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ANIA / CLIFE

20/07/2011

DECLARATION OF COMPLIANCE WITH REGULATIONS

ON MATERIALS AND ARTICLES INTENDED TO COME

INTO CONTACT WITH FOOD

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I, the undersigned, Ms/M (delete as appropriate): …………………………………………………….

- Company/Organisation (delete as appropriate): …………………………………………...

(“Organisation” designates any legal entity that is not a company)

- Address: ………………………………………..………………………….………………..

acting in her/his position of: …………………………………………………………………………....

hereby declares that the material and/or article referenced by the customer as follows (references of

client’s order or article specifications): ………………………………………………………………..

and characterised as follows:

- Type of material (plastic, paper/cardboard, wood, metal, glass):

………………………………………………………………………………………………

- Characteristic components, from the inner to the outer layer (precise whether one of the

layer is a functional barrier) :

………………………………………………………………………………………………

complies with the requirements of :

- Framework Regulation (EC) No 1935/2004 of 27

th

October 2004, on materials and articles

intended to come into contact with food ;

- Commission Regulation (EC) No 2023/2006 of 22

nd

December 2006 amended, on good

manufacturing practices for materials and articles intended to come into contact with food;

- French regulation in force concerning materials and articles intended to come in contact

with food, that is to say sanction decree No 2007-766 of 10

th

may 2007, amended by the

decree No 2008-1469 of 30

th

December 2008.

The compliance of the material and/or article as described above is determined according to the

regulatory texts and/or other reference texts (governmental or professional, or opinion from an

official scientific body) identified in the annex of the declaration of compliance (specify the section

concerned)

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.

…………………………………………………………………………………………………..……

…………………………………………………………………………………………………..……

The present declaration concerns materials and articles intended to come into contact with food as defined in the field of

application of Regulation (EC) No 1935/2004 and amended French decree No 2007-766 of 10

th

may 2007. This declaration

also concerns materials in contact with feedstuff for livestock and pets, as well as teats and dummies / soothers, still

covered by the decree No 92/631.

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See list of referenced texts in annex hereafter.

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ANIA / CLIFE 20/07/2011

The material and/or article referenced above, under normal and forseeable conditions of use which are

not causing any unacceptable change in the composition or a deterioration in the organoleptic

characteristics of the food product, is suitable for (tick the appropriate boxes):

- contact with all types of food products

- or only :

o contact with dry foods

!

!

!

o contact with moist foods

o contact with fatty foods

!

If corrective factor, specify it :……………………………

o Contact with acidic food

s

o Contact with alcoholic foods

o Contact with frozen products

!

!

!

!

!

deep freezing and defrosting in the packaging

deep freezing and defrosting out of the packing

o other type of contact (to be specified): ………………………………………………

- for heat treatment including cooking

!

if applicable, specify the maximum temperature, the duration of cooking : …

……………………………………………………………………………………………….........

……

Heating / Reheating in the micro-wave

!

- contact conditions (shelf life and temperature) with the food,

as specified by the customer

!

In addition,

- The compliance is understood to be subject to the conformity with the conditions of

storage, handling and use, taking into account the specific characteristics of the material or

article, and the conditions such as prescribed by professional practices or codes.

- In the event of a change in the packaged product, its composition or its intended use, as

well as in the event of a change in the conditions for using the material or the article, the

person for whom this declaration is intended must ensure the compatibility packaging /

content for which he/she then accepts responsibility.

This declaration of compliance is based on the following (tick the appropriate boxes, if concerned):

Declaration(s) by suppliers of raw materials

(components of the material aimed by the present declaration)

Overall migration testing

If applicable, please see the Additional Information Document.

Testing of substances subject to restriction (including specific migration limit)

If applicable, please see the Additional Information Document giving a list of the substance subject to

restriction(s)* and the admissible limits.

Presence of dual –use additives

If applicable, please see the Additional Information Document giving a list of the substances concerned

(Nam/CAS No and/or EINECS), purity criteria and the admissible limits.

Where applicable, the actual ratio surface / food volume

In the case of derogation of the ratio surface/volume = 6, specify the conditions in the additional information

document

Presence of recycled materials

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