Order Form Florida DOC Fall/Winter Ordering Dates: September 27 - October 27, 2017 Please complete all info on reverse (print clearly).

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1 NON-TAXABLE ITEMS The Whole Shabang 2 oz. Extreme Cheese Crunchy K H $0.96 / EA DRINKS Coffee Keefe 3 oz. 100% Colombian Coffee K H C R S $4.79 / EA 7022 Maxwell House 4 oz. Select Roast Coffee Pouch K H C R $5.50 / EA 2974 FOOD & SNACKS Cereal & Cereal Bars Golden Valley 1.3 oz. Strawberry Cereal Bar K $0.55 / EA 6045 Toaster Pastries Kellogg s 3.5 oz. Brown Sugar Cinnamon Pop Tarts (2 Pk.) $0.99 / EA Snacks & Nuts Corn Nuts 1.4 oz. Chile Picante Con Limon Crunch Corn Snack $1.10 / EA Kar s 2 oz. All Energy Trail Mix K $1.26 / EA 5866 Kellogg s 2.1 oz. Rice Krispie Treats Blasted with M&M s $1.50 / EA Kings Nut 3.25 oz. Roasted & Salted Sunflower Kernels K H G S $1.15 / EA Moon Lodge 1.75 oz. Hot, Hot, Hot! Peanuts K C G $0.70 / EA 7551 Moon Lodge 1.75 oz. Salted Peanuts K C G $0.70 / EA 7550 Kellogg s 3.5 oz. Frosted Blueberry Pop-Tarts (2 Pk.) $0.99 / EA Snyder s 2.25 oz. Hot Buffalo Wing Pretzel Pieces K $1.25 / EA 6108 Kellogg s 3.5 oz. Frosted Strawberry Pop-Tarts (2 Pk.) $0.99 / EA Snyder s 2.25 oz. Jalapeno Pretzel Pieces K $1.25 / EA 2299 Pastries & Snack Cakes The Whole Shabang 1.75 oz. Peanuts K H C $0.75 / EA Hostess 2.55 oz. Ding Dongs (2 Pk.) $1.45 / EA The Whole Shabang 6 oz. Snack Mix K H C $2.55 / EA Hostess 2.7 oz. Chocolate Twinkie Cake (2 Pk.) $1.35 / EA Hostess 2.7 oz. Twinkies (2 Pk.) $1.35 / EA Hostess 3.17 oz. Chocolate CupCakes (2 Pk.) $1.30 / EA Market Square Bakery 16 oz. Oatmeal Creme Pies (12 Pk.) K $3.20 / BX 6053 Crackers Austin 1.38 oz. Cheese on Cheese Sandwich Crackers (8 Pk.) K $3.90 / BX Austin 1.38 oz. Peanut Butter on Cheese Sandwich Crackers (8 Pk.) K $3.90 / BX Chips Austin 1.45 oz. Peanut Butter & Jelly Crackers (8 Pk.) K $3.90 / BX Cheetos 2 oz. Cheese Crunchy C G $1.05 / EA 7689 Cheez-It 1.5 oz. Cheddar Crackers K $0.90 / EA 9590 Doritos 1.75 oz. Cool Ranch Chips $1.08 / EA Keebler.49 oz. Original Grahams (2 Ct.) K $0.25 / EA 117 Doritos 1.75 oz. Nacho Cheese Chips $0.82 / EA Keebler 5.25 oz. Club Crackers $2.95 / EA Fritos 2 oz. Chili Cheese Corn Chips $0.85 / EA Moon Lodge 1.5 oz. Buffalo Wing Blue Cheese Potato Chips K H $0.90 / EA Nabisco Ritz 1.38 oz. Sandwich Crackers with Peanut Butter K C Cookies $0.66 / EA 4492 Moon Lodge 1.5 oz. Hot!Hot!Hot! Barbeque Chips K H $0.85 / EA 6026 Market Square Bakery 6 oz. Chocolate Chip Cookies K H C $1.10 / EA 6072 Moon Lodge 1.5 oz. Sour Cream and Onion Potato Chips K H S $0.85 / EA 6024 Market Square Bakery 6 oz. Duplex Creme Cookies K H C $1.10 / EA The Whole Shabang 1.5 oz. Extreme Ripple Potato Chips K H $0.85 / EA The Whole Shabang 1.5 oz. Potato Chips K H $0.85 / EA 6025 Market Square Bakery 6 oz. Orange Pineapple Creme Cookies K H C $1.10 / EA 10056

2 Market Square Bakery 6 oz. Peanut Butter Creme Cookies K H C $1.10 / EA Fresh Catch 3.53 oz. Salmon Flakes in Water K H G $2.35 / EA 4391 Market Square Bakery 6 oz. Vanilla Creme Cookies K H C $1.10 / EA Fresh Catch 3.53 oz. Sardines in Soybean Oil K H G $1.45 / EA 4388 Condiments & Spreads Fresh Catch 3.53 oz. Smoked Baby Clams H G $2.65 / EA 4389 Squeez-Ums.15 oz. Mustard (12 Pk.) K H G $1.00 / STR 6513 Fresh Catch 3.53 oz. Smoked Oysters in Cottonseed Oil H G $2.95 / EA 4392 Squeez-Ums.31 oz. Ketchup (12 Pk.) K H G $1.00 / STR 6514 Fresh Catch 4.23 oz. Chunk Light Tuna in Water K H G $1.97 / EA 4317 Pickles Ready-To-Eat Meals Van Holten s 9.6 oz. Dill Pickle K C G S $1.15 / EA 381 Brushy Creek oz. Chili No Beans $3.00 / EA 1710 Van Holten s 9.6 oz. Hot & Spicy Pickle K C G $1.15 / EA 383 Brushy Creek oz. Chili with Beans G $3.00 / EA 1711 Van Holten s 9.6 oz. Zesty Garlic Pickle K H C G S $1.15 / EA 382 Brushy Creek 5 oz. Chicken Vienna Sausage G S $2.40 / EA Cheese Brushy Creek 5 oz. Hot Chicken Vienna Sausage $2.40 / EA Philly 2 oz. Cream Cheese w/jalapenos $1.10 / EA Brushy Creek 5 oz. Jerk Pork G S $5.65 / EA 6300 Velveeta 2 oz. Jalapeno Spread G $0.70 / EA 7738 Brushy Creek 6 oz. Spicy Seasoned Beef Crumbles H $5.15 / EA 4917 Velveeta 2 oz. Sharp Cheddar Spread G $0.70 / EA 7739 Brushy Creek 7 oz. Chunk Ham with Natural Juices $5.50 / EA Meat Snacks Bridgford 3.5 oz. Chorizos G $4.05 / EA 7906 Brushy Creek 8 oz. Chicken Chili w/white Beans $3.11 / EA Hormel 2.5 oz. Spam Single G S $3.00 / EA Bridgford 3.5 oz. Sliced Pepperoni G $4.35 / EA 7905 Rice & Beans Brushy Creek oz. Hot Summer Sausage G $1.45 / EA Sevilla 4.4 oz. HOT Chili Flavor Refried Beans & Rice K H C $1.50 / EA 5940 Brushy Creek 5 oz. Hot Beef Summer Sausage G S $3.83 / EA Ramen Maruchan 3 oz. Cajun Chicken Flavor Ramen C $0.58 / EA 18 Brushy Creek 5 oz. Hot Summer Sausage Made with Beef and Chicken G $3.83 / EA Maruchan 3 oz. Chili Flavor Ramen C $0.58 / EA 10 Brushy Creek 5 oz. Original Summer Sausage Made with Beef and Chicken G $3.83 / EA Maruchan 3 oz. Lime Chili with Shrimp Flavor Ramen C $0.58 / EA 1347 Brushy Creek 5 oz. Turkey Summer Sausage Honey Brown Sugar G $3.83 / EA Maruchan 3 oz. Low Sodium Beef Ramen C $0.63 / EA 6645 Maruchan 3 oz. Low Sodium Chicken Flavor Ramen C $0.63 / EA 6644 Seafood Fresh Catch 3.53 oz. Fillets of Mackerel in Soybean Oil K H G $1.59 / EA 4385 Maruchan 3 oz. Low Sodium Chili Flavor Ramen C $0.63 / EA 6646 Fresh Catch 3.53 oz. Fish Steaks in Louisiana Hot Sauce K H G $1.30 / EA 4397 Maruchan 3 oz. Low Sodium Hot & Spicy Vegetable Flavor Ramen $0.63 / EA Fresh Catch 3.53 oz. Mackerel in Sriracha Hot Chili Sauce K H G S $1.35 / EA 9703 Maruchan 3 oz. Roast Beef Flavor Ramen C $0.58 / EA 1328

3 Maruchan 3 oz. Roast Chicken Flavor Ramen C $0.58 / EA 1327 Skin Care Pharmaceuticals Chap-Et.16 oz. Lip Conditioner LIP BALM LIMIT 1 $1.15 / EA Advil Single Pack (2 tablets) ADVIL LIMIT 21 $1.00 / EA Dial 12 oz. Advanced Therapy Lotion MOISTURIZER LIMIT 1 $4.10 / EA Bayer Aspirin Tablets (2 tablets) ASPRIN LIMIT 42 $1.00 / EA GoodSense 4 oz. SPF 30 Sunscreen Lotion MOISTURIZER LIMIT 1 $4.65 / EA Halls Cherry Flavored Cough Drops (9 Ct.) COUGH DROP LIMIT 4 $1.30 / EA Infuzed Island Naturals 15 oz. Body Lotion Cocoa & Shea Butter MOISTURIZER LIMIT 1 $2.25 / EA Halls Mentholyptus Flavor Cough Drops (9 Ct.) COUGH DROP LIMIT 4 $1.30 / EA NewDay 13 oz. Bath & Shower Powder BATH & SHOWER POWDER LIMIT 1 $1.90 / EA Nasal Spray (Saline; moisturizing) NASAL SPRAY LIMIT 2 $3.00 / EA Tone 12 oz. Cocoa Butter Lotion MOISTURIZER LIMIT 1 $4.80 / EA Tylenol Extra Strength (2 tablets) TYLENOL LIMIT 21 TAXABLE ITEMS Candy $1.00 / EA Chewy Lemonhead 4 oz. - Redrific $1.40 / EA Personal Care Trim Nail Clipper (no file) NAIL CLIPPER LIMIT 1 Deodorant Power-Up 3 oz. Force Clear Roll On A/P Deodorant DEODORANT LIMIT 2 $0.35 / EA $2.49 / EA Sathers 4 oz. Sour Neon Worms $1.40 / EA Dental Care Sour Patch 3 oz. Gummi Watermelon Candy C $1.62 / EA Colgate 2.5 oz. Great Flavor Anticavity Toothpaste TOOTHPASTE LIMIT 2 Colgate 2.5 oz. Tarter Control Whitening Toothpaste TOOTHPASTE LIMIT 2 $2.00 / EA $2.00 / EA HEALTH & BEAUTY Body Wash & Soap Dial 3.5 oz. Soap (1 Bar) Elementz 15 oz. 3 in 1 Coconut Lime Hair & Body Wash Next 1-5 oz. Anti-bacterial Sport Soap (1 Bar) C Next 1-5 oz. Cocoa Butter Soap (1 Bar) C Next 1-5 oz. Moisturizing Soap (1 Bar) C Hair Care Elementz 15 oz. Hydrating Conditioner Almond/Shea CONDITIONER LIMIT 2 Military Style Brush HAIRBRUSH LIMIT 1 Softee 13.5 oz. 3 in 1 Conditioning Shampoo CONDITIONER LIMIT 2 Suave 12 oz. Daily Clarifying Shampoo SHAMPOO LIMIT 2 Suave 12 oz. Juicy Green Apple Shampoo SHAMPOO LIMIT 2 $1.05 / EA $2.50 / EA $0.85 / EA $0.77 / EA $0.93 / EA $2.15 / EA $1.85 / EA $5.20 / EA $2.25 / EA $2.25 / EA Oraline 4 in. Security Flex Crossover Toothbrush TOOTHBRUSH LIMIT 1 Percara 8 oz. Oral Health Rinse MOUTHWASH LIMIT 1 $0.60 / EA $1.20 / EA White Toothbrush Cap (*toothbrush not included) $0.25 / EA CLOTHING Sweats Gildan Sweatshirt - Gray Small, SWEATSHIRT LIMIT 2 Gildan Sweatshirt - Gray 2XL, 3XL SWEATSHIRT LIMIT 2 Russell Sweatshirt - Gray Small, SWEATSHIRT LIMIT 2 Russell Sweatshirt - Gray 2XL, 3XL, 4XL SWEATSHIRT LIMIT 2 Men s T-Shirts Andrew Scott Select Crewneck T-Shirt - White (3 Pk.) Small, Andrew Scott Select Crewneck T-Shirt - White (3 Pk.) 2XL Andrew Scott Select Crewneck T-Shirt - White (3 Pk.) 3XL $10.00 / EA $12.00 / EA $13.20 / EA $15.60 / EA $12.50 / PK $13.50 / PK $14.50 / PK

