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Self-Assessment Survey

You are encouraged to take a self-assessment survey to determine if your organization meets the basic corporate social responsibility and sustainable development criteria, as required by Polpharma Group Polpharma Group Supplier Code of Conduct.
 
By completing the supplier self-assessment survey, you will be able to understand your level of compliance with the requirements defined in the Code. The survey serves as a pre-assessment only, and its results are confidential and accessible exclusively to Polpharma Group’s Purchasing Department.
Those of you who intend to start doing business with Polpharma Group are encouraged to check if your organization meets our basic requirements for suppliers. In the next stages of the implementation of the Code of Conduct the survey will be used as a tool for qualification of suppliers for cooperation.

In case of any technical issues, please report them by e-mail to: ankietapolpharma@polpharma.com
In case of any further questions, please send them on e-mail: ankietapytania@polpharma.com

You need to be a registered user to complete the supplier self-assessment questionnaire online.

Self-Assessment Questionnaire

Select the type of supplier

Select the type of company:

Self-Assessment Questionnaire

Address:

Manufacturing company location (if other than above):













Information on the company/business:

Company profile

Including all supplies and shipping goods and products (min. finished goods, raw materials, packaging, etc.).

Including the following groups of production materials consumed during production process, research and development work, as well as associated with purchase of licenses: raw materials for synthesis, active pharmaceutical substances, complementary substances, packaging materials, fully packaged finished dosage forms (license products), finished forms of "in-bulk" (license product).

Including materials and services: general services, HR, marketing, specialist, promotional, event and travel services.

Including the following goods and services: technical and engineering services, technical materials, replacement parts, machines and devices, laboratory services, IT, telecommunication and car fleet.










1. CONDITIONS OF EMPLOYMENT AND EMPLOYEE RIGHTS

1.1. Does the company have documented procedures pertaining to:
For instance, in the form of relevant provisions in agreements, work regulations or annexes to agreements concluded with employees or subcontractors.

Prevention of child labour?

Freedom of association?

Preventing discrimination?

Remunerations?

Working conditions?

1.2. Are minors employed in compliance with the national laws, excluding employment to perform health and safety hazardous work?*
1.3. Does the company employ people upon employment contracts, with specified working conditions?
It is expected that the company employs people upon employment contracts whenever justified by the type of work performed.
1.4. Have the employees been informed of the possibility of establishing trade unions or other employee right advocacy organisations?
1.5. Does the company provide a competency improvement training programme for employees?

*Basic criterion of compliance with Polpharma Group Supplier Code of Conduct.

2. OCCUPATIONAL HEALTH AND SAFETY

2.1. Does the company ensure safe and healthy working conditions for employees in compliance with standards and laws?*
Proper lighting is provided, workstations comply with ergonomic requirements, employees have access to a staff room / possibility to heat their meals, etc.
2.2. Does the company provide the employees with protective equipment against chemical, biological and physical hazards?*
2.3. Are the employees regularly trained in OHS?
2.4. Has the company implemented certified standards related to occupational health and safety management?

*Basic criterion of compliance with Polpharma Group Supplier Code of Conduct.

3. ENVIRONMENT

3.1. Does the company conduct business in compliance with relevant legal requirments ?*
Typical areas of such activities are emissions (into air, water and/or soil) or waste generation.
3.2. Does the company take action to limit the impact of its business on the environment, e.g. by protecting natural resources?





3.3. Has the company implemented certified standards related to environmental impact management?

*Basic criterion of compliance with Polpharma Group Supplier Code of Conduct.

4. MANAGEMENT AND ETHICS

4.1. Does the company have a Code of Conduct / Code of Ethics in place?

Are employees required to sign a declaration of having read and understood the Code?

Are employees educated in terms of practical application of the provisions of the Code?

For instance, trainings on Code principles, webinars, events for employees to promote the Code and ethical conduct

Are sanctions provided for non-compliance with the Code guidelines?

