For office use: ENAO Acc. No Date of application First Accreditation Renewal of Accreditation 1.THIS FORM SHOULD BE COMPLETED IN FULL AND RETURNED TO : Ethiopian National Accreditation Office Attention: Accreditation Director PO Box 3898 ADDIS ABABA Tel: +251 11 83 02 469 Fax: E-mail: info@enao-eth.org The Following documents shall be submitted together with the application form. Quality Manual and supporting Procedures Authorized certification standard/guide(s) Completed Horizontal Check list form Summary of Internal audit and clearance report. Evidence legal license Evidence about availability of adequate data after Implementation of Quality Management system (i.e. after conduct of internal Audit and NC clearance) as indicated in ENAO P07 recent version. Risk Analysis Report 2. CERTIFICATION BODY DETAILS 2.1 Name of Certification Body Region Postal address Telephone: E-mail: City Fax: Rev 1.0 17 October 2018 Page 1 of 8
e 2.2 Name of Parent Organization (If part of an organization) Telephone: E-mail: 2.3 Legal Status and Date of Establishment (please give Registration No. and name of authority who granted the registration) 2.4 Type of Accreditation Sought Fax: MS-ISO17021 FSMS-ISO 22003 Product-ISO Guide 65 Person-ISO 17024 2.5 Organization Registered as Private limited company Private partnership Public limited company Other 3. ACCREDITATION DETAILS 3.1 Is your organization accredited by another accreditation body? If so please specify (attach documents for proof) No. Activity and Scope of Accreditation Against which Standard/Regulation Name of Accrediting Institution Period of Validity of Accreditation Rev 1.0 17 October 2018 Page 2 of 8
3.2 Scope of Accreditation Sought Please complete the following table as precisely as possible and include, wherever possible, the standard involved. This may be Ethiopian, regional and international standards. The title of the method or specification, it s number and date of issue should be listed. Rev 1.0 17 October 2018 Page 3 of 8
(use extra sheet if necessary) No. Activity Description Scope Classification (refer IAF ID 1 QMS Scope of Accreditation) Applicable standards/guide 3.3 Extension of Scope of Accreditation If you wish to extend existing scope of accreditation, you will need to fill in this form and supply the following Rev 1.0 17 October 2018 Page 4 of 8
additional information: I Accreditation Number II. Brief description of the scope of accreditation III. Date of Expiry of accreditation IV. Extension Requested for and the applicable standard/regulation 4. ORGANIZATION 4.1 Authorized Representative for Accreditation related matters: 4.2 Total number of staff 4.3 Please list the name and technical qualification of the following staff 4.3.1 Quality Manager (or equivalent) of Certification body 4.3.2 Deputy Quality Manager (or equivalent) of Certification body Title Title Full Name Full Name Technical Qualification Technical Qualification 4.4 Resource Available (Please tick the appropriate boxes) 4.4.1 Auditors locally available Some auditors sourced from outside Rev 1.0 17 October 2018 Page 5 of 8
4.4.2 Break down of the staff that are connected with the certification activities Designation Number Permanent Contract 4.4.3 Details of auditors who will be used for auditing purpose on the activities and scope applied Location of site/ branch/ regional/ agent office No. of qualified permanent auditors No. of qualified contracted auditors Local Foreign Local Foreign Rev 1.0 17 October 2018 Page 6 of 8
4.5 Please briefly specify the method adopted to qualify staff for auditing activities 4.6 If you out source audit activities, please five details 4.7 Organization Chart 4.7.1 Indicate in an organization chart the operating departments of the certification body for which accreditation is being sought (please append) 4.7.2 Indicate how the certification body is related to external organizations or to its own parent organization (where applicable) 5. DECLARATION I enclose a copy of the quality manual and copy of the relevant standard/guide(s). I declare that I am authorized, on behalf of the company/ organization, to furnish this information, and the information contained herein is both correct and accurate to the best of my knowledge and belief. Title Full Name Position: Rev 1.0 17 October 2018 Page 7 of 8
Date Signature: Rev 1.0 17 October 2018 Page 8 of 8