Supplier Declaration | Based Pizza

1

Supplier Information

Supplier Name *

ABN/Company Number *

Address *

Primary Contact Name *

Primary Contact Email *

Goods or Services Supplied *

A

Supply Profile

Primary Country of Origin/Manufacture (if applicable)

Do you use subcontractors? *

Yes

No

Do you use labour hire? *

Yes

No

B

Labour Standards

Please confirm the following:

We prohibit forced labour, servitude and human trafficking.

Yes

No

We prohibit child labour and hazardous child labour.

Yes

No

We do not withhold worker passports, IDs or immigration documents.

Yes

No

We do not charge recruitment fees to workers.

Yes

No

We pay wages in line with legal requirements.

Yes

No

We conduct right-to-work and proof of age checks where required.

Yes

No

C

Policies and Controls

We have written policies or documented controls covering the above standards.

Yes

No

We can provide evidence upon reasonable request.

Yes

No

D

Declaration

We confirm the information above is accurate and will notify Based Pizza of any material changes or identified risks relevant to goods or services supplied.

Name *

Title *

Signature (type full name) *

By typing your name, you are providing a legal electronic signature

Date *