Consortium Lead Contact First Name Last Name Job Title Email Organistion Details City Postcode Phone Number Email Please tell us about the legal structure of your organisation Company Limited by Guarantee Yes No Company Number Company Number - Date of registration Community Interest Company Yes No Community Interest Company Number Community Interest Company - Date of registration Charitable Incorporated Organisation Yes No Charitable Incorporated Organisation Number Charitable Incorporated Organisation - Date of registration Industrial and Provident Society Yes No Industrial and Provident Society Number Industrial and Provident Society - Date of registration Constituted Group (Unincorporated Association) Yes No Constituted Group - Date of registration Other Organisation Type Yes No Other Company Type Details Organisation Name (in full) Abbreviated or other name Address line 1 Address line 2 Website Chief Officer / Director / Chief Executive First Name Last Name Job Title Email A written volunteer policy that includes pre-volunteering checks, including DBS Yes No n/a Organisation Details Is your organisation a registered charity? Yes No Charity Number Registered Charity - Date of registration VAT Number Please describe briefly the mission and services/activities of your organisation Who are the main target groups for your services / activities? If you only work in specific areas of Salford, please tell us where City Wide (whole of Salford) Claremont, Weaste & Seedley East Salford Eccles Irlam & Cadishead Little Hulton & Walkden Ordsall & Langworthy Swinton Worsley & Boothstown Please provide a brief summary of the evidence of need & demand for your services/activities What benefits and wider impacts do your organisation’s services/activities generate? During the last financial year how many Salford people benefited from your services/activities? How many Full-Time Equivalent (or FTE) employees do you have? What is the total number of staff you employ? How many volunteers does your organisation have? Financial Information Turnover markup What was your turnover in the last two years? Annual Turnover £ Year 1 £ Date for Year 1 ended Annual Turnover £ Year 2 £ Date for Year 2 ended Funders Please provide details of two recent contracts you have held. Funder name (1) Contract Start Date (1) Contract End Date (1) Contract Value (1) £ £ Funder name (2) Contract Start Date (2) Contract End Date (2) Contract Value (2) £ £ Referee If ‘Yes’, please give details. Please include contract period dates, termination date, value and reasons for termination Referee 1 - Name Referee 1 - Job title Referee 1 - Organisation Referee 1 - Email Referee 2 - Name Referee 2 - Job title Referee 2 - Organisation Referee 2 - Email Insurance Employers Liability Insurance Yes No Employers Liability Insurance Value £ Public Liability Insurance Yes No Public Liability Insurance Value £ Professional Indemnity Insurance Yes No Professional Indemnity Insurance Value £ Quality marks PQASSO Matrix IIP ISO Other Date accreditation was awarded Date accreditation will be reviewed If not, does your organisation have in place a quality assurance system, which is not externally accredited: e.g. PQASSO self-assessment, Social Accounting & Audit etc. (Please specify) If you do not have a quality accreditation or quality assurance system in place please explain what mechanisms you use to ensure quality assurance? Are you registered with HMRC schemes for tax and national insurance payments? Yes No Are your accounts independently examined? Yes No Are your accounts independently audited? Yes No Has your organisation met the terms of its banking facilities and loan agreements (if any)? Yes No If 'No' what were the reasons and what has been done to put things right? Has your organisation met all its obligations to pay its creditors and staff during the past year? Yes No If 'No' please explain why not: Can you supply a copy of your most recent accounts? Yes No A statement of your turnover, profit and loss account and cash flow for the most recent year of trading? Yes No A statement of your cash flow forecast for the next 12 months and a bank letter outlining the current cash and credit position? Yes No Brief Description (1) Brief Description (2) Have you had any contracts terminated for poor performance in the last three years, or any contracts where damages have been claimed by the contracting authority? Yes No If ‘Yes’, please give details. Please include contract period dates, termination date, value and reasons for termination Other Insurance - Please provide details Health and Safety Fire risk assessments Yes No General risk assessments for outings and activities Yes No Does your organisation have a written health and safety at work policy? Yes No Is it reviewed annually? Yes No Does your organisation have an organisational risk register, which covers Governance, Financial, Operational, Legal & Regulatory and External issues? Yes No Policies Safeguarding Children Policy Yes No Not applicable Vulnerable Adults Policy Yes No Not applicable Have you implemented the Salford safeguarding standards? Yes No Equality and Diversity Policy Yes No Data Protection policy or statement Yes No Which of the following statements best applies to your organisation? - None -Our financial procedures are currently not written downWe have a written statement outlining the financial decision making process for our organisationWe have a written financial procedures policy which covers: financial decision making process, how to bank cheques, signatories on your