CP27_SubcontractorQuality Questionnaire.doc

SUBCONTRACTOR QUALITY QUESTIONNAIRE

Quality Assurance Program Page ___of ___

A: Quality Assurance Program General Information

A.1. Document Title (Add Title of Supplier Quality Assurance Program):

A.2. Supplier Information: (Add Supplier Name, Address, & Telephone Number):

A.5. Prepared By (Add the company, name, title, signature, & date of the preparer of this document):

A.6. Reviewed and Approved For Use By (Add the name, title, signature & date of the reviewer/person authorizing the use of this document):

B: QA Program Introduction & Objectives

B.1. This document describes the QA program of ______________________________________________________,[Supplier Name] hereafter referred to as Supplier. This document is based on, and describes how Supplier complies with the U.S. Department of Energy (DOE) Order 414.1C, Quality Assurance, Attachment 2, hereafter referred to as the Order and attached as Appendix A of this document. Supplier adopts the applicable Order requirements, including the Order introduction guidance, objectives, definitions, and principals for work performed by the Supplier.

B.2. This document is organized to correlate with the major headings of the Order. For each major heading, it adopts the Order requirement, if it is applicable for work performed by the Supplier. General applicability is defined as the determination that the identified activities and processes are actually used. As an example of general applicability, if Supplier does not perform design services, then Supplier may indicate “Not Applicable” for the Order design requirements and the associated Supplier implementing method because it is not applicable.

B.3. The Supplier adopts the introduction and Section 1 “Objectives” of the Order.

C: General Quality Requirements

C.1. Supplier has assigned ___________________________________________[Name/Title] as the senior management position responsible for development, implementation, assessment and improvement of this QA program as required by Section 2 of the Order.

C.2. Supplier incorporates the appropriate national or international consensus standard as required in procurement documents or regulatory requirements.

C.3. Supplier shall update this document as required to accurately reflect the QA program of Supplier and/or to meet customer requirements. The updates shall be reviewed and approved by Supplier.

D: Quality Assurance Criteria

D.1. Management/Criterion 1 – Program. Supplier meets this criterion by (check all that apply):

D.1.1. Having a company organizational structure, functional responsibilities, levels of authority, and interfaces for those managing, performing, and assessing work that is: FORMCHECKBOX verbally communicated in meetings among Supplier management/supervisors and workers; FORMCHECKBOX communicated by the Supplier management in organization charts or other documents; FORMCHECKBOX Other: ___________________________________________________________________________________ D.1.2. Establishing management processes, including planning, scheduling, and providing resources for work by FORMCHECKBOX pre-job briefing/instruction;

FORMCHECKBOX

using company or customer planning documents/work schedules, FORMCHECKBOX Other: _____________________________________________________________

D.2. Management/Criterion 2 – Personnel Training and Qualification. Supplier meets this criterion by (check all that apply):

D.2.1. Training and qualifying personnel to be capable of performing assigned work through FORMCHECKBOX mentoring new personnel in on-the-job (OJT) training, FORMCHECKBOX using only personnel that meet regulatory licensing requirements for the State in which work is performed (e.g., construction craft licensing requirements; professional engineering licensing requirements.); FORMCHECKBOX using company or customer training/qualification procedures/work instructions; FORMCHECKBOX Other (Describe): ____________________________________________________________________________________________________________________________ D.2.2. Providing continuing training to personnel to maintain job proficiency by FORMCHECKBOX pre-job/ post-job reviews or briefings; FORMCHECKBOX maintaining personnel licensing requirements for the State in which work is performed; FORMCHECKBOX providing re-training to company or customer training/qualification procedures/work instructions;

FORMCHECKBOX

Other (Describe): _________________

D.3. Management/Criterion 3 – Quality Improvement. Supplier meets this criterion by (check all that apply):

FORMCHECKBOX

pre-job/post-job reviews, including discussion/development of lessons-learned; FORMCHECKBOX Management observation of workers; FORMCHECKBOX inspections; FORMCHECKBOX documented company or customer procedures/work instructions; FORMCHECKBOX requiring workers to control items (tagging, segregating, or other means to prevent their inadvertent use); FORMCHECKBOX Other (Describe): ________________________________________________________________________________________________________

D.4. Management/Criterion 4 – Documents and Records. Supplier meets this criterion by (check all that apply):

D.4.1. Preparing, reviewing, approving, issuing, using and revising documents to prescribe processes, specify requirements, or establish design through

FORMCHECKBOX

use of contract documents; FORMCHECKBOX documented company or customer procedures/work instructions; FORMCHECKBOX use of codes/standards; FORMCHECKBOX Other (Describe): ___________________________________________________________________________________________________________________________

D.4.2 Specifying, preparing, reviewing, approving, and maintaining records through FORMCHECKBOX performing these activities as required and in accordance with the methods outlined in contract documents; FORMCHECKBOX maintaining work files for a specified period of time as required by contract or as determined by management.

FORMCHECKBOX

documented company or customer procedures/work instructions; FORMCHECKBOX Other (Describe): _____________________________________________________

Quality Assurance Program Page ___of ___

D.5. Performance/Criterion 5 – Work Processes. Supplier meets this criterion by (check all that apply):

D.5.1. FORMCHECKBOX

implementing work to contract requirements; FORMCHECKBOX use of applicable codes/standards; FORMCHECKBOX performing work as discussed in pre-job/post- job meetings; FORMCHECKBOX maintaining items in controlled environments to prevent damage, loss, or deterioration as described in pre-job/post job meetings or as instructed by supervisors; FORMCHECKBOX Other (Describe): ________________________________________________________________________________

D.6. Performance/Criterion 6 – Design. Supplier meets this criterion by (check all that apply):

FORMCHECKBOX

Not Applicable (NA). Supplier does not perform design; FORMCHECKBOX documented company or customer procedures/work instructions; FORMCHECKBOX Other (Describe): _______________________________________________________________________________________________________________________

D.7. Performance/Criterion 7 – Procurement. Supplier meets this criterion by (check all that apply):

D.7.1. Procuring items and services that meet established requirements and perform as specified using FORMCHECKBOX requirements as established in customer or company procurement documents; FORMCHECKBOX Other (Describe): ___________________________________________________________________________ D.7.2 Evaluating and selecting prospective suppliers on the basis of specified criteria such as FORMCHECKBOX past supplier performance history; FORMCHECKBOX ability to provide items/services when needed (schedule); FORMCHECKBOX cost; FORMCHECKBOX conformance with customer or company specified technical/quality requirements; FORMCHECKBOX Other (Describe): ___________________________________________________________________________________________________________ D.7.3. Establishing and implementing processes to ensure that approved suppliers continue to provide acceptable items and services including such processes as FORMCHECKBOX inspections/rejection of items/services; FORMCHECKBOX non-conformance reporting/communication with supplier(s); FORMCHECKBOX discontinued or reduced use of supplier; increased use of other suppliers; FORMCHECKBOX Nonpayment or reduce payment for items/services; FORMCHECKBOX Other (Describe):_______________________________________________________________________________________________________________________

D.8. Performance/Criterion 8 - Inspection and Acceptance Testing 8 – Procurement. Supplier meets this criterion by (check all that apply):

D.8.1. Inspecting and testing specified items, services, and processes using established acceptance and performance criteria as FORMCHECKBOX described in company or customer procurement documents; FORMCHECKBOX described in applicable codes and standards; FORMCHECKBOX described in company or customer procedures/work instructions. Other (Describe): __________________________________________________________________________________________________________________ D.8.2. Calibrating and maintaining equipment used for inspection and testing as FORMCHECKBOX described in company or customer procurement documents; FORMCHECKBOX described in applicable codes and standards; FORMCHECKBOX described in company or customer procedures/work instructions. Other (Describe): _____________________________________________________________________________________________________________________________

D.9. Assessment/Criterion 9 – Management Assessment. Supplier meets this criterion by (check all that apply):

Managers assessing their management processes and identifying and correcting problems that hinder the organization from achieving its objectives in FORMCHECKBOX pre-job/post-job reviews, including discussion/development of lessons-learned; FORMCHECKBOX Management observation of workers; FORMCHECKBOX inspections; FORMCHECKBOX documented company or customer procedures/work instructions; FORMCHECKBOX Other (Describe): ___________________________________________________________________________

D.10. Assessment/Criterion 10 – Independent Assessment. Supplier meets this criterion by (check all that apply):

D.10.1 Planning and conducting independent assessments to measure item and service quality, to measure the adequacy service quality, work adequacy/performance and opportunities for improvement; FORMCHECKBOX independent assessments performed by customers and/or other independent entities; FORMCHECKBOX documented company or customer procedures/work instructions for independent assessments; FORMCHECKBOX Other (Describe): _________________________________

D.10.2 Establishing sufficient authority and freedom from line management for independent assessment teams by committing and agreeing to provide such authority and freedom to independent assessment teams as stated FORMCHECKBOX in this document; FORMCHECKBOX in contract documents; FORMCHECKBOX in customer and/or company procedures/work instructions; FORMCHECKBOX Other (Describe): _____________________________________________________________________________________ D.10.3. Ensuring that persons conducting independent assessments are technically qualified and knowledgeable in the areas to be assessed through FORMCHECKBOX review of resumes or other qualification data to ensure persons have performed a minimum of ___number of similar assessments successfully within the past __ years; FORMCHECKBOX qualification as an auditor or lead auditor by customer or other organizations, to recognized standards.

D.11. Suspect/Counterfeit Item (S/CI) Prevention Process. Supplier meets this criterion by (check all that apply):

Addressing the identification, analysis, prevention and removal of S/CI in FORMCHECKBOX awareness training of relevant S/CI issues in pre-job/post-job meetings; FORMCHECKBOX posting and reviews of S/CI issue notifications/bulletins and databases; FORMCHECKBOX pre-job/post-job evaluations, reviews; FORMCHECKBOX inspections; FORMCHECKBOX customer and/or company procedures/work instructions; FORMCHECKBOX management training; FORMCHECKBOX management observations; FORMCHECKBOX engineering/design activities and/or involvement; FORMCHECKBOX acceptance of items/services; FORMCHECKBOX procurement practices; FORMCHECKBOX Other (Describe): ___________________________________________________________________________

D.12. Safety Software Quality Requirements. Supplier meets this criterion by (check all that apply):

FORMCHECKBOX

Not Applicable (NA); Supplier does not develop and/or implement safety software.

FORMCHECKBOX

Use of customer and/or Supplier procedures/work instructions that address the safety software quality requirements of the Order including but not limited to the requirement that work processes involving safety software are developed and implemented using national or international consensus standards that include a) facility design authority involvement, b) identification, documentation and maintenance of safety software inventory, c) establishment of grading levels, selection and implementation of applicable software QA work activities to ensure safety software performs its intended functions.

E: Customer Acceptance

This section of the Supplier QA Program is an optional section that provides space for Customers to document their review and approval of this document as applicable/required in the Supplier/customer contract.

E.1. Customer Approval Recommended by (e.g., Name/ FORMCHECKBOX QA Representative; FORMCHECKBOX Other ________________/Signature/Date):

E.2. Authorized Customer Approval (e.g., Approver Name/Title/Signature/Date):

Appendix A: DOE Order 414.1C, Attachment 2, Quality Assurance Contractor Requirements Document

Instructions for Attachment 4: Example DOE Order 414.1C Program Template

1. Scope and Applicability: This template is an optional template that may be provided to Suppliers to use to demonstrate how the supplier complies with DOE Order 414.1C, Quality Assurance, Attachment 2 (hereafter referred to as the Order) for low-risk, low complexity procurements by Los Alamos National Laboratory (LANL). This template is an example that may be customized as required by LANL or the Supplier. Completion of this template does not imply or otherwise indicate approval of supplier’s QA program. Supplier use of this form is at supplier’s risk.

2. General. This template is designed for the supplier to customize. Electronic versions of this document in MS Word are available. This template may be completed by using the electronic version to add supplier information, or by hand-writing information on a hard copy. Change may be made to this document; however, changes should be made in conformance with the Order.

3. Section A: Quality Assurance Program General Information. Add general supplier QA program information in this section, including the QA program title, revision number, document date, who it was prepared by, and who reviewed and approved it for use. Add the name, date and signature of the preparer and the person that reviewed and authorized the document.

4. Section B: Introduction & Objectives. This section introduces the QA program and states its objectives. This section adopts the objectives of the Order unless otherwise modified by the supplier. This section refers to the Order and indicates that it is attached to the supplier QA program. A copy of the Order may be obtained from the DOE Directives website, https://www.directives.doe.gov/. Obtain and attach the Order. Modify this section as required, however ensure compliance with Order requirements

5. Section C: General Quality Requirements. This section demonstrates how the supplier meets the general quality requirements as stated in the Order. Add the name and title of the supplier’s QA representative. Modify this section if needed, however, modifications should be checked against the Order to ensure this section remains compliant with the Order. Do not check boxes for activities unless the Supplier actually performs the activity.

6. Section D: Quality Assurance Criteria. This section demonstrates how the supplier meets the QA criteria of the Order, including the 10 numbered criteria plus suspect/counterfeit items (S/CI) and safety software criteria. Review the criteria and either check the box, which represent common methods used to satisfy the criteria, and/or add other methods which demonstrate compliance with the criteria. Where “Other” is checked, describe how the requirement is met. Use additional sheets/attachments if necessary.

7. Customer Acceptance. This section is an optional section of the document that provides space for customers to document their review and approval of this document. It is not a mandatory section. This section may be customized as required to meet QA program procurement review and approval sections of the relevant procurement.

Subcontractor Questionnaire

Rev. 00, Dated December 07, 2011 169136-RFP, CP-27 – Solid Waste Disposal Subcontractor Questionnaire

Rev. 00, Dated December 07, 2011 169136-RFP, CP-27 – Solid Waste Disposal