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F0039 - Revision 2Ref: QA-0097 (Medical)Ref: QA-0116 (Medical)Ref: D0118

Confidential Christie Digital Systems Canada, Inc.,

Christie Digital Systems USA, Inc., and Affiliates

SUPPLIER QUESTIONNAIRE

Supplier (Official Name): Completed by:

Address: Position:

City/Province/State: Email Address:

SUPPLIER INFO

Website:

SUPPLIER PROFILE

Postal/Zip: Telephone Number:

Country: Date:

Ownership: Public Private Other

If Public add Stock Symbol:

% Yr on Yr Growth Past 3 Yrs:

Duns#:

Products/Service at this Facility:

Years in Business:

Annual Sales:

No. of Employees:

Facility Size:

Major Customers: Product: % of Revenue:

Supplier Contacts (Name & E-mail)Quality: Engineering:

Sales:

Attach company organization chart: Yes No

Locations of Factories/Head Office/Sales offices globally (other divisions)

Division:

Division:

Division:

Location:

Location:

Location:

May we contact the above customers for a reference? Yes No

Certification InformationSafety Critical

Product CertificationAre you currently supplying products or items certified by regulatory agencies like UL/CSA/ETL? If Yes, Please tick the agencies to which your products are certified and specify the file #.

UL #________ CSA #________ ETL#_______ CCC#_______ KC#_______ CE#_______ VDE#________ PSE#________ Others: 1. ________ 2. ________ 3. ________

QMS Certification Are you certified to a recognized quality program? Yes NoIf yes please attach copies of the certificate/s

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F0039 - Revision 2Ref: QA-0097 (Medical)Ref: QA-0116 (Medical)Ref: D0118

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Is there a Supplier Management process in place?

Yes No N/AQUALITY PROGRAM MANAGEMENT

SUPPLIER QUESTIONNAIRE

Yes No N/A

Are there programs in place for continuous improvement such as TQM, quality circles, Kaizen, Material review board, etc.?

Is there a function responsible exclusively for Quality?

N/ANoYes

N/AYes No

QUALITY CONTROL/ASSURANCE PROGRAM

ENGINEERING & DEVELOPMENTIs a project schedule developed and maintained showing major milestones?

Are there documented design reviews?

Are programs in place to assure reliability such as MTBF (calculated or actual), STRIFE (stress to failure), Component Evaluation, etc.?If Yes ________________________

ENVIROMENTAL CONTROLS

Is your company required by local government regulations to control the disposition of environmentally sensitive or hazardous materials? Please Attach documentation.

Does the company have an Environmental Policy, or are you certified for EMS programs such as ISO14001? Please attach policy/certification if yes.

Do you have a procedure for First Article Inspection documentation?

Is there a Quality Manual under revision control? If yes, provide a copy of the table of contents and Approval pages

Is there a flow chart showing all steps of manufacturing, test and inspection? e.g. Inspection and Test Plan

Are there procedures in place for non-conformance control & corrective action?

Is there a program for supplier selection, audit, source inspection, outsourced processes etc

Would you be receptive to a "custom" quality program for Christie?

Would you consider the use of returnable packaging?

Does your Company have a recycling program for its manufacturing process?

Is your Company able to supply products meeting the most current revision of EU REACH Regulation No.1907/2006?

Is your Company able to supply products meeting the ROHS requirements to the most current revision 2011/65/EU?

Are there procedures in place to control the disposition of these materials?

Are there design and reliability tools in place such as CFD, FEA, HALT, CAM, Mold Simulation, CMM measurement and environmental testing?Are there product or field data on existing product that Christie may review?

Is there a procedure in place for product revision changes (internal and for the Customer)?

Confidential Christie Digital Systems Canada, Inc.,

Christie Digital Systems USA, Inc., and Affiliates

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F0039 - Revision 2Ref: QA-0097 (Medical)Ref: QA-0116 (Medical)Ref: D0118

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MANUFACTURING & WAREHOUSING

Please state which:

Yes No N/AIs it possible to serialize and/or date-code product?

Are special processes controlled by procedures, training and control charts, etc? Examples: Soldering; HV potting; plating; painting; optical coatings, etc.

Are there procedures as necessary for ESD handling, Shelf-life, special environment, clean room levels, storage etc.?

Are tags, stamps or computer entry used to show parts have passed a particular process?

Does production receive work instructions that outline assembly drawings, product instructions, work order sheets, inspection records that show accept/reject criteria and sampling plans on ongoing production (e.g. ongoing FAI, AQL, Pass/Fail after Testing etc).?

No N/AYes

OTHER

Please Specify:

SUPPLIER QUESTIONNAIRE

Christie Digital Comments:

Would you permit a process audit/survey or source inspection by Christie or representative?

When required, can you provide test data results or Certificate of Conformance with each shipment?Is there a calibration cotrol program in place for control of monitoring on measuring devices/gauges/testing equipment/fixtures?Is there an established system of non-comformance control to prevent defecive product from being shipped to customers?

Confidential Christie Digital Systems Canada, Inc.,

Christie Digital Systems USA, Inc., and Affiliates