Thank you for your interest in considering Compliance Australia Certification Services Pty Ltd as a potential Certification service provide for your organisation. As you will appreciate the development of a sustainable management system within your organisation has been a considerable investment and will act as a platform for monitoring process / product conformance, continual improvement and to meet applicable regulatory and legislative requirements. We, at CACS, are keen to ensure that the certification services we offer to you reflect the level of investment you have already committed to. To ensure that you receive a tailored service that adequately addresses your requirements it would be appreciated if you would complete the attached questionnaire. While the amount of information requested may appear extensive, it will ensure that we can provide a service that clearly reflects your needs and meets the certification requirements of each of the requested programs. Regards William Chance Managing Director Compliance Australia Certification Service Pty Ltd www.jas-anz.org/register/ Accredited by the Joint Accreditation System of Australia and New Zealand
Organisation/Company *
Trading as
ABN *
Head Office Address *
Head Office Postal Address
Contact Name *
Position
Website Address
Email Address *
Phone Number *
Fax Number
Mobile Number
Hours of Operation
Design & Dev. Undertaken? Yes No
Approx. Date req. for Certification
Scope of certification (for the provision of ...) Note: if design is not excluded the words Design and or Development must be included within scope.
List (As applicable) all Products, Services and or Key Activities (e.g., Welding / Packaging / Interviewing and so on) Products Services Key Activities
Which of the following industries best describes your Organisation?
Mining Food Manufacture Aviation Transport Government Health Tourism Construction Other (please specify)
Other Comment * Required info
Is the assessment designed to cover the entire organisation? Yes No If no, please provide a description of the Reduced scope / breadth of the business system (e.g., customer service, sales / finance, but not the warehouse to be reviewed ONLY):
Head Office Address Full-time Part-time Casual Contract Total Head Office Activities/Roles ? Local Contact Name Contact Title Ph Fax Email Business Hours
Site 2: Show | Hide
Site 2 Address Full-time Part-time Casual Contract Total Site 2 Activities/Roles ? Local Contact Name Contact Title Ph Fax Email Business Hours
Site 3: Show | Hide
Site 3 Address Full-time Part-time Casual Contract Total Site 3 Activities/Roles ? Local Contact Name Contact Title Ph Fax Email Business Hours
Site 4: Show | Hide
Site 4 Address Full-time Part-time Casual Contract Total Site 4 Activities/Roles ? Local Contact Name Contact Title Ph Fax Email Business Hours
Site 5: Show | Hide
Site 5 Address Full-time Part-time Casual Contract Total Site 5 Activities/Roles ? Local Contact Name Contact Title Ph Fax Email Business Hours
Site 6: Show | Hide
Site 6 Address Full-time Part-time Casual Contract Total Site 6 Activities/Roles ? Local Contact Name Contact Title Ph Fax Email Business Hours
Site 7: Show | Hide
Site 7 Address Full-time Part-time Casual Contract Total Site 7 Activities/Roles ? Local Contact Name Contact Title Ph Fax Email Business Hours
Site 8: Show | Hide
Site 8 Address Full-time Part-time Casual Contract Total Site 8 Activities/Roles ? Local Contact Name Contact Title Ph Fax Email Business Hours
Site 9: Show | Hide
Site 9 Address Full-time Part-time Casual Contract Total Site 9 Activities/Roles ? Local Contact Name Contact Title Ph Fax Email Business Hours
Site 10: Show | Hide
Site 10 Address Full-time Part-time Casual Contract Total Site 10 Activities/Roles ? Local Contact Name Contact Title Ph Fax Email Business Hours
Multi Site Certification Eligibility
Products and services are similar across all sites ? Yes No
There is a Centralised Management System ? Yes No
The Internal Audit Process Addresses all sites ? Yes No
Management Review is Across all Sites ? Yes No
Management Documentation is consistent and Across all Sites ? Yes No
Improvement Process including the NCR and Complaints process is conducted Across all Sites ? Yes No
All the above Multisite Eligibility Criteria MUST be checked yes to enable CACS to issue 1 certificate across multiple sites. Important Note: Final approval for issuance of 1 certificate across multiple sites is totally at the discretion of the Compliance Australia Certification Serves Certification Manager. Please do not hesitate to call a CACS representative for clarification if required.
Multi Site Certification self assessment Approval Guidance ONLY Yes No
Length of System Implementation
Who developed your system?
Is the organisation currently Certified Yes No
Certifiers Name
Certification Ends
Standards Certified to
Date of Most Recent Audit
Copy of last report (Please email as an attachment) ?
Copy of current certificate (Please email as an attachment) ?
Date of Next Audit
Details of critical / specific regulations, licensing / operating permits / standards, etc. that are relevant to the scope of certification being sort. (you can either fill in the register below or e-mail your company legal / regulatory registers to admin@cacs.net.au) (Please attach company list if available)
Products, Services & Activities
RegulatoryRequirements
Licenses/operating permits
Code of Practice
Standards / Other
Please tick the most appropriate reason for seeking certification *
To comply with client requirements
To provide a platform for continual improvement
To enhance tender/contract response capability
Other (please specify)
How did you hear about Compliance Australia Certification Services *
Website
JAS-ANZ
Referral
Yellow pages
What standard do you require Certification to *
Quality: ISO 9001:2015
Quality: ISO 9001:2008
Environmental: ISO 14001:2015
Environmental: ISO 14001:2004
Safety: AS NZS 4801:2001
Safety: OHSAS 18001:2007
Safety: ISO 45001:2018
Please select company RISK against the Standards being applied for, using the guidance below based on five primary complexity categories of the nature, number and gravity of the aspects of an organization that fundamentally affect the auditor time.
If required, please add comments
HIGH: Large number of Environmental / Safety / Quality aspects with significant nature & gravity. Typically manufacturing or processing type organisations with significant impacts in several EMS, OHS & QMS aspects Large / Multi site Many processes, Large Scope Unique Processes and Design responsible.
MEDIUM: Average number of Environmental / Safety / Quality aspects with medium nature and gravity. Typically manufacturing organisations with significant impacts in some of the EMS, OHS & QMS aspects
LOW: Small number of Environmental / Safety / Quality aspects with low nature and gravity. Typically organisations of an assembly type EMS, OHS & QMS aspects with few significant aspects. Few / repetitive processes, Limited Scope, Small and simple site.
LIMITED: Very limited number of Environmental / Safety / Quality aspects with low nature and gravity. Typically organisations of an office type EMS, OHS & QMS aspects with few significant aspects.
SPECIAL: These require additional and unique consideration at the audit planning stage.
Complexity Scale
HIGH
MEDIUM
LOW
LIMITED
SPECIAL
QualityX
Environ.X
SafetyX
1: Please Check the Environmental Impacts as applicable or not. 2: Then rate the level of applicability. 3: You MUST give a brief Description against each potential Environmental impact as it would apply within the scope of activities to be certified within your company.
Do you conduct environmental assessments or engage environmental consultants? If yes, please specify No Yes
Have your operations received an environmental study and or assessment? If yes, please specify and email us a copy and a summary of findings No Yes
IMPACT-AIR: Emissions to air including: particulate matter, chemicals (hazardous and non-hazardous), odour, noise, greenhouse gasses etc.
IMPACT-BIODIVERSITY: Flora and fauna, vegetation management
IMPACT-LAND: Land degradation including: soil erosion, salinity, contamination, extraction / filling etc.
IMPACT-NATURAL: Use of natural resources including: water, fuel and energy (gas, solar, coal, wind, waste generated, nuclear), and minerals etc.
IMPACT-SOCIAL: Social and biophysical including: traffic / transportation, aesthetics, heritage (indigenous & non-indigenous), neighbourhood impact, fire etc.
IMPACT-WASTE: Waste management including: putrescibles and non- putrescibles, liquid, green, fill etc.
IMPACT-WATER: Discharge to water (ocean, streams, groundwater, surface run-off) including: nutrients (e.g., phosphates), chemicals (e.g. oil, pesticides, PCBs), sediment etc.
Applicable No Yes
Brief description. Explain.
If the Environmental status of various locations varies, Please supply details below.
1: Please check the Safety hazards and exposure level as applicable or not. 2: Then rate the level of applicability. 3: You MUST give a brief Description against each potential hazard exposures as it would apply within the scope of activities to be certified within your company.
Do you conduct safety assessments or engage safety consultants? If yes, please specify No Yes
Have your operations received a safety study and or assessment? If yes, please specify and email us a copy and a summary of findings No Yes
EXPOSURE-CHEMICAL: Dangerous goods including solids, liquids & vapours: Flammable, corrosive, explosive, sensitizing agents, toxic substance.
EXPOSURE-PHYSICAL: Plant and equipment, noise, vibration, engulfment, entrapment (moving hazards), heat, cold, pressure, dust, fibers, trips, falls etc
EXPOSURE-RADIATION: Microwaves, gamma rays, infra red, ultraviolet, x-rays, laser.
EXPOSURE-ELECTRICAL: Electrocution, electric shock, burn.
EXPOSURE-ERGONOMICS: Work environment, tools, and workstation design, lighting, manual handling, furniture, job and task design.
EXPOSURE-PHYSIOLOGICAL: Stress, harassment, boredom, abuse, discrimination
EXPOSURE-BIOLOGICAL: Bacteria, viruses, plant and animal materials, contamination.
If the Safety Hazard status of various locations varies, please supply details below.
Statement of Acceptance I/We warrant that we have either received an information pack or viewed the information on CACS internet site www.cacs.net.au and that the information contained in this certification agreement is correct. I/We confirm that the company shown above has agreed to proceed with all assessment activities leading to Certification/Registration by Compliance Australia Certification Services. I/We undertake to pay all other costs required under the Regulations governing the Compliance Australia Certification Services Scheme for Registration connected with assessment and administration, irrespective of the eventual granting of a Certificate of Registration. In the event of being granted a Certificate of Registration, I/We undertake to conform to the Regulations governing the Compliance Australia Certification Services Scheme & in particular pay all fees charged for annual registration & certificate maintenance. I/We as such, accept that this registration or re-registration agreement entered into is a triennial agreement, subject to the terms and conditions of the Regulations, & that notice of intention NOT to renew a Certificate of Registration must be given to the Certification Manager of Compliance Australia Certification Services not later than two months before the expiration date of the Certificate. We also accept that Compliance Australia Certification Services may modify the audit methodology, scope of certification, surveillance schedule & costs depending upon the findings of assessments of our Organisation. If circumstances arise a (witness audit) may be necessary due to JAS-ANZ requirements in conjunction with your regular audit.
I/We warrant that we have read the Certification Agreement document below. A link to download the Certification Agreement document in PDF format will be included in your email confirmation. View as PDF document
Yes No
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