Form No : MTD-QF-11-01

Rev. No. : 1 Date: 25-05-06

Suppliers Assessment Form

Tel. No. :

Fax No. :
Company Name:
Email :

Scope of Work
Trading

Manufacturing
Address: Type of Business :
Service

Others
Contact Person:

Components Categories :
Position:

Rating Rating
Sl. No. Capability Remarks Performance Remarks
Good Fair Bad Good Fair Bad

1 Product / Material / Meeting Specification Stability In Pricing

2 Technical Capability of Supplier's Staff Delivered by Committed Date

3 Credit Facility Supply of MTC

4 Lead Time Products Batched with Expiry Date

5 Market Reputation Delivery of Full Order Every time

6 Price List Quality Always Acceptable

7 Can Supply In - House / Third Party Lab Test

8 ISO Certified Company

Result of Assessment: Comments :

Accepted

Provisional Decisions
Continue Using
Not Approved Discontinue

Assessed By Approved By Assessed By Approved By

Sign: ________________________ Sign: __________________

Date: ________________________ Date: ___________________

If this is a paper copy, it is uncontrolled. You must verify the on-line revision before using.