Order Form Etowah County Jail Effective September 2017

[Pages:4]Order Form Etowah County Jail Effective September 2017

Please complete all info on reverse (print clearly).

ITEM DESCRIPTION

PRICE

ITEM #

QTY

TOTAL PRICE

ITEM DESCRIPTION

PRICE

ITEM #

QTY

TOTAL PRICE

ITEM DESCRIPTION

PRICE

ITEM #

QTY

TOTAL PRICE

DRINKS Coffee, Cocoa & Tea Bigelow 1.64 oz. Vanilla Chai Tea (20 Ct.) GS

$5.15 / BX 10595

Keefe 3 oz. Alturo Blend Coffee KHCRG

$2.75 / EA 10243

Maxwell House 4 oz. Dark Roast Espresso KHCR $5.35 / EA 10704

Swiss Miss 9 oz. Hot Cocoa Mix (9 servings) KHCRG

$2.40 / EA 7495

Drink Mixes

Hawaiian Punch .69 oz. Singles To Go Berry Lime- $2.15 / BX 7810 ade Blast (8 Pk.)

Hawaiian Punch 0.74 oz. SF Singles To Go Fruit Juicy Red (8 Pk.)

$2.10 / BX 6470

Hawaiian Punch 0.91 oz. Singles To Go Berry Blue $2.15 / BX 7809 Typhoon (8 Pk.) GS

Hawaiian Punch 0.93 oz. Singles To Go Wild Purple $2.10 / BX 7916 Smash (8 Pk.)

Wyler's Light .80 oz. SF Singles To Go Strawberry $2.15 / BX 80001731 Lemonade Drink Mix (8 Pk.) K

FOOD & SNACKS

Cereal & Cereal Bars

Golden Valley 20 oz. Berries Bunch O'Krunch Cereal $4.05 / EA 10362 KR

Golden Valley 20 oz. Chocolate Frosted Flakes Cereal KR

$4.05 / EA 80002971

Mrs. Freshley's 1.3 oz. Blueberry Cereal Bar

$0.35 / EA 5024

Quaker 9.8 oz. Assorted Fruit & Cream Instant Oatmeal (8 Pk.) K

$5.85 / BX 80000856

Toaster Pastries

Kellogg's 14.1 oz. Frosted Cookies & Creme Pop $3.25 / BX 6846 Tarts (8 Pk.)

Kellogg's 14.7 oz. Frosted Blueberry Pop Tarts (8 Pk.)

$3.25 / BX 10548

Pastries & Snack Cakes Cloverhill 4.25 oz. Cherry Cheese Danish K

$0.90 / EA 4647

Kellogg's 1.3 oz. Original Rice Krispies Treats

$0.75 / EA 2381

Market Square Bakery 4.75 oz. Mega Honey Bun $0.90 / EA 6540 Chocolate Iced C

Market Square Bakery 4 oz. Cinnamon Crumb Cakes (2 Pk.) K

$0.90 / EA 3210

Market Square Bakery 4 oz. Iced Chocolate Cup- $1.50 / EA 6060 cakes with Creme Filling (2 Pk.) C

Market Square Bakery 6 oz. Monster Iced Honey $1.40 / EA 6043 Bun KC

Chips Cheetos 8 oz. Flamin' Hot Crunchy CG

$3.45 / EA 7687

Cheetos 8 oz. Mix-ups Xtra Cheezy Mix

$6.95 / EA 10649

Cheetos 9 oz. Crunchy CG

$3.45 / EA 7683

Moon Lodge 6 oz. Buffalo Wing & Blue Cheese Potato Chips K

$1.75 / EA 80000894

Moon Lodge 6 oz. Stuffed Jalapeno Potato Chips $1.55 / EA 5110 KHS

The Whole Shabang 6 oz. Extreme Ripple Potato Chips KH

$1.75 / EA 80001671

The Whole Shabang 6 oz. Original Potato Chips KH $1.75 / EA 5114

Snacks & Nuts

Cactus Annie's 11 oz. "The Whole Enchilada" Party $3.00 / EA 902 Mix KHC

Chex Mix 8.75 oz. Bold Party Blend Mix K

$5.50 / EA 736

Combos 6.3 oz. Pepperoni Pizza HGS

$3.85 / EA 6905

Kar's 3.5 oz. Sweet N Salty Trail Mix C

$1.45 / EA 5865

Kar's 7 oz. Nut `N Yogurt Trail Mix C

$2.80 / EA 9811

Kings Nut 10 oz. Mixed Nuts w/Peanuts

$5.30 / EA 80003408

Kings Nut 2 oz. Pistachios

$2.45 / EA 80003350

Kings Nut 3.25 oz. Health Mix

$1.20 / EA 80003371

Kings Nut 8 oz. Roasted & Salted Cashews KGS $6.85 / EA 80003377

Planters 2 oz. Tropical Fruit & Nut Trail Mix

$1.35 / EA 80001255

Snyder's 2.25 oz. Honey Mustard and Onion Pretzel $1.00 / EA 9553 Pieces

Mrs. Freshley's 1.3 oz. Apple Cinnamon Cereal Bar $0.35 / EA 5025

Doritos 8 oz. Nacho Cheese Chips C

$3.45 / EA 10514

TGI Fridays 1 oz. Cheddar and Bacon Potato Skins $0.75 / EA 80003515 Snacks KG

Total

K - Kosher ? H - Halal ? C - Clear ? D - Diabetic ? R - Resealable ? G - Gluten Free ? S - Soy Free

Total

Total

Order Form Etowah County Jail Effective September 2017

Please complete all info on reverse (print clearly).

ITEM DESCRIPTION

PRICE

ITEM #

QTY

TOTAL PRICE

ITEM DESCRIPTION

PRICE

ITEM #

QTY

TOTAL PRICE

ITEM DESCRIPTION

PRICE

ITEM #

QTY

TOTAL PRICE

The Whole Shabang 1.75 oz. Peanuts KHC

$0.60 / EA 80002177

Sour Patch 3 oz. Gummi Watermelon Candy C $1.15 / EA 80002126

Brushy Creek 5 oz. Turkey Summer Sausage Honey $2.80 / EA 80001724 Brown Sugar G

The Whole Shabang 5 oz. Popcorn KHG

$1.70 / EA 80002294

The Whole Shabang 6 oz. Snack Mix KHC

$2.05 / EA 80003008

The Whole Shabang 9.5 oz. Extreme Crunchies KH $2.15 / EA 80001670

Crackers Cheez-It 1.5 oz. Hot & Spicy Crackers K

$0.60 / EA 4214

Wheat Thins 1.75 oz. Crackers

$0.75 / EA 9461

Cookies

Bud's Best 6 oz. Candy `n Cookies - Butterfinger $1.70 / EA 6386 Mini Cookies KGS

Famous Amos 2 oz. Chocolate Chip Cookies

$0.70 / EA 850

Keebler 11.5 oz. Fudge Stripes Cookies K

$3.75 / EA 229

Spices Sevilla 1.5 oz. Sazon con Culantro Y Achiote KHC $1.05 / EA 6034

Condiments Squeez-Ums .24 oz. Hot Sauce (12 Pk.) KHG

$1.25 / PK 6517

Dressing Kraft 1.5 oz. Blue Cheese Dressing Packet

$0.65 / EA 5925

Kraft 1.5 oz. Ranch Salad Dressing Packet

$0.50 / EA 4535

Pickles Van Holten's 9.6 oz. Dill Pickle KCGS

$1.30 / EA 381

Cheese Philly 2 oz. Cream Cheese w/Jalapenos

$0.95 / EA 10911

Jack Link's 1.2 oz. Beef & Cheese Stick

$2.15 / EA 5961

Jack Link's 1 oz. Sasquatch Snack Stick

$1.80 / EA 80003260

Jack Link's 2.4 oz. Screamin' Demon HOT! Pickled $2.45 / EA 3257 Sausage C

Jack Link's 4 oz. Deli Cuts Sausage Bites

$5.40 / EA 6354

Seafood Chicken of the Sea 3.53 oz. Sardines in Oil Pouch $1.30 / EA 10357

Chicken of the Sea 5 oz. Pink Salmon K

$4.40 / EA 4179

Fresh Catch 3.53 oz. Chunk Light Tuna w/Jalapenos $1.80 / EA 10472 KG

Fresh Catch 3.53 oz. Fillets of Mackerel in Soybean $1.60 / EA 4385 Oil KHG

Candy Chewy Lemonhead 4 oz. - Redrific

$1.15 / EA 80000871

Lifesavers 2.75 oz. Sugar Free 5 Flavors Hard Candy $3.25 / EA 7726

Milk Chocolate .3 oz. Peanut Chews (6 Pk.)

