ESG Supply Chain Checklist Form
Use this form to review a supplier’s ESG practices, supply chain scope, certifications, incidents, and overall compliance status.
Supplier Information
Legal Company Name
*
Main Contact Name
*
First Name
Last Name
Contact Email
*
example@example.com
Country/Region of Operations
*
Please Select
Afghanistan
Albania
Algeria
Andorra
Angola
Argentina
Australia
Austria
Bangladesh
Belgium
Brazil
Canada
China
France
Germany
India
Indonesia
Italy
Japan
Mexico
Netherlands
Nigeria
Philippines
Singapore
South Africa
South Korea
Spain
Sweden
United Arab Emirates
United Kingdom
United States
Vietnam
Other
Supply Chain Scope
Products/Services Supplied
*
Primary Sourcing Regions/Countries
*
North America
South America
Europe
Asia-Pacific
Middle East & Africa
Global
Other
Supply Chain Tier Coverage
*
Direct Supplier
Tier 2
Tier 3
Multiple Tiers
Other
ESG Checklist Evaluation
Environmental policy in place
*
Yes
No
Labor and human rights policy in place
*
Yes
No
Governance and compliance policy in place
*
Yes
No
Relevant ESG certifications held
ISO 14001
SA8000
ISO 45001
None
Other
Recent ESG incident or violation reported
*
Yes
No
Incident summary
Review Status and Notes
Overall Assessment Status
*
Compliant
Partially Compliant
Non-Compliant
Pending Review
Reviewer Comments or Corrective Actions Needed
Review Date
*
 -
Month
 -
Day
Year
Date
Submit
Should be Empty: