On letter-headed paper of Applicant

Declaration that Applicant can meet Minimum Health and Safety Standards in regard to Educational and Professional Qualifications in Supplement 3.4.1 to Suitability Questionnaire

To:	[Name and address of Contracting Authority]
Regarding:	[Title of contract]
Date:

Minimum health and safety standards in

Supplement 3.4.1 for criteria 3.4.1a and 3.4.1b

A Dhaoine Uaisle

I declare that as an applicant interested in being assessed for suitability for [insert name of project] I declare that I can meet the minimum health and safety standard for the Educational and Professional Qualifications criteria in Supplement 3.4.1 attached to Suitability Questionnaire QW4.

Furthermore, I will provide the required evidence within seven calendar days to support this declaration when requested to do so prior to short-listing.

Is mise, le meas

Signed ____________________________

On behalf of [Name of Specialist]