Report no.
:
Application Form Report date:
Rev. no:
Prepared By Reviewed By Approved By PROCEDURE ICSIC-P-03
Mr. Pragnesh Mrs. Vidhi Mr. Arpan Page 1 of 9
Dear client,
As an accredited certification body for management systems, we require up-to-date information on
your company for the preparation of offers and for the planning and preparation of certification, ex-
tension and recertification audits. Please support us in this matter in order to ensure a smooth certifi-
cation process for your management system.
We kindly ask you to fill in the questionnaire including standard-specific attachments and to enclose
the required evidence as an attachment.
If we do not receive any feedback from you, we assume that nothing has changed since the last
certification cycle. Should we find that the information is not correct or that changes have occurred,
this may require a new calculation of efforts and prices.
General information (Only main location / Company headquarters)
Company
with legal form
Street
Postcode City Country India
Contact Mr. Mrs.
(First / Second Name)
Telephone Internet
Telefax E-Mail
Sector
Comp. Reg. No. GST No.
FSSAI Licence No. PAN No.
TAN No./Reg.
No
For further locations please fill in Page 4
1. No. of employees at the location (if appropriate, total employees employed in the corporation, group etc.
Total no. of employees of which no. of employees in part time
in addition, no. of AÜG *) employees
*) temporary employees from employment agencies
of which no. of minor employees
of which no. of employees in shift
of which no. of trainees working
Number of unskilled employees (low paid) Number of Shifts
F-04 Rev.00 Dated 01.05.2022
Report no.:
Application Form Report date:
Rev. no:
Prepared By Reviewed By Approved By PROCEDURE ICSIC-P-03
Mr. Pragnesh Mrs. Vidhi Mr. Arpan Page 2 of 9
2. Which certification do you require?
Certification Re-Certification Transfer Extension Pre-audit
ISO 9001 ISO 14001* ISO 50001* ISO 45001* FAMI-QS
FSSC 22000 ISO 27001* BS 10012 ISO 21001 ISO 22000*
EN 9100 HACCP BRC* ISO 29990
Others:
*) Please fill in annexes
2a Accreditation Desired
EGAC ** Others
* (For ISO 9001, ISO 14001, OHSAS 18001/ISO 45001, ISO 22000, ISO 50001 only)
** (For HACCP only)
3. Factors which can influence the time needed for the audit
In-house development? Low process risk Mature Management Family-owned company or
Yes No System simple processes
Large variety of High process risk Large location with Small location with large no.
regulations small no. of employees of employees
High level of Identical activities on Large no. of people Large no. of people who
automation all shifts with unique activities work “off location”
Did a consultant support you? No Yes
Consulting firm Contact
Have you received In house-Trainings from a company of the
No Yes
ICS GROUP?
Training Provider Contact
When do you plan your audit?
Do you have outsourced processes? No Yes, which? NA
F-04 Rev.00 Dated 01.05.2022
Report no.:
Application Form Report date:
Rev. no:
Prepared By Reviewed By Approved By PROCEDURE ICSIC-P-03
Mr. Pragnesh Mrs. Vidhi Mr. Arpan Page 3 of 9
4. Which kind of certification do you require?(Multiple choice possible)
Single certification All locations will be certified separately
Matrix certification All locations will be certified as one group
By certification of two or more management systems at the same time, we can use
Combined / Integrated certification
synergies to reduce the time of the audit
Do you want to have an integrated audit? Yes No
Do you want to have a Remote Audit? Yes No
Do you have the necessary infrastructure for a Remote Audit? Yes No
5. Requirements for Remote Audits (Multiple selection possible) -
Computer with Internet access Yes No
Conferencing tools (WebEx, Skype for Business, Zoom, etc.) Yes No
Webcam Yes No
Good audio equipment (microphone, speakers, headset, telephone, etc.)
Yes No
Secure and stable internet connection (LAN, WLAN), also in all areas of
Yes No
the production facility
If there are specific security requirements in the client organization, the cli-
Yes No
ent is responsible for providing a secure internet connection
Do the information security measures for the remote audits comply with le-
gal requirements, statutory, regulatory or contractual obligations? Yes No
Do the information security measures of the equipment used for the re-
mote audits correspond to the state of the art, e.g. the requirements of
Yes No
ISO 27002, GER BSI baselineprotection or an analogous standard?
Can you offer encrypted communication for remote audits? Yes No
Are the people responsible for the remote audit familiar with the infor-
Yes No
mation security settings for running remote audits?
F-04 Rev.00 Dated 01.05.2022
Report no.:
Application Form Report date:
Rev. no:
Prepared By Reviewed By Approved By PROCEDURE ICSIC-P-03
Mr. Pragnesh Mrs. Vidhi Mr. Arpan Page 4 of 9
6. In case of integrated audits: How high is your level of integration? -
Please fill in following points for certification at the same time:
An integrated documentation set, including procedures and work instructions Yes No
Management Reviews that cover the overall business strategy and plan Yes No
An integrated approach to internal audits Yes No
An integrated approach to policy as well as targets and objectives Yes No
An integrated approach to system processes (process descriptions) Yes No
An integrated approach to improvement mechanisms, (corrective and preventive ac- Yes No
tion; measurement and continual Improvement)
Integrated management support and responsibilities (common management repre- Yes No
sentatives)
7. Information for transfer of certificates –
Are the audit reports from the last certification period available? Yes No
Are there any non conformities from the previous audit? Yes No
Are all nonconformities from the previous audit closed? Yes No
Why do you want to change the certification body? body
Note: In case of an assignment for the transfer of a certification, please attach all issued and transfer-relevant certificates of the
previous certification body, all transfer-relevant audit reports from the last certification period and all non-conformity reports
from the last certification period.
8. Existing Certifications -
Please list all your existing certifications here.
Date of
Certificate number Standard / Directive etc. Certification Body Valid until
initial certification audit
F-04 Rev.00 Dated 01.05.2022
Report no.:
Application Form Report date:
Rev. no:
Prepared By Reviewed By Approved By PROCEDURE ICSIC-P-03
Mr. Pragnesh Mrs. Vidhi Mr. Arpan Page 5 of 9
[Link] / Business operation to be certified
10. In case of Manufacturing Company Explain hazards related to Manufacturing Products (
ISO 45001:2018)
11. Any further information you think may be important for us?
12. Documents to be submitted for the preparation of the offer and for the preparation for
the (re-)certification or extension audit
Documents for the preparation of the offer
☐professional or commercial register entry (or comparable evidence), if applicable
☐organization chart/oganization structure
Documents for planning the (re)certification or extension audit (These documents are to be sent to the lead auditor
before the audit.)
☐company policy
☐management system documentation
☐management review
☐audit program and report of internal audits
☐standard-specific evidence, if applicable (e.g.: environmental permits, accident statistics, energy report).
We confirm all information and agree that this information may be stored for the purposes of drafting
an offer and processing any resulting order or transactions.
Place/Date Name Signature *)
F-04 Rev.00 Dated 01.05.2022
Report no.:
Application Form Report date:
Rev. no:
Prepared By Reviewed By Approved By PROCEDURE ICSIC-P-03
Mr. Pragnesh Mrs. Vidhi Mr. Arpan Page 6 of 9
*) If sending by email, the sender's address will be accepted
TO be filled in case of Multisite for each location -
Location No.
Temporary location Constr. site Project:
Outsourced process Store Others:
General informationen
Company
with legal form
Street
Postcode City Country
Contact Mr. Mrs.
(First / Second Name)
Function QR other
Telephone Internet
Telefax E-Mail
Sector
Comp. Reg. No. VAT No.
