Annex C - Change Request Form - 3 Edition
Annex C - Change Request Form - 3 Edition
Annex C - Change Request Form - 3 Edition
Before submitting the change request to the FCA, the supplier is asked to assess the derived risks by completing this checklist and classifying the overall risk. The
completed and signed checklist, as well as the supporting documentation, must be submitted to the FCA for prior approval, only if the general risk is classified as
ACCEPTABLE.
1) Design changes must be submitted to FCA Engineering.
2) Changes in the manufacturing process (location, layout, equipment, facilities, work instructions, control plans, sub-tiers, etc.) must be submitted to the FCA Supplier Quality Engineering.
3) All identified risks must be addressed (prevented and / or mitigated).
Supplier's Information
Supplier Name: Material Group:
Supplier Code: Product:
Plant Location and Address:
Part Numbers Involved:
Contact and Phone:
Mail: Submission Date:
Type of Change Requested: Design ( ) Location ( ) Layout ( ) Equip ( ) Mfg. ( ) Control Plan ( ) Subtier ( ) Other - explain ( )
3) Were measures planned to protect product quality, including reinforced quality control in accordance with standard SQ.00009 (Safe Launch
Attach plan
Plan)?
4) Is there in place a packaging plan to support bank builds (if applicable) and shipments? Attach plan
5) If this change impact multiple vehicle lines and/or FCA assembly plants, have the responsible person been informed and involved? Indicate lines / plants and people informed
8) If this change request concerns a new supplier, has it been regularly assessed and qualified? Attach supplier QRA or source evaluation forms
09) Is there a traceability plan for materials/parts which will be affected by this change? Attach documented plan
11) Has the Planned Maintenance plan been updated, if applicable? Attach documented plan
12) If this change request is initiated by a direct-buy supplier, has the tier 1 supplier been notified and involved? Is its parts inventory been Provide details, including a detailed volume
considered? analysis
13) Are there pictures, drawings, drafts and other documentation available in order to detail the change requested? Provide pictures in documented plan
14) Is there a contact list for people in your organization involved in this change request? Contact list attached
15) Have the proper measures been taken to ensure that the capacity of new or modified equipment is equal to or greater than that of replaced or
Provide documented details
modified equipment?
Acceptable risk: the required change presents lower or equivalent risks compared to the current
situation ACCEPTABLE RISK
OVERALL RISK RATING:
Unacceptable risk: the required change presents greater risks compared to the current situation
Tipo de Mudança Solicitada: Projeto ( ) Localização ( ) Layout ( ) Equip ( ) Processo ( ) Plano Controle ( ) Subfornecedor ( ) Outro - explique ( )
3) Foram planejadas medidas para proteger a qualidade do produto, incluindo controle de qualidade reforçado, de acordo com a norma SQ.00009
Anexe plano
(Safe Launch Plan)?
4) Existe um plano para providenciar embalagens para acondicionar a produção do banco de peças (se aplicável) e a produção inicial? Anexe plano
10) Existe um layout atualizado da planta (antes e depois), se aplicável? Anexe layout atual e proposto
13) Existem fotos, desenhos, rascunhos e outras documentações disponíveis para detalhar as alterações solicitadas? Anexe documentos
14) Existe uma lista de contatos das pessoas de sua organização envolvidas nessa solicitação de mudança? Anexe lista de contato
15) Foram tomadas as medidas adequadas para garantir que a capabilidade do equipamento novo ou modificado seja igual ou superior à
Anexe evidências
capabilidade do equipamento substituído ou modificado?
Assinatura do Representante do
Assinatura do Comitê de Riscos: fornecedor:
AVALIAÇÃO DA FCA
está de acordo com a continuação das atividades para sua implementação e
A FCA está ciente da solicitação de mudança requerida pelo fornecedor, conforme descrito validação regulares (marque X)
acima, e está em desacordo com a continuação das atividades para sua implementação,
que deve ser cancelada (marque X)
Eng. Qualidade fornecedores: ________________________ _____/_____/___________
Assinaturas Representantes FCA / Qualidade da Planta: ________________________ _____/_____/___________
Data: Engenharia do Produto: ________________________ _____/_____/___________
Compras: ________________________ _____/_____/___________
Rev. 02 - 30.03.2020