New Key Supplier Form - HL Landscapes

SUPPLIER / SUBCONTRACTOR DETAILS

Company Name *

ABN: *

Business Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Is your postal address different from your business address? *

Yes
No

Postal Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

COMPANY CONTACT DETAILS

Name *

Company Contact Phone number *

Company Contact Email *

Purchase Orders Email(s) *

Email(s) where Purchase Orders will be sent

COMPANY STRUCTURE

Type of setup *

Company
Trust
Sole Trader
Other

If 'Other' please nominate:

Do you have the below insurances? *

If so please attach copies below

Public Liability Details

WorkCover Details

Motor Vehicle Details

Plant & Equipment Details

If 'Other' please nominate:

Other Insurance File upload

Upload Copies of Insurances Here

Management Systems

AS4081:2001 – Health and Safety
ISO9001:2015 – Quality
ISO14001:2015 – Environment
Other

If 'Other' Management Systems please nominate:

If 'Other' Management Systems upload here:

Upload Copies of Certificates Here

Key Personnel *

First

Last

Key Personnel Add Another 1

Add another

Key Personnel (2)

First

Last

Key Personnel Add Another 2

Add another

Key Personnel (c3#

First

Last

CAPABILITY AND EXPERIENCE

Client 1

Project 1

Value 1

Date Completed 1

Add another Client 1

Add another

Client 2

Project 2

Value 2

Date Completed 2

Add another Client 2

Add another

Client 3

Project 3

Value 3

Date Completed 3

REFERENCES

Company Reference 1

Contact Name Reference 1

Position Reference 1

Phone Number Reference 1

Add another Reference

Add another

Company Reference 2

Contact Name Reference 2

Position Reference 2

Phone Number Reference 2

BANKING DETAILS

Financial Institution *

Account Name: *

BSB: *

Account Number: *

Payment Terms (days): *

Enter '0' if COD

Credit Limit ($ if applicable):

HL Account Number (if applicable):

SUPPLY ITEMS AND REGIONS

Supply Items:

If Supply Other:

Regions

If Region Other:

DECLARATION

Submitted by: *

First

Last

Submitted By Email: *

Submitter by Position *

Signed *

I have been authorized to complete this questionnaire and declare that all responses made in this questionnaire are true and accurate to the best of my knowledge and declare that I agree to follow and comply with all of HL Landscapes HSE rules, HSE Handbook requirements, Policies and Procedures whilst on any HL Landscapes controlled projects.

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