SUPPLIER QHSE QUESTIONNAIRE

Issue No.:
Name of Supplier: ____________________________________________________________
Address: ____________________________________________________________________
Telephone Number: _________________ Fax Number: ____________________
Nature of Business:
___________________________________________________________________________
Details of services/equipment supplied: ___________________________________________
___________________________________________________________________________
___________________________________________________________________________.
Is your company registered to ISO 9001 Series?
Is your company registered to ISO 14001 Series?
Is your company registered to OHSAS 18001 Series?
If YES please attach a copy of your certificate
If NO please answer the following questions:
1.
2.
3.
4.
5.

Do you intend to apply for registration of ISO 9001,

ISO 14001 or OHSAS 18001 Series?
Do you operate to documented procedures?
Do you have a formal record system?
Does the Company belong to any trade association?
Would you allow a representative of our Company to inspect
your site and assess your QHSE Capability?

YES/NO
YES/NO
YES/NO

YES/NO
YES/NO
YES/NO
YES/NO
YES/NO

Please give the name of the person who should be contacted on any matter regarding Quality in
your Company..
Name: ________________________________ Position: _____________________
Please use the reverse of this sheet for any further comments.
Signed: ________________________________ Position: _____________________
Result of assessment:
____________________________________________________________________
Date: __________________
For Company use only
APPROVAL/ REJECTED BY:

IMS Record No.: MSP.19.R.01

REV.01.02/01/2010

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