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表示言語をここから選択してください:English Revision 1. July 18th 2011
tier level 1
Company Name (*):
Company Unique Identifier:
Address:
Authorized Management Reprentative (*):
Reprentative Title:
Reprentative Email (*):Reprentative Phone:
(If different than reprentative named above) Contact Name (*):
Contact Email (*):Contact Phone:
Date of Completion (*):
Day: (*)Month: (*)Year: (*)1) Are any of the following metals necessary to the functionality or production of your
company's products that it manufactures or contracts to manufacture? If no for all metals,
you are done with this survey. (*)
Answer Tantalum (Ta) (*)
Tin (Sn) (*)
Gold (Au) (*)
Tungsten (W) (*)2) Do the following metals (necessary to the functionality or produc文件格式范本
tion of your
company's products) originate from the DRC or an adjoining country? (*)
Answer Tantalum (Ta) (*)
Tin (Sn) (*)
Gold (Au) (*)
Tungsten (W) (*)3) Do 简爱的读后感
the following metals (necessary to the functionality or production of your products)
come from a recycler or scrap supplier? (*)
Answer Tantalum (Ta) (*)
Tin (Sn) (*)
Gold (Au) (*)
Tungsten (W) (*)
4) Have you identified all the smelters your company and its suppliers u to supply the
following metals? (*)Answer Tantalum (Ta) (*)
Tin (Sn) (*)
Gold (Au) (*)
Tungsten (W) (*)
5) Are all of the smelters your company and its suppliers u on the EICC-GeSI Conflict-
Free Smelter (CFS) list for the fo个人简历模板空白表格
llowing metals? (*)
Answer Tantalum (Ta) (*)
Tin (Sn) (*)
Gold (Au) (*)
Tungsten (W) (*)
Answer the Following Questions:
Answ夯筑的读音
er A. Do you have a policy in place that includes DRC conflict-free sourcing? (*)
B. Is this policy publicly available on your website? (*)
C. Do you require your direct suppliers to be DRC conflict-free? (*)
D. Do you require your direct suppliers to source from smelters validated as DRC Conflict-Free
using the EICC-GeSI Conflict-Free Smelter (CFS) li年终工作汇报
st? (*)
E. Have you implemented Conflict Minerals sourcing due diligence measures? (*)
F. Do you have completed Conflict Minerals reporting templates from all your suppliers? (*)
G. Do you request your suppliers to fill out this Conflict Minerals reporting template? (*)忙的词语
H. Do you request smelter names from your suppliers? (*)
I. Do you verify Conflict Mineral Respons from your suppliers? (*)
J. Does your verification process include corrective action management? (*)
K. Are you subject to the SEC disclosure requirement rule? (*)2011 Electronic Industry Citizenship Coalition, Incorporated a好看的人物图片
nd Global e-Sustainability Initiative. All rights rerved.Comments Comments Conflict Minerals Reporting Template
The purpo of this document is to collect sourcing information on tin, tantalum, tungsten and gold ud in products
Mandatory fields are noted with an asterisk (*). The information collected in this template should be updated annually. Any changes within the annual cycle should be provided to your customers
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