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OTTO Company-EICC Gesi Conflict Mineral Reporting Template.Xlsx

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OTTO Company-EICC Gesi Conflict Mineral Reporting Template.Xlsx Conflict Minerals Reporting Template Select Language Preference Here: 请选择你的语言: 사용할 언어를 선택하시오 : 表示言語をここから選択してください: Sélectionner la langue préférée ici: Click here to check required English Selecione Preferência de idioma Aqui: fields completion Wählen sie hier die Sprache: Seleccione el lenguaje de preferencia aqui: Revision 2.03a Selezionare la lingua di preferenza qui: July 25th, 2013 The purpose of this document is to collect sourcing information on tin, tantalum, tungsten and gold used in products Link to Terms & Conditions Mandatory fields are noted with an asterisk (*). The information collected in this template should be updated annually. Any changes within the annual cycle should be provided to your customers Company Information Company Name (*): OTTO Declaration Scope (*): A. Company Level Description of Scope: Company Unique Identifier: Address: Authorized Company Representative Name (*): Scott Bolanowski Representative Title: Representative Email (*): [email protected] Representative Phone: Date of Completion (*): 26‐Oct‐2013 Answer the following questions 1 ‐ 6 based on the declaration scope indicated above 1) Are any of the following metals necessary to the functionality or production of your company's products that it manufactures or contracts to manufacture? (*) Answer Comments Tantalum (*) Yes Tin (*) Yes Gold (*) Yes Tungsten (*) Yes 2) Do the following metals (necessary to the functionality or production of your company's products) originate from the DRC or an adjoining country? (*) Answer Comments Tantalum (*) Uncertain or Unknown Tin (*) Uncertain or Unknown Gold (*) Uncertain or Unknown Tungsten (*) Uncertain or Unknown 3) Do the following metals (necessary to the functionality or production of your products) come from a recycler or scrap supplier? (*) Answer Comments Tantalum (*) Uncertain or Unknown Tin (*) Uncertain or Unknown Gold (*) Uncertain or Unknown Tungsten (*) Uncertain or Unknown 4) Have you received completed Conflict Minerals Reporting Templates from all of your suppliers? (*) Answer Comments Click here to enter smelter names Tantalum (*) Yes Tin (*) No but > 50% Gold (*) No but > 50% Tungsten (*) Yes 5) For each of the following metals, have you identified all of the smelters your company and its suppliers use to supply the products included within the declaration scope indicated above? (*) Answer Comments Click here to enter smelter names Tantalum (*) No Tin (*) No Gold (*) No Tungsten (*) No 6) Have all of the smelters used by your company and its suppliers been validated as compliant in accordance with the Conflict‐Free Smelter (CFS) Program and listed on the Link to "CFS Compliant Smelter List" Compliant Smelter List for the following metals? (*) Answer Comments Tantalum (*) No Tin (*) No Gold (*) No Tungsten (*) Unknown No list available Answer the Following Questions at a Company Level Question Answer Comments A. Do you have a policy in place that includes DRC conflict‐free sourcing? (*) No B. Is this policy publicly available on your website? (*) No