SUPPLIER SCREEN QUESTIONNAIRE

NAME OF COMPANY:

ADDRESS:

CONTACT:

TECHNICAL:

PRODUCTION:

COMMERCIAL:

PRODUCT(S) SUPPLIED:

1. DO YOU HAVE A SUITABLY QUALIFIED SENIOR MANAGER WHO IS

RESPONSIBLE FOR QUALITY ASSURANCE? YES  NO 
IF YES PLEASE STATE:
NAME:
POSITION:
TELEPHONE: WORK: FAX:
MOBILE:
HOME:

IF NO, WHO DO WE CONTACT IN CASES OF QUALITY EMERGENCIES:

NAME:
POSITION:
TELEPHONE: WORK: FAX:
MOBILE:
HOME:

2. DO YOU HAVE PRODUCT LIABILITY INSURANCE COVER?

YES  NO 
IF YES PLEASE STATE:
INSURER:
POLICY No:
LIMIT OF:

Ref: Supplier screen questionnaire. Issue No. 1 Approved by:

ã Advanced Food Safety Limited 2004
 SUPPLIER SCREEN QUESTIONNAIRE

3. IS YOUR FACTORY LICENSED OR HAVE YOU ACCREDITATION WITH A NATIONALLY

REGISTERED QUALITY ASSURANCE SCHEME? e.g. EFSIS, BRC, BRC / IoP
YES  NO 
IF YES PLEASE STATE:
LICENSE NUMBER
AND / OR
ACCREDITED CERTIFYING AGENCY:
SCOPE OF REGISTRATION:
DATE OF REGISTRATION:
Return a copy of certificate with this questionnaire

IF NO, HAVE YOU A CURRENT WRITTEN QUALITY ASSURANCE MANUAL?

YES  NO 

IF YES A COPY MAY BE REQUESTED.

4. HAVE YOU A HACCP SYSTEM DOCUMENTED TO COVER PRODUCT(S)

SUPPLIED?
YES  NO 
Return a copy of your HACCP with this questionnaire.
If a wholesaler copies of HACCP from manufacturing site are required.

5. ARE ALL LEVELS OF MANAGEMENT AWARE OF RELEVANT LEGISLATION

CONCERNING FOOD SAFETY, HYGIENE, LABELLING AND QUALITY CODES OF
PRACTICE WHICH AFFECT YOUR BUSINESS?
YES  NO 

6. ARE ALL MANAGEMENT AND STAFF APPROPRIATELY QUALIFIED,

TRAINED AND SUPERVISED?
YES  NO 

7. ARE RECORDS OF TRAINING MAINTAINED?

YES  NO 

8. DO YOU HAVE A QUALITY PLAN FOR EACH PRODUCT?

YES  NO 

9. DO YOU HAVE WRITTEN SPECIFICATIONS FOR EACH PRODUCT?

YES  NO 
Return a copy of your specifications with this questionnaire

10. DO YOU CARRY OUT AND DOCUMENT REGULAR TESTS ON FINISHED

PRODUCTS PRIOR TO RELEASE FOR DESPATCH?
YES  NO 

11. DO YOU CARRY OUT CHECKS ON ALL MEASURING & TEST EQUIPMENT?
YES  NO 

12. DO YOU HAVE A SYSTEM OF SPECIFICATIONS AND CONTROL TO ENSURE THAT ALL
YOUR RAW MATERIALS AND INGREDIENTS ARE OBTAINED FROM RELIABLE SUPPLIERS
AND CHECKS ARE MADE TO ENSURE THAT PRODUCTS CONFORM TO ALL LEGAL
REQUIREMENTS? YES  NO

Ref: Supplier screen questionnaire. Issue No. 1 Approved by:

ã Advanced Food Safety Limited 2004
 SUPPLIER SCREEN QUESTIONNAIRE

13. DO YOU EMPLOY A DOCUMENTED SYSTEM OF IDENTIFICATION AND

TRACEABILITY THROUGH BATCH NUMBERS WHERE PRODUCT RECALL MAY BE
DEMANDED?
YES  NO 
Please confirm details of coding to record for traceability purposes.

14. DO YOU HAVE A CHECKING SYSTEM WHICH ENSURES THAT SPECIFIC

STANDARDS OF PERFORMANCE ARE MAINTAINED OVER PRODUCTION
MACHINERY, METAL DETECTION EQUIPMENT ETC.?
YES  NO 

15. DO YOU HAVE A DOCUMENTED SYSTEM FOR MONITORING AND

RECORDING CUSTOMER COMPLAINTS?
YES  NO 

16. DO YOU HAVE A PEST CONTROL SYSTEM IN PLACE?

YES  NO 

IF YES, NAME OF COMPANY .....................................................................................

Is the company a member of a recognized association e.g. BPCA
YES  NO 

17. ARE THE PRODUCTS SUPPLIED GUARRANTEED GMO FREE

YES  NO 

CONFIRM IN WRITING THE GMO STATUS OF THE PRODUCT(S) SUPPLIED INCLUDING

PROCESSING AIDS.

18. ARE YOU AGREEABLE TO PROVIDE ACCESS FOR A REPRESENTATIVE OF

OUR COMPANY TO CARRY OUT A QUALITY APPRAISAL VISIT. IF THOUGHT
NECESSARY AT A REASONABLE TIME?
YES  NO 

COMPANY: …………………………………….

SIGNED: ………………………………………..

POSITION: ……………………………………..

DATE: …………………………………………..

Ref: Supplier screen questionnaire. Issue No. 1 Approved by:

ã Advanced Food Safety Limited 2004
 SUPPLIER SCREEN QUESTIONNAIRE

Ref: Supplier screen questionnaire. Issue No. 1 Approved by:

ã Advanced Food Safety Limited 2004