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1 | Norrsken VC Sustainability Questionnaire | |||||||||||||||||||||||||
2 | This questionnaire is designed to help us understand how you're currently working or thinking about sustainability and ESG in your company. Don't worry if you don't have everything in place yet - these are areas where we'd love to come in and support you! For any questions or support, feel free to reach out to our Chief Impact Officer Agnes Svensson at agnes@norrsken.vc | |||||||||||||||||||||||||
3 | COMPANY NAME: | [Insert] | ||||||||||||||||||||||||
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5 | Area | Question | Answer | Attachments/links | ||||||||||||||||||||||
6 | Impact | How would you describe the positive impact generated by your business? | ||||||||||||||||||||||||
7 | Are you aware of any potential adverse (negative) impact that could be generated by your business? | |||||||||||||||||||||||||
8 | What data can you track to demonstrate your company's positive impact, and have you already started? Have you defined any targets or ambitions? | |||||||||||||||||||||||||
9 | Employees & leadership | Please indicate the gender split of your employees (at time of investment) - measured as full-time equivalents | # Female FTEs: [insert] | |||||||||||||||||||||||
10 | # Male FTEs: [insert] | |||||||||||||||||||||||||
11 | # Non-binary FTEs: [insert] | |||||||||||||||||||||||||
12 | Please indicate the gender split of your founding team (at time of investment) | # Female founders: [insert] | ||||||||||||||||||||||||
13 | # Male founders: [insert] | |||||||||||||||||||||||||
14 | # Non-binary founders: [insert] | |||||||||||||||||||||||||
15 | Please indicate the gender split of your C-Suite (at time of investment) | # Women at C-level:[insert] | ||||||||||||||||||||||||
16 | # Men at C-level: [insert] | |||||||||||||||||||||||||
17 | # Non-binary persons at C-level: [insert] | |||||||||||||||||||||||||
18 | Please indicate the gender split of your Board (at time of investment) | # of Female board members: [insert] | ||||||||||||||||||||||||
19 | # of Male board members: [insert] | |||||||||||||||||||||||||
20 | # of Non-binary board members: [insert] | |||||||||||||||||||||||||
21 | Please indicate how many of your total Board members that are "independent" (i.e. don't have any material/familial relationships with the company; no significant shareholding that might sway decision-making or conflicts of interest) | # of Independent board members: [insert] | ||||||||||||||||||||||||
22 | ESG and adverse impact risks - E: Environmental aspects (e.g. CO2/climate change, waste, water, biodiversity, etc) - S: Social (e.g. human rights, diversity & inclusion, employee rights, health and security) - G: Governance (e.g. policy framework, business ethics, anti corruption & bribery, transparency) | What are your main Environmental, Social or Governance (ESG) risks? See column A for example issues, although each business/industry will face their own set of ESG risks. | ||||||||||||||||||||||||
23 | What mitigation measures do you have in place (or are planning) for your identified ESG risks? | |||||||||||||||||||||||||
24 | Have you had any ESG incidents in the last year? If so, indicate how many and give a summary explanation of these. (Eg. breach of code of conduct/ ethical guidelines, harrassement claims or concerns, health and security, corruption etc). If so, how was the incident handled? | |||||||||||||||||||||||||
25 | Has your company had any work-related injuries in the last year? If so, indicate how many and give a summary explanation of these. | |||||||||||||||||||||||||
26 | Has the company or members of the senior management team faced litigation and/or been convicted in court in any of the following areas: - Labour laws or human rights (incl. harrassment, discrimination or bullying) - Corruption - Tax laws - Competition laws | Yes / No If yes, please provide more detail | ||||||||||||||||||||||||
27 | Who's internally responsible for topics relating to sustainability / ESG? (e.g. issues of environmental, human rights, diversity nature etc) | |||||||||||||||||||||||||
28 | AI | Risk identification: What AI-related risks do you see in your product or business — for example relating to bias, privacy, misuse, safety, or unintended harm? Are there use cases you would refuse? | ||||||||||||||||||||||||
29 | Processes & safeguards: What processes, safeguards, or human-oversight mechanisms do you have in place (or plan to implement) to address those risks (if any)? | |||||||||||||||||||||||||
30 | Governance & accountability: Who is responsible for AI-related decisions and risk in your team? If someone identified an AI risk or ethical concern, how would they raise it? | |||||||||||||||||||||||||
31 | Governance and compliance | What policies do you currently have in place? [Select all that apply, remove the rest. Or if you prefer, you can add in your own explanation for what (if any) policies you have in place] | Overall sustainability policy that addresses one or various ESG areas Environmental policy Anti-discrimination and equal opportunities policy Diversity & inclusion policy Whistleblower procedure Whistleblower protection policy Health & Safety policy Human Rights policy A due diligence process to identify, prevent, mitigate and address adverse human rights impacts Anti-corruption & anti-bribery policy Program to protect against cyber security risks Policy protecting the privacy of their employees and customers Code of Conduct Supply chain screening for ESG-related issues Waste management or a circular economy policy Employee relations policy Employee remuneration policy Tax compliance policy Supplier Code of Conduct | |||||||||||||||||||||||
32 | Would you be willing to share these with us? If so, kindly share in whichever format you prefer. | |||||||||||||||||||||||||
33 | Please select which practices you adopt to implement your policies. [Select all that apply, remove the rest] | Policies are signed/approved by most senior employee Policies are publicly available Policies are available to all employees Code of conduct is signed by all employees Other | ||||||||||||||||||||||||
34 | Does your company have processes and grievance mechanisms in place to monitor compliance with and to address violations of UNGC principles and OECD Guidelines for Multinational Enterprises? | Yes No | ||||||||||||||||||||||||
35 | Has the company faced any violations of United Nations Global Compact (UNGC) or OECD Guidelines for Multinational Enterprises? [Select one, remove the rest] | Yes, to both Yes, to UN Guiding principles Yes, to OECD Guidelines No | ||||||||||||||||||||||||
36 | Is there a person who is responsible for sustainability and compliance? If so, who? | The CEO | ||||||||||||||||||||||||
37 | Is the company involved in the manufacture or selling of controversial weapons? | No | ||||||||||||||||||||||||
38 | Describe the risks of bribery/corruption/fraud in your company and how do you work to address these? | |||||||||||||||||||||||||
39 | Do you consider your company has effective governance mechanisms which ensure ethical, transparent, and responsible decision-making? | |||||||||||||||||||||||||
40 | Environment | Do you track the CO2 emissions of your company? If yes, please share last year's CO2 emissions (in tonnes CO2) | Yes, for reference period [insert]: - Scope 1 [insert] - Scope 2 [insert] - Scope 3 [insert] No | |||||||||||||||||||||||
41 | Has your company defined a GHG emissions reduction target? | Yes, in line with the Paris Agreement Yes, with other target No Other, please specify | ||||||||||||||||||||||||
42 | Please report the following energy consumption and production indicators [Please provide whatever information you have available] | - Renewable energy consumption: - Non-renewable energy consumption: - Renewable energy production: - Non-renewable energy production: - We don't have this | ||||||||||||||||||||||||
43 | Do you have activities in the fossil fuel sector? | Yes (if so, please provide more detail) No | ||||||||||||||||||||||||
44 | Does the business generate emissions to water? Input data in tonnes if this has been quantified. | Yes (if so, please provide more detail) No | ||||||||||||||||||||||||
45 | Does the business generate radioactive or hazardous waste? Input data in tonnes if this has been quantified. | Yes (if so, please provide more detail) No | ||||||||||||||||||||||||
46 | Are any of the business sites/operations located in or near to biodiversity-sensitive areas, and does activities of the company negatively affect those areas? | Yes (if so, please provide more detail) No | ||||||||||||||||||||||||
47 | Internal/ employee sustainability | Are you actively promoting diversity, equality and inclusion in your workplace or through your business? | Yes (if so, please describe your efforts in more detail) No | |||||||||||||||||||||||
48 | Have you implemented an annual employee survey? | Yes (if so, please provide more detail) No | ||||||||||||||||||||||||
49 | Do you have a process or tool for employees to voice concerns or report incidents in the workplace (e.g. whistleblowing tool or grievance mechanism)? | Yes (if so, please provide more detail) No | ||||||||||||||||||||||||
50 | Do you track your unadjusted gender pay gap? | Yes (if so, please provide more information and your findings) No | ||||||||||||||||||||||||
51 | Supply chain | Which are your main suppliers? In which industries do they operate, and where are they based? | ||||||||||||||||||||||||
52 | Are you aware of any sustainability risks in your supply chain? (e.g. environmental, corruption / bribery or human rights)? | Yes (if so, please provide more detail) No | ||||||||||||||||||||||||
53 | Have you conducted an ESG screening / human rights due diligence of your supply chain, or do you have a process for how to monitor such risks? | Yes (if so, please detail the findings of this screening, and share the screening with us) No | ||||||||||||||||||||||||
54 | If you've identified sustainability risks in your supply chain, how are you mitigating or planning to mitigate such risks? | |||||||||||||||||||||||||
55 | Investor-specific question | Kindly confirm if your Company's activities include any of the following: | ||||||||||||||||||||||||
56 | i. Carbon-emitting activities under EU Emissions Trading System (EU ETS) Explanation: Does your company operate installations that are subject to Directive 2003/87/EC (EU ETS)? This applies if you operate combustion facilities above 20MW, or are active in energy-intensive industries such as power generation, steel, cement, glass, or paper production within the EU/EEA. | Yes / No. If yes, confirm that a green transition / decarbonisation plan is in place or being developed, defining targets, an implementation roadmap, and investment needs. | ||||||||||||||||||||||||
57 | ii. Biological waste processing and landfill gas Explanation: Does your company engage in anaerobic digestion of bio-waste, landfill gas capture, or utilisation of landfill gas? | Yes / No. If yes, confirm that a methane leakage monitoring plan is in place. | ||||||||||||||||||||||||
58 | iii. Carbon capture and storage (CCS) Explanation: Does your company engage in the transport of CO₂ via pipelines or the underground permanent geological storage of CO₂? | Yes / No. If yes, confirm that a detailed monitoring plan compliant with CCS Directive 2009/31/EC and EU ETS Directive 2018/410 is in place. | ||||||||||||||||||||||||
59 | iv. Environmental impact assessments Do any of your company's activities or projects require an Environmental Impact Assessment (EIA) under applicable national legislation? | Yes / No. If yes, confirm that all required assessments, permits, and authorisations are in place or formally planned. | ||||||||||||||||||||||||
60 | [if the Company’s activities are subject to the Directive 2003/87/EC, it must be actively required to adopt a green transition / decarbonization plan to improve its carbon footprint (in the short, medium and/or long term). The green transition / decarbonization plan referred in this paragraph, shall define targets, establish the implementation roadmap and identify the investment needs;] [if the Company’s activities include anaerobic digestion of bio-waste, landfill gas capture and utilization, a monitoring plan for methane leakage of these activities must be in place;] [if the Company’s include transport of CO2 and underground permanent geological storage of CO2, a detailed monitoring plan in line with the provisions of the CCS Directive 2009/31/EC and EU ETS Directive 2018/410 must be in place;] [if the Company’s activities or projects require an environmental impact assessment – as per the national legislation – that the assessments, permits and authorizations are in place.] | |||||||||||||||||||||||||
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