Supplier On-Site Assessment Instructions

JF-PU-05, Revision 14.12.1 (December 3, 2014)

Instructions 1. Send this form to selected supplier. INSTRUCTIONS FOR SUPPLIER: and ask to complete the SUPPLIER KEY INFORMATION tab
and the self assessment and record the findings in the "Supplier" column on the AUDIT FORM tab. All sections must be filled-out,
regardless of applicability. Sections and questions that do not apply will be identified with the "N/A" label.

2. Upon return of the completed assessment, the Purchasing Manager and the Quality Manager review the data, request any
clarifications, and then, as applicable, prepares for the on-site evaluation.

3. The Purchasing Manager assembles an appropriate audit team, ideally consisting of representatives from, as required, Quality
Assurance, Design Engineering, Operations, and Purchasing, and schedules the on-site assessment.

4. The team evaluates the supplier by asking the questions on the tab Audit Form and scores each question based on the evidence
observed. Scoring is recorded in the "Jackson" column of the audit sheet in accordance with the Audit Scoring Definitions shown
below.

5. At the completion of the assessment, scores are compiled for both the individual sections of the audit and an overall result.
These results are shown in the tab Scoring Summary.

6. A corrective action sheet is included in the audit materials to address any deficiencies identified in the audit. The sheet can also
be used at the team's discrection to catalogue any other further reqired actions related to sourcing decisions. The Quality Manager
shall assigned Non-Conformance Reports and NCR numbers to each corrective action and will work with the Purchasing Manager to
achieve resolution.

7. Once the audit process is finished and this document is complete, a pdf copy will be forwarded to the supplier, the Jackson
Quality Manager and the Jackson Purchasing Manager. The master pdf copy will be maintained on the Jackson Purchasing Server in
the SUPPLIER ASSESSMENT folder. File name should be set in the following format: Supplier Name - "Audit" - Completed Date.pdf.
Records shall be maintained in accordance with JP-QA-02, Control of Records Procedure.

Audit Scoring Definitions

Score Segmentation Documentation Implementation Results

Full documentation with Full execution. No non- Evidence to support full understanding and
3 Strategic
no missing requirements conformances implementation
Substantial
Execution evident with Evidence supports understanding of requirement with
2 Preferred documentation with some
limited non-conformances partial execution
missing requirements
Limited execution with
1 Maintain Limited documentation
major non-conformances
Limited evidence of requirement
No evidence of Element required but no evidence of execution or
0 Unacceptable No documentation
implementation understanding
N/A N/A Not Required Not Required Element not required
 Supplier On-Site Assessment
Supplier Key Information
JF-PU-05, Revision 14.12.1 (December 3, 2014)

Company Name
Company Address

Contacts
Titles Name Phone Number E-Mail Address
Sales Contact
President/CEO
Financial Officer
Quality Manager

General Information Key Customers

Date of Establishment Customer Name % Business
Head Office Location
Location of Incorporation
# of Locations
Facility Square Footage
Fiscal Year Ending

Listed in Dun & Bradstreet? D&B Number?

Ownership Key Suppliers

Public or Private? Supplier Name % Business
If Private, Name of Owner(s)

Minority Owned?
Union Workforce?
If Yes, Union Name
Federal Tax ID Number
Contract Expiration
Last Work Stoppage?

Manpower (Please provide the number of employees by area)

Area Number of Employees Average Length of Tenure
Management/Office Personnel
Product Design/Engineering
Manufacturing
Quality
Other

Supplier On-Site Assessment

Supplier Key Information
JF-PU-05, Revision 14.12.1 (December 3, 2014)
 Supplier On-Site Assessment
Supplier Key Information
JF-PU-05, Revision 14.12.1 (December 3, 2014)

Actual Plan
Capital Investment (in 1,000 USD)
[Enter Year] [Enter Year] [Enter Year] [Enter Year] [Enter Year]
Business & Facilities
Machinery & Equipment
Tooling
Office Furniture
Other
Total Investment

Continuous Improvement
What major improvements have you recently implemented and what are your next steps?
 Supplier On-Site Assessment
JF-PU-05, Revision 14.12.1 (December 3, 2014) Supplier Score #DIV/0!
Jackson Score #DIV/0!

