Supplier Registration | Silver Chain

Please select the most appropriate option for your business

Sole trader Partnership Limited company (Pty Ltd) Other

DETAILS ABOUT YOUR ORGANISATION

Legal entity name*

ABN*

Trading as name

YOUR ADDRESS DETAILS

Street address*

Select your state*

Suburb*

Postcode*

POSTAL ADDRESS

Is your postal address different to your street address?

Yes No

YOUR CONTACT DETAILS

Main contact name*

Main contact telephone*

Main contact email*

Main contact fax

WHAT SERVICES ARE YOU ABLE TO PROVIDE?

How many of your staff will be providing a service to our clients?

WHICH REGION BEST REPRESENTS THE AREA/S YOU SERVICE?

Please list the city/area/suburbs/towns in which you are prepared to work

DECLARATION

MANDATORY REPORTING OF COVID-19 VACCINATION STATUS

On and from 1 December 2021 all contractors must not enter or remain at our client properties unless they have had at least one dose of a Covid-19 vaccine, with such persons to be fully vaccinated by 31 December 2021.

This evidence may take the form of a written confirmation from the Department of Health, or a digital vaccination certificate or immunisation history statement issued by Medicare showing the Australian Immunisation Register for that contractor (Vaccination Confirmation).

Are you able to provide COVID-19 vaccination status for all of your staff?

Yes No

UPLOAD DOCUMENTATION

Public liability insurance certificate

Please select a file

HSE policies and/or HSE management plan

Please select a file

Professional indemnity insurance certificate

Please select a file

Workers’ compensation certificate

Please select a file

AHPRA registration/trade licences

Please select a file

Police clearance certificates or company policy

Please select a file

Price schedule

Please select a file

Price schedule (if not attached)

Other

Please select a file

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