FSMS/ISO 22000-2005 Initial Enquiry Form
|INITIAL ENQUIRY FORM |
Note:
• Please fill all the information correctly
• Your detailed information will help us in quoting most competitive offer to you
|1. |CONTACT INFORMATION |
|1.1 |Name of Company: |
|1.2 |Company Representative: |
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| |(Position/Title) |
|1.3 | Site Address: |
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|1.4 |Head Office Address: |
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| |Activities at Head Office: |
|1.5 |Telephone Land Line: |Mobile: |
| |E-mail: |
|2. |CERTIFICATION INFORMATION |
|2.1 |Wanted to avail Certification Service for: |
| |1.) FSMS 2.) FSSC 3.) India-HACCP 4.) India-GHP |
| |Do you have a copy of applicable standards? |
| |Yes No |
|2.2 |Is your organization currently certified by any management system (ex ISO 9001/14001/18001) or any other food standards (ex HACCP/GMP/GAP)? |
| |Yes No |
| |If yes, then list those standards & enclose the Certificate/ Audit Report of the applicable management system: |
| |Name of Agency from which applicable management system standard or other food standard taken (If Yes): |
|2.3 |How many employees (Including Permanent and Temporary) at each processing* site/s (Mention Department wise ex Production, Quality, Stores, |
| |Packaging, HR and Logistics etc.): |
| |*(In case of contractual processing please attach a brief detail of location & processing activity) |
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|2.4 |Work Pattern (Operating in how many shifts): |
|2.5 |1st Shift |2nd Shift |3rd Shift |4th Shift |
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| |Number |Number |Number |Number |
|2.6 |Blackout days (Blackout days are time periods when the audited organization is not operating for legitimate business reasons) |
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|2.7 |HAZARD ANALYSIS AND CRITICAL CONTROL POINT (Please list the HACCP studies to be covered in FSMS/FSSC/HACCP/GHP scope) |
| |Total No. of HACCP studies: |
| |Give details of your HACCP studies below: |
| | |Product Group |
| |HACCP study 1 | |
| |HACCP study 2 | |
| |HACCP study 3 | |
| |HACCP study 4 | |
| |HACCP study 5 | |
| |HACCP study 6 | |
| |Note: Incase more than 6 HACCP studies, kindly use an extra sheet or use back side of this Form. |
|2.8 |SCOPE OF CERTIFICATION: |
| |(Activities to be certified under the certification scheme (For ex: Processing of Tea, Manufacturing of Bread, Processing of Carbonated beverages, |
| |Manufacturing of Food colors, etc.): |
|2.9 |Kindly provide Process flow chart for the products: |
|2.10 |If the company is part of a group of companies, please give details: |
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| |Please specify your main company activities, including processing sector: |
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|2.11 |Have you used consultant/s to assist in developing your management system Yes No? |
| | |
| |If Yes, please give us the organization/company name of your consultant |
| | |
| |Management System Implementation: |
|2.12 |Do you have any past relations with OneCert or its related companies Yes No |
|3 |MULTI SITE CERTIFICATION |
| |(Fill in the details in case you have multiple units under the same entity for which you wanted to apply for the certification service) |
|3.1 |DETAILS OF ORGANIZATION FOR MULTI SITE |
| |Name of the Unit |Address and Country |Process Lines, respectively |No. of Employees |
| | | |product(group)s | |
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|3.2 |STATUTORY/REGULATORY STANDARDS FOLLOWED BY YOUR ORGANIZATION (ex FSSAI, Legal Metrology, Pollution Control, DIC, EIC etc.) |
| |S.No. |Name |Agency |Certificate Number |
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|3.3 |INFORMATION ABOUT ANY JUDICIAL PROCEEDINGS RELATING TO ITS OPERATIONS |
| |(any proceedings by any Regulatory body or suspension/cancellation/withdrawal of any relevant approvals/ certifications under any Regulations or |
| |otherwise). |
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|3.4 |DETAILS CONCERNING ANY OUTSOURCED PROCESSES, TECHNOLOGICAL AND REGULATORY CONTEXT (which may affect the product conformity): |
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|4 |AFFIRMATION |
| |I affirm that all statements made in this Questionnaire are true and correct. I agree to comply the standards. I understand that the facility may be|
| |subject to unannounced inspection. I agree to provide further information as required by OneCert International. |
| |I have attached the following additional documents: |
| |Food Safety / Quality manual |
| | |
| |FSSAI license/ Registration |
| | |
| |Facility map/ Blue print |
| | |
| |product flow chart |
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| |other (specify) _________________________ |
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|Submit Completed Form, Fees and Supporting Documents to: |
|OneCert International Pvt. Ltd. |
|H-08, Mansarovar Industrial Area, Mansarovar, Jaipur-302020, Rajasthan, India |
|Phone–0141-2395481 |
|Email: info@onecertInternational.in, Website: |
| |
|Head Office Address |
|OneCert, Inc. |
|Lincoln, USA |
| |
|The information on this form is complete and accurate to the best of my knowledge. |
| |
|Name of authorized signatory: |
| |
|Designation: |
| |
|Signature _________________ Date _____________________ |
|FOR OFFICE USE ONLY (TO BE FILLED BY ONECERT OFFICE) |
|Date received: |
|Date reviewed: |
|Reviewer initials: |
|Product Category as per Table A.1: |
|CB approved for this Category: |
|No. of HACCP Study (as per the flow charts received): |
Note- Information and Supporting Documents for applicable regulatory requirements should be submitted in English language.
For Office Use Only:
As a result of review, above application is :
Accepted Rejected
Reasons for rejecting the application:
Note: Reasons for application rejection to be informed to the client.
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