SF/4

Tier 1 – Basic Grounds Maintenance only (teams with less than 5 employees)

FIELD TEAM/SUBCONTRACTOR QUESTIONNAIRE (SF4) TIER 1

Ground Control Limited is a national company who undertake works in a number of land based sectors. This includes Grounds Maintenance, Arboriculture (including electrical and rail), Pest Control, Construction, Landscaping and Gritting/Snow Clearance. As part of our Health, Safety, Quality & Environmental Assurance systems we require the following information to assess your suitability to be one of our approved field teams/subcontractors.

Please complete all sections of this form; if there are any questions that are not applicable to you mark as N/A.

GENERAL REGISTRATION

Company Name:
Contact Details / Company Address
Contact Name:
Job Title:
Mobile:
Telephone: / City:
Email: / County:
Website: / Postcode:
Ground Control delivers regular safety information, alerts and Tool Box Talks to all approved teams via text and email.
Company Type / Sole Trader / Partnership / Limited Company / Other (specify)
What is your geographical area of work e.g. Counties covered?
Where did you hear about Ground Control?

FINANCIAL INFORMATION

Company Registration
Number: / Bank Name:
Unique Tax
Reference: / Account Name:
VAT Registration
Number: / Sort Code:
Account Number:
Last 3 Years
Turnover / Year Ending:
Turnover: / Year Ending:
Turnover: / Year Ending:
Turnover:

Please ensure that you have registered in the CIS scheme. If not, please call 0300 2003210 and request to join the scheme, all you will need is your UTR number along with your NI (if sole trader) Co Reg(if company) or Partnership No (if partnership) it will only take a few minutes of your time. This will then enable us to offer you extra works or construction work within your area when available.

INSURANCE INFORMATION

Liabilities covered must be at least £2million each

Public Liability Policy Number and Expiry Date: / PROVIDE A CURRENT COPY
Employers Liability Policy Number and Expiry Date:
Professional Indemnity (if held):
Other (Please state):

NATURE OF BUSINESS/SCOPE OF WORK

Please indicate values of work undertaken

Up to £100 / £101 - £500 / £501 - £1000 / £1001 - £5000 / £5000+ / 24 Hour availability?
Grounds Maintenance / Soft Landscaping
Other (Specify)
Expected Hourly rate per man: £ / Expected Hourly rate per team: £
Examples of Clients / Private: / Commercial

REFERENCES

Contact: / Contact: / Contact:
Company: / Company: / Company:
Address: / Address: / Address:
City: / City: / City:
County: / County: / County:
Postcode: / Postcode: / Postcode:
Tel: / Tel: / Tel:

MANAGEMENT OF STAFF

How many people do you employ? / How many teams do you have?
What is your usual team number structure? e.g. supervisor and skilled operatives
(Some areas of the business require a specific team structure) / Supervisors / Ground Workers / Labourers / Other (specify)

SUPERVISION OF STAFF

Do you use trainees or young people?
For example: A Young person is anyone under the age of 18 years old / Yes / No
Are trainees directly supervised at all times by a person competent in the works being undertaken?
For example: When a trainee (holding PA1) is applying pesticides using a hand held applicator a qualified and competent operator (holding PA1 and PA6) must act as the supervisor at all times. / Yes / No / N/A
Do your supervisors receive any additional safety training? / (Specify)
Do you use overseas workers?
For example: Overseas workers whose first language is not English / Yes / No
If you do use overseas workers or young persons, what additional arrangements are in place, e.g. training assessment, visual aids? / (Specify)
Do your operatives ever work alone? / Yes / No
If yes, please explain your lone working process or provide a copy of your process if written: / PROVIDE A
COPY
Do you use subcontractors or labour only resource for all or part of your work?
Using subcontractors is not permitted for field teams working on behalf of Ground Control unless specifically authorised. / Yes / No
Do you provide drinking water, sun block, toilet facilities, etc for your employees while on site? / Yes / No
Do you provide a mentoring process for new staff? / Yes / No / PROVIDE A
COPY

OPERATIVE LIST

Name / Date of Birth / Job Title / N I Number
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

WASTE MANAGEMENT

What are your arrangements for the disposal of waste generated by your work? / (Specify)
Do you hold a Waste Carrier’s Licence? / Yes / No / PROVIDE A CURRENT COPY

