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Save this file to your local computer before entering data. Do not complete this form using your web browser. Data entered on this form can not be saved electronically* After completing the survey, please submit the Supplier Qualification Survey via the email by clicking on the “Submit by Email” button found on page 1 and 4 of this form. Do not attempt to save the file and add it as an attachment to an email as the data entered will be lost*. If you would like an electronic copy, please request one at the time of email submission and an electronic copy will be returned to you. In the event you are unable to submit the form via email, please print the form and fax to 262-970-8665, you will not be able to save the completed form*. Manufacturers: Please complete this form in it's entirety Distributors: Please complete sections 1,3, 5, 8 & 9 *unless you are completing the form using Adobe Acrobat Professional
TLX Technologies, LLC Submit by Email PUR001-B
Supplier Qualification Survey
Company profile
Section 1
Business Name: DUNS:
Trading Name: NAICS:
Type of Business: Individual
Sales Office
Location Corporation
Partnership
Manufacturing Female owned
Location
Minority owned
Other
Manufacturing
Location (#2)
Year of establishment:
Billing Address
Web Page:
Is the Company a division or subsidiary of a larger corporation? Yes No
If yes, Parent Company's
Name and address
Plant Age Plant Sq Ft Warehouse Sq Ft Office Sq Ft
Are you supplying to other customers in TLX's Industry? (Electro-mechanical/ solenoid devices) Yes No
Which Customers?
Labor Profile
Section 2
Number of Employees Number Salary Number Hourly
Number of Production Shifts Days/Week Avg Years of Experience
Are you Unionized? Yes No Union Name: Contract Exp Date
Do you have formal training programs for employees; Yes No
Explain:Contact Inforamtion PUR001-B
Section 3
Name Phone Fax Email Address
President
Sales
Engineering
Plant Manager
Customer Service
Shipping
2nd Shift/ Afterhours
Market Data
Section 4
Current Year's estimated annual Sales (US$)
Latest two years' annual sales Year Amount (US$)
Year Amount (US$)
Who are your three largest Customers? % of total sales (Last
Customer name/ address Product Supplied fiscal year)
1.
2.
3.
Main Products and/or
Service Provided:
What is the standard lead time for your main product?
How are lead time changes
communicated?
Are any products or processes proprietary? Yes No
If so, list them
Who are your three largest suppliers?
Supplier name/ address Material Procured % of total purchases
1.
2.
3.PUR001-B
Quality Assurance
Section 5
Number of employees in the Quality Department
Is there a written quality assurance program? Yes No When was it implemented?
Is the company ISO, TS16949, or QS9000 Certified? Yes No If certified, please provide a copy of your certification.
If not, please provide a copy of your quality manual.
Do you have an inspection process for:
Incoming Material Yes
No Explain:
In Process Yes
No Explain:
Final Product Yes
No Explain:
Is there a system for product traceability? Yes No
Describe
Do you have a quality lab on site? Yes No
Section 6
Please List
Major
Equipment
Do you contract with an outside quality lab? Yes No
May we visit and inspect your facilities? Yes No
Do you have a formal system for control of non-conformance? Yes No
Contact for dispositions for
non-conformance
Name/ Contact info
Do you have a corrective action procedure? Yes No
Describe
Do you have an internal audit program Yes NoProduction & Logistics PUR001-B
Does production take place in more than one plant? Yes No
Section 7
If so, where are the other
locations?
What is your capacity Utilization?
Do you utilize CAD/CAM Applications? Yes No
Do you accept electronic exchange of CAD drawings and/or Solid Models? Yes No
If yes, what format?
Do you offer engineering services for design & review? Yes No
Do you have tooling design and fabrication capabilities Yes No
Explain:
Section 8
Is there a material requirement planning system? Yes No
Are you willing to produce product samples on demand? Yes No
Do you have a bar code labeling system? Yes No
Can you provide a stocking program? Yes No
Do you have an environmental policy? Yes No
Do contingencies exist to assure source of supply of products? Yes No
Do you track past due orders? Yes No
If so, what is your current percentage of on-time delivery?
Additional Comments/ Notes
Section 9
TLX Technologies, LLC is required by strict internal quality procedures to build business relationships with qualified suppliers. TLX
Technologies, LLC created a qualified vendor list for the above purpose. In order to be included in the vendor list and to initiate any
activity with TLX Technologies, LLC all suppliers are required to go through a company assessment process.
Submission of the requested information neither automatically implies supplier's qualification nor commits TLX Technologies, LLC to
involve the suppliers in any negotiation process.
THE DATA FURNISHED HEREWITH IS CORRECT TO THE BEST OF KNOWLEDGE.
Name Title Date
Submit by Email
FOR TLX USE ONLY!
Date Received Approved/Rejected By Approved Rejected DateYou can also read
