KD-CAS-AS-003
Accident Statistics and Enforcement Record
The three-year accident record by year — fatalities, specified injuries, over-seven-day injuries, reportable occupational diseases, dangerous occurrences, lost-time injuries and near misses, split direct workforce and subcontractors — with the last two investigations and what changed, and the five-year check of the HSE public registers under every company name, with any notice and its close-out.
Built against the Common Assessment Standard question set, Version 5 (Build UK). Independent — not affiliated with or endorsed by Build UK, Constructionline or any assessment body. The assessment body decides the outcome.
5 pages · 236 fillable fields · works in Adobe Reader, Preview, Chrome, or on a phone — or complete it online in your browser and download the finished document.
Page 1 of 5 — click to enlarge
Read all 5 pages first — watermarked sample, no email Before you submit: the checklist
Statutory basis, cited on the form
- RIDDOR 2013 regs 4, 6, 7, 8, 9 and 12
- Common Assessment Standard
- SSIP Core Criteria
What it is not
It is not a completed document and it is not health and safety advice. You must adapt it to your site and have a competent person complete and sign it off. See why we don't say "compliant".
Format
AcroForm fillable PDF. Every field has a tooltip. Tab order follows the reading order. Works on desktop and mobile, in Adobe and non-Adobe readers.
This revision was prepared against legislation current at 10 August 2026. Revision A0. Check kubitdocs.com/revisions for the current revision before use.
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