Pre-Qualification Questionnaire (PQQ) for Contractors and Suppliers

Please complete the questionnaire in full and upload all supporting documents where required. Submissions are carefully reviewed by our team and may assist your company in being considered for future tenders and contracts.

01 about your company

please complete all sections

Trade ~ please specify type

Full Company Name

Trading Name (if different)

Address

Telephone Number / Mobile Number

Fax Number (if any)

Email Address

Website URL

Legal Entity (Ltd, Sole Trader, Partnership etc.)

NI Number & Name (if Sole Trader or Partnership)

Company Registration No.

Year Company Registered

VAT Number

Unique Tax Reference Number

Contact Names & Functions - If there is a Parent Company please state name & functions

Name & Address of Bankers

Name & Address of Insurers

02 Insurances & company details

Insurance

Employers Liability

Expiry Date

Professional Indemnity

Expiry Date

All Risks

Expiry Date

Turnover

Year 1 (Current)

Year 2

Year 3

employees & accreditations

Directly Employed

5

Subcontract

5

Is your company UKAS accredited to:

ISO 9001

ISO 14001

Note

you will also be required to work in accordance with our Management System

Does your company have an Equal Opportunities Policy?

03 type of work carried out

Project 1

Project Name and Address

Type of Work

Value

Approx Dates

Client Name and Contact

Project 2

Project Name and Address

Type of Work

Value

Approx Dates

Client Name and Contact

Project 3

Project Name and Address

Type of Work

Value

Approx Dates

Client Name and Contact

04 Health & Safety Information

Has your company received any improvement prohibition notices or prosecutions, or subcontractors to your company, by the enforcing authorities?

If Yes, Please give details below

Does your company hold a CHAS / Safe Contractor or any other SSIP accredited scheme?

The following questions are to assist us in assessing the capability of your company to effectively control risks to the health and safety of your employees and others who may be affected by your work operations.

04 Health & Safety Information

1

Health & Safety Policy

1.1

Please enclose a copy of your latest policy statement, organisation and arrangements, as required under the Health & Safety at Work etc. Act 1974.

1.2

Please give the name and title of the person in your company responsible for coordinating health and safety matters and reporting on these to your Senior Executive.

1.3

Please indicate the methods you adopt to promote and enforce your Company Health & Safety Policy at sites.

04 Health & Safety Information

2

Safety Surveillance & Advice

2.1

Please give the name, title and qualification of your competent person who has been appointed in accordance with Regulation 7 of the Management of Health & Safety at Work Regulations 1999.

This may be your Safety Officer, Adviser or Consultant. Please enclose a copy of their NEBOSH or ISOH certificate.

Click to upload file or drag-and-drop. Max 25 MB

2.2

Confirm your company carries out health surveillance for all employees involved in works where required under current legislation.

04 Health & Safety Information

3

Health & Safety Training

3.1

Please give details of what health and safety training has been given, or would be given, to your managers and foreman (identify any specialist training for scaffold inspection, confined space working etc.). Please enclose a copy of your training matrix.

Click to upload file or drag-and-drop. Max 25 MB

3.2

Please give details of what health and safety training has been given, or would be given to your operatives (identify any specialist training for plant and equipment etc.)

3.3

Please enclose a copy of the Company Safety Handbook issued to your employees.

Click to upload file or drag-and-drop. Max 25 MB

04 Health & Safety Information

4

Accident Investigation & Records

4.1

Please enclose your Company accident statistics for the year-to date and the previous three years and indicate their basis.

Click to upload file or drag-and-drop. Max 25 MB

4.2

Please give details of your procedure for investigating and reporting accidents, dangerous occurrences or occupational illnesses.

4.3

Please attach a copy of your Company Accident Report Form.

Click to upload file or drag-and-drop. Max 25 MB

04 Health & Safety Information

5

Safety Performance Awards

5.1

Please give details, with dates, of any awards received (e.g. ROSPA, British Safety Council).

04 Health & Safety Information

6

Membership Of Safety Groups

6.1

Please give membership details of groups such as ROSPA, British Safety Council, local industry safety groups etc.

04 Health & Safety Information

7

Plant & Equipment Maintenance & Inspection

7.1

Please give details of the procedures to ensure that plant and equipment, for use on site, is issued and kept in a safe condition.

04 Health & Safety Information

8

Safe Systems Of Work

8.1

Please give brief details of any laid-down safety procedures of permit-to-work systems that you have developed.

8.2

Please give details of all substances used in your work operations that are classified as hazardous to health and attach an example copy of an assessment record as required under statutory regulations (e.g. COSHH, Site Waste Management Plan, Control of Lead at Work, Control of Asbestos at Work etc.)

Click to upload file or drag-and-drop. Max 25 MB

8.3

Please give details of your formal system for monitoring and auditing the safety of your systems of work at sites.

8.4

Please attach a copy of your Company Site Inspection Report Form.

Click to upload file or drag-and-drop. Max 25 MB

04 Health & Safety Information

9

Contractors

9.1

Please give details of how you assess the competency and health and safety record of companies with whom you place contracts and the means to ensure that sub-contractors comply with your own safety policy. Please enclose a copy of your Questionnaire.

Click to upload file or drag-and-drop. Max 25 MB

04 Health & Safety Information

10

Safety Communications

10.1

Please give details of your systems for communicating safety information (e.g. bulletins, memoranda etc.).

10.2

Please give details of the structure and frequency of safety meetings held with members of staff / site representatives.

10.3

Please enclose a copy of your Modern Slavery Statement

Click to upload file or drag-and-drop. Max 25 MB

05 CSCS Compliance

Please confirm compliance that all operatives working on our sites are able to present a CSCS Card for their trade and where five or more people are provided by yourselves a Supervisor who has relevant safety training identifying them in such a capacity, such as the 2-day CITB Site Safety Plus Scheme.

Note

if you do not hold the relevant CSCS Card you will not be allowed on site.

Employers liability insurance certificate

Public & product liability insurance certificate

Professional indemnity insurance certificate

ISO 9001 certificate

ISO 14001 certificate

CHAS / Safe Contractor / SSIP certificate

Signed & dated health & safety statement (Q1.1)

NEBOSH or ISOH certificate (Q2.1)

Training matrix (Q3.1 & 3.2)

Company safety handbook (Q3.3)

Accident records & statistics (Q4.1)

Accident report form (Q4.3)

Site inspection form (Q8.4)

Questionnaire (Q9.1)

Please include any other relevant information we should have to assist us in assessing the capability of your company to effectively control risks to the health and safety of your employees and others who may be affected by your work operations.

06 Signature

Answers to all questions should be given, where possible and may assist your company in being properly considered for future work.

We may however request further information to fully evaluate your company.

Print Name

Position in Company

Date of Completion

Page 1 / 1

Pre-Qualification Questionnaire (PQQ) for Contractors and Suppliers

Home

Services

pqq

Please complete the questionnaire in full and upload all supporting documents where required. Submissions are carefully reviewed by our team and may assist your company in being considered for future tenders and contracts.

01 about your company

please complete all sections

Trade ~ please specify type

Full Company Name

Trading Name (if different)

Address

Telephone Number / Mobile Number

Fax Number (if any)

Email Address

Website URL

Legal Entity (Ltd, Sole Trader, Partnership etc.)

NI Number & Name (if Sole Trader or Partnership)

Company Registration No.

Year Company Registered

VAT Number

Unique Tax Reference Number

Contact Names & Functions - If there is a Parent Company please state name & functions

Name & Address of Bankers

Name & Address of Insurers

02 Insurances & company details

Insurance

Employers Liability

Expiry Date

Professional Indemnity

Expiry Date

All Risks

Expiry Date

Turnover

Year 1 (Current)

Year 2

Year 3

employees & accreditations

Directly Employed

5

Subcontract

5

Is your company UKAS accredited to:

ISO 9001

ISO 14001

Note

you will also be required to work in accordance with our Management System

Does your company have an Equal Opportunities Policy?

