Supplier information form

Are you a company, LLP or sole trader?Company/LLPSole trader

Company/LLP name

Unincorporated partnership state firm’s name and list partnership names

Your name

Trading name

Company/LLP registration number

National insurance number

Your unique tax payer reference (UTR)

Are you VAT registered?YesNo

VAT registration number

Registered company address

Postcode

Website

Accounts personnel name*

Accounts personnel email address*

Accounts personnel phone number*

Sales personnel name

Sales personnel email address

Sales personnel phone number

Goods / services offered

Geographical coverage

Company insurance details

Do you have professional indemnity insurance?*

If yes, please provide evidence by attaching documents/certificates at the end of this form

YesNo

Do you have public liability insurance?*

If yes, please provide evidence by attaching documents/certificates at the end of this form

YesNo

Do you have employer liability insurance?*

If yes, please provide evidence by attaching documents/certificates at the end of this form

YesNo

Any other relevant insurance?

If so, please describe and provide evidence by attaching documents/certificates at the end of this form

Business practices

Do you employ more than 5 people?

YesNo

Do you have a health & safety policy in place?

If yes, please provide evidence by attaching documents/certificates at the end of this form

-YesNo

Do you operate a documented health & safety management system?

YesNo

Is your health & safety management system certified to a recognised standard with a UKAS accredited third party certification body?

If yes, please attach a copy of your certificate at the end of this form. If no, please attach details of processes that ensure health & safety management of your services

-YesNo

Are you registered with the SSIP?

If yes, please provide evidence by attaching documents/certificates at the end of this form

-YesNo

Do you operate an environmental management system (EMS)?

If yes, please attach a copy of your certificate at the end of this form. If no, please attach details of processes that ensure environmental management of your services.

YesNo

Have you adopted or work to any environmental guidelines or procedures for your main environmental issues?

If yes, please provide evidence by attaching documents/certificates at the end of this form

YesNo

Do you operate a quality management system (QMS)?

YesNo

Is your QMS certified to a recognised standard with a UKAS accredited third party certification body?

If yes, please attach a copy of your certificate at the end of this form. If no, please attach details of processes that ensure quality management of your services.

-YesNo

Do you have a Data Protection policy in place to evidence compliance with the General Data Protection Regulation (GDPR)?

If yes, please provide evidence by attaching documents/certificates at the end of this form

YesNo

Do you operate an Information Security/Cyber Security System or work towards related procedures/policies?

If yes, please provide evidence by attaching documents/certificates at the end of this form

YesNo

Is your Information Security System / Cyber Security policy certified to a recognised standard with a UKAS accredited third party certification body?

If yes, please attach a copy of your certificate at the end of this form. If no, please attach details of processes that ensure Information/Cyber Security management of your services

-YesNo

Do you have a Corporate Responsibility policy or arrangements in place to manage the wider sustainability (environmental and social) implications of your services/products?

If yes, please provide evidence by attaching documents/certificates at the end of this form

YesNo

Do you have a statement and/or policy against modern slavery?

If yes, please provide evidence by attaching documents/certificates at the end of this form

YesNo

Do you have arrangements in place for business continuity?

YesNo

Do any of the following apply to/in your business?

If yes, please provide evidence by attaching documents/certificates at the end of this form

REACHRoHSConflict Minerals Statement

References

Has your organisation worked for Environmental Instruments Ltd during the last year?

YesNo

Please provide dates and description of the work undertaken with us

Include project number(s) where relevant

Please provide reference information from two companies who you have worked with in the last year

Include name of companies, scope of work and the fee value

Attachments

Please attach any supporting certificates, documents and evidence as required

Alternatively, or for larger files, please send us the documents in a separate email to purchasing@aqmesh.com after completing this form

GDPR

Yes, I give permission to store and process my request.