Submission Schedule
Section 1 / Company Details
Company Name
Section 2 / Schedule of Submission
Part A –Company Information / Yes No N/A
Part B – Health & Safety / Yes No N/A
Part C – Environmental / Yes No N/A
Part D – Quality Management / Yes No N/A
Part E – Rail Associated Works / Yes No N/A
Section 3 / Declaration
As a senior officer of the company I hereby certify that the responses given in this questionnaire and the supporting submissions are accurate, complete and true to the best of my knowledge.
Signed
Position
Date
Note
You must complete Parts A, B, C and D, however Section E only requires completion if it is relevant to your services or products.
Where evidence is required to be submitted please restrict this to relevant documents or sections of your procedures, we do not require a copy of your complete procedure manual, it is expected that each piece of evidence will be contained on a single sheet of A4 paper.
PART A / Company InformationSection 1 / Company Details
Company Name
Address
Post Code
Registered Address
(If different from above)
Post Code
Primary Contact
Telephone Number
Mobile Number
Fax Number
E-mail address
Section 2 / Scope of Work
Please submit a schedule of all types of work your company undertakes or materials / services it supplies clearly indicating those that the company is qualified to undertake.
We enclose a schedule of all types of work / materials and services we provide. / Yes No N/A
We enclose copies of any licences, certifications etc. to show the company is qualified to execute our scope of works. / Yes No N/A
Section 3 / Contract Values
Maximum Value of contract we undertake / £
Minimum Value of contract we undertake / £
Maximum Number of projects we can undertake
Section 4 / Turnover
Please provide details of the company annual turnover for the last three year commencing with the latest end of year results.
Year / £
Year / £
Year / £
We enclose a copy of our last year’s accounts and a statement as to present trading position. / Yes No N/A
Section 5 / Insurance
Cert No. / Level of Cover
Public/Product Liability / Yes No N/A / £
Employers Liability / Yes No N/A / £
Professional Indemnity / Yes No N/A / £
Contract Works/Plant / Yes No N/A / £
Other / Yes No N/A / £
We enclose copies of all Insurance certificates / Yes No N/A
Section 6 / Personnel
We maintain a company record of all employed staff / Yes No N/A
We check all references relating to employees from previous employers / Yes No N/A
We enclose details of the company recruitment / selection, equal opportunities policy. / Yes No N/A
Number of Direct Employees
Section 7 / CSCS,CPCS
Our Main Contractors are dedicated to maintaining a trained and competent workforce and to assist with this goal we require all workers on our site to hold a current CSCS or CPCS card or equivalent as approved by the CECA.
We are committed to maintaining a fully trained and competent workforce / Yes No N/A
We enclose copies CSCS and CPCS cards or proof of registration and active participation in obtaining the relevant qualifications for all operatives who will attend your Main Contractor’s Sites. / Yes No N/A
PART B / Health and Safety Qualification
Pre-Qualification
We are accredited with OHSAS 18001 for Health and Safety Management by a UKAS accredited assessor and enclose a copy of our certification. / Yes No N/A
Date of last audit
We enclose a schedule of Non-compliances and issues and related corrective actions resulting from the last audit. / Yes No N/A
If your company is accredited and you can supply the above information then you only need to complete Sections 1.1, 2, 3, and 8 of Part B.
If not accredited then ALL sections of Part B must be completed.
Section 1 / Health & Safety Policy and Organisation
1.1 / Policy
The Health and Safety Policy must be regularly reviewed and signed of by the Managing Director. The policy must be relevant to the nature and scale of the work.
We enclose a signed and dated copy of our Health and Safety Policy Statement / Yes No N/A
The Policy was last reviewed on (Date)
1.2 / Organisation
Set out the responsibilities for Health and Safety Management at all levels within the company.
We enclose details of the Health and Safety responsibilities of all levels of the company management and staff. / Yes No N/A
Section 2 / Arrangements for Assuring Health and Safety Measures
These should set out the arrangements for Health and Safety management and should be relevant to the nature and scale of the work. They should set out how the company will discharge its duties under all Health and Safety Legislation with clear details as to how these arrangements are communicated to the workforce.
We enclose details of our arrangements assuring health and safety measures and details of how they are communicated to the workforce. / Yes No N/A
Section 3 / Competent Advice
The company and its employees must have ready access to competent Health and Safety advice, preferably from within the company. The advisor must be able to provide general Health and Safety advice as well as industry specific Health & Safety advice.
We enclose a full CV, including all relevant Health and Safety Qualifications, experience and training received, of all persons within and outside the company who provide Health and Safety Advice to the company and its employees. / Yes No N/A
Section 4 / Training & Information
The company must demonstrate that it has in place and is implemented training arrangements to ensure all employees have the skills and understanding to carry out their duties. There must be a demonstrable programme of refresher training to keep employees updated on legislation and H&S good practice. This applies to all employees from upper management to trainees. Possession of a CSCS or CPSC card for their trade is regarded as a minimum requirement but is not regarded as sufficient proof of Health and Safety Training and competence.
We enclose a copy of the company training matrix demonstrating the training given to each level of the staff structure. / Yes No N/A
We enclose a copy of the staff training matrix demonstrating refresher and CPD training that is being provided. / Yes No N/A
We enclose a copy of the curriculum of a typical in-house training course and of 3 ‘Tool Box Talks’ carried out on site by the company. / Yes No N/A
Section 5 / Individual Training
The company employees are expected to have the appropriate qualifications and experience for the assigned tasks, unless they are under controlled and competent supervision.
We enclose a copy of a schedule of training already received by the company employees. / Yes No N/A
We enclose copies of all qualifications, training certification or proof of training/CPD for all Directors and managers of the company. / Yes No N/A
We enclose copies of all qualifications, training certification or proof of training for the personnel who will be involved in works. / Yes No N/A
Section 6 / Monitoring, Audit and Review
The company must have a system of monitoring procedures, for auditing them at periodic intervals, and for reviewing them on an ongoing basis.
We enclose examples of Health and Safety Advisory reports/inspections received during the last 6 months and the actions taken. / Yes No N/A
We enclose copies of minutes of senior management health and safety review meetings. / Yes No N/A
Section 7 / Workforce Involvement
The company must have and implement an established means of consulting with the workforce on matters relating to Health and Safety.
We enclose a copy of the company procedure for implementing workforce consultation. / Yes No N/A
We enclose copies of recent Health & Safety Committee meeting minutes involving the workforce. / Yes No N/A
We enclose details of workforce appointed safety representatives (trades Union and others). / Yes No N/A
Section 8 / Accident Reporting, and Enforcement action, follow up investigations
The company should have available records of all RIDDOR reportable accidents for the last three years. There should be a procedure for reviewing incidents and recording the action taken as a result. There should also be records of all enforcement action taken against the company during the last 5 years and the actions taken to remedy any matters subject to enforcement action.
We enclose details of RIDDOR reportable accidents for the last three years detailing each years Fatal, Major and 3 Day accidents separately. / Yes No N/A
We enclose details of the company accident statistics for the last three years in the form of Accident Incident Rate (AIR) and Accident Frequency Rate (AFR). / Yes No N/A
We enclose details of the last two RIDDOR accidents, their investigation and subsequent actions taken. (Personal details are not required and should be obscured to comply with DPA regulation) / Yes No N/A
We enclose details of all Enforcement action taken against the company in the last 5 years and the remedial actions taken. (If no enforcement action has been taken against the company tick the N/A box) / Yes No N/A
Section 9 / Work Experience & References
The company must demonstrate it’s competence with regard to Health and Safety on previous recent projects.
We enclose details of recent similar projects and the associate contact details to enable your Main Contractor’s to obtain references with regard to Health and Safety performance. / Yes No N/A
PART C / Environmental
Pre-Qualification
We are accredited with BS EN ISO 14001 for Environmental Management by a UKAS accredited assessor and enclose a copy of our certification. / Yes No N/A
Date of last audit
We enclose a schedule of Non-compliances and issues and related corrective actions resulting from the last audit. / Yes No N/A
If your company is accredited and you can supply the above information then you do not need to complete the rest of Part C
If not accredited then ALL sections of Part C must be completed.
Section 1 / Environmental Policy and Organisation
1.1 / Policy
The Environmental Policy must be regularly reviewed and signed of by the Managing Director. The policy must be relevant to the nature and scale of the work.
We enclose a signed and dated copy of our Environmental Policy Statement / Yes No N/A
The Policy was last reviewed on (Date)--
1.2 / Organisation
Set out the responsibilities for Environmental Management at all levels within the company.
We enclose details of the Environmental responsibilities of all levels of the company management and staff. / Yes No N/A
Section 2 / Arrangements for Assuring Environmental Aspect and Impact Measures
These should set out the arrangements for Health and Safety management and should be relevant to the nature and scale of the work. They should set out how the company will discharge its duties under all Environmental Legislation with clear details as to how these arrangements are communicated to the workforce.
We enclose details of our arrangements assuring Environmental measures and details of how they are communicated to the workforce. / Yes No N/A
We enclose details of our Waste management Procedures / Yes No N/A
We enclose details of our policy on purchasing materials from renewable resources. / Yes No N/A
Section 3 / Competent Advice
The company and its employees must have ready access to competent Environmental advice, preferably from within the company. The advisor must be able to provide general Environmental advice as well as industry specific Environmental advice.
We enclose a full CV, including all relevant Environmental Qualifications, experience and training received, of all persons within and outside the company who provide Environmental Advice to the company. / Yes No N/A
Section 4 / Work Experience & References
The company must demonstrate it’s competence with regard to the environment on previous recent projects.
We enclose details of recent similar projects and the associate contact details to enable your Main Contractor’s to obtain references with regard to Environmental performance. / Yes No N/A
PART D / Quality Management
Pre-Qualification
We are accredited with BS EN ISO 9001 for Quality Management by a UKAS accredited assessor and enclose a copy of our certification. / Yes No N/A
Date of last audit
We enclose a schedule of Non-compliances and issues and related corrective actions resulting from the last audit. / Yes No N/A
If your company is accredited and you can supply the above information then you only need to complete Section 1 below.
If not accredited then ALL sections of Part D must be completed.
Section 1 / Competent Quality Management Advice
We enclose details of the appointed Quality Manager/ Co-ordinator and their qualifications and experience. / Yes No N/A
Section 2 / Quality Management Status
As the company is not certified to BS EN ISO 9001how is quality management controlled within the company.
We currently have a programme to achieve BS EN 9001 and attach details of our progress and details of when we hope to be accredited. / Yes No N/A
We currently work to a standard based on BS EN ISO 9001 and enclose details. / Yes No N/A
We currently do not have any quality management system in place and will therefore conform to the Quality Management System of your Main Contractor’s. / Yes No N/A
Section 3 / Work Experience & References
The company must demonstrate it’s competence with regard to the quality management on previous recent projects.
We enclose details of recent similar projects and the associate contact details to enable your Main Contractor’s to obtain references with regard to Quality Management performance. / Yes No N/A
PART E / Rail Associated Works
Section 1 / Link up Certification
We enclose a full schedule of services for which we have current Link-Up certification. / Yes No N/A
We enclose a copy of our current Link-Up Certification, Qualification Profile and most recent Audit. / Yes No N/A
Section 2 / Railway Safety & Assurance
We enclose a copy of our current approved Railway Safety Case / Yes No N/A
We enclose a copy of our current approved Contractors Assurance Case / Yes No N/A
Section 3 / Rail Sector Compliance
We enclose a copy of the company Drugs and Alcohol Policy and random testing of safety critical work personnel procedures. / Yes No N/A
We enclose details of the percentage of personnel randomly drugs and alcohol tested during the previous 12 months. / Yes No N/A
We enclose full details of the procedure for accessing the Railway Group and Network Rail Company standards and how this is documented. / Yes No N/A
We enclose full details on the procedures for ensuring all personnel have access to and are briefed on these standards. / Yes No N/A
Section 4 / Work Experience & References
The company must demonstrate it’s competence with regard to Health and Safety on previous recent projects.
We enclose details of recent similar projects and the associate contact details to enable your Main Contractor’s to obtain references with regard to Rail Works performance. / Yes No N/A
East + Supplier Appraisal / Issue No:1 / Issue Date:27/07/2016 / Page 1 of 1