03 type of work carried out

Project 1

Project Name and Address

Type of Work

Value

Approx Dates

Client Name and Contact

Project 2

Project Name and Address

Type of Work

Value

Approx Dates

Client Name and Contact

Project 3

Project Name and Address

Type of Work

Value

Approx Dates

Client Name and Contact

04 Health & Safety Information

Has your company received any improvement prohibition notices or prosecutions, or subcontractors to your company, by the enforcing authorities?

If Yes, Please give details below

Does your company hold a CHAS / Safe Contractor or any other SSIP accredited scheme?

The following questions are to assist us in assessing the capability of your company to effectively control risks to the health and safety of your employees and others who may be affected by your work operations.

04 Health & Safety Information

1

Health & Safety Policy

1.1

Please enclose a copy of your latest policy statement, organisation and arrangements, as required under the Health & Safety at Work etc. Act 1974.

1.2

Please give the name and title of the person in your company responsible for coordinating health and safety matters and reporting on these to your Senior Executive.

1.3

Please indicate the methods you adopt to promote and enforce your Company Health & Safety Policy at sites.

04 Health & Safety Information

2

Safety Surveillance & Advice

2.1

Please give the name, title and qualification of your competent person who has been appointed in accordance with Regulation 7 of the Management of Health & Safety at Work Regulations 1999.

This may be your Safety Officer, Adviser or Consultant. Please enclose a copy of their NEBOSH or ISOH certificate.

Click to upload file or drag-and-drop. Max 25 MB

2.2

Confirm your company carries out health surveillance for all employees involved in works where required under current legislation.

04 Health & Safety Information

3

Health & Safety Training

3.1

Please give details of what health and safety training has been given, or would be given, to your managers and foreman (identify any specialist training for scaffold inspection, confined space working etc.). Please enclose a copy of your training matrix.

Click to upload file or drag-and-drop. Max 25 MB

3.2

Please give details of what health and safety training has been given, or would be given to your operatives (identify any specialist training for plant and equipment etc.)

3.3

Please enclose a copy of the Company Safety Handbook issued to your employees.

Click to upload file or drag-and-drop. Max 25 MB

04 Health & Safety Information

4

Accident Investigation & Records

4.1

Please enclose your Company accident statistics for the year-to date and the previous three years and indicate their basis.

Click to upload file or drag-and-drop. Max 25 MB

4.2

Please give details of your procedure for investigating and reporting accidents, dangerous occurrences or occupational illnesses.

4.3

Please attach a copy of your Company Accident Report Form.

Click to upload file or drag-and-drop. Max 25 MB

04 Health & Safety Information

5

Safety Performance Awards

5.1

Please give details, with dates, of any awards received (e.g. ROSPA, British Safety Council).

04 Health & Safety Information

6

Membership Of Safety Groups

6.1

Please give membership details of groups such as ROSPA, British Safety Council, local industry safety groups etc.

04 Health & Safety Information

7

Plant & Equipment Maintenance & Inspection

7.1

Please give details of the procedures to ensure that plant and equipment, for use on site, is issued and kept in a safe condition.

04 Health & Safety Information

8

Safe Systems Of Work

8.1

Please give brief details of any laid-down safety procedures of permit-to-work systems that you have developed.

8.2

Please give details of all substances used in your work operations that are classified as hazardous to health and attach an example copy of an assessment record as required under statutory regulations (e.g. COSHH, Site Waste Management Plan, Control of Lead at Work, Control of Asbestos at Work etc.)

Click to upload file or drag-and-drop. Max 25 MB

8.3

Please give details of your formal system for monitoring and auditing the safety of your systems of work at sites.

8.4

Please attach a copy of your Company Site Inspection Report Form.

Click to upload file or drag-and-drop. Max 25 MB

04 Health & Safety Information

9

Contractors

9.1

Please give details of how you assess the competency and health and safety record of companies with whom you place contracts and the means to ensure that sub-contractors comply with your own safety policy. Please enclose a copy of your Questionnaire.

Click to upload file or drag-and-drop. Max 25 MB

04 Health & Safety Information

10

Safety Communications

10.1

Please give details of your systems for communicating safety information (e.g. bulletins, memoranda etc.).

10.2

Please give details of the structure and frequency of safety meetings held with members of staff / site representatives.

