SUCOFINDO INTERNATIONAL

CERTIFICATION SERVICES
SUCOFINDO a Strategic Business Unit of PT. SUCOFINDO (PERSERO)

SUCOFINDO INTERNATIONAL CERTIFICATION SERVICES - QUESTIONNAIRE

Part One - General Information

Name of Organization: ......................................................................................................................

Address: ......................................................................................................................

(See Note 1) ......................................................................................................................

......................................................................................................................

Telephone: ...................................... Facsimile: ................................

NPWP No.: ...................................... Factory Permit Number: .................................

Contact Representative: ......................................................................................................................

Position: ......................................................................................................................

Postal Address: ......................................................................................................................

......................................................................................................................

......................................................................................................................

Telephone: ...................................... Facsimile: ......................................

Please indicate the standard certification is being sought.

(e.g. ISO 9001, ISO 14001, HACCP, etc.)

Please detail the scope of certification being sought.

(e.g. Manufacturing of textile toys; fabricated metals; room air conditioner; life insurance; cargo handling)

Note 1 If the scope of your application covers more than one location, please enter details on page
four (4) of this application. Photo copies of page 4 can be made and attached to the
application form if required.

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Does the facility have a documented management system in place? (If so, please describe its structure and
how long it has been implementation).

Please define the language used in your system documentation and the language you prefer for
communication during the audit.

Did your organization use or is contemplating the use of consultant? (If yes please provide general details).

Company Ownership PMDN (100 % Indonesian) † JV (Joint venture) †

PMA (100 % Foreign) ) † Date organization established:.................

Please provide details of any approvals/licenses/certifications held by the organization.

Please provide details of any trade associations of which the organization is a member.

Please indicate the applicable regulations related your product or services.

Please indicate the finished product or services produced/delivered by the organization.

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Are there any products and/or services offered for sale by the organization outside the scope of certification
being sought? If yes, please list.

Which Markets do you supply?

…Government Bodies …Domestic Markets)

…Export Markets … Others (please specify) ........................................

Is any of the manufacturing and/or service process performed by subcontractors ? If so, please indicate
them.

Does the facility have any special safety, access or security requirements ? If so, please indicate them.

Total number of employees in the organization? .................................

Number of employees within the scope of the system? .................................

Number of employees directly in the system to be certified? .................................

Number of employees in product manufacture/service delivery? .................................

Number of employees in product/service delivery design (if applicable? .................................

Number of employees in sales and marketing and administration ? .................................

Please provide the number of employees who are shift workers and the current number of shifts.

Shift Number 1 2 3

Start/Finish

Number of employees

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Additional Locations (Do not complete if this Questionnaire is submitted with an Application Form)

Name of Location: ......................................................................................................................

Address: ......................................................................................................................

......................................................................................................................

......................................................................................................................

Telephone: ...................................... Facsimile: ......................................

Local contact: ......................................................................................................................

Name of Location: ......................................................................................................................

Address: ......................................................................................................................

......................................................................................................................

......................................................................................................................

Telephone: ...................................... Facsimile: ......................................

Local contact: ......................................................................................................................

Name of Location: ......................................................................................................................

Address: ......................................................................................................................

......................................................................................................................

......................................................................................................................

Telephone: ...................................... Facsimile: ......................................

Local contact: ......................................................................................................................

Name of Location: ......................................................................................................................

Address: ......................................................................................................................

......................................................................................................................

......................................................................................................................

Telephone: ...................................... Facsimile: ....................................

Local contact: ......................................................................................................................

SUCOFINDO ICS FRM 2.16

Issue 04 Rev. 2
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