Supplier self-disclosure
B&R Industrial Automation GmbH

Master data

Company:	Phone:
Street:	Fax:
Post code, Town/City:	Internet:
Country:	Email:
Legal form:	Commercial register no.:
Year founded:	Dun & Bradstreet no.:
Owner:	Type of company:
Affiliation:	Function within the group:
Is there a willingness (if applicable) to provide current excerpt from company or commercial register? If yes, please send as an attachment to B&R	Yes No
What distinguishes your company from other companies on the market?
Arrangement as B&R supplier desired? If so, Annex 1 must be completed in full.	Yes No

Person responsible for:	Name	Email	Function at the company
Management
Sales
Development and design
Production
Purchasing and logistics
Technical support
Quality management
Finance
Compliance & Sustainability

Production locations (name/location)	Production processes	Product groups	not applicable
Do you have your own tool shop?	Yes No
Is it possible to manufacture products according to customer specifications?	Yes No

Do you have customers in the field of automation technology?	Yes No
References in automation technology
Other references:

Sales and employees

Revenue in the last 4 years	Not applicable
Year
Revenue & currency
Number of employees
R&D expenses in % of turnover

Sales region	Asia	USA	Europe	Other countries
%
Customer structure	Automotive	Industry	Communication	Entertainment	Computer	Others
%
Product groups
%

Quality

Quality management system

Is a certified quality management system in place?	Yes No
If so, according to which standard(s)?
Are company areas excluded from the existing QM system? If so, which ones?	Yes No
Are audits by B&R possible?	Yes No
Is there willingness to enter into a quality assurance agreement?	Yes No

Quality assurance of purchased parts

Which of these methods is used to ensure the quality of purchased parts or (raw) materials?
Random sample inspection upon delivery	Initial sample inspection
Manufacturer test certificates	Quality assurance agreements
Audits of suppliers	Quality target agreements
Other	not applicable

Tests during production

Are complete plans for ensuring production quality available?	Yes No not applicable
What test scopes are used?

Final inspection

Is a final inspection performed before delivery?	Yes No not applicable
What test scopes are used?

Sampling

Are initial sample inspection reports provided?	Yes No not applicable

Inspection of a defective material

Are test or analysis options available for inspecting delivered products for the causes of any errors that may exist?	Yes No not applicable
If so, what are the possibilities? Please provide additional information about whether this is carried out internally or through external service providers.

Corrective and preventive measures

What methods are used for solving problems?
How are errors and complaints analyzed and what is done to prevent them from happening again?
Is there a continuous improvement process in place?	Yes No

Complaint handling

Description of the organizational process for handling complaints
Internal goal for the duration of handling complaints	calendar days
Is an 8D report issued upon request in the event of a complaint?	Yes No
How will traceability of your products or services be guaranteed?

Quality performance

Product group	Failure rate [ppm] *	Typical errors

* The failure rate is calculated by the sum of defective quantity divided by the sum of delivered quantity in the warranty period.

Development and design

Is there a documented change management process implemented?	Yes No not applicable
How and when will customers be informed if products are changed or discontinued?
Is there a documented requirements management process implemented?	Yes No not applicable

Production

Does in-house production exist where all products are manufactured?	Yes No not applicable
Does "brand-label" production exist?	Yes No not applicable
If not, is there different type? (Short description)
Are there any manufacturing processes that are carried out by external companies? If so, which ones?	Yes No not applicable
Is it possible for OEM customers to implement brand labeling?	Yes No not applicable

Purchasing and logistics

Is there a willingness to enter into a framework supply contract and logistics agreements?	Yes No
Is there a willingness to enter into a non-disclosure agreement?	Yes No
Is there a willingness to use B&R's SRM tool from ASTRAS-ALLOCATION (eSourcing = request and quoting tool, contract management, master data administration, etc.)?	Yes No
What types of logistics solutions (e.g. forecast, security stock, consignment, etc.) can be offered?
To what extent are customers proactively informed in the event of a delay in delivery?
Does an early warning system exist in the event of a delay in delivery? If yes, please provide a description.	Yes No
Is risk management actively used at your company? If yes, please provide a short description.	Yes No
Is a business continuity management plan in place at your company? If yes, please provide a short description.	Yes No

Product liability insurance

Does extended product liability insurance exist?	Yes No
If yes, what is the total amount covered by the extended product liability insurance?
- Personal injuries	/ Year
- Pure financial losses	/ Year
- Damage to property	/ Year
Is worldwide coverage available?	Yes No

Health, safety and protection of people and the environment

Is a certified environmental management system in place? If yes, according to which standard(s)?	Yes No
Is there willingness to enter into an environmental agreement?	Yes No
Is a certified health and safety management system in place? If yes, according to which standard(s)?	Yes No
Do you have a rule for DRC conflict-free purchasing? Please note the requirements of the Dodd-Frank Act: The US "Dodd-Frank Act"* imposes documentation and publication obligations on companies to ensure that no "conflict minerals" are contained in purchased products. "Conflict minerals" are minerals (tantalum, tin, gold, tungsten) that are mined in the Democratic Republic of Congo or in an adjacent state under the control of armed groups and serve to finance the existing conflict in this region. If yes, do you provide relevant information in accordance with the template IPC-1755 Conflict Minerals Data Exchange Standard and at which level (company, product, user defined)? If not applicable, why not?	Yes No not applicable Yes No

Regulations, directives, standards

Do your products comply with the substance restrictions according to Annex II of EU RoHS directive 2011/65/EU including the amendment in directive 2015/863? Please attach your RoHS statement with reference to the current directives and exemptions. Do your products benefit from an exemption according to Annex III or Annex IV of EU RoHS directive 2011/65/EU? If so, which ones?	Yes No not applicable Yes No Click or type here to enter text.
Do your products contain a substance of very high concern from the candidate list with >0.1 % weight by weight in an article? Please attach your REACH statement with reference to the current candidate list. If yes, please communicate all necessary information required for a SCIP database entry or the SCIP reference number.	Yes No not applicable Click or type here to enter text.
Do your products contain a substance subject to authorization according to Annex XIV of REACH regulation no. 1907/2006? If yes, please specify the substance.	Yes No not applicable Click or type here to enter text.
Do your products contain a substance subject to restrictions according to Annex XVII of REACH regulation no. 1907/2006? If yes, please specify the substance.	Yes No not applicable Click or type here to enter text.
Are processes in place at your company to comply with the requirements of REACH regulation no. 1907/2006?	Yes No not applicable
Will you provide the information necessary for a SCIP entry if you deliver an article with a substance of very high concern from the candidate list with >0.1 % weight by weight?	Yes No not applicable
Will you provide the EFUP information and table in regards to China RoHS associated with your products?	Yes No not applicable
Do your products comply with the substance regulations of POP regulation no. 1021/2019?	Yes No not applicable
Do your products comply with the substance regulations of the Toxic Substances Control Act (TSCA)?	Yes No not applicable
Do your products comply with the substance regulations of the California Prop 65 (Safe Drinking Water and Toxic Enforcement Act)?	Yes No not applicable
Will you provide B&R with video surveillance or telecommunications equipment or services as a complete unit or as part of a unit? If yes, answer following questions to the John S. McCain National Defense Authorization Act for fiscal year 2019, Section 889 (NDAA889): Will you provide any equipment, system(s), or service(s) to B&R that ARE “video surveillance or covered telecommunications equipment or services”? Will you provide any equipment, system(s), or service(s) to B&R that USE “video surveillance or covered telecommunications equipment or services”?	Yes No not applicable Yes No Yes No

