NABL 180

National Accreditation Board for Testing

and Calibration Laboratories (NABL)

Application Form for Proficiency

Testing Providers (PTP)

ISSUE NO. : 01 AMENDMENT NO. : 04

ISSUE DATE : 01-Jun-2011 AMENDMENT DATE : 19-Feb-2018
 AMENDMENT SHEET

Sl Page Clause Date of Amendment Reasons Signature Signature

no No. No. Amendment QM CEO
1 3 4 03.09.2015 Change in fee/ GB Decision Sd/- Sd/-
assessment charges
structure
2 -- -- 29.06.2016 As Highlighted in the Internal review of Sd/- Sd/-
document document
3 10 8.7 12.07.2016 Laboratory replaced with Typo error Sd/- Sd/-
PTP
4 3 6 & 18 Clarity on Legal status 20th Internal audit
& documents of CAB & &
4 Change in Traceability of Revision of NABL 181
artifact in Calibration PT
program
5 5 1.5 As highlighted Clarity about options
for CAB to apply for
scope extension,, GST
and new certificate
19.02.2018 system and uniform Sd/- Sd/-
terminology
6 6 3.1.2 Inclusion of Medical Start of Calibration of
Devices discipline Medical Devices
program
7 9 7 Inclusion of Payment Development of NABL
gateway payment gateway
8 9 6.2 Frequency of Internal Internal review by
audit as ‘ at least once Quality Cell
a year’
9 12 Annex-A- Inclusion of payment Development of
mode Payment gateway by
NABL
10

National Accreditation Board for Testing and Calibration Laboratories

Doc. No: NABL 180 Application Form for Proficiency Testing Providers (PTP)
Issue No: 01 Issue Date: 01-Jun-2011 Amend No: 04 Amend Date: 19-Feb-2018 Page No:1 / 12
 CONTENTS

Sl. No. Title Page

1 Information & Instructions for completing an Application Form 3

2 Application Form 5

3 Annexure A: Guidance for submitting and preparing documents for the Application for 11
Proficiency Testing Provider Accreditation

National Accreditation Board for Testing and Calibration Laboratories

Doc. No: NABL 180 Application Form for Proficiency Testing Providers (PTP)
Issue No: 01 Issue Date: 01-Jun-2011 Amend No: 04 Amend Date: 19-Feb-2018 Page No:2 / 12
Information & Instructions for completing an Application Form
1. Application shall be made in the prescribed form only. PT Provider shall submit separate application
form for each field of accreditation. The application shall consist of the following:
 Three copies of completed application forms
 Two copies of Quality Manual of PT Provider

2. Incomplete application and insufficient number of copies submitted may lead to rejection of application.
In case the space provided is insufficient, please use additional pages clearly indicating to which
section they relate to.

3. The applicant shall undertake to carry out its proficiency testing activities in such a way as to meet the
requirement of ISO/IEC 17043:2010, NABL specific criteria, other relevant additional requirements of
NABL and the regulatory authorities, as applicable at all times. Applicants are advised to ensure that
the latest versions of all documents including NABL documents are available with them.

4. The application fee and other necessary charges related to accreditation process is given in NABL
document NABL 100 ‘General Information Brochure’ under NABL Finance and NABL Fee Structure’.
NABL 100 is available on NABL website.

5. PTP are advised to familiarize themselves with NABL 100 ‘General Information Brochure’, NABL 201
‘Procedure Addressing Changes in Accredited Conformity Assessment Body’s Operations’, NABL 216
‘Procedures for Dealing with Adverse Decisions’ and NABL 131 ‘Terms and Conditions for Obtaining
and Maintaining Accreditation’ before filling up this form.

6. The applicant PT Provider shall provide photocopies of the following appropriate document in support
of the legal status claimed:

 Proprietorship firm (e.g. copy of Bank Passbook, PAN card)

 Partnership ( Copy of Registration under 1932 Act)
 Company Act ( Copy of Registration under 1956 Act)
 Societies Registration Act ( Copy of Registration under 1860 Act)
 Indian Trust Registration Act
 Government (Copy of Government notification/ declaration etc.)

7. The applicant PT Provider shall intimate NABL about any change in the information provided in this
application such personnel, location etc. within 15 days from the date of changes.
8. NABL expects applicant PT Provider(s) that are to be accredited by NABL to provide their
documentation, access to their as well as subcontractors areas, equipment, records and personnel for
purpose of assessment and resolution of complaints.
9. The PT Provider shall also inform NABL in advance about any reservation regarding appointment of
Lead Assessor/ Assessor for the assessment.
10. The applicant PT Provider shall be given due notice of any intended changes relating to NABL
accreditation criteria and will also be given such time, as in the opinion of NABL is reasonable to carry
out the necessary adjustments to its procedure(s). The PT Provider shall inform NABL when such
adjustments have been completed.

National Accreditation Board for Testing and Calibration Laboratories

Doc. No: NABL 180 Application Form for Proficiency Testing Providers (PTP)
Issue No: 01 Issue Date: 01-Jun-2011 Amend No: 04 Amend Date: 19-Feb-2018 Page No:3 / 12
11. The application must be filled up carefully to provide required information in such a manner that further
correspondence for seeking clarifications are not required. Particularly the scope of accreditation (para
3.2) shall be complete to indicate unambiguously. Examples related to filling the scope is provided in
Specific Criteria (NABL- 181) under Introduction section.

12. The PT Provider shall submit NABL 131 duly signed by the Chief Executive or his/ her Authorised
Representative to NABL Secretariat along with this application form. By signing NABL 131 the PT
Provider agrees to comply at all times with Terms and Conditions of NABL.
Note: NABL-131 shall be signed by Chief executive of the organization. In case it is signed by any
other person, an authority letter/copy of resolution from board of directors of limited
organizations/trust/society authorizing the person to sign NABL-131 shall be available. For partnership
firms, the resolution by all partners in favour of the signatory shall be made available .
13. The PT Provider shall extend cooperation to NABL or its representative in:
a. Undertaking any check to verify capability of the PT Provider.
b. the PT Provider shall unambiguously provide names of all authorised signatories/Proficiency
Testing Co-ordinator who are responsible for activities like preparation of sample (testing of
homogeneity and stability) transportation and preservation of sample, use of statistical tools, issue
of PT report.
c. Access to relevant areas of the PT Provider or subcontractor for witnessing the activities being
performed.
d. examination of all relevant documentation and records.
e. interaction with all relevant personnel.
14. The PT Provider shall take all necessary actions and discharge all non-conformities raised
during the assessment within the stipulated time. The same shall be verified to the satisfaction of
NABL. The final decision on accreditation shall rest with NABL.
15. The application shall be kept confidential (until required by law) by NABL and information
obtained during the processing of application, assessment visit and grant of accreditation shall be
safeguarded and dealt with impartiality.
16. Any conflict of interests shall be clearly defined with organization chart.
17. PT Provider shall have initiated or completed at least one Proficiency Testing Scheme
round as per relevant international standard (eg. ILAC G13, ISO/IEC 17043, IUPAC Harmonized
Protocol for Analytical Chemistry, etc) before submitting the application form.
18. In case of PT programs for calibration laboratory, the Reference standard used for
assigning the value of artifact (PT item) shall be calibrated against a standard which is directly
traceable to National Metrological Institute (NMI).
19. PT Provider shall have conducted at least one Internal audit and Management Review
meeting prior to submitting the application form.

20. Please attach relevant documents with details required as per Annexure A

***

National Accreditation Board for Testing and Calibration Laboratories

Doc. No: NABL 180 Application Form for Proficiency Testing Providers (PTP)
Issue No: 01 Issue Date: 01-Jun-2011 Amend No: 04 Amend Date: 19-Feb-2018 Page No:4 / 12
 Application Form for Accreditation of Proficiency Testing Provider
Our organization wish to apply for NABL accreditation of Proficiency Testing provider as per details given
below:

First Accreditation Renewal of Accreditation

Extension of Scope

If accredited by NABL, Please provide accreditation certificate no. & accreditation validity (if applicable) and
CAB ID: PC-1030 Valid upto 04/11/2020

1.0 Organisation Details

1.1 Name of the Proficiency Testing Provider

M/s. SCS ENVIRO SERVICES PVT LTD (PT DIVISION)
(Permanent Facility)
Address : 7, KESAR VIHAR, Opposite Khatu shyamji temple, ramnagariya road, Jagatpura, Jaipur,
Rajasthan
Telephone No.: +91-9414080354 Fax No. __________________ e-mail scspt@scsenviro.in

1.2 Name of Parent Organisation M/s. SCS ENVIRO SERVICES PVT. LTD.
(If part of an larger organisation)
Telephone No.: +91-9414080354 Fax No. __________________ e-mail : scspt@scsenviro.in

1.3 Legal status and date of establishment _______________________________________________

(please give Registration No. and name of authority who granted the registration. Attach copy of relevant documents)
_________________________________________________________________________________________________

