AUDIT REPORT

Job No:

Organisation & Work Address

Company Name:
Subsidiary of:
Organisation Identification:
Assessed Site Address:

Tel Number:
Fax Number:
e-mail:
CAGE code:
Assessment Representative & Title:
Management Representative & Title:

Scope / Main activities:

Product Types or Codes:

No. of employees at assessed site:

ISO Registration
[ ] ISO Standard / Revision:
[ ] Aerospace Standard / Revision:
Expiration Date (If applicable):
Expiration Date (If applicable):
Registrar Name:
Registrar Name:
Assessment Team
Lead Assessor Name:
Other Assessor Team Members:
[ ] Certified Auditor
[ ] Qualified Auditor & Number:
Assessment Dates:
Assessment Scope / Standard:
[ ] Total facility assessed [ ] Initial assessment [ ] All 9100 elements assessed
[ ] Partial facility assessed [ ] Re-assessment
[ ] Partial 9100 elements assessed
[ ] Other:
Clauses not assessed:
[ ] Activity assessed:
Assessment Disposition
Scoring
[ ] Conforming
Scoring result:
[ ] Conforming with minor (mi) corrective action
[ ] Non conforming with Major (MA) corrective
action
Assessment Approval
9100 standard version assessed to:
Assessing Company
Date
Lead Assessor Name
Signature

Distribution Agreement
This Assessment Report is the property of the assessed Organisation and the assessing Company.
Distribution to other companies or individuals is authorized only after written agreement of the
assessed Organisation and of the assessing Company.
To that end, a signature below by an Authorized Representative of the assessing company
indicates that this report may be copied by the organisation for other customers.
If copied, the report must be disclosed in full including findings and any corrective actions.
Authorized
Representative
Assessing Company
Name:

Form 25C/ 4

Signature:

Date:

Page 1 of 10

Verification of Closure of Non-compliances from Previous Audit

For previous assessment dated:
Ref No:

Objective Evidence

General Assessment Information

Status
(open or
closed)

AUDIT REPORT

Job No:

Legal and Financial Aspects

Date of Formation:
Legal Status:
Capital:
Other Data:
Third Prior
Financial Year
(
)

Second Prior
Financial Year
(
)

First Prior
Financial Year
(
)

Current
Financial
Year
(
)

Sales
Earnings
Earnings used for ReInvestment
Workforce

Turnover breakdown and main Customers

Activities

Main Customers

Sales Percentage

Aircraft, Space and

Defense Industry

Other Activity
(be specific)

Clearances or Approvals granted by Authorities

Name of the Authority

Form 25C/ 4

Types and References

End of Validity

Page 4 of 10

AUDIT REPORT

Job No:

ASSESSMENT RESULT SUMMARY

Organisation:
Clauses*

Result
S

Ma

mi

Observation /
Corrective Action
N/A N/E Request Number
(MA/mi)

Specific Areas to check

next time

4 - Quality Management System

4.1 General requirements
4.2 Documentation requirements
4.3 Configuration Management
5 - Management Responsibility
5.1 Management commitment
5.2 Customer focus
5.3 Quality policy
5.4 Planning
5.5 Responsibility, authority and
communication
5.6 Management review
6 - Resource Management
6.1
6.2
6.3
6.4

Provision of resources
Human resources
Infrastructure
Work environment

7 - Product Realisation
7.1 Planning of product realisation
7.2 Customer-related processes
7.3 Design and development
7.4 Purchasing
7.5 Production and service provision
7.6 Control of monitoring and
measuring equipment
8 - Measurement, Analysis and Improvement
8.1 General
8.2 Monitoring and measurement
8.3 Control of nonconforming
product
8.4 Analysis of data
8.5 Improvement
Assessed Organisation
Reps name:

Assessing Company
Lead Assessor Name:
Results

Form 25C/ 4

Page 5 of 10

AUDIT REPORT

Job No:

ASSESSMENT SCORING

Form 25C/ 4

Page 6 of 10

AUDIT REPORT

Job No:

Organisation :

