83-550-00099

13.06.2012
Supplier
Self-Assessment



SupplierSelfAssesement.doc page 1 of 2

1. Address




Phone: Fax:
2. Contact person: Name Direct dial E-Mail
General Management:
Quality assurance:
Sales department:

3. Company data
3 a. Turnover (in M ) during the last year:
thereof exports share:
3 b. Turnover (in M ) during the current year:
3 c. Turnover forecast (in M ) over 3 years:
3 d. Total number of employees:
thereof in manufacturing:
3 e. Locations of the company:










4. Product range


5. Your three most important customers

6. Quality management system
our QM system is not certified (please answer question 9 as well)
A certification according to .............................. is planned for the .........................
(norm) (date)
Current valid certification: (please attach a copy of the certificate)
DIN ISO 9001 QS 9000 VDA 6.1
TS 16949 other: ....................................
A (further) certification according to........................... is planned for the ........................
(norm) (date)

83-550-00099
13.06.2012
Supplier
Self-Assessment



SupplierSelfAssesement.doc page 2 of 2
7. Environmental management system
our EM-System is not certified (please answer question 10 as well)
A certification according to .............................. is planned for the ........................
(norm) (date)
Current valid certification: (please attach a copy of the certificate)
DIN ISO 14001 other: ...............................

A (further) certification according to........................... is planned for the ........................
(norm) (date)

8. Initial sample approval
Initial sample approvals for your customer are made according to following standards:
VDA 2 PPAP according to special agreements
other: ....................................

9. Process details (To answer question 9a to 9d is not necessary if your QM-System is certi-
fied)
9 a. Do you make an incoming inspection?
yes / no
9 b. Do you make a final inspection?
yes / no
9 c. Do you evaluate and document the results of question 9a-9b?
yes / no
9 d. Do you monitor your suppliers?
yes / no

10. Environmental issues (To answer question 10a and 10b is not necessary if your EM-
System is certified)
10 a. Do you work according to fixed processes in terms of
environmental and operational safety?
yes / no
10 b. Has your company defined targets for improving environmental
protection?
yes / no

11. Commercial information

11 a. Do you inform your customers in advance in case of delays?
11 b. How is your delivery accuracy?
11 c. How is your internal ppm-rate?
11 d. How is your external ppm-rate?
yes / no
%
.ppm
.ppm

Remarks:






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13.06.2012 LO-E Rapp LOQL Wagner LOQL Flug