10.3

Please enclose a copy of your Modern Slavery Statement

Click to upload file or drag-and-drop. Max 25 MB

05 CSCS Compliance

Please confirm compliance that all operatives working on our sites are able to present a CSCS Card for their trade and where five or more people are provided by yourselves a Supervisor who has relevant safety training identifying them in such a capacity, such as the 2-day CITB Site Safety Plus Scheme.

Note

if you do not hold the relevant CSCS Card you will not be allowed on site.

Employers liability insurance certificate

Public & product liability insurance certificate

Professional indemnity insurance certificate

ISO 9001 certificate

ISO 14001 certificate

CHAS / Safe Contractor / SSIP certificate

Signed & dated health & safety statement (Q1.1)

NEBOSH or ISOH certificate (Q2.1)

Training matrix (Q3.1 & 3.2)

Company safety handbook (Q3.3)

Accident records & statistics (Q4.1)

Accident report form (Q4.3)

Site inspection form (Q8.4)

Questionnaire (Q9.1)

Please include any other relevant information we should have to assist us in assessing the capability of your company to effectively control risks to the health and safety of your employees and others who may be affected by your work operations.

06 Signature

Answers to all questions should be given, where possible and may assist your company in being properly considered for future work.

We may however request further information to fully evaluate your company.

Print Name

Position in Company

Date of Completion

Page 1 / 1

Pre-Qualification Questionnaire (PQQ) for Contractors and Suppliers

Home

Services

pqq

Please complete the questionnaire in full and upload all supporting documents where required. Submissions are carefully reviewed by our team and may assist your company in being considered for future tenders and contracts.

01 about your company

please complete all sections

Trade ~ please specify type

Full Company Name

Trading Name (if different)

Address

Telephone Number / Mobile Number

Fax Number (if any)

Email Address

Website URL

Legal Entity (Ltd, Sole Trader, Partnership etc.)

NI Number & Name (if Sole Trader or Partnership)

Company Registration No.

Year Company Registered

VAT Number

Unique Tax Reference Number

Contact Names & Functions - If there is a Parent Company please state name & functions

Name & Address of Bankers

Name & Address of Insurers

02 Insurances & company details

Insurance

Employers Liability

Expiry Date

Professional Indemnity

Expiry Date

All Risks

Expiry Date

Turnover

Year 1 (Current)

Year 2

Year 3

employees & accreditations

Directly Employed

5

Subcontract

5

Is your company UKAS accredited to:

ISO 9001

ISO 14001

Note

you will also be required to work in accordance with our Management System

Does your company have an Equal Opportunities Policy?

03 type of work carried out

Project 1

Project Name and Address

Type of Work

Value

Approx Dates

Client Name and Contact

Project 2

Project Name and Address

Type of Work

Value

Approx Dates

Client Name and Contact

Project 3

Project Name and Address

Type of Work

Value

Approx Dates

Client Name and Contact

04 Health & Safety Information

Has your company received any improvement prohibition notices or prosecutions, or subcontractors to your company, by the enforcing authorities?

If Yes, Please give details below

Does your company hold a CHAS / Safe Contractor or any other SSIP accredited scheme?

The following questions are to assist us in assessing the capability of your company to effectively control risks to the health and safety of your employees and others who may be affected by your work operations.

04 Health & Safety Information

1

Health & Safety Policy

1.1

Please enclose a copy of your latest policy statement, organisation and arrangements, as required under the Health & Safety at Work etc. Act 1974.

1.2

Please give the name and title of the person in your company responsible for coordinating health and safety matters and reporting on these to your Senior Executive.

1.3

Please indicate the methods you adopt to promote and enforce your Company Health & Safety Policy at sites.

04 Health & Safety Information

2

Safety Surveillance & Advice

2.1

Please give the name, title and qualification of your competent person who has been appointed in accordance with Regulation 7 of the Management of Health & Safety at Work Regulations 1999.

This may be your Safety Officer, Adviser or Consultant. Please enclose a copy of their NEBOSH or ISOH certificate.

Click to upload file or drag-and-drop. Max 25 MB

2.2

Confirm your company carries out health surveillance for all employees involved in works where required under current legislation.