Supplier Information
Supplier Name: Vendor ID #:
Plant Location: Phone #:

Supplier Contact: Supplier E-Mail:

Audit Information
Lead Name: Auditor Name:
Lead E-Mail: Auditor E-Mail:
Lead Phone: Auditor Phone:
Audit Date: Cooper Division:

1. Customer Satisfaction Supplier Jackson Observations / Evidence

1.1 There is a process in place for determining customer satisfaction that is updated at regular intervals.

Metrics monitoring customer satisfaction are understood and tracked (examples include customer returns,
1.2
warranty, on-time delivery).
There are projects and programs in place to improve customer satisfaction, with corrective actions addressed,
1.3
and a closed-loop review system progress

1.4 Customer dedicated service group with multifunctional team has been established for key accounts

Customer Satisfaction Section Score: #DIV/0! #DIV/0!

2. Quality System Supplier Jackson Observations / Evidence

2.1 Do you have a quality system registered to a recognized standard?

2.2 There are regular, periodic Management Reviews to verify the effectiveness of the quality system.

Each department has goals that are defined and measured and focus on the use quality policy, objectives,
2.3
audit results, analysis of data, corrective / preventive actions

Management regularly reviews the status of the Preventive Maintenence completion to plan. Management
2.4 reviews corrective action plans to ensure any backlog (past due) maintenance has a plan to become current to
the PM schedule.

2.5 Internal audit frequency is modified based on non-conformance trends.

2.6 Internal audits are available to verify that the quality system is being followed.

2.7 A formal business/manufacturing system is in place ( Capacity Planning, Shop Floor Control, ERP, etc.)

2.8 Proactive notification of issues which could affect delivery or quality are documented and performed

2.9 Does the Supplier have a process for final product identification, including bar code, if required.
Does the supplier obtain customer waiver (concession/deviation) prior to further processing when the
2.10 product/process is different from what is approved? And are shipping containers properly identified when this
occurs?
Quality System Section Score: #DIV/0! #DIV/0!
3. Business System Supplier Jackson Observations / Evidence

3.1 A Customer-focused strategy has been developed and deployed to ensure business portfolio diversity

Is there evidence and use of tools like Electronic Data Interface (EDI), Request For Quote (RFQ), Advanced
3.2
Planning and Scheduling (APS) ?
Have contingency plans been prepared to satisfy customer requirements in the event of an emergency such as
3.3
utility interruptions, labor shortages, key equipment failures, and field returns?

3.4 Is there a process to address product liability / recall issues?

Does the supplier have a long-term plan for sustainability, including a system in place to identify key business
3.5
and product risks and opportunities?
Are the Purchase Orders reviewed for commitment to qty, price, delivery date, delivery method, and any
3.6 additional special requirements or instructions? If any differences arises the differences are resolved prior to
acceptance of the order.
Personnel performing specific tasks shall be qualified on the basis of appropriate education, training, and/or
3.7
experience.
Business System Section Score: #DIV/0! #DIV/0!
4. EHS and Risk Management Supplier Jackson Observations / Evidence
An effective process for EHS is formally defined, well documented and understood with systematic root cause
4.1
investigation and tracked corrective actions for all EHS defects
A well documented and understood effective process is in place, that requires formal risk assessment upon
4.2
change or initial set-up of equipment.
Knowledge of each waste stream, final location, regulatory permit states of the disposal site, and quantity
4.3
involved.
Does the company comply with OSHA or other applicable safety and health regulations, specifically in the use
4.4
of Personal Protection Equipment?

