体系认证调查表 Certification Application form.doc

BRC CONSUMER PRODUCTS - QUESTIONNAIREPlease complete this questionnaire in detail and attach any relevant supporting information describing the Company*s scope of operation, e.g. Company brochures or publicity material.Please return in electronic format or hard copy to:Shanghai NQA Certification Co., LtdRoom l-M, 15th Floor,985 Dongfang Road,Pudong，Shanghai200122E-mail: BRC@ Tel: +86 (0)21 6876 6597 Fax: +86 (0)21 6876 6461Compa ny detailsName of CompanyMain site addressPostcode Contact Name:Tel: Fax:•■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■Email: Website:If company is part of a group, please specify group:Consults nt name(if applicable) EmployeesTotal in organisation:Total at main address:Total in those areas for which registration is sought:No of Shifts:Business activities and proposed registration scopeDescription of your business activities:Proposed registration scope: Please list all products produced within your company:■ ■■■■ ■■■■ ■ — ■■■■ ■■■■■ ■■■■■■■■■ ■ ■ ■■■■■ ■ ■■■・Your product(products) within the proposed registration scope:Please give the determined Product Group comply with Product Group Decision TreePG 1 PG2 PG3 PG4□ □ □ □Details of other sites(please continue on separate sheets as necessary):ActivityLocati onNo. of employeesNo. of ShiftsRetail customers:Do you have signed Disclosure Agreements with any retailers to pass on reports and/or certificates? If soplease mark below:Ahold | |Marks & SpencerSain sburys□Tesco | |Asda | |MetroSomerfield□Wal Mart 口Boots 口Morris onsSpar□Other (please give details)Please provide details of your retail customers1 requirement regarding BRC certification:CustomerSpecified Audit Frequency by the customerCertification DeadlinePlease identify the countries/regions where your products are sold, and provide details of legislation, regulations and standards in that countries/regions, which are applicable to your product(s), (Please continue on separate sheets as necessary):ProductThe countries/regions where the product is soldapplicable legislations, regulations and standardsProduction FacilityPlease provide brief details of core product!on processes (e.g. injection moulding, plating, welding, extruding, mixing, packing, packing etc.):Product!on processNumber of lines2Production floor area m—————————■■■■■■■■■■ ■Does the company carry out a design function?Yes □ No □If yes，which product(s)?Test/laboratory facilitiesDoes the company have an in-house test laboratory?Yes □ No □If no, please name the laboratory conducting testsIs the test laboratory accredited to ISO 17025 or other recognized scheme? Yes □ No □If yes, which scheme?Please provide brief details of the type of product test conducted(e.g. physical, chemical, microbial, analytical etc.):Warehousing and distributionWarehouse floor area m2: Is the warehouse located at the product!on site? yes 口 No □If no, where is it located?Yes □ No □Yes □ No □Do you subc on tract any warehousi ng?Product failure/incidentHave you had any incidents of product failure leading to or pending prosecution in the last five years?If yes, please provide details of the nature of the incident:Management systems and certificationPlease provide details of any current registration:Stan dardCertification BodyCertificate No.Certificate ExpiryPre-assessme ntNQA offers a pre-assessment service, which enables you to identify readiness for full evaluation, thereby easing the process to registration.Do you need pre-assessment?Yes □No □CONTACT INFORMATIONWould be happy to receive our marketing information relating to products or services or services we feel you may be interested in?Yes □No □If yes, youd like to receive this information by:Fax □ Email □ Telephone □Where did you hear about NQA?Signed:Date:Print Name:Positi on:GROUP。