PREQUALIFICATION QUESTIONNAIRE (Ireland)

Transcription

1 PREQUALIFICATION QUESTIONNAIRE (Ireland) COMPANY DETAILS 1.1 Please cmplete the cmpany details belw: Cmpany: Cntact: Address: Pst Cde: Tel: Title: CRN: VAT N: Website: 1.2 Des this Cmpany have a Parent Cmpany r Ultimate Hlding Cmpany? If Yes, please prvide details: 1.3 Type f Business/ Service Prvided: FINANCIAL STANDING 2.1 Prvide the annual turnver fr the last three years fr the cmpany r divisin wh wuld carry ut the wrks: Year Turnver Prfit / (Lss) 2.2 Prvide the name and address f yur Bankers and cnfirm clearance t apprach yur Banker fr a reference: Banker s Accunt N. IBAN: Address: Srt Cde: BIC: 2.3 Will yur cmpany be prepared t prvide a Perfrmance Bnd if s required? N 2.4 Prvide with yur submissin, cnfirmatin that yu have a C2 certificate: Yes Yu will be required t present this in persn t ur Office Manager RELEVANT EXPERIENCE / REFERENCES 3.1 Please prvide a list f recent prjects yu have cmpleted which wuld be similar t the type f prject yu wuld expect t carry ut fr StructureTne Limited. Date Prject Name / Lcatin Trade Client Value 3.2 Prvide at least three Client References: Page 1 Revisin - 01

2 Name Psitin Cmpany Cntact N. HEALTH & SAFETY Ref. Questin Respnse 4.1 SAFETY POLICY Have yu a written & current Health & Safety Plicy Statement signed by a Directr? Can yu cnfirm that yu have cmmunicated yur Health & Safety Statement & Plicies t all yur direct and indirectly emplyed peratives & can furthermre cnfirm that they have understd the cmmunicated plicies & safety statements & shall adhere t same? Can yu please prvide evidence t abve? Please enclse e.g. signature page. 4.2 HEALTH AND SAFETY PERFORMANCE Detail number f incidents fr the last 3 years. Fatalities Majr Injuries Over 3 Day Injury Dangerus Occurrence Reprtable Disease Prsecutins by HAS Prhibitin Ntices by HAS Advise Ntice by HAS Year Please prvide details f all prsecutins, taken against yur Cmpany, fr breaches f Health, Safety r Welfare legislatin ver the past five years. 4.3 INTERNAL SAFETY SUPPORT Official Use Only Wh is the persn respnsible fr H&S at Directr Level? Title: Please prvide the name and qualificatin f yur Safety Manager. Prvide the names and qualificatins f all Safety Officers within yur Cmpany. Qualificatins: Title: Qualificatins: Title: Qualificatins: 4.4 EXTERNAL SAFETY SUPPORT D yu have any external safety supprt? eg. Safety Cnsultants Prvide Details: Page 2 Revisin - 01

3 Address: Tel: Ref. Questin Respnse 4.5 SAFETY MANAGEMENT SYSTEM Official Use Only Please prvide details f any Safety Management System that is n peratin within yur Cmpany Is this the system accredited by any rganisatin? Name f awarding rganisatin: If yu answered yes t the abve questin please prvide details Year accreditatin first achieved: 4.6 TRAINING Is the accreditatin currently valid? Please prvide details f safety training and qualificatins prvided t management within yur Cmpany. Cnfirm minimum training prvided t all emplyees e.g. Safe Pass/CSCS 4.7 CONTROL OF SUBCONTRACTORS NOTE D yu subcntract prtin r all f yur wrk? If s: Hw des yur Cmpany ensure that sub-cntractrs engaged by yur Cmpany are cmpetent? Hw des yur Cmpany ensure that sub-cntractrs engaged by yur Cmpany perate safe systems f wrk? 4.8 COMPLIANCE WITH ACTS & REGULATIONS Page 3 Revisin - 01

