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Verifiable Consumer Access and Deletion Request

You may have the right to access or delete the personal information held by VelocityEHS Holdings Inc. (“VelocityEHS”) about you, including the right to know and access specific information or categories of information VelocityEHS may collect about you, and to have that information provided to you or deleted.

In order for us to respond to your request, we ask that you submit your request using the form below.

We will confirm our receipt of your request within 10 days of its receipt by VelocityEHS, and we expect to respond to your request within 45 days of VelocityEHS’s receipt of a fully completed form and proof of identity. You do not have to use this form but using this form should make it easier for you to make sure you have provided us with all relevant information, and for us to process your request. You may also submit your request via phone at 1-888-362-2007.

Verifiable Consumer Access and Deletion Request (CCPA)

1. Name and Contact Information

Please provide your information below. If you are making this request on an individual’s behalf, you should provide your name and contact information in Section 3.

We will only use the information you provide on this form to (i) identify you and the personal information you are requesting access to, (ii) respond to your request and (iii) keep a record of your request and our response.

Name
Name
First
Last
Address
Address
City
State/Province
Zip/Postal
Country

2. Proof of Identity

We must verify your identity before we can respond to your access and/or deletion request. We will use the information provided above to verify your identity, but we may request additional information from you to help confirm your identity and to exercise your rights under the California Consumer Privacy Act. We reserve the right to refuse to act on your request if we are unable to identify you, and will notify you in the event that we cannot identify you.

3. Requests Made by an Authorized Agent

Please complete this section of the form with your name and contact details if you are acting as an authorized agent on an individuals behalf.

Name
Name
First
Last
Address
Address
City
State/Province
Zip/Postal
Country
Example: Solicitor, Other Advisor, Parent, or Caregiver
Do you have legal authority to request the individual’s personal information?
We may request additional information from you to help confirm the individual’s identity. We reserve the right to refuse to act on your request if we are unable to identify the individual or verify your legal authority to act on the individual’s behalf, and will notify you in the event that we cannot identify the individual or verify your ability to act on the individual’s behalf.

4. Request

Please select from the following request categories (check all that apply). I would like to exercise my right to:
To help us process your request quickly and efficiently, please provide as much detail as possible about the personal information you are requesting access to or to have deleted from our systems. Please include time frames, dates, names, types of documents, file numbers, or any other information to help us locate your personal information.

We will contact you for additional information if the scope of your request is unclear or does not provide sufficient information for us to conduct a search. We will begin processing your request as soon as we have verified your identity and have all of the information we need to locate your personal information.

The personal information you request will be mailed to the home or email address you provided above. If you have a question please contact us at [email protected], 1-888-362-2007, or VelocityEHS Holdings Inc., Attn: Privacy Inquiries, 222 Merchandise Mart Plaza, Suite 1750, Chicago, IL 60654.

If we cannot provide you with access to or delete your personal information, we will inform you of the reasons why, subject to any legal or regulatory restrictions.

Our Privacy Policy is available at: https://www.ehs.com/privacy

Acknowledgment

By checking this box I confirm that the information provided on this form is correct and that I am the person whose name appears on this form either as the individual or individual’s Authorized Agent. If I am the individual’s Authorized Agent I confirm that I am authorized to act on behalf of the individual. I understand that VelocityEHS must verify my identity and in the case of Authorized Agents, my legal authority to act on the individual’s behalf, and may need to request additional verifying information. My request will not be valid until VelocityEHS receives all the required information to process the request.
Acknowledgement