VENDOR HEALTH, SAFETY, ENVIRONMENT & QUALITY

QUESTIONNAIRE

Company / Division: AlMansoori Production Services Tel. No.: (+964) 750 1305671
Address: (P.O. Box) Ainkawa – , Erbil, Kurdistan Fax. No.: N/A
Country: Iraq Email: yanwar@almansoori.biz

Risk Rank (for Division use only)

High Medium Low

(Vendor/Supplier/Contractor) Audits: (for Division use only)

Annually Bi-annually Not Required

Name of Vendor/Supplier/Contractor:

Belmont Asia NDT & Quality Services C/o Alfagates Services Limited

Address:

ERBIL OFFICE: Akad Street, Ainkawa Erbil- Kurdistan Region of Iraq

Pakistan Office: 47, Gulshan Jami, Model Colony Karachi
UK Office: Belmont House Low Green Leeds.

Tel. No.: 00964(0)750-8101520 Fax No.: Telex No.:

After office hours Tel. No. & Contacts:

Atta-Ul-Noor Saquib Operation Manager 00964(0)750-8101520, Email: belmonta@comsats.net.pk

Imtiaz Ahmed -- Operations Coordinator 00964(0)750-8173413, Email: imtiaz.ahmed@belmont-asia.com

Products/Service Provided:

Non Destructive Testing & Evaluation , Consultancy and All associates services including MPI, UT and
Load Test

Commercial Contact (s):

Imtiaz Ahmed -- Operations Coordinator

Cell: 00964(0)750-8173413, Email: imtiaz.ahmed@belmont-asia.com

Technical Contact (s):

Aziz Ahmed Janjua

Sohail Akhtar

Health, Safety, Environment and Quality Contact:

Atta Ul Noor Saquib--00964(0)750-8101520 Email: belmonta@comsats.net.pk

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 VENDOR HEALTH, SAFETY, ENVIRONMENT & QUALITY
QUESTIONNAIRE

Is the company registered to any ISO 9000, 14001, OHSAS

1)
18001 or any other HSEQ standard.
ISO 9001:2000
NDT Services
2) If Yes, give details including scope registration

3) Certificate Number LRQ 0964835

If No, is the company in the process of registration and what

4) N/A
is the expected date of completion?

Does the Company,:

Have a document HSEQ Management system? ( if Yes,

1) YES NO N/A
enclose an uncontrolled copy of your quality manual )
Have a representative responsible for the HSEQ
2) YES NO N/A
Management system who reports to a senior manager?

Name : Brisilda Markaj Job Title: Safety Co-Ordinator

Reporting to

Name : Atta Ul Noor Saquib Job Title: QHSE Manager

Audit and review the HSEQ Management system with

3) YES NO N/A
documented records to show actions taken?
Operate in process inspection and control to documented
4) YES NO N/A
procedures and control limits?
Calibrate testing equipment to a regular schedule using a
5) YES NO N/A
documented procedure?
Identify batches / lots of product with a batch number
6) YES NO N/A
ensuring traceability, including deliveries in bulk?
Operate product inspection / testing independent of
7) YES NO N/A
production?
Test finish product before dispatch conformity with
8) YES NO N/A
documented specification, using documented procedures?
Keep readily retrievable records of product quality for at
9) YES NO N/A
least 2 Years?

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 VENDOR HEALTH, SAFETY, ENVIRONMENT & QUALITY
QUESTIONNAIRE

Have procedures which ensure untested material in not

10) YES NO N/A
dispatched?

Segregate or identify non-conforming product to prevent

11) YES NO N/A
inadvertent dispatch?
Operate a documented system for the supply of non-
12) conforming product only by agreed concession prior to YES NO N/A
dispatch?
Supply the Purchaser with an written and agreed product
13) YES NO N/A
specification?

Supply on request a certificate of conformity to the agreed

14) YES NO N/A
specification to arrive with each delivery?

Operate a purchasing system to ensure that materials and

15) YES NO N/A
services supplied meet contract requirements?

Use suppliers selected on the basis of their quality

16) YES NO N/A
capability?

17) Operate a vendor rating system? YES NO N/A

Clearly state technical and quality requirements on

18) YES NO N/A
purchasing documents?

Inspect incoming materials to the extent necessary to

19) YES NO N/A
ensure they meet the order specification?

20) Provide adequate storage for finished product? YES NO N/A

21) Ensure deliveries are adequately protected during transit? YES NO N/A

Ensure all deliveries are adequately identified on each

22) container including product description, shelf life, together YES NO N/A
with any necessary hazards marking as appropriate?
Maintain training records for all personnel whose activities
23) may affect the quality of the product, delivery or service we YES NO N/A
receive?

Allow the purchaser representative to audit its HSEQ

24) YES NO N/A
Management system on request?

Close for annual holidays, and if so, what are the supply
25) YES NO N/A
arrangements during this period?

Use statistical techniques to determine acceptable quality

26) YES NO N/A
levels for compliance to specifications?

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 VENDOR HEALTH, SAFETY, ENVIRONMENT & QUALITY
QUESTIONNAIRE

Please enclose any ’Product Information’ Sheets which your company may routinely

disseminate to customers.

The completed form and attachments to be returned to ;

Corporate HSE & Quality Manager

AlMansoori Specialized Engineering
P.O. Box 3374
Abu Dhabi
United Arab Emirates

Signature of Authorized Company Representative :

Title: Operations Coordinator

Date: 19-04-2012

AlMansoori Use Only

Approved by:

Division Manager: Signature:

Corporate HSEQ Manager: Signature:

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