PRE QUALIFICATION QUESTIONNAIRE Tender ... - Dorsetforyou.com

DORSET COUNTY COUNCIL Page 21 of 33Dorset ProcurementDorset (Weymouth & Portland) RTPI Contract (Tender No. T18470)5. HEALTH & SAFETY5.1 Do you have a Health & Safety Policy Statement of Intent? If so, pleasesupply details.YES/NO5.2 Do you have a Health & Safety Officer appointed who is a ‘Competent Person’in Health & Safety and who can provide advice for the duration of thecontract?YES/NO5.3 If you answered ‘NO’ to 2 above, do you have access to a Qualified Healthand Safety Consultant who can provide advice on Health and Safety mattersfor the duration of the contract?YES/NO5.4 Do you have a Health & Safety Risk Assessment Procedure? If so, pleaseprovide details.YES/NO5.5 Have you, in the past 3 years, been convicted of a criminal offence or gravemisconduct regarding Health & Safety Matters?If YES please give full detailsYES/NO5.6 For the last 3 years, please provide detail of your Company’s AccidentFrequency and Incident Rates:Frequency Rate (AFR) = Number of injuries (all categories) x 1,000,000 =Man hours workedIncident Rate (AIR) = Number of injuries (all categories) x 100,000 =Average No. of Employees2007 2006 2005Version: 06Date: 09/09/2009