Audit/Verification Application Form (CM/GSV/MQP/SQP/TGI/WCA)
Section 1: Service Request:
Intertek Community’s Recommended Programs:/ Chemical Management - CM / An approach to verify the Health & Safety Handling And Discharge of the Chemicals in Supply Chain
/ Global Security Verification - GSV / An evaluation on facility’s security procedures and systems in accordance with U.S. Government and other supply chain security requirements
/ Mill Quality Program –MQP / An evaluation on quality, social and environmental performance of fabric mills
/ Supplier Qualification Program - SQP / An evaluation on supplier’s quality management system, product control, process control, etc.
/ Think Green Initiative -TGI / An Environmental sustainability assessment that evaluates environmental compliance performance, environmental management system, pollution prevention and sustainability practices in various environmental areas
/ Workplace Conditions Assessment- WCA / A social compliance audit aligned with industry standards and best practices to improve working conditions in supply chain
Others Industry Association Programs:
SA8000 WRAP BSCI ICS EICC Other_____
Client Program (please specify client name):
Audit Type: / Initial Audit
Follow-up Audit
Annual Audit / Renewal Audit
Others
Desired Audit date (DD-MM-YYYY):
Section 2: Information of Applicant:
Company Name(English & Local Language) / English
Local
Address
(English & Local Language) / English
Local
Contact Person ‘s Name/Title / Telephone Number
Fax Number / E-mail address
Section 2a: Information of Vendor (If applicable):
Company Name(English & Local Language) / English
Local
Address
(English & Local Language) / English
Local
Contact Person ‘s Name/Title / Telephone Number
Fax Number / E-mail address
Section 3: Invoiced Details
Company Name(English & Local Language)
Address
(English & Local Language)
Contact Name
Telephone Number
Fax Number (For billing)
E-mail address
Section 4: Details of Physical Facility to be assessed:
(English & Local Language) / English
Local
Address
(English & Local Language) / English
Local
Contact of Facility Representative & Title / Telephone Number
E-mail address / Fax Number
Contact of Facility’s Top Management / Web Site
Year of Facility Established / Facility Business License/Permit Number
Facility Business License/
Permit valid up to (If applicable)
(DD-MM-YYYY) / Facility Business License/Permit is issued by:
Product Classification of Manufacturing / Home communications, entertainment and hobby equipment
Furniture and Furnishings
House appliance
Housewares (non-powered)
Chemicals and chemical products
Home workshop apparatus and tools
Yard and garden
Child nursery equipment and supplies
Personal use items
Garments, Footwear and Accessories / Packaging and Containers
Toys
Personal care items
Auto Part & Accessory
Beverage & Food
Pet related products
Medicine
Raw Material
Miscellaneous Products
Servicing Facilities
Other ______
Main Product(s) (please specify): / Total No. of Employees
Main Language of employees / Production Workers
Management Staff
Facility Size / Facility Land Size (m2 )
Total Facility Floor Size (m2)
Number of Buildings / Production
Dormitory
Warehouse
Other (please specify)
Section 5: This Part is for GSV Only
Yes / NoAre warehouse(s) customs bonded?
Are facilities located in a Free-Trade Zone?
High Value Parts
Hazardous Materials
Perishables
Chemicals
Munitions / Dual Use
Section 6: Quotation and Confirmation by Intertek
Proposed Date of On-site Audit: (DD-MM-YYYY) / Manday Required :Audit Fee: / Approximate Cost of Travelling & Accommodation
Date of Quotation:
(DD-MM-YYYY)
Section 7: Declaration of Consent (For CM/GSV/MQP/SQP/TGI/WCA)
1. The goal of the CM, WCA, GSV, TGI, MQP and SQP Programs are to help the manufacturing and export community eliminate redundant assessment/audits. Manufacturers/facility that voluntarily choose to participate in these Program agree to an on-site independent assessments/audits, to measure and verify how well their operation/management system meet the standards outlined in the programs. By signature below, the Applicant agrees and authorizes Intertek to share the audit results (when the facility has met the requirement of granting Achievement Award / ROP) with our GSCC members where the facility currently or plans to produce merchandise for sale,as evidence of accomplishing supply chain obligations.
2. The Applicant agrees that Intertek will list the Achievement Award / ROP information i.e. company name, registration number, award number, date of award, and expiry date etc. on the Achievement Award / ROP directory which will be posted on the related website for the programs.
3. If the Applicant is not the physical audited facility where the audit takes place (for example, the buying agency apply the audit/assessment on behalf of supplier production site),
a) it is the responsibility of Applicant, prior to apply this audit, to seek the permission from the facility to be audited for above report sharing activities
b) the Applicant agrees a copy of report and physical Achievement Award / ROP(if any) will be issued to the actual facility audited.
Section 8: Special Disclaimer
Applicant/Client/Facility to be assessed (“Facility”) hereby agrees that, notwithstanding Intertek’s obligations of providing audit reports on basis of true finding and its confidentiality obligation on information received in audit process hereunder or under any other audit service agreement or terms and conditions, in case that Facility conducts or attempts to conduct improper activities to hamper, influence or interference on the audit process or result, including but not limited to tamper with or force Intertek to change the audit result by means of violence, threat and illegal restriction of personal freedom ("Improper Influence Activities), Intertek issuance of such tampered or changed audit report due to Improper Influence Activities (“Influenced Report”) shall not be deemed as any breach of Intertek’s obligation of providing audit report based on true finding, and Intertek shall be released from its confidentiality obligation to:
1. provide an audit report based on true finding to replace and correct the Influenced Report(if already issued);
2. report the Improper Influence Activities to the supervising authorities of Intertek and/or of the Facility, including but not limited to reporting the threats, violence and other illegal activities of Facility to public security authorities;
3. inform related third parties including but not limited to the buyers, business partners of the Facility, recipient of the audit reports, etc, of the Improper Influence Activities;
4. terminate the audit agreement unilaterally reserving the rights of pursuing service fee and claiming any damages incurred by Intertek; and
5. conduct any other activities or actions which are reasonably necessary for protection of legal interest of Intertek, safety of its employees or the reliability of its audit result.
Remarks:
(1). To make sure Intertek receive the requisition form, kindly follow up with a phone call.
(2). Re-send this form to Intertek for any amendment.
(3). According to Intertek’s company policy, benefit of any kind should not be offered to any of Intertek staff.
(4). Achievement Award Performance Criteria.
TGI and WCA: Overall score 85 or above and without Zero Tolerance or Major Finding.
MQP: Overall score 85 or above, without red flag and all sections scores above 50.
SQP: 85 score or above and without Major Finding.
GSV ROP: 76 score or above
CM: Overall score 85 or above, no critical or major finding, and all business activities fall into the business license are evaluated
[The follow up audit (if applicable) shall be completed within 6 months from initial/annual/renewal audit, otherwise, no Achievement Award could be granted]
We apply for the above services and agree to the Intertek Terms and Conditions of Service stated on page 4 to 6 of this Audit Application form.
X
Date of Application Supplier/Facility Stamp & Signature
TERMS & CONDITIONS – AUDITING SERVICESTerms / Definition/ Condition / Rate
Onsite Audit Access / The facility management’s shall be responsible to ensure full cooperation in providing access to all areas of the facility and an appropriate work environment for auditors to conduct their job in accordance with the audit scope. This may include employees for confidential interviewing, documentation for review and other requirements, / /
Booking Lead Time
/ Applications should be made at least 30 calendar days prior to the desired date. / /Manday
/ 8 hours spent business and/or traveling with 1 hour break or in compliance with local labor law. / As agreed with clientNormal Business Day / Monday to Friday or in compliance with local labor law and customs / /
Working/Traveling on Holidays Charge (Saturday, Sunday or Public Holiday) / Holidays and Weekends will vary depending on local law and customs. A surcharge will be applied for work and travel on such days. / 50% surcharge of audit fee
Audit Preparation, Administration / Scheduling & Report Writing / General administration fee for audit scheduling, preparation and report writing. / As agreed with client
Express Booking / For audit booking within 5 working days from desired audit date. / 50% surcharge of audit fee
Late Cancellation & Rescheduling Charge / If notice of cancellation or rescheduling is made prior to the committed audit date (or start date of the semi-announced audit window), the indicated billing party will be responsible for the following audit fees and expenses: / Within 2 Business Days: 100% of the audit fee plus expenses already incurred
More than 2 and within 5 business days: 50% of the audit fee plus expenses already incurred
Within 10 Business Days:
For audit locations where Intertek has to fly in auditors, the indicated billing party will be responsible for 100% of theaudit fee plus expenses already incurred
Access Denied Charge / Scheduled audit was not performed on the committed audit date due to the facility management not allowing Intertek auditor to enter or conduct the audit for reason outside the control of the auditor. / 100% audit fee plus all expenses incurred
Extra Traveling Time Charge / If travel cannot be completed within the same day of service execution and if the distance from the nearest Intertek office is over 100 km, the traveling time (including the waiting time due to lack of transport resources) will be charged. / - up to 4 hours: 0.5 manday
- more than 4 hours: 1.0 manday
Out of Pocket Expenses (OPE) / Other expenses include traveling, hotel expenses (if any), applicable governmental taxes, visa and administrative fee, etc. / Invoiced in accordance with travel cost matrix or pre-approved price agreement
Value Added Tax (VAT) / In countries where legally applicable, Value added taxes will be added to the invoice as per local country practices / Where applicable
Mailing Expenses / Documents, samples, materials, etc. sent to clients or between different offices at the request of the client. / Invoiced at cost plus 10% handling fee
Service Document Re-issuance Charge / Any changes other than Intertek own corrections required after the original document has been issued (report or certificate) / US 30 per copy
Payment Terms / Net 30 days from the end of the month during which the invoice is issued. If the service is invoiced to parties other than buyer/client (e.g. agent, supplier/ facility, etc.), full prepayment term will be applied.
Any late payment shall incur, after a prior notice of Intertek, a penalty equal to the balance due at the rate of 2% per month from the invoice due date until payment receipt. Intertek reserves the right to suspend services and/or change payment terms to full pre-payment due to credit issue or other issues deemed appropriate. / 2% per month from the invoice due date
Liability / The liability of Intertek in respect of any claims for loss, damage or expense of whatsoever nature and howsoever arising in respect of any breach of contract and/or any failure to exercise due skill and care by Intertek shall in no circumstances exceed a total aggregate sum equal to the amount of the fee payable in respect of the specific service required under the particular contract with Intertek which gives rise to such claims provided however that Intertek shall have no liability in respect of any claims for indirect or consequential loss including loss of profit and/or loss of future business and/or loss of production and or cancellation of contracts entered into by the Principal. / The amount of the audit fee
General Conditions / All activities of Intertek are governed by Intertek General Terms and Conditions of Services (“General T&C”) which is enclosed hereto. If any confliction exists between this Terms and Conditions and the General T&C, the General T&C shall prevail. Business which can be provided upon request. / /
Confidentiality / All information and data received by Intertek while engaged in the activities will be treated as confidential pursuant to confidentiality agreement executed by the parties. / /
Remark: For the avoidance of doubt, The Services are obtained by Intertek, resultant from The Customer’s ordering Intertek to perform and do not relieve the Supplier of its obligations to ensure that The Products and business practices comply with the contractual specification and all applicable laws, regulations, standards and codes of practice as defined in the scope of service offered by Intertek or contractual obligations defined by The Customer. If there are any discrepancies between the two versions, the English version shall prevail.
Intertek General Terms and Conditions of Services
These terms and conditions, together with any proposal, estimate or fee quote, form the agreement between you (the Client) and the Intertek entity (Intertek) providing the services contemplated therein.
1
Form No.: IAS-F01 Issue 15 Date: 15 Jan 2015
Intertek Testing Services Korea Ltd.
1/F, A-Ju Digital Tower, 284-56, Seongsu-2Ga, Seongdong-Gu, Seoul 133-833 Korea
Tel 82-2-6090-9510 Fax 82-2-3409-0026 e-mail
1. INTERPRETATION
1.1 In this Agreement the following words and phrases shall have the following meanings unless the context otherwise requires:
(a) Agreement means this agreement entered into between Intertek and the Client;
(b) Charges shall have the meaning given in Clause 5.1;
(c) Confidential Information means all information in whatever form or manner presented which: (a) is disclosed pursuant to, or in the course of the provision of Services pursuant to, this Agreement; and (b) (i) is disclosed in writing, electronically, visually, orally or otherwise howsoever and is marked, stamped or identified by any means as confidential by the disclosing party at the time of such disclosure; and/or (ii) is information, howsoever disclosed, which would reasonably be considered to be confidential by the receiving party;