GSV申请表格.doc

Initial 初次审核 Re-Audit 跟进审核 Annual Renewal年度审核 (Registration No. 注册号_) Application for GSV On Site VerificationGSV 申请表格 Section 1: Invoiced Details 付费方信息 Company Name(English & Chinese)公司名称(中英文)Address (English & Chinese)地址(中英文)Contact Name联络人Telephone Number电话Fax Number传真E-mail Address电邮地址Section 2: Details of Physical Facility to Be Visited 工厂联络资料 Name of Physical Facility(English & Chinese)工厂名称(中英文)Full Address(English & Chinese)工厂详细地址(中英文)(中文地址应与营业执照相符)Contact Name联络人Telephone Number电话Fax Number传真E-mail Address电邮地址Remark: The factory name and address filled above would be adopted directly for Certificate issuing without further confirmation. 备注： 以上所填工厂名称及地址将直接引用于证书，不再另行确认。Section 3: Basic Information工厂基本资料 Industry Type产业类型 Agriculture 农业 Footwear 鞋类 Electronic 电子 Food 食品 Other 其他: Computer 计算机 Chemical 化学品 Toys and Hardlines 玩具 Cosmetics 化妆品Main Product主要产品电子玩具&电子组件Number of Employees雇员人数Language of Employees雇员语言中文Number of Buildings建筑物数量Distribution Centers分销中心N/AProduction生产Warehouse仓库Container Yards集装箱堆放场地Other其他Yes 是No 否Are warehouse(s) customs bonded? 是否属于海关保税仓库?Are facilities located in a Free-Trade Zone? 工厂是否位于自由贸易区/保税区?High Value Parts是否高额保值产品?Hazardous Materials是否或含有危险原料?Perishables是否易腐烂的产品? Chemicals是否化学品?Munitions / Dual Use是否军需品?Is the Applicant a Member of “Federation of Hong Kong Industries”, “Hong Kong Toys Council” or “Toys Manufacturers Association of Hong Kong” ?申请人是否是“香港工业总会”、“香港玩具协会”或“香港玩具厂商协会”的成员？If Yes, please Enter the Membership Number/Code.如果是，请注明成员号/代码Audit Date Required申请验厂日期2010-6-3Section 4: Confirmation by Intertek Intertek确认 Date日期： Proposed Date of On Site Verification 确认日期Audit Fee验厂费用 Approximate Cost of Traveling交通费Section 5: Declaration of Consent 同意声明 The Applicant agrees that Intertek will list the certification information i.e. company name, registration number, certificate number, date of certification, and expiry date of the certificate, etc. on the certification directory which will be posted on the website for GSV certification.The goal of the Global Security Verification (GSV) Program is to help the foreign manufacturing and export community eliminate redundant inspections. Manufacturers that voluntarily choose to participate in GSV Program agree to an on-site independent security inspection, to measure and verify how well their security practices meet the standards outlined by internationalimport security requirements. By signature below, the Applicant authorizes Intertek to share the security audit results with organizations the Applicant currently or plans to produce merchandise for sale,as evidence of accomplishing supply chain security obligations.If the Applicant is not the Physical Facility where the verification takes place, the Applicant agrees that Intertek to issue the GSV report and certificate to the above Physical Facility.申请人同意Intertek在GSV网站认证目录中登载认证信息，包括公司名称、注册号、证书号、认证日期和证书到期日等。全球供应链安全验证(GSV)的目的是帮助国外制造商和进口商减少重复检验。自愿加入GSV的制造商同意接受独立的现场安全检验，以评估和验证其安全操作是否符合国际进口安全标准的要求。在文件以下部分签字后，申请人则授权Intertek与申请人目前或计划为其销售而生产商品的机构分享安全审核结果，作为履行供应链安全责任的证明。如果申请人不是接受验证的实体工厂，则申请人同意Intertek向上述实体工厂出具GSV报告和证书。Section 6: Confirmation by Customer 客户确认 Date日期：2010-5-5 This is to confirm for the above arrangement.兹确认上述条款和安排 Authorized Signature授权审核签署Name and Position名称和职位Our service is subject to our Terms & Conditions of Business. Details are separately attached.有关的商业条款适用於此服务,详情请参考附件。Please make sure the factory name and address in the application form is applicable to list in the certificate. Otherwise an extra cost of RMB 240 will be charged for any request of amendment on certificate.请确认申请表上所列的工厂名称及地址适用于证书。证书如需更改，我们将收取人民币240元的证书修改费。Cancellations or rescheduling requested more than 2 business days & within 5 business days before the committed audit window will be liable for 50% of the full audit charge in addition to traveling expenses already incurred and non-refundable. If notice of cancellation or rescheduling of a monitoring visit is requested with 48 hours (2 business days) notice or less of the scheduled audit date, the full audit fee is charged in addition to any non-refundable and already incurred traveling expense.如果出现下列情况，申请方将承担相应的损失费用：在已确认的验厂日期前两至五个工作日内通知我方取消或更改已确认的验厂日期，申请方承担50审核费及实际产生的差旅费。在已确认的验厂日期前48小时内(两个工作日)通知我方取消或更改已确认的验厂日期，申请方承担全部审核费及实际产生的差旅费。Normally, the GSV certificate would be valid for 12 months. For more details, please contact our GSV Coordinator. 通常情况下，GSV证书有效期为12个月。有关认证时间的其它详情，敬请联络Intertek GSV协调员。Form No.: GSV-F16 Issue Date: 18 Aug 2009 Issue No.: 02