$0.85 / KIT 80000653

Sathers 1.75 oz. Sugar Free Wild Fruit C

$1.20 / EA 40615

Sathers 4.25 oz. Butterscotch Discs Candy C

$0.90 / EA 40606

Sathers 4 oz. Sour Neon Worms

$1.15 / EA 80000868

Velveeta 2 oz. Sharp Cheddar Spread G

$0.55 / EA 7739

Velveeta 4 oz. Nacho Cheese Dip w/Jalapenos Snack Spread Tub CRG

$1.25 / EA 9398

Meat Snacks Brushy Creek 1.625 oz. Hot Summer Sausage G $0.95 / EA 80001716

Brushy Creek 5 oz. Hot Beef & Chicken Halal Sausage HG

$3.15 / EA 80003317

Brushy Creek 5 oz. Original Beef & Chicken Halal $3.15 / EA 80003316 Sausage HG

Fresh Catch 3.53 oz. Fish Steaks in Oil w/Green $1.25 / EA 4395 Chiles KHG

Fresh Catch 3.53 oz. Fish Steaks in Spicy Mustard $1.15 / EA 4394 Sauce KHG

Fresh Catch 3.53 oz. Sardines in Soybean Oil KHG $1.25 / EA 4388

Fresh Catch 4.23 oz. Chunk Light Tuna in Water KHG

$2.80 / EA 4317

Ready-To-Eat Meals Brushy Creek 11.25 oz. Beef Stew G

$2.75 / EA 1715

Brushy Creek 11.25 oz. Chili with Beans G

$2.05 / EA 1711

Total

K - Kosher ? H - Halal ? C - Clear ? D - Diabetic ? R - Resealable ? G - Gluten Free ? S - Soy Free

Total

Total

Order Form Etowah County Jail Effective September 2017

Please complete all info on reverse (print clearly).

ITEM DESCRIPTION

PRICE

ITEM #

QTY

TOTAL PRICE

ITEM DESCRIPTION

PRICE

ITEM #

QTY

TOTAL PRICE

ITEM DESCRIPTION

Hormel Compleats 7.5 oz. Bacon Breakfast Scramble G

$6.20 / EA 80002656

Maruchan Instant Lunch 2.25 oz. - California Veggie $1.20 / EA

4

Koss CL-3 Clear Earbuds C

Vegetables

Maruchan Instant Lunch 2.25 oz. - Hot & Spicy Beef $1.20 / EA

16

Koss KE5K- 4 Earbuds

Idahoan 4 oz. Roasted Garlic Mashed Potatoes

$3.05 / EA 10863

Noodles

Sentry H0230 Clear Earbuds

El Mexicano 7 oz. Pasta Conditos

$0.75 / EA 80005651

Rice

Skull Candy "Smokin 2" Earbuds

Keefe Kitchens 8 oz. Pre-Cooked Long Grain Rice $1.75 / EA 5880 KCRGS

Thai Palace 3.7 oz. Rice Noodle Soup Chili Flavor CG

$1.00 / EA 3092

Sun Earphone HE08S-M20 (20 ft.)

Knorr 5.3 oz. Rice Sides Steak Fajita Rice

$3.25 / EA 80003287

Velveeta 3 oz. Macaroni and Cheese KHC

$1.15 / EA 4935

Velveeta 2 oz. Cheesy Rice KHC

$0.70 / EA 4937

Velveeta 2 oz. Spicy, Cheesy Rice KHC

$0.75 / EA 4938

Beans Velveeta 4 oz. Spicy, Cheesy Refried Beans KHC $1.90 / EA 4940

Velveeta 4 oz. Spicy, Cheesy Refried Beans & Rice $1.35 / EA 4941 KHC

Tortillas Cactus Annie's 8 oz. Flour Tortillas (6 Pk.) KHCR $2.65 / EA 5070

Ramen Soup Maruchan 3 oz. Beef Flavor Ramen C

$0.79 / EA

9

Maruchan 3 oz. Cajun Chicken Flavor Ramen C $0.79 / EA

18

Maruchan 3 oz. Chili Flavor Ramen C

$0.79 / EA

10

Maruchan 3 oz. Hot & Spicy Vegetable Flavor Ramen C

$0.79 / EA 505

HEALTH & BEAUTY Hair Care Suave 12 oz. Juicy Green Apple Shampoo

$2.45 / EA 26138

Soap Dial 3.5 oz. Soap (1 Bar)

$1.15 / EA 20920

Neutrogena 3.5 oz. Facial Bar Soap (1 Bar)

$4.75 / EA 20776

Pure Soap Antibacterial 3.5 oz. White Soap (3 Pk.) $6.75 / PK 80002252

Dental Care Colgate 4.6 oz. 2-in-1 Icy Blast Toothpaste C

$5.35 / EA 21748

ELECTRONICS Earbuds GPX Clear Earbuds C

$2.00 / EA 5195501099

JVC Gumy Plus White Earbuds

$16.00 / EA 8034801001

Total

K - Kosher ? H - Halal ? C - Clear ? D - Diabetic ? R - Resealable ? G - Gluten Free ? S - Soy Free

Total

PRICE

ITEM #

QTY

TOTAL PRICE

$3.00 / EA 5029401099

$4.50 / EA 5077401099

$2.50 / EA 7205301099

$18.25 / EA 8018801099

$2.75 / EA 5013801099

Total

Order Form Etowah County Jail Effective September 2017

Please complete all info on reverse (print clearly).

SHIP TO:

Inmate's Name Institution/Dorm/Housing#

Street Address

We cannot send orders from one inmate to another. ID#

PROGRAM DATES: New Menu Effective: September 1, 2017 Delivery to facility: Orders deliver weekly

WAYS TO ORDER Online: Phone: 1-800-546-6283 Mail: Access Securepak (AL), 10880 Linpage Place, St. Louis, MO 63132

City

SENDER:

Sender's Name

State

Zip

REQUIRED for order fulfillment.

ACCEPTABLE FORMS OF PAYMENT: ? Credit/Debit Cards--VISA, MasterCard, Discover ? Prepaid cards that have a verifiable United States address ? Cashier's check ? Money order

Street Address

City

State

Zip

Phone Number

Email

(You will receive confirmation emails when the order is placed and shipped.)

CALCULATE AMOUNT DUE:

Merchandise Total: Processing Fee:

$4.00

TAX

x 1.09

=

x 1.09

=

TOTAL AMOUNT DUE:

TOTALS

$4.36

SELECT PAYMENT METHOD:

? Cashier's Check

? Money Order

Make check or money order payable to ACCESS SECUREPAK

? VISA ? MasterCard ? Discover

? Prepaid

Cardholder Name

We do not accept personal checks and will return them to the sender. Credit/debit and prepaid cards will be charged on the day the order is placed. Refunds or credits will be applied to the card used for the order (allow additional time for refunds/credits on prepaid cards). Access Securepak reserves the right to remove one or more items from the order due to insufficient payment.

SALES TAX: Access Securepak is required by the state of Alabama to collect 9% sales tax on all merchandise and the processing fee. Please see the tax calculation example below for more information.

Tax calculation example: $85.52 merchandise total x 1.09 (tax rate) = $93.22 merchandise subtotal $4.00 processing fee x 1.09 (tax rate) = $4.36 processing fee subtotal $93.22 merchandise subtotal + $4.36 processing fee subtotal = $97.58 total amount due

ELIGIBILITY: Access Securepak verifies inmate eligibility before shipping packages, if applicable.

LIMITS: There are no spending limits.

CATALOG CHANGES: Every effort has been made to show and describe the merchandise as accurately as possible. Because many manufacturers change an item's design, color, package size and style after our catalog is produced, we reserve the right to discontinue or change product specifications without prior notice. We regret any changes that might occur and will make every effort to minimize these occurrences. Inadvertent errors in product descriptions, pricing and special offers are not binding on Access Securepak, and we may make adjustments at any time. Additionally, many of our food items may contain common allergens such as milk, eggs, wheat and peanuts. Before consuming a food item, please consult the product packaging for specific information on its ingredients. Prices and offers are subject to change and available while supplies last. Always consult the website for the latest updates on this package program.

In the event of a back order, may we substitute like items of equal or greater value? Note: unless you choose "NO," we may substitute for out-of-stock or restricted items. _YES _NO

CUSTOMER SERVICE: Automated system is available 24 hours a day, seven days a week 1-800-546-6283 Live bilingual representatives are available Monday through Friday, 7:30 a.m.?11:00 p.m. CST, and Saturday, 10 a.m.?4 p.m. CST.

Cardholder Signature Daytime Phone Number

/ /

Today's Date mm/dd/yyyy

Credit Card Number

/ Expiration Date

Security Code

Security code is last three digits of account number panel.

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