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1 of 6 SUPPLIER DECLARATION FORM

Banyan Tree expects all Suppliers to work with honesty and integrity, and to embrace and

comply with the standards listed in this Code of Conduct. Banyan Tree selects and evaluates its Suppliers by their commitment to shared values in this Code. Suppliers are required to

exhibit ethical and sustainable social, environmental and governance practices by adhering to the following at all times: *Compulsory Fields

Section A: Personnel Particulars

No. Question Your Response 1 Your Salutation* Please tick: Mr

Mrs Dr

Mdm Miss

2 Your First Name*

(i.e. given name)

3 Your Last Name*

(i.e. family name)

4 Your Designation

(e.g. owner, manager, executive)

2 of 6 Section B: General Information

No. Question Your Response

5 Company Name*

6 Company Phone

Number*

Country Code: + ___ ___ ___

Area Code: ___ ___ ___ ___

Tel No.: ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___

7 Company Website URL

8 Company Email

Address*

9 Address ʹ First Line*

(Building and Unit

Number)

10 Address ʹ Second

Line* (Street Name)

11 City*

12 Province

13 Country*

14 Total number of

employees*

15 Volume of business

with Banyan Tree1 in previous year

1Including all brands in

Banyan Tree portfolio

- Banyan Tree

Angsana, Cassia,

Dhawa etc USD $ __________________________

3 of 6 Section C: Purchasing Category

No. Question Your Response

16 Type of Business Please tick one only:

Manufacturer

Wholesale

Dealer

17 Type of Supply Please tick where relevant:

Services

Goods

18 Type of Services Please tick where relevant:

Agriculture

Forestry

Fishing

Mining

Livestock

Utilities

Construction

Manufacturing

Furniture and fixtures

Machinery

Wholesale trade: durable

Wholesale: non-durable

Retail trade (misc)

Transportation

Freight

Warehousing

Information

Communications

Finance

Insurance

Real estate,

Professional/scientific/technical

Management

Administrative

Waste management

Education

Health care

4 of 6 No. Question Your Response

Arts and entertainment

Accommodation

Food

Public administration

Other

Section D: Confirmation

Banyan Tree expects all Suppliers to exhibit ethical and sustainable social, environmental and governance practices. I/we hereby confirm that the company named above adheres to the following principles:

I. Social Responsibility

1. Support and respect human rights, without complicity in human rights abuses, and

ensure all employees are aware of and understand these rights.

Yes No

2. Eliminate all forms of forced, compulsory and child labour.

Yes No

3. Encourage a diverse workforce and provide a workplace free from harassment,

discrimination or abuse.

Yes No

4. Treat employees fairly with respect to wages, working hours and benefits.

Yes No

5. Implement occupational health and safety regulations at a high level and ensure a

safe working environment conducive to good health.

Yes No

II. Environmental Responsibility

6. Apply the precautionary principles to minimise environmental impact.

Yes No

7. Manage resource use (energy, water and waste, chemicals and hazardous

materials) to minimise environmental and/or climate change impacts.

Yes No

5 of 6 III. Governance

8. Comply with all applicable local, national and international laws and regulations

including anti-trust and fair-competition.

Yes No

9. Avoid conflicts of interest.

No one shall offer, promise, give or accept, directly or indirectly any payment, gift or benefit in return for special treatment with the intent to influence a business transaction or receive a personal or commercial advantage.

Yes No

10. Eliminate corruption in all forms including but not limited to extortion, bribery,

nepotism, fraud and money laundering.

Yes No

11. Is your organisation a signatory to the United Nations Global Compact?

Yes No

12. Is your organisation currently ISO14001 certified?

Yes No

13. Does your organisation have any other third party environmental, social,

governance, fair trade or sustainability certification?

Yes No

If yes, please state certification name: ________________________________________

14. Does your organisation have a sustainability policy?

Yes No

15. Does your company report its sustainability efforts?

Yes No

If yes, provide URL of latest sustainability report: ______________________________

6 of 6 I/We confirm all information submitted in this form is correct to the best of my

knowledge for this calendar year, and will communicate any changes in to be used by Banyan Tree Global Foundation website, and acknowledge information provided here may be used by Banyan Tree Global Foundation for reporting purposes.

Submitted by (Supplier)

____________________________ Name:

Company:

Designation:

Date:

Received by (Banyan Tree)

____________________________ Name:

Property:

Designation:

Date:quotesdbs_dbs14.pdfusesText_20