AD Construction Group Subcontractor Approval Form

Number of staff directly employed (including Directors and temporary staff)*
(Include your employees, self employed workers, temporary staff)
Number of self employed staff*
(Include your employees, self employed workers, temporary staff)
Financial Information
Annual Turnover:
Have you or your company been subject to a bankruptcy order in the last 3 years?*

YesNo
Please provide details of bankruptcy*
Has the owner/director of the company been subject to an individual voluntary agreement in the last 3 years?*

YesNo
Please provide details of IVA*
Have you failed to fulfil obligations relations to the payment of taxes under the law of any part of the United Kingdom or the relevant state in which you are established?*

YesNo
Please provide details of failed tax payments*
Competent Person Information
Have you employed a competent person (advisor, manager etc.) to take charge of your company's health and safety management and arrangements?*

YESNO
As you have answered 'NO' please outline how you obtain competent advise for health and safety purposes?
Is the competent person an external consultant?*

YESNO
Competent Person(s) Details (internal)
Name
Position
Details of Competent Person's qualifications or credentials?
Please upload copies of Competent Person's qualifications / CV

Cancelof
Competent Person(s) Details (external)
Name
Position
External Consultant Business Address:
Details of (External) Competent Person's qualifications or credentials?
Please upload copies of (External) Competent Person's qualifications / CV

Cancelof
Accreditations and Safety Schemes Information
Do you have current accreditations for ISO45001?*

YESNO
ISO45001 Certificate No.
ISO45001 Certificate Expiry*

DayMonthYear
Date
If you hold ISO45001 please upload a copy of your certificate:*

Cancelof
Do you have current accreditations for ISO9001?*

YESNO
ISO9001 Certificate No.
Do you have current accreditations for ISO14001?*

YESNO
ISO14001 Certificate No.
Is your company a member of a scheme linked, or similar to Safety Schemes in Procurement (SSIP) e.g. CHAS, Constructionline, Safe Contractor?*

YESNO
Number of Schemes*
Scheme Name 1:
e.g. CHAS, Constructionline, Safe Contractor, NASC, SMAS etc.
SSIP 1 Expiry Date*

DayMonthYear
Date
Scheme Name 2:
e.g. CHAS, Constructionline, Safe Contractor, NASC, SMAS etc.
SSIP 2 Expiry Date*

DayMonthYear
Date
Scheme Name 3:
e.g. CHAS, Constructionline, Safe Contractor, NASC, SMAS etc.
SSIP 3 Expiry Date*

DayMonthYear
Date
Scheme Name 4:
e.g. CHAS, Constructionline, Safe Contractor, NASC, SMAS etc.
SSIP 4 Expiry Date*

DayMonthYear
Date
Do you hold PAS 2030:19?*

YESNO
Building Safety Measures - Please tick the appropriate boxes:*

B1 - Cavity Wall InsulationB2 - Draught ProofingB3 - Glazing & DoorsB4 – External Wall InsulationB5 – Flat Roof InsulationB6 – Floor InsulationB7 – Hybrid Wall InsulationB8 – Internal Wall InsulationB9 – Loft InsulationB10 – Pitched Roof InsulationB11 – Solar Blinds, Shutter & Shading DevicesB12 – Room-in-roof InsulationB13 – Insulation of existing park homesNone of the above
Building Services Mechanical - Please tick the appropriate boxes:*

C1 - Condensing boilers, natural gas-fired and liquified petroleum gas-firedC.2 – Oil-fired condensing boilersC.3 – Flue-gas heat recovery devicesC.4 – Heating system insulation ( ducting pipes and cylinders )C5 – Heating, hot water system, air conditioning or ventilation controls and componentsC6 – Hot water systemsC7 – Mechanical Ventilation with heat recoveryC8 – Under-floor heatingC9 – Warm-air heating systemsC10 – Water efficient taps and showersNone of the above
Building Services Electrical - Please tick the appropriate boxes:*

D1 – Electric Storage HeatersD2 – Lighting fittings, lighting systems and lighting systems controlNone of the above
Please upload applicable PAS2030:19 certificates*

Cancelof
Do you hold MCS?*

YESNO
Please tick the appropriate boxes:*

Solar PVAir Source Heat PumpsBattery Storage
Please upload applicable MCS certificates*

Cancelof
If you are a member of SSIP or equivalent, please upload a copy of your certificate:

Cancelof
Health & Safety Policy
Do you have an up to date Health & Safety Policy?

YESNO
Health & Safety - Please upload copies of documents showing your health and safety policy and management arrangements

Cancelof
Risk Management

You will be expected to supply us with copies of risk assessments and method statements detailing a safe system of work before any work involving exposure to significant hazards commences.
Do you have procedures in place to prepare and complete RISK ASSESSMENTS:

YESNO
If you have answered 'NO' - please outline how you identify the hazards and risks associated with your work and how you communicate this to your staff:
Do you have procedures in place to prepare and complete METHOD STATEMENTS:

YESNO
If you have answered 'NO' - please outline how you put in place a safe system of work that can be followed by your staff to execute the work in a safe manner:
Do you have procedures in place to prepare and complete COSHH ASSESSMENTS

YESNO
If you have answered 'NO' - please outline how you ensure your staff understand the hazards and risks associated with the products that you are using in a way that avoids harm and protects the public:
Risk Management - Please attach completed examples of Risk Assessments, Method Statements and COSHH assessments detailing safe systems of work covering the type of work that you will be carrying out with us:

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Supervision and Monitoring
How do you ensure that your policies, procedures, method statements, safe systems of work etc. are followed on site?
Equipment
Do you have a maintenance and inspection regime covering ALL equipment (including electrical and lifting equipment)?

