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    GeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study Request

    EICC and GeSI members have expressed a commitment to taking steps to enhance social and

    environmental performance related to the supply chain for minerals used in the products of members

    companies. This research project will investigate the supply chain for tin, tantalum, and cobalt used in

    electronics. The purpose is to 1) create a picture of the electronics supply chain for these metals; 2)

    ascertain whether companies in the supply chain have codes of conduct addressing social,environmental, health, and labor issues; and 3) identify the challenges of collecting this data and

    consider ways to enhance and maintain transparency of the supply chain.

    The goal is to create a transparent and understandable representation without identifying

    customer/supplier relationships or business termscommercial relationships and terms will be held in

    confidence.

    Please fill out the information (15+ questions) in this survey and submit at your earliest convenience. If

    you have questions about this survey, please contact Jennifer Peyser at RESOLVE ([email protected],

    +1 202-965-6215). Thank you in advance for your time.

    For some questions, you will be asked to email documentation (e.g., codes of conduct) to RESOLVE.

    Please send all documents to Jason Gershowitz at RESOLVE ([email protected]).

    For the purposes of this research project we are focused on the following products, made with cobalt

    that EICC/GeSI members purchase from you: batteries and magnetic recording media.

    1.Instructions

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    GeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study Request

    1. Please provide the follow ing information:

    2.Survey

    *Company Name:

    Company Address:

    Name of person filling

    out form:

    Email address of

    person filling out form:

    Phone number of

    person filling out form:

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    GeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study Request

    2. Supplier A: Please fill out all boxes below for one of your suppliers of

    cobalt or components containing cobalt (batteries and magnetic recording

    media). The goal of this research is to create a transparent and

    understandable representation w ithout identifying customer/ supplier

    relationships or business terms - commercial relationships and terms w ill be

    held in confidence.

    Insertn/ a for supplier tiers that do not apply, or w here the supply chain

    ends.

    Insert the broker company name as the supp lier, if applicable.

    Insert a question mark (?) for the information that you do not have or

    cannot obtain.

    Insert an exclamation point (" !") next to the information that is confidential.

    3.Survey: Supplier Information

    *

    Supplier Company

    Name:

    Supplier Company

    Headquarters Mailing

    Address:

    Supplier Point of

    Contact (Name, phone

    number, email

    address):

    Name of Facility/Mine:

    Mailing Address ofFacility/Mine:

    Does this facility

    provide you with

    recycled cobalt?

    (Yes/No):

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    GeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study Request

    3. What type of operation is Supplier A?

    4. Do you have additional suppliers of components or materials that contain

    cobalt?

    *

    Component Manufacturer

    gfedc

    Shaper

    gfedc

    Refiner

    gfedc

    Smelter

    gfedc

    Trader

    gfedc

    Distributer

    gfedc

    Comptoir

    gfedc

    Negociant

    gfedc

    Artisinal Mine

    gfedc

    Mine

    gfedc

    Other (please specify)

    gfedc

    Ye s

    nmlkj

    No

    nmlkj

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    GeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study Request

    5. Supplier B:

    Please fi l l out all boxes below for one of your suppliers of cobalt or

    components containing cobalt (batteries and magnetic recording media).

    The goal of this research is to create a transparent and understandable

    representation w ithout identifying customer/ supplier relationships or

    business terms - commercial relationships and terms w ill be held in

    confidence.

    Insertn/ a for supplier tiers that do not apply, or w here the supply chain

    ends.

    Insert the broker company name as the supp lier, if applicable.

    Insert a question mark (?) for the information that you do not have or

    cannot obtain.Insert an exclamation point (" !") next to the information that is confidential.

    4.Survey: Supplier Information, continued

    *

    Supplier Company

    Name:

    Supplier Company

    Headquarters Mailing

    Address:

    Supplier Point of

    Contact (Name, phone

    number, email

    address):

    Name of Facility/Mine:

    Mailing Address of

    Facility/Mine:

    Does this facility

    provide you with

    recycled cobalt?

    (Yes/No):

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    GeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study Request

    6. What type of operation is Supplier B?

    7. Do you have additional suppliers of components or materials that contain

    cobalt?

    Component Manufacturer

    gfedc

    Shaper

    gfedc

    Refiner

    gfedc

    Smelter

    gfedc

    Trader

    gfedc

    Distributer

    gfedc

    Comptoir

    gfedc

    Negociant

    gfedc

    Artisinal Mine

    gfedc

    Mine

    gfedc

    Other (please specify)

    Ye s

    nmlkj

    No

    nmlkj

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    GeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study Request

    8. Supp lier C:

    Please fi l l out all boxes below for one of your suppliers of cobalt or

    components containing cobalt (batteries and magnetic recording media).

