Supplier Survey Questionnaire

Organization Information
Date of Survey:
Organization Name:
Division or Subsidiary of: na
Address:
(Include Postal Code /
Zip Code)
Tel. No: Fax No.:
E-mail Address: Web Site Address:
Please state the type of business:
Subsidiary or Division Corporation Single Private Partnership
of Group Ownership

Please attach a copy of your organizational structure and tick the box accordingly: y or n
Key Contacts (General Management, Manufacturing, Engineering, Quality, etc.):
Name Title Ext./ Direct E-mail Address
Line No.

For the entire organization, please state:

Total Size of All Facilities (ft2) Total Headcount Year Founded

Revenue last year: Profit last year:
(US$ or indicate currency) (US$ or indicate currency)
Planned revenue this year: Planned profit this year:
(US$ or indicate currency) (US$ or indicate currency)
For this site address, please state:
Total Size of Facility (ft2) Total Headcount Current Manufacturing Operating
Capacity (%)

# of manufacturing shifts Scheduled site shutdown?
y or n
If yes, when

Document Number 05-040005, Rev. C Page 1 of 5

 Supplier Survey Questionnaire

Revenue last year: Profit last year:

(US$ or indicate currency) (US$ or indicate currency)
Planned revenue this year: Planned profit this year:
(US$ or indicate currency) (US$ or indicate currency)
Define the core business/es of the company:

Please list what you consider the core competencies of the organization:

List your 3 largest (by $ revenue) or your 3 strategically most important customers (please add % of gross
revenue for each):
1. 1. %
2. 2. %
3. 3. %
Name your key competitors:

State what separates or differentiates you from your competitors:

Does a process engineering/tooling department exist? If YES, is the department internal or external?

Can your system receive and utilize Computer Aided Design files? y or n
If so, in what formats? IGES Solidworks

Quality Systems
Does your organization have a Quality Management System? y or n
Is there a Quality Manual? (If so, please attach a copy of the quality policy.) y or n
Is the organization currently registered to any of the following standards?
(If not, we may follow up with a more detailed questionnaire concerning your quality systems.)
Reference Standard Name of Notified Body and/or Registration Number

Document Number 05-040005, Rev. C Page 2 of 5

 Supplier Survey Questionnaire

ISO 9001 y or n
ISO 13485 y or n
ISO 14001 y or n
Please specify any other additional standards you have accreditation for:

Do you have a Quality or Quality Assurance (QA) department? y or n

How many employees are in the Quality Department?
Quality Engineers Quality Technicians/Inspectors Others

Do you have a measurement gage calibration and tracking system? y or n

What is the typical gage calibration frequency? (quarterly, yearly, etc.)
Do you have a climate controlled QA room or lab? y or n
Do you identify and segregate non-conforming material? y or n
Do you have a formal Material Review Board? y or n
How often does the Material Review Board meet? (daily, weekly, monthly)
Are your shop personnel trained to understand and use geometric tolerancing? y or n
Who is responsible for verifying the production set-up and for doing the in-process inspection?
Operator Production Lead QA Inspector Other (please explain):

How does your documentation system assure the use of the latest customer drawings and specifications?

How do you assure advanced customer notification of significant process/product changes?

Business Excellence
Please attach a copy of your organizations visions/mission statement. y or n
Please attach a copy of your organizations value statement. y or n
If there is no formal value statement, what are the core values of the organization?
na

What percentage of payroll is invested in employee training each year?

Document Number 05-040005, Rev. C Page 3 of 5

 Supplier Survey Questionnaire

<0.5% >0.5% but <1% >1% but <3% >5% but <8% >8%

How many training hours on average are invested in each employee per year?
<5 >10 but <20 >20 but <50 >50 but <100 >100

What is your on-time and in-full delivery performance rate?

What is your returned product or percent defective performance rate?

Number of inventory turns per year:

How many management levels are there between the CEO and line workers?

Employee turnover as a % of employee population per year:

>15% <15% but >7% <7% but >3% <3% but >1% <1%

Do you have a formal continuous improvement process? If so, please describe it. y or n

What is the average resolution time for internal corrective actions?

Provide some of the key performance measurements that you use to gauge success in your organization.

Does the company have a documented formal supply chain management strategy? If so,
y or n
please attach it or summarize it.

Please provide any additional information that you may believe to be helpful.

Document Number 05-040005, Rev. C Page 4 of 5

 Supplier Survey Questionnaire

Document Number 05-040005, Rev. C Page 5 of 5