QP100-RE-01 供方调查表-（电子受控）

供方调查表Supplier SurveyForm1企业名称Enterprise Name2联系人姓名Contact:地址Address:电话TeL:传真Fax:邮件Email:3企业成立时间Date ofEstablishment:企业性质Enterprise Property:是外资企业Foreign Enterprise□是合资企业Joint-venture□是私人企业Private Enterprise□是国有/集体企业State/Collective-owned Enterprise□投资/Investment4产品范围Products Range5主要客户公司/行业Major CustomersCompany/Industry6产品交货周期Delivery Lead-Time ofproduct:以卜为生产商填写Manufacturer fills the blank as follows.7职工总数Total Numberof Staff:其中技术人员Technicians:质量人员Quality Personnel:一线工人Front-lineWorkers:8年产量/年产值Yearly Output/Annual Turnover:9生产能力Production Capacity生产特点Production Characteristics成批生产Production inLot□流水线大量生产Mass Production in AssemblyLine□按定量生产ProductioninFixed Quantity□主要生产设备10质量体系、公司组织结构是否建立？Does thecompany establishthe quality system andorganizational structure如果有，请提供相关的产品认证、体系证书If yes,please attachthe copiesof theproduct certificates,qualitysystemcertificates.□ISO9001DISO14001DISO13485DOHSAS18000DFDA DGMP□CCC DCEDSGS DOthers:___________________________________________口否No.11检测能力Quality Capacity产品经第二方检测机构的检验报告Inspection Reportof Productsby ThirdParty InspectionInstitutions口有；口没有YES NO产品出厂合格证明Certificate ofProduct Exit口有；口没有YES NO12主要检测设备Main testing equipment检测设备校准情况Calibration oftestingequipment口有里室内部校准；Metrology roominternal calibration口委托夕卜部量机构校准tl Entrustingexternal measurementorganization tocalibrate13新产品设计开发能力New productdesign anddevelopment capabilities口能自行设计开发新产品；Ability todesign anddevelop newproducts byoneself口只能开发简单产品；Only simpleproducts can be developed口没有新产品开发能力No developmentcapability o技术文件情况14合作意向Intention to cooperate口积极合作、无偿提供样件；口愿意合作、有偿提供样件Active cooperationand freesample supplyWilling；□愿意合作、不提供样件tocooperateand provide samples fora feeWilling tocooperate,not toprovidesamples.15供方负责人签名和盖章日期Signature andSeal ofPerson inCharge ofthe EnterpriseDate:以下经销商或贸易商填写Distributor orCommercial Traderfillstheblankasfollows.16是否可以提供制造商出具的销售授权书？是否可以提供制造商质量证书及产品合格分析证明？Can thesales authorizationissued bymanufacturer beprovided Canthe manufacturersquality certificatesand productcertificationbe offered是口，请各提供一份复印件Yes Providehard copiesof eachcertificate.否No□.17因制造商或代理商责任造成的质量问题，是否能提供质量问题原因分析及纠正预防措施？Whether thecause analysisand correctivepreventive actionscanbeprovided todispose qualityproblems resultingfromthe manufactureror agents是口.Yes否NoD.是否有明确的进货质量控制方式？18Does thedistributor haveclear incomingquality controllingmethods是Yes□.否NoD.入库时是否有产品批号或生产日期的记录WDo theproducts havebatch codesor datesof manufacturewhen inputto thewarehouse是口.Yes否NoD.仓库的区域划分，是否有温、湿度，防静电控制20--是Is thewarehouse physicallyseparated andcontrolled fromtemperature,humidity andstaticYes□.否No□.经销商或贸易商负责人签名和盖章日Signature andSeal ofPerson inCharge ofthe EnterpriseD期ate::以下由调查人及物流管理部填写The followingis filledout bythe investigatorand theLogistics ManagementDepartment.调查人意见opinions ofInvestigators调查人签字日Investigators SignatureD期at:e:物流管理部意见Opinions ofLogistics ManagementDepartment部门经理审批日Departmental ManagerApproval:Da期te::。