Sub-Contractor Questionnaire (Printable) - 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

National Insurance Number:

VAT Registered:

Are you VAT registered: *

VAT Number:

UTR Number:

Do you have a company UTR No: *

UTR Number:

Company Registration Number:

Do you have a company Registration No: *

Company Registration Number:

Bank Name: *

Sort Code: *

Account Number: *

Insurance Information

Employers Liability Level of Cover:

Employers Liability Expiry Date

Employers Liability File Upload

Click or drag a file to this area to upload.

Public Liability Level of Cover:

Public Liability Expiry Date

Public Liability File Upload

Click or drag a file to this area to upload.

Professional Indemnity Level of Cover:

Professional Indemnity Expiry Date

Professional Indemnity File Upload

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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: *

Expiry Date of your H&S policy:

Health and Safety at Work Policy Statement & Organisation and Arrangements Document

Click or drag a file to this area to upload.

As you employ more than five people, you are required under section 2(3) of the Health and Safety at Work Act 1974 to provide a copy of your latest Health and Safety at Work Policy Statement & Organisation and Arrangements Document.

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

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: *

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

Accreditation details:

Accreditation File Upload:

Click or drag files to this area to upload. You can upload up to 9 files.

ISO45001 Accreditation:

Do you currently hold ISO45001 Accreditation: *

ISO45001 Accreditation File Upload:

Click or drag a file to this area to upload.

SSIP Accreditation:

Do you currently hold SSIP: *

CHAS, Safecontractor, Acclaim, SMAS, Constructionline.

SSIP Accreditation File Upload:

Click or drag a file to this area to upload.

Induction & H&S Performance

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

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.

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

Major incidents & fatalities current year:

Major incidents & fatalities previous year 1:

Major incidents & fatalities previous year 2:

Major incidents & fatalities previous year 3:

Reportable incidents as defined by RIDDOR

Reportable incidents as defined by RIDDOR current year:

Reportable incidents as defined by RIDDOR previous year 1:

Reportable incidents as defined by RIDDOR previous year 2:

Reportable incidents as defined by RIDDOR previous year 3:

Minor injuries and incidents

Minor injuries and incidents current year:

Minor injuries and incidents previous year 1:

Minor injuries and incidents previous year 2:

Minor injuries and incidents previous year 3:

Near miss accident / incident

Near miss current year:

Near miss previous year 1:

Near miss previous year 2:

Near miss previous year 3:

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: *

Provide details of any Prohibition / Improvement Notices / Prosecutions / Safety or Industrial Tribunal Hearings:

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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Managers:

Managers File Upload:

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Supervisors:

Supervisors File Upload:

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Operatives:

Operatives File Upload:

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

Are test records kept and up to date:

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.

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

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

PPE Evidence type:

PPE Manual Details
PPE File Upload

PPE Evidence

PPE Evidence details:

Please provide details.

PPE Evidence File Upload:

Click or drag a file to this area to upload.

Are operatives given training on Asbestos Awareness: *

Do you operate arrangements for Face Fit Testing: *

Asbestos Awareness & FFT Evidence type:

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

Asbestos Awareness & FFT Evidence

Asbestos Awareness & FFT Evidence details:

Please provide details.

Asbestos Awareness & FFT Evidence File Upload:

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

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: *

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

Equality, Diversity or Equal Opportunities Policy

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

Equality, Diversity or Equal Opportunities Policy File Upload:

Click or drag files to this area to upload. You can upload up to 3 files.

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: *

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: *

Provide details of any Prosecutions/Tribunal Hearings:

ISO9001

Do you currently hold ISO 9001:2015 Accreditation? *

ISO 9001:2015 Accreditation File Upload:

Click or drag a file to this area to upload.

Quality Policy

Do you have a Quality Policy? *

Quality Policy File Upload:

Click or drag a file to this area to upload.

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

QMS/IMS Evidence type:

QMS/IMS Manual Details
QMS/IMS File Upload

QMS or IMS

QMS/IMS details:

Please provide details.

QMS/IMS File Upload

Click or drag a file to this area to upload.

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

Intention of ISO9001 details:

Please provide details.

ISO14001

Do you currently hold ISO14001 Accreditation? *

ISO14001 Accreditation File Upload:

Click or drag a file to this area to upload.

Environmental Policy

Do you have an Environmental Policy? *

Environmental Policy File Upload:

Click or drag a file to this area to upload.

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

EMS/IMS Evidence type:

EMS/IMS Manual Details
EMS/IMS File Upload

EMS or IMS

EMS/IMS details:

Please provide details or upload file.

EMS/IMS File Upload

Click or drag a file to this area to upload.

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

Intention of ISO14001 details:

Please provide details.

Do you check the environmental performance of your suppliers? *

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

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? *

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? *

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? *

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 *

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