Supplier AssessmentToolkitApril 2003Ingredient Supplier Assessment QuestionnaireName of supplier : Begovi CommerceAddress of factory : Zemljane uprije !2"!#$ No%i Sad&e%ision '(ka$ )umano%ska *+*+This questionnaire has been completed by:Name: ,ego%i Nenad-unction: &irectorTelep.one: 0/3300002-a1:e2mail:MATERIAL DETAILSType of material3s4 produced for Nestl5:6ine %inegar&ate: 0#+!0+20!7+ Signature: 888888888888To *e filled in *y Nestl5Supplier 9onfidence :e%el :o; a; isk :o; Re=ion6ine Ser*ia6.at are your supply net;orks and c.annelsB?roducers on contract$ intermediary agency$ spot purc.ase$ distri*ution$ ot.er+Agriculture manufacturer=o; do you appro%e your supplierB 6ine analysis&o you audit your suppliersB yes no NAI9 yes: =o; oftenB @ccasionaly&o you monitor upstream of your o;n supplierB yes no NA&o your ra; materials .a%e to meet specificationsB yes no NA&id you assess t.e dangers linked to your ra; materials and t.eir originB yes no&oes a monitoring plan e1ist for t.e ra; materials used for t.e Nestl5 productsByes no NAI9 yes: please 9ill in the table in Anne< %"?lease list t.e ot.er ra; materials used on t.e site+None2.5. %&B,CONTACT$N1 2#"# TO POD&CT 3&AL$T45&o you su*2contractB yes noSome of t.e productionB yes no NAI9 yes: ;.ic. part and ;.ereB Some of t.e premises 3retailers$+++4 yes no NAI9 yes: ;.ic. onesB Some of t.e ser%ices yes no NAI9 yes: ;.ic. ones$ 3maintenance$ sanitation$ cleaning of premises$ production lines+++4B AI23!+322 Supplier Assessment Toolkit+Ingredient SupplierAssessment Questionnaire+ ?age /Supplier AssessmentToolkitApril 2003$" '(ALIT) OR&AISATIO&o you .a%e a Duality assurance systemB yes noIs your Quality Assurance system certifiedB yes no6.at is t.e reference standard:=99?6.o is t.e certifying organisationB 6.at is t.e date of t.e last certificationB6.at is t.e title of t.e certification 3application field4B &oes t.e plant .a%e a la*oratoryB yes noI9 yes: list t.e analyses 3Q