SUPPLIER SELF-ASSESSMENT

GENERAL DATA
Company:	Country:
Street:	City:
Phone:	Fax number:
Website:	Legal form:
Year of foundation:	Corporate affiliation:
COMPANY PROFILE
Manufacturer:	Yes	No	Distributor:	Yes	No
CONTACT PERSONS
Division	Name	Phone	Fax	E-Mail	Language
Management	DE EN
Sales Department	DE EN
Sales Representative	DE EN
Quality Management	DE EN
R&D/Production	DE EN
Logistics	DE EN
DE EN
KEY FIGURES
Fiscal year:	2019	2018	2017
Turnover:
Export share in %:
Export to following contries
Number of employees
Total
Production
R&D
Quality Management
Administration
FURTHER PLANTS
Country	City	Employees	R&D	Production	Sales
Yes No	Yes No	Yes No
Yes No	Yes No	Yes No
Yes No	Yes No	Yes No
BUSINESS UNITS
Branch	1.	Share in %	1.
2.	2.
3.	3.
4.	4.
5.	5.
Main clients
INSURANCE
Type	Sum insured	Insurer
Product liability insurance for consequental damages:
Product recall insurance:
PRODUCTION TECHNOLOGIES
Which production processes do you mainly use?	1.	Share in %	1.
2.	2.
3.	3.
4.	4.
5.	5.
Which activities do you make with external suppliers?
PRODUCTION PLANNING AND MONITORING
Own construction department?	Yes	No	Own tool making?	Yes	No
Own production of tools and operating material?	Yes	No	Share in %?
FMEA?	Yes	No	SPC	Yes	No
PRODUCTION CAPACITY
Current capacity utilisation with regard of the shift model in %?	Number of shift per working day and week?
Optimized production batch?	Optimized SPQ (Standard-Pack-Quantity)?
Average time for quotation?	Average production time in days?
Average lead time for samples in days?	Could you react to fluctuating demand?	Yes	No
LOGISTIC
Do you have consignment agreements with other customers?	Yes	No
Do you have KANBAN-agreements with other customers?	Yes	No
Is a separation of production batches or tracability assured?	Yes	No
QUALITY MANAGEMENT
Do you have a full-time Quality Manager?	Yes	No	Since?
Was your quality management system evaluated by a customer in the past 12 months?	Yes	No
Customer	Rating?
What kind of certifications do you have?	1.	Since?
2.	Since?
3.	Since?
Please just answer the following questions only if your are not certified!
Do you have a quality management manual?	Yes	No
Do you have work instructions?	Yes	No
Do you have inspection instructions for incoming goods, prodution and final testing of the products?	Yes	No
Do you have an overview for the test equipment?	Yes	No
Do you use calibrated test equipment?	Yes	No
Could you do all samples test inhouse (measurement and recording)?	Yes	No
Do you have statistics of production errors?	Yes	No
Do you review the effectiveness of the corrective actions?	Yes	No
Do you have regulations for emergency processes (employee protection, fire, etc)?	Yes	No

ENVIRONMENTAL MANAGEMENT
Do you have installed an environmental management system referring to EMAS (EG/1221/2009) or ISO 14001 (valid version) or others in your company?	Yes	No
Is the complete fulfillment of REACH-regulation assured?	Yes	No
Is the complete fulfillment of RoHS-regulation assured?	Yes	No
ATTACHMENTS, AOB AND ADDITIONAL REMARKS
Please enclose your attachments!	Attachments enclosed
Organisation chart	Yes	No
Information of Creditreform and/or Dun & Bradstreet	Yes	No
Certificates of the quality management systems	Yes	No
Dates and results of the customer audits	Yes	No
Current list of production machines	Yes	No
AOB
Are you willing to disclose parts of your calculation?	Yes	No
ADDITIONAL REMARKS
Date	Name	Function