No. of employees at the location
Total no. of employees of which no. of employees in part time
in addition, no. of AÜG *) employees of which no. of minor employees
*) temporary employees from employment agencies (450€-Basis)
of which no. of trainees of which no. of employees in shift working
Number of unskilled employees (low paid) Number of Shifts
Scope / Business operation to be certified
(for example: "Development, manufacture and sale of...", "Trade with..." etc.;
Special feature with IATF 16949: activities adding value and product development, if applicable)
If further locations are to be included, please copy this page and complete.
F-04 Rev.00 Dated 01.05.2022
Report no.:
Application Form Report date:
Rev. no:
Prepared By Reviewed By Approved By PROCEDURE ICSIC-P-03
Mr. Pragnesh Mrs. Vidhi Mr. Arpan Page 7 of 9
Please complete this questionnaire for each location, if necessary attach additional infor-
mation as an attachment. ( ISO 14001 & 45001
1. What is the environmental impact of the company (or location)?
Environmental aspects True Explanations
Emissions to the air
(e.g. Carbondioxide, solvents, NOx, SO2, dust, etc.)
Water extraction from surface waters / groundwater
(e.g. from river, lake, well etc.)
Direct discharge of wastewater
Storage and / or transport of hazardous substances
/ dangerous goods
Self-generation of energy
Use and contamination of soil
Generation, recycling, reuse, transport and disposal
of waste, in particular of hazardous waste
Dangers of environmental impacts that may arise
from incidents and potential emergency situations
Impact on biodiversity
Local phenomena
(Noise, vibrations, odors, aesthetic impairments, etc.)
F-04 Rev.00 Dated 01.05.2022
Report no.:
Application Form Report date:
Rev. no:
Prepared By Reviewed By Approved By PROCEDURE ICSIC-P-03
Mr. Pragnesh Mrs. Vidhi Mr. Arpan Page 8 of 9
2. Please tick the appropriate box if your company belongs to one of the following
branches (multiple choice possible)
- Industry of basic metals, fabricated metal products, machinery and equipment -
- Production of basic metals Electroplating Welding
Surface or other chemical treatment of metal products Coating
- Industry of rubber and plastic products -
Manufacture of plastic and rubber raw materials
- Industry of electrical and optical equipment -
Manufacture of printed circuit boards without components Manufacture of electronic components
- Electricity supply -
Energy generation with nuclear power Electricity generation based on coal
- Industry of pulp, paper and paper products -
Paper recycling Manufacture of pulp / cellulose
- Printing companies -
Photogravure, rotogravure, reproduction of recording media
- Industry of textiles and textile products -
Dyeing of textiles and clothing Tanning of leather
- Industry of non-metallic mineral products -
Processing and manufacture of ceramics Processing and manufacture of glass
Processing and manufacture of cement Processing and manufacture of clay, lime
- Wholesale and retail trade -
Wholesale and retail trading with fossil fuels
- Transport, storage -
Own vehicle fleet administration
- Industry of wood and wood products -
Manufacture of wood planks Treatment/impregnation of wood and wood product
- Industry of disposal and recycling -
Composting Waste dumps Waste processing including special waste, e.g. through incineration etc.
F-04 Rev.00 Dated 01.05.2022
Report no.:
Application Form Report date:
Rev. no:
Prepared By Reviewed By Approved By PROCEDURE ICSIC-P-03
Mr. Pragnesh Mrs. Vidhi Mr. Arpan Page 9 of 9
3. Do you have plant and machinery on site that requires a permission?
If yes, which and according to which legal basis?
Yes List of approved plant and machinery
4. Do you have plant and machinery on site that are relevant to the environment and
Safety?
If yes, List
Yes
which?
of plant and machinery that are relevant to the environment
We herewith confirm the completeness and accuracy of the information given above and in any an-
nexes which may be attached. We agree that this information may be stored for the purposes of
drafting an offer and processing any resulting order or transactions.
Place/Date Name, Function (Signature*)
*) If sending by email, the sender's address will be accepted
F-04 Rev.00 Dated 01.05.2022