Result
SCORING CHART

4
4.1
4.2 & 4.3
5
5.1
5.2
5.3
5.4
5.5
5.6
6
6.1
6.2
6.3
6.4
7
7.1
7.2
7.3
7.3.1
7.3.2-3-4
7.3.5-6
7.3.7
7.4
7.5
7.5.1
7.5.2
7.5.3
7.5.4-5
7.6
8
8.1
8.2
8.2.1
8.2.2
8.2.3
8.2.4
8.3
8.4
8.5

Quality management system

General requirements
Documentation requirements & Configuration management
Management responsibility
Management commitment
Customer focus
Quality policy
Planning
Responsibility, authority and communication
Management review
Resource Management
Provision of resources
Human resources
Infrastructure
Work environment
Product realisation
Planning of product realisation
Customer related processes
Design and development
D& D Planning
Inputs, outputs & review
D&D verification & validation
Control of design and development changes
Purchasing
Product and service provision
Control of production and service provision
Validation of processes for production and service provision
Identification and traceability
Customer property & preservation of product
Control of monitoring and measuring device
Measurement analysis and improvement
General
Monitoring and measurement
Customer satisfaction
Internal audit
Monitoring and measurement of processes
Monitoring and measurement of product
Control of nonconforming product
Analysis of Data
Improvement

Major CAR or minor

CAR on Key
requirement

Signature :

Key requirement

Multiple

Single

Multiple

Single

findings

finding

findings

finding

0
0

10
10

25
25

40
40

NO CAR

(100)
50
50

(150)
0

15

20

30

0
0
0

10
5
10

20
15
25

30
20
40

40
30
50

(100)
0

10

25

40

50

10

25

40

50

0
0

5
10

15
30

20
50

30
60

0
0
0
0
0

5
5
5
5
10

15
15
15
15
30

20
20
20
20
50

30
30
30
30
60

0
0
0
0
0

10
10
10
5
5

25
20
20
15
10

40
30
30
20
15

50
40
40
30
20

10

15

20

0
0
0
0
0
0
0

5
5
5
5
5
5
5

10
15
15
15
15
10
10

15
20
20
20
20
15
15

20
30
30
30
30
20
20

(450)

(200)

The assessed Organisation agrees on the quality management

system scoring and corrective action requests
Name of Representative :

Minor CAR on non

Date :

Total Points Possible

Total Points Achieved
Score
(pts achieved/pts possible)

X 100

Audit Summary

Form 25C/ 4

Page 7 of 10

RESULT

AUDIT REPORT

Job No:

General Comments or Concerns:

Comments of Concerns regarding the reliability of the organisations internal audits and management reviews:

Comments or concerns regarding the qualification, experience and authority of staff encountered:

Comments or concerns regarding the effectiveness of the management system to achieve clients objectives:

Comments or concerns regarding progress of planned activities aimed at continual improvement:

Comments or concerns regarding operational controls:

Recommendations and follow-up action required:

Form 25C/ 4

Page 8 of 10

AUDIT REPORT
Ref
No.

Clause
No.

Form 25C/ 4

IO

Job No:

Improvement Opportunity / Comments / Observations Raised

Page 9 of 10

AUDIT REPORT

Job No:

Opening Meeting Mandatory Agenda

Attendees:

(a)

Review the confidentiality agreement

(b)

Establish official communication links between the audit team and company

(c)

Clarify and confirm or amend the scope for which certification is sought

(d)

Overview of the audit plan, objectives, scope and criteria

(e)

Explain the significance and reporting of major and minor non-compliances

(f)

Verify Administrator on OASIS and Still Current

(g)

Invite questions from the companys representatives.

Notes:

Closing Meeting Mandatory Agenda

Attendees:

(a)

Thank the company for their hospitality and for their assistance and co-operation.

(b)

Overall summary of assessment, non-compliances and observations found during the audit.

(c)

Explain procedure for submitting Corrective Action Plan and Objective Evidence if Required

(d)

Present recommendation for or against certification continuance

(e)

Explain the continued surveillance audit cycle

(f)

Invite questions from the companys representatives including comments on this report

(g)

Leave an Electronic/photocopy of the IMS Audit Report with the company.

Notes:

Form 25C/ 4

Page 10 of 10