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

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

Name

First Name Last Name

Phone Number

Area Code Phone Number

Email

example@example.com

BSB & Account No.

Bank

Insurance *

Yes

No

N/A

Public Liability - min $10M

Professional Indemnity

WorkCover

Plant / Equipment / Vehicle

Marine Cargo (transport only)

Labour Hire Licence

Upload Insurance Certificates

Browse Files

Has your company ever been given an improvementnotice/fine/conviction from any government authority? *

Details *

Have the directors or the company ever been bankrupt? *

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 complete what is relevant 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 *

Date

Signature

Clear

Sub-Contractor Registration Form

Directors

Accounts details

Insurance Details

Compliance

Disclaimer