Attachment_1_-_Third_Party_RAC_Sample_Assignment.pdf

RFQ No. FDA-15-SOL-1146775 Attachment 1: Third Party Recall

Audit Check Sample Assignment

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Memorandum

Date [Date]

From [Recall Coordinator Name], R&E Coordinator, [District]

Subject REQUEST FOR AUDIT CHECKS

To [Accomplishing Organization]

RES Event ID: [Recall Enterprise System Number]

1) PRODUCT:

• Ranch Dip, item 123456

• Sour Onion Dip, item 123457

2) CODE:

• Item code 123456, lot 08742A

• Item code 123457, lots 08765C, 08766A and 08767A

3) RECALLING FIRM: Chip Dip of America 10 Dip Lane Heartland, MD (USA)

4) REASON FOR RECALL: The products were manufactured using recalled hydrolyzed vegetable protein and have the potential to be contaminated with Salmonella.

5) FIRM’S RECALL STRATEGY: Chip Dip of America telephoned their direct accounts on

3/2/12 and sent follow-up recall letters on the same date, informing them that the affected lots of dips were manufactured using recalled hydrolyzed vegetable protein and may be contaminated with Salmonella. The accounts were requested to cease sales, distribution and consumption of the affected products, extend the recall to the retail level, and return any affected product remaining in their inventory to Chip Dip of America. Further, if the consignee repackaged or manufactured into another food, the consignee was urged to consider recalling the new product. Any questions were directed to John Doe, Director of Operations at 555-123-1234.

6) TOTAL NUMBER OF RACs TO CONDUCT: 35

7) RETAIL ACCOUNTS:

8) SPECIAL INSTRUCTIONS:

RFQ No. FDA-15-SOL-1146775 Attachment 1: Third Party Recall

Audit Check Sample Assignment

Directly conduct RAC for the following retailers: (Total 35)

CHI-DO: Grocery Store A/ 123 Chicago Dr, Des Plaines, IL

Convent Store B/ 123 14th Ave, Chicago, IL Retailer C/ 123 Angeles Road, Chicago, IL Retailer D/ 123 Diego Rd, Chicago, IL Retailer E/ 123Little Dr, Chicago, IL

CIN-DO: Retailer A /Louisville, 123 Louisville Dr, Louisville, KY DAL-DO: Retailer X /East Texas, 123 East Dr, Longview, TX

Retailer Y /West Texas, 123 West Pl, Lubbock, TX DEN-DO Retailer X/Denver, 123 Denver St, Denver, CO

Retailer Y/New Mexico, 123 New Rd NE, Albuquerque, NM Retailer Z/Intermountain, 123 Mountain Rd, West Jordan, UT

DET-DO: Retailer A/Grand Rapids, 123 Grand St SE, Grand Rapids, MI FLA-DO: Retailer Y, 123 Big Rd, Melbourne, FL

Retailer Z, 123 Little Rd, Cape Coral, FL KAN-DO: Retailer X/Iowa, 123 Iowa Pl, Ankeny, IA

Retailer X/St. Louis, 123 Louis Rd, Saint Charles, MO LOS-DO: Retailer A, 123 Day Dr, Oceanside, CA

Retailer B/Arizona, 123 14th Ave, Tolleson, AZ Retailer C/Los Angeles, 123 Angeles Road, Walnut, CA Retailer E, 123Little Dr, Vista, CA Retailer F, 123 Midnight St, Oceanside, CA Retailer G/Arizona, 123 14th Ave, Phoenix, AZ Retailer H/Los Angeles, 123 Angeles Road, Walnut, CA Retailer I/San Diego, 123 Diego Rd, Poway, CA Retailer J, 123Little Dr, Vista, CA

MIN-DO: Retailer X, 123 Company Dr, Jackson, WI NWE-DO: Retailer Z, 123New St, Providence, RI NWJ-DO: Retailer T, 123Southeast Rd, South Plainfield, NJ

Retailer U, 123 Small Road, South Plainfield, NJ NOL-DO: Retailer X, 123 Tennessee Ave, Knoxville, TN NYK-DO: Retailer R, 123 E. 120th St, Bronx, NY Retailer S, 123 Tiny Ct, Jamaica, NY

Retailer T/ 123 Central Rd, Queens, NY Retailer U/ 123 San Ave, Brooklyn, NY

SEA-DO: Retailer X, 123 S Seattle Rd, Post Falls, ID

Date [Date]