B1 Enclosure G Supplier Survey Form.doc
DOC document 378 KB Posted
- Solicitation number
- BSA469885
- Issued by
-
Department of Energy Office of Science
About this file
This document is a Supplier Survey Form from Brookhaven Science Associates (BSA), part of the U.S. Department of Energy, designed to comprehensively assess potential suppliers. The form collects detailed information across multiple sections, including company profile, key personnel, customer references, and in-depth assessments of the supplier's quality management systems, environmental management, occupational health and safety, document control, purchasing processes, design/engineering capabilities, inspection/testing procedures, nonconformance handling, training programs, and management review processes.
The survey requires suppliers to provide extensive information about their organizational capabilities, certifications (such as ISO 9001, 14001), socio-economic classifications, business size, years in operation, annual sales, employee count, and technical capabilities. It includes checkboxes for various attributes like small business status (disadvantaged, women-owned, veteran-owned), company capabilities (design, manufacturing, testing), and detailed questions about quality assurance, environmental management, and operational processes. The form is specifically related to a Department of Energy contract opportunity for Type A Reusable Shielded Container Rental and Transportation services at Brookhaven National Laboratory (BNL).
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Text version
Brookhaven Science Associates
U.S. Department of Energy Supplier Survey
Check One:
Phone Survey (completed by BSA):
FORMCHECKBOX
e-Mail Survey (completed by Supplier):
On-site Survey (completed by BSA):
FORMCHECKBOX
1.0
COMPANY PROFILE
| Company Name: |
| Address: |
| Phone: |
| E-mail address: |
| FAX No.: |
| Internet address: |
Socio-economic Class:
(check all that apply)
FORMCHECKBOX
Small Disadvantaged
FORMCHECKBOX
Small Women-Owned
FORMCHECKBOX
HUB Zone
FORMCHECKBOX
Veteran–Owned
FORMCHECKBOX
Disabled Service Veteran
FORMCHECKBOX
Big
| Products/Services: |
| Capabilities: |
| FORMCHECKBOX |
Design FORMCHECKBOX Tooling/Prototype FORMCHECKBOX Manufacturing FORMCHECKBOX Inspection & Testing
| Years in business: |
| Annual sales in USD: $ |
If location of manufacturing facility is different from the location above, complete Section 4.0, otherwise continue below.
| No. of buildings: |
| Total area: sq. ft |
| Total number of employees |
Do you have ISO 9001, 14001 or other accreditations or certifications? FORMDROPDOWN Name(s) of Registrar or certifying body:
If yes, send copy of current certificates.
List other agency approvals, i.e., UL, CSA, FCC, IPC (enclose copy)
Do you do subcontract work? FORMDROPDOWN If yes, please complete Section 4.0.
2.0
KEY PERSONNEL
Relative Title Name Actual Title
| Pres./Owner |
| Years with Co. |
| Head of QA |
| Years with Co. |
| Head of Mfg. |
| Years with Co. |
| Head of Purchasing |
| Years with Co. |
| Other key contact |
| Years with Co. |
3.0
CUSTOMER REFERENCES, ENCLOSURES, COMMENTS, AND CERTIFICATION
PLEASE PROVIDE THE NAME OF THREE (3) CUSTOMER REFERENCES THAT WE MAY CONTACT:
| NAME OF CONTACT |
| TITLE |
| COMPANY |
| PHONE |
PLEASE PROVIDE US WITH ADDITIONAL INFORMATION YOU FEEL WILL CLARIFY ANY OF YOUR RESPONSES OR ASSIST OUR STAFF IN EVALUATING YOUR COMPANY AS A BNL SUPPLIER (as a minimum, provide those items marked).
FORMCHECKBOX
Quality Manual
FORMCHECKBOX
Organization chart
FORMCHECKBOX
Workmanship Standards
FORMCHECKBOX
Plant layout
FORMCHECKBOX
Product/Marketing Literature
FORMCHECKBOX
Procedures & Work Instructions
FORMCHECKBOX
Equipment and facilities list
FORMCHECKBOX
Other
COMMENTS:
Instructions: Check the appropriate box below.
FORMCHECKBOX
Please complete Section 5 to conclude the survey.
FORMCHECKBOX
Section 5 is not required to be completed – END of the survey.
List Alternate Locations (or subcontractors), if applicable below (complete one section 4 for each Location or subcontractor):
4.0 Alternate Locations
Location 1:
| Point of Contact: |
| Title: |
| Telephone: |
| Fax: |
| E-mail: |
| Internet address: |
Name of Facility
Address:
City / State / Zip / Country:
Telephone:
Fax:
Parent Company (if applicable):
| No. of buildings: |
| Total area: sq. ft |
Total number of employees
Do they have ISO 9001, 14001 or other accreditations? FORMDROPDOWN Name of Registrar:
If yes, send copy of current certificates.
List other agency approvals, i.e., UL, CSA, FCC, IPC (enclose copy)
Is a formal training program in place for all employees? FORMDROPDOWN Please explain answer or describe program:
List any ISO 9000, listings, or customer classifications (e.g. UL, CSA, FCC, US military, US automotive):
List Standards that are applicable to your Product:
Capabilities: Design FORMDROPDOWN Tooling/Prototype FORMDROPDOWN Inspection & Testing FORMDROPDOWN
Major products /services: FORMDROPDOWN
What, if any, processes are subcontracted? Briefly describe:
5.0 Supplier Systems/Processes The following are a series of elements to describe systems and processes along with an accompanying set of questions that can be used to focus the response.
5.1 QUALITY SYSTEMS
Describe your Quality Management System or QA Program and the role of your Quality organization. Include the basis for the system or program, e.g. ISO, ANSI/ASQ and responsibility for activities such as assessments/audits, calibration, and inspection.
5.1.1 Is there a written QA Plan or QA Program? FORMCHECKBOX
Yes FORMCHECKBOX
NO
5.1.2 Is the QA Program approved to any standards? FORMCHECKBOX Yes FORMCHECKBOX
NO
Detailed Response:
5.2 ENVIRONMENTAL MANAGEMENT SYSTEM (EMS)
Describe you EMS and consider such factors as ISO14001 EMS registration, federal, state, or local environmental enforcement actions, pollution prevention programs, etc.
5.2.1 Has an EMS program been established? FORMCHECKBOX Yes FORMCHECKBOX
NO
5.2.2 Is it fully implemented? FORMCHECKBOX Yes FORMCHECKBOX
NO
5.2.3 Is the program meeting the intent of ISO 14001? FORMCHECKBOX Yes FORMCHECKBOX
NO
5.2.4 Is the program ISO 14001 registered? FORMCHECKBOX
Yes FORMCHECKBOX
NO
Detailed Response:
5.3 OCCUPATIONAL HEALTH AND SAFETY (OHS) PROGRAM
Describe you OHS program and consider such factors as policy, hazards, risks, objectives, etc.
5.3.1 Has an OHS program been established? FORMCHECKBOX Yes FORMCHECKBOX
NO
5.3.2 Is it fully implemented?
FORMCHECKBOX
Yes FORMCHECKBOX
NO
5.3.3 Is the program meeting the intent of an established standard, e.g. BSI OHSAS 18001, Voluntary Protection Plan (VPP), ILO-OSH ?
FORMCHECKBOX
Yes FORMCHECKBOX
NO
5.3.4 Is the program registered?
FORMCHECKBOX
Yes FORMCHECKBOX
NO
Detailed Response:
5.4 DOCUMENT/DATA CONTROL AND RECORDS
Describe your process for document control including revision, configuration, and change control and types of records maintained regarding quality.
5.4.1 Is there a document control system that provides for identification of documents to be controlled, assignment of responsibilities for preparation, review, approval and issuance of documents? FORMCHECKBOX Yes FORMCHECKBOX
NO
5.4.2 Are obsolete documents controlled? FORMCHECKBOX Yes FORMCHECKBOX
NO
5.4.3 Is there a records management system? FORMCHECKBOX Yes FORMCHECKBOX
NO
5.4.4 Are records legible, readily retrievable and stored in a way that protects their fitness for use? Have responsibilities for record collection and maintenance been clearly defined and documented? FORMCHECKBOX Yes FORMCHECKBOX
NO
5.4.5 Have retention times been defined for records and are they retrievable throughout that time? FORMCHECKBOX Yes FORMCHECKBOX
NO
Detailed Response:
5.5 PURCHASING
Describe your process for assuring purchased items/services meet requirements, including qualification and monitoring of suppliers.
5.5.1 Do you qualify suppliers and subcontractors? FORMCHECKBOX Yes FORMCHECKBOX
NO
5.5.2 Is a performance history maintained for each supplier? FORMCHECKBOX Yes FORMCHECKBOX
NO
5.5.3 Is there a system for supplier corrective action? FORMCHECKBOX Yes FORMCHECKBOX
NO
Detailed Response:
5.6 PROCESS CONTROL
Describe how your manufacturing/assembly processes are controlled, including qualification of personnel, maintenance of equipment and any statistical techniques used.
5.6.1 Do you have a process inspection function? FORMCHECKBOX Yes FORMCHECKBOX
NO
Who does the inspection?
5.6.2 Do you have a system for reviewing new process specifications and inspection instructions?
FORMCHECKBOX
Yes FORMCHECKBOX
NO
5.6.3 Does the company maintain a documented employee training program? FORMCHECKBOX Yes FORMCHECKBOX
NO
5.6.4 Are training records current and complete? FORMCHECKBOX Yes FORMCHECKBOX
NO
5.6.5 Are statistical techniques used? FORMCHECKBOX Yes FORMCHECKBOX
NO
Detailed Response:
5.7 DESIGN/ENGINEERING (If applicable)
Describe the process for converting customer requirements into design specifications, including how drawings, specifications and standards are maintained to ensure products meet applicable requirements.
5.7.1 Does the design process include the review, and validation and verification activities that are appropriate to each stage of the design? FORMCHECKBOX Yes FORMCHECKBOX
NO
5.7.2 Does the company have verification that the design output (e.g., prints, drawings, specifications) met the customer and regulatory requirements? FORMCHECKBOX Yes FORMCHECKBOX
NO
5.7.3 Are validation and verification requirements clearly defined and documented? FORMCHECKBOX Yes FORMCHECKBOX
NO
Detailed Response:
5.8 INSPECTION/TESTING
Describe the processes used to assure contract/PO requirements have been met, specifically relating to the end item or deliverable.
5.8.1 Is there a final inspection before delivery to the customer? Is this inspection documented on a traveler or other final inspection paperwork? FORMCHECKBOX Yes FORMCHECKBOX
NO
5.8.2 Does the organization have the final inspection function separate from the production function? FORMCHECKBOX Yes FORMCHECKBOX
NO
5.8.3 Are written inspection instructions, product specifications, and drawings available? FORMCHECKBOX Yes FORMCHECKBOX
NO
How are these reviewed and kept up-to-date?
Detailed Response:
Describe the processes for the control of measurement and test equipment, e.g., calibration.
5.8.4 Are process control and inspection instruments periodically calibrated? FORMCHECKBOX Yes FORMCHECKBOX
NO
How often are they calibrated?
5.8.5 Are calibration records available for gages and instruments? FORMCHECKBOX Yes FORMCHECKBOX
NO
5.8.6 Are these calibrations traceable to the National Institute of Standards and Technology (NIST)?
FORMCHECKBOX
Yes FORMCHECKBOX
NO
Detailed Response:
5.9 NONCONFORMANCES, CUSTOMER COMPLAINTS, AND CORRECTIVE/PREVENTIVE ACTION
Describe the process for identifying and controlling nonconformances to prevent delivery to the customer, and describe the corrective/preventive action process to prevent recurrence.
5.9.1 Are records kept showing the acceptance, rejection, or disposal of material? FORMCHECKBOX Yes FORMCHECKBOX
NO
5.9.2 Do you have a system for disposition of nonconforming materials? FORMCHECKBOX Yes FORMCHECKBOX
NO
5.9.3 Is there a system for supplier corrective action? FORMCHECKBOX Yes FORMCHECKBOX
NO
5.9.4 Are raw materials controlled and are material analyses periodically verified? FORMCHECKBOX Yes FORMCHECKBOX
NO
5.9.5 Is there a Material Review Process where an individual/group in the organization has the responsibility to review & disposition nonconforming material? FORMCHECKBOX Yes FORMCHECKBOX
NO
5.9.6 Is material awaiting review adequately segregated and identified? FORMCHECKBOX Yes FORMCHECKBOX
NO
Detailed Response:
5.10 TRAINING/QUALIFICATION
Describe the process for ensuring that employees receive and maintain the proper level of training and qualifications commensurate with their job responsibilities.
5.10.1 Does the company maintain a documented employee training program? FORMCHECKBOX Yes FORMCHECKBOX
NO
5.10.2 Are training records current and complete? FORMCHECKBOX Yes FORMCHECKBOX
NO
List training performed:
Detailed Response:
5.11
MANAGEMENT REVIEW
Describe the process for management’s review of the organization’s performance, including management systems and products.
5.11.1 Does management review the status of management systems at planned intervals to determine its suitability, adequacy, and effectiveness? FORMCHECKBOX Yes FORMCHECKBOX
NO
5.11.2 During the past year, have specific improvements to management systems, processes, or products have been initiated or made as a result of management review? FORMCHECKBOX Yes FORMCHECKBOX
NO
Detailed Response:
I certify that the information contained in this profile and any accompanying documents are complete and accurate to the best of my knowledge.
Authorized Reviewer: Title: Date: M/D/YYYY e-mail the completed Supplier Desktop Survey to: mbrock@bnl.gov
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3.0/2p02e011.doc
(09/2021)
File details come from the government source that posted it. Updated .