FORMULIR NO.

DOKUMEN :
VENDOR QUESTIONNAIRE FR-C6.1.0.01-01-04

VENDOR INFORMATION

Company Name

Group of Company

Contact Person

Company Address

Email : Telephone : Fax :

Manufacturing Site
(If different from above)

Email : Telephone : Fax :

GarudaFood Group

2 Juli 2012 No. Rev 0.0 Page 1 / 8

 FORMULIR NO. DOKUMEN :
VENDOR QUESTIONNAIRE FR-C6.1.0.01-01-04

COMPANY POLICY

1. Does your company has a company policy that aligned with Sustainability Criteria and YES NO
signed by top management or a management representative?

If yes, please also send us a copy of the policy.

2. Is the company policy specific towards company and country?

3. Does the policy include a commitment to comply with all relevant national and local
regulations?

4. Does the policy include a commitment to provide adequate resources to ensure effective
implementation of the Sustainability Criteria?

5. Does the policy include a commitment to ensure all staff affected are aware of the
Sustainability Criteria relevant to their role?

6. Does the policy include commitments to promote the health and safety of all, reduce
greenhouse gas emissions, and protect the environment?

7. Does the company evaluate Sustainability Policy at least every year or if there is a
change?

If yes, please also send us a copy of evaluation results.

PROCEDURE DOCUMENTATION AND RECORDS

1. Is there any documentation of procedures and records related to the Sustainability YES NO
Criteria available?

If yes, please also send us a copy of documentation and records results.

2. Is the documentation approved, dated and signed by an authorized person?

3. Is the documentation reviewed at least annually and revised to reflect any significant
changes affecting the Company’s operations?

4. Is the documentation subjected to internal verification at least annually to confirm that

Company practices are aligned with documented procedures?

5. After reviewed and there are findings, are the findings reported to quality management
and the necessary corrective actions recorded and implemented?

6. Are all records required by the Sustainability Program retained for a minimum of two
years?

GarudaFood Group

2 Juli 2012 No. Rev 0.0 Page 2 / 8

 FORMULIR NO. DOKUMEN :
VENDOR QUESTIONNAIRE FR-C6.1.0.01-01-04

7. Have all data protection regulations relevant to the Company and third party record
been complied with?

8. Is there a record keeping procedure in place that protects the record from tampering
and make it easy to retrieve the required records?

9. Is internal/external verification carried out, with findings reported to quality

management and necessary corrective actions noted and implemented?

BUSINESS INTEGRITY

1. Does the company conduct its business with integrity, respect relevant laws and prohibit YES NO
bribery and fraudulent practices?

2. Does the company execute controls on compliance with all laws, rules, regulations, and
requirements related to business integrity?

3. Does the company execute controls on the prohibition of bribes or other 'facilitated'
payments?

4. Does the company execute controls on Entertainment and Gift?

5. Does the company execute controls on Human Rights?

6. Does the company execute controls on Respect at work?

7. Does the company execute controls on Competition and Anti-trust?

8. Does the company execute controls on Conflict of Interest?

9. Does the company execute controls on Money Laundering?

10. Does the company execute controls on the accuracy and correctness of practice records,
procedures, and legal compliance?

11. Does the company have a mechanism to allow employees to report suspected violations
related to Business Integrity where this mechanism is safe, anonymous and protects
employees from any impact?

12. Has the effectiveness and implementation of these procedures been audited by a
competent and qualified, independent assessor?

If yes, please also send us a copy of the audit results.

MANAGEMENT STRUCTURE

1. Does the company have a Management structure and adequately trained personnel to YES NO
GarudaFood Group

2 Juli 2012 No. Rev 0.0 Page 3 / 8

 FORMULIR NO. DOKUMEN :
VENDOR QUESTIONNAIRE FR-C6.1.0.01-01-04

ensure that the Sustainability Criteria are implemented?

If yes, please send us a copy of the organizational chart and the certification.

2. Does the company ensure that the entire supply chain related to the implementation of
Sustainability understands and complies with all Sustainability criteria relevant to its
activities?

