Sample Approved or Preferred Vendor Application Form

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Sample Approved or Preferred Vendor Application Form Powered By Docstoc
					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. ___ Nonprofit? ___Yes ___No State of Incorporation? ______________________

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 ________________________________________ ___No Contact Information ___________________ Phone Number _____________________ Does your company accept credit cards? ___Yes 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 ___No Did your company have a name change in the past 12 months? ___Yes

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 _______________ Certificate Number ___________________ Date of Certification ___________ ____________ Other Registrar _______________________ Expiration Date: ISO READY/Not Certified ________ _________ Mil-I-45208 __________ Mil-Q-9858

Registered or certified to any other Quality Management System or model?

----------------------- QUALITY MANAGEMENT SYSTEM ----------------------Do you maintain operation policies and procedures for your quality management system? ___Yes Does the organizational structure define quality responsibility and authority? ___Yes Does the organizational structure provide access to top management? ___Yes Do you have a documented employee training program? ___Yes ___No ___No ___No ___No ___No ___No Is an internal audit program maintained that reviews compliance with all aspects of the quality program? ___Yes ___No

Is the health and status of your quality management system periodically reviewed with management? ___Yes Is the quality organization responsible for acceptance of product and services? ___Yes

Are records of inspections and tests maintained? ___Yes

___No ___No ___No

Are quality data used in reporting results and trends to management? ___Yes Are quality records available to support customer certifications? ___Yes

----------------------- 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 ___No ___No Does quality control verify that changes are incorporated at the effective points? ___Yes Is there a formal deviation procedure? ___Yes ___No

Is the control of design and manufacturing information applied to the procurement activity? ___Yes

----------------------- PROCUREMENT CONTROL ----------------------Are procurement sources evaluated and monitored? ___Yes ___No ___No ___No ___No Are quality requirements and inspection procedures specified? ___Yes

Is a documented system maintained for the evaluation of purchased materials? ___Yes Are incoming materials identified and segregated until acceptance? ___Yes

----------------------- MATERIAL CONTROL ----------------------Do procedures exist for storage, release, and movement of material? ___Yes Are materials in storage identified and controlled? ___Yes Are in-process materials identified and controlled? ___Yes Are materials inspections identified and controlled? ___Yes ___No ___No ___No ___No ___No ___No ___No ___No

Do storage areas and facilities provide control to protect material from degradation? ___Yes Do you have an electrostatic sensitive device protection program? ___Yes Are nonconforming items identified, segregated, and controlled? ___Yes If required, do you have the ability to provide tractability? ___Yes

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