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

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Jonas Strickland
5 years ago
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1 DRINKS Coffee & Cappuccino Keefe 3 oz. 100% Colombian Coffee K H C R S $4.95 / EA 7022 Wyler s Light.13 oz. Singles To Go Lemonade SF Drink Mix (1 Pk.) K Wyler s Light.1 oz. SF Singles to Go Iced Tea w/lemon Drink Mix (1 Pk.) K $0.65 / EA $0.65 / EA Keefe 3 oz. Alturo Blend Coffee K H C R G $4.50 / EA Milk Keefe 3 oz. Colombian Blend Premium Coffee K H R $4.50 / EA Keefe 4 oz. Instant Coffee K H $4.75 / EA 21 Keefe 8 oz. French Vanilla Cappuccino K H C R $3.50 / EA 3701 Maxwell House 4 oz. Select Roast Coffee Pouch K H C R $5.75 / EA 2974 Nescafe 1.7 grams Taster s Choice Decaf. Stick K H G S $0.45 / EA 4452 Hot Cocoa Keefe.8 oz. Single Serve Hot Cocoa K G $0.50 / EA 114 Creamer Cafe Valet Creamer (10 Pk.) $0.85 / SP 1237 Sugar Sugar (10 Pk.) $0.65 / SP 2136 Drink Mixes Sweet Fusions.5 oz. Fruit Punch Drink Mix (1 Pk.) $0.35 / EA Paramount 10 oz. Instant Nonfat Dry Milk K H $4.50 / EA 6566 Soda & Water Bottled Water 16.9 oz. Clear Plastic $1.20 / EA Coke 20 oz. Plastic Bottle $1.69 / EA 2284 Diet Coke 20 oz. Plastic Bottle $1.69 / EA 2285 Faygo Orange Soda 20 oz. Plastic Bottle $1.29 / EA 6503 Sprite 20 oz. Soda Bottle $1.69 / EA 3118 FOOD & SNACKS Cereal Golden Valley 20 oz. Frosted Flakes Cereal K R $4.80 / EA Golden Valley Cereal 20 oz. Cinnamon Squares K R $4.80 / EA Golden Valley Cereal 20 oz. Fruit Rolls K R $4.80 / EA Golden Valley Cereal 20 oz. Honey Nut Toasted Oats K R $4.80 / EA Sweet Fusions.5 oz. Lemonade Drink Mix (1 Pk.) $0.35 / EA Cereal Bars Sweet Fusions.5 oz. Orange Breakfast Drink Mix (1 Pk.) $0.35 / EA Nature Valley 1.5 oz. Oats n Honey Granola Bar (1 Pk.) K $1.00 / EA 7167 Nature Valley 8.9 oz. Peanut Butter Granola Bars (12 Pk.) K $1.00 / EA 7166

2 Toaster Pastries Moon Lodge 1.5 oz. Regular Potato Chips K H $1.15 / EA 6022 Toast em Pop-Ups 11 oz. Brown Sugar Cinnamon (6 Pk.) $1.00 / EA 631 Moon Lodge 1.5 oz. Sour Cream and Onion Potato Chips K H S $1.15 / EA 6024 Toast em Pop-Ups 11 oz. Strawberry Pastries (6 Pk.) $1.00 / EA Moon Lodge 1.5 oz. Stuffed Jalapeno Potato Chips $1.15 / EA 7637 Pastries & Snack Cakes The Whole Shabang 1.5 oz. Potato Chips K H $1.15 / EA 6025 Chattanooga 2.75 oz. Banana Double Decker Moon Pie $0.90 / EA Popcorn Market Square Bakery 10 oz. Donut Stix (6 Pk.) K $3.30 / BX 6051 Act II 2.75 oz. Butter Microwave Popcorn $1.25 / EA 1730 Market Square Bakery 12 oz. Peanut Butter Wafers (6 Pk.) K $3.30 / BX 6052 Nuts Market Square Bakery 16 oz. Oatmeal Creme Pies (12 Pk.) K $3.30 / BX 6053 Moon Lodge 1.75 oz. Salted Peanuts K C G $0.90 / EA 7550 Market Square Bakery 4.75 oz. Mega Buneez K C $1.50 / EA 6044 Crackers Market Square Bakery 4 oz. Iced Cinnamon Roll K C $1.65 / EA 6057 Golden Valley 13.7 oz. Snack Crackers K $3.00 / BX Market Square Bakery 6 oz. Monster Iced Honey Bun K C $1.59 / EA 6043 Golden Valley 4.2 oz. Saltine Crackers (One Sleeve) K H $2.25 / EA 7914 Chips & Snacks Nabisco Ritz 1.35 oz. Sandwich Crackers with Cheese K C $0.75 / EA 4493 Cactus Annie s 1.5 oz. Hot & Spicy Corn Chips K H $0.85 / EA 7999 Nabisco Ritz 1.38 oz. Sandwich Crackers with Peanut Butter K C $0.75 / EA 4492 Cactus Annie s 10 oz. Nacho Cheese Tortilla Chips K H C G $3.50 / EA 911 Cookies Cheetos 1.75 oz. Flamin Hot Crunchy G $1.29 / EA 7690 Market Square Bakery 2.75 oz. Sugar Free Strawberry Creme Wafers K H $0.99 / EA 6069 Cheetos 2 oz. Cheese Crunchy C G $1.29 / EA 7689 Market Square Bakery 6 oz. Chocolate Chip Cookies K H C $1.50 / EA 6072 Doritos 1.75 oz. Nacho Cheese Chips $1.29 / EA Market Square Bakery 6 oz. Duplex Creme Cookies K H C $1.50 / EA Kar s 2 oz. All Energy Trail Mix K $1.15 / EA 5866 Market Square Bakery 6 oz. Iced Oatmeal Cookies K H $1.50 / EA 6071 Moon Lodge 1.5 oz. Hot!Hot!Hot! Barbeque Potato Chips K H $1.15 / EA 6026

3 Market Square Bakery 6 oz. Orange Pineapple Creme Cookies K H C $1.50 / EA Skittles 2.17 oz. Original G $1.40 / EA 984 Market Square Bakery 6 oz. Peanut Butter Creme Cookies K H C $1.50 / EA Snickers 1.86 oz. Candy Bar K $1.40 / EA Market Square Bakery 6 oz. Vanilla Creme Cookies K H C $1.50 / EA Candy Baby Ruth 2.1 oz. Bar K G $1.40 / EA 844 Jolly Rancher 3.7 oz. Assorted Flavors C $1.50 / EA Kit Kat 1.5 oz. Candy Bar K $1.40 / EA 5409 M&M s 1.69 oz. Plain Candy K $1.40 / EA M&M s 1.74 oz. Peanut Candy K G $1.40 / EA 955 Now & Later 3.25 oz. Assorted Candy $1.39 / EA Pay Day 1.85 oz. Candy Bar K $1.40 / EA 985 Zero 1.85 oz. Bar K $1.40 / EA 987 Sauces Cactus Annie s 11 oz. Regular Picante Sauce $2.90 / EA Condiments Squeez-Ums.15 oz. Mustard (12 Pk.) K H G $1.25 / STR 6513 Squeez-Ums.24 oz. Hot Sauce (12 Pk.) K H G $1.49 / STR 6517 Squeez-Ums.31 oz. Ketchup (12 Pk.) K H G $1.25 / STR 6514 Squeez-Ums.31 oz. Mayonnaise (12 Pk.) K H G $1.55 / STR 6510 Spreads Golden Harvest 12 oz. Honey $4.19 / EA Reese s 1.5 oz. Peanut Butter Cups K G $1.40 / EA 1949 Keefe Kitchens Grape Jelly 20 oz. Squeeze Bottle G S $3.40 / EA 7756 Sathers 3.75 oz. All Star Assorted Candies C $1.35 / EA Sathers 3.75 oz. Star Brites Mints $1.39 / EA Squeez-Ums 2.12 oz. Peanut Butter & Jelly Combo (1 ea.) K H G Spices & Seasonings $0.70 / EA 3787 Sathers 4.25 oz. Butterscotch Discs Candy $1.20 / EA Packets of Pepper $0.60 / EA 4609 Sathers 4.25 oz. Lemon Drops C $1.20 / EA Dixie Crystal Salt (50 Ct) $0.65 / PK 5520 Sathers 4.25 oz. Root Beer Barrels $1.20 / EA Sathers 4.25 oz. Sour Fruit Balls C $1.20 / EA Pickles Van Holten s 9.6 oz. Dill Pickle K C G S $1.50 / EA 381

4 Peppers Brushy Creek oz. Chili No Beans $3.50 / EA 1710 Titos.7 oz. Pickled Jalapeno Pepper Slices C G S $0.75 / EA 1590 Brushy Creek oz. Chili with Beans Hot! G $3.40 / EA 1712 Cheese Brushy Creek 6 oz. Spicy Seasoned Beef Crumbles H $4.00 / EA 4917 Velveeta 8 oz. Sharp Cheddar Cheese Snack Spread Tub C R G $3.10 / EA 9396 Rice Velveeta 8 oz. Spicy Jalapeno Cheese Snack Spread Tub C R G $3.10 / EA 9397 Keefe Kitchens 6.5 oz. Pre-Cooked Long Grain Brown Rice K C R G S $1.85 / EA 7525 Meat Snacks Bridgford 3.5 oz. Chorizos G $3.10 / EA 7906 Keefe Kitchens 8 oz. Pre-Cooked Long Grain Rice K C R G S $1.75 / EA 5880 Bridgford 3.5 oz. Sliced Pepperoni G $2.85 / EA 7905 Beans Sevilla 8 oz. Spicy Refried Beans K H C R $2.40 / EA 9771 Brushy Creek 5 oz. Hot Beef Summer Sausage G S $3.50 / EA Tortillas Brushy Creek 5 oz. Original Summer Sausage Made with Beef and Chicken G $3.50 / EA Cactus Annie s 8 oz. Flour Tortillas (6 Pk.) K H C R $1.95 / EA 5070 O Brien s 1.13 oz. Beef Sticks Hickory Smoked G $1.35 / EA 5379 Ramen Seafood Maruchan 3 oz. Beef Flavor Ramen C $0.65 / EA 9 Chicken of the Sea 3.53 oz. Smoked Oysters in Cottonseed Oil $2.75 / EA Maruchan 3 oz. Cajun Shrimp Flavor Ramen C $0.65 / EA 15 Fresh Catch 3.53 oz. Fillets of Mackerel in Soybean Oil K H G $2.50 / EA 4385 Maruchan 3 oz. Chicken Flavor Ramen C $0.65 / EA 8 Fresh Catch 3.53 oz. Fish Steaks in Louisiana Hot Sauce K H G $2.50 / EA 4397 Maruchan 3 oz. Chili Flavor Ramen C $0.65 / EA 10 Fresh Catch 3.53 oz. Sardines in Soybean Oil K H G $2.50 / EA 4388 Maruchan 3 oz. Hot & Spicy Vegetable Flavor Ramen C $0.65 / EA 505 Fresh Catch 4.23 oz. Chunk Light Tuna in Water K H G $3.20 / EA 4317 Noodles Ready-To-Eat Meals Cinch 7.25 oz. Macaroni & Cheese $1.50 / EA 764 Brushy Creek oz. Beef Stew G $3.75 / EA 1715 Velveeta 3 oz. Macaroni and Cheese K H C $1.60 / EA 4935

5 HEALTH & BEAUTY Next 1-5 oz. Moisturizing Soap (1 Bar) C $1.60 / EA Ethnic Hair Care Lotion Rikayah Protein 8 oz. Styling Gel C $2.90 / EA Crawford 4 oz. Cocoa Butter Lotion C $1.20 / EA Softee 5 oz. Bergamot Blue Hair Dress $3.00 / EA Crawford 4 oz. Skin Care Lotion C $1.20 / EA Softee 8 oz. Protein Gel $1.75 / EA Dawn 4 oz. Mist Baby Lotion $1.20 / EA Shampoo Skin Care Crawford 4 oz. Balsam & Protein Shampoo C $1.50 / EA Chap-Et.16 oz. Lip Conditioner $1.60 / EA Crawford 4 oz. Dandruff Shampoo C $1.50 / EA Freshscent 4 oz. Baby Oil $1.40 / EA Conditioner Heritage 3 oz. Medicated Anti-Fungal Powder $2.90 / EA Crawford 4 oz. Balsam & Protein Conditioner C $1.50 / EA Hydrocortisone Cream.5% (1 oz. Tube) $1.99 / EA Styling Products & Accessories Cardinal 9 in. Extra Heavy Comb $0.50 / EA NewDay 3.75 oz. Petroleum Jelly C $1.90 / EA Military Style Brush $3.00 / EA NewDay 4 oz. Baby Powder $2.00 / EA Palm Brush (Plastic) $0.75 / EA Noxzema 2 oz. Original Cream $3.95 / EA Body Wash Tolnaftate.5 oz. Antifungal Cream $1.90 / EA Freshscent 4 oz. All-In-One Body Wash $1.20 / EA Deodorant Soap Lady Speed Stick Invisible Dry 1.4 oz. Anti-Perspirant Shower Fresh $3.30 / EA Dial 4 oz. Antibacterial Translucent Soap (1 Bar) C $2.00 / EA Power-Up 2.5 oz. Clear Deodorant - Drive C $2.75 / EA Ivory 4 oz. Original Bar Soap (1 Bar) $2.00 / EA Power-Up 2 oz. A/P Deodorant - Bloom C $2.75 / EA Next 1-5 oz. Anti-bacterial Sport Soap (1 Bar) C $1.60 / EA 22098

6 Suave 1.4 oz. A/P Deodorant - Powder $3.30 / EA CLOTHING & ACCESSORIES Dental Care T-Shirts Cool Wave 4 oz. Fresh Mint Fluoride Toothpaste C $2.10 / EA Andrew Scott Crew Neck T-Shirt - White (1 Pk.) Small, Medium, Large, XL $3.75 / EA Dr. Sheffield s.33 oz. Oral Pain Relief $2.45 / EA Andrew Scott Crew Neck T-Shirt - White (1 Pk.) 2XL, 3XL, 4XL, 5XL, 6XL $4.75 / EA NWI Security Toothbrush $0.75 / EA Men s Underclothing Toothbrush 28 Tuft (3 row) $0.45 / EA Andrew Scott Men s Boxers - White (1 Pk.) Small, Medium, Large $2.90 / EA Shaving Products Afta 3 oz. Freshscent After Shave $3.65 / EA Pro-Tection 7 oz. Shave Cream $2.25 / EA Andrew Scott Men s Boxers - White (1 Pk.) XL, 2XL, 3XL, 4XL $3.90 / EA Socks Longer Tube Socks - White (1 Pair) $1.50 / EA Pharmaceuticals Advil Single Pack (2 tablets) $0.99 / EA SHOES Running Shoes Bayer Aspirin Tablets (2 tablets) $0.99 / EA Rawlings Espy Cross Training Shoe 6.5, 7, 7.5, 8, 8.5, 9.5, 10, 10.5, 11, 12, 19 $34.00 / EA GoodSense.5 oz. Tetrasine Eye Drops $2.10 / EA Sandals GoodSense Honey Lemon Cough Drops (30 Ct.) C R $1.25 / EA Cross Strap Sandals Small- #22602, Medium- #22603, Large- #22604, XL- #22615 $2.00 / EA NewDay Cotton Swabs (100 Ct.) C R $1.80 / EA THE GENERAL STORE Rolaids Regular Strength Antacid (1 Roll) $1.25 / EA Personal Care Tylenol Extra Strength (2 tablets) $0.99 / EA Fingernail Clipper without File C $1.45 / EA Stationery #10 Stamped Envelope $0.69 / EA 983

