Title Application for Accreditation Reference DA-00 Revision 06 Date 2014-12-05 Preparation Approval Authorization of issue Application date The Management System Head Officer The Directors of Department The General Director 2014-12-22 1. NOTES FOR COMPLETION APPLICATIONS Date: 2014-12-05 DA-00 rev. 06 Page 1 of 8 1.1. STRUCTURE OF THE APPLICATION The ACCREDIA application for accreditation consists of a general part and of the specific annexes for the accreditation scheme requested. To access ACCREDIA’s application for accreditation, Bodies performing conformity assessment activities (CABs)1, shall complete both the general form and the one specifically for the scheme requested. In order to do this the applicant is requested to flag the appropriate box for the application of accreditation as follows: DA-00 General application for accreditation; DA-01 Application for accreditation for Certification Bodies ( ISO/IEC 17021, ISO/EN 17065, ISO/IEC 17024, etc..); DA-02 Application for accreditation for Testing Laboratories, Testing Laboratories for Food Safety and Medical Laboratories (ISO /IEC 17025,); DA-03 Application for accreditation for Inspection Bodies (ISO/IEC 17020); DA-04 Application for accreditation for Certification and Inspection Bodies for purposes of subsequent notification/s (ISO/IEC 17065, ISO/IEC 17020); DA-05 Application for accreditation for Calibration Laboratories and Producers of Reference Materials (RMP) (ISO/IEC 17025 and/or ISO Guide 34); DA-06 Application for accreditation for organizations managing inter-laboratory testing schemes (ISO 17043); DA-07 Application for accreditation for Bodies verifying the emission of GHG; DA-08 Application for accreditation for Medical Laboratories (ISO 15189). Both the forms shall be completed either by hand or in electronic format and be signed by the legal representative of the Body or by a person authorized by the legal representative and it shall carry the stamp of the CAB. Applications may be sent in paper format to the postal addresses of the departments or by e-mail to the department secretariat – this second solution is preferable. In order for it to be accepted, the application must be completed in its entirety and accompanied by all the necessary documentation requested. Any failure to fully complete the form requires a formal explanation. N.B. a) (only for laboratories and PTPs): in the case of any changes in name/s or address as given in point 2 of DA-02, DA-05 and 06, it is necessary to re-send DA-00 and, respectively, DA-02, DA-05 and DA-06 including all the updated data; b) (only for Calibration Laboratories): in case of renewal, extension or reduction, it is necessary to re-send DA-00 and DA-05. 1.2. NORMATIVE REQUIREMENTS 1 “CAB” means Certification, Inspection, Verification Bodies, Testing, Calibration and Medical Labs, organizers of inter-laboratory assessments (PTPs) and Notified Bodies. APPLICATIONS Date: 2014-12-05 DA-00 rev. 06 Page 2 of 8 The verification of conformity of a CAB to the requirements of the standard and to the ACCREDIA regulations is performed using the modalities in accordance with the general, specific and technical regulations of accreditation which are applicable to every type of CAB, and are available on ACCREDIA’s website, www.accredia.it and also at ACCREDIA’s departments. 2. GENERAL DATA OF THE CAB 2.1. NAME AND CONTACT DETAILS 2.1.1. Acronym and name of the CAB (please give the full name as used on the CAB’s formal and legal documents) ……………………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………………… Address of the registered Head Office STREET NAME POSTAL CODE 2 TOWN/CITY PHONE FAX E-MAIL PEC Fiscal Code (if different from VAT number) WEBSITE VAT number Address of the registered office (*) (if different from above) STREET NAME POSTAL CODE TOWN/CITY PHONE FAX E-MAIL PEC Fiscal Code (if different from VAT number) WEBSITE VAT number (*): the table must be duplicated for each operative location if it is a multi-site laboratory. Addresses of branch offices (including those which are involved, completely or partially, in activities which come within the scope of the requested accreditation and adequately highlighted.) STREET NAME 2 The details concerning the address, phone number, fax, email and website are published in the databank of ACCREDIA’s website once accreditation has been granted. APPLICATIONS Date: 2014-12-05 DA-00 rev. 06 Page 3 of 8 POSTAL CODE TOWN/CITY PHONE FAX E-MAIL WEBSITE Fiscal Code (if different from VAT number) VAT number 2.1.2. Name of the CAB and addresses to give on the certificate of accreditation (among those given above; where applicable, please specify the division, department or unit which is the object of accreditation.) ………………………………………………………………………………...………………………………………………………………………………………………. …………………………………………………………………………………………………………………………………………………………………………………. 2.1.3. Address for invoicing STREET NAME POSTAL CODE TOWN/CITY PHONE FAX E-MAIL Fiscal Code (if different from VAT number) 2.1.4 VAT number Communications with ACCREDIA Give an email address for the receipt of all communications from ACCREDIA. E-MAIL 2.2 DATE OF SET-UP OF CAB …………………………………………………………………………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………………………………………………………………………. 