SUPPLIER SELF-DISCLOSURE

Dear Supplier,

with your supplier self-disclosure you present your company, product and service spectrum.

As the basis for a successful partnership please fill in this questionnaire as completely as possible. The information will be treated confidentially and will not be disclosed to any third party.

With earlier versions of Office, when opening the file a security alert may appear. Should this occur, please select the option “activate content”.

Thank you very much for providing us with this self-disclosure and hence allowing us a detailed overview of your company.

Date:

1.  Information on the company


1.1 General information

Company

Form of company

Year of foundation

Trade register number

Street, house number

Postcode, city

Country

Tel./Fax

e-mail

Homepage

Branch

Production locations
(with statement of place)

Subsidiaries
(with statement of place)

1.2  Contact

Name Tel. Fax e-mail

Sales

Development

Logistics

Production

Quality

1.3 Business language

Other:

1.4 Payment conditions

Which payment conditions do you use?

1.5 Production planning and control

Which production planning and control systems
do you use?

2.  Key performance indicators and market information

2.1 Key performance indicators 2012 2013 2014

Total turnover (in T€)

Annual turnover construction industry (in T€)

Equity ratio in (%)

Market proportion (in %)

Total number of employees

Number of employees in Production

Number of employees in Quality Assurance

Number of employees in Research/
Development

2.2 Main customers/branch

Customer/branch Turnover (in T€) Country Product/Service

Supply to GEZE competitors

If yes, which competitors:

2.3 Main supplier base

Other:

2.4 References/Serial deliveries

Reference customer Contact Project/Service Order volume (in T€) Year of commission

2.5 Product liability

Insurance held

Insurance:

Insurance sum:

3.  Information on the delivery and production program

Product groups (only core competencies)

Other:

List of machinery enclosed

List of product portfolio enclosed

4.  Information on logistics

Barcode label

4.1 Capability to transfer remote data transmission standard messages

VDA

Odette

Edifact

Other:

4.2 Delivery conditions

From supplier plant

Free buyer's address GEZE

Via intermediate storage

4.3 Delivery possibilities

Kanban

Consignment warehouse

E-catalogue

1x weekly

1x monthly

4.4 Materials Management

Minimum stocks in supplier warehouse

Emergency plan

FIFO

5.  Information on Quality Management

5.1 Certificates (Please enclose copies of the certificates)

DIN EN ISO 9001 In year

DIN EN ISO 14001 In year

TS 16949 In year 2

VDA 6.1 In year

DIN ISO 50001 In year

Other:

5.2  Quality Management Methods

Do you use Quality Management Methods?

If yes, which methods are used?

Other:

5.3 Testing facilities

Own testing laboratory

If yes, which testing equipment do you have at your disposal?

Other:

CAQ system available Software

5.4 Audit results

Results of customer audits:

(Please enclose copy of audit report)

5.5 Product legal Information

Do the used materials / substances meet the currently valid
legal requirements for prohibited, restricted, toxic and
hazardous substances?

Do your products completely meet the currently valid legal
requirements (e.g. RoHS, REACH, WEE)?

Remarks:

6.  Development

Own Development/Design Departments

Own Mould/Tool Construction

CAD systems: Patents:

7.  Conditions and Agreements

Confirmation of the GEZE Purchasing Terms and Conditions

Confirmation of the GEZE Delivery Terms and Conditions/
Packaging Regulations

Confirmation of the Non-disclosure Agreement

Readiness to establish a Quality Assurance Agreement

Readiness to participate in the Web SCM portal

Readiness for GEZE procurement logistics

Remarks/supplements:

We hereby confirm that consciously made false allegations represent a major breach of confidence and can therefore - depending on the individual case - mean immediate termination of collaboration.

The following certificates and documents are enclosed:

GEZE supplier self-disclosure – Version 05: January 2015 -3-