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Extended Mineral Reporting Template (EMRT)

English

December 23, 2021

Revision 1.01

The purpose of this document is to collect sourcing information on cobalt or natural mica.

Link to Terms & Conditions

Mandatory fields are noted with an asterisk (*). Consult the instructions tab for guidance on how to answer each question.

Company Information

Company Name (*):

Declaration Scope or Class (*):

Go to Product List tab to enter products this declaration applies to

Company Unique ID:

Company Unique ID Authority:

Address:

Contact Name (*):

Email – Contact (*):

Phone – Contact (*):

Authorizer (*):

Title - Authorizer:

Email - Authorizer (*):

Phone - Authorizer:

Effective Date (*):

Bivar

B. Product (or List of Products)

Click here to enter the products this declaration applies to

02-887-2869

02-887-2869

4 Thomas, Irvine CA 92618

Farzin Farsio

ffarsio@bivar.com

949 951-8808

Farzin Farsio

Quality Manager

ffarsio@bivar.com

949 951-8808

19-Jan-2022

Answer the following questions 1 - 7 based on the declaration scope indicated above

1) Is any of the cobalt or natural mica intentionally added or used in the product(s) or in the production process? (*)

Answer

Comments

Cobalt

Mica

 

 

 

No

No

2) Does any cobalt or natural mica remain in the product(s)? (*)

Answer

Comments

Cobalt

Mica

 

 

 

 

 

3) Do any of the smelters or processors in your supply chain source the cobalt or natural mica from conflict-affected and high-risk areas? (OECD Due Diligence Guidance, see definitions tab)

Answer

Comments

Cobalt

Mica

 

 

 

 

 

4) Does 100 percent of the cobalt originate from recycled or scrap sources?

Answer

Comments

Cobalt

 

 

 

5) What percentage of relevant suppliers have provided a response to your supply chain survey?

Answer

Comments

Cobalt

Mica

 

 

 

 

 

6) Have you identified all of the smelters or processors supplying the cobalt or natural mica to your supply chain?

Answer

Comments

Cobalt

Mica

 

 

 

 

 

7) Has all applicable smelter or processor information received by your company been reported in this declaration?

Answer

Comments

Cobalt

Mica

 

 

 

 

 

Answer the Following Questions at a Company Level

Question

Answer

Comments

A. Have you established a responsible minerals sourcing policy?

 

 

Yes

B. Is your responsible minerals sourcing policy publicly available on your website? (Note – If yes, the user shall specify the URL in the comment field.)

 

 

No

C. Do you require your direct suppliers to source cobalt from smelters or natural mica from processors whose due diligence practices have been validated by an independent third-party audit program?

Cobalt

 

 

No

Mica

 

 

No

D. Have you implemented due diligence measures for responsible sourcing?

 

 

Yes

E. Does your company conduct cobalt and/or natural mica supply chain survey(s) of your relevant supplier(s)?

 

 

Yes, in conformance with IPC1755 (e.g. EMRT)

F. Do you review due diligence information received from your suppliers against your company’s expectations?

 

 

Yes

G. Does your review process include corrective action management?

 

 

Yes

© 2021 Responsible Minerals Initiative. All rights reserved.

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Completion required only if reporting level "Product (or list of Products)" selected on the 'Declaration' worksheet.

Manufacturer's Product Number (*)

Manufacturer's Product Name

Comments

ELM 7-530

 

 

 

© 2021 Responsible Minerals Initiative. All rights reserved.