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Vendor Questionnaire

Are you a Vendor that ships product direct/warehouses for Rogers Poultry? Or a Broker on behalf of Rogers Poultry?(Required)

Vendor

Broker

Broker Name(Required)

If you are a Broker, please submit a separate form for each vendor you bring in product for Rogers Poultry

Vendor Name(Required)

Vendor Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Vendor Phone(Required)

Vendor Fax(Required)

Vendor Email(Required)

Vendor Primary Contact(Required)

First Last

1. Do you currently have a validated HACCP plan? (Hazard Analysis Critical Control Point)(Required)

Yes

No

If you have answered no, do you intend on implementing a HACCP program? And if so, do you have a target date?(Required)

2. Do you currently have a SSOP program? (Sanitation Standard Operating Procedures)(Required)

Yes

No

If you have answered no, do you intend on implementing a SSOP program? And if so, do you have a target date? If this does not apply to your Industry please put N/A(Required)

3. Do you currently have a GMP program? (Good Manufacturing Practices Program)(Required)

Yes

No

If you have answered no, do you intend on implementing a GMP program? And if so, do you have a target date?(Required)

4. Do you currently have a Pest Control program?(Required)

Yes

No

If you have answered no, do you intend on implementing a Pest Control program? And if so, do you have a target date?(Required)

5. Do you currently have an Allergen control program in place?(Required)

Yes

No

Please provide a list of the Allergens which may be associated with the product you provide to us. If this does not apply to your Industry please put N/A

If you have answered no, do you intend on implementing an Allergen Control program? And if so, do you have a target date? If this does not apply to your Industry please put N/A(Required)

6. Do you currently have a Third-Party Audit score available?(Required)

Yes

No

Third-Party Audit score(Required)

At the time of the audit, did any critical or serious non compliances or deviations occur?(Required)

Yes

No

Please explain critical or serious non compliances or deviations that occured(Required)

7. Can you provide a Certificate of Analysis invoice for each shipment?(Required)

Yes

No

If you have answered no, do you believe that you may be able to provide a COA for each shipment of product in the future?(Required)

Yes

No

8. Do you currently have a Supplier Approval program in place?(Required)

Yes

No

If you have answered no, do you intend on implementing a Supplier Approval program? And if so, do you have a target date?(Required)

9. Do you currently have training records for all employees?(Required)

Yes

No

If you have answered no, do you intend on keeping training records in the future? And if so, can these be provided upon request?(Required)

10. Do you currently have a documented complaint procedure?(Required)

Yes

No

If you have answered no, do you intend on implementing a complaint documentation procedure? And if so, do you have a target date?(Required)

11. Do you currently have a product recall/traceability procedure in place?(Required)

Yes

No

If you have answered no, do you intend on implementing a product traceability procedure? And if so, do you have a target date?(Required)

12. Do you currently have a Food Defense Program?(Required)

Yes

No

If you have answered no, do you intend on implementing a Food Defense Program? And if so, do you have a target date? If this does not apply to your Industry please put N/A(Required)

13. Do you currently have a Microbiological Testing Program?(Required)

Yes

No

If you have answered no, do you intend on implementing a microbiological testing program? And if so, do you have a target date? If this does not apply to your Industry please put N/A(Required)

Letter of Guarantee

Max. file size: 512 MB.

Certificate of Liability Insurance

Max. file size: 512 MB.

Pest Control information

Max. file size: 512 MB.

Third Party Audit Certificate

Max. file size: 512 MB.

Product Specification Sheets

Drop files here or

Max. file size: 512 MB.

Extra Notes

I agree to the Supplier Approval process(Required)

By submitting this Vendor Questionnaire, your establishment confirms that to the best of your knowledge you comply with all Federal and State Laws and Regulations governing the food industry and support industries.

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Name

This field is for validation purposes and should be left unchanged.

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Rogers Poultry is in Compliance with all local and state COVID Guidelines
Face Covering required when on Premises

Monday - Friday 6am - 5pm
5050 Santa Fe Ave. Vernon CA 90058
800-585-0802
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