HALLIBURTON Energy Services

3000 N Sam Houston Pkwy E Houston, TX 77302. Tel: 281-871-4000 Fax: 281-871-4595

Office Use Only

Approval

Date Friday, May 22, 2020

SUPPLIER QUESTIONNAIRE

NAME OF COMPANY
ADDRESS
DIVISION OF
LOCATION
PRODUCT OR SERVICE
PRINCIPAL CONTACT TELEPHONE FAX

1. TYPE OF OWNERSHIP
A. If subsidiary, list name and address of Parent Company

B. If privately owned, who are the principles

C. Executive Contact, Name and Title

2. ORGANIZATION
Head of Quality Control Title
Quality Control Manager Title
Number of Quality Control Personnel
Number of Employees at Facility
Head of Production Title
Production Manager Title
Is your company unionized? Yes No
If yes, please provide the name of union and contract expiration date

Have you ever had a strike? Yes No

If yes , date and duration of the strike

3. FINANCIAL
A. Payment Details:
Bank Name (USD):
Bank Address:
State: Country: Postcode:
Account Name:
Account Number:
Swift Code/ABA No.:

B. Dunn and Bradstreet rating

C. Do you publish an annual financial report? Yes No (If yes, please attach.)

D. Are you presently involved in any bankruptcy proceedings? Yes No

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HALLIBURTON Energy Services
3000 N Sam Houston Pkwy E Houston, TX 77302. Tel: 281-871-4000 Fax: 281-871-4595

If yes, please explain

E. SIC Code
F. OSHA Recordable and Lost Work Day Case Incident Rate for each of the previous three years.

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HALLIBURTON Energy Services
3000 N Sam Houston Pkwy E Houston, TX 77302. Tel: 281-871-4000 Fax: 281-871-4595

A. Management Responsibility Yes No

1. Are management responsibilities affecting quality clearly defined?
2. Has management communicated quality policies and objectives to all levels of the
company?
3. Has Senior management visibly demonstrated commitment to continuous
improvement?
4. Are resources available for quality improvement activities?
Comments

B. Quality System Yes No

1. Is there a documented quality control system in place? If yes, please return a non-
controlled copy of your manual with your questionnaire.
2. Are specific quality policies, responsibilities, and functional relationships defined and
are they evident in daily practice?
3. Does your facility hold any certificates of authorization (i.e., API, ASME, etc.)?
Comments

C. Contract Review Yes No

1. Are customer orders (contract, drawings, specifications, etc.) subjected to review by
someone in the organization prior to commencement of work?
2. Are records of all contract reviews maintained and accessible?
Comments

D. Design Control Yes No

1. Does your facility produce engineering designs?
2. Are design documents approved by someone other than the original designer?
Comments

E. Document and Drawing Control Yes No

1. Is there a document control procedure?
2. Are obsolete specifications and drawings identified as such or destroyed?
3. Is document control assigned to a specific person or department?
Comments

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HALLIBURTON Energy Services
3000 N Sam Houston Pkwy E Houston, TX 77302. Tel: 281-871-4000 Fax: 281-871-4595

F. Purchasing Yes No
1. Is there a list of approved suppliers maintained and periodically updated?
2. Are purchase contracts reviewed to assure quality requirements are met?
3. Is there a system for supplier qualification?
3. Is there a system for evaluating your suppliers' performance?
4. Is there a process to ensure that suppliers understand policy, procedure, design, and
technical requirements?
Comments

G. Customer Supplied Product Yes No

1. Is material supplied by a customer controlled in a manner to prevent
unauthorized use?
2. Does the supplier examine material upon receipt and during storage?
3. Is there a process to immediately notify the customer of any damage or quality
concerns with the product received?
Comments

H. Product Identification and Traceability Yes No

1. Are items identified in a manner that they can be tracked throughout the manufacturing
process?
2. Are methods for control of traceability in place as required?
Comments

I. Process Controls Yes No

1. Are shop travelers, operations sheets, and/or inspection instructions used during
manufacturing process?
2. Are process controls in place and being followed?
Comments

3. Does your facility perform production welding (if applicable)?

a. Are welding procedures available?
b. Are these procedures in written form?
c. Are procedures qualified?
d. Are welders qualified?
e. To what standard?
4. Does your facility have heat-treatment capabilities (if applicable)?
a. Is heat-treatment equipment calibrated?
b. Frequency of calibration?
c. Are calibrations traceable to N.I.S.T.?

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HALLIBURTON Energy Services
3000 N Sam Houston Pkwy E Houston, TX 77302. Tel: 281-871-4000 Fax: 281-871-4595

d. Are charts maintained on all heat treatments?

e. Are heat-treat furnace surveys performed?
Comments

J. Inspection and Testing Yes No

1. Is “Receiving Inspection” performed to written procedures?
2. Are copies of purchase contracts, drawings, and specifications available at receiving
inspection?
3. Are provisions made to prevent unauthorized use of material pending acceptance by
receiving inspection?
4. Are inspection and testing procedures documented in a written procedure?
5. Are "first part" inspections performed?
6. Are "in-process" inspections performed?
7. Is a final inspection performed and the results recorded?
Comments

8. Are non-destructive examinations applicable to your facility?

a. What testing capabilities are available:
Ultrasonic Magnetic Particle (wet) (dry)
Liquid Penetrant Radiographic Eddy Current
Others:
b. Are approved written NDE procedures available to operators?
c. Do the NDE procedures contain acceptance criteria?
c. Are level II operators available for each testing capability?
d. Are qualifications of NDE personnel on file?
e. Are level II operators available for each testing capability?
f. To what standards are your level II operators certified (i.e. ASNT, PCN, etc)
Comments
g. Is there a level III person qualified in the NDE processes located at your facility?
h. To what standards are your level II operators certified (i.e. ASNT, PCN, etc)
Comments
i. Are records of non-destructive examinations maintained?
j. Is a set of authorized reference radiographs available?
k. Is X-ray equipment licensed?
If so, by whom?
Comments

