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K - Kosher • H - Halal • C - Clear • D - Diabetic • R - Resealable • G - Gluten Free • S - Soy Free
Total Total
Order Form Philadelphia - PA Effective December 2017Please complete all info on reverse (print clearly). / Por favor complete toda la información al reverso (escriba claramente)
DESCRIPTION/DESCRIPCIÓN PRICE/PRECIO ITEM #/NO. DE ARTÍCULO
TALLA QTY/CANTIDAD
TOTAL/PRECIO TOTAL
NON-TAXABLEDRINKSCoffee & CappuccinoKeefe .81 oz. French Vanilla Cappuccino (Single Serve) K G S $0.35 / EA 905
Keefe 1.5 g. Freeze Dried Coffee (Single Serve) K H G S $0.39 / EA 235
Keefe 3 oz. Colombian Blend Premium Coffee K H R $4.50 / EA 10244
Keefe 4 oz. Instant Coffee K H $3.80 / EA 21
Maxwell House 4 oz. Dark Roast Espresso K H C R $4.45 / EA 10704
Nescafe 1.7 grams Taster’s Choice Decaf. Stick K H G S $0.37 / EA 4452
Hot CocoaKeefe .8 oz. Single Serve Hot Cocoa K G $0.35 / EA 114
TeaKeefe Tea Bags (48 Ct.) K G S $2.30 / BX 416
CreamerInternational Delight .44 oz. Caramel Macchiato Liquid Cream-er (10 Ct.) K G S
$2.00 / SP 80004557
International Delight French Vanilla Liquid Creamer (10 Pk.) $2.00 / SP 80004554
International Delight Hazelnut Liquid Creamer (10 Pk.) K $2.00 / SP 80004555
International Delight Original Creamer (10 Pk.) $2.00 / SP 80004553
Sugar & SweetenerSugar Packets (20 Pk.) K H $0.80 / EA 1136
Sweetmate 3.5 oz. Saccharin (100 Ct.) K H G S $2.30 / BX 9719
Nestea 5.5 oz. Tea w/Lemon and Sugar K H $1.50 / EA 71545
Nutritional DrinksNew Leaf 2 oz. Chocolate Health Shake K $1.70 / EA 80003592
New Leaf 2 oz. Vanilla Health Shake $1.70 / EA 80003593
FOOD & SNACKSGranola & Cereal BarsMrs. Freshley’s 1.3 oz. Apple Cinnamon Cereal Bar $0.46 / EA 5025
Mrs. Freshley’s 1.3 oz. Blueberry Cereal Bar $0.46 / EA 5024
Quaker .84 oz. Chewy Chocolate Chip Granola Bar (1 Pk.) K $0.50 / EA 9366
CerealMalt-O-Meal .75 oz. Tootie Fruities Cereal (Single Serve) K $0.50 / EA 5669
Malt-O-Meal 1.25 oz. Raisin Bran Cereal (Single Serve) K $0.50 / EA 5654
DESCRIPTION/DESCRIPCIÓN PRICE/PRECIO ITEM #/NO. DE ARTÍCULO
TALLA QTY/CANTIDAD
TOTAL/PRECIO TOTAL
Malt-O-Meal 1 oz. Frosted Flakes Cereal (Single Serve) K $0.50 / EA 5667
OatmealQuaker Instant Oatmeal - Maple Brown Sugar (1 Pk.) $0.45 / SP 80004562
Quaker Instant Oatmeal - Original Flavor (1 Pk.) $0.45 / SP 80004561
Toaster PastriesKellogg’s 3.5 oz. Frosted Strawberry Pop-Tarts (2 Pk.) $1.10 / EA 10547
Kellogg’s 3.68 oz. Smores Pop-Tarts (2 Pk.) $1.15 / EA 6398
Pastries & Snack CakesCloverhill 4.25 oz. Apple Danish K C $1.35 / EA 4650
Golden Valley 4 oz. Plain Bagel K H C $0.80 / EA 80000495
Hostess 3.03 oz. M & M Brownie (2 Pk.) $1.80 / EA 80003801
Hostess 3.17 oz. Chocolate CupCakes (2 Pk.) $1.50 / EA 80000343
Hostess 3.7 oz. Glazed Donettes $1.45 / EA 80003805
Hostess 3.81 oz. Vanilla Zingers (3 Pk.) $1.75 / EA 80000346
Hostess 3 oz. Powdered Sugar Donettes $1.45 / EA 80003798
Hostess 4.5 oz. Apple Pie $1.50 / EA 80005968
Market Square Bakery 10 oz. Donut Stix (6 Pk.) K $2.78 / BX 6051
Market Square Bakery 12 oz. Peanut Butter Wafers (6 Pk.) K $2.78 / BX 6052
Market Square Bakery 12 oz. Swiss Rolls (6 Pk.) K $2.78 / BX 6055