C. Do you require your direct suppliers to be DRC conflict‐free? (*) No D. Do you require your direct suppliers to source from smelters validated as compliant to a CFS No protocol using the CFS Compliant Smelter List? (*) E. Have you implemented due diligence measures for conflict‐free sourcing? (*) No F. Do you request your suppliers to fill out this Conflict Minerals Reporting Template? (*) Yes G. Do you request smelter names from your suppliers? (*) Yes H. Do you verify due diligence information received from your suppliers? (*) Yes (documentation review only) I. Does your verification process include corrective action management? (*) Yes J. Are you subject to the SEC Conflict Minerals disclosure requirement rule? (*) No Click here to check required fields completion © 2011 Electronic Industry Citizenship Coalition, Incorporated and Global e‐Sustainability Initiative. All rights reserved. OTTO Page 1 10/30/2013 To begin: Link to "CFS Compliant Smelter List" Step 1. Select Metal in column B Step 2. Select from dropdown in column C Step 3. If dropdown selection is "Smelter Not Listed" complete columns D & E Step 4. Enter all available smelter information in columns F thru N Revision 2.03a July 25th 2013 © 2011 Electronic Industry Citizenship Coalition, Incorporated and Global e‐Sustainability Initiative. All rights reserved. Smelter Facility Location (Country) of Mine(s) or Smelter Facility Location: Smelter Facility Location: Smelter Facility Location: Location: State / Smelter Facility Name of Mine(s) or if recycled or scrap sourced, if recycled or scrap sourced, state Metal (*) Smelter Reference List (*) Standard Smelter Names (*) Country (*) Smelter ID Street address City Province Smelter Facility Contact Name Contact Email Proposed next steps, if applicable state recycled or scrap recycled or scrap Comments Gold Codelco Codelco CHILE 1CHL014 Gold Royal Canadian Mint Royal Canadian Mint CANADA 1CAN050 Gold Johnson Matthey Inc Johnson Matthey Inc UNITED STATES 1USA025 27, Jalan Pantai, 12000 Butterworth. P. 0. Box 2, Butterworth, Penang Mr. Chua Cheong Yong [email protected] 12700 Tin Malaysia Smelting Corporation Berhad Malaysia Smelting Corp MALAYSIA 2MYS016 CFS appoved "80 Moo 8, Sakdidej Road, T. Vichit Phuket Thailand Mr. Nick Thorne [email protected] A. Muang, 83000, Thailand." Tin Thailand Smelting and Refining Co. Ltd. Thaisarco THAILAND 2THA046 CFS appoved Jalan Jenderal Sudirman Abrun 51,Pangkalpinang 33121 Bangka Abrun Abubakar <[email protected]> Tin PT Timah PT Timah INDONESIA 2IDN042 Tin PT Tambang Timah PT Tambang Timah INDONESIA 2IDN049 Tin PT Stanindo Inti Perkasa PT Stanindo Inti Perkasa INDONESIA 2IDN040 "Las Begonias 441 Of. 338 Lima 27, Peru Lima 100 Laila Zollinger [email protected] Minsur‐mine Peru‐mine On Compliant Tin Smelter List (valid to 2‐4‐2014) Casilla 1309" Tin Minsur Minsur PERU 2PER019 CFS appoved Carretera Oruro a Cala Cala, Oruro Oruro Lic.Ruth Garcia F. [email protected] Km 7.5, s/n Zona Vinto Tin Empresa Metallurgica Vinto Empresa Metallurgica Vinto BOLIVIA Huanuni Tin mine Huanuni town, Oruro, Bolivia Nieuwe Dreef 33, 2340 Beerse Vlaanderen Mrs. Inge Hofkens [email protected] Tin Metallo Chimique Metallo Chimique BELGIUM 2BEL017 EST ESTRADA DOS ROMEIROS KM 49, s/n ‐ [email protected] Brazil Luciana Miranda Guarapiranga .br Tin Mineração Taboca S.A. Mineração Taboca S.A. BRAZIL 2BRA018 Huogudu, Zhadian town, Gejiu city, Yunan Gejiu Yunnan Zhou Yun [email protected] Tin Gejiu Zi‐Li Gejiu Zi‐Li CHINA 2CHN011 Yunnan Gejiu China Nine two Huichang County Industrial Base Ganzhou Jiangxi Mr Wang [email protected] Tin Huichang Jinshunda Tin Co. Ltd Huichang Jin Shun Tin Industry Co. Ltd CHINA JL. TPI – KETAPANG PANGKALPINANG BANGKA BELITUNG Tin PT Bangka Putra Karya PT BANGKA PURTA KARYA INDONESIA Smelter contact details not disclosed by trader KETAPANG KAWASAN INDUSTRI, PANGKALPINANG, PANGKALPINANG BANGKA DIAN TRIHARDJO [email protected] BANGKA Tin PT Bukit Timah PT Bukit Timah INDONESIA JI. Anggerek No. 142, Koba, Bangka , Indonesia Bangka Chua Cheong Yong [email protected] Tin PT Koba Tin PT Koba Tin INDONESIA CFS appoved JL. KAWASAN INDUSTRI JELITIK, KEC. SUNGAI LIAT , Bangka ANTON SALIM [email protected] KAB. BANGKA, Tin PT Refined Banka Tin PT Refined Bangka Tin INDONESIA RUA PORTO RICO S/N ‐ CX POSTAL 134 ‐ SETOR 10 ‐ [email protected] ARIQUEMES ‐ RO ‐ CEP 76876‐ Ariquemes Rondônia Carlos Mena (owner) m.br CFC Cooperativa dos Fundidores de Cassiterita da 080 Tin Smelter Not Listed Amazônia Ltda. BRAZIL LINHA C 75, 0 CEP 76870‐971 Ronaldo Barbacena (General gerencia.adm@coopermeta COOPERMETAL ‐ Cooperativa Metalúrgica de ‐ ZONA RURAL ‐ ARIQUEMES ‐ Ariquemes Rondônia Manager) lro.com.br Tin Smelter Not Listed Rondônia Ltda. BRAZIL RO Jl. Hang Tuah No 4 Abrun Prayun Karimun‐Kep. Riau Abrun Abubakar Tin PT Tambang Timah PT Tambang Timah INDONESIA 2IDN049 <[email protected]> Indonesia YUNNAN CHENGFENG NON‐FERROUS METALS 131 Baita Road Kunming Yunnan HONGWU,DU [email protected] Tin Yunnan Chengfeng Non‐Ferrous Metals Co Ltd CO.,LTD CHINA RECYCLED RECYCLED BY CHINA 121 E Jinhu Road Gejiu City Yunnan Mr. Lei [email protected] Tin Yunnan Tin Company Limited Yunnan Tin Company Limited CHINA 2CHN048 China ul. Zakładowa 50, 39‐400 Tarnobrzeg Mr. Collin Hibbs [email protected] Tin Smelter Not Listed FENIX METALS POLAND Ikuno‐cyo Kuchiganaya Asago‐shi Hyogo Prefecture Mamoru Minami [email protected] Tin Mitsubishi Materials Corporation Mitsubishi Material JAPAN recycled recycled Tin PT Belitung Industri Sejahtera PT Belitung Industri Sejahtera INDONESIA Yos Sudarso No. 88, Sunter Jakarta Utara Propinsi DKI Jaya 62‐21‐65314730 Bangka,Jawa Barat Indonesia ‐ Artesian Rodovia 421, Km 1,1 nº 917 CEP 76877‐073 | Cx Postal: Ariquemes Rodovia Mr. Marcelo Camargo [email protected] 433 Tin Smelter Not Listed White Solder Metalurgia BRAZIL 2BRA054 Ariquemes, Rodovia Brazil JL. TPI PANGKALPINANG BANGKA BELITUNG Tin UNITED SMELTER UNITED SMELTER INDONESIA Smelter contact details not disclosed by trader Fen Shi Xiang Nan An Cun LinWu Comte Chenzhou Hunan Mr Yuan [email protected] Tin Smelter Not Listed LINWU XIANGGUI MINERAL SMELTING CO.,LTD CHINA Tungsten Global Tungsten & Powders Corp Global Tungsten & Powders Corp UNITED STATES 4USA007 Tungsten HC Starck GmbH HC Starck GmbH GERMANY 4DEU008 Jiangxi Rare Earth & Rare Metals Tungsten Group Jiangxi Rare Earth & Rare Metals Tungsten Group Tungsten Corp Corp CHINA 4CHN009 Tungsten Jiangxi Tungsten Industry Co
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