Application Form
and Guide for
School Cleaning
Panel Status
Published by the
Infrastructure and Sustainability Division
Department of Education and Training
Melbourne
February 2015
©State of Victoria (Department of Education and Training) 2015
The copyright in this document is owned by the State of Victoria
(Department of Education and Training), or in the case of some
materials, by third parties (third party materials). No part may be
reproduced by any process except in accordance with the
provisions of the Copyright Act 1968, the National Education
Access Licence for Schools (NEALS) (see below) or with
permission.
An educational institution situated in Australia which is not
conducted for profit, or a body responsible for administering such
an institution may copy and communicate the materials, other than
third party materials, for the educational purposes of the institution.
Authorised by the Department of Education and Training,
2 Treasury Place, East Melbourne, Victoria, 3002.
This document is also available on the internet at
http://www.education.vic.gov.au/school/principals/infrastructure/Pa
ges/cleaning.aspx
Contents
1
Application Guide
3
1.1
Effect of this guide
3
1.2
Further information and clarification
3
1.3
Assessment process
3
1.4
Conditions of application
3
1.5
Assessment criteria
4
1.6
Timelines
4
1.7
Achievement of Panel Status
4
1.8
Remaining on the Panel
4
1.9
Panel Status, continuing obligations and revocation
5
1.10
Enquiries
5
1.11
Lodgement of applications
5
1.12
Disclaimer
5
1.13
Statutory declaration
6
1.14
Non-conforming applications
6
1.15
Changes
6
1.16
Updating details
6
1.17
English language and metric units
6
1.18
Commercial background assessment
6
1.19
Assessment of applicant's industrial relations record
7
1.20
Ownership of applications
7
1.21
Employment conditions and equal opportunity
7
1.22
Use of information and exchange of information between government
agencies
7
2
3
1.23
Confidentiality and disclosure
8
1.24
Costs of application
8
1.25
Government procurement guidelines
8
1.26
Assignment and subcontracting
8
1.27
Services delivered under panel system
8
1.28
Definitions
9
Application Form
3
2.1
Application type
3
2.2
Previous Panel registration
3
2.3
School cleaning contracts
3
2.4
Municipalities
4
Application Criteria
3.1
5
Occupational health and safety (OH&S) practices
5
Contents continued
3.2
Sound practices in human resource management
13
3.3
Compliance with industrial awards or instruments
17
3.4
Ability to effectively manage contractual commitments
21
3.5
Ability to provide client focussed services
23
4
Applicant’s Statutory Declaration
26
5
Supporting documents
27
5.1
Department Panel Agreement
27
5.2
List of Attachments
27
1 Application Guide
This Guide is for sole traders and companies with employees (Applicants) to submit
information for assessment by the Department, to determine the eligibility of Applicants
to tender for future cleaning contracts in Victorian government schools.
All School Councils are required to engage the services of a cleaning contractor
with Panel Status.
Please complete ALL sections of the Application Form, unless otherwise specified.
Please DO NOT staple or bind your application.
1.1
Effect of this guide
No contractual or legal obligations arise from this guide beyond the intention of the
Department of Education and Training (the Department) to assess applications and
grant panel status to applicants, if appropriate.
This is not a tender process that will lead automatically to any contractual arrangement
with a school. This guide does not guarantee that schools will offer, continue or extend
cleaning service contracts to cleaners that gain Panel Status. The Department's
intention is to grant panel status to suitable applicants, and those applicants will be
eligible to submit tenders for future cleaning contracts.
A successful application enables the applicant to be listed on a panel of approved
cleaning contractors. Approved applicants should then respond to calls for tenders from
individual school councils advertised in daily newspapers. All contractors must quote
their Panel registration number when submitting a tender.
Applicants are required to sign a contract with the Department (Department Cleaning
Panel Agreement) and attach two copies of that contract to their application.
Applicants who gain panel status will also be required to sign a separate contract with
the individual school council (School Council Agreement for the Provision of Cleaning
Services) if a school wishes to engage the applicant following a tender process.
1.2
Further information and clarification
Despite any other requirement of the Guide, the Applicant must, if so required, submit
additional information to allow full consideration of the Application. There is no
obligation on the part of the Department to seek clarifying or any other information not
provided as part of the Application Form, if the application is incomplete.
1.3
Assessment process
The assessment process will be managed by the Department and its Contract Cleaners
Assessment Committee (CCAC). The CCAC will make recommendations to the
Department concerning the assessment of applications and the ongoing panel status of
applicants, for determination by the Department. The Department is not bound to
accept the CCAC recommendations.
1.4
Conditions of application
Each application must be submitted in accordance with the terms and conditions of
these guidelines and all attachments and any additional terms and conditions that the
Department may provide on its website at
http://www.education.vic.gov.au/school/principals/infrastructure/Pages/cleaning.aspx
Application Guide
3
Applicants will be taken to:

have read this guide, and any other information, including any changes issued and
made available in writing by the Department for the purpose of applying;

have considered all information relevant to the risks, contingencies, and other
circumstances having an effect on their Application; and

be satisfied as to the correctness and sufficiency of their application to be assessed
against the Assessment Criteria of this Application form.
1.5
Assessment criteria
Applicants must demonstrate:

sound practices to promote occupational health and safety

sound practices in human resource management

compliance with relevant industrial awards/instruments

ability to effectively manage contractual commitments

ability to provide client focussed services.
1.6
Timelines
The time frame for consideration of an Application is expected to be between 30 and 90
days. This is only a guideline and should not be relied upon by an Applicant.
1.7
Achievement of Panel Status
The Department is under no obligation to approve any Application.
The Department may deal with an Application as follows:

reject the Applicant (with or without a time period prior to which the Department will
not consider a further or amended Application from the Applicant) or;

approve the Applicant for Panel Status; or

approve an Application for Panel Status, but only with effect from the date when the
Applicant has satisfied the specific requirement (eg. Applicant will be accepted on the
Panel when the Applicant provides the Panel with documents confirming a particular
matter).
Applicants must note that achieving Panel Status is in no way to be taken as approval
by the Department of the adequacy or appropriateness of compliance by the applicant
with any law or legislation.
Admission to the panel is determined by how well an applicant satisfies the assessment
criteria
1.8
Remaining on the Panel
Once a cleaning contractor obtains panel status they will maintain panel status
indefinitely unless:

the Department revokes a cleaning contractor's panel status, or

a cleaning contractor who gains panel status is not engaged by a school for a period
of two years, in which case the panel status will cease automatically after the expiry
of the two year period.
The Department (under the Department Cleaning Panel Agreement) and schools
(under the School Council Agreement for the Provision of Cleaning Services) have the
4
Application Form and Guide for School Cleaning Panel Status
right to terminate these contracts. However, Panel Status is not affected by the
termination of a School Council Agreement for the Provision of Cleaning Services by a
school council.
The grounds for revocation are set out in the Department Panel Cleaning Agreement.
1.9
Panel Status, continuing obligations and revocation
Any Applicant that achieves Panel Status is under an obligation to maintain that status
by ensuring continuing compliance with the assessment criteria and all relevant
legislation, including occupational health & safety legislation and regulations, relevant
industrial legislation and instruments, taxation legislation, corporate regulation and the
criminal law.
Applicants with Panel Status may be subject to an audit at intervals at the discretion of
the Department.
1.10 Enquiries
Applicants may request clarification of this document in writing. Any response by the
Department will be written and may, if of general application, be issued as a change.
All enquiries should be directed, in writing via email, to cleaning@edumail.vic.gov.au
1.11 Lodgement of applications
Applicants shall address and lodge applications as follows:
labelled
APPLICATION FOR PANEL STATUS
addressed to
School Contract Cleaning Unit
Infrastructure and Sustainability Division
Department of Education and Training
and posted to
GPO Box 4367
MELBOURNE VIC 3001
OR delivered in
person to
GOODS RECEPTION
Basement, 2 Treasury Place
EAST MELBOURNE VIC 3002
1.12 Disclaimer
While these guidelines and Application Form have been prepared with all due care, the
Department does not warrant the document is free from errors or omissions.
Please advise the School Contract Cleaning Unit if you identify any discrepancy, error
or omission in the guidelines,
The Department is in no way liable for the accuracy of any information printed or stored
by a user after downloading material from the Department's website. Any applicant who
utilises an automatic language translation service in connection with the guidelines
does so at their own risk.
Application Guide
5
1.13 Statutory declaration
An Applicant must submit its Application with a fully completed Statutory Declaration as
set out in the Application Form. Applications not accompanied by the appropriate
Statutory Declaration may be regarded as non-conforming.
Failure to supply
information in full may render the Application non-conforming. A non-conforming
Application may be rejected by the Department.
1.14 Non-conforming applications
An application that is:

at variance with or does not respond to or does not fully comply with any requirement
of the Application; or

contains erasures or is illegible;
may be deemed to be non-conforming.
The Department may, in respect of an Application that is non-conforming or which has
been deemed by the Department to be non-conforming:

reject and not further consider the application; or

ignore any non-conformance in the application; or

if it is possible to correct the non-conformance without affecting the probity of the
assessment process, permit the Applicant to do so.
1.15 Changes
At any time, the Department may issue changes to the Guide for the purposes of
clarifying documents or to notify any amendments to this Guide. Where a Guide is
downloaded from the Department's website, Applicants assume responsibility for
ensuring that any changes are incorporated or taken into account in their Application. It
is the sole responsibility of the Applicant to check the Department's website for any
changes prior to submitting an Application.
Applicants must sign any amendment or change to their Application and may be
considered non-conforming if they do not do so.
1.16 Updating details
If information provided in an Application changes (for example, the ABN changes or the
business structure changes) you must provide this updated information to the School
Contract Cleaning Unit.
In some circumstances, such as a change of status from Proprietor Labour to
Contractor with Employees, a new Application may be necessary.
1.17 English language and metric units
All Application Schedules and all communications with the Department must be in the
English language. All references to measurements must be in metric units.
1.18 Commercial background assessment
By submitting an Application, the Applicant consents to the Department seeking further
information and investigating the Applicant's commercial viability and financial status.
Where an Act or Regulation requires that an applicant (as described by that Act or
6
Application Form and Guide for School Cleaning Panel Status
Regulation) be registered or licensed to carry out the services, evidence of registration
or licensing must be produced by the Applicant in its Application. The Department may
seek information from sources, including regulatory and law enforcement bodies,
relevant to whether the Applicant can perform the Services.
1.19 Assessment of applicant's industrial relations record
By submitting an Application, the Applicant consents to the Department investigating
the Applicant's Industrial Relations compliance on behalf of the Department.
1.20 Ownership of applications
All applications will become the property of the Department, which may use each
Application for assessment for Panel Status.
Applicants shall retain intellectual property rights in their Application. By submission of
an Application, each Applicant authorises the Department to copy, reproduce, use or
supply intellectual property of the applicant for any purpose in respect of the
assessment of the Application.
The Applicant will ensure that no third party intellectual property rights are infringed by
the Department's possession or use of the material provided by the Applicant
1.21 Employment conditions and equal opportunity
Without limiting the obligations of any Applicant to comply with all industrial relations
and employment conditions applicable to it, the Victorian Government requires that any
contractor engaged by the Department ensures that the appropriate legislative
minimum rates of pay and conditions of employment are afforded all employees
engaged by the Applicant and any of its subcontractors.
1.22 Use of information and exchange of information
between government agencies
By submitting an Application, the Applicant:

authorises the Department to obtain from any Victorian Government department or
agency, or any other Australian State or Federal department or agency, information
including, but not limited to, details of the Applicant's performance during any
previous or current contracts for services similar to those sought in this Guide; and

confirms that to the extent legally possible it shall take all steps as are necessary to
satisfy any request from the Department for information (including without limitation
police criminal record statements or citizenship visa or residency status) as relating to
any employee, shareholder or officer of the Applicant if that information could affect
the potential or actual or ongoing delivery of cleaning services to the Department; and

authorises the Department to contact any third party who is referred to in the
Application, or the author of any documents which are provided by the Applicant in its
Application.
The provision of information by the Department to any other Victorian Government
department or agency is acknowledged by the Applicant to be a communication in
circumstances of qualified privilege and the Applicant shall have no claim against the
Department, in defamation or otherwise, in respect of any matter arising out of the
provision or receipt of such information, including any claim for loss to the Applicant
arising out of the communication.
Application Guide
7
1.23 Confidentiality and disclosure
Applicants should be aware that the Department may be required to disclose
information regarding an Applicant, either under the Freedom of Information Act 1982
(Vic) or by the responsible minister or under the provisions of the Financial
Management Act 1994 (Vic).
1.24 Costs of application
The Department will make no payment to an Applicant:

for any costs, losses or expenses incurred by an Applicant in preparing its
application; or

in respect of any discussions, negotiations, enquiries or requests for details or
information made by or on behalf of the Department after the submission of
Applications; or

for any work undertaken by any applicant after its application is submitted including
work requested by the Department in accordance with any provision of the
Application.
1.25 Government procurement guidelines
By virtue of the Financial Management Act 1994 (Vic), the Victorian Government
Purchasing Board may issue procurement guidelines and policies that will influence
future Victorian government contracts.
Applicants who have Panel Status and are successful in being engaged by schools, will
be required on an ongoing basis to demonstrate their compliance with the Department's
Ethical Employment Standard, as defined in the Department Cleaning Panel
Agreement.
1.26 Assignment and subcontracting
An Application is valid only for the Applicant submitting it and Panel Status, if granted,
is not assignable or transferable by an Applicant to any contractor, subcontractor,
franchisee or other person or legal entity.
1.27 Services delivered under panel system
The services to be delivered under contract by Panel Status contractors are cleaning
services in Victorian government schools. Cleaning frequency and scope will be
specified by schools and will include all general and specialist areas such as toilet and
shower areas, carpeted areas, kitchen, food preparation and staff rooms and furniture,
fittings and fixtures.
Major cleans in holiday periods may be undertaken. Other cleans required by individual
schools will be specified in contract documentation.
8
Application Form and Guide for School Cleaning Panel Status
1.28 Definitions
In this Guide, unless a contrary intention is indicated:
Term
Meaning as used in this document
Applicant
means the party submitting an application to gain panel
status
means the submission by an applicant seeking
admission to the Contract Cleaners Panel
means the Department's Contract Cleaners'
Assessment Committee which makes
recommendations to the Department about the
assessment of applications and the ongoing panel
status of cleaning contractors
includes step children and foster children
Application
CCAC or
children
conflict of interest
DET or
the Department
Department Cleaning
Panel Agreement
discretion of the
Department
EEO
Guide
OHS
OHS Act 2004
means a situation where an applicant has a personal or
family relationship, or an actual or potential business
relationship with:
 a person employed by a school or on a school council
or in a position to materially influence that employee
or school council member, at a school where the
applicant is currently performing cleaning services, or
at a school where the applicant would seek to
perform cleaning services
 a member of the Department who is or is likely to be,
involved in the assessment of an application for
admission to the Contract Cleaners Panel
means the Department of Education and Training
means the agreement between the Department and a
cleaning contractor that sets out the obligations of
contract cleaners on the panel
means the sole, absolute and unfettered discretion of
the Department
means Equal Employment Opportunity
means this document which describes the conditions,
requirements and selection criteria associated with the
Contract Cleaners Panel
means occupational health and safety
Panel status
means the Occupational Health and Safety Act 2004
(Vic)
means the Panel of Contract Cleaners established by
the Department comprised of applicants that have
successfully qualified or been preselected by the
Department
means being on the Contract Cleaners Panel
Parent
includes a step parent or foster parent or parent-in-law
Panel
Application Guide
9
Term
Meaning as used in this document
proprietor labour
means:
 an applicant operating or proposing to operate as a
sole trader, or as a partnership of no more than two
partners, to deliver school cleaning services without
employee labour
 an applicant operating or proposing to operate as a
sole trader, or as a partnership of no more than two
partners, that employs a maximum of four persons to
perform services and that those employees are
exclusively, themselves, their parents, spouse or
children
 an applicant operating as a company engaging up to
a maximum of four employees, and those employees
are either shareholders of the applicant, or the
parents, spouse or children of a shareholder
provided that:
 the applicant will never have more than four people
working in the business, including any proprietor, sole
trader, partners or employees
 during the time it has panel status the applicant must
continue to operate within the above definitions
means the assessment process conducted by the
Department for appointment to the panel of applicants
who, at the time they submit their application, have an
existing cleaning engagement with one or more schools
means cleaning services sought to be provided by the
applicant including as set out in the statement of
requirements
means the agreement that an Applicant with Panel
Status would be required to sign with an individual
school council, if it is determined by that school that it
wishes to make arrangements to engage the Applicant
means a husband, wife or de facto
Qualification
Services
School Council
Agreement for the
Provision of Cleaning
Services
Spouse
Specialist Cleaning
Services
State
10
means persons providing, on an intermittent or periodic
basis, carpet, curtain or other fabric steam cleaning,
window cleaning, specialist toilet cleaning or steam or
pressure cleaning by third parties of interior or exterior
school walls
means the Crown in the right of the State of Victoria
Application Form and Guide for School Cleaning Panel Status
2 Application Form
Entity Name:
Record the name on your Australian Business Number (ABN) registration
Registered
Name:
Business
If you are operating as a sole trader, partnership or a trust, and not as a company, provide your business
name registered with the Australian Securities and Investments Commission (ASIC).
ABN:
Australian Business Number
ACN:
Australian Company Number (if any)
Registered for GST?
Registered
Address:
Yes
No
Business
NOT a Post Office Box. Enter any building details and Street eg. Level 1, Victoria House, 12 Smith Street
Town / Suburb
State
Postcode
Business Telephone:
Office
Mobile
Business Email:
Correspondence regarding this application will be sent to this email address
Postal Address:
If your postal address is the same as your registered business address, please state “as above”
Town / Suburb
State
Contact Person:
Name of person submitting application / Company or business representative
Contact Telephone:
Office
Mobile
Contact Email:
Application Form
3
Postcode
2.1
Application type
Are you applying for admission to the School Contract Cleaners Panel as a contractor
with employees or as proprietor labour?
Indicate 
Contractor with employees
Proprietor Labour*
*Please refer to the full definition of Proprietor Labour in the table at Section 1.28.
Applicants granted Panel status as Proprietor Labour may not employ staff to
provide cleaning services. The cleaning services must be provided by the sole
trader applicant or a family partnership of up to four immediate family members.
2.2
Previous Panel registration
Have you previously applied for admission to the School Contract Cleaners Panel?
Indicate 
yes
no
If ‘yes’, please provide:
Panel Application Number (if known):
____________
Panel Registration Number (if known):
____________
2.3
School cleaning contracts
Have you ever had a cleaning contract with a Victorian government school?
Indicate 
yes
no
Have you ever had a cleaning contract with a childcare centre or non-government
school?
Indicate 
yes
no
List the schools and child care centres and include the relevant contract expiry date/s.
School Name
Contract dates
If insufficient space, please attach a separate list
Application Form
3
2.4
Municipalities
Indicate  municipalities within Victoria in which you are willing to provide cleaning
services.
2.4.1
2.4.2
4
Metropolitan Melbourne
Banyule
Glen Eira
Maroondah
Port Phillip
Bayside
Greater Dandenong
Melbourne
Stonnington
Boroondara
Hobson’s Bay
Melton
Whitehorse
Brimbank
Hume
Monash
Whittlesea
Cardinia
Kingston
Moonee Valley
Wyndham
Casey
Knox
Moreland
Darebin
Manningham
Mornington Peninsula
Frankston
Maribyrnong
Nillumbik
Alpine
Gannawarra
Macedon Ranges
South Gippsland
Ararat
Glenelg
Mansfield
Southern Grampians
Ballarat
Golden Plains
Mildura
Strathbogie
Bass Coast
Greater Bendigo
Mitchell
Surf Coast
Baw Baw
Greater Geelong
Moira
Swan Hill
Benalla
Greater Shepparton
Moorabool
Towong
Buloke
Hepburn
Mount Alexander
Wangaratta
Campaspe
Hindmarsh
Moyne
Warrnambool
Central Goldfields
Horsham
Murrindindi
Wellington
Colac-Otway
Indigo
Northern Grampians
West Wimmera
Corangamite
Latrobe
Pyrenees
Wodonga
East Gippsland
Loddon
Queenscliff
Yarriambiack
Regional Victoria
Application Form and Guide for School Cleaning Panel Status
3 Application Criteria
3.1
Occupational health and safety (OH&S) practices
Applicants must demonstrate a commitment to the principles of Occupational Health
and Safety.
3.1.1
Occupational health and safety management system
The Department is committed to ensuring the safety, health and wellbeing of its
employees, students and visitors through the provision of safe schools and workplaces.
All workplaces require systems for managing health and safety.
An Occupational Health and Safety Management System (OHSMS) is a set of plans,
actions and procedures to systematically manage health and safety in the workplace to:

provide a safe and healthy workplace and prevent/reduce the incidence of illness and
injury to employees, and others in the workplace;

identify workplace hazards and assess and control risks;

gain involvement of managers, supervisors and employees and their representatives
in health and safety matters;

provide information and training for employees at all levels so they can work safely;
and

measure and continuously improve the OHSMS.
Applicants who are contractors with employees must have an OHSMS which is
consistent with the OHS Act 2004 (Vic) which also requires employers to provide
information in appropriate languages about health and safety at the workplace,
including the names of persons to whom an employee may make an enquiry or
complaint about health and safety.
All Applicants are to complete the section below, choosing either the
“contractor with employees” or “proprietor labour”, as applicable.
EITHER
Contractors with employees
Attach a copy of your OHSMS and compliance with the relevant legislation.
How do you inform your staff about your OHSMS?
OR
Proprietor labour
Proprietor labour applicants do not need to have their own OHSMS and may adopt the
school policy if awarded a school cleaning contract.
Application Criteria
5
How do you demonstrate a commitment to the principles of the OHS Act 2004?
How would you apply this within a school setting?
3.1.2
Risk assessment
All Applicants are to complete the section below, choosing either the
“contractor with employees” or “proprietor labour”, as applicable.
EITHER
Contractors with employees
The OHS Act 2004 (Vic) states that risk assessments must be conducted in various
circumstances. A risk assessment must be recorded in writing, and include:

name/s of assessor/s;

date of assessment;

the workplace/unit/process;

substances/ tasks reviewed;

controls in place to prevent a risk to health;

degree of exposure or nature of risk identified;

why decisions about risk were made; and

results of monitoring.
Risk assessments shall be conducted according to the Victorian Occupational Health
and Safety Regulations 2007 on:

manual handling;

hazardous substances;

noise;

prevention of falls; and

WorkSafe Victoria “Prevention of falls compliance code” - ladders.
Attach copies of all relevant risk assessments conducted in accordance with
the OH&S Regulations for the three years prior to submitting this
Application.
6
Application Form and Guide for School Cleaning Panel Status
If you have fewer than three risk assessment documents, identify the three highest
OH&S risks that you consider your employees might face while working in a school
environment.
For each of these risks, list the relevant sections in your OH&S policy that describe
your management strategies for minimising both the likelihood and the consequences
of each risk occurring including:

actions (steps to be taken);

resources (what and who is required);

responsibility (who is responsible for what); and

timing (when each step should take place).
Risk 1
Mitigation/Resolution
process
Risk 2
Mitigation/Resolution
process
Risk 3
Mitigation/Resolution
process
Application Criteria
7
OR
Proprietor labour
Sign the following declaration:
I confirm that if I obtain work at a school, I will discuss with the school's Principal or
designated OH&S officer, the risks relevant to cleaning at that school and the following
OH&S regulations:

manual handling;

hazardous substances;

noise;

prevention of falls; and

WorkSafe Victoria “Prevention of falls compliance code” - ladders.
_________________________________________
Signature of Director / Proprietor
_________________________________________
PRINT NAME
3.1.3
OH&S compliance and incident history
Sections 37-39 of the OHS Act 2004 state that a range of actual or potentially serious
OH&S incidents must be recorded and the relevant authorities notified. Such records
must be kept for at least five years.
EITHER
Provide copies of:

any OH&S serious incident reports for the last five years;

any improvement or prohibition notices issued to your business in the last three
years; and

any OH&S charges against the Applicant or the Applicant’s business in the last five
years, with details of the status of those charges.
OR
Sign the following declaration:
The applicant has not had:

any OH&S serious incident reports for the last five years;

any improvement or prohibition notices issued to your business in the last three
years; and

any OH&S charges laid against the applicant or the applicant’s business in the last
five years, with details of the status of those charges.
_________________________________________
Signature of Director / Proprietor
_________________________________________
PRINT NAME
8
Application Form and Guide for School Cleaning Panel Status
3.1.4
Chemical management
Provide:

a copy of your register of cleaning chemicals and hazardous substances that
complies with the Victorian Occupational Health and Safety Regulations 2007;

the manufacturer’s Material Safety Data Sheet (MSDS) for each chemical that you
use. (Material safety data sheets are available from the product manufacturer and
can usually be downloaded from their websites). Hand written sheets are not
acceptable; and

For Applicants without current contracts, supply information for the chemical products
you intend on using.
Where and how do you typically store cleaning chemicals?
How do you train your staff to safely use and store cleaning chemicals and hazardous
substances?
Where and how do you make available to your employees the MSDS for the chemicals
they use?
3.1.5
First aid
Applicants should note generally section 21(2)(d) of the OHS Act 2004 which requires
they maintain facilities for the welfare of the employees. Applicants should also note
the Work Safe Victoria Compliance code “First aid in the workplace” states that “First
aid facilities should be located at points convenient to the workforce”.
If you are not currently cleaning a school, please answer the questions as if you are
currently cleaning a school.
Does your first aid kit/s comply with the WorkSafe Victoria Compliance code?
Indicate 
yes
no
Where do you locate first aid kits in the work place?
Application Criteria
9
What is your procedure for checking stock and restocking first aid kits?
3.1.6
OH&S training
PROPRIETOR LABOUR APPLICANTS DO NOT NEED TO COMPLETE SECTION 3.1.6
Applicants need to prove that information, instruction and training to enable their
employees to work safely without risk to their health or the health of others at the
workplace has been provided in accordance with the OHS Act 2004.
Provide the following details about how you train your employees in OH&S.
Total number of Victorian staff
Number of employees trained in OH&S
Number of training hours per trained staff member
Who provides OH&S training?
Is training provided by a registered training organization
(RTO)?
Most common level of staff OH&S certification,
qualification or training
Provide a list of topics covered in current OH&S induction training provided to your staff
and also the topics covered in supervisor training.
If you maintain training attendance records or other documents, attach an example
copy of these as evidence of this communication.
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Application Form and Guide for School Cleaning Panel Status
3.1.7
Maintenance of cleaning equipment
Attach a copy of your equipment register showing in-service safety inspection and
testing of electrical equipment maintained in accordance with the Australian / New
Zealand Standard 3760 (“AS/NZS 3760”).
For each item, include:
Plant ID No
Description of Electrical Equipment
Storage Location
Test Period as per AS/NZ 3760
Due test date
Date tested
Passed/Failed
Record of repairs
Signature of competent person
All Applicants should provide dates of past tests as evidence that testing has been
completed. Information should be provided for all equipment.
What is your procedure for in-service inspection testing and tagging of electrical
equipment?
Describe the manner/location and storage of your cleaning equipment
Application Criteria
11
3.1.8
Hazards and accidents
Applicants need to explain how they meet their obligations under sections 35 and 36 of
the OHS Act 2004 to consult with employees about OH&S matters, workplace risks and
the need for reporting of workplace risks and hazards.
To whom and how do you and/or your employees alert cleaning and site managers
about health and safety issues and risks?
What is your process for notifying accidents and injuries?
Do you have a register of injuries for staff, and how long has this been in place?
Who maintains this register?
How do you instruct your employees about reporting hazards and accidents?
3.1.9
Personal protective equipment
What type of personal protective equipment (PPE) do you issue to your cleaning staff?
eg. gloves, eye protection.
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Application Form and Guide for School Cleaning Panel Status
What is your procedure for maintaining and renewing this equipment?
3.2
Sound practices in human resource management
Applicants must demonstrate sound practices in human resource management and a
commitment to the prevention of discrimination and harassment in the workplace.
3.2.1
Equal Employment Opportunity Policy
EITHER
Contractors with employees
The Victorian Government seeks to ensure that contractors working in Victorian
Government facilities will promote the principles of Equal Employment Opportunity
(EEO).
Attach a copy of your written policies that support EEO that:

comply with anti-discrimination legislation; and

include the grievance procedure for an employee who might wish to lodge a sexual
harassment complaint.
Explain when and how you inform your staff about your EEO policies.
Attach a pro-forma attendance record or other documents that verify this
communication of EEO policies.
How do you train your supervisors to increase their understanding of EEO and to
respond appropriately to EEO issues?
OR
Proprietor labour
Proprietor Labour Applicants are not required to have their own EEO policy, however
the following questions will need to be answered.
Application Criteria
13
How do you demonstrate a commitment to the prevention of discrimination and
harassment in the workplace?
How would you demonstrate a commitment to and compliance with the EEO principles
of the school?
3.2.2
Management structure
PROPRIETOR LABOUR APPLICANTS DO NOT NEED TO COMPLETE SECTION 3.2.2
Attach a diagram of your business management structure down to and including the
level of supervisor with respect to your Victorian operations.
3.2.3
Management qualifications
Attach a brief resume of your management personnel down to and including the level of
supervisor at each of your contract sites that includes:

former employers/clients;

work history; and

educational qualifications and competency certificates.
3.2.4
Corporate history
Identify all associated companies with which the Applicant has been involved in the
past three years. (An associated company is one which has or had some or all of the
same directors or shareholders/owners as the applicant.)
Company name
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Application Form and Guide for School Cleaning Panel Status
ACN or ABN
3.2.5
Business management systems
What business systems do you use, including electronic or other bookkeeping
methods, and quality and information systems that generate reports to assist with
contract management?
3.2.6
Professional and industry organisations
Is the Applicant a member of any professional or industry association?
Indicate 
yes
no
If so, provide the following details.
Membership
Category
3.2.7
Industry Association and membership
Telephone
Number
Specialist skills
List any specialist skills held by your staff e.g. steam cleaning carpets, high window
cleaning and the qualifications they hold.
Specialist Skill and Training/Qualification
Held by
If insufficient space, please attach a separate list.
Please list the cleaning services you consider to be “specialist cleaning services”.
Application Criteria
15
3.2.8
Working with Children Checks and Criminal Matters declaration
All cleaning contractors and employees need to obtain an employee (not volunteer)
Working with Children Check prior to commencing any work in schools. You can find
more information about this at the Working With Children Check, Victoria webpage.
Please attach a copy of your current Working with Children check(s).
I understand that, if awarded a school cleaning contract, the Applicant will be
responsible for ensuring that all nominated representatives and employees need to
obtain a Working with Children Check as an employee (not volunteer) prior to
commencing work at any Victorian government school.
_________________________________________
Signature of Director / Proprietor
_________________________________________
PRINT NAME
You must complete the form below, signed by each shareholder and officer of the
Company (e.g. directors, company secretary).
We the undersigned are all the proprietors, shareholders and officers of the
Applicant. Each of us declares for ourselves that we have no previous criminal
convictions. We also each declare that we will ensure that no employee of our
organisation who has a criminal record will work for the Applicant at or nearby to a
school in respect of which our organisation holds the cleaning services contract
without prior written permission from the Department and the relevant School
Council. We understand that that a criminal record includes a criminal record in
Australia or any other country and that any failure to comply with this criterion may
result in permanent disqualification from the School Contract Cleaners Panel.
__________________________
PRINT NAME
_______________________
Signature
____________
Date
__________________________
PRINT NAME
_______________________
Signature
____________
Date
__________________________
PRINT NAME
_______________________
Signature
____________
Date
If any proprietor, director, manager or company officer has a criminal conviction
explain why, despite that conviction, you consider your Application should not
be rejected.
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Application Form and Guide for School Cleaning Panel Status
3.3
Compliance with industrial awards or instruments
Applicants must demonstrate a commitment to meet or exceed the requirements of the
Cleaning Services Award 2010.
3.3.1
Applicable instruments
PROPRIETOR LABOUR APPLICANTS DO NOT NEED TO COMPLETE SECTION 3.3.1
The Cleaning Services Award 2010 (MA000022) came into effect on 1 January 2010. It
replaces the Building Services (Victoria) Award 2003 as the benchmark for conditions
of employment of employees who deliver cleaning services in Victorian government
schools.
Do you base pay rates and conditions for your employees on an industrial award?
Indicate 
Which award?
yes
no
____________________________________________________
Are you party to another industrial instrument such as an enterprise bargaining
agreement (certified by the Australian Industrial Relations Commission) or an
Australian Workplace Agreement?
Indicate 
yes
no
If yes, please attach a copy of that industrial instrument (eg the relevant certified
agreement or a pro-forma copy of the Australian Workplace Agreement used as a
standard).
3.3.2
Employee details
PROPRIETOR LABOUR APPLICANTS DO NOT NEED TO COMPLETE SECTION 3.3.2
Provide the following details about your employees in Victoria as at the date of your
Application.
Number of full-time employees
Number of part-time employees
Number of casual employees as at date of Application
Number of staff for whom you pay superannuation
Are long service leave entitlements and contributions up to date?
Applicants must demonstrate that they maintain their employee records in compliance
with parts 9A and 9B of the Workplace Relations Regulations.
EITHER
Attach a statement from an ASIC registered accountant stating the following:
“We confirm that in respect of the 12 months to (insert date) we have
considered the applicant’s employee records subject to the Workplace
Relations Regulations 2006. We are satisfied that the applicant has kept
those records for each of its employees in accordance with the
requirements of those Regulations.”
Application Criteria
17
OR
Provide the following information with respect to each of your Victorian employees as at
the date of your Application:

employee number;

employee gender;

employee and age, rounded to nearest five years;

name of industrial award or other industrial instrument as described in Section 3.3.1

award classification of employee;

employment status (full-time, part-time or casual);

employment commencement date;

annual leave balance; and

long service leave taken to date.
3.3.3
Superannuation
PROPRIETOR LABOUR APPLICANTS DO NOT NEED TO COMPLETE SECTION 3.3.3
Applicants must demonstrate that they keep records, according to the terms of the
Workplace Relations Regulations 2006 of superannuation contributions made by them
for the benefit of their employees. These records shall include the amount of the
contributions made; when and the period over which the contributions are made; the
name of the fund or funds to which the contributions were made; and the basis on
which the employer became liable to make the contributions. Employers must also
keep a record of (i) an employee’s election of fund to which contributions are to be
made, (ii) the date of such election (iii) and the name of the person who made each
relevant election.
EITHER
Attach a statement from an Australian Securities and Investment Commission (ASIC)
approved accountant stating:
“We confirm that in respect of the 12 months to (insert date) we have
considered the employee records required to be kept by the Workplace
Relations Regulations 2006 relating to superannuation. We are satisfied
that the Applicant has kept those records for each of its employees in
accordance with the requirements of those regulations and furthermore we
are satisfied that the Applicant has paid the correct amount of
superannuation in respect of each of those employees”.
OR
Attach copies of the superannuation records for each of your employees in Victoria as
at the date of your Application.
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Application Form and Guide for School Cleaning Panel Status
3.3.4
Compliance with industrial minimums
PROPRIETOR LABOUR APPLICANTS DO NOT NEED TO COMPLETE SECTION 3.3.4
Applicants must provide evidence of their compliance with minimum terms and
conditions of employment provided by industrial awards and industrial law.
EITHER
Attach a statement from an ASIC approved accountant stating the following:
“We confirm that in respect of the 12 months to (insert date) we have
considered the relevant award or other industrial instrument; industrial
legislation; and payslips for one employee of the Applicant at each of the
cleaning contracts currently held by the applicant. We are satisfied that
those documents show compliance by the applicant with minimum terms
and conditions of employment provided by the relevant award and industrial
legislation. Furthermore, we have conducted the same comparison in
respect of the period of 12 months to (insert date) in respect of 10% of the
Applicant’s total number of Victorian employees, and confirm that we are
satisfied that they received payment in accordance with the relevant award
and industrial legislation.”
OR
For a period of 52 weeks up to one month prior to the date of your Application, attach:

a copy of pay slips for all employees, if your workforce is below 20 people; or

a copy of pay slips for ten percent of your total workforce, if you have more than 20
employees.
3.3.5
Industrial history
Applicants must declare any proceedings arising from industrial, employment or
workplace law that have been brought against the applicant in any Court, Tribunal or
Commission, in particular:

breach of an award or agreement;

unfair dismissal;

any complaint under anti-discrimination legislation other than section 99 of the
Workplace Relations Act; or

any matter relating to the certification of an agreement.
EITHER
Attach a statement with respect to any proceedings described above and include the
following details:

name of proceeding;

date;

court, tribunal or commission;

case number; and

outcome.
Application Criteria
19
OR
Sign the following declaration:
No proceedings arising from industrial, employment or workplace law have been
brought against the Applicant in any court, tribunal or commission for:

breach of an award or agreement;

unfair dismissal;

any complaint under anti-discrimination legislation; or

any matter relating to the certification of an agreement.
_________________________________________
Signature of Director / Proprietor
_______________________________
PRINT
3.3.6
NAME
Processes for resolving grievances
PROPRIETOR LABOUR APPLICANTS DO NOT NEED TO COMPLETE SECTION 3.3.6
List three possible industrial grievance issues you have faced or may face, and
describe the processes you have in place for resolving such a grievance?
Grievance 1
Resolution process
Grievance 2
Resolution process
Grievance 3
Resolution process
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Application Form and Guide for School Cleaning Panel Status
3.3.7
Past directorships
In the past three years, have you or any of the Applicant’s directors controlled any
cleaning companies, either by directorship, ownership or managerial responsibility?
Indicate 
yes
no
If yes, please list those cleaning companies and explain or attach evidence to
demonstrate that these companies had a sound industrial record.
3.4
Ability to effectively manage contractual commitments
Applicants must demonstrate financial viability, commercial standing and sound quality
assurance processes.
3.4.1
Financial history
All Applicants must confirm that they have no adverse financial history by
signing the following declaration.
I declare that none of the Applicant’s Directors and the three next most senior
managers at the time of Application:

