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SUPPLIER REGISTRATION CUM EVALUATION / RE-EVALUATION FORMDate Page ofDocument No.1.Name of the Organization:(in full, in Block letters)3.Name & Telephone No. of contact person:4.(a) Head Office/Registered Office/Address: Telephone No. Fax No.(b) Branch Office, if any Address : Telephone No. Fax No.(c) Works/Factory/Address. Telephone No. Fax No.5.Name of Chief Executive/Proprietor/Partners: Telephone No. Fax No.6.Type of OrganizationDocuments to be enclosed(Strike out those not applicable)a)Proprietaryb)Partnershipc)Private Limited Companyd)Public Limited Companye)Public SectorSignature of Vendor COMMERCIAL DETAILS:A) Bank Name:B ) Branch :C) Account No:EXCISE DETAILS:A) Range : B ) Division :C) Commissioner ate:D) Central Excise RegNo:E) CST TIN No:F) VAT TIN No:G) Service Tax No.:H) PAN No.:7.Organization Structure No. of Employees (Total)a)Administrativeb)Technical/Supervisoryc)Skilled Workmend)Unskilled Workmen8 Details of production facilities a) Covered Area.9.Quality Assurance Plana)Have company obtained certification in ISO 9001 : 2008 ISO 14001: 2004, ISO 18001:2007? Yes/No.If yes, enclosed copyb)Are you API Certified Yes/No? If yes, specify and enclosecopy of the certificate c) Other Certificates if any :10 Quality, QHSE & ENVIRONMENT QUESTIONNAIRE * : (Refer Attached Annexure A,B C )11: Other Facilities / Information:-Signature of Vendor Evaluation/Re evaluation Results:VERIFIED BY: APPROVED BY: ANNEXURE A(ISO 9001:2008 ) QUESTIONNAIREA) QUALITYSr. No.EVALUATION QUESTION1Does the company have ISO 9001:2008?YesNo2Does the company have control of documents & Control of records ?YesNo3Does the company have quality policy & quality objectives ?YesNo4Does the company necessary resources, infrastructure to maintain the quality of products?YesNo5Whether appropriate training is given to employee?YesNo6Does the company have training records ?YesNo7Does the company have your design? YesNo8Does the company operate internal audits & are they received by top management?YesNo9Does the company maintains identification and traceability in the products ?YesNo10Does the company preserve the product to delivery to the intended destination with proper packaging, identification, storage & protection ? YesNo11Does the company operate a calibration system?YesNo12Does the company maintain a corrective action and preventative action system?YesNo13Does segregate & identify non-conforming product to prevent in-advertent dispatch?YesNo14Does use statistical techniques to determine acceptable quality levels for compliance to specification?YesNo15Does the company provide a test certificate w.r.t. P.O specification requirement?YesNoSignature of Supplier : Date : ANNEXURE BQHSAS (ISO 18001:2007 ) QUESTIONNAIRE QUESTIONNAIREB) HEALTH & SAFETYSr. No.AUDIT QUESTION1Does the company have ISO 18001:2007 system?YesNo2Do you have written HSE policy statement?YesNo3How the company communicate this HSE policy to employees.4Are the hazardous material are identified?YesNo5Have an awareness of the hazardous material is in place?YesNo6Does the company carry out risk assessments?YesNo7Does the company record and investigate accidents and incidents?YesNo8 Does the company have operational control procedures?YesNo9Does the company have emergency preparedness and response procedure ?YesNo10Have emergency procedures in place?YesNo11Does the company carry out regular safety checks on your equipment and material?YesNoSignature of Supplier : Date : ANNEXURE CISO 14001 :2004 QUESTIONNAIREC) ENVIORNMENTSr. No.AUDIT QUESTION1Does the company have ISO 14001:2004 system?YesNo2Does the company have complains with regulatory requirement?YesNo3Does the company have an environmental policy?YesNo4Does the company have environmental objectives, targets programmers?YesNo5Does the company gives training to employees regarding environmental programmers? YesNo6Does the company have operational procedures ?YesNo7Does the emergency preparedness and response procedure ?YesNo8Does the company have procedure for wa