Supplier Name:

Address:

City:

State:

Zip:

Phone:

Fax:

Respondent Name:

Respondent Title:

Date Completed:

Is your company ISO registered?

Please Select Yes No

If yes, please send a copy of your certificate in lieu of completing this survey.If no, please answer the following questions:

1. ) Management Responsibility / Quality Systems

1. Have you established and maintained a documented quality system?

Please Select Yes No

2. Has management documented its policy on quality?

Please Select Yes No

3. Does management review the quality system to ensure the effectiveness?

Please Select Yes No

4. Is management review documented?

Please Select Yes No

5. Is the commitment to quality known by all employees?

Please Select Yes No

Comments:

2.) Contract Review

1. Does your company perform contract review prior to accepting an order?

Please Select Yes No

Comments:

3.) Document Control

1. Are there procedures for the creation, approval, and changes to a document?

Please Select Yes No

2. Are current copies of necessary documents accessible where needed?

Please Select Yes No

Comments:

4.) Purchasing

1. Is the ability to meet your requirements criteria for selecting a supplier?

Please Select Yes No

2. Do you have an approved suppliers list?

Please Select Yes No

3. Do you review and approve purchasing documents for accuracy prior to release?

Please Select Yes No

4. Is the product or service ordered clearly described on purchasing documents?

Please Select Yes No

Comments:

5.) Training

1. Have all personnel received the necessary training in accordance with documented procedures?

Please Select Yes No

Comments:

6.) Servicing

1. If applicable, does your procedures document how servicing will meet the requirements of the Customer?

Please Select Yes No

Comments:

7.) Products Identification and Traceability

1. Does each batch or lot have its own unique identification?

Please Select Yes No

2. Is this identification maintained through out production and delivery?

Please Select Yes No

3. Can this product be traced from any point of manufacture or delivery?

Please Select Yes No

Comments:

8.) Process Control

1. Do line personnel perform their job in accordance with documented work instructions?

Please Select Yes No

2. Is there a system to change processes and record changes made coincident with Customer notification?

Please Select Yes No

Comments:

9.) Handling, Storage, Packaging, Preservation and Delivery

1. Do you have documented procedures for the handling, storage, packaging, preservation and delivery?

Please Select Yes No

2. Do you require 100% on time delivery?

Please Select Yes No

Comments

10.) Quality Records

1. Are your product records for quality identified, readily retrievable, and legible?

Please Select Yes No

2. Have you established retention times for quality records?

Please Select Yes No

Comments:

11.) Inspection and Testing

1. Do you have a system to ensure incoming materials are not used until verified?

Please Select Yes No

2. Do you document the results of the inspection and testing?

Please Select Yes No

3. Do you have a system to identify and separate non-conforming materials?

Please Select Yes No

Comments

12.) Inspection, Measuring and Test Equipment

1. Do you identify and control all inspection, measuring and test equipment?

Please Select Yes No

2. Do you have written calibration procedures?

Please Select Yes No

3. Do you have a positive recall system to identify equipment due for calibration?

Please Select Yes No

4. Are all standards traceable to N.I.S.T. or an equivalent accepted industry standard?

Please Select Yes No

5. Do you have a system to identify the calibration status of all equipment?

Please Select Yes No

Comments:

13.) Non-conforming Material / Corrective Action

1. Do you have documented procedures for review and disposition of non-conforming materials?

Please Select Yes No

2. Do you re-inspect product that has been reworked or repaired?

Please Select Yes No

3. Do you have documented procedures for the handling of Customer complaints?

Please Select Yes No

4. Do you have documented procedures for handling corrective actions?

Please Select Yes No

5. Do you have a system for prioritizing problems?

Please Select Yes No

Comments:

14.) Statistical Techniques

1. Where applicable, do your procedures identify the need for statistical techniques?

Please Select Yes No

2. Are statistical applications implemented within your processes?

Please Select Yes No

Comments: