Supplier/Contractor Pre-Qualification Questionnaire

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This field is for validation purposes and should be left unchanged.

Thank you for your interest in becoming an Approved Supplier/Contractor of Ambiente Systems Ltd. So that we may verify you we need to gather certain information about you and your business. Please complete the below and return any supporting documentation requested to support your application.

Please note that until verification has been confirmed by either the Group Finance Manager and/or Group HR & Office Manager you may not accept any order and/or work instruction. All orders from us should be accompanied by a valid purchase order before acceptance.

Approved Supplier/Contractor

Are you applying to become an Approved Supplier or an Approved Contractor?(Required)

Financial Information

Business Type(Required)

Please confirm that you have the Right to Work within the United Kingdom and provide a copy of one of the following: 1) Your biometric residence permit number. 2) Your biometric residence card number. 3) Your passport or national identity card.(Required)

Accepted file types: jpg, png, pdf, Max. file size: 256 MB.

Please provide a copy of your Certificate of Incorporation(Required)

Accepted file types: jpg, png, pdf, Max. file size: 256 MB.

VAT Registration Number

UTR Number

Company Registration Number

National Insurance Number

Are you registered with Construction Industry Scheme (CIS)?(Required)

Name of Bank/Building Society(Required)

Address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Account Number(Required)

Sort Code(Required)

Full Name of Account(Required)

Number of Employees(Required)

Insurance Information

Please note that we require minimum levels of insurance depending on the product and/or services that you are providing to us, and we have given a guide below of our minimum expectations. By law if you have one or more employee then in addition to the below you are required to hold Employers Liability Insurance:

Type of Insurance

Employers Liability

Public Liability

Professional Indemnity

Other

Employers Liability Expiry Date(Required)

Public Liability Expiry Date(Required)

Professional Indemnity Expiry Date(Required)

Upload all Certificates(Required)

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Accepted file types: jpg, png, pdf, Max. file size: 256 MB.

Contractors Only

Under the law we have a duty to ensure that our sub-contractors have the necessary skills, knowledge, and experience to manage health and safety when carrying out works on our behalf. With this in mind, we need to know if you sub-contract works or use any form of additional labour (i.e., temporary labour). If you have answered ‘Yes’ to any of the questions below, please provide details of how you assess the competence of your sub-contractors or temporary workers.

Do you sub-contract any of your works?(Required)

Do you use temporary workers (i.e. Labourers)?(Required)

If you have answered 'Yes' to any of above, please confirm that you have the appropriate insurance in place for this and have provided us with a copy of this?(Required)

Health & Safety at Work Act/Policy Statements

Do you employ five people or more?(Required)

Please upload a signed Health & Safety Policy Statement dated within the last 12 months(Required)

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Max. file size: 256 MB.

Do you have a Business Ethic and Integrity Policy detailing Modern Slavery & Human Trafficking?(Required)

Please upload a signed Policy Statement dated within the last 12 months(Required)

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Max. file size: 256 MB.

Do you have a Quality Policy Statement supported by a QMS?(Required)

Please upload a signed Policy Statement dated within the last 12 months(Required)

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Max. file size: 256 MB.

Environmental & Sustainability

Do you have an Environmental & Sustainability Policy?(Required)

Please upload a signed Environmental Policy Statement dated within the last 12 months(Required)

Drop files here or

Max. file size: 256 MB.

Business Ethics & Integrity Trading

Has your Organisation verified that all their workers have the right to work within the UK and have provided you with proof of identity?(Required)

Has the Organisation a process or policy in place to ensure that workers are paid fairly and above the minimum wage?(Required)

Has the Organisation verified that all workers do not have barriers of their free movement?(Required)

Safety Monitoring, Advice & Responsibilities

What is the name and title of the individual with overall responsible for all health and safety matters within your organisation?

First Name(Required)

Last Name(Required)

Job Title(Required)

Phone Number(Required)

Name the competent person or organisation you use to advise on all matters relating to health and safety.

Contact/Company Name(Required)

Job Title(Required)

Phone Number(Required)

Address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Accreditations

Do you hold any of the following accreditations?

Achilles

CHAS

Construction Line

ISO: 9001 Quality Management Systems

ISO: 45001 Health & Safety Management

Safe Contractor

SSIP (Safety Schemes in Procurement)

SMAS (Safety Management Advisory Services)

Training

All site-based staff will be required to have a valid CSCS and/or SKILLcard as a minimum requirement.

Please note that any personnel found working on behalf of us, who has not been named above and/or details of their involvement with your organisation (i.e., Employee, Sub-Contractor, Worker, Labourer etc.) given to us, you risk them being asked to leave site immediately and your company maybe removed from our Approved Database.

Please provide certificates if necessary

Drop files here or

Max. file size: 256 MB.

Accident & Incident Investigation and Records

Please provide numbers of ALL accident/incidents reported as required by the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR), during the last 3 years.(Required)

Please provide details of the year, and if fatal, specified injuries, dangerous occurences, diseases, over 7 day injuries

Enforcement History

During the last 5 years have you had any of the following Enforcement Notices issued to you by the HSE or a Local Authority Enforcement Office? If you have answered ‘Yes’ to any of the questions below, please provide full details.

Improvement Notice(Required)

Please provide full details(Required)

Prohibition Notice(Required)

Please provide full details(Required)

Have you ever been prosecuted for a breach of Health and Safety Regulations or Environmental legislation?(Required)

Please provide full details(Required)

Risk Assessments and Safe Methods of Working (RAMS)

As an employer or self-employed person, you must do a risk assessment before carrying out any work activity. However, you only need to record it if you employ five or more people. While a safety method statement is not required by law, it describes in a logical sequence exactly how a job is to be carried out in a safe manner and without risks to health.

You are responsible for your own Risk Assessment of the work activities and be able to demonstrate a Safe Method of Working (RAMS). Please confirm if you are able to provide us with any of the written procedures below. If you have answered ‘Yes’ to any of the questions below, please provide a sample.

COSHH Assessments(Required)