InfraCore Supplier Questionnaire - Printed

• Conducted on

  Date

• Prepared by

• Location
  Address

• Supplier Name

  Select

• Supplier Review

BUSINESS INFORMATION

• Registered Company Name

• NZBN

Contact Information

• Phone Number

• Fax Number

• Email Address

• Website

• InfraCore Account Manager

• Position

• Phone/Mobile Number

• Email Address

• Do you have insurance? (Public Liability, Professional Indemnity, Motor Vehicle Insurance, etc.)

  Yes

  No

  N/A

• If Yes, Please provide a copy of your current insurance/s (Public Liability, Professional Indemnity, Motor Vehicle Insurance, etc.)

• What is your company's current scope of activity / products / services:

InfraCore Specific Information

• InfraCore Annual Spend (Estimated)

• What percentage (%) of your business is InfraCore's Account?

• What are InfraCore's top purchases?

• Who is your main contact at InfraCore?

• Do you have a standing agreement with InfraCore?

  Yes

  No

  N/A

• If Yes above, On whose terms were the contract/agreement?

  Ours

  InfraCore's

• Are there set discounted prices as part of the contract?

  Yes

  No

  N/A

• If there are discounted prices, have these been used to date?

  Yes

  No

  N/A

QUALITY MANAGEMENT SYSTEM

• Do you have a Quality Policy?

  Yes

  No

  N/A

• If Yes, Please provide a copy of your Quality Policy statement.

• Do you have a Quality Management System?

  Yes

  No

  N/A

• If Yes, Is your Quality Management System Certified?

  Yes

  No

  N/A

• What standard is your Quality Management System certified to?

• Please provide a copy of your QMS accreditation certificate.

• If No, Is your company considering ISO 9001 or an alternative structured approach to quality management?

  Yes

  No

  N/A

• Are you able to provide details of the proposed action plan for implementation?

  Yes

  No

  N/A

COMPLETED BY: Company Quality Representative

• Name and Signature

  Sign

• Position

• Phone/Mobile Number

• Email Address

• Do you have a Health and Safety Policy?

  Yes

  No

  N/A

• If Yes, Please provide a copy of your Health and Safety Policy Statement.

• Do you have a Health and Safety Management System

  Yes

  No

  N/A

• If Yes, Is your Health and Safety Management System accredited?

  Yes

  No

  N/A

• Provide Accreditation Details if applicable.

• Please provide a copy of your current H&S accreditation certificate if applicable.

• Do you have procedures for Emergency Preparedness?

  Yes

  No

  N/A

• Do you have procedures for Employee Participation?

  Yes

  No

  N/A

• Are your products/services manufactured/processed to a recognized standard?

  Yes

  No

  N/A

• If Yes, Provide Details

• Do you provide hazard information and other pertinent documentation relating to your products and services?

  Yes

  No

  N/A

COMPLETED BY: Company Health and Safety Representative

• Name and Signature

  Sign

• Position

• Phone/Mobile Number

• Email Address