Title Page
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Company Trading Name
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Conducted on
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Prepared by
Company Details
Company Details
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Type of Business
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Registered Company Name
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Company ABN
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Street Address
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Town / City
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State
- NSW
- VIC
- TAS
- NT
- WA
- SA
- QLD
- ACT
- New Zealand
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Post Code
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Country
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Is the postal address different to your physical address
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Postal Address
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Town / City
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State
- NSW
- VIC
- TAS
- NT
- WA
- SA
- QLD
- ACT
- New Zealand
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Post Code
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Country
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Telephone Number
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Company Website
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Select the States you Operate In
- NSW
- VIC
- TAS
- NT
- WA
- SA
- QLD
- ACT
- New Zealand
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Business Type
Contact Details
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Company Contact Name
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Company Phone Number
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Company Email
Company Insurances
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WorkCover Certificates for each State you Operate In
- NSW
- VIC
- TAS
- NT
- WA
- SA
- QLD
- ACT
- New Zealand
NSW
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Insurer
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NSW WorkCover Expiry Date
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Upload the WorkCover Certificate
VIC
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Insurer
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VIC WorkCover Expiry Date
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Upload the WorkCover Certificate
SA
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Insurer
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SA WorkCover Expiry Date
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Upload the WorkCover Certificate
ACT
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Insurer
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ACT WorkCover Expiry Date
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Upload the WorkCover Certificate
WA
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Insurer
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WA WorkCover Expiry Date
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Upload the WorkCover Certificate
NT
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Insurer
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NT WorkCover Expiry Date
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Upload the WorkCover Certificate
QLD
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Insurer
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QLD WorkCover Expiry Date
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Upload the WorkCover Certificate
TAS
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Insurer
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TAS WorkCover Expiry Date
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Upload the WorkCover Certificate
Public Liability Insurance
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Do you have public liability insurance
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Insurer
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Public Liability Insurance Expiry Date
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Upload Evidence of the Insurance
Professional Indemnity Insurance
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Do you have professional indemnity insurance?
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Insurer
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Professional Indemnity Insurance Expiry Date
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Upload Evidence of the Insurance
Company Licences
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Company Licence
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Company Licence Expiry Date
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Upload Evidence of the Insurance
Company Documentation & Certificates
AUS/NZ and ISO Certificates
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Select the Applicable ISO or AUS/NZ Certificates
- ISO 9001 - Quality Management System
- ISO 45001 - Safety Management System
- ISO 14001 - Environmental Management System
- N/A
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ISO 9001 - Quality Management System
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ISO 9001 - Quality Management System Expiry Date
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Upload Evidence of the Certificate
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ISO 14001 - Environmental Management System
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ISO 14001 - Environmental Management System Expiry Date
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Upload Evidence of the Certificate
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ISO 45001 - Safety Management System
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ISO 45001 - Safety Management System Expiry Date
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Upload Evidence of the Certificate
Company Policies
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Select the Appropriate Company Policies
- Quality Management Policy
- Environmental Management Policy
- Safety Management Policy
- Drugs and Alcohol Policy
- Bullying and Harassment Policy
- Ethical Procurement Policy
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Safety Management Policy
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Upload the Policy as a PDF
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Quality Management Policy
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Upload the Policy as a PDF
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Environmental Management Policy
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Upload the Policy as a PDF
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Drugs and Alcohol Policy
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Upload the Policy as a PDF
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Bullying and Harassment Policy
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Upload the Policy as a PDF
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Ethical Procurement Policy
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Upload the Policy as a PDF
Compliance and Performance Questions
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Answer compliance questions using the Yes or No buttons. If for any reason you answer “Yes” to any of the questions in these two sections, ensure you have a clear comment explaining the reason for your Company not meeting these requirements.
Compliance and Performance Questions
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In the past 5 years has your company been convicted of any OHS breaches or been issued with a breach notice by the regulator
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Provide details of the breach or breach notice
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In the past 5 years has your company had a work place fatality
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Add details if possible
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In the past 5 years has your company had a safety incident that is notifiable to the regulator
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Provide details of the reportable safety incidents
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In the past 5 years has your company been convicted of any enviromental breaches or been issued with a breach notice by the regulator
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Provide details of the environmental breaches
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In the past 5 years has your company had a environmental incident that is notifiable to the regulator
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Provide details of the reportable environmental incident
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Have your organisation had any lost time injuries have you had in the past 12 months?
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How many lost time injuries have you had in the past 12 months?
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Has you company failed to complete or had a contract cancelled for any reason?
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Please Provide Details
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Are there any sanction claims or judgements outstanding against the company?
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Please Provide Details
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Any outstanding warrenties required to be satisfied on any prior completed contracts
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Please Provide Details
Vendor Representative Declaration
Vendor Representative Declaration
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I declare that the information above is accurate and true, and suitable evidence is provided
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Signature
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Job Title
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Date
Internal Use - Contractor Approval
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Please press "Complete Inspection" when you reach this page. This page is for internal use at time of company review.
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Reviewed By
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Review Date
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Review Outcome
