COMPANY RELATED QUESTIONS:

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* 1. Name of Restaurant / Food/ Beverage Provider:

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* 2. Point of Contact Name:

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* 3. Point of Contact Email:

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* 4. Point of Contact Phone Number:

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* 5. Mailing Address:

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* 6. Physical Address (if different from mailing address):

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* 7. What days are you open?

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* 8. Food or Beverage Specialty:

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