1. If your company is hired by MIP, will there be personnel working in the field, at a job site, or in a MIP office to complete the services requested?* Required
2. Does your company have more than ten (10) employees?* Required
3. Does your company transport, deliver or pick up hazardous materials as defined by the Department of Transportation (DOT) or by Canadian Transportation of Dangerous Goods (TDG) or hazardous waste legislation?
* Required
4. Are your workers (i.e. employees or other hired personnel) required to use hazardous chemicals or wear personal protective equipment (PPE) as regulated by OHS legislation (federal or provincial)?
* Required
5. Do your workers (i.e. employees or other hired personnel) enter a "work zone" at a project site where there is a potential for exposure to hazardous substances or health hazards as per OHS regulations (federal or provincial).* Required
6. Do your workers (i.e. employees or other hired personnel) operate tools (i.e. electric, pneumatic, hydraulic) or mobile equipment (i.e. heavy, forklift, aerial manlift)?* Required
7. Is the sole business of your company to provide of any of the following? surveying, utility locating, utility supplier or equipment rental services?
* Required
Whom requested that you fill out this form? * Required
* Required
Must provide Parsons Employee Name or a Contractor Name, Contact Name,Telephone Number and Contact E-mail Address.
Please enter a valid e-mail address.
Contractor Home Office Information:
Company
Name:* Required
* Required
Address 1:* Required
* Required
Address 2:
City:* Required
* Required
Province/Country:* Required
* Required
Please select a state or country
Postal Code:* Required
* Required
Web Address:(ie. http://123.com)
Please enter a valid Web address
Health and Safety Contact Name:
* Required
* Required
Health and Safety Contact Title:* Required
* Required
Telephone:
Fax:
H&S Contact e-mail Address:* Required
* RequiredPlease Enter a valid e-mail Address
Parent Company Information (if applicable) :
Company Name:
Address 1:
Address 2:
City:
Province/Country:
Please select a state or country
Postal Code:
Web Address: (ie. http://123.com)
Please enter a valid Web address
Health and Safety Contact Name:
Health and Safety Contact Title:
Telephone:
Fax:
H&S Contact e-mail Address:
Please enter a valid e-mail address
Person Completing This Contractor Registration Form
Name:* Required
* Required
Title:* Required
* Required
Note: If you plan to have lower level subcontractors perform this work they must register separately.