04 Health & Safety Information

3

Health & Safety Training

3.1

Please give details of what health and safety training has been given, or would be given, to your managers and foreman (identify any specialist training for scaffold inspection, confined space working etc.). Please enclose a copy of your training matrix.

Click to upload file or drag-and-drop. Max 25 MB

3.2

Please give details of what health and safety training has been given, or would be given to your operatives (identify any specialist training for plant and equipment etc.)

3.3

Please enclose a copy of the Company Safety Handbook issued to your employees.

Click to upload file or drag-and-drop. Max 25 MB

04 Health & Safety Information

4

Accident Investigation & Records

4.1

Please enclose your Company accident statistics for the year-to date and the previous three years and indicate their basis.

Click to upload file or drag-and-drop. Max 25 MB

4.2

Please give details of your procedure for investigating and reporting accidents, dangerous occurrences or occupational illnesses.

4.3

Please attach a copy of your Company Accident Report Form.

Click to upload file or drag-and-drop. Max 25 MB

04 Health & Safety Information

5

Safety Performance Awards

5.1

Please give details, with dates, of any awards received (e.g. ROSPA, British Safety Council).

04 Health & Safety Information

6

Membership Of Safety Groups

6.1

Please give membership details of groups such as ROSPA, British Safety Council, local industry safety groups etc.

04 Health & Safety Information

7

Plant & Equipment Maintenance & Inspection

7.1

Please give details of the procedures to ensure that plant and equipment, for use on site, is issued and kept in a safe condition.

04 Health & Safety Information

8

Safe Systems Of Work

8.1

Please give brief details of any laid-down safety procedures of permit-to-work systems that you have developed.

8.2

Please give details of all substances used in your work operations that are classified as hazardous to health and attach an example copy of an assessment record as required under statutory regulations (e.g. COSHH, Site Waste Management Plan, Control of Lead at Work, Control of Asbestos at Work etc.)

Click to upload file or drag-and-drop. Max 25 MB

8.3

Please give details of your formal system for monitoring and auditing the safety of your systems of work at sites.

8.4

Please attach a copy of your Company Site Inspection Report Form.

Click to upload file or drag-and-drop. Max 25 MB

04 Health & Safety Information

9

Contractors

9.1

Please give details of how you assess the competency and health and safety record of companies with whom you place contracts and the means to ensure that sub-contractors comply with your own safety policy. Please enclose a copy of your Questionnaire.

Click to upload file or drag-and-drop. Max 25 MB

04 Health & Safety Information

10

Safety Communications

10.1

Please give details of your systems for communicating safety information (e.g. bulletins, memoranda etc.).

10.2

Please give details of the structure and frequency of safety meetings held with members of staff / site representatives.

10.3

Please enclose a copy of your Modern Slavery Statement

Click to upload file or drag-and-drop. Max 25 MB

05 CSCS Compliance

Please confirm compliance that all operatives working on our sites are able to present a CSCS Card for their trade and where five or more people are provided by yourselves a Supervisor who has relevant safety training identifying them in such a capacity, such as the 2-day CITB Site Safety Plus Scheme.

Note

if you do not hold the relevant CSCS Card you will not be allowed on site.

Employers liability insurance certificate

Public & product liability insurance certificate

Professional indemnity insurance certificate

ISO 9001 certificate

ISO 14001 certificate

CHAS / Safe Contractor / SSIP certificate

Signed & dated health & safety statement (Q1.1)

NEBOSH or ISOH certificate (Q2.1)

Training matrix (Q3.1 & 3.2)

Company safety handbook (Q3.3)

Accident records & statistics (Q4.1)

Accident report form (Q4.3)

Site inspection form (Q8.4)

Questionnaire (Q9.1)

Please include any other relevant information we should have to assist us in assessing the capability of your company to effectively control risks to the health and safety of your employees and others who may be affected by your work operations.

06 Signature

Answers to all questions should be given, where possible and may assist your company in being properly considered for future work.

We may however request further information to fully evaluate your company.

Print Name

Position in Company

Date of Completion

Page 1 / 1