Metal Bellows at Flexial

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Supplier Support

Supplier Questionnaire

Identification and Contact Information
	Company Name
	Address 1
	Address 2
	City
	State
	Postal Code (Zip)
	Country
	Company Website URL
	Company SIC Code (Standard Industrial Classification (SIC) System Search)
	Primary Telephone Number
	Primary Fax Number

	Contact Name
	Contact Email Address
	Contact Title
	Contact Telephone Number
	Contact Mobile (Cell) Phone Number
	Contact Fax Number
BILLING ADDRESS (if different from above)
	Address 1
	City
	State
	Postal Code (Zip)
	Country

IRS W9 INFORMATION
		Entity Type (Select One)
		If other, enter type here
With the tax classification of Disregarded Entity Corporation Partnership.

Yes	No	Are you exempt from backup withholding?
		Taxpayer Identification Number
		Name of Individual Certifying
Date


OPERATIONS INFORMATION
What product or service best fits your classification (Select one only)
PART MANUFACTURERS	MATERIAL SUPPLIERS	DISTRIBUTORS	TEST \ CALIBRATION LABS

*List any special processes your organization can perform about which you would like Flexial to be aware (One per box).

Number of Employees (complete for each section)
	# of Employees (All)
	# Sales \ Marketing
	# Engineering
	# Quality Assurance
	# Manufacturing

Facility and Financial
	Sq. Feet (ft²) or	Sq. M. (m²)	Annual Sales ($)

QUALITY & DELIVERY
QUALITY		DELIVERY
What is your defect rate in Parts Per Million for customer defects, rejects and returns? (Answer through current year.)		What is your delivery performance in terms of Percent (%) on-time delivery for each year? (Answer through current year.)
2000		2000
2001		2001
2002		2002
2003		2003
2004		2004
2005		2005
2006		2006
2007		2007
2008		2008
2009		2009
2010		2010
Check HERE if your company does not know its defects \ returns performance.		Check HERE if your company does not know its Delivery performance.

Quality Certifications (Check all that apply):
	ISO9000:1994
	ISO9001:1994
	ISO9000:2000
	ISO9001:2000
	AS9000:1998
	AS9100:2000
	EN9100
	Others
	List Others

If your company is ISO9000:2000 or AS9100:2000 registered, is your registrar Accredited by (Check all that apply):
	ANAB - ANSI-ASQ National Accreditation Board
	SCC (Standards Council of Canada)
	JAB (Japanese Accreditation Board)
	RVA (Raad Voor Accreditatie)
	UKAS (United Kingdom Accreditation Service)
	OTHER
- OR -
	My Registrar is Not Accredited

COMMUNICATIONS

Flexial prefers all suppliers to utilize Internet and Email technology for primary communication. Flexial prefers to issue Purchase Orders, drawings, specifications, and procedures via Email. Does your company have the standard and necessary infrastructure to send and receive documents and text through the internet?

Yes

CONTRACT REVIEW

We confirm that if selected as a supplier to Flexial Corporation, we agree to be bound by the Content, Terms, and Conditions of any Purchase Order that we receive and accept, including all Design, Quality, Delivery, and Specification requirements. This acceptance may be required to supply products, materials, or services to Flexial Corporation.

The supplier understands that the contents of any purchase order issued by Flexial Corporation is issued conditionally and, except for rights expressly granted to the United States government, neither receipt or possession thereof confers or transfers any right in, or license to use the subject matter or any design or technical information, nor any right to reproduce any contents of the purchase order except for manufacture by suppliers for Flexial Corporation, and for manufacture under Flexial Corporation's written permission.

Agree

Not Agree