APPLICATION FOR PROCESSING AND STORAGE OF SEMEN Owners Name: ______________________________________________________________ Address: ______________________________________________________________ ___________________________ Phone: No straws required: __________________________ NZ: __________ Export:______________________________________ (Important note; please specify which countries are required) Bull Name: ______________________________________________________________ Breed: ___________________________ Country of Origin: __________________ Date of Birth/Place: ___________________________ ID: ______________________________ _________________________ SIRE: __________________________ ___________________________ ___________________________ DAM: __________________________ ___________________________ Last date of natural service was: ____/_____/_____ DNA PROFILE OF BULL: Is a DNA Profile required? YES NO CONDITIONS 1. 2. 3. The owner or signatory to this form agrees to pay the charges for the processing of semen as detailed. Any semen unpaid for 30 days from invoice remains the property of Xcell Breeding Services Ltd. While undertaking to exercise all due care, Xcell Breeding Services Ltd does not accept responsibility for any livestock, semen or equipment which may come into its charge. Livestock, semen or equipment delivered to, or received by Xcell Breeding Services Ltd is accepted at the sole risk of the owner. It is a condition of the use or supply of the Company’s services that Xcell Breeding Services shall not be liable for loss or damage of any kind, however occurring to livestock, semen or equipment in Xcell Breeding Services Ltd’s care or in transit to or from the Company’s Centres. We recommend clients insure all semen. I understand and agree to abide by the conditions under which Xcell Breeding Services Ltd accepts all and any livestock, semen or equipment delivered to or received by the Company now and in the future. Signed: ________________________________________________ Date: Xcell Breeding Services Ltd Bovine Application Form and Pre-Entry Certificate 12/02/2016 -1- _______________ Status: ________________________________________________ FOR OFFICE USE ONLY Bull Arrived: ________________________ Bull Departed: __________________________ Date of 1st Collection: ____________Inspected by Centre vet prior to first collection__________ Approved by Centre Vet to move to ‘On Centre Side’. Date_______ Signed_________________ CHARGES No. Straws: ________________________ at $ ______________________ / straw Grazing: ________________________ days at $ __________________ / day Health Test Charges: $ __________________________ Blood Typing Charges: $ __________________________ Miscellaneous Charges: $ __________________________ TOTAL: $ _______________________ Invoice Number: ______________________ Date: ______________________ PROCESSING CHARGES Export Projects Carry Special Charges, Apply for Details On Farm Domestic Projects $4.00 per straw - On Centre $3.50 200 - 250 doses $3.25 251 - 500 doses $3.00 501 - 1000 doses Projects over 1000 P.O.A. Project Minimum $600.00 (200 doses) If the project fails, grazing charges plus a fee of $250.00 will be charged. GRAZING CHARGES *Semen collected on farm will only be despatched back to the premise of collection & will not be distributed to other client’s storage or destinations All Bulls $6.50 per day Health Testing Fees $350.00 per set DNA Profile $100.00 (optional) Storage Charges- @$0.07 cents per straw per month. (includes full material damage insurance covering semen at a value of $10 per straw) We still recommend clients insure their own semen. PACKAGING AND FORWARDING CHARGES WITHIN NEW ZEALAND a.Fees will be charged for the despatch of semen within New Zealand. A late notice fee applies when 3 working days or less notice is given. Liquid nitrogen will be charged at $6.50 a litre, and freight at cost. Xcell Breeding Services Ltd Bovine Application Form and Pre-Entry Certificate 12/02/2016 -2- All prices G.S.T. exclusive. BOVINE PRE-ENTRY DISEASE TEST CERTIFICATE Veterinary Certificate I ________________________________________ Veterinary Surgeon certify that the animal below has been subjected to the below tests with the results shown. The animal was examined by me on __________________________ and was found to be free of clinical signs of infectious disease and showed no signs of hereditable defects. Bulls Name: __________________________________ Breed: __________________________ ID: __________________________________ Date of Birth: ____/____/____ Date Isolation commenced:________/______/_________ Place of Birth: ____________________ Owners Name: __________________________________ Phone: __________________________ Address: ____________________________________________________________________ Note: Serology requires 10mls plain *ALL SEROLOGICAL TESTING TO BE COMPLETED AT GRIBBLES PALMERSTON NORTH, please request serum to be stored with GRIBBLES for 24 months under the Xcell Breeding Services account. Birth Ident Date TB Brucella CFT DAM IDENT: IBR Elisa Pom Cop Lepto Har Johnes CFT BVD Antigen Elisa EBL Agit If bull less than 24 months old EBL DAM Bull treatment for internal and external parasites: Date: ____/____/____ Product: __________________ Dose: ______________ Bull treatment with Streptomycin is required @ 25mg/kg if Lepto Titre positive on 2 occasions, 24 hours apart. Times and dates are critical. Date: ____/____/____ Date: ____/____/____ Product: __________________ Product: __________________ Dose: ______________ Dose: ______________ PROPERTY OF ORIGIN: To the best of my knowledge and after due inquiry: Xcell Breeding Services Ltd Bovine Application Form and Pre-Entry Certificate 12/02/2016 -3- (Property of origin questions below reflect breeding centre export requirements) Johne’s Disease - No case of clinical Johne’s disease has been diagnosed or suspected during the five years preceding collection and vaccination against Johne’s disease is not practised:1. On the farm of origin. 2. On any premises where bulls have been located during the two years prior to collection. Brucellosis and Tuberculosis - All premises where the donor bulls have been resident during the two years prior to the first collection have been officially declared free of tuberculosis and bovine brucellosis for the previous three years. All properties where the donor bulls have been resident during the 12 months prior to entry of the AB centre have not had: 1. A clinical diagnosis made of campylobacteriosis (vibriosis), enzootic bovine leucosis or trichomoniasis on the premises during the previous two years. 2. A clinical diagnosis made of infectious bovine rhinotracheitis made on the premises during the previous 12 months. 3. A clinical diagnosis of leptospirosis made on the premises during the previous six months. After due inquiry and to the best of my knowledge and belief, the donors of semen to which this certificate applies are neither animals which have been resident in the UK/ Republic of Ireland since 1 January 1982 or are not first generation progeny of such animals or are derived from reproductive material of UK/ Republic of Ireland since 1 January 1982. The animal has been continuously resident in New Zealand or Australia since birth: YES NO Please emphasise to clients the importance of bulls being isolated after testing until they enter the AB Centre. I certify that _________________________________ was kept in isolation and shipped according to MAF standards and between testing and entry to the AI Centre. The information that I have provided is true, correct and complete in every particular. I am aware that this declaration is made for the purposes of supporting export certification under the Animal Products Act 1999. I am aware that section 127 of the Animal Products Act 1999* makes it an offence for a person to make a false declaration under that Act. *Section 127 of the Animal Products Act 1999 A person commits an offence who, with intent to deceive and for the purpose of obtaining any material benefit or avoiding any material detriment, falsifies, alters, or misapplies any certificate or declaration or other statutory form attached or relating to any animal material or animal product that is required or authorised to be used under this Act,or any official assurance, or tampers with any animal material or animal product that is subject to such a certificate, declaration, form or assurance. Xcell Breeding Services Ltd Bovine Application Form and Pre-Entry Certificate 12/02/2016 -4- Signature of Veterinarian: ____________________________________________ Date: ____________________________________________ Practice Name: ____________________________________________ Phone: ________________________ Fax: ____________________ Xcell Breeding Services Ltd Bovine Application Form and Pre-Entry Certificate 12/02/2016 -5- Notes on Bovine Pre-Entry Disease Certificates The owner should arrange for his Veterinarian to have the bull disease tested and this certificate must be in the hands of Xcell Breeding Services Ltd before the bull can be unloaded at the AB Centre. This testing must be done prior to entry to the AB Centre. Bulls will not be accepted from herds that are not officially tuberculosis free. Tests required are: (a) (b) (c) (d) (e) (f) Caudal fold intradermal tuberculin test. Brucella abortus CFT. IBR Elisa. Leptospiral MAT.L.pomona L.copenhagen L.hardjo. Johnes CFT. Enzootic Bovine Leucosis Agit. For EBL (f) only please note: If the bull is under 24 months of age, the dam must also be tested. In the case of animals derived by embryo transfer, ‘dam’ means the recipient of the embryo. If the dam cannot be tested, then semen cannot be traded until the bull can be tested at two years of age. (g) BVD Elisa antigen. The bull must be treated for internal and external parasites within the testing period. Bull’s positive to Leptospirosis must be treated twice at a 24 hour interval with streptomycin at a dose rate of 25mg/kg body weight. The bull can then be accepted at the AB Centre. Bulls with a positive IBR Elisa will be accepted. Bull’s positive to other tests will not be accepted. Please ensure that the bull is isolated during and after testing. Precondition the bull with hay at least 7 days prior to departure to the AB Centre. Xcell Breeding Services Ltd Bovine Application Form and Pre-Entry Certificate 12/02/2016 -6- CHECK LIST FOR PRE-ENTRY HEALTH REQUIREMENTS TO XCELL BREEDING SERVICES LTD SOUTH ISLAND BREEDING CENTRE Following request from a client for a pre-entry test, contact Xcell Breeding Services Ltd for a current form specifying species (bovine, ovine, cervine or caprine). We prefer to send forms on request so we know what is happening. Completed certificate must be with Xcell Breeding Services Ltd before animals come on centre (see sample). Veterinarians name. Date of examination - please ensure they are examined and appear to be reproductively sound. Animals name. Identification - ear tag, tattoo, photograph, etc. Breed. Owners name and/or syndicate name. Owners address. Test panel - ensure complete - NB: no need for TB test if within previous 60 days. Requires min 10mls plain. Treated for internal and external parasites. EBL - If bull is under 24 months of age and dam is unable to be tested, then bull’s semen is ineligible for trade until the bull can be tested at 24 months of age. Property of origin questions “After due inquiry” means that the questions are asked, response confirmed and that there is compliance with the requirements of the certificate. Continuously resident in NZ or Australia since birth. Isolation - In my opinion, this is critical and I feel that it is the testing veterinarians responsibility to ensure the animal is isolated during pre-entry (ie ask the owner to point out the isolation paddock and impress on him the importance of isolation). Signature of Veterinarian. Date. Practice name, phone, fax - this is really helpful to us if we need to confirm details or request additional tests. Finally, hay feeding will help pre conditioning of animals during the pre-entry isolation period. Xcell Breeding Services Ltd Bovine Application Form and Pre-Entry Certificate 12/02/2016 -7- Remember, the pre-entry certificate is part of Xcell Breeding Services Ltd’s health records which are subject to audit by MAF and exporting country regulatory authorities. Xcell Breeding Services Ltd Bovine Application Form and Pre-Entry Certificate 12/02/2016 -8-