Bureau Veritas Certification
APPLICATION
BRC
GLOBAL STANDARD FOR FOOD SAFETY
GLOBAL STANDARD FOR PACKAGING
AND PACKAGING MATERIALS
GLOBAL STANDARD - STORAGE &
DISTRIBUTION
GLOBAL STANDARD – AGENTS &
BROKERS
Bureau Veritas Certification Local Office Address:
Page 1 of 7
BRC Application form Version 3 September 2015
Rev. 30/03/2015
Bureau Veritas Certification
Enquiry Number
Date:
Before we can prepare a written estimate of costs we need some information about your organisation and staff, so if you will please complete
the application form (section A to D) and return it to the address on the accompanying letter (or e-mail), we will then submit a quotation
tailored exactly to your situation. All information supplied will be treated with strict confidence.
Your application does not commit you to using our services in any way, and o application fee will be charged.
BRC is site specific, please fill in an application for each site (plant)
Please state which certification you require:
Global Standard for Food Safety Issue 7
Global Standard for Packaging and Packaging Materials - High Hygiene Issue 5
Global Standard for Packaging and Packaging Materials - Low Hygiene Issue 5
BRC Global Standard - Storage and Distribution Issue 2
Global Standard for Agents and Brokers Issue 1
Please state which Voluntary Module you require
ASDA AA
ASDA Free From
Traded Goods
Environmental Awareness (Packaging only)
Animal Feed
COSTCO Addendum
Please state which audit type you require
Announced
Unannounced
UKAS Accreditation will apply for any of the above certifications except Agents & Brokers & Voluntary Modules.
We look forward to helping you to obtain this increasingly important product certification in the near future.
SECTION A
COMPANY DETAILS (One application form shall be completed for each company site
COMPANY NAME:
COMPANY ADDRESS:
POSTCODE:
TEL NO:
BRC SITE NUMBER:
CONTACT NAME:
- BRC certification normally is site specific)
COUNTRY:
FAX NO:
WEBADDRESS:
EMAIL ADDRESS
PRODUCTS AND SERVICES (please detail the products you produce and /or the services you provide)
SCOPE (Please note that this description will be the Certification scope shown on the Approval Certificate issued by Bureau Veritas
Certification.)
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BRC Application form Version 3 September 2015
NUMBER OF EMPLOYEES:
ADMINISTRATION
PRODUCTION
MAINTENANCE
WAREHOUSE
DRIVERS
SUBCONTRACTED
SEASONAL
TEMPORARY
TOTAL
COMPANY DATA:
Size of the facility in m2
Number of HACCP studies
Number of production lines
Building year (age of)
WORK PATTERN:
1st ST SHIFT:
2nd SHIFT:
3rd SHIFT:
4th SHIFT:
Number:
Number:
Number:
Number:
Agents & Brokers
Services provided:
Agent
Brokers
Import/export
Location (country) of offices:
Number of
suppliers:
SECTION B
ACTIVITIES AND PROCESSES ON SITE:
PLEASE LIST HERE (OR ATTACH) INFORMATION RELATING TO ALL SITE ACTIVITIES INCLUDING NUMBER OF
PERSONNEL INVOLVED AND THE EXTENT OF ACTIVITY:
IF ANY PART OF THE SITE IS SUB-LET OR UNDER SEPARATE MANAGEMENT PLEASE GIVE DETAILS:
1. INCOMING MATERIALS
2. PROCESSES
3. PRODUCT STORAGE - INCLUDING IN-PROCESS
4. BUILDING AND SITE ASPECTS Please give any significant details, e.g., Any neighbour whose activity may effect operation, etc.
5. WASTE AND DISCHARGES (list main wastes and effluents)
6. TRANSPORT (distribution, sales, etc.)
7. LIST OF SUB CONTRACTED ACTIVITIES (i.e.: Machining, calibration, delivery, etc.).
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BRC Application form Version 3 September 2015
SECTION C
HAZARDS IDENTIFIED BY THE ORGANISATION AND MANAGED AS CCP OR BY PREREQUISITE PROGRAM.
1
2
3
4
5
6
SECTION D
OTHER MANAGEMENT SYSTEMS
(Please circle the correct answer and fill in when appropriate):
QUALITY
HAVE YOU IMPLEMENTED OTHER
MANAGEMENT SYSTEMS?
IF IT HAS BEEN APPROVED BY A
THIRD PARTY, PLEASE GIVE
DETAILS OF THE FOLLOWING:
A.
B.
C.
D.
E.
CERTIFICATION BODY:
STANDARD:
APPROVAL DATE:
VALID UNTIL:
COPY OF CERTIFICATE ATTACHED?
Yes
IFS
NO
If yes:
Yes
OTHER
NO
If yes:
A.
B.
C.
D.
E
A.
B.
C.
D.
E
Yes
NO
If yes:
A.
B.
C.
D.
E.
PLEASE GIVE THE NAME OF THE MANAGEMENT REPRESENTATIVE:
TARGET DATE FOR AUDIT:
AUTHORISED SIGNATORY:
POSITION
DATE
THANK YOU FOR HAVING COMPLETED THIS APPLICATION FORM
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BRC Application form Version 3 September 2015
PRODUCT CATEGORY
1) FOOD:
1: Raw red meat (Chilled and Frozen)
Beef/veal, pork, lamb, venison, offal and other meat.
2: Raw poultry (Chilled and Frozen)
Chicken, turkey, duck, goose, quail, farmed and wild game.
