SDQA 100
Rev. 3: 2/00
s
POWER TRANSMISSION AND DISTRIBUTION, INC
Raleigh Facility
Supplier Assessment Questionnaire
Supplier Name
Address
Numbers
Phone Number
Fax Number
Contacts
Department
Sales
Purchasing
Quality
Engineering
Manufacturing
Name
Title
SIEMENS PERSONNEL TO COMPLETE BELOW THIS LINE

Does the supplier have or is he pursuing a certificate of Quality System
Registration?
Yes [ ] No [ ]

Was a copy of the Quality Assurance Manual reviewed?
Yes [ ] No [ ] N/A [ ]

Were relevant process equipment & machines reviewed?
Yes [ ] No [ ] N/A [ ]

Were samples of similar products and/or workmanship criteria reviewed? Yes [ ] No [ ] N/A [ ]

Were references reviewed (optional)?
Yes [ ] No [ ] N/A [ ]

D&B Analysis (optional)? If reviewed attach to this sheet.
Yes [ ] No [ ] N/A [ ]

Is an audit necessary?
Yes [ ] No [ ] N/A [ ]
____________________ _________ ______________________
___________
Note: This form to be completed in accordance with RAL-PUOP-06-01 (Subcontractor Assessment), Section 3.4.
N/A [ ]
SDQA 100
Rev. 3: 2/00
Quality Assurance
Date
Purchasing
Date
Note: This form to be completed in accordance with RAL-PUOP-06-01 (Subcontractor Assessment), Section 3.4.