Market Square Bakery 16 oz. Oatmeal Creme Pies (12 Pk.) K $2.78 / BX 6053
Market Square Bakery 4.25 oz. Strawberry Cheese Danish K C $1.40 / EA 6058
Market Square Bakery 4.75 oz. Chocolate Iced Mega Honey Bun K C
$1.05 / EA 6540
Market Square Bakery 4.75 oz. Mega Buneez K C $0.99 / EA 6044
Market Square Bakery 4 oz. Cream Cheese Pound Cakes (2 Pk.) K C
$1.00 / EA 6538
Market Square Bakery 4 oz. Iced Swirl Cinnamon Roll K C $0.99 / EA 6057
Market Square Bakery 6 oz. Monster Iced Honey Bun K C $1.15 / EA 6043
Otis Spunkmeyer 3.5 oz. Marble Loaf Cake K $1.35 / EA 80003171
Otis Spunkmeyer 4 oz. Cinnamon Crumb Loaf Cake $1.35 / EA 80003170
Otis Spunkmeyer 4 oz. Lemon Loaf Cake with Lemon Icing $1.35 / EA 80003169
K - Kosher • H - Halal • C - Clear • D - Diabetic • R - Resealable • G - Gluten Free • S - Soy Free
Total Total
Order Form Philadelphia - PA Effective December 2017Please complete all info on reverse (print clearly). / Por favor complete toda la información al reverso (escriba claramente)
DESCRIPTION/DESCRIPCIÓN PRICE/PRECIO ITEM #/NO. DE ARTÍCULO
TALLA QTY/CANTIDAD
TOTAL/PRECIO TOTAL
Chips & SnacksAndy Capp’s .85 oz. Hot Fries $0.65 / EA 6743
Cactus Annie’s 1.5 oz. Nacho Cheese Tortilla Chips K H G $0.80 / EA 920
Cactus Annie’s 10 oz. Nacho Cheese Tortilla Chips K H C G $2.07 / EA 911
Cactus Annie’s 11 oz. “The Whole Enchilada” Party Mix K H C $2.35 / EA 902
Cactus Annie’s 11 oz. Cheese Crunchy K H C G S $2.85 / EA 7996
Cactus Annie’s 12 oz. Barbeque Corn Chips K H C G S $2.32 / EA 7990
Cactus Annie’s 2 oz. Cheese Puffs K H $0.91 / EA 7994
Cheetos 1.75 oz. Flamin’ Hot Crunchy G $0.90 / EA 7690
Cheetos 2 oz. Cheese Crunchy C G $0.80 / EA 7689
Del Monte 1.5 oz. Raisins K G S $0.75 / EA 819
Doritos 1.75 oz. Cool Ranch Chips $0.95 / EA 80003280
Doritos 1.75 oz. Nacho Cheese Chips $0.95 / EA 10513
Fritos 2 oz. Chili Cheese Corn Chips $1.00 / EA 10446
Kellogg’s 1.3 oz. Original Rice Krispies Treats $1.15 / EA 2381
Moon Lodge 1.5 oz. BBQ Potato Chips K H $0.65 / EA 6023
Moon Lodge 1.5 oz. Buffalo Wing Blue Cheese Potato Chips K H
$0.65 / EA 80000963
Moon Lodge 1.5 oz. Hot!Hot!Hot! Barbeque Potato Chips K H $0.65 / EA 6026
Moon Lodge 1.5 oz. Regular Potato Chips K H $0.65 / EA 6022
Moon Lodge 1.5 oz. Sour Cream and Onion Potato Chips K H S $0.65 / EA 6024
Moon Lodge 1.5 oz. Stuffed Jalapeno Potato Chips $0.70 / EA 7637
Moon Lodge 11 oz. Pretzels Mini Twists K C $1.85 / EA 5139
Sunsweet 8 oz. Chopped Dates $2.64 / EA 10609
The Whole Shabang 1.5 oz. Potato Chips K H $0.65 / EA 6025
PopcornMoon Lodge 3.53 oz. Caramel Popcorn K H G $1.00 / EA 7758
Moon Lodge 5 oz. Jalapeno Cheddar Popcorn $1.95 / EA 80000562
Moon Lodge 5 oz. White Cheddar Popcorn K H G $1.95 / EA 5133
NutsKings Nut 2.5 oz. Roasted & Salted Cashews K H C $2.09 / EA 80003352
DESCRIPTION/DESCRIPCIÓN PRICE/PRECIO ITEM #/NO. DE ARTÍCULO
TALLA QTY/CANTIDAD
TOTAL/PRECIO TOTAL
Kings Nut 4 oz. Tropical Mix $1.25 / EA 80003373
Kings Nut 8 oz. Roasted & Salted Cashews K G S $6.70 / EA 80003377
Moon Lodge 1.75 oz. Salted Peanuts K C G $0.65 / EA 7550
CrackersAustin 1.38 oz. Toasted Peanut Butter Sandwich Crackers (1 Pk.)
