Vendor declaration according to Article 11 of Council Regulation (EU) No 2018/848
Name, address of vendor:

Identification (e.g. lot or stock number):

Product name:

Components:

(Specify all components existing in the product/used the last in the production process)

I declare that this product was manufactured neither ‘from’ nor ‘by’ GMOs as those terms are used in Articles 3 and 11 of Council Regulation (EU) No 2018/848. I do not have any information which could suggest that this statement is inaccurate.

Thus, I declare that the above named product complies with Article 11 of Regulation (EU) No 2018/848 regarding the prohibition on the use of GMOs.

I undertake to inform our customer and its control body/authority immediately if this declaration is withdrawn or modified, or if any information comes to light which would undermine its accuracy.

I authorise the control body or control authority, as defined in Article 3, items 58-60, of Council Regulation (EU) No 2018/848, which supervises our customer to examine the accuracy of this declaration and if necessary to take samples for analytic proof. I also accept that this task may be carried out by an independent institution which has been appointed in writing by the control body.

In the case of flavourings, the signatory certifies that they comply with the requirements of Regulation (EU) 2018/848, Annex II, Part IV, paragraph 2, point 2.2.2. b) and are therefore substances and products defined in Article 3(2), points (c) and (d)(i) of Regulation (EC) No 1334/2008 that have been labelled as natural flavouring substances or natural flavouring preparations in accordance with Article 16(2), (3) and (4) of that Regulation.

The undersigned takes responsibility for the accuracy of this declaration.

date, signature & function of the person signing

Company stamp of vendor (if appropriate):

Vendor declaration

QC&I GmbH / Dok. 348 – Vendor declaration
Revision 1 / 03.02.2022	Page 1 of 1

Dok 58-5 VA Datenschutz

Rechtschreibfehler korrigiert 17.11.09

Lukas Eichberger

2022-02-22

QCI