Document Number :B08-02-4043-F-001

Document Title : Initial Supplier or Contractor Evaluation

***Please complete this form in English***
Company name :
Branch : Head office branch no. 000
Branch no.
Address :
:
Tel no. :
Fax no. :
Tax ID number :
Website :
Contract person/Sales representative
Gender :
Name : Position :
Mobile phone : e-mail :
Certificate ISO 9001 ISO 17025 ISO 26000 CSR
ISO 14001 ISO Other
Type of goods / service
Group ( 1 ) ISO 9001
Group ( 2 ) ISO 14001
Group ( 3 ) ISO 17025
Group ( 4 ) ISO 26000 CSR
Group ( 5 ) ISO Other
Related document
1. Affidavit
2. VAT Registration 3. Corporate/Business registration
4. ISO certificate
5. Company profile 6. Catalogue
7. ID Card
Criteria of Evaluation Payment Details (for Overseas suppliers only)
1. Business registered date
2. Capital amount 2. Bank branch
3. Currency
4. Payment terms
5. Tax code
1 3
2 4
For Glow input only
1. Bank name
3. Bank account
4. Swift code
15. Main departments and number of employee of each department
Mr. Mrs. Miss
Initial Supplier or Contractor Evaluation
Supplier code :
No Vat Vat 7%
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Document Number :B08-02-4043-F-001
Document Title : Initial Supplier or Contractor Evaluation
16. Top four of your customers reference
1 3
2 4
17. Top four of your subcontractors for reference
1 3
2 4
18. Does your company have corporate Social responsibility (CSR) policy? Yes No
(If yes, please attach copy of latest policy.)
19. Corporate Social Responsibility (CSR)- Have your company been complained on below issues? (If yes, please explain)
19.1. Human Right Protection Yes No
19.2. Labor Protection Yes No
19.3. Ethic/ Business Governance Yes No
19.4. Consumer Protection Yes No
19.5. Community Cooperation and Development Yes No
19.6. Possess of Corporate Code of Conduct Yes No
Yes No
Result of evaluation
Capabilities satisfactory
Improvement required
Capabilities unsatisfactory
Requested Approved
Date Date
20.8 Is suitable and appropriate Personal Protective Equipment (PPE) provided employee?
Comments
20. Safety, Health and Environment data
20.9 Does your company maintain Job Risks Assessment for Working?
20.10 Does your company have the program or procedure to manage the following items?
(If yes, please attach copy)
***Below for Glow input Only***
20.4 Does your company establish Safety, Health and Environment System which is certified by
an independent institution according to international standard?
(If yes, please attach copy)
20.5 Does your company have Safety Training Programs?
(If yes, how often are formalized programs conducted? ____ per year)
20.6 Does your company conduct regular Emergency Response drills and exercises?
(If yes, please attach copy)
20.7 Does your company maintain Safety Record /or Accidents/Incidents Report?
(If yes, please attach copy)
20.3 Does your company have Safety, Health and Environment committee or
similar organization? (If yes, please attach copy)
20.1 Does your company have Safety Policy and Safety Manual?
(If yes, please attach copy)
20.2 Does your company have Safety officer as required by law?
(If yes, please attach certificate)
Purchasing Manager Purchasing Officer
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Document Number :B08-02-4043-F-001
Document Title : Initial Supplier or Contractor Evaluation
Remark / Suggestion
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File Name : B08-02-4043-F-001
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