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Assessment details:

Code of Conduct:


Production site details:

This form is being completed by:

Indicate country’s telephone code

Assessment details:

Code of Conduct:
Audit setting:
In Case of BSCI audit
In Case of SMETA
Upload to Sedex platform required?
In Case of SA8000
Has the Social Fingerprint Self-Assessment been completed?
The Facility has been operating for at least 6 months? YesNo
The Facility has currently active contracts (producing/executing a product/service for a client)? YesNo
If certification transfer is requested, please attach the previous two SA8000 audit reports YesNo
Scheduling window:

Due Date:

Production site contact details:

Production site technical details:

Anything in between raw material receiving until shipping (example: design, confection, cutting, suing, QC process, labeling)
Dormitories:* YesNo
Indicate the shifts working hours, for example :
1. Shift: 8:00 -15: 00 and 2. Shift: 17:00 - 22:00
On payroll and employment agency workers
Ratio Male/Female
All workers that are not management or administrative
Including permanent full time, part time
Are there exclusive suppliers working onsite and/or offsite?* YesNo
Indicate valid certifications, if applicable please attach evidence:
ISO Evidence:
GAP Evidence:
WRAP Evidence:
SA8000 Evidence:
In case of multi-site audit, check the box and indicate a phone number and we will call you shortly:
if the distance between two locations is less than 10km apart, the number of employees at both sites may be added together (clubbed) for audit effort planning purposes

Payer Details:

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