Appendix F Example of a Contractor Competency Questionnaire

6.1 Contractor Competency Questionnaire

As the client, the (organisation removed for confidentiality) has a duty under the Health and Safety at Work etc. Act 1974 (HASAWA) and the Construction (Design and Management) Regulations 2015 (CDM) to ensure that the Contractor engaged for work is competent to meet the obligations conferred on them by law.

To ensure we can meet the requirements of this duty the (organisation removed for confidentiality) use the Safety Schemes in Procurement Registered Members Scheme (SSIP) as a basis for evaluating contractor competence. If you do not have a current listing in SSIP that relates to the types of work required by the project, please complete this questionnaire and provide evidence in support of your submission.

Declaration
I confirm that the information I have given in this form is a true and accurate statement of my organisation’s Safety Management procedures.
Name of person completing this form:
Name of organisation:
Position in organisation:
Signature and date:
Section 1 – COMPANY INFORMATION
Name of Organisation: No. of Employees:
Address
Contact Name and Position:
Tel. No.: E-mail:

Insurance:

Employer’s Liability Insurance held:

Attach a copy of your policy

Insurer:
Policy No.:
Extent of Cover:

Insurance:

Public Liability (3rd party) insurance held: Attach a copy of your policy

Insurer:
Policy No.:
Extent of Cover:
Section ...

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