Development Impact Report. An annual report for each hospital and clinic project within 120 days of the financial year including: a. EBITDA for the past 12 months; b. Taxes paid to the government (both business taxes and income taxes) for the past 12 months; c. Number of employees; d. Number of female employees; e. Number of outpatients served; f. Number of inpatients treated; g. Number of staff trained; h. Cost of training provided to staff for the past 12 months (both an average per staff member and an aggregate amount); and i. Value of free or discounted treatment provided to patients for the past. Thank you for choosing DEG – Deutsche Investitions- und Entwicklungsgesellschaft mbH, Köln, as your financing partner. For more than 45 years, DEG has been financing and structuring the investments of private companies in developing and emerging market countries. An important part of DEG’s due diligence for all investments is to assess the environmental and social impacts of our lending and investments. We consider environmental protection, the sustainable use of natural resources and proper social standards to be fundamental factors in the process of ecological, economic and social development – and also a key factor for a successful long-term business operation. This Annual Environmental and Social Management Report (AESMR) has been designed as an easy and quick way for our clients to provide information to DEG so that we can understand the scale and significance of potential environmental and social issues. During project monitoring DEG will review this information and, if necessary, visit the project sites to discuss and evaluate environmental and social impacts with you and other stakeholders. In the unlikely event that significant issues are identified, it may be necessary to follow up with a closer investigation of these specific environmental and social aspects by further experts. All information will of course be treated confidentially. DEG’s review will be based on widely used and international recognized requirements laid out in (1) DEG’s environmental and social policies, guidelines and procedures and (2) World Bank/IFC guidelines as well as (3) the fundamental labor standards of the International Labor Organization (ILO). When filling out the AESMR, please keep in mind that it is designed to assist you in analyzing your company’s environmental and social situation. Please be as full and specific in your answers as possible and where appropriate attach additional information. The AESMR comprises three sections, namely Section A – Fact Sheet, Section B – Compliance Statements, and Section C – Additional Questions. Please complete both Section A and Section B and, depending on your responses to Section B, you may be required to complete certain corresponding questions in Section C. Please note, that DEG might well be in a position to assist you in circumstances requiring more detailed assessment and management of environmental and social issues. It is very important for our understanding of the answers provided that you define which system boundaries you are referring to. Environmental and social impacts may differ considerably, whether you are describing one single site or project, several sites or a company or even group of companies with varied activities and many locations. In general we would require you to describe the impacts and situation of the legal entity DEG is financing, i. e. all sites and facilities of the company implementing the financed activities or project. In some cases, especially when looking at a group of sites or companies, it might be convenient to fill out more than one questionnaire. Please complete Sections A and B (and as necessary Section C) as fully as you can. Consider especially the scope of the Company’s impacts which can include, (i) the Company’s physical assets and related facilities that the Company (and its contractors) develops or controls (such as transmission corridors and access roads), (ii) associated facilities which may not be funded by the Company but whose viability and existence depend exclusively on the Company and whose goods and services are essential to successful Company activities (for example captive power plants and dedicated supply chains), (iii) areas that could be affected by cumulative impacts from the combined activities of the Company and other activities. Please complete an AESMR for each site or operation related to the DEG support. If you have already prepared environmental and social audits of your sites and operation, you can also send us those. If you are part of a larger group of companies, please explain the management structures in place with regard to environmental and social issues. Some information has been filled in by DEG already; this information is based on information available on the project. Please check and confirm correctness or correct, if necessary. Please provide all information in the English language. If you have any questions or comments, please do not hesitate to contact your DEG contact person DEG contact information: Tel.: +00-000-0000-0 Investment Manager Xia Tian T-Ext.: 1754 F-Ext.: e-mail: Xxx.xxxx@xxxxxxxxx.xx Environmental/ Social Manager Xxxxxxxxx Xxxxxxx T-Ext.: 1539 F-Ext.: xxxxxxxxx.xxxxxxx@xxxxxxxxx.xx 62163708_8 1 September 2009 Company (incl. site details if different): Name/ Address/ Position: Phone Number: Fax Number: Website/ home page: Executive board member with responsibilities for environment and social issues: T-Ext.: F-Ext.: e-mail: Environmental & social contact person: T-Ext.: F-Ext.: e-mail: Occupational Health & Safety contact: T-Ext.: F-Ext.: e-mail: Human Resources and Social contact: T-Ext.: F-Ext.: e-mail:
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