Orde o Kentucky DOC ood Effectiv October 019

Order Form Kentucky DOC - Food Effective October 1 2019

Please complete all info on reverse (print clearly).

ITEM DESCRIPTION

PRICE

ITEM #

QTY

TOTAL PRICE

TAXABLE ITEMS FOOD & SNACKS Candy Atkinson's 3.75 oz. Sugar Free Chick-O-Stick K $2.18 / EA 9765

Atkinson's 3.75 oz. Sugar Free Crunchy Peanut Butter Bars KC

$2.18 / EA 9764

Chewy Lemonheads 4 oz. Redrific Candy

$1.14 / EA 80006094

E.Z. Digby's 2.75 oz. Bit-O-Honey C

$1.14 / EA 40626

GoLightly 2.75 oz. Sugar Free Fruit Chews K

$2.55 / EA 6439

GoLightly 2.75 oz. Sugar Free Starlight Mints KC $2.13 / EA 6330

GoLightly 2.75 oz. Sugar Free Vanilla Caramels KC $2.13 / EA 6331

Jolly Rancher 3.6 oz. Sugar Free Hard Candy KH $4.31 / EA 6866

Lifesavers 2.75 oz. Sugar Free 5 Flavors Hard Candy $3.27 / EA 7726

Mars Milky Way 1.84 oz. Chocolate Caramel Bar $1.61 / EA 80006634

Nips 4 oz. Chocolate Parfait Hard Candy

$1.31 / EA 80001073

Nips 4 oz. Peanut Butter Parfait Hard Candy

$1.31 / EA 80001074

Old Fashion Mix 9 oz. Hard Candy C

$2.50 / EA 733

Rocky Road 1.65 oz. Candy Bar

$1.61 / EA 7016

Russell Stover 1.125 oz. Mint Dream

$1.66 / EA 6876

Sathers 4 oz. Gummi Bears Candy

$1.66 / EA 80005555

Sathers 4 oz. Sour Neon Night Crawlers Candy

$1.66 / EA 80005556

Skittles 2.17 oz. Original Candy

$1.61 / EA 80006636

Sour Patch 3 oz. Gummi Watermelon Candy C $1.18 / EA 80002126

Swedish Fish 3 oz. Red Candy

$1.20 / EA 80005733

Wonka 4.2 oz. Assorted Laffy Taffy

$1.61 / EA 80001080

York 2.5 oz. Peppermint Patty Minis

$2.87 / EA 80001130

Zachary 5 oz. Double Dipped Chocolate Peanuts $2.50 / EA 3975

Zachary Confections 5 oz. Chocolate Peanut Clusters

$3.17 / EA 80000356

Zachary Confections 5 oz. Maple Peanut Clusters $3.07 / EA 80000357

TAXABLE ITEMS SUBTOTAL:_________

NON-TAXABLE ITEMS DRINKS Coffee & Cocoa Folger's 4 oz. 100% Colombian Coffee KHCR $6.85 / EA

Folger's 4 oz. Traditional Roast Coffee KHCRV $6.75 / EA

10961 10963

ITEM DESCRIPTION Keefe 4 oz. Instant Coffee KH

PRICE $2.72 / EA

ITEM # 21

QTY

TOTAL PRICE

Maxwell House 4 oz. Dark Roast Espresso KHCR $3.95 / EA 10704

Maxwell House 4 oz. Select Roast Coffee Pouch $4.96 / EA 2974 KCR

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

$2.35 / EA 7495

Tea

Arizona 1.0 oz. Sugar Free Green Tea with Ginseng $4.11 / BX 6455 Drink Mix (10 Pk.)

Creamer

International Delight 3 oz. Original Liquid Creamer (10 Pk.)

$2.00 / SP 80004553

International Delight 4.4 oz. Caramel Macchiato Liquid Creamer (10 Pk.) K

$2.00 / SP 80004557

International Delight 4.4 oz. Irish Cream Liquid Creamer (10 Pk.) K

$2.00 / SP 80004556

Drink Mixes Country Time SF Lemonade Drink Stick (6 Pk.)

$2.35 / SP 80004851

Crystal Light SF Raspberry Lemonade Drink Stick $2.35 / SP 80004848 (6 Pk.)

Crystal Light Sugar Free Variety Flavors Drink Sticks $2.35 / SP 80004852 (6 Ct.)

Hawaiian Punch .69 oz. SF Singles To Go Berry Limeade Blast (8 Pk.)

$1.93 / BX 7810

Hawaiian Punch .74 oz. SF Singles To Go Fruit Juicy $1.93 / BX 6470 Red (8 Pk.) K

Hawaiian Punch .91 oz. SF Singles To Go Berry Blue $1.93 / BX 7809 Typhoon (8 Pk.)

Hawaiian Punch .94 oz. SF Singles To Go Lemon $1.93 / BX 7811 Berry Squeeze (8 Pk.)

Wyler's Light .63 oz. SF Singles to Go Raspberry Lemonade Drink Mix (8 Pk.) K

$2.35 / BX 80001733

Wyler's Light .80 oz. SF Singles To Go Strawberry $2.35 / BX 80001731 Lemonade Drink Mix (8 Pk.)

Nutritional Drinks New Leaf 2 oz. Chocolate Health Shake Mix K

$1.50 / EA 80003592

New Leaf 2 oz. Vanilla Health Shake Mix

$1.50 / EA 80003593

FOOD & SNACKS Breakfast OvaEasy 2 oz. Egg Crystals KH

$5.15 / EA 80001639

Cereal, Cereal Bars & Granola Bars Cap'n Crunch's 4.40 oz. Crunch Berries Cereal

$2.50 / EA 80005520

Cinnamon Toast Crunch 2 oz Cereal Cup Single Serve

$2.50 / EA 80006664

Cocoa Puffs 1.42 oz. Cereal Bar

$0.80 / EA 80006661

Total

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

Total

ITEM DESCRIPTION

Golden Valley Cereal 20 oz. Chocolate Frosted Flakes KR

PRICE $4.26 / EA

ITEM #

QTY

TOTAL PRICE

80002971

Honey Nut Cheerios 1.8 oz Cereal Cup Single Serve $2.50 / EA 80006665

Kellogg's 3.1 oz. Apple Jacks Cereal Resealable Package

$2.03 / EA 80006256

Nature Valley 1.49 oz. Oats `n Honey Granola Bar K $1.19 / EA 7167

Nutrigrain 1.3 oz Apple Cinnamon Cereal Bar

$1.07 / EA 5799

Trix 1.42 oz. Cereal Bar

$0.80 / EA 80000135

Oatmeal

Quaker Express 1.51 oz. Apples & Cinnamon Oatmeal

$2.25 / EA 80000734

Quaker Maple & Brown Sugar Instant Oatmeal (10 Pk.)

$3.85 / SP 80004559

Toaster Pastries

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

$3.15 / BX 10548

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

$3.15 / BX 10550

Kellogg's 14 oz. Frosted Brown Sugar Cinnamon $3.15 / BX 10549 Pop Tarts (8 Pk.)

Pastries & Snack Cakes 7 Days 2.65 oz. Chocolate Croissant

$1.75 / EA 80007188

7 Days 2.65 oz. Strawberry Vanilla Croissant

$1.75 / EA 80007191

Cloverhill 4.25 oz. Cherry Cheese Danish

$1.05 / EA 80006844

Cloverhill 4.75 oz. Jumbo Chocolate Iced Honey $0.91 / EA 6540 Bun KC

Duchess 10 oz. Powdered Sugar Gem Donuts

$3.85 / EA 80007120

Duchess 4 oz. Cinnamon Roll

$0.89 / EA 80005739

Golden Valley 4 oz. Everything Bagel KH

$0.80 / EA 80004433

Hostess 4.5 oz. Apple Fruit Pie

$1.35 / EA 80005968

Hostess 4.5 oz. Cherry Fruit Pie

$1.35 / EA 80005970

Mrs. Freshley's 3.5 oz. Carrot Cake KC

$1.35 / EA 7218

Chips & Snacks 7 Days 3.17 oz. Roasted Garlic Bagel Chips

$1.75 / EA 80007192

7 Days 3.17 oz. Sea Salt Bagel Chips

$1.75 / EA 80007193

Cheetos 2 oz. Cheese Crunchy CG

$0.65 / EA 7689

Cheetos 8 oz. Flamin' Hot Crunchy CG

$2.50 / EA 7687

Chester's 1.75 oz. Flamin Hot Fries

$0.89 / EA 80002842

Chex Mix 1.75 oz. - Bold N' Zesty K

$0.79 / EA 1471

Total

Order Form Kentucky DOC - Food Effective October 1 2019

Please complete all info on reverse (print clearly).

