FoodCert India Pvt Ltd.
H.No : 8-2-601/P/6, Panchavati Colony, Road No.10, Banjara Hills, Hyderabad  500 034 ,A.P.
Tel.:040- 23313547, Fax.:040- 23313048
Mail: foodcert@foodcert.in ; srihari@foodcert.in
COMPANY INFORMATION SHEET[HACCP/ISO 22000]
Please send a quote based on the following information
1)  Accreditation Requested:
2)  Stage-1(including Document Review) Anticipated Date:
3)  Stage-2 (Final Assessment) Anticipated Date:
4)  Company Name:
Postal Address  :
Physical Location  :
  Notes
1. IN case of HO with administrative functions, list out the activities at HO related to the site to be covered under FSMS including the number of employees relevant for the site.
2. In case of production/service sites, information to be provided for each of the sites as per this application form.
5)  Contact Person
Name :
Designation :
Phone No. :
Fax No. :
E-Mail :  
6)  Product Information : (Enclose process flow chart of the products )
6.1 Product information
Description of the product group including specific claims and usersNumber of varieties in product group Own brands And / or Private labelsNumber of production lines High care departments? Other special production conditions?
6.2 Product information
If products are excluded from the scope of certification, please give the motivation. :
ProductMotivation
7)  Site Information
7.1 Company/Site information
Describe scope of company activities for certification application.(for scope text on certificate)
Departments/Activities Management Number of production lines
Note:Also tick mark the departments directly involved in handling of up packed raw materials and products. Managers Supervisors/ Operators Helpers Out sourced** Part-time/temporary**
highest number of employees*  
Shifts 1 2 3 1 2 3 1 2 3
Intake / storage raw materials / packaging
Processing
Packaging
Storage finished product
Distribution
Transportation
Lab / QC
Quality assurance  (QA)
Maintenance
Human resources
Planning / Logistics
Purchasing
Sales
Research & Development
Marketing
General Management
Total
* All personnel, e.g. own fte (full time equivalent), part-time, temporary, seasonal, Contracted employees which are on duty during full production

**List out helpers/outsourced/part time employees out of the numbers listed under above under these categories are involved in similar activities like cleaning, loading/unloading which are not effecting the food safety issues
7.2 Company information
If departments are excluded from the scope, please give the motivation:
Department Motivation
8)  Status of the Operational Management System & Operations to be assessed.
Inventory of the status of the operational management system to be assessed as well as the operations
Below mentioned questionnaire will be used to estimate how far your management system is operational and is being used. Moreover what the present situation is on process installation, buildings and premises.

8.1 Is your company already certified? If yes, which schemes (i.e. ISO9001, HACCP etc):
If yes, by which Certification Body?
8.2 Has your company any other certificates? Which:
8.3 Has your company introduced a quality management system in which the following aspects have been documented and are operational:
8.3.1 specifications of: raw materials, ingredients, packing, final products.
8.3.2 production/process instructions/procedures regarding quality & food safety.
8.3.3 determination of HACCP-hazards and risk analysis in general control measures and CCP’s per production phase/product.
8.3.4 effective use of determined control measures and CCP-activities and results registration
8.3.5 traceability completely introduced and demonstrable with raw materials, ingredients, in process and with final products
8.3.6 recall procedure is demonstrable present and tested
8.3.7 internal audit of the quality system
8.3.8 management review by managing director regarding the system effectiveness
8.3.9 determination/adjusting of company policy by directors regarding quality & food safety
8.3.10 training program for personnel regarding hygiene & food safety
8.3.11 suppliers assessment/approval/surveillance
8.4 Did you have any assistance of a consultant with the development of your quality system, If yes, please provide the details of the consultant engaged.
8.4.1 Did you or your consultant assess your company’s quality system?
8.4.2 Are you familiar with the certification standard you have applied for?
8.4.3 Have you made up a cross reference list between the Standard and your quality management system?
8.5 Information about the premises:  
8.5.1 more then 1 main building / widely spread buildings?
8.5.2 older buildings / not specific designed for the present production activities?
8.5.3 complex internal logistics (like many different buildings etc)?
8.5.4 risks for cross contamination (low, medium, high)?
8.5.5 product handling mainly by workers?
8.5.6 product handling mainly automated?
8.5.7 List of major process equipment with year of installation.
8.6 Area of premises (in sq. meters)
Surface in square meters
 
 
 
 Number
8.6.1 raw materials (including receiving & storage)
8.6.2 processing (from incoming goods till final products)
8.6.3 final product handling (storage and loading/shipping)
9)  Scope to be mentioned on the certificate:
10)  any outsourcing of activities included in the scope :
11)  Distance : Actual distance in Kilometres from the nearest town and travel time from the town by road to the place of audit:
12)  In case of Re-registration, any Major concerns were reported in earlier audits ie., 3 years prior to this date:
13)  Other Information:
Are you part of a larger group or company
Approximate Yearly Turnover   :
Has your company hold any product inspection certification from any agency   :
How or from whom did you hear about FoodCert India?
14)  Applicable statutory/regulatory standards (law of the land & destination countries)?
15)  Any safety precautions to be taken by the Audit Team.
16)  Timing of the audit preferred to demonstrated the full scope of the organisation.
17)  Correctness of filled data

Undersigned declares that the filled data in this form are correct and represent the present organisation and company situation.

Name: Function:
Signature Date