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‫‪Form Number: 2100-F-067/03-1/2‬‬

‫ﭼﻚ ﻟﻴﺴﺖ ﺍﺭﺯﺑﺎﺑﻲ ﻋﻤﻮﻣﻲ ﺗﺄﻣﻴﻦ ﻛﻨﻨﺪﮔﺎﻥ)ﺗﻮﻟﻴﺪ ﻛﻨﻨﺪﮔﺎﻥ ﻭ ﺳﺎﺯﻧﺪﮔﺎﻥ(‬

‫)‪[∑(wiyi)100]/ MAX(wi2‬‬ ‫ﻓﺮﻣﻮﻝ ﻣﺤﺎﺳﺒﻪ ﺍﻣﺘﻴﺎﺯ=‬ ‫ﻧﺎﻡ ﺗﺄﻣﻴﻦ ﻛﻨﻨﺪﻩ‪:‬‬

‫ﻭﺿﻌﻴﺖ ﺍﻧﻄﺒﺎﻕ‬
‫ﺍﻣﺘﻴﺎﺯ ﻧﻬﺎﻳﻲ‬ ‫ﻧﻴﺎﺯﻣﻨﺪ‬ ‫ﻭﺯﻥ‬

‫ﺭﺩﻳﻒ‬
‫ﭘﺮﺳﺶ ﻫﺎ‬
‫ﻋﺪﻡ ﺍﻧﻄﺒﺎﻕ‬ ‫ﺍﻧﻄﺒﺎﻕ ﻛﺎﻣﻞ‬
‫)‪(WiYi‬‬ ‫ﺍﺻﻼﺡ‬ ‫‪Wi‬‬
‫‪Y=0‬‬ ‫‪Y=2‬‬
‫‪Y=1‬‬
‫‪2‬‬ ‫ﻭﺍﺣﺪ ﻭ ﺳﺎﺑﻘﻪ ﻃﺮﺍﺣﻲ ﻭ ﻣﻬﻨﺪﺳﻲ‬ ‫‪1‬‬
‫‪3‬‬ ‫ﮔﻮﺍﻫﻴﻨﺎﻣﻪ ﻫﺎﻱ ﺳﻴﺴﺘﻤﻬﺎﻱ ﻣﺪﻳﺮﻳﺖ ﻛﻴﻔﻴﺖ‬ ‫‪2‬‬
‫‪4‬‬ ‫ﺗﺎﻳﻴﺪﻳﻪ ﻣﻮﺳﺴﻪ ﺍﺳﺘﺎﻧﺪﺍﺭﺩ ﻳﺎ ﻣﺮﺍﺟﻊ ﺑﻴﻦ ﺍﻟﻤﻠﻠﻲ‬ ‫‪3‬‬
‫‪5‬‬ ‫ﮔﺎﺭﺍﻧﺘﻲ ﻭ ﻭﺍﺭﺍﻧﺘﻲ‬ ‫‪4‬‬
‫‪4‬‬ ‫ﮔﻮﺍﻫﻴﻨﺎﻣﻪ ﻫﺎﻱ ﺳﻴﺴﺘﻤﻬﺎﻱ ‪HSE‬‬ ‫‪5‬‬
‫‪2‬‬ ‫ﻭﺍﺣﺪ ﻛﻨﺘﺮﻝ ﻛﻴﻔﻴﺖ)‪(QC‬‬ ‫‪6‬‬
‫‪4‬‬ ‫ﻗﺪﺭﺕ ﻣﺎﻟﻲ ﻭ ﭘﺸﺘﻴﺒﺎﻧﻲ‬ ‫‪7‬‬
‫‪3‬‬ ‫ﺗﺎﻳﻴﺪﻳﻪ ﻣﺤﺼﻮﻝ ﻳﺎ ﺭﺿﺎﻳﺖ ﻛﺎﺭﻓﺮﻣﺎﻳﺎﻥ‬ ‫‪8‬‬
‫‪3‬‬ ‫ﺳﻮﺍﺑﻖ ﻫﻤﻜﺎﺭﻱ ﺑﺎ ﺷﺮﻛﺖ ﻫﺎﻱ ﺗﺎﺑﻊ ﻧﻔﺖ‬ ‫‪9‬‬
‫‪4‬‬ ‫‪ 10‬ﺳﺎﺑﻘﻪ ﺻﺎﺩﺭﺍﺕ‬
‫‪2‬‬ ‫‪ 11‬ﻫﻤﻜﺎﺭﻱ ﻫﺎﻱ ﺧﺎﺭﺟﻲ‬
‫‪2‬‬ ‫‪ 12‬ﻋﻀﻮﻳﺖ ﺩﺭ ﺍﻧﺠﻤﻦ ﻫﺎ ﻭ ﻣﻮﺳﺴﺎﺕ ﭘﮋﻭﻫﺸﻲ‬
‫ﺟﻤﻊ‪:‬‬

‫=ﺩﺭﺻﺪ ﺍﻣﺘﻴﺎﺯ ﻛﻞ‬

‫ﻧﺘﺎﻳﺞ‪:‬‬
‫‪Grade A: 100-80‬‬
‫‪Grade B: 50-80‬‬
‫‪Grade C: 30-50‬‬
‫≤‪Grade D: 30‬‬
‫ﻻﺯﻡ ﺑﺬﻛﺮ ﺍﺳﺖ ﮔﺮﻳﺪ ‪ D‬ﭘﺬﻳﺮﻓﺘﻪ ﻧﻤﻲ ﺑﺎﺷﺪ‪.‬‬

‫ﺍﻳﻦ ﻣﻬﺮ ﻭ ﺍﻣﻀﺎء ﺑﻪ ﻣﻨﺰﻟﻪ ﺁﮔﺎﻫﻲ ﻛﺎﻣﻞ ﺍﺯﻣﻨﺪﺭﺟﺎﺕ ﻓﻮﻕ ﺑﻮﺩﻩ ﻭ ﺍﺩﻋﺎﻱ ﻋﺪﻡ ﺁﮔﺎﻫﻲ ﺑﻪ ﻫﻴﭻ ﻋﻨﻮﺍﻥ ﻣﺴﻤﻮﻉ ﻧﺨﻮﺍﻫﺪ ﺑﻮﺩ ‪.‬‬
‫ﻣﻬﺮ ﻭ ﺍﻣﻀﺎء ﭘﻴﺸﻨﻬﺎﺩ ﺩﻫﻨﺪﻩ‬

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