2.2.1 Legal status of CAB (please attach any relevant document attesting the legal identity of the CAB along with the identification of its legal representative): [ ] Private organization [ ] Public entity APPLICATIONS Date: 2014-12-05 DA-00 rev. 06 Page 4 of 8 [ ] Different category from above. (Specify the precise legal nature of the CAB: public, private, consortium etc.): ………………………………………………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………………… 2.2.2 CAB shareholders (applicable for Certification and Inspection Bodies also for the purposes of notification). Give the names of physical and legal persons and their shares (of the CAB of or corporate enterprises if they are CAB shareholders.) ………………………………………………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………………… 2.2.3 Does the CAB belong to a group? yes no If yes, give details of the group: NAME STREET NAME POSTAL CODE TOWN/CITY PHONE TELEFAX E-MAIL WEBSITE 2.3 ATTESTATIONS and VERIFICATIONS 2.3.1 Has the CAB has obtained other accreditations, designations, authorizations, notifications or recognitions in the last 4 years? yes no If “yes” what were they? (indicate the Body – national or foreign – the public or private entity which issued the declaration.) ………………………………………………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………………………………………………………… 2.3.2 Other Indicate the date and the Body, public or private, which conducted the assessment activity at the CAB in the last four years: a) …………………………………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………………………………… APPLICATIONS Date: 2014-12-05 DA-00 rev. 06 Page 5 of 8 b) …………………………………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………………………………… c) …………………………………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………………………………… 2.4. GEOGRAPHICAL AREAS IN WHICH THE CAB OPERATES AND IF IT HAS ANY OPERATIVE BRANCHES ABROAD Name of operative branch abroad (write the Geographical area (Italy/abroad – if operative status) abroad write the name of the country) Main activity 3. ORGANIZATION 3.1 Name, qualification2, function and contact details (phone, fax, e-mail) of the legal representative of the CAB: …………………………………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………………………………… . 3.2 Name, qualification2, function and contact details (phone, fax, e-mail) of the CAB’s Officer in charge: …………………………………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………………………………… 3.3 Name, qualification2 (including study details), function of the CAB’s Management System Officer: …………………………………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………………………………… 3.4 Name, qualification2, function and contact details (phone, fax, e-mail) of the person in charge of contacts with ACCREDIA …………………………………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………………………………… 4. CAB PERSONNEL 4.1 Total number of CAB dependent personnel APPLICATIONS Date: 2014-12-05 DA-00 rev. 06 Page 6 of 8 …………………………………………………………………………………………………………………………… Full-time employees Other types of contract 4.2 University graduates University graduates High school graduates High school graduates Others Others Total number of CAB personnel involved in assessment activities coming within the scope of accreditation (technical, administrative, commercial, quality, testing etc.). …………………………………………………………………………………………………………………………… 5. OTHER ACTIVITIES Describe the activities undertaken by the CAB, apart from conformity assessment activities, for which accreditation is sought, such as training, publications and so forth, indicating the type of client for which the activities are destined (if necessary an attachment may be used.) …………………………………………………………………………………………………….................................... ............................................................................................................................................................................ ............................................................................................................................................................................ ........................................................................................................................................................................... 6. AVAILABILITY FOR ASSESSMENT Indicate the date when the CAB is available for assessment: …………………………………………………… Is the assessment urgent? yes [ ] no [ ] If yes, give reasons: …………………………………………………………………………………………………….................................... ............................................................................................................................................................................ ............................................................................................................................................................................ ............................................................................................................................................................................ 2 indicate the study title 7. DECLARATION I hereby declare that I have read, understood and fully accept the requirements of the applicable ACCREDIA documents, including the pricelist. I also hereby declare that I have read and that I accept and shall sign the Contractual Agreement of Accreditation CO-00 without requesting any modifications. I also declare, in accordance with Law Decree 196/03 “Protection of persons with regard to the treatment of personal data”, that I accept the treatment of data contained in the present document for the process of accreditation performed by ACCREDIA and that the information given above may be used by ACCREDIA for APPLICATIONS Date: 2014-12-05 DA-00 rev. 06 Page 7 of 8 accreditation, administrative, international recognition activities in both the voluntary and mandatory sectors, in accordance with the EA, IAF and ILAC agreements. Such information may be communicated and made available to the competent authorities whenever so requested. In such cases ACCREDIA shall notify the organization in question, with the modalities and timeframe given by the authorities. ……………………………………………………………………………………………………………………………… Rev. number: ………………………. Date:………………………….. Stamp of the CAB………………………………….. Signature of the Officer in charge (Director of the Body or Head Officer of the Testing or Calibration Laboratory)…………………………………………. APPLICATIONS Date: 2014-12-05 DA-00 rev. 06 Page 8 of 8