Lieferantenselbstauskunft

Receiver*

General Information

Company name:*

Address (PO Box):

Address (Street):*

Town/Postal code:*

Country:*

Phone:*

Fax:*

Homepage (Internet):*

Name of person completing the form:*

E-mail address of person completing the form:*

Contact Details

General Manager:

Phone/Fax:

Mobile:

E-mail:

Production:

Phone/Fax:

Mobile:

E-mail:

Quality:

Phone/Fax:

Mobile:

E-mail:

Engineering:

Phone/Fax:

Mobile:

E-mail:

Logistics:

Phone/Fax:

Mobile:

E-mail:

Sales:

Phone/Fax:

Mobile:

E-mail:

Company Details

Ownership structure:

Private Public

DUNS:*

Vat Id. No.:*

Parent company:

Other locations:

Asset value in €k:

Annual revenue in €k:

Current year -2:

Current year -1:

Current year:

Purchasing volume in €k:

Current year -2:

Current year -1:

Current year:

Number of employees:

Total:

Production:

Quality:

Development:

Production Details

Product type:

Main products in % of total production:

Shift systems:
(e.g. 8h/shift; 3 shifts/day; 6 days/week)

Engineering

Do you have in-house tool engineering and manufacturing?

Yes No

Comment

Are you capable of producing prototypes?

Yes No

Comment

Do you have a CAD system/systems?

Yes No

Comment

Do you have a lab with suitable measuring and test equipment?

Yes No

Comment

Quality

Are you ISO9001/2015 certified?*

Yes No

Comment

Do you have product liability insurance?*

Yes No

Comment

Scope of insurance policy

Logistics

Do you have an ERP system?

Yes No

Comment

Do you have EDI? Please specify service provider:

Yes No

Comment

Do you have video conferencing capabilities?

Yes No

Comment

Do you use a freight consolidator?

Yes No

Comment

Main types of transport:

Rail Road Sea Air

Environment

Do you have an environmental strategy/policy?

Yes No

Comment

Are you ISO14001 certified?

Yes No

Comment

Are you ISO 50001 certified?

Yes No

Comment

Acceptance of SIMONA Standard Terms and Conditions

Payment terms 14 days/3% deduction - 30 days/No deduction*

Yes No

Comment

Acceptance of *

Yes No

Comment

Acceptance of Data Protection Statement

We process and store your personal data exclusively for the purpose of responding to your enquiry. Further information on data processing and your rights can be found in our data protection information.

I have read the and accept it.*

Supplier self-declaration

General Information

Contact Details

Company Details

Production Details

Engineering

Quality

Logistics

Environment

Acceptance of SIMONA Standard Terms and Conditions

Acceptance of Data Protection Statement

SIMONA AG