Order Form for Bwi Label

ORDER FORM FOR BWI LABEL

SECTION 1

Company / Farm Name:
List of registered brands:
Farm/Erf numbers:
Full Name of Owner, CEO or Managing Director:
Name and position of BWI contact person:
Contact details: (phone, cell, email)
Postal Address
Company VAT No. for invoicing

Please tick the appropriate block below:

Please list all cellars used to produce your brands:
………………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………………

SECTION 2

BWI label options / Quantity / Price
(/roll of 1500) / TOTAL
BWI champion - Front label in colour (gold bird) / / R60/1500
BWI member - Front label in colour / / R45/1500
Sub total
14% VAT
TOTAL
TOTAL AMOUNT - strictly cash on delivery basis
To be settled directly with BWI office (cash payment) or
EFT payment to WWF-SA (BWI)– see banking details in Section 3 below)

SECTION 3

/ BWI logo for incorporation in backlabel
(To be settled directly with BWI office (cash payment or EFT payment to WWF_SA) - strictly cash on delivery basis ) / Cooperative cellar (R1500) / Producer (R500 once –off admin fee)
Banking Details:
Account Holder: WWF South Africa
Bank: ABSA
Branch code: 33 44 10 (Stellenbosch)
Account Number: 410 720 086
Reference: BWI + Your farm name
Please fax proof of payment to
086535 9433
Attention: Joan Isham together with your name and farm name.

Conditions of use attached to the BWI Label:

1. BWI championship & membership is valid for a period of 2 years, from the date on which the BWI certificate is signed.

2. A BWI internal audit will then take place to reassess membership status. BWI members and champions are only eligible to use this sticker if this BWI membership is still valid and all outstanding documentation requested during a BWI audit has been provided.

3. BWI members that only have farm level certification are not eligible to use the BWI label.

BWI may act against an individual or company that misrepresents the BWI or their association with it.

Signed: (Managing Director/ Farm Owner or authorized person) ……………………………………………

Signed at on this day of .

Authorization of Order (TO BE COMPLETED BY A BWI OFFICIAL ONLY)

…………………………..,……………………………………………………………..(name of producer and farm) is hereby authorized to use the ……………………………………… …..BWI label (specify which option).

Date authorized:………………………………………

Signed: ………………………………………….

Project officer: ……………………………………………(print name)