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FOREVERMARK 001:2015 DIAMOND PIPELINE INTEGRITY CHECKLIST

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FOREVERMARK 001:2015

DIAMOND PIPELINE INTEGRITYCHECKLIST

Management System forForevermark

FOREVERMARK – DIAMOND PIPELINE INTEGRITYFM001:2015

Document Reference No: SGS01

Date: dd/mm/yyyy Job No: <...> Visit: <insert sequential visit number>

Assessor: name(s) Pipeline entity name and address:

<...> <...>

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(FOREVERMARK 001:2015)

Assessment Checklist

Lead Assessor Summary – to include statement of compliance and correction actions.

Statement of Compliance

Number of non-conformities identified Material: <...> Major: <...> Minor: <...>

Pipeline Stages – to be specified by Lead Assessor

Stage 1 Stage 2 Stage 3

Pipeline Name: Diamantaire name <...>

Pipeline Address: <...>

<...>

Pipeline Tel. & Fax: <...>

Pipeline Contact: <...> Pipeline Assessor: <...>

<...>

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Diamond Pipeline Integrity Specification Forevermark 001:2015Management System Checklist Guidance

Assessor to complete Checklist as comprehensively as possible providing Observations & Objective evidence against relevant clauses of the Management System for Forevermark 001:2015.

If a documented procedure exists which satisfies a clause, then the Document Reference should be stated in the observations.

If a clause can be demonstrated through satisfactory observation & objective evidence to be in conformance then “Yes” can be stated in the column titled “Conformance”. Conversely “No” would apply to a Non Conformance.

Photographs and computer data records can be submitted as supplementary objective evidence by attachment to the Checklist.

Where a non-conformance is noted, this should be clearly written into the column titled “Observations & Objective evidence” and a duplicate statement written on to the Corrective Action Plan.

When answering the Diamond Pipeline Integrity Specification Forevermark 001:2015 Management System Checklist, if more space is required for your answer other than the allocated space – add the overflow of the answer into the “Opportunity to feedback to the Verifier” section (on page 18 of 18 of this document). Alternatively, provide the Verifier a separate Word document, clearly referencing the section the overflow that the answer comes from.

Audit Checklist Definitions

Assessment: Systematic, independent and documented process for obtaining assessment evidence and evaluating objectively to determine the extent to which assessment criteria are fulfilled.

Assessment Programme: Set of one or more assessments planned for a specific time frame and directed towards a specific purpose.

Corrective Action: Action to eliminate the cause of a detected non conformity or other undesirable situation.

Inspection: Conformity evaluation by observation and judgement accompanied as appropriate by measurement, testing or gauging.

Nonconformity: Non fulfilment of a requirement.

Objective Evidence: Data supporting the existence of something. Objective evidence may be obtained through observation, measurement, test or other means. Pipeline entities may provide computer data records and photographs in support of objective evidence.0

Observation: Witness of an object or activity.

Preventive Action: Action to eliminate the cause of a potential non conformity or other undesirable situation.

Procedure: Specified way to carry out an activity or a process. This may be in the form of a documented procedure detailing associated resources applied by whom and when to a product or process.

Record: Document stating results achieved or providing evidence of activities performed.

Statement of Compliance: Outcome of the assessment provided by the Assessor after consideration of the assessment compliance criteria and all assessment findings.

System: Set of interrelated or interacting elements.

Applicability of Questions

Questions with no shading should apply to all entities, unless specific reasons apply. Where a question is marked N/A the assessor would clearly define the reason for this.

Questions shaded pink only apply to entities with buying and sales operations.Questions shaded blue only apply to entities with cutting/polishing or other manufacturing type activities.

PLEASE NOTE:

If the most recent annual BPP Workbook has been completed for the entity being assessed for Pipeline Integrity, then the listed sections and questions below do not need to be answered in full in this Checklist document and you can refer to the relevant BPP Workbook. If this is not the case, please complete in full. PLEASE BE AWARE THAT THE SGS AUDITOR WILL VERIFY THESE SECTIONS AND QUESTIONS DURING THE PIPELINE INTEGRITY ONSITE AUDIT: 6.b Section 7 Section 19.a.ii

For Tier B operations the focus of the assessment is on the implementation and practice of applicable points. Documented policies and procedures are not necessarily a requirement as long as the entity can evidence compliance through its practices.

Forevermark 001: 2015 – Diamond Pipeline Integrity Checklist Page 3 of 18

FOREVERMARK – DIAMOND PIPELINE INTEGRITYFM001:2015

Document Reference No: SGS01

Date: dd/mm/yyyy Job No: <...> Visit: <insert sequential visit number>

Assessor: name(s) Pipeline entity name and address:

<...> <...>

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RequirementStandard Clause Ref

Document reference (list below)

Conformance Yes/No Observations & Objective Evidence

Section 1 – Assessment Overview

1a Assessment ProceduresWhat is your system for carrying out pipeline integrity assessments?

8.1 <...> <select> <...>

1b i Programme of AssessmentsWhat is the planned programme for carrying out pipeline integrity assessments?

6.3 <...> <select> <...>

1b ii What is the assessment frequency?

<...> <select> <...>

Section 2 – Assessment Procedure

2 What are your Pipeline Integrity Assessment and Verification Procedures?

8.2 <...> <select> <...>

Section 3 – Interview at Facility

3a i Forevermark facility InterviewDoes the (Applicant or Participant) allow the Verifier access to all the Pipeline Entities?

6.3 <...> <select> <...>

3a ii Is there full access for the verifier to visit appropriate members of the Pipeline Entities?

<...> <select> <...>

Section 4 – Pipeline Integrity Assessment

4a Pipeline Integrity Assessment of Forevermark 001:2015Is the organisation referring to Management System for Forevermark (FM001:2015) Annex A?

8.2 <...> <select> <...>

Forevermark 001: 2015 – Diamond Pipeline Integrity Checklist Page 4 of 18

FOREVERMARK – DIAMOND PIPELINE INTEGRITYFM001:2015

Document Reference No: SGS01

Date: dd/mm/yyyy Job No: <...> Visit: <insert sequential visit number>

Assessor: name(s) Pipeline entity name and address:

<...> <...>

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RequirementStandard Clause Ref

Document reference (list below)

Conformance Yes/No Observations & Objective Evidence

4b i De Beers Best Practice PrinciplesIs there a recently completed BPP workbook? Is there a self declaration of compliance with BPP?

<...> <select> <...>

4b ii Does the organisation make best endeavours to ensure that any eligible diamonds that are given to associated entities which are outside the jurisdiction of the Forevermark Standard fully comply with BPP?

<...> <select> <...>

Section 5 – Internal Assessments

5 Has the Review of Pipeline Integrity by the Internal Assessor been completed?

8.1 <...> <select> <...>

Section 6 – Control procedures and implementation

6a Management SystemsWhat procedures are in place throughout all stages of the Pipeline to comply with the Forevermark 001:2015?

8.2.2 <...> <select> <...>

6b Does the facility have policies and/or procedures addressing the following:

<...> <select> <...>

• Addressing money laundering, terrorism financing and other financial offences?

<...> <select>

• Providing confidence that unusual or suspicious transactions are identified

<...> <select>

• Full disclosure of treated diamonds, synthetics or simulants?

<...> <select>

• Child Labour <...> <select>

• Employment Conditions <...> <select>

• Freedom of Association and Collective Bargaining

<...> <select>

• Equal Opportunities <...> <select>

• Discipline and Grievances <...> <select>

• Abuse of Drugs, Alcohol and illegal substances

<...> <select>

Forevermark 001: 2015 – Diamond Pipeline Integrity Checklist Page 5 of 18

FOREVERMARK – DIAMOND PIPELINE INTEGRITYFM001:2015

Document Reference No: SGS01

Date: dd/mm/yyyy Job No: <...> Visit: <insert sequential visit number>

Assessor: name(s) Pipeline entity name and address:

<...> <...>

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RequirementStandard Clause Ref

Document reference (list below)

Conformance Yes/No Observations & Objective Evidence

6b i Internal Communications and ReportingWhat internal communications and reporting systems are in place within the Pipeline Entity and between entities within the pipeline?

