Supplier QMS Approval Questionnaire

Oracle Supplier Id. #
Section(s) with √ Check Mark Required for Completion 1 2 3 4 5
N/A
Instructions for use: Complete the required sections as indicated by the selected box below.
Does your company operate Yes No If yes, please list other names under any other names? Employees (Provide a breakdown by facility/location): Detailed organization chart preferred Total # Employees 7/120 # in Manufacturing Production full time, temporary hires # of inventory control Production support Facility/Production capabilities PRODUCTION PROFILE # in Quality Group 1/19 # Quality Engineers # Auditors Units per month

ATEX Parts Supplier
Custom Part Manufacturer Type of Supplier (Check all that apply)
Distributor (off-the-shelf-std. spec.)
Medical Parts Supplier
Supplier Contact Information
(To be completed by Supplier) Name (print) Engineering Contact Name (print) Operations Contact Name (print) Survey Completion Contact Name (print) Signature of Survey Completion Contact Date Title Phone FAX Email Address
0/60
1/8
1/4
# Of Engineers (breakdown by type of engineers) # independent Inspectors
请填写 of a production runs 1. Normal 2. Smallest Number of different products per months 1. 2. 3. 4. High Production (>4000) Medium Production (>2000 <4000) Low Production (>50 <2000) Prototype (<50 typically)
Please include additional comments or attachments (describe)
Page 1 of 8
Section 2 - Supplier Profile
(To be completed by the Supplier) Facility Quality Certifications (check all that apply) Please provide a copy of all certificates. (If ISO 9001, ISO 13485 or ISO 17025 registered --- You can skip section 3) ISO 9001 Certified ISO 13485 Certified ISO 17025 Certified ISO 14001 Certified FDA registered facility Other Certifications / Registrations (Includes countries outside the US) Senior Company Official’s Name Senior Quality Official’s Name Is the Sr. Quality Official above the Management Representative? About Your Company Parent Corporation Name Yes Yes Yes Yes Yes Yes No No No No No No Last Audit Date Last Audit Date Last Audit Date Last Audit Date Last Audit Date Provide details Title Title
Jianhua Gao
Jianhua Gao
Hongxiang Jin
General manager 86-21-62116287 86-21-62116240 intech.shanghai@
General manager 86-21-62116287 86-21-62116240 intech.shanghai@
Office manager
86-21-62116216 x838
Hongxiang Jin
1/4/2013
1) GB/T19001-2008idt ISO9001: 2008 standard (Chinese &English version) 2) Subsidiary Shanghai Intech organization chart
8621-62116287
Jianhua Gao
Yes No
If not, please provide name of the Management Representative
Worldwide Energy and Manufacturing, USA. Inc.
Shanghai Intech (subsidiary)
various types of products (large, medium, small) 1,200,000pcs
various types of products (large, medium, small) 800,000pcs
B.
30
22
18
30
30-45 days
C.
Average lead time (delivery) as defined in B 1. High Production 2. 3. 4. Medium Production Low Production
(depending on whether tooling is needed)
Production 1st shift 2 shift
nd
请填写
3 shift
rd
Other
Page 2 of 8
Safety and Environment
Business Practices; Code of Conduct
(To be completed by Creation Technologies LP , select one box below) New Supplier Profile – required for initial Custom suppliers and engineering services providers’ review/approval. Re-Certification only (Category 1 & 3; Suppliers currently approved by Creation for over 2 years) New Supplier Profile – required for initial distributor’s review/approval. Re-Certification only (Category 2; Suppliers currently approved by Creation for over 2 years)
Service Calibration Service Transportation Provider IEC Software development Engineering services Custom fixture/stencil Software (off the shelf-std.) Mfg. FA activity Other: List products, processes or services available Attach a list of your major equipment (i.e. Machine list, Capabilities list, brochures, catalogs, etc.)
Does the company follow any of the international standards such as; Universal Declaration of Human rights (UDHR), Social Accountability International (SAI) and/or the Ethical Trading Initiative (ETI) standards If you answer “yes” to this question, proceed to next section. 1. Labor: Are all employees freely able to choose their employment? Free to leave with reasonable notice? Is child labor (< 14 or 15 years of age based on your laws) used at any stage of your manufacturing? Is your working environment free from sexual harassment, sexual abuse, corporal punishment, mental or physical coercion or verbal abuse to workers? Does your company pay the minimum wages as defined by your laws? Does your company enforce a maximum working hours per week of < 60 hours? If not, please specify Health and Safety: If your company is certified to a recognized management system such as OHSAS 18001 or ILO Guidelines on Occupational safety and Health? If so, please provide certification #, proceed to question 4 below; 3. Does your company provide machine safeguarding for all workers? Including eye safety glasses, steel toe shoes, hand protection where required. Does our company have an industrial hygiene policy? Which include the identification, evaluation and control of exposure to chemical, biological and physical agents Does the company have an implemented Emergency Preparedness and Response procedure in place? Does the company provide for their workers with clean toilet facilities, access to potable water and sanitary food preparation and storage facilities? Does the company provide their workers with adequate heating and cooling and ventilation? If your company is certified to a recognized management system such as ISO 14001 and/or Eco Management and Audit system (EMAS)?If so, please provide certification #, proceed to next section; 4. Does your company participate in the adherence to all applicable laws and regulations regarding prohibition or restriction of specific substances including labeling, recycling and disposal? Does your company identify and manage your chemicals and hazardous materials to ensure their safe handling, movement, storage, recycling or reuse and disposal? Does your company monitor, control and treat your wastewater and solid waste as per your laws and regulations? Yes No N/A Describe