Use Standard Quotation and Specification Form [ PDF ] [ Excel ]
Bottle Label or image of Bottle Label must accompany Standard Quotation and Specification Form.
Submit product registration to the Mississippi ABC Purchasing Department, P.O. Box 540, Madison, MS 39130-0540.
Questions? Call 601-856-1342
Instructions for Standard Quotation and Specification Form. Form must be completely filled out except where otherwise indicated.
- Vendor of Record (Supplier Name)
- Line 1 State (Mississippi)
- Line 2 Date Submitted
- Line 3 Brand (product description)
- Line 4 Effective Date
- Line 5 State Plan (Not applicable)
- Line 6 Bailment (Check line 6 or line 7)
- Line 7 Special Purchase Order Plan (Check line 6 or line 7)
- Line 8 Type (Spirit, Still Wine, Sparkling Wine)
- Line 9 Class (Spirit type, e.g., vodka, bourbon or Wine type, e.g., chardonnay, merlot)
- Line 10 Not Required
- Line 11 Age/Vintage (age or vintage when appropriate)
- Line 12 Proof/Alcohol (Alcohol proof for distilled spirits, percent % alcohol for wines)
- Line 13 Domestic (Check line 13 or line 14)
- Line 14 Imported (Check line 13 or line 14)
- Line 14a INBOND __Yes __No (Check No)
- Line 15 Distilled/Produced by:
- Line 16 Address:
- Line 17 Not Required
- Line 18 Not Required
- Line 19 Not Required
- Line 20 Ship Point (U.S. ship point)
- Line 21 FOB: Must be FOB ABC Warehouse (Madison, Mississippi) if vendor has any products in bailment. If vendor has no products in bailment, FOB can be ship point if freight collect; destination Madison, Mississippi if freight prepaid.
- Line 22 Not Required
- Lines 23 through 31 Check if applicable
- Line 32 Unit Pack (Bottles per case)
- Line 33 Not Required
- Line 34 Not Required
- Line 35 Not Required
- Line 36 Not Required
- Line 37 SCC14 or GTIN bar codes - More information on SCC14/GTIN14 bar codes can be found at http://gtin.info/.
- Line 38 NABCA Control State code or State code - More info on NABCA codes at http://www.nabca.org/States/Forms.aspx
- Line 40 Case Weight (LBS)
- Line 47 Total Invoice Cost (per case)
- Line 48 Case Dimensions (L/W/H)(Inches)
- Line 57 Representative for the State
- Name
- Address
- Not Required: Lic No:
- Telephone:
- Fax or email
- Line 58 Supplier
- State Lic/Permit No.:
- Fed ID No.:
- Address:
- Telephone:
- Fax or Email
- By: (Print Name followed by email address or signature)
- Title:
Vendor Links