4.5 Procedures in place for hazardous substance control

4.6 Emergency Action and Disaster Recovery Plans established and in place

All governing requirements are effectively in place (i.e. RoHS, UL/ETL, NSF, Conflict Materials, WEEE) and all
4.7
materials are approved under applicable requirements.
EHS and Risk Management Section Score: #DIV/0! #DIV/0!
5. New Product Development Supplier Jackson Observations / Evidence
A formalized New Product Introduction process has been established for new product development projects:
New Product Development Questions

- Process identifies key milestones and tollgates

- Includes evidence of training on the process
- Documented inputs/outputs for each critical phase
DESIGN RESPONSIBLE SUPPLIERS

-Process shows evidence of Advanced Product Quality Planning techniques (APQP)

There is a process in place to ensure key elements of the Product Design and Development are performed:
- Engineering drawings & spec.
- Design for Manufacturability and Assembly
- DFMEA
-Development of Prototypes
- Design review and verification
- Material spec.
- Drawing & spec changes
- Evidence of design validation testing and confirmation
Process in place to ensure key elements of the process design, development and validation are performed:
- Product / Process quality review
- Floor Plan Layout
- Packaging standards and spec
- Preventive Maintenance Planning
- Process Capability Study
- Testing and Measurement
New Product related questions

- Production validation testing

N/A N/A
N/A N/A
N/A N/A
N/A N/A
N/A N/A
N/A N/A
N/A N/A
N/A N/A
N/A N/A
N/A N/A
N/A N/A
N/A N/A
N/A N/A
N/A N/A
New Product Development Section Score: #DIV/0! #DIV/0!
6. Purchasing and Sub-Supplier Management Supplier Jackson Observations / Evidence

Purchase Order's are used to communicate product requirements to sub-suppliers to ensure the requirements
6.1
are understood and can be met. Differences are resolved prior to acceptance of the order.

6.2 Quality requirements are communicated to the sub-suppliers

6.3 Product and capacity requirements are understood throughout the facility and supply chain

6.4 Sub-supplier performance is evaluated on a regular basis

6.5 A vendor approval process is employed.

6.6 Sub-suppliers are required to submit first articles samples prior to acceptance.

6.7 Material certification is employed.

Purchasing and Sub-Supplier Management Section Score: #DIV/0! #DIV/0!

7. Production Control and Planning Supplier Jackson Observations / Evidence

7.1 Is Statistical Process Control being used?

Utilization of product control plans with inspection requirements and identification of key product/process
7.2
characteristics
7.3 Process set up verification is used and documented
The supplier has and maintains a system for traceability on individual product or batches as
7.4
required.
Inspections based on appropriate sampling plans and are sufficient to detect product nonconformance. Do the
7.5
inspection items on the inspection plan meet Customer requirement?

7.6 An Incoming Inspection process is in place.

Is there evidence of in-process checks, including final inspection, to validate the manufacturing process and
7.7
the packaging requirements?
Production Control and Planning Section Score: #DIV/0! #DIV/0!
8. Change Management Supplier Jackson Observations / Evidence
8.1 An effective change control process is formally defined, well documented and understood. Strict advance
customer notification process is followed, prior to executing the change.
8.2 There is a drawing change control system that also provides access to latest revisions for use by employees as
required.
8.3 Does the supplier have a process to assure the timely review, distribution and implementation of all customer
engineering standards/specifications and changes including a record of the date on which each change is
implemented in production
8.4 Is there a process to ensure parts, product, and materials comply with environment and regulatory
requirements
Change Management Section Score: #DIV/0! #DIV/0!
9. Inventory Control and Housekeeping Supplier Jackson Observations / Evidence
Is there a warehouse management system in place that uses formal inventory control systems like First in First
9.1
Out (FIFO)?
9.2 Are materials kept within a controlled environment?

9.3 There is a process for continuous improvement in the areas of cleanliness and organizations (i.e 5S).

9.4 Finished and released product/containers are properly labeled and identified

9.5 Work instructions contain steps/comments about area and/or part cleanliness where applicable.

Inventory Control and Housekeeping Section Score: #DIV/0! #DIV/0!

10. Corrective Action and Control of Non-Conforming Product Supplier Jackson Observations / Evidence
10.1 A corrective action procedure exists and is followed for internal quality issues

10.2 A corrective action procedure exists and is followed for supplier quality problems

10.3 A corrective action procedure exists and is followed for customer issues.

10.4 Problem solving is done in cross-functional teams, using a disciplined problem solving process (e.g. 8D or 7D)?

10.5 Root Cause analysis and corrective action response are completed within agreed upon time frame.

10.6 Nonconforming material is identified and controlled to prevent its use or shipment to customers in receiving, in-
process, outgoing and customer returns
10.7
Returned material is analyzed for determination of cause for rejection and initiation of corrective action

10.8
Corrective actions are verified for suitability and effectiveness at some interval after implementation?

10.9 Incoming Quality Operator follows a reaction plan if raw material or purchased part is found to be out of
specification.
10.10
Reworked material is re-qualified prior to use or shipment

Corrective Action and Control of Non-Conforming Product Section Score: #DIV/0! #DIV/0!
11. Continuous Improvement Supplier Jackson Observations / Evidence
11.1 Does the supplier use management reviews to guide and track continuous improvement projects.
11.2
There is a documented plan/schedule for continuous improvement.

11.3 The supplier implements a standardized method of continuous improvement activity (i.e. Kaizen, Poka Yoke).

11.4 The supplier plans for continuous improvement as it relates to the evaluation of the effectiveness of the quality
systems.
Continuous Improvement Section Score: #DIV/0! #DIV/0!
12. Measurement and Test Supplier Jackson Observations / Evidence

12.1 Is there a calibration program in place for critical tools and instruments?

Does the supplier evaluate the impact on the product when an out-of calibration issue is identified? Reaction
12.2
plans are identified and followed.

12.3 Calibration records are maintained and easily accessible?

If the measuring devices are calibrated internally, a qualified internal calibrator is a must. The calibrating
12.4
methods and instructions for internally-calibrated devices shall be documented.
Master gages / standards are traceable to a recognized national / international standard.
12.5
(for example: NIST)
Calibration status readily available to operators. The expiration date of the calibration is shown.
12.6

12.7 The appropriate precision of the gage based upon print tolerances is determined.
Measurement and Test Section Score: #DIV/0! #DIV/0!
13. Process Walk Supplier Jackson Observations / Evidence
13.1 Process work instructions are documented, up-to-date, available to operators, and are being followed.

13.2 Setup and operating parameters are documented and utilized as specified.
13.3 Required tools and inspection equipment are identified for each operation and are utilized as specified.

13.4 Each setup is qualified prior to the start of production as required and critical parameters are identified,
reviewed and approved.
13.5 Repaired production tooling is qualified prior to production use and results documented.
13.6 Is there a culture of "pride in workmanship" by the employees? Are employees actively engaged in maintaining
a safe, effective work environment?
13.7 Material identification, acceptance status, and control of non-conforming material is maintained throughout
the manufacturing process and while product is in storage.
13.8 There are control plans that exist for each part number/process, that include the following:
- Standard for approval and rejection
- Signature and date
- Reaction plans for out of control conditions
- Characteristics to be inspected and/or tested
- Engineering revision level
- Sample size and frequency of observations
- Methodology and tools to be used for inspection and/or test
All inspections are completed, per the control plan, before inventory (stores) or shipping and include records of
appropriate product characteristics.
Are the basic statistical methods widely used to measure the process / product, such as checklist, histogram,
trends chart and etc., where applicable.
Where statistical methods are utilized for control of key characteristics and process parameters
- Evaluate how they are chosen
- Define what are the statistical methods used
- Determine if the appropriate level of control is established
13.9 Where the Process Control Plan calls for SPC,
- Is the data properly recorded?
- Does the data make sense and are reasonable control limits shown?
- Are out of control points noted with the corrective action taken?
- Does the manufacturing process demonstrate the required capability or performance?
Process Walk Section Score: #DIV/0! #DIV/0!
 Supplier On-Site Assessment
Corrective Action Form
JF-PU-05, Revision 14.12.1 (December 3, 2014)

Supplier Information
Supplier Name: 0 Vendor ID #: 0
Plant Location: 0 Phone #: 0

Supplier Contact: 0 Supplier E-Mail: 0

Audit Information
Lead Name: 0 Auditor Name: 0
Lead E-Mail: 0 Auditor E-Mail: 0
Lead Phone: 0 Auditor Phone: 0
Audit Date: 0 Cooper Division: 0

No. Item Non-Conformance NCR Number Responsibility Due Date Verification Date and Comments

10

11

12

13
 Supplier On-Site Assessment Summary
JF-PU-05, Revision 14.12.1 (December 3, 2014) Supplier Score #DIV/0!
Jackson Score #DIV/0!

