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Annex G - C-PIQ Export Document – Form no. CFIA/ACIA 5314

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Specimen - Export document for Canadian Partners in Quality establishments Fresh fruit and vegetables

Description for Export document for Canadian Partners in Quality establishments Fresh fruit and vegetables


The establishment described above is operating under a Canadian Food Inspection Agency (CFIA) recognized quality assurance program aimed at verifying that the products meet the Safe Food for Canadians Regulations and the U.S. Import Requirements of 7 U.S.C. 608e-1. The establishment is monitored and audited by the CFIA for compliance with the requirements of this program, referred to as Canadian Partners in Quality (C-PIQ).

Information may be accessible or protected as required under the provisions of the Access to Information Act.

Commodity Code

C-PIQ Registration No.

C-PIQ Establishment



Same as Establishment


C-PIQ Establishment

Product Description

Marks on packages



Lot Identification

Number and Type of Packages

Declared Grade


The product described above originates in the province of

Net weight (kg)

U.S. Customs Entry No.

Inspector Name (print)


Client account number.

I hereby warrant and certify that I have the authority to sign this Export Document on behalf of the C-PIQ establishment identified above.

I hereby do warrant and certify that all the information contained on and in this Export Document is fully true and accurate and that the product described above was prepared in and shipped from a facility operating under the C-PIQ program.

I understand and acknowledge that if any information set out herein is found to be false, misleading or deceptive, this may result in legal action by the CFIA.

Name of Establishment signatory



Instructions for completing the export document for C-PIQ establishments

To be completed by the CFIA:

Note: Informed Filler will assign a unique official export document number for each document.

To be completed the C-PIQ registered establishment:

Product description

Date modified: