SUPPLIER QUALITY SYSTEM SURVEY

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SUPPLIER QUALITY SYSTEM SURVEY DATE (M/d/yy): 55 Dragon Court Woburn, MA 01801 Tel: (781) 933-7300 Fax: (781) 935-4529 GENERAL INFORMATION Supplier Name: Physical Address: City: State: Zip: Sr. Company Official: Sr. Quality Official: Title: Title: PLANT PERSONNEL (TOTAL EMPLOYEES) Production Technical/ Engineering Quality Regular Contract SUPPLIER TYPE Manufacturer Distributor Other (specify): ASSESSMENT Type of assessment performed: Self Assessment Lytron Assessment Completed By: Title: Recognized Quality Management System Qualifications (specify standard with date completed) ISO AS Other Expiration Date: Expiration Date: Expiration Date: Please provide the following (check all provided documents): Quality Objectives Quality Policy Quality Manual Organization Chart If the Quality Program is in compliance with ISO or AS please send a copy of the certificate and most recent audit report with this page only. Form F4.6.2, Rev C, 3/12/09 Page 1 of 10

Instructions: This survey consists of 66 questions; please check the most appropriate response. If a question does not apply to the supplier s organization, a valid reason should be given in the Comments section under the question. The question will not be scored for any Not Applicable answer. Always True Frequently True Sometimes True Never True Not Applicable (NA) 3 points 2 points 1 point 0 points Not Scored The supplier s approval status is determined by dividing the raw points score by the points available for applicable questions and using the scale as follows: Approved 70% Required Minimum Conditionally Approved 60% Required Minimum Approval Withheld Less than 60% Results of Conditionally Approved and Approval Withheld will require corrective action to obtain Approved status and possibly a follow-up on-site Assessment by Lytron, Inc. In order to utilize a supplier with either the Conditionally Approved or Approval Withheld status, approval must be granted by Quality Assurance Manager and the Purchasing Manager. These scoring requirements apply to each applicable section as well as the survey in total. Points are distributed between sections as shown below: Section Description Points Available 1 Management Responsibility 9 2 Quality System 6 3 Contract Review 9 4 Design Control 9 5 Document Control 12 6 Purchasing 9 7 Customer Supplied Product 3 8 Product Identification and Traceability 9 9 Process Control 12 10 Monitoring and Measurement of Product 12 11 Inspection, Measuring, and Test Equipment 12 12 Control of Non-Conforming Product 15 13 Corrective and Preventative Action 15 14 Handling, Storage, Packaging, Pres. and Delivery 12 15 Quality Records 9 16 Internal Quality Audits 18 17 Resource Management 15 18 Analysis of Data 3 19 Monitoring and Measurement of Processes 9 Points Counted Points Scored Totals 198 0 0 Percent Form F4.6.2, Rev C, 3/12/09 Page 2 of 10

1 MANAGEMENT RESPONSIBILITY 3 2 1 0 NA 1.1 Does senior management ensure that responsibilities and authority are defined and communicated within the organization? 1.2 Does management periodically review the quality system for effectiveness and initiate actions for improvement? 1.3 Is there a written record of the management reviews? 2 QUALITY SYSTEM 3 2 1 0 NA 2.1 Has the quality system been accurately documented in a quality manual? 2.2 Do quality control plans exist for each product produced or service produced? 3 CONTRACT REVIEW 3 2 1 0 NA 3.1 Is there a procedure for reviewing contracts which assures that the customer requirements can be met and differences resolved? 3.2 Is the capability to meet requirements verified prior to making a commitment to supply product to the customer? 3.3 Are changes to contracts properly documented and communicated to affected departments within the organization? Form F4.6.2, Rev C, 3/12/09 Page 3 of 10

4 DESIGN CONTROL 3 2 1 0 NA 4.1 Does the design process include records documenting inputs, outputs, verification, and validation activities? 4.2 Have applicable statutory and regulatory requirements been identified? 4.3 Are design reviews held with a cross-functional team and are records of the results of the reviews maintained? 5 DOCUMENT CONTROL 3 2 1 0 NA 5.1 Is there a procedure that describes how documents and data are controlled? 5.2 Are all required documents available to personnel operating the processes (i.e. drawings, BOM s, work instructions, spec s, etc.)? 5.3 Are obsolete documents promptly removed from all points of issuance and is there a system to ensure that this process is followed? 5.4 Is a system established so that all document changes are reviewed and approved and is there evidence that this process is followed? Form F4.6.2, Rev C, 3/12/09 Page 4 of 10

6 PURCHASING 3 2 1 0 NA 6.1 Is there a documented process for supplier evaluation/re-evaluation and are records maintained? 6.2 Is the quality performance of suppliers recorded and reviewed to identify improvement opportunities? 6.3 Is an approved supplier list maintained? 7 CUSTOMER PROPERTY 3 2 1 0 NA 7.1 Are there written procedures for identification, storage and preservation of customer supplied property? 8 PRODUCT IDENTIFICATION AND TRACEABILITY 3 2 1 0 NA 8.1 Is product identity maintained throughout production operations? 8.2 Is product status identified by suitable means throughout production operations? 8.3 Is there a system in place that provides unique traceability for products delivered when required? Form F4.6.2, Rev C, 3/12/09 Page 5 of 10

9 PROCESS CONTROL 3 2 1 0 NA 9.1 Are key product and process characteristics that directly affect quality identified and documented? 9.2 Are there a formal review and approval process and equipment prior to use? 9.3 Is there a preventative maintenance program for equipment? 9.4 Have special processes been identified and a method for control established (welding, soldering, heat treating, painting, etc.?) 10 MONITORING AND MEASUREMENT OF PRODUCT 3 2 1 0 NA 10.1 Is there a documented procedure for verification of purchased product? 10.2 Are records kept to show acceptance and rejection of incoming material? 10.3 Are there documented inspection and test procedures and do they reflect equipment to be used, specification requirements, and acceptance criteria? 10.4 Are there records to show that finished product has passed final test and inspection? Form F4.6.2, Rev C, 3/12/09 Page 6 of 10

11 INSPECTION, MEASURING AND TEST EQUIPMENT 3 2 1 0 NA 11.1 Is all inspection, measuring, and test equipment used for product acceptance uniquely identified (label, ID, due date, etc.) and calibrated? 11.2 Are master reference standards traceable to NIST used while calibrating measuring equipment? 11.3 Are calibration records (including gage history and a recall file) available? 11.4 Is there a documented procedure describing the need to perform an impact analysis when equipment is found to be out of calibration? 12 CONTROL OF NON-CONFORMING PRODUCT 3 2 1 0 NA 12.1 Is there a documented method to prevent inadvertent use of nonconforming product? 12.2 Is there a documented procedure that defines the process to be used to rework and inspect non-conforming product and is there evidence that the procedure is followed? 12.3 Is authority defined for the disposition of non-conforming product? 12.4 Is there a documented procedure defining the action to be taken when non-conforming product has been detected after shipment? 12.5 Is data collected on non-conforming product and analyzed for trends and improvement opportunity? Form F4.6.2, Rev C, 3/12/09 Page 7 of 10

13 CORRECTIVE AND PREVENTATIVE ACTION 3 2 1 0 NA 13.1 Is there a system established to effectively analyze and correct customer complaints and product process nonconformance? 13.2 Are corrective actions documented for internal and supplier nonconformance? 13.3 Do corrective action requests result in root cause analysis for the nonconformance? 13.4 Is process/product performance data analyzed to identify preventative action and potential causes of nonconformities? 13.5 Is effectiveness of corrective and preventative actions verified through follow-up audits? 14 HANDLING, STORAGE, PACKAGING, PRESERVATION AND DELIVERY 3 2 1 0 NA 14.1 Are procedures and instructions followed to ensure product quality in handling, storage, packaging and delivery? 14.2 Are age sensitive materials properly stored? 14.3 Is a FIFO process used? 14.4 Is data collected and analyzed in regards to shipping damage to verify packaging is adequate and to improve as necessary? Form F4.6.2, Rev C, 3/12/09 Page 8 of 10

15 QUALITY RECORDS 3 2 1 0 NA 15.1 Is there a documented procedure to define the controls needed for the identification, storage, retention and disposition of records? 15.2 Are quality records stored in a place that adequately maintains their integrity through the retention period? 15.3 Are quality records available to customers upon request? 16 INTERNAL QUALITY AUDITS 3 2 1 0 NA 16.1 Is there a documented procedure covering the scope, plan, schedule, frequency, and responsibility for internal auditing? 16.2 Are all areas of the quality system being audited periodically? 16.3 Are auditors independent of the areas being audited? 16.4 Are the results of the audit documented and retained? 16.5 Is timely corrective action taken to correct deficiencies? 16.6 Do internal quality audits include verification of corrective from previous audits? Form F4.6.2, Rev C, 3/12/09 Page 9 of 10

17 RESOURCE MANAGEMENT 3 2 1 0 NA 17.1 Does the organization provide adequate resources to implement and maintain the quality management system and continually improve its effectiveness? 17.2 Do documented training requirements exist for everyone affecting quality? 17.3 Are qualification and training records maintained for personnel? 17.4 Is effectiveness of training verified and documented? 17.5 Do special processes require certification and periodic re-certification? 18 ANALYSIS OF DATA 3 2 1 0 NA 18.1 Is customer satisfaction data collected and analyzed to identify improvement opportunities? 19 MONITORING AND MEASUREMENT OF PROCESSES 3 2 1 0 NA 19.1 Has the need for statistical techniques been identified in order to control processes? 19.2 Is statistical process control being used where quality plans specify? 19.3 Are the applied statistical techniques monitored and is corrective action taken when out of control processes are identified? Form F4.6.2, Rev C, 3/12/09 Page 10 of 10