Illinois Administrative Code
Title 35 - ENVIRONMENTAL PROTECTION
Part 740 - SITE REMEDIATION PROGRAM
Subpart I - REVIEW OF REMEDIATION COSTS FOR BROWNFIELDS SITE RESTORATION PROGRAM
Appendix B - Review and Evaluation Licensed Professional Engineer Information

Universal Citation: 35 IL Admin Code ยง B
Current through Register Vol. 48, No. 38, September 20, 2024

* Firm name.

* Address.

* Telephone/fax.

* Principal officials and titles.

* Number of full-time employees.

* Business structure (corporation, partnership, LLP, LLC, PSC).

* Licensed by Secretary of State? #___________

* Licensed by Dept. of Professional Regulation? #___________

* Name of Illinois Registered Managing Agent.

Names of insurance carriers and amount of coverage:

Worker's Compensation:_____________________________________________

General Liability:___________________________________________________

Professional Liability:________________________________________________

* Does the stated professional liability policy include coverage for "environmental" claims related to release of pollutants? If not covered, or covered by a different carrier or in a different amount, so state.

* Has the firm or owners ever filed bankruptcy? If "yes," state when and explain.

* Is the firm an outgrowth, result, continuation or reorganization of a former business? If "yes," explain background.

* List RELPEs and other key full-time employees that will participate on this project with the RELPE. Provide resumes for each, including Illinois P.E. License #, certifications, project role, years of experience in related work and education.

* List five projects similar in nature and identify the role of the RELPE.

* Are employees to be assigned to the project in compliance with 29 CFR 1910.120 (HAZWOPER training and medical surveillance) as applicable to their role on the project?

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