Doc: SCPL/F/01

certification / re-certification Issue: 01

application form for quotation Rev.: 01
Date: 21/10/2018

SAGACI CERTIFICATIONS PVT. LTD.

Office No: 20, A-2/544 B, Shiva Arcade, Acharya Niketan,
Mayur Vihar Phase 1, Delhi – 110091, India
Tel: 011-43601987, Fax 011-43601911 & Mobile No.: 09560472730, 09818392734
E-mail: info@sagacicert.com / ceo@sagacicert.com || Website: www.sagacicert.com

This Application Form is intended as a self-description of your company. The questionnaire helps us to estimate the scope of and
resulting effort involved in the performance of a certification.

General Questions:
General Details
Organisation Name ARK TARPS – ARK PARTS PTY LTD
Corporate/ Legal Entity Company
Address (H.O.) Heland Place, Braeside, Victoria 3195, Australia
Phone +61 395805363 Fax ______________
Company Website ARKTARPS.CO.AU

Contact Person Details

Name NIMIT GUPTA
Designation OWNER
Phone No./Mobile +61 395805363
E-mail NIMIT.ARKTARPS.CO.AU

Seeking Accreditation For

*(For ISO 9001, ISO 14001, ISO 22000 & OHSAS 18001 only)
IAS IOAS Others -------
Scope of Certification
_________________________
*Please attach Organization Chart
*Please attach simple process flow chart.

Organisation Details:
Manpower Details
Number of Employees engaged in
No. of employees (at all locations) engaged in Full Time Part Time
identical or similar activities
Management & Administrative Activities 2 ---- ----
Design & Development Activities 2 ---- ----
Sales/Marketing 3 ---- ----
Purchase 1 ---- ----
Production & QC/QA ---- ---- ----
Stores, Warehouse & Transport Activities 2 ---- ----
Other Activities( please specify) ---- ---- ----
No. of Employees in
General Shift Shift-1 Shift-2 Total No. of Employees
10 ---- ---- 10

Details of the Sites to be covered under Certification

Number of Location 1
Please list all Sites: Main Activities at each Site:
________________ ________________
Applicable Regulatory & Statutory Requirements to the products/Services/Processes:
________________

Additional Information:
New Renew Transfer
Type of Application
Any Changes in Certificate(s)

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 Doc: SCPL/F/01
certification / re-certification Issue: 01
application form for quotation Rev.: 01
Date: 21/10/2018

(i.e. Extensions to scope,Address change or addition, others)

ISO 9001:2015 ISO 14001:2015 OHSAS 18001:2007
Applicable Certification Programme Other(s) – Please Specific
ISO 45001:2018
________________
In the case of several certification
programmes, would you like the audits to Combined Separate
be combined or carried out separately?
If combined, specify the combination
________________
required
Have You A Specific Programme/Time
________________
schedule for Achieving Certification?
Have you called on the services of a
No Yes
consultant?
If yes, please specify Name & Contact No. ________________
Name of Business Associate ________________
Except Marketing, Does the Business
No Yes
Associate have any other involvement?
If Yes, how Business Associate involved
________________
other than marketing?

Standard(s) Specific Information:

Quality Management System ISO 9001:2015
Is there any process outsourced that affects
No Yes - Describe ________________
product conformity?
If yes, give the name of the outsourced process ________________
Exclusions, if any? No Yes - Describe ________________
Is the documented system (Procedures, W.I.,
Forms/Formats etc.) has been implemented for a
No Yes - Describe ________________
period of at least three months followed by at least
one internal audit and a management review?
If yes, give the dates of Internal Audit and
________________
Management Review.

Environmental Management Systems ISO 14001:2015

Type of Industry ________________
What is the total surface area? ________________
Is a Register of Significant Environment aspect
No Yes
available?
Are Environmental Management Manual/
No Yes
Procedure etc. available?
An Internal Environmental Audit Programme? No Yes
Has the Internal Environmental Audit Programme
No Yes
been implemented?
What are the Environmental Laws/Acts applicable
______________
to your organization? Please list them.

Occupational Health & Safety Management OHSAS

ISO 45001:2018
System 18001:2007
Detail processes and detail any licences,
No Yes
authorisations and consents held
Do you have any OH & S risks which require
No Yes
regulatory requirements?
Are Site Plans (including drainage system) available
No Yes
for the site?
Details of Waste Management activities for the site ________________
Details of outsourced processes significant to the ________________

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 Doc: SCPL/F/01
certification / re-certification Issue: 01
application form for quotation Rev.: 01
Date: 21/10/2018

OH & S Management
Detail significant utilities used in the site/facility ________________
(Gas, Electric, Water, Oil….)
List of chemicals/materials in the site/facility ________________
Sensitivity of audit site ________________
(Interest groups, high regulations, populations…)

Declaration: We accept the terms and conditions of certification process and agree to abide by the Certification
requirements as provided by SCPL.

Client’s Name Designation Client’s Signature Date

NIMIT GUPTA OWNER ------------

(FOR SAGACI CERTIFICATIONS PVT. LTD. USE ONLY)

Can the application be further processed? No Yes - Describe
(If Yes) Reason for Non-processing:_________
Reviewed By: _________ Date: --------
Signature: