Supplier Evaluation Form
General
Name
Position
Company Name
Company Address
Telephone Number
Fax
E-mail Address
Website Address
Date of Formation/Incorporation
Registered Number of Company
Registered Address (if different from above)
VAT Number
Type of Company
Sole Ownership
Partnership
Private Limited
Purchase
Other (please specify)
Terms & Conditions
Please read our
Terms and Conditions
before completing the remainder of this form.
Select here to acknowledge our Terms & Conditions of supply.
Group Structure
If applicable please state the Head Office and registered nationality for the following:
Holding/Parent Company
Nationality
Address
Subsidiary Companies
Nationality
Address
Customer Relationship Management
Name of Key Contact
Position
Telephone
Mobile
Fax
Email
Sales Office Contact
Telephone
Fax
Email
Technical Contact
(if different from above)
Telephone
Mobile
Fax
Email
Financial
Please detail Bank Account to which payments should be made.
Bank
Address
Sort Code
Account Number
Health & Safety
Please tick to confirm that you will comply at all times with the requirements of United
1. Health & Safety at Work Act 1974 (and amendments)
2. Control of Substances Hazardous to Health Regulations 1994
3. and all other current United Kingdom Health and Safety Legislation.
Please describe the process by which your customers are provided with the lastest reviews.
Quality Assurance
Please identify your Quality Assurance Representative
Name
Position
Has your quality system been approved by a third party recognised standard/s eg: ISO series?
Yes
No
If so, please state which standard/s
Do any of the following procedures apply to your company?
Batch identification system
Yes
No
Document Specifications
Yes
No
Supply materials to an agreed specification
Yes
No
Supply Certificate of Analysis for every batch of material supplied.
Yes
No
Sub-Contracted
Are any elements of the suppied product or service offered to Leighs sub contracted?
Yes
No
Acknowledge that any sub contractors will comply to the same terms and condisions.
Yes
No
Name Subcontractor
Supplied Product
Are you the manufacturer of the supplied product
Yes
No
Name Manufacturer
Submit