ITEM DESCRIPTION

Corn Nuts 1.4 oz. Chile Picante Con Limon Crunch Corn Snack

PRICE $0.89 / EA

ITEM # 40713

QTY

TOTAL PRICE

Doritos 7.5 oz. Spicy Sweet Chili Chips

$2.23 / EA 80005365

Doritos 8 oz. Cool Ranch Chips C

$2.23 / EA 10354

Doritos 8 oz. Nacho Cheese Chips C

$2.23 / EA 10514

El Sabroso 3 oz. Guacamole Flavored Tortilla Chips $1.56 / EA 7089

El Sabroso 3 oz. Spicy Salsa Flavored Tortilla Rounds

$1.56 / EA 7091

Fritos 4 oz. Regular Corn Chips

$1.04 / EA 6378

Gardetto's 2.5 oz Original Recipe Snack Mix

$1.30 / EA 80006670

Herr's 7 oz Buffalo Blue Cheese Curls

$3.70 / EA 80006657

Kar's 2 oz. All Energy Trail Mix K

$1.10 / EA 5866

Kar's 6 oz. Sweet `N Spicy Mix C

$2.60 / EA 9674

Kellogg's 1.3 oz. Original Rice Krispies Treats

$0.72 / EA 2381

Kellogg's 1.3 oz. Rice Krispies Treats Double Chocolatey Chunk

$0.80 / EA 80000029

Kings Nut 3.25 oz. Health Mix KH

$1.09 / EA 80003371

Kings Nut 3.25 oz. Roasted & Salted Sunflower Kernels KH

$0.98 / EA 80003356

Lay's 5.5 oz. Barbeque Potato Chips K

$2.35 / EA 80000892

Lay's 5.5 oz. Stax Cheddar Potato Crisps

$2.75 / EA 80003580

Planters 2 oz. Tropical Fruit & Nut Trail Mix

$1.31 / EA 80001255

Ruffles 5.5 oz. Cheddar & Sour Cream Potato Chips $2.50 / EA 10525

Snyder's 2.25 oz. Jalapeno Pretzel Pieces K

$3.02 / EA 2299

TGI Fridays 1 oz. Cheddar and Bacon Potato Skins $0.79 / EA 80003515 Snacks K

The Whole Shabang 2 oz. Pork Rinds

$0.94 / EA 80003053

The Whole Shabang 6 oz. Extreme Ripple Potato Chips KH

$1.93 / EA 80001671

Popcorn

Fiddle Faddle 6 oz. Butter Toffee Popcorn with Peanuts K

$2.45 / EA 6607

Moon Lodge 5 oz. Jalapeno Cheddar Popcorn

$1.41 / EA 80006283

Nuts Kings Nut 3 oz. Roasted & Salted Peanuts

$0.85 / EA 80003354

Kings Nut 3 oz. Roasted Unsalted Peanuts

$0.85 / EA 80003355

Zachary 5 oz. Bridge Mix Chocolate Covered Nuts $3.02 / EA 7286

ITEM DESCRIPTION

Crackers Austin Cheese on Cheese Sandwich Crackers (8 Pk.) K

PRICE

ITEM #

QTY

TOTAL PRICE

$2.65 / BX 80007343

Austin Peanut Butter and Jelly Sandwich Crackers $2.65 / BX 80007340 (8 Pk.) K

Austin Peanut Butter on Cheese Crackers (8 Pk.) K $2.65 / BX 80007341

Cheez-It 1.5 oz. Cheddar Crackers K

$0.44 / EA 9590

Cheez-It 1.5 oz. Hot & Spicy Crackers K

$0.67 / EA 4214

Keebler .952 oz. Gripz Chocolate Chip Grahams $0.75 / EA 80002334

Keebler 5.25 oz. Original Club Crackers K

$1.93 / EA 80000896

Nabisco 3.4 oz. Ritz Crackers - Convenience Pack $2.95 / EA 4486 KH

Cookies

Bud's Best 6 oz. Chocolate Peanut Butter Mini Cookies K

$1.83 / EA 6384

Bud's Best 6 oz. Pecan Chocolate Chip Supreme $1.83 / EA 9697 Cookies

Bud's Best 6 oz. Pecan Supreme Cookies

$1.83 / EA 9699

Bud's Best 7.5 oz. Bite Size Chocolate Chip Cookies $1.83 / EA 9824

Famous Amos 2 oz. Chocolate Chip Cookies K

$0.62 / EA 850

Grandma's 2.5 oz. Chocolate Chip Cookies

$1.04 / EA 80001046

Keebler 12.5 oz. Deluxe Grahams Cookies

$3.59 / EA 80003283

Lil Dutch Maid 13 oz. Mint Creme Cookies

$1.95 / EA 80002239

Lil Dutch Maid 5 oz. Duplex Creme Cookies

$0.94 / EA 80002230

Marias 4.94 oz. Gamesa Cookies

$0.79 / EA 80005515

Market Square Bakery 15.25 oz. Double Stuffed Mint Sandwich Creme Cookies KHC

$3.49 / EA 80003141

Market Square Bakery 6 oz. Chocolate Chip Cookies $0.89 / EA 6072 KHC

Nabisco 13 oz. Chips Ahoy! Chewy Chocolate Chip $5.52 / EA 4488 Cookies K

Nabisco 9.5 oz. Chips Ahoy! w/Reese's Peanut Butter Cups

$5.62 / EA 7792

Twix 1.79 oz. Chocolate Caramel Cookie Bars

$1.61 / EA 80006633

Twizzlers 12.4 oz. Rainbow Twists

$4.53 / EA 80001134

Twizzlers 5 oz. Strawberry Twists K

$1.98 / EA 9742

Zachary 5.5 oz. Thin Mints

$2.18 / EA 5234

Salad Dressing Kraft 9 oz. Blue Cheese Packets (6 Pk.)

$4.31 / SP 80000083

Kraft 9 oz. Ranch Packets (6 Pk.)

$3.59 / SP 80000081

Total

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

Total

ITEM DESCRIPTION

Condiments Woeber 9 oz. Mustard Squeeze Bottle KHS

PRICE

ITEM #

QTY

TOTAL PRICE

$1.45 / EA 9779

Sauce A-1 .5 oz. Steak Sauce (10 Pk.)

$4.43 / SP 75837

Sweet Baby Ray's 1.5 oz. Original BBQ Sauce Pouch $0.80 / EA 10914 (1 pouch)

Viva Pancho Salsa 5 oz. Picante Hot Sauce C

$1.24 / EA 1700

Spreads

Keefe Kitchens 12 oz. Honey Peanut Butter KHCRG

$2.90 / EA 10191

Moon Lodge 3.5 oz. Onion Dip RG

$1.03 / EA 172

Spices & Seasonings Colonna Brothers 2.5 oz. Garlic Powder

$2.80 / EA 80007067

Colonna Brothers 3 oz. Cinnamon

$2.86 / EA 80007071

Colonna Brothers 3 oz. Garlic Salt

$3.27 / EA 80007079

Colonna Brothers Spices 2.5 oz. Salt Free Original $3.25 / EA 80007074 Blend

Sevilla 1.5 oz. Sazon con Culantro Y Achiote KHC $1.09 / EA 6034

Taco Bell 1.4 oz. Fajita Seasoning Mix

$1.50 / EA 80002984

Taco Bell 1 oz. Original Taco Seasoning Mix

$1.50 / EA 80002308

Pickle Van Holten's 9.6 oz. Zesty Garlic Pickle KHCG $0.94 / EA 382

Cheese

Old Fashioned 6.35 oz. Cheese and Salsa Cheese Dip

$2.13 / EA 80002188

Painted Cow 2 oz. Cream Cheese Pouch

$0.94 / EA 80003625

Philly 2 oz. Cream Cheese w/Jalapenos

$0.89 / EA 10911

Risparmio 3 oz. Grated Parmesan Cheese Blend $1.55 / EA 80007075

Velveeta 1.5 oz. Instant Spicy Nacho Cheese Sauce $1.34 / EA 4942 KHC

Velveeta 16 oz. Sharp Cheddar Squeezable Cheese G

$4.26 / EA 9393

Velveeta 2 oz. Sharp Cheddar Cheese Spread (10 Pk.)

$5.30 / EA 10417

Velveeta 2 oz. Spicy Jalapeno Cheese Spread G $0.52 / EA 7738

Velveeta 4 oz. Cheese Bar Mini Blocks (3 Pk.)

$6.24 / EA 80004844

Velveeta 8 oz. Spicy Jalapeno Cheese Snack Spread $1.96 / EA 9397 Tub CRG

Meat Snacks Bridgford 3.5 oz. Chorizos

$3.17 / EA 7906

Total

Order Form Kentucky DOC - Food Effective October 1 2019

Please complete all info on reverse (print clearly).

ITEM DESCRIPTION

Brookfield Farms 2.1 oz. Fully Cooked Hickory Bacon (15 slices)

PRICE $6.51 / EA

ITEM # 5885

QTY

TOTAL PRICE

Brushy Creek 5 oz. Beef Salami Stick G

$2.65 / EA 80001739

Brushy Creek 5 oz. Hot Beef Summer Sausage G $2.91 / EA 80001721

Brushy Creek 5 oz. Original Beef Summer Sausage G

$2.66 / EA 80001719

Butterball 1.2 oz. Smoked Turkey Snack Stick

$2.20 / EA 80005906

Carmela 10 oz. Vienna Sausage Bites

$2.40 / EA 80001054

Double Barrel 1.125 oz. Spicy Meat & Jalapeno Cheese

$1.30 / EA 80001205

Jack Link's 1 oz. Wild Snack Stick

$1.76 / EA 80003260

Midamar 5 oz. Halal Beef Summer Sausage C $4.21 / EA 7239

Seafood

Chicken of the Sea 2.5 oz. Pink Salmon in Sriracha $2.50 / EA 80003004 Sauce K

Chicken of the Sea 2.5 oz. Sweet & Spicy Pink Salmon Steak

$2.70 / EA 80001663

Chicken of the Sea 2.5 oz. White Albacore Tuna K $3.00 / EA 10356

Chicken of the Sea 3.53 oz. Sardines in Oil Pouch K $1.19 / EA 10357

Chicken of the Sea 3 oz. Light Tuna in Water K

$3.00 / EA 10061

Chicken of the Sea 5 oz. Mackerel Fillet in Soybean $2.18 / EA 80000051 Oil K

Fresh Catch 12 oz. Jack Mackerel in Brine HG $2.92 / EA 7934

Fresh Catch 3.53 oz. Chunk Light Tuna w/Jalapenos $1.93 / EA 80005516 K

Fresh Catch 3.53 oz. Fish Steaks in Spicy Mustard $1.10 / EA 4394 Sauce HG

Fresh Catch 3.53 oz. Mackerel Flakes in Chili Oil $1.41 / EA 80000211 with Jalapenos H

Fresh Catch 3.53 oz. Sardines in Soybean Oil KHG $1.09 / EA 4388

Fresh Catch 3.53 oz. Yellowfin Tuna Steak in Spicy $3.64 / EA 5696 Thai Chili Sauce KHG

