BSCI验厂自我评估表.docx

1、BSCI验厂自我评估表自我评估Self-AssessmentBSCI 5-01/09January 20092009年1月A. Master DataA. 主要资料Location of Company公司地点Basic Data基本资料Company Name公司名称Year of foundation成立年份Legal status公司性质Street街道Language(s) spoken in company公司所在使用的语言City城市Self Assessment date:自我评估日期：Zip Code邮政编码Contact Person联系人Country国家Name姓名Pho

2、ne电话Position / Language职位/语言Fax传真Phone电话E-mail电邮Business Structure商业架构No. of customers?客户数量No. of companies own units?公司辖下部门数量（见生产部门记录单）No. of subcontractors?分包商的数量（见生产部门记录单）No. of suppliers, sub-suppliers?供应商、分供应商的数量（见生产部门记录单） Company Figures 公司概况Share of sales revenue for export and domestic marke

3、t during the last 3 years:最近三年出口和国内市场销售额的比例Export Markets出口市场Year年份Export/Local出口/本地%Turn Over (US $)营业额(美元)Capacity 能力 Total capacity per month月生产能力（测量部门）Business Activities 业活动Clothing:服装:Construction Material:建筑材料:Electronic Groups:电子集团:Eyewear (Glasses):各类眼镜(眼镜):Furniture:家具:Leather Goods (excep

4、t shoes):皮制品 (除鞋类):Machinery:机械:Other hard goods:其他耐用品:Shoes:鞋类:Textiles:纺织品:Toys:玩具:Textiles raw material or accessories纺织原料或配件: Company Size & Structure 公司规模和结构Company Size公司规模Property Area产权所在地Factory Area厂址Dormitories宿舍Provided已提供Not applicable不适用Number of workers/employees living in dormitories

5、 provided by the company:在公司宿舍居住的工人/员工人数Location of dormitories varies from the site location:宿舍地址与公司地址不同：请说明宿舍所处位置：1)2)3)请列出位于公司的所有部门以及各部门工人/员工的人数：Departments部门1.2.3.4.5.No. of workers/employees工人/员工人数Departments部门6.7.8.9.10.No. of workers/employees工人/员工人数 Employment Structure 雇佣结构Number人数Number人数W

6、orkers/Employees in total工人/员工总数Young workers/employees aged to 18 years未成年员工年龄 18岁Female workers/employees女工人/员工Pregnant / maternity leave 怀孕/产假/Male workers/employees男工人/员工Apprentices 学徒B. Social PerformanceB. 社会绩效Questions问题Please mark with a cross请打勾Yes是No否 Have social audits already been conduc

7、ted in your company? 你的公司已经进行了社会责任审核吗？ If yes, please indicate who has conducted the audit: 如果是，请说明审核执行方： If yes, please indicate the standard (Code of Conduct) which has been audited: 如果是，请说明已经进行了审核的标准（行为守则）： Are audit reports available? 有审核报告吗？ If yes, please attach a copy of these reports: 如果是，请附

8、上这些审核报告的副本： Has your company been certified according to any social standard? . SA8000 or other recognised standards)? 你的公司依照社会责任标准进行了认证吗？（比如：SA8000 或者其它公认的标准）？ If yes, please indicate who has conducted the audit: 如果是，请说明审核执行方： If yes, please indicate the social standard: 如果是，请说明依照的社会责任标准： If yes, p

9、lease attach a copy of this certificate: 如果是，请附上认证证书的副本： Is your company under preparation for a social certification procedure? 你的公司正在准备进行社会认证程序吗？ If yes, please indicate the social standard: 如果是，请说明依照的社会责任标准： Did you receive the BSCI Code of Conduct? 你收到BSCI的行为守则吗？ Are you aware of the BSCI requir

10、ements? 你知道BSCI责任要求吗？LIABILITY DECLARATION责任声明Herewith I confirm that all data have been given to my best knowledge and belief.在此我声明，我已经收到所有资料，非常理解其中内容并且认同。Date / signature / stamp Company 日期 /签名 / 印章 公司Production Unit Record Sheet生产部门记录单Production Unit No. 1生产部门1Name姓名Street街道City, Zip Code城市，邮编Cou

11、ntry国家Phone电话Fax传真E-mail电邮Contact Person联系人Active for the supplier since (date) 供应商起始有效日期Own unit (share of production %)辖下部门（生产比例%）Subcontractor (share of production %)分包商（生产比例%）Supplier / Sub-Supplier(mark with a cross)供应商/下级供应商（用x划去不适用者）Social audited社会责任是否审核Yes是 No否 If yes 如果是Audit Company审核公司Au

12、dit Number审核编号Date of Audit审核日期Result结果Associated with BSCI?是否与BSCI有联系？Production Unit No. 2生产部门 2Name姓名Street街道City, Zip Code城市，邮编Country国家Phone电话Fax传真E-mail电邮Contact Person联系人Active for the supplier since (date)供应商起始有效日期Own unit (share of production %)辖下部门（生产比例%）Subcontractor (share of production

13、%)分包商（生产比例%）Supplier / Sub-Supplier(mark with a cross)供应商/下级供应商（用x划去不适用者）Social audited社会责任是否审核Yes是 No否 If yes 如果是Audit Company审核公司Audit Number审核编号Date of Audit审核日期Result结果Associated with BSCI?是否与BSCI有联系？Production Unit No. 3生产部门 3Name姓名Street街道City, Zip Code城市，邮编Country国家Phone电话Fax传真E-mail电邮Contact

