CONTRACTOR PRE-QUALIFICATION QUESTIONNAIRE FOR COMPANIES EMPLOYING FIVE OR LESS EMPLOYEES

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1 CONTRACTOR PRE-QUALIFICATION QUESTIONNAIRE FOR COMPANIES EMPLOYING FIVE OR LESS EMPLOYEES GENERAL INFORMATION Company Name: Company Address: Telephone No. Fax No. Mobile No. Address Year Company Founded No. of Employees Type of Work Undertaken: Please select all relevant trade activities from Appendix 1 Preferred Minimum Order Preferred Maximum Order Please provide main contact details: Name Contact No. Address FINANCIAL INFORMATION Companies UTR (Unique Tax Reference) Sole Traders UTR (Unique Tax Reference) Partnership Partnership UTR Individual Partner UTR Company Registration No. National Insurance No. Name of one Partner: Beyond CIS Scope (explanation required) VAT Registration No: (Copy Required) What was your turnover in each of the last 2 financial years?... for year Ended.../.../ for year Ended.../.../...

of Employees Type of Work Undertaken: Please select all relevant trade activities from Appendix 1 Preferred Minimum Order Preferred Maximum Order Please provide main contact details: Name Contact No.

2 INSURANCE: Insurer: Policy No: Sum Insured: Expiry Date: Employers Liability Insurance Public Liability Insurance Insurer: Policy No: Sum Insured: Expiry Date: Contractors All Risk Insurance SELF BILLING AGREEMENT Please complete and return Appendix 2 Professional Indemnity (Copy Required) QUALITY CONTROL Would you be prepared to work to our Quality System/Procedures ENVIRONMENTAL Would you be prepared to work to our Environmental System/Procedures Has your organisation been prosecuted or had any notice served upon it in the last three years by any environmental regulator or authority (including local authority? If Yes, please provide details. HEALTH & SAFETY 1. Is your Company registered with any of the following: Construction Health & Safety Assessment Scheme (CHAS) National Britannia Safe Contractor Scheme Construction Industry Training Board (CITB) Royal Society for the Prevention of Accidents (RoSPA) British Safety Council (BSC) A Safety Group (Specify which) 2. Do you operate a health & safety management system, e.g. HSG65? If YES, please provide details. 3. Please provide evidence of any Health & Safety/Competence Training.

be prepared to work to our Environmental System/Procedures Has your organisation been prosecuted or had any notice served upon it in the last three years by any environmental regulator or authority

3 4. What are your Company s Health & Safety Arrangements? 5. Does your company have an active monitoring system? If yes please provide evidence of site inspections / auditing, risk assessments and method statements. If no state how you monitor your compliance with health and safety legislation. Please provide evidence. Sub-let Works How do you satisfy yourself that anyone you employ or engage as a third party are competent and adequately resourced? (CDM Regs) 6. Do you sub-let works? If yes, how do you assess the competency of your subcontractors? (Please provide evidence.) 7. Who will be your single point of contact for all health & safety issues on site? Design (including temporary works) 8. Do you undertake any design duties for your work? If YES, please provide evidence of: The competence of those undertaking design; Design risk assessments to avoid/minimise risks/environmental impacts during construction and maintenance. 9. Statistics for incidents reportable under RIDDOR Have you had any RIDDOR reportable accidents in the last three years? If so, please provide details

Please provide evidence. Sub-let Works How do you satisfy yourself that anyone you employ or engage as a third party are competent and adequately resourced? (CDM Regs) 6. Do you sub-let works?

4 10. Has your company been served with any enforcement notices from the HSE for any breaches of Health & Safety legislation in the last three years? If yes, please provide details including corrective action. Please note we do check all contractors. 11. Risk Assessments & Method Statements Please provide evidence of Risk Assessments & Method Statements Please provide evidence of plant & equipment maintenance records, e.g. PAT Testing, Thorough Examination Test Certificates, etc. 12. Do you use any hazardous substances under the COSHH Regulations? If so, please provide evidence of COSHH assessments. TECHNICAL EXPERIENCE: State IT Software available for Receipt/Transmittal of Drawings including ability to print. Are you able to receive, open and print tender documents, including drawings.. Please provide a brief statement regarding Scope of Works, highlighting suitability/capability for undertaking contracts of various size within various sectors. Please note your particular areas of speciality. Anglesey/Gwynedd Preferred Work Location: (Please tick all areas you can cover) Conwy/Denbighshire Flintshire/Wrexham Cheshire/Wirral Shropshire

Risk Assessments & Method Statements Please provide evidence of Risk Assessments & Method Statements Please provide evidence of plant & equipment maintenance records, e.g.

