~~:;T~:::Sb'es ~.~Ops\ I:~~::'I~:::'I~:~~ I -~----I'.~.n. ~--~... ~...--~--. "=

Transcription

1 SUMMARV END Im'ODUCT DATA'sCHEDULE WITH COMMERCIAL PRICING PRODUGT: Potato Products nus IS,liN ORIGIN~L SUMMIIRY SCHeOUlE UNlESS ~Hec~,EO Jle~Ow:, PROCESSOR. " <'" QuOte 1001 q R~~n~' c~"hi~ i" ~O '"".~te~~':" NAME:,),R. Simplor Company Information Certified as'accuratefrom Approved 'EPDS I (require,," ~iil;'''ture from 'abe~~ that appprd~~deposr '. iii Ct-s.(1fpUOrt POTATO BULK.FOR PROCESS,FIIZ l/2" Crinkle Cut ' POTATO'BULK FORPROCES5FRZ Coru:jluIst5idewinder :,24.00' : POTATO'BU~K FOR PROCESS.FRZ BurfaloSidewinder24.00, ; I!ROCESS, FRZ Tater. Pals Oven 1/2",Ci'inJdeCut30.oo 160:00' 3: porato BULK FORpROCE55 FRZ ',22f241ITilter Pals Oven 1/4':" Shoe String I I T4!t:65:!3: POTATO BUU< FORPROCESS:FRZ ' ~1'nn~n~ "DnTJ\Tr\ 0111 irr::"d 'DDnr.c:<::~.t:D'" ~~:;T~:::Sb'es ~.~Ops\ I:~~::'I~:::'I~:~~ I -~----I'.~.n. ~--~... ~...--~--. "= lTinyTrlangies I I I ' ITater.Bucks'l ' Sa'\Ioiy~loops KrunchieWedges:8:Cut: IConquest 5/16'~x 3/8" StdlightCutl Skin-On.,.47,8089IS;ivory&:-CutWedge SavorYlalticeCut ' RoastWorksyukon.Gold:& Rcrlskin!?otatoes. }57672IRoastl,'lJo'rksRosemary Redskin: 'IRoastWorks;Hcrb&GarliecRussets SiinpiotSweets Sweet P.olaloFriesCrinkleCut SimplofSweets Sweet Potato Gems Roas,IWorks SweetP.otato Unseasoning Chunk, implot Sweets,'Sweet Potato lattice Cut I'Sii'nplot Sweets Sweet Potatol0-CutWedge 80.00, 15:<i<rl80.00' 15: '~ ls.00,,.80.00,15:00'1,80:00, 3:00 [) Add.lJon., Ptoducu. U~tiH:t VDluo PftS'. o (Otr#ctkll\ P-OTATO,BULK FORPROCESS:FRl POTATO.BUlK FOR PROCESS ~RZ" POTATO:BUlK FORPROCE5S FRZ' PROCESS F,RZ POTATO BUlHOR'P.ROCESS FRZ POTAtO BULK for PROCESSF.RZ POTATO, BULK;f:ORI'RO,CESS FRZ potato BULK FOR PROCESS F'RZ SWEErPOTATo ButK FRESH PROc SWEET POTATO'BULK FRESH.PROC FRESH PROC' 'FRESH,PROC, FRESH PROC I',When 18~PfodUC.If,' ( "V.hu~~r C'nmmodiIV' I A~plic..bkt, Ptoduood. M~..l';'IoI'~,. o"imi,1id ~l;wrcd' ~f~ptict" G;;'r.i;:'~I~ 54.55' 0, S 0,1018,43,63 0, ,63,0, :5S.0,1018'.49.10'. 0,:1618:, ;54.55'; :0;1018, '0:1018' 54'.55,,0.1018' ;54: ' : : i ();l018,18.75 ' ' :1018 ' '2~t41 0:2332' 29.41, 0,2332,29.4.1". 0, :29;'41, 0,2332 o 'Olfl:(t'}a1tH IXI R.(v~d ~ Ro('iplent Acenqo. (B] ~et"fi(" lb(oiol~~' Oktiliirt.Or ~ ~~* for ittw~fb~'~ ~,Pr~~..,rr,D ~"for $fl"w'lcf (b'ill~d I>V DtllributOl) liiooi$irlbtitlon,upcharlie'lriduded! t(c.ue' P1tr'Port"'" Nl'lPtkeCaSl!, Oi28S1 1!nS ' ,61,,18,81 ' ,26 ' Al 0; :97 25:41,0:21S7 20:97 '14: ' ' 8:4i1 ',20,31 :: i9:65 :16:63 >17:28 16:63,17:32 i6.s7i. 0: W ~~ l7.q m~ :17,6210: ' Net Price P., P~rtio~ : :037~ : PROCESSOR: J.R.'simplot Company N~me' at ~~.~~~ny Briiln Wells.,Director Potilto Marketing -ff bv products ~ produ(~d. pl'o'fide value and method credit ww be given APPROVAL:, Caldwell CountY SdioOls Child Nutrilion Program Name of Company " '. 'Guy GarnerI Director -':f7, " 'f N,~.,,{TiI1. oi,"'"tho,1teci R.pr'J.~taitV. "", r ~?~ta:::e-..~- January 13 ;2016 Hame and nue 'of 4~filrd~ ~~plel.n~ve. _,Sl'n.c~r." Oite SlenOd, d 'By my signature I certify that I have read pages 1 13 and agree,:wit~:allitems'in quqle,document., SliIl.cure,OactiSIi""d" '",.,. ', 'J',j,.:,,",. '.,.... ", '..... ~.;'.,.' '.' '.' ~,t ",. 'toni:baca- ike@simplot:com address of Authorized Representative

2 j [E) SUMMARY END PROOUCT OATA'SCHEDUlE WITH,COMMERCIAl PRICING' I'ROOUCT:Oeliydrated Potatoes,Quote '1002 THIS iran or'!l.i!,als~~mtiry S,OIEPUU! 1J':Il SS '?i ~!,I).~ElOW: o '1cf'<ct. Ch."'1I; 1ft fcfltlucith:m o. ~diu'an'ipi~h.lki«l,' d (Crie'.tI~ Informatlh;fCertifled as Accurate.frOm A~Pl'Oved EPOS!roqulro. "gname from agenc'l:'ihat appp~.d lii>c)s). PRO~ESSOR NAlliiE:J:R. SlmploiCompany }J'!Ilue~~.; o nlfet:is.a~. 'l&j. AefuM: 10 ~fc~ht..,t ~ ~ ',00:. N.el f'k~,~"~r:c~t..~i~~~b~~~~. 111<,qr Sfrwlc.lWlcd by 'l1k.nott: o f.~!":f~!i';~1u r~~'i~d b :QI\trl~lorl.(~~y (~If. 'Codf~ Ptodij~t ~ "I t)c\t1l'ptto~.n~tw!.h1.j s.:1vtn,. Per' ( comm~iiy codfi.n1 sho;n Tftlf) PetCit.co ~~~~~ ~l"~i.~ ~====~==~~~~==~~==~~~~~ SImpiot Traditions wit~vitamin CAdded Mashed Potatoes (12/26 'ozl '984: INTO OEHY PRO':BUlK' ,--- _... ~ ISlmplot Traditions.Low Sodium Mashed Potatoes I :1271 POTATO F.OR PROCESS'IIIITO DEHY PRO:SULK 95.63'.....:...:.P.:.R::O:,;C::E::S::S::O:;, ;,;R.;..:..;...,i I/~V p<i;rducu.,ap(c1lu<.o,. ~",<rid".i.u'.nd,mot~.d 'r.~h wolb. sl... Na~a~~~~ny J:R: Simplot 'Company APPROVAL: Caldwell County'School!,"ChlldNulrllloil PrOgram',, Nlma,rir"Company,,Guy Garner,Olrector, 'Name and Title of A~tho,b:ed A:eptosGl1tatiwe. By. niy,slgn<it(mij certify. tliat I'have rcad pages'},13 an'dagree,with all items In 'Quote Document: toi'li;baca eike@simplot.com' E Maii address of Authorized Representative Sien.tu~e Slcntd II

3 1" '..;;'.<."{, ';';"':~";''''':;'S''EP'DS".,.;.,::" -":~~$;':'", A'".v ",.."1:.' ",',r; "~ '-,::-c.-".-~:<,,,,}.,. ",~>. ~... "'"...>'..~,., ~" SUMMARY END PRODUCT DATA SCHEDULE 1 ;"'.' >;;;', ~:,SIMP,L'(~T;:fiZ~~;'~':':;";id VALUE PASS THROUGH SYSTEMS APPROVED: National Summary (EPOS approvad by USDA) THIS IS AN ORIGINAL SUMMARY SCHEDULE UNLESS CHECKED BELOW: o Direct Sale o ::state ::summary o Reflects Change in Formulation (/talic) Refund to Recipient Agency o (EPOS approved by slate agency) (2) Additional Products Listed ::.9fi';: o Correction o End Product Code & Description Information Certified as Accurate from Approved EPDS (requires signature from agency that approved EPDS) Net weight WRSCM (ozl WBSCM Description DF Inventory Produced" pound of DF Value of DF per (F x HI Net Price Through Distributor Fee for Service (billed by Processor Fee for Service (billed by Distributor Certified by A B C D E F G H I J K RoastWorks Roasted Potato Medley RoastWorks Whole Baby Bakers Infinity 3/8" Crinke Cut Infinity 3/8" Straight Cut JR Buffalo Sticks Tater Gems Savory 8-Cut Crinkle Wedge , Jiffi Crisp 114" Shoestring 27, , Jiffi Crisp 5/16" Straight Cui , Jiffi Crisp 112" Crinkle Cut Oven Roasted 112" Crinkle Cut Oven Roasted 10-<:ut Crinkle Cui Wedae Simply Gold 3/8" SC Oven Sensations 1/2" Crinkle Cut Thunder Crunch 3/8" SC Infinity 112" Crinkle Cut Conquest Loop 114" Skin-Off Simply Gold 5/16" SC Conquest 5/16" Straight Cut Conquest 3/8" SC Skin-on Conquest Sidewinder JR Buffalo Sidewinder Smokey BBO Sidewinder Tater Pals Oven 112" Crinkle Cut Tater Pals Oven 114" Shoe String Skincredibles Potato Chip , No $ $ No $0,1018 $5,55 54,55 No $0,1018 $ ,10 No $ $ No $ $4.44,~ ACOA 10/04 J. R. Simplot 1/26/2016 Page 1 of 4

4 Information Certified as Accurate from Approved EPDS (requires signature from agency that approved EPDS) Certified by End Product Code & Description WRSCM (oz) WBSCM Description OF Inventory Produced" pound of OF Value of OF per (F x H) A B C 0 E F G H I J K Skincredibles Lattice Cut Skincredibles 10-Cut Wedge Skincredibles 8-Cut Wedge Skincredibles Loops Blue Ribbon 3/8 Straight Cut NW Shield Blue Ribbon 1/2" Crinkle Cut NW Shield Blue Ribbon 3/8" Straight Cut Blue Ribbon 112" Crinkle Cut Tri-Taters Tiny Triangles Spudster Original Butter Flavor Skicredibles Chunks Tater Sticks Tater Bucks 's Hash Brown Patty Blue Ribbon 5/15" Straight Cut Blue Ribbon 5/16" x 3/8" Siraight Cut Blue Ribbon 114" Shoestring Blue Ribbon 114" Shoestring Infinity 5/16" X 3/8" Straight cut Infinity 10-Cut Wedge Infinity 1/4" Shoestring Savory Loops Savory 3/8" Straight Cut Conquest 3/8" Straight Cut Jiffi Crisp 3/8" Straight Cut Krunchie Wedges 8-Cut Conquest 5/16" x 3/8" Straight Cut / Skin-On Savory 5/16" Straight Cut " Sour Cream and Chive 3/8" x 5/16" Strajght Cut NatrualCrisp 5/16" x 3/8" Straight cut No $ $3.70 ~~ ACDA 10/ /2016 Pago 2 of 4 J.R. Simplot

5 Information Certified as Accurate from Approved EPDS (requires signature from agency that approved EPDS) Certified by End Product Code & Description WRSCM (oz) WIISCM Description OF Inventory Produced" pound of OF Value of OF per (F x H) A B C 0 E F G H I J K I NaturalCrisp 1/4" Shoestring Batter Bites Savory 1 O-Cut Wedge Sour Cream and Chive 10-cut Wedge ,~~easoned Crisp Fiesta Wedge 10. ~ ;...,, Cut Savory 8-C ut Wedge Savory Lattice Cut JR Buffalos Slices Conquest 1/4" Shoestring RoastWorks Yukon Gold & Redskin Potatoes RoastWorks Rosemary Redskin RoastWorks Redskin Halves RoastWorks Unseasoned Redskin Chunks RoastWorks Herb & Garlic Russets i,~'.:,;'.: : "...:,-,.j. ~>;:"~(;:,:~.",,,;:7;.",::~J:~i. : " ~;::{:Y::~t,~j' ~~;~!~;i;j.:t:;%t;~;;:;';{1~}sweet,pojatoes '~: ;:.; ;.".' ~'",;. " ;. ;.,::': "..,./,:,.' '.','c """.. Simp lot Sweets Sweet Potato Fries Crinkle Cut FRESH PROC Simp lot Sweets Sweet Potato Gems FRESH PROC RoastWorks Sweet Potato Unseason ina Chunk FRESH PROC Simplot Sweets Sweet Potato 1/2" Crinkle Cut FRESH PROC Simplot Sweets Sweet Potato Lattice Cut FRESH PROC Simp lot Sweets Sweet Potato Cut Wedae FRESH PROC Simplot Sweets Sweet Potato %/16 SC wnanilia SUQar FRESH PROC RoastWorks Sweet Potato No $ $6.86,~;.;,<....,,f<,,;: ':;~;:,,:,:;;;,?),:~~:,?-t~;{~;j;;;::<' wlmaple seasoning FRESH PROC I;i: ~,/::/" i;\y>'c~:,;. >.::;c""\ l~;:' :~ ;:; :\"'t~::~:>;;:t$;1!t:~:i~;m;;;';~~:f~ilftn ilpi;!iiyp~'ii;d;~:oiatqe.$:;j;:;;,:~y ;;,:/;\<" t;;~,;~;;~<;~~<,:~, f ;;;/: «J~r<JK(,r~;:!~;i~:~~;;Y<_ Simplot Traditions Mashed Potatoes (50 lb. bag) Simp lot Traditions Mashed Polatoes (12/26 oz) Simp lot Traditions with Vitamin C Added Mashed Potatoes (12/ oz) Simp lot Traditions Hash Brown Potato Shreds (6/2.125Ib) Simplot Traditions Mashed Potatoes (Gable Top Carton) No $ $14.80 No $ $5.77 No $ $5.77 No $ $3.77 No $ $5.75 -D ACDA J.R. Simplot Page 3 of 4

6 Information Certified as Accurate from Approved EPDS (requires signature from agency that approved EPDS) Certified by End Product Code & Descrtptton WRSCM (oz) WRSCM Description OF Inventory Produced' pound of OF Value of OF per (F x H) A B C 0 E F G H I J K Simplot Traditions Simply Reds Mashed Potatoes Simplot Traditions Mashed Potatoes (24/13 oz) Simplot Tradilions Sliced Potaloes Simplot Traditions AuGratin Potato Casserole ( z) Simp lot Traditions Scalloped Potato Casserole (12/20.350z) Simplot Traditions No Sail Added Mashed Potatoes Simplot Traditions Low Sodium Mashed Potatoes Simplot Legacy Mashed Polatoes True Recipe Granules Complete with Vit C ( # Cans) ZGTF True Recipe Granules Plain with Vit C (6-13# cans) ZGTF 'If by products are produced, provide value and method credit will be given No $ $ No $ $ No $ $ No $ $ No $ $ No $ $ No $ $ No $ $ No $ $ No $ $10.66 PROCESSOR: USDA APPROVAL: STATE AGENCY APPROVAL: not aoolicable for state summa JR SIMPLOT COMPANY Name of Company Brian Wells - Director Potato Marketing Name and Tille of Authorized Representative FNS FDD HQ Name of Approving Agency Name of Approving Agency Name and Title of Authorized Representative 7...)-6 dt~ 1217/ /2015 Signature Signed Signed Signature Signed.~.. ACDA '0/ /20'6 Page 4 of 4 J.R. Simplot