Document No.

Revision 0
Supplier Pre-Assessment
QuestionnaireVendor
Evaluation Form
COMMODITY:
SUPPLIER NAME: __________________________________
PHYSICAL ADDRESS:
SUPPLIER CONTACTS :_____________________________

TELEPHONE No.:___________________________________

QUALITY MANAGEMENT SYSTEM:

ESKOM VENDOR NUMBER : (if applicable)
Question ISO9001 Ref. Comments
No.
1. Scope of supply General
Please state whether you conduct the work using
your own company and resources, or that of a
subcontractor?

2. Resource Authorisation OHS 18001,

 Please state whether your staff is authorised in ISO9001,
terms of Operating Regulations for High Clause 6
Voltage Systems (ORHVS)
 State the outcome (level) of the authorisation
 State the number of people authorised

3. Quality Management System [QMS] 4

Please confirm that you are either ISO 9001
certified or operate a fully defined and documented
QMS complying to ISO9001: 2008

4. Professional/Regulatory Registration 6
 Is the supplier registered with Electrical
Contractors Association (ECA)?
 What is the level of registration with CIDB?
 What is the supplier’s B-BBEE level?
 What is the supplier’s current B-BBEE status?
Exempt Micro Enterprise (EME), Qualifying
Small Enterprises (QSE) , Large Measured
Entity LME

5. Tools & Equipment 6

 Does the supplier have own tools &
equipment?
If YES attach the list on reply
 Does the supplier have own vehicles?
If YES attach the list of vehicles

6. Facilities 6
Does the supply have storage & office space?

7. Work History General

Please attach the list of previously completed
projects of a similar nature and scale within the
past two years
 INDEX OF PROCUREMENT QUALITY RETURNABLE
DOCUMENTS (REFERENCE QM 58)
COMPANY REPRESENTATIVE:_________________________________

DESIGNATION:_______________________________________________

SIGNATURE:_________________________________________________ DATE:___________________
Ref Clause Description of Quality Document
This document shall be read together with the QM 58 attachment.
(ESKOM USE ONLYSupplier Use Only)
The contractor shall complete and sign form A
RECOMMENDATION:
The contractor shall complete and sign form B
QUALITY ADVISOR The contractor shall attach the following :
The contractor shall attach a copy of the CV / Resume of the contractors Quality
1
NAME:_____________________________________________________
Management Representative responsible for the contract/service.
The contractor shall attach a copy of a valid ISO 9001 2008 certification or objective
DESIGNATION:______________________________________________
2
evidence of a Quality Management System that complies with ISO 9001 2008.
The contractor shall attach a copy of the latest structure / organogram of the quality
SIGNATURE:________________________________________________
3 function, including an indication of qualifications of personnel. This structure shall
DATE:___________________
indicate the quality reporting structure.
The contractor shall attach information / historic data on similar work/contracts
4
performed (within the last two years).
TECHNICAL SPECIALIST:
The contractor shall attach a sample Contract Quality Plan (including a Quality
5 Control Plans and Inspection Testing Plans) from a similar project carried out within
NAME:_____________________________________________________
the last two years.
The contractor shall attach a typical sample of a completed and closed out Non-
DESIGNATION:______________________________________________
6
Conformance Report.
SIGNATURE:________________________________________________
The contractor shall attach a typical example of a completed and closed out
DATE:___________________
7
Corrective Action Report, and a completed Preventative Action Report
The contractor shall attach a copy of their Supplier Audit Schedule together with a
8
completed audit report on one of their critical suppliers.
The contractor shall attach a copy of their Supplier/sub-contractors Control
9 Procedures including records of evaluation, selection and control of suppliers and
1

QUALITY MANAGEMENT DEPARTMENT – SUPPLIER ASSESSMENTS

sub-contractors)
The contractor shall attach a copy of any QMS accreditations or any information
10 relating to specific standards within their industry. (e.g. Welding, NDT, NDE) or any
7 other special processes requiring certification
11 The contractor shall submit a list of identified potential long lead times items
12 The contractor shall submit a copy of their manufacturing schedule (if applicable)
13 The contractor shall supply preliminary risk assessment data from similar projects.
14 The contractor shall supply a list of identified risk of critical characteristics
The contractor shall supply copies of any QMS / Technical assessment reports carried
17
out by Eskom in the last two years
The contractor shall attach a minimum of 5 copies of typical customer satisfaction
18
surveys / questionnaires as per the requirements of ISO 9001 2008 (Clause 8.2.1)
Access to the suppliers’ and sub-contractors’ site or premises for the purpose of
assessments and audits of the Quality Management System will form part of quality
Note
requirements
 APPENDIX A : TENDER & CONTRACT QUALITY REQUIREMENTS

Enquiry/contract no:
Equipment/service
Indicate with an X as applicable in box below or N/A

Section A: General Requirements (Clause 3.1 of QM-58) X

Section B: Tender Submission Phase (Clause 3.2 of QM-58) X
Section C: Tender evaluation, adjudication and negotiation phase (Clause 3.3 of QM-58) X
Section D: Contract Award Phase (Clause 3.4 of QM-58) X
Section E: Contract Execution and Quality Control Phase (Clause 3.5 of QM-58) X
Section F: Supplier Quality Performance Monitoring (Clause 3.6 of QM-58) X
Section G: e-Quality Tool (Clause 3.7 of QM-58) X
Section H: Payment and Delivery (Clause 3.8 of QM-58) X

ADDITIONAL/ALTERNATIVE QUALITY INFORMATION SUBMITTED BY CONTRACTOR

REFERENCE NUMBER TITLE OF STANDARD/SPECIFICATION/GUIDELINE

Employer Name: Signature: Date:

Contractor

Employer’s quality representative

appendix b: Quality requirements for iso 9001 series

QUALITY REQUIREMENTS FOR Doc. no.:

QUALITY MANAGEMENT ISO 9001 Ref. no.: Rev. 0
SERIES Doc. type: FORM Page 1 of 1
Enquiry/contract/order no.: ……………..………………………Plant:
……………………………………….

Equipment/service: ……………………………………………………………………………………………

The following areas of ISO 9001 quality management systems will be mandatory as indicated:

Quality management system:

General requirements Yes

Document requirements Yes

Management responsibility:

Management commitment Yes

Customer focus Yes

Quality policy Yes

Planning Yes

Responsibility, authority, and communication Yes

Management review Yes

Resource management:

Provision of resources Yes

Human resources Yes

Infrastructure Yes

Work environment Yes

Product realisation:

Planning of product realisation Yes

Customer-related processes Yes

Design and development Yes

Purchasing Yes

Product and service provision Yes

Control of monitoring and measuring devices Yes

Measurement analysis and improvement:

General planning Yes

Monitoring and measurement Yes

Control of non-conforming product Yes

Analysis of data improvement Yes

Requirements accepted by: Name: Signature: Date:

Employer

Contractor

Employer’s quality representative

Document No. Revision 0

Supplier Pre-Assessment
Questionnaire

COMMODITY:
SUPPLIER NAME: __________________________________
PHYSICAL ADDRESS:

SUPPLIER CONTACTS :_____________________________

TELEPHONE No.:___________________________________

TECHNICAL QUESTIONAIRE:
ESKOM VENDOR NUMBER : (if applicable)

Question Ref. No. Comments

CIDB Rating for all Building Services General

Please state the CIDB Rating for the main

contractor and all contractors including

Civil

Mechanical

Electrical

Fire Protection

Fire Detection

HVAC

Business Organogram General

Please provide a business organogram

List of projects completed/ previous work General

experience in construction of an industrial
office complex with a project value above
R15m

List of associated subcontractors and provide their General

project track record (structural, civil, electrical,
electronic & HVAC)
Experience with employing local labour on a project General

COMPANY REPRESENTATIVE:_________________________________

DESIGNATION:_______________________________________________

SIGNATURE:_________________________________________________ DATE:___________________

(ESKOM USE ONLY)

RECOMMENDATION:

TECHNICAL ADVISOR

NAME:_____________________________________________________

DESIGNATION:______________________________________________

SIGNATURE:________________________________________________

DATE:___________________
TECHNICAL SPECIALIST:

NAME:_____________________________________________________

DESIGNATION:______________________________________________

SIGNATURE:________________________________________________ DATE:___________________

TECHNICAL – SUPPLIER ASSESSMENTS

 Document No. Revision 0

Supplier Pre-Assessment
Questionnaire

COMMODITY:

SUPPLIER NAME: __________________________________

PHYSICAL ADDRESS:

SUPPLIER CONTACTS :_____________________________

TELEPHONE No.:___________________________________

HEALTH AND SAFETY MANAGEMENT SYSTEM:

ESKOM VENDOR NUMBER : (if applicable)

Question Ref. No. Comments

Is company registered with Compensation Commissioner? General

Provide CC Fund number and Letter of Good Standing. If
yes, attach proof
Does company have an Organisational Organogram (detailing General
all statutory appointments – List all possible
appointments)? If yes, attach proof

Has a Person charged with the responsibilities of the Act been OHS
appointed? (Provide appointment letters16 (1) & 16(2)). Act,
(Reference Section 16 OHS Act) If yes, attach proof Section
16

Has a Person charged with the responsibilities of the Act been OHS
appointed? (Provide appointment letters16 (1) & 16(2)). Act,
(Reference Section 16 OHS Act) If yes, attach proof Section
16

Does the company have a written SHE (Safety, Health and OHSA
Environmental) Policy in place? If yes, attach proof. 85/1993
Reference Section 7 - OHSA 85/1993 ,
Section
7

Does the company provide training for employees and General

appointees (Training Matrix)? If yes state training in
relation to appointee / employee using the format below.
Attach proof of Competency

18.2 Provide appointment letters and proof of competency for

all legally appointed persons?

Appointee / Workers Training

Does the company have a SHE Plan? If yes, attach. Reference CR 5(4)
CR 5(4)

Provide details of Hazard Identification and Risk Assessment CR 7

methodology/procedure with risk matrix. Attach
examples of baseline risk assessment and issue based
risk assessment. Reference CR 7

How does the company ensure legislative, contractor and client CR 5

requirement compliance of sub-contractors (Sub-
contractor management)? Provide details. Reference CR
5

Provide incident statistics for current year and previous two

years using below format

Type of incident
Incident Corrective Responsible Lost Time
Date
Description (Fatal / LTI / Action Person Injury Rate
Medical/Environmental)

Has the company made provision for the cost of Health, Safety CR4 (h)
and Environment? Provide details. Reference CR4 (h)

COMPANY REPRESENTATIVE:_________________________________

DESIGNATION:_______________________________________________

SIGNATURE:_________________________________________________ DATE:___________________
(ESKOM USE ONLY)

RECOMMENDATION:

RISK ADVISOR

NAME:_____________________________________________________

DESIGNATION:______________________________________________

SIGNATURE:________________________________________________

DATE:___________________

RISK SPECIALIST:

NAME:_____________________________________________________

DESIGNATION:______________________________________________

SIGNATURE:________________________________________________ DATE:___________________

RISK MANAGEMENT DEPARTMENT – SUPPLIER ASSESSMENTS