Needs Assessment Form

Manufacturing Restaurant Livestock Processing (Farm/Slaughterhouse) Catering Kitchen Grocery Store or Marketplace Distribution Center Other (Add to special instructions)

AC - Activated Carbon CH - Chemicals CS - Cosmetics DY - Dairy FL - Flavors LS - Livestock MM - Menu/Meals NS - Non-Specific NU - Nutraceuticals OL - Oils PM - Packaging Material PH - Pharmaceuticals PL - Plastics PY - Poultry PR - Produce RM - Raw Meat RC - Refined Consumables Other (specify below)

Standard Processing Expedited Processing (Delivery within 10 days)

US UK Indonesia Malaysia Singapore UAE Other (Add Country to special instructions)

$0 - $200,000 $200,001 - $500,000 $500,001 - $999,999 $1,000,000 - $4,999,999