SUPPLIER ASSESSMENT FORM

COMPANY NAME : ________________________ COMMODITY : ________________________

ADDRESS : ________________________ ASSESSMENT DATE : ________________________

A. GENERAL 1 2 3 4 5

1. Company Profile
2. Response to Brief
3. Complain handling
4. Training & training record
5. Process control and documentation
6. Continuous improvement
7. Company stability
8. House keeping/ safety
9. Communication

B. SPECIFIC TO MACHINERY AND EQUIPMENT

1. Product design and development
2. Testing and measuring facilities
3. Manufacturing facilities
4. Manufacturing capability
5. Tool design and fabrication
6. Access to technology
7. Computer application
8.

C. SPECIFIC TO SERVICE SUPPLIES

1. Product design and development
2. Affiliates/ facilities
3. Computer application
4. Office facilities
5. Testing and measuring facilities
6.

TOTAL SCORE _______________________ AVERAGE SCORE _________________________

ASSESSOR 1 _______________________ ASSESSOR 2 _________________________

ASSESSOR 3 _______________________ ACKNOWLEDGED BY __________________________

Scoring Description :
1. Supplier is not familiar with the requirement of the element, or partially familiar with the
requirement of element, but there no evidence of source documentation planning or
implementation (Flow chart, forecasts, plan, procedure, strategies etc)
2. Supplier is familiar with requirement of the element and has preliminary source
documentation with implementation (with assigned responsibilities) has just started ( 0-
30% complete). Deficiencies have been identified but improvement are not quantifiable.
3. Source documentation is available and implementation is in progress (30-80%
complete), and there is preliminary evidence of relevant result.
4. Implementation is nearly complete (80-95%) and documented evidence of
implementation effectiveness exists.
5. Full implementation of source documentation for the requirement and complete
confirmed evidence of implementation effectiveness.

Within each element, the result (1 to 5) is marked in the appropriate row on the record of
findings. The Final score is obtained by adding the point score column and dividing by the
number of scored element.
Guideline to fill in the form (for assessors only)

The following are guideline to fill in the form, please note that is guideline is intended as
general guideline, specific condition may apply to different commodities.

A. GENERAL

The assessor should look at the general condition of the company

1. The company profile can be reflected on the product range & diversity, number of
employee, turnover rate etc.
2. Response to brief refers to the company’s response & understanding to GM
Indonesia requirement.
3. Complain handling refers to company procedure to handle complain from clients.
4. Training & training record refers to any internal documentation describing
employee’s training.
5. Process control & documentation refers to control & control documentation of all
process within the company.
6. Continuous improvement refers to any documentation/process for company’s
continuous improvement, can be combined with the training record.
7. Company stability, normally refers to how long the company has been
established.
8. House keeping/safety refers to general condition of the office, e.g. efficiency of
the office, safety of the building, etc.
9. Communication refers to equipment, supportive communication internally and
outside, sometimes also can be combined with item # 1.

B. Specific to machinery and equipment

1. Product development & design refers to the development & design of the
commodity assessed.
2. - 7. Self explanatory

C. Specific to service supply

1. As 1B above
2. Affiliates refers to the company’s affiliated with other international company
3. - 4. Self explanatory
5. Testing & measuring activities refers to all facility used to test/validate the
product.