Supplier Self Audit Form

SUPPLIER SELF-AUDIT QUESTIONNAIRE PUR-FT- 06 w.e.f 01.12.09

1

GENERAL INFORMATION

Sr. 1.1

Supplier Details Organisation Name :

1.2

Address :

1.3

Fax No.

1.4

Technical Contact Name :

1.5

Designation :

1.6

Contact No. :

1.7

E-Mail Id :

1.8

Commercial Contact Name :

1.9

Designation :

1.1

Contact No. :

1.11

E-Mail Id :

1.12

Emergency Contact Name :

1.13

Designation :

1.14

Contact No. :

1.15

E-Mail Id :

1.16

No. of Employees :

1.17

Accreditation Details : (Please attach certificate copies.)

1.18

ISO 9001 / ISO 140001 :

1.19

HACCP / BRC/IoP :

1.2

Products Supplied to Supreme :

1.21

Name & Designation :

1.22

Signature :

1.23

Company Seal :

SUPPLIER SELF-AUDIT QUESTIONNAIRE PUR-FT- 06 w.e.f 01.12.09 2. Sr.

Criteria

Comply

2.1

Does the company have a documented QMS system?

Yes / No

2.2

Does the company have a document of Quality Policy?

Yes / No

2.3

How quality policy is communicated to employees?

Yes / No

2.4

Are legislative requirement & Hygiene is a part of quality policy?

Yes / No

2.5

Is company carrying out regular system / management reviews?

Yes / No

2.6

Do you have a documented product recall procedure? When was

Yes / No

it last tested? 2.7

Does the company carry out internal audit of QMS, GMP &

Yes / No

Hygiene? If so what is the audit frequency? When was the last audit conducted? 2.8

Do trained auditors carry out audits?

2.9

Is there a formal system to deal with customer complaints? Who

Yes / No Yes / No

is responsible for customer complaints? 2.10

Do you enclose a test certificate along with consignments?

2.11

Do you take corrective action / preventive action on the customer

Yes / No Yes / No

complaints? Please attach your corrective / preventive action procedure. 2.12

2.13

Do you have full trace ability system from Raw materials till

Yes / No

finished product? If yes briefly explain your upward & downward

Yes / No

traceability system?

Yes / No

Do you have product specification & Raw material specification

Yes / No

for all products? Are these controlled? 2.14

Do you have full trace ability system from Raw materials till

Yes / No

finished product? If yes briefly explain your upward & downward trace ability system? 2.15

Do you have in house Laboratory for necessary tests & inspection?

2.16

Do you get any tests done form outside lab? Are these

Yes / No Yes / No

laboratories accredited? If yes, provide evidence. 2.17

Is their policy for control of wood in manufacturing area?

Yes / No

2.18

Is there a documented blade & knife control Policy & Procedure?

Yes / No

2.19

Do you verify the Traceability System implemented by your suppliers?

Yes / No

SUPPLIER SELF-AUDIT QUESTIONNAIRE PUR-FT- 06 w.e.f 01.12.09 3

RAW MATERIALS

Sr.

Criteria

3.1

Does the company have procedure for selecting / approving &

Comply Yes / No

monitoring supplier of materials, services, transport and warehouse facilities? 3.2

How do you control nonconforming purchased products?

Yes / No

Are specifications formally approved & signed by you & the supplier? 3.3

How often the specifications are reviewed?

4

PROCESS CONTROL

Sr.

Criteria

4.1

Are all critical processing conditions are monitored?

4.2

Have all measuring equipments are calibrated to national

Yes / No

Comply Yes / No Yes / No

standard? 4.3

Please explain as how the nonconforming products are identified,

Yes / No

labeled, reworked & recorded in the system. Attach copy of your procedure. 4.4

Have you done any hazard analysis (HACCP) of your process? If

Yes / No

yes, please enclose a copy of your HACCP Plan 4.5

Do you subcontract any manufacturing? If yes, please explain as

Yes / No

how you have approved the subcontractor’s site. 5

CONTAMINATION CONTROL & HYGIENE

Sr.