STAKEHOLDER ENGAGEMENT

1. Has the company identified stakeholders that are relevant to the Sustainability YES NO
Criteria?
If yes, please send us a copy of the identification results.

TRAINING ON SUSTAINABILITY CRITERIA

1. Is there a training program related to Sustainability Criteria provided to all YES NO

Sustainability teams and employees whose activities are related to Sustainability
standards?

If yes, please send us training attendance certifications

2. Does the training material provided at a minimum include the following:

- Knowledge of how to implement Sustainability in the company?
- The process for monitoring Sustainability criteria has been implemented in the
company
- Reporting issues related to Sustainability criteria
- Methodology for implementing action plans related to issues related to Sustainability
criteria

If no, materials that not include:………………………………………………………………..

3. Does the company carry out evaluations to check the understanding of related
personnel to always be up to date regarding Sustainability criteria through internal or
external tests?

If yes, please send us a copy the evaluation results.

REGULATIONS AND LEGISLATION

1. Is there a decision on regulation of? YES NO

a. Lighting at work
GarudaFood Group

2 Juli 2012 No. Rev 0.0 Page 4 / 8

 FORMULIR NO. DOKUMEN :
VENDOR QUESTIONNAIRE FR-C6.1.0.01-01-04

b. Workplace comfort (temperature, etc.)

c. Ergonomics at work
d. Toilet, washroom and bathroom
e. Changing room facilities
f. Biohazard control in the workplace
g. Warning signs
h. Interlocks
i. PPE use
j. PPE signs
k. Work accident analysis and report, Near Miss, Prompt Action
l. Evacuation Drill
m. Gathering point
n. Firefighter
o. First aid (first aid room)
p. Medicines and medical supplies
q. Facility access
r. Safety briefings
s. Vehicle condition
t. Vehicle safety equipment
u. Driving safety training
v. Vehicle management and facilities
w. WWTP

SUSTAINABILITY SELF-ASSESSMENT

YES NO
1. Does the company ensure that the Sustainability system is updated periodically?

2. Does the company maintain information and evidence regarding the implementation of
Sustainability?

RISK ASSESSMENT

1. Does the company use a Risk Assessment methodology to identify and mitigate YES NO
significant risks affecting the Criteria in the company's Insiders Pillar?
If yes, please send us a copy of Risk Assessment Methodology that company used.

GarudaFood Group

2 Juli 2012 No. Rev 0.0 Page 5 / 8

 FORMULIR NO. DOKUMEN :
VENDOR QUESTIONNAIRE FR-C6.1.0.01-01-04

2. Is risk assessment available so as to reduce costs, protect people and the environment
from hazards, and enhance the Company's reputation?

3. Does the company review the Risk Assessment at least annually, or in case of operational
changes, to ensure that it can continue to address all current and new issues?

4. Does the company use a systematic approach to conducting Risk Assessment &
Identification that includes the following steps?
- Estimate the risk (Probability x Severity)
- Evaluate the risk and agree how it can be reduced
- Implement mitigation measures to manage identified risks
- Review the effectiveness of the mitigation measures implemented

Please send us a copy of Risk Assessment & Identification steps that company used

EMPLOYMENT CONTRACT

YES NO
1. Does everyone working at the company have an employment contract?

2. Does everyone working at the company have written clear and fair employment
contracts?

3. Does the company ensure that both contractors and contractors providing labor meet
all applicable regulatory requirements related to employment contracts?

4. Does the employment contract include:?

- Working hours
- Overtime payment arrangements
- Notification period to give and receive
- Holiday entitlement
- Additional benefits and any deductions to be made
- Due date
- Payment frequency (at least every month)
- Payment method

Please send us a copy of Risk Assessment & Identification steps that company used

5. Are all Employment Contracts dated and signed by the employee concerned and an
authorized representative of the Company?

