Form Builder

COMPANY DETAILS

Subcontractor Name

Operating Address

Post Code

Telephone

Mobile

Email address

Web Address

Registered Address

Registered Address Postcode

Type of Business

Company Registration No.

VAT Registration No.

CITB No.

UTR No.

The registering partners UTR number

Passport Number and Place of Issue (sole trader only)

Do you hold a current UK Driving Licence (sole trader only)

driving_license

If yes please list the number & attach a copy/ picture of the license.

CSCS Card Type and Number (sole trader only)

CSCS Card

If "Yes" please list the type of card, number & attach a copy / picture of the card

Do you have SMSTS / SSSTS Accreditation? (sole trader only)

SMSTS

If "Yes" please attach a copy / picture of the certificate

NI Number (sole trader / partnerships only)

Date of Birth (sole trader only)

Next of Kin: Name and Contact Number (sole trader only)

Annual Turnover

Bank Account Name

Bank Name

Bank Address

Sort Code

Account Number

INSURANCE DETAILS

Do you hold the following insurance?

*Please attach a copy of your current insurance certificates.
Documents are to be verified by KDM prior to you being able to operate on site.

Public Liability Insurance

Cover (£m)

Expire Date

Attach certificate

Employers Liability Insurance

Cover (£m)

Expire Date

Attach certificate

Contractors 'All Risk' Insurance

Cover (£m)

Expire Date

Attach certificate

Products Liability Insurance

Cover (£m)

Expire Date

Attach certificate

Professional Indemnity Insurance

Cover (£m)

Expire Date

Attach certificate

HEALTH & SAFETY

SSIP Certificate

Please supply if available a copy of your current SSIP (CHAS, Avetta, SAFE Contractor).
KDM will look to engage subcontractors in the first instance who can verify SSIP accreditation.

Please provide details of the person within your organisation who is responsible for health & safety

Name

Position

Telephone

Please provide details of any external advisor for health and safety

Company

Name

Position

Telephone

If employing more than 5 employees we require a copy of your health and safety policy

Copy attached

Have you been subject to any; prohibition or improvement notices in the last 5 years by the HSE?

If yes please attached a full description of the incident, report and how the issues were resolved

Upload prohibition or improvement notice documents

Confirm that all operatives who attend site will hold a current CSCS or affiliated card which is relevant to their work activity.

Confirm that, when applicable, all operatives on site will hold current asbestos awareness training

Risk and Method Statements

Please provide copies of recent Risk and Method Statements for works completed within the last 6 months

RECOGNITION & COMPETENCE

Do you carry out in house/external training?

If so please attach details?

Are you a member of any trade federations/accreditation, if so please list below?

Federation/Accreditation / Details / Date received / expiry

DECLARATION

I, the undersigned have read and agree to adhere to all KDM working policies and procedures and confirm that
the information provided is accurate.

Signed by Name

Signed by Position

Sign by Date

Disclaimer

*This document should be electronically signed by the Business Owner in the case of Sole Trader/Partnership or Director in the case of a Limited Company and forwarded by clicking on the Submit button below. Alternatively you can email a copy to subcontractors@kdmshopfitting.com. Please note that failure to submit this document for approval will delay any payments due to your business.