FOR-1.6.1b Supplier_s Assessment Questionnaire Food

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

SUPPLIER DETAILS

• Supplier Name:

• Address:

• Telephone:

• Fax:

• Email:

• Please list and attach specifications for each product supplied to our company

• Address of manufacturer if different from above:

• Commercial Details

  Drawing

• Name:

• Phone & Mobile:

• Email:

• Technical Details

• Name:

• Phone & Mobile:

• Email:

• Company Background

• Age of Company:

• Years on Present Site:

• Number of Employees on Site:

• Production Capacity:

• Operating Shift Regime:

• Membership of Advisory Bodies:

• Is site security maintained 24 hours?

  Yes

  No

  N/A

• Is site access controlled 24 hours?

  Yes

  No

  N/A

• The following questions are divided into eight sections and relate to the food manufacturing plant(s), which supply product to our company. If some of the questions are not applicable to the product and processes used within your industry mark not applicable against the questions and explain why

• NOTE: If you are certified by a third party against a recognised food standard (such as BRC, IFS, ISO 22000, SALSA), there is no need to complete the following sections. Please attach a valid copy of the certificate and sign off the questionnaire on page 3

1. PERSONNEL

• Are staff formaly trained to the legally required level of hygiene and safety?

  Yes

  No

  N/A

• Is there a formalised system of identifying and recording training requirements?

  Yes

  No

  N/A

• Is protective clothing provided?

  Yes

  No

  N/A

2. PREMISES

• Are the premises designed and fitted such that legal requirements are met?

  Yes

  No

  N/A

• Are high and low risk areas and any other routes for cross contamination effectively controlled?

  Yes

  No

  N/A

• Do you have an EEC License? Please state the License Number (if applicable)

  Yes

  No

  N/A

3. PEST CONTROL

• Are your premises effectively proofed against all pest?

  Yes

  No

  N/A

• Do you have a pest control contractor?

  Yes

  No

  N/A

• How many pest inspections/year are carried out by the contractor?

  Yes

  No

  N/A

4. RAW MATERIALS

• Are your suppliers formally approved?

  Yes

  No

  N/A

• Do you have specifications for all incoming goods, packaging materials and finished products?

  Yes

  No

  N/A

• Do you receive Certificates of Analysis/Conformance from suppliers as needed?

  Yes

  No

  N/A

• Do you carry out tests to ensure that materials meet specification?

  Yes

  No

  N/A

5. PRODUCTS

• Please provide Certification for any products sold as organic (if applicable)

  Yes

  No

  N/A

• Do any of your products contain Genetically Modified foods (GMO) or their derivatives?

  Yes

  No

  N/A

• Do products supplied contain allergens? If yes, please specify

  Yes

  No

  N/A

• Are other allergens handled on site? If yes, please specify

  Yes

  No

  N/A

• Do products supplied contain any trace allergens which could impact on the legal threshold level? ? If yes, please specify

  Yes

  No

  N/A

• What systems do you have in place to controll allergens (if applicable)?

6. HACCP

• Is there a fully documented HACCP system in place with associated critical procedures?

  Yes

  No

  N/A

• Are all critical points monitored and records kept?

  Yes

  No

  N/A

7. PROCESS CONTROL

• Is there a foreign body control policy?

  Yes

  No

  N/A

• Is there metal detection in place?

  Yes

  No

  N/A

SUBJECT

• Is there formalised glass control?

  Yes

  No

  N/A

• Is there full traceability in place? How often is being tested?

  Yes

  No

  N/A

Please attach a summary of last test

• Are there procedures for quantity control in place?

  Yes

  No

  N/A

• Do you operate a positive-release system?

  Yes

  No

  N/A

• Are cleaning procedures detailed and checks carried out?

  Yes

  No

  N/A

• Are swabs used to verify effectiveness of cleaning?

  Yes

  No

  N/A

• How is temperature control monitored?

• Are distribution vehicles temperature controlled and records kept?

  Yes

  No

  N/A

• Are product storage temperatures documented?

  Yes

  No

  N/A

• Is there a continuous monitoring temperature system in place with alarm?

  Yes

  No

  N/A

8. QUALITY ASSURANCE

• Do you have a Food Safety & Quality policy?

  Yes

  No

  N/A

• Who does the microbiological testing? Are they accredited?

• Is testing equipment calibrated to British Standards?

  Yes

  No

  N/A

• Is there a formalised product recall system in place? If yes, how often is being tested?

  Yes

  No

  N/A

• Is there a formalised customer complaint system?

  Yes

  No

  N/A

• Is shelf life confirmed by microbiological analysis?

  Yes

  No

  N/A

• Are internal audits carried out? How often?

  Yes

  No

  N/A

• Yes/No (please circle as appropriate)

  Yes

  No

  N/A

• Would you accept an audit from a technical representative from our company, in order to verify that you have the necessary controls in place to ensure consistently satisfactory product quality and compliance with food safety standards?

  Yes

  No

  N/A

• Yes/No (please circle as appropriate)

  Yes

  No

  N/A

• Could you confirm that your traceability system is capable of retrieving necessary data from suppliers and customers alike, if needed?

  Yes

  No

  N/A

• Questionnaire completed by:

• Position:

• Name:

• Signature:

  Sign

• Date:

  Date

• Thank you for completing this form

  Drawing

FOR OFFICE USE ONLY

• STATUS:

• Completed Questionnaire:

• Satisfactory/ Further Information Required

  Yes

  No

  N/A

• Formal Audit Required:

  Yes

  No

  N/A

• YES / NO / TBC on receipt of further information

  Yes

  No

  N/A

• Signed

  Sign

• Position

• Date

  Date