TRAINING

1. Are all those working in the company provided with the necessary training to enable YES NO

GarudaFood Group

2 Juli 2012 No. Rev 0.0 Page 6 / 8

 FORMULIR NO. DOKUMEN :
VENDOR QUESTIONNAIRE FR-C6.1.0.01-01-04

them to work efficiently, effectively and safely?

2. Does the contractor providing labor meet all applicable regulatory requirements
regarding worker training?

3. Is all necessary training provided to full-time and part-time employees and contract
workers?

4. Is all training provided to employees and contract workers provided by qualified

trainers?

5. Are records kept of all training provided to employees?

6. Are the main training/qualifications of contract workers confirmed?

7. Is all training provided to employees and contract workers kept up to date and any
additional training or refreshment training provided as circumstances and risk
assessments dictate?

8. Does the company have procedures to verify that any training provided to employees
and contract workers is effective?

APPRAISAL

1. Does the company use a documented annual appraisal system that seeks to identify YES NO
potential training and development needs for full-time employees?
If yes, please send us a copy of documented annual appraisal.

2. Is the company's appraisal system formally structured and documented?

3. Should the purpose of the Assessment identify any support needed for the employee in YES NO
terms of training needs and any potential opportunities for advancement?
If no, the purpose of Assessment:………………………………………………………………………

4. Does the process take into account the comments of employees, line managers and
above managers to achieve a balanced Assessment?

5. Does the appraisal procedure recognize any areas that are performing well and
highlight any areas that need improvement?

6. Does the company map out career development for employees who want it and are
suitable for potential promotion or role expansion?

7. Is an appraisal procedure available to the employee concerned and should an

opportunity be provided for them to discuss all aspects of the appraisal with their line
manager?

GarudaFood Group

2 Juli 2012 No. Rev 0.0 Page 7 / 8

 FORMULIR NO. DOKUMEN :
VENDOR QUESTIONNAIRE FR-C6.1.0.01-01-04

8. In the event of a dispute over valuation, does the employee have the right and
opportunity to appeal to a senior manager?

CHILD LABOR

YES NO
1. Does the company ensure that there is no child labor in the company, including
contractors who provide labor, meeting all applicable regulatory requirements related
to child labor?

2. Does the company set a minimum age for entry to work of not less than 15 years, or is
the minimum age provided by country law, whichever provides greater protection?

3. Does the company ensure that no person under 18 years of age is involved in any type
of hazardous work?

4. Does the company ensure that no work by children is too strenuous or requires them to
work long hours?

5. Does the company ensure that no work done by children interferes with their education
and social development?

6. Are all contractors and sub-contractors required to comply with all applicable labor
regulations and ILO conventions regarding child labor?

SERVITUDE

YES NO
1. Does the company ensure that there is no Forced Labor in any of its facilities including
contractors providing labor that meet all applicable regulatory requirements in relation
to Forced Labor?

2. Are workers not working under bondage, debt or threats?

3. Do workers receive wages directly from the Company or its contractors who provide
labor?

4. Are workers free to leave their jobs at any time with reasonable notice?

5. Do the company and its contractors who provide the labor do not keep any workers'
original identity documents?

GarudaFood Group

2 Juli 2012 No. Rev 0.0 Page 8 / 8

 FORMULIR NO. DOKUMEN :
VENDOR QUESTIONNAIRE FR-C6.1.0.01-01-04

6. Do companies and their contractors who provide labor not employ prison or compulsory
labor?

7. Are all contractors and sub-contractors required to comply with all applicable labor
regulations and ILO conventions relating to Forced Labor?

FREEDOM OF ASSOCIATION AND COLLECTIVE BARGAINING

YES NO
1. Does the company uphold all of its workers' rights to freedom of association and
collective bargaining including contractors providing labor meeting all applicable
regulatory requirements in relation to Freedom of Association and collective
bargaining?

2. Does the company have a labor union?

If yes, Continue to the next question.

If no, The reason company doesn’t have a labor union:…………………………….

3. Does the Company enter into constructive dialogue with their preferred representatives
and make good faith deals with those representatives?

4. Are workers allowed to be involved in Labor Union activities without restrictions and
free from retaliation, intimidation or harassment?

