PRIMEX - 01-13-00 Rev 02

PRIMEX PLASTICS PVT LTD.

BANGALORE - 560058 SUPPLIER ASSESSMENT FORM A. General Information
1. Name of the Supplier 2. Address : Apex Techno Polymer Pvt Ltd : Plot # V22B, Near Post Office, 2nd Stage, Peenya Indl Area, Nelagadaranahalli, Bangalore 560 058. 3. Telephone No 4. Fax No 5. Email ID 6. Type of Company 7. Name of the Contact Person 8. Customers at present : 9611116687/080-40964674 : Na : mahesh@apextechnopolymer.com :Private Ltd Indivdual / Partership / Private Ltd.Co

: Mahesh.V.R/ Kinjal Shah :Autoliv & Denso

9. No of Employees

26

Executives: Casuals:

Operators: Others:

10. Spare Production Capacity 11. Testing Facility Available 12. Process

: : No :

13. Registration No 14. CST No 15. KST No 16. Any Other Point

: 29930617827 : 29930617827 : 29930617827 :

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PRIMEX - 01-13-00 Rev 02

PRIMEX PLASTICS PVT LTD.

BANGALORE - 560058 SUPPLIER ASSESSMENT FORM
B. QUALITY SYSTEMS a) Is documented quality policy available? b) Is responsibility & authority defined in the organisation? c) Is a person identified who will report a non conformity and can stop the production? d) Is the person / department identified who will initiate corrective action? C. PROCESS CONTROL A) Are the machines maintained properly? b) Is the shop floor cleaned & proper house keeping maintained? c) Instruments & Gauges are available and are calibrated at specified intervals? d) Are process carried out by trained operators? e) System of identification is available? f) Are inspection records maintained at different stage of manufacturing? g) Is the quality plan available? h) are special processes qualified? Note: If the answer to any of above question is No, Prepare the action plan. Result: Approved / Conditionally Accepted / Rejected Audited By Sign Date : : :

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