Shell egg.
3: Raw prepared products (meat and vegetarian)
(Chilled and Frozen)
Bacon, comminuted meat products, e.g. sausages, meat
pudding, ready to cook meals, ready prepared meat
products, pizzas, vegetable prepared meals, steamer meals.
4: Raw fish products and preparations (Chilled and
frozen)
Wet fish, molluscs, crustacean, comminuted fish products,
cold smoked fish, ready prepared fish products (e.g. fish
pie), fish fingers
5: Fruits, vegetables and nuts (Chilled and Ambient)
Fruit, vegetables, salads, herbs and nuts (unroasted).
6: Prepared fruit, vegetables and nuts (Chilled and
Frozen)
Prepared/semi-processed fruit, vegetables and salads
including prepared ready to eat salads, coleslaw, chips,
frozen vegetables.
7: Dairy, liquid egg (Chilled, Frozen and Ambient)
Liquid egg, liquid milks/drinks, cream, liquid tea and
coffee creamers, yoghurts, fermented milk based products,
fromage frais/crème fraîche. Ice cream, butter. Cheeseshard, soft, mould ripened, unpasteurised, processed.
Long-life milks, non-dairy products (e.g. soya milk)
ambient yoghurts, custards, etc.
Fruit juices (includes freshly squeezed and pasteurised,
smoothies) Dried whey powder, dried egg, dried milk/milk
formulation.
8: Cooked meat/fish products. (Chilled and Frozen)
Cooked meats (e.g. ham, meat pâté, hot eating pies, cold
eating pies) molluscs (ready to eat), crustacean (ready to
eat), fish pâté.
Hot smoked fish, poached salmon
9: Raw cured and/or fermented meat and fish (Chilled)
Parma ham, cold smoked salmon (e.g. gravalax), air dried
meats/salami, ready to eat smoked fish, fermented meats,
dried fish.
2. Packaging Materials
Glass manufacture &
forming
Paper making &
conversion
Metal forming
Rigid plastic forming
Flexible plastic
manufacture
Other manufacturing
Print processes
10: Ready meals and sandwiches; ready to eat
desserts. (Chilled and Frozen)
Ready meals, sandwiches, soups, sauces, pasta, quiche, flans,
meal accompaniments, cream cakes, trifles, assembled high
risk sweet desserts.
11: Low/high acid in cans/glass. (Ambient)
Canned products (e.g. beans, soups, meals, fruit, tuna)
Products packed in glass (e.g. sauces, jams, pickled
vegetables).
Pet food.
12: Beverages (Ambient)
Soft drinks including flavoured water, isotonics,
concentrates, squashes, cordials, minerals, table waters, ice,
herbal drinks, milk and cereal beverages; food drinks.
13: Alcoholic drinks and fermented/brewed
products. (Ambient)
Beer, wine, spirits.
Vinegars.
Alcopops.
14: Bakery (Ambient)
Bread, pastry, biscuits, cakes, tarts, breadcrumbs.
15: Dried foods and ingredients (Ambient)
Sugar, Soups, sauces, gravies, spices, stocks, herbs,
seasonings, stuffings, pulses, legumes, rices, noodles, nut
preparations, fruit preparations, vitamins, salt, additives,
gelatine, glace fruit, home baking, syrups, gases.
Dried pet food.
Tea, instant coffee and coffee creamers.
16: Confectionery (Ambient)
Chocolate, gums and jellies, other sweets.
17: Cereals and snacks (Ambient)
Oats, muesli, breakfast cereals, roasted nuts, crisps,
poppadoms.
18: Oils and fats (Ambient)
Cooking oils, margarine, shortening, spreads, suet, ghee.
Salad dressings, mayonnaise, vinaigrettes.
3. Storage & Distribution
1. Chilled and Frozen
Food
2. Ambient Food
3. Consumer products &
packaging materials
BRC Application form Version 3 September 2015
4. Agents & Brokers
1 Raw meat, fish and prepared
food
2 Fruit & vegetables prepared
and fresh
3 Dairy
4 Ready-to-eat chilled and
frozen products
5 Canned and jarred products
6 Alcoholic & non-alcoholic
drinks
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RC A
Chemical processes
7 Ambient grocery products
8 Glass
9 Paper
10 Metals
11 Plastics
12 Wood & other materials
To be filled in by local sales offices:
Allocated
auditor:
Country:
Planning:
Preparation & Planning
On-site audit
Report
Certification - MD 
Re - Certification - MD 
Combined audit : BRC+
Comments (to be used for justification of decreasing/increasing of the MD according to the procedure/standard):
Note 1
Note 2
Note 3
Note 4
The MD- and code allocation is
performed by:
Position:
Bureau Veritas Certification office:
Sign & date:
APPROVAL BY THE INTERNATIONAL COMPETENCE CENTRE:
Comments & Remarks:
Note 1
Note 2
Note 3
Note 4
Note 5
This review is done by:
Position:
Bureau Veritas Certification
office:
Sign & date:
BRC ANNUAL CONTRACT REVIEW / AUDITOR ROTATION CHECK AND REVIEW
Changes to Scope, to Product or Product Categories
Confirm auditor has not completed > 3 audits (Food)
5 audits (Packaging and Storage & Distribution)
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BRC Application form Version 3 September 2015
Confirm Number of Employees
Comments (include any changes in MD)
Date of review
Reviewed by
Page 7 of 7
BRC Application form Version 3 September 2015