1. Rainforest Alliance Certified™
Application Form for an Audit Quotation
Instructions for filling out the form
1. Please fill out the blank areas in the form. Most important is information about
your group’s exact location, size and type of facilities. Based on your
information we have to be able to make a quotation.
2. If available, please attach:
 A map showing the group’s location on a topographic sheet of 1:50.000
 A map showing the distribution of the group and clear symbols for the
identification of: production area, roads, rivers, housing areas, water
sources, the administrator’s main office, points of reference
3. Kindly send the filled out form to the applicable address below. Please use these
addresses for questions about the application.
For Indonesia: For all other countries:
Rainforest Alliance Asia Pacific Regional Office Rainforest Alliance
Sustainable Agriculture Auditing Services Sustainable Agriculture Auditing Services
Jl. Ciung Wanara No. 1 P.O. Box 11029-1000
Renon, Denpasar, Bali 80225 Indonesia San José, Costa Rica
Tel: 62-361-224-356 Fax: 62-361-235-875 Tel: 506-2234-8916
Peter Sprang, Regional Manager Adelaide Webster, Customer Services
Email: psprang@ra.org Email: awebster@ra.org

2. Application form for Auditing Services (group)
1. General information about the group
Name of the group
Website (if available)
Legal identification number
of the group (if available)
Nearest town to the group
Region
Municipality
Country
Postal address of the head
office of the group (or in
another city)
Describe how to get to the
group from the head office
or the nearest town
(airport), what type of
transport is required and
how long it takes
Name of the group
administrator
Postal address of the group
administrator
Phone of the group
administrator
Email of the group
administrator
Type of group (delete all  Membership groups or private farm organizations, such
the options that do not as cooperatives, associations
apply)  Multiple farms of a single owner
 Traders and suppliers
 Communal lands: for example, government, ethnic or
religious groups
 Federation of groups , unions
Coordinates (WGS-84) of Latitude:
the central offices of the Longitude:
group:
Legal representative of the
group
Postal address of the
owner/legal representative
Email of the owner/legal
representative
Is the group already
Rainforest Alliance
Certified™, or has it been in
the past?
Does the group have other
certifications/verifications?
If so, indicate which ones
Size of the group Total production area Ha.
Protected areas Ha.
Other conservation area Ha.
Infrastructure Ha.
Other Ha.
TOTAL Ha.
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3. Application form for Auditing Services (group)
2. Structure of the group
Total number of farms
in the group (includes
farms that will not be
included in the audit)
Total number of Ha.
hectares (incl.
production and other
areas):
Total number of
owners:
3. Scope of the audit
Total number of farms
to be included in the
audit process:
Total number of
owners of these farms:
Total number of Ha.
hectares under
production of these
farms:
Total hectares included Ha.
in the audit
(production and other):
4. General information about the contact person for the
audit
Name of the contact
person for this audit
process
Position
Phone number of this
person (cell phone or
home phone, please
include a number for
emergencies)
Email of this person
Mailing address of this
person (not a PO Box)
5. General information for the certification agreement
Name of the person
who will sign the
Certification
Agreement
Mailing address of this
person (not a PO Box)
Position
Email of this person
Number of hectares to Ha.
be included in the
certification (= the sum
of area under
production of the
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4. Application form for Auditing Services (group)
crop(s) that are being
certified):
6. Sales representative of the group
Name
Position
Phone
Email
7. Information about the service requested
Audit type requested  Pre audit (formerly diagnostic audit)
(delete all the options that  Certification audit
do not apply)  Annual audit
Preferred audit date
(specify month)
Describe the resources the  Audit team’s transportation to the country
group can provide during  Audit team’s transportation to the group (within the
the audit (delete all the country)
options that do not apply)  Audit team’s lodging
 Audit team’s meals
8. Information about the crop(s) to be included in the
audit
production
Crop and variety Product Harvest Kg per Total
quality period hectare Production
(kg)
1 Eg, Coffee, Arabica Specify, for Specify Specify in Kg.
example, harvest For coffee:
quality months green coffee.
grades. For tea: made
tea. For
cocoa: beans
weight in Kg
2
3
4
5
9. Detailed information about the group
Specify the Office(s)
infrastructure in the Plant nursery
group (delete all the Warehouse
options that do not Laboratory
apply) Workshop for vehicles
Store
Processing area /factory
Employee’s dining room
Boilers
Gasoline or diesel storage
Housing for workers
Waste treatment area
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5. Application form for Auditing Services (group)
Airport
Water treatment system
Irrigation system
Pumping station /hydro electric
School
Health care center / hospital
Specify the types of Rivers / Streams
water resources present Lakes
in the group (delete all Wells
the options that do not Mangroves / Wetlands
apply) Other, specify:
The permanent
workforce of the group is
about how many people?
At peak harvest time, the
temporary workforce is
about how many people?
Are there labour
organizations or unions
active at the group level?
Please describe.
If there is a labour or
union active, please
specify contact details.
How many members
does the labour
organization or the union
have?
List and specify the
service providers
(agrochemicals, waste
disposal, etc.) of the
group.
10. List of farms to be included in the audit (you can also
submit this in an excel sheet or other format, as long as all data are
included)*
No. Farm name Owner name Total farm Producti Production of
area on the farm (final
hectares product eg
green coffee,
in Kg)
1
2
3
4
5
6
7
*Make list as long as needed
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6. Application form for Auditing Services (group)
11.Product flow (traceability)
Name of first Location (city, Contact details Annual quantity
buyer of your crop country) (name and email) (tons, kg or boxes)
12.Indicator collection
This information is helpful for making a quote but not a requirement at this point.
Once you agree that we conduct an audit you will be asked to fill out this table with specific
indicators about your group. Rainforest Alliance has the objective to measure the social,
environmental and economic impact of its work to better demonstrate its benefits to farmers
and buyers of certified products. The collected data are used on a confidential basis and
farmers and the public in general will be informed of the results once available.
1. General Information
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7. Application form for Auditing Services (group)
Average water consumption in common Irrigation Processing
1
operations (liters):
Treated residual waters in common
2
operations (liters):
Class I Class II Other
3 Agrochemicals purchased annually (kg):
4 Total protected hectares:
5 Total hectares under conservation:
N° of species identified in farms
6 Flora Fauna
(optional):
Total meters of river beds or bodies of
7
water permanently protected:
Total number of permanent local
8 Men Women
workers:
Total number of permanent foreign
9 Men Women
workers:
Total number of temporary local
10 Men Women
workers:
Total number of temporary foreign
11 Men Women
workers:
Number of minors benefiting from
12
support for their education:
Do workers have access to potable water
13 YES NO
in the work site?
Is the workers salary greater than $2 for
14 YES NO
the daily full time work day?
N° of serious accidents during the last
15
year:
16 Current certified production (kg):
17 Production sold as certified (kg):
National International
Percentage of certified products sold in
18 the market:
% %
Date:
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