Supplier/Subcontractor Questionnaire

*Company Name: *Contact Person:
*Address: *Telephone:
Fax:
SupplierEmail
Name of Parent Company (if applicable):
*Will company be a: (Can select more than one)
Supplier Subcontractor
 
Statistics submitted in this questionnaire should be for the location being registers. If statistics provided include other locations, please indicate scope of statistics (i.e.: Provincal, Atlantic Canadian, National, International).
 
*Average annual sales for past 5 years:
Under $250 000 From $250 000 to $1 million From $1 million to $10 million Over $10 million
 
Number of Employees:
*Goods & Services Available: (Must check at least one)

Health and Safety Equipment/Services
Environmental Equipment/Service
Onshore Transportation Services (Freight & Personnel)
Offshore Transportation Services (Freight & Personnel)
Consulting / Engineering / Manpower Services
Civil and Structural Materials/Services
Construction Materials/Services
QA/QC Services (Testing, NDE, etc..)
Testing Equipment
Diving/ROV Services
 Crane and Heavy Lift Services (Onshore & Offshore)

Equipment Rental
Industrial Supplies
Warehouse Services
Pipe, Valves, Fittings
Painting
Insulation
Electrical Material/Supplies/Services
Instrumentation Material/Supplies/Services
Specialty Services
Maintenance Services
Rotating Equipment Supply & Service
Machining Services
Other:

 
Summary Description of Services offered by company:
List Relevant Company Owned Facilities and Equipment Available:
List Union Affiliations:
Is company currently a supplier to:
AMEC Black & McDonald Contact Name:
AMEC Contact Name:
Black & McDonald Contact Name:

Health and Safety Information

*Does the company have a written Health and Safety Policy?
Yes No
*Does the company have a structured safety management system?
Yes No
Is Health and Safety Management System currently certified?
Yes No
Standard:
Certified by what authority:
Date Certification was achieved:
*Person responsible for H&S: 
Do you keep Health and Safety Incident Statistics?
Yes No
If yes, please provide the number of Health & Safety Inicidents in the last 24 months:
These safety satistics should follow BLS guidelines.
Near Miss:
First Aid:
Medical Aid:
Lost Time:
Fatalities:
Manhours Worked in the last 24 months:
*Has your company had any convictions under any labour legislation in the past five years?
Yes No
*Do you have a published alcohol and drug policy?
Yes No
*Are you registered with:
Nova Scotia WCB
Newfoundland WHSCC
Other:

Environmental Information

*Does company have a written Environmental Policy?
Yes No
*Does company have a structured Environmental Management System?
Yes No
Is Environmental Management System certified to:
ISO 14001:1996
Other:
None
Organization who certified Environmental System? (i.e. Lloyd's Register, QMI, etc..)
Date Certification was achieved:
Person responsible for Environment:
Has your company had any Environmental incidents in past 24 months?
Yes No
*Has your company had any convictions under any environmental legislation in past five years?
Yes No

Quality Control Information

*Does the company have a written Quality Control and Assurance Policy?
Yes No
*Does the company have a structured Quality Management System?
Yes No
The Quality Management System certified to:
ISO 9001:2000
Other:
None
Organization who certified Quality System? (i.e. Lloyd's Register, QMI, etc..)
Date Certification was achieved:
Person Responsible for Quality:
Date of last third party audit of Quality Management System:
Names and descriptions of recently completed projects:
List of References:
AMEC Black & McDonald encourages the development of new technologies and innovation within industry. If you are a small or medium enterprise company (SME), please provide a short description of your company's innovations & ideas.

Traditionally Underrepresented Community Information

If you wish, you may indicate any community associations that are applicable to your firm
Please note: Identification is Voluntary
Aboriginal Community
Women's Community		 Racially Visible Community
Physically/Mentally Challenged