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Yes
No
Signature of Supplier :
Date :
ANNEXURE B
QHSAS (ISO 18001:2007 )QUESTIONNAIRE
QUESTIONNAIRE
B) HEALTH & SAFETY
Sr. No.
AUDIT QUESTION
1
Does the company have ISO 18001:2007 system?
Yes
No
14
Does use statistical techniques to determine acceptable quality levels for compliance to specification?
Yes
No
15
Does the companyprovide a test certificate w.r.t. P.O specification requirement?
C) ENVIORNMENT
Sr. No.
AUDIT QUESTION
1
Does the company have ISO 14001:2004 system?
Yes
No
2
Does the company have complains with regulatory requirement?
Yes
No
Yes
No
11
Does the company carry out regular safety checks on your equipment and material?
Yes
No
Signature of Supplier :
Date :
ANNEXURE C
ISO 14001 :2004QUESTIONNAIRE
Fax No.…………………………………..
of Chief Executive/Proprietor/Partners:
Telephone No.…………………………………..
Fax No.…………………………………..
6.Type of OrganizationDocuments to be enclosed
Yes
No
9
Is environmental aspect & its impact identified?
Yes
No
10
Does the company monitor emissions?
Yes
No
11
How the waste disposal is carried out?
Signature of Supplier :
(Strike out those not applicable)
a)Proprietary
b)Partnership
c)Private Limited Company
d)Public Limited Company
e)Public Sector
Signature of Vendor
COMMERCIAL DETAILS:
Yes
No
11
Does the company operate a calibration system?
Yes
No
12
Does the company maintain a corrective action and preventative action system?
Yes
No
13
Does segregate & identify non-conforming product to prevent in-advertent dispatch?
Yes
No
6
Does the company have operational procedures ?
Yes
No
7
Does the emergency preparedness and response procedure ?
Yes
No
8
Does the company have procedure for wastedisposal?
If yes, enclosed copy
b)Are you API Certified Yes/No?
If yes, specify and enclose
copy of the certificate
c) Other Certificate’s if any :
10Quality,QHSE & ENVIRONMENT QUESTIONNAIRE * :
3
Does the company have an environmental policy?
Yes
No
4
Does the company have environmental objectives, targets programmers’?
Yes
No
5
Does the company gives training to employees regarding environmental programmers?
& Telephone No. of contact person:
4.(a) Head Office/Registered Office/Address:…………………………………………………………………………
Telephone No.…………………………………..
Fax No.…………………………………..
SUPPLIER REGISTRATION CUM EVALUATION / RE-EVALUATION FORM
Date
Page of
Document No.
of theOrganization:…………………………………………………………………………
(in full, in Block letters)
H) PAN No.:
anization Structure No. of Employees (Total)
a)Administrative……………………………
b)Technical/Supervisory……………………………
c)Skilled Workmen……………………………
d)Unskilled Workmen……………………………
A) Bank Name:
B ) Branch:
C) Account No:
EXCISEDETAILS:
A) Range :
B ) Division :
C)Commissionerate:
D) Central ExciseRegNo:
E) CST TIN No:
F) VAT TIN No:
G)Service Tax No.:
Yes
No
5
Have an awareness of the hazardous material is in place?
Yes
No
6
Does the company carry out risk assessments?
Yesቤተ መጻሕፍቲ ባይዱ
No
7
Does the company record and investigate accidents and incidents?
Yes
No
3
Does the company have quality policy & quality objectives ?
Yes
No
4
Does the company necessary resources, infrastructure to maintain the quality of products?
Yes
No
2
Do you have written HSE policy statement?
Yes
No
3
How the company communicate this HSE policy to employees.
4
Are the hazardous material are identified?
(b) Branch Office, if any Address :
Telephone No.…………………………………..
Fax No.…………………………………..
(c) Works/Factory/Address………………………………….
Telephone No.…………………………………..
8 Details of production facilities
a)Covered Area…………………………..
9.Quality Assurance Plan
a)Have company obtainedcertificationin ISO 9001 : 2008
ISO 14001: 2004, ISO 18001:2007?Yes/No.
VERIFIED BY:APPROVED BY:
ANNEXURE A
(ISO 9001:2008 )QUESTIONNAIRE
A) QUALITY
Sr. No.
EVALUATION QUESTION
1
Does the company haveISO9001:2008?
Yes
No
2
Does the company have control of documents & Control of records ?
Yes
No
5
Whether appropriate training is given to employee?
Yes
No
6
Does the company have training records ?
Yes
No
7
Does the company have your design?
Yes
No
8
Does the company operate internal audits & are they received by top management?
Yes
No
9
Does the company maintains identification and traceability in the products ?
Yes
No
10
Does the company preserve the product to delivery to the intended destination with proper packaging, identification, storage & protection ?
Yes
No
8
Does the company have operational control procedures?
Yes
No
9
Does the company have emergency preparedness and response procedure ?
Yes
No
10
Have emergency procedures in place?
