NASA SUPPLIER INFORMATION SURVEY
PLEASE PRINT OR TYPE INFORMATION TO THE BEST OF YOUR KNOWLEDGE. FEEL FREE TO ATTACH ANY ADDITIONAL DOCUMENTATION YOU FEEL IS NECESSARY OR USEFUL.
(0) CURRENT DATE: SURVEY APPLICABILITY
The purpose of this Supplier Information Survey (SIS) is to gather data on Suppliers’ facilities and operations involved in supplying products and/or services to NASA through Field Centers, Prime Contractors, and/or other Subcontractors. The data collected is used for reference purposes only. This SIS is used to provide information to assist NASA in determining prospective supplier capabilities, qualifications, and assist in the determination of need for a formal survey. The information survey is not intended to preclude suppliers from competition, but is a tool to provide information necessary to better understand your facility. Questions should be directed to the NASA point of contact from which you received it. This information may be shared with other Government Agencies.
GENERAL BUSINESS INFORMATON (1) LEGAL BUSINESS NAME (4) DOING BUSINESS AS (DBA) NAME (2) CAGE CODES* (3) DUNS Number
(5) OTHER COMPANY NAME(S)
(6) STREET ADDRESS
(7) PREVIOUS COMPANY NAME(S)
(8) CITY (12) BUSINESS PHONE
(9) STATE (13) WEBSITE
(10) ZIP CODE
(11) COUNTRY (if not in USA)
SUPPLIER POINT OF CONTACT (POC) (14) GENERAL CONTACT NAME (16) TELEPHONE NO. (17) EXTENSION: (18) FAX NO. (15) TITLE (19) EMAIL (21) TITLE (24) FAX NO. (25) EMAIL
(20) ALTERNATE CONTACT NAME (22) TELEPHONE NO. (23) EXTENSION:
BUSINESS SIZE / EMPLOYEES (26) APPROXIMATE FACILITY SIZE (Sq. Ft.) (27) TOTAL NUMBER OF EMPLOYEES
(28) APPROXIMATE SIZE OF MANUFACTURING AREA (Sq. Ft.) (30) TOTAL NUMBER OF BUILDINGS
(29) TOTAL NUMBER OF EMPLOYEES WORKING IN QUALITY
(31) TOTAL NUMBER OF EMPLOYEES WORKING IN PRODUCTION
(32) OFF-SHIFT OPERATION
2 SHIFT (HOURS: RD 3 SHIFT (HOURS:
Additional Info:
ND
) )
* NASA USES CAGE CODES AS THE PREFERRED METHOD TO IDENTIFY SUPPLIERS. CAGE CODES ARE REQUIRED BY THE FEDERAL ACQUISITON REGULATION (FAR). FOR MORE INFORMATION ABOUT CAGE CODES, OR TO REGISTER FOR A CAGE CODE, GO TO: https://www.bpn.gov/bincs/faq.asp.
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COMMODITY INFORMATION (33) LIST THE STANDARD INDUSTRIAL CLASSIFICATION (SIC) CODES THAT APPLY TO THE BUSINESS / ORGANIZATION. (34) LIST THE NORTH AMERICAN INDUSTRIAL CLASSIFICATION SYSTEM (NAICS) CODES THAT APPLY TO THE BUSINESS / ORGANIZATION.
(35) LIST THE FEDERAL SUPPLY CLASSIFICATION (FSC) CODES THAT APPLY TO THE BUSINESS / ORGANIZATION.
(36) LIST A DESCRIPTION OF ALL THE TYPES OF COMMODITIES / CAPABILITIES (PRODUCTS OR SERVICES) AVAILABLE AT YOUR FACILITY. ATTACH ANY MAJOR EQUIPMENT LIST, CAPABILITIES LIST, BROCHURE, OR CATALOG, IF NECESSARY.
