Facility Bottling Work Order all fields required unless otherwise noted Customer* Billing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contact Name* First Last Title* Phone*Fax(optional)Contact Email* Prod. Contact* First Last Prod. Email* Prod. Cell*Requested Bottling Date* MM slash DD slash YYYY Wine InformationBrand* Wine Varietal(s)* Vintage* Alcohol %*(stated on label) Appellation* Estimated Gallons*Estimated Cases*Wine Product Code* Wine Shipping Company* Shipment Method* Tanker Portable Shiner Blending*If yes, please complete the Cellar Work Order Yes No Additions*If yes, please complete the Cellar Work Order Yes No Cross Flow Filter* Yes No Sterile Filter* Yes No S02 Target at bottling* Service* Full Shiner Label Only GlassGlass Supplier* Glass Shape* Burgundy BDX Hock Claret Glass Size* 750 1.5 375 Mold # and Color*Glass Shipper* Glass Contact Person* First Last Glass Contact Phone*CapsulesCapsule Type* Polylam Tin Shrink Capsule Supplier* Branded Capsule* Yes No Capsule Color* Capsule Size* Other Capsule Info(optional)ClosureClosure* Cork Screwcap Branded Closure* Yes No Branding Description(optional)Cork Supplier* Cork Sizerequired for cork closures 24mm X 45mm 24mm X 49mm Other Cork Info(optional)Labels & LaserFront Label Placement*(from bottom) Back Label Placement*(from bottom) Label Supplier* Laser Code on the Bottle* Yes No Laser Code Description Other Label InfoCaseCases Packed As* 6 pack 12 pack Case Sealing* Glue None Bottle Label on Case*Additional charges apply for additional case label Front Back No Standard Case Label*See standard case label and pallet tag examples Yes No PalletCases per Pallet* 44 56 Cases on Pallet* Neck Up Neck down Standard Pallet Tag*See standard case label and pallet tag examples Yes No Ships*Tax Paid or Export must be on Pallet Tag Bond to Bond Tax Paid Export Other InformationAdditional Notes(optional)Please NotePlease schedule all shipments of bulk wine, dry goods and finished case goods through Mari Ceja at 707-252-3330 or mceja@topitoffbottling.com. Any shipments without a pre-arranged appointment may be turned away.
