Company	Supplier number (if known)
Address – street / postcode / town/city / PO box / country	Website
E-mail
Production site – corporate name / town/city / country	Number of employees (prod. site)
Group affiliation – corporate name / town/city / country
Contacts	Title / name	E-mail	Telephone	Fax
Company management
R&D
Production
Quality management
Sales
Purchasing
For delivery-related queries
For technical queries
Number of employees	Total	Quality management	Production
Turnover / investments in € (response optional)	Annual turnover	Invest. in current fiscal year	Purchasing volume / year
Your TOP 5 per category (descending order according to turnover)
Customer	Product	Industry
1.
2.
3.
4.
5.
Product-related information
Do you manufacture CE-parts?	☐ Yes ☐ No	Do you have in-house development?	☐ Yes ☐ No
Are your products REACH-compliant?	☐ Yes ☐ No	Are your products RoHS-compliant?	☐ Yes ☐ No
Do you have management systems? If yes, which? (Please enclose certificates)
☐ No ☐ ISO 14001 (environment) ☐ OHSAS 18001 (health and safety) ☐ ISO 9001 (quality management) ☐ ISO 50001 (energy) ☐ Other: ☐ ISO / TS 16949 (automotive) ☐ EMAS (environment and energy)
You agree that we have permission to visit you with customers or perform process and product audits.

1.	Do you have a quality management system conforming to ISO 9001, is it described in writing in a QM manual and has it been certified by an independent certification company? If yes, please specify the certification company, the date when the standard was issued, certificate number and expiry date (company department, if necessary). If no, are you working towards certification and when is this expected to be achieved? Target date:	☐ Yes ☐ No
Certification company
Standard issue date
Certificate number
Expiry date
The following questions must only be answered if you answered "No" for question 1.
2.	Do you have an organigram?
3.	Are the responsibilities regarding quality management clearly defined? If yes, please specify name and role.
4.	Have other customers already performed audits at your site? If yes, please specify the date, customer and result.
5.	Are new parts generally supplied with an initial sample inspection report?
6.	Do you have a distribution system with an amendment service and suitable archiving measures for contractual documents (signatures, standards, Q specifications, etc.)?
7.	What measures do you have in place for ensuring the quality of your purchased goods?
8.	Do you have defined measures in place for assessing and developing suppliers? If yes, which?
9.	Please describe the quality control methods used in your production department.
10.	Do you carry out final inspections and can you provide us with documented evidence of these?
11.	Are test results from receiving, intermediate and final inspections documented and saved?
12.	Is testing equipment regularly checked, the test documented and traceability to standards guaranteed?
13.	Are causes of faults generally determined and remedied at your site? Please describe the process.
14.	Do you have a training and further education program for employees?
Signature of person responsible for the correctness of this information Town/city, date, company stamp, signature	Approved by KIPP quality management Date, signature