Supplier Registration Questionnaire Survey

Supplier Information:

Supplier Information: Supplier Name:
Address:
City:
State:
Zip:

Organization Type (Business Model)

Organization Type (Business Model) Corporation

Limited Partnership

Sole Partnership

Partnership

Limited Liability Company

President/Owner Information

President/Owner Information Name:
Phone:
Email:

Primary Contact Information

Primary Contact Information Name:
Phone:
Email:

Business Information

Business Information General Business Description
Company Website
Years in Business
NAICS Code
Tax ID

Change of ownership in the past 3 years? (If yes, please explain)

Change of ownership in the past 3 years? (If yes, please explain) No

Yes

If yes, please explain change in ownership.

Ownership Classification (Check all that apply)

Ownership Classification (Check all that apply) Large Business

Small Business Enterprise

Minority Owned Business (MBE)

Women Owned Business

Small Disadvantaged Business (SDB)

Disadvantaged Business Enterprise (DBE)

Historically Under-Utilized Business (HUB)

SBA 8(A) Program

Veteran Owned Business

Service Disabled Veteran Owned Business Enterprise

Sheltered Work Shop

Third Party Certification

Third Party Certification National Minority Supplier Development Council (NMSDC)

Women Business Enterprise National Council (WBENC)

Association for Service Disabled Veterans

The California Public Utiltities Commision (CPUC)

Local Municipality

State Government

Central Contractor Registration

Ability One

Other Third Party Certification (please specify below)

Certification Status (UL, ISO, QS, TS, etc):

Gross Annual Sales (State in Millions $USD).

Gross Annual Sales (State in Millions $USD). 2012:
2011:
2010:

If you are currently doing business with Snap-on, list your primary contact and location:

If you are currently doing business with Snap-on, list your primary contact and location: Primary Contact Name:
Primary Contact Location:

If you are currently doing business with Snap-on, explain what goods/ services you are providing as well as the application:

Industries Served (specify % of total business)

Industries Served (specify % of total business) Automotive
Appliance
Aerospace
Bio-medical
Chemical
Consumer Goods Products
Industrial Manufacturing
Oil/Gas Production
Packaging
Retail
State/Local Municipalities
Service Industry
U.S Government
Utilities
All Others

Please select the Direct Material Categories that best align with your products/services to our classification of needs

Please select the Direct Material Categories that best align with your products/services to our classification of needs Abrasives

Air Control Devices/ Equipment

Assembly and Kitting

Bearings

Cabinet Hardware

CableComponents and Assemblies

Castings and Forgings

Cutting Tools

Electronic/ Electro-Mechanical

Fasteners

Finished Goods Contract Manufacturer

Fluid Control Device/Equipment

Hose and Fittings All Pressure

Hydraulic Devices / Equipment

Metal Components - Fabricated

Metal Components - Mach/Formed

Non-Ferrous Metals

Paint

Passive Components

Plastic Components

Plastic Materials

Printed Circuits

Proprietary Replacement Parts

Rubber Components

Semi-Conductors

Sensing Devices

Steel

Steel Bars/Coil

Steel Shapes

Steel Sheet,Tubing,Plate

Subassemblies

Switches and Relays

Tooling and Fixtures

Transformer Comp / Assemblies

If your firm provides a Direct Material Category that is not listed, specify offering here. (If N/A leave blank)

If your firm provides a Direct Material Category that is not listed, specify offering here. (If N/A leave blank) Other Raw Materials:
Others 1:
Others 2:

Please select the Indirect Material Categories that best align with your products/services to our classification of needs

Please select the Indirect Material Categories that best align with your products/services to our classification of needs Advertising

Computers and Peripherals

Engineering Services

HVAC Services

Inspection Tools

IT Systems and Services

Janitorial Services

Laboratory Services

Maint, Repair, and Operations

Marketing Services

Material Handling Supplies

Office Supplies

Packaging Items

Painting Services

Premium/Sales Promo Hardgoods

Printed Materials

Professional Services

Safety First Aid

Sales Supplies

Temporary Staffing

Transportation

Warehouse / Fulfillment

If your firm provides IT systems or services, please specify offering here.

If your firm provides IT systems or services, please specify offering here. IT Systems and Services (Hardware)
IT Systems and Services (Software)

If your firm provides professional services, please specify offering here.

If your firm provides a good or service that is not listed, please specify offering here.

If your firm provides an Indirect Material Category that is not listed, specify offering here. (If N/A leave blank)

If your firm provides an Indirect Material Category that is not listed, specify offering here. (If N/A leave blank) Other 1:
Other 2:

General Company Information

General Company Information Has your company ever claimed bankruptcy? If so, explain.
Has your company been litigated or is your company under litigation or party to any lawsuits in the last five years related to your products, services, or other? If so, explain.
Are there any judgments, claims, arbitration proceedings or suits pending or outstanding against your company or officers? If so, explain.
Safety is critical to Snap-on, what is your safety practice?
Describe your sales channel (direct sales force, independent reps, distributors, etc)

Please forward the following documents, if applicable; to: supplierdiversity@snapon.com
1. Machine / Machine Family List and Production Capabilities
2. Organizational Chart
3. Third Party Certification
4. Any Marketing Material. (You may provide a link to your website below)

Links to marketing material websites: