企业背景信息调查表_WWF-OPF_DD Form双语

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企业背景信息调查表(Corporate Background Information Form)

2017年10月版本

October 2017

目录 Table of Content

1. 企业背景信息表 Corporate Information List 1

2. 企业补充信息表 Attachment and Additional Information 8

企业背景信息表 Corporate Background Information Form

本调查表列出了WWF(世界自然基金会)-OPF(一个地球自然基金会)针对与贵企业合作事宜进行审慎调查所需的信息和文件。随着本项目进程和相关审慎调查工作的深化,可能会要求贵企业对相关问题进行深入解释、说明,以及进一步提供文件和材料。对此,WWF希望能够获得贵企业的理解和配合,促进审慎调查工作的顺利开展并完成。若贵企业对本次调查有任何疑问,请与WWF-OPF项目负责人联络。

The following form listed background information and documents requested by WWF(Worldwide Fund for Nature) – OPF(One Planet Fundation) in order to form a cooperative relationship with the corporation. As we progress with the cooperation and conduct further background check, the corporation may be required to provide explanation and elaboration on certain concerns and questions, and may be required to provide additional documents and materials. For the aforementioned reasons, WWF hope to reach an understanding with the corporation to ensure the swift completion of the background checking process. Please contact WWF-OPF project holder if the corporation has any question regarding inquiries made in this form.

请贵企业如实提供以下信息/文件:

Please provide information/documentations required below truthfully:

1.合作历史 Cooperation History



企业是否曾与WWF合作?

Has the corporation worked with WWF in the past?

(是(若是,请简述合作项目,时间,及WWF对接人员)

(否

(Yes (If yes, please describe the collaboration project briefly, specify the time and WWF contact person)

(No



企业是否曾与其他NGO/基金会合作?

Has the corporation worked with other NGO/Fundations?

(是(若是,请简述)

(否

(Yes(If yes, please describe briefly)

(No





2.联络信息 Contact Information



联系人姓名:

Name of the contact





岗位名称及岗位职责简介:

Title and Responsibilities:





电话:

Phone:





邮箱:

Email:







3.企业信息 Corporate Information



企业基本信息 Basic Information



企业名称:

Name of the Corporation





注册地址:

Registration Address





官方网址:

Official Website





企业类型(如私有企业/公有企业/有限***等):

Type of the Corporation (Private/Public/Co. Ltd.)





注册时间:

Time of Registration





开展业务的国家或地区:

Country or Region of Business:





主营业务:

Main Area of Business:





其他业务:

Other Business:





年营业额(人民币/美元):

Annual Income (RMB/USD)





员工总数:

Number of Staff





重***、参股企业情况:

Status of Important Branch Companies and Share-Holder Companies





最终控制方(若企业隶属于某大型企业时,需填写下述信息)

Ultimate Share Holder



企业名称:

Corporate Name





注册地址:

Address of Registration





官方网址:

Official Website





企业类型(如私有企业/公有企业/有限***等):

Type of the Corporation (Private/Public/Co. Ltd.)





注册时间:

Time of Registration





开展业务的国家或地区:

Country or Region of Business:





主营业务:

Main Area of Business:





年营业额(人民币/美元):

Annual Income





员工总数:

Number of Staff







4.合作意向 Collaboration Interests



合作基本信息 Basic Information of Collaboration



企业与WWF合作项目目标:

(若企业向WWF提供资金捐赠,请描述捐赠金额)

Goals of the Collaboration with WWF (If the corporate is donating to WWF, please describe the amount)





合作类型:

Type of Collaboration

(企业转型项目

(环保意识传播与提升

(Transformation Projects

(Raising awareness of environmental conservation



企业计划的合作项目时间:

Planned time of the collaboration





企业期望WWF答复是否合作的日期:

Expected Response Time from WWF





企业期望通过与WWF的合作获得哪些收获:

Expected Gains from the Collaboration with WWF





企业期望与WWF仅合作本项目或进一步长期合作:

Is the collaboration one-time only or possibly long term







5. 企业立场及业务 Corporate Perspective and Business



请企业完成以下方面的自评:Please complete the following self- evaluation of the corporate



涉及制造、销售或分销有争议的武器或其组件,包括集束炸弹、杀伤性地雷、生物或化学武器及核武器等

Involved in making, selling or partial selling of controversial weapons and their components, including cluster bombs, anti-personnel mines, biological, chemical and nuclear weapons.

(是 (否

(若是,请详述)

(Yes (No

(If Yes, please describe in detail)



涉及制造、销售或分销有争议的武器或其组件,包括军用物资和设备等

Involved in making, selling or partial selling of controversial weapons and their components, including military supply and devices.

(是 (否

(若是,请详述)

(Yes (No

(If Yes, please describe in detail)



涉及向儿童出售仿真武器

Involved in selling simulated weapons to children

(是 (否

(若是,请详述)

(Yes (No

(If Yes, please describe in detail)



涉及制造、销售或分销烟草或烟草产品

Involved in making, selling or partial selling of tabaco and related products

(是 (否

(若是,请详述)

(Yes (No

(If Yes, please describe in detail)



涉及参与生产、销售或分销色情商品

Involved in making, selling or partial selling of pornography

(是 (否

(若是,请详述)

(Yes (No

(If Yes, please describe in detail)



涉及制造、销售或分销国际禁令列示的产品,或违背野生动物保护规定的产品

Involved in making, selling or partial selling of products prohibited by international agreements, or products prohibited by wildlife protection regulations.

(是 (否

(若是,请详述)

(Yes (No

(If Yes, please describe in detail)



涉及参与赌场或赌博(不包括公益福彩)

Involved or participated in gambling or casinos

(是 (否

(若是,请详述)

(Yes (No

(If Yes, please describe in detail)



涉及侵犯人权或合谋侵犯人权

Involved in human rights violation or conspired to violate human rights

(是 (否

(若是,请详述)

(Yes (No

(If Yes, please describe in detail)



涉及强制或容许强制劳动

Involved in or tolerated forced labor

(是 (否

(若是,请详述)

(Yes (No

(If Yes, please describe in detail)



涉及雇佣或容许雇佣童工

Involved in hiring or tolerating child labor

(是 (否

(若是,请详述)

(Yes (No

(If Yes, please describe in detail)



涉及使用动物进行非医学实验

Involved in non-medical animal experiments

(是 (否

(若是,请详述)

(Yes (No

(If Yes, please describe in detail)



涉及使用涉危动物做医学实验

Involved in medical experiments using endangered animals

(是 (否

(若是,请详述)

(Yes (No

(If Yes, please describe in detail)



涉及生产、销售或分销核能装备

Involved in making, selling or partial selling of nuclear devices

(是 (否

(若是,请详述)

(Yes (No

(If Yes, please describe in detail)



未来有可能新建水坝

May build dams in the future

(是 (否

(若是,请详述)

(Yes (No

(If Yes, please describe in detail)



未来有可能在自然生态保护区新建基础设施(如铁路,机场等)

May build infrastructure (such as railway and airport) in nature reserves

(是 (否

(若是,请详述)

(Yes (No

(If Yes, please describe in detail)



在过去5年内,企业是否卷入环境事故、公共舆论热点、监管调查等事件中?

In the past five years, has the corporate been involved in environmental incidents, public hot spot events, supervised investigation or such events?

(是 (否

(若是,请详述)

(Yes (No

(If Yes, please describe in detail)



在过去5年内,企业是否进入政府机构/媒体发布的环境影响黑名单?

In the past five years, has the corporate been blacklisted by governmental organizations or the media?

(是 (否

(若是,请详述)

(Yes (No

(If Yes, please describe in detail)



在过去5年内,企业是否曾某某NGO的关注?NGO是否对企业有过评论?

In the past five years, has the corporate drawn attention from NGOs, has there been comments from NGOs about the corporate

(是 (否

(若是,请详述)

(Yes (No

(If Yes, please describe in detail)



在过去5年内,企业是否曾被媒体报道?(含纸媒/互联网)

In the past five years, has the corporate be reported by the media (including paper based and digital media)

(是 (否

(若是,请详述报道媒体、报道时间、报道内容等)

(Yes (No

(If Yes,Please provide the detail of the reporting media, the time and content of the report. etc.)



企业是否参与某贸易组织/游说团体?

Has the corporate been part of 内容过长,仅展示头部和尾部部分文字预览,全文请查看图片预览。 no obligation to confirm the validity of the provided information. ( ) assumes full responsibility for any conflict and all legal consequences caused by false information on ( ), WWF-China/OPF denies any such responsibilities.

公司名称(盖章):

Corporate Name (Official Stamp)

声明人(签名):

Contact Name (Signature)

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