<...> <select> <...>

6b ii How have relevant personnel been made aware of all applicable procedures including:

• AML• Kimberley Process• Disclosure Requirements• Health & Safety• Human Rights

<...> <select> <...>

6c i Interview & RecordWho is responsible for updating approving and releasing procedures?

8.1.2 & 8.2.2

<...> <select> <...>

6c ii What evidence is provided to confirm that staff have read and understood the procedures?

8.2.5 <...> <select> <...>

6c iii How do you ensure the accuracy, content and robustness of data and reports produced with respect to pipeline integrity?

8.2.4 <...> <select> <...>

6c iv Inspection: Show me where archived records are stored for the duration of the programmes?

8.2.4c <...> <select> <...>

6d i System Track & LocationIs there a system that enables tracking and location of an Eligible Diamond anywhere in the pipeline at any given time?

8.2.3 <...> <select> <...>

6d ii Is there evidence that all diamonds put into Forevermark have been sourced from Approved Suppliers?

6.1.1 & 8.2.3a

<...> <select> <...>

Forevermark 001: 2015 – Diamond Pipeline Integrity Checklist Page 6 of 18

FOREVERMARK – DIAMOND PIPELINE INTEGRITYFM001:2015

Document Reference No: SGS01

Date: dd/mm/yyyy Job No: <...> Visit: <insert sequential visit number>

Assessor: name(s) Pipeline entity name and address:

<...> <...>

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RequirementStandard Clause Ref

Document reference (list below)

Conformance Yes/No Observations & Objective Evidence

Section 7 – Responsible Business Practice

7a AML – DisclosureDoes the facility adhere to all relevant regulations with respect to reporting cash and similar non-cash transactions in excess of US$10,000 (or a different threshold as set by relevant applicable law?

Does this extend to reporting suspicions?

<...> <select> <...>

7b Kimberley ProcessDo all invoices for rough and polished diamonds or diamond jewellery received and/or issued by the company contain appropriate declarations?

<...> <select> <...>

7c Has the local Kimberley Process Authority denied the company/entity/facility an export certificate or detained any imported shipments within the Assessment period?

<...> <select> <...>

7d RecordsAre records maintained for the relevant period of time?

<...> <select> <...>

7eDoes the facility have all required policies, procedures and risk assessments in relation to possible contamination points to prevent an undisclosed synthetic entering its natural diamond supply chain?

<...> <select> <...>

7fDoes the facility have auditable systems in place to ensure that the pipeline risk assessment, policies, procedures and training are current, active and effective?

<...> <select> <...>

7gIs there evidence that the facility has implemented the required screening of eligible diamonds in accordance with the De Beers Group BPP Standard Guidance on Undisclosed Synthetics prior to despatch for inscription?

<...> <select> <...>

Forevermark 001: 2015 – Diamond Pipeline Integrity Checklist Page 7 of 18

FOREVERMARK – DIAMOND PIPELINE INTEGRITYFM001:2015

Document Reference No: SGS01

Date: dd/mm/yyyy Job No: <...> Visit: <insert sequential visit number>

Assessor: name(s) Pipeline entity name and address:

<...> <...>

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RequirementStandard Clause Ref

Document reference (list below)

Conformance Yes/No Observations & Objective Evidence

Section 8 – Responsible Employment Practices

8a Working HoursDo working hours comply with legal requirements in terms of:

6.2 <...>

• Total Hours <...> <select>

• Overtime being voluntary <...> <select>

• Provision of rest days <...> <select>

8b WagesDo workers wages meet legal requirements in terms of:

<...>

• Minimum wage <...> <select>

• Overtime pay <...> <select>

• Pay for holidays etc. <...> <select>

8c DiscriminationIs there evidence of any discrimination?

<...> <select> <...>

8d DisciplineIs there evidence of any deductions or other harsh disciplinary procedures?

<...> <select> <...>

8e i Health & Safety – ManagementHas a manager been appointed with responsibility for health & safety with sufficient seniority?

<...> <select> <...>

Forevermark 001: 2015 – Diamond Pipeline Integrity Checklist Page 8 of 18

FOREVERMARK – DIAMOND PIPELINE INTEGRITYFM001:2015

Document Reference No: SGS01

Date: dd/mm/yyyy Job No: <...> Visit: <insert sequential visit number>

Assessor: name(s) Pipeline entity name and address:

<...> <...>

Page 9: FM Diamantaire pipeline inte…  · Web viewManagement System . Checklist. ... provide the Verifier a separate Word document, clearly referencing the section the overflow that the

RequirementStandard Clause Ref

Document reference (list below)

Conformance Yes/No Observations & Objective Evidence

8e ii Health & Safety – FireIs there evidence of sufficient, properly maintained fire prevention measures including exits, fire fighting equipment, training and regular drills?

<...> <select> <...>

8e iii Health & Safety – First AidAre there sufficient, properly trained first aiders and first aid supplies?

<...> <select> <...>

8e iv Health & Safety – Hygiene and WelfareAre there sufficient facilities covering:

<...>

• Toilets <...> <select>

• Potable water <...> <select>

• Canteens and rest areas <...> <select>

• Ventilation and lighting <...> <select>

8e v Health & Safety – Worker ProtectionIs all equipment properly installed and guarded? Are workers provided with relevant PPE free of charge?

<...> <select> <...>

8e vi Health & Safety – Chemicals and WasteAre there adequate and safe facilities for the disposal of chemicals and waste (for example, used acid, etc)?

<...> <select> <...>

8f Child LabourIs the facility complying with all legislation concerning child labour and the protection of minors?

<...> <select> <...>

Forevermark 001: 2015 – Diamond Pipeline Integrity Checklist Page 9 of 18

FOREVERMARK – DIAMOND PIPELINE INTEGRITYFM001:2015

Document Reference No: SGS01

Date: dd/mm/yyyy Job No: <...> Visit: <insert sequential visit number>

Assessor: name(s) Pipeline entity name and address:

<...> <...>

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RequirementStandard Clause Ref

Document reference (list below)

Conformance Yes/No Observations & Objective Evidence

8g Forced LabourIs there any evidence of forced labour, e.g. retention of deposits or important documents, restrictions on movement or leaving the company, forced overtime?

<...> <select> <...>

Section 9 – Management Systems

9a Management System used for SegregationWhat system has been developed to ensure that segregation exists between Eligible Diamonds used in Forevermark and all other diamonds?

6.2b <...> <select> <...>

9b IdentificationWhat identification system has been developed to ensure that at all times the location of individual diamonds within Forevermark can be identified away from Non Eligible diamonds?

8.2.3c <...> <select> <...>

Section 10 – Control Systems

10a TraceabilityWhat traceability system is in place for enabling the tracing of either individual diamonds, or packets/parcels of diamonds from the rough purchase through to the marked product?

6.2b & 8.2.3

<...> <select> <...>

Forevermark 001: 2015 – Diamond Pipeline Integrity Checklist Page 10 of 18

FOREVERMARK – DIAMOND PIPELINE INTEGRITYFM001:2015

Document Reference No: SGS01

Date: dd/mm/yyyy Job No: <...> Visit: <insert sequential visit number>

Assessor: name(s) Pipeline entity name and address:

<...> <...>

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RequirementStandard Clause Ref

Document reference (list below)

Conformance Yes/No Observations & Objective Evidence

10b i Processing SummaryWhat process system is in place for recording rough to polished outcomes (batch processing summaries) for each rough purchase containing diamonds eligible for Forevermark?

6.2e <...> <select> <...>

10b ii Show me your production and stock control system?

Assessor: Note the type of stock control system in operation and report briefly on its essential control mechanisms.

List at least three rough purchases.

<...> <select> <...>

10c i Sample & RecordsShow a reasonable Number of samples (minimum 6 samples).

Do records correspond with diamond physical location?

Records should be viewed then the relevant diamond should be sought in the location specified. This should include all boundaries from rough purchase through to the marked product.

Diamonds in a particular location should be examined, then the records should be viewed for confirmation.

This should include all boundaries from marked product to rough purchase.

<...> <select> <...>

10c ii Interview & InspectionHow long are records maintained?

<...> <select> <...>

10c iii Where are records maintained? <...> <select> <...>

Forevermark 001: 2015 – Diamond Pipeline Integrity Checklist Page 11 of 18

FOREVERMARK – DIAMOND PIPELINE INTEGRITYFM001:2015

Document Reference No: SGS01

Date: dd/mm/yyyy Job No: <...> Visit: <insert sequential visit number>

Assessor: name(s) Pipeline entity name and address:

<...> <...>

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RequirementStandard Clause Ref

Document reference (list below)

Conformance Yes/No Observations & Objective Evidence

10d Interview & RecordsDo records refer to the original rough purchase?

<...> <select> <...>

Section 11 – Elimination of Anomalies

11a Elimination of Anomalies RecordsWhat is the system for ensuring that anomalies in the transfer of diamonds in the pipeline that occur as a result of day to day activities are corrected promptly?

6.3e <...> <select> <...>

11b When are corrections made? <...> <select> <...>

11c Show where records are stored? <...> <select> <...>

Section 12 – Reconciliation Records

12a i Reconciliation RecordsWhat is the system for ensuring reconciliation records are completed?

6.3f <...> <select> <...>

12a ii When are reconciliations made? <...> <select> <...>

12a iii Show where records are stored? <...> <select> <...>

Forevermark 001: 2015 – Diamond Pipeline Integrity Checklist Page 12 of 18

FOREVERMARK – DIAMOND PIPELINE INTEGRITYFM001:2015

Document Reference No: SGS01

Date: dd/mm/yyyy Job No: <...> Visit: <insert sequential visit number>

Assessor: name(s) Pipeline entity name and address:

<...> <...>

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RequirementStandard Clause Ref

Document reference (list below)

Conformance Yes/No Observations & Objective Evidence

12a iv Sample – Reasonable Number (minimum 6 reconciliation records.

Review a sample of reconciliation records to demonstrate whether it is complete and that the output is realistic.

<...> <select> <...>

12b i Communication to Forevermark of significant ChangesWhat is the system for informing Forevermark (17 Charterhouse Street, London, EC1N 6RA) of any changes that could affect the integrity of Forevermark and, more specifically, the integrity of Eligible Diamonds in the pipeline?

6.3j <...> <select> <...>

12b ii When was the last change in sub-contractor involved in the pipeline integrity?

<...> <select> <...>

12b iii Show records of such communications?

<...> <select> <...>

Section 13 – Authority Levels

13 Review of level of authority of personnel

8.2.5 <...> <select> <...>

Section 14 – Systems Operatives

14 Systems OperativesOperatives Interview – Check a Reasonable Number of operatives (minimum 6 Operatives).

8.2.5.1 <...> <select> <...>

Forevermark 001: 2015 – Diamond Pipeline Integrity Checklist Page 13 of 18

FOREVERMARK – DIAMOND PIPELINE INTEGRITYFM001:2015

Document Reference No: SGS01

Date: dd/mm/yyyy Job No: <...> Visit: <insert sequential visit number>

Assessor: name(s) Pipeline entity name and address:

<...> <...>

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RequirementStandard Clause Ref

Document reference (list below)

Conformance Yes/No Observations & Objective Evidence

14a What is your understanding of:i. Pipeline Entity’s correct operating procedures and policy?

ii. De Beers BPPs

iii. Forevermark 001:2015

<...> <select> <...>

14b What is your permitted limit of authority with respect to passwords, signatures and stamps?

<...> <select> <...>

Section 15 – Supervisors

15 SupervisorsSupervisors Interview – Check a Reasonable Number of supervisors (minimum 2 Supervisors).

8.2.5.2 <...> <select> <...>

15a What is your understanding of:i. Pipeline Entity’s correct operating procedures and policy?

ii. De Beers BPPs

iii. Forevermark 001:2015

<...> <select> <...>

15b What is your permitted limit of authority with respect to pass words, signatures and stamps?

<...> <select> <...>

Section 16 – Review of pipeline security

16a Review degree of security of the pipeline

SystemWhat security systems are in place to protect Eligible Diamonds and Forevermark Diamonds?

8.2.7 <...> <select> <...>

Forevermark 001: 2015 – Diamond Pipeline Integrity Checklist Page 14 of 18

FOREVERMARK – DIAMOND PIPELINE INTEGRITYFM001:2015

Document Reference No: SGS01

Date: dd/mm/yyyy Job No: <...> Visit: <insert sequential visit number>

Assessor: name(s) Pipeline entity name and address:

<...> <...>

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RequirementStandard Clause Ref

Document reference (list below)

Conformance Yes/No Observations & Objective Evidence

16b i ProceduresWhat procedures are in place specifying good practice with regard to process control, work in progress and stock control?

<...> <select> <...>

16b ii What are the control measures in place to change control system data without trace (e.g. is this function password protected)?

<...> <select> <...>

16b iii What are the control measures in place to prevent substitution or switching of diamonds and to identify quickly when diamonds are misplaced or wrongly located?

<...> <select> <...>

16b iv Do you have a computer data back up procedure?

<...> <select> <...>

16b v Do you have a Disaster Recovery Plan with respect to any potential computer system crash?

<...> <select> <...>

Section 17 – Review of packaging, transport and delivery

17a Review of packaging, transport and delivery

8.2.8 <...> <select> <...>

Forevermark 001: 2015 – Diamond Pipeline Integrity Checklist Page 15 of 18

FOREVERMARK – DIAMOND PIPELINE INTEGRITYFM001:2015

Document Reference No: SGS01

Date: dd/mm/yyyy Job No: <...> Visit: <insert sequential visit number>

Assessor: name(s) Pipeline entity name and address:

<...> <...>

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RequirementStandard Clause Ref

Document reference (list below)

Conformance Yes/No Observations & Objective Evidence

17b i System – Transport/Packaging/ LabellingWhat are the control systems in place for protection of the integrity of the diamonds after final inspection and testing, through to delivery to their destination (including compliance with import/export procedures)?

<...> <select> <...>

17b ii What are the control systems in place for packing, packaging and labelling processes?

<...> <select> <...>

17b iii What are the control systems in place for protection of the integrity of the diamonds after final inspection and testing, through to delivery to their destination (including compliance with import/export procedures)?

<...> <select> <...>

17b iv What are the control systems in place to demonstrate compliance with the Kimberley Process? (Rough diamond shipments only)

<...> <select> <...>

Section 18 – Responsibilities of Pipeline Entities Assessed

18a Responsibilities of the Pipeline Entity being assessed

8.1.2 <...> <select> <...>

18b ObservationDoes the Pipeline Entity under assessment provide guides, interpreters and all necessary assistance during the assessment?

<...> <select> <...>

Forevermark 001: 2015 – Diamond Pipeline Integrity Checklist Page 16 of 18

FOREVERMARK – DIAMOND PIPELINE INTEGRITYFM001:2015

Document Reference No: SGS01

Date: dd/mm/yyyy Job No: <...> Visit: <insert sequential visit number>

Assessor: name(s) Pipeline entity name and address:

<...> <...>

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RequirementStandard Clause Ref

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Conformance Yes/No Observations & Objective Evidence

18c Does the Pipeline Entity being assessed co-operate with the assessor with the Assessor and provide access to all Forevermark pipeline operations?

