Super Micro Computer, Inc. | Gift & Gratuities Exchange Disclosure

Name & Contact Information

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First Name

M.I.

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Last Name

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Job Title

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Employee ID

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Phone Number (Preferred)

Include the area code, extension, and/or dialing codes if applicable.

Phone Number (Alternative)

Include the area code, extension, and/or dialing codes if applicable.

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Email

Format: username@domain.com

Reporter

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Are you entering the report on behalf of another individual?

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Role (In the Exchange)

Presenter Recipient

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Attention

During the exchange, if you are both a recipient and a presenter, you will need to complete separate disclosure for each role.

Name & Contact Information

Prefix

Select One

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First Name

M.I.

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Last Name

Job Title

Employee ID

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Phone Number (Preferred)

Include the area code, extension, and/or dialing codes if applicable.

Phone Number (Alternative)

Include the area code, extension, and/or dialing codes if applicable.

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Email

(Format: username@domain.com)

Location

Click the button labeled Look-Up to locate and select a location.

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Name

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Branch

Address

City

St./Prv.

Zip/Pst. Code

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Country

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Organization & Contact Information

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Role (In the Exchange)

(This value is based off of the Role of the Reporter in this exchange as selected above.)

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Relationship to the Company

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Organization / Entity Name

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Job Title

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Is the Outside Party an official or employee of a government entity or a foreign government?

Yes No

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Prefix

Select One

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First Name

M.I.

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Last Name

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Phone Number (Preferred)

Include the area code, extension, and/or dialing codes if applicable.

Phone Number (Alternative)

Include the area code, extension, and/or dialing codes if applicable.

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Email

Format: username@domain.com

Date

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Approximate Date of Exchange

Format: mm/dd/yyyy

Purpose

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Purpose of Exchange

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Items Exchanged

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Using the input controls below, create a list of records.

(At least one record is required.)

	Name▼	Type of Item	# Rcpt.	$ Value	Total

Type of Item

*

Classification

*

Define Other Type of Item

*

Description:
Cash or cash equivalents, e.g. gift cards, no matter the amount. Exception: If an employee chooses to attend a vendor sponsored event on their own time, and the Company is not requiring, encouraging or paying the employee to attend, the employee may accept a Cash or Equivalent distributed at the training event as long as the amount is no greater than $50 USD.

Description:
Goods or services for the Company or are involved in the procurement process, you must treat all suppliers uniformly and fairly. In deciding among competing suppliers, you must objectively and impartially weigh all facts and avoid even the appearance of favoritism. For this reason, gifts from suppliers or vendors must not be accepted, except advertising or promotional items of nominal value such as a pen, key chain, water bottle, visor cup or glass, or similar item displaying a company's logo. Established routines and procedures should be followed in the procurement of all goods and services.

Description:
Occasional meals, refreshments, entertainment and other business courtesies (sometimes including spouses) are permitted as long as the cost is reasonable, the activity is clearly related to and necessary for the Company's business, and the vendor is in attendance. Invitations for excessive or extravagant entertainment and/or without a specific business purpose must be declined. Local sporting events are permitted in this category. Note: A major sporting event, such as the Super Bowl, World Cup, or Kentucky Derby, are never considered a local event and thus not permitted under this heading.

Description:
Acceptable if it is for vendor convenience, the vendor is in attendance, the travel is not extravagant, there is a clear business purpose, and the travel is limited to that business purpose.

Description:
Any other Gift or Courtesy not referenced within the Company Policy or you feel may need further review to ensure policy guidelines are not being compromised.

Name of Item

*

Recipients

*

Value/Rcpt.

*

Total

*

Provide a detailed description of the item or business courtesy exchanged.

*

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Type of Item

Select One

Description:
Cash or cash equivalents, e.g. gift cards, no matter the amount. Exception: If an employee chooses to attend a vendor sponsored event on their own time, and the Company is not requiring, encouraging or paying the employee to attend, the employee may accept a Cash or Equivalent distributed at the training event as long as the amount is no greater than $50 USD.

Description:
Goods or services for the Company or are involved in the procurement process, you must treat all suppliers uniformly and fairly. In deciding among competing suppliers, you must objectively and impartially weigh all facts and avoid even the appearance of favoritism. For this reason, gifts from suppliers or vendors must not be accepted, except advertising or promotional items of nominal value such as a pen, key chain, water bottle, visor cup or glass, or similar item displaying a company's logo. Established routines and procedures should be followed in the procurement of all goods and services.

Description:
Occasional meals, refreshments, entertainment and other business courtesies (sometimes including spouses) are permitted as long as the cost is reasonable, the activity is clearly related to and necessary for the Company's business, and the vendor is in attendance. Invitations for excessive or extravagant entertainment and/or without a specific business purpose must be declined. Local sporting events are permitted in this category. Note: A major sporting event, such as the Super Bowl, World Cup, or Kentucky Derby, are never considered a local event and thus not permitted under this heading.

Description:
Acceptable if it is for vendor convenience, the vendor is in attendance, the travel is not extravagant, there is a clear business purpose, and the travel is limited to that business purpose.

Description:
Any other Gift or Courtesy not referenced within the Company Policy or you feel may need further review to ensure policy guidelines are not being compromised.

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Name of Item

(Examples: Round trip airfare PXD to ORD, Tickets to Cubs game, Concessions at Concert, Logoed swag, etc…)

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Recipients

(1-1000)

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Value/Rcpt.

$

( #.##)

Total

$

Provide a detailed description of the item or business courtesy exchanged.

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Additional Information

Provide any additional information that could be valuable in the evaluation of this exchange.

Acknowledgment

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Acknowledgment

I hereby represent that the information contained in this report is true and accurate. By completing and submitting this disclosure form I understand the information will be made available for review annually by the Company's executive leadership.

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