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Name*
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Are you currently a U.S. licensed Distilled Spirits Plant (DSP)?
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Have you begun the application process to become a DSP?
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Do you currently use any alcohol?
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What type of alcohol are you interested in/currently using?
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Please indicate volume needs and frequency of orders:
If a hospital, please indicate which Group Purchasing Organization (GPO) you are a part of
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Are you currently licensed to purchase high proof alcohol?
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What application will you be using alcohol for?
Estimated Monthly Volume in Gallons
Estimated Monthly Volume in Gallons
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What is your shipping zip code?
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Do you currently own a spirits brand?
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Are you currently working with a bottler/blender?
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190 Proof Non-GMO Sugar Cane Ethyl Alcohol Brazil Spec Sheet SS

190 Proof Non-GMO Sugar Cane Ethyl Alcohol Brazil Spec Sheet SS

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50 Old Kings Highway North
Darien, Connecticut 06820

203.662.9761
877.778.5872

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Industrial Sales: industrial@ultrapure-usa.com

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