Validero New Supplier Qualification Form

Supplier Qualification Form

In order for us to evaluate and register your company as a supplier, please complete the information requested below. The information will be used as part of our supplier approval process and to ensure that your company meets [COMPANY NAME] requirements regarding quality, food safety, sustainability, traceability and compliance.
Email address for follow-up regarding this form
example@example.com
Responsible contact person at [COMPANY NAME]
example@example.com
Company Details
Company Name
Company Registration Number
VAT Number
Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Billing Email Address
example@example.com
Is your billing address different from your company address?
Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Contact Person (Your Company)

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Financial Information
Select Payment Method

Other
IBAN
Other Payment Method
BIC / SWIFT
Bank Name
Select Currency
Specify Currency
Select Payment Terms
I confirm that I have reviewed and understood [COMPANY NAME] invoicing requirements and will include the required references on all invoices.
If the required reference information is missing, incomplete or incorrect, [COMPANY NAME] reserves the right to reject and return the invoice unpaid.

[COMPANY NAME]
address
adress line 2
VAT:
Invoice address/email:

Rows	Check all that apply
Cleaning and sanitation
Pest control
Temperature control
Allergen management
Supplier approval

Rows	Yes	No
Comply with EU Food Information Regulation (EU) No 1169/2011?
When a change occurs in your product that affects food safety, for example if an allergen is added, you must contact us.
Declaration of Compliance (DoC) for food contact materials upon request?

Rows	Check all that apply
Packaging material types
Plastic type (e.g. PET, PE, PP)
Packaging weight
Material composition / breakdown
Packaging specifications
Packaging designed for recyclability (PPWR compliance)

Final Declaration
Code of Conduct
Do you comply with [COMPANY NAME] Supplier Code of Conduct?
[Supplier Code of Conduct link] covering people, animal welfare and the environment
Please describe any deviations and how you are addressing them
Privacy Policy
I confirm that I have read and understood the Privacy Policy
Read [Privacy policy link]
Confirmation & Authorization
I confirm that the information provided is accurate and complete, and that I am authorized to submit this on behalf of the company.
NamePosition / Title
Date

DayMonthYear
Date
Should be Empty:

Rows	Yes	No
Do you have a documented food safety management system (e.g. HACCP)?
Do you have a documented traceability system?
Do you have a recall/withdrawal procedure in place?
Are your operations regularly inspected by authorities?

Supplier Qualification Form

Company Details

Financial Information

Food Safety

Product Issue Contact

Requirements

Packaging

Certifications & Product Claims

Manage Certificates & Documents

Final Declaration

Code of Conduct

Privacy Policy

Confirmation & Authorization