Supplier & Contractor Form

Please complete the full details:

Company Name

Company Number

Company Address

Company Website

Main Contact Name

Main Contact Phone

Main Contact Email

Company Type (ONLY TICK ONE BOX)

Sections of Work (ONLY TICK ONE BOX)

Working Location / Geographic Area

Professional Indemnity Insurance

Public Liability Insurance

Employers Liability Insurance

VAT Status

UTR & CIS Status

National Insurance Number

Reference 1 (Company, Name, Phone, Email)

Reference 2 (Company, Name, Phone, Email)

Qualification or Certification