Please Provide a Primary and Secondary Contact If Possible

Please Provide a Primary and Secondary Contact If Possible

Appendix E
For completion by the Contractor
For the provision of
Minor Works and Responsive Repairs
(Contractor’s Name and Address)
In respect of Lots:


1. Contact Form

Please provide below the contact points for your organisation should the Council need to contact you. Please also provide summary details about your organisation e.g. size of company, resources, years trading etc.

Please provide a primary and secondary contact if possible

Organisation name and address:


Primary Contact:

Address (if different to above)

Secondary Contact:

Address (if different to above)

2.Mandatory Requirements

Contractors must satisfy these mandatory criteria before their bid will be considered further.


Please provide details of two referees in the table below. These should be organisations for which you or your organisation has undertaken similar work within the last 5 years. The Contractor must provide a reference from each of the referees. The form at Section 4 below should be used and attached to this Response Pack. It is not necessary to provide references if you currently provide a similar service for the Council.

Following the guidance above about appropriate references, please state the Company names, site addresses, telephone and contact names of two referees from whom references are attached.
Contact name / Position in company / Company name, full postal address, telephone number & email address / Date and nature of contact
Referee 1:
Referee 2:

2.2Health & Safety:

2.2.1Please provide any documentation which makes up your Health and Safety Policy. Please provide copies of any health and safety accreditations that the organisation holds, and qualifications of staff. As part of this arrangement Contractors are encouraged to hold Health and Safety Accreditation to reach the standard set in the Safety Systems In Procurement Standard (see

2.2.2Please provide at least two examples of Method Statements and Risk Assessments that you have previously used whilst carrying out work of a similar nature to the category for which you are bidding.

2.2.3Please provide details of any Health and Safety Executive (HSE) / local authority enforcement action taken against your organisation in the past 3 years.

2.2.4Please provide details of any accidents reportable under HSE legislation in the last 3 years and any remedial action taken by your organisation.


2.3.1Please confirm that your organisation has or can obtain the following cover, including insurance company, policy number, amount of cover and the date cover ends for existing insurance:-

Employer’s Liability (if appropriate) (£10m)

Public Liability (£5m)

2.3.2Have any claims in excess of £50,000 been made against your organisation within the last 3 years? If so, please provide details below:

3. Pricing Schedule

3.1Mandatory Pricing Requirements

Contractors should read and confirm statements 1-3 below prior to submitting prices.

Mandatory Requirements : / Delete as appropriate
1 / All costs are in pounds sterling and are exclusive of VAT / Confirm/Decline
2 / All costs are inclusive of all travelling / subsistence, expenses and disbursements / Confirm/Decline
3 / Prices have been provided on the basis of and inclusive of all the mandatory requirements / Confirm/Decline

3.2Pricing – Contractors to Complete (Attach additional information in relation to pricing if required)

Lot: / Normal Hourly Rate per operative (excl. VAT) 07:00-18:00 Monday to Friday
Note: Please identify any different rates for different levels of operative. E.g. skilled/unskilled
Any differences in rates for the first, and subsequent hours, should be highlighted / Outside of Normal Hours
Hourly Rate per operative
(excl. VAT)
Note: Please identify any different rates for different levels of operative. E.g. skilled/unskilled
Leave blank if you do not wish to undertake work outside of normal hours. / Preferred Locations To Work.
Please tick any preference(s) from Northallerton(N),Thirsk(T)Bedale(B) Easingwold(E)Stokesley(S)
N / T / B / E / S
Lot 1 Joinery
Lot 2 General Building Works
Lot 3 Drainage
Lot 4 Plumbing
Lot 5 Minor Civils Works
Lot 6 Electrical
Lot 7 Flooring Works
Lot 8 Painting and Decorating
Lot 9 Handyperson
Lot 10 Roofing
Lot 11 Glazing
Lot 12 Arboriculture

NOTE: Materials will be paid for by the Client at normal trade rates, or supplied by the Client. Any specialist equipment needed to carry out any works, and additional cost, shall be agreed in advance. Please advise of any additional charges for work outside of normal hours.



4. To: Hambleton District Council, Civic Centre, Stone Cross, Northallerton, DL6 2UU

Please be aware that the reference must be accurate and must not contain any material misstatement or omission and that any relevant factual content of this reference may be discussed with the supplier.

Supplier Name:
Your Name:
Job Title:
Organisation Name:
Organisation Address:
Contact Number:
Contact Email:

Section 1 Contract Details

Please provide a brief description of the goods or services supplied to your organisation.
a) Contract Start and End Dates: From To
b) Approximate Contract Value: Year 1Year 2Year 3Year 4
Section 2 Supplier Performance
A / Quality of Goods / Services Provided / Technical Knowledge / Excellent / Good / Fair / Poor
B / Invoicing and administration / Excellent / Good / Fair / Poor
C / Ability to resolve technical issues / queries / faults. / Excellent / Good / Fair / Poor
D / Delivery within targets / Excellent / Good / Fair / Poor
E / Reliability of the supplier / Excellent / Good / Fair / Poor
F / Approach to Health and Safety / Excellent / Good / Fair / Poor
G / Would you enter a new contract with this supplier? / Yes / No
Please use the space below to add any comments you think may be appropriate.