Do the provisions of the Code and sanctions for non-compliance with them (if any) refer to all employees equally?

4.2. Are the issues related to preventing corruption:

Regulated with the provisions of the Code of Conduct / Code of Ethics?

Regulated in separate internal documents?

For instance, in a special anti-corruption policy, procedure or other documents describing rules of conduct.

Does the company have documented anti-corruption procedure other than Code of Conduct/ Ethics?

4.3. Are the issues related to preventing conflicts of interest:

Regulated with the provisions of the Code of Conduct / Code of Ethics?

Regulated in separate documents?

Does the company have documented conflict of interest prevention procedure other than Code of Conduct/ Ethics?

4.4 Does the company have a system in place for reporting violations of the Code of Conduct / Code of Ethics? (if yes, please specify the tools)
The system should identify the manner of reviewing reports and mechanisms of preventing retaliation against whistleblowers.

Anonymous e-mail address / phone number – internally

Anonymous e-mail address / phone number – externally

Providing such a possibility is to provide additional confidentiality to the person reporting violations/concerns

A person was delegated to whom employees may report irregularities in confidence.

4.5. Does the company have documented procedures pertaining to risk management?
4.6. Has the organisation appointed a person at the top management level, responsible for sustainable development / corporate social responsibility?
4.7. Does the company have a sustainable development / corporate social responsibility strategy?
The strategy does not have to be a long and complex document. For instance, a written/formalised identification of objectives related to sustainable development in the short and the long term is sufficient.
4.8. Has the company introduced a Code of Conduct or Policy for its suppliers?
Company’s requirements to set to its suppliers, eg. in terms of management, working conditions and product quality, may be included not only in the Code, but also in the agreements with the supplier or special procedures signed by the supplier under the cooperation.
4.9. Has the company ever been subject to an external ethical audit?
Third party/ external ethical audit verifies the effectiveness of organisation management in the audited areas. An external ethical audit is considered best practice rather than a precondition to be compliant with the requirements of the Polpharmа Group Supplier Code of Conduct.

Date of last audit (please tick as appropriate)

Refers to all standards – if the company was audited for a number of standards, please specify the date of the most recent one.

Audit standard:





For instance, in line with client’s requirements, SGS Code of Conduct, International Classification for Standards (ICS), Fair Working Conditions (FWC), Worldwide Responsible Accredited Production (WRAP), Initiative Clause Sociale (ICS), etc.

4.10. Does the company have certified quality management systems?

*Basic criterion of compliance with Polpharma Group Supplier Code of Conduct.

1. CONDITIONS OF EMPLOYMENT AND EMPLOYEE RIGHTS

1.1. Does the company have documented procedures pertaining to:
For instance, in the form of relevant provisions in agreements, work regulations or annexes to agreements concluded with employees or subcontractors.

Prevention of child labour?

Freedom of association?

Preventing discrimination?

Remunerations?

Working conditions?

If the company does not have procedures related to the freedom of association, have employees been informed of the possibility of establishing organisations to represent their stance in dialogue with the employer?

The dialogue may be related to working conditions, remuneration, additional benefits, etc.
1.2. Are minors employed in compliance with the national laws, excluding employment to perform health and safety hazardous work?*
1.3. Does the company employ people upon employment contracts, with specified working conditions?
It is expected that the company employs people upon employment contracts whenever justified by the type of work performed.
1.4. Does the company have trade unions or other employee right advocacy organisations?
1.5. Does the company provide a competency improvement training programme for employees?

*Basic criterion of compliance with Polpharma Group Supplier Code of Conduct.

2. OCCUPATIONAL HEALTH AND SAFETY

2.1. Does the company have documented occupational safety procedures in place?*
2.2. Has the company implemented certified standards related to occupational health and safety management?
2.3. Does the company ensure safe and healthy working conditions for employees in compliance with standards and laws?*
Proper lighting is provided, workstations comply with ergonomic requirements, employees have access to a staff room/possibility to heat their meals, etc.
2.4. Does the company provide the employees with protective equipment against chemical, biological and physical hazards?*
2.5. Are the employees regularly trained in OHS?

*Basic criterion of compliance with Polpharma Group Supplier Code of Conduct.

3. ENVIRONMENT

3.1. Does the company conduct business in compliance with relevant legal requirments ?*
Typical areas of such activities are emissions (into air, water and/or soil) or waste generation.
3.2. Does the company have documented procedures and/or strategy in the area of environment protection?
The procedures should regulate mechanisms of environmental impact verification and/or key objectives and refer to the applicable regulations, including international regulations such as UE Directives (REACH, WEEE and others).
3.3. Has the company implemented certified standards related to environmental impact management?
3.4. Does the company take action to limit the impact of its business on the environment, e.g. by protecting natural resources?





*Basic criterion of compliance with Polpharma Group Supplier Code of Conduct.

4. MANAGEMENT AND ETHICS

4.1. Does the company have a Code of Conduct / Code of Ethics in place?

Are employees required to sign a declaration of having read and understood the Code?

Are employees educated in terms of practical application of the provisions of the Code?

For instance, trainings on Code principles, webinars, events for employees to promote the Code and ethical conduct

Are sanctions provided for non-compliance with the Code guidelines?

Do the provisions of the Code and sanctions for non-compliance with them (if any) refer to all employees equally?

4.2. Are the issues related to preventing corruption:

Regulated with the provisions of the Code of Conduct / Code of Ethics?

Regulated in separate internal documents?

For instance, in a special anti-corruption policy, procedure or other documents describing rules of conduct.

Does the company have documented anti-corruption procedure other than Code of Conduct/ Ethics?

4.3. Are the issues related to preventing conflicts of interest:

Regulated with the provisions of the Code of Conduct / Code of Ethics?

Regulated in separate documents?

Does the company have documented conflict of interest prevention procedure other than Code of Conduct/ Ethics?

4.4 Does the company have a system in place for reporting violations of the Code of Conduct / Code of Ethics? (if yes, please specify the tools)
The system should identify the manner of reviewing reports and mechanisms of preventing retaliation against whistleblowers.

Anonymous e-mail address / phone number – internally

Anonymous e-mail address / phone number – externally

Providing such a possibility is to provide additional confidentiality to the person reporting violations/concerns

A person was delegated to whom employees may report irregularities in confidence

4.5. Does the company have documented procedures pertaining to risk management?
4.6. Has the organisation appointed a person at the top management level, responsible for sustainable development / corporate social responsibility?
4.7. Does the company have a sustainable development / corporate social responsibility strategy?
The strategy does not have to be a long and complex document. For instance, a written/formalised identification of objectives related to sustainable development in the short and the long term is sufficient.
4.8. Does the company publish a Sustainable Development Report or a Corporate Social Responsibility Report?


4.9. Has the company introduced a Code of Conduct or Policy for its suppliers?
Company’s requirements to set to its suppliers, eg. in terms of management, working conditions and product quality, may be included not only in the Code, but also in the agreements with the supplier or special procedures signed by the supplier under the cooperation.
4.10. Has the company ever been subject to an external ethical audit?
Third party/ external ethical audit verifies verifies the effectiveness of organisation management in the audited areas. An external ethical audit is considered best practice rather than a precondition to be compliant with the requirements of the Polpharmа Group Supplier Code of Conduct.

Date of last audit (please tick as appropriate)

Refers to all standards – if the company was audited for a number of standards, please specify the date of the most recent one.

Audit standard:





For instance, in line with client’s requirements, SGS Code of Conduct, International Classification for Standards (ICS), Fair Working Conditions (FWC), Worldwide Responsible Accredited Production (WRAP), Initiative Clause Sociale (ICS), etc.

4.11. Does the company have certified quality management systems?

*Basic criterion of compliance with Polpharma Group Supplier Code of Conduct.