Oga Producer Audit Update

PO Box 810 NUNDAH (18 Eton St) BRISBANE QLD 4012 Ph: 07 3350 5706 Fax: 07 3266 5996 [email protected] www.aco.net.au OGA – PRODUCER AUDIT UPDATE CERTIFIED CLIENT STATEMENT

*Please keep the original and forward a copy to the ACO office.

SECTION ONE: General Information FIRST NAME: «firstname» SURNAME: «surname» FIRST NAME: «firstname1» SURNAME: «surname1» TRADING «operation_name» NAME: CERTIFICATION CERTIFICATION «cert_no» «description» NUMBER: DESCRIPTION: «Products1», «Products2», «Products3», «Products4», «Products5», «Products6», «Products7», «Products8», «Products9», «Products10», «Products11», CERTIFIED «Products12», «Products13», «Products14», «Products15», «Products16», PRODUCTS: «Products17», «Products18», «Products19», «Products20»

Total farm hectares: «total_farm_area» Description of certified Certified farm hectares: «area» property Property location: «operation_address1» «operation_address2»«operation_city» «operation_state» «operation_postcode»

SECTION TWO: Description of Measures Taken to Meet Previous Year’s Corrective Action Requests If you did not receive any CAR from previous audit, please write down “N/A” Corrective Action Requests Action taken to address the CAR

SECTION THREE: Organic Management Plan Update – Summary of Changes Made

Write down any changes from last year:

Approved: Kellie Lewis 02/11/2013 OGA Producer CCS & OMP Update Page 1 of 3

© Australian Organic Pty Ltd Form 220-32 v2.0 SECTION FOUR: Inputs Fertilisers, Manures and Other Inputs: List all purchases of mulch materials, pesticides, composts, microbes, fungicides, herbicides, livestock treatments, cleaning chemicals and any other inputs used since last audit. *Please attach a copy of your Record of Farm Inputs. Product Supplier / Brand Qua Certification Registered Allowed or Reason for name ntity Body Product or Restricted use Certification in Annex 1 Number

SECTION FIVE: Certified Organic & In Conversion production details

Production details Year Year Year Year Year Expected production next year ………… ………… ………… ………… …………

Months Months… Months… Months…… Months… ………… ……… ……… …… ………

Product Ha Volume Volume Volume Volume sold Volume Increase Decrease No planted sold (kg) sold (kg) sold (kg) (kg) sold (kg) % % change PO Box 810 NUNDAH (18 Eton St) BRISBANE QLD 4012 Ph: 07 3350 5706 Fax: 07 3266 5996 [email protected] www.aco.net.au OGA – PRODUCER AUDIT UPDATE CERTIFIED CLIENT STATEMENT

(COMPLETE ABOVE OR ATTACH SEPARATE DOCUMENT FOR PRODUCTION DETAIL)

AUTHORISATION

Please sign this Statement, and have witnessed by a 3rd party. . I/we have a copy of the ACOS (Australian Organic Standard) and have read and understood the requirements for certification. . I/we agree to farm to the ACOS (Australian Organic Standard) to the best of our ability until our next annual audit. . I/we are aware that we will be liable for penalties applicable to the relevant State for any wilfully false statement. . I/we hereby request ACO to renew our certification and agree to pay all relevant fees and charges associated with the renewal of certification. . I/we confirm that our gross income from certified organic sales for the past financial year was less than $75,000 (ex GST) per annum. . I/we confirm that our produce/products will not be exported as certified organic.

I declare that all relevant records and documentation have been made available to the ACO office which gives a comprehensive description of production practices as required in the current ACOS Australian Organic Standard. Where there have been non-compliances with the ACOS Australian Organic Standard in regard to the management of certified area/s and or livestock, these have been communicated in writing to the ACO office.

I declare that the statements made in this declaration are a true and accurate description of the activities of the certified operation listed in the declaration. CLIENT’S SIGNATURE: Print Full Name Clearly Signature Date WITNESS:

Print Full Name Clearly Signature Date

Approved: Kellie Lewis 02/11/2013 OGA Producer CCS & OMP Update Page 3 of 3