Order Form Bucks County Effective January 2018 Please complete all info on reverse (print clearly).

Transcription

1 ITEM DESCRIPTION ITEM # Size QTY ITEM DESCRIPTION ITEM # Size QTY NON-TAXABLE ITEMS DRINKS Coffee, Tea, Cocoa & Cappuccino Keefe.81 oz. French Vanilla Cappuccino (Single Serve) K G S $0.60 / EA 905 Keefe.8 oz. Single Serve Hot Cocoa K G $0.50 / EA 114 Quaker 6.72 oz. Chewy Variety Pack Granola Bars (8 Pk.) K $3.93 / BX 9367 Quaker Instant Oatmeal - Maple & Brown Sugar (1 Pk.) $0.75 / SP Quaker Instant Oatmeal - Original Flavor (1 Pk.) $0.75 / SP Pastries & Snack Cakes Cloverhill 4.25 oz. Apple Danish K C $1.40 / EA 4650 Keefe 1.5 g. Freeze Dried Coffee (Single Serve) K H G S $0.40 / EA 235 Golden Valley 4 oz. Cinnamon Raisin Bagel K H C $1.05 / EA Keefe 3 oz. Colombian Blend Premium Coffee K H R $4.35 / EA Golden Valley 4 oz. Plain Bagel K H C $1.05 / EA Keefe 3 oz. Decaffeinated Freeze Dried Coffee K H C R $4.25 / EA 7024 Hostess 3.03 oz. M & M Brownie (2 Pk.) $1.80 / EA Keefe 4.5 oz. Instant Coffee $4.25 / EA Hostess 3.17 oz. Chocolate CupCakes (2 Pk.) $1.50 / EA Nescafe 1.7 grams Taster s Choice Decaf. Stick K H G S $0.40 / EA 4452 Hostess 3.7 oz. Glazed Donettes $1.45 / EA Nestea 0.1 oz. Tea Bag - Heritage K $0.35 / EA 53 Hostess 3.81 oz. Vanilla Zingers (3 Pk.) $1.75 / EA Nestea 5.5 oz. Tea w/lemon and Sugar K H $2.10 / EA Hostess 3 oz. Powdered Sugar Donettes $1.45 / EA Creamer, Sugar & Sweetener International Delight.44 oz. Caramel Macchiato Liquid Creamer (10 Ct.) K G S $2.50 / SP Hostess 4.5 oz. Apple Fruit Pie $1.50 / EA Kellogg s 3.5 oz. Frosted Strawberry Pop-Tarts (2 Pk.) $1.35 / EA International Delight French Vanilla Liquid Creamer (10 Pk.) $2.50 / SP Kellogg s 3.68 oz. Smores Pop-Tarts (2 Pk.) $1.35 / EA 6398 International Delight Original Creamer (10 Pk.) $2.50 / SP Market Square Bakery 10 oz. Donut Stix (6 Pk.) K $3.30 / BX 6051 Keefe 12 oz. All Natural Pure Sugar K H C R $2.75 / EA 38 Market Square Bakery 12 oz. Peanut Butter Wafers (6 Pk.) K $3.95 / BX 6052 Paramount 8 oz. Non-Dairy Creamer K H C R $1.80 / EA 26 Market Square Bakery 12 oz. Swiss Rolls (12 Rolls) K $3.60 / BX 6055 Sweetmate 3.5 oz. Saccharin (100 Ct.) K H G S $3.10 / BX 9719 Market Square Bakery 16 oz. Oatmeal Creme Pies (12 Pk.) K $3.40 / BX 6053 Drink Mixes Cool Off 1.4g Sugar Free Tea Drink Mix (1 Pk.) $0.40 / EA Paramount 10 oz. Instant Nonfat Dry Milk K H $4.50 / EA 6566 Nutritional Drinks New Leaf 2 oz. Chocolate Health Shake K $1.70 / EA New Leaf 2 oz. Vanilla Health Shake $1.70 / EA FOOD & SNACKS Cereal & Cereal Bars Golden Valley 1.3 oz. Strawberry Cereal Bar K $0.50 / EA 6045 Malt-O-Meal.75 oz. Tootie Fruities Cereal (Single Serve) K $0.75 / EA 5669 Malt-O-Meal 1.25 oz. Raisin Bran Cereal (Single Serve) K $0.75 / EA 5654 Market Square Bakery 4.25 oz. Blueberry Cheese Danish K C $1.40 / EA 6059 Market Square Bakery 4.25 oz. Strawberry Cheese Danish K C $1.40 / EA 6058 Market Square Bakery 4.75 oz. Mega Buneez K C $1.40 / EA 6044 Market Square Bakery 4.75 oz. Mega Chocolate Iced Honey Bun K C Market Square Bakery 4 oz. Cream Cheese Pound Cakes (2 Pk.) K C $1.45 / EA 6540 $1.35 / EA 6538 Market Square Bakery 4 oz. Iced Cinnamon Roll K C $1.35 / EA 6057 Market Square Bakery 6 oz. Monster Iced Honey Bun K C $1.50 / EA 6043 Chips Cactus Annie s 1.5 oz. Nacho Cheese Tortilla Chips K H G $1.05 / EA 920 Malt-O-Meal 1 oz. Frosted Flakes Cereal (Single Serve) K $0.75 / EA 5667 Mrs. Freshley s 1.3 oz. Apple Cinnamon Cereal Bar $0.55 / EA 5025 Mrs. Freshley s 1.3 oz. Blueberry Cereal Bar $0.55 / EA 5024 Quaker.84 oz. Chewy Chocolate Chip Granola Bar (1 Pk.) K $0.60 / EA 9366 Cactus Annie s 1.5 oz. Scorchin Habanero Tortilla Chips K H C G $1.05 / EA 7666 Cactus Annie s 11 oz. The Whole Enchilada Party Mix K H C $2.95 / EA 902 Cactus Annie s 11 oz. Cheese Crunchy K H C G S $3.99 / EA 7996

2 ITEM DESCRIPTION ITEM # Size QTY ITEM DESCRIPTION ITEM # Size QTY Cactus Annie s 12 oz. Barbeque Corn Chips K H C G S $3.15 / EA 7990 Golden Valley 16 oz. Saltine Crackers (Box) K H $2.65 / BX 7914 Cactus Annie s 13 oz. Corn Chips K H C G S $2.80 / EA 7991 Cheetos 1.75 oz. Flamin Hot Crunchy G $1.15 / EA 7690 Doritos 1.75 oz. Cool Ranch Chips $1.15 / EA Cookies Marias 4.94 oz. Gamesa Cookies $1.20 / EA Market Square Bakery 2.75 oz. Soft Baked Chocolate Chip Cookies (2 Pk.) K $0.95 / EA 7647 Doritos 1.75 oz. Nacho Cheese Chips $1.15 / EA Moon Lodge 1.5 oz. BBQ Potato Chips K H $1.05 / EA 6023 Moon Lodge 1.5 oz. Buffalo Wing Blue Cheese Potato Chips K H $1.05 / EA Moon Lodge 1.5 oz. Hot!Hot!Hot! Barbeque Potato Chips K H $1.05 / EA 6026 Moon Lodge 1.5 oz. Regular Potato Chips K H $1.05 / EA 6022 Moon Lodge 1.5 oz. Sour Cream and Onion Potato Chips K H S $1.05 / EA 6024 Moon Lodge 1.5 oz. Stuffed Jalapeno Potato Chips $1.05 / EA 7637 Market Square Bakery 2.75 oz. Soft Baked Oatmeal Raisin Cookies (2 Pk.) K Market Square Bakery 2.75 oz. Sugar Free Strawberry Creme Wafers K H $0.95 / EA 7648 $1.10 / EA 6069 Market Square Bakery 6 oz. Chocolate Chip Cookies K H C $1.70 / EA 6072 Market Square Bakery 6 oz. Duplex Creme Cookies K H C $1.70 / EA Market Square Bakery 6 oz. Iced Oatmeal Cookies K H $1.70 / EA 6071 Market Square Bakery 6 oz. Peanut Butter Creme Cookies K H C $1.65 / EA The Whole Shabang 1.5 oz. Potato Chips K H $1.05 / EA 6025 Market Square Bakery 6 oz. Vanilla Creme Cookies K H C $1.70 / EA Snacks & Nuts Andy Capp s.85 oz. Hot Fries $0.75 / EA 6743 Cactus Annie s 2 oz. Cheese Puffs K H $1.25 / EA 7994 Oreo 2.4 oz. Cookies $1.00 / EA Candy Atkinsons.7 oz. Chick-O-Stick K C G $0.50 / EA 1477 Cheetos 2 oz. Cheese Crunchy C G $1.15 / EA 7689 Atomic 3 oz. Fireball $1.40 / EA Kar s 7 oz. Nut N Yogurt Trail Mix C $2.99 / EA 9811 Baby Ruth 2.1 oz. Bar K G $1.30 / EA 844 Kings Nut 3.25 oz. Health Mix $1.40 / EA Hershey s 3 oz. SF Dark Chocolate Candy Bar Miniatures $3.85 / EA 2776 Kings Nut 3.5 oz. Spicy Cajun Mix $1.30 / EA Hershey s 5.3 oz. Miniatures Bag K $3.50 / EA 865 Kings Nut 3.75 oz. Student Snack Mix $1.40 / EA Jolly Rancher 3.7 oz. Assorted Flavors C $1.65 / EA Kings Nut 4 oz. Tropical Mix $1.40 / EA Kit Kat 1.5 oz. Bar K $1.30 / EA 5409 Moon Lodge 1.75 oz. Hot, Hot, Hot! Peanuts K C G $1.00 / EA 7551 M&M s Peanut 5.3 oz. Candy $3.50 / EA 9732 Moon Lodge 1.75 oz. Salted Peanuts K C G $1.00 / EA 7550 M&M s Plain 5.3 oz. Candy $3.50 / EA 9733 Moon Lodge 11 oz. Pretzels Mini Twists K C $2.95 / EA 5139 Milky Way 3 oz. Mini Pack $2.10 / EA Moon Lodge 5 oz. Jalapeno Cheddar Popcorn $1.95 / EA Nestle 1.9 oz. Butterfinger Bar K G $1.30 / EA Moon Lodge 5 oz. White Cheddar Popcorn K H G $2.00 / EA 5133 Reese s 1.5 oz. Peanut Butter Cups K G $1.30 / EA 1949 Quinlan 1.5 oz. Minis Pretzels K $1.05 / EA 2015 Sathers 1.75 oz. Sugar Free Wild Fruit C $1.30 / EA Crackers Austin 1.38 oz. Toasted Peanut Butter Sandwich Crackers (1 Pk.) $0.60 / EA Sathers 3 oz. Vanilla Caramels C $1.40 / EA Sathers 4.25 oz. Butterscotch Discs Candy $1.40 / EA Cheez-It 1.5 oz. Cheddar Crackers K $0.85 / EA 9590 Sathers 4.25 oz. Jelly Beans $1.40 / EA Golden Valley 13.7 oz. Snack Crackers $2.95 / BX Sathers 4.25 oz. Lemon Drops C $1.40 / EA 40609

3 ITEM DESCRIPTION ITEM # Size QTY ITEM DESCRIPTION ITEM # Size QTY Sathers 4.25 oz. Root Beer Barrels $1.40 / EA Fresh Catch 4.23 oz. Chunk Light Tuna in Water K H G $3.00 / EA 4317 Sathers 4.25 oz. Sour Fruit Balls C $1.40 / EA Sathers 5.75 oz. Orange Slices C $1.40 / EA Snickers 4.4 oz. Miniatures K $2.75 / EA 6090 Starburst 7.2 oz. Fruit Chews Bag R $3.50 / EA 1640 Twix 1.79 oz. Chocolate Caramel Cookie Bars K $1.30 / EA 799 Peanut Butter, Jam & Jelly Keefe Kitchens Grape Jelly 20 oz. Squeeze Bottle G S $5.50 / EA 7756 Ready-To-Eat Meals Brushy Creek oz. Beef Stew G $2.95 / EA 1715 Brushy Creek oz. Chili with Beans G $2.95 / EA 1711 Brushy Creek oz. Chili with Beans Hot! G $2.95 / EA 1712 Brushy Creek oz. Lasagna with Beef in Sauce $2.85 / EA 1721 Brushy Creek oz. Sloppy Joe Sauce with Beef $3.70 / EA 1723 Brushy Creek 4.5 oz. Premium Chicken Breast G S $3.90 / EA 5360 Keefe Kitchens Strawberry Preserves 20 oz. Squeeze Bottle G S $4.60 / EA 7757 Squeez-Ums 1 oz. Grape Jelly (1 Pk.) K H G $0.55 / EA 4787 Squeez-Ums 2 oz. Peanut Butter (1 Pk.) K H $0.98 / EA Condiments Squeez-Ums.31 oz. Mayo - Single Packet K H G $0.25 / EA 6510 Cheese Cactus Annie s 2 oz. Cheddar Cheese Squeeze Snack G $1.05 / EA 2586 Cactus Annie s 2 oz. Jalapeno Cheese Squeeze Snack G $1.05 / EA 2585 City Cow 4 oz. Nacho Cheese Dip with Jalapenos C R G $1.70 / EA 2858 Painted Cow 2 oz. Dippins Cream Cheese C G $1.25 / EA 9655 Meat Snacks Brushy Creek oz. Hot Summer Sausage G $1.60 / EA Brushy Creek 5 oz. Hot Summer Sausage Made with Beef and Chicken G $3.60 / EA Brushy Creek 5 oz. Chicken Vienna Sausage G S $2.45 / EA Brushy Creek 5 oz. Hot Chicken Vienna Sausage $2.45 / EA Brushy Creek 5 oz. Pulled Chicken in Buffalo Style Sauce G $4.50 / EA 6476 Brushy Creek 7 oz. Whole Kernel Corn H C G S $2.50 / EA 3718 Rice Keefe Kitchens 6.5 oz. Pre-Cooked Long Grain Brown Rice K C R G S $2.15 / EA 7525 Keefe Kitchens 8 oz. Pre-Cooked Long Grain Rice K C R G S $2.10 / EA 5880 Sevilla 2 oz. Spicy Cheesy Spanish Rice K H $1.10 / EA Velveeta 2 oz. Cheesy Rice K H C $1.10 / EA 4937 Beans Brushy Creek 10 oz. Black Beans G $2.50 / EA 4915 Sevilla 4.4 oz. Chili Flavor Refried Beans & Rice K H $2.00 / EA 5939 Velveeta 4 oz. Cheesy Refried Beans K H C $2.00 / EA 4939 Brushy Creek 5 oz. Original Summer Sausage Made with Beef and Chicken G Brushy Creek 5 oz. Turkey Summer Sausage Honey Brown Sugar G $3.60 / EA $3.60 / EA O Briens oz. Beef & Cheddar Sticks G $1.20 / EA 2228 O Briens 1.13 oz. Beef Sticks Hickory Smoked G $1.15 / EA 5379 Seafood Fresh Catch 3.53 oz. Fillets of Mackerel in Brine K H G $1.70 / EA 7935 Velveeta 4 oz. Spicy, Cheesy Refried Beans K H C $2.00 / EA 4940 Tortillas Cactus Annie s 8 oz. Flour Tortillas (6 Pk.) K H C R $2.00 / EA 5070 Ramen Maruchan 3 oz. Beef Flavor Ramen C $1.00 / EA 9 Maruchan 3 oz. Cajun Chicken Flavor Ramen C $1.00 / EA 18 Maruchan 3 oz. Cajun Shrimp Flavor Ramen C $1.00 / EA 15 Fresh Catch 3.53 oz. Fish Steaks in Oil w/green Chilies K H G $1.45 / EA 4395 Maruchan 3 oz. Chicken Flavor Ramen C $1.00 / EA 8 Fresh Catch 3.53 oz. Mackerel in Sriracha Hot Chili Sauce K H G S $1.60 / EA 9703 Fresh Catch 3.53 oz. Salmon Flakes in Water K H G $1.95 / EA 4391 Fresh Catch 3.53 oz. Sardines in Soybean Oil K H G $1.45 / EA 4388 Maruchan 3 oz. Chili Flavor Ramen C $1.00 / EA 10 Maruchan 3 oz. Hot & Spicy Vegetable Flavor Ramen C $1.00 / EA 505 Maruchan 3 oz. Shrimp Flavor Ramen C $1.00 / EA 12 Maruchan 3 oz. Texas Beef Flavor Ramen C $1.00 / EA 13

4 ITEM DESCRIPTION ITEM # Size QTY ITEM DESCRIPTION ITEM # Size QTY Noodles Velveeta 3 oz. Macaroni and Cheese K H C $1.40 / EA 4935 HEALTH & BEAUTY Vitamins Mason Naturals Multivitamin No Iron (100 Ct.) $3.90 / EA Moore Medical Antacid Tablets (2 Pk.) $0.20 / EA Moore Medical APAP 500 mg (Tylenol) (2 Pk.) $0.22 / EA Moore Medical Cold, Cough, Flu (2 Pk.) $0.45 / EA Rolaids Regular Strength Antacid (1 Roll) $1.25 / EA Naturalist Vitamin C 500 mg. (100 Ct.) $3.65 / EA Skin Care Products Goodsense 1 oz. Hydrocortisone (1% Cream) $3.00 / EA CLOTHING & APPAREL Socks Deluxe White Quarter Socks (1 Pair) $1.35 / EA Heritage 3 oz. Medicated Anti-Fungal Powder $2.80 / EA Men s Tube Socks - Stripe $1.15 / EA Tolnaftate.5 oz. Antifungal Cream $3.75 / EA Triple Antibiotic Ointment (1 oz. Tube) $4.95 / EA Dental Care Aim 5.5 oz. Mint Gel Cavity Toothpaste $3.10 / EA Cool Wave 4 oz. Fresh Mint Fluoride Toothpaste C $2.00 / EA Effergrip 2.5 oz. Denture Adhesive Cream Tube $5.60 / EA Floss Loops (30 Pk.) $2.40 / EA Freshmint.85 oz. Toothpaste $0.50 / EA Freshmint Denture Tablets (40 Pk.) $3.00 / BX