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Tell us about your manufacturing needs * Processing Needs: Distillation Crystallization Extraction Synthesis Purification Process Development Toll Processing Other   * Name of Product : CAS Number (if Available) :   Is the Product listed in Toxic Substances Control Act (TSCA) Chemical Substances Inventory?   Yes No Unknown     Describe the specifications this product needs to meet: specifications file:   OR attach a word file or PDF file with specifications   * Please estimate the quantity of product you expect to need : Select <100kg 100kg to 1000kg 1MT to 10MT 10MT to 100MT >100MT   What type of order will this be : Select Single Order Multiple Orders Long-Term Supply Agreement     If there are Multiple Orders or a Long Term Supply Agreement, in what annual quantities do   you expect to order this product? Select <100kg 100kg to 1000kg 1MT to 10MT 10MT to 100MT >100MT   Your Target Price/Price Range : $ USD per Select lb kg   Does the Product require manufacture under the FDA’s Good Manufacturing   Practices (GMP)? Select Not Required Food GMP Pharma GMP   Does this Product require Kosher certification? Select Not Required Orthodox Union Kosher OK Kosher Star-K Kosher Unknown   Do you currently use this product? Yes No If Yes, in what yearly quantities? Select <100kg 100kg to 1000kg 1MT to 10MT >10MT   Do you currently have a supplier for this product? Yes  No Are you ready to place an order for this material? Yes No   How would you like to be contacted? Select Please Call Email Quote & Call Fax Quote & Call Email Only Fax Only   How did you hear about Organic Technologies? Select Tradeshow Company Literature Internet Search Chemical Producers Directory Existing Customer Other     Other Comments:               All information collected is for internal Organic Technologies use only. Organic Technologies does not sell, transmit, or distribute this information to third parties.