<p> IMO II 00.1.11 G-e Application for MSC COC Certification (incl. ASC Scope) 1. Applicant</p><p>Operator / Address:</p><p>Legal status Email:</p><p>Contact Person: Phone:</p><p>Director:/Manager in charge Fax:</p><p>2. Operational units, which are involved in handling MSC or ASC certified products (e.g. processing unit, cold storage; name and physical address, access details) Name operational unit and address Processin Sub- Packaging Trade Storage Restaurant g contracted or Catering processing Service</p><p>1</p><p>2</p><p>3</p><p>4</p><p>3. MSC species, products (if more than 3 products, please copy table below)</p><p>Species: </p><p>Products (e.g. frozen fillets): </p><p>Direct supplier (suppliers with MSC COC certification listed on www.msc.org):</p><p>Species: </p><p>Products (e.g. frozen fillets): </p><p>Direct supplier (suppliers with MSC COC certification listed on www.msc.org):</p><p>Species: </p><p>Products (e.g. frozen fillets): </p><p>Direct supplier (suppliers with MSC COC certification listed on www.msc.org):</p><p>0f24d63da7d1df2a3f3efcbab72b26d9.doc Version 1 Page 1 of 3 12.2013 4. ASC species, products (if more than 3 products, please copy table below) Species:</p><p>Products (e.g. frozen fillets):</p><p>Direct supplier:</p><p>Species:</p><p>Products (e.g. frozen fillets):</p><p>Direct supplier:</p><p>Species:</p><p>Products (e.g. frozen fillets):</p><p>Direct supplier:</p><p>5. Previous Application for MSC-Certification</p><p>Name and Contact details of certification agency to which application for certification according to the MSC (final rule) has been previously made: Year of Application:</p><p>Scope of activities for which certification had been requested Outcome of application Please explain the outcome of the application and enclose any notification of noncompliance or denial of certification if relevant.</p><p>Actions taken by the applicant to correct all identified non- compliance</p><p>5. Other certifications Please list other standards implemented in the operational units:</p><p>1 2 3 4 5 6 </p><p>6. Confirmation By submitting this application for certification the applicant acknowledges that: - The applicant may withdraw the application prior to issuance of notice of non-compliance and in this case will neither receive a notice of non-compliance nor a denial of certification. However, the applicant still has to bear all costs for all service that have been delivered until the withdrawal.</p><p>0f24d63da7d1df2a3f3efcbab72b26d9.doc Version 1 Page 2 of 3 12.2013 - If the application for certification can be accepted the applicant will have to sign the IMO inspection contract in which all deeds and obligations are outlined in more detail before certification can be granted. - The applicant will submit the operators profile and all relevant documentation</p><p>, ------Place, Date Name of signatory Signature</p><p>Please send the application to:</p><p>IMOswiss AG (IMO) Weststrasse 51 8570 Weinfelden Switzerland</p><p> [email protected] </p><p>0f24d63da7d1df2a3f3efcbab72b26d9.doc Version 1 Page 3 of 3 12.2013</p>