5. Does management engage in good faith with workers/union representatives in

collective bargaining discussions and comply with collective bargaining agreements?

6. Are all contractors and sub-contractors required to comply with all applicable labor
regulations and ILO conventions related to Freedom of Association?

WORKING HOURS, PAYMENT & BENEFITS

YES NO
1. Do the working hours not violate the Labor regulations set by the competent authority?
and does the company provide opportunities for employees to develop skills and
abilities and provide opportunities for improvement, if possible?

2. Is the income earned during the pay period sufficient to meet the basic needs of the
worker?

3. Does the payment of all workers (including temporary workers, piece rates, seasonal
and migrant workers) meet, as a minimum, national legal standards or industry
benchmark standards?

4. Do hours of work, excluding overtime, not exceed 48 hours per week on a regular basis?
GarudaFood Group

2 Juli 2012 No. Rev 0.0 Page 9 / 8

 FORMULIR NO. DOKUMEN :
VENDOR QUESTIONNAIRE FR-C6.1.0.01-01-04

5. Are workers given at least one day off in every seven day period?

6. Is overtime work voluntary?

7. Is overtime pay paid at a premium as required by local law or by applicable collective

agreement?

8. Are all workers provided with the benefits, days off and leave to which they are entitled
under local law or by applicable collective agreements?

9. Are workers not subject to illegal or excessive deduction fees or fees, including fees for
personal protective equipment, deposits for accommodation, tools, etc.?

10. Are permanent workers employed in preference to long-term contract workers?

11. Are all contractors and sub-contractors required to comply with all applicable labor
regulations and ILO conventions regarding Hours of Work, Pay and Benefits?

FAIR TREATMENT

YES NO
1. Does the company ensure fair treatment of all workers including contractors who
provide labor to meet all applicable regulatory requirements regarding fair treatment?

2. Does the company ensure that no worker is subjected to physical abuse, threats of
physical abuse or physical contact with the intent to injure or intimidate?

3. Does the company ensure that no worker is a victim of harassment or sexual

harassment?

4. Have no workers experienced verbal abuse or harassment?

5. Are no workers subject to discrimination based on race, color, sex, religion, political
affiliation, membership or trade union status as representative of the worker, ethnicity,
pregnancy, disability, sexual orientation?

COMPLAINT MEHCANISM FOR WORKERS

YES NO
1. Is it that workers have access to a fair and effective complaint mechanism?

2. Are workers given access to direct their complaint to their line managers in the hope
that appropriate action will be taken and without fear of reprisal?

3. Are division leaders given training on how to deal with employee complaints
effectively?

GarudaFood Group

2 Juli 2012 No. Rev 0.0 Page 10 / 8

 FORMULIR NO. DOKUMEN :
VENDOR QUESTIONNAIRE FR-C6.1.0.01-01-04

4. Are workers' complaint available through labor unions or other organizations?

5. Does the company provide a mechanism for complaining of workers' complaints in

accordance with the local culture and the types of problems encountered and the
handling process for all types of workers' complaints?

WELFARE PROGRAM

YES NO
1. Does the company support employees and the local community with regard to
welfare services?

2. Does the company measure the benefits and results of each welfare program
implemented at least annually for each welfare program?

COMMUNITY AND LAND RIGHTS

YES NO
1. Does the company recognize and protect the rights of communities to maintain access to
land and natural resources around its facilities? Does the company respect and prohibit
violations of individual and community land rights around the facility?

2. Does the company use land where it operates that is legally owned and not contested
legally by local communities as indicated by the company's land ownership certificate?

3. Are the rights of communities and traditional communities to access land and natural
resources around facilities owned and managed by the Company recognized and
protected?

4. Are all land acquisitions carried out with respect for the rights of affected individuals and
communities?

5. Are positive relationships maintained as much as possible with the community

surrounding the company?

6. Does the company provide support for the economic development of the community
around the company?

GarudaFood Group

2 Juli 2012 No. Rev 0.0 Page 11 / 8