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HALLIBURTON Energy Services
3000 N Sam Houston Pkwy E Houston, TX 77302. Tel: 281-871-4000 Fax: 281-871-4595

K. Inspection, Measuring, and Test Equipment Yes No

1. Are measuring and test equipment inspected and calibrated at pre-established
intervals?
2. Is equipment used for calibrating traceable to N.I.S.T. or a recognized industry
standard?
3. Are records of calibrations maintained and traceable to measuring and test equipment?
4. Is testing and measuring equipment identified by decal or other means to indicated
current calibration status?
5. Are employee-owned tools and gauges utilized for product acceptance?
6. Are employee-owned tools calibrated at pre-established intervals with records
retained?
7. If outside sources are used for calibration, do their calibration certificates show
traceability to standards traceable to N.I.S.T?
Comments

L. Inspection and Test Status Yes No

1. Is there a system in place which indicates a product's inspection status throughout all
stages of manufacturing?
2. How is the inspection status identified?
Stamp Signature
Other
Comments

M. Control of Non-Conforming Product Yes No

1. Are there procedures to cover non-conforming materials?
2. Are non-conforming materials identified and segregated from acceptable material?
3. Is a system in effect to investigate cause, including corrective action for non-
conformance?
Comments

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HALLIBURTON Energy Services
3000 N Sam Houston Pkwy E Houston, TX 77302. Tel: 281-871-4000 Fax: 281-871-4595

N. Corrective Action Yes No

1. Does a corrective action system exist for system or procedural problems?
Explain

2. Is there a follow-up system to review that corrective action taken is effective?

3. Is disposition of customer complaints documented?
Comments

O. Handling, Storage, Packaging, and/or Shipment Yes No

1. Are there procedures for preservation, packaging, storage, marking, and shipping?
Explain

2. Are environmental conditions considered prior to packaging and shipping?

3. Are outgoing shipments verified for conformance to applicable requirements?
4. By what means are raw materials and/or finished goods in storage identified?
Comments

5. Does the supplier evaluate stored material for deterioration at regular intervals?
Comments

P. Quality Records Yes No

1. Are quality records available that provide evidence of compliance to the suppliers'
quality system?
2. Do the quality records contain data in regards to inspections, calibrations, etc.?
3. Are records legible and protected from deterioration and loss?
4. What is the retention period for quality records? Years
5. Are certified test reports maintained that are traceable to raw materials?
Comments

Q. Internal Quality Audits Yes No

1. Is the quality system periodically audited?
2. Is there an audit schedule available?
3. Are the results of the audits documented and brought to the attention of the personnel
responsible for the areas having been audited?
Comments

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 HALLIBURTON Energy Services
3000 N Sam Houston Pkwy E Houston, TX 77302. Tel: 281-871-4000 Fax: 281-871-4595

R. Training Yes No
1. Are training programs implemented in your organization?
2. Are employee training records available for review?
3. Are training programs available to provide for personnel development?
Comments

S. Servicing Yes No
1. Where servicing is specified in the contract, are there methods in place to verify
servicing meets the specified requirements?
Comments

T. Statistical Techniques Yes No

1. Are statistical process control techniques used in your facility?
Comments

List three major customers

List three major suppliers

Comments

Questionnaire completed by: Date Friday, May 22, 2020

Note: Please complete the next page on Safety and Environmental issues.

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HALLIBURTON Energy Services
3000 N Sam Houston Pkwy E Houston, TX 77302. Tel: 281-871-4000 Fax: 281-871-4595

Safety/Environmental Regulations

Office Use Only

VN #

HSE Approval

Date Friday, May 22, 2020

Safety/Environmental Regulations Yes No

1. Does your facility have a documented Health, Safety and Environmental Management
System?
2. Does your facility perform self audits/reviews to access Health, Safety and
Environmental performance?
3. What processes are in use to prevent pollution or minimize waste? (i.e.recycling,
controls, treatment, etc.)

4. Does your facility have a documented Emergency Preparedness and Response Plan?
5. Does your facility have Federal, State or Local environmental permits or registrations?
List all permits and registrations:

6. Have there been health, safety or environmental violations of Federal, State or Local
codes or regulations in the past 5 years?
If yes, explain

7. Have inspections by regulatory agencies been conducted at your facility with the past 5
years?
If yes, explain

8. Does your facility audit their waste disposal vendors?

9. Does your facility have Health, Safety or Environmental personnel?
Contact Names
10. Does your facility track manifested waste?
If yes, indicate volume for previous three years
Gal.
#'s Gal.
#'s Gal.
Comments

Safety/Environmental questions completed by Date: May 22, 2020

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HALLIBURTON Energy Services
3000 N Sam Houston Pkwy E Houston, TX 77302. Tel: 281-871-4000 Fax: 281-871-4595

This section to be completed by Halliburton personnel:

Yes No
A. Management Responsibility
B. Quality System
C. Contract Review
D. Design Control
E. Document and Drawing Control
F. Purchasing
G. Purchaser Supplied Products
H. Product Identification and Traceability
I. Process Control
J. Inspection and Testing
K. Inspection, Measuring, and Test Equipment
L. Inspection and Test Status
M. Control of non-conforming product
N. Corrective Action
O. Handling, Storage, Packaging and Delivery
P. Quality Records
Q. Internal Quality Audits
R. Training
S. Servicing
T. Statistical Techniques
Comments

D00326309 Revision A Page 10 of 10