May 2012
Risk Management Procedure /RMP/12a
Contractor’s Questionnaire / Issue: 1Notes to Contractors
This form is used to assess the competence of potential contractors. Contractors should complete all sections giving as much detail as possible and return it to your College contact with all requested support documentation.
1. Company name and address:
2. Who in your company is ultimately responsible for health and safety?
Name: / Position:
Tel: / Email:
3. Please supply a copy of your company’s health and safety policy.
4. If you are CHAS accredited please supply a copy of your accreditation certificate.
5. Please supply the following company insurance documents, noting the amounts of insurance cover provided below:
Employers’ liability insurance / Public liability insurance / Professional indemnity
(if applicable)
Expiry date: / Expiry date: / Expiry date:
Limit of Indemnity:
£ / Limit of Indemnity:
£ / Limit of Indemnity:
£
Certificate attached? / Yes / No / Certificate attached? / Yes / No / Certificate attached? / Yes / No
6. Please provide the following documents (where applicable):
Relevant examples of your Risk Assessments
Relevant examples of your COSHH Assessments
Relevant examples of your Manual Handling Assessments
Relevant examples of your Work Method Statements
7. Have all your employees/sub contractors received information on risk assessments and work method statements relevant to the proposed work in College? / Yes / No
8. Do you have a system in place for employees to report defective work equipment? / Yes / No
9. Does your company have maintenance procedures in place for plant and/or portable tools? / Yes / No
10. Does your company employ sub-contractors? / Yes / No
If ‘Yes’ please supply a copy of your sub-contractors policy? / Policy attached?
Yes / No
Do you check sub-contractors’ insurance cover? / Yes / No
Do you check their competency to do the work? / Yes / No
If Yes, How?
If No, Who does?
11. How many RIDDOR reportable incidents has your Company had at work over the past three years?
12. Have you been issued with any HSE improvement or prohibition
notices during the past 3 years? / Yes / No
If Yes, please provide details:
13. Do you ensure your employees wear all necessary PPE? / Yes / No
If Yes, How?
14. Please supply details below of any relevant trade/professional associations that your company subscribes or belongs to:
Please supply contact names and addresses of two organisations that you have carried out similar work for in the past 18 months:
Company name: / Company name:
Address: / Address:
Contact: / Contact:
Tel: / Tel:
Email: / Email:
Nature of contract completed: / Nature of contract completed:
15. Questionnaire completed by:
Name: / Position:
Signature: / Date:
Checklist for Heads of Departments
Heads of Departments must check that all relevant documents have been provided by contractors to ensure they are valid. No contractor should be appointed without valid certificates.
Health and safety Policy provided and dated within the last 12 months? / Yes No
Risk Assessment suitable and sufficient and dated within the last 12 months? / Yes No
Method Statements suitable and sufficient and dated within the last 12 months? / Yes No N/A
COSHH Assessments suitable and sufficient and dated within the last 12 months? / Yes No N/A
Manual Handling Assessments suitable and sufficient and dated within the last 12 months? / Yes No N/A
Copy of valid certificate of CHAS or similar registration provided? / Yes No N/A
Employers’ liability insurance certificate:
Dated within the past 12 months?
Provides an insured indemnity of at least £2 million (for short-term contracts?
Provides an insured indemnity of at least £5 million (for longer-term contracts? / Yes No
Yes No N/A
Yes No N/A
Public liability insurance certificate:
Dated within the past 12 months?
Provides an insured indemnity of at least £2 million. / Yes No
Yes No N/A
Professional indemnity insurance certificate:
Dated within the past 12 months?
Provides an insured indemnity of at least £2 million. / Yes No
Yes No N/A
Will the works be completed within the validity date of all documents provided? / Yes No
Register of Approved Contractors (‘ContractH&S’ folder on the shared drive) updated? / Yes No