4 Hanes Tagless Crew Neck T-Shirt - White (3 Pk.) Small, Pro Club Heavyweight Crew T-Shirt - White Small, Medium, Pro Club Heavyweight Crew T-Shirt - White 2XL, 3XL Pro Club Heavyweight Crew T-Shirt - White 4XL, 5XL Pro Club Heavyweight Crew T-Shirt - White 7XL Pro Club Short Sleeve Crewneck T-Shirt - White Small, Medium, Pro Club Short Sleeve Crewneck T-Shirt - White 2XL, 3XL Pro Club Short Sleeve Crewneck T-Shirt - White 4XL, 5XL Pro Club Short Sleeve Crewneck T-Shirt - White 7XL Women s T-Shirts Fruit of the Loom T-Shirt - Gray Small, Fruit of the Loom T-Shirt - Gray 2XL Fruit of the Loom T-Shirt - Gray 3XL Pro Club Heavyweight Gray T-Shirt - Gray Pro Club Heavyweight Gray T-Shirt - Gray 2XL, 3XL Pro Club Heavyweight Gray T-Shirt - Gray 4XL, 5XL $10.95 / PK $5.95 / EA $8.25 / EA $10.50 / EA $12.85 / EA $4.20 / EA $6.15 / EA $8.15 / EA $9.15 / EA $4.50 / EA $6.38 / EA $7.01 / EA $5.95 / EA $8.25 / EA $10.50 / EA Badger 11 Inseam Mesh Shorts - Navy 4XL Russell 9 Nylon Tricott Mesh Shorts - Navy Small, Medium, Russell 9 Nylon Tricott Mesh Shorts - Navy 2XL, 3XL Russell 9 Nylon Tricott Mesh Shorts - Navy 4XL, 5XL, 6XL Men s Underwear Andrew Scott Men s Boxers - White (1 Pk.) Small, Medium, UNDERSHORTS LIMIT 4 Andrew Scott Men s Boxers - White (1 Pk.) 2XL, 3XL, 4XL, 5XL, 6XL UNDERSHORTS LIMIT 4 Women s Underwear Fruit of the Loom Hi-Cut Briefs - White (3 Pk.) 5, 6, 7, 8, 9, 10 PANTIES LIMIT 7 Hanes Her Way Cotton Briefs - White (3 Pk.) 6, 7, 8, 9, 10 PANTIES LIMIT 7 Hanes Her Way Cotton Briefs - White (3 Pk.) 11, 12 PANTIES LIMIT 7 Women s Bras Bestform Bra - White 36 C, 38 B, 38 C, 38 D, 40 B, 40 D, 42 B, 44 C BRA LIMIT 4 Champion Sports Bra (White) Small, ATHLETIC BRA LIMIT 1 Mighty Hugs Ladies Bra (White) 32B, 32C, 34B, 34C, 34D, 36B, 36C, 36D, 38B, 38C, 38D, 40B, 40C, 40D, 42A, 42B, 42C, 42D, 44B, 44C, 44D, 46B, 46C, 46D, 48B, 48C, 48D BRA LIMIT 4 Men s Thermals $25.00 / EA $17.50 / EA $20.00 / EA $25.00 / EA $3.00 / EA $5.25 / EA $8.50 / PK $7.40 / PK $7.99 / PK $12.00 / EA $20.00 / EA $7.47 / EA Pro Club Heavyweight Gray T-Shirt - Gray 7XL Pro Club Short Sleeve Crewneck T-Shirt - Gray Small, Medium, Pro Club Short Sleeve Crewneck T-Shirt - Gray 2XL, 3XL Pro Club Short Sleeve Crewneck T-Shirt - Gray 4XL, 5XL Russell Basic T-shirt - Gray Small, Medium, Large, X-Large, 2XL, 3XL, 4XL Shorts Badger 11 Inseam Mesh Shorts - Navy Small, Medium, Large, XL Badger 11 Inseam Mesh Shorts - Navy 2XL, 3XL $12.85 / EA $4.20 / EA $6.15 / EA $8.15 / EA $5.99 / EA $17.50 / EA $20.00 / EA Indera Mills Thermal Ankle-Length Drawers - Natural Small, Indera Mills Thermal Ankle-Length Drawers - Natural 2XL, 3XL, 4XL, 5XL, 6XL Indera Mills Thermal Long Sleeve Shirt - Natural Small, Indera Mills Thermal Long Sleeve Shirt - Natural 2XL, 3XL, 4XL, 5XL, 6XL Women s Thermals Indera Mills Women s Thermal Drawers - White Small, Medium, Indera Mills Women s Thermal Drawers - White 2XL $6.30 / EA $9.00 / EA $6.30 / EA $9.00 / EA $6.00 / EA $6.50 / EA

5 Indera Mills Women s Thermal Long Sleeve Shirt - White Small, Indera Mills Women s Thermal Long Sleeve Shirt - White 2XL Socks No-Show Socks - White - (1 Pair) SOCKS LIMIT 6 Soft Touch Deluxe Crew Socks (1 Pair) SOCKS LIMIT 6 Tube Socks - White (1 Pair) SOCKS LIMIT 6 SHOES Men s Shoes New Balance MX608V4W Cross Training Shoes 7, 7 4E, 7.5, 7.5 4E, 8, 8 4E, 8.5, 8.5 4E, 9, 9 4E, 9.5, 9.5 4E, 10, 10 4E, 10.5, E, 11, 11 4E, 11.5, E, 12, 12 4E, 12.5, E, 13, 13 4E, 14, 14 4E, 15, 15 4E, 16, 16 4E SHOES LIMIT 1 New Balance MX608V4W Cross Training Shoes 17, 17 4E, 18, 18 4E SHOES LIMIT 1 Reebok Classic Leather Running Shoes 6.5, 7, 7.5, 8, 8.5, 9, 9.5, 10, 10.5, 11, 11.5, 12, 13, 14, 15 SHOES LIMIT 1 Boots Leather Boot (Black) 4, 4.5, 5, 5.5, 6, 6.5, 7, 7.5, 8, 8.5, 9, 9.5, 10, 10.5, 11, 11.5, 12, 12.5, 13, 13.5, 14, 15, 16, 17, 18, 19 BOOTS LIMIT 1 $6.00 / EA $6.50 / EA $1.35 / EA $1.15 / EA $1.35 / EA $68.00 / EA $70.00 / EA $68.00 / EA $42.65 / EA Wayferer Sunglasses SUNGLASSES LIMIT 1 Stationery Bic Round Stick (Black) PEN LIMIT 4 Bic Round Stick (Blue) PEN LIMIT 4 Photo Album 20 Pages (10 Sheets) PHOTO ALBUM LIMIT 1 Wireless Notebook 10.5 X 8 (80 Ct.) PAPER LIMIT 2 Games Aviator - US Playing Cards PLAYING CARDS LIMIT 2 Aviator Pinochle US Playing Cards PLAYING CARDS LIMIT 2 Miscellaneous Cereal Bowl w/lid 24 oz. BOWL LIMIT 1 Charmin Toilet Paper Single Roll TOILET PAPER LIMIT 1 Sharkeyes Reading Glasses 1, 1.25, 1.5, 1.75, 2, 2.25, 2.5, 2.75, 3, 3.25 EYEGLASSES LIMIT 2 Single Handkerchief 16 x 16 HANDKERCHIEF LIMIT 4 $6.00 / EA $0.20 / EA $0.20 / EA $2.50 / EA $2.25 / EA $2.50 / EA $2.50 / EA $1.00 / EA $1.05 / EA $4.95 / EA $1.00 / EA Sandals Cross Strap Sandals Small- #22602, Medium- #22603, Large- #22604, XL- #22615, 2XL- #24356 SHOWER SLIDES LIMIT 1 ELECTRONICS Earbuds & Headphones GPX Clear Earbuds C EARBUD LIMIT 1 JVC Gumy Plus White Earbuds EARBUD LIMIT 1 Koss CL-2 Clear Headphones C HEADPHONES LIMIT 1 Koss KE5K- 4 Earbuds EARBUD LIMIT 1 Koss PTX-6 Headphones HEADPHONES LIMIT 1 THE GENERAL STORE Sunglasses Keirto Sunglasses SUNGLASSES LIMIT 1 $1.75 / EA $2.00 / EA $15.80 / EA $8.00 / EA $5.00 / EA $13.50 / EA $6.75 / EA

6 SHIP TO: We cannot send orders from one inmate to another. SENDER: REQUIRED for order fulfillment. CALCULATE AMOUNT DUE: Inmate s Name ID# Sender s Name Taxable Items Subtotal: (items in taxable area) Handling Fee: + $4.95 Institution/Dorm/Housing# Street Address Taxable Items (items+handling fee) = City State Zip Calculate Sales Tax Street Address Phone Number Taxable Items : x Sales Tax Rate: (see tax chart) City State Zip PROGRAM DATES: Ordering Begins: September 27, 2017 Ordering Ends: October 27, 2017 Postmark date for mail orders: October 20, 2017 Orders must be received by: October 27, 2017 Delivery to facility: November 27, 2017 December 15, 2017 WAYS TO ORDER Online: flpackages.com Phone: Mail: Access Securepak (FL), Linpage 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. INMATE ELIGIBILITY: All inmates are eligible to receive a package except those with the following bed missions per FL DOC: AC/SOS, Close Management, Close Management I, Close Management II, Close Management III, CM/SOS, CSU-Crisis Stabilization Unit, Disciplinary Confinement, DC/SOS, Isolation-Medical, CMHI Unit Beds, CMHI/Beds, Maximum Management, CSU/TSU-Dual Usage, Reception/Orientation, Suicide Observation and TCU-Transitional Care Unit. The inmate s ability to receive a package will be verified before orders are shipped. PLEASE NOTE Inmates participating in the Department s Religious Diet Program (RDP) are not authorized to receive non-kosher food items from the Florida Food and Property Package Program. Access Securepak will restrict the ordering of non-kosher food items for inmates participating in the RDP Program. If a non-kosher item has been ordered for an inmate whose participation in the RDP started after the ordering period ended, the item will not be shipped and the customer will be refunded. Per the Department s regulation, inmates participating in the RDP who are found in possession of a non-kosher food item may be required to return the item at the inmate s expense. (You will receive confirmation s when the order is placed and shipped.) LIMITS: Multiple packages can be ordered; the inmate s total order cannot exceed the dollar limit of $ per vendor. Inmates may receive a $ package from each approved vendor. There is a minimum spending limit of $15.00 per order. All items have been approved by the Florida Department of Corrections. Inmates are not permitted to purchase packages for themselves or for other inmates. 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 flpackages.com website for the latest updates on this package program. In the event of missing or damaged item(s) a refund will be issued. CUSTOMER SERVICE: flpackages.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. Per Florida Dept. of Corrections, inmates may only possess the quantities of items specified in the F.A.C. policy. It is the inmate s responsibility to never possess more than those quantities allowed. Any items exceeding the inmate s limit will be disposed of at the inmate s expense, in accordance with the FL DOC rules and regulations. SALES TAX: Access Securepak is required by the state of Florida to collect sales tax on select food items, all property items and handling fees. Reference the tax chart provided noting the facility s tax rate. To figure sales tax amount take the subtotal and multiply it by the tax rate of the inmate s facility. Example: Apalachee East $63.52(subtotal) X 0.075(tax rate) = $4.45(tax total) $63.52(subtotal) + $4.45(tax total) = $67.97(total) Taxable Items Grand : ( Taxable Items + Sales Tax ) Non-Taxable Items Subtotal: Handling Fee: Non-Taxable Items Grand : AMOUNT DUE: ( Taxable Items Grand + Non-Taxable Items Grand ) SELECT PAYMENT METHOD: 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 Credit Card Number / Expiration Date Security Code + $4.95 (Only add this amount if you re NOT ordering taxable items) / / Today s Date mm/dd/yyyy Security code is last three digits of account number panel.

7 Facilty Name Zip Tax Rate Facility Name Zip Tax Rate Apalachee Correctional Institution East % LOWELL BOOT CAMP % Facilty Name Zip Tax Rate Facility Name Zip Tax Rate Dade Correctional Institution % Orlando Reception Release % Apalachee Correctional Institution West % Lowell Correctional Institution % Daytona Beach Community Release % Pensacola Community Release % Atlantic Community Release % Lowell Correctional Institution Annex % Desoto Annex % Pinellas Community Release % Avon Park Correctional Institution % Lowell Work Camp % Desoto Work Camp % Polk Correctional Institution % Avon Park Work Camp % Loxahatchee Road Prison % Everglades Correctional Institution % Polk Work Camp % Baker Correctional Institution % Madison Correctional Institution % Everglades Re-Entry % Putnam Correctional Institution % Baker Re Entry % Madison Work Camp % FL Women's Reception % Quincy Annex % Baker Work Camp % Marion Correctional Institution % Florida State Prison % Reception & Medical West % Calhoun Correctional Institution % Marion Work Camp % Florida State Prison West Unit % Reception and Medical % Calhoun Work Camp % Martin Correctional Institution % Central Florida Reception East % Martin Work Camp % Franklin Correctional Institution % Reception and Medical Work Camp % Franklin Work Camp % Sago Palm Work Camp % Central Florida Reception Main % Mayo Correctional Institution Annex % Ft. Myers Work Camp % Santa Rosa Annex % Central Florida Reception South % Mayo Work Camp % Ft. Pierce Community Release % Santa Rosa Correctional Institution % Century Correctional Institution % Miami North WRC % Gadsden Reentry % Santa Rosa Work Camp % Century Work Camp % New River Correctional Institution % Gainesville Work Camp % South Florida Reception % Charlotte Correctional Institution % Northwest Florida Reception % Graceville Work Camp % South Florida Reception - South % Columbia Correctional Institution % Northwest Florida Reception Annex % Gulf Correctional Institution % St. Petersburg Community Release % Columbia Correctional Institution Annex % Okaloosa Correctional Institution % Gulf Correctional Institution Annex % Sumter Annex % COLUMBIA WORK CAMP % Okaloosa Work Camp % Gulf Forestry Camp % Sumter Correctional Institution % Cross City Correctional Institution % Okeechobee Correctional Institution % Hamilton Correctional Institution % Sumter Work Camp % Cross City East Unit % Okeechobee Work Camp % Hamilton Correctional Institution Annex % Suwannee Correctional Institution % Cross City Work Camp % Opa Locka WRC % Hamilton Work Camp % Suwannee Correctional Institution Annex %

8 Facilty Name Zip Tax Rate Facility Name Zip Tax Rate Hardee Correctional Institution % Suwannee Work Camp % Hardee Work Camp % Tallahassee Community Release % Hernando Correctional Institution % Taylor Correctional Institution % Hollywood W.R.C % Taylor Correctional Institution Annex % Holmes Correctional Institution % Taylor Work Camp % Holmes Work Camp % Tomoka Correctional Institution % Homestead Correctional Institution % Tomoka Work Camp % Jackson Correctional Institution % Union Correctional Institution % Jackson Work Camp % New River Work Camp % Jefferson Correctional Institution % Wakulla Annex % Kissimmee Reception Release % Wakulla Correctional Institution % Lake Correctional Institution % Wakulla Work Camp % Lancaster Correctional Institution % Walton Correctional Institution % Lancaster Work Camp % Walton Work Camp % Largo Road Prison % West Palm Beach Community Release % Lawtey Correctional Institution % Zephyrhills Correctional Institution % Liberty Correctional Institution % Liberty South Work Camp %

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