$0.75 / EA 80000115
Cheez-It 1.5 oz. Cheddar Crackers K $0.75 / EA 9590
Golden Valley 13.7 oz. Snack Crackers $2.81 / BX 80005523
CookiesGamesa 4.94 oz. Marias Cookies $1.10 / EA 80005515
Market Square Bakery 16 oz. Vanilla Wafers K H $2.60 / EA 6070
Market Square Bakery 2.75 oz. Soft Baked Oatmeal Raisin Cookies (2 Pk.) K
$0.95 / EA 7648
Market Square Bakery 2.75 oz. Sugar Free Strawberry Creme Wafers K H
$0.75 / EA 6069
Market Square Bakery 6 oz. Chocolate Chip Cookies K H C $1.30 / EA 6072
Market Square Bakery 6 oz. Peanut Butter Creme Cookies K H C
$1.30 / EA 10055
Oreo 2.4 oz. Cookies $0.80 / EA 80003305
Candy3 Musketeers 1.92 oz. Bar K $1.05 / EA 10503
Atkinsons .7 oz. Chick-O-Stick K C G $0.35 / EA 1477
Baby Ruth 2.1 oz. Bar K G $1.05 / EA 844
Cordial 6 oz. Milk Chocolate Covered Cherries (10 pcs.) $2.95 / EA 80001174
Hershey’s 1.45 oz. Milk Chocolate Bar w/Almonds K $1.05 / EA 1779
Hershey’s 3 oz. SF Dark Chocolate Candy Bar Miniatures $3.85 / EA 2776
Hershey’s 5.3 oz. Miniatures Bag K $3.49 / EA 865
Jolly Rancher 3.7 oz. Assorted Flavors C $1.25 / EA 40601
Lemonheads 4 oz. Redrific Candy $1.30 / EA 80006094
Lifesavers .72 oz. PepOMint Roll $0.50 / EA 1120
M&M’s 1.74 oz. Peanut Candy K G $1.05 / EA 955
M&M’s Peanut 5.3 oz. Candy $2.94 / EA 9732
M&M’s Plain 5.3 oz. Candy $2.94 / EA 9733
K - Kosher • H - Halal • C - Clear • D - Diabetic • R - Resealable • G - Gluten Free • S - Soy Free
Total Total
Order Form Philadelphia - PA Effective December 2017Please complete all info on reverse (print clearly). / Por favor complete toda la información al reverso (escriba claramente)
DESCRIPTION/DESCRIPCIÓN PRICE/PRECIO ITEM #/NO. DE ARTÍCULO
TALLA QTY/CANTIDAD
TOTAL/PRECIO TOTAL
Nestle 1.9 oz. Butterfinger Bar K G $1.05 / EA 80000662
Old Dominion 6 oz. Peanut Brittle $2.45 / EA 80003030
Reese’s 1.5 oz. Peanut Butter Cups K G $1.05 / EA 1949
Sathers 1.75 oz. Sugar Free Wild Fruit C $0.70 / EA 40615
Sathers 3.75 oz. Starlight Mints $0.95 / EA 80006101
Sathers 3 oz. Vanilla Caramels C $1.15 / EA 40629
Sathers 4.25 oz. Jelly Beans $1.26 / EA 80006097
Sathers 4.25 oz. Root Beer Barrels $1.00 / EA 80006098
Sathers 4.25 oz. Sour Fruit Balls C $1.15 / EA 40607
Snickers 4.4 oz. Miniatures K $2.15 / EA 6090
Starburst 7.2 oz. Fruit Chews Bag R $3.25 / EA 1640
Twix 1.79 oz. Chocolate Caramel Cookie Bars K $1.05 / EA 799
CondimentsSqueez-Ums .15 oz. Mustard (12 Pk.) K H G $1.05 / STR 6513
Squeez-Ums .31 oz. Ketchup (12 Pk.) K H G $1.07 / STR 6514
Squeez-Ums .31 oz. Mayo - Single Packet K H G $0.14 / STR, / EA 6510
Squeez-Ums .31 oz. Mayonnaise (12 Pk.) K H G $1.14 / STR, / EA 6510
SpreadsGolden Harvest 12 oz. Honey $3.60 / EA 80001536
Squeez-Ums 1 oz. Grape Jelly (1 Pk.) K H G $0.21 / EA 4787
Squeez-Ums 2 oz. Peanut Butter (1 Pk.) K H $0.80 / EA 80003920
Squeez-Ums Pure Honey (10 Pk.) K H $1.10 / PK 6522
Sauces & DressingBrushy Creek 4 oz. Italian Pasta Sauce C G $1.10 / EA 2587
Kraft 1.5 oz. Ranch Salad Dressing Packet $0.77 / EA 4535
Pickles & PeppersTitos .7 oz. Pickled Jalapeno Pepper Slices C G S $0.55 / EA 1590
Van Holten’s 9.6 oz. Dill Pickle K C G S $1.02 / EA 381
CheeseCactus Annie’s 2 oz. Cheddar Cheese Squeeze Snack G $0.80 / EA 2586
Cactus Annie’s 2 oz. Jalapeno Cheese Squeeze Snack G $0.80 / EA 2585
City Cow 4 oz. Hot Pepper Cheese Stick C G S $1.80 / EA 178
DESCRIPTION/DESCRIPCIÓN PRICE/PRECIO ITEM #/NO. DE ARTÍCULO
TALLA QTY/CANTIDAD
TOTAL/PRECIO TOTAL
City Cow 4 oz. Nacho Cheese Dip with Jalapenos C R G $1.45 / EA 2858
City Cow 4 oz. Provolone Cheese Stick C G $2.50 / EA 2131
Philly 2 oz. Cream Cheese w/Jalapenos $1.15 / EA 10911
Meat SnacksBridgford 3.5 oz. Sliced Pepperoni G $3.50 / EA 7905
Brushy Creek 1.625 oz. Hot Summer Sausage G $1.39 / EA 80001716
Brushy Creek 1.625 oz. Regular Summer Sausage $1.39 / EA 80001715
Brushy Creek 5 oz. Hot Summer Sausage Made with Beef and Chicken G
$3.01 / EA 80001722
Brushy Creek 5 oz. Original Summer Sausage Made with Beef and Chicken G
$3.01 / EA 80001720
Brushy Creek 5 oz. Turkey Summer Sausage Honey Brown Sugar G
$2.62 / EA 80001724
O’Briens 1.125 oz. Beef & Cheddar Sticks G $1.34 / EA 2228
O’Briens 1.13 oz. Beef Sticks Hickory Smoked G $1.17 / EA 5379
SeafoodChicken of the Sea 3.53 oz. Smoked Clams in Oil $2.45 / EA 80005308
Fresh Catch 3.53 oz. Fillets of Mackerel in Brine K H G $2.11 / EA 7935
Fresh Catch 3.53 oz. Fish Steaks in Louisiana Hot Sauce K H G
$1.92 / EA 4397
Fresh Catch 3.53 oz. Salmon Flakes in Water K H G $2.10 / EA 4391
Fresh Catch 3.53 oz. Yellowfin Tuna Steak in Spicy Thai Chili Sauce K H G
$3.37 / EA 5696
Fresh Catch 4.23 oz. Chunk Light Tuna in Water K H G $2.60 / EA 4317
Ready-To-Eat MealsBrushy Creek 11.25 oz. Beef Stew G $3.05 / EA 1715
Brushy Creek 11.25 oz. Chili with Beans G $3.37 / EA 1711
Brushy Creek 11.25 oz. Chili with Beans Hot! G $3.18 / EA 1712
Brushy Creek 11.25 oz. Lasagna with Beef in Sauce $3.48 / EA 1721
Brushy Creek 11.25 oz. Sloppy Joe Sauce with Beef $4.01 / EA 1723
Brushy Creek 4.5 oz. Premium Chicken Breast G S $3.81 / EA 5360
Brushy Creek 5 oz. Chicken Vienna Sausage G S $2.35 / EA 80002944
Brushy Creek 5 oz. Hot Chicken Vienna Sausage $2.35 / EA 80002945
Brushy Creek 5 oz. Jerk Pork G S $3.65 / EA 6300
K - Kosher • H - Halal • C - Clear • D - Diabetic • R - Resealable • G - Gluten Free • S - Soy Free
Total Total
Order Form Philadelphia - PA Effective December 2017Please complete all info on reverse (print clearly). / Por favor complete toda la información al reverso (escriba claramente)
DESCRIPTION/DESCRIPCIÓN PRICE/PRECIO ITEM #/NO. DE ARTÍCULO
TALLA QTY/CANTIDAD
TOTAL/PRECIO TOTAL
Brushy Creek 5 oz. Pulled Chicken in Buffalo Style Sauce G $3.05 / EA 6476
Brushy Creek 6 oz. Beef Barbacoa Shredded Beef with Sauce H
$3.95 / EA 10113
RiceBrushy Creek 8 oz. Cajun Style Rice with Chicken & Sau-sage G
$3.99 / EA 80003084
Keefe Kitchens 6.5 oz. Pre-Cooked Long Grain Brown Rice K C R G S
$2.22 / EA 7525
Keefe Kitchens 8 oz. Pre-Cooked Long Grain Rice K C R G S $1.75 / EA 5880
Sevilla 2 oz. Spicy Cheesy Spanish Rice K H $0.75 / EA 10757
BeansSevilla 4.4 oz. Chili Flavor Refried Beans & Rice K H $1.48 / EA 5939
TortillasCactus Annie’s 8 oz. Flour Tortillas (6 Pk.) K H C R $1.50 / EA 5070
RamenMaruchan 3 oz. Beef Flavor Ramen C $0.60 / EA 9
Maruchan 3 oz. Cajun Shrimp Flavor Ramen C $0.55 / EA 15
Maruchan 3 oz. Chicken Flavor Ramen C $0.60 / EA 8
Maruchan 3 oz. Low Sodium Beef Flavor Ramen C $0.60 / EA 6645
Maruchan 3 oz. Low Sodium Chicken Flavor Ramen C $0.60 / EA 6644
Maruchan 3 oz. Shrimp Flavor Ramen C $0.60 / EA 12
Maruchan 3 oz. Texas Beef Flavor Ramen C $0.60 / EA 13
NoodlesVelveeta 3 oz. Macaroni and Cheese K H C $1.20 / EA 4935
Women’s Hygiene
Always Fresh Super Long Maxi Pads (28 Ct.) $8.00 / PK 22890
Massengill 4.5 oz. Vinegar & Water Douche $4.78 / EA 80002146
Playtex Gentle Glide Tampon (Super) 8 Ct. $3.00 / BX 20738
Playtex Gentle Glide Tampons (Regular) 20 Pk. $5.25 / BX 21899
Playtex Stayfree Maxi Pads (Super) 10 Pk. $1.75 / EA 80000659
Playtex Tampon Unscented (Super) 18 Ct. $5.75 / EA 22899
Preference Panty Shields (22 Pk.) $2.10 / EA 21067
Pharmaceuticals
A & D 1.5 oz. Original Skin Ointment $3.03 / EA 80005068
DESCRIPTION/DESCRIPCIÓN PRICE/PRECIO ITEM #/NO. DE ARTÍCULO
TALLA QTY/CANTIDAD
TOTAL/PRECIO TOTAL
Diphen (Like Benadryl) $0.15 / EA 21424
Goodsense 12 oz. Milk of Magnesia $2.35 / EA 20848
Goodsense 2 oz. Hemorrhoidal Ointment $4.00 / EA 80000559
Goodsense 4 oz. Tussin DM Cough Formula $3.00 / EA 22718
GoodSense Sugar Free Cherry Cough Drops (25 Ct.) C R $1.90 / EA 22681
Moore Medical 200 MG Ibuprofen (2 Pk.) $0.32 / EA 80003392
Moore Medical Antacid Tablets (2 Pk.) $0.30 / EA 21430
Moore Medical APAP 500 mg (Tylenol) (2 Pk.) $0.22 / EA 24525
Trojan Lubricated Condom (3 Pk.) $1.57 / EA 22818
Uni-Syn Meal Replacement Powder - Strawberry $2.99 / EA 22657
Dental Care
4 1/4” Flexible Medium-Bristle Toothbrush $2.25 / EA 22747
Colgate 4.2 oz. Anti-Cavity Toothpaste $2.70 / EA 26096
Cool Wave 4 oz. Fresh Mint Fluoride Toothpaste C $1.25 / EA 21017
Effergrip 2.5 oz. Denture Adhesive Cream Tube $2.85 / EA 20312
Freshmint Denture Tablets (40 Pk.) $2.99 / BX 24125
Oraline Security U-Floss $1.25 / BAG 80001012
Ultra Brite 6 oz. Advanced Whitening Toothpaste $2.50 / EA 20640
SKIN CARE
Goodsense 1 oz. Hydrocortisone (1% Cream) $2.20 / EA 80005524
Heritage 3 oz. Medicated Anti-Fungal Powder $2.00 / EA 20329
Hydrocortisone Cream .5% (1 oz. Tube) $2.20 / EA 24723
Muscle Rub 3 oz. $2.20 / EA 24725
NewDay 3.75 oz. Petroleum Jelly C $1.04 / EA 20319
Tolnaftate .5 oz. Antifungal Cream $2.05 / EA 24126
Triple Antibiotic Ointment (1 oz. Tube) $3.15 / EA 24726
SHOES
Cross Strap Thong Sandal X-Large $1.25 / EA 22615
CLOTHING & ACCESSORIES
Shorts
Jam Shorts - Gray Small, Medium, Large, XL $8.00 / EA 51690-02 ______
K - Kosher • H - Halal • C - Clear • D - Diabetic • R - Resealable • G - Gluten Free • S - Soy Free
Total Total
Order Form Philadelphia - PA Effective December 2017Please complete all info on reverse (print clearly). / Por favor complete toda la información al reverso (escriba claramente)
DESCRIPTION/DESCRIPCIÓN PRICE/PRECIO ITEM #/NO. DE ARTÍCULO
TALLA QTY/CANTIDAD
TOTAL/PRECIO TOTAL
Jam Shorts - Gray 2XL, 3XL, 4XL $10.00 / EA 51690-02 ______
Jam Shorts - Gray 5XL $12.00 / EA 51690-02 ______
Jam Shorts - Navy Small, Medium, Large, XL $9.00 / EA 51690-09 ______
Jam Shorts - Navy 2XL, 3XL, 4XL $11.00 / EA 51690-09 ______
Robes
Kimono Waffle Robe $25.00 / EA 5119801001
Terry Velour Bath Robe - White $20.00 / EA 5199701001
