Supplier Questionnaire Date* Company Name* Contact information:*FirstLast Phone* Email* Food Safety Contact*FirstLast Food Safety Contact Phone:* Food Safety Contact Email* Address* Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d'IvoireCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWalesYemenZambiaZimbabwe Country Is the company registered under the Bio-terrorism Act of 2002 administered by the US Food and Drug Administration? *YesNo Does your company have a HACCP program?*YesNo If there is no HACCP program, has a risk assessment been conducted on the product(s) supplied? *YesNo Is there a Food Defense Program in place at the company? *YesNo Does the company have a Recall Program in place?*YesNo Will your company be able to supply COA’s and specification for each product supplied? *YesNo Is there a supplier authenticity program (Provider Guaranty) on raw materials? *YesNo Is there a Food Safety Program, (production, sanitation, maintenance) Consisting of self-inspection and procedure audits? *YesNo Is there an Allergen program in place to identify all allergens?*YesNo Does the company have documented employee plant policies and follow The FDA Good Manufacturing Practices (GMP’s), including training documentation? *YesNo Is there a customer complaint procedure in place?*YesNo Do delivery vehicles have a lock or seal program?*YesNo Are allergens used anywhere in the production of packaging, including Boxes or bags? *YesNo Is there a metal detection system on all lines and a documented log? *YesNo Is there a glass and brittle plastic policy in place?*YesNo Are manufacturing safety data sheets (MSDS) on file for all ingredients Used in the manufacture of products? *YesNo Is there a bioterrorism preparedness and response program in effect at this location? *YesNo Do your products have GTIN’s?*YesNo Is there a quality control process in place?*YesNo Are there procedures for inspection of transport vehicles?*YesNo Is there a written pest control policy in place?*YesNo Is there a documented recall program in effect? *YesNo Is there lot trace-ability on all raw material, products or packaging materials? *YesNoSubmitReset
