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Company Information
	Vendor Name:*
	Address:*
	City:*
	State/Province:*
	Zip/Postal Code:*
	Country:*
	Phone:*
	Fax:
	Email:*
Organizations Structure
	President:
	Vice President:
	Quality Assurance Manager:*
	Chief Inspector:
Types of Business
	Certified Manufacturer Distributor Air Carrier Repair Station Broker Others	Government Certifications:
Number of Employees
	Office:
	Production:
	Quality Assurance:
	Years in Business:
	Others:
Facilities Layout
	Office Space: sq ft Production: sq ft Inspection: sq ft Others: sq ft Prepared By:* Email Address:*
Quality Administration
	1. Does your company have an FAA approved drug awareness plan? Program #        Yes:        No:       N/A: 2. Is there any quality manual that adequately describe your quality system?        Yes:        No:       N/A: 3. Does company management approve the quality manual?        Yes:        No:       N/A: 4. Is the quality manual system organized in accordance with?        Yes:        No:       N/A: 5. The quality manager reports to       6. Are staff training program utilized?        Yes:        No:       N/A: 7. Is there a system to provide surveillance of suppliers?        Yes:        No:       N/A:
Inspection Equipment
	1. Inspection staff have access to gauges and tools to perform the inspection function?        Yes:        No:       N/A: 2. Gauges and tools are checked periodically and records are kept to document this function        Yes:        No:       N/A:
Housing and Facilities
	1. Are parts/materials properly controlled and stored?        Yes:        No:       N/A: 2. Are parts/materials properly identified to include shelf life?        Yes:        No:       N/A: 3. Do you stock non-aerospace materials?        Yes:        No:       N/A: 4. If yes, are all aerospace materials segregated from non-aerospace materials?        Yes:        No:       N/A: 5. Is access to sereorooms and material storage areas restricted?        Yes:        No:       N/A:
Material Procurement/Receiving Inspection
	1. Do you have an approved supplier vendor list?        Yes:        No:       N/A: 2. Do your procurement document reflect your specification requirements?        Yes:        No:       N/A: 3. Are there qualified receiving inspectors?        Yes:        No:       N/A: 4. Are parts/materials subject to receiving inspection?        Yes:        No:       N/A: 5. Do you require material certifications or traceability on all items purchased back to a certified source. I.E. 121/129 Air Carrier FAA 145 repair station        Yes:        No:       N/A: 6. Are rejected parts/materials properly identified and segregated?        Yes:        No:       N/A: 7. Is there a bonded or separate area to hold non-conforming material?        Yes:        No:       N/A: 8. If applicable, are scrapped parts/materials mutilated to prevent their inadvertent reuse?        Yes:        No:       N/A:
Final Inspection/Shipping
	1. Are all parts/materials subject to final shipping inspection?        Yes:        No:       N/A: 2. Do shipping documents list or reference vendor name, date of shipment, customer purchase, nomenclature, serial number and quantity?        Yes:        No:       N/A: 3. Are certificates of conformance shipped with each item?        Yes:        No:       N/A: 4. Can you provide traceability to a certified regulated source on materials sold?        Yes:        No:       N/A: 5. Do you provide this traceability for all material sold?        Yes:        No:       N/A: 6. Does your facility have appropriate packaging materials that meet customer and industry specifications? ATA 300        Yes:        No:       N/A:
	Comments and Suggestions:
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