<p> 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 </p><p>*Please keep the original and forward a copy to the ACO office. </p><p>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»</p><p>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»</p><p>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</p><p>SECTION THREE: Organic Management Plan Update – Summary of Changes Made</p><p>Write down any changes from last year:</p><p>Approved: Kellie Lewis 02/11/2013 OGA Producer CCS & OMP Update Page 1 of 3</p><p>© 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</p><p>SECTION FIVE: Certified Organic & In Conversion production details </p><p>Production details Year Year Year Year Year Expected production next year ………… ………… ………… ………… …………</p><p>Months Months… Months… Months…… Months… ………… ……… ……… …… ………</p><p>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 </p><p>(COMPLETE ABOVE OR ATTACH SEPARATE DOCUMENT FOR PRODUCTION DETAIL)</p><p>AUTHORISATION</p><p>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. </p><p>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.</p><p>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:</p><p>Print Full Name Clearly Signature Date</p><p>Approved: Kellie Lewis 02/11/2013 OGA Producer CCS & OMP Update Page 3 of 3</p><p>© Australian Organic Pty Ltd Form 220-32 v2.0</p>