Sub-Contractor Questionnaire (one page) - Vaughandale Construction Ltd

Company Name: *

Address: *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Main Contact Name: *

Phone Number: *

Company Email: *

Company Services: *

Please list services your company can provide:

Trading Status Information:

Trading Status: *

PLC
Limited
Partnership
Sole Trader

VAT Registered:

Are you VAT registered: *

Yes
No

UTR Number:

Do you have a company UTR No: *

Yes
No

Company Registration Number:

Do you have a company Registration No: *

Yes
No

Bank Name: *

Sort Code: *

Account Number: *

Insurance Information

Employers Liability Level of Cover:

Employers Liability Expiry Date

Public Liability Level of Cover:

Public Liability Expiry Date

Professional Indemnity Level of Cover:

Professional Indemnity Expiry Date

Contacts

Quality Contact Name: *

Provide the contact details of the person responsible for Quality systems.

Quality Contact Email: *

Quality Contact Phone: *

Environmental Contact Name: *

Provide the contact details of the person responsible for Environmental systems.

Environmental Contact Email: *

Environmental Contact Phone: *

Health & Safety Docuemnt:

Do you employ more than five people: *

Yes
No

Do you carry out DBS (Disclosure & Barring Service) checks on your members of staff? *

Yes
No

Health and safety executive name: *

Full name of the person having executive responsibility for health and safety in your company:

Health and safety executive job title: *

Job title of the person having executive responsibility for health and safety in your company:

Is your company a member of any accreditation schemes: *

Yes
No

For example: Gas Safe & NICEIC, Asbestos(ARCA).

Accreditation details:

ISO45001 Accreditation:

Do you currently hold ISO45001 Accreditation: *

Yes
No

SSIP Accreditation:

Do you currently hold SSIP: *

Yes
No

CHAS, Safecontractor, Acclaim, SMAS, Constructionline.

Induction & H&S Performance

Do you have a Company Induction to brief staff on your policies: *

Yes
No

Please provide evidence on how you monitor the Health and Safety performance of your direct employees: *

Click or drag a file to this area to upload.

Example RAMS, Safe Systems of Work.

As you have provided ISO45001 and SSIP you do not need to complete this section. Please continue to the next section.

Please provide details of any accidents / incidents in the last three years:

Major incidents & fatalities
Reportable incidents as defined by RIDDOR
Minor injuries and incidents
Near miss

Type of accident / incident:

Major incidents & fatalities

Reportable incidents as defined by RIDDOR

Minor injuries and incidents

Near miss accident / incident

Prosecuted / Breach details:

Has your company or an individual employed by your company been prosecuted for any breach of health and safety legislation within the past three years: *

Yes
No

Please give details, supported by documentary evidence, of any Health and Safety training given to your Managers/Supervisors/Operatives within the last three years:

Managers
Supervisors
Operatives

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As you have provided ISO45001 and SSIP you do not need to complete this section. Please continue to the next section.

Under current regulations (PUWER 1998) do you provide tested and tagged equipment: *

Yes
No

Are test records kept and up to date: *

Yes
No

Who carries out the tests and inspections: *

Please provide examples of PUWER 1998 in action: *

Click or drag files to this area to upload. You can upload up to 5 files.

As you have provided ISO45001 and SSIP you do not need to complete this section. Please continue to the next section.

Are operatives given training & instructions on the use, maintenance and storage of PPE: *

Yes
No

Do you operate arrangements for testing of PPE (e.g. respiratory, harnesses, etc): *

Yes
No

PPE Evidence type: *

PPE Manual Details
PPE File Upload

PPE Evidence

Are operatives given training on Asbestos Awareness: *

Yes
No

Do you operate arrangements for Face Fit Testing: *

Yes
No

Asbestos Awareness & FFT Evidence type: *

Asbestos Awareness & FFT Manual Details
Asbestos Awareness & FFT File Upload

Asbestos Awareness & FFT Evidence

Please explain how you bring to the notice of site personnel (direct and sub-contract employed) the requirements of your systems of work on the sites upon which you work, including Risk Assessments, COSHH Assessments, Method Statements, etc. and how is such information communicated to such personnel to satisfy yourselves that the information has been fully understood: *

Please provide details.

Provide an example of a Risk and Method Statement: *

Click or drag files to this area to upload. You can upload up to 2 files.

Is it your policy to comply with the statutory obligation under the Equalities Act 2010: *

Yes
No

Accordingly, is it your practice not to discriminate directly or indirectly against any of the protected characteristics outlined in the Equalities Act 2010: *

Yes
No

Equality, Diversity or Equal Opportunities Policy

Do you have an Equality, Diversity or Equal Opportunities in Employment Policy: *

Yes
No

As you do not have an Equality, Diversity or Equal opportunities in employment Policy, do you agree to accept the terms of Vaughandale Construction’s Equal Opportunities Policy: *

Yes
No

Go to www.vaughandle.com/downloads for a copy of our Equal Opportunities Policy.

Equality and Human Rights Commission details:

Has your company or any individual employed by your company been the subject to a compliance action by the Equality and Human Rights Commission or an equivalent body on grounds of alleged unlawful discrimination within the past three years: *

Yes
No

ISO9001

Do you currently hold ISO 9001:2015 Accreditation? *

Yes
No

Quality Policy

Do you have a QMS (Quality Management System) or IMS (Integrated Management System)? *

Yes
No

QMS/IMS Evidence type: *

QMS/IMS Manual Details
QMS/IMS File Upload

QMS or IMS

Do you intend to gain accreditation to ISO9001 in the near future? *

Yes
No

Intention of ISO9001 details: *

Please provide details.

ISO14001

Do you currently hold ISO14001 Accreditation? *

Yes
No

Environmental Policy

Do you have an EMS (Environmental Policy Management System) or IMS (Integrated Management System)? *

Yes
No

EMS/IMS Evidence type: *

EMS/IMS Manual Details
EMS/IMS File Upload

EMS or IMS

Do you intend to gain accreditation to ISO14001 in the near future? *

Yes
No

Intention of ISO14001 details: *

Please provide details.

Do you check the environmental performance of your suppliers? *

Yes
No

Has there ever been any notices/prosecution served upon the organisation under environmental legislation within the past three years? *

Yes
No

Environmental notices/prosecution details: *

Please provide details.

Please provide details of your designated waste disposal site or waste disposal contractor: *

Provide Details
N/A

Waste disposal details:

Please provide details.

Do you hold a Waste Carrier or Hazardous Waste Carriers Licence? *

Yes
No

Upload Waste Carrier or Hazardous Waste Carriers Licence: *

Click or drag files to this area to upload. You can upload up to 5 files.

Are you classed as a producer under the WEEE Regulations 2006? *

Yes
No

WEEE2006 regulations details: *

Please detail who it is intended will take responsibility for the collection, treatment, recovery and environmentally sound disposal of WEEE.

Has your organisation been convicted or fined for any breach of the WEEE 2006 regulations in the past three years? *

Yes
No
N/A

WEEE2006 notices/prosecution details: *

Please provide details.

Declaration *

I confirm that all the information provided in this questionnaire is to the best of my knowledge accurate and correct.

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Print Name: *

Position in company: *

Date: *

Signature *