Client Information Form (CIF)

GT002, rev. 2 Document # F101-1 Release Date: 25-AUG-2017

SECTION 1: CLIENT INFORMATION

Dr Pramod Goyal, CDIPS Contact:
Client Name:
Title:      
Email: goyalpramod@yahoo.com
Address:
Gram UmeriKheda , Khandwa Road, Indore Mobile
Telephone Number: 9827275282
VAT no (EU only)      
Billing Address (if different): Fax Number:      
      Website

Total # of Employees * Language(s) used # of shifts Shift Pattern # of Emp./shift *

English Hindi Single
20-25

* Employees include permanent and non–permanent (seasonal, temporary and sub-contracted) personnel. Calculate Full Time Employees (FTE)
SECTION 2: MANAGEMENT SYSTEM INFORMATION
Project Type: ✘ Initial Certification Change in Scope (describe):
Re-Certification Multi-site (Details recorded in Multi-Site Worksheet)
Upgrade
From To:
Transfer of Certificate Office Use: On-site Off-site
Reason for Transfer:
Certification is requested for the following standard(s):
Quality ✘ ISO 9001 Other QMS Audit Criteria: ISO 39001
Health & Safety OHSAS 18001 ISO 45001
Environment ISO 14001 GHG Verification ISO 50001
Risk mngmnt ISO 22301 ISO 37001 ISO 55001 ISO 18788
Inform. Tech. ISO 27001 ISO 20000-1
Other (please specify):
Accelerated Audit (Provide justification here) Accelerated Audit requires Form F101-9 signed by customer

Are you currently certified?   No No Yes (specify audit criteria) Registrar:

Scope of certification:
     

Is Design applicable? (quality related standards No Yes

only)
Are some processes outsourced? No Yes, please specify

Audit Frequency 12-month ✘ Other, 9- or 6-month Target Audit Dates:

SECTION 3: GENERAL FEATURES OF THE ORGANIZATION

Are there legal/regulatory requirements relevant to the scope of the certification (i.e. National Environmental, Health & Safety, etc. regulations)?

Are site specific clearances required (e.g., security clearance)? ✘ No Yes

If Yes: please provide specific details:
Section 3B: OHSAS 18001 Audit Criteria (Significant Hazard/Risk Areas) Section 3C: ISO 14001 Audit Criteria (Significant Environmental Aspects)
Fire Safety: Emissions to Air, including Noise:

Electricity: Release to land and water (storm sewers, surface water, sanitary
sewer, ground water):
Hazardous Substances: Waste management (hazardous, non-hazardous, special: batteries,
bulbs):
Machinery Safety: Use of raw materials and natural resources (distribution, transportation,
energy/water use):
Air Quality: Other local environmental issues (including end of life of product):

Other, specify: Other, specify:

SECTION 4: ADDITIONAL INFORMATION

Per your scope, what are the significant processes and/or products covered under the certification? Academics MBA Program

Shift wise activities / processes that are to be covered under certification, to be detailed

SECTION 5: GENERAL
Have you used a consultant? ✘ No Yes (if yes, consultant must be specified)
Are you using Intertek for other services? ✘ No Yes (if yes, what service, what location?)
Form Completed By: Title: Date:
Dr Pramod Goyal Associate Professor 18/11/2017
 Client Information Form Approval (CIFA)
GT002, rev. 2 Document # F101-1 Release Date: 25-AUG-2017

Ref #:
Accredia ANAB CNAS COFRAC DAkkS
Accreditation Traceability DANAK EGAC itSMF JAB KAN
NA SCC SWEDAC TURKAK UKAS Unaccredited
Accelerated Audit (justify below) EAC Code: NACE Code:
Complexity Level (EMS & OHSMS only): High Medium Low Limited Special Case
Multi-sites With sampling Without sampling Campus (justification req’d)
Audit GOP Sales doc. Used: Other:
Criteria: Release Date:            
Number of effective personnel: Basic number of audit-days per the table:

Adjustment factors for audit duration Additional Information or justification:

Subtractive Factors Justification (as per Sales Process Document):

Calculation of number of effective personal (if shift operation, describe set up)

Additive Factors

Calculation of audit-days

Enter standard Std 1 Std 2 Std 3 Std 4 Std 5 Std 6 Std 7

Base number of audit days

Resulting adjustment factor (+ or -%)
# of days for Certification Audit 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Audit Day Rate
Annual Fee
Number of Audit-days assigned
Certification Audit Max. alloc for prep & plan: Max. alloc for remote auditing:
0.0 0.0 0

Annual Surveillances: Max. alloc for prep & plan: Max. alloc for remote auditing:
0.0 0.0 0

Recertification Audit: Max. alloc for prep & plan: Max. alloc for remote auditing:
0.0 0.0 0

Pre-Audit (optional): Other: Other: Other:

COMMENTS/SPECIAL INSTRUCTIONS:
     

Completed by:      

Date:      

Approved by:       Date:      

 Multi-site calculation

Document #: F101-1
Release date: 25-AUG-2017 Please enter text or figures in the blue cells

Ref #:

Head Office Site 1 Site 2 Site 3 Site 4 Site 5 Site 6 Site 7 Site 8 Site 9 Site 10
Line 1 Number of effective personnel:
Line 2 Base number of audit days:
Line 3 Resulting adjustment factor (+ or -%)
Line 4 # of days for Certification audit for each site 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
Line 5 # of days for Surveillance visits audit for each site 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
Line 6 # of days for re-certification audit for each site 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Three Year Sampling plan Select sites to be visited at each visit by "knocking-off" sites "not to be visited"

Initial audit 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
Surveillance 1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
Surveillance 2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
Re-certification 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

# of sites to
Total Prep. Remote be visited
Certification Audit 0.0 0.0 0.0
Surv. Visit #1 0.0 0.0 0.0
Surv. Visit #2 0.0 0.0 0.0
Re-certification audit 0.0 0.0 0.0

MULTI-SITE INFORMATION (where applicable) Support

Multi-site (Corporate Scheme Certification) Multi-site (Separate Certificates) Functions
1. Does the scope of certification embrace the activities of all sites? Yes No
2. Is the same management system policy in effect at all sites? Yes No
3. Is the management system documentation in effect applicable at all sites? Yes No
4. Are internal audits conducted at all sites and scheduled and reviewed centrally? Yes No
5. Are the following activities managed at one central site? Yes No
·         Evaluation of Corrective Action Yes No