ISP | Service Provider Registration Form

INSURAPLEX SERVICE PROVIDER APPLICATION FORM

Thank you for choosing Insuraplex as a building partner. At Insuraplex we value a high level of transparency between Insuraplex and the sub-contractors completing our building works.

Please refer to our website www.insuraplex.com.au to review our terms and conditions, policies and codes of conduct to ensure you are the right fit to work for Insuraplex.

Employee / contractor code of conduct
Environmental Policy
Work Health & Safety Policy
Purchase order terms and conditions

We appreciate that every trade and supplier is different. Please complete this form and provide as many attachments as you can to assist Insuraplex in making the right decision going forward.

Please have the following information ready to prepare yourself for this application process:

Company details e.g Name, ABN, address and contact details
Bank account details i.e account to be paid into
Current Public Liability Insurance certificate
Current Work Cover Insurance certificate
Contact details for two (2) referees who can confirm your quality of work

Company Details

Trading Name

ABN

ABN Lookup

Are you registered for GST?

You can get this information from abr.business.gov.au

Address

Street Number

Street Name

Street Type

Suburb

State

Postcode

Postcode Lookup

Country

Day-to-day Contact Person Details

The main person we'll be speaking to about jobs

Salutation

First Name

Last Name

Phone No

Mobile No

Company Contact Email Address

Company Finance Email Address

Bank Account Details (Account where Invoices will be paid into)

BSB Number

Account Number

Trades and Services

Are you available for after hours make safe work?

Primary Trade or Service

Secondary Trade or Service 1 (Optional)

Secondary Trade or Service 2 (Optional)

Secondary Trade or Service 3 (Optional)

What geographic areas do you cover?

Other:

How many working site staff do you have?

What is your preferred job value?

(Can choose multiple)

Please provide name and contact number for two referees who can confirm your quality of work

Documents

Insuraplex don't want to waste your time asking you to travel from job to job quoting work at tendering stage when we have not won the work yet. Therefore to assist us in quantifying costs can you please supply us with any relevant documentation for example -1-Schedule of charge out rates for your staff and any relevant equipment and advise if you add a margin to any materials what this is IE 5% etc. Also, please include SWMS as relevant to your trade or service.

(Maximum of 20MB total)

Type

Select File

Type	Filename	Trade	Policy No	Expiry Date	Del

Declaration

We acknowledge that our company will induct our staff and contractors in to the Insuraplex Subcontractor Generic OH&S / WH&S Induction prior to commencing works. We acknowledge that our company will perform Reference Checks and Criminal History Checks on all staff and contractors, and verified that they can Legally Work in Australia prior to commencing works. I have checked that all details in this form are correct.

Message

Information

INSURAPLEX SERVICE PROVIDER APPLICATION FORM

Please have the following information ready to prepare yourself for this application process:

Company Details

Address

Day-to-day Contact Person Details

Bank Account Details (Account where Invoices will be paid into)

Trades and Services

(Can choose multiple)

Documents

Declaration

Application Completed

Thank you for filling out your information!

Message

Information

Are You Sure?

Message

INSURAPLEX SERVICE PROVIDER APPLICATION FORM

Please have the following information ready to prepare yourself for this application process:

Company Details

Address

Day-to-day Contact Person Details

Bank Account Details (Account where Invoices will be paid into)

Trades and Services

(Can choose multiple)

Documents

Declaration

Application Completed

Thank you for filling out your information!