供应商物料环境管理体系调查表(中英文)
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This Survey is prepared by 该调查表填写人Name 姓名
Title 职位Date 日期
The Company undertakes the above information is true and believable 本公司承诺以上资料真实可信附加材料说明
1、营业执照复印件(提供有效期内的有年检的营业执照复印件,字迹清晰并加盖公章)
2、开户许可证(提供有效期内的有年检的营业执照复印件,字迹清晰并加盖公章)
3、经销商提供代理证书或长期经销合同,代理产品或企业ISO9000认真复印件(字迹清晰,加盖公章)
4、生产企业提供企业认证证书复印件(字迹清晰,加盖公章)
5、企业情况介绍
XXCo., Ltd recognises the confidentiality of the information you provide and will treat the information accodingly.XX 有限公司认可贵司对于提供信息的保密性,
please complete the survey and send the email to the following address 请认真填写该调查表并以邮件的形式发送到下面的地址Department 部门:Sourcing Superior 采购主管
Email 邮箱M.B.手机Address 地址
SUPPLIER EVALUATION SURVAY
供应商调查表。
供应商调查表中英文版供應商調查表編號(Code):年月日公司名稱(CompanyName) 中文Chinese 英文English公廠地址Factory Address公廠聯系電話Factory Phone NumberTel:Fax:辦公室地址Office Address辦公室電話Office Phone NumberTel:Fax:業務代表人Sales Representative業務聯系電話Sales Contact NumberTel:Fax:公司法人代表(中方)Company Owner法人代表(港.奧.臺.外方)公司營業證號Irrelevant to oversea vendor公司稅務證號Irrelevant to oversea vendor公司年營業業績Company Turn Over公司性質Company Type公司組織架構Company Structure管理人員狀況Management Personnel 高級管理人員/HigherLevel Manager 人, 中層管理人員/Mid Level Manager 人, 基層管理人員/Supervisory 人.技術人員/Engineer 高級工程師/Senior Engineer 人,工程師/Engineer 人, 技術人員/Technician 人.品管人員Quality Control Personnel 品管管理人員/QC Manager 人,品質工程師/QC Engineer 人, QA 人,QC 人,IQC 人.員工狀況No. of Worker 1.員工人數/Worker 人.2員工通過培訓/Trained Worker 人.3員工有拿到上崗證/Worker with working permit 人.品質系統Quality Certificate 1.有無通過ISO品質系統/Factory passed ISO Audit: 有無2通過哪個論證系列/Certification passed: ISO9001 GMPC QS14001,其它/Others主要產品Mainstream Product 1. 2. 3. 4.5. 6.月產能MonthlyProduction主要設備List of Majore Machinery儲存狀況Storage area 工廠總面積/Factory Floor Area 平方米,倉庫總面積/Warehouse Floor Area 平方米,儲存量/Store Volume 立方米.運輸能力狀況Transportation Capability車輛/No. Of Truck 輛,噸位/No. of Tonne樣板/Sample:合格/Pass:不合格/Fail:驗廠員/Auditor: 采購部主管/Purchasing Supervisor: 經理/Purchasing Manager:。
PREQUALIFICATION FORMFOR SUPPLIERS / CONTRACTORS供应商调查表A)PARTICULARS OF THE FIRM 企业概况: of the Firm公司全称:2.Registered Address注册地址:3.Mailing Address邮寄地址(If different from 2)4.Telephone No.电话:5.Fax No.传真::6.Web-site Address公司网址:7.E-mail Address 电子邮件:8.Type of Company公司性质Public/Private/ Partnership/ Sole Proprietor/Joint Venture/Others (Please specify)国营/私营/股份制/独资/合资/其他(请列出)9.Country of Incorporation国家:10.Registration No.营业执照号::11.Date of Registration/Incorporation注册日期NB : To attach a copy of the latest Business Instant Information from Registry ofCompanies请附上最近的公司登记情况表12.Registration with Professional, Trade or Quality Control Organisation, board and/orAssociation etc.在有关专业团体,贸易机构和质量控制机构的登记证书:(Please attach a copy of the certificate of registration请附上营业执照附本)13.Other Affiliations, Subsidiaries or Joint Venture (with indication of % owned)其他从属关系或合资关系(请用%指出)B)PARTICULARS OF HEAD QUARTERS (IF ANY) 总公司概况(如有): of the Firm公司全称:2.Registered Address注册地址3.Telephone No.电话:4.Fax No.