Supply Change Notification (SCN)

All suppliers are required to notify and receive written approval from Vyaire prior to making any changes to the design or manufacture of products Vyaire purchase.

SCNs should be submitted a minimum of 90 days prior to proposed implementation date. End of Life (EOL) notification should be submitted at a minimum of 180 days prior to material last time buy (LTB) dates. Please contact your Purchasing Agent if you have any questions on how to fill out this form.

*Required

Supplier Information

Supplier Name :
(as stated on Purchase Order) *
Contact Name :
(First name and Last name) *
Contact Title : *
Phone Number : *
Email : *

Change Impact:

Type Of Change:*
(Select the option(s) that best represent the type of change)
Other Change *
(Provide the details of Other change type)

Maximum Allowed:200 characters.

Description of Change *
(Identify change in terms of - from what and to what statements)
Maximum Allowed:1000 characters.
Impacted Supplier Manufacturing Site(s) *
(Provide Address(es))
Maximum Allowed:500 characters.
Impacted Vyaire Ship To Location:*
(Check all that apply)
List Affected By Vyaire Parts Number:*
Maximum Allowed:500 characters.
Vyaire Purchasing Contact(s):*
(Select no more than 3 contacts)
When do you propose that the change take place?*
/ /
MM DD YYYY
Attach a file (multiple files can be selected) (File size should NOT be more than 10 MB)
Disclaimer
The receipt of a Supplier Change Notification (SCN) by Vyaire, does not signify acceptance of the proposed change and we will work with Vyaire to provide the necessary documented evidence in order to support the compliance of the proposed change.
Acceptance *
I have read and understand the above.

CF/000/17/0043