SUPPLIER SELF-AUDIT QUESTIONNAIRE

PUR-FT- 06
w.e.f 01.12.09

1 GENERAL INFORMATION
Sr. Supplier Details
1.1 Organisation Name :

1.2 Address :

1.3 Fax No.

1.4 Technical Contact Name :
1.5 Designation :
1.6 Contact No. :
1.7 E-Mail Id :
1.8 Commercial Contact Name :
1.9 Designation :
1.1 Contact No. :
1.11 E-Mail Id :
1.12 Emergency Contact Name :
1.13 Designation :
1.14 Contact No. :
1.15 E-Mail Id :
1.16 No. of Employees :
1.17 Accreditation Details : (Please attach certificate copies.)
1.18 ISO 9001 / ISO 140001 :
1.19 HACCP / BRC/IoP :

1.2 Products Supplied to Supreme :

1.21 Name & Designation :

1.22 Signature :

1.23 Company Seal :

 SUPPLIER SELF-AUDIT QUESTIONNAIRE
PUR-FT- 06
w.e.f 01.12.09

2.
Sr. Criteria Comply
2.1 Does the company have a documented QMS system? Yes / No
2.2 Does the company have a document of Quality Policy? Yes / No
2.3 How quality policy is communicated to employees? Yes / No
2.4 Are legislative requirement & Hygiene is a part of quality policy? Yes / No
2.5 Is company carrying out regular system / management reviews? Yes / No
2.6 Do you have a documented product recall procedure? When was Yes / No
it last tested?
2.7 Does the company carry out internal audit of QMS, GMP & Yes / No
Hygiene? If so what is the audit frequency? When was the last
audit conducted?
2.8 Do trained auditors carry out audits? Yes / No
2.9 Is there a formal system to deal with customer complaints? Who Yes / No
is responsible for customer complaints?
2.10 Do you enclose a test certificate along with consignments? Yes / No
2.11 Do you take corrective action / preventive action on the customer Yes / No
complaints? Please attach your corrective / preventive action
procedure.
2.12 Do you have full trace ability system from Raw materials till Yes / No
finished product? If yes briefly explain your upward & downward Yes / No
traceability system? Yes / No
2.13 Do you have product specification & Raw material specification Yes / No
for all products? Are these controlled?
2.14 Do you have full trace ability system from Raw materials till Yes / No
finished product? If yes briefly explain your upward & downward
trace ability system?
2.15 Do you have in house Laboratory for necessary tests & inspection? Yes / No
2.16 Do you get any tests done form outside lab? Are these Yes / No
laboratories accredited? If yes, provide evidence.
2.17 Is their policy for control of wood in manufacturing area? Yes / No
2.18 Is there a documented blade & knife control Policy & Procedure? Yes / No
2.19 Do you verify the Traceability System implemented by your Yes / No
suppliers?
 SUPPLIER SELF-AUDIT QUESTIONNAIRE
PUR-FT- 06
w.e.f 01.12.09

3 RAW MATERIALS
Sr. Criteria Comply
3.1 Does the company have procedure for selecting / approving & Yes / No
monitoring supplier of materials, services, transport and
warehouse facilities?
3.2 How do you control nonconforming purchased products? Yes / No
Are specifications formally approved & signed by you & the
supplier?
3.3 How often the specifications are reviewed? Yes / No

4 PROCESS CONTROL
Sr. Criteria Comply
4.1 Are all critical processing conditions are monitored? Yes / No
4.2 Have all measuring equipments are calibrated to national Yes / No
standard?
4.3 Please explain as how the nonconforming products are identified, Yes / No
labeled, reworked & recorded in the system. Attach copy of your
procedure.
4.4 Have you done any hazard analysis (HACCP) of your process? If Yes / No
yes, please enclose a copy of your HACCP Plan
4.5 Do you subcontract any manufacturing? If yes, please explain as Yes / No
how you have approved the subcontractor’s site.

5 CONTAMINATION CONTROL & HYGIENE

Sr. Criteria Comply
5.1 Do you have GMP to prevent any contamination during Yes / No
manufacturing?
5.2 Do you have procedure in place for the control of glass & hard Yes / No
plastic in production & non-production areas?
5.3 Do you have glass & hard plastic breakage procedure? Yes / No
5.4 Do you maintain a glass register? How often it is been reviewed? Yes / No
5.5 Is all glass is protected and controlled? Yes / No
5.6 Are documented cleaning schedules, procedures & record in Yes / No
place?
5 CONTAMINATION CONTROL & HYGIENE
5.7 Is the cleaning work regularly checked and recorded independently? Yes / No
 SUPPLIER SELF-AUDIT QUESTIONNAIRE
PUR-FT- 06
w.e.f 01.12.09

5.8 Are incoming vehicles & dispatch vehicles checked for any Yes / No
contaminants? Are records for the same maintained? What is the
procedure if during checks the vehicles are rejected?
5.9 Are suppliers of contracted transport and distribution audited to Yes / No
ensure that they maintain condition that will not risk
contaminating products?
5.10 Are hands washing facilities provided at entry points where Yes / No
appropriate?
5.11 Are eating / drinking & smoking banned in changing room & Yes / No
operational areas?
5.12 Are toilets / bathrooms are maintained clean & monitored Yes / No
regularly?
5.13 Are wooden articles controlled in production areas? Yes / No
Are any wooden materials are used for packing finished products
supplied to SUPREME? If yes, are these wooden items are
fumigated / treated appropriately to avoid wood contamination
during storage at SUPREME? Provide copy of fumigation
certificates with the consignments.

6 FACTORY AND GROUNDS

Sr. Criteria Comply
6.1 Are external areas of site maintained clean & tidy? Yes / No
6.2 Is process flow & equipment designed maintained, laid out to Yes / No
minimize risk of cross contamination?
6.3 Is temporary engineering allowed on the equipments? If yes, is it Yes / No
logged & controlled to ensure permanent repairs within a
specified period?
6.4 Maintenance work is followed by documented cleaning method to Yes / No
minimize the risk of contamination?
6.5 Do you have yearly maintenance program in place? Are records Yes / No
of maintenance being maintained? Provide a copy of Annual
Maintenance Plan.
6.6 Is production floor is kept free from dust contamination? Yes / No

7 PEST CONTROL
 SUPPLIER SELF-AUDIT QUESTIONNAIRE
PUR-FT- 06
w.e.f 01.12.09

Sr. Criteria Comply

7.1 Does the company have formal pest control program in place? Yes / No
7.2 Is the pest control contractor used to provide the service? If yes, Yes / No
what is the name of the pest control company? Also attach the
scope of pest control work carried out.
7.3 Are all technician & biologists employed by the contractor are Yes / No
trained to the recognized pest control qualification?
7.4 Have insecticutor appropriately positioned to ensure insect Yes / No
control?
7.5 Are finished products protected from contamination during Yes / No
storage & distribution? If yes, please explain the methods of
protection / precaution.
7.6 Are ornaments, Jewellery, wristwatches are controlled from Yes / No
taking to production areas?
7.7 Is wearing of protective clothing’s & headgears compulsory in Yes / No
production areas?
7.8 What policy is adopted if the employee is suffering from diseases, Yes / No
which can affect product safety? Please explain briefly.
7.9 Do all new staffs receive documented induction training including Yes / No
hygiene rules? If yes, records for the same are maintained?
7.10 Are staff given formal training in the following and please state as Yes / No
to how the effectiveness of training is verified
a. Food hygiene
b. Specific tasks
c. HACCP
d. Safety

8 ETHICAL SOURCING
Sr. Criteria Comply
8.1 Does the company adhere to applicable all local laws and Yes / No
regulations? ( Attached copy ) - Mandatory.
8.2 Are working conditions safe and hygienic? Yes / No