BV申请表VOC AFRICA

Return the form andother documentsto yournearest BVoffice.REQUEST FORCERTIFICATE FORMYourreference numberif any:IDF/Licence numberIf any:^^^^nsignmenVUCR^DUM No.Country ofdestination:□Algeria□Botswana□Cdte dIvoire□Ethiopia□Gabon□Ghana□Libya□Kenya□MoroccoZl TanzaniaMainland□Tanzania Zanzibar□Zimbabwe____________________________________________________________________________________If any,BV RegistrationSoR No.:BV LicensingSoL No.:Note:the Certificateor NonConformity Reportis issuedbased onthe informationcommunicated.Unless ofa specificarrangement,the draftof thecertificate isnot sentprioHssuance.Trade parties:Buyer Importer:name andaddressSeller Exporter:name andaddressTelephone:Telephone:Email:Email:Contact name:Contact name:BPN ZWE/ICE MARNo.:Payment informationInvoice tobe sentto:Purchase OrderNo.:Same asSeller□orCompany name:Address:VAT number:Contact name:Tel:Email:Proforma Invoice/Contract PurchaseOrderPFI number and date987ET Currency:Freight value If applicablePOnumberanddate TotalValue InsurancevalueIfapplicableIncoterm:FOB ValueOther valueIf applicableShipmentinspection informationPacking:□FCL:x20FCL x40TCLType ofdelivery:□Total□Partial□FinalFCL couldbe ontruckShipment method:Details:□LCL:□Bulk□General Cargo/Conventional□trucks size/volume:□□Air□Sea□Road□Rail□UnknownConsolidated cargoLocationwhere goodsare availablefor inspectionif sameas theapplicant,please tickthe box□:Address:Contact name:Country ofsupply:Telephone:Expected dateof shipment:Date ofavailability ofgoods:Expected portofEmail:destination:Goods informationGoodsDescription:Please attachlist ofproducts includingHS codesproforma invoice…Goods conditions:□New□Second hand/Used□Complete□Complete KnockDown CKD□Semi knockdown SKDISO9001Certificate:□Yes□No OtherCertification:Test Reportprovided:□Yes□No Testingdone by:□Own lab□Third partylabCertificates provided:□Yes□NoApplicable standardsif Known:Lab information:IS017025accreditation□Yes□No□Other:Country ofAlgeriaBotswana Cotedlvoire EthiopiaGabon GhanaLibya KenyaMorocco TanzaniaZanzibar ZimbabwedestinationElectronic-□□-□□-□□□□□certificateemail toexporterOriginal□□□□□□□□□□□-certificate toexporterOriginal--□----□Nairobi□□--certificate to□MombasaimporterCommentsGeneral declarationof theApplicantI herebydeclare that:my shipmentswill beaccompanied witha validcertificate ofconformity,I acceptBureau Veritasterms andconditions ofservice andIauthorize Bureau Veritas todisclose informationto concernedauthorities whenrequested todo so,□I wouldlike toask foran accountof Verigatesto followup allmyfiles onlineApplicantname:Title:Company:If differentfrom above:Signature:Email:Date:Telephone:Please completethe aboveinformation andkindly returntheformtogether withproforma invoice,copy ofLC-if applicable-and documentsproving conformitysuch asdetailed descriptionofthe goodswith technicalcharacteristics andproperties,available testreports,quality managementsystem certificates,marks ofconformity,national approvals,franchise agreementorsimilar forsupplying brandedgoods aswell ashealth,hygienic,phytosanitary,fumigation certificatesas applicable.BV remainsavailable toprovide additionalinformation aboutthe VoCPrograms.〃The Applicantaccepts thequotation/fees mentionedin thedatasheet ofthe programavailable onhttps:Remark:The Servicew川be carriedout accordingto theBureauVeritas^General Conditionsof Service.The issuanceof inspectionreport doesnot releasethe Sellerand Buyerfrom theirownresponsibilities andfulfilment oftheir respectiveobligations.If youhave anycomments/complaints/appeals regardingthe certificationservice,please informin writingtoVOC AFRICA-REQUEST FORCERTIFICATE FORMRFC1/1Edition:

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