certificate no.: 000xxx-xxxx · certificate of gmp compliance certificat de conformitÉ aux bpf...

CERTIFICATE OF GMP COMPLIANCE CERTIFICAT DE CONFORMITÉ AUX BPFCertificate No.: 000XXX-XXXXCERTIFICAT No: 000XXX-XXXX

This Certificate of Good Manufacturing Practice (GMP) Compliance is issued by Consumer Health Products Canada / Produits de santéconsommateurs du Canada délivre le présent certificat.

SITE LICENCE HOLDER INFORMATION / RENSEIGNEMENTS SUR LE TITULAIRE DE LICENCE D'EXPLOITATION

NAME OF APPLICANT:Nom du demandeur:

STREET ADDRESS:Adresse:

CITY: PROVINCE:Ville: Province:

COUNTRY: POSTAL CODE:Pays: Code postal:

Customer Name

123 ADDRESS

CITY PROVINCE

Canada A1A 1A1

SITE INFORMATION / RENSEIGNEMENTS SUR LE SITE

AUTHORIZED ACTIVITIES BUILDING ADDRESS SITE LICENCE NO. DATE OF EXPIRYActivités autorisées Adresse du bâtiment No. de licence d'exploitation Date d'expiration

MANUFACTURING:Fabrication:

Company X123 ADDRESSCITY, PROVINCE A1A 1A1

Canada

###### MONTH 01, 20**

PACKAGING :Emballage:

Company X 123 ADDRESS CITY, PROVINCE A1A 1A1 Canada

###### MONTH 01, 20**

LABELLING :Étiquetage:

Company X123 ADDRESSCITY, PROVINCE A1A 1A1 Canada

###### MONTH 01, 20**

CERTIFYING AUTHORITY INFORMATION / RENSEIGNEMENTS SUR AUT0RITÉ DE CERTIFICATION

ADDRESS OF CERTIFYING AUTHORITY /Adresse d'autorité de certification

ADDRESS OF REGULATING AUTHORITY /Adresse d'autorité de regulation

CONSUMER HEALTH PRODUCTS CANADA CONSTITUTION SQUARE, TOWER III, 240-340 ALBERT STREET OTTAWA, ON K1R 7Y6

NATURAL AND NON-PRESCRIPTION HEALTH PRODUCTS DIRECTORATE 250 LANARK AVENUE, AL 2002, OTTAWA ON, K1A 0K9, CANADA

NOTARY PUBLIC /Notaire public:

COORDINATOR, TRADE CERTIFICATE PROGRAMCONSUMER HEALTH PRODUCTS CANADA

ISSUANCE DATE /Date de délivrance:

ISSUANCE DATE /Date de délivrance:

SAMPLE

PINA MILITO AUTHORIZED OFFICIAL /Responsable authorisé:

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