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ENVIRONMENTAL QUESTIONNAIRE 2007 - Complete form online and submit or print a copy and mail it to us now. This may take about 15 minutes to complete, we thank you for your valued reponse.

Clarks Wood Co. Ltd* & Y. Goldberg & Sons Ltd - Silverthorne Lane, Bristol, BS2 0QJ, England.

Tel - +44 (0) 117 971 6316

Fax - +44 (0) 117 972 3119

Section A - Supplier Details

A1) Supplier - Full Trading Name:

A2) Company Postal Address:

A3) Environmental Contact: (Person responsible for the completion of this questionairre)

A4) Name of Managing Director/Chief Executive:

A5) Telephone number:

A6) Fax number:

A7) Email:


Section B - Supplier Purchasing Policy

B1) Does your Company have a written Environmental Procurement Policy?

If Yes please enclose copies Yes / No

If no, are you committed to any Code of Conduct or equivalent concerning Environmental matters?

(please give details):

Please enclose copies of your Code of Conduct.

B2) Are you aware of the WWF-UK Forest and Trade Network objectives? Yes / No WWF

B3) What is your policy on Illegal Timber and what action do you take to ensure that your supplies are from legal sources?

B4) Are certificates available which Independantly Verify that the timber products you supply are derived in accordance with the appropriate national criteria for sustainable forest management.

If yes, please enclose copies Yes / No

B5) Does your Company hold Internationally recognised Chain of Custody certificates ?

If yes, please provide copies Yes / No

Details of CoC certificate reference number:


Section C - Shipper Details

Following detail to be completed by or on behalf of Shipper. (Agencies to submit one form for each shipper)

C1) Name of Shipper

C2) Does (the shipper) have an Environmental Policy?

If yes please enclose copies Yes / No

If no, are (the shippers) committed to any Code of Conduct or equivalent concerning Environmental matters?

(please give details):

Please enclose copies of shippers Code of Conduct.

C3) Are (the shippers) aware of the WWF-UK Forest and Trade Network objectives? Yes / No WWF

C4) What is (the shippers) policy on Illegal Timber and what action is taken to ensure that supplies are from legal sources?

C5) Are certificates available which Independantly Verify that the timber products supplied are derived in accordance with the appropriate national criteria for sustainable forest management.

If yes, please enclose copies Yes / No

C6) Does (the shipper) hold Internationally recognised chain of custody certificates ?

If yes, please enclose copies Yes / No

C7) Please indicate the proportion (in %) of timber by volume derived from the following sources:-

a) Forests owned and/or managed by your company

%

b) Third Parties such as private owners, state forests, other timber companies

%

If you source timber from forests owned and/or managed by your company, please complete Section D.

If you source from third parties, please complete Section E.

If you source from a combination of both the above, please complete Sections D and E.


Section D - Forests Managed by The Shipper

(Please copy and complete this form for each Forest Management Unit managed by your company).

D1) Name of Forest Management Unit - (Forest Name)

D2) Location of Forest Management Unit - (Region and Country)

D3) Primary Mill Name

D4) Size of the Forest Management Unit

Hectares

D5) Does this suppliers source of timber comply with our purchasing policy? Yes / No

If yes please give details.

D6) Has the forest been certified to any sustainable forestry standards, for example the Forest Stewardship Council (FSC) or ISO14000? If yes please supply details. Yes / No

If yes please give full details.

D7) Is the Forest Managment Unit:

a) owned by your company? Yes / No

b) managed under license or concession agreement by company? Yes / No

If yes to (b) please specify who owns the forest

c) How long is the concession/license agreement for?

Years

D8) What type of Forest Management Unit?:

a) natural forest b) plantation c) other

If yes to (b) when was the plantation established

D9) Is there a management plan for the Forest Management Unit? Yes / No

If yes:

a) What subjects does the management plan cover?

b) What period does the management plan cover?

c) Has the plan been approved by a government agency or their representative? Yes / No

d) if required, is a copy of the plan available. Yes / No

D10) What is the species mix of the forest by volume and area?

D11) What is the commercial volume (by specie if possible)?

D12) What is the volume of commercial timber extracted annually (by specie if possible)?

m3/ha

D13) What is the cutting or rotation cycle?

Years

D14) What is the silvicultural system used?

Single tree selection / group selection / shelterwood / seed tree / clearcutting.

D15) How is forest regeneration accomplished?

Replanting / natural regeneration.

15) Are you involved in any State or Local Sustainable Forestry Initiatives Yes / No

If yes please give details


Section E - Where The Timber Is Purchased From A Third Party

E1) Please indicate the proportion (in %) of timber by volume that can be traced to

a) Country of origin

%

b) Region of origin

%

c) Forest of origin

%

E2) How many forests do you source from?

E3) Where the original forest of origin can be identified, what evidence (e.g. government certificates,management plans) can you provide to show that the forest(s) is/are being managed in an environmentally sound manner.

E4) Where the original forest of origin cannot be identified, what information have you sought from Third Party(ies) to ensure that the timber sold comes from an environmentally sound source?

E5) Do you intend to take any further action to check on or improve the environmental integrity of your suppliers? Yes / No

If yes, what action do you intend to take?


Questionairre completed by:

I certify that to the best of my knowledge, the information provided in this questionairre is correct.

(signature)

_______________________________________________________

Signature

(print)

On behalf of:

(company)

Date:

Copyright E-Forest Certification 2007 REF: SQ97/2007


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