NWI Security Toothbrush $0.85 / EA Sensodyne 4 oz. Maximum Strength Toothpaste $7.80 / EA Tek Firm Straight Toothbrush C $0.75 / EA Hats Stocking Cap - Orange $2.15 / EA Accessories Kiwi 54 Flat Athletic Shoe Laces - White $1.20 / EA THE GENERAL STORE Stationery #10 Stamped Envelope $0.64 / EA Stamp $0.02 / EA 3628 First Class Stamp $0.49 / EA 928 Security Pen 1 Ct. (Black) $0.40 / EA Stamp (.01) $0.01 / EA 2041 Stamps (Book of Ten) $4.90 / CS 928 Miscellaneous Toilet Paper (One Roll) $1.48 / EA Tek Medium Straight Toothbrush C $0.80 / EA TEK Soft Straight Toothbrush C $0.75 / EA TAXABLE ITEMS Toothbrush 28 Tuft (3 row) $0.30 / EA Ultra Brite 6 oz. Advanced Whitening Toothpaste $2.45 / EA Women s Hygiene Playtex Gentle Glide Tampons (Regular) 20 Pk. $4.86 / BX Playtex Stayfree Maxi Pads (Super) 10 Pk. $3.30 / EA Pharmaceuticals Diphen (Like Benadryl) $0.30 / EA DRINKS Drink Mixes Cool Off 1.4 g Sugar Free Fruit Punch Drink Mix (1 Pk.) $0.40 / EA Cool Off 1.4g Sugar Free Orange Drink Mix (1 Pk.) $0.40 / EA Cool Off 1.4g. Sugar Free Lemonade Drink Mix (1 Pk.) $0.40 / EA Country Time 6 oz. Lemonade Drink Mix K H C $2.10 / EA 7044 Keefe 12 oz. Orange Flavored Breakfast Drink K H C R $3.00 / EA 7030 Goodsense 12 oz. Milk of Magnesia $4.00 / EA Kool-Aid 6 oz. Cherry Drink Mix K H C $2.10 / EA 7042 Goodsense 2 oz. Hemorrhoidal Ointment $4.15 / EA Kool-Aid 6 oz. Grape Drink Mix K H C $2.10 / EA 7043 GoodSense Sugar Free Cherry Cough Drops (25 Ct.) C R $2.50 / EA Kool-Aid 6 oz. Tropical Punch Drink Mix K H C $2.10 / EA 7041 Medi-Seltzer (2 Pk.) $0.70 / EA Sweet Fusions.5 oz. Fruit Punch Drink Mix (1 Pk.) $0.40 / EA

5 ITEM DESCRIPTION ITEM # Size QTY ITEM DESCRIPTION ITEM # Size QTY Sweet Fusions.5 oz. Lemonade Drink Mix (1 Pk.) $0.40 / EA Ivory 1.03 oz. Bar Soap (1 bar) $1.15 / EA Tang 6 oz. Breakfast Drink Mix K H C $2.10 / EA 7040 Neutrogena 3.5 oz. Facial Bar Soap (1 Bar) $4.75 / EA HEALTH & BEAUTY Next 1-3 oz. Deodorant Soap $1.00 / EA Hair Care 5 Black Comb $0.35 / EA Afro Pick - Nylon $0.50 / EA Club Brush $1.65 / EA Crawford 4 oz. Balsam & Protein Conditioner C $1.60 / EA Next 1-5 oz. Anti-bacterial Sport Soap (1 Bar) C $1.25 / EA Next 1-5 oz. Cocoa Butter Soap (1 Bar) C $1.25 / EA Next 1-5 oz. Moisturizing Soap (1 Bar) C $1.25 / EA Skin Care Products Acne Treatment Cream 1 oz. Benzoyl Peroxide Xtra-Strength $3.00 / EA Crawford 4 oz. Dandruff Shampoo C $1.60 / EA Chap-Et.16 oz. Lip Conditioner $1.60 / EA Elementz 15 oz. 3 in 1 Coconut Lime Hair & Body Wash $3.00 / EA Crawford 4 oz. Cocoa Butter Lotion C $1.10 / EA Elementz 15 oz. Daily Shampoo Eucalyptus & Mint $2.30 / EA Freshscent 4 oz. Baby Oil $1.20 / EA Elementz 15 oz. Dandruff Shampoo Almond/Shea $3.00 / EA Heritage 4.5 oz. Skin Cream Facial Cleanse $2.45 / EA Goody Large Green Foam Rollers (10 Pk.) $2.15 / EA NewDay 4 oz. Baby Powder $1.40 / EA Military Style Brush $3.24 / EA No Rub 12 oz. Saline Solution $6.00 / EA Pony-O s (1 ea.) $0.25 / EA Pro Glo 4 oz. Cocoa Butter Cream w/aloe $2.60 / EA Softee 13.5 oz. 3 in 1 Conditioning Shampoo $3.85 / EA Suave 10 oz. Advanced Therapy Lotion $5.00 / EA Vent Hair Brush $1.40 / EA VO oz. Extra Body Conditioner C $2.80 / EA Personal Care Trim Nail Clipper (no file) $0.60 / EA VO oz. Extra Body Shampoo C $2.80 / EA Ethnic Hair Care Dark & Lovely Conditioning Relaxer System $12.65 / EA Deodorants Freshscent 1.5 oz. Deodorant Roll-On Anti-Perspirant $1.00 / EA Power-Up 2.5 oz. Clear A/P Deodorant - Drive C $2.79 / EA Percara 16 oz. Styling Gel $3.10 / EA Power-Up 2.5 oz. Clear Deodorant - Drive C $2.45 / EA Pro Glo 4 oz. Pomade $2.20 / EA Power-Up 2 oz. A/P Deodorant - Bloom C $2.35 / EA Softee 5 oz. Bergamot Blue Hair Dress $3.25 / EA Suave 1.4 oz. A/P Deodorant - Powder $3.00 / EA Softee 5 oz. Bergamot Green Hair Dress & Pressing Oil $3.13 / EA Softee 5 oz. Coconut Oil Hair & Scalp Conditioner $2.69 / EA Dental Care Percara 8 oz. Oral Health Rinse $1.50 / EA Softee 8 oz. Curl Activator Gel $4.48 / EA Sea Bond Denture Bath $2.60 / EA Sulfur8 2 oz. Medicated Original Conditioner $4.20 / EA Sulfur8 7.5 oz. Medicated Shampoo $3.50 / EA Soap Dial 3.5 oz. Soap (1 Bar) $1.35 / EA Shaving Products Bic Disposable Single Razor (1 ea.) $0.30 / EA Magic Cream 6 oz. Depilatory $3.05 / EA Pro-Tection 7 oz. After-Shave Gel C $1.55 / EA Dove 3.17 oz. Moisturizing Beauty Soap (1 Bar) $3.00 / EA Pro-Tection 7 oz. Shave Cream $3.00 / EA Pro-Tection Twin Blade Disp. Razors (1 ea.) C $0.40 / EA 22317

6 ITEM DESCRIPTION ITEM # Size QTY ITEM DESCRIPTION ITEM # Size QTY Pharmaceuticals GoodSense 4 oz. SPF 30 Sunscreen Lotion $4.00 / EA NewDay Cotton Swabs (100 Ct.) C R $1.00 / EA Cosmetics Wet n Wild Eyeshadow Trio - Sweet As Candy $3.50 / EA Wet n Wild Lipstick - Just Garnet $1.25 / EA Wet n Wild Mega Protein Mascara C137 - Very Black $1.60 / EA CLOTHING & APPAREL Sweats Gildan Sweatpants - Gray - No Pockets Medium, Large, XL $11.19 / EA Gildan Sweatpants - Gray - No Pockets 2XL, 3XL, 4XL $15.33 / EA Gildan Sweatpants - Gray - No Pockets 5XL, 6XL $16.33 / EA Gildan Sweatshirt - Gray Medium, Large, XL $11.19 / EA Gildan Sweatshirt - Gray 2XL, 3XL, 4XL $14.91 / EA Gildan Sweatshirt - Gray 5XL, 6XL $15.91 / EA T-Shirts Andrew Scott Crew Neck T-Shirt - White (1 Pk.) 4XL $6.63 / EA Andrew Scott Crew Neck T-Shirt - White (1 Pk.) 5XL, 6XL $8.29 / EA Andrew Scott V-Neck Shirt (1 Pk.) Small, Medium, Large, XL $4.01 / EA Andrew Scott V-Neck Shirt (1 Pk.) 2XL, 3XL $6.63 / EA Men s Underwear Andrew Scott Men s Boxers - White (1 Pk.) Medium, Large, XL $3.31 / EA Andrew Scott Men s Boxers - White (1 Pk.) 2XL $5.30 / EA Andrew Scott Men s Boxers - White (1 Pk.) 3XL $6.63 / EA Women s Underwear Hanes Her Way Cotton Briefs - White (1 Pk.) 6, 8, 10 $2.30 / EA Thermals Indera Mills Thermal Long Sleeve Shirt - Natural Small, Medium, Large, XL $6.00 / EA Indera Mills Thermal Long Sleeve Shirt - Natural 2XL, 3XL $7.90 / EA SHOES Men s Tennis Shoes Rawlings Marc II Velcro Tennis Shoe 7, 7.5, 8.5, 9, 10, 10.5, 11, 11.5, 12, 13, 14 Men s Running Shoes Reebok Classic Leather Running Shoes 7, 7.5, 8, 8.5, 9, 9.5, 10, 10.5, 11, 11.5, 12, 13, 14, 15 Men s Basketball Shoes Rawlings Kingdom High Basketball Shoes (White) 6, 6.5, 7, 7.5, 8, 8.5, 9, 9.5, 10, 10.5, 11, 11.5, 12, 13, 14, 15 Rawlings Urban Low Basketball Shoe (White) 6, 6.5, 7, 7.5, 8, 8.5, 9, 9.5, 10, 10.5, 11, 11.5, 12, 13, 14, 15 Reebok BB4500 Royal Basketball Shoes (White) 7, 7.5, 8, 8.5, 9, 9.5, 10, 10.5, 11, 11.5, 12, 13, 14, 15 Sandals, Boots & Slippers Access Desert Boot (Brown) 5, 5.5, 6, 6.5, 7, 7.5, 8, 8.5, 9, 9.5, 10, 10.5, 11, 11.5, 12, 13, 14, 6 Wide, 6.5 Wide, 7 Wide, 7.5 Wide, 8 Wide, 9 Wide, 9.5 Wide, 10 Wide, 10.5 Wide, 11 Wide, 12 Wide, 13 Wide, 14 Wide Crawford Deluxe Shower Shoes Small- #20268, Medium- #20265, Large- #20266, XLarge- #20267, 2XL- #20269 Cross Strap Sandals Small- #22602, Medium- #22603, Large- #22604, XL- #22615 Timberland Direct Attach Work Boot Wheat Waterproof 7, 7.5, 8, 8.5, 9, 9.5, 10, 10.5, 11, 11.5, 12, 13, 14, 15, 7 Wide, 8 Wide, 8.5 Wide, 9 Wide, 9.5 Wide, 10 Wide, 10.5 Wide, 11 Wide, 11.5 Wide, 12 Wide, 13 Wide, 14 Wide Timberland Men s Pit Boss Work Boot 7 Wide, 7.5 Wide, 8, 8 Wide, 8.5 Wide, 9, 9.5, 10 Wide, 10.5 Wide, 11, 11.5, 12 Wide, 13, 13 Wide, 14, 14 Wide, 15, 15 Wide M $24.03 / EA $53.99 / EA $26.00 / EA $21.54 / EA $46.40 / EA $35.00 / EA $3.50 / EA $1.20 / EA $ / EA $95.00 / EA Hanes Her Way Cotton Briefs - White (1 Pk.) 11, 12 $3.10 / EA Manhattan Hosiery Sports Bra - No-Wire (White) Small-32, Medium-34, Large-36, XL-38, 2XL-40, 3XL-42, 4XL-44/46, 5XL-48, 6XL-50 $9.94 / EA Women s Shoes Reebok Classic Royal Nylon Women s Running Shoe (White/ Gray) 5, 5.5, 6, 6.5, 7, 7.5, 8, 8.5, 9, 9.5, 10, 11, 12 $40.00 / EA Thermals Indera Mills Thermal Long Sleeve Shirt - Natural Small, Medium, Large, XL $6.00 / EA ELECTRONICS Televisions AMP D 13 Color LED TV w/speakers $ / EA Indera Mills Thermal Long Sleeve Shirt - Natural 2XL, 3XL $7.90 / EA Radios GPX AM FM Digital Radio - Clear $12.00 / EA

7 ITEM DESCRIPTION ITEM # Size QTY ITEM DESCRIPTION ITEM # Size QTY Earbuds Webster s New Pocket Dictionary $4.00 / EA GPX Clear Earbuds C $2.50 / EA Koss KE5K- 4 Earbuds $6.00 / EA Greeting Cards Acetate Anniversary Card $2.20 / EA Accessories Acetate Birthday Card $2.20 / EA Coaxial Cable (3 ft.) $2.25 / EA Acetate Friendship Card $2.20 / EA Batteries Ion 3 AA Battery (1 Pk.) $0.90 / EA Ion 3 AAA Battery (1 Pk.) $0.90 / EA Clocks LaCrosse Equity Alarm Clock - Clear $7.09 / EA THE GENERAL STORE Athletic Accessories Backpack - Clear $20.00 / EA Acetate Get Well Card $2.20 / EA Gallant Seasonal Greeting Card $2.20 / KIT Gallant Spanish Birthday Card $2.20 / EA Juvenile Birthday Card $2.20 / EA Thank You Card $2.20 / EA Towels Bath Towel 24 x 50 (Grey) $8.25 / EA Penn Racquetball (1 Pk.) $1.50 / EA Wash Cloth 12 X 12 (Beige) $1.10 / EA Detergent All 2 oz. Ultra Laundry Detergent $0.50 / EA Miscellaneous 22 oz. Tumbler Only (No Lid) $0.70 / EA Stationery #10 Envelope $0.15 / EA Beveled Pink Eraser $0.50 / EA Bic Blue Round Pen (1 Ct.) $0.30 / EA Black Pen - Sparco (1 Ct.) $0.30 / EA Golf Pencil $0.15 / EA Legal Pad Yellow 8.5 x Sheet Pad $1.25 / PAD No Clasp Envelope 9.5 x 12.5 $0.21 / EA Sketch Pad 8.5 X 11 (50 Sheet Pad) $2.00 / PAD White Paper Pad 8.5 x 11 (50 Sheet Pad) $1.20 / PAD Yellow #2 Pencil w/eraser $0.25 / EA Games Aviator - US Playing Cards $1.95 / EA Aviator Pinochle US Playing Cards $1.95 / EA Crossword Puzzle Booklet $2.35 / EA Word Search Booklet $2.35 / EA Dictionaries Webster s English/Spanish Dictionary $2.08 / EA Acrylic Mirror without Magnet 6 x 4.5 C $2.90 / EA Cereal Bowl w/lid 24 oz. $1.00 / EA Coffee Cup w/handle 12 oz. $1.00 / EA Hinged Soap Dish (Soap Not Included) C $0.65 / EA Sharkeyes Reading Glasses 1.25, 1.5, 2, 2.25, 2.5, 3, 3.25 $3.50 / EA Soup Spoon $0.55 / EA Toothbrush Holder (Toothbrush Not Included) $0.65 / EA FAITH ITEMS Prayer Rug Prayer Rug 28 x48 - Colors/Sizes May Vary $21.50 / EA 2211 Faith Books Abbott Church King James Bible $13.50 / EA Holy Qur an $24.30 / EA

8 SHIP TO: Inmate s Name Institution/Dorm/Housing# Street Address City State Zip SENDER: Sender s Name Street Address City State Zip Phone Number We cannot send orders from one inmate to another. (You will receive confirmation s when the order is placed and shipped) ID# REQUIRED for order fulfillment. PROGRAM DATES: Ordering Begins: January 22, 2018 WAYS TO ORDER: Online: pacountypackages.com Phone: Mail: Access Securepak (PA) Lin Page Place St. Louis, MO 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. SALES TAX: 6% sales tax is charged on select items. These items are shown on the order form under taxable items. LIMITS: Maximum $50 of product per inmate, per week. Multiple packages can be ordered, and we will consolidate orders not to exceed the maximum $50 of product per week. 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 pacountypackages.com 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 CALCULATE AMOUNT DUE: TAX Non-Taxable Items: x = Taxable Items: x 1.08 = AMOUNT DUE: SELECT PAYMENT METHOD: S Tax calculation example: $63.52 non-taxable merchandise total = $63.52 subtotal taxable merchandise total * 1.06 tax = $23.92 $63.52 non-taxable merchandise subtotal + $23.92 taxable merchandise = $87.44 total due ELIGIBILITY: Access Securepak verifies inmate eligibility before shipping packages, if applicable. CUSTOMER SERVICE: pacountypackages.com Automated system is available 24 hours a day, seven days a week 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. Cashier s Check Money Order Make check or money order payable to ACCESS SECUREPAK VISA MasterCard Discover Prepaid Cardholder Name 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.