Assix - C&R Questionnaire (Do Not Delete)

SUPPLY CHAIN REGISTRATION FORM

Please complete the form below to register your interest in joining the Assix Supply Chain.

We are committed to providing quality, excellence and value for our clients and if you share these values we would like to find out more about your business.

Please note this form is an expression of interest and adds your business to the Assix database. A further stage of pre-qualification would be required prior to being eligible for the award of sub-contract works.

If you experience any problems with this form please email team@assix.co.uk
Company Details
Company Name*
Please ensure this is your Registered Company Name not trading name.
Type of Company*

Private company limited by shares (LTD)Sole Trader/Self EmployedPublic Limited Company (PLC)Limited liability partnership (LLP)Limited PartnershipCommunity interest companyOther
Company Registration Number (if applicable)
Head Office Address*

Street Address

Street Address Line 2

CityCounty

Postal Code
Do you wish to add a 2nd business address?

YesNo
Company Address 2

Street Address

Street Address Line 2

CityCounty

Postal Code
Contact Details
Contact Name For New Tender Enquiries*
Contact Email Address*
Phone Number*
If you have another general email address for tender enquiries please add here
Company Information
Select most relevant business type*

Supply & Fix Sub-ContractorLabour Only Sub-ContractorMaterials SupplierPlant & Equipment Supply/HireDesigner / ConsultantOther
Briefly Describe Trades/Services Offered*
Please Confirm Geographical Areas where you are prepared to work*

NationwideAll of EnglandSouth EastLondonNorth WestEast of EnglandWest MidlandsSouth WestYorkshire & The HumberEast MidlandsNorth EastScotlandNorthern IrelandOther
Do you provide in-house design services?*

YesNo
Number of Years Trading*
Annual Turnover Forecast for Current Financial Year*
Do you hold Occupational Health & Safety accreditation from any of these bodies

CHASAlcumus Safe ContractorConstruction Line GoldAchillesOther
Details of other Trade Organisations/Bodies which the company is a member of
Please confirm the minimum value of contracts undertaken
Please confirm the maximum value of contracts undertaken
Project Case Study 1
Project Case Study 2
Should be Empty:

SUPPLY CHAIN REGISTRATION FORM

Company Details

Contact Details

Company Information