Blackeye Peas (B0474)

SWORN STATEMENT OF ALLERGENS Company name: GOYA FOODS Product: BLACKEYES PEAS 03/01/2026 Date: 18/08/2026 We hereby declare under oath that our company does not handle the products listed below, which are considered allergens and may have adverse effects on the consumer, assuming responsibility for any consequences that may arise should this statement be false. Mark the corresponding box with an X: This declaration will be verified through an unannounced visit to the establishment, in order to corroborate its No. ALLERGEN Present due to cross contamination in the raw material Present in the raw material 1 Cereals containing gluten (wheat, rye, barley, oats, spelt, kamut or their hybrid varieties) and derived products Crustaceans and crustacean-based products S S NX S NX NX S 2 3 4 NX NX S Eggs and egg products S Fish and fish products S 5 NX NX S NX NX S 6 Peanuts and peanut-based products S Soybeans and soy-based products S 7 NX S Milk and its derivatives (including lactose) S NX NX NX S 8 Nuts, i.e. almonds (Amygdalus communis L.), hazelnuts (Corylus avellana), walnuts (Juglans regia), cashews (Anacardium occidentale), pecans [(Carya illinoiesis) (Wangenh.) K Koch], Brazil nuts (Bertholletia excelsa), pistachios (Pistacia vera), macadamia nuts and Australian nuts (Macadamia ternifolia), and derived products. NX S 9 Celery and celery products S NX S NX 10 Mustard and derived products S NX S NX 11 Sesame seeds and sesame seed-based products S NX S NX S NX 12 Sulfur dioxide and sulfites in concentrations greater than 10 mg/kg or 10 mg/l expressed as SO2 NX S NX S 13 Mollusks (gastropods, bivalves, cephalopods) S NX 14 Lupins and derived products S NX S NX NX S information, which will be signed as a sign of agreement. _____________________________________________ NAME AND SIGNATURE LEGAL REPRESENTATIVE “Any copy or reproduction of this document CONSORCIO DEL VALLE constitutes an UNCONTROLLED COPY. Total or partial reproduction of this document is prohibited without authorization from the Quality Manager.” N

Bean / Legume