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REF: NO - IQC Global

APPLICATION FOR MANAGEMENT SYSTEM CERTIFICATION. Accreditation(s): ... 4801-2001. (Only for Australian & New Zealand market) (Rev 03). ISO 9001: 2015. ISO 14001:2015 ... Integrated Quality Certification Pvt Ltd. Regd. & Corp ...




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APPLICATION FOR MANAGEMENT SYSTEM CERTIFICATION

Accreditation(s) Required:
( NABCB( JAS-ANZ( NABCB + JAS-ANZ

Management System Standards (Accredited)
( ISO 9001:2008( ISO 14001:2004( BS 18001:2007 OHSAS( AS 4801-2001
(Only for Australian & New Zealand market) (Rev 03)( ISO 9001:2015( ISO 14001:2015
( Integrated Management System (Accredited) (Rev 03)
( QMS + EMS ( QMS + OHSAS ( EMS + OHSAS ( QMS + EMS + OHSASPlease complete Annexure I also for OHS complexity (Low, Medium or High), as per JAS-ANZ Procedure 2, Part 1, Issue 3

Management System Standard(s) (IQC Plus Certificate)

( ISO 30000( ISO 13485( SA 8000( Other(s)

Corporate Office
Integrated Quality Certification Pvt Ltd
Regd. & Corp. Off: Platinum City, G/13/03, site # 02, Next to CMTI, HMT Main Road,
Yeshwanthpur Post. Bangalore – 560 022, India
Tel: + 91(80) 41172752, 41277353
Fax: + 91(80) 41280347
E-mail: iqccorporate@iqcglobal.com
Web: www.iqcglobal.com
CIN No: U74140KA2003PTC031851

Local Liaison OFFICE representative (for communication)







Liaison Representatives in India:

Aurangabad, Ambala, Baroda, Chennai, Cochin, Daman, Hyderabad and Kolkata

International representatives:


Australia, Bangladesh, Egypt, Indonesia, Jordan, Malaysia, Romania, Taiwan, UAE and Vietnam
Note: Please Provide Complete Details For Items Marked * In The Questionnaire.*Part 1: Company Details*Company Name
(As it should be appeared on the certificate.)*Name of contact person and Designation*PLANT (Work) Address:
(As it should be appeared on the certificate)*Corporate Office Address:
(If different from the plant location)





*P O Box : *Postal Code: *Company Identification Number :*Goods and Service Tax No:*Tel no: *Mobile No:Fax:*E-Mail: *Website: *Type of certification request:Initial Certification (Recertification (Transfer Certification (Scope Expansion (RC (SA-I (SA-II (RC (SA-I (SA-II (*If transfer certification, please provide the details of present certification bodyName of Certification Body: Accreditation Body:
Certificate number:
Expiry date:
Type of last audit done:
*Proposed Scope of Certification (scope of certification will be reviewed during the assessment and may be revised, if required for clarity):*Please note that details of trade wise number of employees will assist IQC in estimating the effective audit duration. Hence, please provide accurate details to avoid any potential concerns during the audit. The details shall be reviewed during the audit and onsite audit mandays will be revised accordingly.
You may change the employee’s description as applicable to your industry and use additional sheets if required to provide below requested information.*General Shift
Time:
*Shift 1
Time:
*Shift 2
Time:
*Shift 3
Time:
1.0. Total no. of employees ’!*General*Shift 1*Shift 2*Shift 32.0. Break up of employees in Corporate Office and Plant Functions as Applicable as below (2.1. Top Management (Proprietor, MD, Partners, etc)2.2. Number of Managers / Engineers personnel in each location.a). Managersb). Human Resourcesc). Engineersd). Marketing and Salese). Design and Developmentf). Purchase Managerg). Quality Assurance, Quality Control, Laboratoryh). Stores, Inspectioni). Maintenancej). Doctorsk). Finance (Accounts Dept.)2.3. Number of supervisory personnel / technicians in production.a). Production shift supervisorsb). Skilled technicians.
Please provide a list of various positions with numbers in an attachment or in this format.MachinistWeldersFittersElectricianAssemblyTestingNursesLab techniciansTeachers / Lecturersc). Unskilled technicians
Please provide a list of various or similar positions with numbers in an attachment or in this format.DistributionTransportationCuttersPackagingHelpersSecurity Guard3.0. Others (please specify, as applicable to your industry)*Locations to be covered under the scope of certificationCorporate Office (Plant (Regional Office(s) (Branches (If Regional Office(s) & branches to be certified.Number of Regional Office(s):
Number of branches:
(Please attach a separate sheet, if required to indicate location of branches and number of personnel in each regional / branch office)LocationGeneral Shift
Time:Shift 1
Time:Shift 2
Time:Shift 3
Time:Regional Number of personnel working in each department.BranchNumber of personnel working in each department.Project sites:Temporary Project Sites: YES (No (Permanent Sites:YES (NO (Number of active projects and Activities as on date:


Number of personnel working for each project / site. (in each department wise)
(Please attach a separate sheet, if required.)Is the scope of projects within the QHSE scope of certification? (Rev 00)Yes (No (Indicate the number of active projects within the scope of certification and brief of activities: (Rev 00)


*2.15. Does the Organization operate in Shift?Yes: (No: (* If Yes, indicate the Number of Shifts: *2.16. Are the manufacturing process (es) same in all shifts?Yes: (No: (Not
Applicable (If No, provide the details of operation in each shifts: *2.17
Does the organization utilized consultant service for development of management systems: YES: ( / NO: (*If Yes, indicate the name of consultant or consultancy organization:

*2.18. Significant changes to the management systems of the organization as compare to the previous certification process: (Not Applicable in case of Initial Certification ()
(Applicable in case of recertification ( / Scope Expansion ( / Transfer Certification ()ParticularsIf any changesIf Yes, Specify the changesContext of the Organization:Yes (No (Organization Structure:Yes (No (Introduction of technological changes resulting in up gradation of the process and products:Yes (No (Employees (Increase/Decrease)Yes (No (Scope of Certification:Yes (No (*2.19: Information on Integrated Management Systems:Indicate the management systems included in IMS:

Is the document developed covering all management systems as one Integrated Management System document (
Or separate documentation for each of the management systems (

Information relating to the level of integration, including the level of integration of documents, management system elements and responsibilities. Please tick the below elements as applicable.
Documentation (Document control and Record Control): (
Policy and Objectives: (
Support Processes: (
Operation of processes: (
Monitoring and Measurement: (
Correction, Corrective & Preventive Actions: (
Internal Audits: (
Management Reviews: (
Continual Improvement: (
Ability of client management to respond to audit questions: (
Others, if any.
*2.20. ISO 14001: Environmental Aspects:Whether aspects /impacts cover any of the following and controls defined?Emissions to air (Releases to water (Energy emitted, e.g. heat, radiation, vibration (Waste and by-products (Use of energy (Releases to land (Physical attributes, e.g. size, shape, color, appearance (Use of raw materials and natural resources (Others, if any specify (attach list)Identification of legal and other requirements: Yes ( No (Access to applicable legal and other requirements: Yes ( No (*2.20.1: BS 18001 OHSAS:Whether the hazards/risk assessment covers all processes considering any or some of the following operational controls, as applicable fpor the scope of certification? Yes ( No (Working at Heights (Permit to work (Confined space entry (Energy isolation (Job safety analysis (Lifting operations (Storage racks (Heat Stress (Critical equipment and system override (Personal Protective Equipment (Control of purchased products / Services (Management of visitors to the work place (Storage of hazardous materials (Storage and handling of radioactive materials (Safety in office environment (Safe handling of chemicals (Safe handling of machinery, equipment, materials (Storage of finished goods / products, acids, alkalis, etc ( Work environment for storage like temperature control / pest control (Work environment for humidity control / proper ventilation / house keeping (Others, if any (specify): Identification of legal and other requirements: Yes ( No (Access to applicable legal and other requirements: Yes ( No (*Part 2: BUSINESS INFORMATION*Details of processes outsourced:YES (NO (If Yes, provide details of outsourced processes:





*Applicable Statutory requirements for the Product and / or Service and other legal obligations:






*Details of manufacturing / Service processes:Provide details of ProductionProvide details of Service provision











*Details of Products manufactured or services provided: (Please attach list. If required)Provide details of Products manufacturedProvide details of services provided











ISO 9001:2008: *Any Exclusion Taken for any clause(s) of ISO 9001:2008 requirements:YES (NO (If Yes, indicate the clause number(s):


ISO 9001:2015: *Any Processes not applicable for quality management systems:YES (NO (If Yes, indicate the clause number(s):


*Please provide brief justification for exclusion or considering the process as not applicable:
NOTE: (Exclusion or process not applicable claimed will be reviewed during Stage I audit and may be accepted with justification or otherwise:



*Client authorized Representative completing the above information:*Designation and date:




Attachment - Annexure I to be completed for OHS complexity (Low, Medium or High)
Annexure-1:
Purpose: Determine the OHS complexity (Low, Medium or High) of a site or temporary site as per Procedure 2, Part 1, and Issue 3 JAS-ANZ.
Potential hazards and other factorsRange indicators for determining scoresScoreRe-Review of Check List Score by IQC Lead AuditorDangerous GoodsScore = 0, 5 or 10

5 There are some dangerous goods (but not licensable quantities).10 There are licensable quantitiesVehicle/pedestrian interaction (including fork-lifts)Score = 0, 5 or 10

5 there is vehicle traffic that has the potential to interact with employees or other persons but this interaction is very limited due to the low numbers of vehicles involved and limited potential pedestrian impact.10 there are a number of forklifts or other vehicle movements around employee work areas, and/or pedestrians are able to enter vehicle work zones.Powered plant (including building plant rooms)Score = 0, 5 or 10

5 powered plant is used occasionally.10 powered plant is used regularly or daily.Other plant (including scaffolding) or mechanical hazardsScore = 0, 5 or 10

5 other plant is used occasionally.10 other plant is used regularly or daily.Manual handling (includes Occupational Overuse Syndrome)Score = 0, 5 or 15

5 There is manual handling but it is limited to a small number of tasks.15 There are many manual handling tasks.Hazardous substances (includes asbestos)
Score = 0, 5 or 15

5 There is handling, storage, transport or use of hazardous substances.15 There is handling, storage, transport or use of hazardous substances on a daily basis by a number of persons.
Atmospheric contaminants other than hazardous substances (excludes confined spaces)Score = 0, 2 or 5

2 There has been or could be the need to test atmospheric contaminants to confirm they are below hazardous levels.5 There are known airborne contaminants in the atmosphere requiring breathing apparatus to be worn on a regular basis (may be in limited parts of the worksite).Use of ionising or non-ionising radiationScore = 0, 5 or 10

5 There are low radiation sources.10 There are high radiation sources.Confined Space (as per AS/NZS 2865)Score = 0,10 or 20

10 There is a confined space requiring entry.20 There are a variety of confined spaces requiring entry and/or a numberSlips, trips and fallsScore = 5 or 20

5 There are slip, trip or fall hazards.20 There are a range of activities that expose people to slip, trip and fall hazards.NoiseScore = 0, 5 or 15

5 There are nuisance noise levels that do not exceed the maximum legislated noise level.15 There are noise levels that exceed the maximum legislated noise level.Thermal environmentScore = 0 or 5

5 There is exposure to extreme thermal discomfort.Below ground work environmentScore = 0,10 or 30

10 There is occasional below ground work.30 There is regular or daily below ground work.Storage and/or use of explosivesScore = 0, 5 or 10

5 There are explosives on site.
10 There are explosives being used.Electrical hazardsScore = 0, 2, 5 or 10

2 Use of electrical equipment.
5 Occasional need for personnel to work on electrical equipment.
10 Regular or daily need for personnelPressurised environmentScore = 0 or 5

5 There is work in a pressurised environment.Threats of bullying, violence or occupational assaultScore = 0, 2,10 or 12

2 Exposure to internal bullying or violence.
10 Exposure to external bullying or violence.
12 Both conditions applyTotal score for determining OHS ComplexityLow OHS complexity
Score = 0 to 80

Medium OHS complexity
Score = 81 to 115

High OHS complexity

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