Transcription of EXTENSION TO REGISTRATION APPLICATION …
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EXTENSION TO REGISTRATION APPLICATION …
EXTENSION TO REGISTRATIONAPPLICATION FORMAPPLICANT BUSINESS1 Trading Title of Business:(as registered with NICEIC Approved Contractor Scheme) REGISTRATION No:Address:Postal Town:County:Postcode:Telephone No:Business Email:Does your business subcontract (outsource) any of its activities? Yes NoIf yes, please detail the activities: Examples: Scaffolding, Design, etcELECTRICAL WORK IN POTENTIALLY EXPLOSIVE ATMOSPHERESPUBLIC LIABILITY INSURANCE2I confirm that the business s public liability insurance policy covers electrical work in potentially explosive atmospheresYes NoPROPOSED QUALIFIED SUPERVISOR(S) (HA)3 Continued overleaf >The following are proposed to be Qualified Supervisors (HA) with particular responsibility for electrical work inpotentially explosive atmospheresCurrently registered with NICEIC as aName.
NICEIC,Warwick House,Houghton Hall Park,Houghton Regis,Dunstable LU5 5ZX HA/APP/10-01-17 T: 0333 015 6625 E:customer.services@niceic.com W: www.niceic.com 4 RANGE AND SCOPE OF EXTENSION TO REGISTRATION FOR HAZARDOUS AREA APPROVAL Explosive Gas/ Vapour (G) Intrinsic Safety (I) Filling Stations …
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