Sub-Contractor Questionnaire Printable Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Company Name: *Address: *Address Line 1Address Line 2CityState / Province / RegionPostal CodeMain Contact Name: *Phone Number: *Company Email: *Company Services: *Please list services your company can provide:Trading Status: *PLCLimitedPartnershipSole TraderNational Insurance Number: *Are you VAT registered: *YesNoVAT Number: *Do you have a company UTR No: *YesNoUTR Number: *Do you have a company Registration No: *YesNoCompany Registration Number: *Bank Name: *Sort Code: *Account Number: *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 * Click or drag a file to this area to upload. 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: *Do you employ more than five people: *YesNoHealth and Safety Policy expiry date: *Health and Safety Policy File Upload: * 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? *YesNoHealth 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: *YesNoFor example: Asbestos(ARCA), FSC, Gas Safe, NICEIC, UKCA (CE) Marking (BS EN 1090)Select accreditations:ARCANICEICFSC - Wood SupplierUKCA (CE) MarkingGas Safety CertificateOther ARCA expiry date: *ARCA file upload: * Click or drag a file to this area to upload. FSC - Wood Supplier expiry date: *FSC - Wood Supplier file upload: * Click or drag a file to this area to upload. Gas Safety Certificate expiry date: *Gas Safety Certificate file upload: * Click or drag a file to this area to upload. NICEIC expiry date: *NICEIC file upload: * Click or drag a file to this area to upload. UKCA (CE) Marking expiry date: *UKCA (CE) Marking file upload: * Click or drag a file to this area to upload. Accreditation details: *Give details of other accreditations.Accreditation File Upload: * Click or drag files to this area to upload. You can upload up to 9 files. Do you currently hold ISO45001 Accreditation? *YesNoISO45001 expiry date: *ISO45001 Accreditation File Upload: * Click or drag a file to this area to upload. Do you currently hold SSIP - Safety Schemes in Procurement Accreditation? *YesNoCHAS, Safecontractor, Acclaim, SMAS, Constructionline.SSIP - Safety Schemes in Procurement expiry date: *If you hold multiple SSIP accreditations, then please enter the date from the certificate with the longest expiry date.SSIP - Safety Schemes in Procurement upload: * Click or drag a file to this area to upload. If you hold multiple SSIP accreditations, then please use the certificate with the longest expiry date.Do you have a Company Induction to brief staff on your policies: *YesNoPlease 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 & fatalitiesReportable incidents as defined by RIDDORMinor injuries and incidentsNear missType of accident / incident: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 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 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 current year:Near miss previous year 1:Near miss previous year 2:Near miss previous year 3: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: *YesNoProvide 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:ManagersSupervisorsOperativesManagers:Managers File Upload: Click or drag a file to this area to upload. Supervisors:Supervisors File Upload: Click or drag a file to this area to upload. Operatives:Operatives File Upload: Click or drag a file to this area to upload. 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: *YesNoAre test records kept and up to date: *YesNoWho 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: *YesNoDo you operate arrangements for testing of PPE (e.g. respiratory, harnesses, etc): *YesNoPPE Evidence type: *PPE Manual DetailsPPE File UploadPPE 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: *YesNoDo you operate arrangements for Face Fit Testing: *YesNoAsbestos Awareness & FFT Evidence type: *Asbestos Awareness & FFT Manual DetailsAsbestos Awareness & FFT File UploadAsbestos 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: *YesNoAccordingly, is it your practice not to discriminate directly or indirectly against any of the protected characteristics outlined in the Equalities Act 2010: *YesNoDo you have an Equality, Diversity or Equal Opportunities in Employment Policy: *YesNoEquality, 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: *YesNoGo to www.vaughandle.com/downloads for a copy of our Equal Opportunities Policy.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: *YesNoProvide details of any Prosecutions/Tribunal Hearings: *Do you currently hold ISO9001 Accreditation? *YesNoISO9001 expiry date: *ISO9001 Accreditation File Upload: * Click or drag a file to this area to upload. Do you have a Quality Policy? *YesNoQuality Policy expiry date: *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)? *YesNoQMS/IMS Evidence type: *QMS/IMS Manual DetailsQMS/IMS File UploadQMS/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? *YesNoIntention of ISO9001 details: *Please provide details.Do you currently hold ISO14001 Accreditation? *YesNoISO14001 expiry date: *ISO14001 Accreditation File Upload: * Click or drag a file to this area to upload. Do you have an Environmental Policy? *YesNoEnvironmental Policy expiry date: *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)? *YesNoEMS/IMS Evidence type: *EMS/IMS Manual DetailsEMS/IMS File UploadEMS/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? *YesNoIntention of ISO14001 details: *Please provide details.Do you check the environmental performance of your suppliers? *YesNoHas there ever been any notices/prosecution served upon the organisation under environmental legislation within the past three years? *YesNoEnvironmental notices/prosecution details: *Please provide details.Please provide details of your designated waste disposal site or waste disposal contractor: *Provide DetailsN/AWaste disposal details:Please provide details.Do you hold a Waste Carrier or Hazardous Waste Carriers Licence? *YesNoWaste Carrier Licence expiry date: *If you hold multiple Waste carrier licences, then please use the licence with the longest expiry date.Waste Carrier Licence file upload: * 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? *YesNoWEEE2006 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? *YesNoN/AWEEE2006 notices/prosecution details: *Please provide details.Modern Slavery Act declarations: Do you monitor your suppliers operations/facilities to ensure compliance with the Modern Slavery Act 2015? *YesNoIn returning this document it is expected that you have checked your supply chain so as to ensure no child/slave labour (Modern Slavery Act 2015) was used in any way to produce the products and that goods are sourced/manufactured ethically. Do you agree? *YesNoIn supplying any labour resource to the Company, it is incumbent upon you to have completed suitable and sufficient checks on your workers ensuring their eligibility to work in the UK. This information must be readily available for all individuals and may be requested for audit purposes. Do you agree? *YesNo Environmental Sustainability & Carbon Footprint: Do you have measures in place to reduce the environmental impact throughout your supply chain, from sourcing raw materials to product delivery? *YesNoWhat measures do you have in place? *Do you assess and manage the environmental and social impacts of your products or services? *YesNoWhat specific initiatives have you implemented to minimise these impacts? *Do you measure, reduce, and offset carbon emissions associated with your products or services? *YesNoHow do you plan to further reduce your carbon footprint in the future? *Declaration *I confirm that all the information provided in this questionnaire is to the best of my knowledge accurate and correct.Print Name: *Position in company: *Date: *Signature * Clear Signature Submit