Part I: Details of dispatched consignment

COUNTRY

Veterinary certificate to EU

I.1. Consignor

Name

Address

Tel.

I.2. Certificate reference No

I.2.a.

I.3. Central competent authority

I.4. Local competent authority

I.5. Consignee

Name

Address

Postal code

Tel.

I.6.

I.7. Country of origin

ISO code

I.8. Region of origin

Code

I.9. Country of destination

ISO code

I.10. Region of destination

Code

I.11. Place of origin

Name

Approval number

Address

I.12. Place of destination

I.13. Place of loading

Address

Approval number

I.14. Date of departure

I.15. Means of transport

Aeroplane

Ship

Railway wagon

Road vehicle

Other

Identification

Documentary references

I.16. Entry BIP in EU

I.17. No(s) of CITES

I.18. Description of commodity

I.19. Commodity code (HS code)

01.06.41

I.20. Quantity

I.21.

I.22. Number of packages

I.23. Identification of container/seal number

I.24.

I.25. Commodities certified for:

Breeding

I.26.

I.27. For import or admission into EU

I.28. Identification of the commodities

Species

(scientific name)

Part II: Certification

COUNTRY

Model QUE

II. Health information

II.a. Certificate reference number

II.b.

II.1. Animal Health attestation

I, the undersigned, hereby certify, that the animals referred to in Part I of this certificate meet the following requirements:

II.1.1. they come from the territory with code: … (1) in which, American foulbrood, the small hive beetle (Aethina tumida) and the Tropilaelaps mite (Tropilaelaps spp.) are notifiable diseases/pests.

II.1.2. they:

(a) come from a breeding apiary, which is supervised and controlled by the competent authority;

(b) come from an area which is not subject to any restrictions associated with an occurrence of American foulbrood, and where no such occurrence has taken place within at least 30 days prior to the issuance of the present certificate. Where an outbreak of American foulbrood has occurred previously, all hives within a radius of three kilometres have been checked by the competent authority and all infected hives burned or treated and inspected to the satisfaction of the said competent authority within 30 days following the last recorded case:

(c) are from hives or come from hives or colonies (in the case of bumble bees) from which samples of the comb have been tested in the last 30 days for American foulbrood as laid down in the OIE Manual of Diagnostic Tests and Vaccines for terrestrial Animals with negative results;

(d) come from an area of at least 100 km radius which is not subject to any restrictions associated with the occurrence of the small hive beetle (Aethina tumida) or Tropilaelaps spp., and where these infestations are absent;

(e) are from hives or come from hives or colonies (in the case of bumble bees), which were inspected immediately prior to dispatch and show no clinical signs or suspicion of disease including infestations affecting bees;

(f) Have undergone detailed examinations to ensure that all bees and packaging do not contain the small hive beetle (Aethina tumida) or their eggs and larvae, or other infestations, in particular Tropilaelaps spp., affecting bees.

II.1.3. the packaging material, queen cages, accompanying products and food are new and have not been in contact with diseased bees or brood-combs, and all precautions have been taken to prevent contamination with agents causing diseases or infestations of bees.

Notes

Part I:

Box reference I.12: the introduction of queen bees and their accompanying attendants (Apis mellifera) is not authorised into the territories of Member States listed in the third column of the table set out in the Annex to Commission Implementing Decision 2013/503/EU (OJ L 273, 15.10.2013, p. 38).

Box reference I.20: Number of queen bees (Apis mellifera and Bombus spp.). Each queen bee may be accompanied by a maximum of 20 attendants.

Part II:

(1) Code of the territory as it appears in Part 1 of Annex II or Section 1 of Part 1 of Annex IV to Commission Regulation (EU) No 206/2010.

Official veterinarian/Official inspector

Name (in capital letters):

Qualification and title:

Date:

Signature:

Stamp:’