Supplier Information
Supplier Name: 0 Vendor ID #: 0

Plant Location: 0 Phone #: 0

Supplier Contact: 0 Supplier E-Mail: 0

Audit Information
Division : 0 Auditor Name: 0
Commodity Family: 0 Auditor E-Mail: 0
Product Type: 0 Auditor Phone: 0
Audit Date: 0 Cooper Division: 0

Initial (Self) Assessment Summary

Customer… Points
Section Score
100% Total Possible Percentage
Process Walk Quality System
80% Customer Satisfaction 0 0 #DIV/0! #DIV/0!
Quality System 0 0 #DIV/0! #DIV/0!
Measure and Test 60% Business System
Business System 0 0 #DIV/0! #DIV/0!
40% EHS and Risk Management 0 0 #DIV/0! #DIV/0!
Continuous…
20%
EHS and Risk… New Product Development 0 0 #DIV/0! #DIV/0!
0% Purchasing and Sub-Suplier Management 0 0 #DIV/0! #DIV/0!
Production Control and Planning 0 0 #DIV/0! #DIV/0!
Corrective… New Product… Change Management 0 0 #DIV/0! #DIV/0!
Inventory Control and Housekeeping 0 0 #DIV/0! #DIV/0!
Corrective Action and Non-Conforming Prod. 0 0 #DIV/0! #DIV/0!
Inventory… Purchasing and… 0 #DIV/0! #DIV/0!
Continuous Improvement 0
Change… Production… Measure and Test 0 0 #DIV/0! #DIV/0!
Process Walk 0 0 #DIV/0! #DIV/0!

Jackson Assessment Summary

Customer Points
Satisfaction Section Score
Total Possible Percentage
Process Walk
100% Quality System Customer Satisfaction 0 0 #DIV/0! #DIV/0!
80%
Quality System 0 0 #DIV/0! #DIV/0!
Measure and Test 60% Business System Business System 0 0 #DIV/0! #DIV/0!
40% EHS and Risk Management 0 0 #DIV/0! #DIV/0!
Continuous 20% EHS and Risk New Product Development 0 0 #DIV/0! #DIV/0!
Improvement 0% Management Purchasing and Sub-Supplier Management 0 0 #DIV/0! #DIV/0!
Production Control and Planning 0 0 #DIV/0! #DIV/0!
Corrective Action New Product
Change Management 0 0 #DIV/0! #DIV/0!
and Non-… Development
Inventory Control and Housekeeping 0 0 #DIV/0! #DIV/0!
Inventory Control Purchasing and Corrective Action and Non-Conforming Prod. 0 0 #DIV/0! #DIV/0!
and Housekeeping Sub-Supplier… Continuous Improvement 0 0 #DIV/0! #DIV/0!
Change Production
Management Control and… Measure and Test 0 0 #DIV/0! #DIV/0!
Process Walk 0 0 #DIV/0! #DIV/0!

On-Site Assessment Scoring

Overall Score Segmentation Description

All Green Current Supplier: Supplier is currently performing at a Level 1 - Recommend strongly
Level 1- Strategic
>79% New Supplier: Performance is consistent with Level 1 performance - Recommend strongly
Current Supplier: Not currently performing at a Level 1 but has the potential with minimal improvements. Existing business
can continue and the supplier can be considered for new business - Recommend with Corrective Actions
60-79% Level 2 - Preferred
New Supplier: Has the potential to perform at a Level 1 with minimal improvements required - Recommend with Corrective
Actions
Current Supplier: Corrective actions are needed for the supplier to improve performance. During this time, business can
continue upon review of corrective actions - Not Recommended - Source with Risk
40-59% Level 3 - Maintain
New Supplier: Significant corrective actions needed to bring the performance to an acceptable level - Not Recommended -
Source with Risk
Current Supplier: Performance not consistent with minimum Cooper standards. Not Recommended for New Business. A
< 39% Level 4 - Non-Performing corrective action plan must be provided and implemented within 60 days. Failure wil result in alternative site sourcing
New Supplier: No new business will be awarded. Not Recommended - Do Not Source