Supplier Self Assessment Form
Step 1
App 9a SAF
Self Assessment
If you would like to become our Registered Supplier, please answer the below questions and calculate your total
score achieved.
Q. 1 - Q. 5
1. Company Structure
Company Particulars
SCORE
a)
Government or Related Organizations / Listed Limited Company or its subsidiary
3 marks
b)
Private Limited Company
2 marks
c)
Sole Proprietorship / Partnership
1 mark
SCORE
ACHIEVED
2. Length in Business
a)
Over 8 years
3 marks
b)
4 - 8 years
2 marks
c)
1 - 3 years
1 mark
d)
Less than 1 year
0 mark
3. Business Nature
a)
Manufacturer / Sole Agent / Consultancy Firm
3 marks
b)
Authorised Agent / Distributor
2 marks
c)
Others
1 mark
4. Employee Size
Manufacturer
Trading Co & others
a)
Over 100
Over 25
3 marks
b)
51
- 100
13 - 25
2 marks
c)
1
- 50
1 - 12
1 mark
5. Any Business Litigation in Progress
Q. 6 - Q. 8
Systems Adopted
a)
No
2 marks
b)
Yes, please provide details with supporting documents
0 mark
6. Quality System Adopted
a)
ISO9000 series or equivalent
2 marks
b)
Certification of Quality Program in progress
1 mark
c)
No
0 mark
7. Industrial Safety Program Adopted
a)
Yes
2 marks
b)
No
0 mark
8. Environmental System Adopted
Q. 9
Major Customers
a)
ISO14000 series or equivalent
2 marks
b)
Certification of related Program in progress
1 mark
c)
No
0 mark
9. Major Customers
a)
Company Structure of Major Customers
Bus Company / Bus Manufacturer / Government or Related Organizations /
i)
2 marks
Listed Limited Company / Subsidiary of a Group
ii)
Private Limited Company
1 mark
iii)
Others
0 mark
Please answer b), c) and d) below, if your answer to 9a) is i).
b)
c)
d)
Q.10
Export Experience
Any business transaction with Major Customers in the last 12 months
i)
Yes
1 marks
ii)
No
0 marks
Length of business transaction with Major Customers
i)
Over 5 years
3 marks
ii)
1 to 5 years
2 marks
iii)
less than 1 year
1 mark
Annual business volume with Major Customers
i)
HKD1,000,000 or above
3 marks
ii)
HKD100,000 to HKD999,999
2 marks
iii)
below HKD100,000
1 mark
10. Export Experience (for overseas applicants only)
a)
Over 3 years
2 marks
b)
below 3 years
1 mark
c)
No
0 mark
The maximum score for this Supplier Self Assessment Form is 31 and the minimum score required is 15.
Signature with Company Chop
Total Score:
Date
Page 1 of 2
Supplier Self Assessment Form
Step 2
Documents
Submission
App 9a SAF
If your total score achieved is 15 or above, please fill in the below information and return this completed Supplier Self Assessment Form together
with the supporting documents to 8 Chong Fu Road, Chai Wan, Hong Kong; Attention: Procurement Department.
Company Name:
Contact Person:
Position held:
E-mail:
Tel:
Fax:
Major Products and/or Services that your company can supply:
1.
2.
3.
Checklist of Supporting Documents:
*Document no.
Relevant
questions in
Step 1:
#Submission
checkbox
Description of the Document
Copy of valid Business Registration Certificate and
Applicant who is Hong Kong
company:
Yes / No
Copy of Certificate of Incorporation (if limited company)
1
OR
Q.1
Applicant who is not Hong
Kong company:
2
Copy of any official document proving the applicant's legal status
Yes / No
Manufacturing/Factory information in details (for manufacturers)
Yes / No
Copy of authorization letter/agency letter (for distributors or sole agents; at least 1 brand
expected)
Yes / No
Organization chart with employee size breakdowns
Yes / No
Copy of Quality / Safety / Environmental system certificates (ISO or equivalent)
Yes / No
Major customers list with breakdowns to details like order value, goods / service description,
order date, contact person … etc.
Yes / No
Q.3
3
Q.4
4
Q.6~Q.8
5
Q.9
Remarks:
*Please mark the document no. in the respective supporting documents to be submitted.
#Citybus/Firstbus shall validate the scores that are declared by the applicant in Step 1 ONLY IF the applicant provides
the corresponding supporting documents with this self assessment form.
Citybus/Firstbus has sole discretion to entertain or not the re-application from the disqualified applicants.
Signature with Company Chop
Date
For Internal Use Only
Minimum Score Achieved
Yes
No
Further Assessment Required
Yes
No
Remarks:
Handled by:
Date:
Endorsed by:
Date:
Page 2 of 2