Criteria

5.1

Do you have GMP to prevent any contamination during

Comply Yes / No

manufacturing? 5.2

Do you have procedure in place for the control of glass & hard

Yes / No

plastic in production & non-production areas? 5.3

Do you have glass & hard plastic breakage procedure?

Yes / No

5.4

Do you maintain a glass register? How often it is been reviewed?

Yes / No

5.5

Is all glass is protected and controlled?

Yes / No

5.6

Are documented cleaning schedules, procedures & record in

Yes / No

place? 5 5.7

CONTAMINATION CONTROL & HYGIENE Is the cleaning work regularly checked and recorded independently?

Yes / No

SUPPLIER SELF-AUDIT QUESTIONNAIRE PUR-FT- 06 w.e.f 01.12.09 5.8

Are incoming vehicles & dispatch vehicles checked for any

Yes / No

contaminants? Are records for the same maintained? What is the procedure if during checks the vehicles are rejected? 5.9

Are suppliers of contracted transport and distribution audited to

Yes / No

ensure that they maintain condition that will not risk contaminating products? 5.10

Are hands washing facilities provided at entry points where

Yes / No

appropriate? 5.11

Are eating / drinking & smoking banned in changing room &

Yes / No

operational areas? 5.12

Are toilets / bathrooms are maintained clean & monitored

Yes / No

regularly? 5.13

Are wooden articles controlled in production areas?

Yes / No

Are any wooden materials are used for packing finished products supplied to SUPREME? If yes, are these wooden items are fumigated / treated appropriately to avoid wood contamination during storage at SUPREME? Provide copy of fumigation certificates with the consignments. 6

FACTORY AND GROUNDS

Sr.

Criteria

6.1

Are external areas of site maintained clean & tidy?

6.2

Is process flow & equipment designed maintained, laid out to

Comply Yes / No Yes / No

minimize risk of cross contamination? 6.3

Is temporary engineering allowed on the equipments? If yes, is it

Yes / No

logged & controlled to ensure permanent repairs within a specified period? 6.4

Maintenance work is followed by documented cleaning method to

Yes / No

minimize the risk of contamination? 6.5

Do you have yearly maintenance program in place? Are records

Yes / No

of maintenance being maintained? Provide a copy of Annual Maintenance Plan. 6.6

7

Is production floor is kept free from dust contamination?

PEST CONTROL

Yes / No

SUPPLIER SELF-AUDIT QUESTIONNAIRE PUR-FT- 06 w.e.f 01.12.09 Sr.

Criteria

7.1

Does the company have formal pest control program in place?

7.2

Is the pest control contractor used to provide the service? If yes,

Comply Yes / No Yes / No

what is the name of the pest control company? Also attach the scope of pest control work carried out. 7.3

Are all technician & biologists employed by the contractor are

Yes / No

trained to the recognized pest control qualification? 7.4

Have insecticutor appropriately positioned to ensure insect

Yes / No

control? 7.5

Are finished products protected from contamination during

Yes / No

storage & distribution? If yes, please explain the methods of protection / precaution. 7.6

Are ornaments, Jewellery, wristwatches are controlled from

Yes / No

taking to production areas? 7.7

Is wearing of protective clothing’s & headgears compulsory in

Yes / No

production areas? 7.8

What policy is adopted if the employee is suffering from diseases,

Yes / No

which can affect product safety? Please explain briefly. 7.9

Do all new staffs receive documented induction training including

Yes / No

hygiene rules? If yes, records for the same are maintained? 7.10

Are staff given formal training in the following and please state as

Yes / No

to how the effectiveness of training is verified a. Food hygiene b. Specific tasks c. HACCP d. Safety 8

ETHICAL SOURCING

Sr.

Criteria

8.1

Does the company adhere to applicable all local laws and

Comply Yes / No

regulations? ( Attached copy ) - Mandatory. 8.2

Are working conditions safe and hygienic?

Yes / No