Supplier Registration & Qualification Form (Oct-23)

Banneker Supplier Registration & Qualification Form (Oct-23)

For All Prospective Banneker SCS Suppliers
As part of our supplier quality assurance program, and in accordance with the requirements of our ISO9001/AS9100 registration, new and periodic assessments are conducted of our suppliers and sub-contractors. Please complete and return the attached vendor questionnaire. Information from this questionnaire will be used to update our records and enable us to maintain our approved supplier list. Analysis of this information may result in the need for an assessment or audit by one of our Quality staff. In this event, we would contact you to arrange a convenient date. Please be assured that any information provided will be treated in complete confidence. Along with completing this form, please upload copies of your Quality Management System registration (e.g., ISO 9001 certificate). For electronic component suppliers, please also upload your Supplier Counterfeit Avoidance Procedure and checklist.
General Supplier Information

Please provide some general information about your business.
Date Completed

MonthDayYear
Date
Current Supplier?*
Sales to Banneker in the past 12 month
Registered Company Name
Must Match Name on Invoices
Date and Place of Incorporation
(ex: 2002, New York City
Email Address of the Person Completing this Form
Add your email address to receive a copy of this submission
Company Phone Number
Company Website Address
http:///www.
Total Company Employees
Company Address
Details of your company's scope of activity, products, and or services offered to Banneker.
Attach organizational chart below if available
Business Structure
Business Classification
Business Type
List Parent Company Name
If applicable
CAGE Code
DUNS Number

Please provide contact information for various roles within your business.

	First & Last Name	Title	Email	Phone
Primary Contact
Quality
Sales/CSR
Technical
Accounts Receivable

Supplier Payment Information

Please provide information to set your company up in our system.
Payment Remit To Address*
Tax ID or EIN
Payment Terms
Terms Begin at Banneker Acceptance
Supplier Quality Management Systems

Please tell us more about how quality is managed at your company.
Number of Quality Personnel in Your Company
Agree to use Banneker's directed and/or approved suppliers, if required?
Agree to allow scheduled Banneker onsite audits?
Agree to adhere to all Banneker purchase orders flow down requirements?
QMS System Details

Documented QMS?Documented Inspection Procedures?Calibration Management System?Corrective Action Program?Other
Standards / Certifications

ISO Registered (9001, AS9100, etc.)Food Grade (AIB, GMP, etc.)CTPATOther

Standards / Certification Details

	Type/Name	Issuer / Registrar	Certificate No.	Expiration Date
Certificate 1
Certificate 2
Certificate 3
Certificate 4
Certificate 5

Quality Assurance & Control | *For Suppliers of Electronic Components only | **ITAR (for USA Suppliers only)*

	Yes	No	Comments
Quality: Do you have a Quality Manual?
Quality: Do you have an internal and external audit program?
Quality: Do you have a staff training program/matrix?
Quality: Are Statistical Process Control (SPC) techniques used for control of processes?
Quality: Are monitoring and measuring devices controlled and calibrated?
Quality: Do you have a procedure on Design and Development processes?
Quality: Do you have full / partial traceability of product and materials? Please specify:
Quality: Do you have a procedure for controlling customer property?
Quality: Do you have a configuration control system?
Quality: Do you have a procedure to confirm the correct revision before issuing or using documents?
Quality: Do you have a procedure for controlling changes to customer product?
Quality: Control of records (process cards, test results, etc.). How long do you retain quality records?
Quality: Are ambiguities documented and approved by the customer?
Quality: Do you have a formal customer complaint procedure?
Quality: Are there documented procedures for corrective and preventative actions?
Quality: Would you be willing to provide a copy of your Quality Manual?
Purchasing: Do you have a controlled list of approved suppliers?
Purchasing: Are your suppliers assessed and monitored?
Purchasing: Are order quality requirements clearly defined?
Purchasing: Are your suppliers under contract with you?
*Purchasing: Do you have a written Counterfeit avoidance procedure?
*Purchasing: Do you have a written Counterfeit inspection procedure and checklist?
Inspection: Are there documented inspection and testing procedures for the products/services provided?
Inspection: Are there documented procedures for in-process inspection?
Inspection: Are incoming products and raw material inspected upon receipt?
Inspection: Is acceptance/rejection criteria defined?
Inspection: Are rejected items identified and segregated?
Inspection: Are process cards used for monitoring product inspection and test activities at each stage?
Inspection: Are QA stamps used and controlled?
Inspection: Is non-conforming material clearly identified?
Handling: Do you have a procedure on handling and storage of products?
Handling: Are shelf-life products controlled and monitored?
Handling: Do you have facilities and procedures for handling Electrostatic Sensitive Devices (ESD)?
Handling: Are ESD packaging materials used when ESD sensitive products?
**Do you know and maintain adequate records of “export classifications” (e.g., USML Category or ECCNs) for all products, technology, and services provided and disclose such classifications to customer as requested?
**Do you secure valid export licenses (in accordance with required delivery schedules) for any exported products & technical data?
**Do you regularly monitor and maintain compliance with all license restrictions and provisos?
**Do you prevent any unauthorized “deemed exports” of ITAR and EAR controlled products and technical data to unauthorized persons?

Supplier Contract Management System

Please tell us more about your contract management system.

Contract Management*

	Yes	No	Comments
Do you have a procedure on Contract review processes?
Are point of contacts for each discipline between your Customer (us) and you (supplier) clear?
Are terms and conditions clearly defined? (including payments terms and flowdowns)
If you service products for Cubic, do you ensure that servicing meets contractual requirements?
Is your company registered with the U.S. Dept of State?
Do you have an export compliance program?
How are your customers’ Intellectual Property (IP) being safeguarded?
Do you have NDA (Non-Disclosure Agreement) with your suppliers?
Do you employ non-US citizens in your work force?

Uploads/Attachments

Upload any required files and additional supporting documents.
Upload ISO Quality Certificate

Cancelof
Upload Other Relevant Certificate/Document

As needed
Cancelof
Upload Other Relevant Certificate/Document

As needed
Cancelof
Upload Other Relevant Certificate/Document

As needed
Cancelof
The undersigned hereby is authorized to provide, and certifies that the information provided, including any attachments, is true and correct to the best of their knowledge and that all information provided reflects the current business situation of their company.
Reviewer's Signature*

Powered by Jotform SignClear
Banneker Quality Email
Should be Empty:

Banneker Supplier Registration & Qualification Form (Oct-23)

General Supplier Information

Supplier Payment Information

Supplier Quality Management Systems

Supplier Contract Management System

Uploads/Attachments