Contact Valdez Spice

Company Name

Contact

Phone

Date

Email Address

Sales Representative

Shipping Address

Blend Name

Customer Provided Customer Provided Sample Recipe / Formula Ingredient Declaration

Sample Amount Needed Sample Amount Needed Standard Sample Portion Size for Product Other

Sample Requirements - *Processing facility is not certified by the non-GMO project. **Not processed in a certified gluten-free facility. Sample Requirements - *Processing facility is not certified by the non-GMO project. **Not processed in a certified gluten-free facility. Kosher Non-GMO* No MSG Gluten-Free** Will need COA upon request Clean Label Other:

Acceptable Allergens Acceptable Allergens All None Peanuts Milk Tree Nuts Eggs Soy Wheat

Preference of Sample Delivery Preference of Sample Delivery Ship Customer Pick Up Sales Representative will deliver

If Ingredient Declaration provided, does the sample ingredient statement need to match exactly? If Ingredient Declaration provided, does the sample ingredient statement need to match exactly? Yes No

Desired Packaging Desired Packaging Bulk - 25 lbs. Bulk - 50 lbs. Portion Pack Retail Jar Other