Attachment_08a_Korea_Transporter_Form_Instructions.pdf

SP4500-18-R-0000 Korea HW Attachment 08a

Transporter Qualification Review Application Instructions (OCONUS)

1. Transporter Name (enter the name of the firm in English as it will appear in correspondence)

2. Transporter Address (enter the address of the firm in English as it will appear in correspondence)

Where the requested information is not applicable enter N/A.

3. Transporter EPA I.D. Number: (Leave blank, new transporters will be assigned a number by the Disposition Services Contracting Officer Representative.)

4. List primary state waste transporter permit numbers: (If the prefecture issues numbers enter them, if not enter N/A)

Motor Carrier Safety

5. Federal Motor Carrier Safety Administration (FMCSA) USDOT Number: (Enter N/A)

6. FMCSA audit date: (Enter N/A)

Provide audit report from regulatory agency. (If the prefecture or city conducts an audit enter date, name of auditing authority and if possible provide the cover page of the report as an attachment. Include English translation if possible.)

7. List dates, city and state location of any Federal or State safety violations in the last 3 years: (Enter if any violations)

8. Has the company had any traffic citations or hazardous materials incidents within the last three years? (Click on “Choose an Item” and select either Yes or No)

If yes, provide enforcement agency copies of traffic citations or hazardous materials incident report. (Enter if Yes)

9. Provide current Office of Motor Carrier Safety rating (OMCS) Carriers must have an OMCS rating within the last 3 years to qualify. (Enter N/A)

Risk Mitigation

10. Does company have a written hazardous materials safety training program? Select an item. (Click on “Select an item” and click on Yes or No.)

If yes, provide a copy of the training program. (Rather than send the whole program provide a copy of the cover page and table of contents (if only available in Korean still send.))

SP4530-18-R-0000

Korea HW

Attachment 08a

11. Does company maintain general, property, bodily injury and pollution liability insurance coverage? Select an item. (Click on “Select an item” and click on Yes or No.)

If yes, provide copy of insurance certificates. (If yes, rather than send the whole policy provide a copy of the cover page and summary of coverage (if only available in Korean still send.))

12. Are all loads transported by company owned/leased vehicles? Choose an item. (Click on “Select an item” and click on Yes or No.)

If no, all contractors must meet same criteria to qualify as a DLA approved transporter.

13. List company names and city location below for all contract carriers. (Enter into the spaced provided in the form.)

14. Will carrier be providing transportation services using marine vessels? Select an item.

(Click on “Select an item” and click on No.)

If question 14 was yes, carrier is required to submit International Maritime Dangerous Goods (IMDG) transportation licenses.

15. Will carrier be required to transport material outside the continental United States?

Choose an item. (Click on “Select an item” and click on No.)

If yes to question 15, provide list of countries below and submit foreign country license documentation. Skip to the second block numbered 15

Click to select country/state. Click to select country/state.

Company Representation

15. Name of company representative completing application:

Enter the name of the person (company person) completing the form and then click on Click here to enter a date. and select a date from the calendar.