Become an Electrical Subcontractor - Online application

Fields marked with an * are compulsory.

Section 1 Company/Personal Details
Name*
Business Type*
Address
Telephone*
Fax Number
Email*
Website Address
Name of Parent or Holding Company:
Address of parent or Holding Company:
Registered Office Address:
Date of Registration(dd/mm/yyyy)
Registration Number
Number of Employees
VAT Number (if Applicable)
Type of Business*

Section 2 Contact Details
Contact Name*
Contact Position*
Contact Mobile Numbers*
Contact Email*

Section 3 Health Safety
Please Confirm whether you have a Health and Safety Policy*	If yes you may be asked to provide a copy at a later date.
Details of the person with overall H&S Responsibility:*
Has your Company had any prosecutions or notices in the last 3 years? If yes, please give details.*

Section 4 High Risk Trade
The following activities will classify your company as a High Risk Trade: Asbestos Removal, Demolition, Scaffolding, Working at heights e.g. Roofing Works etc
Please confirm whether your company is High Risk Trade. If yes, please give details.*

Section 5 Additional Skills Training
Please provide details of any relevant additional skills
Electrical Testing 2391:
Scissor Lift (IPAF):
Scaffold Assembly (PASMA):
Any Other:
Tick all that are applicable:
	Distribution Tray Work Basket Trucking and Distribution Systems Specialist Lighting Small Power and Lighting
Specialist Areas
Telecoms and Data Cabling	1st Fix 2nd Fix Commission
Nurse Call Systems	1st Fix 2nd Fix Commission
Fire Alarms	1st Fix 2nd Fix Commission
CCTV	1st Fix 2nd Fix Commission
Intruder Alarms	1st Fix 2nd Fix Commission
Control Systems	1st Fix 2nd Fix Commission
Heating and Ventilation	1st Fix 2nd Fix Commission

Section 6 References (worked with within last 2 years)
Reference 1
Contact Name*
Company Name*
Company Address*
Contact Number*
Email Address*
Reference 2
Contact Name
Company Name
Company Address
Contact Number
Email Address
Reference 3
Contact Name
Company Name
Company Address
Contact Number
Email Address

Section 7 Previous Contracts
Please provide details of contracts you have undertaken:
Contract 1
Contract Title*
Client*
Value*
Type of Work*
Contract 2
Contract Title
Client
Value
Type of Work
Contract 3
Contract Title
Client
Value
Type of Work

Section 8 Future Contracts
Please Give an indication of the future contracts wou would be interested in, stating minimum and maximum values of contracts you have resources to undertake:
Type*
Location*
Minimum*
Maximum*
Please confirm your willingness to operate nationally*

Section 9 Additional Information
National Insurance No:
CIS Registration No:
UTR No:
CSCS Card:
	Exp date
Public Liability Insurance Details:
Policy No:
Company:
Value:
Expiry: