Bureau Veritas FOOD CERTIFICATION APPLICATION FORM FSSAI Audits –

Application Form
Certification v4 – March’24
Page 1 of 3

(Confidential document)

In order to prepare a formal commercial proposal specific to a HACCP/ GMP Codex, EN 15593,
various assessment schemes driven by FSSAI or QCI related to food or any other Customized / 2 nd
Party audits Bureau VERITAS (India) Private Limited requires certain information on your activities
and organisation.

Thank you in advance for providing us the information in details so that we can prepare a precise
proposal to meet your exact needs. All information provided will be kept confidential.

Please indicate the Activity of your organisation. The supply chain model will determine the terms of
your certification and the way we perform the audit.

Manufacturing
Storage , Logistics and Distribution
Retail
Agents , Brokers and Trading
Food Processing
*Please tick the applicable box
1. COMPANY DETAILS

Name of the organisation JW MARRIOTT

Head Office Address
Website
Phone Fax
Invoicing address
(if different)
EC VAT Number
IE Code ( if Applicable )
Legal Status
(with registration number
whenever different)
Main activity Catering
Organisation legal
representative
Whether any consultancy No
relating to the management
system to be certified has
been provided and, if YES,by
whom
Diotima Roy

Organisation Certification Position Hygiene Manager Phone

Manager Mobile phone 7604070219 Email diotima.roy@marriotthotels.com
Other relevant information
Bureau Veritas FOOD CERTIFICATION APPLICATION FORM FSSAI Audits –
Application Form
Certification v4 – March’24
Page 2 of 3

2. AUDIT PLANNING REQUIREMENT

2.1 FSSAI License along with validity (Attach the Copy of the license)

*2.2 No. of Food Handlers working for your organisation.

235

*2.3 Number of production lines / Product group in FBO / No. of HACCP Study.

HACCP - 6

*2.4 Floor area of the organisation. (In Sq. Ft)

*2.5 Please describe in detail kind of products being manufactured / process activity.

*2.6 No. of Food handlers with FoSTaC trained and certified

Sr No Name of the Food Handler FoSTaC Certificate Number

Preferred period for auditing:

Audit language:
Specific expectations (if any)

I hereby certify that the statements written down on the present certificate are accurate.
At _______________, date ____________________

Name of organisation representative CHEF DEVIS

Position EXE CHEF

Signature

To be filled by Bureau VERITAS:-

Allocated auditor or audit team : Country: Code:

 Bureau Veritas FOOD CERTIFICATION APPLICATION FORM FSSAI Audits –
Application Form
Certification v4 – March’24
Page 3 of 3

For single site

Preparation &
Stand-Alone On-site audit Report
Planning
Certification Audit –- Print MD 
Surveillance Audit – Print MD Annual
Re–Certification Audit - Print MD 

The Audit time (Man Days) and code

allocation is performed by:
Position:
Bureau Veritas Certification office:
Sign & date:
The Audit time (Man Days) and code
allocation is approved by:
Position:
Bureau Veritas Certification office:
Sign & date: