Dexter Magnetic Technologies - Supplier Survey Form

Company Name

Address

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

Phone - (###) - ### ####

Fax - (###) - ### ####

Cage Code

DUNS Code

Business Type

Type of Products or Services

Business Percentage (%)

Commercial %

Military %

Medical %

Other %

Plant Area (sq ft)

Years Established

Major Customers

President's Name

President's Phone - (###) - ### ####

President's E-mail

Quality Manager's Name

Quality Manager's Phone - (###) - ### ####

Quality Manager's E-mail

Operations Manager's Name

Operations Manager's Phone - (###) - ### ####

Operations Manager's E-mail

Sales Manager's Name

Sales Manager's Phone - (###) - ### ####

Sales Manager's E-mail

Purchasing Manager's Name

Purchasing Manager's Phone - (###) - ### ####

Purchasing Manager's E-mail

Engineering Manager's Name

Engineering Manager's Phone - (###) - ### ####

Engineering Manager's E-mail

Title & Description of Quality System(s)

If your system is certified, please attach a copy of the Certificiate of Registration with this survey. No further information is needed and you may scroll to the bottom and select SUBMIT.

Upload a File

Upload a File

Is there an established documented Quality Management System (QMS)? Yes No N/A

If yes,

Document Title

Revision

Date / MM / DD YYYY

Does the QMS documet include a Quality Policy? Yes No N/A

Are Quality Objectives established? Yes No N/A

Are responsibilities and authorities defined? Yes No N/A

Are there regularly scheduled management reviews? Yes No N/A

Are the Quality Objectives measurable and consistent with the Quality Policy?
Yes No N/A

Has management ensured that Quality Objectives including those needed to meet requirements for product are established at relevant functions and levels of the organization?

Yes No N/A

Has management appointed a quality management representative who has the organizational freedom to resolve matters pertaining to quality?
Yes No N/A

Are the documents required by QMS controlled? Yes No N/A

Are records established and maintained to provide evidence of conformity to requirements?
Yes No N/A

Are all records available for review by customers? Yes No N/A

Does the organization plan and develop the processes needed for product realization?
Yes No N/A

Does the organization determine requirements specified by the customer? Yes No N/A

Does the organization determine required verification, monitoring, inspection and test activities specific to the product?
Yes No N/A

Does the organization determine the need to establish processes and documents? Yes No N/A

Does the organization maintain product traceability of the raw materials?
Yes No N/A

Does the organization establish verification for ensuring that purchased product meets specified purchase requirements including
objective evidence of the quality of the product from suppliers (e.g. Certificate of Conformance, test reports, inspection reports, DFARS , ITAR, and RoHS compliance documents)?
Yes No N/A

Is purchased product held until it has been verified as conforming
to specified requirements?
Yes No N/A

Where appropriate has the organization identified the product by suitable means throughout product realization?
Yes No N/A

Where traceability is a requirement, does the organization control and record the unique identification number of the product? Yes No N/A

Does the organization conduct internal audits at planned intervals
to determine whether the Quality Management System conforms to the planned arrangements and is effectively implemented and
maintained?
Yes No N/A

Does the organization maintain a formal calibration system? Yes No N/A

Are records of the results of calibration maintained? Yes No N/A

Does the organization deal with nonconforming product in one or more of the following ways by taking action to eliminate the detected nonconformity? Yes No N/A

Does the organization deal with nonconforming product in one or more of the following ways by authorizing its use, release or acceptance by customer? Yes No N/A

Does the organization deal with nonconforming product in one or more of the following ways by taking action to preclude its original intended use or application?
Yes No N/A

Does the organization prevent dispositions of use-as-is or repair unless specifically authorized by the customer if the product is produced to customer design?
Yes No N/A

Does the organization prevent dispositions of use-as-is or repair unless specifically authorized by the customer if the nonconformity results in a departure from contract requirements? Yes No N/A

