Certification Request

COMPANY DETAILS

Company name

Head office address

VAT / Tax ID number

Sector of activities (ATECO/NACE, as per legal docs)

Company manager / Legal representative

Telephone number

E-mail

Website

Name of the Management System Manager

CERTIFICATION REQUEST

First certification Recertification Surveillance / Transfer Scope extension Scope reduction

Other (please specify)

CERTIFICATION SCHEME

ISO 9001 ISO 14001 ISO 45001 ISO 27001

Other scheme (please specify)

Scope of the certification / Subject of the certificate

PRESENCE OF OTHER CERTIFICATION SCHEMES

Are other ISO schemes implemented in the organization?

Yes No

Please specify

Is the management system part of an Integrated Management System (IMS)?

Yes No

Please specify

MAIN MANDATORY REGULATIONS

D.Lgs. 81/2008 (Health & Safety at Work - Italy) D.Lgs. 152/2006 (Environment - Italy) Regulation (EU) 679/2016 - GDPR Directive (EU) NIS 2 Regulation (EU) 2017/745 – MDR (Medical Device Regulation) Employment contracts applied (CCNL / category)

NUMBER OF EMPLOYEES AND LOCATIONS TO BE CERTIFIED

Total number of employees

Number of employees out of scope

Number of full-time employees in scope

Number of part-time / contract workers in scope

Number of FTE employees in scope

Head office / main site

Address	Core process / activities (ATECO/NACE)	Effective number of employees (FTE)	Work shifts (details)	Similar work only for claims reduction

Operational offices / sites (if any) (Fill in if other operational sites are present.)

Address	Core process / activities (ATECO/NACE)	Effective number of employees (FTE)	Work shifts (details)	Similar work only for claims reduction

Temporary offices / sites (if any) (Fill in for construction sites, temporary or mobile sites.)

Address	Core process / activities (ATECO/NACE)	Effective number of employees (FTE)	Work shifts (details)	Similar work only for claims reduction