The purpose of this HTML page is to display the information as found on the application for viewing only. If you wish to submit an application please use the MS Word (124 kb) or PDF (40 kb) version. If you cannot access the MS Word or PDF version or require printed copies of this application, please contact the Certification and accreditation Office.
Company name: _______________________________________________________
Corporate address: ____________________________________________________
____________________________________________________________________
____________________________________________________________________
Contact name: ________________________________________________________
Title: ________________________________________________________________
Telephone number: ____________________________________________________
Fax number: __________________________________________________________
Email address: ________________________________________________________
Audit services to be provided:
__ CIPRS __ CIPRS+ HACCP __ CGC HACCP
Auditors proposed by assessment body to conduct audits for each program (please use separate list if required and attach resume)
Name: ______________________________________________________________
Location: ____________________________________________________________
Qualifications*: _______________________________________________________
Name: ______________________________________________________________
Location: ____________________________________________________________
Qualifications*: _______________________________________________________
Name: ______________________________________________________________
Location: ____________________________________________________________
Qualifications*: _______________________________________________________
Date of application: _______/_______/_______ (YYYY/MM/DD)
Other registrations or accreditations (e.g. ISO Registrar):
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Complete and return to:
Process verification and accreditation
Canadian Grain Commission
900-303 Main Street
Winnipeg MB R3C 3G8
or email to elaine.bernardin@grainscanada.gc.ca
* Qualifications – see CGC ASP-STAN 2.0.0 for requirements
IS-IP-PVA-01-E