HALAL APPLICATION FORM

Section 1: Company/Organisation Details

Name of Company or Organization International Beverages Private Limited

( please enter the wording of your Company name
EXACTLY as you wish it to appear on the
certificate)
Address Habirbari, Valuka, Mymensingh, Bangladesh
Postcode 2240
ADDRESS FOR INVOICE: if above, enter “same” Same
Trade License Number:
If company is part of a group, please specify Bottler Investor Group
group
Management Representative (Contact) Mr. Mohammad Kamrul Hasan Bhuiya
Position Deputy. Manager QA
Food safety Manager Mr. Mohammad Kamrul Hasan Bhuiya
E-mail address mkamrulhasan@coca cola.com.bd
Tel No: 008801799990123 Fax No:

Section 2: Certification (s) Required (please tick):

Halal products - Part one: General Requirements for Halal Food (UAE.S 2055-1:2015)

Halal Products- Part 4: Requirements for Cosmetics and Personal Care (UAE.S 2055-4:2014)

Animal Slaughtering Requirements according to Islamic Rules (UAE.S 993 :2015)

Others (please indicate below):

More details (if others selected above):

 Type of request: Please tick below

Certification Renewal of existing certification

Extension , modification Certification audit integrated with

existing standard
For integrated please identify your existing certified standard you wish to combine with the above
certification:
NA

D4-AE-AFL-HA-01, Rev.02, Dated 21.05.2017 Page 1

  Does your company already have third party certification? If yes, please indicate below:

Standard (s) : ISO 9001 CB (Certification Body)

ISO 14001 CB
OHSAS 18001 CB
ISO 22000 CB
FSSC 22000 CB
HACCP/GMP CB
SQF 1000/2000 CB
BRC CB
IFS CB
GAP / Global GAP Please indicate
Halal Requirements
ISO 22716
Others

 Results of any prior previous audit(s) :

Section 3: Scope/Processes

 Please define the scope of registration e.g. product produced (please complete this question
in detail or attach/send supporting information)

Manufacturing of carbonated soft drinks and drinking water.

 Exclusions: Are there any local activities that are not included within the scope of the
certification? If so, please describe the exclusions (if any)
Local Research and development

 Give details if any specialist operations or services carried out by a sub contractor
(Outsourced).

P E ST CO NT RO L S E R VI C E - C PM

FO O D FO R C ANT E EN - BY G R E E N CH ILI

D4-AE-AFL-HA-01, Rev.02, Dated 21.05.2017 Page 2

  Give details if any consultancy relating to the management system to be certified has been
provided.

NA

 Product/Process Information:
 Please list below each product family (ies) and product types.
(A product family shown common process or technology)
Exp. of product family: production of canned fruit juices and frozen fruit juices (2 product families)
Exp. of product types: canned mango juice, canned pineapple juice, canned guava juice and canned strawberry juice. (4 product
types)

Product Family

C AR BO N AT E D DR IN KI NG
SO FT DR IN K S W AT ER
Product Type

 Total number of production lines: 2 *

 Number and type of HACCP study (ies ): C C P 1 O P R P 2

A HACCP study corresponds to a hazard analysis for a family of products/services with similar
hazards and similar production technology and, where relevant, similar storage technology. E.g.
Production of ice-cream and cheese = 2 HACCP studies

 List of raw materials: CONCENTRATE BASE, SUGAR, WATER, CARBON DI OXIDE,

NITROGEN

 Please check off any of the following that apply to your business:

Simple process &/or

Labour intensive
Repetitive Tasks Process
environment
automation

 Any other relevant information on production lines:

NA

D4-AE-AFL-HA-01, Rev.02, Dated 21.05.2017 Page 3

  Please indicate if you have a timescale(s) for the following:

Implementation date of the By November 2017 English

Audit language
system

Pre-audit(if applicable) Yes Certification audit

1 21
Total Number of Employees

Non Shift

Shift
Agency
1
No. of Shifts

In case of seasonal product(s), please indicate the period(s) of production for each category of
product including number of employees (permanent & temporary) included in the scope.

N/ A

 Production floor area (ft2) or ( m 2 )

< 107,000 ft2 108,000 - 323K ft2 324,000 - 538K ft2 > 538,000 ft2

< 10,000 m2 10,001- 30,000 m2 30,001- 50,000 m2 >50,000 m2

D4-AE-AFL-HA-01, Rev.02, Dated 21.05.2017 Page 4

Gross annual turnover (Revenue) of your business (Required for SQF applicants only) ($):

N/ A

Documentation at this is site

If additional sites, provide details; Products or same as the main office?
# of staff
site/company name and address. activities Does it follow the same
system?

1. 1A
N/

2.

3.

4.

5.

Section 5. Operations

Please provide brief details about your operations, so that we can provide a more accurate quote and be better
prepared for the audit. Please include the following:

a) A process diagram of your whole operation and submit it with this form. This should include main
processes and aspects of your operations
b) A list of main equipment utilised
c) A list of other sites utilised such as off-site warehouses, processing facilities, storage & transport.

Section 6.Sales

For the products you wish certified,

please indicate the intended countries
for marketing and sales?

D4-AE-AFL-HA-01, Rev.02, Dated 21.05.2017 Page 5

 Appendix 1

Classification of Halal product/service categories

Please indicate with tick products produced (Internal use only if indicate in proposal worksheet no
need to submit this part)

Category Categories Examples of sector Tick

Codes

animals: fish; egg production; milk production;

A Farming 1 (Animals)
beekeeping; fishing; hunting;

fruits; vegetables; cereals; spices; horticultural

B Farming 2 (Plants)
products

Processing 1 (Perishable includes all activities after farming, e.g. animal

C animal slaughtering , poultry, eggs, dairy and fish
products) products

Processing 2
fresh fruits, fresh juices; preserved fruits; fresh
D (Perishable vegetable
vegetables; preserved vegetables
products)

Processing 3 OK
(Products with long shelf canned products; biscuits; snacks; oil; drinking
E
life at water; beverages; pasta; flour; sugar; salt
room temperature)
Feed production
F animal feed; fish feed

G
Food Service hotels; restaurants; catering
Distribution
H retail outlets; shops; wholesalers
water supply; cleaning; sewage; waste disposal;
I Services product development , process and equipment;
veterinary services, Islamic financial services
J Transport and storage Transport and storage
Equipment
K Industrial equipment, Vending machines
manufacturing
Chemical and
Food additives; dietary supplements; cleaning
L Biochemical
agents; processing aids, microorganisms
manufacturing
Packaging and wrapping
M packaging and wrapping material
material manufacturing
Other materials
N cosmetics, textile, leather products etc.
manufacturing

D4-AE-AFL-HA-01, Rev.02, Dated 21.05.2017 Page 6

 Appendix 2

Primary Sector

In case of primary sector, please indicate the following information:

Cattle Breeding:

Type of cattle Nº of producers Activity Number of animals

Poultry:

No of house Activity

Vegetables producers:

Type of vegetable Nº of Activity Surface

producers

D4-AE-AFL-HA-01, Rev.02, Dated 21.05.2017 Page 7

Notes:

1. Following the completion of your application, SGS will prepare a proposal which include details of the scope and
duration of audit, certification process and costs.

2. Please note that certification is site and product specific.

3. Clients will be provided a list of information and documents required as part of a pre-audit process (as above). This is
designed to facilitate the stage I and stage II audits and identify in advance any corrective actions or areas of concerns
that can be addressed.

4. Information about complaint and appeal can be obtained from the SGS website.

5. In cases of complaints, the client makes all the necessary arrangements for the investigation. They shall keep a record of
all customer complaints made known to them, takes appropriate action and document the actions taken and makes these
records available to SGS when requested.

6. The client must comply and implement any changes in the certification requirements as detailed by SGS. Likewise, they
must inform SGS should there be changes that may affect their ability to comply with the certification requirements

7. The client shall not make reference to its product certification in communication media such as documents, brochures or
advertising unless authorized by the company. If the certification applies to ongoing or continuous production, the
client must ensure the certified products continue to fulfil the product requirements. Rules for the suspension and
withdrawal of the Certificate of Conformity are available at SGS Website.

8. All SGS services are rendered in accordance with the applicable SGS Conditions of service available on request and
accessible at SGS Terms and Conditions .

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