Integrity

Do you accept the ABB supplier code of conduct https://new.abb.com/about/supplying/code-of-conduct? Acceptance will be confirmed by signing this supplier self-disclosure.	Yes No
Is it anticipated that your company will interact with any Public Official(s) and/or ABB customer(s) on ABB’s behalf?	Yes No Click or type here to enter text.
Is your company or any of your company's affiliates or subcontractors engaged for the provision of goods and/or services to ABB fully or partially owned by, or connected to, a current or former Public Official or a Family member of, or an individual with a Close Personal Relationship with, a current or former Public Official relevant to the provision of goods/services to ABB	Yes No Click or type here to enter text.
To the extent you are aware, does your company or any shareholder, director or member of senior management: (i) currently work for ABB, or (ii) have any personal or commercial relationship with any employee of ABB that may give rise to a conflict of interest?	Yes No Click or type here to enter text.
To the extent you are aware, in the past five years, have there been (i) any government investigations, prosecutions and/or settlements (including for bribery, corruption, fraud, environmental, health and safety, human rights/modern slavery, money laundering, sanctions, export controls, competition or tax evasion law violations) involving your company or any shareholder, director or member of senior management of your company, or (ii) any significant human rights related incidents or violations that occurred in your company's operations or value chain (e.g., related to child labor, modern slavery or forced labor)?	Yes No Click or type here to enter text.
Is your company headquartered in or manufacturing, shipping or sourcing from any of the following countries/locations? Crimea region/Cuba/Iran/North Korea/Syr	Yes No Click or type here to enter text.
Is your company, or any of its directors, officers or shareholders included on any list of sanctioned/targeted persons, (i) blocked parties or persons subject to asset-freezing or other restrictions enforced by any governmental or regulatory bodies, including, but not limited to, those of the United States of America and the European Union (hereafter referred to as a “Restricted Person”), or (ii) directly or indirectly owned fifty percent (50%) or more, in the aggregate or individually, or otherwise controlled by a Restricted Person	Yes No Click or type here to enter text.
If required under applicable laws, does your company have a valid permit and/or license to provide goods and/or services to ABB?	Yes No Click or type here to enter text.
List all primary countries where the proposed third party will provide goods and/or services to ABB.	Click or type here to enter text.
Are any current directors, members of senior management or key employees within your company who are in the scope of this engagement a current or former Public Official or a Family member of, or an individual with a Close Personal Relationship with, a Public Official?	Yes No Click or type here to enter text.
Is your company publicly traded?	Yes No Click or type here to enter text.
Has your company been in business for fewer than three years?	Yes No Click or type here to enter text.
Has your company been selling goods and/or services similar to the goods and/or services you will be selling/providing to ABB for fewer than three years?	Yes No Click or type here to enter text.
Is your company a multinational company with global operations?	Yes No Click or type here to enter text.
Is the annual turnover of your company in excess of USD 1 million?	Yes No Click or type here to enter text.
Does your company have a compliance / integrity program, including provides integrity related trainings to its employees?	Yes No Click or type here to enter text.
If your company provides hospitality, travel, gifts or sponsorships or donations to Public Officials or on their request, does your company have controls and processes in place to mitigate bribery, corruption and fraud in connection with such activities?	Yes No Click or type here to enter text.
Does your company allow facilitation payments?	Yes No Click or type here to enter text.
In the scope of this engagement with ABB, will your company retain subcontractors or any other parties to provide assistance in providing services and/or goods to ABB?	Yes No Click or type here to enter text.

Attached documents

Please include a copy of the following documents:
Company profile	Implemented Management Systems (e.g. ISO 9001, ISO 14001)
Company organizational chart	Environmental policy
Line card	Annex 1 to supplier document
Quality policy	Confirmation documents for the in point 9 specified regulations, directives and standards.
Quality policy	Confirmation documents for the in point 9 specified regulations, directives and standards.
Code of conduct	current excerpt from company or commercial register
Remarks:

,
..........................................................
Signature ,
Name in capital letters, title

Annex 1 - Master data for supplier document

Invoicing party data

Full company name
Street / House number
Post code / City
Optional post office box
Optional post code / city for post office box
Country
Telephone number and extension
FAX number and extension
Contact person and email address
Website
VAT identification numbers (=UID) and countries
Optional commercial book no. / commercial register no.
Is optional RMA process for return of goods available? If so, contact person and email address	Yes No

Order address data (if different)

Full company name
Street / House number
Post code / City
Optional post office box
Optional post code / city for post office box
Country
Telephone number and extension
FAX number and extension
Contact person and email address
Website
VAT identification numbers (=UID) and countries
Optional commercial book no. / commercial register no.

Supplying company data (if different)

Full company name
Street / House number
Post code / City
Optional post office box
Optional post code / city for post office box
Country
Telephone number and extension
FAX number and extension
Contact person and email address
Website
VAT identification numbers (=UID) and countries
Optional commercial book no. / commercial register no.

Payment transactions

Currency 1 (e.g. EURO, US Dollar, etc.)
Name and address of the financial institution where the account is held.
IBAN no.
BIC / SWIFT CODE
Optional account number
Optional bank code number
Currency 2 (e.g. EURO, US Dollar, etc.)
Name and address of the financial institution where the account is held.
IBAN no.
BIC / SWIFT CODE
Name and address of the financial institution where the account is held.
Optional account number
Optional bank code number