Name and address of
Supplier:
This statement is bad on the best of our knowledge, taking in account, all of the added starting materials during the manufacturing process for the materials.
List for the purchad materials on page 3
(If the Supplier has a prepared Statement this may be ud in lieu of this Statement) –––––––––––––––––––––––––––––––––––––––––––––––––––––– The list on page two is bad on the EU-Directive “on the approximation of the laws of the Member States relating to the labelling, prentation and advertising of foodstuffs” 2000/13/EC as amended by 2003/89/EC and 2005/26/EC.
The list also includes additional requirements from Recipharm.
Yes, we confirm that the material is free from the potential allergenic
substances listed o n page two.
No, the material is NOT free from one or more of the potential allergenic
substances listed on page two; e comments below.
If “Yes” it is not necessary to complete the list on page 2.
Comments:
Potential Allergens Included
in the
material
Potential risk
for cross
contamination
Additional comments or remarks
(e.g. origin / source of cross
contamination)日本人体写真
Cereals containing gluten
(i.e.wheat, rye, barley, oats, spelt,
kamut or their hybridid strains)
and products thereof
Crustaceans and products thereof Eggs and products thereof Fish and products thereof Peanuts and products thereof Soybeans and products thereof Milk and products thereof (including
lacto)
如何降肌酐呢
Almond (Amygdalus communis L.),
Hazelnut (Corylus av e llana), Walnut
励才(Juglans regia), Cashew
(Anacardium occidentale), Pecan
周南卷耳nut (Carya illinoiesis (Wangenh.)
K.Koch), Brazil nut (Bertholletia
excelsa), Pistachio nut (Pistacia
瘦人吃什么能长胖vera), Macadamia nut and
Queensland nut (Macadamia
社区服务总结ternifolia) and products thereof
Celery and products thereof Mustard and products thereof Sesame eds and products thereof Sulphur dioxide and sulphites at
垂美四边形concentrations of more than
10mg/kg or 10mg/litre
expresd as SO2.
ADDITIONAL REQUIREMENTS
Latex Poppy or Sunflower eds and
products thereof
好听的个性签名女生
Yeasts and yeast extracts and
products thereof
Moulds and products thereof Colorants Antioxidants Prervatives Phenylalanine Glutamate
List of materials purchad by Recipharm:
(Supplier’s Name and if applicable, identification number)
Note:
If this statement is general and therefore covers all manufactured materials at the site, it is not necessary to complete the list below with the specified names and numbers of the purchad materials.
Name of the material:Number of the material:
Date, issued at: Signature:
