Application for GS1 South Africa Membership (Foreign Exporting into SA)

Important Notice >> The terms and conditions of the GS1 SA Membership & Licence Agreement, which you must read, form part of and are terms of this document. By applying for a GS1 SA Membership Licence you, as a member, will be deemed to have read and understood these Terms and Conditions. They are also available on our website or upon request. >> Failure to complete this form in full and legibly will result in a processing delay.

STEP 1 Has your company previously been a member of GS1 SA? Yes No Unknown Do you have a related company that is already a GS1 SA member? Yes No Unknown If yes, please identify your GS1 SA Prefix Number(s) _____________________________________________________ STEP 2 Company Name
Company Registration Number
(ID Number if Company Registration Number is not available)

VAT Registration Number (leave blank if not available)

Postal Address Suburb Physical Address Suburb Business Phone Business Email Website Province Business Fax Postcode Province Postcode

GS1 Co-ordinator: Person responsible for allocating Bar Code Numbers within your company
Title Surname Position / Title within the company Phone Email Cellular First Name(s)

Application for GS1 SA Membership (Foreign Exporting)

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Accounts Contact: (If different to Person responsible for allocating Bar Code Numbers)
Title (Mr/Mrs) Surname Position / Title within the company Phone Email Cellular First Name(s)

STEP 3
1. 2. 3.

Further Information
Do you export products to North America (USA/Canada)? If so, please also contact GS1 SA on + 2711 789 5777 to apply for UCC numbers. How do you prefer to receive the GS1 SA quarterly magazine? How did you hear about becoming a subscriber member of GS1 South Africa? Other, please specify_____________________ What is/are your reasons for joining as a member to GS1 SA? (Please tick all applicable answers) To apply bar code symbols to my products To apply bar code symbols to my cartons/shippers To apply bar code symbols to my shipments/logistic units For company internal process improvement (for Serial Shipping Container Code - SSCCs) For Data Synchronisation: For Electronic Product Codes: EPC/RFID For GS1 South Africa Alliance Partner Program For other GS1 South Africa Services e.g. GLN, GTIN 8 To meet trading partner requirements Other, please describe______________________________________ If you are joining to meet the requirements of any particular Trading Partner(s), please identify the trading partner:______________________________________________________________________________ What is the current size of your product range? (including variants such as colour/ size/ quantity) No Products 1 Product >2 - <10 Products >10 - <100 Products >100 - <1000 Products >1000 - <10 000 Products >10 000 - <100 000 Products

To assist us in providing better service levels, please answer the following questions.

4.

5. 6.

7.

Please tick what training you would like to receive, training is compulsory to all new members:
Workshop in a Box DVD Face to Face training in Johannesburg

Generating the Bar Code Symbol (Printing):

Who will be printing the symbol?
Name of printing company? In which town is the printing company situated? Contact person Name: Phone Email Cellular

yourself

printer

packaging company

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STEP 4

Industry Verticals
Recording Industry Retailer Seafood Semiconductor Manufacturing Sports & Recreation Standards Body Textile/Apparel & Footwear Timber Tobacco Trade Organisation / Association Transport & Logistics

Which of the following industry verticals do you work within (please tick appropriate box) Academic Institution/ Dairy Industrial Supplies Education Aerospace/Defence Electrical Appliances Liquor Electronic Luxury Goods Agricultural Components Automotive/ Food & Grocery Market Research Aftermarket Automotive OEM Food Service Meat/Poultry Beverages Fresh Produce Metal/Steel Book/Magazine/ Furniture Mining Resources Publishing Chemicals General Merchandise Office Products Confectionery Government Paper Construction Consulting/ Professional Services Convenience Cultural/Recreation Entertainment Green Life Hardware Healthcare & Life Sciences ICT/Solution Provider Plumbing Printing & Packaging

Property & Business Utilities Services Other, please detail: _____________________________________________________

STEP 5 Industry Classification Which of the following industry verticals do you work within (please tick appropriate box) D. Electricity, Gas & Water Supply 01 Agriculture E. Construction F. Wholesale Trade