14、 Person联系人Active for the supplier since (date)供应商起始有效日期Own unit (share of production %)辖下部门（生产比例%）Subcontractor (share of production %)分包商（生产比例%）Supplier / Sub-Supplier(mark with a cross)供应商/下级供应商（用x划去不适用者）Social audited社会责任是否审核Yes是 No否 If yes 如果是Audit Company审核公司Audit Number审核编号Date of Audit审核日期Res

15、ult结果Associated with BSCI?是否与BSCI有联系？Production Unit No. 4生产部门 4Name姓名Street街道City, Zip Code城市，邮编Country国家Phone电话Fax传真E-mail电邮Contact Person联系人Active for the supplier since (date)供应商起始有效日期Own unit (share of production %)辖下部门（生产比例%）Subcontractor (share of production %)分包商（生产比例%）Supplier / Sub-Supplie

16、r(mark with a cross)供应商/下级供应商（用x划去不适用者）Social audited社会责任是否审核Yes是 No否 If yes 如果是Audit Company审核公司Audit Number审核编号Date of Audit审核日期Result结果Associated with BSCI?是否与BSCI有联系？Production Unit No. 5生产部门 5Name姓名Street街道City, Zip Code城市，邮编Country国家Phone电话Fax传真E-mail电邮Contact Person联系人Active for the supplier

17、since (date)供应商起始有效日期Own unit (share of production %)辖下部门（生产比例%）Subcontractor (share of production %)分包商（生产比例%）Supplier / Sub-Supplier(mark with a cross)供应商/下级供应商（用x划去不适用者）Social audited社会责任是否审核Yes是 No否 If yes 如果是Audit Company审核公司Audit Number审核编号Date of Audit审核日期Result结果Associated with BSCI?是否与BSCI有

18、联系？Production Unit No. 6生产部门 6Name姓名Street街道City, Zip Code城市，邮编Country国家Phone电话Fax传真E-mail电邮Contact Person联系人Active for the supplier since (date) 供应商起始有效日期Own unit (share of production %)辖下部门（生产比例%）Subcontractor (share of production %)分包商（生产比例%）Supplier / Sub-Supplier(mark with a cross)供应商/下级供应商（用x划

19、去不适用者）Social audited社会责任是否审核Yes是 No否 If yes 如果是Audit Company审核公司Audit Number审核编号Date of Audit审核日期Result结果Associated with BSCI?是否与BSCI有联系？Production Unit No. 7生产部门 7Name姓名Street街道City, Zip Code城市，邮编Country国家Phone电话Fax传真E-mail电邮Contact Person联系人Active for the supplier since (date)供应商起始有效日期Own unit (sh

20、are of production %)辖下部门（生产比例%）Subcontractor (share of production %)分包商（生产比例%）Supplier / Sub-Supplier(mark with a cross)供应商/下级供应商（用x划去不适用者）Social audited社会责任是否审核Yes是 No否 If yes 如果是Audit Company审核公司Audit Number审核编号Date of Audit审核日期Result结果Associated with BSCI?是否与BSCI有联系？Production Unit No. 8生产部门 8Nam

21、e姓名Street街道City, Zip Code城市，邮编Country国家Phone电话Fax传真E-mail电邮Contact Person联系人Active for the supplier since (date)供应商起始有效日期Own unit (share of production %)辖下部门（生产比例%）Subcontractor (share of production %)分包商（生产比例%）Supplier / Sub-Supplier(mark with a cross)供应商/下级供应商（用x划去不适用者）Social audited社会责任是否审核Yes是 N

22、o否 If yes 如果是Audit Company审核公司Audit Number审核编号Date of Audit审核日期Result结果Associated with BSCI?是否与BSCI有联系？Production Unit No. 9生产部门 9Name姓名Street街道City, Zip Code城市，邮编Country国家Phone电话Fax传真E-mail电邮Contact Person联系人Active for the supplier since (date)供应商起始有效日期Own unit (share of production %)辖下部门（生产比例%）Sub

23、contractor (share of production %)分包商（生产比例%）Supplier / Sub-Supplier(mark with a cross)供应商/下级供应商（用x划去不适用者）Social audited社会责任是否审核Yes是 No否 If yes 如果是Audit Company审核公司Audit Number审核编号Date of Audit审核日期Result结果Associated with BSCI?是否与BSCI有联系？Date / signature / stamp Company日期 / 签名 / 印章 公司B. BSCI Social Re

24、quirementsB. BSCI 社会责任要求 Management Practice 管理实践Questions问题Please mark 请打勾Yes是No否 Has a senior management representative been appointed who, irrespective of other responsibilities, ensures compliance with the BSCI Code of Conduct? 已经委派了高级管理代表吗？其职责是确保符合BSCI行为守则，暂不考虑其它职责。 If yes, please indicate name

25、 and function: 如果是，请说明其姓名和职位： Have representatives of the operational level (production, human resources, storage etc.) been appointed who are responsible to ensure compliance with the BSCI Code of Conduct? 已经委派了管理层（生产、人力资源、仓储等）的代表吗？其职责是负责确保符 合BSCI行为守则？ If yes, please indicate name/s and function/s:

26、 如果是，请说明其姓名和职位： Are executives, management and staff aware of the legal rights and duties under labour legislation? 行政人员、管理人员和员工都知晓劳工法赋予的法律权利和职责吗？ Is a system implemented to identify specific risks for health and safety of the employees and prevent recurrence of work accidents? 实施了一个用来辨别对员工健康和安全的特殊危险以及防止工伤事故发生的体系吗？