SUPPLIER INFORMATION
QUESTIONNAIRE
(NOTE: Information furnished will be held confidential within Tribar Manufacturing)
1. Candidate Supplier Name: __________________________________________________
Subsidiary or Division of: __________________________________________________
Street Address: ___________________________________________________________
Mailing Address: __________________________________________________________
City, State, Zip Code: ______________________________________________________
Telephone Number: ________________________________________________________
2. KEY PERSONNEL
INDIVIDUAL’S NAME
TITLE
_________________________________ _______________________________________
_________________________________ _______________________________________
_________________________________ _______________________________________
_________________________________ _______________________________________
3. Please supply or identify your After Hours Contact including weekends and holidays:
Name: ____________________________
Title: _____________________________
Phone: ____________________________
4. Is your company a manufacturer or distributor? ___________________________________
5. Name of Sales Representative or Agency: ________________________________________
Street Address: _____________________________________________________________
Mailing Address: ___________________________________________________________
City, State, Zip Code: ________________________________________________________
Work Phone: _______________________________________________________________
Cell Phone: ________________________________________________________________
6. Primary Products, Product Lines: _______________________________________________
__________________________________________________________________________
7. Major customers (Minimum of 2):______________________________________________
8. Are you a supplier to the automotive industry? ______
Name of automotive customers:
__________________________________________________________________________
__________________________________________________________________________
9. Have you been surveyed by Ford, GM, Chrysler, other automotive companies? __________
(Specify which, rating, and date of last survey)
Company: ___________________________
Rating: _____________________________
Date: _______________________________
QR 7.4.06 Revision: 02 Date: 04/23/14
SUPPLIER INFORMATION
QUESTIONNAIRE
10. Are you currently ISO-9000 registered? ________
To which standard?
9001_____
9002_____
9003_____ ISO 9001:2000_____
Registrar: __________________________________ Date Registered: _________________
Please submit a copy of your certification.
11. Are you TS-16949 registered? __________ Registrar: ______________________________
Date Registered: __________________ Are you pursuing third party registration? ______
What is your estimated date of registration? ______________________________________
Please submit a copy of your certification.
12. Do you have any active Minority Certifications? Please list if Yes.
__________________________________________________________________________
__________________________________________________________________________
13. Number of Employees: ___________ Hourly: ____________
Salary: _______________
14. Union or Non-union? ________ Represented by: _________________________________
Contract Expiration Date: _______________
15. Year Company Established: _____________ Facility Square Footage: _______________
Office: ______________ Manufacturing: ____________ Year Facility Built: ____________
16. List special processes and/or environmentally controlled areas available in your plant:
(i.e.: clean rooms, welding, plating, heat treatment, etc.)
__________________________________________________________________________
__________________________________________________________________________
17. Since 2010, Legislature was passed to reveal use of Conflict Materials (Gold, Tin, Tantalum,
Tungsten, the derivations of Cassiterite, Tantalite, and Wolframite). Are any of these used
in your processes? _____ If yes, please identify which materials and processes and explain
the use:
__________________________________________________________________________
__________________________________________________________________________
18. Please submit equipment and machinery listing on a separate document:
Included: _________ Not included: ________
19. Please submit a listing of any laboratory equipment on a separate document:
Included: _________ Not included: ________
20. Is your laboratory certified? _______ Name of certifying agency: _____________________
QR 7.4.06 Revision: 02 Date: 04/23/14
SUPPLIER INFORMATION
QUESTIONNAIRE
21. Please submit a copy of the Company’s organizational chart and include the names of
individuals holding Management and Quality Assurance positions on the charts:
Included: _________ Not included: ________
22. All Suppliers are Mandated to have read our full terms and conditions listed on our web site
(tribarmfg.com). Please sing below and also sign the Tribar Manufacturing signature page
found in the supplier portal and submit as attachment.
COMPLETED BY: ________________________________________________________
TITLE: __________________________________________________________________
DATE: __________________________________
APPROVED BY: __________________________________________________________
QR 7.4.06 Revision: 02 Date: 04/23/14