Check in Date: Approx. Arrival Time Pick up at Store Delivery Name Credit Card # Exp. Date CVC Billing Zip Code Phone Number Property Management Company CARDHOLDERS SIGNATURE BEVERAGES SIZE PRICE QTY Coke Classic 2L 2.99 Diet Coke 2L 2.99 Sprite 2L 2.99 Canada Dry Ginger Ale 2L 2.99 Pepsi 2L 2.99 Gatorade-Fruit Punch 20oz 8 pk 9.99 Gatorade -G2 8pk 9.99 Ocean Spray Cranberry 64 oz 4.99 Tropicana OJ 59 oz 4.99 Lemonade - Simply 59 oz 4.99 Limeade - Simply 59 oz 4.99 Diet Pepsi 2L 2.99 Mountain Dew 2L 2.99 Diet Mountain Dew 2L 2.99 Tonic Water 1L 2.99 Club Soda 1L 2.99 Coke Classic 12pk 6.99 Diet Coke 12pk 6.99 Sprite 12pk 6.99 Ginger Ale 12pk 6.99 Pepsi 12 pk 6.99 Diet Pepsi 12 pk 6.99 BREAD Thomas Plain Bagel 6 ct 5.99 Thomas Everything Bagel 6 ct 5.99 Thomas Cinnamon Bagel 6 ct 5.99 English Muffins 6 ct 4.99 Whole Wheat Sandwich 3.49 White Sandwich Bread 3.49 Hot Dog Buns 8 ct 2.99 Hamburger Buns 8t 2.99 Mountain Dew 12 pk 6.99 Diet Mountain Dew 12 pk 6.99 Smart Water 20 oz 2.99 Arrowhead Water 24 pk 10.99 Gatorade-Lemon Lime 20 oz 8 pk 9.99 Gatorade-Orange 20 oz 8 pk 9.99 BREAKFAST SIZE PRICE qty Kellogs Fruit Loops 8.7 oz 4.99 Kellogg s Frosted Flakes 14 oz 4.99 Kellogg's Rice Krispies 9 oz 4.99 Kellogg's Raisin Bran 15 oz 4.99
Kellogg's Special K 7 oz 4.99 Honey Bunches of Oats 14 oz 4.99 Cheerios 14 oz 4.99 Honey Nut Cheerios 14 oz 4.99 Cinnamon Toast Crunch 14 oz 4.99 Apple Jacks 14 oz 4.99 Lucky Charms 12 oz 4.99 Pop Tarts - Strawberry 8 pk COFFEE/TEA/OTHER Starbucks Breakfast Blend- Ground 12 oz 10.49 Starbucks French Roast 12 oz 10.49 Gevalia Coffee - Ground 12 oz 9.99 Seattle s Best Pikes Peak 12 oz 10.49 English Tea Pop Tarts - Blueberry 8 pk Quaker Instand Oatmeal - Variety 10 pk 5.49 CONDIMENTS SIZE PRICE QTY Krusteaz Pancake Mix 4.99 Eggo Waffles 4.49 Johnsonville Breakfast Sausage 4.99 Bacon - 1# 16 oz 6.99 Ketchup 14 oz 2.99 French s Mustard 8 oz 2.99 Kraft Mayonaise 8 oz 3.59 Grey Poupon Dijon Mustard 8 oz 3.59 Newman s Ceaser Dressing 4.99 Newman's Ranch Dressing 4.99 CANNED GOODS SIZE PRICE QTY Chef Boyardee - Ravioli 15 oz 1.99 Chef Boyardee - Beefaroni 15 oz 1.99 Spaghetti O s 7 oz 1.99 Newman's Balsamic Dressing 4.99 Smucker s Grape Jelly 12 oz 4.49 Smucker's Strawberry Jelly 12 oz 4.49 Bonne Mamani Apricot Preserves 6.19 Progresso Soup - Vegetable Beef 18 oz 2.99 Bonne Mamani Wild Berry Preserves 6.19 Progresso Soup - Tomato 18 oz 2.99 Progresso Soup - Chicken Noodle 18 oz 2.99 Bush s Baked Beans 15 oz 2.99 Chicken of the Sea Tuna Fish 8 oz 2.99 JIf Peanut Butter 4.99 Honey 8 oz 4.99 Vegatable Oil 3.49 Olive Oil 5.49 Salt and Pepper Shakers 2.49
DELI DAIRY Eggs Large Dozen 1 dozen Land O Lake s Butter 16 oz 5.99 Milk - Whole Milk Gallon 5.99 Milk - Whole Milk 1/2 Gallon Boar s Head Turkey 1/2 # 5.99 Boars Head Black Forest Ham 1/2 # 5.99 Boars Head Roast Beef 1/2 # 5.99 Nathan s Hot Dogs 8 ct 5.99 Johnsonville Brats 7.99 Oscar Meyer Hot Dogs Milk - 2% Gallon 5.99 Milk - 2% 1/2 Gallon DAIRY CONTINUED SIZE PRICE QTY Milk - 2% Pint 2.49 Half and Half - 16 oz Yogurt - Yoplait Mixed Berry 8 oz 1.49 Yogurt - Yoplait Strawberry/ Banana 8 oz 1.49 Chobani Yogurt 8 oz 1.99 Chobani Yogurt Sour Cream Laughing Cow - Cheese Wedges 6.99 Red Wax Gouda Cheese 7.99 Kraft Singles 6 oz 5.99 FROZEN FOOD SIZE PRICE QTY Tyson Chicken Strips 25 oz 9.99 Tyson Buffalo Chicken Strip 25 oz 9.99 Ore-Ida Tator Tots 28 oz 5.19 Ore-Ida Hash Browns 28 oz 5.19 Hot Pockets - Pepperoni 4 oz Hot Pockets - Ham and Cheese 4 oz Red Baron Pizza - Supreme 20 oz 9.99 Red Baron Pizza - Pepperoni 20 oz 9.99 Red Baron Pizza - Cheese 20 oz 9.99 Totinos Pizza - Cheese 6 oz 2.99 Totinos Pizza - Pepperoni 6 oz 2.99 Kraft Sharp Cheddar 8 oz 4.99 Kraft Pepper Jack 8 oz 4.99 Kraft Parmesan Cheese 8 oz 3.49 Philadelphia Cream Cheese 8 oz 4.49 Kraft Mozzerella Cheese 8 oz 4.99 ICE CREAM/DESSERT Hagaan Daz- Vanilla 14 oz 5.99 Hagaan Daz - Mint Chocolate Chip 14 oz 5.99
Hagaan Daz - Chocolate Chip Cookie Dough 14 oz 5.99 Ben & Jerrys - Half Baked 14 oz 5.99 Ben & Jerrys - Mint Cookie 14 oz 5.99 Ben & Jerry - Phish 14 oz 5.99 PASTA Barilla Spaghetti 16 oz 2.99 Barilla Sauce - Marinara Sauce 10 oz 4.99 Macaroni and Cheese 7.5 oz 2.59 Velveeta Shells 7.5 oz 4.19 PRODUCE SIZE PRICE QTY Red Apple 3# 5.99 Granny Smith Apple 3# 5.99 Clementine Oranges 3# 6.99 Lemon each 0.99 Lime each 0.99 Banana each 0.99 Dole Caesar Salad Mix 4.99 Tomatoes - Red each 1.49 Avocado each 1.99 Red Bell Pepper each 1.99 Green Bell Pepper each 1.99 Carrots 16 oz English Cucumber each 2.99 Yellow Onion each 1.49 Russet Potatoes 3# 5.99 Garlic each 1.49 SNACKS SIZE PRICE QTY Lays Potato Chips 11 oz 4.49 Lays BBQ Chips 11 0z 4.49 Kettle Chips - BBQ 8.5 oz 4.49 Kettle Chips - Sea Salt 8.5 oz 4.49 Kettle Chips - Salt & Pepper 8.5 oz 4.49 Tostitos - Round Crips 10.5 oz 4.49 Tostitos - Restaurant Style 10.5 oz 4.49 Fritos 8.5 oz 4.49 Cheetos 8.5 oz 4.49 Doritos - Nacho 4.49 Doritos - Cool Ranch 4.49 Smartfood Popcorn 5 oz 2.99 Tostitos Medium Salsa 15.5 oz 4.99 Tostitos Mild Salsa 15.5 oz 4.99 Tostitos Cheese Dip 15.5 oz 5.99 Saltines 4oz 3.25 Wheat Thins 4 oz 4.99
Triscuit - Original 4 oz 4.99 Keebler Graham Crackers 3.75 Oreos 10 oz 4.49 Chips Ahoy 10 oz 4.49 MISCELLANEOUS