1.4 (a) Other accreditation for e.g.: ISO/IEC 17025, ISO 15189, ISO/IEC 17020, ISO Guide 34:
_________________________________________________________________________________

1.5 Goods and Service Tax (GST) Number along with PAN/TAN Number
GSTN – 08AATCS6792D2ZN PAN No.-AATCS6792D

1.6 Indicate exactly how the name of the PT Provider and the address is to be printed on the certificate

In English SCS ENVIRO SERVICES PRIVATE LIMITED

PT DIVISION
7, KEAR VIHAR, RAMNAGARIYA ROAD, JAGATPURA, JAIPUR, RAJASTHAN
2.0 Proficiency Testing Scheme - SIMULTANEOUS
2.1. Provide information of the PT Schemes designed and organized along with the standard used (eg.
ILAC G:13, ISO/IEC 17043, IUPAC Harmonised Protocol for Analytical Chemistry).
Sl. No. Name of Program Total Number of Standard Used Statistical Technique
Participants Adopted
1 SCS/PT/O & M/01/17 15 IS: 1760(1,2,3) RA 2006 ISO 13528:2015
2 SCS/PT/O & M/02/18 21 ISO ISO 13528:2015
(If a similar program has been repeated please provide details individually with unique ID)
(Please submit a copy of report)

National Accreditation Board for Testing and Calibration Laboratories

Doc. No: NABL 180 Application Form for Proficiency Testing Providers (PTP)
Issue No: 01 Issue Date: 01-Jun-2011 Amend No: 04 Amend Date: 19-Feb-2018 Page No:5 / 12
2.2 Are you conducting proficiency testing activities

a. Independently at permanent facility Yes No

b. With the help of sub-contractor Yes No

3.0 Scope for Application

3.1 Discipline in which accreditation is sought

 Testing
 Calibration
 Medical
 Inspection

3.1 .1 Field of Testing for which accreditation is sought (includes sampling also)
 Biological  Mechanical
 Chemical  Non-Destructive
 Electrical  Photometry
 Electronic  Radiological
 Fluid-Flow
 Forensic

3.1.2 Field of Calibration for which accreditation is sought

 Electro-Technical
 Mechanical
 Fluid Flow
 Thermal
 Optical
 Radiological
 Medical Devices

3.1.3 Field of Medical for which accreditation is sought

Clinical Biochemistry
Clinical Pathology
Haematology and Immunohaematology
 Microbiology and Serology
 Histopathology
 Cytopathology
 Genetics
Nuclear medicine (in-vitro tests only)

National Accreditation Board for Testing and Calibration Laboratories

Doc. No: NABL 180 Application Form for Proficiency Testing Providers (PTP)
Issue No: 01 Issue Date: 01-Jun-2011 Amend No: 04 Amend Date: 19-Feb-2018 Page No:6 / 12
3.1.4 Field of Inspection for which accreditation is sought
 NDT  Forensic inspection

 Agriculture and agricultural products  Industrial equipment and machinery

 Manufactured goods  Natural resources and refined products

 IT products and services  Transport

 Tourism accommodation  Factory inspection

 Health inspection  Technical regulation inspection

 Building construction and maintenance  Environment & Environmental protection products

 Industrial and commercial construction  Others

& maintenance

3.2 Desired Scope of Accreditation

PT Scheme Proficiency Test Item Analyte or Parameter Range of Periodicity Remarks**

(Matrix/Group/Field)* Measurement (Minimum)
(if applicable)

* Refer definition in ISO/IEC 17043:2010 section 3.8

** Remarks can include Type of scheme, test method adapted, any other information deemed necessary by PT Provider

3.3 Description of sub-contractor

Sl. Name of sub- Address and Phone No Whether the organization Description of activity
No. contractor is accredited, Provide subcontracted*
details

* Subcontracting activities can include formal arrangement for production, testing, measurement, sampling, storage and distribution of
PT materials/samples or measurement artifacts and data processing as in ISO/IEC 17043 :2010 section 5.5 ref 5.5)

4.0 Organisation
4.1 Senior Management (Name, Designation, Telephone, Fax, e-mail)
4.1.1 Chief Executive of the PT Provider __________________________________________________________

4.1.2 Person(s) responsible for the Proficiency Testing Activities (PT Co-ordinator)*__________________________

4.1.3 Person responsible for Quality Management ____________________________________________________

4.1.4 Contact person for NABL ___________________________________________________________________

National Accreditation Board for Testing and Calibration Laboratories

Doc. No: NABL 180 Application Form for Proficiency Testing Providers (PTP)
Issue No: 01 Issue Date: 01-Jun-2011 Amend No: 04 Amend Date: 19-Feb-2018 Page No:7 / 12
4.1.5 Any other key personnel involved in the PT Activities____________________________________________

* There could be more than one person for different schemes

4.2 Employees

4.2.1 Total number of employees in the organization ___________________________________________________

4.2.2 Total number in employees involved in running PT schemes ________________________________________

4.2.3 Details of staff (including contracted, part time, etc) having responsibility about any aspect of Proficiency
Testing Scheme (please refer NABL 181)

Sl. Name & Qualification with Experience in years Relevant Training Role & Responsibility in the
No Designation of Specialization related to present work specific PT scheme
person

4.2.4 Details of Authorised Signatory

Sl. Name & Qualification with Experience in years Authorize for Relevant Training Specimen Signature
No. Designation of Specialization related to present which field
person work

(Refer to annexure A of NABL 181

4.2.5 Details of Steering/Advisory Committee:

Sl. Name of Qualification Experience in years Relevant Training Affiliation Area of Responsibility
No. Person with related to present
Specialization work

4.2.6 Information regarding any individual or organisation that has provided consultancy for preparing towards NABL
Accreditation __________________________________________________________________________

4.3 Brief description of main activities of Parent organization

4.4 Organisation Chart

4.4.1. Indicate in an organisation chart the operating departments of the proficiency testing activities for
which accreditation is being sought (please append)

4.4.2 Indicate how the proficiency department is related to external organizations and/or to its own parent
organisation (where applicable)

National Accreditation Board for Testing and Calibration Laboratories

Doc. No: NABL 180 Application Form for Proficiency Testing Providers (PTP)
Issue No: 01 Issue Date: 01-Jun-2011 Amend No: 04 Amend Date: 19-Feb-2018 Page No:8 / 12
5.0 Equipment and Reference Materials/Standards
5.1 List of major equipment available for use (where applicable)

Sl. Name of Model/ Receipt date & Range and Date of last Calibration Traceability**
No. equipment type/Sl. No./ date placed in accuracy calibration due on *
year of service
make

5.2 List of reference materials/reference standards (where applicable) available for use

Sl. Name of reference material/standards Source Date of Traceability**

No strains/ cultures expiry/ validity

* The PT Provider to decide the calibration interval based on ISO 10012

** Please indicate the traceability to National/ International standards through unbroken chain of Accredited laboratories
Note- For traceability in measurement, refer NABL policy document NABL 142

6.0 Internal Audit and Management Review

6.1 Date of last Internal Audit _________________________________________________________

6.2 Whether all requirements of ISO/ IEC 17043:2010 covering all activities of Proficiency Testing
Provider have been audited at least once in last one year: Yes No

6.3 Date of last Management review____________________________________________________

7.0 Application fees

7.1 Number of schemes & proficiency test items (Matrix/Group/Field) applied for accreditation

 Number of Schemes  Number of PT items

7.2 Application fees (Rs.)________________________________________________________

(Information regarding the groups applied for accreditation in each discipline. Refer relevant specific criteria for more
details on groups).

7.3 DD / At par Cheque** number/

**All payments made through Cheques or Demand Draft shall be made in favor of ‘Quality Council of India' payable at
Gurgaon.

National Accreditation Board for Testing and Calibration Laboratories

Doc. No: NABL 180 Application Form for Proficiency Testing Providers (PTP)
Issue No: 01 Issue Date: 01-Jun-2011 Amend No: 04 Amend Date: 19-Feb-2018 Page No:9 / 12
 Note: Kindly make all kind of payments preferably through the ‘Payment Gateway’ available on NABL website
(www.nabl-ndia.org)

8.0 Willingness to undergo Assessment

We declare that

8.1 We are familiar with the terms and conditions of maintaining accreditation (NABL 131), which is
enclosed and will abide by them.
8.2 We agree to comply fully with ISO/IEC 17043:2010 for the accreditation of PT provider.
8.3 We agree to comply with accreditation procedures, pay all costs for pre-assessment,
assessment, verification visit (if any), surveillance and reassessment irrespective of the result.
8.4 We agree to co-operate with the assessment team appointed by NABL for examination of all
relevant documents by them and their visits to those parts of the PT Provider and subcontractor
that are part of the scope of accreditation.
8.5 We shall maintain confidentiality of customer information and shall not disclose the identity of the
participant to the third party without the prior permission of participant concerned.

8.6 We agree to maintain integrity for samples distributed to customers/participants and take effective
measures to prevent any possible collusion and falsification of results.

8.7 No adverse action has been initiated / taken against the PTP in the past. (If yes, please provide
the details with present status ………………………………………………………..)

8.8 We agree to conduct our operations in an impartial manner.

Signature of Chief Executive or his authorised representative ________________________________

Name & Designation_______________________________________________________________

Date & Place ______________________________________________________________________

National Accreditation Board for Testing and Calibration Laboratories

Doc. No: NABL 180 Application Form for Proficiency Testing Providers (PTP)
Issue No: 01 Issue Date: 01-Jun-2011 Amend No: 04 Amend Date: 19-Feb-2018 Page No:10 / 12
 Annexure A

Guidance for preparing and submitting documents for the Accreditation for Proficiency
Testing Provider

Purpose and Scope: This part is intended to give PT Provider(s) understanding for addressing
major issues in the application process.

This guidance document applies to all applicants and accredited PT Provider(s).

Table 1: Checklist

Sl.N Specific requirement/ document Reference to Complete

o. document
1. Legal Identity of your organisation
2 Identified the following with qualification, experience and specimen signature
PT Co-ordinator(s),
Management of PT
Authorized signatories
List of Staff involved in PT schemes.
3 Quality Manual (QM) addressing all clauses of ISO/IEC 17043:2010 with
cross references (if applicable)
4 Master List of all Quality Documents.
5 Completed draft scope of accreditation
6. Goods and Service Tax (GST) Number along with PAN/TAN Number

7 Completed organizational chart (including staff name, job titles & reporting
relationship
8 Declaration of Independence in case of identified Potential Conflict of Interest
9* Staff has signed declaration for maintaining confidentiality
10 Copy of at least one original version of proficiency testing report for each
proficiency testing field
11 Documentation for subcontracting (if applicable):
 list of areas for subcontracting
 list of subcontractors with field of activity
 evidence of competence (e.g. copy of accreditation certificate, audit
reports).
12 Written contract with the subcontractor along with Completed sub-contractor
information sheet (if applicable)
13 Documentation on Advisory Committee/Steering group (if applicable):
 list of Advisory Committee/Steering group with fields of activity
 lists of members with information on the background of persons
(e.g. affiliation to companies, organizations)
 terms of reference of the Advisory Committee/Steering group

National Accreditation Board for Testing and Calibration Laboratories

Doc. No: NABL 180 Application Form for Proficiency Testing Providers (PTP)
Issue No: 01 Issue Date: 01-Jun-2011 Amend No: 04 Amend Date: 19-Feb-2018 Page No:11 / 12
14 Read /understood and signed copy of NABL-131.
15 Documentation of the procedure to carry out proficiency testing:
 planning
 subcontracting (if applicable)
 stability testing
 homogeneity testing
 selection of the statistical methods
determination of assigned values and evaluation criteria (standard deviation
of proficiency assessment)
16* Site plan showing the areas of operation
Total built up area for PT Provider Activities
Provide a layout diagram of the area (marking dimensions) under PT
Provider/laboratory activities clearly highlighting access, emergency exists,
area under different activities (the areas for incompatible activities for
homogeneity and stability should be clearly highlighted as microbiology;
chemical testing, mechanical testing) special areas as for storage,
calibration, reception, dispatch,
17 Submitted fees as applicable:
Demand Draft / At Par Cheque in favor of ‘Quality Council of India’ & details
of NEFT & details of payment made through Payment Gateway of NABL ”
18 List of certified reference materials used with traceability
19 List of equipment to be used with calibration status and traceability**
20* Internal audit and Management Review reports
21 Completed Annexure 'A' (checklist) for the accreditation of PT Provider

(*These documents have to be kept ready during review at on-site assessment. Other documents should be
submitted along with the Application form NABL-180. ** Artifacts circulated in calibration PT programs shall have
direct traceability to NMI)

Place, Date Signature of the Authorised Representative

Name and Designation

The Authorized Representative confirms the completeness and correctness of all the above mentioned documents by
signature. The listed documents shall be up-dated for each assessment.

National Accreditation Board for Testing and Calibration Laboratories

Doc. No: NABL 180 Application Form for Proficiency Testing Providers (PTP)
Issue No: 01 Issue Date: 01-Jun-2011 Amend No: 04 Amend Date: 19-Feb-2018 Page No:12 / 12
National Accreditation Board for Testing and Calibration Laboratories (NABL)
NABL House
Plot No. 45, Sector 44,
Gurgaon - 122002, Haryana
Tel. no.: 91-124-4679700 (30 lines)
Fax: 91-124-4679799
Website: www.nabl-india.org