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1、APPLICATION FOR AGRICULTURAL PRODUCTION农业生产认证申请表BCS农业生产认证申请表申请人全称_法人（负责人）（签字、盖章） _申请日期_年_月_日文件编号：BCSCHINA-CX01-01发布日期；2009年1月1日Please fill out completely this application serves as a basis for the calculation of your offer it is NOT A CONTRACT本申请表是计算认证费用的依据，不是合同, 请仔细填写!1. NAME AND CONTACT OF APPLICA
2、NT 申请单位的名称和联系方式:Name 公司中文名:公司中英文名:Phone 电话: Cell phone 移动电话:Address: Zip Code and Town:详细地址 (邮政编码):Fax 传真: E-mail 电子邮箱:Legal form of the company 公司的性质:Contact person in charge of the organic project to be certified (if different from above)负责有机项目的联系人:Name:姓名:Phone 电话: Cell phone 移动电话:Address & Zip C
3、ode and Town 详细地址 (邮政编码):Fax 传真: E-mail 电子邮箱:Invoice recipient (if different from applying company) 发票接受联系人( 如与以上联系人不同):Name 姓名:Phone 电话: Cell phone 移动电话:Address & Zip Code and Town 详细地址 (邮政编码):Fax 传真: E-mail 电子邮箱:2. PRIOR CERTIFICATION AND CONVENTIONAL PRODUCTION 认证历史和常规生产Do you produce conventiona
4、l products and organic products in same facility(ies)? 在同一场地, 是否生产有机产品和常规产品？YES 是 NO 否 Has the operation ever applied for organic certification? 以前是否申请过有机认证?YES是 NO否 If YES, please provide the following 如果是，请填写以下资料 Name(s) of certification body 认证机构名称: According to which Standard(s) 认证标准: Year(s) of
5、 Application 申请的年份: Outcome of submission, including - if appropriate - copies of any notifications of non-compliance or denial of certification 申请的结果，包括所有没有通过的认证或拒绝认证的结论: Please provide a description and evidence (copies of letters from the certification body, etc.) of all corrective measures imple
6、mented. 请提供认证结果与改进措施（如认证机构的信件副本等）3. SCOPE OF CERTIFICATION 认证范围Certification according to which standard(s) is requested (please tick) 申请以下哪些标准的认证(请划勾):EU Organic Regulation (EU Market) 欧盟有机标准NOP Final Rule (US Market) 美国NOP标准Organic JAS (Japanese Market) 日本JAS有机标准GLOBALGAPBioSuisseUTZ CERTIFIEDOthe
7、r(s) 其它标准if other(s): which one(s) ? 其它标准名称4. PRODUCTS FOR CERTIFICATION - PLEASE LIST ALL PRODUCTS TO BE CERTIFIED 申请认证的产品名称 请详细列出所有申请认证的产品名称。Product 产品名称:Expected amount to be certified 预计认证的数量:1.2. 3. 4. 5. 6. 7. 8. 9. 5. INFORMATION ABOUT THE CERTIFICATION PROJECT 认证项目的基本情况Short description of y
8、our project: (Please list the facilities involved in project)项目基本情况的简述:(请列出该项目所涉及到的场所/范围)Note 备注:If applicant is not legal owner of all the facilities (= sub-units), please fill in Annex “List of sub-units and structogram”. In case of NOP certification handling and export facilities may be exempt or
9、 excluded. 若申请者不是该项目的所有者,请填写申请附件.若只申请NOP标准，贸易和出口项可以不填。1 Single farm(s) 单一农场2 Farmers Group(s) 小农户团体 Total number of farmers 总农户数: legally organised (e.g. cooperative)合法的组织(合作社) Internal control system implemented 建立了内部监督体系 3 Post harvest treatment facility(ies) 采后处理4 Packing facility(ies) 包装5 Export
10、ing facility(ies) 出口Facilities used for conventional and organic products: 用于处理有机产品和常规产品的场所有:Total area of farm production (in ha): (including conventional area)农场的总面积(公顷) (包括常规面积):Total area of organic farm production (in ha):农场的有机生产面积(公顷):Field history of farms: (date and type of last application(
11、s) of conventional inputs, former crops, former inspection body, etc.) *农场的历史: (最后使用化学物质的时间,以前的作物,过去认证的情况)*Location(s) of the facility(ies): (Province, region, city, village(s), add. helpful information) if different from applying company * 项目所涉及到的所有场所的位置:(省,区/县,乡镇,村以及其它信息)Note 备注:If applicant is no
12、t legal owner of all the facilities (= sub-units), please fill in Annex “List of sub-units and structogram”. 若申请项目不属申请者所有,请填写申请附表.Next (inter-)national airport:(Estimated time / distance to get from airport the main facility)与最近的机场之间的距离和所需要的时间:Accessibility, distances and travel times between indivi
13、dual facilities / sub-units:* 各企业（生产基地、加工厂与出口公司等）之间的距离以及所需的旅途时间:* If necessary, use additional page 如有必要, 请添加附页!I, the applicant for the above mentioned facility(ies), declare to be legally entitled to request certification for agricultural production (and post harvest treatment, resp. export if app
14、licable) of organic products according to the scope of certification as mentioned in item 3. of this application. 作为农业生产(加工或出口)项目的申请者在此郑重声明,本企业是一个符合以上申请标准要求的合法单位._ _ _, _Signature of responsible person Position Place Date签名 职位 地点 日期This part is for BCS internal use only 以下由BCS 内部填写Application checked and approved._
