SC OIL DEPOL SERVICE SRL SUPPLIER ASSESSMENT QUESTIONAIERE

Dear supplier,
Using this questionnaire, SC OIL DEPOL SERVICE SRL intent to make an objective evaluation of
services /products quality supplied by your company.
In this way SC OIL DEPOL SERVICES SRL understands to give high importance to the quality of
services/products provided by you.
Thank you for the time to complete this questionnaire.

Products/services provided:
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
(please to enumerate all products or services that you provide)

1. GENERAL INFORMATIONS

1.1. COMPANY NAME: ________________________________________________________________

1.2. ADRESS: ________________________________________________________________________
1.3. PHONE: _________________________________________________________________________
1.4. AREA OF ACTIVITY: ______________________________________________________________

Note: Please mark with X the box that you consider applicable for your case.

1.5. INFORMATIONS ABOUT PAYMENT CONDITION:

Order of payment CEC Pre-payment

What methods of payment do you accept?
45 days 30 days 15 days
What is your preferred term for payment?

2. INFORMATIONS ABOUT DELIVERY OF PRODUCTS/ SERVICES:

YES NO
The products are delivered to the client address?

Which is the delivery time?

3. PRODUCTS ARE ACCOMPANIED ON DELIVERY BY:

Certificate of Conformity Using Warranty Distribution

quality statement instructions certificate authorisation/
manufacturer
statement

4. POSSIBILITY FOR OFFERING OF SERVICE/ TECHNICAL ASSISTANCE:

YES NO
5. PRODUCTS WARANTEE (please mark with X the corresponding answer):

< 6 months 6 months 12 months 24 months <24 months

6. INFORMATIONS REGARDING THE QUALITY/ ENVIRONMENT/ HEALTH AND SAFETY/ OTHERS

MANAGEMENT SISTEM

6.1. COMPANY HSEQ MANAGER/ RESPONSIBLE:

Name:……………………………………….Position:……………………………..
Phone/Fax:………………………………………………………………………….

6.2. Quality/ Environment/ Health and Safety Management Sistem/ others

Do you have implemented the Quality/ YES NO

Environment/ Health and Safety
Management Sistem
In conformity with OHSAS
ISO 9001:2008 ISO 14001:2005 Other
requirements: 18001:2008

6.3.Other certifications/ licences/ authorizations:

…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………

(Please attach on this questionnaire all copies of documents mentioned above).

6.5. Number of environment incidents in the last year:

0-3 3-10 <10

Number of environment incidents in the last year

6.7. Number of incidents on HSO in the last year:

0-3 3-10 <10
Number of incidents HSO in the last year

6.8. Solving of complaints:

0-3 3-5 <5
Number complaints registered in the last year

2 hour 3-10 hour <10 hour

Term for solution of complaints (if exist)

7. THE QUESTIONNAIRE WAS COMPLETED BY:

Name:……………………………………………………………………………………………
Position:…………………………………………………………………………………………
Signature/Stamp………………………………….Date:……………………………………….