Contractor Registration
Code of Behaviour for Contractors
The day to day operations of HOMESSA Inc. will be conducted most effectively if all contractors are aware of the expectations placed upon them. To clarify these expectations, this Code of Behaviour has been developed for all HOMESSA Inc. contractors. All contractors are asked to sign this Code of Behaviour before they can be added to the approved contractors register.
Name
*
First Name
Last Name
I, by adding my name agree
To treat all written or verbal information that I receive or use during my duties as highly confidential. I agree not to disclose any confidential information about clients, their families, staff, or members of Home Assist Community Services, or any matters related to Home Assist Community Services, to external sources while working on behalf of Home Assist Community Services or at any time in the future.I agree to abide by the Home Assist Community Services Contractor Guidelines and to represent Home Assist Community Services positively. I will treat all clients and/or their caregivers with understanding and dignity, practicing polite and sensitive communication. I will never solicit work from a client or offer to purchase any items from a client and/or caregiver unless they are publicly offered for sale. I will present myself and perform all work in a professional manner and will refrain from smoking in a client's home. I will respect the rights of clients and/or their caregivers and treat all client information as confidential. Any conflict of interest, or potential conflict of interest, will be declared in writing to the CPM as soon as possible. I will never subcontract any part of the work requested unless permission has been given by Home Assist Community Services.
I agree to have Read our Incident Management Policy
Date
*
-
Month
-
Day
Year
Date
Contractor Signature
*
Witness Signature
*
Business / Trading
*
Entity Type
*
GST Registered
*
Please Select
Yes
No
ABN
*
Prefer Jobs Via
*
Please Select
Email
Fax
Collet
Mail
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email (Jobs)
example@example.com
Email (Accounts)
example@example.com
Phone Number
*
Please enter a valid phone number.
Contact Person 1
Contact Person 2
Accounts
Labour Rates
Hourly
Call Out Fee
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Finance
Payable To
*
Account Name
Bank Name
*
BSB Number
*
Account Number
*
QBCC - QLD Building & Constuction Commission (if applicable)
Expiry date
Others i.e. Electrical/Plumbing/etc (if applicable)
Certificate Number
Expiry date
Public Liability Insurance Certificate Number
*
Public Liability Insurance Expiry Date
*
Please provide a copy of the above certificates
*
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Additional Certificates (Yellow Card / NDIS Card/ Police Checks)
Yellow card / NDIS Card / Police Check Please provide original or certified copy for all workers
Worker (1) Certificate Expiry Date
*
Worker (1) Certificate Number
*
Worker (1) Certificate Expiry Date
*
-
Month
-
Day
Year
Date
Worker (2) Certificate Expiry Date
Worker (2) Certificate Number
Worker (2) Certificate Expiry Date
-
Month
-
Day
Year
Date
Worker (3) Certificate Expiry Date
Worker (3) Certificate Number
Worker (3) Certificate Expiry Date
-
Month
-
Day
Year
Date
Worker (4) Certificate Expiry Date
Worker (4) Certificate Number
Worker (4) Certificate Expiry Date
-
Month
-
Day
Year
Date
Please Provide a Copy of the above certificates
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Cancel
of
Please Provide COVID-19 vaccination certificates for the above workers
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of
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Please indicate the areas you are prepared to work in by ticking the boxes
Town / Suburb (Region - Bundaberg)
Town / Suburb (Region - Bundaberg)
Bundaberg
Childers
Gin Gin
Monto
Other, Please specify
Town / Suburb (Region - Gympie)
Town / Suburb (Region - Gympie)
Cooloola Cove
Curra
Glastonbury
Goomoorian
Goomeri
Gympie
Kilkivan
Mary Valley
Neerdie
Rainbow Beach
Tin Can Bay
Widgee
Wolvi
Woolooga
Other, Please specify
Town / Suburb (Region - Hervey Bay)
Town / Suburb (Region - Hervey Bay)
Aldershot
Booral
Burrum Heads
Dundowran Beach
Hervey Bay
Howard
River Heads
Toogoom
Torbanlea
Other, Please specify
Town / Suburb (Region - Maryborough)
Town / Suburb (Region - Maryborough)
Aramara
Bauple
Boonooroo
Broweena
Glenwood
Gootchie
Granville
Maaroom
Maryborough
Mungar
Oakhurst
Poona
St Helen's
Tiaro
Tinana
Tinnanbar
Tuan
Woocoo
Yengarie
Yerra
Other, Please specify
Town / Suburb (Region - North Burnett)
Town / Suburb (Region - North Burnett)
Biggenden
Eidsvold
Gayndah
Mundubbera
Other, Please specify
Town / Suburb (Region - South Burnett)
Town / Suburb (Region - South Burnett)
Blackbutt
Kingaroy
Murgon
Nanango
Wondai
Other, Please specify
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Please indicate the work your Business provides by ticking the boxes
Air Conditioning - Filter Cleaning
Air Conditioning - Installations
Air Conditioning - Repairs
Antenna Repairs
Antenna Installer
Building - Minor
Building - Major
Carpentry
Carpet Cleaning
Concreting - Large Areas
Concreting - Small Areas
Door Locks External - Repairs
Door Locks External - Replaced
Door Locks Internal - Repairs
Door Locks Internal - Replaced
Electrical
Electrical Appliances
Fencing
Freezers
Fridges
Gardening
Gas Fitter
Glass and Glazing
Gutter Cleaning - Highset
Gutter Cleaning - Lowset
Guttering - Repairs
Guttering - Replacement
Handyperson Work
House Cleaning External - High
House Cleaning External - Low
House Cleaning Internal - High
House Cleaning Internal - Low
HWS Repairs (Electric)
HWS Repairs (Gas)
HWS Repairs (Solar)
HWS Replacement (Electric)
HWS Replacement (Gas)
HWS Replacement (Solar)
Lawn Mowing
Locks - Rekeying
Metal Fabrications
Occupational Therapist
Painting - External
Painting - Internal
Pest Control
Plumbing - Major
Plumbing - Minor
Pressure Cleaning
Roofing - Repairs
Roofing Replacement
Roofing (Tiled) - Repairs
Roofing (Tiled) - Replacement
Rubbish Removal (yard)
Security Door - Installer
Security Door - Repairs
Security Screen - Installer
Security Screen - Repairs
Sewerage Blockages
Shrub Pruning
Stoves (Electric)
Stoves (Gas)
Stump Replacement - Highset
Stump Replacement - Lowset
Television Cabling
Television Repairs
Tiling
Tree Lopping - Large Trees
Tree Pruning - Small Trees
Washing Machines
Weed Spraying
Whipper Snipping
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Would you like a copy of this Submission?
Email
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