Approved Supplier Application Step 1 of 6 - Supplier Details Your Full Name Email Account Username Account Password Repeat Password Supplier Trading Name Fax Number Supplier Registered Name Website Address Please list any trade memberships and/or professional associations Telephone Number Please provide details of: Any previous or pending Health and Safety Executive prosecutions Any previous or pending Environment Agency prosecutions Please provide details of the following contacts: Name Telephone Number Email Address Contract Supervisor / Manager Person with H&S Responsibilities for Contract Name Position Who is the competent person for Health & Safety issues in your organisation? Are they a consultant? Yes No Are they on the HSE consultancy register? Yes No What are their Health & Safety qualifications? If different from above, please supply the contact name(s) and position(s) for Quality and Environmental issues? Name Position Who is the Certificate of Technical Competence (CoTC) Holder? Who is the Competent Person EA assessed?
