ebrit Services Ltd Sub Contractors Pre Qualification Questionnaire
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- Elinor French
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1 Company Title and Address: Contact & Position in Company: Address & Contact Number List the services that you provide and wish to be considered for: To be completed by a senior manager or director of ebrit Services Name & Position Signed Approved Date SUB CONTRACTOR & CONSULTANT
2 SAFETY ASSESSMENT QUESTIONNAIRE The purpose of this document is to assist and evaluate the capability of each subcontractor to effectively control risks to the health and safety. The completed PQQ will be reviewed by a senior manager/director of ebrit Services. HEALTH & SAFETY 1. Please enclose a copy of your Company health and safety policy statement (not the policy) Please tick if the document is enclosed Is your H&S policy certified (ISO 18001) 2. Are you accredited to either CHAS or an alternative SSIP scheme Please tick if the certificate is enclosed INSURANCES 3. Please provide the name of your insurer and policy number for your Employers Liability Insurance & Public Liability Insurance. (Minimum 10m Employers Liability & 5m for Public Liability). Name of Insurer Employers Liability Public Liability Please tick if the certificate of insurance is enclosed
3 SAFETY SURVEILLANCE AND ADVICE 4. Please give the name, title and qualification of your Safety Officer, Advisor or Consultant, (please note the minimum qualification required is NEBOSH General Certificate) : Name Position (please state if you use an external consultant) Qualifications HEALTH AND SAFETY TRAINING 5. Please list typical training courses that your employees attend and provide copies of example certificates. This must include any specialist training for scaffold inspection, confined space working and asbestos surveying. Please tick if the copies of are enclosed
4 ACCIDENT INVESTIGATION AND RECORDS 6. Please attach a copy of your procedure for investigating and reporting accidents, dangerous occurrences or occupational illnesses that may occur on an ebrit site. Please tick if enclosed ENVIRONMENTAL POLICY 7. Please enclose a copy of your company environmental policy statement (not the policy) Please tick if the document is enclosed Is your environmental policy certified (ISO 14001) MEMBERSHIP OF PROFESSIONAL BODIES OR SAFETY GROUPS 8. Please list and provide copies of membership certificates to any professional bodies that your company belongs to. (Example UKAS - ARCA - ACAD - NFDC - IATP - ROSPA - BSC IOSH - etc) Please tick if enclosed
5 ENFORCEMENT NOTICES OR PROSECUTIONS 9. Please give details of any improvement / prohibition notices issued, or prosecutions that are pending. Please note this section will be checked with the HSE by a senior Manager/Director. PLANT AND EQUIPMENT MAINTENANCE AND INSPECTION 10. Please provide details of the procedures to ensure that all site plant and equipment and checked to ensure they are safe to use.
6 SAFE SYSTEMS OF WORK. 11. Please describe how you assess all site risks and provide H&S information for the purpose of producing a plan of work and risk assessment. Please provide an example of a site specific plan of work risk and COSHH assessments. Please tick if enclosed 12. Please give details of your formal system for monitoring and site auditing including the frequency of each site audit
7 13. Do you use the services of sub-contractors SUB-CONTRACTORS If yes please describe how you evaluate the competencies of each sub-contractor QUALITY 14. Please provide details of your quality procedures. Is your quality system certified (ISO 9001) and by who
8 15. REFERENCES Please provide 3 references from companies you have previously worked with. Company - Contact Name & Position - & Contact Number - Project Title - Description of the work - Duration of the work - Estimated Cost - Company - Contact Name & Position - & Contact Number - Project Title - Description of the work - Duration of the work - Estimated Cost -
9 Company - Contact Name & Position - & Contact Number - Project Title - Description of the work - Duration of the work - Estimated Cost -
10 FURTHER INFORMATION 16. Please include any other relevant information that would enhance your competences and capabilities such as safety awards. Please sign to confirm that the information that you have provided is correct and concise Name of Signatory (block capitals): Position in Company (block capitals): Signature Date COMPLETED FORMS TO BE SENT BACK TO : ebrit Services Enterprise House Kings Road Canvey Island Essex SS80PQ [email protected]
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