Name | Â |
Address | Â |
Internet Address | Â |
Name of Parent Organization (if any) | Â |
Correspondent: Name / Title | Â |
Phone Number | Â |
Fax Number | Â |
E-Mail Address | Â |
Vendor Approval: | Â | |
Name | Position | Date |
 |  |  |
 |  |  |
1 | Company Activity | Yes | No | N/A |
1.1 | Distributor (a wholesaler who takes title to the property of the goods) | Â | Â | Â |
1.2 | Transportation ( a courier service that collects and delivers product) | Â | Â | Â |
1.3 | Broker (an agent who buys or/and sells for a principal on a commission basis without having title to the property) | Â | Â | Â |
   1.4 | Other (please specify): ………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………… | |||
1.5 | Percentage of your company Business in the Pharmaceutical Industry / Other main activities | ….. % ………………………… | ||
2 | Materials Handled | Yes | No | N/A |
2.1 | Active Pharmaceutical Ingredients (APIs) | Â | Â | Â |
2.2 | Excipients | Â | Â | Â |
2.3 | Fine chemicals | Â | Â | Â |
2.4 | Radioactive | Â | Â | Â |
2.5 | Flammables | Â | Â | Â |
2.6 | Controlled drugs (Schedule 1 to 5) | Â | Â | Â |
 2.7 | Others (specify) …………………………………………………………………… | |||
3 | Quality System & Quality Management | Yes | No | N/A |
3.1 | Is there a quality management system implemented? | Â | Â | Â |
 3.2 | Is there a third-party certification of the quality system (Covered by ISO 9001:2008 certification or other)? Please provide copies of current version |  |  |  |
 3.3 | Does the company hold a wholesale dealer licence or a GDP certificate of compliance? Please provide copies of current version. |  |  |  |
 3.4 | Does your company have a written policy including management's active commitment to Quality? |  |  |  |
3.5 | Are there written standard operating procedures (SOPs) in place that describe operations to be performed by the personnel? | Â | Â | Â |
 3.6 | Is there a quality manual and written procedures describing Good Distribution Practices related processes? |  |  |  |
   3.7 | Does the company have a written procedure on internal audits and audits of contracted services? If yes, please briefly describe the process followed: …………………………………………………………………………………… …………………………………………………………………………………… …………………………………………………………………………………… …………………………………………………………………………………… |  |  |  |
3.8 | Does the company operate a documented system for quarantining suspect product? | Â | Â | Â |
3.9 | Does the company have a formal system for documenting and investigating incidences that impact on the product quality? | Â | Â | Â |
3.10 | Is there a procedure for internal audits of the quality management system including an audit plan? | Â | Â | Â |
  3.11 | In case of emergency does the company have a written procedure for deliveries outside normal business hours and does the company offer this service? …………………………………………………………………………………… ……………………………………………………………………………………. |  |  |  |
3.12 | Is a formal management review of the Quality Management System held at least once a year? | Â | Â | Â |
3.13 | Is there a document control system in place ensuring proper design, approval, review, and distribution of necessary documentation? | Â | Â | Â |
4 | Organisation & Personnel | Yes | No | N/A |
4.1 | Has the company a sufficient number of qualified employees for these operations? | Â | Â | Â |
 4.2 | Have all (including administrative) personnel, involved in handling and transporting medicinal products, been made aware of the potential risks to human health? |  |  |  |
  4.3 | For new personnel employed or contractors, please indicate the checks performed on the individual, in particular any security checks : …………………………………………………………………………………… …………………………………………………………………………………… …………………………………………………………………………………… |  |  |  |
 4.4 | Is there a specific qualification required for employees responsible for key activities in Safety, Health, Environment and Quality? If yes, please specify : …………………………………………………………. |  |  |  |
4.5 | Are the health and safety responsible persons providing regular training to employees dealing with hazardous materials? | Â | Â | Â |
4.6 | Have job descriptions been made and regularly updated? | Â | Â | Â |
4.7 | Has an evaluation been made of all activities to identify training needs? | Â | Â | Â |
4.8 | Is initial and ongoing general training provided? | Â | Â | Â |
4.9 | Are employee training and qualification records maintained? | Â | Â | Â |
 4.10 | Are internal and external training courses documented? (Documentation of training should include records of training effectiveness.) |  |  |  |
4.11 | Are contracted service providers included in the training program? | Â | Â | Â |
4.12 | Are contractors provided with information relevant to the job to be done? | Â | Â | Â |
4.13 | Are contractors provided with appropriate training if necessary? | Â | Â | Â |
4.14 | Are contractors provided with appropriate personal protective equipment? | Â | Â | Â |
 4.15 | Are there procedures in place ensuring good hygiene of the personnel where exposure to material in open containers may occur (e.g. monitoring of health conditions, wearing of protective clothes etc.)? |  |  |  |
4.16 | Is there a person with the specific responsibility and the appropriate authority to deal with GDP issues in the company? | Â | Â | Â |
 4.17 | Is initial and ongoing GDP training provided? Are training sessions recorded? Is there a training evaluation system? |  |  |  |
5 | Transportation | Yes | No | N/A |
5.1 | Does the company have a dedicated fleet of vehicles for the transportation of medicinal products? | Â | Â | Â |
5.2 | Do the vehicles have dual temperature capabilities? | Â | Â | Â |
 5.3 | If the company possesses any vehicles that have temperature controlled chambers, has any validation study been performed and documented to ensure optimal operating conditions, taking into consideration any environmental variables? |  |  |  |
5.4 | Do the vehicles have temperature controlling, monitoring and reporting devices? | Â | Â | Â |
  5.5 | If yes to 5.4, are these devices serviced and calibrated?  Please specify frequency of maintenance and calibration: …………………………………………………………………………………… …………………………………………………………………………………… |  |  |  |
5.6 | Are the vehicles locations tracked via GPS? | Â | Â | Â |
  5.7 | Are transportation vehicles cleaned on a frequent basis and are records available to view on request? Please specify frequency of cleaning and any additional information: …………………………………………………………………………………… …………………………………………………………………………………… …………………………………………………………………………………….. |  |  |  |
  5.8 | Are transportation vehicles serviced on a frequent basis and are records available to view on request? Please specify frequency of servicing and any additional information: …………………………………………………………………………………… …………………………………………………………………………………… …………………………………………………………………………………….. |  |  |  |
  5.9 | Are Transportation/distribution records kept for each shipment? Please specify the records that are retained and the archive period for these records: …………………………………………………………………………………… …………………………………………………………………………………… …………………………………………………………………………………… |  |  |  |
 5.10 | Is there a written procedure detailing the process to be followed in the event of an unexpected occurrence such as vehicle breakdown (engine or storage chamber temperature control failure) or non-delivery? Please specify: …………………………………………………………………………………… …………………………………………………………………………………… …………………………………………………………………………………… |  |  |  |
6 | Transportation (Medicinal Products Requiring Special Conditions) | Yes | No | N/A |
6.1 | Does your company transport scheduled drug products such as narcotics or psychotropics? | Â | Â | Â |
 6.2 | If yes, do you maintain a safe and secure means of transportation in accordance with requirements laid down by your country medicines regulatory authority? |  |  |  |
  6.3 | Briefly describe the security measures in place at your company to ensure secure transportation of scheduled drug products: …………………………………………………………………………………… …………………………………………………………………………………… …………………………………………………………………………………… |  |  |  |
  6.4 | Briefly describe the customer checks performed and documented at time of delivery of a scheduled drug product: …………………………………………………………………………………… …………………………………………………………………………………… …………………………………………………………………………………… |  |  |  |
    6.6 | Does your company transport radioactive or highly leachable toxic products?  If yes, please specify the safety precautions taken when transporting these types of products: …………………………………………………………………………………… …………………………………………………………………………………… …………………………………………………………………………………… …………………………………………………………………………………… …………………………………………………………………………………… |  |  |  |
6.7 | Is a Material Safety Data Sheet (MSDS) provided with each order? | Â | Â | Â |
7 | Premises (Distribution Warehouses and Hubs) | Yes | No | N/A |
7.1 | Do you conduct physical handling of the product such as: | Â | Â | Â |
7.1a | - Warehousing and Storage for greater than 24 hours | Â | Â | Â |
7.1b | - Repackaging | Â | Â | Â |
  7.1c | Do you re-label the product? Palette label? Container label? If yes, do you edit labels in your facilities? |  |  |  |
 7.2 | Does the company utilise transportation hubs? If yes and products are unloaded at hubs, what is the maximum storage period? ………………………………………………………………………….. |  |  |  |
7.3 | Have you performed a GDP audit of the hubs used by your company? | Â | Â | Â |
7.4 | Is a Quality Agreement in place with these hubs used by your company? | Â | Â | Â |
  7.5 | Briefly describe how the quality of medicines is assured during unloading, storing and loading at hubs? …………………………………………………………………………………… …………………………………………………………………………………… …………………………………………………………………………………… …………………………………………………………………………………… |  |  |  |
8 | Complaints – Recalls | Yes | No | N/A |
8.1 | Does the company operate a complaint procedure that describes actions to be taken? | Â | Â | Â |
8.2 | Does the complaint procedure contain recall criteria? | Â | Â | Â |
8.3 | Is there a procedure ensuring that customers are informed in the event of serious quality problems? | Â | Â | Â |
8.4 | Are complaints recorded and investigated to identify the origin and reason? | Â | Â | Â |
8.5 | Does the company have a procedure in place for prevention of counterfeit products entering the supply chain? | Â | Â | Â |
9 | Returned Goods | Yes | No | N/A |
9.1 | Are returned products handled according to written procedures? | Â | Â | Â |
 9.2 | Is there a system in place to ensure that returned goods are placed in a separate location in the vehicle storage chamber (separate from saleable product)? |  |  |  |
10 | Additional Comments | |||
 |