[supplier management manuals acceptance form ]

GENERAL INFORMATION
Supplier Name

Contact Person

Supplier Code

Job Title

Location

Phone

Address

email

CONFIRMATION OF ACCEPTANCE BY SUPPLIER

We have reviewed you Supplier Quality Manual#: Revision level: ___ in detail, and we

o
o
o

ACCEPTED all requirements stated in Supplier Quality Manual WITHOUT any reservations OR
exceptions.
ACCEPTED all requirements stated in SQM WITH EXCEPTIONS as identified below.
REJECTED as requirements stated in SQM are not feasible for supplier to adhere to.

EXCEPTIONS LIST
[Exceptions must be documented in the table below. Exceptions are not accepted until approved by Customer]
ITEM #
PARAGRAPH #
SUPPLIER COMMENT / PROPOSAL
Is it approved by
(use additional sheets if required)
Customer? (Yes /No)

SUPPLIER SIGN OFF

NAME

TITLE
Purchasing - Head

SIGNATURE

DATE

Sales - Head
Quality - Head
Operations - Head

SIGN OFF (Only when exceptions need to be reviewed & approved)

NAME

TITLE
Purchasing Manager
Supplier development Manager

SIGNATURE

DATE