Supplier Approval Form

SUPPLIER APPROVAL FORM ADVANCE \d8Section 1: Company Details Supplier Name Business Registration No. (ABN or national equivalent) GST Registered? (Or national sales tax equivalent) [ FORMCHECKBOX ] Yes [ FORMCHECKBOX ] No Premises Address Post Code Account (Postal) Address Post Code Phone No Fax No Sales Contact Position Quality Contact Position Health, Safety & Environment Contact Position Accounts Contact Position What generic business is conducted at your premises? Manufacturer [ FORMCHECKBOX ] Rail Safety Maintenance [ FORMCHECKBOX ] Stockist [ FORMCHECKBOX ] Other [ FORMCHECKBOX ] Brief Description of Company Products Brief Description of Design / Production / Testing Capabilities Current / Previous Major Contracts Sales Turnover ($) Do you agree to the management system requirements detailed within the Downer EDI Rail Supplier Quality Manual? [ FORMCHECKBOX ] YES [ FORMCHECKBOX ] NO Note: The ‘Downer EDI Rail Supplier Quality Manual’ can be accessed via the Downer EDI Rail website ‘Downloads’ page. (http://www.downeredi.com/Default.aspx?aCateId=935) Section 2: Additional documentation requirements Confidentiality Agreement (Form:SPP5043/4/5/6) signed and enclosed [ FORMCHECKBOX ] YES [ FORMCHECKBOX ] NO [ FORMCHECKBOX ] Not required (Downer EDI Rail to complete) Electronic Funds Transfer Application (Form:SPP3052) signed and enclosed [ FORMCHECKBOX ] YES [ FORMCHECKBOX ] NO [ FORMCHECKBOX ] Not required (Downer EDI Rail to complete) Supplier Insurance Details (Form:SPP3054) enclosed [ FORMCHECKBOX ] YES [ FORMCHECKBOX ] NO [ FORMCHECKBOX ] Not required (Downer EDI Rail to complete) Direct Digital Manufacturing (Form:SPP3055) questionnaire enclosed [ FORMCHECKBOX ] YES [ FORMCHECKBOX ] NO [ FORMCHECKBOX ] Not required (Downer EDI Rail to complete) Independent supplier performance reference enclosed [ FORMCHECKBOX ] YES [ FORMCHECKBOX ] NO [ FORMCHECKBOX ] Not required (Downer EDI Rail to complete) Section 3: Management System Details Do you have a third-party certified Quality Management System? [ FORMCHECKBOX ] YES Details below [ FORMCHECKBOX ] NO If NO, please go to Section 4 Quality System Standard Certificate Number Certificate Issue Date (please attach a copy) Do you have a third-party certified Environmental Management System? [ FORMCHECKBOX ] YES Details below [ FORMCHECKBOX ] NO If NO, please complete Section 5 Environmental Management System Standard Certificate Number Certificate Issue Date (please attach a copy) Do you have a third-party certified OH&S Management System? [ FORMCHECKBOX ] YES Details below [ FORMCHECKBOX ] NO If NO, please complete Section 5 OH&S Management System Standard Certificate Number Certificate Issue Date (please attach a copy) Do you have Rail Safety Accreditation to AS4292 ‘Rail Safety Management’? [ FORMCHECKBOX ] YES Details below [ FORMCHECKBOX ] NO If NO, please complete Section 5 Certificate Number Certificate Issue Date (please attach a copy) Section 4: Quality Management System Details If Third Party certification not held please provide listings of available Quality Management System (QMS) procedures. QMS procedure listing enclosed: [ FORMCHECKBOX ] YES [ FORMCHECKBOX ] NO Section 5: Company Environmental, Occupational Health & Safety and Rail Safety Management System’s documentation (If yes, to any of the questions below, please attach supporting documentation) 1. Do you have a documented; YES NO a) Environmental Management System? [ FORMCHECKBOX ] [ FORMCHECKBOX ] b) Occupational Health & Safety Management System [ FORMCHECKBOX ] [ FORMCHECKBOX ] c) Rail Safety Management System? [ FORMCHECKBOX ] [ FORMCHECKBOX ] 2. Do you have a documented; a) Environmental Policy [ FORMCHECKBOX ] [ FORMCHECKBOX ] b) Occupational Health & Safety Policy? [ FORMCHECKBOX ] [ FORMCHECKBOX ] c) Rail Safety Policy? [ FORMCHECKBOX ] [ FORMCHECKBOX ] 3. Do you have a documented procedure that outlines how your company identifies and access’s applicable legal and other requirements, and how your company determines how they apply to your responsibilities in regards to; a) The Environment [ FORMCHECKBOX ] [ FORMCHECKBOX ] b) Occupational, Health & Safety [ FORMCHECKBOX ] [ FORMCHECKBOX ] c) Rail Safety [ FORMCHECKBOX ] [ FORMCHECKBOX ] 4. Do you have documented procedures to identify potential emergency situations and accidents, and how to respond to them, for; a) Environmental emergencies? [ FORMCHECKBOX ] [ FORMCHECKBOX ] b) Health & Safety emergencies? [ FORMCHECKBOX ] [ FORMCHECKBOX ] c) Rail Safety emergencies? [ FORMCHECKBOX ] [ FORMCHECKBOX ] 5. Do you have a documented procedure for consulting with employees in regards to issues relating to; a) OHS [ FORMCHECKBOX ] [ FORMCHECKBOX ] b) Rail Safety [ FORMCHECKBOX ] [ FORMCHECKBOX ] 6. Is your organisation accredited as a Rail Operator by your state Regulator? [ FORMCHECKBOX ] [ FORMCHECKBOX ] 7. Has you organisation had an environmental, OH&S or Rail Safety incident on site, which was required to be reported to a regulatory body? (If yes, please provide details) [ FORMCHECKBOX ] [ FORMCHECKBOX ] 8. Has your organisation been issued with a notice (eg clean up notice, improvement notice, prohibition notice) from a government regulatory body of an environmental, OH&S or Rail Safety incident? (If yes, please provide details) [ FORMCHECKBOX ] [ FORMCHECKBOX ] 9. How many Lost Time Injuries have occurred in the last 12 months? 10. Do you provide environmental / safety / rail safety training to all new and existing employees? [ FORMCHECKBOX ] [ FORMCHECKBOX ] Completed by: Name Position Date Please append any other information you wish to include within your submission. For Downer EDI Rail HSE Review Use Only Supplier action plan required? YES[ FORMCHECKBOX ] NO[ FORMCHECKBOX ] Details Reviewed By: Name Signature Date Page 1 of 3 Form:SPP3051 (11.08) Created by: Sunil Sharma Approved by: J Rzetelski