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Declaration Regarding Food Safety Management System (FSMS)

I, Dr. Deepak Sahu S/o Sh. Hari Bux Sahu, R/o Subhash Nagar, 120, EXT
WEST, OPP UIT, BHILWARA, Rajasthan-311001 designated as Authorized
Signatory in M/s SIMPL INNOVATIVE BRANDS PRIVATE LIMITED situated at
1201-1204, 12th Floor and 1301-1302, 13th Floor, Elanza Vertex, Bodakdev,
Ahmedabad-380054, Gujrat hereby declare that:

1. I am an applicant for new license under the Food Safety and Standards Act (FSS Act),
2006.

2. The nature of our firm is

a) Marketer of Food categories mentioned in Form B.

b) I have Food Safety Plan to ensure that the articles of food, as mentioned above satisfy
the requirements of the FSS Act, 2006 and the Rules and Regulations there under.

c) I further undertake that I shall put in place a Food Safety Management System (FSMS)
and get the same certified from the Accredited Agency as soon as the Accredited
Agencies are notified by the Food Authority.

d) Our facility shall comply with the general hygiene and sanitary requirements as
mentioned in the schedule 4 of the Food Safety and Standards (Licensing and
Registration of food Business) Regulations, 2011.

For: M/s SIMPL INNOVATIVE BRANDS PRIVATE LIMITED

Authorized Signatory
(Dr. Deepak Sahu)

Name & Address of the FBO:


Place: Ahmedabad 1201-1204, 12th Floor and 1301-1302,
13th Floor, Elanza Vertex, Bodakdev, Ahmedabad-380054
Date: 21-05-19

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