{"id":1458,"date":"2024-10-22T13:28:16","date_gmt":"2024-10-22T13:28:16","guid":{"rendered":"https:\/\/thetyre-network.co.uk\/?page_id=1458"},"modified":"2024-10-22T15:42:27","modified_gmt":"2024-10-22T15:42:27","slug":"application-form","status":"publish","type":"page","link":"https:\/\/thetyre-network.co.uk\/index.php\/application-form\/","title":{"rendered":"Application Form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1458\" class=\"elementor elementor-1458\">\n\t\t\t\t<div class=\"elementor-element elementor-element-57a0fff e-flex e-con-boxed e-con e-parent\" data-id=\"57a0fff\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-936f692 elementor-widget elementor-widget-shortcode\" data-id=\"936f692\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-shortcode\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f1456-o1\" lang=\"en-GB\" dir=\"ltr\" data-wpcf7-id=\"1456\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/index.php\/wp-json\/wp\/v2\/pages\/1458#wpcf7-f1456-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"1456\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.0.1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_GB\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1456-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<input type=\"hidden\" name=\"_wpcf7cf_hidden_group_fields\" value=\"[]\" \/>\n<input type=\"hidden\" name=\"_wpcf7cf_hidden_groups\" value=\"[]\" \/>\n<input type=\"hidden\" name=\"_wpcf7cf_visible_groups\" value=\"[]\" \/>\n<input type=\"hidden\" name=\"_wpcf7cf_repeaters\" value=\"[]\" \/>\n<input type=\"hidden\" name=\"_wpcf7cf_steps\" value=\"{}\" \/>\n<input type=\"hidden\" name=\"_wpcf7cf_options\" value=\"{&quot;form_id&quot;:1456,&quot;conditions&quot;:[],&quot;settings&quot;:{&quot;animation&quot;:&quot;yes&quot;,&quot;animation_intime&quot;:200,&quot;animation_outtime&quot;:200,&quot;conditions_ui&quot;:&quot;normal&quot;,&quot;notice_dismissed&quot;:false}}\" \/>\n<\/div>\n<div class=\"uacf7-form-1456\"><p>Please complete all sections. Where a section is not applicable, please state the reason why. Incomplete forms will not be submitted for approval.<\/p>\n\n<label>Date of completion:<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"date-completed\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date-completed\" \/><\/span>\n\n<div class=\"two-column\">\n    <div class=\"column\">\n        <label>The Tyre Network supplier number:<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"supplier-number\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"supplier-number\" \/><\/span>\n    <\/div>\n    <div class=\"column\">\n        <label>Company name:<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"company-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"company-name\" \/><\/span>\n    <\/div>\n<\/div>\n\n<div class=\"two-column\">\n    <div class=\"column\">\n        <label>Address:<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"address\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"address\"><\/textarea><\/span>\n    <\/div>\n    <div class=\"column\">\n        <label>Post code:<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"post-code\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"post-code\" \/><\/span>\n    <\/div>\n<\/div>\n\n<div class=\"two-column\">\n    <div class=\"column\">\n        <label>Tel No:<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"tel-no\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"tel-no\" \/><\/span>\n    <\/div>\n    <div class=\"column\">\n        <label>Email:<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email\" \/><\/span>\n    <\/div>\n<\/div>\n\n<div class=\"two-column\">\n    <div class=\"column\">\n        <label>Website:<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"website\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-url wpcf7-text wpcf7-validates-as-url\" aria-invalid=\"false\" value=\"\" type=\"url\" name=\"website\" \/><\/span>\n    <\/div>\n    <div class=\"column\">\n        <label>Date the company was founded:<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"company-founded\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"company-founded\" \/><\/span>\n    <\/div>\n<\/div>\n\n<div class=\"two-column\">\n    <div class=\"column\">\n        <label>Legal Status (PLC, Partnership etc):<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"legal-status\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"legal-status\" \/><\/span>\n    <\/div>\n    <div class=\"column\">\n        <label>Company Reg No:<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"company-reg-no\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"company-reg-no\" \/><\/span>\n    <\/div>\n<\/div>\n\n<h2>2. Contact Details<\/h2>\n<div class=\"two-column\">\n    <div class=\"column\">\n        <label>Name of contact person:<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"contact-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"contact-name\" \/><\/span>\n    <\/div>\n    <div class=\"column\">\n        <label>Tel No:<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"contact-tel-no\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"contact-tel-no\" \/><\/span>\n    <\/div>\n<\/div>\n\n<div class=\"two-column\">\n    <div class=\"column\">\n        <label>Mobile Number:<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"contact-mobile-no\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"contact-mobile-no\" \/><\/span>\n    <\/div>\n    <div class=\"column\">\n        <label>Fax Number:<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"contact-fax-no\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"contact-fax-no\" \/><\/span>\n    <\/div>\n<\/div>\n\n<div class=\"two-column\">\n    <div class=\"column\">\n        <label>Email:<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"contact-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-text wpcf7-validates-as-email\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"contact-email\" \/><\/span>\n    <\/div>\n<\/div>\n\n<h2>3. Company Accountability<\/h2>\n<label>Directors of the company:<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"directors\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"directors\"><\/textarea><\/span>\n\n<div class=\"two-column\">\n    <div class=\"column\">\n        <label>Business Tel:<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"business-tel\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"business-tel\" \/><\/span>\n    <\/div>\n    <div class=\"column\">\n        <label>Contact\/Mobile Tel:<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"contact-mobile\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"contact-mobile\" \/><\/span>\n    <\/div>\n<\/div>\n\n<label>Organisational Chart Attached?<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"org-chart\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"org-chart\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"org-chart\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\n<h2>4. Scope of Company<\/h2>\n<div class=\"two-column\">\n    <div class=\"column\">\n        <label>Number of direct employees:<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"direct-employees\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-required wpcf7-validates-as-number\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"direct-employees\" \/><\/span>\n    <\/div>\n<\/div>\n<label>Type of service (please circle):<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"service-type\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"service-type[]\" value=\"Mobile car\/van\" \/><span class=\"wpcf7-list-item-label\">Mobile car\/van<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"service-type[]\" value=\"Mobile truck\" \/><span class=\"wpcf7-list-item-label\">Mobile truck<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"service-type[]\" value=\"Drive in car\/van\" \/><span class=\"wpcf7-list-item-label\">Drive in car\/van<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"service-type[]\" value=\"Drive in truck\" \/><span class=\"wpcf7-list-item-label\">Drive in truck<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"service-type[]\" value=\"Motorbike tyres\" \/><span class=\"wpcf7-list-item-label\">Motorbike tyres<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"service-type[]\" value=\"Servicing\" \/><span class=\"wpcf7-list-item-label\">Servicing<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"service-type[]\" value=\"MOT\" \/><span class=\"wpcf7-list-item-label\">MOT<\/span><\/span><\/span><\/span>\n\n<h2>5. Legal Details<\/h2>\n<label>Name of responsible person for legal compliance:<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"legal-compliance\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"legal-compliance\" \/><\/span>\n\n<div class=\"two-column\">\n    <div class=\"column\">\n        <label>Facing litigation or investigation?<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"litigation\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"litigation\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"litigation\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n    <\/div>\n    <div class=\"column\">\n        <label>Any litigation in the last three years?<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"litigation-past\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"litigation-past\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"litigation-past\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n    <\/div>\n<\/div>\n\n<h2>Health, Safety And Environment<\/h2>\n\n<p>Please supply The Tyre Network with up-to-date copies of the following:<\/p>\n<div class=\"two-column\">\n    <div class=\"column\">\n        <label>Employers liability insurance - minimum of \u00a35,000,000 cover:<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"eliinsurance1\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"eliinsurance1\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"eliinsurance1\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n    <\/div>\n    <div class=\"column\">\n        <label>Public liability insurance - minimum of \u00a35,000,000 cover:<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"eliinsurance2\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"eliinsurance2\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"eliinsurance2\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n    <\/div>\n<\/div>\n\n<div class=\"two-column\">\n    <div class=\"column\">\n        <label>General policy statement:<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"eliinsurance3\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"eliinsurance3\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"eliinsurance3\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n    <\/div>\n    <div class=\"column\">\n        <label>Environmental policy statement:<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"eliinsurance4\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"eliinsurance4\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"eliinsurance4\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n    <\/div>\n<\/div>\n\n<div class=\"two-column\">\n    <div class=\"column\">\n        <label>Training records and risk assessments:<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"insurance5\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"insurance5\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"insurance5\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n    <\/div>\n    <div class=\"column\">\n        <label>Accreditation for roadside breakdowns (REACTS):<\/label>\n        <span class=\"wpcf7-form-control-wrap\" data-name=\"insurance6\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"insurance6\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"insurance6\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n    <\/div>\n<\/div>\n\n<h2>Mandatory Operational Requirements<\/h2>\n\n<p>Operational compliance:<\/p>\n<label>All tyre technicians must be supplied with:<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"compliance1\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"compliance1[]\" value=\"Hard hats\" \/><span class=\"wpcf7-list-item-label\">Hard hats<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"compliance1[]\" value=\"Safety glasses\" \/><span class=\"wpcf7-list-item-label\">Safety glasses<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"compliance1[]\" value=\"Visibility jackets\" \/><span class=\"wpcf7-list-item-label\">Visibility jackets<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"compliance1[]\" value=\"Waterproofs\" \/><span class=\"wpcf7-list-item-label\">Waterproofs<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"compliance1[]\" value=\"Safety footwear\" \/><span class=\"wpcf7-list-item-label\">Safety footwear<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"compliance1[]\" value=\"Ear defenders\" \/><span class=\"wpcf7-list-item-label\">Ear defenders<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"compliance1[]\" value=\"First aid kit\" \/><span class=\"wpcf7-list-item-label\">First aid kit<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"compliance1[]\" value=\"Fire extinguisher\" \/><span class=\"wpcf7-list-item-label\">Fire extinguisher<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"compliance1[]\" value=\"High visibility coat\" \/><span class=\"wpcf7-list-item-label\">High visibility coat<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"compliance1[]\" value=\"Hazard lights\" \/><span class=\"wpcf7-list-item-label\">Hazard lights<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"compliance1[]\" value=\"Compressor\" \/><span class=\"wpcf7-list-item-label\">Compressor<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"compliance1[]\" value=\"Traffic cones\" \/><span class=\"wpcf7-list-item-label\">Traffic cones<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"compliance1[]\" value=\"Bottle jacks\" \/><span class=\"wpcf7-list-item-label\">Bottle jacks<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"compliance1[]\" value=\"Wheel chocks\" \/><span class=\"wpcf7-list-item-label\">Wheel chocks<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"compliance1[]\" value=\"Inverter\" \/><span class=\"wpcf7-list-item-label\">Inverter<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"compliance1[]\" value=\"Torque wrench\" \/><span class=\"wpcf7-list-item-label\">Torque wrench<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"compliance1[]\" value=\"Job sheets\" \/><span class=\"wpcf7-list-item-label\">Job sheets<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"compliance1[]\" value=\"Wheel security\" \/><span class=\"wpcf7-list-item-label\">Wheel security<\/span><\/span><\/span><\/span>\n\n<h2>Accident Statistics<\/h2>\n<label>Company name:<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"accident-company-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"accident-company-name\" \/><\/span>\n\n<label>Number of RIDDOR incidents in the past 3 years:<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"riddle-incidents\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"riddle-incidents\"><\/textarea><\/span>\n\n<label>Documented lacerations:<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"documented-lacerations\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"documented-lacerations\"><\/textarea><\/span>\n\n<label>Number of lost time accidents:<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"lost-time-accidents\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"lost-time-accidents\"><\/textarea><\/span>\n\n<label>Number of fatalities:<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"fatalities\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"fatalities\"><\/textarea><\/span>\n\n<label>Number of employees:<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"employees\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"employees\" \/><\/span>\n\n<strong>The Tyre Network Health and Safety Definitions<\/strong>\n\nLaceration: A work related wound that damages a person\u2019s physical or mental health.\nNote: a laceration results from a single event. Cases resulting from anything other than a single event are considered professional affliction.\n\nDocumented lacerations: it is a fatality- a documented, work-related fatality\nOr days away from work laceration- a work- related laceration other than a fatal laceration which concludes in an individual being incapable for work on any day after the day of event.\nOr limited workday laceration- A work- related laceration other than a fatality or days away from work case which proceeds in an individual being unfit for full performance of the fixed job on any day after the occurrence.\nOr medical treatment case- a case that is not severe enough to be documented as fatality or lost time laceration or restricted workday case but is more extreme than requiring first aid treatment.\nLost time laceration\nA work related laceration other than a fatal laceration which concludes in an individual being unable to perform any regular job or restricted work on any day after the event.\n\nRIDDOR reportable injuries or accidents\nAny injury, accident or incident that has been reported to the HSE or Environment agency under the reporting of injuries, diseases and dangerous occurrence regulations 1995( RIDDOR)\n\n\n\n<h2>Company Declaration<\/h2>\n<p>I confirm that the information provided is an accurate representation of our company's Health and Safety systems, working procedures and performance.<\/p>\n\n<label>Responsible person:<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"responsible-person\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"responsible-person\" \/><\/span>\n\n<label>Signature (Type your initials):<\/label>\n\t\t<span class=\"wpcf7-form-control-wrap comp-person-sign\"\n\t\t\tdata-name=\"comp-person-sign\">\n\t\t\t<input hidden type=\"file\" class=\"img_id_special\" class=\"wpcf7-form-control wpcf7-uacf7_signature\" pen-color=\"#000000\" bg-color=\"#dddddd\" aria-invalid=\"false\" name=\"comp-person-sign\">\n\n\t\t\t<div class=\"signature-pad\" data-field-name=\"comp-person-sign\">\n\t\t\t\t<canvas id=\"comp-person-sign\"\n\t\t\t\t\tdata-field-name=\"comp-person-sign\" width=\"300\"\n\t\t\t\t\theight=\"100\"><\/canvas>\n\t\t\t<\/div>\n\t\t\t<div class=\"control_div\">\n\t\t\t\t<button data-field-name=\"comp-person-sign\"\n\t\t\t\t\tclass=\"clear-button\">Clear<\/button>\n\t\t\t<\/div>\n\n\t\t<\/span>\n\n\t\t\n\n<label>Date:<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"declaration-date\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"declaration-date\" \/><\/span>\n\n<label>Position:<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"compposition\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"compposition\" \/><\/span>\n\n<p>Documents reviewed by:<\/p>\n<label>The Tyre Network contact:<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"thetyrenetwork-contact\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"thetyrenetwork-contact\" \/><\/span>\n\n<label>Signature:<\/label>\n\t\t<span class=\"wpcf7-form-control-wrap tyrenet-person-sign\"\n\t\t\tdata-name=\"tyrenet-person-sign\">\n\t\t\t<input hidden type=\"file\" class=\"img_id_special\" class=\"wpcf7-form-control wpcf7-uacf7_signature\" pen-color=\"#000000\" bg-color=\"#dddddd\" aria-invalid=\"false\" name=\"tyrenet-person-sign\">\n\n\t\t\t<div class=\"signature-pad\" data-field-name=\"tyrenet-person-sign\">\n\t\t\t\t<canvas id=\"tyrenet-person-sign\"\n\t\t\t\t\tdata-field-name=\"tyrenet-person-sign\" width=\"300\"\n\t\t\t\t\theight=\"100\"><\/canvas>\n\t\t\t<\/div>\n\t\t\t<div class=\"control_div\">\n\t\t\t\t<button data-field-name=\"tyrenet-person-sign\"\n\t\t\t\t\tclass=\"clear-button\">Clear<\/button>\n\t\t\t<\/div>\n\n\t\t<\/span>\n\n\t\t\n\n<label>Date:<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"network-date\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"network-date\" \/><\/span>\n\n<label>Authorised by Manager:<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"tyrenetmanager\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"tyrenetmanager\" \/><\/span>\n\n<label>Signature:<\/label>\n\t\t<span class=\"wpcf7-form-control-wrap tyrenet-manager-sign\"\n\t\t\tdata-name=\"tyrenet-manager-sign\">\n\t\t\t<input hidden type=\"file\" class=\"img_id_special\" class=\"wpcf7-form-control wpcf7-uacf7_signature\" pen-color=\"#000000\" bg-color=\"#dddddd\" aria-invalid=\"false\" name=\"tyrenet-manager-sign\">\n\n\t\t\t<div class=\"signature-pad\" data-field-name=\"tyrenet-manager-sign\">\n\t\t\t\t<canvas id=\"tyrenet-manager-sign\"\n\t\t\t\t\tdata-field-name=\"tyrenet-manager-sign\" width=\"300\"\n\t\t\t\t\theight=\"100\"><\/canvas>\n\t\t\t<\/div>\n\t\t\t<div class=\"control_div\">\n\t\t\t\t<button data-field-name=\"tyrenet-manager-sign\"\n\t\t\t\t\tclass=\"clear-button\">Clear<\/button>\n\t\t\t<\/div>\n\n\t\t<\/span>\n\n\t\t\n\n<label>Date:<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"manager-date\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"manager-date\" \/><\/span>\n\n\nContractors safety and environment site rules\n\nIn addition to its lawful responsibilities under the Health and Safety at Work Act 1974, and the Environmental Protection Act 1990, The Tyre Network has adopted a number of Rules and Safety Practices in order to set and sustain a high quality of safety and environmental preservation on its customers premises.\n\nThe following rules have accordingly been drawn up in order to acquaint those carrying out work on behalf of The Tyre Network with the minimum standard of safety and environmental practices they are required to maintain at all times.\n\nThe main reason is to guarantee that all work is executed in such a manner, as to be safe not only for our customers employed working or moving about in the surrounding area, but also for the contractors own employees.\n\nThe rules and regulations are not to be considered  in any way as relieving contractors of their statutory obligations or their efforts to avoid accidents, nor are they intended to  confine or hinder the way in which the work is carried out.\n\nIn this latter respect The Tyre Network believes that if its safety rules are recognized and are included at the planning stage, contractors should not have trouble in abiding. The Tyre Network therefore expects for full cooperation from all parties.\n\n\n\nPlease sign and return a copy of the final page of this document to confirm that you have understood and will abide with all of The Tyre Network requirements.\n\n\n\n________________________________________\n\n\n\nHEALTH, SAFETY AND ENVIRONMENTAL REQUIREMENTS\n\n1.\tPrior to starting work\n1.1       Access Authority- No work may occur earlier to this document being signed and dated by the contractor as verification to their compliance and acceptance of the company\u2019s Health, Safety and Environmental Rules.\n\n1.2     Notify The Tyre Network\u2019s customer of your attendance and accept by signature these conditions of working. The customer may guide you of any special safety measures he\/she thinks may be important, and will plan for extra copies of these instructions and regulations as required.\n\n1.3     Visitor\u2019s Book- Contractor\u2019s are recommended to register in the location Visitor\u2019s Book and always wear the hi-vis vest prior to commencing work and passes displayed.\n\n1.4    Make sure that each of your employees, agents and subcontractors receives a copy of these regulations and rules and fully recognises them, and that all obligatory precautions are noticed and executed by all employees in The Tyre Network customers facilities.\n\n1.5    All work must be executed in a guarded manner and strictly according to any Government Acts, Regulations, Guidance notes and with any extra safety rules provided. Contractors must conduct oneself whilst working on The Tyre Network customer premises. Foolish behaviour, the playing of games or running on site is not allowed.\n\n1.6    All contractors must ensure that they are conscious of their obligations and responsibilities under the Health and Safety at Work Act 1974, The Management of Health & Safety at Work Regulations 1992, The Environmental Act 1990 and other relevant regulations.\n\nAll contractors must communicate to the The Tyre Network customer location manager\/ supervisor and notify her\/him of the work they will carry out that day and of any outcomes it may have on local staff. A method statement must be assembled  whenever possible implementing a safe system of work.\n\n1.7   Contractors must make sure that all duty risk assessments have been completed and are ready to use for inspection, all the required personal protective equipment is available and used when working in The Tyre Network customer premises.\n\n2.\t Work Arrangements & Personal Protective Equipment \n\n             2.1      All work areas must be orderly and kept clean. Care must be taken to not block any safety apparatus, fire fighting equipment, emergency exits, steps, passageway and doors in the way.\n\n2.2     All substances to be used on The Tyre Network Customers premises must have been evaluated under the control of Substances Hazardous to Health(COSHH) Regulations, any assessments and product Data Sheets must be accessible.\n\n2.3    Entry to areas other than those in which work is being carried out is clearly forbidden except for purposes of necessary access.\n\n2.4    All waste products must be withdrawn from work areas, all classified Special or Hazardous Waste must be dealt with accordingly as specified in the Environmental Protection Act 1990, The Duty of Care Code of Practice and removed from The Tyre Network customers premises.\n\n2.5    Contractors must supply their employees with suitable PPE whilst working on site and ensure it is used.\n\n2.6    Contractors are not, under any circumstances, permitted to bring any children or pet animals onto a Tyre Network Customers site.\n\n3.\tFire Safety\n\n             3.1     Everyone must take precautions to prevent the likelihood of fire and must be familiar with the Tyre Network customers local area fire\/emergency procedures.\n\n            3.2      No smoking rules may be imposed while on The Tyre Network customers property. Any failure to respect the smoking restrictions will be a breach of contract for which work can be immediately ceased at The Tyre Networks discretion. Designated smoking areas may be available on some The Tyre Network customer facilities.\n\n          3.3      Where diesel or petrol powered equipment is used inside a building, prior permission must be obtained from Tyre Network customer site Manager\/ Supervisor and precautions must be taken against excessive exhaust emission.\n\n         3.4       Permission must be obtained from Tyre Networks customer Local Manager\/Supervisor before flammable liquids are stored on Tyre Network customer premises.\n\n        3.5        Under no circumstance may explosives be used on Tyre Network customer premises.\n\n4.\tElectricity and Other Facilities \n\n        4.1        All electrical equipment used by contractors on Tyre Networks customer premises must abide by the Electricity at work Regulations 1989 and the Provision of Work Equipment Regulations 1998. Evidence of certification and examinations of portable electrical equipment must be made accessible. Whenever possible 110- voltage equipment must be used and be suitable for the electrical supply available. Any electrical equipment used outside must be the greatest of 110 vaults and be suitably insulated.\n\n       4.2        Compressed air, gas or other piped services may not be used without prior authorisation from Tyre Network customer local Manager\/supervisor. Pressure systems must meet the Pressure Systems Safety Regulations 2000.\n\n       4.3        All electrical work must conform with the Electricity at Work Regulations and IEE Regulations.\n\n\n5.\tContractors Equipment\n\n5.1         Contractors are to supply their own tools and equipment to carry out the work.\n\n              Contractors must ensure that equipment brought onto Tyre Network customers premises abides with statutory demands including The Noise at Work Regulations 1989, The Provision and Use of Work Equipment Regulations 1998, Lifting Operations and Lifting Equipment Regulations 1998 and that the required periodic examination records, test certificate, shall, if required be available for inspection by the Tyre Network customers local Managers or Supervisors. All equipment brought on to a Tyre Network customer's premises must be maintained and in good working order.\n\n5.2        The safe working goods must be noted and distinct on all items of liftin\n\ng equipment and must not be surpassed. All attached and lifting equipment must meet the PUWER 1998 and LOLER 1998 regulations, competent persons must check the equipment for faults at the statuary intervals. Lifting tackle must be assembled by a competent person and must not be attached to any vessels, handrails, pipelines or unstable plant.\n\n5.3        All portable machines must be guarded in agreement with the Work Equipment Regulations 1998. Electrical equipment must respect the Electricity at Work Regulations 1998, maximum 110 volts if to be used for outdoor working. Test certificates must be available on request.\n\n6.Control of Substances Hazardous to Health (COSHH) \n\n    6.1         Contractors shall undertake to comply with all COSHH Regulations and amendments. It is the responsibility of the contractor to carry out all necessary assessments of substances falling within the COSHH Regulations.\n\n7.Documentation - Policy statement, Public Liability Insurance, Risk assessment, Method Statements.