The Director General



The Director General

SRI LANKA STANDARDS INSTITUTION

I/We hereby apply for a certification of Good Manufacturing Practices used in ………………………………………………………………………………………………………

(Name of Applicant Company)

Relevant particulars my/our establishment are given below:

1. Address

1.1 Postal Address

……………………………………………………..…………………………………………………

……………………………………………………..…………………………………………………

……………………………………………………..……………………………………………………………….……………………………………………………...………………………………….……………………………………………………………………………………………………….

Tel : Fax: E-mail :

2. Address of the establishment to which the Application is made :

……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

Tel: Fax: E-mail :

2. Management Representative/s (names and designations of the persons who will be responsible to Sri Lanka Standards Institution for the work in connection with the GMP Certification Scheme)

2.1 Nominee: ……………… Designation : ……………………… Tel :…………

2.2 Deputy : ………………… Designation : ……………………… Tel :………..

3. Manufacturing/Service Activities

(In respect of which the application is made)

………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

4. Applicable Standards

(Please select from the list of Code of practice Standards SLSI Doc. GL-GP-02)

………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

5. Category of Organization

Category of organization in terms of value of fixed assets. (This information will be treated strictly confidential and will not be divulged to any person or institution)

|Type of Organization |Value of fixed assets |Tick in relevant box |

| |(Excluding land and building) | |

|Category 1 |Below LKR 1.0 million | |

|Category 11 |Above LKR 1.0 million & | |

| |Below LKR 5.0 million | |

|Category 111 |Above LKR 5.0 million | |

6. Declaration by Applicant

In order to ensure compliance to the requirements given in relevant code of practice standard I/We undertake to operate good manufacturing practices as recommended by the Institution.

I/We agree to extend to the institution all reasonable facilities at my/our command and I/We also agree to pay all fees payable prior to grant the certification.

I/We are conversant with the rules and regulations framed under the Good Manufacturing Practices (GMP) Certification Scheme of the Sri Lanka Standards Institution and I/We are agree to pay the annual fees applicable to the certification.

In the event the certification being cancelled or withdrawn I/We undertake to cease with immediate effect the use of GMP Logo on any document/material and to withdraw from all advertising materials.

Signed at …………………………………………………………on this ……………of (Place) (Day)

……………………………………………………………..…………………………………

(Month) (Year)

Signature: ……………………………………………………………………………………

Name:…………………………………………………………………………………………

Designation:………………………………………………………………………………….

for and on behalf of :

(name of the organization) : ……………………………………………………..

-ltf.

-----------------------

√

-----------------------

[pic]

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download