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    Application Form For License To Operate - Packing Facility 2023

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    EXPORT SECTION NPQSD
    This document is an application for a license to operate a packing facility submitted to the Director of the Bureau of Plant Industry in the Philippines. It includes details about the applicant, their facility, and 14 required documents needed for the application, such as a notarized application form, business permits, food safety plans, standard operating procedures, personnel qualifications, and a BPI inspection report. The applicant certifies that the information provided is true and agrees any misrepresentation can result in denial or cancellation of the application.

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    Application Form For License To Operate - Packing Facility 2023

    Uploaded by

    EXPORT SECTION NPQSD
    106 views2 pages
    This document is an application for a license to operate a packing facility submitted to the Director of the Bureau of Plant Industry in the Philippines. It includes details about the applicant, their facility, and 14 required documents needed for the application, such as a notarized application form, business permits, food safety plans, standard operating procedures, personnel qualifications, and a BPI inspection report. The applicant certifies that the information provided is true and agrees any misrepresentation can result in denial or cancellation of the application.

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    Application Form for License to Operate - Packing Facility 2023

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    This document is an application for a license to operate a packing facility submitted to the Director of the Bureau of Plant Industry in the Philippines. It includes details about the applicant, their facility, and 14 required documents needed for the application, such as a notarized application form, business permits, food safety plans, standard operating procedures, personnel qualifications, and a BPI inspection report. The applicant certifies that the information provided is true and agrees any misrepresentation can result in denial or cancellation of the application.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    106 views2 pages

    Application Form For License To Operate - Packing Facility 2023

    Uploaded by

    EXPORT SECTION NPQSD
    This document is an application for a license to operate a packing facility submitted to the Director of the Bureau of Plant Industry in the Philippines. It includes details about the applicant, their facility, and 14 required documents needed for the application, such as a notarized application form, business permits, food safety plans, standard operating procedures, personnel qualifications, and a BPI inspection report. The applicant certifies that the information provided is true and agrees any misrepresentation can result in denial or cancellation of the application.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Department of Agriculture

    BUREAU OF PLANT INDUSTRY


    National Plant Quarantine Services Division
    692 San Andres Street, Malate, Manila, Philippines
    Email Address: [email protected]
    Tel. No.: (02) 8525-7909, (02) 8525-2987 ǀ Website: buplant.da.gov.ph

    APPLICATION FOR LICENSE TO OPERATE - PACKING FACILITY

    TO: DIRECTOR
    Bureau of Plant Industry

    THRU: CHIEF
    National Plant Quarantine Services Division

    Sir/Madam:

    I , owner of
    with facility address at _,
    wish to apply for License to Operate-Packing Facility

    That I am submitting the following requirements for the said License:

    1. Notarized Application Form with attached 2x2 colored picture of the owner, authorized representative
    and/or designated Food Safety Compliant Officer (FSCO) in white background
    2. Current Mayor’s Permit/Business Permit
    3. Current Sanitary Permit
    4. Proof of business Establishment:
    For Corporation: Security and Exchange Commission (SEC)
    For Cooperatives: Cooperative Development Authority (CDA)
    For Single Proprietorship: Department of Trade and Industry (DTI) Registration
    For Philippine Economic Zone Authority (PEZA): Certificate of Registration
    5. Internal Control System (ICS) and Food Safety Plan
    a. Traceability System and Recall Program
    b. Disposal System for rejected fruits
    c. Disinfestation Program for the Packing facility
    d. Written SOP including Pest Management, and other safeguards
    6. Certificate of Attendance of Owners, Facility Manager, or Quality Assurance Personnel on
    training/seminar of Good Agricultural Practices (GAP)
    7. Lay-out, pictures and location of the facility
    8. Packing Facility Process Flow
    9. List of technical and Non-technical personnel, and Quality assurance personnel with corresponding qualifications
    10. Certificate of Registration (COR) of farm Source
    11. List of Licensed Exporters and Licensed Distributor
    12. Designated FSCO/FSCOs
    13. Certificate of Completion (Orientation of Applicant)
    14. BPI-PQS Inspection Report

    I hereby certify under oath that all information and attached documents regarding this application is true and
    correct and Iexpressly agree that any materials or misrepresentations of facts in this application shall be the basis
    for denial/cancellation.

    Very truly yours,

    Signature over Printed Name

    REPUBLIC OF THE PHILIPPINES)


    PROVINCE OF )
    MUN./CITY OF )S. S.

    SUBSCRIBED AND SWORN to me this day of 20 at Affiant exhibited to


    mehis/her Community Tax Certificate No. issued on at , Philippines.

    Doc. No.
    Page No.
    Book No.
    Series of

    EFFECTIVITY DATE: February 24, 2023


    FORM NO.: BPI “Q” Form No. 10d
    REVISION NO.: 0 Page 1 of 1
    Department of Agriculture
    BUREAU OF PLANT INDUSTRY
    National Plant Quarantine Services Division
    692 San Andres Street, Malate, Manila, Philippines
    Email Address: [email protected]
    Tel. No.: (02) 8525-7909, (02) 8525-2987 ǀ Website: buplant.da.gov.ph

    VALIDATION AND EVALUATION FORM FOR


    LICENSE TO OPERATE - PACKING FACILITY
    NEW RENEWAL PACKING FACILITY CODE (for renewal): _________________________________
    COMMODITY (specify):

    APPLICANT’S INFORMATION
    Company/Business Name:

    Office Address:

    Contact Number/s: Email Address :

    Location of Facilities:

    Name of Representative/s (If any) :

    Date of Application : Name, Signature and Designation of Applicant:

    This portion is to be accomplished by the BPI – NPQSD Evaluator


    LIST OF REQUIREMENTS REMARKS
    1. Notarized Application Form with attached 2x2 colored picture of the
    owner,authorized representative and/or designated Food Safety
    Compliant Officer (FSCO) in white background
    2. Current Mayor’s Permit/Business Permit
    3. Current Sanitary Permit
    4. Proof of business Establishment:
    For Corporation: Security and Exchange Commission (SEC)
    For Cooperatives: Cooperative Development Authority (CDA)
    For Single Proprietorship: Department of Trade and Industry (DTI)
    Registration
    For Philippine Economic Zone Authority (PEZA): Certificate of
    Registration
    5. Internal Control System (ICS) and Food Safety Plan
    a. Traceability System and Recall Program
    b. Disposal System for rejected fruits
    c. Disinfestation Program for the Packing facility
    d. Written SOP including Pest Management, and other safeguards
    6. Certificate of Attendance of Owners, Facility Manager or Quality
    AssurancePersonnel in trainings on Good Agricultural Practices
    7. Lay-out, pictures and location of the facility
    8. Packing Facility Process Flow
    9. List of technical and Non-technical personnel, and Quality assurance
    personnel with corresponding qualifications
    10. Certificate of Registration (COR) of farm Source
    11. List of Licensed Exporters and Licensed Distributors
    12. Designated FSCO/FSCOs
    13. Certificate of Completion (Orientation of Applicant)
    14. BPI-PQS Inspection Report

    EVALUATED AND PROCESSED BY: DATE OF INSPECTION

    Signature over Printed Name


    EFFECTIVITY DATE: February 24, 2023
    FORM NO.: BPI “Q” Form No. 10e
    REVISION NO.: 0 Page 1 of 1

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