Compile following form to open new request

1. TYPE OF CERTIFICATION REQUESTED
 
First certification Extension ( scope site)
Recertification Transfer of certificate (change of body)

 
2. DATA OF ORGANISATION APPLYING FOR CERTIFICATION
Company Registered Name:  NACE code 
Head Office Address:  Post Code/Town  
Statutory Representative:
Country:
Contatti: E-mail  Tel  Fax 
VAT Number:  Internet Site 
 

 
3. INFORMATION RELATED TO CERTIFICATION
Reference standards:
ISO9001:2015 ISO14001:2015 iso45001:2018 Other 
 
Activity to be certified
Outsourced process
Is the Head Office a site to be certified? YES NO
 
OTHER SITES TO BE CERTIFIED AND/OR OPERATIONAL SITES AND/OR EXTERNAL WORKS
OTHER SITES Indicate all sites subject to certification (offices, plants, warehouses, etc.) if different from head office.
Attach additional sheet, if necessary.
N.A.
  Name or type Address Activities carried out No staff
1.
2.
3.
4.
TEMPORARY SITES WHERE THE ORGANISATION WORKS N° (Indicate average number of operational yards established per year)   N.A.
Only in the case of construction and installation companies (EA 28) see also section 5
 
ANY EXCLUSIONS
Exclusion of requirements of the ISO 9001 standard YES NO - If YES, of which?
Exclusion of other sites of the organisation YES NO If YES, how many?
Exclusion of other outsourced activities/services provided by the organisation YES NO If YES, which ones?
 
PERSONNEL INVOLVED IN THE MANAGEMENT SYSTEM (By personnel is meant partners + employees + collaborators + subcontractors, etc)
INDICATE IN THE SPACES BELOW THE TOTAL STAFF IN HEAD OFFICE + PERSONNEL OF ANY SITES TO BE CERTIFIED + YARD PERSONNEL)
TOTAL no of personnel    
No of part time personnel  No of work shifts:
Average hours worked per week by part timers:  No of personnel per shift:
 

 
4. OTHER INFORMATION (applicable to all standards)
Did a consultancy company help prepare the Manual and procedures? YES NO
Name of this company (a)  Name of consultant (a):
Any management system certification already obtained: YES NO
If yes, for which standard(s):
Standard:
Certification body:
Is the certificate still valid?
YES 
NO
 
Language of the audit:
Italian English Slovenian
Other
System established from:
Requested date of audit:
 

 
5. ONLY FOR ISO 45001 CERTIFICATION
Significant risks to occupational health and safety Hazardous materials used in the processes
Legal obligations relevant to applicable OH&S legislation Environmental accidents occurred in the last 3 years (number and type)
 

 
6. SPECIFIC INTEGRATIVE INFORMATION (only to be filled in if applicable)
ONLY FOR CONSTRUCTION AND INSTALLATION COMPANIES (EA 28), insert the data required in the table below for each operational
  Address Activities performed No Staff Notes
1.
2.
 

 
7. ONLY FOR ISO 14001 CERTIFICATION
Significant risks to environmental Hazardous materials used in the processes
Legal obligations relevant to applicable EMS legislation Environmental accidents occurred in the last 3 years (number and type)
 

 
According to the EU Regulation 2016/679, cluase, laying down provisions for the protection of persons and other subjects regarding the processing of personal
data, I'm agree to the processing of my personal data and to the communication of my personal data to public bodies and private subjects for the purposes
envisaged by the regulation,
I agree I don't agree
 
  Date: Signature:
 
 

 
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(a) The name of the consultancy company enables ESQ certification Assurance to avoid possible conflict of interest between certification activities and the activities of the associated companies