Wholesale Order Form Order InfoName* First Last Title* Email* Billing InfoThis is where the invoice will be sentName* First Last P.O./Reference # Sales Tax License # (required if you are a Colorado company) Company Name* Phone*Billing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Special InstructionsShipping InfoShipping Method* Customer picks up at Empire Warehouse - (*REQUIRED - IN THE “SPECIAL INSTRUCTIONS” SECTION ABOVE, PLEASE LET US KNOW WHAT DAY YOU’D LIKE TO PICKUP - 24 hrs / 1 full business day notice is required for pickups.) Pickup address: 11701 E 53rd Ave, Denver, CO 80239 (*REQUIRED – Prior to pick up, please call Christine Barkley at 303-807-0996, and provide your credit card info unless we already have it on file.) Product shipped to customer at customer's expense (amount TBD) HiddenShipping Method* Customer picks up at Empire Warehouse - (*REQUIRED - IN THE “SPECIAL INSTRUCTIONS” SECTION ABOVE, PLEASE LET US KNOW WHAT DAY YOU’D LIKE TO PICKUP - 24 hrs / 1 full business day notice is required for pickups.) Pickup address: 11701 E 53rd Ave, Denver, CO 80239 (*REQUIRED – Prior to pick up, please call Christine Barkley at 303-807-0996, and provide your credit card info unless we already have it on file.) Product shipped to customer at customer’s expense Name First Last Company Name Shipping Address* Same as billing Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Brewery Products(Most brewers are using the Unsweetened Cholaca. If you received a sample from us, it was Unsweetened)Liquid Coconut - 5 Gallon Bag in Box Price: $302.50 Quantity: Cholaca Unsweetened - 1.5 gallon (1 case of six 32 oz bottles) * Price: $110.00 Quantity: Cholaca Unsweetened - 3 gallon * Price: $175.00 Quantity: Cholaca Original - 1.5 gallon (1 case of six 32 oz bottles) * Price: $110.00 Quantity: Cholaca Sweet - 1.5 gallon (1 case of six 32 oz bottles) * Price: $115.00 Quantity: Cholaca Sweet - 3 gallon * Price: $190.00 Quantity: Liquid Coconut - 50 Gallon Drum Price: $2,915.00 Quantity: Cholaca Bulk Cacao ProductsChaparral, Colombia cacao: KosherCholaca Single bag - Chaparral (55.1 lbs @ $7.50/lb) * Price: $413.25 Quantity: Cholaca Pallet - Chaparral (2200 lbs. @ 4.50/lb.) for 1 or 2 pallets * Price: $9,900.00 Quantity: Total $0.00 PLUS SHIPPING* Please review your order for accuracy before submitting. By clicking the “submit order” below button, you understand that SHIPPING CHARGES will apply to your final invoice. Cholaca is a refrigerated product and must be kept at 40 degrees or cooler at all times. Storage fees will be incurred on any pickup orders that are not picked up within 30 days of pickup date. * Kosher available by special order. Please contact info@cholaca.com for more information. CAPTCHA Δ
