Sanok RC S.A. / Questionnaire
Information about supplier of Sanok RC S.A. / JSF-W1.3.001 form
belongs to Selection and Evaluation of Supplier Guide
page 1 / pages 4

Dear Sirs!

Knowing our supplier and their productive potential is of significant importance for Sanok RC S.A. in the scope of forming of effective and profitable for both parties principles of cooperation with suppliers.

Taking it into consideration we adress you with a request to provide us with information in the questionnaire.

In case of any significant changes, please send us all the updates. Also, please update the information about your company by the end of each year.

We inform contemporaneously, that data delivered to us by you will be available exclusively for the persons responsible for realization of the purchasing process at Sanok RC S.A.. Information transferred by you is being treated as confidential and will not be made available to third parties without written consent from you.

Yours sincerely,

SanokRubber Company S.A. Purchasing

Number of supplier in Sanok RC S.A.: / New supplier:
Section A: Supplier’s contact person
Person responsible for questionnaire at the supplier / Name: / Position:
e-mail: / phone.:
Date: / Sections updated: First questionnaire?
Section B: Communication data:
Name of the company
Address
Telephone headquarters:
E-mail (general)
Web page
Fax
Section C: Management of the company, persons responsible for areas of the activity of the company:
Item / Position / Name / Position / Telephone fax e-mail
1 / Persons authorized to make statements of will
2 / Business matters
3 / Production
4 / Quality
5 / Person responsible for contacts with Sanok RC SA / Mobile phone
6
7
SectionD: Remaining data referring to the company:
Name of the bank
Account number
Tax (VAT) Identification Number
Registration in the court register /
Registration in register / (please enclose actual copy of the registration in the court register / Registration in register)
Form of property: / Private company / individual
Ordinary partnership
Limited liability company / the Treasury company
Joint stock company
Foundation
Property structure (shareholders etc.)
Section E: Data about the company activity
Income from sale [mln PLN] current / last year
Expenses for investments [mln PLN] current / last year
Net profit before tax [mln PLN] current / last year
Capital (basic/share/initial)
Kind of company insurance / Amount of insurance: [mln PLN]
Section F: Employment data / Number of employed persons / Other remarks. (e.g. info about temporary employment)
Employment: (present state,number of employed on the base of contract; other remarks. e.g. info about the other form of employment)
Total:
Production:
Engineering / design:
Logistics / warehouse:
Sale / trade:
Quality:
Section G: Type of activity and range of production / Only commercial activity? Yes No
Component parts
Machining
Cutting out metal plates
Presswork
Extrusion moulding
Founding of steel and cast iron
Founding of aluminium
Forging
Production of steel pipes
Production of aluminium pipes
Production of metal plates / metal strips
Other metal products
Galvanic treatment
Other surface treatment / coatings / Raw materials
Rubber
Carbon black
White fillers
Chemicals
Plasticizer, production oils
Plastics
Other chemicals
Half-finished products
Plastic moulding parts
Plastic extrusion parts
Fabrics / textiles
Rubber compounds / Production devices
Measurement devices
Software / IT systems
Services: production / logistic / other
Section H: Machinery (including control-measuring devices)
We are asking to enclose the list in the electronic form (MS Word, MS Excel, .rtf, or .txt)) containing following data:
Type of device (1), manufacturer (2), year of production (3), key parameters of the device (4),
form of the property / owner
We possess our own laboratory (if yes please present the range: )
SectionI: Detailed data referring to the location of production
List of separate localizations(different postal codes) where the activity is runned:
General number of buildings:
Land: arProduction area: m2
Office area: m2Warehouse area: m2 – number of pallet places
The most often form of property Does the property has a mortgage? ?
SectionJ: Data concerning internet infrastructure
Technical data of access to internet (supplier, bandwidth and the like)
Information systems utilized for business management (manufacturer, name, covered areas)
SectionK: Capability of the company in the range of designing:
CAD/CAM software (type, manufacturer, number of posts / licences), modules
Preferred format of the data exchange / 2D: / 3D:
Number of persons trained / working in CAD/CAM
Section L: Main customers / referential list and range of cooperation
Name / Country / Assortment / Sales volume
Section M: Key suppliers of raw materials / of semi-finished products:
Name / Country / Assortment / Purchase volume
SectionN: Capability of the company in the field of reaction to complaints:
Possibility to sort (description - principles of the organization, efficiency, person responsible for realization and the like):
Mass dimensional control (description - principles of the organization, efficiency, person responsible for realization and the like):
SectionO: Logistic data
Road distance to Sanok RC SA
Warehouse opening hours / from Monday to Friday from to
on Saturdays from to
Responsible person: / Telephone / e-mail
System of work: 1 shift / day 2 shifts / day 3 shifts / day 4 shifts / day other which?
Description of the system of work if "other":
SectionP: Quality management system:
Elements / applied methods/ availble in organization
Quality book / SPC
APQP / 8D
FMEA / MSA
Certification of Quality and Environmental Management System – please match and enclose a certificate
Certificate / Possessed / Planned certification / Date of certification / Certification organization / Comments
ISO 9001
ISO/TS 16949
ISO 14001/EMAS
OHSAS 18001
Other
Section R: Enclosures
Copy of registration (Section D) / List of machines and devices (Section H) / Information folder (Section G)
Organizational chart (Section C) / Financial report (Section E) / Copy of certificate (Section P)

END OF DOCUMENT

Poufnewyd. 4, sierpień 2007