ACCIDENTS AND INCIDENTS

Do you record and investigate accidents? / Yes / No / PROVIDE LAST INCIDENT / ACCIDENT COPY
Who is responsible and carries out accident investigations within your company and what documentation is produced? / Name: / Position
How many Near Misses/Close Calls have been reported during the past 12 months? / Number: / Details:
Has your company received any HSE, Environment Agency or SEPA enforcement notices and/or prosecutions, improvement or prohibition notices in the past three years? / Yes / No
If yes, provide details:

EQUIPMENT AND PPE

Please select the types of equipment you will have available should you be successful / Strimmers / Brushcutters / Pedestrian Mowers / Ride on Mowers
Chainsaws / Chippers / Powered Pole Pruners / Other
Specify any other equipment not listed above:
How often do you undertake equipment and machinery inspections? / Pre-Start / 6 Monthly / PROVIDE COPIES OF COMPLETED CHECK LISTS
Annual / Random
Do you use any lifting and lowering equipment e.g. ropes, harnesses, lanyards etc? / Yes / No / PROVIDE COPIES OF CURRENT LOLER CERTIFICATION
How do you issue and replace Personal Protective Equipment (PPE) / (Specify) / PROVIDE COPY OF COMPLETED RECORD OF ISSUE

COMPANY ACCREDITATIONS

Does your company hold any external accreditations? / CHAS / Safe Contractor / AA Approved Contractor / PROVIDE COPIES OF CERTIFICATES
Construction Line / Other (specify) / None
Please specify any other accreditations held that are not listed above:

TRAINING AND COMPETENCE OF STAFF

Ground Control requires that operatives carry their competency cards and records at all times. Teams are subject to random audits and inspections.

Please provide evidence of all training and/or competence for all employees that will be working on Ground Control contracts, e.g. copies of certificates of competence, CSCS Cards (front and back of card), ROLO, LANTRA & NPTC certificates / PROVIDE COPIES OF CERTIFICATES
If you are unable to provide formal training certificates please explain staff experiences and how many years practical experience they each have. / (Specify)
DBS (Disclosure & Barring Service) and CRB (Criminal Records Bureau)
We sometimes carry out work which may be classed as a regulated activity and requires a disclosure. Please indicate if you and your staff have any of the following? / None / Basic
Standard / Enhanced
If ‘no’, would you and your team be willing to complete checks if required? / Yes / No

HEALTH & SAFETY ARRANGEMENTS

Does your company have an induction process for new starters? / Yes / No / PROVIDE COPY OF PROCESS
How do you communicate safety messages to your staff? / (Specify)
How do the on-site staff access safety and environmental information? / (Specify)

RISK ASSESSMENTS AND METHOD STATEMENTS (RAMs)

Do you carry out your own risk assessments? / Yes / No / PROVIDE EXAMPLECOPY
How do you tell your staff about risk assessments and method statements? / (Specify)
How do you know where your teams are each day? / (Specify)
Explain how you manage occupational health risks, e.g. noise, vibration, stress. / (Specify)

OCCUPATIONAL HEALTH

Does your company have a procedure in place which sets out fitness to work and health surveillance standards? / Yes / No
Do you have an occupational health provider / Yes / No
Do they provide face to face screening? / Yes / No

ADDITIONAL INFORMATION

Please provide details of any other supporting information relevant to the questions you have answered in this application / (Specify)

DRIVER AUTHORISATION AND DECLARATION

I confirm that all driving licences submitted have been checked through the DVLA;
This will inform you of vehicles your staff are able to drive and penalty points and disqualifications.
Name:
Signature:

DECLARATION

I declare that the information provided in this application is true and correct to the best of my knowledge.
Name:
Signature:
Date:
Position:

Once complete, please return this questionnaire, and all supporting evidence, to Ground Control Ltd for review.

USEFUL LINKS TO HELP YOUR PQQ SUBMISSION

DVLA -

HSE -

NPTC / City & Guilds -

LANTRA -

Environment Agency -

Manual Handling online course link-

First Aid providers -

Issue No: 3.0Page 1 of 8Field Team/Subcontractor Questionnaire

Issuer: GPB / RB / EODIssue Date: March 2013

Document ref: SF/4 Tier 1 Basic GMLast Reviewed: September 2015