Part 3 - Application for Inclusion Form

LEGAL SERVICES MULTI-USE LIST
Application for Inclusion
PART 3 – Application for Inclusion Form (as amended by Addendum Number 3)
APPLICATION FOR INCLUSION FORM
Section 1 - Applicant Details
TABLE 1a: APPLICANT DETAILS
Applicant Name / Trading Name
[Insert]
ABN/ACN
[Insert]
Address for Notices
[Insert]
Registered Address
[Insert]
Small and Medium Enterprise (SME)
[Check box if Applicant is an SME]
(an Australian or New Zealand firm
with fewer than 200 full time
equivalent employees)
TABLE 1b: CATEGORY/IES OF LEGAL WORK APPLYING FOR
Government and Administrative Law
Corporate and Commercial Law
Dispute Resolution and Litigation
All Other Legal Services
Legal Services Multi-Use List – Application for Inclusion
Part Three – Application for Inclusion Form
Section 1 – Applicant Details
Page 1 of 19
LEGAL SERVICES MULTI-USE LIST
Application for Inclusion
PART 3 – Application for Inclusion Form (as amended by Addendum Number 3)
Note: the contact listed in Table 1c will be listed as the primary contact in the LSMUL Information
System and will be sent notifications from OLSC concerning the evaluation process and
administration of the LSMUL.
TABLE 1c: PRIMARY LSMUL CONTACT
Name
[Insert]
State/Location
[Insert]
Category of legal work
[Insert]
Position
[Insert]
Telephone
[Insert]
Email
[Insert]
TABLE 1d: ADDITIONAL RELATIONSHIP CONTACTS
Name
[Insert]
State/Location
[Insert]
Category of legal work
[Insert]
Position
[Insert]
Telephone
[Insert]
Email
[Insert]
Legal Services Multi-Use List – Application for Inclusion
Part Three – Application for Inclusion Form
Section 1 – Applicant Details
Page 2 of 19
LEGAL SERVICES MULTI-USE LIST
Application for Inclusion
PART 3 – Application for Inclusion Form (as amended by Addendum Number 3)
Section 2 - List Rates and innovative fee arrangements
TABLE 2a: LIST RATES
National/State/Territory/Region: [Insert]
Classification
Hourly Rate
Daily Rate
Secondment Rate
Partner (or
equivalent position)
[Insert]
[Insert]
[Insert or mark N/A]
Special Counsel (or
equivalent position)
[Insert]
[Insert]
[Insert or mark N/A]
Senior Associate
Lawyer (or
equivalent position)
[Insert]
[Insert]
[Insert or mark N/A]
Lawyer (2-5 years
working experience
as a legal
practitioner)
[Insert]
[Insert]
[Insert or mark N/A]
Junior Lawyer (less
than 2 years working
experience as a legal
practitioner)
[Insert]
[Insert]
[Insert or mark N/A]
Graduate Lawyer
[Insert]
[Insert]
[Insert or mark N/A]
Paralegal
[Insert]
[Insert]
[Insert or mark N/A]
Administration
[Insert]
[Insert]
[Insert or mark N/A]
(over 5 years
working experience
as a legal
practitioner)
Legal Services Multi-Use List – Application for Inclusion
Part Three – Application for Inclusion Form
Section 2 – List Rates and Innovative Fee Arrangements
Page 3 of 19
LEGAL SERVICES MULTI-USE LIST
Application for Inclusion
PART 3 – Application for Inclusion Form (as amended by Addendum Number 3)
TABLE 2b: DISBURSEMENTS
[Insert details]
TABLE 2c: INNOVATIVE FEE ARRANGEMENTS
[Insert details]
Legal Services Multi-Use List – Application for Inclusion
Part Three – Application for Inclusion Form
Section 2 – List Rates and Innovative Fee Arrangements
Page 4 of 19
LEGAL SERVICES MULTI-USE LIST
Application for Inclusion
PART 3 – Application for Inclusion Form (as amended by Addendum Number 3)
Section 3 - Categories of Legal Work
TABLE 3a: SUMMARY OF PRACTICE AREAS
Category of Legal Work
Practice Areas
Government and
Administrative Law
Public administration and governance
Judicial review and merits review
Ombudsman inquiries
Crown liability
Commonwealth employment law
Statutory interpretation
Freedom of Information (FOI)
Privacy
Royal commissions and inquiries
Coronial inquiries
Military discipline
Commissions of enquiries
Tort law
Tied work
Other:
[List additional practice areas within this category]
Corporate and
Commercial Law
Taxation law
Property law
Legal Services Multi-Use List – Application for Inclusion
Part Three – Application for Inclusion Form
Section 3 – Categories of Legal Work
Page 5 of 19
LEGAL SERVICES MULTI-USE LIST
Application for Inclusion
PART 3 – Application for Inclusion Form (as amended by Addendum Number 3)
TABLE 3a: SUMMARY OF PRACTICE AREAS
Contract law
Insurance law
Banking and finance law
Intellectual property (IP) law
Construction law
Corporations law
Competition and consumer protection law
Information technology (IT / ICT) law
Media and communications law
Probity
Environmental law
Tort law
Bankruptcy and Insolvency
Other:
[List additional practice areas within this category]
Dispute Resolution and
Litigation
Litigation
Arbitration
Mediation
Conciliation
Expert determination
Case management
Legal Services Multi-Use List – Application for Inclusion
Part Three – Application for Inclusion Form
Section 3 – Categories of Legal Work
Page 6 of 19
LEGAL SERVICES MULTI-USE LIST
Application for Inclusion
PART 3 – Application for Inclusion Form (as amended by Addendum Number 3)
TABLE 3a: SUMMARY OF PRACTICE AREAS
Other:
[List additional practice areas within this category]
All Other Legal Services
Family law
Criminal law (including justice and enforcement
services)
Criminal law (including justice and enforcement
services)
Other:
[List additional practice areas within this category]
Page limit: 5 pages for response to Table 3b
TABLE 3b: APPROACH TO MANAGING LEGAL MATTERS AND CLIENT RELATIONSHIPS
[Insert details]
Page limit: 5 pages for response to Table 3c per category of legal work
TABLE 3c: KEY PERSONNEL AND SIZE OF PRACTICE AREA(S)
Category of Legal Work: [insert]
[Insert details]
Page limit: 10 pages for response to Table 3d per category of legal work.
TABLE 3d: EXPERIENCE AND EXAMPLES TO DEMONSTRATE CAPACITY
Category of Legal Work: [insert]
[Insert details]
Legal Services Multi-Use List – Application for Inclusion
Part Three – Application for Inclusion Form
Section 3 – Categories of Legal Work
Page 7 of 19
LEGAL SERVICES MULTI-USE LIST
Application for Inclusion
PART 3 – Application for Inclusion Form (as amended by Addendum Number 3)
TABLE 3e: VALUE ADD SERVICES
[Insert details]
Legal Services Multi-Use List – Application for Inclusion
Part Three – Application for Inclusion Form
Section 3 – Categories of Legal Work
Page 8 of 19
LEGAL SERVICES MULTI-USE LIST
Application for Inclusion
PART 3 – Application for Inclusion Form (as amended by Addendum Number 3)
Section 4 – Conflicts of Interest
Page limit: 5 pages for all of Section 4 response.
TABLE 4a: CONFLICT OF INTEREST PROCEDURES
[Insert details]
TABLE 4b: OPERATIONAL EXAMPLES
[Insert details]
Legal Services Multi-Use List – Application for Inclusion
Part Three – Application for Inclusion Form
Section 4 – Conflicts of Interest
Page 9 of 19
LEGAL SERVICES MULTI-USE LIST
Application for Inclusion
PART 3 – Application for Inclusion Form (as amended by Addendum Number 3)
Section 5 – Legal Services Directions
Page limit: 5 pages for all of Section 5 response.
TABLE 5a: LEGAL SERVICES DIRECTIONS
[Insert details]
TABLE 5b: TIED WORK
[Insert details]
TABLE 5c: PRO BONO WORK TARGET
[Insert details]
TABLE 5d: COMMITMENT TO PRO BONO WORK
[Insert details]
Legal Services Multi-Use List – Application for Inclusion
Part Three – Application for Inclusion Form
Section 5 – Legal Services Directions
Page 10 of 19
LEGAL SERVICES MULTI-USE LIST
Application for Inclusion
PART 3 – Application for Inclusion Form (as amended by Addendum Number 3)
Section 6 - Referee Reports
TABLE 6a: REFEREE DETAILS
Category of Legal Work
Referee 1
Referee 2
Government and
Administrative Law
Name: [insert]
Name: [insert]
Position: [insert]
Position: [insert]
Organisation: [insert]
Organisation: [insert]
Phone: [insert]
Phone: [insert]
Email: [insert]
Email: [insert]
Reference attached? Y/N
Reference attached? Y/N
Name: [insert]
Name: [insert]
Position: [insert]
Position: [insert]
Organisation: [insert]
Organisation: [insert]
Phone: [insert]
Phone: [insert]
Email: [insert]
Email: [insert]
Reference attached? Y/N
Reference attached? Y/N
Name: [insert]
Name: [insert]
Position: [insert]
Position: [insert]
Organisation: [insert]
Organisation: [insert]
Phone: [insert]
Phone: [insert]
Email: [insert]
Email: [insert]
Reference attached? Y/N
Reference attached? Y/N
Corporate and
Commercial Law
Dispute Resolution and
Litigation
Legal Services Multi-Use List – Application for Inclusion
Part Three – Application for Inclusion Form
Section 6 – Referee Reports
Page 11 of 19
LEGAL SERVICES MULTI-USE LIST
Application for Inclusion
PART 3 – Application for Inclusion Form (as amended by Addendum Number 3)
TABLE 6a: REFEREE DETAILS
Category of Legal Work
Referee 1
Referee 2
All Other Legal Services
Name: [insert]
Name: [insert]
Position: [insert]
Position: [insert]
Organisation: [insert]
Organisation: [insert]
Phone: [insert]
Phone: [insert]
Email: [insert]
Email: [insert]
Reference attached? Y/N
Reference attached? Y/N
REFEREE REPORT Template
Referee Firstname Surname
Position
Referee Contact
T 00 0000 0000
M 0000 000 000
E [email protected]
Nature of
relationship
between referee
and applicant
Applicant's name
Category of law
Please describe the type of work undertaken the Applicant has undertaken for you or your
organisation/agency.
Has the Applicant provided quality legal services to your organisation/agency? Please provide
examples.
In your opinion does the Applicant have capacity to provide quality legal services to the
Commonwealth? If so, please provide examples/supporting reasons.
Legal Services Multi-Use List – Application for Inclusion
Part Three – Application for Inclusion Form
Section 6 – Referee Reports
Page 12 of 19
LEGAL SERVICES MULTI-USE LIST
Application for Inclusion
PART 3 – Application for Inclusion Form (as amended by Addendum Number 3)
Has the Applicant provided you with value add services? If so, please provide examples.
In your opinion does the Applicant have capacity to identify and manage conflicts of interest? If
possible, please provide examples.
In your opinion does the Applicant have an understanding and capacity to meet the requirements of
the Legal Services Directions 2005? Please provide examples, such as:

