Sub-Contractor Registration Form

Sub-Contractor Registration Form
Who from Comiskey Mining Services requested you to register? *
Company Name *
ABN *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
Email *
example@example.com
Contact Name *

First Name Last Name
Contact Name Phone Number *

Area Code Phone Number
Email *
example@example.com
Directors
Name *

First Name Last Name
Email *
example@example.com
Phone Number *

Area Code Phone Number
Name

First Name Last Name
Email
example@example.com
Phone Number

Area Code Phone Number
Accounts details
Name

First Name Last Name
Phone Number

Area Code Phone Number
Email
example@example.com
BSB & Account No.
Bank
Insurance Details

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 *
Our expectations of our subcontractors:
- Comply with all applicable health and safety laws, regulations and statutory obligations.
- Ensure Safety Standards and rules are consistently applied throughout the places where we work.
- Personnel will not endanger or cause unacceptable risk to themselves or others through any act or omission.
- Plant, equipment & tools are maintained, serviceable and fit for purpose and only being used in the manner for which it is intended.
- Activities will be performed in accordance with our site processes, procedures, guidelines and agreed work practices in line with legislative requirements.
- Be qualified, trained and competent to perform tasks that they are employed for.
- Have the correct and appropriate personal protective equipment available to complete the task
- Be fit for work
- Be professional
Please download the subcontractor Management Checklist and forward to info@comiskeymining.com.au (failure to provide the checklist will slow the application process down)
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.
Should be Empty:

Sub-Contractor Registration Form

Directors

Accounts details

Insurance Details

Compliance

Disclaimer