Contractor health & safety questionnaire
Please complete all sections below and provide supporting documentation where required.
Your details
| Criteria | Expected Evidence | Evidence Provided (links and text accepted) |
Supporting Documents |
|---|---|---|---|
| Legal entity details | |||
| Company registration details / number(s) | Provide company registration number and VAT number. |
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| Insurance certification (e.g. Employer's Liability, Professional Indemnity Insurance Certificates.) |
Attach current insurance certificates. |
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| Health and safety capability | |||
| Relevant proffesional memberships | List any relevant trade or safety memberships. |
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| Organisation chart (as per contractual scope) |
Attach organisational chart. |
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| Recent references and details of scope of works carried out (covering all contractual scopes (construction, O&M, etc.)) |
Provide 2-3 recent references. |
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| Health and safety policies | |||
| Health and safety policy | Attach a signed copy of your H&S policy. |
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| ISO accreditations (e.g SIO 45001) | Provide details or certificates of any ISO accreditations. |
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| Contractor accreditations / verification schemes (named) |
e.g, CHAS, SafeContractor SMAS. |
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| Trade association memberships | List any relevant trade association memberships. |
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| Identified competent person(s) (for each contractual scope) |
Name and qualifications of your competent person(s) for H&S |
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| Health and safety performance | |||
| Any health and safety prosecutions (last 5 years) | Provide details if applicable otherwise state "none". |
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| Any health and safety enforcements (last 3 years) | Provide details if applicable otherwise state "none". |
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| Any RIDDOR incidents (last 3 years) | Provide details if applicable otherwise state "none". |
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| Total recorded incident rate (TRIR) & lost time incident frequency (LTIF) (last 12 months & average last 3 years) |
Provide figures if recorded. | ||
| Currently or recently issued safety alerts or product recalls (last 3 years) |
Provide details if applicable otherwise state "none". |
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| Any open claims made by employees or other persons (personal injury or illness) |
Provide details if applicable otherwise state "none". |
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| Health and safety management | |||
| Example risk assessment method statements (RAMS) (applicable to all contractual scopes) |
Attach an example RAMS for a relevant task. |
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| How subcontractors health and safety capability is checked and monitored |
Describe your process for managing subcontractors. |
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| Scope and evidence of health and safety training provided to employees and contractors |
Provide a summary of training and examples |
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| Accident / injury reporting process | Briefly describe your reporting process. |
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| Mandatory licenses / consent conditions (where applicable) |
e.g, Waste carriers license. Provide details if applicable. |
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| Signatory | |||
| I confirm the details in this questionnaire are accurate and up to date and provide our ackonwledgment and support of health and safety commitments. |
Type your name in the evidence box to confirm. |
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| Your name: | Signatory name | ||
| Your position: | Signatory position | ||
| Today's date: | Date of completion | ||
This will package your answers and all uploaded files into a ZIP.