传真::5.Web-site Address公司网址:6.Type of Company经济性质7.Country of Incorporation国家:C)FINANCIAL CAPACITY 财务概况: of Bank and Address银行全称和地址:2.Credits Facilities / Overdrafts信用设备/透支款项3.Financial Standing of the Last 3 Financial Years:过去三年里财务状况Year 20__ Year 20__ Year 20__ Authorized Capital 注册资金Paid up Capital 已缴资金Net Worth 净值Turnover 交易额Net Profit / <Loss> after Tax 除税后净利/损Current Assets 流动资金Current Liabilities 流动债务NB : To attach complete annual reports with corresponding Statements of Profit and Loss Account certified by accountants and a certified copy of the audited Balance Sheet for the last 3 years.请会计员附上过去3年完整的相应年度亏赢报告和审计对比报告。
环境管理物质部件展开表--中英文公司名稱Compony Name 填表人/職稱Contact Name/Title 填表日期Date:YY/MM/DD 電子郵件E-mail address 電話Tel. No.Pb Cd Hg Cr6+PBB PBDE Cl Br ………………供應商應保證上述所提供之資料為正確無誤.Supplier shall guarantee that the above information and test data are correct and accurate.★不同的均質材料需檢附相應的測試報告以及成份表(或MSDS 文件), 基本測試項目為RoHS 六項禁用物質及其他客戶所要求的禁用物質(例如: 鹵素或鄰苯二甲酸鹽類),執行單位可以按照實際要求進行添加選項Test report and MSDS must be provided for each homogeneous material, the basical test susbstances are six RoHS-banned substances plus other substances restricted by customers(e.g. halogen, phthalate).Implemented unit may add the items needed in accordance with actual operational requirements.★有害物質在均質材料中的含量必須滿足Foxlink 之《綠色採購程序》的要求(GQS-ZZ09-13)。
The concentration of restricted substance in each homogeneous material shall comply with last Foxlink "Green procurement Procedure" (GQS-ZZ09-13).核准:審查:制表:O-193B`環境管理物質部件展開表The Parts List of Enviromental Management Substances產品訊息 Product Information供應商訊息 Supplier Contact Information成品名稱Product name 總重量Total weight (g)Foxlink 成品料號Foxlink Product No.供應商成品料號Supplier Product No.編號No.供應商料號Supplier's part no.零件名稱Part name/description 製造商名稱Manufacturer Name 製造地點Manufacurering site 測試報告Test report 重量百分比Weight(%)備註Remark製造商料號Manufacturer Part no.測試報告編號Test Report No.測試日期Test Date (YY/MM/DD)測試結果Test result (ppm)成份表或MSDS。
序号审核要素分数(0,1,2,NA)备注-1*Do you have an Environmental Management System(RoHS, REACH, Holagen Free)? 是否建立环境管理体系(RoHS, REACH, Holagen Free)?2*Do you have an Environmental Substance Management Database(RoHS, REACH, Holagen Free)? 是否建立环境物质管理数据库(RoHS REACH Holagen Free)?3*Does your company have an Environmental Policy? If so, please enclose/quote/give link-info.,the policy is covering the environmental controlled substances management.贵公司是否有环境方针? 如果有,请附上环境方针或提供链接信息,该方针包含环境管制物质的管理4*Does your company have a continuous environment improvement program/plan, including elimination and reduction for the environmental controlled substances? 是否有持续环境改善方案/计划包括消除和减少环境管制物质?5Is it ISO 14001 certified/EMAS registered/others? 是否已通过ISO14001认证?6*Is there a list of environmental controlled substances? and the controlled substances list is revised timely in response to applicable laws and regulations and the customer requirements.是否有环境管制物质清单,并依照相关法律法规或客户要求及时修订?7Are the responsibility and authority of the persons in charge of environmental management clearly defined? 负责环境管理的人员职责和权限是否已清楚定义?8Can the responsible department effectively get the laws, regulations and customer requirements? the related information is provided timely to the organization inside and suppliers. 