Date:
Supplier:
Name of Contact:
Position of Contact:
As part of our Quality Management System, Dortech Maintenance Ltd operates an Approved Supplier Procedure. To ensure that your company is eligible to carry out works for, or provide services to, Dortech Maintenance Ltd, please complete and submit this questionnaire. Thank you.
1. Name of Company:
2. Registered Business Address:
3. Telephone Number:
4. Fax Number:
5. Web Address:
6. Business Type: Sole TraderPrivate Limited CompanyPublic Limited CompanyLLP
7. Company Registration Number:
8. Incorporation Date:
9. UTR Number (For LLP Please Also Include Senior Partners' UTR & NI Numbers):
10. Bank Details:
11. Goods / Services Provided:
12. Sales Department Contact:
13. Accounts Department Contact:
14. Director(s):
15. List Any Trade Associations of Which Your Company is a Member:
1. Insurance Broker:
2. Employer Liability Insurance:
Please Upload Your Employer Liability Insurance Certificate:
3. Public & Products Liability Insurance:
Please Upload Your Public & Products Liability Insurance Certificate:
4. List Any Specific Exclusions or Warranties Which May Bear Relevance to the Work to Be Carried Out:
5. Does the Policy Include an Indemnity to Principal's Clause? YesNo
6. Indemnity Limit in Respect of Removal / Weakening of Support:
1. Does Your Company Have a Policy in Respect of Quality Assurance? YesNo
2. Please Attach a Copy of Your Company's Quality Assurance Policy (if Applicable):
3. Is Your Quality System Registered? YesNo
Please Confirm the Following:
4. Do You Intend to Register? YesNo
Expected Date of Registration:
5. Have You a Management Representative With Authority to Resolve All Matters Relating to Quality? YesNo
Please complete the following questions (fields 5-16) formulated from ISO 9000. If you feel that a simple yes/no answer does not give an adequate representation of your company, please attach any additional documentation or statements here:
6. Do You Have a Formal Quality System Even if It Has Not Yet Been Approved? YesNo
7. Do You Have a Quality Manual? (If Yes, Please Enclose Details.) YesNo
8. Do You Have Regular Reviews of the System? YesNo
9. Are All Incoming Orders Reviewed to Ensure You Have the Capability to Meet the Contractual Requirements? YesNo
10. Do You Have the Documented Procedures for Identifying and Segregating Non-conforming Product? YesNo
11. Do You Have Documented Inspection Procedures? YesNo
12. Is All Your Test and Measurement Equipment Regularly Calibrated? YesNo
13. Do You Regularly Assess Your Supplier's Quality System? YesNo
14. Do You Have a Procedure for Dealing With Customer Complaints? YesNo
15. What is the Name of the Person to Whom Complaints Should Be Directed?
16. Would You Object to Our Quality Representative Visiting Your Premises to Review Your Quality System? YesNo
17. Any Comments Relating to Quality:
1. Does Your Company Have a Formal Environmental Management System? (i.e. ISO 14001.) YesNo
2. Do You Intend to Register a Formal Environmental Management System? YesNo
3. Have You a Management Representative With Authority to Resolve All Matters Relating to Environment? YesNo
4. Please Explain How Your Company Assesses, Manages and Controls the Impact That Its Products and Services Have on the Environment and How You Provide Such Information to Your Customers:
5. Please Attach a Copy of Your Company's Environmental Policy (if Applicable):
1. Please Attach a Copy of Your Company's Health and Safety Policy (if Applicable):
2. Have You a Management Representative Responsible for Matters Relating to Health and Safety? YesNo
3. Do You Employ an Independent Health and Safety Advisor? YesNo
4. Have You Had Any Reportable Accidents in the Last 3 Years? YesNo
5. Do You Supply Sub-contract Services (Including Commissioning and Testing on Site)? YesNo
6. Do You Prepare Risk Assessments for Your Works? Please Provide Examples.
7. Do You Prepare Method Statements for Your Works? Please Provide Examples.
8. What PPE Do You Provide?
9. Are Your Operatives Registered Under the Construction Skill Card Scheme (CSCS)? YesNo
Do They Hold Valid Card Identification? YesNo
What % of Your Operatives Are Registered?
10. Comments Relating to Health and Safety:
We Hereby Accept the Standard Terms and Conditions of Dortech Maintenance Ltd and Agree to Be Bound by Them.
We Acknowledge the Standard Payment Terms for Credits Accounts Are 60 Days Month End.
I the Undersigned Confirm That to the Best of My Knowledge the Statements Made in This Questionnaire Are Up to Date and Accurate.
I the Undersigned Confirm That I Have Read and Acknowledge Dortech Maintenance Ltd Terms and Conditions.
Please Provide Your Signature in the Box Below:
Full Name:
Position:
Before Submitting, Please Check That You Have Uploaded All Applicable Insurance, Quality Assurance, Environmental, and Health and Safety Documents.