Is product dispositioned for scrap conspicuously and permantly marked until physically rendered unusable?
Yes No N/A

Are records regarding nonconformities maintained? Yes No N/A

When nonconforming product is detected after delivery, does the organization notify the customer by providing complete information(e.g. job number, part number, part description, quantity, date delivered etc)?
Yes No N/A

When nonconforming product is corrected, is it subjected to re-verification to demonstrate conformity to the requirements?
Yes No N/A

Does the organization take action to eliminate the cause of nonconformities in order to prevent recurrence?
Yes No N/A

Are the corrective actions appropriate to the effect of the
nonconformities encountered?
Yes No N/A

Does the organization determine action to eliminate the causes
of potential nonconformities in order to prevent their occurrences?
Yes No N/A

Are the preventative actions appropriate to the effect of preventing them from occurring?
Yes No N/A

Has there been any significant changes, improvements, personnel changes, etc.?

Date / MM / DD YYYY

Supplier Representative's Name

Title

Name First Last

Title

Name First Last

Title

Results Approved Disapproved Conditional

Date / MM / DD YYYY

Comments

Assessment Team Member #1 First Last

Title

Phone - (###) - ### ####

Email

Assessment Team Member #2 First Last

Title

Phone - (###) - ### ####

Email

Results Approved Disapproved Conditional

Date / MM / DD YYYY

Comments

Supplier Survey Form

Supplier Survey Form

GENERAL

FACILITY

MANAGEMENT

QUALITY SYSTEM(S)

1.0 QUALITY MANAGEMENT

2.0 CONTROL OF DOCUMENTS AND RECORDS

3.0 PRODUCT REALIZATION

4.0 VERIFICATION OF PURCHASED PRODUCT

5.0 IDENTIFICATION AND TRACEABILITY

6.0 INTERNAL AUDIT

7.0 CONTROL OF MONITORING AND MEASUREMENT DEVICES

8.0 CONTROL OF NONCONFORMING PRODUCT

9.0 CORRECTIVE / PREVENTATIVE ACTION

COMMENTS

SELF SURVEY ASSESSMENT

DEXTER APPROVALS
(DO NOT COMPLETE--PLEASE SCROLL TO BOTTOM AND SELECT SUBMIT.)

ONSITE SUPPLIER ASSESSMENT--FOR DEXTER USE ONLY
(DO NOT COMPLETE--PLEASE SCROLL TO BOTTOM AND SELECT SUBMIT.)

Supplier Survey Form

Supplier Survey Form

GENERAL

FACILITY

MANAGEMENT

QUALITY SYSTEM(S)

1.0 QUALITY MANAGEMENT

2.0 CONTROL OF DOCUMENTS AND RECORDS

3.0 PRODUCT REALIZATION

4.0 VERIFICATION OF PURCHASED PRODUCT

5.0 IDENTIFICATION AND TRACEABILITY

6.0 INTERNAL AUDIT

7.0 CONTROL OF MONITORING AND MEASUREMENT DEVICES

8.0 CONTROL OF NONCONFORMING PRODUCT

9.0 CORRECTIVE / PREVENTATIVE ACTION

COMMENTS

SELF SURVEY ASSESSMENT

DEXTER APPROVALS (DO NOT COMPLETE--PLEASE SCROLL TO BOTTOM AND SELECT SUBMIT.)

ONSITE SUPPLIER ASSESSMENT--FOR DEXTER USE ONLY (DO NOT COMPLETE--PLEASE SCROLL TO BOTTOM AND SELECT SUBMIT.)

DEXTER APPROVALS
(DO NOT COMPLETE--PLEASE SCROLL TO BOTTOM AND SELECT SUBMIT.)

ONSITE SUPPLIER ASSESSMENT--FOR DEXTER USE ONLY
(DO NOT COMPLETE--PLEASE SCROLL TO BOTTOM AND SELECT SUBMIT.)