Supplier Questionnare - Section A General Info_modified.docVIP

A. General Information on Company, Product and Quality Management Company Information 1.1 Company Address Information Name of company: Address: Postcode: Country: Telephone number: Fax number: Web address: 1.2 Is the address listed above the only site for production? Yes No If NO, please provide details below: Name of company(s): Address: Postcode: Telephone number: Fax number: 1.3 Is your company a subsidiary? Yes No If Yes, please provide details below: Name of company: Address: Postcode: Telephone number: Fax number:  1.4 Contact Information (Please provide details of an available contact) Name: Position: Telephone number: Fax number: Email address: 1.5 Site Personnel Information 1.5.1 Approximate total number of employees at facility of interest: 1.5.2 Approximate number of employees in the Quality Unit (Quallity Assurance/Quality Control) 1.5.3 Approximate number of employees in Production/Operations Unit 1.5.4 If available, please enclose a copy of your Organisational chart indicating key personnel. Enclosed Ref: N/A 1.5.5 If available, could you please supply copies of any sales information for the products listed on the front of this form? Enclosed Ref: N/A 1.5.6 Does your factory operate in a shift system? Yes No How many? How many days a week? 1.6 Company structure 1.6.1 What is the legal ownership structure of your company? 1.6.2 Please give a brief structure-diagram Ref: 1.6.3 Do you expect a change of the legal status and/or ownership of your company in the near future? Yes No 1.6.4 Do you have an annual report available? Yes No If yes, please enclose the annual report Ref: Product Information 2.3 Origin of the main ingredients Comments 2.3.1 Synthetic Yes No N/A 2.3.2 Fermentation Yes No N/A 2.3.3 Vegetable Yes No N/A 2.3.4 Mineral Yes No N/A 2.3.5 Animal (if YES, please complete section B as well) Yes No N/A 2.3.5 Bovine (or