This Health and Safety application pack should be used for private business working on Council land or in a Council-owned building.

Example as part of Corporate Social Responsibility, business employees clearing weeds and tidying the area on a grass verge.

PACK 2 - PART A – PRIVATE SECTOR VOLUNTARY GROUPS - To be completed by the Council Manager organising the activity with assistance from the employer’s voluntary group representative.

Details of Bradford Council contact:

Manager	Service

Contact number

Email address	Date of application

Details of voluntary group or person

Name of organiser	Email contact

Phone Contact	Registered Charity No	or N/A

Number of volunteers	Work on or close to the highway Yes / No

Summary of voluntary activity

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Proposed dates for activity (or period of time)

Maximum numbers of volunteers on site at any time

Insurance Details

Copy or evidence of Insurance cover from private sector organisation attached

Yes / No (please delete as appropriate)

Insurance arranged through the Council

Yes / No (please delete as appropriate)

PACK 2 PART B – To be provided by the employer of the volunteers.

Names of the private sector employer’s supervisors, who will be responsible for the safety of the activities and supervising their volunteer employees.

NAME	AGE	EXPERIENCE/SKILLS/KNOWLEDGE

(Add supplementary sheet if required)

Risk Assessment of Activity (See Risk Assessment Template)

All activities or projects will require a risk assessment. Examples of activities that will require detailed risk assessment are listed below – please note this is not a complete list

Risk assessment must be produced and provided by the employer of volunteers. Council services can support the production of risk assessments.

For your project, please circle/highlight where risks are applicable or delete if not relevant

Work at height	Work on or near the highway	Work with pesticides or bio hazards	Work with machinery and power tools
Work/digging that could interfere with buried services	Volunteers involved with special needs and/or disabilities (adults/children)	Work with hazardous chemicals	Any work interfering with a fabric of a building (asbestos risk)
Safeguarding issues	Driving	Work near or on water	Lone working

Risk assessment(s) enclosed	Yes / No (please delete as appropriate)

TO BE SIGNED BY REPRESENTATIVE OF PRIVATE SECTOR EMPLOYER

All the information requested above is supplied to the best of my knowledge and we will comply with minimum requirements required by the Council

Name of Representative	Signature	Date

BRADFORD COUNCIL MANAGER OR VOLUNTEER CONTACT

Risk assessment(s) and controls measures have been reviewed

Yes / No (please delete as appropriate)

Any advice received from Occupational Safety Team and Insurance is attached

Yes / No (please delete as appropriate)

I have liaised with this private sector voluntary group and collated all the information

required in Part A and B of this pack.

I have sort additional advice from the Occupational Safety Team and or Insurance Services as required.

I am satisfied after consultation with all parties that this volunteer project will be adequately managed.

Name of Manager	Signature	Date

FINAL APPROVAL - HEAD OF SERVICE

Name of Head of Service	Signature	Date