责任部门是否能有效地获取法律法规和客户要求?相关信息及时传达到组织内部和供应商Are there the documented procedures used for environmentalManagement System管理体系9Are there the documented procedures used for environmental training(REACH, Halogen Free, RoHS…) ? 是否有文件化的环境培训程序?10Does your company submit the REACH declaration to Pulse? 是否对Pulse进行REACH声明?11Does your company submit the raw material bill of substance to Pulse?是否向Pulse提供原材料物质组成表?12*Are trainings conducted to the employees responsible for the environmental product compliance(REACH, RoHS, Halogen Free …)? The training records are kept. 负责环境产品符合的员工是否有经过培训并保存培训记录?13Have the used subtances been registered for REACH? If yes, please list the subtances name the registration ID.所用的物质是否已注册?若注册请列出被注册物质的注册号14*Are there SVHC substances list? Have the procedure for REACH notifiaction? Do you make the material declaration for REACH to your customers?是否有SVHC物质列表?是否有程序就REACH进行通报? 是否对客户进行材料通报?15Are environmental controlled substances included in internalaudit process? The related regulations and standards are usedfor internal audit. 内部审核是否包含环境管制物质,且相关法规和标准被用于内审?-16*Are there the environmental criteria for selecting the new supplier and raw materials/components?是否有建立选择新供应商和原材料/部件的环境标准?17Does your design process take into consideration environmental concerns?是否在产品设计中考虑到环境问题?18Is non-use of banned substances clearly identified in components/raw materials drawing/spec./purchase orders? 不使用禁用物质是否清楚地标识在物料图纸/规格书/采购订单上?19*Are there any inspection procedures for the environmental controlled substances to be used on the purchased materials inspection?是否有建立环境管制的物质检验程序,用于采购物料的检验?20Are the purchased materials verified not including the banned substances?采购的物料是否有验证不含禁用物质?Supplier Management 供应商管理序号审核要素分数(0,1,2,NA)备注21*Can the supplier provide the certificate of RoHS,HF and REACH compliance(RoHS,HF and REACH CoC)?是否能提供RoHS, HF and REACH符合保证书?22*Are MSDS/Chemical Ingredient List/Measurement data filed and managed for use?Test reports need be made by certified lab.是否有物料安全数据表/化学成分表/测试报告?测试报告是须由有资格的实验室提供23Do you use any tools to quantify/assess the environmental burden?是否有使用工具检测和评估环境影响?24Is there the schedule established for the supplier environmental management system survey? And the survey is implementedaccording to the schedule. 是否有供应商环境管理系统审核计划?并按计划执行-25*Is there a documented procedure on regulations/ requirements on hazardous substances (REACH, HF, RoHS European directive, Sony SS-00259 standard)? 是否有就危险物质限制使用的法规/要求(REACH, HF, RoHS指令,索尼SS-00259标准) 制订形成文件的程序?26*Are the environmental controlled substances controlled in the production?在生产过程中,是否有对环境管制物质进行管制?27Are checks performed to the production equipments,test equipments including environmental substance measurement equipment before use?生产设备,测试设备包括环境物质检测设备在使用前是否有检查?28Are verifications made to the equipments, fixtures and tools previously contacted the banned substances to ensure that they are not contaminated? 对曾接触过禁用物质的设备,治具和模具是否有验证以确保没有被污染?Are methods defined to prevent the products from contamination and mixture of the banned substances and verifications made to th l d t i l?Production Management 生产管理29the recycled materials? 是否有方法防止产品污染和混入禁用物质?再生料是否经验证?30Are the shipping goods inspected according to the outgoing inspection standards and inspection records available? 成品出货是否根据出货检验标准进行检验并保存相关记录?31Is there identification labels on the outer box of the RoHS/REACH/HF compliant materials/products? 符合RoHS/REACH/HF的物料及产品外包装是否有标签标识?32Are the RoHS/REACH/HF & non-RoHS/REACH/HF compliant products built on separate production equipment and line? 符合及不符合RoHS/REACH/HF的产品是否在分开的生产设备和生产线上生产?33Is there a separate storage location for RoHS/REACH/HF & non-RoHS/REACH/HF compliant parts including raw materials/sub-assembly/finish goods? 符合及不符合RoHS/REACH/HF的产品包括原材料/半成品/成品是否分开存储?34Is there a separate REWORK area for RoHS, REACH or HF compliant parts? 对于符合RoHS, REACH,或HF的产品是否有分开的”返工”区域?35Are there long term inventory management criteria, considering the possible change of legislation in the future? 考虑到将来法规的可能变更是否有长期库存管理办法?36Are actions taken to the inventories when there have changes inthe environmental laws, regulations and the customerrequirements? 环境的法律法规和客户要求变更时,是否对库存品采取必要的处理措施?-37*Is there any procedure to define the requirement of customer notification for any change to component related to RoHS/REACH/HF compliance?是否有程序定义任何有关符合RoHS/REACH/HF的产品变更须通知客户?38Are checks made to the changes to see if they can meet the customer requirements and verifications performed viaMSDS/material ingredient lists and test reports when necessary?是否有进行变更检查以确保符合客户要求,必要时通过MSDS/材料成分表和测试报告进行验证?Is a written change notification used for the change request and response of Pulse is documented? 是否有书面的变更通知用于申Change Control 变更管制39请变更并保存普思的回复?序号审核要素分数(0,1,2,NA)备注40Is there a similar change management procedure established for changes by secondary supplier? 对供应商的管理是否有类似的变更管理程序?-41Please provide your company’s definition of lead-free. 请提供贵公司的无铅标准定义(铅含量)42For all currently available lead-free product offerings, please specify, termination finishing (e.g. Sn, Sn/Ag/Cu, etc.), and moisture sensitivity levels per JEDEC standards. 请说明你们现有无铅产品端子镀层情况(如:锡,锡银铜合金等)和MSL防潮等级,按照JEDEC标准43Are the lead free components in compliance with a “high temperature soldering profile” with a peak of 260°C. 无铅产品是否能承受260°C峰值温度的高温回流焊接?44Is your qualification process for solder joint reliability in accordance with IPC 9701 standard? If no, please describe your process. 焊接点可靠性验证方法是否符合IPC 9701标准? 如果不符合请说明你们的验证方法45If pure Sn is one of the plating offerings, Is there any testingdone with regard to tin-whisker growth? 如果使用纯锡作为镀层,是否有进行锡须增长测试?-46*Do the transportation packaging materials comply with the European packaging directive? 运输包装物料是否符合欧洲包装指令?47Do you have a reuse and recycling program for these materials?是否有此类物料重复使用和再循环程序?-48Do you provide instructions for end-of-life treatment for delivered product?已出货的产品是否有提供产品终止使用处理说明? Have you a program for take back of products as delivered byLead-free Product (if applicable) 无铅产品 (如适用):Transportation Packaging Materials运输包装物料End-of-Life Treatment产品终止使用的处理49your company?是否有产品回收程序? Subtotal 本部分分数合计Percent 百分比。