Request edit access
JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Next Level Significant Supplier CSR Questionnaire
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Organization Name
*
Your answer
Your First Name & Last Name
*
Your answer
1. Does your Organization comply with all local laws and regulations, including those related to social (labor laws, minimum wage, etc.) and environmental performance?
*
Yes
No
2. Does your company have an ethics / anti-bribery / anti-corruption policy?
*
Yes
No
If you do, and if it is public, please paste the link here:
Your answer
3. Does your Organization currently have any independent third-party environmental, or social performance certification, like B Corp, or similar
Non Profit organization that does not sell Carbon Offset programs
? if so, which one(s); year
*
Your answer
4. Does your organization buy Carbon Offset, from programs like Native Energy, TerraPass or CarbonNeutral, or are you member of environmental investment programs such as the 1% for the planet? If so, which one(s), since what year?
*
Your answer
5. Does your Organization have formal goals to contribute the United Nations' Sustainable Development Goals, especially #12 (Responsible Production and Consumption) and #13 (Climate Action)? If so, please specify / share the link.
*
Your answer
6. Does your Organization have published policy on fair and ethical treatment of your employees, contractors ans suppliers?
*
No, we just abide by the law
Yes, for employees only / we don't publish it
Yes
7. Do your Organization have anti-discrimination / anti-harassment policies and/or Diversity & Inclusion clauses in your Organization Work Rules? If so, please specify.
*
No, we don't
Yes, we have one, but not both (for example anti-harassment, but not D&I)
Yes, we have these
8. If you manufacture physical products, do you track / disclose / consider that you have reached your goals to minimize your emissions of GHGs?
*
We don't manufacture physical products
No, we don't track
We're working on it
Yes, we track our emissions
Yes, we track, we have reduction goals, and we publish our achievements against these goals
We consider that we have reached our Goals (if you do, please specify below)
If you consider that we have reached your goals, please specify here:
Your answer
9. If you manufacture physical products, do you track / disclose / set responsible consumption goals on use of non renewable resources such as rare earth?
No
We're working on it
Yes, we track our emissions
Yes, we track, we have reduction goals, and we publish our achievements against these goals
We consider that we have reached our Goals (if you do, please specify below)
Clear selection
If you consider that we have reached your goals, please specify here:
Your answer
10. If you manufacture physical products, do you have processes in place on life cycle end, such as Return, Recycle, Reuse (RRR)?
No
We're working on it
Yes, we do and it's public
Clear selection
11. If you sell Services, do you track resources or utilities needed to produce and maintain your services, such as electricity or water? And do you have any policy to reduce consumption, or do you have third party assessment attesting that you have reached your goals on these?
*
We don't sell Services
No, we don't track
Yes, we track
Yes, we track, we have reduction goals, and we publish our achievements against these goals
We consider that we have reached our Goals (if you do, please specify below)
If you consider that we have reached your goals, please specify here:
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Next Level.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report