1. Organisation Information Registered Company / Organisation Name * Any additional trading names to appear on certificate? Company / Organisation Type *
Management representative or Food Safety Team Leader: (person who has the applicant’s authority in relation to the certification process and approval of invoices)
Name * Position * Phone * Fax Email * Mailing Address (For correspondence) * Physical Address (Workshop premises) - Leave blank if same as above
Contact for accounts payable Name * Position * Phone * Fax Email * Name & Surname * Position * Phone * Fax Email * Company Registration Number * Comany VAT Number Do you wish to apply for Product / CE Marking? Yes No Where did you hear about SACAS Ireland * Advertising Conference Promotional Letters Online Referral Word of Mouth Website Other Other (Please Specify) Which Service do you wish to apply for? (tick all those applicable) * 2. Product Certification Information
When do you expect the workshop/system to be ready for the Pre permit assessment?
Proposed for assessment * Do you currently have any Product/Management systems certified by SACAS Ireland or any other certification body? * Yes No Standard Certificate Number Scope Do you have a current Permit certified by another certification body for the same standard? * Yes No If so, by Whom? * Reason for transfer of certification *
Transfer clients have to submit to SACAS Ireland the following records to enable SACAS Ireland to transfer the Permit:
Transfer of permit will only be allowed when this records are submitted to SACAS Ireland please advise if these documents are available? Current valid permit from the certification body * Yes No The last workshop audit and site inspection reports available with objective evidence for effective clearance of all non-conformances raised during the audits? * Yes No 3. General Business Information Please list the range of products and/or services that your organisation provides * * List regulatory requirements for your product * Size of Workshop * Is the Workshop located in an industrial area or having consent approval from the local municipality * Testing and/or inspection capability of company ( List in house testing/inspections conducted) Is any processes used by organisation outsourced? * Yes No If so, please indicate institution * Indicate Trade names and/or any trademarks which will be used in conjunction with the SACAS Ireland mark Preferred Language of Personnel * Indicate company vehicle or trailer registration(s) used for services of fire equipment * Is the business activities operational from a commercial or residential address? *
If operating from a residential address then a permit is required from your local authorities as required by law
4. Health and Safety Requirements Important – Please complete prior to submitting application form Occupational Health and Safety We at SACAS Ireland care for the safety and well-being of our staff. Please indicate through the following checkboxes any special details regarding safety whilst at your premises Please explain Personnel Protective Equipment (PPE) and/or safety induction process required * 5. Terms and Conditions
The applicant warrants that the information provided in this application form is correct.
By signing the application forms only put the applicant under no obligation to any fees and information is purely used to compile a quotation/service level agreement.
The applicant acknowledge that it has received and agree to abide by the following contractual documents:
SACAS Ireland Terms and Conditions for Certification, Assessment services will become applicable only if quotations are accepted;
Certification Procedures relevant to the Product, Process or Service Certification Services requested (strike out if not applicable); and
Terms and Conditions of the Certification Mark License (where relevant).
The applicant agrees that:
When applicant accepts this application in writing with the service level agreement; or
If the application is not accepted in writing, but accepts the service level agreement in writing and SACAS Ireland starts to supply Certification Services to the applicant; the applicant will be obliged to pay all fees due in respect of the certification services rendered till date of dispute after acceptance of the service level agreement, as calculated in accordance with the agreement reached with SACAS Ireland and signed by both parties.
The applicant agrees that if SACAS Ireland issues a Permit, the applicant will use the Marks in accordance with the Certification Mark Terms.
This application remains valid for twelve months from the date at which the application was made, after which period the application will expire.
I confirm if our operations activities is running prom a residential address that a permit is required from our local authorities as the auditors will verify this during the audits
If indicated yes that processes are operational and auditors arrive on site and found evident that the processes are not operational, the system will be audited but the auditors will have to go back for the process areas audits, ensuring both the system and processes have been audited before certification will be granted if successful, at customers expense. SACAS Ireland cannot be hold responsible for costs if client did not inform SACAS Ireland in writing especially if there are processes based on seasoning activities, as this may differ from country to country and it stays the applicant’s responsibility to inform SACAS Ireland whether the processes is operational or not and when seasonal activities takes place.
All fees are non-refundable.
The applicant agrees this application has been signed without prejudice or pressure from external parties.
I confirm that no discussion was held with regards to any other certification body.
Signed for and on behalf of applicant Title * Mr Ms Mrs Miss Dr Prof Full Names * By checking this box, you agree to our terms and conditions and sign this application. * Privacy
* Applicants may undergo a check on credit history through existing Creditors and Credit Reporting Agencies. SACAS Ireland reserves the right to reject any application.
** Attach additional pages as required.
www.sacasireland.com or phone the Chief Privacy Officer on +35389 449 0553 or e-mail email@example.com