Conflict Minerals Reporting Template (CMRT)
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- Bartholomew Alexander
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1 Conflict Minerals Reporting Template (CMRT) A Select Language Preference Here: 请 选 择 你 的 语 言 : 사용할 언어를 선택하시오 : 表 示 言 語 をここから 選 択 してください: Click here to check required fields Sélectionner la langue préférée ici: English completion Selecione Preferência de idioma Aqui: Wählen sie hier die Sprache: Seleccione el lenguaje de preferencia aqui: Selezionare la lingua di preferenza qui: Burada Dil Tercihini Belirleyin: The purpose of this document is to collect sourcing information on tin, tantalum, tungsten and gold used in products Company Name (*): Declaration Scope or Class (*): Mandatory fields are noted with an asterisk (*). Description of Scope: Company Information Vitrohm Protuguesa Unipessoal, Lda A. Company Revision 4.10 April 29, 2016 Link to Terms & Conditions Company Unique ID: Company Unique ID Authority: Address: Contact Name (*): Contact (*): Phone Contact (*): Authorizer (*): Title - Authorizer: - Authorizer (*): Phone - Authorizer (*): Effective Date (*): Tiago Sobral tiago.sobral@yageo.com (+351) José Carlos Conde Operations Director carlos.conde@yageo.com (+351) May-2016 Answer the following questions 1-7 based on the declaration scope indicated above 1) Is the 3TG intentionally added to your product? (*) Answer Tantalum (*) Tin (*) Gold (*) Tungsten (*) No Yes No No 2) Is the 3TG necessary to the production of your company s products and contained in the finished product that your company manufactures or contracts to manufacture? (*) Tantalum (*) Tin (*) Gold (*) Tungsten (*) Answer No Yes No No 3) Do any of the smelters in your supply chain source the 3TG from the covered countries? (SEC term, see definitions tab) (*) Tantalum Tin (*) Gold Tungsten Answer No 4) Does 100 percent of the 3TG (necessary to the functionality or production of your products) (*) Tantalum Tin (*) Gold Tungsten Answer Unknown 5) Have you received data/information for each 3TG from all relevant suppliers? (*) Tantalum Tin (*) Gold Tungsten Answer Yes, 100% 6) Have you identified all of the smelters supplying the 3TG to your supply chain? (*) Tantalum Tin (*) Gold Tungsten Answer Yes 7) Has all applicable smelter information received by your company been reported in this declaration? (*) Tantalum Answer
2 Conflict Minerals Reporting Template (CMRT) A Select Language Preference Here: 请 选 择 你 的 语 言 : 사용할 언어를 선택하시오 : 表 示 言 語 をここから 選 択 してください: Click here to check required fields Sélectionner la langue préférée ici: English completion Selecione Preferência de idioma Aqui: Wählen sie hier die Sprache: Seleccione el lenguaje de preferencia aqui: Selezionare la lingua di preferenza qui: Burada Dil Tercihini Belirleyin: The purpose of this document is to collect sourcing information on tin, tantalum, tungsten and gold used in products Mandatory fields are noted with an asterisk (*). Revision 4.10 April 29, 2016 Link to Terms & Conditions Tin (*) Gold Tungsten Yes Question A. Do you have a policy in place that addresses conflict minerals sourcing? (*) Answer the Following Questions at a Company Level Answer Yes B. Is your conflict minerals sourcing policy publicly available on your website? (Note If yes, the user shall specify the URL in the comment field.) (*) No None at this moment C. Do you require your direct suppliers to be DRC conflict-free? (*) Yes D. Do you require your direct suppliers to source the 3TG from smelters whose due diligence practices have been validated by an independent third party audit program? (*) No E. Have you implemented due diligence measures for conflict-free sourcing? (*) Yes F. Do you collect conflict minerals due diligence information from your suppliers which is in conformance with the IPC-1755 Conflict Minerals Data Exchange standard [e.g., the CFSI Conflict Minerals Reporting Template]? (*) Yes G. Do you request smelter names from your suppliers? (*) Yes H. Do you review due diligence information received from your suppliers against your company s expectations? (*) Yes I. Does your review process include corrective action management? (*) No J. Are you subject to the SEC Conflict Minerals rule? (*) No 2016 Conflict-Free Sourcing Initiative. All rights reserved.
