Subcontractors

Phone

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Subcontractor Pre-Qualification Form

Purpose

This form must be completed by all subcontractors, owner-operators and labour hire providers before engagement with Cropline Group. It covers employment compliance, right to work, modern slavery, WHS, insurance and heavy vehicle accreditation. Responses are assessed by Compliance and Human Resources prior to engagement and reviewed annually. This form operates alongside the CLG Subcontractor Agreement (CLG-WHS12-AGR-001).

⚠ Mandatory Disqualifiers

Certain responses (marked below) will automatically prevent engagement. Not holding required insurance or accreditation is also a mandatory disqualifier. Contact [email protected] if you believe a response was made in error.

Note for Sole Traders & Owner-Operators

Sole traders and owner-operators are not required to hold Workers’ Compensation Insurance; however, they are required to hold Personal Injury Insurance providing cover for up to 104 weeks. A written Modern Slavery Policy is not required for sole traders or small businesses, but should be uploaded if the business has one. Select N/A only where a question genuinely does not apply to your business structure.

Section 1 — Subcontractor / Supplier Details

Legal / Trading Name(Required)

ABN(Required)

11-digit Australian Business Number

Primary HR / Compliance Contact(Required)

Role / Position(Required)

Email(Required)

Phone Number(Required)

Date of Submission(Required)

Section 1 continued — Business Overview

Legal Structure(Required)

Approximate Workforce Size(Required)

Worker Engagement Model (tick all that apply)

Employees (full-time / part-time)

Casual employees

Independent contractors

Labour hire workers

Type of Engagement with Cropline(Required)

Estimated Number of Workers Performing Cropline Work

All persons who will perform work for Cropline under this engagement

No. of Trucks Available(Required)

No. of Trailers Available

Trailer Combinations

Side Tipper

End Tipper

Flat Top

Other

None - Please supply

Nature of Services / Work(Required)

Brief description of work to be performed — e.g. Bulk grain transport, Katanning to Kwinana terminal

Section 7 — WA Heavy Vehicle Accreditation & Vehicle Documents

Mandatory disqualifier where WAHVA accreditation is required for the proposed work.

WAHVA Accreditation

Do you hold current WAHVA Accreditation and agree to upload all required WAHVA documents?(Required)

Yes

No

N/A

Required documents include: (1) current WAHVA Certificate; (2) WAHVA Audit Report dated within the last 12 months; (3) WAHVA Audit Approval Letter dated within the last 12 months. All three documents must be provided. Select N/A only where WAHVA accreditation is genuinely not required for the type of work to be performed. | ⚠ MANDATORY DISQUALIFIER if NO (where WAHVA accreditation is required for the proposed work). N/A is acceptable only where WAHVA is genuinely not required for the work type.

Upload WAHVA Documents

Drop files here or

Accepted file types: pdf|jpg|png, Max. file size: 10 MB, Max. files: 10.

Upload all three required WAHVA documents: current WAHVA Certificate, WAHVA Audit Report (within 12 months), and WAHVA Audit Approval Letter (within 12 months). Multiple files accepted. PDF preferred.

Vehicle Registrations & Permits

Are you willing and able to upload current registrations for all prime movers and trailing assets, including any applicable AMMS permits?(Required)

Yes

No

N/A

Upload current registration documents for all vehicles and trailing equipment intended to be used for Cropline Group work, including prime movers, trailers, dollies and any applicable Accredited Mass Management Scheme (AMMS) or Performance-Based Standards (PBS) permits. | ⚠ MANDATORY DISQUALIFIER if NO (where vehicles or assets are required for the proposed work). Select N/A only where the subcontractor is not providing vehicles or assets.

Section 8 — Safety Management

Does the contractor have a Safety Management Plan (SMP) and safety management system in place?(Required)

Yes

No

N/A

Includes documented safety procedures, hazard identification, risk assessments, incident reporting, emergency response and toolbox / safety meeting records

Section 9 — Additional Information

Required for any YES answers that need explanation, and for FWO / regulatory history.

Details on any YES answers requiring explanation

Reference the question number (e.g. Q—FW8: FWO investigation 2023, resolved by...)

FWO / Regulatory history (if applicable)

Dates, outcomes and remediation taken. A past issue does not automatically disqualify engagement.

Any other relevant information

Section 9 continued — Supporting Document Uploads

Document Uploads

Please upload the three documents below where available. All documents are treated as confidential and used solely for pre-qualification assessment purposes. PDF, Word or image files accepted — max 10MB per file.

Sample VEVO or Right-to-Work Check Record (de-identified)

Drop files here or

Accepted file types: pdf|doc|docx|jpg|png, Max. file size: 10 MB, Max. files: 10.

Remove worker names before uploading. A screenshot or printed VEVO result is acceptable.

Evidence Supporting Modern Slavery Controls

Drop files here or

Accepted file types: pdf|doc|docx|jpg|png, Max. file size: 10 MB, Max. files: 10.

e.g. Modern Slavery Policy, supplier or subcontractor code of conduct, grievance mechanism documentation, or training records.

Sample Employment or Contractor Agreement (de-identified)

Drop files here or

Accepted file types: pdf|doc|docx|jpg|png, Max. file size: 10 MB, Max. files: 10.

Remove individual names before uploading. This shows your standard engagement terms and conditions.

Section 10 — Declaration & Sign-Off

I confirm that the information provided is true and correct and that our business complies with all applicable employment, industrial relations, safety and modern slavery laws. Without limitation, I confirm that:

Workers are correctly classified as employees or independent contractors.
Employees are paid at least the minimum lawful rates, including applicable overtime, penalties, allowances and entitlements.
Independent contractors are genuinely independent and not misclassified.
Employment records are maintained in accordance with Fair Work requirements.
No sham contracting arrangements are used.
All insurances and accreditations declared as held are current and meet the minimum requirements specified.
All information provided in this form is true and accurate to the best of my knowledge.
I agree to notify Cropline Group immediately if any circumstances change that may affect my responses, including the cancellation or lapse of any insurance policy.
I acknowledge that my engagement is subject to the CLG Subcontractor Agreement (CLG-WHS12-AGR-001), including modern slavery obligations in clause 24.
I consent to Cropline Group retaining this submission as part of their compliance and due-diligence records and acknowledge that false or misleading information may result in termination of engagement.

Declaration Confirmation(Required)

I have read and agree to the declaration above. All information provided is true and accurate to the best of my knowledge.

You must tick this box to submit the form.

Full Name of Signatory(Required)

Position / Title(Required)

Business / Trading Name(Required)

Date(Required)

Digital Signature

By typing your full name below and ticking the confirmation box, you are providing a digital signature and confirming your identity. This digital signature has the same legal effect as a handwritten signature under the Electronic Transactions Act 2011 (WA) and Electronic Transactions Act 1999 (Cth). Your submission timestamp, IP address and form data will be recorded as evidence of execution.

Sign by typing your full legal name exactly as it appears above. Your typed name constitutes your digital signature and confirms your agreement to the declaration.

Type your full name to sign *

Signed on behalf of: [Business / Trading Name] | Date: [Date]

Digital Signature — Type Full Legal Name(Required)

By typing your full legal name below, you acknowledge and agree that this constitutes your electronic signature for the purposes of the Electronic Transactions Act 2011 (WA) and Electronic Transactions Act 1999 (Cth).

Untitled

Become a subcontractor with Cropline Group

Expression of Interest

Subcontractor Pre-Qualification Form

Subcontractor Pre-Qualification Form

Section 1 — Subcontractor / Supplier Details

Section 1 continued — Business Overview