Social Responsibility and Responsible Sourcing Home APPLICATION FORM FOR SOCIAL AUDITS (SMETA, etc) You must have JavaScript enabled to use this form. Authorisation Requested by (full name) Company Email address GUIDANCE NOTE: The person who is filling in this form. Section A - Audit details Code of Conduct / Standards Code of Conduct / StandardsSMETAOthers If others, please state Who requested you do this audit? Who requested you do this audit?AB InBevadmAlplaAmcorAssociated British FoodsBarry Callebaut BeiersdorfBEL GroupBritvicCargillThe Clorox CompanyCoca-ColaColgate-PalmoliveCotyCreative WerksDanoneDiageoEstee LauderFerreroGeneral MillsGivaudanHeinekenHenkelHershey’sKellogg’sKimberly-ClarksL’OccitaneMondelez InternationalMarsMcCain FoodsMcDonald’sNestléOrklaPepsicoProcter & GamblePernod RicardReckitt BenckiserSC JohnsonUnileverWestRocOther Other Please add additional customers you want to share the report with (Optional) Do you intend to share the audit report with other client(s)? Yes No If yes, please state the client(s) Audit Notification Pattern Audit Notification PatternAnnouncedSemi-announcedunannounced For SMETA audits only 2-Pillar 4-Pillar Sedex Virtual Assessment SGP FSA (SAI platform) Other SVA Pillar 2-Pillar 4-Pillar If Other, please state Audit Type Full Initial Audit Periodic Audit / Re-audit Full Follow Up Audit Partial Follow Up Partial Other Please Specify Expected Audit Date Final Report Distribution GUIDANCE NOTE: MASTER CLIENT NOMINATED IN THE BOOKING FORM EXPECTS THAT A FULL COPY OF THE ETHICAL REPORT IS MADE AVAILABLE TO THEM BY BUREAU VERITAS. PLEASE CHECK THIS BOX TO GRANT YOUR PERMISSION TO DO THIS. BY CHECKING THE BOX, THIS ALSO MEANS YOU ALLOW BUREAU VERITAS TO CONTACT ANY OF THE LISTED MASTER CLIENTS CHOSEN OR ADDED IN OTHER TO SHARE AUDIT AND SCHEDULING INFORMATION WITH THEM. BUREAU VERITAS WILL FOLLOW ANY SERVICE LEVEL AGREEMENTS WE HAVE IN PLACE WITH RETAILER/BRAND NOMINATED. (PLEASE NOTE: REQUESTS CANNOT BE PROCESSED WITHOUT THIS PERMISSION BEING GIVEN). Section B - Facility to be audited details Factory name Factory contact Factory Address State/city Zip/Post code Country CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAscension IslandAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCanary IslandsCape VerdeCaribbean NetherlandsCayman IslandsCentral African RepublicCeuta and MelillaChadChileChinaChristmas IslandClipperton IslandCocos [Keeling] IslandsColombiaComorosCongo - BrazzavilleCongo - KinshasaCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d’IvoireDenmarkDiego GarciaDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong Kong SAR ChinaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacau SAR ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmar [Burma]NamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorth KoreaNorwayOmanOutlying OceaniaPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaSão Tomé and PríncipeTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluU.S. Outlying IslandsU.S. Virgin IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Factory contact Telephone Factory Contact Fax Factory Province Factory Email Description of products/Services Are you Service Provider for your Master client Yes No Are HR, working hours & payroll records held onsite? Yes No Not Sure If No, please provide details/address of where these documents are held Employee Information (At site to be audited) Permanent (Employed directly) Male Female Temporary Male Female Agency Male Female Home Workers/Outworkers Male Female Number of shifts Please list the different languages that are spoken by employee on site Existing Certificates Existing CertificatesSA 8000ISO 14001ISO 45001RBASMETA 2 pillersSMETA 4 pillersSGPURSASWAFSA (SAI platform)Others Sedex member Sedex memberYesNo Sedex codes (ZC# & ZS#) Others platform upload name and membership codes (ARAVO, COSMOS, Rizepoint, etc.) Date Sedex SAQ was last updated Other comments I agree to receive marketing communications from Bureau Veritas Certification I agree to the terms of service. 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