4 4.8.1 The Safety Health and Welfare Act 2005, The Safety Health and Welfare at Wrk (Cnstructin) Regulatins 2006 and The Safety Health & Welfare at Wrk (General Applicatin) Regulatins 2007 impse duties n Cntractrs. Please cnfirm that yu understand yur respnsibilities as identified in the regulatins and, in particular, that yu will undertake yur wrks in cmpliance t: C-perate with the PSCS; Prvide a cpy f yur safety statement and methd statement (where required) tgether with all relevant infrmatin t the PSCS Prmptly prvide the PSCS with infrmatin required fr the safety file; Cmply with directins f Prject Supervisr Cnstructin Stage; Reprt accidents t the Health & Safety Authrity and t the PSCS where an emplyee cannt perfrm their nrmal wrk fr mre than three days fllwing an accident n the site; Cmply with site rules and the safety and health plan and ensure that yur emplyees cmply; Identify hazards, eliminate the hazards, r reduce risks during cnstructin; Facilitate the Site Safety Representative; Ensure that relevant wrks have FAS safe pass card and a cnstructin skills card where required; Prvide wrkers with site specific inductin; Appint a safety fficer where there are mre than 20 n site r 30 emplyed; Cnsult wrkers and Safety Representatives; Mnitr cmpliance and take crrective actin. ANTI-BRIBERY AND CORRUPTION Ref. Questin Respnse 5.1 COMPLIANCE PROGRAM Have yu implemented prcedures designed t ensure cmpliance with all applicable anti-bribery and crruptin laws and regulatins, and that address the risks faced by yur business? Have all persns wh will be engaged in the prvisin f services t Structure Tne undergne apprpriate training and agreed t cmply with the anti-bribery and crruptin prcedures referenced in sectin 5.1.1? Des yur cmpany perfrm due diligence screening n the cmpanies yu subcntract wrk t? Please identify the persn r persns within yur rganisatin with verall respnsibility fr anti-crruptin cmpliance. Please prvide additinal detail if answering N t any questin in sectin 5.1. Official Use Only 5.2 REGULATORY COMPLIANCE Has yur cmpany ever been, r is it nw, the subject r target f any criminal investigatin by a gvernment bdy r regulatry agency? Have there been any allegatins (substantiated r nt) f bribery r crruptin within the last six years invlving yur Cmpany, its fficers, directrs, emplyees, jint ventures, agents r intermediaries r ther assciates? Has yur cmpany ever been frmally accused, indicted, r cnvicted f any crime (misdemeanur r felny)? Has any Key Individual 1 ever been under investigatin r frmally accused, arrested, indicted, r cnvicted f: 1 ( Key Individual includes any wner, sharehlder, principal, directr, fficer r high-managerial agent f yur cmpany, r any ther individual r agent authrised t cntrl r direct strategic, plicy-making, r peratinal decisins fr yur cmpany.) Page 4 Revisin - 01

5 (1) a crime related t yur cmpany r any ther crprate entity; r (2) any crime invlving fraud, frgery, perjury, theft, tax evasin, bribery, crruptin, embezzlement, falsificatin r destructin f recrds, anti-cmpetitive behaviur, bid rigging, cllusin, r anti-trust? Has yur cmpany r any f its Key Individuals ever been suspended, disbarred, disqualified, r had its r their prequalificatin revked r therwise been declared ineligible t bid r t perfrm wrk? Has yur cmpany r any f its Key Individuals had any businessrelated licenses r certificatins revked r suspended? Please prvide additinal detail if answering yes t any questin in sectin 5.2. Page 5 Revisin - 01

6 5.3 CONTACTS WITH DOMESTIC AND FOREIGN GOVERNMENTS Is yur cmpany, r any parent r affiliate entity, wned in whle r in part by: (1) a freign, natinal, reginal, r lcal gvernment; (2) any entity wned r cntrlled by a freign, natinal, reginal, r lcal gvernment; r (3) a Gvernment Official (as that term is defined belw) 2 Are any f yur Key Individuals r ther emplyees wh render gds r services t Structure Tne currently Gvernment Officials r have they been Gvernment Officials within the last twelve mnths? Will yur Cmpany r any third party acting n yur behalf prvide hspitality, entertainment, gifts, travel expenses, r any ther benefits r things f value t any Gvernment Official while cnducting business fr Structure Tne? Will yur wrk with Structure Tne invlve acting as an agent r intermediary between Structure Tne and a gvernment agency r Gvernment Official? Cmpanies that act as agents r intermediaries in this fashin btain r assist in btaining gvernment apprvals, permits, licenses, r inspectins. These can include cmpanies that: (a) expedite gvernment inspectins r licensing; (b) facilitate the transit f gds acrss different cuntries r secure custms apprval; (c) prcess gvernmental papers, such as visas and wrk rders; (d) assist in securing gvernment services, such as pwer, water, plice prtectin, phne service, mail delivery, r carg transprt. Please prvide additinal detail if answering yes t any questin in sectin DOING BUSINESS AROUND THE GLOBE Are yu ding wrk r seeking t d wrk fr Structure Tne in any territry with a scre f 60 r belw in the Transparency Internatinal s mst recent Crruptin Perceptins Index. 3 Please prvide additinal detail if answering yes t questin Gvernment Official includes (1) any emplyee, fficial, fficer, r persn acting fr r n behalf f a (a) freign, dmestic, reginal, r lcal gvernment, r any department, agency, rganisatin, r instrumentality theref, (b) cmmercial r nnprfit entity in which a gvernment bdy has any wnership interest r the ability t cntrl ( Instrumentality ), (c) public (quasigvernmental) internatinal rganisatin, such as the United Natins, Wrld Bank, r Wrld Health Organizatin, r (d) plitical party; (2) any judge r ambassadr; r (3) any hlder f, r candidate fr, plitical r public ffice. 3 The mst recent Crruptin Percent Index can be accessed here: Page 6 Revisin - 01

7 STRUCTURETONE LIMITED TERMS & CONDITIONS SUB-CONTRACTORS RESPONSIBILITIES 1. All subcntractrs will be expected t cmply with the Cmpany Plicy fr Health and Safety and must ensure their wn Cmpany Plicy is made available n site whilst wrk is carried ut. They must als cmply with the requirements f any Health and Safety Plan develped fr the site and c-perate with arrangements made t ensure health and safety n site. 2. All sub-cntractrs are required t review Structure Tne s Supplier Cde f Cnduct ( Supplier Cde ), accept its terms, and adhere t its principles. The latest versin f the Supplier Cde can be accessed at Structure Tne s website: Sub-cntractrs are required t reprt any allegatin f wrngding r crruptin r any vilatin f the Supplier Cde. Vilatins shuld be reprted t the sub-cntractr s Structure Tne representative respnsible fr the particular prject r t Structure Tne s Cmpliance and Ethics Department: Cmpliance@structuretne.cm r All wrk must be carried ut in accrdance with the relevant statutry prvisins and take int accunt the safety f thers n the site and the general public. 4. Assessment f risk assciated with any substance, prcess r wrk activity n site which will be hazardus t health and safety, must be prvided t the cntract management befre wrk cmmences. Any material r substance brught n site which has health, fire r explsin risks must be used and stred in accrdance with Regulatins and current recmmendatins and that infrmatin must be prvided t any ther persn wh may be affected n site. 5. Scafflding used by subcntractrs emplyees (even when scaffld erected fr ther cntractrs) must be inspected by their emplyer r a cmpetent persn appinted by their emplyer t ensure that it is erected and maintained in accrdance with the Regulatins and cdes f practice. 6. Subcntractrs emplyees are nt permitted t alter any scaffld prvided fr their use r use r interfere with any plant r equipment n the site unless authrised. 7. All plant r equipment brught nt site by subcntractrs must be CE marked safe and in gd wrking cnditin, fitted with any necessary guards and safety devices and with any necessary certificatin available fr checking. Infrmatin and assessment n nise levels f plant, equipment r peratins t be carried ut by the sub-cntractr must be prvided t ur cmpany s site representative befre wrk cmmences. 8. N pwer tls r electrical equipment f greater vltage than 110 vlts may be brught nt site. All transfrmers, generatrs, extensin leads, plugs and sckets must be t latest Standards fr industrial use, in gd cnditin and cmply with the relevant regulatins. Where applicable, a certificate must be available fr prtable appliances that are required t be tested under the General Applicatin Regulatins 2007 & ETCI guidelines. 9. Any injury sustained r damage caused by sub-cntractr s emplyees must be reprted immediately t this cmpany s site representative. Sub-cntractr s emplyees must cmply with any safety instructins given by this cmpany s site representative. 10. This Cmpany will inspect sites and reprt n health and safety matters n a regular basis. Sub-cntractrs infrmed f any hazards r defects nted during these inspectins will be expected t take immediate actin. Sub-cntractrs will prvide the cmpany s site representative with the name f the persn they have appinted as safety adviser. 11. Suitable welfare facilities and first aid equipment in accrdance with the Regulatins must be prvided by subcntractrs fr their emplyees unless arrangements have been made fr the sub-cntractrs emplyees t have the use f this Cmpany s facilities in which case details will be recrded in the site cnstructin phase safety plan. 12. Sub-cntractrs are particularly asked t nte that wrkplaces must be kept tidy and all debris, waste materials, etc., cleared as wrk prceeds. 13. All peratives, sub-cntractrs, visitrs, etc., n the cmpany s sites will wear safety helmets at all times ther than in areas specifically designated as n risk areas by site management. Signs erected n site that safety helmets t be wrn must be cmplied with by subcntractr persnnel. Page 7 Revisin - 01

8 14. In accrdance with the requirements f the site Health and Safety Plan a detailed methd statement will be required frm subcntractrs carrying ut high risk activities, e.g. asbests remval, steel erectin, demlitin, rfing, entry int cnfined spaces, etc. The methd statement must be agreed with ur cmpany site representative befre wrk begins and cpies made available n site s that cmpliance with the agreed methd statement can be mnitred. I/we cnfirm that I/we have read and agree t abide by the respnsibilities as nted abve fr all Prjects we will carry ut fr Structure Tne Limited. Date: Cmpany: CERTIFICATES OF INSURANCE 7.1 Public Liability & Emplyer s Liability Please attach a cpy f yur insurance certificates. 7.2 Prfessinal Indemnity Insurance Befre being appinted, yur cmpany may be required t prvide evidence frm yur brker r insurance cmpany cnfirming yu have current prfessinal indemnity insurance cver, and that it will be maintained fr years after cmpletin f the cnstructin wrks. Will yur cmpany be prepared t Prfessinal Indemnity Insurance, if s required? CHECKLIST OF DOCUMENTATION TO BE PROVIDED Please check the items belw in accrdance with dcumentatin t be prvided with yur respnse. Item Cmpleted Prequalificatin Questinnaire Last tw (2) years Audited Accunts Cpy f Insurance Certificates Cpy f signed Health & Safety Plicy Statement Included I/We cnfirm the infrmatin prvided is true and accurate and I/We agree t abide by the H&S respnsibilities as nted fr all prjects we carry ut fr Structure Tne Limited. Directr / Principal Secretary / Directr Date: Date: Cmpany: Page 8 Revisin - 01