Socks
Tube Socks - White (1 Pair) $0.85 / EA 5088801001
TAXABLEFOOD & SNACKS
Drink Mixes
Country Time 6 oz. Lemonade Drink Mix K H C $1.50 / EA 7044
Keefe 12 oz. Georgia Peach Drink Mix K H C R $2.61 / EA 7145
Keefe 12 oz. Orange Flavored Breakfast Drink K H C R $2.61 / EA 7030
Kool-Aid 6 oz. Cherry Drink Mix K H C $1.50 / EA 7042
Kool-Aid 6 oz. Grape Drink Mix K H C $1.50 / EA 7043
Kool-Aid 6 oz. Tropical Punch Drink Mix K H C $1.50 / EA 7041
HEALTH & BEAUTYVitaminsMason Naturals Multivitamin No Iron (100 Ct.) $2.42 / EA 80003631
ShampooCrawford 4 oz. Dandruff Shampoo C $1.30 / EA 20032
Freshscent .34 oz. Shampoo & Conditioner $0.15 / EA 20188
Softee 13.5 oz. 3 in 1 Conditioning Shampoo $5.50 / EA 24716
Suave 12 oz. Daily Clarifying Shampoo $1.60 / EA 26136
ConditionerCrawford 4 oz. Balsam & Protein Conditioner C $0.78 / EA 20025
Suave 12 oz. Refreshing Waterfall Mist Conditioner $1.80 / EA 26137
Ethnic Hair CareDark & Lovely Conditioning Relaxer System $6.90 / EA 22661
Luster’s 8 oz. Pink Oil Moisturizer $4.95 / EA 20380
Percara 16 oz. Styling Gel $2.25 / EA 24341
DESCRIPTION/DESCRIPCIÓN PRICE/PRECIO ITEM #/NO. DE ARTÍCULO
TALLA QTY/CANTIDAD
TOTAL/PRECIO TOTAL
Softee 5 oz. African Crown Hair Dress $2.80 / EA 24872
Softee 5 oz. Bergamot Blue Hair Dress $1.90 / EA 22949
Softee 5 oz. Bergamot Green Hair Dress & Pressing Oil $2.80 / EA 22950
Softee 5 oz. Coconut Oil Hair & Scalp Conditioner $1.93 / EA 22951
Styling Products & AccessoriesGoody Large Green Foam Rollers (10 Pk.) $2.15 / EA 20351
Military Style Brush $2.40 / EA 80001297
Body WashElementz 15 oz. 3 in 1 Coconut Lime Hair & Body Wash $2.50 / EA 24942
SoapDial 3.5 oz. Soap (1 Bar) $0.85 / EA 20920
Dove 3.17 oz. Moisturizing Beauty Soap (1 Bar) $1.40 / EA 80000661
Irish Spring 3.2 oz. Original Soap (1 Pk.) $0.85 / EA 21487
Next 1 - 5 oz. Anti-bacterial Sport Soap (1 Bar) C $1.31 / EA 22098
Next 1 - 5 oz. Cocoa Butter Soap (1 Bar) C $1.25 / EA 22096
Next 1 - 5 oz. Moisturizing Soap (1 Bar) C $1.10 / EA 22097
LotionCrawford 4 oz. Cocoa Butter Lotion C $1.00 / EA 20033
Dial 12 oz. Advanced Therapy Hand & Body Lotion $4.50 / EA 26045
Heritage 4.5 oz. Skin Cream Facial Cleanse $1.65 / EA 20646
Infuzed Island Naturals 15 oz. Coconut Lime & Aloe Lotion $2.50 / EA 24967
Suave 10 oz. Advanced Therapy Lotion $4.25 / EA 21926
Woltra 1 oz. Cocoa Butter Stick $1.30 / EA 80001561
Skin CareAcne Treatment Cream 1 oz. Benzoyl Peroxide Xtra-Strength $2.50 / EA 24540
Chap-Et .16 oz. Lip Conditioner $1.11 / EA 20517
NewDay 13 oz. Bath & Shower Powder $1.69 / EA 22377
No Rub 12 oz. Saline Solution $5.80 / EA 21986
DeodorantFreshscent 1.5 oz. Deodorant Roll-On Anti-Perspirant $1.15 / EA 20465
Power-Up 2.5 oz. Clear A/P Deodorant - Drive C $2.75 / EA 22336
Power-Up 2 oz. A/P Deodorant - Bloom C $2.90 / EA 22344
K - Kosher • H - Halal • C - Clear • D - Diabetic • R - Resealable • G - Gluten Free • S - Soy Free
Total Total
Order Form Philadelphia - PA Effective December 2017Please complete all info on reverse (print clearly). / Por favor complete toda la información al reverso (escriba claramente)
DESCRIPTION/DESCRIPCIÓN PRICE/PRECIO ITEM #/NO. DE ARTÍCULO
TALLA QTY/CANTIDAD
TOTAL/PRECIO TOTAL
Speed Stick 3 oz. Ultimate Sport A/P Deodorant $3.50 / EA 20068
Suave 1.4 oz. A/P Deodorant - Powder $2.10 / EA 24623
Dental CarePercara 8 oz. Oral Health Rinse $1.20 / EA 80001537
Sea Bond Denture Bath $2.60 / EA 20349
White Toothbrush Cap (*toothbrush not included) $0.35 / EA 21822
Shaving ProductsMagic Cream 6 oz. Depilatory $2.83 / EA 24409
Pro-Tection 7 oz. After-Shave Gel C $2.20 / EA 22318
Pro-Tection 7 oz. Shave Cream $1.65 / EA 22319
PharmaceuticalsGoodSense 4 oz. SPF 30 Sunscreen Lotion $5.95 / EA 20841
NewDay Cotton Swabs (100 Ct.) C R $1.75 / EA 21952
CosmeticsWet n Wild Twin Eyebrow Pencil - Black $1.31 / EA 80002845
SHOES
Basketball Shoes
Rawlings Urban Low Basketball Shoe (White) 6, 6.5, 7, 7.5, 8, 8.5, 9, 9.5, 10, 10.5, 11, 11.5, 12, 13, 14, 15
$28.00 / EA 81667-01 ______
Reebok BB4500 Royal Basketball Shoes (White) 7, 7.5, 8, 8.5, 9, 9.5, 10, 10.5, 11, 11.5, 12, 13, 14, 15
$40.00 / EA 80389-01 ______
Running Shoes
Reebok Classic Leather Running Shoes 7, 7.5, 8, 8.5, 9, 9.5, 10, 10.5, 11, 11.5, 12, 13, 14, 15
$50.00 / EA 50404-01 ______
Reebok Classic Royal Nylon Women’s Running Shoe (White/Gray) 5, 6, 6.5, 7, 7.5, 8, 8.5, 9, 9.5, 10, 11
$31.95 / EA 81677-01 ______
Reebok Run Supreme 2.0 LD Running Shoes 6.5, 7, 7.5, 8, 8.5, 9, 9.5, 10, 10.5, 11, 11.5, 12, 12.5, 13, 14
$42.00 / EA 81712-01 ______
Tennis Shoes
Rawlings Marc II Velcro Tennis Shoe 7, 7.5, 8, 8.5, 9, 9.5, 10, 10.5, 11, 11.5, 12, 13, 14, 15
$25.00 / EA 81670-01 ______
Cross Training Shoes
Rawlings Espy Cross Training Shoe 7, 7.5, 8, 8.5, 9, 9.5, 10, 10.5, 11, 11.5, 12, 13, 14
$25.00 / EA 81668-01 ______
Sandals
Crawford Deluxe Adjustable Velcro Sandals (Black) Small Sizes 6-7 - #22610, Medium Sizes 8-9 - #22611, Large Sizes 10-11 - #22612, XL Size 12 - #22613, 2XL Sizes 13-14 - #22614
$3.25 / EA 22610-99 ______
DESCRIPTION/DESCRIPCIÓN PRICE/PRECIO ITEM #/NO. DE ARTÍCULO
TALLA QTY/CANTIDAD
TOTAL/PRECIO TOTAL
Cross Strap Sandals Small- #22602, Medium- #22603, Large- #22604
$1.25 / EA 22602-01 ______
CLOTHING & ACCESSORIES
T-Shirts
Hanes Crew Neck T-Shirt - White (1 Pk.) Small, Medium, Large, XL
$3.29 / EA 51798-01 ______
Hanes Crew Neck T-Shirt - White (1 Pk.) 2XL $3.88 / EA 51798-01 ______
Players Pride Crewneck T-Shirt (2 Pk.) White 4XL, 5XL, 6XL $6.00 / PK 50436-01 ______
Men’s Underclothing
Hanes Men’s Briefs - White (1 Pk) Small, Medium, Large, XL $3.05 / EA 50738-01 ______
Hanes Men’s Briefs - White (1 Pk) 2XL, 3XL $4.75 / EA 50738-01 ______
Players Men’s Boxers - White (1 Pk.) 3XL, 4XL, 5XL, 6XL $6.00 / EA 50416-01 ______
Players Men’s Briefs - White (1 Pk.) 4XL, 5XL, 6XL $6.95 / EA 51610-01 ______
Gildan Men’s Boxers - White (1 Pk.) Small, Medium, Large, XL $4.25 / EA 80187-01 ______
Gildan Men’s Boxers - White (1 Pk.) 2XL (3 Pack) $4.75 / EA 80187-01 ______
Women’s Underclothing
Hanes Her Way Cotton Briefs - White (1 Pk.) 5, 6, 8, 10, 11 $2.15 / EA 50691-01 ______
Hanes No-Wire, Just My Size Bra (White) 38C, 38D, 40C, 40D, 42B, 42C, 42D, 42DD, 44C, 46D, 46DD, 50DD
$12.80 / EA 51222 ______
Manhattan Hosiery Sports Bra - No-Wire (White) Small-32, Medium-34, Large-36, XL-38, 2XL-40, 3XL-42, 4XL-44/46, 5XL-48, 6XL-50
