Application Form - ISO 22000

BUREAU VERITAS CERTIFICATION

APPLICATION

ISO 22000; “ISO 22000 + ISO/TS 22002-1”; FSSC 22000

FOOD SAFETY MANAGEMENT SYSTEMS

(FSMS)

REQUIREMENTS FOR ANY ORGANIZATION

IN THE FOOD CHAIN

(ISO 22000)

Prerequisite ProgramMEs on Food Safety – Part 1 Food manufacturing (ISO/TS 22002-1)

FOOD SAFETY SYSTEM CERTIFICATION
(FSSC 22000)

BUREAU VERITAS CERTIFICATION Local Office Address:

BEFORE WE CAN PREPARE A WRITTEN ESTIMATE OF COSTS WE NEED CERTAIN INFORMATION ABOUT YOUR ORGANISATION AND STAFF, SO IF YOU WILL PLEASE COMPLETE THE APPLICATION FORM AND RETURN IT TO THE ADDRESS SHOWN ON THE ACCOMPANYING LETTER, WE WILL THEN SUBMIT A QUOTATION TAILORED EXACTLY TO YOUR SITUATION. ALL INFORMATION SUPPLIED WILL BE TREATED WITH STRICT CONFIDENCE.
YOUR APPLICATION DOES NOT COMMIT YOU TO USING OUR SERVICES IN ANY WAY, AND NO APPLICATION FEE WILL BE CHARGED.
PLEASE STATE WHICH CERTIFICATION/REGISTRATION YOU REQUIRE:
ISO 22000 /

FSSC 22000

/ /

ISO 9000(new/re-cert.) + ISO 22000

ISO 22000 + ISO/TS 22002-1 /

UKAS accreditation

/ /
WE LOOK FORWARD TO HELPING YOU TO OBTAIN THIS INCREASINGLY IMPORTANT FOOD SAFETY MANAGEMENT SYSTEM (FSMS) CERTIFICATION IN THE NEAR FUTURE.
SECTION A
COMPANY DETAILS
COMPANY NAME:
Registered Office Address:
POSTCODE: / Email :
TEL NO: / Mobile No
CONTACT NAME: / Web Site
BRANCH AND SITE DETAILS; If any of your sites, Regional or Branch offices are responsible for any process required by the Management System, please provide complete address and number of employees at each location.(Use annex if required)
2.
3.
4.
5.
6.
NB: IF YOUR COMPANY REQUIRES CERTIFICATION OF MORE THAN ONE SITE, THE INFORMATION PROVIDED IN THIS SECTION IS REQUIRED ON A SITE-BY-SITE BASIS. PLEASE ENSURE THAT THE ADDRESS AND TELEPHONE DETAILS FOR EACH SITE ARE INCLUDED, (Use annex if required))
PRODUCTS AND SERVICES (please detail the products you produce and the services you provide)
SCOPE (Please note that this description will be the Certification scope shown on the certificate of approval issued by Bureau Veritas Certification, please specify different scopes for ISO 22000 /” ISO 22000 + ISO/TS 22002-1” / FSSC 22000, if applicable)
NUMBER OF EMPLOYEES:
1 ADMINISTRATION/MANAGEMENT
2. PROCESS
3. MAINTENANCE/SERVICE
4. LOGISTIC, SALE, ETC.
TOTAL
SEASONAL:
TEMPRORY:
SUBCONTRACTED:
WORK PATTERN:
1st ST SHIFT: / 2nd SHIFT: / 3rd SHIFT: / 4th SHIFT:
Number / Number / Number: / Number:
IF THE COMPANY IS PART OF A GROUP OF COMPANIES, PLEASE GIVE DETAILS
LOCATION:
Please give information and/or enclose a site plan showing the following: / LOCATION OF SITE INCLUDING DETAILS OF NEIGHBOURS, LAYOUT OF SITE INCLUDING SIZE, STORAGE, PROCESS AND ADMINISTRATION FACILITIES, SITE SERVICES INCLUDING DRAINAGE, ACCESS ROUTES, ETC.,
SECTION B
ACTIVITIES AND PROCESSES ON SITE:
PLEASE LIST HERE (OR ATTACH) INFORMATION RELATING TO ALL SITE ACTIVITIES INCLUDING NUMBER OF PERSONNEL INVOLVED AND THE EXTENT OF ACTIVITY:

1. INCOMING MATERIALS

2. PROCESSES

3. SPECIFIC ACTIVITIES (tick off please)
Number of product types. Please state the number of ------à
Number of products ------à
Number of production lines ------à
Number of buildings ------à
Number of warehouses ------à
In house laboratory
Logistic & transport (not outsourced)
External warehouse (under direct responsibility of your factory)
Product development
Staff speaking in more than on language (if requiring interpreter for this audit)
Please explain if needed:
4. LIST OF SUB CONTRACTED ACTIVITIES (i.e.: Machining, calibration, delivery, etc.).
SECTION C

