TÜV SUD America Inc.
10 Centennial Drive
Peabody, MA 01960 USA
Tel 978-573-2575
Fax: 978-977-0182
www.TUVamerica.com / SQF & Food Safety Application /

This application helps us to quote and prepare for an audit. Please complete each field or mark as NA.

/ Address for Audit / Billing Address

Company

Address
City
St./Prov./code
Internet URL:
Is this a multi-site operation? yes no If yes, complete Multi-site section below
Company Rep.
Telephone / Extension
Fax / E-Mail
SQF Practitioner Name:
When do you plan to select a certification body?
Requested date for a Pre-audit? (Optional)
Requested date for a Certification audit?
Number of employees?
Total Facility Square Footage (excluding administration offices)
Check applicable code and level: SQF 1000 SQF 2000
Level 1 Level 2 Level 3
In addition to SQF we request information on the following: (check all that apply)
Non Certified PRE AUDIT SQF GAP
Non Certified GMP audit
Non Certified Animal Welfare Audit
Non Certified GAP (good agricultural practices audit) / Non Certified HACCP audit
Animal Welfare
BRC / FSC22000
HACCP
IFS
ISO22000
Social Responsibility Module (Code 36 SQFI)

SQF Food Category, Products and processes.

Refer to the appendix 1 at the end of this document.

In the spaces below indicate Food Categories, Products /Processes.

Use additional pages if necessary. Please chose only from this list.

PLEASE INCLUDE A CURRENT COPY OF YOUR FLOW CHART FOR PROCESSING REVIEW

PLEASE ensure you offer details on your what you do at this facility (example, harvest fruits and vegetables, wash, pack and warehouse for distribution), and list all the products handled – choose from the list in the appendix.

For more information refer to the list of food categories on the SQFI web site.

http://www.sqfi.com/Food_Sector_Categories.pdf

Food Categories
(1 per line) / Products/Processes (choose from the list in the appendix) / How many HACCP plans do you have this categoy

Tell us about your customers

Do you Supply to McDonalds yes no

Do you Supply to Wal-Mart yes no

Do you Supply to Sysco yes no

Do you Supply to Whole Foods yes no

Do you Supply to Panera Bread yes no

Do you Supply to HEB yes no

Do you Supply to USFoodservice yes no

The Safe Quality Food Institute (SQFI) administers the SQF certification program via a web based application called Quickfire. The first step of the process is for a supplier to register the locations to be certified on the Quickfire database.

Please logon to the SQFI website:

http://www.sqfi.com/#

Click on the Supplier link and follow the instructions to register on Quickfire. Be advised that Quickfire requires an annual registration and an annual fee. The fee must be paid at the time of the site registration, otherwise the database will not allow a second attempt at registration. Once registered on Quickfire you must also select TUV SUD America as your Certification Body.

Registration in Quickfire must be done before the audit can be scheduled. (Registration in Quickfire is not required during the inquiry phase)

Multi- Site Considerations

Are the sub-sites eligible for certification to SQF 1000 code? / yes / no
Do the sub-sites carry out essentially similar activities? / yes / no
Is there legal or contractual link between the Central site and the sub sites? / yes / no
Are the sub-sites subject to continuous surveillance by the Central Site? / yes / no
Does the Central site have the authority to implement corrective action when needed at the sub sites? / yes / no
Is the Central Sites management system administered under a centrally controlled plan and subject to central management review? / yes / no
Are the sub-sites and the central administration function all subjected to the Central Sites internal audit program? (Note: all internal audits must be conducted prior to initial assessment.) / yes / no
Does the Central Site control the following:
·  System documentation and system changes / yes / no
·  Management? / yes / no
·  Complaints? / yes / no
·  Evaluation of corrective actions? / yes / no
·  Internal audit planning and evaluation of results? / yes / no
Note: if the answer to any of the above question is no, the organization does not meet the minimum requirements for multi-site.
Sub site Name and address: / Approximate Size and # of employees / Food Sector Category # / Products and/or services
Is the scope of your operations seasonal? / yes no
If yes, please explain:
Do you utilize seasonal and/or temporary employees? / yes no
If yes, please explain:

Are you currently certified by another certification body?

/

yes no

If yes, please attach copy of certificate.

Are you using a consultant?

/

yes no

If yes, what company ?

If applicable, what other regulatory / industry standards are relevant to your company?

/
If applicable, list any other Management System certifications currently held.
e.g. ISO 9001, ISO 14001,
ISO 22000 /
Dress Code is: /

business (tie) business casual (no tie) casual

Safety Equipment auditors should bring: / ear plugs steel-toed shoes

safety glasses safety glasses with side-shields

other ______

Are there any food safety requirements the auditor should know about? For example, an extra set of clothes: cannot have visited a farm in the last 72 hours, etc.

Enclosed with this application:

/ advertising material facility layout

organization chart other information ______

Other than English, what languages should the auditors speak or need translators for?

Date / Signature

Signature not required if sent by e-mail.

Type in name of person completing application.

Appendix 1 – SQF Food Categories with related products/processes

Category / Products/Processes /
1a Free Range Animal Production / Deer, cattle, goats, sheep, lamb, poultry, chicken, turkey, emu, ostrich, pig, eggs, buffalo, beef, elk, antelope, wild pigs.
1b Intensive Animal Production
1c Dairy Farming
1d Game Animals
1e Apiculture
2 Growing and harvesting of Animal Feeds / Corn, pasture, rice, silage, hay, wheat
3 Growing and Production of Fresh Produce / Apples, apricots, artichoke, asparagus, avocados, bananas, beans, beets, blackberries, blueberries, bok choy, broccoli, cabbage, cantaloupe, carrots, cauliflower, celery, cilantro, coconuts, corn, cucumbers, eggplant, garlic, grapefruits, grapes, green beans, green leaf lettuce, green onions, green peppers, head lettuce, herbs, honeydews, horseradish, kale, kiwi, leeks, lemons, limes, mangos, melons, mushrooms, okra, onions, oranges, papayas, parsley, peaches, peanuts, pears, peas, peppers, pineapple, plums, potatoes, radish, raisins, raspberries, red leaf lettuce, rhubarb, romaine, rutabagas, spices, squash, strawberries, sweet potato, tangerine, tomatoes, turnip, watermelon, cherries, brussel sprouts, pumpkin, lychees, cress, nuts, sprouts, almonds, pistachios, tree nuts, olives, zucchini, nectarines, egg fruit.
4 Fresh Produce Pack House Operations / Same products as Food Category 3 above.
5 Extensive Broad Acre Agricultural Operations / Alfalfa, barley, corn, cotton, maize, mung beans, oats, soy beans, watercress, wheat, chia seed, grains, pulses, oil seeds.
5a Seed Production
6 a Wild caught fish / Abalone, aholehole, alewife, alfonsio, amberjack, anchovy, angelfish, barracuda, barramundi, basa, bass, bigeye, bluefish, bluegill, bluenose, Bombay duck, bonito, bowfin, bream, buffalo fish, bullhead, burbot, butterfish, capelin, carp, catfish, char, chimera, chub, clam, cobia, cod, conch, corvina, crab, crappie, crawfish, dory, drum, eel, escolar, flounder, flying fish, gar, gem fish, goatfish, grayling, greenling, grenadier, grouper, grunion, grunt, haddock, hake, halibut, hamlet, herring, hind, hogfish, jack, jellyfish, kingfish, krill, langostino, limpet, ling, lobster, mackerel, mahi-mahi, marlin, milkfish, mullet, mussel, octopus, opal eye, Oscar, oyster, pacu, paddlefish, parrotfish, Patagonian tooth fish, perch, pickerel, pike, Pollock, porgy, puffer, queen fish, rockfish, roughy, salmon, sardine, sauger, scad, scallop, searobin, sea trout, shad, shark, shiner, shrimp, silverside, skate, smelt, snail, snakehead, snapper, snook, sole, spadefish, squid, sturgeon, sucker, sunfish, swordfish, tang, tarpon, threadfin, tilapia, tilefish, tomcod, triggerfish, trout, tuna, wahoo, walleye, whelk, whitefish, whiting, yellowtail
6b Aquaculture and RTE fish
7a Slaughterhouse, Boning and Butchery – red meat. / Antelope, beef, buffalo, cattle, chicken, deer, eggs, elk, emu, goats, lamb, ostrich, pig, poultry, sheep, turkey, horse.
7b Slaughterhouse, Boning and butchery – Poultry meat.
8 Processing of manufactured Meats and Poultry / Bacon, beef, bologna, bratwurst, braunschweiger, brisket, butt, Canadian bacon, chicken, chicken breasts, chicken wings, chops, corn dogs, cube steak, cutlets, deer, drumsticks, fajitas, franks, from legs, fryers, goat, ground beef, ground turkey, gyro, ham, hot dogs, hot wings, jerky, lamb, liver, luncheon meats, nuggets, pastrami, pepperoni, pork, riblets, ribs, roast, sandwich, sausage, steaks, tenderloins, turkey, turkey legs, venison, wieners, chicken products.
9a Raw fish and fishery products processing / Same as food category 6 above.
9b Uncooked RTE Fish Processing
9c Cooked RTE Fish Processing
10 Dairy Food Processing / Aerosol cream, butter, butter substitute, buttermilk, cheese, cheese dip, chocolate milk, coffee creamer, cottage cheese, cream, cream cheese, dried milk, half and half, heavy cream, ice cream, infant formula, milk, novelty ice cream, powdered milk, pudding, sour cream, soymilk, string cheese, tofu, veggie dip, whipped cream, yogurt.
11 Honey Processing / Honeycomb, honey, pollen, royal jelly
12 Egg Processing / Shell Eggs, liquid eggs, powdered eggs, pasteurized in shell eggs, pasteurized eggs ,egg albumen, egg pulp, egg white, egg yolk, fresh shell eggs, pavolova, pickled egg, salted egg, scrambled egg, sugared egg, sugared egg yolk.
13 Bakery and Snack Food processing / Bagels, biscuit mix, biscuits, bread, breadsticks, breakfast bars, cake mix, cakes, cheese curls, chips, cookies, corn chips, crackers, croissants, croutons, donuts, English muffin, graham crackers, melba toast, noodles, pastry, pies, pizza crusts, popcorn, potato chips, pretzels, rice cakes, rolls, saltines, snack crackers, snack mix, taco shells, toast, tortilla chips, tortillas, trail mix, wafers, pancakes.
14 Fruit and Vegetable Processing / Frozen beans, apple butter, apple chips, applesauce, bean salad, bruschetta, coleslaw, corn meal, deli salad, egg rolls, French fried onions, French fries, frozen corn, frozen mixed vegetables, frozen okra, fruit cup, fruit salad, guacamole, mush, pickles, pico de gallo, pie filling, potato salad, prepared salad, pumpkin, rice, salsa, sauerkraut, soy burgers, spaghetti, vegetable burgers, kimchi, salted vegetable, seasoned vegetable, tofu, vegetable mix, vegetable powder, vegetable salad, vegetable soup, dried tomato, dried fruit, frozen fruit, sliced vegetables, sliced fruit, mushrooms, onion rings, glazed fruit, salad mix, spring mix, ripening of fruit
15 a Canning Operations / Aseptic fruit juice, beans, canned vegetable juice, chicken, chili, condensed milk, crab, creamed corn, lasagna, mushrooms, olives, , peaches, peppers, ravioli, salmon, sauerkraut, soups, tomatoes, tuna, vegetables, water chestnuts, canned nut meat, canned nuts, canned pet food, canned sauces, canned silkworm pupa, UHT fruit juice, UHT soy milk, UHT vegetable juice, peas, corn
15 b Pasteurizing and UHT Operations
16 Ice, Drink and Beverage Processing / Beer, coffee, distilled liquor, drink mixes, egg nog, flavored drink, fruit juice, instant coffee, lemonade, mineral water, nutritional drink, soda pop, sport drink, tea, tea bags, vegetable juice, water, wine, wine coolers, ice, soy milk, rice mil
17 Confectionary Manufacturing / Candy bars, carmels, chocolates, cotton candy, creams, gum, gumi products, hard candies, jello, licorice, marshmallows, mints, nut candies, peanut brittle, peanut candies, popsicles, suckers, syrup.
18 Preserved Foods and Manufacture / Alfredo sauce, barbecue sauce, dips, French onion dip, horseradish, hot sauce, jam, jelly, ketchup, marinades, mayonnaise, miracle whip, mustards, peanut butter, pickled beets, pickled onions, queso dip, salad dressing, tartar sauce, teriyaki, Worcestershire sauce, soy sauce, soybean paste, syrup, pickles.
19 Food ingredient Manufacturing / Chili mix, food coloring, gravy mix, instant potatoes, pepper, salt, spices, sauce mix, soup mixes, sugar, vanilla, vinegar, yeast, enzyme, flavoring, gelatin, genu, genugel, genulacta, GeNutsine, genuvisco, gluten, grindsted, hydrocolloid, mixed ingredients, mixed spices, oil based ingredients, soy sauce, spice mix, starch, refined sugar, liquid sugar, syrup, breadcrumbs, chia seed, bread crumbs, chia seed, mustard.
20 Recipe Meals Manufacture / Beef Stew, burritos, chicken salad, egg salad, frozen soup, ham salad, lasagna, macaroni and cheese, macaroni salad, meal replacements, pancake mix, pasta, pizza, prepared meals, protein salads, sous vides, stir fry, tuna salad,
21 Oils, Fats, and the manufacture of oil or fat-based spreads / Lard, margarine, oil, oil spread, shortening, spray butter, spreads.
22 Processing of Cereal, Grains and Nuts / Barley, farfalle, breakfast cereal, cashews, chopped nuts, corn, fettucini, lasagna, macaroni, millet, mixed nuts, nut powder, oatmeal, oats, pasta, peanut butter, peanuts, pine nuts, pumpkin seeds, raisin bran, rice, soy nuts spaghetti, sunflowers, walnuts, wheat, flour, husk powder, non-dairy cream, chia seed.
23 Food Catering and Food Service Operations / Bar, canteens, catering, central kitchen, deli, hospital, hotel, motel, restaurant, school, chilled meals, dehydrated meals, desserts, freeze dried meals, frozen meals, RTE meals, sauces, soups.
24 Food retailing / Grocery store, vending machine, convenience store, gas station, alcoholic beverage, canned foods, chilled foods, dried foods, frozen foods, non-alcoholic beverage
25 Fresh Produce Wholesaling and Distribution / Warehouse, distribution center, repacking, merge in transit, controlled storage, frozen storage, transportation, fruit, fungi, herbs and spices, nut, vegetable.
26 Food Wholesaling and distribution / Warehouse, distribution center, repacking, merge in transient, controlled storage, frozen storage, transportation, alcoholic beverage, canned foods, carbonated soft drinks, chilled foods, confectionary, dairy products, dried foods, frozen foods, fruit juice, non-alcoholic beverages, prepared salads, shelf stable foods.
27 Manufacture of Food Sector Packing materials / Flexible film, flexible pouches, food-grade packing materials, glass containers, metal containers, paperboard based containers, plastic containers, single-use food service products, Styrofoam containers, waxed fiberboard containers, ice cream sticks
28 Provision of Crop Spray Services / Applicators, ferticides, pesticides, fertilizers
29 Provision of Field Harvest Services / Harvest crew, picker, supervisor, fodder, fruit, grain, table grapes, wine grapes, irrigation equipment, nut, rice, silage, vegetable,
30 Provision of Sanitation and Hygiene Services / Chemical application, chemicals, cleaning, clothing, detergents, food safety audits, foot baths, hand washing stations, laboratory equipment, laboratory services, pest control services, portable lavatories, protective clothing, sanitizers, thermometer, training materials.
31 Manufacture of dietary supplements / Herbal supplements, nutritional supplements, probiotics, supplements, vitamins, weight loss.
32 Fertilizer Manufacture / Chemical fertilizers, organic fertilizers, soil conditioners
33 Manufacture of Agricultural Chemicals and Food Processing Aides / Chemicals for clean-in-place systems, food grade lubricants, post-harvest spray treatments, post-harvest waxes
34 Manufacture of animal feeds / Dog food, cat food, fish food, cattle food, horse food, poultry food, wild game food, compounded animal feeds, medicated animal feeds
35 Broker or Agent / Exporter, broker, merchandiser, all foods and beverages, non-foods, pet foods

ISOF-71 Rev 8 Effective November 9, 2010 Page 1 of 10