PARISH NAME Contractor Competency Questionnaire

The purpose of this questionnaire is to obtain information from which PARISH NAME can assess the extent to which health and safety and its management are organised within your business.

  • Your answers should cover all your activities and not just those conducted on our sites.
  • The questionnaire should be completed a ‘responsible person’ within your business.
  • Please answer each question fully- remembering to substantiate answers with supporting documentation as far as practicable.
  • Your submission will be assessed and be taken into consideration in the evaluation process leading to a contract award decision.
  • Following receipt of your submission, we may wish to discuss it with your management team at a mutually convenient time.

Company Name:
Contact Name:
Address:
Tel/ Mob:
Email address:
Type of work being undertaken:
Relevant qualifications/ experience/ competency of persons undertaking the work:

Please answer the following questions and supply the information requested. Please note that the disclosure of the information as requested in Q6 & Q7 will not automatically mean exclusion from our list of contractors.

No. / Issue / Disclosure
1 / We require a copy of your current liability insurance certificate. Copy attached/ submitted? / Y/N
2 / Does your organisation have a Health and Safety Policy as required by the Health and Safety at Work etc Act 1974? / Y/N
3 / We require risk assessments/ method statements for the work you will be undertaking for the Parish/ Diocese. Copy attached/ submitted? / Y/N
4 / Who in your organisation has overall responsibility for management of health and safety? / Name/ Position
5 / Who on this site will be responsible for the health and safety of your day to day activities? / Name/ Position
6 / Has your organisation reported any accidents or incidents to the Health and Safety Executive (HSE) during the last 3 years under RIDDOR? / Y/N
7 / Has your organisation been subject to any prosecutions, prohibition or improvement notices issued by the HSE in the last 3 years? / Y/N
8 / Do you ensure the competence and health and safety compliance of your sub-contractors? / Y/N
9 / Do you undertake regular health and safety inspections and audits of your operations and arrangements and record the details in an inspection record? / Y/N
Contractor
Signed:
Print Name:
Position held:
Date:
Parish/ Diocese
Checked by:
Signature:
Position held:
Date: