Conflict Minerals Reporting Template (CMRT)  
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English   Revision 6.4
April 26, 2024
 
  The purpose of this document is to collect sourcing information on tin, tantalum, tungsten and gold used in products Link to Terms & Conditions  
A  
  Mandatory fields are noted with an asterisk (*).  Consult the instructions tab for guidance on how to answer each question.  
  Company Information  
  Company Name (*):   Metal Surfaces International, LLC.   
  Declaration Scope or Class (*):   A. Company        
  Description of Scope:   Company-wide  
     
  Company Unique ID:   DUNS 00-835-8145  
  Company Unique ID Authority:   0  
  Address:   6060 Shull St, Bell Gardens, CA 90201 USA  
  Contact Name (*):   Sam Bell  
  Email – Contact (*):   sbell@metalsurfaces.com  
  Phone – Contact (*):   562-927-1331  
  Authorizer (*):   Sam Bell  
  Title - Authorizer:   Environmental Compliance Manager  
  Email - Authorizer (*):   sbell@metalsurfaces.com  
  Phone - Authorizer:   562-927-1331  
  Effective Date (*):   23-Jul-2024    
   
  Answer the following questions 1 - 8 based on the declaration scope indicated above  
  1) Is any 3TG intentionally added or used in the product(s) or in the production process? (*) Answer Comments        
  Tantalum     No    
  Tin  (*)   Yes    
  Gold  (*)   Yes    
  Tungsten     No    
           
  2) Does any 3TG remain in the product(s)? (*) Answer Comments        
  Tantalum        
  Tin  (*) Yes    
  Gold  (*) Yes    
  Tungsten        
   
  3) Do any of the smelters in your supply chain source the 3TG from the covered countries? (SEC term, see definitions tab) (*) Answer Comments    
  Tantalum        
  Tin  (*) Yes    
  Gold  (*) No    
  Tungsten        
   
  4) Do any of the smelters in your supply chain source the 3TG from conflict-affected and high-risk areas? (*) Answer Comments        
  Tantalum        
  Tin  (*) Yes    
  Gold  (*) No    
  Tungsten        
   
  5) Does 100 percent of the 3TG (necessary to the functionality or production of your products) originate from recycled or scrap sources?  (*) Answer Comments        
  Tantalum        
  Tin  (*) No    
  Gold  (*) No    
  Tungsten        
   
  6) What percentage of relevant suppliers have provided a response to your supply chain survey?  (*) Answer Comments        
  Tantalum          
  Tin  (*)   100%    
  Gold  (*)   100%    
  Tungsten          
                 
  7) Have you identified all of the smelters supplying the 3TG to your supply chain?  (*) Answer Comments    
  Tantalum        
  Tin  (*) Yes    
  Gold  (*) Yes    
  Tungsten        
   
  8) Has all applicable smelter information received by your company been reported in this declaration?  (*) Answer Comments  
  Tantalum          
  Tin  (*)   Yes    
  Gold  (*)   Yes    
  Tungsten            
   
  Answer the Following Questions at a Company Level  
  Question   Answer   Comments    
  A. Have you established a responsible minerals sourcing policy? (*)   Yes      
           
  B. Is your responsible minerals sourcing policy publicly available on your website? (Note – If yes, the user shall specify the URL in the comment field.) (*)   Yes   https://www.metalsurfaces.com/customer-service  
                 
  C. Do you require your direct suppliers to source the 3TG from smelters whose due diligence practices have been validated by an independent third party audit program? (*)   Yes      
                 
  D. Have you implemented due diligence measures for responsible sourcing? (*)   Yes      
                 
  E. Does your company conduct Conflict Minerals survey(s) of your relevant supplier(s)? (*)   Yes, in conformance with IPC1755 (e.g., CMRT)      
   
  F. Do you review due diligence information received from your suppliers against your company’s expectations? (*)   Yes      
           
  G. Does your review process include corrective action management? (*)   Yes      
           
  H. Is your company required to file an annual conflict minerals disclosure? (*)   No      
   
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