account, petty cash process and who you bank withWe have a financial handbook which covers: payroll, purchase order process, raising sales invoices, credit control and capital equipment purchases A written recruitment policy Yes No A written Disciplinary and Grievance policy Yes No A written appraisal, supervision and management policy Yes No A written contract and terms and conditions of employment Yes No A written environmental policy Yes No Do you have a written Annual plan Three year Business plan Five year Strategy Business plan A written comments and complaints policy Yes No A written business continuity policy Yes No Governance Does your organisation's governing document enable your organisation to enter into contracts to fulfil your organisation's primary purposes (objects)? Yes No Does your organisation's governing document enable your organisation to work in partnership? Yes No Does your governing document stipulate which geographic areas you are allowed to operate in? Yes No If yes, please specify Does your organisation have a Trustee handbook that includes information on Trustee roles and responsibilities and register of interests? Yes No Do you submit annual returns to the appropriate authorising body for your organisation? Yes No Do you hold an annual AGM? Yes No Professional and Business Standing Is in a state of bankruptcy, insolvency, compulsory winding up, receivership, composition with creditors, or subject to relevant proceedings Yes No Has been convicted of a criminal offence related to business or professional conduct Yes No Has committed an act of grave misconduct in the course of business Yes No Has not fulfilled obligations related to payment of social security contributions Yes No Has not fulfilled obligations related to payment of taxes Yes No Is guilty of serious misrepresentation in supplying information Yes No Is not in possession of relevant licences or membership of an appropriate organisation where required by law Yes No If the answer to any of these is 'Yes' please give brief details, including what has been done to put things right: Monitoring and Evaluation Monitoring and evaluation systems Unique Selling Points What are your organisation's unique selling points? Most recent accounts Most recent accounts Year 1 One file only.2 MB limit.Allowed types: gif, jpg, jpeg, png, txt, pdf, doc, docx. Most recent accounts Year 2 One file only.2 MB limit.Allowed types: gif, jpg, jpeg, png. Most recent accounts Year 1 Most recent accounts Year 2 Employers Liability Insurance Certificate Employers Liability Insurance Certificate One file only.2 MB limit.Allowed types: gif, jpg, jpeg, png, txt, pdf, doc, docx. Employers Liability Insurance Certificate Public Liability Insurance Certificate Public Liability Insurance Certificate One file only.2 MB limit.Allowed types: gif, jpg, jpeg, png, txt, pdf, doc, docx. Public Liability Insurance Certificate Professional Indemnity Insurance Professional Indemnity Insurance Certificate One file only.2 MB limit.Allowed types: gif, jpg, jpeg, png, txt, pdf, doc, docx. Professional Indemnity Insurance Certificate Quality Mark Certificate Quality Mark Certificate One file only.2 MB limit.Allowed types: gif, jpg, jpeg, png. Quality Mark Certificate Safeguarding Children Policy Safeguarding Children Policy One file only.2 MB limit.Allowed types: gif, jpg, jpeg, png, txt, pdf, doc, docx. Safeguarding Children Policy Document Vulnerable Adults Policy Vulnerable Adults Policy One file only.2 MB limit.Allowed types: txt, pdf, doc, docx. Vulnerable Adults Policy Document Health and Safety policy Health and Safety policy One file only.2 MB limit.Allowed types: txt, pdf, doc, docx. Health and Safety policy Equality and Diversity Policy Equality and Diversity Policy One file only.2 MB limit.Allowed types: gif, jpg, jpeg, png, txt, pdf, doc, docx. Equality and Diversity Policy Document Data Protection policy or statement document Data Protection policy or statement document One file only.2 MB limit.Allowed types: gif, jpg, jpeg, png, txt, pdf, doc, docx. Data Protection policy or statement document Governing document Auto File Filling Javascript Governing document One file only.2 MB limit.Allowed types: gif, jpg, jpeg, png, txt, pdf, doc, docx. Governing document Collaboration Agreement Collaboration Agreement Markup Please upload your signed Collaboration Agreement. Digital signatures are accepted. Our Collaboration Agreement One file only.2 MB limit.Allowed types: gif, jpg, jpeg, png, txt, pdf, doc, docx. Declaration Declaration We certify that the information given in this questionnaire about our organisation is true and confirm that any enclosures are current, accurate and adopted or approved by our organisation. We understand that, if we make any seriously misleading statements (whether deliberate or accidental) at any stage during the membership process, or if we knowingly withhold any information, this could make our application to the Consortium invalid. We understand that the information provided within this questionnaire, which is not commercially sensitive, will be used in the membership directory of the Salford Third Sector Consortium. We understand that all the information provided within this questionnaire will be used to allocate our organisation to an appropriate contract threshold and cluster group membership. We agree to notify the Hub, currently Salford CVS, of any changes or updates in our policies and the information contained within the questionnaire. Declaration agreement Our organisation agrees to the above declaration