Supplier Questionnaire Supplier: Questionnaire: SQ-Supplier Self Description (v2.0-20110101) Number: Status: Created on: Last change: Page: 1 of 12
Legend Name ( ) (X) ( ) [X] [ ] [X] Questions marked like this are mandatory fields and must be filled out. Questions with answers in this brackets show you some given answers you can select. You can only choose one answer. Questions with answers in this brackets show you some given answers you can select. You can choose more than one answer. Page: 2 of 12
Introduction Dear Partners, The Supplier Qualification process is the initial stage of Supplier Management @ Siemens for all new suppliers. Existing suppliers will gradually be qualified retroactively with regard to our Supplier Qualification requirements. The questionnaire "Supplier Self Description (SSD)" is part of the Siemens-wide mandatory and standardized supplier-related qualification process. Having fulfilled a number of basic business criteria, companies wishing to become a Siemens supplier must meet certain minimum economic, environmental and social performance standards by completing up to six qualification modules. This company-wide mandatory and standardized supplier-related qualification process is integrated within our supplier platform click4suppliers easy and releases the supplier for business with Siemens, independent of later product and process related qualifications. Supplier Qualification is a cross-functional process which is driven by the Siemens buyer in close interaction with the supplier. Link for additional information: https://w9.siemens.com/cms/supply-chain-management/en/supplier-at-siemens/download-ce nter/pages/dc.aspx (below Registration & Communication: Download file "Supplier Self Description (SSD)" ) Yours faithfully Siemens Page: 3 of 12
Relevant Contacts Please enter the relevant contacts according to their functions in the following chapters. Management Salutation ( ) Ms. ( ) Mr. Title Last name First name Phone Mobile Fax E-Mail Org. / Dept. Street ZIP code City Country Function Page: 4 of 12
Sales Salutation ( ) Ms. ( ) Mr. Title Last name First name Phone Mobile Fax E-Mail Org. / Dept. Street ZIP code City Country Function Quality Salutation ( ) Ms. ( ) Mr. Title Page: 5 of 12
Last Name First Name Phone Mobile Fax E-Mail Org. / Dept Street ZIP code City Country Function Product related environmental protection Salutation ( ) Ms. ( ) Mr. Title Last Name First Name Phone Page: 6 of 12
Mobile Fax E-Mail Org. / Dept. Street ZIP code City Country Function Logistics Salutation ( ) Ms. ( ) Mr. Title Last name First name Phone Mobile Fax E-Mail Page: 7 of 12
Org. / Dept. Street ZIP code City Country Function Additional Contacts Additional Contact Basic Company Data Which type of business is your company focus? [ ] Product related business [ ] Project- / investment business [ ] Service business Does your company already supply Siemens or connected Companies (subsidiary, joint ventures)? ( ) yes ( ) no If yes, where and since when: Portfolio ESN List UNSPSC for download Portfolio - Comment (Catchwords / Synonyms) Page: 8 of 12
Financial When does your business year start? ( ) January ( ) February ( ) March ( ) April ( ) May ( ) June ( ) July ( ) August ( ) September ( ) October ( ) November ( ) December Currency ( ) EUR ( ) USD Total Sales Revenue 2012: 2013: 2014 (planned): What's your effort on R&D (in percent of Total Sales Revenue) 2012: 2013: 2014 (planned): How is this Total Sales Revenue spread over the different regions (in percent)? Western Europe Eastern Europe Page: 9 of 12
NAFTA South and Latin America Asia and Pacific Africa Others Infrastructure Number of employees 2012: 2013: 2014 (planned): Please list your production sites Market Please list your top 10 customers (Siemens areas and others). Please list your main competitors Logistics Has your company already realized an EDI connection? ( ) Yes ( ) No, but possible / aspired ( ) No, not possible / not aspired Page: 10 of 12
Does you company provide logistic supply systems? ( ) Yes ( ) No ( ) Not relevant If yes, which? [ ] Consignment concept [ ] Contracts store concept [ ] Stockpile sourcing [ ] Synchronized production processes [ ] Standard parts management [ ] Individual sourcing [ ] Kanban Quality Does your company have any quality assurance agreements with Siemens? ( ) yes ( ) no If yes, with whom and since when? Has your QM System been audited by Siemens? ( ) yes ( ) no If yes, please set following parameters for last Q Audits: Page: 11 of 12
Country specific Questions Supplier diversity (just relevant for suppliers with registered office in USA) ( ) applicable ( ) not applicable Percentage of ownership Supplier diversity key ( ) N Native American ( ) B African American ( ) A Asian Pacific American ( ) H Hispanic ( ) A Asian Indian American ( ) SB Small Business ( ) SBH Small Business Hub Zone ( ) SBV Small Business Veteran ( ) SD Small Disadvantage Business ( ) WD Woman owned Disadvantage Business ( ) WS Woman owned Small Business ( ) X Not available Page: 12 of 12