Personal Details Your Name* Telephone No.* Email Address* Street Name & No.* Address Line2 Town or City* Postcode* Date of Birth* Do you have the right to work in the UK?* —Please choose an option—YesNo Job Title* National Insurance No.* UTR No.* CSCS Card No.* CSCS Card Expiry Date Please double check before sending that you have checked the information above. If you are not yet registered as Self Employed and don’t have a UTR or Unique Tax Reference the government will automatically stop 30% of any wages earned. If you are not registered as self employed please enter 000000000 into the box provided. Company Details Company or Trading Name, if not put your own name in this box Company Registration No., if your company has a registration number Bank Account No. (THIS IS NOT THE LONG CARD NUMBER)* Sort Code* Name of Account Holder (Required) Bank Account Numbers: your Bank account number is NOT the long number across the card, the Bank Account number is between 8 to 10 digits long and is located near your sort code. All operatives must provide us with accurate information. Whilst we make every effort to assist you correct any errors that have been made we pay you based on the information you provide. Any errors in the information you provide may delay us getting your money to you, so please check carefully before hitting the send button. Emergency Contact Name* Emergency Contact No.* Do you have any serious medical condition that may affect you at work?* —Please choose an option—YesNo If yes, please specify Site Details Site* —Please choose an option—Barking Fielders QuarterChelmsford Beaulieu ParkHarbour Village EbbsfleetFobbing Maple CreekBurnham-on-Crouch Corinthian PlaceHarlow Staple TieCambridge North West M4Cambridge North West M3Ebbsfleet CrossBasildon BroadmayneCuffley King George's ValeGreat Dunmow The GrangePoppy View Saffron WaldenOther Start Date* Subcontractor Details GSQ BRICKWORK LTD SELF EMPLOYED CONTRACT FOR SERVICES This contract of services is between you (the Subcontractor) and us (GSQ Brickwork LTD). Date of Contract* Contractor: GSQ Brickwork LTD, Unit 5, Hadleigh Hub, Hadleigh Park, Chapel Lane, Essex. SS7 2PP Subcontractor Name Subcontractor Email Address Subcontractor Address Right To Work You will be unable to start on Site if these documents are not returned with this form. Please also bring your original documents to Site on day 1 for the Supervisor to Verify. Passport or birth certificate Full picture of photo page CSCS Card Picture of front & back Public Liability Picture of Insurance Certificate Share Code (if non-UK passport) Official confirmation of share code Contract By signing this contract, you are confirming that while you are providing bricklaying services and so on to us, you are working as a self-employed subcontractor. You must do the following: Act in a professional manner at all times Make all reasonable efforts to complete the work to deadline Follow Health & Safety regulations regarding working hours and keep to all reasonable site guidelines relating to work hours and site security Take responsibility for the quality of your work. You must correct any faulty work in your own time, free of charge Hold public liability insurance Provide your own hand tools Pay your own Tax and National Insurance(we deduct CIS tax & forward to HMRC) You will not have to do the following: Move to a different site, although you can agree to do this if you want to and negotiate a new price for doing so Provide written tenders. We will agree rates for all works verbally Provide major items of equipment or materials Do any work you don’t want to do. You can choose whether you want to provide your services. You are not under any obligation to do so Work fixed hours Provide an invoice. We will operate the CIS scheme on all payments to you and provide you with a pay statement for your records You have the right to do the following: Decide how to carry out the work Leave the site without our permission (although you should tell us for Health & Safety reasons) Send someone with similar experience and qualifications in your place. You will be paid for work they do and must arrange to pay them yourself. (You must tell us if you are sending someone else) End this contract without giving notice Take legal advice before signing this contract and to have a copy of it You do not have the right to do the following: Receive sick pay or pay for work that is cancelled due to bad weather Take part in our grievance procedure Refer to yourself as being our employee By signing this contract, you are agreeing to keep to these terms and you are agreeing that these terms will control the working relationship between you and us. You are also agreeing that the terms of this contract represent the whole contract between you and us, not including any verbal negotiation about the price or where you will provide the services. Contractor In this working relationship you are an independent subcontractor and we are the contractor. We must do the following: Agree the rate for the work you do verbally. We will either agree to pay you a fixed price for the work, or an hourly rate. We do not have to do the following: Offer you any work, we may offer you the chance to provide your services, but we do not have to. We have the right to do the following: End this contract without giving notice Take legal advice before signing this contract We do not have the right to do the following: Control the methods you use when you provide your services to us Expect you to drop whatever you are doing to come and provide your services to us By signing this contract, we are agreeing to keep to its terms and we are agreeing that these terms will control the working relationship between you and us. We are also agreeing that the terms of this contract represent the whole contract between you and us, not including any verbal negotiation about the price or where you will provide the services. General The laws of England & Wales apply to this contract. If you break any clause in this contract, the rest of this contract will still be valid. Signatures Contractor: GSQ Brickwork LTD Signature: Subcontractor: Please write your signature in the box below*