3 1 ページ TO BEGIN: Link to "CFSP Compliant List" Option A: If you know the, input the number in A (columns B, C, D, E, F, G, I, and J will auto-populate). Option B: If you have a Metal and Reference List name combination, complete the following steps: Step 1. Select Metal in column B Step 2. Select from dropdown in column C (wrong combination will trigger RED color) Step 3. If dropdown selection is " Not Listed" complete columns D & E Step 4. Enter all available smelter information in columns H thru P Revision 4.10 April 29, 2016 Mandatory fields are noted with an asterisk (*). NOTE: A combination of Options A and B can be used to complete the List tab. Do not alter autopopulated cells. All errors in the Reference List should be reported to CFSI by contacting info@conflictfreesmelter.org Conflict-Free Sourcing Initiative. All rights reserved. Metal (*) Reference List (*) Name (*) Country (*) Street City Facility Contact Name Contact Proposed next steps sourced, enter CID Tin Metallo-Chimique N.V. Metallo-Chimique N.V. BELGIUM CID CFSI Beerse Antwerp CID Tin Minsur Minsur PERU CID CFSI Paracas Ica CID Tin Yunnan Tin Company Limited Yunnan Tin Company Limited CHINA CID CFSI Geiju Yunnan CID Tin Cooperativa Metalurgica de Rondônia Ltda. Cooperativa Metalurgica de Rondônia Ltda. BRAZIL CID CFSI Ariquemes Rondonia CID Tin EM Vinto EM Vinto BOLIVIA CID CFSI Oruro Cercado CID Tin Malaysia Smelting Corporation (MSC) Malaysia Smelting Corporation (MSC) MALAYSIA CID CFSI Butterworth Penang CID Tin PT Timah (Persero) Tbk Mentok PT Timah (Persero) Tbk Mentok INDONESIA CID CFSI Mentok Bangka CID Tin PT Timah (Persero) Tbk Kundur PT Timah (Persero) Tbk Kundur INDONESIA CID CFSI Kundur Riau Islands CID Tin Mineração Taboca S.A. Mineração Taboca S.A. BRAZIL CID CFSI Bairro Guarapiranga São Paulo CID Tin Thaisarco Thaisarco THAILAND CID CFSI Amphur Muang Phuket CID Tin PT Bukit Timah PT Bukit Timah INDONESIA CID CFSI Pangkal Pinang Bangka CID Tin PT Sumber Jaya Indah PT Sumber Jaya Indah INDONESIA CID CFSI Pangkal Pinang Bangka CID Tin Operaciones Metalurgical S.A. Operaciones Metalurgical S.A. BOLIVIA CID CFSI Oruro Cercado CID Tin PT Tinindo Inter Nusa PT Tinindo Inter Nusa INDONESIA CID CFSI Pangkal Pinang Bangka CID Tin Yunnan Chengfeng Non-ferrous Metals Co., Ltd. Yunnan Chengfeng Non-ferrous Metals Co., Ltd. CHINA CID CFSI Geiju Yunnan CID Tin PT Inti Stania Prima PT Inti Stania Prima INDONESIA CID CFSI Sungailiat Bangka CID Tin White Solder Metalurgia e Mineração Ltda. White Solder Metalurgia e Mineração Ltda. BRAZIL CID CFSI Ariquemes Rondonia CID Tin PT DS Jaya Abadi PT DS Jaya Abadi INDONESIA CID CFSI Pangkal Pinang Bangka CID Tin CV United Smelting CV United Smelting INDONESIA CID CFSI Pangkal Pinang Bangka CID Tin PT Mitra Stania Prima PT Mitra Stania Prima INDONESIA CID CFSI Sungailiat Bangka CID Tin PT Prima Timah Utama PT Prima Timah Utama INDONESIA CID CFSI Kepulauan Bangka CID Tin PT Refined Bangka Tin PT Refined Bangka Tin INDONESIA CID CFSI Sungailiat Bangka CID Tin PT Sariwiguna Binasentosa PT Sariwiguna Binasentosa INDONESIA CID CFSI Pangkal Pinang Bangka CID Tin CV Serumpun Sebalai CV Serumpun Sebalai INDONESIA CID CFSI Pangkalan Bangka CID Tin Fenix Metals Fenix Metals POLAND CID CFSI Chmielów Subcarpathian Voivodeship CID Tin Gejiu Non-Ferrous Metal Processing Co., Ltd. Gejiu Non-Ferrous Metal Processing Co., Ltd. CHINA CID CFSI Geiju Yunnan CID Tin PT Eunindo Usaha Mandiri PT Eunindo Usaha Mandiri INDONESIA CID CFSI Karimun Kepulauan Riau CID Tin Mitsubishi Materials Corporation Mitsubishi Materials Corporation JAPAN CID CFSI Asago Hyogo CID Tin Alpha Alpha UNITED STATES CID CFSI Altoona Pennsylvania CID Tin PT Bangka Tin Industry PT Bangka Tin Industry INDONESIA CID CFSI Sungailiat Bangka CID Tin Magnu's Minerais Metais e Ligas Ltda. Magnu's Minerais Metais e Ligas Ltda. BRAZIL CID CFSI São João del Rei Minas Gerais CID Tin Rui