· Web viewGLOBALG.A.P. IFA v5.1. NURTURE Module v11. Registration/Renewal Form. GLOBALG.A.P. scope that you are applying for? (e.g. Fruit and Veg, Flowers and Ornamentals etc.):

GLOBALG.A.P. IFA v5.1

NURTURE Module v11

Registration/Renewal Form

GLOBALG.A.P. scope that you are applying for? (e.g. Fruit and Veg, Flowers and Ornamentals etc.):

Have you previously been, or are you registered for GLOBALG.A.P. with another certification body?

Note: Please declare if there are any outstanding sanctions to the local NSF office

Certification Body:

Previous/existing GGN/GLN. (If you are transferring from another CB please state your GGN here).

If you are already registered with NSF, please provide your registration number (e.g. CMi 044/XXXX/1/15):

Company Name:

Address:

City:

Postcode:

Country:

Company Website:

(mandatory if the company has one)

VAT/Tax number:

Longitude:

Latitude:

Full Contact name

Role/

Responsibilities:

Telephone:

Mobile:

Fax:

Email:

Parallel Ownership Declaration - Does the producer handle or pack both GLOBALG.A.P. Certified and non-certified product in the packhouse (PHU) that is owned by the producer?

Yes:

No:

Name of 1st PHU (please complete the additional sheet for additional PHUs):

Address:

City:

Postcode:

Country:

Full Contact name of PHU including title (if different from above):

If using the GLN method for identifying Parallel Production or Parallel ownership

Sub GLN for PHU handling Certified product:

Sub GLN for PHU handling Non-Certified product:

GLOBALG.A.P. products handled through the PHU:

Non GLOBALG.A.P. products handled through the PHU:

Is this site covered by any of the following or other GFSI standards?

BRC:

IFS:

Other:

Does the packhouse (PHU) pack products for other GLOBALG.A.P. certified producers? (Y/N):

5) Products

Please register below all hectares of product to be GLOBALG.A.P. certified

UNCOVERED

GG Code:

Product:

Area (Number of hectares):

Multiple or further harvest (Y/N):

In Field produce handling included (Y/N):

Produce handling facility (incl. Storage) included (Y/N):

Harvest Period

(from/to dates):

Packhouse in operation for GG registered crops (from/to dates):

Nurture

Registration required? (Y/N) *

Total Area in hectares of all UNCOVERED products:

* If answer is YES, please complete: Section 8 NURTURE MODULE V.11 – PRODUCT INFORMATION SHEET

COVERED

GG Code:

Product:





Harvest Period

(from/to dates):


Nurture

Registration required? (Y/N) *

Total Area in hectares of all COVERED products:

* If answer is YES, please complete: Section 8 NURTURE MODULE V.11 – PRODUCT INFORMATION SHEET

Please list below all Countries Of Destination (COD) of products to be GLOBALG.A.P. certified (per crop/product)

Product:

Countries Of Destination (COD) (Recognised abbreviations accepted)

Please register below all hectares of product which are NOT to be considered under GLOBALG.A.P. Certification

This section below applies ONLY to PARALLEL PRODUCTION

UNCOVERED

GG Code:

Product:





Harvest Period

(from/to dates):


Total Area in hectares of all UNCOVERED products:

COVERED

GG Code:

Product:





Harvest Period

(from/to dates):


Total Area in hectares of all COVERED products:

Harvesting Exclusion: Should the producer sell the products in the field before harvest, and is not involved with the harvest, then this may be excluded from the certificate Please indicate and contact the local office if applicable

Yes:

No:

Products to be excluded from harvest:

Subcontractors - Please provide details of the subcontractors used for the following services

Name and Business Location

GGN

Distance from Producer

Product Handling: (e.g. Packhouse, storage)

Crop Protection:

Fertiliser Application:

Cultivation:

Harvesting:

Washing:

Other:

NURTURE MODULE V11 – PRODUCT INFORMATION SHEET – To completed ONLY by Producers requesting NURTURE Module