YESNO
Details of the arrangements in place for the maintenance and inspection of your equipment:
Please explain why you do not have an equipment inspection regime in place?
Worker Competence and Training
Are the workers you expect to send to our site trained and competent in their roles?*

YESNO
Please summarise their training and qualifications relevant to the work they'll be carrying out:
Please upload your training matrix, records or qualifications:

Cancelof
Please outline how you will demonstrate/ensure that people working on projects will be suitably qualified:
Environmental Management
Does your company hold a waste carriers license?*

YESNO
Please upload a copy of your waste carriers license:

Cancelof
Does your company have any environmental targets?*

YESNO
Details of your company's environmental targets
Please confirm when asked that you will assist AD Construction Group in meeting their environmental objectives:

WE AGREE
High Risk Activities
Please indicate if you undertake any of the following activities:

Hot WorksExcavationThe Use of MEWP Cherry PickersPower CradlesRope Access WorkConfined SpacesLifting EquipmentLift Shafts
Please ensure this is covered on your insurance and is highlighted when your insurance documents are uploaded as part of this application.
FRA & Cladding Works
Please indicate if you undertake any of the following activities:

Installation/repair/maintenance of fire detection and alarm systemsInstallation/repair/maintenance of fire doorsFire StoppingExternal cladding worksSurveying, Specifications and design of fire systemsInstallation/repair/maintenance of emergency lightingInstallation/repair/maintenance of fire suppression systemsInstallation/repair/maintenance of AOV systems
Please ensure you provide a copy of your professional indemnity insurance that covers the activity
Insurances
Do you have EMPLOYER'S LIABILITY Insurance Cover?*

YESNO
EMPLOYER'S LIABILITY Sum Assured
EMPLOYER'S LIABILITY Expiry Date

DayMonthYear
Date
EMPLOYER'S LIABILITY - Exemptions and Exclusions:
EMPLOYER'S LIABILITY - You answered 'NO' - Please explain why employer's liability insurance is not needed?
Do you have PUBLIC LIABILITY Insurance Cover (a minimum of £2M is required)?*

YESNO
Do you agree to raise your public liability cover to the minimum requirement of £2M and provide evidence within 7 days?

I/We Agree to meet the PL requirements
PUBLIC LIABILITY Sum Assured*
PUBLIC LIABILITY Expiry Date*

DayMonthYear
Date
PUBLIC LIABILITY - Exemptions and Exclusions:
Do you have DESIGN/PRODUCT LIABILITY Insurance Cover?*

YESNO
DESIGN/PRODUCT LIABILITY Sum Assured
DESIGN/PRODUCT LIABILITY Expiry Date

DayMonthYear
Date
DESIGN/PRODUCT LIABILITY - Exemptions and Exclusions:
DESIGN/PRODUCT LIABILITY - You answered 'NO' - Please explain why design/product liability insurance is not needed?
Do you have PROFESSIONAL INDEMNITY Insurance Cover?*

YESNO
PROFESSIONAL INDEMNITY Sum Assured
PROFESSIONAL INDEMNITY Expiry Date

DayMonthYear
Date
PROFESSIONAL INDEMNITY - Exemptions and Exclusions:
PROFESSIONAL INDEMNITY - You answered 'NO' - Please explain why professional indemnity insurance is not needed?
INSURANCE CERTIFICATES - Please upload copies of current insurance certificates:*

Cancelof
Asbestos Works
Are you licensed in the UK to undertake work with Asbestos?

YESNO
Has your workforce received Asbestos Awareness Training?

YESNO
If you undertake work with Asbestos, please mention below what type of work you carry out.
Details of Asbestos Awareness Training your workforce has received:
Asbestos Work - Please upload a copy of your current license

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Asbestos Training - You have answered 'NO' please explain what information has been given to your staff on what to do if they come across Asbestos Containing Material:
If you have no formal training you will need to complete the AD Group Asbestos Online Training as part of your onboarding process.
Enforcement
Have you had enforcement action (Improvement, Prohibition Notice or Prosecution) taken against you in the last 5 years?

YESNO
Details of enforcement action taken against you:
RIDDOR Accidents
Please give details of any reportable injuries, diseases and dangerous occurrences that have been notified to Enforcing Authorities in the last 12 months?
Disclosure and Barring
Do you undertake DBS checks?

YESNO
Declaration

I certify that all of the information I have supplied on this questionnaire is complete, accurate and true.
*For those employing four employees or less

I/We will endeavour to familiarise myself with, and work in accordance to AD Construction Group's RAMS and Safe System of Work. I/We agree to bring to the attention of AD Construction Group representatives any issues or situations which could compromise the safety of site workers or members of the public and will adhere to the highest standards set by AD Construction Group throughout the progress of our work.
Name of Person Completing Form:*
Position:*
Email:*
example@example.com
Telephone:
Signature*

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AD Construction Group Subcontractor Approval Form

Financial Information