GFSI Supplier Questionnaire

Prepared By: Justin Miller

Approved By: Paul Scola Jr.

Document Number: FS-2.3.4c

Version Number: 2

Effective Date: April 16, 2021

First name*

Last name*

Email*

Company Name*

Company Address*

Manufacturing Address (If Different)

Phone Number*

Fax Number

Sales Contact/Customer Service/Emergency contact*

Technical/QA/PCQI/HACCP/SQF Practitioner*

24 Hour Emergency Contact*

Please list all products that will be supplied*

Is your plant FDA registered?*

Yes

If yes, please provide your registration number and expiration date

Has your facility been inspected by FDA, USDA, or other government agencies?*

Yes

If yes, what is the name of the agency and what was the date of the lastinspection?

If Yes, were any findings or citations issued? please explain

Do you have a foreign supplier verification program?*

Yes

Are your carriers in compliance with the sanitary transportation act?*

Yes

Has your company been involved in a recall in the past 3 years?*

Yes

If yes, please explain

Is your company GFSI Certified? (SQF, BRCGS, FSSC22000, IFS etc.)*

Yes

GFSI Certificate (Required)*

Audit report with corrective actions (Required)*

HACCP Letter of Guarantee with current year date*

Last FDA inspection report if citations were issued (If applicable)

Recall information if any in the last 3 years (If applicable)

MSC or other 3rd party certificate (If applicable)

CONTACT & LOCATION

How can we help you?

Thanks for submitting!

10 Codfish Way Boston, MA 02210

617-946-9850

Monday - Friday 6:00 AM - 2:30 PM

Saturday 6:00 AM - 9:30 AM

Closed on Sunday

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