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OMB No. 0581-0125
United States
Department of
Agriculture
AGRICULTURAL MARKETING SERVICE, SPECIALTY CROPS PROGRAM
AGREEMENT FOR PARTICIPATION IN AUDIT VERIFICATION PROGRAMS
Good Agricultural Practices & Good Handling Practices Audit Program (GAP&GHP)
Identity Preservation Program (IP)
Partners in Quality Audit Program (PIQ)
Company Information
I
a duly authorized representative of
(Insert Name)
(Name of Company)
(Street Address, City, State, and Zip Code)
hereinafter referred to as the applicant, do hereby agree to be audited under a voluntary USDA, AMS, Specialty Crops
Inspection Division audit program. The audit shall include verification of the company’s farm(s), packing facilities, storage
facilities, wholesale distribution centers or other locations as applicable to the audit scope(s).
1. The applicant agrees that with respect to:
a. Laws, Regulation, Statutes - To conform with all applicable Federal, State, and local government laws, regulations,
or statutes, including, but not limited to: Regulations Governing Inspection and Certification of Fruits and Vegetables
and Related Products (7 CFR, Part 51), any other pertinent regulations, and any such instructions covering inspection
and certification of the products and verification of the processes as may be issued by AMS.
b. Audit Request - To contact and schedule the audit with the appropriate federal or federal-state inspection office
(using the SC-237A form). The request for the initial audit will be made no later than two (2) weeks prior to the end of
the growing/harvesting/packing season.
c. Records - To maintain all records required by the specific audit program including, but not limited to, quality manual,
food safety manual, water test results, employee training records, manure use records, laboratory testing results and
other records as required by the quality manual, food safety manual or specific audit program requirements. The
applicant shall make these records available to USDA federal and/or federal-state auditors.
d. Access to Facilities - To grant permission for AMS authorized personnel to enter any and all farms and/or facilities
covered by the specific audit program for the purposes of conducting the audit. This includes the initial audit and any
unannounced audits as may be required by the program.
e. Payment - To pay by credit card, check, draft, or money order drawn to the order of the appropriate federal or federalstate agency for the services covered herein on or before the due date specified on the billing statement. Charges for
GAP&GHP audits include, but are not limited to, the audit fee as listed in the fee schedule or Federal Register and
travel expenses for the initial audit and any unannounced audits as may be required by the program. Failure to pay for
services will result in decertification.
2. AMS agrees that with respect to:
a. Perform Audit – To provide objective third-party verification of the applicant’s specific audit program using
internationally recognized audit principles.
b. Opening & Exit Interviews - To discuss the audit prior to and report the results and observations with the applicant
after each audit and provide a timeframe in which a copy of the completed audit report or checklist will be provided.
c. Reports - To issue to the applicant reports of all audits and evaluations of the applicant’s specific audit program and
provide written notification of any deficiencies found, if any.
d. Confidentiality - To consider and treat any trade secrets or confidential information as proprietary and confidential.
To consider any records and related information provided to AMS as information that is voluntarily submitted to AMS
because of their participation in the specific audit program.
e. Issuance of Certificate, Posting and Sharing Audit Results - To issue a certificate to the applicant and to post
audit results to the USDA website, only when the applicant meets the USDA acceptance criteria for each scope being
audited. NOTE: If an applicant does not want their company to be posted on the USDA website they must put their
request in writing. To provide the specific applicant checklist and results of individual questions to other parties or
web-based systems only at the written request of the applicant (See the Optional section on page 2 of this form).
NOTE: Reports containing a compilation of audit information can be shared with the Food and Drug Administration.
In addition, AMS will notify FDA in the event of an imminent food safety risk.
SC-651 (6-2017)
Page 1 of 2
OMB No. 0581-0125
3. It is mutually agreed that with respect to:
a. Length of Service - That the audit results for GAP&GHP audits are valid for one year from the date of the initial audit,
provided that the USDA acceptance criteria is met on both the initial audit and any unannounced audits that may be
required by the program. For all other audit programs, the length of service is outlined in the specific audit program
policy guide. This agreement shall remain in effect for the length of time the auditee remains a participant in the
specific audit program.
b. Maintaining Certification - That a company’s information will only remain on the USDA website if any and all
unannounced audits show satisfactory adherence to the program. If the minimum passing score is not achieved, the
company’s information will be removed from the website until a follow-up audit is conducted by AMS verifying that
effective corrective actions have been taken and the company attains the minimum score on all appropriate scopes of
the audit.
Approved By:
Name of Applicant (Print):
Title:
Signature:
Date:
USDA Agricultural Marketing Service, Specialty Crops Program/ Federal or Federal-State Inspection Program
Supervisor
Name of Representative (Print):
Title:
Signature:
Date:
(OPTIONAL) The applicant request AMS to release audit results to:
a. Web-based Systems- The auditee designates the audit report is loaded into the following database (check all that
apply):
___ icix
___ Azzule Systems
___ FoodLogiQ
b. Other Parties- The auditee designates the specific applicant checklist and results of individual questions be sent to:
___________________________________
(Name of Company/Representative)
_____________________________
(Email Address)
___________________
(Phone)
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it
displays a valid OMB control number. The valid OMB control number for this information collection is 0581-0125. The time required to complete this information collection is
estimated to average 8.5 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information.
Non-Discrimination Policy: In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its
Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin,
religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance
program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs).
Remedies and complaint filing deadlines vary by program or incident.
Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.)
should contact the responsible Agency or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800)
877-8339. Additionally, program information may be made available in languages other than English.
To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at How to File a Program Discrimination
Complaint and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint
form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400
Independence Avenue, SW, Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: [email protected].
USDA is an equal opportunity provider, employer, and lender.
SC-651 (6-2017) (Previous editions are to be destroyed)
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File Type | application/pdf |
File Title | FORM APPROVED BY OMB No |
Author | jfrey |
File Modified | 2019-07-08 |
File Created | 2017-06-02 |