Date
Request Made By
Address
City
State/Province
Zip/Postal Code
Contact Phone
Fax
Contact Person
Best Time to Call
Product to be Altered
New Product to be Created
Product Code
Name of Product
Type of Product
Date Samples Required
Is a Similar Product Available on the Market?
Yes
No
Does it need to be exclusive?
Yes
No
Target Cost (Without Shipping)
Ingredients Not to be Used (i.e. MSG)
Does it have to be exactly the same?
Yes
No
Product will be used by
Restaurant
Manufacturer
Processor
Other
Copy of (brand or Recipe)
if recipe please attach copy of recipe with detailed instructions. If copy of Brand please supply a sample of the product.
Yield Requirements
Sample Yield requirement
qt
1/2 gal
1 gal
Other
Handling Requirements
if other, please specify
How will product be used? (Equipment and cooking techniques used)
Projected Yearly Volumes
Pack Size Requirements (per case)
Brand Name
