Food Matters Live 2016
Exhibitor’s Food/Drink Safety Form
About this Form
This form should be completed by all exhibitors who are intending to offer food and/or drinkfor sampling, tasting or as a giveawayto the visitors during Food Matters Live 2016.
Please refer to the Food Safety and Hygiene Section of the “Operations Guide” prior to completing this form.
Please email the completed form, along with the additional documentation required to Andy Watts,
Email: prior to the deadline date of7 October 2016.
Part 1: Exhibitor Supplying Food/Drink: Contact Details
Exhibitor DetailsCompany Name: / Stand Number:
Contact Name: / Position:
Direct Tel No: / Mobile Tel No:
Email:
Part 2: Food/Drink Details and Quantities
Please specify the food/drink you will provide from your stand: NB.(This includes all samples, giveaways and priced items):Food/Drink / Quantity (estimated) to be provided
as samples, giveaways and priced items
: / :
: / :
: / :
: / :
: / :
: / :
Part 3: Food Business Details
If you are a food business registered with a Local Authority please complete thispart, if not please go to Part 4
Name of theLocal Authority where your food business is registered:Date of last inspection by Local Authority Env. Health Officer:
Food Hygiene Rating awarded to business (if applicable)
Part 4: Documentation
Documentation to be provided in addition to this form(please indicate whether attached, to follow, or not applicable) / Attached / To Follow / Not Applicable
HACCP based Food Safety Procedures/Risk Assessment for your food/drink activity at the event(and any supporting documentation from your main food business activity).(This must be provided by all exhibitors providing food/drink)
Level 2 & Level 3 Food Hygiene Certificates for staff (where required).Please provide the names of all Persons with Food Hygiene Certificates working at the event:
Please provide copies of all certificates.
Employers Public Liability Certificate
(This must be provided by all exhibitors)
Personal Licences to sell alcohol
(This must be provided by all exhibitors serving alcohol)
Where foods requiring temperature control are to be provided, please indicate the food temperature record or log sheet to be used:
Own in house food temperature record/log sheetFood temperature record/log sheet from this Operations Guide
Part 5: Third Party Catering / Food Supply Company Details
If you are not producing the food/drink you are providing at FML yourself, but sourcing it from another business; eg: restaurant, bakery etc. Please provide full details as follows:(Please supply additional pages if you need more space).
Company name:
Address of food/drink preparation:
Contact Name: / Direct Tel No:
Email: / Mobile Tel No:
Name of Person with Food Hygiene Certificate:
Name of Local Authority where the food business is registered:
Date of last inspection by Local Authority EHO:
Food Hygiene Rating awarded to business (if applicable)
Part 6:Additional Information
Please provide any other additional information you feel might be useful:
Please email this form to prior to the deadline date of 7 October 2016.
If you have any questions about this form please call Andyon +44 07939 009049.