8) Product Related Data

Crop

TN Area

Uncovered (HA)

TN Area

Covered (HA)

TN Area (Further Harvest)

(Y/N)

TN Parallel Production (Y/N)

TN Parallel Ownership

(Y/N)

Produce Handling

(Y/N)

Country(ies) Of Destination (COD)

Crop

Primary Supplier 1

O-Key 1

Primary Supplier 2

O-Key 2

Primary Supplier 3

O-Key 3

By signing below producers are confirming that:

· They agree to abide by the applicable and current version of the GLOBALG.A.P. Standard (control points and compliance criteria and General Regulations which is available from – www.globalgap.org

· They have read, understood and agree to abide by the requirements of the current version (and updated versions as available) of the GLOBALG.A.P. Sub-licence Agreement. This is available on the NSF Certification UK website or from the local office upon request.

http://www.nsf-foodeurope.com/service.asp?service_id=certification&servicepage_id=154&subservice_id=11

· Their details may be displayed on the GLOBALG.A.P. website and shared with GLOBALG.A.P. members as defined in the applicable standard General Regulations and sub-licence agreement.

· They understand and agree that they are entering into a contract with NSF Certification UK, and will abide by NSF Certification UK Regulations which are available on the link below or upon request.

http://www.nsf-foodeurope.com/service.asp?service_id=certification&subservice_id=46

By signing below producers who are requesting Nurture Module Certification (applicable only for producers requesting Nurture Module Certification) are also confirming that:

· They agree to abide by the applicable and current version of the NURTURE Module (control points and compliance criteria and Scheme Rules) which is available from – www.globalgap.org

· They agree to abide by the applicable and current version of the NURTURE Module Data Access Rules which is available from – www.globalgap.org

No responsibility can be taken by NSF Certification UK for any supplied incorrect data and any subsequent financial penalties imposed by GLOBALG.A.P. which will be passed back to the producer.

Registration/Renewal Form guidance notes and GLOBALG.A.P. fee tables, are available from your audit provider

If you wish to participate in the GLOBALG.A.P. unannounced audit reward programme please mark here (x)

Signed:

Date:

Name (print):

Position:

Company Stamp (if available):

Name of PHU:

Address:

City:

Postcode:

Country:

Full Contact name of PHU including title:




GLOBALG.A.P. Products handled through the PHU:

Non-certified GLOBALG.A.P. products handled through the PHU:


BRC:

IFS:

Other:


Name of PHU:

Address:

City:

Postcode:

Country:

Full Contact name of PHU including title:




GLOBALG.A.P. products handled through the PHU:

Non-certified GLOBALG.A.P. Products handled through the PHU:


BRC:

IFS:

Other:


If the Producer has more than 4 sites, does the producer have a Quality Management System?

Do you want the audit to be conducted following the GLOBALG.A.P. Option 1 with QMS rules?

Producer Name:

Address:

Postcode:

Sub GLNs if applicable:

Products:

Covered Hectares:

Non-Covered Hectares:

Multiple or Further Harvest Y/N:



Current Registration Details

3) Company Contac Information (Responsible for Legal Entity)

2) Producer Details (Legal Entity/Company details)

4) Produce Handling Unit (PHU/Packhouse) - (Only to be completed if included in the scope certification). For additional PHUs please complete section 10.

6) Parallel Production only

7) Other Details

9) Declaration

10) Additional Packhouse Details

11) Additional Site Details

NSF GG IFA (C) RF1 / Issue 19 (Producer Registration Form)

© NSF Certification UK, Long Hanborough, Oxon, OX29 8SJ

Tel. +44 (0)1993 885600 Fax +44 (0)1993 885613

Email. [email protected]

Documents

· Web viewGLOBALG.A.P. IFA v5.1. NURTURE Module v11. Registration/Renewal Form. GLOBALG.A.P. scope that you are applying for? (e.g. Fruit and Veg, Flowers and Ornamentals etc.):