AMMROC Proprietary Information
QMS-400-019 D Rev 02

AMMROC Supplier Survey: Non Product and Temporary approval

When complete, please e-mail completed questionnaire to the following address:

AMMROC HQ:

I hereby confirm that all responses and information provided herein is to the best of my knowledge true, accurate and correct.

NAME / POSITION
SIGNATURE / DATE
COMPANY IDENTIFICATION
FULL LEGAL BUSINESS NAME
REGISTERED ADDRESS
DATE COMPANY STARTED
COUNTRY
TRADE LICENCE* / ATTACHED? YES NO
CAGE CODE
DUNS NUMBER (If applicable)
* Please provide a copy of a valid trade license or certificate of company incorporation / registration or similar documentation issued by the Competent Trade Authority for your business jurisdiction.
ORGANIZATION / OWNERSHP
ORGANIZATION /

SOLE PROPRIETOR PARTNERSHIP

CORPORATION JOINT VENTURE

PERCENTAGE OF COMPANY OWNERSHIP /

Name

/

Value

/

Currency

/

Percentage

Date of Incorporation /

Number of Years in Business

Number of Employees
JURISDICTION OF INCORPORATION /

UAE OWNED & OPERATED NON-UAE OWNED (SPECIFY)

Emirates ID copy for all Owners (for all UAE registered LLC companies, Proprietorships & Partnership Entities)
Trade License copies of owners if your company is owned by another company.
NATIONALIZATION
PARTICIPATION /

% PERCENTAGE OF UAE NATIONALS EMPLOYED

TYPE OF BUSINESS /

MANUFACTURER CONSTRUCTION – Specify Grade Below:


SERVICE PROVIDER
DISTRIBUTOR
OTHER (DESCRIBE)
BUSINESS SIZE /

Small Business ≤ 250 Employees

Medium Business ≤ 500 Employees

Large Business ≤ 1000 Employees

Enterprise ≥ 1000 Employees
ACTIVITIES AS PER TRADE LICENSE:
POINTS OF CONTACT
PRIMAMRY CONTACT / FINANCE CONTACT
TITLE / TITLE
PHONE NUMBER / PHONE NUMBER
MOBILE PHONE / MOBILE PHONE
EMAIL / EMAIL
LEGAL COMPLIANCE / Yes / NO
1 / Does your company have a compliance and business practices program/policy?
2 / Does your company have an Ethics program /policy?
3 / Does your company have a delegation of authority policy?
4 / Does your company have a conflict of interest, gifts and gratuities policy?
5 / Does your company have a protection of intellectual and confidential information program/policy?
6 / Does your company have an anti-bribery program/policy?
7 / Has your company performed Government contracts in the last 5 years?
8 / Does your company have export jurisdiction and classification for the product(s)/service(s) it provides?
9 / Does your company have an export control program? (If yes – please provide a point of contact)
10 / Does your company provide regular export compliance training to its employees?
11 / Is your company currently, or has it been in the last three years, involved in any material litigation or arbitration (either as plaintiff or defendant); or any regulatory or government related investigation, action or proceeding, in any jurisdiction?
12 / Is any of your management team / owners have any direct or indirect relationship with AMMROC
13 / Is any member or relative of that member of your management team / owners currently or previously employed with AMMROC
14 / Is any of your management team / owners have any direct or indirect relationship with Mubadala
15 / Is any member or relative of that member of your management team / owners currently or previously employed with Mubadala
16 / Is any of your management team / owners have any direct or indirect relationship with Sikorsky
17 / Is any member or relative of that member of your management team / owners currently or previously employed with Sikorsky
18 / Is any of your management team / owners have any direct or indirect relationship with Lockheed Martin
19 / Is any member or relative of that member of your management team / owners currently or previously employed with Lockheed Martin

If any of the answers to questions 12 to 19 is YES, please provide further details in the space below

Financial Compliance / Yes / No
1 / Did the company receive qualification from auditors on the financial statements in the last three years? (This means have the auditors found major audit points and financial discrepancies to such an extent that the financial statements are signed off as NOT representing a true and fair reflection of the financial performance of the company).
2 / Does the company have any claims from vendors outstanding beyond six months?
3 / Does the company have any receivables pending from customers beyond six months?
4 / Can the company provide guarantee for advanced payment and/or performance for the value of the product(s)/service(s)?
5 / Do you already provide goods/services to Mubadala, Sikorsky or Lockheed Martin for a value greater than AED 100,000?
6 / In case point 7 as below is not applicable provide the last two years’ audited Financial Statement.
7 / Does your website provide audited Financial Statements? If Yes, please provide link:

If any of the answers to Questions 2&3 is YES or if Questions 4 or 6 is NO, please provide further information below.

Bank Details:

Bank Account Name:
Branch:
Branch Address:
(Street)
(City)
(Country)
Account Code:
Sort Code:
Account Type:
SWIFT Code:
Currency:
IBAN (If applicable)

*** Notice ***

A hard copy of this document may not be the document currently in effect. The current version is always on the AMMROC network.

Parent Doc: QMS-200-009Current Revision Date: 15-July-14