PF035.1 Supplier Qualification Questionnaire (Non Safety Critical) PF035.1 SUBCONTRACTOR / SUPPLIER PRE-QUALIFICATION QUESTIONNAIRE INITIAL REQUEST FOR INFORMATION Please complete this questionnaire and return to ECS with all supporting documentation as requested. PF035.1.3 SUPPLIER RISK ASSESSMENT The following questions support with assessing which category the required supplier is applicable Proposed Supplier Name * Address * Address Address Address City City County County Post Code Post Code Address Main Contact Name * Main Contact Name First Name First Name Last Name Last Name Main Contact Email Main Contact Phone Number * Type of Business * Trading AccountSub Contract Off SiteSub Contract On SiteSupply of ServicesPlant & Equipment HireSupply of Training ServicesOther Type of Business Supplier Accreditation Risk Assessment 1. Is the value of the order with the supplier of strategic significance on your contract? * YesNo 2. Is the trade already identified as high risk or accredited? * YesNo 3. Is the supplier providing design services? * YesNo 4. If the material/service supplier fails to deliver on goods or services will this have serious consequences on the job timescale and cost? * YesNo 5. Is the supplier working in high risk environment (highways, excavations, working at height, water, rail, confined spaces, plant operations etc)? * YesNo 6. Does the work the supplier is completing impact on: Refuelling on Site, Treatment/Disposal of Waste, Using Chemical &/or involves the treatment and management of vegetation? * YesNo 7. Is supervision or monitoring required for the supplier / contractor for the works they are procured? * YesNoN/A 8. Is the supplier providing their own risk assessment and/or safe system of work? * YesNoN/A 9. Are the supplier’s competency certification required for the procurement? Such as: PTS/COSS/CPCS/POS Rep etc, and other required electrical competencies? * YesNoN/A 10. Is the supplier a provider of calibrated equipment? Such as crimping tools & testing equipment. * YesNo ** YOU ANSWERED YES TO ONE OR MORE OF THE QUESTIONS WITHIN THE RISK ASSESSMENT - THE SUPPLIER IS DEEMED AS "SAFETY CRITICAL" ** SEND THE SUPPLIER THE LINK FOR THE: : Safety Critical Questionnaire Risk Assessment Completed by: Name * Name First Name First Name Last Name Last Name Email * Date * Signature * signature keyboard Clear Upload any supporting information Prior to Submitting the Risk Assessment Drop a file here or click to upload Choose File Maximum file size: 67.11MB Part 1 Company Information Supplier Name (Trading) * Company Reg Number * VAT Number * UTR Number * Address * Address Address Address City City County County Post Code Post Code Address Contact Name * Contact Name First Name First Name Last Name Last Name Phone * Email * Bank Details: Billing Details Bank * Account Name * Address * Account Number * Sort Code * Default Terms (Trading) Go to top Brief Description of Services Provided to ECS: * List your main Risk Areas (Safety Critical Suppliers): * Submit If you are human, leave this field blank.
