LLRWMO - Procurement & Contracting - Low Level Radioactive Waste Management Office

About the LLRWMO

Vendor Questionnaire

Introduction

As a potential supplier to the Low-Level Radioactive Waste Management Office (LLRWMO), a division of AECL, you are requested to complete this questionnaire that will allow us to assess your capabilities and determine your suitability as a supplier for our project.

The questionnaire is designed to be comprehensive and, depending upon the work you undertake and/or the products/services you offer, some of the detail we ask may not apply to your area of interest.

Part A - General Information

SECTION I - SUPPLIER INFORMATION

Name and Address

Legal Name of Company:
Street Address:
Mailing Address (if different from above):

Telephone Number:

Facsimile Number:

E-mail Address:

Remit to Address

Mailing Address:

Contract Terms/Business Identifiers (GST/HST numbers)

Contract Terms (please specify funds if payable in Cdn or US funds)

Terms of Payment:

Business Identifiers (for Individuals - the supplier’s SIN & if available the BN or the GST/HST number, for Partnership or Corporation - the BN or the GST/HST. If a partnership does not have a BN then the SIN number of a partner is required.

Individual

Partnership or Corporation

SIN Number:
GST/HST Number:
BN Number:

Key Personnel

President:
Vice President:
Quality Assurance Manager:
Consultants should attach list of key staff with their corresponding area(s) of expertise and/or responsibilities.

SECTION II - BACKGROUND/FINANCIAL INFORMATION

Nature of Business

Consultant	Contractor
Distributor	Services
Manufacturer	Other (please specify):

Define in one phrase your company’s business (example: Environmental Consultant):

Please indicate

Proprietorship

Partnership

Corporation

Date company was founded:
List Names of Parent Company, Subsidiaries and Affiliates:
Parent Company:
Subsidiaries:
Affiliates:

Size of Company

List office locations, number of employees and activity at each location:

Location	Number of Employees	Activity

Financial Information

Annual dollar volume (each of the last three years):

1.
$

2.
$

3.
$

Is a certified financial or income statement available? If "YES", please attach the latest statement.	YES	NO
Provide your references for the following services:
Banking:
Bonding:
Insurance:
Please indicate the type and value of insurance carried by your firm:

SECTION III - PRODUCT(S) AND/OR SERVICE(S) OFFERED

Product/Service Offered

Please list product(s)/service(s) offered to the LLRWMO. Your listings will establish how we record your firm in our database. Please format this information using the proper noun as found in a trade index or professional journal (example: DOORS, overhead, DOORS, glass)

Technical Capabilities

Please list all certificates or other authorizations held by your company to perform work, supply products or perform work, such items as ASME, TSSA certifications/recognition professional accreditation should be included.

Inventory

Advise average value of inventory in stock and available for sale:

Nuclear Industry

If the product or service offered is unique to the nuclear industry, list four (4) major contracts completed over the last five (5) years:

Customer	Contract Value	Type of Work	Location of Project	Order date / Completion date

Major Projects

Please include a brief description/profile of significant projects you have completed over the last three (3) years. The description/profile should include:

Customer;

Contract value;

Scope of work;

Location of project; and

Date of order and completion.

Part B - Detailed Information

SECTION IV - QUALIFICATIONS (CONSULTANTS)

Profile

Please provide a profile of your operations including but not limited to:

Unique or exceptional experience;

Specialized capability of your professional staff;

Education and experience of key personnel assigned to projects;

Affiliations, memberships; and

Awards, distinctions granted to your firm or staff.

SECTION V - MANUFACTURING CAPABILITIES (MANUFACTURERS)

Capability

Please detail your current capability including but not limited to:

Tools/equipment employed;

Limits on any particular process;

Capacity;

Design/Development capability;

Special processes; and

Authorizations/Certifications bestowed by various jurisdictions.

SECTION VI - QUALITY ASSURANCE

Programs

Do you have a Quality Assurance Program in effect?

YES

If yes, please indicate whether it is in compliance with any nationally or internationally recognized QA program. Please list those standards:

Audits

Please indicate whether your QA program has been audited recently and the results of such an audit:

Reference Standard	Auditing Organization	Date of Audit	Outcome/Comments

QA Details

Please provide the name and phone number of the senior person within your organization responsible for QA and his/her reporting relationship to the Senior Executive Officer.

Senior Person:	Telephone Number:

SECTION VII SAFETY PROGRAM (CONTRACTORS)

Please provide information regarding the Safety Program employed in construction work. The information provided should reflect the current state of your safety program implementation in your Company.

Also please enclose a report that documents your safety statistics over the last three (3) years.

SECTION VIII UNIQUE QUALIFICATIONS

Please use this section to provide any other information not requested that you feel is important and that makes you uniquely qualified to be considered as a supplier to AECL’s Low-Level Radioactive Waste Management Office’s requirements:

This questionnaire was completed by:

Name (print):		Date:
Title:		E-mail:
Phone Number:		Facsimile Number:

Other Pages in This Section