Slide 1GPIQGREAT TASTE - LESS WASTE Company Name(Required)Year EstablishedAre you operating under a Parent Company or using a DBA?(Required) Yes No Parent CompanyDBAAddress(Required) 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 WebsiteContact Name(Required) First Last Position(Required)Phone(Required)Email(Required) Section BreakBusiness Type(Required) Bar/Tavern Restaurant Entertainment Center Brewery Other Tell us About Your Draft System: Number of beer brands in total?(Required)Number of taps in total?(Required)Number of bars in this location?(Required) One Bar Multiple Bars Number of taps per bar?(Required)Number of bars and distances?(Required)If there are multiple bars in this location, please state the total, and the approximate distances from each other.Number of auto-pour bars/taps?(Required)Age of your lines in each bar?(Required)How many split lines?(Required)How many shutoffs on split lines?(Required)Number of coolers, and approximate proximity to each other?(Required)Number of beer brands in each cooler?(Required)Delivery Method(Required) Direct Draw Glycol? Number FOBs(Required)Number Flow-jets(Required)How often are your lines cleaned?(Required)Who cleans them?(Required)Do You Have Cold Water Access Close to Cooler(s)?(Required) Yes No Do You Have Power Access Close to Cooler(s)?(Required) Yes No Do You Have Wifi?(Required) Yes No Upload photos of your bar(s), taps, and cooler(s)(Required) Drop files here or Select files Accepted file types: jpg, jpeg, png, pdf, Max. file size: 512 MB, Max. files: 10. NameThis field is for validation purposes and should be left unchanged.