1.3(f) Postal address 1.3(g) Signature (electronic is acceptable) 1.3(h) Date Part 2: Exclusion Grounds Please answer the following questions in full. Note that every organisation that is being relied on to meet the selection must complete and submit the Part 1 and Part 2 self-declaration. Section 2 Grounds for mandatory exclusion Question number Question Response 2.1(a) Regulations 57(1) and (2) The detailed grounds for mandatory exclusion of an organisation are set out on this , which should be referred to before completing these questions. Please indicate if, within the past five years you, your organisation or any other person who has powers of representation, decision or control in the organisation been convicted anywhere in the world of any of the offences within the summary below and listed on the . Participation in a criminal organisation. Yes No If Yes please provide details at 2.1(b) Corruption. Yes No If Yes please provide details at 2.1(b) Fraud. Yes No If Yes please provide details at 2.1(b) Terrorist offences or offences linked to terrorist activities Yes No If Yes please provide details at 2.1(b) Money laundering or terrorist financing Yes No If Yes please provide details at 2.1(b) Child labour and other forms of trafficking in human beings Yes No If Yes please provide details at 2.1(b) 2.1(b) If you have answered yes to question 2.1(a), please provide further details.
8.1 Insurance a. Please self-certify whether you already have, or can commit to obtain, prior to the commencement of the contract, the levels of insurance cover indicated below: Employer’s (Compulsory) Liability Insurance = £5m Public Liability Insurance = £5m Professional Indemnity Insurance = £5m Environmental Liability £5m *It is a legal requirement that all companies hold Employer’s (Compulsory) Liability Insurance of £5 million as a minimum. Please note this requirement is not applicable to Sole Traders. Yes No 8.2 Project Specific Questions a. Have you, your company, any directors or partners previously been prosecuted under waste handling or carriage of waste regulations and/or Health and Safety Legislation? (If yes, please provide details including name, address, description, reason for the claim and remedies taken). Yes No A "no" response will score 5 marks and a "yes" response will score 0 marks unless there is sufficient mitigation in place - which will score 3 Weighting 10 b. Does the supply of this service fit with your core activity? Yes No A "no" response will score 5 marks and a "yes" response will score 0 Weighting 10 c. Method statement – please provide a method statement that describes how you manage a waste related contract? Maximum words 500 (TBA) Weighting 20 d. Method statement – please provide a method statement that describes how you work with a client in the delivery of a waste related service? Maximum words 500 (TBA) Weighting 20 e. Management system – describe the scope of the management system you employ to deliver a waste a related service delivery? Maximum words 500 (TBA) Weighting 10 f. Management system – Do you have any externally certified management systems? Please specify the systems that you operate that are externally certified. Yes No A "yes" response will score 5 marks and a "no" response will score 0