CAPABILITIES (37) (38)
Does the facility handle Electrostatic Discharge (ESD) sensitive hardware? Does the facility have Clean Room capability? *If YES, what kind of capability? Does the facility perform any special processes? *If YES, check all that apply: Brazing Processes Calibration Document Control Electrical Testing Fastener Test Methods Final Ship Inspection First Article Factory Acceptance, Individual Acceptance Flame Spray Heat Treatment Hydrostatic Testing Inspection and Testing Material Control Metallurgical/Chemical Testing Non-Destructive Testing Nonconformance Material Control Packaging and Preservation Paint and Surface Preparation Plating Receiving Inspection Soldering Controls Teflon Coating Torque Welding Other, please list: Does the facility work to customer supplied drawings? Comments: Does the facility use Government furnished equipment or property? (i.e. tooling, computers, raw
materials)
YES YES*
NO NO
(39)
YES*
NO
(40)
YES YES YES* YES
NO NO NO NO
(41)
Comments:
(42) (43)
Does the facility have environmental test capabilities? (i.e. vibe, shock, altitude, thermal, physical, or chemical). *If YES, please LIST: Does the facility have Material Laboratory / Chemistry? Comments: Does the facility perform in-house calibration? * If YES, to what Standard: YES*, Mechanical
(44)
Electrical
Standards
Other
N/A
NO
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NASA SUPPLIER INFORMATION SURVEY
(45) (46) (47) (48) (49)
Does the facility subcontract calibration services?
YES, Mechanical
Electrical
Standards
Other
N/A YES
NO NO NO NO NO
Does the facility use a Nonconformance-tracking System? Comments: Does the facility have a delegated Material Review Board (MRB) authority? YES, Full Limited Preliminary
Customer Notification Only YES
Does the facility use Statistical Process Control (SPC)? Comments:
(50)
Does the facility use/produce any Limited Life Material(s)? YES Comments: YES, Metallic Raw Material Non-metallic Raw Material Does the facility Electronic Components Paints, Chemicals and/or Adhesives distribute ONLY? Industrial/Military Standard Parts and/or Fasteners Commercial Off The Shelf (COTS) Items (i.e. connectors, cables, fiber-optic cables, software) Are your products or services used for Flight, Non-Flight, or GSE purposes? Comments: Do you subcontract work outside of your facility? Comments: Are you a certified maintenance, repair, and overhaul (MRO) facility or maintenance depot? *If YES, for what products? QUALITY SYSTEM Flight Non-Flight YES YES*
NO
(51)
GSE NO NO
(52)
(53)
Is the business / facility: ISO 9001:2000 Compliant? AS9100 Compliant? AS9003 Compliant? (54) AS9120 Compliant?
YES YES YES YES
NO NO NO NO
ISO 9001:2000 Certified/Registered? AS9100 Certified/Registered? AS9003 Certified/Registered? AS9120 Certified/Registered?
YES YES YES YES
NO NO NO NO
Certificate Number(s) & Comments:
(55)
* If YES, provide a copy of the Certification / Registration. YES* NO
Has the facility been audited by NASA or NASA Prime Contractor for space products/services? *If YES, list the organization that conducted the audit and the audit date:
(56) (57)
If the facility is not compliant or Certified/Registered to the above listed Quality Management Systems, please list the type of Quality Management System your business operates under: Please list any other Certifications the facility or employees have (i.e. NADCAP, DCMA, DSCC): Do you anticipate any changes to the facility’s Quality Management System within the next twelve months? (i.e. ISO or AS9100 Certification/Registration or renewal) *If YES, please explain: Is there a customer assigned Resident Inspector at the facility? *If YES, please provide: Resident ‘s Company/Agency: Resident’s name and phone: Is there a DCMA Representative at the facility? *If YES, provide Representative’s name and phone: Does your company have a resident or itinerant at any of your supplier or subtier supplier’s facility? *If YES, provide Representative’s name, phone, supplier name, and supplier location(s):
(58)
YES*
NO
(59)
YES*
NO
(60)
YES* Resident Itinerant YES* Resident Itinerant
NO
(61)
NO
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NASA SUPPLIER INFORMATION SURVEY
(62) (63)
Does the facility have a documented Safety Program? Comments: Do you have a documented Configuration Management System? *If YES, list specification/standard complied with: Does the facility have a current and active membership in the Government Industry Data Exchange Program (GIDEP)? Comments: Does the facility flow down requirements for GIDEP to sub-tier contractors? Comments: Do you track and have data on the reliability of your product(s)? Comments: Do you track Mean Time Between Failures (MTBF) of your product(s)? Comments: Do you test for lifetime of your product(s)? Comments: Does the facility actively participate in a Lean program (i.e. SEA, CMTC, Six Sigma) * If YES, do you use an outside consultant or an internal organization? Which one? Does the facility have an Approved Supplier List? * If YES, explain how do you approve, maintain, and disapprove suppliers: * If NO, explain the method used to manage suppliers. Does the facility flow down Quality Requirements to contractors? *If YES, list the method used to flow down such requirements (i.e. through Quality Clauses/Provisions): Has the facility received Level 3 Corrective Action Report (CAR) from DCMA or any delivery suspended by a customer in past 12 months? *If YES, please explain:
BUSINESS & WORKFLOW INFORMATION
YES YES*
NO NO
(64)
YES
NO
(65) (66) (67) (68)
YES YES YES YES
NO NO NO NO
(69)
YES*
NO
(70)
YES*
NO*
(71)
YES*
NO
(72)
YES*
NO
Business Type: (Please select category(s) your business falls under) Construction Services Distributor Engineering/design Fabrication/prototyping Human Resource Manufacturer Repair Service Research & Development Testing & Calibration Transportation/shipping OTHER(S): How long has the business been at the current facility? Comments: Has the company changed ownership? *If YES, what year(s), explain: Year(s) YES* NO
(73)
(74) (75)
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NASA SUPPLIER INFORMATION SURVEY
(76) (77)
Has the business extensively remodeled any existing facilities in the past 3 years? *If YES, please explain: Has the business invested significant resources to add capital equipment in the past 3 years? *If YES, please explain: Has the business acquired new capabilities/processes/services in the past 3 years? *If YES, please explain: Does the business have any current facilities or capability expansion plans? *If YES, please explain: Is there any anticipation for NASA contracts in the near future? Comments: Is the business currently bidding on any subcontracts for NASA Programs/Projects? Comments: Has the employment rate increased or decreased (+/- 25%) within the past 3 years? Comments: What percentage of the total business does NASA contracts currently represent? Comments: What percentage of the total business does NASA contracts represent in the last 24 months? Comments: Does the company have a Union? *If YES, when are contracts renewed?
CUSTOMER INFORMATION
YES* YES* YES* YES* YES YES YES % % YES NO
NO NO NO NO NO NO NO
(78) (79) (80) (81) (82) (83) (84) (85)
Check the box of NASA Centers that your company has DIRECTLY provided products/services to; if your company has provided products/services to NASA through a Prime Contractor, check off the appropriate Prime Contractor box. Please NOTE: The information you provide in this survey will be available for the customers (Center & Primes) you indicate below.
NASA CUSTOMER (S)
Check off your DIRECT NASA Customer(s) NASA Headquarters (HQ) Ames Research Center (ARC) Applied Physics Lab (APL) Dryden Flight Research Center (DFRC) (86) Glenn Research Center (GRC) Goddard Space Flight Center (GSFC) Jet Propulsion Laboratory (JPL) Johnson Space Center (JSC) Kennedy Space Center (KSC) Langley Research Center (LaRC) Marshall Space Flight Center (MSFC) Stennis Space Center (SSC) What type(s) of Programs/Projects has the company supported, either directly or indirectly through a subcontract with a Prime (if known)? Space Shuttle Program (SSP) International Space Station (ISS) Un-manned/Robotics Program(s) i.e., Mars Exploration, Expendable Launch Vehicles, Delta, Taurus, Hubble, Webb Telescope, SBIR, etc. LIST KNOWN PROGRAMS: Are the products/services used for: Flight Non-flight Ground Support Equipment (GSE) Prototype Test R&D List the product/service your company provided and for what Program/Project (if known) When was your last contract?
(87)
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PRIME CONTRACTOR CUSTOMER(S)
Check off your Customer(s) BAE Systems (BAE) Ball Aerospace Boeing Hamilton Sundstrand (HS) Harris Honeywell Lockheed Martin (LM) Northrop Grumman/TRW Orbital Sciences (OS) Parker Hannifin (PH) Pratt & Whitney (PW) Raytheon Spectrum Astro (SA) Thiokol Propulsion United Space Alliance (USA) Others: List Customer’s facility location(s) (City, State) List Product/Service and for what Program / Project (includes NASA or Non-NASA programs).
(88)
GOVERNMENT CUSTOMER (S)
Check off your Customer(s) Department of Defense (DoD) Air Force Army Marines Navy (89) Department of Energy (DoE) Missile Defense Agency (MDA) Defense Contract Management Agency (DCMA) Others: List Customer’s facility location(s) (City, State) List Product/Service and for what Program (if known).
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