Uniseal UK LTD

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Homeowner Self Assessment Declaration - Pre Installation

Thank you for choosing Uniseal UK Ltd to carry out your installation.
Following government guidelines and in conjunction with our recognised and authorised Trade Association, CERTASS, we require that all home owners must complete the following declaration.
This is to ensure we can safely carry out your installation and continue to protect both yourselves and our team members.
This declaration must be completed WITHIN the 24 hour period prior to commencement of any work
We would like to thank you on your cooperation.

Customer Full Name
Address
Postcode
DECLARATION
Are you, or anyone in your household considered to be in the vulnerable group who are at increased risk of severe illnesses from Covid 19 (coronavirus)?*
If you selected YES please choose the following options*
Is your household, or anyone in your household isolating?
Have you, or anyone, in your household experienced any recognised coronavirus symptoms in the past 7 days? (including today) e.g. a continious cough or a high temperature.
1 out of 4
I will demonstrate the safe route in/around the home to installers on arrival and open internal doors in rooms that require works*
I will allow the installers, if need be, to use a designated WC facility at my property providing they bring their own toiletries and clean after use with their own cleaning materials. (Please note: This is your preference, the installation will still go ahead if you select no)
2 out of 4

Please provide an email and telephone number. This is required should we need to contact you*

Emergency Contact Email
Emergency Contact Phone
3 out of 4
TERMS AND CONDITIONS
- Please respect social distancing by remaining a minimum of 2 metres away from the installer/s and keep any family members or pets away from the room where work is being carried out, wherever possible.

- Do not offer installers food or drink

- Please help the installer/s to work room by room (staying away whilst they work)

- Co-operate with the installer/s to help everyone stay safe and follow the Government social distancing guidelines.

- Please stop or limit visitors to the home during the installation wherever possible.

- Inform Uniseal UK Ltd and installer immediately if a member of the household becomes unwell with any recognised symptoms of coronavirus.
Print Name
Date
4 out of 4
Uniseal UK Ltd is authorised and regulated by the Financial Conduct Authority FRN 733677. We are a credit broker not a lender and have a facility with a panel of lenders.

© 2019 Uniseal UK ltd All Rights Reserved.
Registered in England & Wales. Registered office: Unit 26c Ring Road, Burntwood, Staffordshire, WS7 3JG, GB Tel: 01543674404 Email: sales@uniseal-uk.co.uk. Company No: 05778735 VAT No: 05778735

COVID-19 UPDATE

As lockdown measures are being eased by the goverment, we have re-opened our office and factory with skeleton staff. Our showroom is also open but will be by appointment only, so that we can ensure social distancing.