5 REFERENCES Please provide two trade references: REFERENCE 1 REFERENCE 2 Company Name: Address: Contact/Position: Telephone/ Address: ADDITIONAL INFORMATION Any additional information that you may wish us to consider to support the information requested in this questionnaire. Person completing the Questionnaire Name:... Position in Company:... Date:...

information that you may wish us to consider to support the information requested in this

6 Appendix 1 NBS Code Trade Code Trade Description Select Y74 SC1001 DOMESTIC S/C - ALARMS M23 SC1002 DOMESTIC S/C - ARTEXING J20 - J22 SC1003 DOMESTIC S/C - ASPHALT C40 SC1004 DOMESTIC S/C - BRICK CLEANING H SC1005 DOMESTIC S/C - CLADDING A SC1006 DOMESTIC S/C - CLEANING E05 - E11 SC1007 DOMESTIC S/C - CONCRETE FLOORS INSITU C20 SC1008 DOMESTIC S/C - DEMOLITION / ASBESTOS REMOVAL F30 & P31 SC1009 DOMESTIC S/C - DRILL & GROUT K10 SC1010 DOMESTIC S/C - DRY LINING D20 & Q20 SC1011 DOMESTIC S/C - EARTHMOVING/HAULAGE Y60 -Y92 SC1012 DOMESTIC S/C - ELECTRICAL SERVICES Q40 SC1013 DOMESTIC S/C - FENCING F30 SC1014 DOMESTIC S/C - FIREPLACES N10 SC1015 DOMESTIC S/C - FITTED BEDROOMS M42 - M51 SC1016 DOMESTIC S/C - FLOOR COVERINGS L20 SC1017 DOMESTIC S/C - GARAGE DOORS L40 SC1018 DOMESTIC S/C - GLAZING D SC1019 DOMESTIC S/C - GROUNDWORKERS C41 SC1020 DOMESTIC S/C - INJECTED DPC P10 - P11 SC1021 DOMESTIC S/C - INSULATION N10 SC1022 DOMESTIC S/C - KITCHENS Q30 -Q32 SC1023 DOMESTIC S/C - LANDSCAPING X SC1024 DOMESTIC S/C - LIFTS INSTALLATIONS Y30 SC1025 DOMESTIC S/C - LOUVERS P22 SC1026 DOMESTIC S/C - MASTIC SEALING K10 SC1027 DOMESTIC S/C - METAL PARTITIONS A SC1028 DOMESTIC S/C - OPERATED PLANT M60 SC1029 DOMESTIC S/C - PAINTING & DECORATING D30 SC1030 DOMESTIC S/C - PILING M20 - M22 SC1031 DOMESTIC S/C - PLASTERING / RENDERING Y10 - Y53 SC1032 DOMESTIC S/C - PLUMBING/HEATING SERVICES E60 SC1033 DOMESTIC S/C - PRECAST CONC FLOORS Q26 SC1034 DOMESTIC S/C - ROAD MARKING D, Q & R SC1035 DOMESTIC S/C - ROADS & SEWERS L20 SC1036 DOMESTIC S/C - ROLLER SHUTTERS H60 -H76 SC1037 DOMESTIC S/C ROOFING A SC1038 DOMESTIC S/C - SCAFFOLDERS M10 SC1039 DOMESTIC S/C - SCREEDERS E20 SC1040 DOMESTIC S/C - SHUTTERING A SC1041 DOMESTIC S/C - SIGN BOARD SITE A SC1042 DOMESTIC S/C - SITE SECURITY Y60 -Y92 SC1043 DOMESTIC S/C - STREET LIGHTING G10 - G12 SC1044 DOMESTIC S/C - STRUCTURAL STEEL Z50 SC1045 DOMESTIC S/C - SUNDRY Q21 -Q26 SC1046 DOMESTIC S/C SURFACING

