#VALUE! BVCPS_SAC HIGG INDEX 4.

0_BOOKIN
THE BELOW SECTIONS MUST BE COMPLETED CLEARLY, ACCURATELY AND IN FULL, In
By which brand/client your factory is request for the verification?
(If multiple client pls list all with the main client at the 1st)
Factory/ Production Site Name (Worldy Platform Account Name)
Factory/ Production Site Name (Worldy Platform Account Name)in local language
Factory/ Production Site Worldy ID
Factory/ Production Site Detailed Address
Factory/ Production Site Detailed Address in local language
Contact Person Name
Contact Person Email Address
Contact Person Phone Number
Specific Production Process(Needs to be Detailed)
Products Produced

Mandatory Primary Language(s) Spoken by Management

Primary Language(s) Spoken by Employees
Type of Services Requested HIGG FEM Core V

Total Area Covered by the factory (㎡）

If the factory has Onsite ETP

If the factory meet below any (one or multiple) option?

*The factory is a fabric dyeing mill

Daily water consumption in the factory (including water consumption in

production and domestic water consumption) (m³/day)

If the factory has chemical used in production process(es)

Optional
Optional

If the factory ever performed third-party FEM verification previously?

If the fatory has finished and posted Higg FEM self-assessment to Worldly
platform?

We apply for the above services and agree that all services will be carried out subject to the Bureau Veritas Consumer Products Services quotation and/or proposal rece
stated on SHEET 3(page 3) <TERMS & CONDITIONS> of this form.
CPS_SAC HIGG INDEX 4.0_BOOKING FORM
BE COMPLETED CLEARLY, ACCURATELY AND IN FULL, In English

HIGG FEM Core Verification (Onsite)

If "YES", what’s the average daily treatment volume of your onsite ETP (m³/day)?

If "YES", pls list out the production process(es) during which the chemical is used
 If "YES", in which year(s)

If "YES", the overall self-assessment (FEM) score is 若是，自评总分是多少

au Veritas Consumer Products Services quotation and/or proposal received by our company as amended by the special terms and conditions
HEET 3(page 3) <TERMS & CONDITIONS> of this form.
SIGNATURE
COMPANY CHOP
DATE

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