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    Point of Contact

    First Name

    Last Name

    Email

    Phone

    Mobile



    Company Details

    Name

    Phone

    Mobile

    Email

    Position in Company

    Postcode

    Address


    Legal Structure

    Date Established

    Structure

    VAT Registered?

    Companies House Number

    Years Registered

    VAT Number

    Charity Number


    Service Area

    Geographic Area


    Insurances

    Public Liability

    Value

    Document

    Professional Indemnity

    Value

    Document

    Other Insurance

    Value

    Document


    Health & Safety

    Do you have a Health & Safety Policy?

    Document


    ISO Accreditation

    Do you hold any ISO Accreditations?

    Document


    Other Accreditation

    Do you hold any other Accreditations?

    Document


    Services

    Maintenance

    Describe Other

    Security

    Describe Other


    Equipment

    Equipment

    Describe Other


    Contractor Agreement

    For and on behalf of

    Date


    Acknowledgement

    Signed By

    Date