(Refer Attached Annexure A,B C )
11: Other Facilities / Information:
-------------------------------
Signature of Vendor
Evaluation/Re evaluation Results:
Date :
No
Signature of Supplier :
Date :
ANNEXURE B
QHSAS (ISO 18001:2007 )QUESTIONNAIRE
QUESTIONNAIRE
B) HEALTH & SAFETY
Sr. No.
AUDIT QUESTION
1
Does the company have ISO 18001:2007 system?
Yes
No
14
Does use statistical techniques to determine acceptable quality levels for compliance to specification?
Yes
No
15
Does the companyprovide a test certificate w.r.t. P.O specification requirement?
C) ENVIORNMENT
Sr. No.
AUDIT QUESTION
1
Does the company have ISO 14001:2004 system?
Yes
No
2
Does the company have complains with regulatory requirement?
Yes
No
Yes
No
11
Does the company carry out regular safety checks on your equipment and material?
Yes
No
Signature of Supplier :
Date :
ANNEXURE C
ISO 14001 :2004QUESTIONNAIRE
Fax No.…………………………………..
of Chief Executive/Proprietor/Partners:
Telephone No.…………………………………..
Fax No.…………………………………..
6.Type of OrganizationDocuments to be enclosed
Yes
No
9
Is environmental aspect & its impact identified?
Yes
No
10
Does the company monitor emissions?
Yes
No
11
How the waste disposal is carried out?
Signature of Supplier :
(Strike out those not applicable)
a)Proprietary
b)Partnership
c)Private Limited Company
d)Public Limited Company
e)Public Sector
Signature of Vendor
COMMERCIAL DETAILS:
Yes
No
11
Does the company operate a calibration system?
Yes
No
12
Does the company maintain a corrective action and preventative action system?
Yes
No
13
Does segregate & identify non-conforming product to prevent in-advertent dispatch?
Yes
No
6
Does the company have operational procedures ?
Yes
No
7
Does the emergency preparedness and response procedure ?
Yes
No
8
Does the company have procedure for wastedisposal?
If yes, enclosed copy
b)Are you API Certified Yes/No?
If yes, specify and enclose
copy of the certificate
c) Other Certificate’s if any :
10Quality,QHSE & ENVIRONMENT QUESTIONNAIRE * :
3
Does the company have an environmental policy?
Yes
No
4
Does the company have environmental objectives, targets programmers’?
Yes
No
5
Does the company gives training to employees regarding environmental programmers?
& Telephone No. of contact person:
4.(a) Head Office/Registered Office/Address:…………………………………………………………………………
Telephone No.…………………………………..
Fax No.…………………………………..
SUPPLIER REGISTRATION CUM EVALUATION / RE-EVALUATION FORM
Date
Page of
Document No.
of theOrganization:…………………………………………………………………………
(in full, in Block letters)
H) PAN No.:
anization Structure No. of Employees (Total)
a)Administrative……………………………
b)Technical/Supervisory……………………………
c)Skilled Workmen……………………………
d)Unskilled Workmen……………………………
A) Bank Name:
B ) Branch:
C) Account No:
EXCISEDETAILS:
A) Range :
B ) Division :
C)Commissionerate:
D) Central ExciseRegNo:
E) CST TIN No:
F) VAT TIN No:
G)Service Tax No.:
Yes
No
5
Have an awareness of the hazardous material is in place?
Yes
No
6
Does the company carry out risk assessments?
Yesቤተ መጻሕፍቲ ባይዱ
No
7
Does the company record and investigate accidents and incidents?
Yes
No
3
Does the company have quality policy & quality objectives ?
Yes
No
4
Does the company necessary resources, infrastructure to maintain the quality of products?
Yes
No
2
Do you have written HSE policy statement?
Yes
No
3
How the company communicate this HSE policy to employees.
4
Are the hazardous material are identified?
(b) Branch Office, if any Address :
Telephone No.…………………………………..
Fax No.…………………………………..
(c) Works/Factory/Address………………………………….
Telephone No.…………………………………..
8 Details of production facilities
a)Covered Area…………………………..
9.Quality Assurance Plan
a)Have company obtainedcertificationin ISO 9001 : 2008
ISO 14001: 2004, ISO 18001:2007?Yes/No.
VERIFIED BY:APPROVED BY:
ANNEXURE A
(ISO 9001:2008 )QUESTIONNAIRE
A) QUALITY
Sr. No.
EVALUATION QUESTION
1
Does the company haveISO9001:2008?
Yes
No
2
Does the company have control of documents & Control of records ?
Yes
No
5
Whether appropriate training is given to employee?
Yes
No
6
Does the company have training records ?
Yes
No
7
Does the company have your design?
Yes
No
8
Does the company operate internal audits & are they received by top management?
Yes
No
9
Does the company maintains identification and traceability in the products ?
Yes
No
10
Does the company preserve the product to delivery to the intended destination with proper packaging, identification, storage & protection ?
Yes
No
8
Does the company have operational control procedures?
Yes
No
9
Does the company have emergency preparedness and response procedure ?
Yes
No
10
Have emergency procedures in place?
(Refer Attached Annexure A,B C )
11: Other Facilities / Information:
-------------------------------
Signature of Vendor
Evaluation/Re evaluation Results:
Date :