NPCRS Application Form

On application to the NPCRS, contractors provide:
- Undertakings to have, maintain and use safety management systems
- Undertakings to ensure all staff and subcontractors are remunerated according to the law
- Undertakings to ensure that all staff who travel to site complete the ACAPMA NPCRS Course
- Copies of certificates of currency for Workers Compensation and Public Liability insurance ($20M)
- Professional Indemnity Insurance ($10M) is also required for any business that is undertaking works that include the provision of advice such as design, construction or project management
Business Plan
Payments are processed through Stripe Secure Payment Gateway. You may pay using any major credit card / debit card or request an invoice.
Business Details
Business Name*
ABN*
ACN
Contact Name*

First NameLast Name
Contact Title*
E-mail*
example@example.com
Contact Number*
Format: (00) 0000-0000.
Address*

Street Address

Street Address Line 2

CityState

Post Code
Business Documents
Public Liability Insurance

Cancelof
Workers Compensation

Cancelof
Professional Indemnity Insurance (if applicable)

Cancelof

Approved Contractor Directory - Online Listing
Your Online Contractor Register Listing is how potential customers will locate you, please carefully complete the following with details that are to go online
Company Name*
Sales Contact Name*

First NameLast Name
Sales Contact Number*
Please enter a valid phone number.Format: 00 0000-0000.
Sales Contact Email*
example@example.com
Website
Social Media Links
Short Business Description
ACTNSWNTQLDSATASVICWA
ATMA/C & RefrigerationCar WashCleaningElectrical & LightingEnvironmentalEngineeringExcavationFire SafetyGlass and GlazingIn Store ServicesIT & TelecomLawn & LandscapeMarketingPest ManagementPlumbingPOSProject ManagementPump ServicesSafety ServicesSecurityShop FitoutSignageSite DesignTanker & TransportTank ServicesUnderground Service LocatorsWaste ManagementOther
Do you offer other services that are not listed above, you can manually add up to 5 Specialist Services below:
The undersigned, as a duly appointed representative of the business, makes the following commitments and undertakings:

Employment
The business commits to the appropriate engagement of employees and contractors and undertakes to ensure compliance with State and Federal laws and regulations as they apply to the employment and engagement of worker, including appropriate remuneration.

Safety
The business commits to the establishment and utilisation of appropriate Risk Assessments, Safety Controls and Management Systems. The extent and nature of such systems will be dependent on the actual works conducted but will include as a minimum: Safe Work Method Statements, Risk Assessment protocols that include empowering onsite staff to cease or delay works when safety concerns arise and Near Miss and Incident Reporting.

Training
The business commits to the training of ALL site workers in the appropriate ACAPMA Working on Fuel Sites online course and that all site workers will carry with them proof of completion of this training while onsite.

Insurance
The business commits to holding current insurances in Public Liability. Professional Indemnity and Building and Construction Insurances may also be required depending on the nature of the works. The business commits to providing proof of current insurances to ACAPMA on request.

Audits
The business commits to complying with random desktop and/or worksite audits. Audits are with notice. The business understands that Recognition may be revoked on the grounds of failure to adhere to any of these commitments.
Yes
Yes
Date*

MonthDayYear
Date
Signature*

Clear

Should be Empty:

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Business Plan

Business Details

Business Documents