Da Hung Rui Da Hung TAIWAN CID CFSI Longtan Shiang Taoyuang Taiwan CID Tin Soft Metais Ltda. Soft Metais Ltda. BRAZIL CID CFSI Bebedouro São Paulo CID Tin Melt Metais e Ligas S.A. Melt Metais e Ligas S.A. BRAZIL CID CFSI Ariquemes Rondonia CID Tin PT Belitung Industri Sejahtera PT Belitung Industri Sejahtera INDONESIA CID CFSI Kepulauan Bangka CID Tin PT Karimun Mining PT Karimun Mining INDONESIA CID CFSI Karimun Kepulauan Riau CID Tin Gejiu Zili Mining And Metallurgy Co., Ltd. Gejiu Zili Mining And Metallurgy Co., Ltd. CHINA CID CFSI Geiju Yunnan CID Tin PT Pelat Timah Nusantara Tbk PT Pelat Timah Nusantara Tbk INDONESIA CID CFSI Kabupaten Bangka CID Tin PT Bangka Kudai Tin PT Bangka Kudai Tin INDONESIA CID CFSI Sungailiat Bangka CID Tin Huichang Jinshunda Tin Co., Ltd. Huichang Jinshunda Tin Co., Ltd. CHINA CID CFSI Ganzhou Jiangxi CID Tin PT Artha Cipta Langgeng PT Artha Cipta Langgeng INDONESIA CID CFSI Sungailiat Bangka
4 2 ページ Metal (*) Reference List (*) Name (*) Country (*) Street City Facility Contact Name Contact Proposed next steps sourced, enter
5 3 ページ Metal (*) Reference List (*) Name (*) Country (*) Street City Facility Contact Name Contact Proposed next steps sourced, enter
6 4 ページ Metal (*) Reference List (*) Name (*) Country (*) Street City Facility Contact Name Contact Proposed next steps sourced, enter
7 5 ページ Metal (*) Reference List (*) Name (*) Country (*) Street City Facility Contact Name Contact Proposed next steps sourced, enter
8 6 ページ Metal (*) Reference List (*) Name (*) Country (*) Street City Facility Contact Name Contact Proposed next steps sourced, enter
9 7 ページ Metal (*) Reference List (*) Name (*) Country (*) Street City Facility Contact Name Contact Proposed next steps sourced, enter
10 8 ページ Metal (*) Reference List (*) Name (*) Country (*) Street City Facility Contact Name Contact Proposed next steps sourced, enter
11 9 ページ Metal (*) Reference List (*) Name (*) Country (*) Street City Facility Contact Name Contact Proposed next steps sourced, enter
12 10 ページ Metal (*) Reference List (*) Name (*) Country (*) Street City Facility Contact Name Contact Proposed next steps sourced, enter
13 11 ページ Metal (*) Reference List (*) Name (*) Country (*) Street City Facility Contact Name Contact Proposed next steps sourced, enter
14 12 ページ Metal (*) Reference List (*) Name (*) Country (*) Street City Facility Contact Name Contact Proposed next steps sourced, enter
15 13 ページ Metal (*) Reference List (*) Name (*) Country (*) Street City Facility Contact Name Contact Proposed next steps sourced, enter
16 14 ページ Metal (*) Reference List (*) Name (*) Country (*) Street City Facility Contact Name Contact Proposed next steps sourced, enter
17 15 ページ Metal (*) Reference List (*) Name (*) Country (*) Street City Facility Contact Name Contact Proposed next steps sourced, enter
18 16 ページ Metal (*) Reference List (*) Name (*) Country (*) Street City Facility Contact Name Contact Proposed next steps sourced, enter
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22 20 ページ Metal (*) Reference List (*) Name (*) Country (*) Street City Facility Contact Name Contact Proposed next steps sourced, enter
23 21 ページ Metal (*) Reference List (*) Name (*) Country (*) Street City Facility Contact Name Contact Proposed next steps sourced, enter
24 22 ページ Metal (*) Reference List (*) Name (*) Country (*) Street City Facility Contact Name Contact Proposed next steps sourced, enter
25 23 ページ Metal (*) Reference List (*) Name (*) Country (*) Street City Facility Contact Name Contact Proposed next steps sourced, enter
26 24 ページ Metal (*) Reference List (*) Name (*) Country (*) Street City Facility Contact Name Contact Proposed next steps sourced, enter
27 25 ページ Metal (*) Reference List (*) Name (*) Country (*) Street City Facility Contact Name Contact Proposed next steps sourced, enter
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