PAC | Pennsylvania Accreditation Centre

Apply For Accreditation

All Applicants shall fill Part I & Part III while Part II will be filled according to each of their specific scheme eg. ISO/IEC 17025, 17020, 17065, 17043, 17024... etc.

Part I : General Information

LOGIN CREDENTIAL

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INSTRUCTIONS:

1. Your application cannot be processed unless attached with the required document in soft(pdf/docs/jpg/png) copies.
									2.	Additional advice or information may be obtained by contacting the relevant PAC accreditation manager as displayed on PAC website or by emailing us on info@pacofusa.org.
									3.	Granting accreditation will be subject to the applicant entity fully complying with the accreditation criteria, PAC accreditation requirements and PAC regulation.
									4.	The applicant is specifically advised to read relevant PAC information pack before applying for accreditation.
									5.	If the applicant does not receive an Acknowledgement of receipt of this form, please contact PAC relevant accreditation manager by emailing us on info@pacofusa.org.

A) INFORMATION ABOUT CAB

CAB Full Name

CAB Address

City/State

PO Box/Zip Code

Country

Website (URL)

Email ID

Phone/Mobile No.

Contact Person Name

Designation

Phone/Mobile No

Email ID

B) PLEASE COMPLETE THE BELOW INFORMATION REGARDING CAB

CAB Key Location: Entities performing and/or managing key management system certification activities, on behalf of accredited certification bodies, which are wholly or partly owned or employed by the CAB.

YES

Subcontractor Key Location: Entities performing and/or managing key management system certification activities, on behalf of accredited certification bodies, which are not wholly or partly owned or employed by the CAB.

YES

Subcontractor: Entities performing and/or managing processes related to management system activities, on behalf of accredited certification bodies, which are not wholly or partly owned or employed by the CAB (processes include; marketing, communications, outreach, etc. This list is not all-inclusive; any non-key activity related to the accredited CB's certification program is applicable.)

YES

C) Information About Ownership (Legal status of your organization)
Please tick the appropriate box.

Owned by an Individual	Part of an Academic Institution
Owned by a Private Company / Partnership	Part of Learned / Technical Institution
Owned by a Public Body / Nationalized Industry	Owned by Public Limited Company
National / Governmental Organization	Other
(*) Attach Support Document

D) OTHER DESCRIPTION OF THE THE ORGANIZATION SEEKING ACCREDITATION

Total no. of Employees
(in Digit)

Number of Employees involved in area(s)
seeking Accreditation (in Digit)

(*) Attach an organization chart indicating the
structure of the areas to be accredited

Name and position (Director level) of person authorizing this application

Title

Name

Position

Technical/Scheme Manager

Name

Technical Qualifications

Position within the organization

Quality Manager

Name

Qualifications

Position within the organization

E) INDICATE EXACTLY HOW THE NAME OF YOUR CAB APPEARS ON THE ACCREDITATION CERTIFICATE

F) INTERNAL AUDIT AND MANAGEMENT REVIEW

Last Internal Audit Report (*)

Last Management Review Report (*)

G) LOCAL REGULATION
Please mention the current regulation / law that related to your organization activities.

Name of the Regulation/Law	Issue Date	Item(s) related to the applied scope

H) OTHER ACCREDITATION/CERTIFICATIONS (INCLUDING PAC ACCREDITATION)

Are you currently accredited or have you been accredited within the past five years.

YES

If YES, please provide the name of Accreditation body and the current expiration date of accreditation. If no longer accredited, provide the approximate end date of accreditation.
Please note below if your accreditation has ever been Suspended/Cancelled
Suspended	Cancelled	Not Suspended/Cancelled
Please provide the approximate date of Suspension/Cancellation
Reason For Suspension/Cancellation
Was your Accreditation fully reinstated after the Suspension/Cancellation	Yes	No	Not Applicable

I) APPLICANT OUTSIDE USA
Applicants from outside country will be processed according to ILAC-G21(Cross-Frontier Accreditation Principles for Cooperation), IAF MD12 (Accreditation Assessment of Conformity Assessment Bodies with Activities in Multiple Countries)

Considering the questions above, what are the reasons for choosing PAC instead of the local accreditation body?

J) NAME(S) OF COUNTRIES WHERE CAB INTENDS TO PROVIDE PAC ACCREDITED CERTIFICATIONS

K) RELATIONSHIP AND SISTER CONCERN RELATED INFORMATION

Other activities of CAB	Details
Relationship in a larger entity if any, addresses of all its physical location(s) and, information on activities conducted at all locations including virtual site(s)	Not Applicable
Related Bodies of CAB's top management (Please include complete details of all BODs & share holders)	Not Applicable
Activities executed by the related bodies	Not Applicable
Requirement for preliminary visit prior to the commencement of assessment process	Not Applicable

Part II: Inforamtion About Scheme Seeking Accreditation

SELECT THE SCHEME SEEKING ACCREDITATION

Testing Laboratory (TL) - ISO/IEC 17025 (Section 2.1)	Calibration Laborator (CL) - ISO/IEC 17025 (Section 2.2)
Medical Laboratory (ML)- ISO 15189 (Section 2.3)	Inspection Body (IB) - ISO/IEC 17020 (Section 2.4)
MS Certification Body (MsCB)- ISO/IEC 17021-1 (Section 2.5)	Proficiency Testing Provider (PTP) - ISO/IEC 17043 (Section 2.6)
Product Certification Body (PdCB) - ISO/IEC 17065 (Section 2.7)	Person Certification Body (PsCB) - ISO/IEC 17024 (Section 2.8)

Section II.I : Testing Laboratory (TL) - ISO/IEC 17025

A. FIELD FOR WHICH ACCREDITATION IS SOUGHT: (Please tick the appropriate boxes)

B. SCOPE OF TESTING FOR WHICH ACCREDITATION IS SOUGHT:

Materials/Product Tested	Types of Test/Properties Measured Range of Measurement	Standard/Specifications/Techniques used

C. LIST THE MAJOR ITEMS OF EQUIPMENT CURRENTLY USED FOR THE TYPES OF TEST:

Description of equipment (Include Manufacturer, Model& Serial number/Code number)	Range/ Capacity of equipment and other relevant information

D. PLEASE INDICATE THE TYPE OF CALIBRATION FOR THE TESTING LAB EQUIPMENT:

External Calibration

Internal Calibration

* In case of internal calibration for equipment used, please fill in the following details for the scope of the internal calibration.

Please indicate the type of calibration sites:
Customers Premises	Mobile Facilities
The locations of temporary sites	Collection sites (premises that only collect sample)
Other

Measured Quantity	Range	Calibration & Measurement Capability (#) Uncertainity	Brief Description of Measurement and Equipment Used

Section II.II : Calibration Laborator (CL) - ISO/IEC 17025

A) FIELD FOR WHICH ACCREDITATION IS SOUGHT: (Please tick the appropriate boxes)

B) SCOPE OF CALIBRATION FOR WHICH ACCREDITATION IS SOUGHT:

Measured Quantity	Range	Calibration & Measurement (Capability)*

C) LIST THE MAJOR ITEMS OF EQUIPMENT CURRENTLY USED FOR THE TYPES OF CALIBRATION:

Description of equipment (Include Manufacturer, Model & Serial/Code number)	Range/Capacity of equipment and other relevant information

D) PLEASE INDICATE THE TYPE OF CALIBRATION LAB EQUIPMENT:

External Calibration

Internal Calibration

* In case of internal calibration for equipment used, please fill in the following details for the scope of the internal calibration.

Please indicate the type of calibration sites:
Customers Premises	Mobile Facilities
The locations of temporary sites	Collection sites (premises that only collect sample)
Other

Measured Quantity	Range	Calibration & Measurement Capability (#) Uncertainity	Brief Description of Measurement and Equipment Used

Section II.III : Medical Laboratory (ML) - ISO 15189

A) FIELD FOR WHICH ACCREDITATION IS SOUGHT: (Please tick the appropriate boxes)

Chemical Pathology/Clinical Biochemistry	Clinical Pathology
Hematology and Immunohematology	Microbiology and Serology
Immunology	Clinical Cytogenetics and Molecular Biology
Anatomic Pathology	Blood Baking and Transfusion Medicine
* For others: Please, write the field:

B) DETAILS OF PRIMARY SAMPLE COLLECTION FACILITIES:
(Please mention clearly with full addresses the primary sample collection facilities)

Primary sample collection facility	Address

C) LABORATORY BRANCHES: DOES THE LABORATORY HAVE BRANCHES?

YES

PLEASE MENTION CLEARLY WITH FULL ADDRESSES THE LABORATORY BRANCHES WITHIN THE ACCREDITATION SCOPE:

Branch	Address

DO THE LABORATORY BRANCHES HAVE SEPARATE MANAGEMENT SYSTEMS?

YES (Branches should apply for accreditation with separate Applications)

NO (Please specify the scope of each branch in the following tables)

LIST OF MEDICAL SCOPES AND MAJOR ITEMS OF EQUIPMENT CURRENTLY USED:

Discipline/Types of Tests (Department)	Standard Specifications / Techniques Used / Equipment
Name of test	Method name and Reference	Equipment name and SN

D) PLEASE INDICATE THE TYPE OF MEDICAL LAB EQUIPMENT:

External Calibration

Internal Calibration

* In case of internal calibration for equipment used, please fill in the following details for the scope of the internal calibration.

Please indicate the type of calibration sites:
Customers Premises	Mobile Facilities
The locations of temporary sites	Collection sites (premises that only collect sample)
Other

Measured Quantity	Range	Calibration & Measurement Capability (#) Uncertainity	Brief Description of Measurement and Equipment Used

Section 2.4: Inspection Body (IB) - ISO/IEC 17020

A. FIELD FOR WHICH ACCREDITATION IS SOUGHT: (Please tick the appropriate boxes)

B. SCOPE OF INSPECTION FOR WHICH ACCREDITATION IS SOUGHT:

Field of Inspection such as :product design, products (specified as materials or equipment) Installations, plant, premises, processes, services and surveys	Type and Range of Inspection e.g. In-service inspection or inspection of new products	Methods and Procedures such as:EC directives, regulations, standards, specifications, internal procedures

C. FOR WHOM DOES THE INSPECTION BODY UNDERTAKE INSPECTION?

Own organization

Parent organization

Other organization

D. WHAT DO YOU CONSIDER TO BE THE TYPE OF YOUR INSPECTION BODY, AS DEFINED IN ISO/IEC 17020

Type A

Type B

Type C

E. DO YOU PERFORM INSPECTION OUTSIDE USA ?

Yes *

If yes state the countries in which inspections performed

F. PLEASE INDICATE THE TYPE OF CALIBRATION FOR THE INSPECTION BODY EQUIPMENT:

External Calibration

Internal Calibration

* In case of internal calibration for equipment used, please fill in the following two tables for the scope of the internal calibration:
Please indicate the type of calibration sites:
Customers Premises	Mobile Facilities
The locations of temporary sites	Collection sites (premises that only collect sample)
Other

Measured Quantity	Range	Calibration & Measurement Capability (#) Uncertainity	Brief Description of Measurement and Equipment Used

Section 2.5: MS Certification Body (MsCB) - ISO/IEC 17021-1

IDENTIFY THE MANAGEMENT SYSTEM CERTIFICATION SCHEME(S) FOR WHICH ACCREDITATION IS SOUGHT:

CERTIFICATION AREA

SCOPE

Countries

QMS-ISO 9001
supplementary accreditation standard for this certification area is ISO/IEC 17021-3

IAF Codes according to IAF MD 17

EMS-ISO 14001
supplementary accreditation standard for this certification area is ISO/IEC 17021-2

OH SMS-ISO 45001
supplementary accreditation standard for this certification area is ISO/IEC TS 17021-10:2018 & IAF MD 22:2018

FSMS-ISO 22000
supplementary accreditation standard for this certification area is ISO/TS 22003

FSMS subcatagory according to Table A.1 - Food chain categories of ISO/TS 22003 :2013

ISO 37000
Supplementary accreditation standard for this certification area is ISO/TEC TS 17021-9:2016

Subcatagory According to ISO/TEC TS 17021-9:2016	Normative documents	Countries

EnMS-ISO 50001
supplementary accreditation standard for this certification area is ISO 50003

EnMS Technical areas according to ISO 50003
Technical Area	Description of technical areas for EnMS	Countries

MDQMS-ISO 13485
Supplementary accreditation standard for this certification area is IAF MD 9

Scope According to IAF MD 9
Main Technical Areas	Product Categories Covered by the Technical Areas	Countries

ISMS-ISO 27001
Supplementary accreditation standard for this certification area is ISO/IEC 27006

MS ISO 21001
Educational organizations

Supply chain security Management Systems - according to ISO 28001. Supplementary accreditation standard for this certification area is ISO 28003

Other
(Please mention details)

Section 2.6: Proficiency Testing Provider (PTP) - ISO/IEC 17043

COLLABORATORS / SUBCONTRACTORS INFORMATION:

Please complete this table for all collaborator/subcontractors with which the proficiency testing provider has formal arrangements for the production, testing, measurement, sampling, storage, and distribution of the PT materials/samples or measurement artifacts, and for data processing.
Subcontractor / Collaborator Name and address	Accreditation held(if applicable)	Activities/services rendered

Scope of proficency testing for which accreditation is sought:

Sample/ Artifact Sample	Tests/ Properties measured	Scheme Title/ Type	Frequency

Part III : Declaration by the Applicant

Declaration:

I declare that I am authorized, on behalf of the organization to submit this application, and that the information contained herein is both correct and accurate to the best of my knowledge and belief.
Upon accreditation the organization agrees to comply with PAC requirements.
I will enclose a copy of the quality manual (if any), PAC relevant Assessment Checklist Report, relevant procedures, the application fees and any needed documentation(s).
I understand the manner by which the accreditation system operates and functions.
I agree to cooperate with the visit assessment team appointed by PAC for examination of all relevant documents by them and their visits to those parts of the CAB which are part of the scope of the accreditation.
I agree to comply with the accreditation procedures, pay all the costs for pre-assessment (if any), initial assessment, sequential assessment and re-assessment.

Position

Full Name

Signature (jpg)

Is there a local accreditation body?	Yes No
Is the local accreditation body a signatory to the arrangement of ILAC, IAF?	Yes No
Does the local accreditation body offer the required scope?	Yes No
Do you permit:
That PAC informs the local accreditation body about your application and the development of the accreditation process?	Yes No
That the local accreditation body may send an observer to join the assessment?	Yes No
That the local accreditation body may send (an) assessor/s (joint assessment for a dual accreditation)?	Yes No

Chemical Analysis	Microbiology, Hydrobiology & Toxicity
Civil Engineering and Materials Testing	Electrical & Electronics
Environmental including Ambient Air Monitoring	Heat & Temperature
Mechanical	Non-destructive
Optics and Radiometry	Veterinary
Pharmaceutical	Others*

Accelerometer	Acoustics	Chemical	Density
Dimensional	Electrical	Fiber Optics	Flow
Force	Hardness	Humidity	Mass
Optical	Pressure	Radiological	Temperature
Torque	Ultrasonic	Viscosity	Volume
Other (Please Describe)

Glass and ceramics industries	Health care technology	Natural sciences	Services
Mechanical systems& components	Metrology and measurement	Environment. Safety	Testing
Fluid systems& components	Manufacturing Engineering	Energy and heat transfer	Electrical Engineering
Generalities. Standardization. Documentation	Domestic and commercial equipment. Entertainment. Sports	Information technology. Office machines	Image technology
Construction materials and building	Road vehicles engineering	Railway Engineering	Paper technology
Material handling equipment	Packaging and distribution of goods	Textile and leather technology	Clothing industry
Agriculture	Food Technology	Chemical technology	Metallurgy
Petroleum and related technologies	Telecommunications. Audio and video	Wood technology	Electronics
Rubber and plastic industries	Shipbuilding& marine structure	Paint and color industries	Jewellery
Civil engineering	Mining and minerals	Other
* For others: Please, write the field:

If the answer is yes fill the following:
Accreditation body name		Date of application
Fields of conformity evaluation which are accredited or for which accreditation has been applied:
Approvals and other recognitions of the certification body:

Apply For Accreditation

Apply For Accreditation

Part I : General Information

Part II: Inforamtion About Scheme Seeking Accreditation

Section II.I : Testing Laboratory (TL) - ISO/IEC 17025

Section II.II : Calibration Laborator (CL) - ISO/IEC 17025

Section II.III : Medical Laboratory (ML) - ISO 15189

Section 2.4: Inspection Body (IB) - ISO/IEC 17020

Section 2.5: MS Certification Body (MsCB) - ISO/IEC 17021-1

Section 2.6: Proficiency Testing Provider (PTP) - ISO/IEC 17043

Section 2.7: Product Certification Body (PdCB) - ISO/IEC 17065

Section 2.8: Person Certification Body (PsCB) - ISO/IEC 17024

Part III : Declaration by the Applicant

Declaration:

Product (s) / Product Group (s)	Certification Standard / Scheme

DOCUMENTED STRUCTURE TO SAFEGUARD IMPARTIALITY	No	Yes
WHO ARE THE STAKEHOLDERS REPRESENTED IN THIS STRUCTURE (COMMITTEE)?

Number of	Staff	Other staff (Part-time workers)
Persons with university education
Persons with technical school education
Persons trained in quality management

What are the rules and procedures of certification for the fields of conformity listed in the application?
Are the proposed certification systems for accreditation described by own procedure and administration rules?	No	Yes
Does the certification body have special departments, groups or technical committees responsible for determined fields of certification?	No	Yes
If YES, Information on the special field (name, address):
Does the certification body itself carry out tests of products, processes and services in the fields of certification applied for?	No	Yes
Is there an accreditation of the testing laboratories of the certification body?	No	Yes
If YES, By which accreditation bodies?:
Fields of testing:
Does the certification body itself carry out the surveillance of products, processes and services in the fields of certification applied for?	No	Yes
Who are the subcontractors for surveillance visits?

Which testing laboratories work for the certification body?
Name / Identification	Test fields	Accredited by

In the case of non-accredited subcontractors, in which way does the certification body make sure that it complies with the requirements of the concerning international documents (e.g. ISO/IEC 17025)?

Does the certification body have a quality manual?	No	Yes
Has a quality manager been appointed	No	Yes
If YES, Name
To ensure the compliance with the criteria of the standard ISO/IEC 17065, are there Internal audits and repetitive checks?	No	Yes
Where are they documented?
Which arrangements are made to ensure confidentiality?
Is there a procedure for handling of complaints against decisions of the certification body?	No	Yes

Locations of the applicant organization/ certification body:
Address	PO Box / Code	City

*Org. chart Please attach the organisational structure (the structure within an organisation) of the certification body.
B. Identify the certification scheme for persons for which accreditation is sought:

D. DOCUMENTED STRUCTURE TO SAFEGUARD IMPARTIALITY	No	Yes
E. WHO ARE THE STAKEHOLDERS REPRESENTED IN THIS STRUCTURE (COMMITTEE)?

Do the applicant organization / the certification body complywith any standard for quality system?	No	Yes	If YES, which one?
Has a quality manager been appointed	No	Yes	If YES, Name
Is there a documented system for internal quality audits to ensurethe compliance with ISO 17024?	No	Yes	Reference document
Are there documented procedures to ensure confidentiality?	No	Yes	Reference document
Are there procedures regarding the misuse of certificates?	No	Yes	Reference document
Is a description of the certification system available in published form?	No	Yes	Reference document