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									                                Scottish Water

              Contractor Competency Assessment Form


All information supplied within this questionnaire will be treated as confidential
and is required to be completed by all contractors working for Scottish Water,
prior to be being allowed to carry out any work on Scottish Water premises or
in public areas.

The information is part of the assessment of contractors to ensure that
Scottish Water allocates work to contractors who can carry out work safely.



Date of Application:

Supplier Name:

Contact Name:

Telephone No:

Mobile No:

Email address of the person completing the form:

Managing Directors Name:

Contact No:

Email Address:


Most contractors will require one of four types of external accreditation in order to
become an Approved H&S Contractor. Please select which one is applicable to your
organisation using the tick box (s) below. There are some exceptions to this general
rule – if you do not have any of these accreditations then submit this form and SW
will advise whether it is required.

We will also require your Achilles Verify No (if applicable) and OSHAS18001 /
CHAS or SAFEContractor certificate (if applicable).

      Accreditation                     Yes √                         No √
     Achilles Verify
      OSHAS18001
         CHAS
     Safe-Contractor


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Please advise what other accreditation your company currently holds (for example
RoSPA, and CITB) please provide details.


What types of work do you carry out?


How many years & what type of experience do you have for each of these types of
work?


How many employees do you have?



Accident Statistics (RIDDOR) – please provide statistics for the last 3 years
Year:
No of Fatalities
No of Major
Injuries
No of Dangerous
occurrences
No of Lost time
accidents


Please summarise the qualifications and training requirements for all employees, by
attaching a training matrix or by completing the table below. Please list vocational
training/qualifications/skills as well as ones directly related to H&S management

Role                                           Training Provided / Qualification
                                               Required




Can you please confirm which trades you can currently provide and which areas
throughout Scotland you can cover using the map provide in Appendix A.




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Referees – Please provide the names of two referees that Scottish Water would be
able to contact, to comment on your recent work (i.e. carried out in the last 12
months).

Company            Contact Name        Position          Telephone        Relationship
Name                                                     Number           to your
                                                                          organisation




Please provide details of your company’s insurance details and attach an electronic
copy of your certificate for Public Liability, Employer Liability, Professional Liability
(if applicable) and Product Liability (if applicable). [N.B. if you are a member of
UVDB then you only need to provide your supplier number – we will check your
insurance details]



Name ……………………...

Position within the company …………………………………………………………..

Date …………………………….

Email the completed form to approved.contractors@scottishwater.co.uk




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Appendix A



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