| PRELIMINARY EVALUATION FORM |
| * Legal Name of the Organization |
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| * Address |
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| * City |
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| * State/Province |
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| * Postal Code |
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| * Country |
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| * Phone |
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| Mobile Phone |
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| * Email |
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| Fax |
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| Website |
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| * Total Employees |
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| Please select the standards to which your organization seeks certification |
| ISO 9001 – Quality Management |
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| ISO 13485 – QMS for Medical Devices |
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| ISO 14001 – Environmental Management |
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| ISO 18788 – Management system for private security operations |
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| ISO 22000 – Food Safety Management |
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| ISO 20000 – Technology Service Management |
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| ISO 27001 – Information Security Management |
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| ISO 28001 – Security Management |
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| ISO 50001 – Energy Management |
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| ISO 45001 – Occupational health and safety |
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| ISO 29990 – Learning services for non-formal education and training |
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| QSI-ESAS – Automotive Safety |
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| QSI – ISO 26001 |
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| Please define the Certification Scope |
| * Please describe the activities to be included. |
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| * Please list and explain any exclusions.
If there are none please type “NONE” |
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| Is this a multi-site certification? |
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| * Number of Sites |
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| Number of Employees @ Principal Site |
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| Number of Employees @ Largest Site |
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| Number of Employees @ 2nd Largest Site |
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| Number of Employees @ Smallest Site |
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| Number of Employees @ 2nd Smallest Site |
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| Average Number of Employees – All Sites |
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| Please lists the countries where the above sites are located: |
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| Planning and Preparation Details |
* Approx. Date for the Stage 1 Certification Audit
(mm-dd-yyyy) |
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* Approx. Date for the Stage 2 Certification Audit
(mm-dd-yyyy) |
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| * Will an (optional) Initial Review/Pre-Assessment be required? |
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| * Has a Policy Manual been issued? |
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| * Has a complete Internal Audit been conducted? |
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| * Has a complete Management Review been conducted? |
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| Purchase Order Number |
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| Management Representative Information |
| * Name of Management Rep. |
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| * Position |
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| * Phone |
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| * Email |
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| Additional Comments |
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| RBP |
If you were referred by a Regional Business Partner select their code below; otherwise select 999. |
