Supplier Qualification Survey

Please complete this form and contact Brian Campbell at 860-688-4844 Ext 104 if you have any questions.

Company Name:
Address:
City:   State:   Zip: 
Website:   Telephone: 
Fax:
Type of Business:  Manufacturer Distributor Service Other:
Number of Employees:   Number of Years in Business: 

Contact Information

Management Representative: Quality Representative:
Title: Title:
Email Address: Email Address:
Telephone: Telephone:

Quality Systems Certifications

 ISO 9001  ISO 17025  AS9100  FAA
 ISO 9002  ISO 14001  NADCAP  Other:

If your company holds a current accreditation listed above, it is not necessary to complete the questionnaire.
Please submit a copy of your current certifications with a signed copy of this form.

If your company provides calibration services, please submit a copy of your Scope of Accreditation as well.

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Questionnaire

 YES NO  Do you have a documented Quality Assurance Manual?
 YES NO  Is there a person responsible for Quality who is separate from production?
 YES NO  Is your system subject to management review?
 YES NO  Do you have document control procedures which ensure only current revisions used?
 YES NO  Do you have documented procedures? Are they controlled?
 YES NO  Do you have a procedure for control and retention of Quality records?
 YES NO  Do you carry out regular audits and reviews of your procedures?
 YES NO  Is non-conforming product segregated?
 YES NO  Do you have a documented procedure to prevent non-conforming products/materials from being used?
 YES NO  Does purchased material receive inspection to assure conformance with purchase order requirements?
 YES NO  Do you carry out in process and final inspection?
 YES NO  Is there evidence that each manufacturing process has been completed in accordance to written procedures?
 YES NO  Is inspection, measuring and test equipment calibrated to a required standard?
 YES NO  Do you maintain product identification at all stages of manufacturing with traceability?
 YES NO  Do you issue certificates of conformance/compliance?
 YES NO  Do you have a system to assess customer satisfaction and utilize the results for improvements?
 YES NO  Do you have corrective action and preventative procedures?
 YES NO  Do you maintain an approved list of suppliers and/or evaluate their performance?
 YES NO  Are customer requirements defined, documented, and communicated to all levels?

The information submitted on this form is to the best of my knowledge accurate at the time of completion.

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SIGNATURE:   
   
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