GROCERY REQUEST ORDER FORM

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1 GROCERY REQUEST ORDER FORM If you have any questions about your order please contact us at: 844-JBS-TEAM or Please submit all completed grocery request forms to: MV Name: Company: ETA: MV Phone: Contact: PO#: Quantity Unit Item/Description Quantity Unit Item/Description MEATS BEEF LUNCH MEATS PORK Chuck Roast, Boneless Cube Steak Ground Beef Ground Chuck Rib-eye Steak Rolled Rump Roast Round Steak Short Ribs Sirloin Steak Skirt Steak Stew Meat, Boneless Swiss Steak T-Bone Steak Bologna Beef, Roast Chicken, Oven Roasted Chicken, Buffalo Corned Beef Ham, Honey Ham, Smoked Old Fashioned Pepperoni Salami, Genoa Salami, Hard Turkey, Butterball Turkey, Cajun Turkey, Loaf Turkey, Oven Roasted Turkey, Peppered Bacon POULTRY MISCELANEOUS MEATS JBS-AD0003 Revision Date: August 8, 2017 Page 1 of 8 Breakfast Sausage Links Breakfast Sausage Roll, Mild Breakfast Sausage Roll, Spicy Breakfast Sausage Patties Butt Roast, Boston Ham (boneless) Ham (bone in) Italian Sausage Italian Sausage, Ground Pork Chops Pork Cutlets Pork Hocks Pork Loin Roast Pork, Salted Pork Steak Ribs, Baby Back Ribs, Country Ribs, Spare Smoked Jowls Smoked Picnic Ham Capons Chicken Breast Chicken Legs Chicken Thighs Chicken Patties Chicken Wings Cornish Hens Fryers Turkeys Boiled Ham Bratwurst Brick Chili

2 MISCELANEOUS MEATS CONTINUED PRODUCE FRESH FRUITS VEGETABLES Lard Liverwurst Polish Sausage Smoked Sausage Spiced Ham Apples Avocado Bananas Blackberries Blueberries Cantaloupe Clementine Cranberries Grapes, Green Grapes, Red Grapefruit Kiwi Lemons Limes Nectarines Oranges Peaches Pears Pineapple Plums Raspberries Strawberries Watermelon Asparagus Beets Broccoli Brussel Sprouts Cabbage Carrots Cauliflower Celery Collard Greens Corn, Sweet Cucumbers Eggplant Garlic CANNED GOODS Green Beans Canned Hams Jalapenos JBS-AD0003 Revision Date: August 8, 2017 Page 2 of 8 Lettuce, Shredded Lettuce, Whole Head Onions, Green Onions, Red Onions, White Onions, Yellow Parsley Parsnips Pepper, Green Pepper, Orange Pepper, Red Pepper, Yellow Potatoes, Red Potatoes, Sweet Potatoes, White Potatoes, Yukon Radishes Spinach Squash, Acorn Squash, Butternut Squash, Green Squash, Yellow Tomato, Beefsteak Tomato, Cherry Tomato, Heirloom Tomato, Roma Tomatoes, On The Vine Turnip Greens Rutabagas Zucchini CANNED MEATS, HASH, & FISH Anchovies Corn Beef Hash Oysters Pork n Beans Red Salmon Roast Beef Hash Sardines Spam Tuna Vienna Sausage

3 FRUITS & FILLINGS VEGETABLES Apple, Pie Apple, Sliced Apple, Sauce Apricot, Halves Blueberries Blueberry, Pie Blackberries Blackberry, Pie Cherries Cherries, Maraschino Cherry, Pie Cranberry, Sauce Lemon, Pie Mandarin Oranges Peach, Pie Pumpkin, Pie Raisin, Pie Raspberries, Red Plums Peach, Halves Peach, Sliced Pear, Halves Pear, Sliced Pineapple, Chunks Pineapple, Crushed PACKAGED GOODS JBS-AD0003 Revision Date: August 8, 2017 Page 3 of 8 Mushrooms, Sliced Mushrooms, Whole Mustard Greens Peas CONDIMENTS & SAUCES Peas and Carrots Potatoes Sauerkraut Spinach Tomato Sauce Tomato Paste Tomato Puree Tomatoes, Diced Tomatoes, Rotel Tomatoes, Stewed Tomatoes, Whole Turnip Greens Water Chestnuts Yams A-1 Sauce Alfredo Sauce BBQ Banana Peppers Chili Sauce Pineapple, Sliced Heinz 57 Asparagus Blackeye Peas Bean Sprouts Beans, Butter Beans, Lima Beans, Wax Beets, sliced Carrots Corn, Creamed Corn, Golden Corn, White Chop Suey Vegetables Green Beans, cut Green Beans, French Green Beans, whole Hominy Mixed Vegetables Country Bob s Steak Jalapenos, Sliced Ketchup Liquid Smoke Molasses Mustard Olives, Black Olives, Green Pickles, Dill Pickles, Sweet Pickles, Whole Pimentos Prime Choice Red Hot Sauce Ragu Sauce Relish Soy Sauce Spaghetti Sauce Syrup, Hershey s Chocolate