    The goal of this research is to create a transparent and understandable

    representation w ithout identifying customer/ supplier relationships or

    business terms - commercial relationships and terms w ill be held in

    confidence.

    Insertn/ a for supplier tiers that do not apply, or w here the supply chain

    ends.

    Insert the broker company name as the supp lier, if applicable.

    Insert a question mark (?) for the information that you do not have or

    cannot obtain.Insert an exclamation point (" !") next to the information that is confidential.

    5.Survey: Supplier Information, continued

    *

    Supplier Company

    Name:

    Supplier Company

    Headquarters Mailing

    Address:

    Supplier Point of

    Contact (Name, phone

    number, email

    address):

    Name of Facility/Mine:

    Mailing Address of

    Facility/Mine:

    Does this facility

    provide you with

    recycled cobalt?

    (Yes/No):

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    GeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study Request

    9. What type of operation is Supp lier C?

    10. Do you have additional suppliers of components or materials that

    contain cobalt?

    Component Manufacturer

    gfedc

    Shaper

    gfedc

    Refiner

    gfedc

    Smelter

    gfedc

    Trader

    gfedc

    Distributer

    gfedc

    Comptoir

    gfedc

    Negociant

    gfedc

    Artisinal Mine

    gfedc

    Mine

    gfedc

    Other (please specify)

    Ye s

    nmlkj

    No

    nmlkj

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    GeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study Request

    11. Supp lier D:

    Please fi l l out all boxes below for one of your suppliers of cobalt or

    components containing cobalt (batteries and magnetic recording media).

    The goal of this research is to create a transparent and understandable

    representation w ithout identifying customer/ supplier relationships or

    business terms - commercial relationships and terms w ill be held in

    confidence.

    Insertn/ a for supplier tiers that do not apply, or w here the supply chain

    ends.

    Insert the broker company name as the supp lier, if applicable.

    Insert a question mark (?) for the information that you do not have or

    cannot obtain.Insert an exclamation point (" !") next to the information that is confidential.

    6.Survey: Supplier Information, continued

    *

    Supplier Company

    Name:

    Supplier Company

    Headquarters Mailing

    Address:

    Supplier Point of

    Contact (Name, phone

    number, email

    address):

    Name of Facility/Mine:

    Mailing Address of

    Facility/Mine:

    Does this facility

    provide you with

    recycled cobalt?

    (Yes/No):

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    GeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study Request

    12. What type of operation is Supplier D?

    13. Do you have additional suppliers of components or materials that

    contain cobalt?

    Component Manufacturer

    gfedc

    Shaper

    gfedc

    Refiner

    gfedc

    Smelter

    gfedc

    Trader

    gfedc

    Distributer

    gfedc

    Comptoir

    gfedc

    Negociant

    gfedc

    Artisinal Mine

    gfedc

    Mine

    gfedc

    Other (please specify)

    Ye s

    nmlkj

    No

    nmlkj

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    GeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study Request

    14. Supp lier E:

    Please fi l l out all boxes below for one of your suppliers of cobalt or

    components containing cobalt (batteries and magnetic recording media).

    The goal of this research is to create a transparent and understandable

    representation w ithout identifying customer/ supplier relationships or

    business terms - commercial relationships and terms w ill be held in

    confidence.

    Insertn/ a for supplier tiers that do not apply, or w here the supply chain

    ends.

    Insert the broker company name as the supp lier, if applicable.

    Insert a question mark (?) for the information that you do not have or

    cannot obtain.Insert an exclamation point (" !") next to the information that is confidential.

    7.Survey: Supplier Information, continued

    *

    Supplier Company

    Name:

    Supplier Company

    Headquarters Mailing

    Address:

    Supplier Point of

    Contact (Name, phone

    number, email

    address):

    Name of Facility/Mine:

    Mailing Address of

    Facility/Mine:

    Does this facility

    provide you with

    recycled cobalt?

    (Yes/No):

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    GeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study Request

    15. What type of operation is Supplier E?

    16. Do you have additional suppliers of components or materials that

    contain cobalt?

    Component Manufacturer

    gfedc

    Shaper

    gfedc

    Refiner

    gfedc

    Smelter

    gfedc

    Trader

    gfedc

    Distributer

    gfedc

    Comptoir

    gfedc

    Negociant

    gfedc

    Artisinal Mine

    gfedc

    Mine

    gfedc

    Other (please specify)

    Ye s

    nmlkj

    No

    nmlkj

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    GeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study Request

    17. Supplie r F:

    Please fi l l out all boxes below for one of your suppliers of cobalt or

    components containing cobalt (batteries and magnetic recording media).

    The goal of this research is to create a transparent and understandable

    representation w ithout identifying customer/ supplier relationships or

    business terms - commercial relationships and terms w ill be held in

    confidence.

    Insertn/ a for supplier tiers that do not apply, or w here the supply chain

    ends.

    Insert the broker company name as the supp lier, if applicable.

    Insert a question mark (?) for the information that you do not have or

    cannot obtain.Insert an exclamation point (" !") next to the information that is confidential.

    8.Survey: Supplier Information, continued

    *

    Supplier Company

    Name:

    Supplier Company

    Headquarters Mailing

    Address:

    Supplier Point of

    Contact (Name, phone

    number, email

    address):

    Name of Facility/Mine:

    Mailing Address of

    Facility/Mine:

    Does this facility

    provide you with

    recycled cobalt?

    (Yes/No):

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    GeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study Request

    18. What type of operation is Supplier F?

    Component Manufacturer

    gfedc

    Shaper

    gfedc

    Refiner

    gfedc

    Smelter

    gfedc

    Trader

    gfedc

    Distributer

    gfedc

    Comptoir

    gfedc

    Negociant

    gfedc

    Artisinal Mine

    gfedc

    Mine

    gfedc

    Other (please specify)

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    GeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study Request

    19. Are you w il l ing to ask that your supplier(s) cooperate w ith RESOLVE and

    EICC/ GeSI as w e take the next step in this research and request similar

    information from them?

    20. Please explain or no te any questions about contacting your suppliers:

    9.Survey, continued

    *

    55

    66

    Ye s

    nmlkj

    No

    nmlkj

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    GeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study Request

    21. Does your company have a code of conduct, standards or requirements

    in place that address human rights, conflict, and environmen tal, social,

    economic and/ or labor issues?

    If you have a code of conduct in please, please email a copy to Jason

    Gershowitz at RESOLVE: jgershow [email protected].

    22. If, as a member of a trade association you subscribe to any codes of

    conduct, standards, or requirements on the issues listed above, please notethis below and email any relevant documents or resources to Jason

    Gershowitz at RESOLVE (jgershow [email protected]).

    23. Are there any issues of concern on w hich your company is particularly

    focused ( e.g., child labor, fair trade, funding conflict, etc.) and w ould like to

    address through an assurance mechanism?

    10.Survey, continued

    *

    55

    66

    *

    Ye s

    nmlkj

    No

    nmlkj

    If you do not have codes of conduct in place, a re you willing to consider putting such a mechanism in place in the

    future? Please explain.

    55

    66

    Ye s

    nmlkj

    No

    nmlkj

    If yes, please describe the issue(s) of concern and the by which your company tracks and verifies the issue(s).

    55

    66

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    24. Do you require that your suppliers have such a code of conduct,

    standards , or requirements in place?

    25. P lease describe any mechanism(s) (e.g., supplier aud iting, corporate

    social responsibility report, investor report, government reporting) that you

    institute to provide evidence of supplier compliance w ith these codes of

    conduct, standards, or requirements, either directly or through a trade

    association or voluntary initiatives.

    26. Are the mechanisms or reports described above publicly available?

    11.Survey, continued

    *

    55

    66

    *

    Ye s

    nmlkj

    No

    nmlkj

    If you answered "Yes" to the above question, please email a copy of the code of conduct you require for your

    suppliers, or any related documentation to Jason Gershowitz at RESOLVE([email protected]), and describe the

    document(s) below:

    55

    66

    Ye s

    nmlkj

    No

    nmlkj

    If yes, please describe below how and where the information is accessible to the public. If you answered no, are you

    willing to consider putting such a mechanism in place in the future? Please explain.

    55

    66

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    GeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study Request

    27. Have you undertaken any supply chain aud it activities in the past?

    12.Survey, continued

    *

    Ye s

    nmlkj

    No

    nmlkj

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    GeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study Request

    28. For past audit activities, please share the fo llow ing:

    29. What did your company learn about from past audits?

    13.Survey, continued

    Name of audit:

    Company/Organization

    that managed theaudit:

    Date(s) of audit:

    55

    66

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    GeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study RequestGeSI EICC Extractives Supply Chain Transparency Study Request

    Please be sure to send any documentation related to this project to Jason Gershowitz at RESOLVE

    ([email protected]).

    Documents could include:

    - Your company's code(s) of conduct- Code(s) of conduct you require of your suppliers

    - Publicly available reports or audits

    - Other documents related to human rights, conflict, environmental, social, economic, and labor that describe your

    company's approach to these issues.

    Thank you very much for your participation in this survey.

    14.Survey - Thank you

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