PF-SC - Rev. C

VENDOR/ SUBCONTRACTOR PREQUALIFICATION FORM

PRIVACY COLLECTION STATEMENT

Edgecorp Constructions Pty Ltd (“we” or “us”) is committed to protecting the subcontractor or suppliers (“you” or “your”) personal information. We collect your personal information which will allow us to assess your suitability to engage you as a supplier or subcontractor; to respond to and assess incidents or matters which have been reported; and to establish a commercial relationship with your business. Occasionally, we may use your personal information for the purposes of marketing our products and services, sending electronic newsletters and promotional offers about our products and services. Should you wish to access, correct or update your personal information, make a complaint, report a breach of your privacy or would like a copy of our Privacy Policy, please contact support@edgecorp.com.au

1.1 VENDOR DETAILS

1.1.1 Registered Business Name

1.1.2 Date

1.1.3 ABN

1.1.4 ACN

1.1.5 Address

1.1.6 Suburb

1.1.7 State

1.1.8 Postcode

1.1.9 Country

1.1.10 Business Phone

1.1.11 Fax Number

1.1.12 Email Address

1.2 KEY CONTACTS DETAILS

Please provide contact details of your team.

1.2.1 Primary Contact

1.2.2 Mobile Number

1.2.3 Email Address

1.2.4 Role

1.2.5 Secondary Contact

1.2.6 Mobile Number

1.2.7 Email Address

1.2.8 Role

1.2.9 Third Contact

1.2.10 Mobile Number

1.2.11 Email Address

1.2.12 Role

1.3 COMPANY OVERVIEW

Describe your company and list the number of your employees.

1.3.1 Trade

Please provide a list of the products and services your company provides.

1.3.2 Type of Business

1.3.3 Nature of Business

1.3.4 Years Trading

1.3.5 Management Department

Number of employees.

1.3.6 Project Management Department

Number of employees.

1.3.7 Trade Department

Number of employees.

1.3.8 Admin Department

Number of employees.

1.3.9 Sales Department

Number of employees.

1.3.10 WHS/EM Department

Number of employees.

1.4 INSURANCES

Please provide policy numbers and copies of your insurances. Refer to attachments checklist at the end of the form to upload your insurance certificates of currency.

1.4.1 Workers Compensation

1.4.2 Public/Product Liability

1.4.2.1 Limit Amount ($)

1.4.3 Contract Works

1.4.3.1 Limit Amount ($)

1.4.4 Professional Indemnity

1.4.4.1 Limit Amount ($)

1.5 RELEVANT LICENSES

Please provide details and copies of your contractor licences. Refer to attachments checklist at the end of the form to upload your contractor licences.

1.5.1 Contractor Licences (relevant in your State)

1.5.2 Other Licences

1.6 FINANCIAL DETAILS

1.6.1 Registered for GST

Please provide a copy of your registration. Refer to attachments checklist to attach your GST registration.

1.6.2 Financial Institution

1.6.3 BSB Number

1.6.4 Account Number

1.6.5 Account Name

1.6.6 Authorised by

2.1 QUALITY MANAGEMENT

2.1.1 Do you have a Quality Management System?

2.1.2 Do you have a Quality Assurance Policy?

Does your Company have procedures for:

2.1.3 Design Control

2.1.4 Document Control

2.1.5 Inspection and Testing

2.1.6 Corrective and Preventive Actions

2.1.7 Internal Auditing

2.1.8 Customer Feedback

2.1.9 Training

2.2 ENVIRONMENTAL MANAGEMENT

2.2.1 Do you have an Environmental Management System?

2.2.2 Do you have an Environmental Management Policy?

Does your company have procedures for:

2.2.3 Environmental Planning

2.2.4 Waste Management

2.2.5 Noise Management

2.2.6 Spill Control

2.2.7 Environmental Aspect & Impact Analysis

2.3 WHS MANAGEMENT

2.3.1 Do you have a Company Safety Management System?

2.3.2 Do you have a Health & Safety Policy?

2.3.3 Are WHS roles & responsibilities clearly identified for all levels of staff?

2.3.4 Have you prepared Safe Work Method Statements relevant to your operations?

2.3.5 Do you keep up to date with changes to WHS legislation, A.S. and Industry Specific requirements and ensure changes are incorporated into work procedures?

2.3.6 Do you prequalify all subcontractors you may engage?

2.3.7 Do you/your workers hold an Industry Construction card?

2.3.8 Are records of toolbox talks held?

2.3.9 Are regular WHSE inspections at worksites undertaken and records held?

2.3.10 Does your company have any permit to work systems?

2.3.11 Please list all your permit to work (Hot Works, Confined Spaces etc.)

2.3.12 Are incidents & injuries recorded, investigated and records held?

2.3.13 Do you have procedures for maintaining, inspecting & assessing the hazards of plant operated / owned by you?

2.3.14 Do you have procedures for identifying, assessing & controlling risks associated with manual handling?

2.3.15 Do you have procedures for identifying, assessing & controlling risks associated with working at heights?

2.3.16 Do you have procedures for identifying, assessing & controlling risks associated with confined space?

2.3.17 Do you have processes ensuring the risks associated with managing traffic (including pedestrian) are appropriately controlled?

2.3.18 Are all portable electric tools & equipment inspected/tagged and records available?

2.3.19 Electrical Safety - do you have provision for ensuring isolation procedures (to ensure that no work is performed on ‘live’ equipment)?

2.3.20 Do you have procedures for storing & handling hazardous substances?

2.3.21 Do you provide your workers relevant PPE?

2.3.22 Do you have a procedure for identifying & controlling non-conformances?

2.3.23 Do you maintain a record of all training & induction programs undertaken?

2.3.24 Do you assess the competency of your workers?

2.3.25 Are workers involved in decision making over WHSE matters?

2.3.26 Do you have a system for recording & analysing WHSE performance statistics?

2.3.27 Have you ever been convicted of a WHSE offence?

If yes, please provide details.

2.4 WHS PERFORMANCE

2.4.1 LTI - Number of Lost Time Injuries

2.4.2 MTI - Number of Medical Treated Injuries

2.4.3 FAI - Number of First Aid Injuries

2.4.4 NM - Number of Near Misses

2.4.5 EI - Number of Environmental Incidents

2.4.6 IA - Number of Incidents Reported to Authorities

Comments

2.5 CORPORATE AND SOCIAL RESPONSIBILITY

2.5.1 Do you have a Corporate Social Responsibility Policy?

2.6 CONFLICT OF INTEREST

2.6.1 Do you have a Conflict of Interest Policy?

3.1 EXPERIENCE & REFERENCES

Please provide details for the 5 most recent projects/services completed/provided by your Company.

3.1.1 Client Name

3.1.2 Client Number

3.1.3 Client Role

3.1.4 Details of product/services provided

3.1.5 Value of the project

3.1.6 Completed on time

3.2.1 Client Name

3.2.2 Client Number

3.2.3 Client Role

3.2.4 Details of product/services provided

3.2.5 Value of the project

3.2.6 Completed on time

3.3.1 Client Name

3.3.2 Client Number

3.3.3 Client Role

3.3.4 Details of product/services provided

3.3.5 Value of the project

3.3.6 Completed on time

3.4.1 Client Name

3.4.2 Client Number

3.4.3 Client Role

3.4.4 Details of product/services provided

3.4.5 Value of the project

3.4.6 Completed on time

3.5.1 Client Name

3.5.2 Client Number

3.5.3 Client Role

3.5.4 Details of product/services provided

3.5.5 Value of the project

3.5.6 Completed on time

4.1 FINANCIAL CAPACITY

4.1.1 Capacity to achieve subcontractor value up to $ 100,000?

4.1.2 Capacity to achieve subcontractor value between $100,000 up to $250,000?

4.1.3 Capacity to achieve subcontractor value between $250,000 up to $500,000?

4.1.4 Capacity to achieve subcontractor value up to $1,000,000?

Please provide any further comments to assist with your Subcontractor Assessment

5.1 ATTACHMENTS

Please use the checklist to ensure required documentation is provided.

Public/Product Liability

WorkCover

Contract Works Insurance

Personal Income Protection

Professional Indemnity

WHS Management System

SWMS

Construction Card

Permits to Work

QA Management System

EMS Management System

CSR Policy

Conflict of Interest Policy

EBA

Any Accreditations

Other

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