EXPIRED MATERIAL SUPPLIER EVALUATION FORMEXPIRED MATERIALS SUPPLIER

566633258.DOCX
EVALUATION FORM

Version:  19/01/2018 Page: 1/2

1. GENERAL INFORMATION (filled by PVM Quality Department)

5Date: 13.12.2021
Requested by (name & job tittle): Nguyễn Mai Ngọc Trúc
PVM Production Location: Supply Planning

10SUPPLIER DETAILS:
Name of Supplier: Cty CP San xuat nhua Duy Tan
Supplier contact
person:_____________________________________________________________________
_
15Address of manufacturing location:
_____________________________________________________________
___________________________________________________________________________
_______________

20

MATERIAL DETAILS:

Quantity
Mtl code Material Description Expiration Date Batch
(KG)
315179 Cap MPF Bubblefresh Med Curvy Ukraine 19,500 15.10.2021 15.04.2021
315179 Cap MPF Bubblefresh Med Curvy Ukraine 1,000 13.07.2021 13.01.2021
315179 Cap MPF Bubblefresh Med Curvy Ukraine 6,896 26.08.2021 26.02.2021

25

2. MATERIAL EVALUATION (filled by Supplier)

Evaluation date:

30Evaluation done by:

DESCRIPTION OF MATERIAL EVALUATION:

Verify by Group Pack Dir, CMO Approved C R&D O

Classification: Internal
 EXPIRED MATERIAL SUPPLIER EVALUATION FORMEXPIRED MATERIALS SUPPLIER
566633258.DOCX
EVALUATION FORM

Version:  19/01/2018 Page: 2/2

Test all typical attachment on table below:

3. CONCLUSION (filled by Supplier)

☐ The shelf life of the material can be extended without any health and safety risks
☐ Shelf life for the material may be extended to (dd/mm/yy):
☐ It is not recommended to extend the shelf life of the material

Required storage conditions for the material:

Temperature (°C):

Humidity (%RH):

Other specific requirements or concerns:

__________________________________________________________________________________
__________________________________________________________________________________
________________________________________________________________________________
Potential Risks to consider for PVM linked to the extension of the shelf life of the material:
________________________________________________________________________________
Date:

Name and job title, Supplier: ________________________________________________________

Verify by Group Pack Dir, CMO Approved C R&D O

Classification: Internal