<...> <select> <...>

18d Who within the Pipeline Entity is responsible for initiating corrective and preventive actions as a result of the assessment findings?

(Name & position)

<...> <select> <...>

Section 19 – Assessment procedures

19a Programme of Assessments <...> <select> <...>

19a i Has the assessment programme been followed and is the programme up to date?

<...> <select> <...>

19a ii Is there evidence of financial accounts approved as being acceptable to international accounting standards, within the Assessment period, by an independent financial auditor with internationally accepted accounting qualifications?

<...> <select> <...>

Is there evidence that the financial auditors have been made aware of the legislation imposing special requirements on dealers in precious stones?

<...> <select> <...>

Is there appropriate internal and external monitoring of compliance measures including annual reconciliation by an appropriately qualified auditor?

<...> <select> <...>

19b Is there evidence that the assessments have been effective? Have corrective and preventative actions been taken as a result of findings from the assessments?

<...> <select> <...>

Forevermark 001: 2015 – Diamond Pipeline Integrity Checklist Page 17 of 18

FOREVERMARK – DIAMOND PIPELINE INTEGRITYFM001:2015

Document Reference No: SGS01

Date: dd/mm/yyyy Job No: <...> Visit: <insert sequential visit number>

Assessor: name(s) Pipeline entity name and address:

<...> <...>

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RequirementStandard Clause Ref

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Conformance Yes/No Observations & Objective Evidence

Section 20 – Assessor Overview

20 What are the Qualifications, independence and conduct of the assessor?

7.1.1 &7.1.2

<...> <select> <...>

Section 21 – Qualifications and training of Assessor

21a i Interview & RecordWho is the Assessor that performs regular assessment of pipeline integrity in accordance with the procedures set out in FM001:2015 (including, where appropriate assessments of the Associated Entities)?

7.1.1 &7.1.2

<...> <select> <...>

21a ii Show of the Assessor:1. CV of Assessor2. Organogram3. Job Description of Assessor4. Authority & Responsibilities

<...> <select> <...>

21b Show the Assessor’s training records?

<...> <select> <...>

21c If nominated assessor is a current employee.

<...> <select> <...>

21d Interview & RecordWhat departments is the Assessor responsible for?

<...> <select> <...>

Section 22 – Post assessment briefing

22a Post assessment briefingWas there a formal close meeting?

8.2.9 <...> <select> <...>

22b Was an attendance record completed?

8.2.9 <...> <select> <...>

Forevermark 001: 2015 – Diamond Pipeline Integrity Checklist Page 18 of 18

FOREVERMARK – DIAMOND PIPELINE INTEGRITYFM001:2015

Document Reference No: SGS01

Date: dd/mm/yyyy Job No: <...> Visit: <insert sequential visit number>

Assessor: name(s) Pipeline entity name and address:

<...> <...>

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RequirementStandard Clause Ref

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Conformance Yes/No Observations & Objective Evidence

22c Was a Corrective Action Plan completed?

8.2.9 <...> <select> <...>

Forevermark 001: 2015 – Diamond Pipeline Integrity Checklist Page 19 of 18

FOREVERMARK – DIAMOND PIPELINE INTEGRITYFM001:2015

Document Reference No: SGS01

Date: dd/mm/yyyy Job No: <...> Visit: <insert sequential visit number>

Assessor: name(s) Pipeline entity name and address:

<...> <...>

Page 20: FM Diamantaire pipeline inte…  · Web viewManagement System . Checklist. ... provide the Verifier a separate Word document, clearly referencing the section the overflow that the

Opportunity of Feedback to Verifier

<...>

Forevermark 001: 2015 – Diamond Pipeline Integrity Checklist Page 20 of 18

FOREVERMARK – DIAMOND PIPELINE INTEGRITYFM001:2015

Document Reference No: SGS01

Date: dd/mm/yyyy Job No: <...> Visit: <insert sequential visit number>

Assessor: name(s) Pipeline entity name and address:

<...> <...>