New Address Effective 2/1/2018!

Company Name

Mailing Address

Telephone

Fax

Quality Contact Information

Name

Title

Telephone

Survey Completed by

Name

Title

Telephone

If Applicable, list the name of your parent company or any subsidiary

Parent

Subsidiary

BUSINESS CATEGORY (Check one or more as applicable)

ManufacturerParts DistributorSpare Parts DealerAir CarrierRepair StationOther

Years in Business

Personnel

Total number of people employed by your company

Administration

Engineering

Production

Quality

Key Management Positions

General Management (Name and Position)

Quality (Name and Position)

Engineering (Name and Position)

Production (Name and Position)

Sales (Name and Position)

Products and Services Offered

List the product(s) or service(s) sold, assembled or distributed by your company

Please Answer the Following Questions

1. Does your company have an established Quality Assurance Manual?
YesNoN/A
If Yes, please indicate its date of issue and current revision level:

Original Date of Issue

Revision

Date of Revision Issue

2. Has your company been accredited by any Second (or) third party Quality System?
YesNoN/A
If Yes, which one(s):

Airworthiness Agencies

Others

** Please upload all relevant certificates

3. Does your company have an FAA approved Drug and Alcohol Testing Program?

YesNoN/A
If Yes, please answer questions 3a and 3b, if no, please skip to question 4.

3a. Is pre-employment drug and alcohol testing performed?

YesNoN/A
3b. is random drug and alcohol testing performed?

YesNoN/A

4. Who is directly responsible for any quality related question (or) problem regarding the goods you supply?

Name

Title

Direct Phone

5. Do you keep records of parts purchased by purchase order number, source, part number, serial number (if applicable), quantity and condition?

YesNoN/A

6. Do you keep records of parts subcontracted from your facility for inspection, repair modification and /or or overhaul by purchase order number, source, part number, serial number (if applicable), quantity and work performed?

YesNoN/A

7. Do you keep records of sales by purchase order number, source, part number, serial number (if applicable), quantity and condition of part at time of sale?

YesNoN/A

8. Do you require a certification from suppliers of new parts that the parts are manufactured under a quality system approved by the CAAS (or) FAA in accordance with CAAS SAR-145 (or) FAR part21 subpart F, K, G (or 0?)

YesNoN/A

9. Do you inspect parts for damage due to extreme heat, extreme stress or a crash, corrosion, deterioration and applicable FAA Airworthiness Directives and disclose inspection finding at time of sale?

YesNoN/A
If yes, please indicate the individual who conducts these inspections and the FAA certification held:

Name:

Certificate Type/Number

10. Do you use only FAA (or) other airworthiness agencies, certified subcontractors to inspect, repair, modify, overhaul and / or test parts?

YesNoN/A
If no, do you audit your vendors, and how frequently are audits conducted?

11. Do you keep records of parts purchased, maintenance subcontracting, inspection an / or sales for at least seven (7) years?

YesNoN/A

12. Do you warrant parts sold? If yes, please provide a copy of your warranty.

YesNoN/A

13. Do you ensure that used parts sold as "overhauled" have not been operated since overhaul and that the overhaul was performed less than 24 months prior to the time of sale?

YesNoN/A

14. Do you maintain current manufacturer's information for the type of parts you sell including but not limited: Parts Catalogs, Service Letters, Service Bulletins, Airworthiness Directive and Inspections Procedures?

YesNoN/A

15. Does your storage facility provide security to all serviceable parts? Are the serviceable and unserviceable parts segregated?

YesNoN/A

16. Do you have an acceptable system of monitoring the environmental factors such as temperature and humidity? Are the floors sealed to minimize dust generation?

YesNoN/A

17. Are the aircraft parts and material protected against deterioration, contamination and damage? Are they packed properly against corrosion during storage?

YesNoN/A

18. Are the storage racks strong enough to hold the aircraft components and provide sufficient support large aircraft components such that the component is not distorted during storage?

YesNoN/A

19. Do you have a record of the qualification, training, experience and the scope of approval of the inspection personnel?

YesNoN/A

20. Do you keep the records of inspection carried out? Do you have copies of all incoming inspection and outgoing certificates and nay associated airworthiness data that are retrievable within an acceptable time frame?

YesNoN/A

21. Do you have a independent quality system to monitor compliance with and adequacy of procedures to ensure good inspection handling and storage practices and airworthy aircraft components?

YesNoN/A

22. Do you have a system of traceability to birth for all repair parts?

YesNoN/A

CERTIFICATION

I certify that the above questionnaire has been answered correctly and to the best of my ability and knowledge.

Name

Title

Date

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