C-1 The number and type of HACCP study

A HACCP study corresponds to a hazard analysis for a family of products/services with similar hazards and similar production technology and, where relevant, similar storage technology.
Example; if a factory is producing liquid food (pasteurized and packed aseptic) and solid food (other process type), the factory has two HACCP studies. Another example is production of two not-related products (e.g. ice cream and cheese).
Number of HACCP study
HACCP study 1:
HACCP study 2:
HACCP study 3:
HACCP study 4:
HACCP study 5:
HACCP study 6:
C-2 HAZARD ANALYSIS AND CRITICAL CONTROL POINT ASPECTS (CCP’s ) & Prerequisite programme (PRP’s)
(Please list the principal FSMS aspects/hazards/risks of your activities)
1
2
3
4
C-3 CONSENTS, LICENCES, PERMITS, AUTHORISATIONS, AGREEMENTS, CODES OF PRACTICE, ETC. (please list)
1
2
3
4
SECTION D
OTHER MANAGEMENT SYSTEMS:
Please inform about other existing certified management system (name of the standard, type of certification)
If you have an accredited and available ISO 9000 certificate, please complete below:
CERTIFICATION BODY: / APPROVAL DATE: / VALID UNTIL: / COPY OF CERTIFICATE ATTACHED? (Yes/No)
PLEASE GIVE THE NAME OF THE MANAGEMENT EPRESENTATIVE
TARGET DATE FOR AUDIT:
COMPANY REGISTERED NUMBER/ VAT NUMBER:
LIMITED BY GUARANTEE / PLC / SOLE TRADE/PARTNERSHIP
AUTHORISED SIGNATORY: / POSITION / DATE
THANK YOU FOR COMPLETING THIS APPLICATION FORM
BUREAU VERITAS CERTIFICATION - ACTION ONLY

This part has to be completed by a trained ISO 22000 A/LA, or in cooperation with the ICC:

CERTIFICATION/REGISTRATION REQUIRED

Code allocation:

UKAS
ISO 22K / PQC / SQC / NACE / In Scope?
Food Safety Leg. Covered by (Audit Team shall cover Food Safety Legislation and Food Safety Code, plus any other requirements specific to the company. Please allocate Audit Team):
Food Safety code covered by (name): / Country: / Approval Status:
Recommended team and Team Leader*:
* in case of FSSC 22000 certification, at least, one team member has to be a ISO/TS 22002-1;FSSC 22000 approved auditor

CALCULATION

1. Calculation of MD for initial audit:

ISO 22000: Minimum audit time for single site, Ts: Ts=(D +H +MS +FTE)
D is the basis on-site audit time; H is the audit days for additional HACCP studies; MS is the audit days for absence of relevant management system; FTE is the audit days per number of employees.

2. MD allocation -. Certification/re-certification:

ISO 22000 / ISO/TS 22002-1, FSSC 22000

Subject à

A) Preparation, Planning & Report

B) FSMS Doc. Review

/ TS (on-site) / Report & TS (on-site)
C) Stage 1 / D) Stage 2
MD allocation à
Sub-Total:
TOTAL:
A) Program preparation, reporting, etc. This is not a part of MD allocation for on-site audit. B) Off-site. Review of documents from the Food Safety Management System. This includes the review of hazard analysis, procedures, etc. It is strongly recommended to allocate 0.5 - 1½ MD for off-site review. C) & D) The MD for stage 1 should be a minor part of the total allocated MD for on-site audit (less than stage 2). Please look at the procedure (and section B above) for the list of factors that could require additional TS time.
3. MD allocation – Surveillance audit:
/ ISO 22000 / ISO/TS 22002-1, FSSC 22000
/ Half-yearly visit / Yearly visit / Half-yearly visit / Yearly visit

MD for each visit

Sub-Total MD for the next 3 period
TOTAL MD for the next 3 period
The minimum surveillance audit time should be one-third of the initial certification audit time (1/3 * Ts), with a minimum of 0.5 audit days.
4. Minimum audit time (onsite) for multi-site:
Is calculated by adding minimum time for each site calculated by Tm = Ts* 50/100
For more than 21 sites, please look at the procedure.
ISO 22000 / ISO/TS 22002-1, FSSC 22000
Number of sites
>1 to 20 / > 20
Certification /
Re-certification / Allocated
Code / Number of site
Already calculated MD for the 1st site (See point 2. above)
Additional MD
Surveillance Audit / Yearly
½ yearly
It’s recommended to prepare a plan for the audit on all sites during this certification period. This plan shall be attached to with this application before forwarding to the ICC.
Sampling is only relevant for multi-site organisation bigger than 20 sites and only from codes A, B, G, H and J.
All sites must be visited during stage 2 and each surveillance audits, if there are less than 21 sites.
Comments:
Note 1
Note 2
Note 3
Note 4
The MD- and code allocation is performed by:
Position:
Bureau Veritas Certification office:
Sign & date:
APPROVAL BY International Competence Centre (ICC)
The code allocation above is performed correct
YES / NO
Comments & Remarks:
Note 1
Note 2
Note 3
Note 4
Note 5
This review is done by:
Position:
Bureau Veritas Certification:
Sign
Date

Version March 2010 2/6