\n\n    7.1      Contractors must have provided a copy of their Health and Safety Policy Statement.\n\n    7.2     Contractors shall provide evidence that they hold a minimum of \u00a35,000,000 Public Liability Insurance cover.\n  \n7.3    Contractors must have provided evidence that Risk Assessments ( General Site Tyre Fitting) have been carried out and that a Safety System of work will be adopted. Copies must be available on site for inspection.\n\n7.4   Contractors must have provided evidence for Lone Working risk assessments and ensure a safe system of work is in place to manage, assess, monitor and supervise lone workers whilst on Tyrenet customer sites.\n\n8. Security\n    8.1    Contractors are responsible for the security of their tools, equipment and security on site. Contractors will comply with and observe local security arrangements.\n   \n   8.2     The Tyre Networks customer reserves the rights to search any vehicle or person operating on behalf of The Tyre Network.\n\n9. Environmental Requirements\n             The Tyre Network is committed to a policy of environmental protection throughout its operations and activities. Contractors will be required to meet, or exceed our own standards in both recognising and minimising the harmful effects of its activities on the environment.\nIn order to assist in achieving this set below are a number of rules which Contractors must comply with when working with The Tyre Network, both on and off site. Contractors must ensure that their employees are aware of these rules and that they are compiled with.\n   \n\n           9.1 \tContractors must comply with current environmental legislation.\n\n           9.2        Contractors are responsible for disposing of any waste materials resulting from their work activities and must ensure that waste is disposed of in the appropriate manner. Small quantities of general waste may be disposed of at the location provided that prior authorisation from The Tyre Network customer Local manager has been obtained.\n\n           9.3    Any substance to be used, whether solid,liquid or gas, must be notified to the Tyre Network Local Manager before work commences. Appropriate written risk assessments must be made available on request. And only sufficient materials required to perform the task may be brought on site. Storage on site beyond this amount is not allowed.\n\n   Any spills that occur must be dealt with immediately, and must be reported to The Tyre Network Customer local manager on that exact day.\nRefrigerant gases must not be released to the atmosphere.\n\n       9.4    Contractors are allowed to use the utility services provided on site with an agreement that has already been made before by The Tyre Network Customer Local Manager. Equipment using water must be sound and not leak. Contractors must not allow unnecessary operation or running of vehicle engines on site, or allow oil, fuel or coolant to leak.\n\n\n\n<strong>I \/ We acknowledge that we have read and understood the site rules contained in this document and agree to abide by them at all times.<\/strong>\n\n\n\n<p>Contractors must acknowledge that they have read and understood the site rules contained in this document.<\/p>\n\n<label>Signature: <\/label>\n\t\t<span class=\"wpcf7-form-control-wrap contractor-signature\"\n\t\t\tdata-name=\"contractor-signature\">\n\t\t\t<input hidden type=\"file\" class=\"img_id_special\" class=\"wpcf7-form-control wpcf7-uacf7_signature wpcf7-validates-as-required\" pen-color=\"#000000\" bg-color=\"#dddddd\" aria-required=\"true\" aria-invalid=\"false\" name=\"contractor-signature\">\n\n\t\t\t<div class=\"signature-pad\" data-field-name=\"contractor-signature\">\n\t\t\t\t<canvas id=\"contractor-signature\"\n\t\t\t\t\tdata-field-name=\"contractor-signature\" width=\"300\"\n\t\t\t\t\theight=\"100\"><\/canvas>\n\t\t\t<\/div>\n\t\t\t<div class=\"control_div\">\n\t\t\t\t<button data-field-name=\"contractor-signature\"\n\t\t\t\t\tclass=\"clear-button\">Clear<\/button>\n\t\t\t<\/div>\n\n\t\t<\/span>\n\n\t\t\n\n<label>Name:<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"contractor-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"contractor-name\" \/><\/span>\n\n<label>Date:<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"contractor-date\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"contractor-date\" \/><\/span>\n\n<label>Position\/Appointment:<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"contractor-position\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"contractor-position\" \/><\/span>\n\n<label>Company:<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"contractor-company\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"contractor-company\" \/><\/span>\n\n<label>Address:<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"contractor-address\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"contractor-address\"><\/textarea><\/span>\n\n<div class=\"cf7-cf-turnstile\" style=\"margin-top: 0px; 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