SUPPLIER SELF-SURVEY QUESTIONNAIRE
1. GENERAL COMPANY INFORMATION
 
Company Name:
Address:
 
Phone Number: FAX No.:
Years In Business:  EIN/State or City License #:
2. ORGANIZATION.   List names of Executives and Key Personnel:
   Name    Position    Reports To    Phone
     
     
     
     
     
3. PRODUCTS AND SERVICES.   List details of all products and or services that may be of interest to our organization.
4. QUALITY SYSTEM
Mil-Q-9858:  Mil-I-45208:  ISO9001, 9002, 9003*:  Other: 
*(Specify which. If Registered, provide copy of Certificate. If applying, give target date for registration:
)
UL Registered?  Yes    No CSA Registered?   Yes    No Other: 


Answer the following questions by placing a check mark in the appropriate column. If the question does not apply to the type of work you perform, write "N/A" to indicate Not Applicable.
QUALITY ADMINISTRATION
1. Is a Quality Assurance Manual available and utilized? If yes, please provide. YES    NO    N/A
2. Is there a self-audit program in place to review both quality and manufacturing procedures? YES    NO    N/A
3. Is the Quality Assurance department independent of Engineering and Manufacturing? YES    NO    N/A
4. Is there a Management and Quality organizational chart? If yes, please provide. YES    NO    N/A
DOCUMENT CONTROL
1. Is there a retention period for your records? YES    NO    N/A
2. Do you have a back-up & retrieval system for your records / documents? YES    NO    N/A
3. How do you maintain external documentation; ie, Specs, Stds, etc. ? YES    NO    N/A
PROCUREMENT CONTROL
1. Are written procedures in use for quality control of purchased material and services? YES    NO    N/A
2. Do your procurement documents reflect drawing or specification requirements? YES    NO    N/A
3. Are certified test reports or certificates of conformance required by purchase orders? YES    NO    N/A
4. Is there an approved supplier list utilized? YES    NO    N/A
INCOMING INSPECTION
1. Does Receiving Inspection check incoming material to requirements of the purchase order, referenced specifications or applicable drawings? YES    NO    N/A
2. Are the inspection and test equipment used adequate for the type of inspection performed? YES    NO    N/A
3. Are periodic spot checks made to verify the validity of raw material test reports and certifications? YES    NO    N/A


MATERIAL STORAGE AND HANDLING
1. Are there procedures for the control and issuance of material? YES    NO    N/A
2. Are materials handled and stored in such a manner as to prevent damage? YES    NO    N/A
3. Do materials in the stock area reflect proper identification and inspection status? YES    NO    N/A
4. Are materials traceable to the chemical/physical analysis, inspection records, certificates of conformance, documents and purchase orders? YES    NO    N/A
5. Are materials stored to facilitate First-in First-out issuance? YES    NO    N/A
IN-PROCESS CONTROL
1. Do written procedures exist for in-process control of fabrication and manufacturing processes? YES    NO    N/A
2. Is Statistical Process Control (SPC) applied to the manufacturing process? YES    NO    N/A
3. Are written procedures used in addition to drawings and specifications for in-process inspection? YES    NO    N/A
4. Is adequate inspection and test equipment available for in-process inspection? YES    NO    N/A
5. Is non-conforming material promptly identified and segregated? YES    NO    N/A
FINAL INSPECTION/TEST
1. Is final inspection and/or test performed by or under the surveillance of Quality Assurance? YES    NO    N/A
2. Are inspection test procedures documented? YES    NO    N/A
3. Are inspection/test results maintained on file for customer review? YES    NO    N/A
4. Can SPC data on critical requirements be provided for each shipment of material upon request? YES    NO    N/A
DRAWING AND CHANGE CONTROL
1. Is there a formal written procedure for implementing drawing and specification changes? YES    NO    N/A


EQUIPMENT MAINTENANCE AND CALIBRATION CONTROL
1. Do detailed procedures exist for control and calibration of tools, gages and test equipment? YES    NO    N/A
NON-CONFORMING MATERIAL CONTROL
1. Do written procedures exist for:  
 
  - Non-Conformance Reports YES    NO    N/A
  - Identification of Discrepant Material YES    NO    N/A
  - Segregation on non-conforming material YES    NO    N/A
  - Discrepant material review / disposition (MRB) YES    NO    N/A
  - Re-test, inspection of reworked material YES    NO    N/A
  - Returned Material Procedures YES    NO    N/A
  - Closed-loop Corrective Action and Customer Service YES    NO    N/A
  - Control of Scrap material YES    NO    N/A
2. Do management reports reflect root-cause of non-conforming products? YES    NO    N/A
3. Are they published regularly and acted upon? YES    NO    N/A
TRAINING
1. Is there a training program in place to initially train and update employee(s) knowledge and skills? YES    NO    N/A
2. Is there an ongoing training record on file for each employee? YES    NO    N/A
SURVEY COMPLETED BY:
POSITION:
DATE: PHONE:
DC 330B