Product declaration
This Product Declaration is an annex of the Supplier Declaration. In case you have signed the Supplier Declaration not longer than 2 years ago, it is not needed to sign it again.
In order to deliver sustainable products to our customers, we need to be sure our raw materials are positively defined according Cradle to Cradle®. Therefore we need information from our suppliers.
Next to Cradle to Cradle®, we also want to produce EPD’s where we need reliable LCA information, which is compliant with EN15804.
Please provide us with that information by completing and signing this document (incl. initials on every page) and the possible attachmentsfor each product Desso purchases from your company.
When we have received the completed forms, the information will be send to our assessor (currently EPEA) to assess the product with a view to two of the subjects for Cradle to Cradle® certification: Material Health and Material Reutilization.
The cooperation between Desso and the assessor aims at the development of Cradle to Cradle® products for technical or biological cycles for differentiation on the market place. The establishment of the quality of the product of Cradle to Cradle® requires positive definition of its composition and its production process and therefore information including and exceeding information contained typically in MSDS and Technical Data Sheets.
The sequence of interaction betweenthe assessor and the supplier will be typically:
Step 1:Transfer of information on the function and the composition of the product and its production process by the supplier or of alternatives regarded as environmentally superior for the same function: CAS-Number, percentage in the formulation, eventual specification of the production process.
Step 2:Feedback ofassessor on the capability to assess the product.
Step 3:Feedback of the supplier to answer possible additional questions from the assessor
Step 4:Statement by the assessor on the ABC-X-categorisation
The toxicological and ecotoxicological assessment will include the impact of the product on:
- the organisms likely to be exposed to the chemicals in current scenarios of material flows and in the perspective of material flow. Toxicity for mammals, aquatic organisms, higher soil organisms and micro-organisms.
- the succession of generations (mutagenicity, impact on fertility and reproduction)
- food chain (bioaccumulation)
Confidential data can be delivered on the basis of a secrecy agreement with Desso or with the assessor.
Material Input and Process Information Collection Form
PLEASE COMPLETE ONE FORM FOR EACH MATERIAL INPUT
GENERAL MATERIAL INPUT INFORMATION
Background on the material for reference and communication
NAME: TITLE:
ADDRESS:
CITY:
STATE/PROVINCE:
COUNTRY:
POSTAL CODE:
TELEPHONE:
FAX:
EMAIL:
ADDRESS PRODUCTION LOCATION:
CITY:
STATE/PROVINCE:
COUNTRY:
POSTAL CODE:
Load factor products to Desso: %
AVAILABLE (ATTACHED)NOT AVAILABLE (LIST REASON)
Product Declaration (v1.2)1 van 5
Printed copies are not controlled
The reference of the latest version is available on the purchase order
INGREDIENT AND COMPONENT DETAIL
Specific information about the material input
INGREDIENTS (INCL. ADDITIVES AND PIGMENTS, RESIDUAL MONOMERS) / CAS No[1] / C.I.[2] / EC No[3] / M% in product / % Post- Industrial[4] recycled content / % Post-Consumer4 recycled content / PRODUCTION LOCATION (address) / MEANS OF TRANSPORTATION / LOAD FACTOR / SVHC or C2C Banned List SUBSTANCE?[5]YES / NO
Composition completely listed (including all additives, pigments, etc.) / Composition not completely listed. 1) Please list reason:
2) SVHC or C2C Banned List substances5 incorporated (Yes/No)?
Product Declaration (v1.2)1 van 5
Printed copies are not controlled
The reference of the latest version is available on the purchase order
EPD (according to ISO 14025[6]) attached: YES / NO
If no EPD is available, is there an internal (not verified) LCA for your product available: YES / NO
- If yes: are you willing to share the results with us? YES / NO (If yes, please attach.)
- If no: are you willing to co-operate with Desso or any other trustee to build a life cycle inventory or a life cycle impact assessment for your product? YES / NO
Who within your company can be contacted for LCA issues and further proceedings concerning LCA? Please provide contact details:
Name:
Telephone number:
Mail address:
If any toxicological or ecotoxicological information available (exceeding the information in the MSDS), please list or attach / no information availableorganohalogen content / Yes, as follows: / no organohalogen content
no information available
metal contentological / Yes, as follows: / no metal content
no information available
TOTAL COMPANY / PRODUCT RELATED PER KG
Used electricity (GJ)
Green electricity (%)
Self-produced electricity (%)
Used gas (GJ)
Green gas (%)
Self-produced gas (%)
Water consumption (m3) + type:
drink / surface / ground / total / / / / /
Waste generated (ton) + categorisation (f.i. glass, wood, metal)
"As an authorized representative of the company, I verify that all responses provided are correct, based upon our currently available data. I am aware of the fact that random analysis will be possible"
Product Declaration (v1.2)1 van 5
Printed copies are not controlled
The reference of the latest version is available on the purchase order
[1] CAS registry number „Chemical Abstract Service“ are unique numerical identifiers for chemical compounds, polymers, biological sequences, mixtures and alloys.
[2] Colorants (dyes and pigments) are listed according to Colour Index Generic Names and Colour Index Constitution Numbers
[3] EC-No "European Commission number" is the seven-digit code that is assigned to chemical substances that are commercially available within the European Union.
[4] Material can be derived from an internal of external process, but must not be recycled within the same process where it is derived from; ‘recycling’ comprises some additional effort, like an additional cleaning step or mechanical grinding step or any other processing; (definition according ISO 14021).
[5] and
[6] An EPD is an external document that publishes the results of an LCA study conform ISO14041/44; The information is validated by an EPD program holder; LCA calculations are made according to rules that are agreed in an open stakeholder dialog, the so called “Product Categorization Rules”.