APPLICATION TO CONVERT FROM A FULL CPCS COMPETENT OPERATOR CARD TO AN MPQC OPERATOR CARD

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APPLICATION TO CONVERT FROM A FULL CPCS COMPETENT OPERATOR CARD TO AN MPQC OPERATOR CARD This application form is appropriate for individuals applying to convert their BLUE CPCS Competent Operator card to an MPQC Operator card. SECTION G Terms and Conditions of MPQC Application 1. This form is only valid when Section E is signed by an employer representative. 2. It is the responsibility of the applicant to ensure that all conversion requirements for the application as set out in the Procedure for Conversion from CPCS to MPQC are adhered to, including: a) the applicant's stated details are correct and the photograph in Section A is a true likeness of the applicant, b) the applicant has a Contractors Safety Passport course with Quarry option passed within 3 years of application for a MPQC Operator card, c) the applicant holds a current Blue CPCS Competent Operator card. 3. Application forms are subject to audit checks in accordance with MPQC requirements. Application forms, which are incorrect or not found to meet the requirements, will be returned. SECTION H Completion Requirements Section A: Complete Section A with full details, and attach a photograph that meets passport requirements, with a light background. Section B: Confirm you have passed the Contractor Safety Passport course with Quarry option. To book a course telephone 01926 817450. Section C: You must complete the table with the plant categories you are applying for to transfer to MPQC Operator card and attach copies of the following: the front and back of your current Blue CPCS Competent Operator card the front and back of your current Contractors Safety Passport card Section D: It should be noted that if this section is not complete the card will be sent to the applicant's home address as provided in Section A 1. Section E: The Independent Declaration of the applicant's identity must be completed by an employer representative having appropriate line management responsibility. Section F: Payment must be included with this application. However, please do not send cash. If you have paid by Credit/Debit card via the MPQC H/Office please enter your authorisation code in Section F on the front* of the application. This is a non-refundable fee for the service of processing the application. Forms will be returned to the address detailed in Section D, if the correct payment/invoicing information is not attached. General: Please return the completed form with payment, a photograph and copies of relevant certificates to: MP Awards, MP House, 4a Meadowbank Way, Eastwood, Nottinghamshire NG16 3SB If you require help completing this form please contact MPQC on 0115 972 6121. On receipt of this application it will usually take 15 working days to produce the card, providing all registration conditions have been met. If you have any comments on the service you have received from MPQC please contact the General Manager at the address given above. MPQC C1 21 /03/2011

Procedure for Transferring from CPCS to MPQC All current CPCS Blue card holders can convert their CPCS Blue card to a MPQC Operator card by following the below steps: 1. Pass the Contractors Safety Passport course Day 2 only - Quarry option. To book a course call 01926 817450. 2. Complete the CPCS to MPQC application C1 in full, including the Employer Declaration and submit along with a: a) passport style photograph b) copy of their CPCS Blue card (front and back) c) copy of their Contractors Safety Passport (front and back) d) cheque for 30.00 made payable to MPQC. Payment can be made using a credit/debit card by phoning MPQC on 0115 964 4920. If payment is made using a credit/debit card you will be given an Authorisation Code and this number must be entered onto the application form Section F. 3. MPQC Operator card will be issued. Once an applicant has transferred to the MPQC Operator Scheme they are required to meet the MPQC Scheme rules for renewal of the MPQC Operator card. For further information about the transfer of CPCS categories to a MPQC card, please contact MPQC on 0115 964 4920. Applications fees are non- Notes: Incomplete applications will be returned. refundable. Page 1 of 1 v.1march 2011

CPCS to MPQC Category Mapping Chart CPCS Category held Agricultural Tractor Crawler Tractor/Dozer Crusher Dragline Dump Truck Articulated Chassis Dump Truck Rigid Chassis CPCS endorsement held Claimable MPQC Category Agricultural Tractor (available from mid 2011) Bulldozer Mobile Crusher (Exc. Above 200t) Roped Excavator Claimable MPQC Endorsement Water bowser Fuel bowser Ordinary trailer Dumper trailer Up to 15 t Articulated Dumper Up to 20t manual and automatic All sizes Articulated Dumper Up to 50t manual and automatic Up to 15t Rigid Dumper Up to 20t manual and automatic Up to 50t Rigid Dumper Up to 50t manual and automatic All sizes Rigid Dumper Up to 100t manual or automatic Above 100t manual and automatic Tracked Rigid Dumper Up to 20t manual and automatic Excavator 180 above 5 Excavator 180 above 5 Excavator 360 below 10 Excavator 360 above 10 Tracked Wheeled Tracked with Attachments up to 7t with Attachments over 7t Mini Digger Hydraulic Excavator Pecker Forks Backacter Pecker Forks Backacter Up to 1t 1 5 t Up to 9t Up to 30t Tracked - standard 31 60t Tracked - standard 61 100t Tracked - standard Over 100t Tracked - standard Up to 30t Tracked - long 31 60t Tracked - long 61 100t Tracked - long Over 100t Tracked - long Page 1 of 3 CPCS/MPQC Category Conversion 25 March 2011

CPCS Category held Excavator 360 above 10 CPCS endorsement held Wheeled Claimable MPQC Category Hydraulic Excavator Forward Tipping Dumper Wheeled Forward Tipping Dumper Forward Tipping Dumper Tracked Forward Tipping Dumper Grader Industrial Forklift Truck Loader-Compressor Lorry Loader Platform Scissor Motorised Scraper Ride-on Roller Rough Terrain Forklift/Masted Truck Skid Steer Loader Skip Handler Soil/Landfill Compactor Screener Telescopic Handler Tracked Loading Shovel Hook Clamshell Bucket Hydraulic Clamp Vehicle Mounted Self Propelled Industrial telescopic Up to 9m All sizes excluding 360 slew All sizes including 360 slew Motor Grader Counterbalanced Forklift Truck Tractair (endorsements refer to bucket capacity) Lorry Mounted Crane Platform Scissor Wheeled Motor Scraper Road Roller Rough Terrain Forklift Truck Skid steer Skip Handler Compactor Mobile Screener Telehandler Tracked Loading Shovel Claimable MPQC Endorsement Up to 30t Wheeled standard Up to 30t Wheeled - long Under 6t Rigid Under 6t Articulated 6 8t Rigid 6 8t Articulated Over 8t Articulated Over 8t Rigid Under 6t Rigid 6 8t Rigid Over 8t Rigid Up to 3.5m 3 Over 3.5m 3 Lorry Mounted Self Propelled Deadweight all categories Vibrating below 14t Vibrating all weights Pnuematic Industrial telescopic Up to 9m Over 9m Over 9m Page 2 of 3 CPCS/MPQC Category Conversion 25 March 2011

CPCS Category held Claimable MPQC Category (endorsements refer to bucket capacity) Claimable MPQC Endorsement Quarry below 3.5m 3 Quarry below 7.5m 3 Quarry below 13m 3 Quarry above 13m 3 Non-quarry below 1.5m 3 Non-quarry below 3.5m 3 Non-quarry below 7.5m 3 Non-quarry below 13m 3 Non-quarry above 13m 3 All MPQC listed individual endorsements need to be claimed for by the applicant. There is no automatic award of multiple endorsements per category. Page 3 of 3 CPCS/MPQC Category Conversion 25 March 2011