Wholesaling G. Retail Trade 52 Personal & Household Retailing C. Manufacturing

Other Food Manufacturing

od Retailing

H. Accommodation, Cafes & Restaurants I. Transport & Storage

turing Transport

J. Communication Services 71 Communication Services Product Manuf K. Finance & Insurance L. Property & Business Services M. Government Administration & Defence -Metallic Mineral Product Manufacturing Machinery & Equipment Manufacturing N. Education O. Health & Community Services 86 Health Services

Manufacturing P. Cultural & Recreational Services Q. Personal & Other Services Other, Please Specify ___________________________

294 Other Manufacturing

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STEP 6

Scale of Fees

Please select the fee category that applies to you and the month that you will join GS1 South Africa. Please add the Entrance fee to the pro rata fee for the month that you are joining in. Pro-rata Annual Licence Fee for joining in Month: Size of Numberbank Single Number 10 Numbers 100 Numbers Entrance Mar 2011 Apr 2011 May 2011 Jun 2011 Jul 2011 Fee 1703.00 2513.00 3485.00 226.80 810.00 1 215.00 2 376.00 4 860.00 207.90 742.50 1 113.75 2 178.00 4 455.00 189.00 675.00 1 012.50 1 980.00 4 050.00 170.10 607.50 911.25 151.20 540.00 810.00 Aug 2011 132.30 472.50 708.75 Sep 2011 113.40 405.00 607.50 Oct 2011 94.50 337.50 506.25 990.00 Nov 2011 75.60 270.00 405.00 792.00 Dec 2011 56.70 202.50 303.75 594.00 Jan 2012 37.80 135.00 202.50 396.00 810.00 Feb 2012 18.90 67.50 101.25 198.00 405.00

1,000 Numbers 4187.00 10,000 Numbers 100,000 Numbers GLN 4187.00

1 782.00 1 584.00 1 386.00 1 188.00

3 645.00 3 240.00 2 835.00 2 430.00 2 025.00 1 620.00 1 215.00

4187.00 14 580.00 13 365.00 12 150.00 10 935.00 9 720.00 8 505.00 7 290.00 6 075.00 4 860.00 3 645.00 2 430.00 1 215.00 972.00 226.80 207.90 189.00 170.10 151.20 132.30 113.40 94.50 75.60 56.70 37.80 18.90

PLEASE NOTE: If you are applying for a SECONDARY Prefix please only pay the licence fee due for the range. If you are outside the borders of SA VAT is NOT payable.

Calculate your Fees Payable (R)

Entrance Fee:

Pro-rata Licence fee (month): Sub Total: TOTAL PAYABLE:

STEP 7

Payment Methods

Total payment including Entrance Fee, Pro-rata Licence Fee & VAT (if applicable) = R _________________________ Electronic Transfer Cash Credit Card Visa Master Card

Other: _______________________ Card Holder Name Company Name

Company Name on card

Card Number Authorisation Signature -

Expiry Date Y Y Y Y M M D D

CVV Number

GS1 South Africa Banking Details Account Name CGCSA Bank Standard Bank of SA Ltd Branch Account Type Account No 02 229 445 7 IBT No 00 66 05

Hyde Park Branch Cheque / Current

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Business Classification:

Supplier

Retailer/ Wholesaler

Agent

GDS Contact: (If different to Person responsible for allocating Bar Code Numbers)
Title (Mr/Mrs) Surname Position / Title within the company Phone Email Cellular First Name(s)

STEP 8

Signature Approvals
Your GS1 SA Company Prefix will be sent to you upon receipt of your completed application form and payment of appropriate fees. The GS1 Company Prefix allocated to your company is exclusively for your use - you may not assign, licence or allow its use by any other company. Your membership & licence may be terminated if your account is not paid annually or if you do not abide by GS1 South Africa specifications and guidelines. You must advise GS1 South Africa by completing the appropriate termination form if you wish to cancel your membership. Cancellation will result in the withdrawal of the right to use GS1 Identification Keys (i.e. Barcodes). Applicants who wish to attend training or order the training DVD,can complete the booking/order form at additional cost for the training, this training is not compulsory but it is recommended.

