REC10 BRC by fxZU7u4

VIEWS: 5 PAGES: 7

									   REC.10:                  Preliminary Questionnaire


1213 Bakers Way                                                              Tel: 785-537-4750
PO Box 3999                               AIB International –                Fax: 785-537-0106
Manhattan, KS 66505-3999                  Certification Body                 e-mail: GFSI@aibonline.org



      The following information is required to enable us to schedule an evaluation audit against the
                     BRC Global Standard for Food Safety Issue #5 or Issue #6.

  Please complete the questionnaire completely. If a box does not apply, please write N/A in the space.
                                     COMPANY INFORMATION
Company                                         Parent Company
Name:                                           (if relevant):
Street                                          Street Address:
Address:
City:                                                 City:
State:                                                State:
Zip/Post Code:                                        Zip/Post Code:
Country:                                              Country:
Telephone:                                            Telephone:
Fax:                                                  Fax:
e-mail:                                               e-mail:
Website:                                              Website:

Legal status
(corporation, sole proprietor, etc.):
VAT no./Tax ref. No.:

Are you currently BRC certified?                            Yes                         No


If yes, please list BRC site code number, certificate
expiry date and provide a copy of your certificate:
Do you have any formal accreditations/certifications        Yes                         No
(e.g. ISO 9000, ISO 22000)?

If yes, list formal accreditations/certifications (e.g.
ISO 9000, ISO 22000) including scope and expiry
dates:
Details of Company Membership in Trade Bodies,
Research Organisations, etc.:
EU/USA/Other license No. or Health Mark:




Raised by     Sophia Vigil – Certification Body Assistant                   Date         9 Aug 2011
                                                                            Rev. No.     17
Approval      Loree Allen – Quality System Certification Administrator      File Name    REC10
                                                                            Page         1 of 7
   REC.10:                    Preliminary Questionnaire


                                        CONTACT DETAILS
Upon certification AIBI-CB will upload the audit report to the BRC Directory. The BRC Directory
will automatically send an email to the primary contact listed in the system when new audit
details are validated.
Please list the name and e-mail            Name:                            E-mail:
address of the person to be the BRC
Directory contact:
Primary Contact:                                        Secondary Contact:
Job Title:                                              Job Title:
Street Address:                                         Street Address:
City:                                                   City:
State:                                                  State:
Zip/Post Code:                                          Zip/Post Code:
Country:                                                Country:
Direct phone:                                           Direct phone:
Mobile/cell:                                            Mobile/cell:
e-mail:                                                 e-mail:
                  Please indicate if you would like to receive a copy of the report:
                        (Please note that all copies of the report will be sent by e-mail)
Primary:         Yes                 No                      Secondary:         Yes            No


Invoice Contact:
Job Title:
Street Address:
City:                                                          State:
Zip/Post Code:                                                 Country:
Direct phone:                                                  Mobile/cell:
e-mail:
Receive a copy of the report:         Yes                      No
(Please note that all copies of
the report will be sent by e-mail)

                                        AUDIT REQUEST
Please indicate the type of audit you are Please specify preferred time frame for option(s)
interested in:                            selected:
(more than one may be selected)           (please note that the certification audit should be
                                                  scheduled no earlier than three months after the pre-
                                                  assessment)
Pre-assessment                                    Pre-assessment:


Certification Audit                               Certification Audit:

                                                  Re-certification Audit:
Re-certification Audit
(applicable if already certified

Raised by      Sophia Vigil – Certification Body Assistant                       Date        9 Aug 2011
                                                                                 Rev. No.    17
Approval       Loree Allen – Quality System Certification Administrator          File Name   REC10
                                                                                 Page        2 of 7
   REC.10:                   Preliminary Questionnaire


with another Certification Body)


Are there Multiple sites that require certification?             Yes                   No

If yes, please complete an application (REC 10) for each site
Are you interested in unannounced surveillance audits? Yes                             No
(please note only available once grade A or B are achieved)
If an approved subcontractor needs to be used for the            Yes                   No
evaluation, is this acceptable?
I understand that by joining the BRC scheme there may            Yes                   No
be times when the auditor will need to be accompanied
by other personnel for training, assessment or
calibration purposes.

                                              CUSTOMERS
List main retailers/customers:




Are you a supplier to                 Yes                                 No
McDonalds?
If yes, do you require the            Yes                                 No
McDonalds addendum to be
completed in addition to the
BRC audit?
Are you a supplier to                 Yes                                 No
Wal-Mart?
If yes, do you require the            Yes                                 No
ethical sourcing module?


                                            FACILITY DETAILS
Number of employees:                          Total:
                                              In Production:
Work/Shift Pattern:
Number of Employees per main shift:
Factory Size                                  Production:
                                              Warehousing:
Location (rural, urban, etc.):
Number of processing lines:
Number of packing lines:
Number of HACCP plans:
Annual Tonnage:
Details of any major changes or capital
spending/investment in the last few years:
Raised by      Sophia Vigil – Certification Body Assistant                 Date        9 Aug 2011
                                                                           Rev. No.    17
Approval       Loree Allen – Quality System Certification Administrator    File Name   REC10
                                                                           Page        3 of 7
     REC.10:                   Preliminary Questionnaire


Details of the warehousing and distribution system in
place (e.g. on/off site warehouse. Warehouse and
distribution vehicles company owned or contracted):
                                        SCOPE DETAILS
The following information will be used to determine the scope of your certification.
Scope should include the processes, products and intended user.
An example of scope of certification could be: The processing (cleaning, milling,
sterilization) and bulk packaging of spice supplied to the food industry.
Processes to be included in certification:
(e.g. cleaning, milling, heat-sterilization)
Products to be included in certification:
(e.g. bread, buns, sugar, spices, sauces)
Factored goods to be included in
certification:
(i.e. goods not manufactured or part
processed on site but brought in and sold,
stored and shipped)
Products manufactured but excluded
from the scope of the audit:
Packing to be included in certification:
(e.g. in bulk containers, canning, in glass
jars)
End use to be included in certification:
(e.g. retail sale, food service, bulk
ingredient)
Seasonal products to be included in
certification:
(i.e. products harvested and processed on
site that opens/runs the product for the
duration of the harvest, typically 12 weeks or
less)


                                  PRODUCT CATEGORY
                 Please mark the category(ies) that best describes your site.
   Refer to Appendix 3 of the BRC Global Standard for Food Safety for additional guidance.
Cat. Category Description                              Storage Conditions         This applies
No.                                                                               to my site
1    Raw red meat                                      Chilled; frozen
2    Raw poultry                                       Chilled; frozen
3    Raw prepared products (meat and vegetarian)       Chilled; frozen
4    Raw fish products and preparations                Chilled; frozen
5    Fruits, vegetables and nuts                       Chilled; ambient
6    Prepared fruit, vegetables and nuts               Chilled; frozen
7       Dairy, liquid egg                                       Chilled; frozen; ambient
8       Cooked meat/fish products                               Chilled; frozen
9       Raw cured and/or fermented meat and fish                Chilled
10      Ready meals and sandwiches; ready to eat                Chilled; frozen
        desserts
Raised by       Sophia Vigil – Certification Body Assistant                 Date           9 Aug 2011
                                                                            Rev. No.       17
Approval        Loree Allen – Quality System Certification Administrator    File Name      REC10
                                                                            Page           4 of 7
     REC.10:                Preliminary Questionnaire


11      Low/high acid in cans/glass (Ambient stable            Ambient
        products with pasteurization or sterilization as
        heat treatment)
12      Beverages                                              Ambient
13      Alcoholic drinks and fermented/brewed                  Ambient
        products
14      Bakery                                                 Ambient
15      Dried foods and ingredients                            Ambient
16      Confectionery                                          Ambient
17      Cereals and snacks                                     Ambient
18      Oils and fats                                          Ambient



Please check to confirm you have read PR.3: Overview of the AIBI-CB Certification
Scheme:
Please check to confirm you have read PR.4: Rules for Certification:
Please check to confirm you a have copy of the BRC Food Standard: Issue #5:
Please check to confirm that you have included a copy of your previous certificate, if
applicable (N/A may be entered if not applicable):
  If any of the above are not checked, please read or obtain a copy. All audits from July
 2008 are to issue 5 of the Standard. It is essential that you have obtained a copy of the
standard and have reviewed each of the clauses to make sure programs and documents
        required by the standard are in place and operational before the evaluation.

Please complete Appendix A below


Signed by:
        (Signatory is authorized by the company/firm to sign this application and ensure that
        products conform to requirements)

Print name:


Job Title:


Company:


Date:


        Upon receipt of this completed questionnaire AIBI-CB will will calculate expected audit duration
        and confirm the scope applied for. Our auditors will then be notified of your request and will begin
        looking for available dates to offer. Our office will contact you as soon as dates are available.

Raised by     Sophia Vigil – Certification Body Assistant                    Date          9 Aug 2011
                                                                             Rev. No.      17
Approval      Loree Allen – Quality System Certification Administrator       File Name     REC10
                                                                             Page          5 of 7
   REC.10:                 Preliminary Questionnaire




                                                                                      Appendix A
                                          Company Profile
History and Ownership:




Age of Company:


Years on Present Site:


Number of sites (sister companies & subsidiaries):




Plant information (location, purpose built, security):




Product Types:




Raw Materials:




Preservative Methods:




Product Distribution:

Raised by    Sophia Vigil – Certification Body Assistant                Date        9 Aug 2011
                                                                        Rev. No.    17
Approval     Loree Allen – Quality System Certification Administrator   File Name   REC10
                                                                        Page        6 of 7
   REC.10:                Preliminary Questionnaire




Raised by   Sophia Vigil – Certification Body Assistant                Date        9 Aug 2011
                                                                       Rev. No.    17
Approval    Loree Allen – Quality System Certification Administrator   File Name   REC10
                                                                       Page        7 of 7

								
To top