Demonstrated commitment to pro bono work;

Acting with honesty and integrity, including acting as a model litigant; and

Commitment to resolving matters through a variety of mechanisms including alternative
dispute resolution.
Please provide any other details of the Applicant’s experience that would be relevant to assessing their
application for inclusion on the Commonwealth Legal Services Multi-Use List.
Signed:
Date:
Legal Services Multi-Use List – Application for Inclusion
Part Three – Application for Inclusion Form
Section 6 – Referee Reports
Page 13 of 19
LEGAL SERVICES MULTI-USE LIST
Application for Inclusion
PART 3 – Application for Inclusion Form (as amended by Addendum Number 3)
Section 7 - Applicant CVs
Page limit: 10 pages of CVs per category of legal work.
CV Template
Firstname Surname
Position
–
Contact
Office
T 00 0000 0000
M 0000 000 000
E [email protected]
–
Areas of law
–
Qualifications
Qualification (Honours), University, 200X
Qualification, University, 200X
Qualification, University, 200X
–
Admissions
State, 200X
State, 200X
–
Security clearance
Yes/No
Profile
CV profile details. - summary of key achievements
Key experience
Client name : description of matter in general terms
Agency secondments
Agency name: Project description.
Relevant experience from other past positions
Project name: Project description.
Project name: Project description.
Project name: Project description.
Memberships
Legal Services Multi-Use List – Application for Inclusion
Part Three – Application for Inclusion Form
Section 7 – Applicant CVs
Page 14 of 19
LEGAL SERVICES MULTI-USE LIST
Application for Inclusion
PART 3 – Application for Inclusion Form (as amended by Addendum Number 3)
Section 8 – Applicant’s Declarations
Table 8a: APPLICANT’S DECLARATION – KEY PERSONNEL
I, ^INSERT NAME^, confirm that as required by threshold condition 7.1.a, the key personnel
nominated in the application for inclusion and listed below are admitted to legal practice in
Australia and are subject to the regulation of a relevant State/Territory law society or
professional body, or the National Board on its commencement, or Part VIIIB of the
Judiciary Act 1903. This confirmation relates to the following key personnel:




^insert full name of key personnel 1^
^insert full name of key personnel 2^
^insert full name of key personnel 3^
Note: no limits apply to the number of key personnel you can nominate.
Dated this ^insert day^ day of ^insert month^ 201^year^
^Name of signatory^
Signature
In the presence of:
^Name of witness^
Signature of witness
Legal Services Multi-Use List – Application for Inclusion
Part Three – Application for Inclusion Form
Section 8 – Applicant’s Declarations
Page 15 of 19
LEGAL SERVICES MULTI-USE LIST
Application for Inclusion
PART 3 – Application for Inclusion Form (as amended by Addendum Number 3)
Attach: Certificates of currency.
Table 8b: INSURANCE DETAILS
Public Liability Insurance
Insurer:
^insert name of insurer^
Policy No:
^insert policy number^
Insured Amount:
^insert insured amount ^
Expiry Date:
^insert expiry date^
Workers Compensation Insurance
Insurer:
^insert name of insurer^
State/Territory:
^insert State or Territory^ – ( a policy must be provided for each relevant jurisdiction)
Policy No:
^insert policy number^
Expiry Date:
^insert expiry date^
Professional Indemnity Insurance
Insurer:
^insert name of insurer^
Policy No:
^insert policy number^
Insured Amount:
^insert insured amount ^
Expiry Date:
^insert expiry date^
Attach certificates of currency for the Insurances listed above.
Legal Services Multi-Use List – Application for Inclusion
Part Three – Application for Inclusion Form
Section 8 – Applicant’s Declarations
Page 16 of 19
LEGAL SERVICES MULTI-USE LIST
Application for Inclusion
PART 3 – Application for Inclusion Form (as amended by Addendum Number 3)
Table 8c: APPLICANT’S DECLARATION – INSURANCES
For the purposes of threshold condition 7.1.b, I ^INSERT NAME^, confirm that the
Applicant has:
a. public liability insurance for an amount not less than $10 million (Aud) per event per
policy;
b. professional indemnity insurance for an amount not less than $10 million (Aud) per
event per policy; and
c. workers compensation insurance as required by law for each jurisdiction in which
the Applicant is practising,
and that these insurances are current at the time of application and will be maintained.
For the purpose of threshold condition 7.1.c, I confirm that: (select one)
the Applicant is a member of a limitation of liability scheme through a State
Territory law society or similar, and I have attached evidence that the Applicant has a
liability cap for an amount not less than AU$10 million; or
the Applicant is not a member of a limitation of liability scheme.
Dated this ^insert day^ day of ^insert month^ 201^year^
^Name of signatory^
Signature
In the presence of:
^Name of witness^
Signature of witness





Legal Services Multi-Use List – Application for Inclusion
Part Three – Application for Inclusion Form
Section 8 – Applicant’s Declarations
Page 17 of 19
LEGAL SERVICES MULTI-USE LIST
Application for Inclusion
PART 3 – Application for Inclusion Form (as amended by Addendum Number 3)

Table 8d: APPLICANT’S DECLARATION – GENERAL
YES
NO
Is the Applicant, or any of its subcontractors (if any) currently named as
not complying with the Equal Opportunity for Women in the Workplace
Act 1999 (Cth)?*
Does the Applicant, or any of its subcontractors (if any), having made all
reasonable enquiries, have any unsettled judicial decisions against it
relating to unpaid employee entitlements?
Has the Applicant had any judgment against it from any Court or
Tribunal (including overseas jurisdictions but excluding judgments
under appeal or instances where the period for appeal or
payment/settlement has not expired) relating to a breach of workplace
relations law, work health and safety law or workers’ compensation
law?
If yes, has the Applicant fully complied with any such judgement?
After having made all reasonable enquiries, does the Applicant have
any actual or potential perceived conflicts of interest in respect of
participating in the LSMUL arrangements or the provision of legal
services?
Is the Applicant (including its personnel) the subject of any disciplinary
investigations, proceedings or orders by a law society or other
professional body?
To the Applicant’s knowledge is any of the information submitted in the
Applicant’s application for inclusion inaccurate?
* It is Australian Government policy not to purchase goods or services from suppliers who do not
comply with their obligations, if any, under this Act. Applicants should note their potential obligations
under the LSMUL Deed in relation to equal opportunity for women in the workplace.
Legal Services Multi-Use List – Application for Inclusion
Part Three – Application for Inclusion Form
Section 8 – Applicant’s Declarations
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LEGAL SERVICES MULTI-USE LIST
Application for Inclusion
PART 3 – Application for Inclusion Form (as amended by Addendum Number 3)
Please provide details below, where an Applicant has answered YES to one of the above
questions.
Table 8e: DETAILS
Legal Services Multi-Use List – Application for Inclusion
Part Three – Application for Inclusion Form
Section 8 – Applicant’s Declarations
Page 19 of 19