*sample report* qc_covid... · export markets: markets y/n us/north america european union south...
TRANSCRIPT
COVID-19 Medical Personal Protective Equipment (PPE) Supplier Verification
*Sample Report*
North America
+1-813-252-4770
Latin America +52-81-2721-0928
Europe & Middle-East
+49-8179-998-7593
Asia & Asia Pacific +886-2-2832-2990
India
+91-120-4291971
Website www.proqc.com
Contact Pro QC at [email protected]
“By opting to receive a copy of this sample Report from Pro QC, users accept and agree to be bound by the clause on Confidential Information outlined in the General Terms and Conditions of Service. This sample report is provided by Pro QC International to prospective clients for reference purposes only. Users may not share or re-distributed this Sample Report with third parties, nor use or alter, in part or whole, the structure or content of this Sample Report for use other than as intended herein.”
Rev
1
Assessment Date
1/0/1900
Supplier Information:
Supplier Name:
Supplier Address:
Supplier Address:
Phone Number:
Fax Number:
E-mail:
Year Established: Business License No.
Production Area: m^2 Warehouse Area: m^2
*Include Photo
Type of Ownership
Owner Name: E-mail:
Owner Name: E-mail:
Owner Name: E-mail:
COVID-19 Medical Personal Protective Equipment (PPE)
Supplier Profile
Please select one
A. General Information
Supplier Name
0
Report Number
0
Pro QC's Recommendation
Does the factory has a COVID-19 virus prevention plan (e.g. government manual)?
VERIFIED: The supplier is a legit Medical PPE manufacturer. During the visit, Pro QC representative was able to verify all
the products were available on-site.
ON-HOLD: The supplier is a legit Medical PPE manufacturer. However, during the visit, Pro QC representative only able to
verify some of the products were available on-site.
NOT VERIFIED: The supplier is not a manufacturer of Medical PPE and/or is only a reseller of Medical PPE.
0
0
Photo of Main Gate Photo of Building Entrance
Rev
1
Assessment Date
1/0/1900
COVID-19 Medical Personal Protective Equipment (PPE)
Supplier Profile
Supplier Name
0
Report Number
0
*Please include a photo of the certificate in the Photo Report.
Standard Y/N
ISO 9001:2015
ISO 13485:2016
GMP for Medical
Devices
Others [write name]
Others [write name]
Capacity per Day
days
Does the factory have a cleanroom? If yes, class level of cleanroom:
What is the factory's average lead time from PO placement to delivery of production parts?
How many production lines are in the factory?
Product Name Quantity In-stockProduct Certificate No.
B. Certificates
Certificate Number Expiration Date
Factory Certificates:
*Please include a photos of the product and the certificate in the Photo Report.
Photo of Manufacturing/Cleanroom Area Photo of Finished Product Warehouse
Medical PPE Information (Non-US markets):
Rev
1
Assessment Date
1/0/1900
COVID-19 Medical Personal Protective Equipment (PPE)
Supplier Profile
Supplier Name
0
Report Number
0
*Please include a photo of the certificate in the Photo Report.
FDA Registration Owner/Operator Number:
Export Markets:
Markets Y/N
US/North America
European Union
South America
Domestic
Others
Photo of FDA Registration Photo of GMP for Medical Devices Certificate
D. Exporting Markets
Factory Certificates (for US Market ONLY):
Product Certificates (for US Market ONLY):
Listing Number Proprietary Name Model
C. United States (US) Market Only
Units Exported % of Business Volume
Rev
1
Assessment Date
1/0/1900
COVID-19 Medical Personal Protective Equipment (PPE)
Supplier Profile
Supplier Name
0
Report Number
0
Production and Quality Assurance & Quality Control:
E. Employee Information
Total # of Employees:
Total # of Inspectors:
Total # of Auditors:
Total # of Machine Maintenance:
Total # of Lab Technicians:
Total # of Production Employees:
Total # of Assembly Employees:
Total # of Packaging Employees:
0
1
COVID-19 Medical Personal Protective Equipment (PPE) Rev.
Photo Report
Supplier Name Audit Date Report No.
0 1900/1/0 0
Others [write name]
A. FACTORY CERTIFICATES
ISO 9001:2015 ISO 13485:2016
GMP for Medical Devices COVID-19 Virus Prevention Plan
Others [write name]
1
COVID-19 Medical Personal Protective Equipment (PPE) Rev.
Photo Report
Supplier Name Audit Date Report No.
0 1900/1/0 0
Product - Photo Product - Certificate
Product - Photo Product - Certificate
Product - Photo Product - Certificate
B. PRODUCT PHOTO & CERTIFICATE
1
COVID-19 Medical Personal Protective Equipment (PPE) Rev.
Photo Report
Supplier Name Audit Date Report No.
0 1900/1/0 0
Product - Photo Product - Certificate
Product - Photo Product - Certificate
Product - Photo Product - Certificate
1
COVID-19 Medical Personal Protective Equipment (PPE) Rev.
Photo Report
Supplier Name Audit Date Report No.
0 1900/1/0 0
Product - Photo Product - Certificate
Product - Photo Product - Certificate
Product - Photo Product - Certificate
1
COVID-19 Medical Personal Protective Equipment (PPE) Rev.
Photo Report
Supplier Name Audit Date Report No.
0 1900/1/0 0
Product - Certificate
Product - Photo Product - Certificate
Product - Photo Product - Certificate
Product - Photo
1
COVID-19 Medical Personal Protective Equipment (PPE) Rev.
Photo Report
Supplier Name Audit Date Report No.
0 1900/1/0 0
Photo Photo
Photo Photo
Product - Photo Product - Certificate
C. ADDITIONAL PHOTOS
1
COVID-19 Medical Personal Protective Equipment (PPE) Rev.
Photo Report
Supplier Name Audit Date Report No.
0 1900/1/0 0
Photo Photo