Fresh Catch 4.23 oz. Chunk Light Tuna in Water $3.28 / EA 4317 KHG

Geisha 3.53 oz. Sardines in Hot Sauce

$1.66 / EA 80006259

Geisha 3.53 oz. Smoked Oysters in Hot Sauce

$3.12 / EA 80006260

Ready-To-Eat Meals Brushy Creek 11.25 oz. Beef in Barbecue Sauce $5.37 / EA 1722

Brushy Creek 11.25 oz. Chili with Beans G

$2.98 / EA 1711

Brushy Creek 11.25 oz. Lasagna with Beef in Sauce $2.26 / EA 1721

ITEM DESCRIPTION

PRICE

Brushy Creek 11.25 oz. Sloppy Joe Sauce with Beef $3.99 / EA

ITEM # 1723

QTY

TOTAL PRICE

Brushy Creek 4.5 oz. Premium Chicken Breast GS $3.48 / EA 5360

Brushy Creek 5 oz. Chicken Vienna Sausage

$1.66 / EA 80002944

Brushy Creek 5 oz. Hot Chicken Vienna Sausage $1.66 / EA 80002945

Brushy Creek 7 oz. Chunk Ham with Natural Juices $4.26 / EA 80002117

Brushy Creek 8 oz. Chicken Chili w/White Beans $2.18 / EA 80001465

Brushy Creek 8 oz. Mexican Style Chicken Stew $3.55 / EA 80003085

Hamburger Helper 6.4 oz. Stroganoff

$3.69 / EA 80003587

Hamburger Helper 7.5 oz. Cheesy Enchilada

$3.65 / EA 80003589

Hormel 2.5 oz. Spam Single

$2.03 / EA 80001495

Hormel Compleats 10 oz. Meatloaf & Mashed Potatoes

$4.73 / EA 10085

Hormel Compleats 9 oz. Beef Pot Roast

$4.68 / EA 10083

Rip N Ready 6 oz. Shredded Beef Brisket w/Broth & $5.47 / EA 80004163 Smoke Flavoring

Rip N Ready 6 oz. Shredded Beef Brisket with BBQ $5.20 / EA 80004162 Sauce

Tuna Helper 7.3 oz. Tetrazzini

$3.69 / EA 80003582

Velveeta 9 oz. Cheesy Bowls Bacon Mac & Cheese $5.50 / EA 80002407

Velveeta 9 oz. Cheesy Bowls Bean and Rice Burrito $5.50 / EA 80002406 Bowl

Velveeta 9 oz. Cheesy Bowls Chicken Alfredo

$5.50 / EA 80003547

Vegetables

Brushy Creek 7 oz. Whole Kernel Sweet Corn HCGS

$1.56 / EA 3718

Idahoan 2 oz. Instant Mashed Potatoes

$1.35 / EA 80000147

Libby's 14 oz. Cut Green Beans Pouch K

$1.83 / EA 80002300

Rice

Brushy Creek 8 oz. Cajun Style Rice with Chicken & Sausage

$3.39 / EA 80003084

Minute Rice 8 oz. White Rice Clear Resealable Pouch

$1.46 / EA 80005364

Sevilla 2 oz. Spicy Cheesy Spanish Rice KH

$0.95 / EA 10757

Velveeta 2 oz. Cheesy Rice KHC

$0.80 / EA 4937

Zatarain's 8.8 oz. Big Easy Rice - Jambalaya

$4.63 / EA 10453

Beans

Brushy Creek 10 oz. Seasoned Kidney Beans in Sauce

$1.83 / EA 80002107

Brushy Creek 10 oz. Seasoned Pinto Beans in Sauce $1.93 / EA 80002106

ITEM DESCRIPTION

Sevilla 4.4 oz. HOT Chili Flavor Refried Beans & Rice KHC

PRICE $1.38 / EA

ITEM # 5940

QTY

TOTAL PRICE

Velveeta 4 oz. Cheesy Refried Beans KHC

$1.31 / EA 4939

Velveeta 4 oz. Spicy, Cheesy Refried Beans KHC $1.31 / EA 4940

Velveeta 4 oz. Spicy, Cheesy Refried Beans & Rice $1.56 / EA 4941 KHC

Zatarain's 8.8 oz. Big Easy Rice - Red Beans & Rice $4.85 / EA 10451

Tortillas & Taco Shells Chi-Chi's 9 oz. White Corn Tortillas (10 Pk.) KC $1.36 / EA 6190

Old El Paso 11 oz. Flour Tortillas (8 Pk.)

$4.16 / EA 6694

Ortega 5.8 oz. Taco Shells (12 Pk.)

$4.43 / EA 7865

Ramen Maruchan Instant Lunch 2.25 oz. - Beef

$1.00 / EA

2

Maruchan Instant Lunch 2.25 oz. - Cheddar Cheese $1.00 / EA 1332

Maruchan Instant Lunch 2.25 oz. - Chicken

$1.00 / EA

1

Maruchan Instant Lunch 2.25 oz. - Hot & Spicy Beef $1.00 / EA

16

Noodles Anatina 16 oz. Ziti Pasta

$1.19 / EA 4315

El Mexicano 7 oz. Codito Elbow Pasta

$0.81 / EA 80005651

Knorr 4.1 oz. Pasta Sides Cheesy Spinach Dip Fettuccini

$3.05 / EA 80001123

Knorr 4.4 oz. Pasta Sides Alfredo Noodles

$3.05 / EA 7121

Knorr 4 oz. Stroganoff Pasta & Sauce

$3.05 / EA 80003674

Mama 2.1 oz. Pork Flavour Noodles

$0.90 / EA 10098

Mama 2.1 oz. Shrimp Flavour Noodles

$0.90 / EA 10195

NON-TAXABLE ITEMS SUBTOTAL:_________

Total

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

Total

Total

Order Form Kentucky DOC - Food Effective October 1 2019

Please complete all info (print clearly).

SHIP TO:

Inmate's Name Institution/Dorm/Housing#

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

PROGRAM DATES: Effective Date: October 1, 2019 Quarter 1: January 1 ? March 31 Quarter 2: April 1 ? June 30 Quarter 3: July 1 ? September 30 Quarter 4: October 1 ? December 31 Delivery to facility: Weekly

Delivery to facility: Facilities will receive weekly shipments

Street Address

City

SENDER:

State

Zip

REQUIRED for order fulfillment.

Sender's Name

Street Address

City

State

Zip

Phone Number

Email

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

CALCULATE AMOUNT DUE:

Merchandise

Taxable: Non-Taxable: Processing Fee: $5.95

Sales Tax

x 1.06

=

x

=

x 1.06

=

TOTAL AMOUNT DUE:

TOTALS

$6.31

SELECT PAYMENT METHOD:

? Cashier's Check

? Money Order

Make check or money order payable to ACCESS SECUREPAK

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Cardholder Name

WAYS TO ORDER Online: Phone: 1.800.546.6283 Mail: Access Securepak (KY), 10880 Linpage Place, St. Louis, MO 63132

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

PROCESSING FEE: There is a processing fee of $5.95 for all orders. The processing fee is waived if the order is placed by the Inmate or Institution.

SALES TAX: Access Securepak? is required by the state of Kentucky to collect 6% sales tax on all candy items including the processing fee. All other non-candy items are NOT taxable. See the tax calculation example below for more information.

Tax calculation example: $63.52 non-candy merchandise total $15.46 candy total + $5.95 processing fee = $21.41 candy subtotal $21.41 candy subtotal x 0.06 tax rate = $1.28 tax total + $21.41 = $22.69 candy total w/tax $63.52 non-candy merchandise total + $22.69 candy total w/tax = $86.21 total due

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

LIMITS: Maximum $125 of product per inmate per quarter. Multiple packages can be ordered, and we will consolidate orders not to exceed the maximum $125 of product.

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.

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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, 8:30 a.m.?11:59 p.m. EST, and Saturday, 11 a.m.?5 p.m. EST.

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