DECLARATION BY APPLICANT
I/ We_______________________________________________ have read and understood, and shall abide by the Terms and Conditions of the GS1 South Africa Membership & Licence Agreement. The Company hereby agrees to adhere to the GS1 specifications and guidelines, abide by the rules of GS1 South Africa and pay the appropriate licence st fees by the 31 of March annually.

Signature Full Name

Date

Position / Title in company (Please note only authorised signatories are permitted to sign this agreement.)

General Terms of Membership (extract)

GS1 Global Trade Item Numbers (GTINs) may only be allocated by the member. In the event where a company, brand name or individual product is sold to a third party, written permission and approval from GS1 South Africa is required if the GTIN is to remain with the product(s) temporarily. Individual GTINs may, under no circumstances whatsoever, be sold to any other party. Should any member be found to be in breach of these rules, membership shall be terminated with immediate effect and the entire number bank will be withdrawn. Members agree to abide by and comply with all technical standards as set out by Global Standard 1 and GS1 South Africa. GS1 South Africa reserves the right to inspect your operation with regard to the identification, numbering and bar coding of your products as and when necessary to ensure that the terms and conditions are being observed and complied with. Any use of the GS1 Numbering System after termination of membership for whatever reason is strictly forbidden. Continued use renders the ex member liable for any outstanding licence fee and damages which might be suffered by GS1 South Africa and/or any of its members. The annual licence fee must be paid in full by no later than 30 days from date of invoice. GS1 South Africa reserves the right to cancel membership should payment remain outstanding thereafter. Barcode Training: It is mandatory for each new member to attend training (either classroom or online, dependent on your geographical location), as part of the GS1 SA service offering, within one year of joining GS1 South Africa. GDS Training: You are required to register and undergo training, within 1 year of joining GS1 South Africa at a fee stipulated at the time the training is booked. Product Data Catalogue: You are required to publish your product data on the GS1 Product Data Catalogue within 1 year of joining GS1 South Africa. The complete Terms and Conditions of Membership are included in the documentation sent to all new Members. Application for GS1 SA Membership (Foreign Exporting) Page 5 of 10

Terms and Conditions of Membership with GS1 South Africa

The following terms and conditions apply to the Membership of GS1 South Africa and the Licence to use the GS1 System and numbers granted by GS1 South Africa to the Member. Use of GS1 Numbers constitutes agreement by the Member to these Terms and Conditions. Failure to observe and abide by these terms and conditions may lead to termination of the Membership and the Licence. 1. DEFINITIONS: The following definitions will apply within these terms and conditions: 1.1 Business Day" means any day of the week except Saturday, Sunday or a national public holiday. 1.2 GS1" means GS1 South Africa, a Division of CGCSA, an Incorporated Association not for gain. 1.3 GS1 Numbers" means the GS1 membership number and product numbers that are issued to You by GS1 for Your use in accordance with these terms and conditions. 1.4 Intellectual Property" means patents, registered designs, utility models, trade marks, applications for any of the foregoing, inventions, unregistered trade marks, copyright, confidential information, know-how, processes and trade secrets and other intellectual property, and equivalents of any of the foregoing anywhere in the world and includes the Trade Marks. 1.5 Licence" means the licence granted by GS1 to You to use the GS1 Numbers. 1.6 Licensee" means You. 1.7 Member means You. 1.8 Membership means the state of being a member of GS1 South Africa. 1.9 Products" means the products manufactured and/or sold by You. 1.10 Application Form" means the GS1 Application form whereby persons apply to become members of GS1 and for the issue of GS1 Numbers. 1.11 terms and conditions" means these terms and conditions as varied by time to time by GS1 in accordance with clause 9. 1.12 Trade Marks" means the trade marks associated with GS1 and/or the GS1 numbering system. 1.13 You" means the person, company, corporation or other legal entity that has signed the Application Form applying for membership of GS1 and the issuance of GS1 numbers. Your" has a corresponding meaning. 2. GRANT OF MEMBERSHIP AND LICENCE 2.1 If GS1 accepts Your application for membership and issues You with GS1 Numbers, GS1 also grants You a nonexclusive non-transferable licence to use those GS1 Numbers in connection with the supply and sale of Your Products. The Licence will commence on the date that GS1 issues You with Your GS1 Member Number and will continue until terminated as provided in clause 15. 2.2 Notwithstanding the above clause 2.1, the written permission and approval of GS1 South Africa is required in the event that You sell the company, brand name, or individual products to a third party and require that Your GS1 Member Number, or specific GS1 Numbers transfers with the products to the new owner. (Such approval to be granted or withheld at GS1's sole discretion; such approval will not be unreasonably withheld.) 3. COMMENCEMENT DATE 3.1 Effect: These terms and conditions come into effect for You on the later of 1 January 2004 or the date on which the GS1 Numbers are issued to you. 4. FEES 4.1 Entrance Fee: On joining GS1 South Africa, You will pay an Entrance Fee as specified in the Application Form. Entrance Fee Single Number: You will pay an Entrance Fee as specified in the Application Form when applying for a Single Number. If you need to apply for a range of numbers after you have applied for a single number you will pay an Entrance Fee as specified in the Application Form, 4.2 Annual Licence fee is Payable: You will pay to GS1 an annual Licence fee to be invoiced 1st March of every year. This must be paid within 30 days from date of invoice. GS1 may, from time to time, increase the Licence fee by giving You at least 20 Business Days written notice. On expiry of the notice period the increase shall be effective and due and payable. 4.3 Amount of Entrance Fee and Licence fee: As at the commencement of the Membership the amount of the Entrance Fee and the annual Licence fee is as specified in the Application Form. Your initial Licence fee will be a pro-rata amount dependent on the month of joining. 4.4 Subscription to the Product Data Catalogue: On joining GS1 South Africa, You will automatically be subscribed to the GS1 Product Data Catalogue. 4.5 Fees Payable after Termination of Membership: Where Products bearing GS1 Numbers issued to You are already in the marketplace at the time of termination of the Membership pursuant to clause 15, notwithstanding such termination You will remain liable for a fee equivalent to the Licence fee for the period that those Products remain in the marketplace. 4.6 Default Interest: You will pay interest on any amount due and not paid within 60 days of due date. Such interest will be payable on the amount outstanding from the due date until payment at the maximum interest rate allowable. 4.7 VAT: All amounts payable under this clause are exclusive of VAT. You will also pay any VAT in addition to the base amount payable. 5. YOUR CONDUCT 5.1 Training: You are required to register and undergo training, either classroom or online, dependant on location, within 1 year of joining GS1 South Africa (one delegate at no cost). 5.2 Product Data Training: You are required to register and undergo training, within 1 year of joining GS1 South Africa at a fee stipulated at the time the training is booked. 5.3 Product Data Catalogue: You are required to publish your product data on the GS1 Product Data Catalogue within 1 year of joining GS1 South Africa. 5.4 Not Prejudice GS1's Goodwill: You will not at any time during the term of the Membership, or after its termination, be a party to any act, matter or thing whereby GS1's goodwill, trade or business may be prejudicially affected or brought into disrepute. 5.5 Standards: You will abide by and comply with the technical standards set out in the GS1 South Africa manuals/guidelines and such other directions as GS1 may give from time to time. 6. USE OF GS1 NUMBERS AND OTHER INTELLECTUAL PROPERTY 6.1 Use of GS1 Numbers: You are only entitled to use the GS1 Numbers issued to You by GS1. You must not use any numbers issued by GS1 to any other person. You may not use any numbers which purport to be issued by GS1 but which are not genuine GS1 numbers or which copy the GS1 numbering system. You will only use the GS1 Numbers issued to You in connection with the manufacture, sale and identification of Your Products. 6.2 Not Alter the Numbers: You will not alter the GS1 Numbers licensed to You in any way. 6.3 No Dealing with Numbers: You recognise GS1's title to the GS1 Numbers and related Intellectual Property and shall not at any time do or suffer to be done any act or thing which may in any way impair GS1's rights in the GS1 Numbers or related Intellectual Property. 6.4 No Challenge or Misuse of GS1 Numbers: You shall not at any time, either during the term of this Licence or after termination, directly or indirectly: 6.4.1 Challenge Ownership of Numbers: challenge, call into question or raise any questions concerning the validity or ownership of the GS1 System or related Intellectual Property; or 6.4.2 Seek Registration of similar Numbers: use or seek registration of any Intellectual Property including any design which incorporates or includes, or is substantially identical to, or deceptively or confusingly similar to, the GS1 Numbers or related Intellectual Property without GS1's prior written consent. 6.5 Proprietary Notices: You will ensure that all proprietary notices that GS1 may require from time to time, appear on the Products. Terms and Conditions of Membership with GS1 South Africa 7. USE OF GS1 NUMBERS AND TRADE MARKS FOR MARKETING /PROMOTION 7.1 Limited Rights to Use for Marketing / promotion: GS1 understands that in the marketing and promotion of the Products, You may also wish to use the GS1 Numbers and the Trade Marks. Your only rights to use the GS1 Numbers and the Trade Marks on marketing and promotional materials are specified in this clause. 7.2 GS1 Consent: GS1 must be given prior written notice of Your desire to use the GS1 Numbers and the Trade Marks in marketing and promotional materials. You may only use the GS1 Numbers and/or the Trade Marks if GS1 gives its approval to such use (such approval to be granted or withheld in GS1's sole discretion; such permission will not be unreasonably withheld). You will submit samples of the proposed marketing and promotional materials to GS1 for approval at least 15 Business Days prior to the intended date of publication. 7.3 Correct Reproduction of Trade Marks: If You are permitted to use the Trade Marks for marketing and promotional materials, You must ensure that the Trade Marks are correctly reproduced. 8. INTELLECTUAL PROPERTY INFRINGEMENT In the event that it comes to Your notice that: (a) there is an infringement or suspected infringement of the Intellectual Property in the GS1 Numbers or the Trade Marks; or (b) the GS1 Numbers infringe or are suspected of infringing intellectual property rights of others, You will promptly notify GS1 in writing. GS1 will have control over any steps GS1 may wish to take in relation to the suspected infringement and all such steps shall be at GS1's cost. You will provide information and assistance in respect of such suspected infringement as GS1 reasonably requests. 9. VARIATION OF TERMS AND CONDITIONS GS1 has the right to vary these terms and conditions at any time by giving written notice to You. Any such variation notified by GS1 shall take effect immediately (unless a later date is specified in the notice). 10. COMPLIANCE WITH GS1 RULES As long as You remain a member of GS1 You must comply with the rules of GS1, as contained within these Terms and Conditions as well as with the GS1 General Specifications. GS1 South Africa reserves the right to inspect Your operations and Products which relate to the GS1 Numbers at regular intervals to ensure that these terms and conditions are being observed and complied with. 11. SURVIVAL The covenants and acknowledgements contained in clauses 4.3, 5.2, 8, 12, 13 and 15 shall remain in force and effect after the termination or expiry of the Licence for any reason and shall not be deemed waived, merged or extinguished upon such termination or expiry. 12. INDEMNITY You agree to indemnify GS1 against claims, suits, losses, damages or costs suffered or incurred by GS1 as a result of Your conduct, Your use of the GS1 Numbers and any breach of these terms and conditions by You (except to the extent GS1 causes or contributes to the claims, suits, losses, damages or costs). 13. CONFIDENTIALITY You will always keep confidential and secure, and not exploit or otherwise misuse, any information of GS1's which is identified as or would reasonably be expected to be, proprietary, confidential or commercially sensitive. You will only disclose that information to the extent: (a) necessary to perform Your obligations under the Licence and on a need-to know" basis only; (b) GS1 authorises it in writing; or (c) as required by law. 14. ASSIGNMENT AND SUBLICENCES You shall not assign, transfer or sublicense Your rights and obligations under the Licence. 15. TERMINATION

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GS1 shall have the right to terminate the Licence immediately by giving notice if:

16.3. Cease applying GS1 Numbers to Products: cease applying the GS1 Numbers to any of Your

19. GENERAL LEGAL PROVISIONS 19.1 Governing law: The terms and conditions are

Terms and Conditions of Membership with GS1 South Africa (continued)

15.1 Failure to Pay Licence fee: You fail to pay the annual Membership fee by its due date; 15.2 Breach: You commit a breach of Your obligations under these terms and conditions, and you fail to remedy such breach; 15.3 Insolvency: You are declared bankrupt, go into liquidation, have a receiver or statutory manager appointed, or (being a company) are wound up otherwise than for the purpose of a reconstruction; or 15.4 Head Licence Terminates: GS1 ceases to hold the necessary licence rights to issue GS1 numbers in South Africa. 15.5. Termination by either Party: Either GS1 or You may otherwise terminate this Licence in any other circumstances by giving six months written notice to the other party. 15.6. No Release from Obligations: Termination of this Licence does not relieve either GS1 or You from liability arising from any prior breach of the terms of this Licence. 16. CONSEQUENCES TERMINATION On termination of this Licence, Your rights under this Licence shall terminate and You will immediately comply with the following: 16.1. Cease to Use Intellectual Property: cease all direct or indirect use of the GS1 Numbers and related Intellectual Property save in respect of products bearing GS1 numbers that are already in the market place at the date of termination of membership; 16.2. Return Materials: return (without retaining copies thereof ) all material, notes, data, instructions and other papers, samples, materials and property GS1 has supplied or other items which contain GS1's confidential information or Intellectual Property relating to the GS1 Numbers; and Products manufactured or sold by You after the termination date. 16.4 All your product information on the GS1 Product Data Catalogue will be suspended from view. 17. DISPUTE RESOLUTION Where any dispute arises in relation to the Licence or any matter arising under it, GS1 and You will make genuine efforts to resolve the dispute by negotiation. Nothing in this clause prevents either GS1 or You from applying to a court for urgent relief. 18. NOTICES All notices and other communications required or permitted under this Licence shall be in writing and shall be delivered personally, sent by registered post (within South Africa), sent by facsimile transmission (and promptly confirmed by registered post or, in the case of overseas mail, by air courier service), or via the GS1 South Africa Newsletter. Any such notice shall be deemed given when so delivered personally, or if sent by facsimile transmission on the next following business day in the country in which it is received, or the next day after sending by registered or ordinary post within South Africa. Notices for You will be sent to the address specified on Your Application Form (or such other address as You may notify GS1 of from time to time). Notices for GS1 must be sent to the Chief Executive Officer of GS1 at GS1's address as notified to You from time to time. governed by the law of South Africa and GS1 and You submit to the nonexclusive jurisdiction of the South African courts. 19.2 Waiver: No waiver, extension or excuse (as the case may be) shall be deemed to arise unless it is in writing and signed by the relevant party providing it. 19.3 No favour, delay, relaxation or indulgence on the part of either party in exercising any power or right conferred on such party in terms of this agreement shall operate as a waiver of such power or right nor shall any single or partial exercise of any such power or right preclude any other or further exercises thereof or the exercise of any other power or right under this agreement. 19.4 Severance: If any provision contained in these terms and conditions is held to be illegal, invalid or unenforceable, it shall be severable, shall be deemed to be deleted from these terms and conditions and shall not affect the validity or enforceability of other provisions in these terms and condition.

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Physical Address:

Postal Address:

Contact Info:

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