CONTRACTOR REGISTRATION & INDUCTION	PF244

Completion of this form is required before a company can be placed on the UQ Property and Facilities (P&F) Contractor Register and allowed to commence work for or on behalf of P&F on any UQ buildings or grounds.  NOTE: Attach additional name or licence information, if required.

Company Details (Please print clearly):	
Company Name:	     	ABN No.:	     	
Postal Address:

	     	Suburb / City /
Post Code:	     	
Physical Address:

	     	Suburb / City /
Post Code:	     	
Contact Phone No.:	     	Fax No.:	     	
				
Main Contact Name:	     	Position Title:	     	
Phone No.:	     	Phone Ext:	     	
Email Address:	     	Web Address:	     	
Business Activity (Select one activity with a cross which one of the below best describes your business):	
	
 Air Compressors	 Cranes / Hoists	 Pest Control	 Water Treatment	
 Animal Handlers	 Demolition	 Plumbing & Gas Fitters	 Waste	
 Architect	 Earthmoving	 Pumps		
 Asbestos/Haz. Materials	 Electrical	 RO Water		
 Autoclaves/Boilers	 Fencing	 Roofing		
 Battery	 Fire Services	 Rope Access		
 Blinds/Curtains	 Fume Cupboards	 Scaffolding		
 Brick/Block Laying	 Furniture	 Security		
 Builders	 Glaziers	 Signage		
 Building Mgt Systems	 HVAC	 Stonemasons		
 Carpet/Vinyl	 Landscaping/Lawn Mowing	 Telecommunication/Data		
 Civil Works	 Lift	 Test and Tag Services		
 Cleaning	 Locksmith	 Tilers		
 Concreting	 Painting	 Traffic Consultant	 Other:      	

Office Use Only	
Induction completed on:	     /     /     			

Company Insurance (Please print clearly): 	
 Workers Compensation:	Policy No.:	     	Expiry Date:	     /     /     	
 Public Liability:	Policy No.:	     	Expiry Date:	     /     /     	
Insurer’s Company Name:		Insured Amount:		
 Licences Held by Company (please attach certificate)	
Licence Type	Licence No.	Expiry Date	
     	     	     /     /     	
     	     	     /     /     	
     	     	     /     /     	
     	     	     /     /     	
     	     	     /     /     	
Contractor Declaration
Below must be signed after attending and completing the P&F Contractor Induction.  By signing the Contractor agrees to adhere to the P&F Occupational Health, Safety & Environmental policies and procedures.

Name of person making declaration:	     	

Position of person making declaration:	     	

Signature:		

Date:	     	

NOTE: The contractor company will be registered with the University for a period of 24 months from the date of signing. 

UQ reference name:	     	

Office Use Only	
 UQ contact confirmation.			
 Ensure minimum insurance $10 million. 

 Confirm with UQ contact that contractor is suitable for the work nominated.	

Please forward this completed form, along with the:
•	Copy of the Business Licence;
•	Copy of Workers Compensation;
•	Copy of Third Party Liability Insurance.
To:	Health & Safety Co-ordinator
	Prentice Building (42)
	The University of Queensland  4072
	Ph:  3346 9268
hsc@pf.uq.edu.au 

Further information on this process can be found at the Property & Facilities website: https://www.pf.uq.edu.au/contractors.