Title Page

  • Conducted on

  • Full Name

  • Address

  • DOB

  • Email

  • Telephone No

  • Mobile No

Company / Employment Status

  • Company Type (Select Option

  • Name & Title of Dirctors / owner

  • Company Registration No

  • VAT No

  • NI No

  • UTR No

  • No Direct (PAYE) employees (Office Based)

  • No Direct (PAYE) employees (Site Based)

  • No of Available Subcontractors (Site Based)


  • Please upload photos of the following ID - If you do not have a driving licence or passport please leave blank.

  • Driving Licence Front

  • Driving Licence Back

  • Passport


  • Please attached a copy of all relevant insurance certificates and include details below

  • Insurance Type (eg Public Liability)

  • Policy No

  • Expiry

Working Environment

  • Do you or any of your employees know of any circumstances that would affect their ability / eligibility to work in the following environments ?

  • Education Sector

  • Retail

  • Finance

  • Call Centre

  • Warehouse / Factory

  • Residential

Trade Experience

  • Please give a brief description of experience for each category, include any Projects worked on , Training etc.

  • No of Years Experience

  • Manufacturing Training

  • Industry Training

Company Certification (if applicable)

  • Please attach a copy of all relevant certificates

  • CHAS

  • Safe Contractor

  • Construction Line

  • Do you have arrangements for ensuring that you apply quality management measures that are appropriate for the work you are being engaged (if yes please add details)

  • Do you meet the requirements of the positive equality duties in relation to the Equality Act 2010


  • Please attach copies of all training certificates

  • ECS / CSCS - This is mandatory (attached copy of card front & back)

  • Asbestos Awareness - This is mandatory (attach copy of in date certification)

  • Manual Handling - This is mandatory (attach copy of in date certification)

  • Working at Height - This is mandatory (attach copy of in date certification)

  • First Aid

  • IPAF


  • Other (please list)


  • Please answer Yes , No, In Progress to any of the security clearances listed below & Include all ref / Expiry's. If you have any that aren't listed please add in 'other' section and include expiry

  • DBS (CRB) Disclosure and Barring Service

  • MOD (Ministry of Defence)

  • MOJ (Ministry of Justice)

  • Other

Tool & Equipment

  • Please select if you have any of the following

  • Vehicle

  • Roof Rack

  • Steps

  • Testing Equipment

  • Cordless Drill

  • Extension Ladders


  • Please list two references that you are happy for us to contact.

  • Company Name

  • Contact Name

  • Job Title

  • Address

  • Telephone No

  • Email

  • Company Name

  • Contact Name

  • Job Title

  • Address

  • Telephone No

  • Email

Emergency Contact

  • Provide contact information of someone we can contact in case of an emergency

  • Name

  • Address

  • Telephone No

  • Mobile No

  • Email


  • If you are using your own vehicle please attach a copy of your insurance certificate and supply details below

  • Vehicle Registration Number

  • Vehicle Make / Model & Colour

  • Insurance Type & Expiry *attach insurance certificate if applicable

  • We use the DVLA service to check licence information, for example, vehicles that can be driven, penalty points or disqualifications. Please use this link to generate a code or visit https://www.gov.uk/check-driving-information

  • DVLA Code

  • Last 8 Characters of Driving Licence number

Vehicle Handbook & Policy

  • Please confirm you have read and understood the vehicle handbook and Policy reference P-13.https://www.dropbox.com/sh/9he02re65bvlx26/AADcOXDGWCcfdrP6Eeyn3_mqa?dl=0

Policies & Agreements

  • Listed below are the company policies and procedures, please take the time you read and confirm you have read and understood. Should you have any queries please don’t hesitate to contact us. https://www.dropbox.com/sh/9he02re65bvlx26/AADcOXDGWCcfdrP6Eeyn3_mqa?dl=0

  • P-01 Equality and Diversity Policy P-02 Quality Policy P-03 Environmental Policy P-04 Anti Bribery /Corruption Policy P-05 Modern Slavery & Human Trafficking P-06 Security Policy P-07 Ethics and Business Integrity Policy P-08 Data Protection Policy P-09 Health & Safety Policy P-10 Ethical Sourcing Policy Statement P-11 Recruitment & Selection Policy P-12 Communication Policy P-13 Vehicle Handbook & Policy P-14 Code of Conduct Policy P-15 Performance Appraisal Policy P-16 Alcohol & Drug Abuse Policy P-17 Safe Handling & Safekeeping of DBS Certificate Info P-18 Social Media Policy

  • Select the link to view the company Confidentiality Agreement (P-19) Once reviewed please sign in field provided.


  • PLEASE ENSURE YOU HAVE READ IN FULL & SIGN THIS SECTION AFTER YOU HAVE COMPLETED ALL PARTS OF THE FORM. All work orders shall be accomanied by an official C-Tech Solutions purchase order for a fixed value. Should the value be amended, i.e variation, this shall not be recognised unless confirmed in writing and agreed by C-Tech Solutions Ltd.

  • Should any of your details within this document change, it is your responsibility to inform C-Tech Solutions by writing with reasonable notice. Changes must be acknowledged by C-Tech

  • Signed

  • Date

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.