Sample Approved/Preferred Vendor Application Form
Company Name ______________________________________________________
Address __________________________________________________________
City/State/Zip ________________________________________________________
Phone ____________________________ Fax _____________________________
CEO Name ________________________ CEO Title __________________________
CEO E-mail _______________________ CEO Phone _________________________
Marketing E-mail ___________________
Social Security Number _______________ Name of SSN Owner ___________________
Federal Tax ID Number _______________
----------------------- COMPANY INFORMATION -----------------------
Organization Type: Sole Owner ___ Corporation ___ S-Corp. ___
State of Incorporation? ______________________ Nonprofit? ___Yes ___No
Other Socioeconomic Factor(s)? ___________________________________________
Domestic/Foreign Owned? _______________________________________________
Is your company owned by a parent company? ___Yes ___No
Parent Company Name _________________________________________________
Parent Company Address ________________________________________________
Parent Company Tax ID ________________________
Are you: Small Business? ___ Minority-Owned Business? ___ Veteran-Owned
Business? ___ Women-Owned Business? ___ Veteran Disabled-Owned Business? ___
Other Socioeconomic Factor(s)? ___________________________________________
Certifications: 8a Certified? ___ Minority? ___ Women-Owned? ___ HUBZone? ___
Mentor Program: Mentor Company ________________________________________
Contact Information ___________________ Phone Number _____________________
Does your company accept credit cards? ___Yes ___No
Primary Standard Industrial Code __________________________________________
Additional SICs _______________________________________________________
Primary North American Industry Classification System Code (NAICS) _______________
Additional NAICSs _____________________________________________________
Products/Services (short narrative): _________________________________________
_________________________________________________________________
_________________________________________________________________
Company’s Web Site(s): _________________________________________________
FSCM/Cage Code _____________________________________________________
Registered CCR? ___Yes ___No Registered Pro-Net? ___Yes ___No
Did your company have a name change in the past 12 months? ___Yes ___No
Name _____________________________________________________________
Company Contact _________________ Quality Assurance Contact _________________
----------------------- GENERAL INFORMATION -----------------------
Area in Sq. Ft.: Manufacturing ____ Office _____ Total _____
Number of Personnel: Manufacturing _____ Quality Assurance ____ Engineering _____
Are clean room facilities used for manufacturing product? ____ Yes____ No
What percentage of present work is: Government ____ Commercial ____ Other ____
Describe any special processes that you perform (e.g., plating, painting, soldering, welding, wire wrap, etc.). _____
________________________________________________________________
_________________________________________________________________
Are you ISO-9000 certified? ___Yes ___No ISO Certificate Type _______________
Registrar _______________________ Certificate Number ___________________
Expiration Date: ISO READY/Not Certified ________ Date of Certification ___________
Registered or certified to any other Quality Management System or model?
_________ Mil-I-45208 __________ Mil-Q-9858 ____________ Other
----------------------- QUALITY MANAGEMENT SYSTEM -----------------------
Do you maintain operation policies and procedures for your quality management system? ___Yes ___No
Is an internal audit program maintained that reviews compliance with all aspects of the quality program? ___Yes ___No
Does the organizational structure define quality responsibility and authority? ___Yes ___No
Does the organizational structure provide access to top management? ___Yes ___No
Is the health and status of your quality management system periodically reviewed with management? ___Yes ___No
Do you have a documented employee training program? ___Yes ___No
Is the quality organization responsible for acceptance of product and services? ___Yes ___No
Are records of inspections and tests maintained? ___Yes ___No
Are quality data used in reporting results and trends to management? ___Yes ___No
Are quality records available to support customer certifications? ___Yes ___No
----------------------- DESIGN INFORMATION -----------------------
Do procedures cover the release, change, and recall of design and manufacturing information, including correlation of customer specification? ___Yes
___No
Do records reflect the incorporation of changes? ___Yes ___No
Does quality control verify that changes are incorporated at the effective points? ___Yes ___No
Is the control of design and manufacturing information applied to the procurement activity? ___Yes ___No
Is there a formal deviation procedure? ___Yes ___No
----------------------- PROCUREMENT CONTROL -----------------------
Are procurement sources evaluated and monitored? ___Yes ___No
Are quality requirements and inspection procedures specified? ___Yes ___No
Is a documented system maintained for the evaluation of purchased materials? ___Yes ___No
Are incoming materials identified and segregated until acceptance? ___Yes ___No
----------------------- MATERIAL CONTROL -----------------------
Do procedures exist for storage, release, and movement of material? ___Yes ___No
Are materials in storage identified and controlled? ___Yes ___No
Are in-process materials identified and controlled? ___Yes ___No
Are materials inspections identified and controlled? ___Yes ___No
Do storage areas and facilities provide control to protect material from degradation? ___Yes ___No
Do you have an electrostatic sensitive device protection program? ___Yes ___No
Are nonconforming items identified, segregated, and controlled? ___Yes ___No
If required, do you have the ability to provide tractability? ___Yes ___No