Title Page

  • Site conducted

  • Company Name:

  • Assessment on behalf of (Lidl Contact):

  • Completed by:

  • Date of Assessment:

Assessment Criteria

Your assessment has been completed by one of our health and safety professionals in line with PAS91 and any additional Client requirements.

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Safetyform have assessed your submission based on the evidence provided in support of your assessment and the outcome of the assessment can be found on the front cover of this report.

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If the assessment was completed successfully then you will receive a letter from Safetyform confirming you were successful and will be added to the Client's list of approved contractor.

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If the assessment was unsuccessful you will receive details of why you were unsuccessful in the "Failed Items" section of this report. If you were unsuccessful, you will be required to submit further information in the areas identified to enable the assessor to re-evaluate your submission.

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**Please Note**

Safetyform will only re-evaluate any submission once, following the initial assessment. If after the second evaluation you are deemed to have been unsuccessful, you and the Client will be informed of the reasons why and the assessment will end and no further submissions will be considered unless authorised by the Client.

1. General Information

General Information

  • Registered Name:

  • Trading Name (if applicable):

  • Head Office Address & Postcode:

  • Main Contact Name:

  • Telephone Number(s):

  • Mobile Number(s):

  • E Mail Address:

  • Company Registration Number:

  • Company Status:

  • To what criteria is your company being assessed:

  • Description of products and services supplied:

  • Details of the type of work you are providing:

  • Confirm the geographical area you are willing to cover (miles from your offices):

  • Company Size:

2. Commercial Information

Commercial Information

  • Does your organisation hold any membership of any trade bodies or organisations:

  • Body Name:

  • Membership Number:

  • Body Name:

  • Membership Number:

  • Details of any accreditation bodies for which you are a member:

  • Other (please specify):

  • Details of Gross Turnover for last 3 financial years?

  • Year One (last Year):

  • Year Two:

  • Year Three:

  • Details of 3 projects undertaken in last 2 years similar to the work for which you wish to tender:

  • Contract One:

  • Contract Name:

  • Contract Value:

  • Brief Description of Project:

  • Contract Two:

  • Contract Name:

  • Contract Value:

  • Brief Description of Project:

  • Contract Three:

  • Contract Name:

  • Contract Value:

  • Brief Description of Project:

  • Please indicate the level of insurance cover for:

  • Public Liability:

  • Employers Liability:

  • Professional Indemnity:

  • Other (please specify):

  • Please detail any endorsements or restrictions on your policies?

3. Health and Safety

Health and Safety

  • Does your company have a Health & Safety Policy, aligned to the requirements of the HSWA 1974? (i.e. Policy statement, Organisation and Arrangements)?

  • Do you operate a process of risk assessment, capable of supporting safe systems of work?

  • Do you record and review accidents/incidents and undertake follow-up action?

  • Do you have arrangements for ensuring that your suppliers also apply H&S measures that are appropriate to the activities that your organization is likely to undertake?

  • Construction (Design & Management) Regulations 2015 (CDM)

  • Does your company ever undertake the role of Principal Contractor under CDM 2015?

  • If yes, please provide evidence as to how you comply with your duties as a Principal Contractor under CDM 2015?

4. Access to Competent Health & Safety Advice

Access to Competent Health & Safety Advice

  • Do you have ready access to competent H&S advice/ assistance?

  • Name:

  • Contact Number:

  • Contact Address:

  • Details of professional qualifications held:

  • How does your organisation stay updated in relation to H&S legislative requirements & changes?

5. Training

Training

  • Do all of your employees / others have H&S and other relevant skills, knowledge, experience and training to carry out the activities that your organisation is likely to undertake?

  • Has suitable evidence of training been provided?

  • Further evidence of training in the form of certification and licences is required before we can advise our client of your competency.

  • Does your company have a training & competence matrix for all your employees and managers?

  • Has a suitable training & competence matrix been provided?

  • Further evidence of training in the form of a training & competence matrix is required before we can advise our client of your competency.

  • Does your company regularly review staff training & competence?

  • It is advised that regular assessment of staff training & competence is undertaken at least once per year.

  • Please advise on the types of training evidence provided as part of the assessment - i.e. CSCS cards, SMSTS & SSSTS Qualifications etc.

  • Please state other qualifications or training cards held:

6. Accident Reporting

Accident Reporting

  • Please provide information on accidents & dangerous occurrences for the past 3 years & this year to date

  • DEATHS

  • Please provide details:

  • SPECIFIED INJURIES

  • OVER 7 DAYS

  • INJURIES TO PEOPLE NOT AT WORK

  • WORK RELATED DISEASES

  • DANGEROUS OCCURRENCES

  • GAS INCIDENTS

7. Enforcement Action & Prosecutions

Enforcement Action & Prosecutions

  • Has your organisation had any of the following notices issued by a HSE or a Local Authority Enforcing Officer in the last 5 years?

  • Improvement Notices?

  • How Many?

  • Please provide details of all Improvement Notices issued & corrective actions you took to resolve?

  • Prohibition Notices?

  • How Many?

  • Please provide details of all Prohibition Notices issued & corrective actions you took to resolve?

  • Has your company ever been prosecuted for breaches of Health & Safety Legislation?

  • Please provide details of prosecution(s) and outcome(s)?

  • During the past 5 years, has your company been prosecuted for contravening the Health and Safety at Work Act 1974 or any other legislation, or has your company been (or is currently) the subject of a formal investigation by the health and safety executive (HSE), local authority enforcement agency or any other

  • Please provide information relating to the offence and outcome.

8. Environmental

Environmental

  • Does your company hold any of the following environmental licenses?

  • LOWER TIER WASTE CARRIER LICENSE

  • UPPER TIER WASTE CARRIER LICENSE

  • WASTE MANAGEMENT LICENSE

  • OTHER (please specify):

9. Competence Assessment Checklist

Competence Assessment Checklist

  • Details of membership of any trade bodies or organisations (Please attach certificate)

  • Details of any accreditation or certification (Please attach certificate)

  • Details of gross turnover for last 3 full financial years

  • Copies of training matrix and certification

  • Details of insurance cover – enclose certificates or schedule of insurance

  • Full Health and Safety Policy aligned to the requirements of the Health & Safety at Work Act 1974

  • Examples copies of completed risk assessments and method statements

  • Example copy of a construction phase plan

  • A copy of your company accident policy and reporting procedure

  • A copy of your sub-contractor competence assessment questionnaire

  • A description of how you comply with your duties under CDM

  • A copy of your H&S advisor’s CV and qualifications

  • A copy of recent enforcement actions & how you have dealt with them?

  • A copy of your environmental licences

  • A signed copy of the declaration below by a company Director

10. Declaration Section

Declaration Section

  • Confirmation that either, a company’s Proprietor, Director, Partner or equivalent person has stated:

  • I hereby declare that all the information provided as part of this declaration is accurate to the best of my knowledge

  • Name:

  • Date:

11. Outcome of the Assessment

Outcome of the Assessment

  • Given the information provided in support of the assessment, Safetyform can confirm the contractor:

  • Dear Approved Contractor

    Lidl UK GmbH – Principal Contractor Health and Safety Competence Approval Letter

    Lidl has a legal duty under CDM 2015 Regulation 5 to appoint a Principal Contractor where there is more than one contractor on a project at any one time and to ensure their appointment have the skills, knowledge, experience and if an organisation the organisational capability to manage health and safety risk.

    Following your recent submission of the Appraisal Questionnaire and supporting documents, I am pleased to report that your company have met the requirements to act as a Principal Contractor as defined in L153 CDM 2015.

    This however does not mean you are accepted onto the Lidl Framework Agreement, only that you fulfil the health and safety requirements necessary for inclusion on their approved contractor list.

    The Team at Safetyform will visit selected projects during construction work and inspect and audit your company for Construction Health and Safety management and performance on site. We are instructed to report back to Lidl every month the results of these inspections and you should be aware that your continued inclusion on the List of Approved Contractors will be determined by your actual site performance. The site manager is provided with a verbal summary of our report at the end of each inspection.

    We will provide you with a copy of the Lidl Health and Safety Specification for Construction Works. This document is very important and contains all the requirements expected of Principal Contractor when carrying out works on Lidl sites. Your tenders will be deemed to include and provide for all the standards contained in this specification and it becomes an integral part of your contract with Lidl. You can therefore be assured that all contractors tendering for Lidl projects are working to the same standards of Health and Safety as yourself.

    H&S documentation is to concentrate on site specific issues only, making it easier for you to readily identify the additional Health and Safety measures required for inclusion within your tender submissions.

    It is not intended to distribute this specification with every tender document, and you are therefore required to carefully read it and ensure you always retain a copy for your records. Please also ensure you retain a copy of this letter.

    We would be pleased to respond to any comments or questions.


    Yours sincerely,


    Safetyform Ltd

  • Dear Contractor

    Lidl UK GmbH – Principal Contractor Health and Safety Competence Unsuccessful Letter

    Lidl has a legal duty under CDM 2015 Regulation 5 to appoint a Principal Contractor where there is more than one contractor on a project at any one time and to ensure their appointment have the skills, knowledge, experience and if an organisation the organisational capability to manage health and safety risk.

    Following your recent submission of the Appraisal Questionnaire and supporting documents, I regret to inform you that your company has not met the requirements to act as an approved Contractor as defined in L153 CDM 2015.

    Although your company has failed at this stage, this however does not mean you cannot re-submit your documents again for re-assessment, providing that the information requested or was missing in your first submission, is re-submitted as part of your second attempt.

    At this stage your Lidl contact will be informed of the outcome of your assessment and your company will not be added to the Lidl approved contractor list.


    We would be pleased to respond to any comments or questions.


    Yours sincerely,


    Safetyform Ltd

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