Howard Bros Joinery Ltd

SUB-CONTRACTORS H&S QUESTIONNAIRE

In order for us to assess your systems for managing health & safety, please
complete the form below and return to me by:

Company Details

Name of Company :

Address:

Contact Name:

Telephone No:

Fax No:

Email:

Membership of professional, trade and safety groups

Please provide details of membership of professional, trade and safety groups:

ATTACHED SUPPORTING INFORMATION YES / NO

Qualification and experience of key staff

Please provide details of training, qualifications and experience of key staff who have
management/supervisory responsibility

ATTACHED SUPPORTING INFORMATION YES / NO

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Health & Safety Assistance

Name of safety advisor (employee or consultant):

Experience and qualifications of safety advisor:

If applicable, consultant’s address and telephone number:

References

Please provide names and addresses of two companies who will provide a reference
concerning your management of health & safety on significant contracts:

Company 1 Contact:
Company 1 Name:
Company 1 Address:

Company 2 Contact:
Company 2 Name:
Company 2 Address:

Health & Safety Policy

Do you employ more than 5 people (including yourself)?

If yes, please attach a signed copy

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CSCS cards

Please confirm all operatives you will be sending to site has current CSCS cards

Safe Systems of Work

Please attach examples of risk assessments relevant to the work you will be
undertaking.

Please attach copies of typical method statements relevant to the work you will be
undertaking.

Briefly explain your system for producing project specific Risk Assessments and
Method Statements that take into account site specific conditions:

Briefly explain how you notify your employees / self employed subcontractors about the
risks they face and how they are made aware of the safe system of work for each job:

Hazardous Substances

Please list the materials or substances you use or are exposed to which are harmful or
hazardous such as paint / glues / finishes / solvents / MDF dust etc:

Have you undertaken a COSHH risk assessment for each of the above, identified
measures for controlling hazards and kept records of the assessment?

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Tools and Equipment

Explain briefly what steps you take to make sure all the equipment used (hired, owned
by you or owned by operatives) on company business is safe to use:

Safety Management

Explain briefly how you make sure your operatives are working safely to your rules and
the rules on site:

Explain how you provide relevant health and safety information and training to your
employees and self-employed subcontractors:

Accident / Incident Reporting

Please provide details of any accidents / incidents reported to the HSE under RIDDOR
either pending or in the past 5 years:

Health & Safety Executive Enforcement Action

Has any HSE enforcement action been taken against your company either pending or
in the past 5 years? This includes improvement or prohibition notices and
prosecutions:

Once complete, questionnaire and supporting information should be sent to;

Howard Bros Joinery Ltd, Station approach, Battle, East Sussex TN33 0DE

This section must be completed by a director, Partner or equivalent person.

I hereby declare that to the best of my knowledge the information provided as part
of this appraisal is accurate.

Signed Position

Print Date
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