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1、Self-Assessment版权所有。未经对外贸易协会许可，本文件中的内容不可以任何形式，或任何方式如电子、机械、影印、录制等方式复制、转化或保存于一个检索系统中，或传输出去，不得外借、转售、出租或者流传。Copyright 2004 FTA 設於布鲁塞尔的对外贸易协会； gsm 設於科隆的环球可持续管理有限责任公司；Migros苏黎世Migros连锁超市集团；汉堡Systain咨询有限责任公司BSCI 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 Nam
2、e公司名称Year of foundation成立年份http:/www.网址：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Phone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
3、?(see Production Unit Record Sheet)公司辖下部门数量（见生产部门记录单）No. of subcontractors?(see Production Unit Record Sheet)分包商的数量（见生产部门记录单）No. of suppliers, sub-suppliers?(see Production Unit Record Sheet)供应商、分供应商的数量（见生产部门记录单）A.1 Company FiguresA.1 公司概况Share of sales revenue for export and domestic market during
4、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(including unit of measurement)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
5、具:Leather Goods (except 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:A.2 Company Size & Structure A.2 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/em
6、ployees living in dormitories 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A.3 Employment
7、 Structure A.3 雇佣结构Number人数Number人数Workers/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B.1
8、Have social audits already been conducted 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）：B.2Are audit reports available? 有审核报告吗？If yes, please att
9、ach a copy of these reports:如果是，请附上这些审核报告的副本：B.3Has your company been certified according to any social standard?(i.e. 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
10、standard:如果是，请说明依照的社会责任标准：If yes, please attach a copy of this certificate: 如果是，请附上认证证书的副本： B.4Is 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：B.5Did you receive the BSCI Code of Conduct?你收到BSCI的行为
11、守则吗？B.6Are you aware of the BSCI requirements?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
12、门1Name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
13、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. 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
14、%）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. 3生产部门 3Name姓名Street街道City, Zip Code城市，邮编
15、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 No否 If yes如果是Audit Company审核公司A
16、udit 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. 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
17、 %)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. 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
18、 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Resu
19、lt结果Associated with BSCI?是否与BSCI有联系？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-Supplie
20、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. 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 s
21、ince (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有联系
22、？Production Unit No. 8生产部门 8Name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
23、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. 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
24、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？Date / signature / stamp Company日期
25、/ 签名 / 印章 公司B. BSCI Social RequirementsB. BSCI 社会责任要求B.1 Management PracticeB.1 管理实践Questions问题Please mark 请打勾Yes是No否B.1.1Has 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，
26、暂不考虑其它职责。If yes, please indicate name and function: 如果是，请说明其姓名和职位： B.1.2Have 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 ye
27、s, please indicate name/s and function/s: 如果是，请说明其姓名和职位： B.1.3Are 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？B.1.4Is a system implemented to identify specific risks for health and safety of the employees and prevent re
28、currence 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？B.1.5Is a cost accounting method in use?采用了成本会计方法吗？B.1.6 Is there a system in place for anti-corruption/anti-bribery for all business activities? 对于所有业务活动的反腐败/反贿赂，公司是否有适当的体制？B.1.7Is a capacity planning method in use?采用了生产能力计划方法吗？B.1.8Do
29、 you have a procedure for updating and implementing legal regulations with regard to matters subject to continuous change like wages and safety?针对薪水和安全这样持续变化的问题，你制定了用来晋升、实施法令规章的程序吗？Questions问题Please mark 请打勾 Yes是No否B.1.9Have you forwarded the BSCI Code of Conduct to your subcontractors and informed
30、them about the requirements?你已经将BSCI行为守则发给你的分包商并传达了其中的要求吗？B.1.10Are social standards ensured at your subcontractors production facilities?在分包商的工厂中能保证社会责任标准吗？B.1.11Do you have established a system to monitor your subcontractors social performance?你已经建立监控分包商的社会绩效体系吗？B.1 Number of questions out of 10 a
31、nswered with Yes or NoB.1 回答为Yes或者No10个以上的问题数目 B.2 DocumentationB.2 文件Questions问题Please mark 请打勾 Yes是No否B.2.1Is a written policy documented that describes the social responsibility of the company especially with regard to child labour, female employees, discrimination, forced labour, working hours,
32、compensation, working conditions, health and social facilities, safety, freedom of association and collective bargaining?书面的方针形成文件了吗？该方针说明了公司的社会责任，尤其是在对待童工、女员工、歧视、强迫劳工、工时、报酬、工作条件、健康和社会福利设施、安全、结社自由以及集体谈判等方面的社会责任。B.2.2Do personnel data files (e.g. copies of ID-cards, working contracts) exist? 有个人资料档案吗
33、（例如：身份证和工作合同的副本）？B.2.3Is a time record system in place ( e.g. attendance list, punch and time cards) where the beginning and the end of a workday is registered for each individual employee?具备时间纪录系统（例如：出勤表、打孔卡和时间卡），用来登记每位员工工作日的开始和结束时间？B.2.4Do the employees receive payslips?员工有工资单吗？B.2.5Do wage lists
34、exist?有薪水清单吗？Questions问题Please mark 请打勾 Yes是No否B.2.6Do work rules exist and are they documented and applied to all employees?有工作规则吗？都形成文件了吗？它们都适用于所有员工吗？B.2.7Is documentation on health and safety training (e.g. fire protection) available?有关于健康和安全培训（例如防火培训）方面的培训记录吗？B.2.8Is documentation on all hazardo
35、us chemicals in use available (especially material safety data sheets/MSDS)?有关于正在使用中的所有有危害化学品的文件证明吗（尤其是物料安全数据表/MSDS?B.2.9Are certificates on first-aid qualification available?有关于急救资格的证书吗？B.2.10Are inspection documents for lifts and machinery available?有电梯和机械设备的检查记录吗？B.2.11Do you keep records of acci
36、dents and injuries?你们有事故和工伤记录吗？B.2.12Is a business licence available?有营业执照吗？B.2 Number of questions out of 12 answered with Yes or NoB.2 回答为Yes或者No12个以上的问题数目B.3 Working TimeB.3 工作时间Questions问题Please mark 请打勾 Yes是No否B.3.1What is the regular number of working hours per working week in your company?你公司
37、每周正常的工作小时是多少？Hours:小时：What is the statutory number of working hours per working week in your country?你公司每工作周法定的工作小时数为多少？Hours:小时：Are working hours in compliance with statutory laws and regulations?工作小时数符合国家的法律法规吗？B.3.2What is the regular number of working days per working week in your company?你公司每周正
38、常的工作天数为多少？Days:天数：What is the statutory number of working days per working week in your country?你公司每工作周正常的工作天数为多少？Days:天数：Are working days in compliance with statutory laws and regulations?工作天数符合国家的法律法规吗？B.3.3What is the average amount of overtime hours per week?每周平均加班小时数？Hours:小时数：What is the maxim
39、um amount of overtime hours per week defined by your national labour laws?你所在国家劳动法规定每周最多的加班工作小时数？Hours:小时数：Are hours worked overtime in compliance with statutory laws and regulations?加班工作小时数符合国家法律法规吗？B.3.4Is ensured that the maximum amount of working hours for the workforce does notexceed 48 hours of regular working time plus 12 hours of overtime a week in the case that there are no stronger legal regulations? (for example, if the regular hours allowed are 40, the total maximum should be 52).如果当地没有更严厉的法规，最多工作时数是否保证不会超过每星期48小时固定工时及12小时超时工作呢？（例如：如果固定工时为40小时，那么最多工作时数应是52小时）B.3.5
