DOC TYPE DOC NUMBER EFFECTIVE DATE REVISION

Form QA0254 31st August 2020 005

DEPARTMENT TITLE
Supplier Management SUPPLIER QUESTIONNAIRE

Supplier Details Pall Site

Supplier Name: ACT Sistemas Hidraúlicos ltda Name:
Location: Rua: Maria Fet ,96 Location
Contact Name: Qualidade Amanda katayama
Phone No. 11 99307-1197
E-MAIL: [email protected]

To assist Pall in making an assessment of your company as a potential supplier or to maintain your existing approval, it would be appreciated if you would complete and
return this questionnaire. This form, once completed, will be treated as Private Information.
Thank you for your assistance

INSTRUCTIONS - PLEASE READ CAREFULLY THE 10 POINTS BELOW

1 - This self questionnaire has been designed to give Pall Corporation an understanding of how your company operates.
- The completion of this assessment is mandatory prior to continuing through the approval process.

2 - Each section has a detailed list of questions which you are required to answer as you feel appropriate.
- Please if questions are not applicable, mark n/a.

3 - All fields require an answer.

4 - Once you have read the questions you are required to 'score' your results.

5 This task can be completed by referring to the appropriate '"Reference" pages.

By cross referencing your answers to the ones on the assessment tabs, you can determine your score.
Please enter this score in the appropriate column next to your given answers.

6 - These "Reference pages" will also aid you when completing the questionnaire in terms of understanding the question in full. A
Glossary of Terms with definitions is available in the final sheet of this workbook should you require it for your business.
- Please provide details as requested.
- Please note: in order for you to award yourself a particular score, you must satisfy all the points in the particular section.

7 - Once you have answered all the questions in MS Excel, save, print, sign and scan the document as per the format below.
- Name of your Company_Supplier Questionnaire.pdf (e.g. Pall_Supplier Questionnaire.pdf), and then Adobe (.pdf) versions need to
be returned

8 - Please then return the document to the sender via e-mail.

9 - This document will then be used as a discussion document when the Pall representative visits your company. i.e. to audit some of
your scores, look at some of the processes you have in place or obtain examples were applicable etc.

10 - If you have any queries or questions , please contact your Pall point of contact.

Page 1 of 16_x000D_ Confidential - Company Proprietary

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 DOC TYPE DOC NUMBER EFFECTIVE DATE REVISION
Form QA0254 31st August 2020 005
DEPARTMENT TITLE
Supplier Management SUPPLIER QUESTIONNAIRE

Supplier Details Pall Site

Supplier Name: ACT Sistemas Hidraúlicos ltda Name:
Location: Rua: Maria Fet ,96 Location
Contact Name: Qualidade Amanda katayama
Phone No. 11 99307-1197
E-MAIL: [email protected]

1) GENERAL
Answer
a) Certifications Yes or No

a. Do you have certification to either ISO9001, ISO13485, ISO16949 or AS9100 quality standard? (If yes, please provide a copy.) No
b. If YES please disregard the following questions:

Do you have a Quality / Inspection Department? Yes

Is Inspection / test equipment regularly calibrated? Yes

Are such calibrations recorded and traceable to National standard? No

Do you operate and record Goods Inwards Inspection / testing? Yes

Do you operate and record In-Process Inspection and Testing? No

Do you operate and record Final Inspection / Testing? No

Are all orders received reviewed for completeness, accuracy and delivery? Yes

Do you operate a procedure that ensures document and data control? Yes

Are regular internal quality audits performed on the system? Yes

Do you operate a procedure that ensures identification and control of non-conforming product? Yes

Do you have full traceability of original raw materials? Yes

Are you prepared to supply certificates of conformity and / or certificates of analysis on request? No

Would you permit an audit of your quality system by a member of Pall Corporation Quality Assurance? Yes

b) Business Continuity Management (BCM)

a. Do you have certification to ISO 22301? (If yes, please provide a copy.) No

b. If YES please disregard the following questions:

Is there an active BCM programme in place in your organisation? No

Is there a person appointed with overall responsibility and authority for managing the BCM programme? No

Has a risk assessment been carried out within the business and all the outcomes recorded into a risk register? Yes

Is there an emergency response plan in place? If yes, please provide a copy. Yes

c) Environmental Management
a. Do you have certification to ISO 14001? (If yes, please provide a copy.) No

b. If YES please disregard the following questions:

Is there an active Environmental programme in place in your organisation? Yes

Is there a person appointed with overall responsibility and authority for managing the Environmental programme? Yes

Does your organisation have an environmental policy? (If so please forward a copy). No

Do you have environmental objectives and include environmental aspects in your risk assessments? Yes

d) Health & Safety Management

a. Do you have certification to ISO 45001? (If yes, please provide a copy.) No

b. If YES please disregard the following questions:

Is there an active Health & Safety programme in place in your organisation? Yes

Is there a person appointed with overall responsibility and authority for managing the Health & Safety programme? Yes

Does your organisation have an Health & Safety policy? (If so please forward a copy). No

Do you have Health and Safety objectives and include Health and Safety aspects in your risk assessments? Yes

e) Dual Use
a. Do you supply items that are classed as ‘dual-use’ such as items that can be used for both civilian and military applications or that No
have a high level of technical capabilities as laid down in the dual-use list?

b. If No please disregard the following questions:

Will you inform Pall each time you supply a new part that is subject to the ‘dual-use’ regulations.

Page 2 of 16_x000D_ Confidential - Company Proprietary

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 DOC TYPE DOC NUMBER EFFECTIVE DATE REVISION
Form QA0254 31st August 2020 005
DEPARTMENT TITLE
Supplier Management SUPPLIER QUESTIONNAIRE

Supplier Details Pall Site

Supplier Name: ACT Sistemas Hidraúlicos ltda Name:
Location: Rua: Maria Fet ,96 Location
Contact Name: Qualidade Amanda katayama
Phone No. 11 99307-1197
E-MAIL: [email protected]
Current Approval held (Certificates)
Authority Quality / Environmental/ H&S Registration Originally registered Latest Issue Expiry date Scope of approval
(e.g.. CAA, LRQA, BSI,..) system standard Number

Please supply copies of all current certificates

Page 3 of 16_x000D_ Confidential - Company Proprietary

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 DOC TYPE DOC NUMBER EFFECTIVE DATE REVISION
Form QA0254 31st August 2020 005
DEPARTMENT TITLE
Supplier Management SUPPLIER QUESTIONNAIRE

Supplier Details Pall Site

Supplier Name: ACT Sistemas Hidraúlicos ltda Name:
Location: Rua: Maria Fet ,96 Location
Contact Name: Qualidade Amanda katayama
Phone No. 11 99307-1197
E-MAIL: [email protected]

2) QUESTIONS / MEASUREMENT (Self Assessment)

a) Delivery & Supply Chain Please refer to the Reference No. 1 Tab to fill out the score.

Seq. Measure Supporting Explanation (if needed) Score

a.1 How does the company currently receive customer orders?
2
a.2 How long does it take for customer orders to be processed?
3
a.3 How are new customer orders scheduled into the production plans.
4
a.4 How does the company provide feedback to its customers regarding orders?
3
a.5 What is the average manufacturing lead-time?
4
a.6 What is previous years On time in full (OTIF) delivery performance to customer
request date ( as a percentage)? 4

a.7 What is your Delivery performance to confirmed promise date (as a

percentage)? 4
a.8 What is your Measurement of delivery accuracy (as a percentage)?
4
a.9 Average Customer arrears (past due) value & performance.
1
a.10 Current arrears age profile e.g. 1 day late, 7 days late etc.
5
a.11 How is customer documentation produced & controlled?
4
a.12 How are materials receipted into the facility?
4
a.13 Are all pertinent customer-specific requirements flown down to sub-suppliers,
including requirements for FOD program? 4
Total 46

b) Quality Please refer to the Reference No. 2 Tab to fill out the score.

Seq. Measure Supporting Explanation (if needed) Score

b.1 How are customer complaints / rejections managed through the business?
4
b.2 To what extent are Standard Operating Procedures used?
4
b.3 What is your process for identifying non-conforming product?
3
b.4 Process for identifying root cause & taking corrective actions for internal and
external rejections. 3

b.5 Supplier identification & selection process.

3
b.6 Supplier performance metrics & controls.
3
b.7 Is there a formal FOD (foreign object damage) program in place, including risks identification,
audits, and preventive controls to prevent damage / contamination? 1
Total 21

c) Cost reduction & Continuous Improvement Please refer to the Reference No. 3 Tab to fill out the score.

Seq. Measure Supporting Explanation (if needed) Score

c.1 What is your sites approach to continuous improvement?
3
c.2 Do you have annual cost reduction programs?
3
c.3 How extensive is the policy deployment & continuous improvement?
2
c.4 What are the measurements of 'lean' manufacturing / continuous
improvement? 3
c.5 What is the company's approach to business planning?
4
c.6 Can you add additional capacity if required?
4
Total 19

Page 4 of 16_x000D_ Confidential - Company Proprietary

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 DOC TYPE DOC NUMBER EFFECTIVE DATE REVISION
Form QA0254 31st August 2020 005
DEPARTMENT TITLE
Supplier Management SUPPLIER QUESTIONNAIRE

Supplier Details Pall Site

Supplier Name: ACT Sistemas Hidraúlicos ltda Name:
Location: Rua: Maria Fet ,96 Location
Contact Name: Qualidade Amanda katayama
Phone No. 11 99307-1197
E-MAIL: [email protected]

d) Environmental and Health & Safety Please refer to the Reference No. 4 Tab to fill out the score.

Seq. Measure Supporting Explanation (if needed) Score

d.1 Do you have a documented environmental incident procedure?
4
d.2 Do you know what the significant environmental aspects of the business are?
4

d.3 Can your product or packaging be returned or recycled? Are sources of paper,
cardboard & wood from sustainable routes? 4

d.4 Do you assess your suppliers and sub-contractors for environmental

competence? Do you check if your suppliers and sub-contractors effectively
promote reduction impact activities to environmental hazards? 1

d.5 Do you have a register of relevant environmental legal, local and other
requirements? 1

d.6 Do you have a documented Health and Safety procedure?

1
d.7 Does your company develop, leads and promotes a culture that supports the
intended outcomes of the Health & Safety Management system? 1
Does your company have a process for consultation and participation at all
d.8 applicable levels and functions in identifying health and Safety hazards and
assessing risks and opportunities? 1

d.9 Do you have a process to determine and have access to legal requirements
applicable to Health and Safety hazards and risks? 2
d.10 Has your company had any enforcement action for non-compliance to
Environmental or Health and Safety rules or laws? If so, provide details 2
d.11 Is there an internal audit program covering Environmental and Health and
Safety processes? 2
d.12 How do you ensure the competence of your staff to perform their duties safely
and without adverse effect to the environment? 4
d.13 Would you allow a Pall representative to carry out an environmental audit
and/or a Health & Safety audit of your company? 1

Total 28

e) Technical Please refer to the Reference No. 5 Tab to fill out the score.

Seq. Measure Supporting Explanation (if needed) Score

e.1 What sort of employee skill development programs do you operate?
3
e.2 What is the company approach to succession planning?
3
e.3 Process Controls
3
e.4 Inspection and Test
3
e.5 Control of Inspection, Measuring & Test Equipment
3
e.6 Business Continuity
3

Total 18

Page 5 of 16_x000D_ Confidential - Company Proprietary

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 DOC TYPE DOC NUMBER EFFECTIVE DATE REVISION
Form QA0254 31st August 2020 005
DEPARTMENT TITLE
Supplier Management SUPPLIER QUESTIONNAIRE

Supplier Details Pall Site

Supplier Name: ACT Sistemas Hidraúlicos ltda Name:
Location: Rua: Maria Fet ,96 Location
Contact Name: Qualidade Amanda katayama
Phone No. 11 99307-1197
E-MAIL: [email protected]

Maximum
Criteria Score Actual Score Percentage

Delivery and Supply Chain 52 46 88

Quality 28 21 75
Cost Reduction & Continuous Improvement 24 19 79
Environmental and Health & Safety 52 28 54
Technical 24 18 75
Overall Total 180 132 73

Summary Assessment Score

100
90
80
70
Percentage

60
50
88
40
75 79 75 73
30
54
20
10
0
Delivery and Quality Cost Reduction & Environmental and Technical Overall Total
Supply Chain Continuous Im- Health & Safety
provement

Criteria

I certify that the information provided in this questionnaire is accurate and complete to the best of my knowledge and belief. I understand that the provision of inaccurate
or misleading information may lead to my company being removed from the Pall Corporation Approved Supplier List.

Name (Please print)

Position within the organization

Date:

Signature:

Pall Use Only

Review (*Strike through where necessary) Comments
- * Accepted
- * Accepted subject to a satisfactory audit
- * Rejected
Supply Chain
Name (Please print)

Position within Pall

Date:

Signature:
Quality Assurance
Name (Please print)

Position within Pall

Date:

Signature:
>>>>Please ensure to use the latest version of this form for completion by double-checking valid revision in SmartSolve..<<<<

Page 6 of 16_x000D_ Confidential - Company Proprietary

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 DOC TYPE DOC NUMBER EFFECTIVE DATE REVISION
Form QA0254 31st August 2020 005
DEPARTMENT TITLE
Supplier Management SUPPLIER QUESTIONNAIRE

Reference 1.

Area Seq MEASURE SCORE

1 2 3 4
Delivery & a.1 How does the company currently Fax / mail Telephone / Email Combination of 2 & 4 EDI / intranet based interface
Supply Chain receive customer orders?

Delivery & a.2 How long does it take for >3 days 1-3 days 1 day < 1 hour
Supply Chain customer orders to be processed?

Delivery & a.3 How are new customer orders New customer orders are not actively planned. No Monthly review of production plans. Manually driven Weekly production planning reviews. MPS process in Daily production planning review. MPS process in
Supply Chain scheduled into the production mechanism for reporting back to the customer on process for production scheduling. Customer receives place to review customer demand against build plans. place to review customer demand against build plans.
plans progress. status updates on request Some evidence of statistical tools and control charts to Business uses history and forecast information to
identify where future demand > capacity. Customer determine build plans. Use of statistical tools to
receives status updates weekly. analyse demand and variation. Formal acceptance
process & confirmation back to customer. Customer
receives regular order status reports

Delivery & a.4 How does the company provide Telephone / fax - on request by customer. No regular Telephone / fax - proactive. Occasional reviews with Electronic updates - spreadsheets / emails. Company EDI / intranet based status reporting. Customers can
Supply Chain feedback to its customers? meetings with key customers, communication is ad key customers, usually when there is a delivery / holds regular reviews with key customers. log in and track status of open orders. Company holds
hoc quality problem. regular reviews with key customers.

Delivery & a.5 What is the average >8 weeks. No evidence that the company is actively 4 to 8 weeks. Awareness of need to reduce lead- 1 to 4 weeks. Spot kaizen events addressing set up <1 week. Evidence of considerable improvement
Supply Chain manufacturing lead-time? attempting to reduce lead-times. times, however no co-ordinated activities to achieve times. Awareness of need to reduce lead-times. activity to reduce lead-times over time. Company has
this. eliminated waste through co-ordinated lean events.
Lead-times are measured and controlled.
Delivery & a.6 OTIF delivery performance to Not measured, therefore no process to relate Delivery performance is measured ad hoc / quarterly. Delivery performance is measured at least monthly, Delivery performance is measured weekly. Current
Supply Chain customer request date improvements to delivery performance. Customer Current levels are <70% OTIF. No evidence of an preferably weekly. Current performance is 70-90% performance is 90% plus OTIF. Company has good
requirements not defined & communicated within the improvement plan in place to address shortfall in OTIF. Company has good understanding of customer understanding of customer requirements and there is
company. performance. No visual displays in place. requirements and there is evidence of improvement evidence of a detailed improvement plan in place. Root
actions in place. Visual measures are in place for the cause analysis undertaken for all delivery failures,
whole site and manufacturing cells / modules. owned by the module. Visual measures are in place for
the whole site and manufacturing cells / modules.

Delivery & a.7 Delivery performance to Not measured, therefore no process to relate Delivery performance is measured ad hoc / quarterly. Delivery performance is measured at least monthly, Delivery performance is measured weekly. Current
Supply Chain confirmed promise date improvements to delivery performance. Customer Current levels are <95% OTIF. No evidence of an preferably weekly. Current performance is 95%-98% performance is 98% plus OTIF. Evidence of a detailed
requirements not defined & communicated within the improvement plan in place to address shortfall in OTIF. Evidence of improvement actions in place. improvement plan in place. Root cause analysis
company. performance. Customers are not informed when Visual measures are in place for the whole site and undertaken for all delivery failures, owned by the
deliveries are missed, revised promise dates are not manufacturing cells / modules. Customers receive module. Visual measures are in place for the whole
issued. No visual displays in place revised promise dates when deliveries are missed. site and manufacturing cells / modules. Customers are
contacted before delivery is missed with recovery plan
and revised promise dates.

Delivery & a.8 Measurement of delivery accuracy Not measured, therefore no process to relate Delivery accuracy measured but no corrective actions Delivery accuracy measured and corrective actions put Delivery accuracy measured, no incidents of failures in
Supply Chain improvements to delivery accuracy. put in place if failures occur. in place if failures occur. Final conformance checks in last 12 months.
place
Delivery & a.9 Customer arrears value & Not measured, therefore no process to relate Customer arrears are measured ad hoc / quarterly. No Customer arrears are measured monthly by value & Customer arrears are measured weekly by value and
Supply Chain performance improvements to delivery performance. Customer evidence of a plan in place to reschedule and clear order lines. Overdue items are rescheduled into order lines. Arrears are profiled by age and
requirements not defined & communicated within the backlog. No visual displays in place. production plans. Information fed back to the rescheduled into production plans. RCA carried out on
company. customer. Visual displays are in place for the whole arrears and corrective actions are put in place for
site and manufacturing cells / modules. future prevention. Information fed back to the customer
routinely and progress updates are issued.

Delivery & a.10 Current arrears age profile e.g. 1 All customer orders ≤ 20 days All customer orders ≤ 15 days All customer orders ≤ 10 days All customer orders ≤ 5 days
Supply Chain day late, 7 days late etc
Delivery & a.11 How is customer documentation Frequent customer complaints, production of Documentation is produced (system generated). Combination of 2 & 4 Systems in place to record customer documentation
Supply Chain produced & controlled? documentation is a manual process However, no systems in place to record requirements / requirements & checks at final conformance to ensure
no checks at final conformance. documentation is correct. Customer complaints - very
low
Delivery & a.12 How are materials receipted into Visually, the goods-in & stores areas are disorganised. Good-in and stores areas have visual controls in place Good-in and stores areas have visual controls in place Material deliveries occur daily, many direct to point of
Supply Chain the facility? Difficult to identify locations. Material sat around for and inventory is labelled. Receipt of material takes <24 and inventory is labelled. Receipt of material takes <4 use. Majority of product is controlled through kanbans
days before booked into the facility. Processing of hours. Evidence of kanbans in place on low value, hours through use of bar-coding. Kanbans in place for systems. Direct Line Feed provider in place for
paperwork & transactions is very labour intensive. consumable parts. Transaction volumes constrain a wide range of materials, some are supplier consumable items. Transactions minimal, bar-coding
Material is moved around & handled many times father improvement. Materials are delivered either replenished. Materials located close to point of use. used extensively. Turnover to material through the
before it is issued. Material is delivered from suppliers weekly or monthly, and GI know the delivery schedule Materials are delivered weekly to a published business is very high.
on an ad hoc basis, no ability to plan daily workload. for major suppliers. schedule.

Delivery & a.13 Are all pertinent customer-specific No flow-down process to communicate Pall’s Some requirements are communicated verbally. Requirements are communicated in writing to sub- All customer-specific requirements are communicated
Supply Chain requirements flown down to sub- requirements to sub-suppliers. Some evidence of compliance is on file and available. suppliers. Some evidence of compliance is on file and in writing and on purchasing documents. Evidence of
suppliers, including requirements available. compliance is routinely collected and evaluated.
for FOD program?

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 DOC TYPE DOC NUMBER EFFECTIVE DATE REVISION
Form QA0254 31st August 2020 005
DEPARTMENT TITLE
Supplier Management SUPPLIER QUESTIONNAIRE

Reference 2.

Area Seq MEASURE SCORE

1 2 3 4
Quality b.1 How are customer complaints / No process in place for tracking and measuring Quality problems are not consistently identified and Quality problems are communicated within the site and Quality problems are quickly picked up and
rejections managed through the customer complaints and rejections. investigated in a timely manner. Communication with investigations are launched. Corrective actions are put investigation launched. Progress is regularly reported
business the customer is erratic. RCA not taken and problems in place but not always sustainable. There are some back to customer. Open incidents are reviewed by
are seen to be recurring. Measures are in place but reccurrences of rejections. Measures are in place and management team. Visual measures are in place
not meeting overall business goals the trend is improving but not meeting overall business around the site. Use of appropriate tools and
goals techniques to identify root cause. No repeat customer
quality problems. Trend has been consistently
improving over last few years. Metrics are at industry
benchmark standard.

Quality b.2 To what extent are Standard There are no Standard Operating Procedures (SOPs). Basic work procedures exist, but are not strictly SOPs and standardised work have been developed SOPs are used for training team members and
Operating Procedures used? Team members work by instinct. Activities vary followed and are not easily accessible by team and some are posted at stations. Most team members standardised work is used for frequent improvement
between operators and are different from shift to shift. members. follow procedures activities. Team members assist with developing SOPs
and standardised work.
Quality b.3 Process for identifying non- The customer identifies a problem with the product. In Process or Final Inspection process Non-conformances identified at point of error by the Robust Poke-Yoke process which clearly identifies
conforming product process owner non-conforming product.
Quality b.4 Process for identifying root cause No process in place for understanding root cause of Basic problem solving tools used. No evidence of Root cause analysis taken at customer's request. Root cause analysis undertaken for all failures. Use of
& taking corrective actions for rejections (internal & external). rigorous root cause analysis. Does not include use of Includes use of basic statistical tools understand the statistical tools in analysis and problem solving. SPC
internal and external rejections statistical tools to define and understand the problem. problem. charts to track deviations & flag potential problems.

Quality b.5 Supplier identification & selection No formal vendor selection process, no quality audits Basic supplier selection process - suppliers visited, Basic supplier selection process - suppliers visited, Structured supplier selection process - suppliers
process or supplier accreditation requirements. New suppliers required ISO as standard. Absence of detailed supplier require ISO as standard. Supplier assessment process visited, require ISO as standard. Detailed supplier
are selected ad hoc. The bid process is unstructured assessment process. Current supply base is covers standard requirements. Supply base is starting assessment process in place, covers procedural and
without clear objectives. fragmented, low average value spend, many single to consolidate, and high level plans exist by process capability. Supplier receives report
part suppliers. No auditing of existing suppliers. commodity. Major suppliers are audited ad hoc. highlighting areas for improvement. Supply chain
strategy in place by commodity, current suppliers
assessed against strategy. Clear plans in place for
each supplier. Company actively looks for new
suppliers in areas of weakness. Supplier audit
schedule in place, timescales and owners.

Quality b.6 Supplier performance metrics & Delivery, cost and quality performance from the supply On time delivery and rejections are measured, Complete series of measures in place against targets. Intranet based, portal measures covering the supply
controls base is not measured. however no targets are in place nor improvement Visual measures are displayed across the site and chain. OTIF delivery performance, early deliveries,
plans. Company views the performance as owned by reviewed by management team. Output is fed back to rejections ppm. Company measures total acquisition
the supplier. suppliers on a monthly basis. Corrective actions are cost and flows down targets to supply base. Company
taken if measures deviate from control limits. gets actively involved in supplier development to
support improvement activities.

Quality b.7 Is there a formal FOD (foreign There is no understanding of FOD risk, no program in The concept of FOD is understood and implementation FOD risk areas are identified, but no documented FOD program is in place including procedure,
object damage) program in place, place. of controls are currently being considered. procedure or program is in place. identification of FOD risk areas, and protection in place
including risks identification, to prevent damage and contaminants.
audits, and preventive controls to
prevent damage/contamination?

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 DOC TYPE DOC NUMBER EFFECTIVE DATE REVISION
Form QA0254 31st August 2020 005
DEPARTMENT TITLE
Supplier Management SUPPLIER QUESTIONNAIRE

Reference 3

Area Seq MEASURE SCORE

1 2 3 4
Cost reduction & c.1 Site approach to continuous No continuous improvement in place and only knee- Some awareness within management team of Demonstrated continuous improvement results in Embedded continuous improvement programme,
CI improvement jerk reaction to problems. No corrective actions and continuous improvement tools & techniques. Current evidence and tracked (lead-time and inventory driven by customer CTQs. Delivering tangible results
the work place is dirty and untidy. value stream map exists but not a future state map. reduction can be demonstrated). High level of site over time. High level of site awareness, supported by
Therefore, there is no structured programme to awareness, supported by training and development training and development programme. Visual
support improvement. Evidence of ad hoc kaizen programme. Starting to roll out six sigma green belt measures across site to illustrate achievement against
events. Workplace looks organised, but it is difficult to training & projects. Visual measures across site to goals. Where required, dedicated improvement / six
determine what is needed and there are few markings illustrate achievement against goals. Discipline is high sigma black belt resource available. Projects are
to identify proper locations. In general, the cleanliness on the shop floor and 5s principles are applied in the formally structured and managed, utilising six sigma /
level is low. non-production areas (offices, conference/team rooms, DMAIC approach. 5s improvement activities are
etc) planned according to improvement targets and audits
are performed by management (including plant
manager periodically).

Cost reduction & c.2 Do you have annual cost No annual Cost Reduction programme Major costs measured and reduction targets in place Major costs measured and reduction targets in place Cost Reduction is part of the overall business strategy,
CI reduction programmes? and is part of the overall business strategy with clear reduction targets, action plans and owners.

Cost reduction & c.3 How extensive is the policy Little or no connection between company goals & shop A clear business plan is in place & specific metrics to Vertical & horizontal alignment with the business plan The PDCA cycle is used to develop & maintain plans.
CI deployment & continuous floor activities. Employees do not understand how they support all goals/objectives have been developed and exists throughout the organisation. "3 level" meetings Departmental C.I. Training where team members lead
improvement? can support the company objectives. There are no cascade through all levels of the business. Formal are conducted to ensure alignment with goals. A activities on a rotational basis. Greater than 80% of the
improvement activities involving team members and review system has been established for identified structured CI plan has been developed (including employees have been a member of an improvement
there is no formal improvement organisation. Upper metrics, e.g., daily/weekly/monthly meetings. CI targets) with a CI champion/office to support activities team.
management/engineering focus is on large-scale activities occur, but random and not tied into an overall are visibly documented throughout business.
innovations. strategy. Full-time resources are dedicated to
improvements.

Cost reduction & c.4 What are the measurements of Little or no evidence of continuous improvement. No A suite of 'Lean' KPI's including QCD. has been Positive trends over time. Major inventory & lead-time Lessons learned through measurement used to
CI 'lean' manufacturing / continuous measures in place to capture improvements. developed. Measures link to company policy & reduction exists throughout the organisation. Proven improve processes. Result based business. Top down
improvement? strategy. Assessment & review process in place but waste elimination. Targets are being achieved. bottom up targets established in line with business
used on ad hoc basis. Understanding of links between Assessed & reviewed on regular basis. strategy. Trends meet or exceed targets over time.
enabler & results. QCD benefits shared with customers.
Cost reduction & c.5 What is the company's approach No formal business planning process. The company Business planning is carried out on an ad hoc basis. Company produces a five year plan, which is reviewed Company produces a five year plan, which is reviewed
CI to business planning? reacts to changes within the industry and market Usually following changes in the market. Typically is a annually. Integrated marketing, financial and annually. Integrated marketing, financial and
conditions as they occur. marketing plan & does not include detailed financial manufacturing plans. Communicated to all employees manufacturing plans. Actual vrs forecast financial
projections or manufacturing plans. The plan is not and used to set business measures. measures are reviewed quarterly. The plan forms the
translate into business measures and is not flowed basis for business operating review. The plan and
down within the business. progress against it is regularly communicated to all
employees.

Cost reduction & c.6 Can you add additional capacity if No opportunity to add additional capacity < 10% increase 10% - 20% increase >20% increase
CI required?

Page 9 of 16_x000D_ Confidential - Company Proprietary

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 DOC TYPE DOC NUMBER EFFECTIVE DATE REVISION
Form QA0254 31st August 2020 005
DEPARTMENT TITLE
Supplier Management SUPPLIER QUESTIONNAIRE

Reference 4

Area Seq MEASURE SCORE

1 2 3 4
Environmental d.1 Do you have a documented No Yes
environmental incident
procedure?
Environmental d.2 Do you know what the significant No Yes
environmental aspects of the
business are?
Environmental d.3 Can your product or packaging be No provision for recycling or return of products or Products and / or packaging has recycle or eco Products and / or packaging has recycle or eco Products and / or packaging has recycle or eco
returned or recycled? Are sources packaging. No evidence that paper, cardboard & wood labelling. Evidence that some paper, cardboard & labelling. Some provision for return of waste products labelling. Provision for return of waste products and /
of paper, cardboard & wood from is from sustainable routes. wood is sourced from sustainable routes. For example and / or packaging exists. Evidence that some paper, or packaging exists.Evidence that all paper, cardboard
sustainable routes? recycled material is used or wood is obtained from cardboard & wood is sourced from sustainable routes. & wood is sourced from sustainable routes. For
managed forests. For example recycled material is used or wood is example recycled material is used or wood is obtained
obtained from managed forests. from managed forests

Environmental d.4 Do you assess your suppliers and No formal assessment Some suppliers / contractors have been assessed for All suppliers / contractors have been assessed for All suppliers / contractors have been assessed for
sub-contractors for environmental environmental competence environmental competence environmental competence and checked if they
competence? Do you check if effectively promote reduction impact activities to
your suppliers and sub- environmental hazards
contractors effectively promote
reduction impact activities to
environmental hazards?

Environmental d.5 Do you have a register of relevant No register in place Partially completed register Full complete register in place Full completed register in place and documented
environmental legal, local and process to manage changes to requirements
other requirements?
Health & Safety d.6 Do you have a documented No Yes
Health and Safety procedure?
Health & Safety d.7 Does your company develop, No formal programme in place Some evidence of communicating outcomes of the Outcomes of the Health & Safety Management system The Health & Safety Management system is supported
leads and promotes a culture that Health & Safety Management system is clearly communicated throughout the organisation by the organisations leadership and promoted
supports the intended outcomes throughout the organisation
of the Health & Safety
Management system?

Health & Safety d.8 Does your company have a No process in place Ad-hoc process in place, but with limited levels and Documented process in place, but with limited levels Documented process in place, including all levels and
process for consultation and functions and functions functions of the organisation. Defined actions to
participation at all applicable continually mitigate risks and hazards.
levels and functions in identifying
health and Safety hazards and
assessing risks and
opportunities?

Health & Safety d.9 Do you have a process to No process in place and limited access Ad-hoc process, with limited access and ownership not Documented process in place, with full access to legal Documented process in place, with full access to legal
determine and have access to clearly defined requirements requirements and assessed by competent personnel
legal requirements applicable to
Health and Safety hazards and
risks?

Environmental d.10 Has your company had any Visits from the local authority or enforcement agency Visits from the local authority or enforcement agency No action, only visits
Health & Safety enforcement action for non- have resulted in a fine or several fines over the last 3 have not resulted in a fine but have resulted in an
compliance to Environmental or years order to address legal non-compliances over the last 3
Health and Safety rules or laws? If years
so, provide details

Environmental d.11 Is there an internal audit program No internal audit programme. Company relies solely Internal audits are carried out on an ad-hoc basis. Annual internal audit plan covering all procedures Annual internal audit plan covering procedures /
Health & Safety covering Environmental and on external audits to highlight deficiencies. There is no plan in place demonstrating a timetable. across the site. Dedicated, objective resource to processes across the site. Dedicated, objective
Health and Safety processes? Corrective actions have no ownership or defined undertake audit. Visual measures in place throughout resource to undertake audit. Corrective actions &
closure date / milestones. No visual measures or the site. closure timetable is owned by process owners. There
cross-functional communication is a system in place to track progress, which is
reported to leadership .

Environmental d.12 How do you ensure the No formal training programme or plan for employees. Some employees have received formal health, safety All employees have received formal health, safety and All employees receive annual training and competence
Health & Safety competence of your staff to and environmental training and records are available. environmental training and records are available. assessments on health, safety and the environment.
perform their duties safely and
without adverse effect to the
environment?

Environmental d.13 Would you allow a Pall No Yes

Health & Safety representative to carry out an
environmental audit and/or an
Health & Safety audit of your
company?

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 DOC TYPE DOC NUMBER EFFECTIVE DATE REVISION
Form QA0254 31st August 2020 005
DEPARTMENT TITLE
Supplier Management SUPPLIER QUESTIONNAIRE

Reference 5

Area Seq MEASURE SCORE

1 2 3 4
Technical e.1 What sort of employee skill Employees are not cross-trained and most workers Most employees have knowledge of more than one Qualification boards are shown in all areas and a Advanced knowledge training occurs and is linked to
Staffing development programmes do you work to a narrow role definition. There is no formal role, but there is still no formal cross-training process. structured training programme is used to develop skills advancement opportunities. Skills gap analysis is
operate? process for qualifying direct operators. All employees Most training is limited to basic job skills only. based on specific company/employee needs. regularly undertaken. Employees are offered
training is "hands-on". Dedicated time is reserved for training. supplementary skills training programmes (e.g.
languages).
Technical e.2 What is the company approach to Succession planning is not undertaken. Key jobs can Some degree of succession planning is done at Succession planning process in place for most indirect Structured succession planning in place within all
Staffing succession planning? remain unfilled for months. Exit interviews not director level. Jobs tend to be back filled after areas. Business analyses potential candidates for indirect areas. System in place to record employee
conducted. employees have left. Exit interviews are carried out for forthcoming roles. Part of annual performance review skills & role history. Company analyses potential
some roles. process. candidates for forthcoming roles. Operates across
multi-sites. Employees are presented with assignments
and opportunities at the point they are ready to move
on within the company.

Technical e.3 Process Controls Do not understand process variation Tool / method in place. Understand process variation Developed capable processes and use Improvement Fully capable (supplier demonstrates process
Cycles improvement over time, real time process control and
data management)
Technical e.4 Inspection and Test Lack of Inspection Gating (Final Product Characteristics measured, data React and adjust (inspection performed during Preventing Defects (Inspection performed only at key
collected) process, defined sampling plan, data analysed points in the process and based on process control
periodically, product 100% inspected) evaluations)
Technical e.5 Control of Inspection, Measuring Gauge does not exist Gauging exists (gauging exists for all critical Competent Measurement Systems (Gauge capability Continuous Measurement System Improvements (out
& Test Equipment characteristics specified in the control plan) studies (R&R <20%). Documented calibration process of calibration plan which includes product assessment,
in use) investigation)
Technical e.6 Business Continuity No Plans Limited Plan (only product inventory) Plan (Plan, 6 months worth of inventory) Plan (Detailed plan with second source, one year worth
of inventory. Plan revised on annual basis and plan
trial run on annual basis)

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 DOC TYPE DOC NUMBER EFFECTIVE DATE REVISION
Form QA 0254 31st August 2020 005
DEPARTMENT TITLE
Supplier Management SUPPLIER QUESTIONNAIRE

Term Definition
PPM Parts Per Million, usually used in the context of quality performance.

Statistical Process Control, compares current performance of a process against a template. The template defines control limits
SPC
based on +/- 3 standard deviation to warn when process variation is moving outside of acceptable limits.

RCA Root Cause Analysis, methods of working through to understand the real causes of a particular problem.

Usually a rapid, team based event activity. The objectives for the activity are clearly defined and aim to deliver a continuous
Kaizen
improvement.

Critical To Quality, characteristics of a product or service that are of key importance to customers. These can be used to set
CTQ measures and performance tolerances within a business. E.g. Customer wants on time deliveries and the business measures %
on time in full.

The attainment of perfect quality in customer critical areas (zero defects) & commonly used to describe the tools and techniques
Six Sigma
that companies can use to move towards this goal.

Define, Measure, Analyse, Improve, Control. Standard project management approach to carrying out improvement projects.
DMAIC
Typically uses statistical tools & techniques to understand the problem and arrive at a solution.

5S Five steps used to continuously improve the workplace organisation. Can be applied to manufacturing and office environments.

OTIF On Time In Full, relates to deliver performance measurement.

Purchase price of a product or service plus the internal cost of making the purchase (purchasing, quality, transportation,
Total Acquisition Cost
inventory management).

MRP Materials Requirement Planning. System to flow down manufacturing demand and manage inventory.

A signal (usually a card) within the production system to pull material from the previous stage and trigger replenishment. Used to
Kanban
help control production and inventory.

DLF Direct Line Feed. Low value material managed by a supplier and delivered direct to a production area.

Classification of materials based on annual purchasing spend. ABC, corresponds with 80% of total spend, 15% total spend and
ABC Analysis
5% total spend.

Analysis of materials, assemblies or finished goods based on demand frequency. Over the course of a year, Runners are items
Runner/Repeater/Stranger
where there is demand in 10 or more months, Repeaters are items where there is demand in 3 to 9 months and Strangers have
Analysis
demand in 2 or less months.

Enterprise Resource Planning. More integrated than an MRP system, includes activities linking distribution, suppliers and all
ERP
manufacturing facilities.

Delivery Accuracy Measure of accuracy on the quantities and part numbers shipped against a customer order.

Electronic Data Interface. Mechanism for paperless transactions, typically for activities such as order placing between customers
EDI
& suppliers.

Master Production Scheduling. A high level schedule that anticipates customer demand. The aim is to reduce the level of variation
MPS
in customer demand, smooth production load and increase delivery performance.

Accident Frequency Rate Number of Injuries x 100,000 divided by Total Number of Hours Worked

PDP Personal Development Plan. Tool to review employee performance and identify areas for development over a given time period

PDCA Plan, Do, Check, Act. An improvement cycle for problem solving.

QCD Quality, Cost, Delivery. Standard operation measures of performance

A document that outlines roles, responsibilities and expectations prior to and during an emergency situation the purpose of which
is the preservation of life.
Emergency Response procedure
A document that outline roles, responsibilities and expectations prior to and during an emergency situation the purpose of which
is the preservation of life.

Business Continuity Management System. A documented process for identifying and minimising potential threats that if realised
BCM would cause a disruption to the organisation. Have documented plans in place that are exercised periodically that when invoked
would return the business to normal operations before the customer experiences and unacceptable adverse impact.

FOD Foreign Object Damage / Debris. A provisions for the prevention, detection, and removal of foreign objects

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 DOC TYPE DOC NUMBER EFFECTIVE DATE REVISION

Form QA0254 31st Aug 2020 005

DEPARTMENT TITLE
Supplier Management SUPPLIER QUESTIONNAIRE

Revision Requested Revised Description of Change Effective Date Change Order

No. By By Number
001 L. Harreld P. Whitefield Initial release per approval and issuance 10/8/2012 DIV CO - 8821

002 P.Whitefield T. Thorpe Remove contact and bank details (now on master data forms). BCM 13-Feb-15 DIV CO-20114
Questions added. General reformatting

003 B. Rush P. Whitefield Added FOD requirements, to sections 'a.13' and 'b.7'. FOD Definition 26-Aug-18 DIV CO - 37945
added to definitions worksheet.

004 P.Rushton / B.Ezzo / P. Whitefield Added section C, 'Dual Use'. General reformating and minor updates 19-Jul-19 DIV CO - 41771
K.Vanuytrecht

005 B.Ezzo P. Whitefield Added Section 1C and 1D. see header DIV CO - 48020
Environmental section 2D and Reference 4 worksheet updated to
include Health & Safety

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 SUPPLIER NOTICE OF CHANGE AGREEMENT QA0251

SUPPLIER NOTICE OF CHANGE AGREEMENT

Rua: Maria Fet ,96 (“Supplier”) understands that products

Name of Company
supplied to Pall Corporation, pursuant to our specifications or Purchase Agreement, will be used in certain
critical filtration products. In order to enable Pall to determine if any proposed change in the product(s)
will have any effect on the safety and/or efficacy of any of Pall’s products, or Pall’s commitment to
regulatory agencies, Supplier agrees to notify Pall in writing 6 months prior to making a change on any of
the following aspects of the product(s):

1. Composition of any raw material;

2. Source of any raw material;
3. Method of producing, processing or testing;
4. Change in subcontractors for producing, processing or testing;
5. Site of manufacture.

Supplier also agrees to guarantee to Pall in writing the amount of inventory required by Pall to
complete necessary activities prior to implementation of the change.

Rua: Maria Fet ,96 has agreed to conform to this requirement,

Name of Company

this ____________________ day of ______________________, __________.

Signature: ______________________________________________________

Confidential - Company Proprietary

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 REVISION
REACH Supplier Questionnaire (R/CLP) QProc 053
001

Company Name Rua: Maria Fet ,96

Location Qualidade Amanda katayama

Dear Supplier

The European Union introduced the REACH Regulations (EC) 1907/2006 on Registration, Evaluation, Authorisation
and Restriction of Chemicals making organizations which place substances on the EU market responsible for
understanding and managing the risks associated with their use. Mostly, the duties are on manufacturers and physical
importers of substances (including those in formulations, mixtures or preparations), but there are also requirements for
downstream users to share information within the supply chain.
More recently the EU introduced the CLP Regulations (EC) No. 1272/2008 for the Classification, Labelling and
Packaging of Substances and Mixtures, adopting in the EU the Globally Harmonised System (GHS).

Please complete the REACH/CLP questionnaire below and return to Please let us
know if you have any questions or need any clarification on this request

REACH/CLP QUESTIONAIRE

Please provide full contact details below for the person in your company responsible for REACH and CLP issues:

If you have different responses for different “products” supplied to Pall please send separate response sheets for each
category of product supplied.

Q1. We supply Pall with :

SUBSTANCES PREPARATIONS ARTICLES

Part numbers and product names

With REACH and CLP compliant format safety data sheets:

YES ATTACHED YES WILL BE SENT NOT APPLICABLE

SHORTLY

Q2. Please advise Pall if any of the substances in the products and packaging you supply to Pall require REACH
registration by your Company.

YES THIS HAS BEEN COMPLETED ALREADY

YES AND THIS WILL BE COMPLETED ON………………………………….………..……..

NO AS …………………………………………………………………………….…..…………..
(Please explain)

If NO does PALL need to consider registration and C&L notification?

YES PALL NEEDS TO ACT AS THE EU IMPORTER

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 REVISION
REACH Supplier Questionnaire (R/CLP) QProc 053
001

NO AS……………………………………………………………………………………….……..
(Please explain)

Q3. Please advise Pall if any of the products you supply to Pall contain substances on the current, candidate SVHC
list at a concentration at 0.1% or greater (w/w article).

YES NO

If Yes please give details:

Q4. You agree that as new SVHC are added to candidate lists you will advise Pall immediately in writing if present
at 0.1% or greater

YES NO

Q5. You agree that if you Company becomes aware that continuity of supply to Pall may be affected by these
Regulations you will give Pall advanced notification.

YES NO

Signature Date

Name (Print) Title

# Confidential - Company Proprietary