F-023-Supplier Approval Form

• Conducted on

  Date

• Assessor's Name & Signature

  Sign

• Prepared by

• Location
  Address

• Date of inspection completion:

  Date

• Supplier Name:

• Telephone:

• Address:

• Fax:

• Technical Contact Name:

• Technical Contact Email:

• Products Supplied:

• Summary of Process:

• Is the supplier able to provide a GTIN/UPC code?

  Yes

  No

  N/A

Requirements

• Letter of Guarantee

• Completion Date

  Date

• Product / Service Specifications

• Completion Date

  Date

• Supplier FSMS / GMP / GAP Questionnaire (Satisfactory Responses)

• Completion Date

  Date

• Proof of QA / Lab Testing per product and Provide Analysis Certificates

• Completion Date

  Date

• Evidence of Coding, Traceability, and Recall Systems

• Completion Date

  Date

• Allergen Statements for Facility

• Completion Date

  Date

• Satisfactory Evidence of HACCP or GMP Plan

• Completion Date

  Date

Conclusion

• Is supplier clear for supply?

  Yes

  No

  N/A

• Is supplier suspended/de-listed?

  Yes

  No

  N/A

• Supplier Approved (or De-listed) By:

  Sign

• Date

  Date

• Verified By:

  Sign

• Verification Date:

  Date