are or have been bankrupt;

have been involved in a business where, the employees were not paid out their
entitlements upon termination by the employer; or

have been involved in a company that has been placed in administration.
_______________________________
Signature of Director / Proprietor
_______________________________
PRINT NAME
Application Criteria
21
3.4.2
Insurances
Please complete the following table with details of your Public Liability and
Workcover/Personal Sickness and Accident insurance.
Note: All Applicants are required to hold public liability insurance worth $10 million and
WorkCover or Personal Sickness and Accident Insurance (if a sole trader or Proprietor
Labour).
A copy of each certificate of currency must be attached to this Application.
Insurer details / Coverage
Public liability insurance
$10 million
WorkCover / Personal sickness
and accident insurance
Insurer
Broker's telephone number if
relevant
Amount of current cover
Policy number
Expiry date
3.4.3
Current and former cleaning contracts
Provide details of concurrent cleaning contracts held at any time in the past five years,
and an indicative floor area (square metres) for each contract.
Client/contract name & location
22
Floor area (m2) Start date
Application Form and Guide for School Cleaning Panel Status
End date
3.4.4
Quality assurance
EITHER
If you have more than 100 employees in Australia, provide details about your quality
assurance practices including:

quality systems, or partial quality systems, based on ISO standards that are capable
of being audited by an accredited certifying body; and

professional qualifications relevant to the task.
OR
Sign the following statement:
The Applicant has fewer than 100 employees and does not have formal quality
assurance processes.
_________________________________________
Signature of Director / Proprietor
_________________________________________
PRINT NAME
3.5
Ability to provide client focussed services
Applicants must demonstrate a proven ability to provide client-focussed services.
3.5.1
Referees
Provide contact details for three referees – employers or clients for three of your
largest, current cleaning contracts in Victoria that have been in place for more than 12
months. If you have held no previous contracts in Victoria, provide details of cleaning
contracts interstate. If you have no previous experience in cleaning, provide details for
two previous employers.
Referees name
Title/Position
Company Name
Contract date (start/finish)
Telephone number
Application Criteria
23
Referees name
Title/Position
Company Name
Contract date (start/finish)
Telephone number
Referees name
Title/Position
Company Name
Contract date (start/finish)
Telephone number
3.5.2
Contract cancellations
If you have been party to a cleaning contract that either you or the other party cancelled
or terminated in the past five years, provide details as per table below.
Contract name
Date of cancellation
Reason for cancellation or
termination
Contract name
Date of cancellation
Reason for cancellation or
termination
Contract name
Date of cancellation
Reason for cancellation or
termination
Contract name
Date of cancellation
Reason for cancellation or
termination
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Application Form and Guide for School Cleaning Panel Status
3.5.3
Conflict of interest
Applicants must disclose any conflict of interest in relation to their Applications.
(Conflict of interest means a situation where the Applicant has a personal or family
relationship, an actual or potential business relationship or interest with another party,
one of which could corrupt the motivation).
If applicable, please disclose below any conflict of interest.
OR
Sign the following statement to certify that no conflict of interest is applicable to this
Application:
The Applicant, its Children, Spouse and other related people has no conflict of interest
in the Application for panel status.
_________________________________________
Signature of Director / Proprietor
_________________________________________
PRINT NAME
Application Criteria
25
4 Applicant’s Statutory Declaration
I
……………………………………………………………………………….……..
of
[insert full name]
………………………………………………………………………………………………
[address]
………………………………………………………………………………………………
[occupation]
apply to the Department of Education and Training to be admitted to the School
Contract Cleaners Panel and thereby to become eligible to provide cleaning services to
Victorian government schools.
I acknowledge that this declaration is true and correct, and I make it with the
understanding and belief that a person who makes a false declaration is liable to the
penalties of perjury.
Signature of Applicant
PRINT NAME
Date:
Declared at …………………………………………………………………………
this ……. day of ….……………….20……..
BEFORE ME
……………………………………………...
Signature of Authorised Witness
…………………………………….
PRINT NAME
……………………………………………………………………………………………….
PRINT Status or qualification of Authorised Witness taking declaration.
The authorised witness must print or stamp his or her name, address and title under section 107A of
the Evidence (Miscellaneous Provisions) Act 1958 (Vic) (eg. Justice of the Peace, Pharmacist, Police
Officer, Court Registrar, Bank Manager, Medical Practitioner, Dentist)
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Application Form and Guide for School Cleaning Panel Status
5 Supporting documents
5.1
Department Panel Agreement
The Applicant has read and signed TWO original copies of the Department of
Education and Training’s Cleaning Panel Agreement and has attached those originals
to this Application.
_________________________________________
Signature of Director / Proprietor
_________________________________________
PRINT NAME
5.2
List of Attachments
Please provide a list of all attachments that accompany this Application.
Please ensure that all attachments are clearly labelled with the Section they refer to.
Please sign all attachments.
Attachment
Details
5.1
2 copies of Department Cleaning Panel Agreement
Supporting documents
27