SC1009 DOMESTIC S/C - DRILL & GROUT K10 SC1010 DOMESTIC S/C - DRY LINING D20 & Q20 SC1011 DOMESTIC S/C - EARTHMOVING/HAULAGE Y60 -Y92 SC1012 DOMESTIC S/C - ELECTRICAL SERVICES Q40 SC1013 DOMESTIC S/C

7 D20 & Q20 SC1049 DOMESTIC S/C - TIPPING Y10 - Y53 SC1050 DOMESTIC S/C - VENTILATION & A/C SERVICES M40 & M41 SC1051 DOMESTIC S/C - WALL TILING N10 & N13 SC1052 DOMESTIC S/C - WASHROOM CUBICLES & FITTINGS L10 - L20 SC1053 DOMESTIC S/C - WINDOW INSTALLATION Y10 - Y53 SC1054 DOMESTIC S/C - MECHANICAL SERVICES L10 - L20 SC1055 DOMESTIC S/C - WINDOWS & DOORS u PVC L10 - L20 SC1056 DOMESTIC S/C - WINDOWS & DOORS METAL G20 SC1057 DOMESTIC S/C - TIMBER FRAME F & G SC2001 LABOUR ONLY - S/C AGENCY LABOUR F & G SC2002 LABOUR ONLY - S/C BUILDING HAND F SC2003 LABOUR ONLY - S/C BRICKLAYERS D SC2004 LABOUR ONLY - S/C GROUNDWORKER G SC2005 LABOUR ONLY - S/C JOINERS M SC2006 LABOUR ONLY - S/C PLASTERERS M SC2007 LABOUR ONLY - S/C WALL TILER G SC2008 LABOUR ONLY - S/C STEELFIXERS F SC2009 LABOUR ONLY - S/C STONEMASONS Z50 SC2010 LABOUR ONLY - S/C SUNDRY K40 SC1047 DOMESTIC S/C - SUSPENDED CEILINGS Y74 SC1048 DOMESTIC S/C - TV AERIAL INSTALLATIONS

WINDOWS & DOORS METAL G20 SC1057 DOMESTIC S/C - TIMBER FRAME F & G SC2001 LABOUR ONLY - S/C AGENCY LABOUR F & G SC2002 LABOUR ONLY - S/C BUILDING HAND F SC2003 LABOUR ONLY - S/C BRICKLAYERS D SC2004

8 Appendix 2 SELF-BILLING AGREEMENT This is an agreement to a self-billing procedure between: Anwyl Construction Company Ltd (Self-Biller) of Mona Terrace, Prince Edward Avenue, Rhyl, Denbighshire, LL18 4PH. VAT Registration No: Company Name (Self-Billee): V.A.T Registration No.: Registered Office (full address): Whereby the following agreement is made: Anwyl Construction Company Ltd agrees (Self-Biller): 1. To issue self-billed invoices in the form of a remittance advice sheet together with payment until further notice. AND 2. To complete self-billed invoices, in the form of a remittance advice sheet, indicating the Subcontractors name, address and VAT registration number, together with any other details under Section 6(5) of the VAT Act To make a new self-billing agreement in the event that the Contractors VAT registration number changes. 4. To inform the Subcontractor if the issue of Self-Billed invoices will be outsourced to a third party. The Self Billee.(Subcontractor) 1. To accept invoices raised by the Self-Biller on their behalf until further notice. 2. Not to raise Sales Invoices, VAT invoices or authenticated receipts for the transactions covered by this agreement. 3. To notify Anwyl Construction Company Ltd immediately if they:- i. Change their VAT registration number ii. Cease to be VAT registered; or iii. Sell their business, or part of their business Signed By: Signed By: On Behalf of Anwyl Construction Company Limited On Behalf of Date: Date:

To issue self-billed invoices in the form of a remittance advice sheet together with payment until further notice. AND 2.

Acceptance on the Approved List of contractors cannot however guarantee that any work orders will be issued to that contractor.

Acceptance on the Approved List of contractors cannot however guarantee that any work orders will be issued to that contractor. PROPERTY MANAGEMENT INTRODUCTORY GUIDANCE NOTES FOR THE APPLICATION TO THE APPROVED LIST OF CONTRACTORS CONTRACTORS GUIDANCE NOTES APPLICATION FORM ISSUED BY: PROPERTY MANAGEMENT UNIT WEST YORKSHIRE FIRE