SUBCONTRACTOR DETAILS

JOB NO............................. – PROJECT.................................................

COMPANY DETAILS
COMPANY NAME: PHONE:
A.C.N. NO: FAX:
POSTAL ADDRESS: CONTACT:
MOBILE:
STREET ADDRESS: EMAIL:

COMPANY RESOURCES
NUMBER OF PERSONNEL: STAFF WAGES

TYPE OF BUSINESS: (MECHANICAL, BUILDING, ETC.)

SAFETY MANAGEMENT SYSTEM

DOES THE COMPANY HAVE A DOCUMENT SAFETY
YES NO
MANAGEMENT SYSTEM (COPY NEEDS TO BE SIGHTED)

WORKCOVER
INSURER: EMPLOYER NO:

PLEASE ATTACH ACOPY OF THE POLICY

PUBLIC LIABILITY
INSURER: POLICY NO:

AMOUNT OF COVER: EXPIRY DATE:

PLEASE ATTACH A COPY OF THE POLICY

PROFESSIONAL INDEMNITY INSURANCE

INSURER: POLICY NO:

AMOUNT OF COVER: EXPIRY DATE:

PLEASE ATTACH A COPY OF THE POLICY

PREPARED BY: TITLE:

SIGNATURE: DATE:
SUBCONTRACTORS DETAILS
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Subcontractors Details

SUPERANNUATION:
DOES THE COMPANY CONTRIBUTE TO A
YES NO
SUPERANNUATION SCHEME:

SCHEME NAME:

REGISTRATION NO:

LONG SERVICE LEAVE:

IS THE COMPANY REGISTERED WITH THE VICTORIAN
YES NO
BUILDING INDUSTRY LONG SERVICE LEAVE BOARD:

REGISTRATION NO:

REDUNDANCY:

IS THE COMPANY REGISTERED WITH THE INCOLINK

YES NO
REDUNDANCY SCHEME OR ANY OTHER SCHEME:

SCHEME NAME:

REGISTRATION NO:

DETAILS OF COMPANY CERTIFIED WORKPLACE AGREEMENT

PLEASE ATTACH A COPY OF THE SIGNED AND SEALED CERTIFICATION OF THIS AGREEMENT

PREPARED BY: TITLE:

SIGNATURE: DATE:

SUBCONTRACTORS DETAILS
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