APPROVED (SUB)-CONTRACTOR APPLICATION Notes for completion of this form: 2 BIRCH COURT : BLACKPOLE EAST : WORCESTER : WR3 8SG T. 0905 759 700 : F. 0905 759 7 sales@vanguardcontracts.co.uk : www.vanguardcontracts.co.uk - Sub Contractors / Sole Traders are requested to complete Sections / 2 / 3 / 4 / & 9 only (all other sections can be N/A) - Companies with 5+ direct employees are requested to fill in all sections - 9 - Supply only service should complete Section & 9 only Section : Company Information Section 2 : Training & Certification Section 3 : Method Statement / Risk Assessment Section 4 : Insurance Documentation Section 5 : Health & Safety Section 6 : Management Qualifications & Health & Safety monitoring Section 7 : Accident Reporting Section 8 : References Section 9 : Signed Declaration CHECKLIST Once all the relevant sections have been completed, Applications should be sent with supporting documentation either by POST or E-mail to: - VANGUARD CONTRACTS LIMITED, 2 BIRCH COURT, BLACKPOLE EAST, WORCESTER, WR3 8SG - subcontractor@vanguardcontracts.co.uk Where applicable your application should include the following supporting documentation. - Company Health & Safety Policy - Accident Reporting - Company Insurance Certificate - Training Certification e.g. CSCS / PASMA / SMSTS / Plant Operator - Example Method Statement / Risk Assessment - Accreditations e.g. CHAS / SAFE Contractor
SECTION - COMPANY INFORMATION Company Name: Registered Office Address: Telephone Number: Fax No: E-Mail Address: Accounts Office E-Mail Address : Managing Director: Number of Direct Employees: Company Registration Number / National Insurance Number: Unique Tax Reference No (UTR): VAT Registration Number: Company Incorporation / Registration Date: Bank Name: Sort Code: Account Number: Is your Company a member of a Professional Institute / Trade or similar: Scope of Works undertaken
SECTION 2 - TRAINING & CERTIFICATION Yes No Do you / & your site operatives hold current certificates of competence and participation in Health & Safety training? e.g. CSCS cards / Plant Operation Licences / Access equipment licenses Please provide copy certification for all operatives working on site for Vanguard Contracts. 2 Please Provide copies of all relevant training certification (for example) SMSTS Certificate CSCS Card (s) First Aid Certificate IPAF MEWP Other SECTION 3 - METHOD STATEMENT & RISK ASSESSMENT Method Statement / Risk Assessment Legislation requires that you are required to provide Method Statements / Risk assessments for your works. - Please provide a worked example of a Method Statement appropriate to your works - Please provide a worked example of a Risk Assessment appropriate to your works NOTE: Once works are advised, you will be required to provide a Site Specific Method Statement & a Site Specific Risk Assessment for your element of works
SECTION 4 - INSURANCES Please complete as below / or return a copy of your current Company Insurance Certificate Type of insurance Limit of Indemnity Date of Expiry Insurance Company and Broker Please enclose copy Public Liability Employers Liability Professional Indemnity Design Liability Product Liability Contractor All Risks NOTE ON INSURANCE REQUIREMENTS - The requirement under our policy is for Bona Fide Sub Contractors (BFSC) to carry a minimum of 2m Public Liability. - If the BFSC is a sole trader / partnership there is no requirement for them to carry Employers Liability Insurance unless they have employees / labour only sub contractors - If there are employees or 2 or more directors companies should carry Employers Liability cover.
SECTION 5 - HEALTH & SAFETY 2 Does your Company employ more than 5 persons and have a Health & Safety Policy? Does your organisation have an environmental policy? Yes No Please enclose copy If so please enclose the policy statement SECTION 6 - MANAGEMENT / QUALIFICATIONS / MONITORING 2 Provide current company management chart identifying Health and Safety management structure and lines of communication; how your company structure would be applied to the project; the arrangements for implementing, auditing and reviewing; and how these arrangements are communicated to the workforce. Who within your Company is appointed to advise on Health & Safety? - Internal Advise & Qualifications - External Advise & Qualifications 3 4 5 6 Provide details of your system for monitoring H & S procedures, auditing them at periodic intervals and for reviewing them on an ongoing basis. Information provided should include evidence of: - inspection/audit schedules giving types and frequency - copies of site inspection reports - monitoring/management responses. Provide details of the methods used for consulting with the workforce on health and safety matters, including safety committee meetings and how you implement the use of safety representatives. What arrangements do you have in place to ensure that your own employees / labour and site personnel are adequately trained in Health & Safety? Provide details of qualifications/experience of directors, senior managers etc. by identifying positions and names with relevant qualifications/experience. 7 Identify the percentage of your workforce who are CSCS accredited. Provide details of specific site safety training for site managers and S/NVQ certificates for site workers
SECTION 7 - ACCIDENT / RIDDOR REPORTING Yes No Within the last 3 years has your company had any - Reportable Accidents (RIDDOR) - Dangerous Occurrences - Improvement or Prohibition Notices - Prosecution under Health & Safety Legislation - Fatality Please provide further details on a separate sheet if you have answered yes. 2 Provide details of any improvement notices, prohibitions notices or prosecutions served on your company by any Enforcing Authority within the last three years. 3 Provide details of how information from enforcement actions and Incident/Accident reports is used to improve safety performance. 4 How do you monitor the Health & Safety performance on site of your operatives? Please provide further details SECTION 8 - REFERENCES Please provide two references from existing Clients. Client Address Contact Name Contact Number Approx. Contract Value
SECTION 9 - SIGNED DECLARATION This section must be completed by a Director, Partner or equivalent person appointed. I hereby declare that to the best of my knowledge, the information provided as part of this appraisal is accurate Name _ Position in Company _ Signature - Dated To be completed by Vanguard SUB CONTRACTOR / CONTRACTOR / SUPPLIER ASSESSMENT Overall Assessment : (To be completed by Assessor) The information provided in this questionnaire and the above company is considered *to be satisfactory/not satisfactory for the requirements of this project. (* Delete as appropriate) If not satisfactory, the reasons are: Assessed by: Date: Reassessment Date: