Title Page
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Supplier
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Conducted on
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Prepared by
Untitled Page
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If the Supplier wants to complete the PSW on paper rather than online. Attached is a copy of the PSW document that needs to be emailed back to the appropriate Malibu SQE (Matt McDonald or Chris Weatherbie).
Contact Lists & RMA
*Quality Contact will be responsible for logging into Malibu's QT9 Software to supply root cause investigation and corrective actions for any CAR/QA
*RMA information needed when defective product is found: -RMA "return merchandise authorization" (The supplier will issue this) -Contact(s) for RMA's -Shipping Address -Preference on return -Shipping account number (FedEx or UPS) or a Call Tag
Quality Assurance Contact
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Name
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Number
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Email
Sales Contact
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Name
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Number
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Email
Management Contact
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Name
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Number
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Email
Return Merchandise Contact
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Name
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Number
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Email
Production Part Sample Shipping Info
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Purchase Order:
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Date Shipped:
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Carrier Used:
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Tracking #:
Malibu Engineering Approval
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Please insert picture/screenshot/snip of Malibu Engineering Approval
Ballooned Part Drawing
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Please insert ballooned Drawing to the latest/current Revision
Dimensional Results
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Supplier to use below inspection sheet or their own as long as all information as shown below is reported.
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Please add dimensional results based off of ballooned drawing. ALL QCD and Safety Critical Dimensions must be measured/reported.
Safe Launch Plan
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Supplier is to read the attached Safe Launch Plan. If the Supplier Agrees to the Safe Launch Plan, then they will sign the attached copy and upload it below.
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Please Upload Signed Safe Launch Plan if the supplier has agreed to it's terms.
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Below is the Safe Launch Labeling that will be needed for the Safe Launch Plan.
Part Warrant
Malibu Part Submission Warrant
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Malibu Part Name
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Malibu Part Number
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Engineering Drawing Change Level and Date
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Additional Engineering Changes and Date
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Are these changes backwards compatible?
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If NOT backward compatible. Are previous revision parts available for service?
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Shown on Drawing No.
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Purchase Order No.
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Engineering Change Level
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Dated
Supplier Manufacturing Information
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Supplier Name
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Street Address
Submission Information
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Submission Info - Please Check all that Apply
- Dimensional
- Materials/Functional
- Appearance
- Packaging Requirements
- Labeling Requirements
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Reason for Submission - Please Check all that Apply
- Initial Submission
- Engineering Change(s)
- Tooling: Transfer, Replacement, Refurbishment, or Additional
- Correction of Discrepancy
- Tooling Inactive > 1 Year
- Changes to Optional Construction or Material
- Sub-Supplier or Material Source Change
- Change in Part Processing
- Parts Produced at Additional/Alternate Location
- Other
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Requested Level
- Level 1 - Warrant and product sample submitted to Malibu SQE.
- Level 2 - Warrant with product samples and drawing(s) with dimensional results submitted to Malibu SQE.
- Level 3 - Warrant with product samples and complete supporting documentation.
- Level 4 - Warrant and other requirements as defined by Malibu SQE.
- Level 5 - Warrant with product sample, complete supporting documents, site visit to Suppliers manufacturing location
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Submission Results - Please Check all that Apply
- Dimensional Measurements
- Material and Functional Tests
- Appearance Criteria
- Statistical Process Package
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Results meet all drawing and specification requirements?
Declaration
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I hereby affirm that the samples represented by this warrant are representative of production parts.
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The part price will be effected by this change.
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Explanation/Comments
Supplier Authorized Signature
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Name
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Title
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Phone No.
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Fax No.
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Supplier Authorized Signature
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Date