Contractors Competency

Questionnaire - CCQ2

IMPORTANT NOTE: Please complete this form fully and use Guidance Notes (GD2) for further details of required information.

Section 1: General Information about the company:

Company Name:
Full Address:

Office Use
Only
Guidance Sppld N/A Pass Fail
Note
Contact name/s (for questions/correspondence relating to this form): 1

Contact details:
Tel No.(s) 2
Fax
Email
Full description of the nature of the company's work: 3

Number of employees: 4

Section 2: General Documentation:

Please provide:
2.1: Your company's Health & Safety Policy including arrangements made for dischargning your duites under the CDM2007 5
regulations.
2.2: A current, signed & dated Health & Safety Statement. 6

2.3: A company organisation chart that includes the person/persons who is/are responsible for Health & Safety within the
company. 7

2.4: Full details of any/all external Health and Safety consultants/advisers, evidence of their competence and written 8
experience of their work in the construction sector.
2.5: Full details of any internal Health and Safety professional and evidence of their competence. 9
2.6: Full details of the arrangements you have in place to assess the competence/suitability of any subcontractors and/or
consultants you may use to carry out work - including: 10
- Their Insurance
- Their Training
- Their own arrangements for appointing further sub-contractors and/or consultants.
2.7: A copy of your Employers Liability Insurance certificate clearly showing
- The Insurance company 11
- The period (dates) of cover
- The cover value (Min £10,000,000)

2.8: A copy of your Public Liability Insurance certificate clearly showing

12
- The Insurance company
- The period (dates)of cover
- The cover value (Min £5,000,000)

2.9: Full details of any claims made against any of the Insurance policies within the last 5 years. 13

Section 3: Training & Information:

Please provide:
14
3.1: A detailed TRAINING MATRIX showing:
- the training category
- the employee name
- the date received
- future training courses booked
 Office Use
Only
Guidance Sppld N/A Pass Fail
3.2: Health & Safety training: Note

Proof/Evidence detailing the Health and Safety training and competence of employees who will be carrying out work:
- CSCS card accreditation 15
- CITB training (Proof/Evidence detailing the Health and safety training attended by persons who manage or 16
supervise work on site).
- Proof/Evidence detailing the Health and safety training attended by Directors. 17

3.3: First Aid Training:

- Provide details and evidence/proof of any First Aid training. 18

3.4: Other training:

Provide details and evidence/proof of any additional training for site operatives for the works they are carrying out 19
- on-site induction record (for individuals)
- evidence of on-site toolbox talks
- asbestos awareness
- use of plant
- specific tools
- other

Section 4: Accidents:

Please provide:
20
4.1: Full details of your company's reporting procedure for ALL accidents.
4.2: The number, type and details of REPORTABLE accident/diseases that have occurred within the last 3 years. 21

4.3: Details of ALL non-lost-time accidents and civil claims made within the last 3 years. 22

4.4: Details of how all acidents are investigated including follow up actions to prevent recurrence. 23

Section 5: Prosecutions and Notices:

Please provide:
5.1: Full details of ANY/ALL prosecutions and convictions under Health and Safety legislation within the last 5 years. 24

5.2: Full details of ANY/ALL improvement or prohibition notices issued against the company within the last 5 years. 25

Section 6: Workforce involvement:

Please provide:
6.1: Details and evidence of workforce consultation on Health & Saftety matters. 26

Section 7: Control of Work:

Please provide:
7.1: Details of how Health & Safety is supervised when working on site. 27

7.2: Details of what welfare provisions are provided for operatives on site. 28

7.3: Copies of a previously used risk assessment and the method statement relating to it - demonstrating how you assess and
control work. 29
7.4: Details of how will you ensure co-operation and co-ordination between your employees and other contractors and/or
staff on site? 30

7.5: A copy of any PERMIT TO WORK or HOT WORK permits:

- provided by your company to any sub-contractor 31
- provided by a site to your company.
7.6: Details of how you assess & control COSHH materials. 32

7.7: Details of how you assess and & control working at height. 33

7.8: Details of the procedures used for the disposal of ALL waste generated from site works. 34

Section 8: Resources:

Please provide:
8.1: Full details of your experience in carrying out previous similar work: 35