Company Name*
Address*
Street Address City County / State / Region ZIP / Postal Code Country
Contact Name*
First Last
Email*
Telephone*
Mobile
Fax
Website
Year of establishment*
Number of employees*
As your number of employees are less than 5, some of our requirements will not apply.
Please confirm status:*
- Supply Only
- Site Works Required
- Training or Recruitment
- Marketing
Who is your current Clarke Energy contact person?
Product/Service Supplied to Clarke Energy Ltd*
Scaffolding companies must be TG20:13 compliant and work to the NASC comprehensive guide to good practice. Please indicate this above.

SECTION 1 – QUALITY, ENVIRONMENTAL, SAFETY AND HEALTH

PART A - QUALITY
Are you certified to BS EN ISO 9001 or an equivalent standard?
- No
- Yes
SECTION 1 - 9001 UPLOAD*
Max. file size: 256 MB.

Please make a copy (pdf or image file) and call it SECTION1-9001.
A1) Do you Have a documented Quality Policy?*
- No
- Yes
SECTION1-A1*
Max. file size: 256 MB.

Please provide details or examples of your documented quality policy. Save the file as A1.

This provides evidence that your organization has and implements a quality management policy that is authorised by the Chief Executive or equivalent and periodically reviewed at a senior management level. The policy should be relevant to the nature and scale of the work to be undertaken and set out responsibilities for quality management throughout the organization. Signed & dated
A2) Do you operate a formal non-conformance procedure with records?*
- No
- Yes
Do you have arrangements for ensuring that your quality management, including the quality of output and general performance, is effective in reducing/ preventing sub-standard delivery?
SECTION1-A2*
Max. file size: 256 MB.

Please provide details or examples of your formal non-conformance procedure. Save the file as A2.
Test procedures. Non-conformance handling procedures.
A3) Do you have Inspection criteria’s for your goods/ services?*
- No
- Yes
Do you have arrangements for ensuring that your quality management, including the quality of output and general performance, is effective in reducing/ preventing sub-standard delivery?
SECTION1 - A3 UPLOAD*
Max. file size: 256 MB.

Please provide details or examples of your inspection criteria. Save the file as A3.

(Evidence that your Organization keeps copies of documentation setting out quality management organization and procedures that meet currently agreed good practice. These should include the arrangements for quality management throughout the organization. Quality Control plans. Quality inspection and/or testing Records.)

SECTION 2 – COMPANY COMPETENCY/TRAINING
Provide evidence that your organization has in place and implements, training arrangements to ensure that its staff/ workforce has sufficient skills and understanding to discharge their various duties. This should include refresher training (e.g. a CPD programme) that will keep the workforce updated on good H&S practice applicable throughout the company.
SECTION 2 – COMPANY COMPETENCY/TRAINING
As you have BS EN ISO 45001 or an equivalent. This section is covered.
Do you have a process for providing your employees/other workforce with training and other information appropriate to the activities that your organisation is likely to undertake?*
- No
- Yes
If yes, you will be asked to upload your policy.
Please attach a copy of your policy
Max. file size: 256 MB.

SECTION 3 SUB-CONTRACTING
Do you Sub-contract any part of your service?*
- No
- Yes
Comments regarding sub-contracting
Please include what percentages of jobs are sub-contracted.
If required Clarke Energy Ltd may audit your Quality Management System*
- No
- Yes
Comments

SECTION 5 – ACCOUNTS
Is your accounts payable address the same as the address given above?*
- No
- Yes
Accounts Payable Address
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
Vat Registration Number
Invoice Currency
Are You CIS Registered?*
- No
- Yes
CIS Number
Entity Type*
- Company
- Sole Trader
- Partnership (individual)
- Partnership (company)
Company Name*
Company Registration Number
Company Unique Tax Reference (UTR)*
Sole Trader Name*
Sole Trader National Insurance Number:*
Sole Trader Unique Tax Reference (UTR)*
Partnership (Individual): Full Names of the Persons with NI Numbers*
Partnership Unique Tax Reference (UTR):*
Partnership (Company) Name*
Full Names of the Persons with NI Numbers
Partnership Unique Tax Reference (UTR)
Partnership Registration Number*

SECTION 5 – ACCOUNTS CONTINUED

Details for BACS Payment
Please supply these details on official letterhead paper.
BANK DETAIL LETTERHEAD UPLOAD*
Max. file size: 256 MB.

Please provide bank details as a scan of letterhead paper. Save the file as SECTION5-BANK-DETAILS. Company bank details including: name & address of bank, account name, account number, sort code, IBAN, and BIC Code on official letter headed paper
Accounts Receivable Email
Please tick this box to confirm you have pre-existing/agreed terms between your company and Clarke energy UK or Ireland(excluding general purchase order std terms – these will be overridden by agreed terms). If so, please attach a copy of this agreement.
- I confirm
Please attach a copy of this terms agreement
Max. file size: 256 MB.
Please tick this box to confirm you are aware of and agree to Clarke Energy Ltd’s standard payment terms of 60 Days
- I agree
Copy of terms documents can be found below (opens in new window):
CEL-Standard-Terms-and-Conditions-of-Purchase-29.11.22
CEIL-Standard-Terms-and-Conditions-of-Purchase-Rev-A

SECTION 5 – INSURANCE

Supplier Insurance Checklist

Type of Supplier	Type of Policy	Minimum Requirement
Subcontractor - anyone doing work on site	Public liability	£2 million
Subcontractor - anyone doing work on site	Product liability	£2 million
Subcontractor - hot works on site	Public liability	£5 million (ideally £10m)
Subcontractor - heavy works (using plant ie digger, lifting eqipment etc.)	Public liability	£5 million
Supplier - supply only	Public liability	£2 million
Supplier - supply only	Product liability	£2 million
Survey/Design/Advice	Professional Indemnity	£1 million
Survey/Design/Advice - involving site visits or site works	Public liability	£2 million
Agents/Representatives	Public liability	£2 million

Do you have Public Liability Insurance?*
- No
- Yes
SECTION 5 - LIABILITY INSURANCE UPLOAD*
Max. file size: 256 MB.

Please provide details of your Public Liability Insurance. Save the file as SECTION5-LIABILITY-INSURANCE .
Do you have Product Liability Insurance?*
- No
- Yes
SECTION 5 - PRODUCT LIABILITY UPLOAD*
Max. file size: 256 MB.

Please provide details of your Public Liability Insurance. Save the file as SECTION5-PRODUCT-LIABILITY.
Do you have Professional Indemnity Insurance?*
- No
- Yes
SECTION5 - PROFESSIONAL INDEMNITY UPLOAD*
Max. file size: 256 MB.

Please provide details of your Professional Indemnity Insurance. Save the file as SECTION5-PROFESSIONAL-INDEMNITY.

SECTION 6 - DIVERSITY
As part of our supplier Diversity assessment and review, can you please advise which category your business would fall into;
Can you please advise if you would fall into what would be class as a minority enterprise group where the majority of the company is owned or operated by;
(Please only answer this if you feel comfortable to do so)

COMPANY DECLARATION

Clarke Energy Limited Terms of Payment are 60 days from date of invoice. This is none negotiable and will apply to all orders. By signing this form you are agreeing to the above payment terms.

As a senior officer of the company I hereby certify the responses given in this questionnaire are accurate and complete to the best of my knowledge
Name of Senior Officer*
Position*
Date*
DD slash MM slash YYYY
Payment Terms*
- Please tick this box to confirm you are aware of and agree to Clarke Energy Ltd’s standard payment terms of 60 Days
Declaration
- As a senior officer of the company I hereby certify the responses given in this questionnaire are accurate and complete to the best of my knowledge and agree to the Clarke Energy terms & conditions, provided for you below in pdf format.
Ticking this box indicates that you have read the General Conditions (see pdf file).

Questionnaire

Clarke Energy LTD. – Supplier/Contractor Approval Questionnaire

Step 1 of 12

SECTION 1 – QUALITY, ENVIRONMENTAL, SAFETY AND HEALTH

PART A - QUALITY

SECTION 1

PART B - ENVIRONMENTAL

SECTION 1

PART C - HEALTH AND SAFETY

SECTION 2 – COMPANY COMPETENCY/TRAINING

SECTION 2 – COMPANY COMPETENCY/TRAINING

SECTION 3 SUB-CONTRACTING

SECTION 4 – CORPORATE RESPONSIBILITIES

SECTION 5 – ACCOUNTS

SECTION 5 – ACCOUNTS CONTINUED

Details for BACS Payment

SECTION 5 – INSURANCE

Supplier Insurance Checklist

SECTION 6 - DIVERSITY

COMPANY DECLARATION

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