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Please complete the following survey to receive a comprehensive quote for our services.

*Fields with an asterisk must be completed.

*Company Name
*Street Address
*City *State *Zip
*Phone *Fax
*Contact *Title
*Email *Are you the decision maker? Yes No
*Best time to contact *Preferred method of contact
*Number of employees at this location?
Number of buildings Number of floors
Number of break rooms with coffee brewers
 
*Preferred type of service (check all that apply)
Coffee Service Beverage Service Snack Service
Bottled Water Service Filtered Water Service
 
Preferred type of brewing equipment (check all that apply)
 
Preferred type of single cup brewers (requires a representative to contact for program details)


Keurig Brewing System


Flavia Drink Station


Starbucks Interactive-Cup System

Peet’s Branded Colibri LX

 
Preferred water filtration system

Purlogix systems floor model with UV light

Number of units needed

RO system
Multi-stage filtration
Single filtration

Purlogix systems counter top model with UV light

Number of units needed

Multi-stage filtration
Single filtration

 

 

MTN Reflection Series hot and cold bottled water stand, floor model

Number of units needed

 

 

MTN Reflection Series hot and cold single filtration, floor model

Number of units needed

 
Bottled Water Service (choose one)
Spring water 5 gallon bottles Approximate monthly usage
bottles
Purified water 5 gallon bottles
Purified water 3 gallon bottles
 
*Preferred Coffee (give us an idea of what you're looking for)
Peet's Starbuck's Tully's
Ultimate Java Premium Blends Private Label
 
*Preferred coffee roast and packaging
Dark roast Medium roast Light roast
Whole bean Pre-ground bulk Portion packs
 
 

Available configurations

Whole bean coffees:
Peet's
Starbucks
Bulk coffees pre-ground:
Peet's
Starbucks
Tully's
Ultimate Java
Will you require coffee grinders with the purchase of whole bean coffee?
Yes No Number of units

 

 
*Allied and related products
Will you be purchasing kitchen supplies from Associated? Yes No Don't know
If purchasing beverages, will you require a cooler? Yes No Don't know
If coolers are necessary, how many? Single door Double door
 
*How soon do you plan to start service?
  ASAP 30 days 60 days 90 days Give us a date
 
Comments:
 
 


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