7 Envelope #10 (10 Ct.) $0.85 / SP Plain Paper Mother s Day Card $1.75 / EA First Class Stamp (1 ea.) $0.50 / EA 928 Valentine s Day Card $1.75 / EA No Clasp Envelope 9.5 x 12.5 $0.30 / EA Miscellaneous Security Pen 1 Ct. (Black) $0.90 / EA /8 Spoon (All Purpose Plastic) $0.10 / EA Stamped Post Card $0.41 / EA 2418 Acrylic Mirror without Magnet 6 x 4.5 $2.30 / EA Stamps (Book of Ten) $5.00 / CS 928 Cereal Bowl w/lid 24 oz. $1.20 / EA White Paper Pad 8.5 x 11 (50 Sheet Pad) $1.45 / EA Nylon Mesh Laundry Bag 24 x 36 $8.30 / EA Art Supplies Sharkeyes Reading Glasses 1.25, 1.5, 1.75, 2, 2.25, 2.5, 2.75, 3, 3.25 $10.59 / EA Sketch Pad 8.5 X 11 (50 Sheet Pad) $1.90 / EA Toothbrush Holder C $0.99 / EA Games Aviator - US Playing Cards $2.50 / EA Double Six Dominoes $5.20 / EA Greeting Cards Two Piece Soap Dish C $0.99 / EA FAITH ITEMS Oils C.K. One 1 oz. Oil $6.95 / EA Acetate Anniversary Card $1.75 / EA Acetate Thinking of You Card $1.75 / EA Prayer Rug Prayer Rug 44 x 26 (Sizes/Colors May Vary) $29.00 / EA Birthday Card $1.75 / EA Christmas Paper Card $1.75 / EA Head Coverings Kufi Knit Cap Crochet - White $11.25 / EA Juvenile Birthday Card $1.75 / EA Plain Paper Father s Day Card $1.75 / EA 29029

SHIP TO: Inmate s Name Institution/Dorm/Housing# Street Address City State Zip SENDER: Sender s Name Street Address City State Zip Phone Number Email CALCULATE AMOUNT DUE: We cannot send orders from

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 CALCULATE AMOUNT DUE: We cannot send orders from one inmate to another. (You will receive confirmation s when the order is placed and shipped) TAX ID# REQUIRED for order fulfillment. S Merchandise : x 1.07 = Processing Fee: $5.95 x 1.07 = $6.37 SELECT PAYMENT METHOD: Cashier s Check Money Order Make check or money order payable to ACCESS SECUREPAK AMOUNT DUE: VISA MasterCard Discover Prepaid PROGRAM DATES: Ordering Begins: May 7, 2018 Delivery to facility: Weekly on Mondays WAYS TO ORDER: Online: mississippipackages.com Phone: Mail: Access Securepak (MS) 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. SALES TAX: Access Securepak is required by the state of Mississippi to collect 7% sales tax on food items including the processing fee. Please see the tax calculation example below for more information. Tax calculation example: $63.52 merchandise total + $5.95 processing fee = $69.47 subtotal $69.47 subtotal x 0.07 tax rate = $4.86 tax total $69.47 subtotal + $4.86 tax = $74.33 total due ELIGIBILITY: Access Securepak verifies inmate eligibility before shipping packages, if applicable. LIMITS: Maximum $ of product per inmate. Multiple packages can be ordered, and we will consolidate orders not to exceed the maximum $ of product per program. 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 mississippipackages.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 CUSTOMER SERVICE: mississippipackages.com Automated system is available 24 hours a day, seven days a week Live bilingual representatives are available Monday through Friday, 7:30 a.m. 11 p.m. CST, and Saturday, 10 a.m. 4 p.m. CST. 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.

SAMPLE. Ordering Dates: December 1-15, A wide variety of snacks, hygiene and candy! GEORGIA RYDC HOLIDAY PACKAGE PROGRAM. rydcpackages.

SAMPLE. Ordering Dates: December 1-15, A wide variety of snacks, hygiene and candy! GEORGIA RYDC HOLIDAY PACKAGE PROGRAM. rydcpackages. GEORGIA RYDC HOLIDAY PACKAGE PROGRAM Ordering Dates: December 1-15, 2017 A wide variety of snacks, hygiene and candy! rydcpackages.com ORDERING INFORMATION PROGRAM DATES: Ordering Begins: December 1, 2017