Appendix Table 1
Evaluation Sheet (Green Procurement Standards/Evaluation Survey) Ver2.1 (Appendix 2) Date of submission: FGGP-002-1-A
Supplier Name: #REF!
1. Standard for Environment Management System (EMS) Note 1) Supplier Code: #REF!
Item Evaluation Standards Evaluation Points Manufacturer Name:
ISO14001 certification is already acquired. 40 Company/Plant Name:
ISO14001 certification will be acquired within 6 months. 30 Address:
A third party certification other than ISO14001 is already acquired. 30 Telephone number:
（1） EMS structure A third party certification other than ISO14001 will be acquired within 6 months. 20 Main Product/Process:
Original EMS of your company is already built. 20
Original EMS of your company will be built within 6 months. 10 Responsible person for control
Original EMS of your company will not be built within 6 months. Nonconformance Position/Department:
2-1. Standard for Environmental Hazardous Substance (EHS)
Item Evaluation Standards (based on GPC-001-A) Evaluation Points Person in charge
Environment Management promises "EHS control" in "Environment policy/objectives". 5 Position/Department:
Policy/Objective We do not have "Environment policy/objectives" itself, or if there is, it does not mention "EHS control". 0 Name:
Customer Each related department defines the integrated target, means and program for the observance of GGP-001. 10 Telephone number:
Requirement Each related department does not have projects for the observance of GGP-001. 0 Fax number:
There are both responding organizations and responsible personnel for the observance of GGP-001. 5 E-mail:
There are not both responding organizations and responsible personnel for the observance of GGP-001. 0 Notes:
The compliance with GGP-001 is verified by internal audit. 5 1 Responsible person for control means responsible personnel for compliance with GGP-001.
(5) Internal Audit
The compliance with GGP-001 is not verified by internal audit. 0 2 If you are a trading company, please prepare this slip for yourself and your manufacturing facilities.
When you prepare this slip as a trading company, you should evaluate whether you have influence over applicable
Prohibited EHS is defined as inspection matter in your company's inspection standard for part/material. 10
Selection of Suppliers manufacturers on each item.
and Parts Prohibited EHS is not defined as inspection matter in your company's inspection standard for part/material. 0 Please submit only in writing because this slip is used as record of environmental conservation activities' evaluation of
Supplier Written agreement for nonuse regarding prohibited EHS is exchanged with at least primary supplier. 5
Management Written agreement for nonuse regarding prohibited EHS is not yet exchanged with a supplier. 0 Comments: please enter your opinion, requests, activity report and so on.(Another sheet is acceptable)
Receiving Inspection items regarding prohibited EHS are defined for receiving parts/materials in your company. 5
Parts/Materials Inspection items regarding prohibited EHS are not defined for receiving parts/materials in your company. 0
Materials containing prohibited EHS and clean ones are separated in manufacturing process. 5
Materials containing prohibited EHS and clean ones are not separated in manufacturing process. 0
Material lot can be identified by shipping history. 5
Material lot cannot be identified by shipping history. 0
Recurrence If prohibited EHS is found, the procedure for root cause analysis and recurrence prevention is defined. 5
Prevention If prohibited EHS is found, the procedure for root cause analysis and recurrence prevention is not defined. 0
2-2. The Result of EHS Audit/Sample Measurement by Pioneer Note 1)
Item Evaluation Standards (The following items were reported by a department in charge of evaluation at our company.) Evaluation Points Note 1) Please select every eveluation point from the right pull-down menu.
The Result of EHS EHS audit has not been conducted yet by Pioneer, or the result was conformance. (The latest audit conclusion) 0 Note 2) If there is "Nonconformance" in "Evaluation Points" column, please enter "0" in "Total" column below.
Audit (Note 2) The result of EHS audit by Pioneer was nonconformance. (The result of another audit still is not "conformance". Nonconformance Note 3) As to Item (12), if more than three years has passed since the last audit, it means "not conducted yet".
Measurement of mass products and parts to be newly inspected has not implemented yet, or the existence of 0
The Result of Sample prohibited EHS was not found as the result of the measurement. Note 4) As to Item (13), the evaluation period is for the past one year.
Measurement (Note 3) The existence of prohibited EHS was found by the measurement of either mass products or parts to be newly * Note 4) Note 5) As to Item (13), when "EHS was found", some points are taken off from the total score.
3. Green Procurement Evaluation: Please make self-evaluation and enter the evaluation points based on the standards stipulated in 1,2-1 or 2-2.
Evaluation Points Total (Perfect
Manufacturer Name Company/Plant Name
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) score is 100)
#REF! #REF! 0
Entry by #REF!
#REF! #REF! 0
#REF! #REF! 0
#REF! #REF! 0
#REF! #REF! 0