4 CONDIMENTS & SAUCES OILS & DRESSINGS PRESERVES & JELLIES SOUPS & BROTHS Syrup, Hershey s Strawberry Syrup, Log Cabin Syrup, Mrs. Butterworth Tabasco Sauce Tartar Sauce Tiger Sauce Worcestershire Sauce Chicken Noodle Chili Beans, Hot Chili Mac Cream of Chicken JBS-AD0003 Revision Date: August 8, 2017 Page 4 of 8 Cream of Mushroom Cream of Potato Onion Soup Tomato Vegetable Beef 1000 Island MISCELANEOUS PACKAGED GOODS Blue Cheese Bacon Bits Cole Slaw Crisco Oil Crisco Shortening French Garlic Hellman s Mayo Italian Mayonnaise Mazola Oil Miracle Whip Olive Oil Pam Ranch Vinaigrette Vinegar, Cider Vinegar, White Wesson Oil Western Honey Jelly, Apple Jelly, Grape Jelly, Strawberry Peanut Butter Preserves, Blackberry Preserves, Cherry Preserves, Peach Preserves, Raspberry Preserves, Strawberry Beef Broth Cheddar Cheese Chicken Broth DRIED GOODS BAKING GOODS AuGratin Potato Mix Beef Stroganoff Mix Chili Mix Fajita Mix Instant Potato Mix Jello Knox Gelatin Macaroni and Cheese Marshmallows Pizza Mix Popcorn Pudding, Instant Pudding, Regular Scalloped Potato Mix Spaghetti Mix Taco Mix Tapioca Baking Powder Baking Soda Baker s Chocolate Butterscotch Chips Chocolate Chips Coconut Cornmeal, Self-Rising Cornmeal, White Cornmeal, Yellow Cornstarch Equal Flour Hershey Chocolate Marshmallow Crème Milk, Evaporated Pecans

5 BAKING GOODS CONTINUED BATTER MIXES Splenda Stevia Sugar, Brown Sugar, Grain. Sugar, Powder Sugar, White Sweet N Low Sweet-Ten Walnuts Angel Food Cake Mix Bisquick Blueberry Muffin Mix Brownie Mix Cheesecake Mix Chocolate Cake Mix Cornbread Mix Devil s Food Cake Mix Dream Whip Fish Fry Mix Fudge Brownie Mix Funfetti Cake Mix Hot Roll Mix Lemon Cake Muffin Mix Pancake Mix Pie Crust Mix Shake n Bake BBQ Shake n Bake Chicken Shake n Bake Pork White Cake Mix Yellow Cake Mix BREADS, CEREALS, & NOODLES Bread, French Bread, Italian Bread, Oatnut Bread, Raisin Bread, Rye Bread, Wheat, Honey Bread, Wheat, Whole Bread, White Cap n Crunch Cap n Crunch Berries Cheerios CRACKERS & SNACKS JBS-AD0003 Revision Date: August 8, 2017 Page 5 of 8 Chow Mien Noodles Cinnamon Toast Crunch Cocoa Puffs Corn Flakes Cream of Wheat Dinner Rolls Donuts Froot Loops Frosted Flakes Fruity Pebbles Grits Hamburger Buns Hot Dog Buns Noodles Oatmeal Oatmeal, Instant Raisin Bran Rice Krispies Rice, Brown Rice, Minute Rice, Long Grain Rice, White Shells Shredded Wheat Spaghetti Special K Special K w/ Berries Sweet Rolls Wheaties Chips Ahoy Chips, BBQ Chips, Cheddar Chips, Potato, Baked Chips, Potato, Reg Chips, Salt & Vinegar Chips, Sour Cream Chips, Tortilla Cookies, Assorted Cracker Meal French Fried Onions Graham Crackers Graham Cracker Crumbs Little Debbie s, Assorted Mixed Nuts

6 CRACKERS & SNACKS CONTINUED Oreos Pringles Ritz Crackers Saltines Town House Crackers Vanilla Wafers DRIED FRUITS & VEGETABLES SPICES Beans, Baby Lima Beans, Lima Beans, Navy Beans, Pinto Beans, Red Kidney Dates Peas, Split Peas, Blackeyed Prunes Raisins Accent Allspice Almond Extract Basil Leaves Bay Leaves Blackening Bouillon, Beef Bouillon, Chicken Celery Seeds Chili Powder Chili Seasoning Mix Cinnamon Cloves, Ground Cloves, Whole Cream of Tartar Crab Boil Creole Seasoning Croutons Curry Powder Dried Beef Dry Mustard Garlic Juice Garlic, Powder Garlic, Salt Ginger Gumbo File BEVERAGES REFRIDGERATED CHEESE Italian Seasoning Meat Tenderizer Nutmeg Onions, Minced Orange Extract Oregano Paprika Parsley Flakes Pepper, Black Pepper, Red Pepper, White Rum Extract JBS-AD0003 Revision Date: August 8, 2017 Page 6 of 8 Sage Salad Crispins Salt Salt, Celery Seasoning Pepper Seasoning Salt Spaghetti Sauce Mix Taco Seasoning Mix Thyme Vanilla Extract Coffeemate Community Coffee (if available) Dry Milk Foldger s Foldger s, Decaf. Hot Cocoa Mix Instant Tea Kool-Aide Lemonade Lipton Tea Bags Maxwell House Mr. Coffee Filters Taster s Choice Instant Tea Bags Soda Soda, Diet American Cheese, Loaf American Cheese, Sliced Brick, Cheddar, Mild Brick, Cheddar, Sharp

7 CHEESE CONTINUED JUICES MILK Brick, Colby & Monterey Jack Brick, Mozzarella Cheese Brick, Parmesan Cheese Brick, Pepper Jack Cheese Wiz Cottage Cheese Cream Cheese Longhorn Cheese Munster Cheese Shredded, Cheddar, Mild Shredded, Cheddar, Sharp Shredded, Cheddar Mix Shredded, Colby/Monterey Jack Shredded, Italian 5 Cheese Shredded, Mexican Style Shredded, Mozzarella Shredded, Pepper Jack Swiss Cheese Velveeta Apple Juice Cranberry Grape Grapefruit Hawaiian Punch Orange Juice Pineapple Real Lemon Strawberry-Banana Tomato MISCELANEOUS REFRIDGERATED FROZEN FOODS JBS-AD0003 Revision Date: August 8, 2017 Page 7 of 8 FISH Butter Eggs Horseradish Tortillas, 6 Corn Tortillas, 8 Corn Tortillas, 6 Flour Tortillas, 8 Flour Cookie Dough, Rolls Cookie Dough, Tub Hungry Jack Biscuits Margarine, Soft Margarine, Squeeze Margarine, Tub Pierogi s Pillsbury Biscuits Pillsbury Croissants Pillsbury Rolls Sour Cream Tortellini Whipped Cream Yeast, Dry Catfish Fillets Cod Fillets Crawfish Tails Oysters, Breaded Oysters, Fresh Perch, Fillets Shrimp, Breaded V-8 Shrimp, Green V-8 Fusion Sole, Fillets Almond Milk ICE CREAM Bars 1% Milk Butter Pecan 2% Milk Chocolate Butter Milk Chocolate Milk Half & Half Heavy Cream Lactate Skim Milk Soy Milk Whole Milk Chocolate Chip Coffee Cookie Dough Cookies & Cream Cones Mint Chocolate Chip Neapolitan Sandwiches

8 ICE CREAM CONTINUED VEGETABLES Sherbet Strawberry Vanilla Asparagus Broccoli Brussel Sprouts California Mixed Veggies Carrots Cauliflower Corn, Cut Corn on the Cob Green Beans Lima Beans Mixed Veggies Okra Peas Peas and Carrots Spinach Squash MISCELANEOUS FROZEN FOODS Biscuits Breaded Okra Breaded Squash Coffee Rich Cool Whip Corn Dogs Egg Beaters Egg Rolls French Fries Hash Browns Hot Pockets Jalapeno Poppers Mozzarella Sticks Onion Rings Pizza Rolls Pizza, Everything Pizza, Meat Lovers Pizza, Pepperoni Pizza, Sausage Pizza, Sausage and Pepperoni Pizza, Veggie Potatoes Skins Pierogi s OTHER ITEMS NOT LISTED ON THIS FORM CASH-ON-DELIVERY ITEMS (MUST CALL AHEAD TO CONFIRM) JBS-AD0003 Revision Date: August 8, 2017 Page 8 of 8

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