate which of the following
insurance policies your
subcontractor carries,
the name(s) of the carrier, and the amount of the coverage (you may need to
provide this for each of your subcontractors):
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Insurance: |
Yes/No: |
Carrier: |
Coverage: |
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Comprehensive General Liability |
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Workers Compensation |
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Automobile: |
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Pollution Liability |
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Other |
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DOCUMENTS
WE WISH TO REVIEW ON THE SITE: