ASQR-01 Rev 10
Supplier ASQR-01 Annual Internal Audit Checklist Form 1

WARNING

/ EXPORT CONTROL CLASSIFICATION

No Technical Data

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2. ECCN(s):

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4. USML (ITAR):

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1. Canadian ECL(s):

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3. P-ECCN(s):

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5. P-USML:

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Instructions for Completing the ASQR-01 Form 1 Self-Assessment

This Annual Internal Audit Checklist has been designed not only as an annual verification that UTC aerospace suppliers are compliant to the requirements of ASQR-01 but is also a significant tool to allow suppliers to prepare for actual on-site Member audits. This self-assessment should be completed in conjunction with the ASQR-01 Form 5 Compliance Gap Analysis. The Question Guidance provided in this Checklist has been developed so that on-site Member audits will use similar interpretations when required.

In order to complete this Form, please enter the requested information in the sections below:

1:  Enter your company’s name as it appears on the Member PO

2:  Enter the current DUNS number for the company the Member places POs with

3:  Enter the vendor code for P&W for your company

4:  Enter the vendor code for P&WC for your company

5:  Enter the vendor code for UTAS for your company

6:  Enter the name of the individual conducting the audit

7:  Enter the primary address where the audit is being conducted (in the event of multiple locations)

8:  Input the audit date or dates when it was conducted

9:  Enter the name and title of the appropriate Quality Manager (QM) at your company that is responsible for either Quality Systems or for the Member product line/business/manufacturing plant. This Manager should review the completed Checklist for completeness and that any questions not found conforming are addressed in a timely manner (e.g. internal corrective actions raised in the supplier’s own system).

10: QM electronically signs the Checklist by double clicking on the signature box and following the MS Word instructions

·  Note: all questions should be responded to prior to the QM signing the Checklist

1. Supplier Name:

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2. DUNS #:

3. P&W V/C:

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4. P&WC V/C:

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5. UTAS V/C:

6. Auditor Name:

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7. Audit Date(s):

8. Supplier Location Audited:

I have reviewed and approved this Checklist and have added my electronic signature

9. QM Name:

QM Title:

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10: Electronic Signature

Audit Specification References
Specification / Rev / Specification / Rev / Specification / Rev / Specification / Rev / Specification / Rev / Specification / Rev
AS 9100 / C / ASQR-01 / 10 / ASQR-15.1 / 2 / ASQR-07.5 / 1 / ASQR-15.1 / 2 / ASQR-20.1 / 5
Table of Audit Elements
1. General / 4. Material Verification / 7. FOD Control
2. Contract Review / 5. Production Control / 8. Inspection
3. Sub-Tier Control / 6. Mfg Process Review / 9. Non-Conforming Product

Rev: 2017-02-21 UTC Proprietary Information Page 1 of 44

See page 1 for any technical data content

ASQR-01 Rev 10
Supplier ASQR-01 Annual Internal Audit Checklist Form 1

1 / GENERAL REQUIREMENTS
# / Applicability Code / ASQR Ref / AS9100 Ref / Requirement
1.1 / 1 / 2 / 6 / 4.1.1 / 4.1 / Supplier receiving a PO from Member(s) shall be certified by an IAQG accredited Certification Body (CB) to AS/EN/JISQ 9100.
Question:
Provide the following information on your current AS9100/AS9120/NADCAP AC7004 certification or provide the information below on the approved waiver to this requirement from the Member. / Response(s)
Certification Information
Certification body:
Last audit date: (mm/dd/yy)
Certificate expiration: (mm/dd/yy)
# of Minor findings:
# of Major findings:
Waiver Information
Waiver Issue date: (mm/dd/yy)
Issuing Member:
Question Guidance:
·  If your company does not currently hold a AS/EN/JISQ 9100 certification or an approved waiver from the Member, immediately fill out ASQR-01 Form 3 and submit to Members that you are doing business with. Member acceptance is required. / Reference to Internal Documents for Compliance
(if applicable)

# / Applicability Code / ASQR Ref / AS9100 Ref / Requirement
1.2 / 4 / 4.1.4 / 4.1 / Special Process Suppliers shall be certified to Nadcap AC7004 or AS/EN/JISQ 9100.
Question:
If you are classified as a Special Process Supplier as described in ASQR-01 Rev 10, is your company Nadcap certified for the Special Processes performed against a Member PO? / Response(s)
YesNoN/A - Not a Special Process Supplier
Question Guidance:
Section 7.5.2 Qualifier:
All Special Process Suppliers in the supply chain shall be Nadcap accredited for the following special processes:
·  Chemical Processing
·  Coatings
·  Heat Treating
·  Materials Testing Laboratories
·  Nonconventional Machining and Surface Enhancement
·  Nondestructive Testing
·  Welding / Reference to Internal Documents for Compliance
(if applicable)

# / Applicability Code / ASQR Ref / AS9100 Ref / Requirement
1.3 / 1 / 2 / 3 / 4 / 5 / 6 / 4.1.7 / 4.1 / Supplier shall notify Member(s) of any changes in its certification, registration, or accreditation within 48 hours of receiving notification of the change.
Question:
Do your procedures include a provision to notify Member(s) of any changes to your AS9100 certification, registration, or accreditation within 48 hours of receiving notification of the change? / Response(s)
YesNo
Question Guidance:
·  Either in a documented procedure or work instruction, there should be instructions for those involved in maintaining your certification to notify the UTC Member in the event of any change described in this section.
·  Notify the Member of any AS9100 certification changes through the submittal of ASQR-01 Form 3. / Reference to Internal Documents for Compliance
(if applicable)

# / Applicability Code / ASQR Ref / AS9100 Ref / Requirement
1.4 / 1 / 2 / 3 / 4 / 5 / 6 / 4.1.9
Table 4 / 4.1 / Supplier shall adhere to Member submission instructions for ASQR-01 Form 3 and each form listed in Table 4
Question:
Are appropriate employees in your company aware of the various Forms for communicating with the Member as outlined in Section 4.1.9.2? / Response(s)
YesNo
Question Guidance:
Ensure employees working with Member product are aware of Section 4.1.9.2 Communication Forms:
·  ASQR-01 Form 1: ASQR-01 Audit Checklist
·  ASQR-01 Form 2: Process Change Notification
·  ASQR-01 Form 3: Supplier Request for Information
·  ASQR-01 Form 4: Supplier Work Transfer Request
·  ASQR-01 Form 5: Compliance Gap Analysis
·  ASQR-01 Form 6: Notice of Potential Quality Escape (NOPQE)
·  ASQR-01 Form 7: Delegated Quality Representative (DQR) Candidate Application
·  ASQR-01 Form 8: Letter of Agreement, Delegated Quality Representative Program
·  ASQR-01 Form 9: Distributor Request / Reference to Internal Documents for Compliance
(if applicable)

# / Applicability Code / ASQR Ref / AS9100 Ref / Requirement
1.5 / 1 / 2 / 3 / 4 / 5 / 6 / 4.1.10 / 4.1 / Supplier shall comply with the latest revisions of ASQR, UTCQR, Member-specific quality system requirements, and other documents referenced herein.
Supplier shall confirm compliance by performing a documented gap analysis for each new revision of ASQR, UTCQR and Member-specific quality system requirements using ASQR-01 Form 5, Compliance Gap Analysis, or equivalent. Supplier shall ensure gap closure within 60 days of document publication unless otherwise specified in the Member Notification. Supplier shall request and obtain approval from Member using ASQR-01 Form 3 for any deviation from these requirements.
Question:
a) Provide the revision of the following UTC specifications that are currently in your document control system / Response(s)
ASQR-01:
ASQR-20.1:
ASQR-07.5:
(where NC/CNC or deliverable Software is involved)
ASQR-09.1:
(if providing Flight Safety Parts)
ASQR-15.1:
ASQR-09.2:
(if UPPAP called out by Member)
Question:
b) Does your company have a completed ASQR-01 Form 5 (or equivalent) on file as evidence of compliance to all Quality Systems requirements (i.e. ASQR, UTCQR, and Member-Specific Quality System Requirements)? / Response(s)
YesNo
Question Guidance:
·  Go to www.utc.com to ensure you have the latest revisions of the ASQR specifications.
·  Consult each of the specifications above to determine it’s applicability to your business.
·  For each new ASQR revision, ensure ASQR-01 Form 5 (or equivalent) is filled out. If there are any gaps, ensure closure within 60 days of document publication or Member deviation approval through ASQR-01 Form 3. / Reference to Internal Documents for Compliance
(if applicable)

# / Applicability Code / ASQR Ref / AS9100 Ref / Requirement
1.6 / 1 / 2 / 4 / 6 / 4.1.12 / 4.1 / Supplier that provides Flight Safety Parts shall comply with the requirements of ASQR-09.1 unless otherwise specified by Member.
Note: Some Member specific designations for Flight Safety Parts (FSP) include Flight Critical Parts, UTAS Flight Safety Part, UTAS Safety Part, P&W Prime Reliable Part, P&WC Critical Part, P&WC Critical Rotating Part, P&WC Engine Structural Integrity Program (ENSIP) Critical Part.
Question:
a) Do you have any open P.O.'s for Flight Safety Parts as defined by ASQR-09.1? / Response(s)
YesNo
Question:
b) If yes, has the Member conducted a Flight Safety-specific audit at your facility in the last 12 months? / Response(s)
YesNo - one is scheduledNo - none is scheduled
Question Guidance:
·  Review all open POs and check if any parts provided to the Member are Flight Safety Parts.
·  For the purpose of this document the term Flight Safety Part (FSP) is synonymous with:
o  PW Prime Reliable Part
o  PWC Critical Rotating Part
o  PWC Critical Part
o  PWC Engine Structural Integrity Program (ENSIP) Critical Part
o  HS Flight Safety Part / Reference to Internal Documents for Compliance
(if applicable)

# / Applicability Code / ASQR Ref / AS9100 Ref / Requirement
1.7 / 1 / 2 / 3 / 4 / 5 / 6 / 4.2.3 1. / 4.2.3 c) / Changes to manufacturing documentation (e.g., work instructions, travelers, routers) shall be recorded, dated and traceable to a qualified person making the change (e.g., name, signature, stamp, electronic signature) with a permanent marking method with the original information being legible and retrievable after the change.
Question:
a) Do your documented procedures require that all quality records are documented in ink or other permanent marking? / Response(s)
YesNo
Question:
b) Do your procedures require that changes to floor documents (e.g. work instructions, travelers, routers) shall be recorded, dated and traceable to a qualified person making the change (e.g., signature, stamp) with the original data being legible and retrievable after the change? / Response(s)
YesNo
Question Guidance:
·  In general, a "qualified person" will be one that is documented in a procedure or work instruction as having the necessary skills and authority to make the change in question. / Reference to Internal Documents for Compliance
(if applicable)

# / Applicability Code / ASQR Ref / AS9100 Ref / Requirement
1.8 / 1 / 2 / 3 / 4 / 5 / 6 / 4.2.4 1. / 4.2.4 / All electronic records shall be retained, retrievable and readable on storage media capable of maintaining the data integrity for the full retention period.
Question:
Do your company's record retention policies require that electronic records shall be retained, retrievable and readable on storage media capable of maintaining the data integrity for the full retention period (similar to hard copy records)? / Response(s)
YesNo
Question Guidance:
·  Ensure there is a disaster plan in place to retain records during natural or man-made disasters (floods, earthquakes, etc.). / Reference to Internal Documents for Compliance
(if applicable)

# / Applicability Code / ASQR Ref / AS9100 Ref / Requirement
1.9 / 1 / 2 / 3 / 4 / 5 / 6 / 4.2.4 3. Table 5 / 4.2.4 / Retention Periods for Records Pertaining to the Following Part Types:
40 years: Flight Safety Parts, Safety Parts, Flight Critical Parts, ESA parts (P&W, P&WC), Frozen Process Parts (UTAS)
30 years: Manned Space Program Hardware
10 years: All other parts
Question:
Please enter the retention periods in your internal records retention policy(s) for each of the following categories (if applicable): / Response(s)
Time Period (from time of manufacture)
Flight Safety/Flight Critical Parts:
ESA/Frozen Process Parts:
Manned Space Program Hardware:
All other parts:
Question Guidance:
·  The UTC requirements for records retention required documented evidence that records are being kept for a minimum time (from time of manufacture) of:
o  40 years for Flight Safety Parts, Safety Parts, Flight Critical Parts, ESA parts (P&W, P&WC), Frozen Process Parts (UTAS)
o  30 years for Manned Space Program Hardware
o  10 years for all other parts
·  Ensure that the appropriate retention period(s) are being flowed down to sub-tiers. / Reference to Internal Documents for Compliance
(if applicable)

# / Applicability Code / ASQR Ref / AS9100 Ref / Requirement
1.10 / 1 / 2 / 3 / 4 / 5 / 6 / 7.2.3 / 7.2.3 / For communication with the Member, Supplier shall have the capability to communicate in English. The following documents shall be in English unless otherwise approved by the Member:
● Quality Manual
● First level Quality procedures
● Process documentation requiring Member approval
● All formal communication (e.g., ASQR, UTCQR and Member-specific Forms, FAI, UPPAP documents)
In cases where Supplier maintains copies in their native language as well as in English, and there is a conflict, the English language document shall take precedence.
Question:
Are the below documents available to the Member in the English Language?
● Quality Manual
● First level Quality procedures
● Process documentation requiring Member approval
● All formal communication (e.g., ASQR, UTCQR and Member-specific Forms, FAI, UPPAP documents) / Response(s)
YesNo
Question Guidance:
·  As a general rule, all documentation needed to demonstrate compliance to Member requirements need to be in the English language, including:
o  Top level QMS documentation
o  Top level working instructions pertaining to the QMS
o  Process Documentation Requiring Member Approval
o  Formal Communication with the Member / Reference to Internal Documents for Compliance
(if applicable)