Ingredient Sourcing Form If you are human, leave this field blank. What is your business name? * Who will be attending the Product Review on March 1st, 2020? * Tell us about your menu or products. Please list all items and include all prices and sizes offered, estimated if not yet determined. * Do you use any locally grown produce (grown within 200 miles)? * Yes No If yes, please identify which ingredients and sources. If there are many, just identify a few. Do you use any locally raised meat (raised within 400 miles)? * Yes No If yes, please identify which meat(s) and your source(s). If there are many, please just name a few. Please tell us about anything that was made in OR or WA but its raw ingredients may not have been grown or raised in OR or WA, and your sources. Note if any ingredients are Certified Organic (CO). Do you use any ingredients that are Certified Organic (CO) that are not listed in the above section? * Yes No If yes, please identify which meat(s) and your source(s) in the comments section. If there are many, please just name a few. Do you use any ingredients with any other certifications? * Yes No If yes, please identify those ingredients and their certifications. Does your business have any other sustainability practices or other work towards the greater good that you would like to share with us?