Sub-Contractor Registration Form

Address *

Insurance *

Yes

N/A

Public Liability - min $10M

Professional Indemnity

WorkCover

Plant / Equipment / Vehicle

Marine Cargo (transport only)

Labour Hire Licence

Upload Insurance Certificates

Browse Files

Cancel of
Compliance
Has your company ever been given an improvementnotice/fine/conviction from any government authority? *
Details *
Have the directors or the company ever beenbankrupt? *
Details *
Has your company ever been in receivership or administration or has a suspension of trade placed against them? *
Details *
Have the directors ever been convicted of bribery,fraud or any other criminal offence? *
Details *
Declaration - *

True and correct to the best of my knowledge
Name *

First Name Last Name
Position *
Date *

Day Month Year
Date
Signature

Clear
Disclaimer

This document is not an approval to conduct work for Comiskey Mining Services PTY LTD, any approvals will be in writing via a contractor service agreement, written request and or purchase order. Any breaches to an agreement of works with Comiskey Mining Services PTY LTD may result in termination of any proposed or in-place agreement or contract. ALL INVOICES MUST HAVE A PO NUMBER AND ARE PAID 30 DAYS EOM UNLESS OTHERWISE AGREED.
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Directors