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? |

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| |If Yes, please give us the organization/company name of your consultant |

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| |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 |

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| |FSSAI license/ Registration |

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| |Facility map/ Blue print |

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| |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: |

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|Head Office Address |

|OneCert, Inc. |

|Lincoln, USA |

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|The information on this form is complete and accurate to the best of my knowledge. |

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|Name of authorized signatory: |

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|Designation: |

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|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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