MANAGEMENT SYSTEMS QUOTE REQUEST FORM

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MANAGEMENT SYSTEMS QUOTE REQUEST FORM Instructions for completion Please click on the appropriate button to send via email or print. If you wish to save the form to complete at a later time, you can save your progress by selecting File then Save As. If you are using a tablet or mobile device it is recommended only to use the official Adobe PDF readers available from your app store. 1. To which management systems standards are you requiring registration? (please tick) Standalone Integrated/Combined Quality management systems (ISO 9001). Complete Section B. Environmental management systems (ISO 14001, EMAS). Complete Section C. Health and Safety management systems (OHSAS 18001, ISO 45001). Complete Section D. Energy management systems (ISO 50001:2011). Complete Section E. 2. Combined and integrated management systems: Do you require the auditing of your management system to form part of a combined audit with other management system standards? If yes, please provide details of the management systems which are integrated and an outline of the structure. Fully integrated systems shall be recorded as 100% integrated. If the management systems are only partially integrated, then the level of integration should be indicated 3. Organisation details: Company name: Company number: Main office address: Postcode: Telephone: Web site: Contact name: Job title: Email: Direct dial: Mobile: Page 1 of 10

4. Details of main office and branches: Address and postcode: Core Hours Shift 1 Shift 2 Shift 3 Total no. of employees* Main Office:. of staff Branch 1:. of staff Branch 2:. of staff Branch 3:. of staff Branch 4:. of staff Branch 5:. of staff If you have more than 5 branches, please contact us. Total no. of employees*: Where part time workers or seasonal workers are employed, please provide full details below: 5. Are you? a) A new NQA client b) A transferring client If a transferring client, please provide details of previous registration(s): te: Copies of current certificates of registration and previous audit reports will need to be supplied. c) Expanding your scope of certification? d) Have you previously been registered with NQA? 6. Requested scope of certification: te: The scope should explain succinctly the purpose and output covered by the management system; it should describe what the organisation does, not how it does it. E.g. The provision of architectural design services. Page 2 of 10

7. Do you provide installation or other contract site works? 8. Do you have outsourced or subcontracted activities? Please provide details of outsourced or subcontracted activities: 9. Organisational and process complexity: Does the organisation have a simple structure with vertical lines of management communication and few decision makers? Is the management system highly complex with numerous specific processes? (e.g. a manufacturer where each process is critical to the end product may have many procedures and references to legislative and regulatory documentation) Are there a large number of the employees completing a similar simple task(s)? (e.g. manned guarding, commercial cleaning, similar assembly lines) Is the organisation highly regulated by external agencies? (typical industry sectors would be food preparation, aerospace, automotive, electricity generation & gas/oil production etc) Do stakeholders have specific expectations of the organisation? (e.g. security, health/safety inspections, dangerous waste processing etc) Does the organisation work within/operate areas having strict security controls? (e.g. chemical plants, oil/gas refineries, electricity generating stations etc) Are the organisation s operations managed as part of or influenced by a larger organisation s management system? (e.g. controlled by parent company or heavily influenced by local/central government etc) Are there any other factors which affect the complexity of the organisation s management and processes? If you have answered yes to any of the above questions please provide details below: 10. Legal Obligations: Please list below legal obligations relevant to the proposed scope of certification 11. Do you have a target assessment date? Page 3 of 10

12. Consultant use: Will you be using a consultant to help you implement/manage the management system? (If yes, please complete their details below, or contact NQA to be referred to a consultant.) Consultancy name: Contact name: Email: Telephone: Postcode: 13. Completed by: Date: Company: Name: Job title: 14. Where did you hear about NQA s service? Tick all that apply. Recommendation from consultant (please complete question 12) NQA s web site Exhibition Recommendation from another company Trade press Social media Search engine: e.g. Google Other (please specify) Please ensure that sections Sections B, C, D and E of this form are also completed (as appropriate) If you have any problems completing this form please call 0800 052 2424 or email info@nqa.com Or print and send to: NQA Sales, Warwick House, Houghton Hall Park, Houghton Regis, Dunstable, Bedfordshire, LU5 5ZX, UK. Contact us NQA, Warwick House, Houghton Hall Park, Houghton Regis, Dunstable, Bedfordshire LU5 5ZX, UK T: 0800 052 2424 E: info@nqa.com www.nqa.com QRF/MS/APR16 Page 4 of 10

SECTION B - QUALITY MANAGEMENT Only complete this section if appropriate 1. To which standard are you requiring registration? ISO 9001:2008 ISO 9001:2015 2. How long has your quality management system been in place? 3. Do you undertake design activity? Number of staff engaged in design activity: If yes please provide details: 4. Please list the requirements of ISO 9001 that you do not deem applicable to the proposed scope of the management system. Clause: Reason: Return to page 4 to submit or print document Page 5 of 10

SECTION C - ENVIRONMENTAL MANAGEMENT Only complete this section if appropriate 1. To which standard are you requiring registration? ISO 14001:2004 ISO 14001:2015 EMAS 2. How long has your environmental management system been in place? Please complete questions 3 to 9 for each site within the scope of certification. Contact us for a Site Supplement form. Site name: 3. Permits to operate: Are your operations subject to an authorisation/permit/licence/registration from a regulatory body? (e.g. environmental permit, hazardous waste producer registration, abstraction licences, registered waste or water discharge exemptions, etc.) If yes, please provide details (including permit/licence/registration numbers): 4. Discharges to water/sewer: Do you produce any industrial effluent (other than domestic sewage and surface water)? Frequently Occasionally Never If yes, please provide details: 5. Waste: Do you produce hazardous, special or clinical waste? Frequently Occasionally Never If yes, please provide details: Page 6 of 10

6. ise and nuisance: Have you had complaints with respect to noise or other nuisances (smoke, dust, fumes, odours or other escapes) from your premises? Frequently Occasionally Never If yes, please provide details: 7. Radioactive and dangerous substances: Do you keep, use, accumulate or dispose of radioactive substances? Does your business handle, produce, use or store dangerous substances (including toxic, oxidising, explosive, flammable, etc.) in large quantities and could therefore be subjected to COMAH (Control of Major Accident Hazards)? If you have answered yes to any of the above questions, please provide details below: 8. Incidents/Prosecutions: Have you had any environmental incidents leading to high clean-up costs or a breach of legislation (including prosecution)? If you have answered yes to any of the above questions, please provide details below: 9. Site sensitivity: Are there any surface waters (rivers, lakes, streams, etc.) or boreholes within or adjacent to the site boundaries? Is your site overlying groundwater of significance (e.g. major / minor aquifer)? Do you have listed buildings (Grade I, Grade II*, Grade II) or archaeological sites (tumuli, burial mounds etc.) on site? Is the site within or adjacent to any designated nature conservation sites including Site of Special Scientific Interest (SSSI), National Park, or Special Areas of Conservation? Are there any other conservation issues at the site? Is there evidence to suggest land contamination requiring clean-up is present at the site? If you have answered yes to any of the above questions, please provide details below: Return to page 4 to submit or print document Page 7 of 10

SECTION D - HEALTH AND SAFETY MANAGEMENT Only complete this section if appropriate 1. To which standard are you requiring registration? OHSAS 18001 ISO 45001 SSIP 2. How long has your health and safety management system been in place? 3. Please provide details of the hazards associated with your activities: Hazards Please Tick Details Working with asbestos Working with explosives Working with and storage of flammable substances Transport of dangerous goods Underwater diving at work Working with materials at extreme temperatures Working with dangerous animals Working in proximity to water (risk of drowning) Working with gas Working with ionising radiation Working with lifting equipment and lifting operations Working with biological hazards Working in proximity to moving vehicles Food preparation for other parties Working in compressed air (risk of decompression illness) Working at heights Working in confined spaces Working with pressure systems Use of lead and heavy metals at work Working with fumes/gasses/dust Working with chemical hazards Use of work equipment (PUWER) Other (please specify) Page 8 of 10

4. Please provide details of legislation, regulations and guidance notes applicable to the business: (e.g. Construction Design and Management Regulations, Control of Major Accident Hazards Regulations, etc.) 5. Have you had any incidents leading to or pending prosecution/insurance claims/enforcement notices in the last five years? If yes, please provide details: 6. Please provide a brief description of the company s relationship with regulatory bodies (e.g. HSE): 7. Please state accurately all injuries, diseases and dangerous occurrences (RIDDOR) for the past 12 months: Number of reportable injuries: Fatal Major Over three days Number of reportable dangerous occurrences: Number of reportable accidents involving a member of the public: Details of reportable diseases: Details of reportable injuries: te: Disclosure of information is a requirement for contractual obligation. The applicant may be contacted before issue of a quotation. 8. Please provide a brief description of subcontract activities (if necessary): Return to page 4 to submit or print document Page 9 of 10

SECTION E - ENERGY MANAGEMENT Only complete this section if appropriate 1. To which standard are you requiring registration? ISO 50001 ISO 50001 for ESOS compliance 2. How long has your management system been in place? Please complete questions 3 & 4 for each site within the scope of certification. Contact us for a Site Supplement form. Site name: 3. Energy legislation: Please provide details of the energy regulatory requirements applicable to the site: (e.g. Energy Performance of Buildings Regulations, CRC Energy Efficiency Scheme, EU Emissions Trading System, Climate Change Agreements etc) If yes, please provide details (including permit/licence/registration numbers): 4. Energy usage: Please provide details on the following; Annual energy usage: Estimated premises size (usable floor space in m 2 or sq ft): Description of significant energy uses: Return to page 4 to submit or print document Page 10 of 10