$8.25 / EA 50457-01 ______
Thermals
Indera Mills Thermal Ankle-Length Drawers - Natural Small, Medium, Large, XL
$6.95 / EA 50544-99 ______
Indera Mills Thermal Ankle-Length Drawers - Natural 2XL, 3XL, 4XL
$7.15 / EA 50544-99 ______
Indera Mills Thermal Ankle-Length Drawers - Natural 5XL $8.15 / EA 50544-99 ______
Indera Mills Thermal Long Sleeve Shirt - Natural Small, Medium, Large, XL
$6.95 / EA 50543-99 ______
Indera Mills Thermal Long Sleeve Shirt - Natural 2XL, 3XL, 4XL $7.15 / EA 50543-99 ______
Indera Mills Thermal Long Sleeve Shirt - Natural 5XL $8.15 / EA 50543-99 ______
Pajamas
Blue Pajama Pants Small, Medium, Large, XL, 2XL, 3XL $12.00 / EA 53181-04 ______
Blue Pajama Pants 4XL $13.00 / EA 53181-04 ______
Blue Pajama Pants 5XL $15.00 / EA 53181-04 ______
K - Kosher • H - Halal • C - Clear • D - Diabetic • R - Resealable • G - Gluten Free • S - Soy Free
Total Total
Order Form Philadelphia - PA Effective December 2017Please complete all info on reverse (print clearly). / Por favor complete toda la información al reverso (escriba claramente)
DESCRIPTION/DESCRIPCIÓN PRICE/PRECIO ITEM #/NO. DE ARTÍCULO
TALLA QTY/CANTIDAD
TOTAL/PRECIO TOTAL
ELECTRONICSRadiosGPX AM FM Digital Radio - Clear $17.00 / EA 8183501099
EarbudsGPX Clear Earbuds C $2.75 / EA 5195501099
HeadphonesKoss KPH7 Headphones $4.75 / EA 5128501099
BatteriesIon 3 “AA” Batteries (4 Pk.) $3.00 / PK 21675
Ion 3 “AAA” Batteries (4 Pk.) $3.00 / PK 21676
THE GENERAL STOREPersonal CareEmery Boards (10 Pk.) $0.69 / PK 20294
Trim Nail Clipper (no file) $0.59 / EA 20656
DetergentAll 2 oz. Ultra Laundry Detergent $0.60 / EA 20667
Heritage 14.4 oz. Concentrated Laundry Detergent $3.00 / EA 21788
Tide 20 oz. Powder Detergent $5.45 / EA 21271
Storage1.6 Quart Round Serving Saver Bowl With Lid $2.70 / EA 24150
Stationery#10 Envelope $0.08 / EA 20240
#10 Stamped Envelope $0.62 / EA 983
Beveled Pink Eraser $0.65 / EA 20251
First Class Stamp $0.49 / EA 928
Golf Pencil $0.09 / EA 20462
No Clasp Envelope 9.5” x 12.5” $0.36 / EA 20243
Security Pen 1 Ct. (Blue) $0.33 / EA 21796
White Paper Pad 8.5” x 11” (50 Sheet Pad) $1.06 / PAD 20235
GamesAviator - US Playing Cards $2.00 / EA 20211
Aviator Pinochle US Playing Cards $2.00 / EA 20215
DictionariesWebster’s New Pocket Dictionary $3.00 / EA 24214
Greeting Cards
DESCRIPTION/DESCRIPCIÓN PRICE/PRECIO ITEM #/NO. DE ARTÍCULO
TALLA QTY/CANTIDAD
TOTAL/PRECIO TOTAL
Acetate Anniversary Card $0.98 / EA 29026
Acetate Birthday Card $0.98 / EA 29016
Acetate Friendship Card $0.98 / EA 29021
Acetate Get Well Card $0.98 / EA 29018
Gallant Seasonal Greeting Card $0.98 / KIT 80000104
Gallant Spanish Birthday Card $0.98 / EA 80003665
Juvenile Birthday Card $0.98 / EA 29034
Silver Muslim Greeting Card $1.50 / EA 3610
Silver Ramadan Greeting Card $1.03 / EA 3621
Thank You Card $0.98 / EA 29036
Towels & LinensBath Towel 24” x 50” (Grey) $4.40 / EA 5063201002
Bath Towel 24” x 50” (White) $4.40 / EA 5063201001
Towel 24” x 48” White $4.40 / EA 5135501001
Washcloth 12” X 12” (White) $0.60 / EA 20544
Washcloth 12” X 12” (White) $0.93 / EA 5063701001
MiscellaneousAcrylic Mirror without Magnet 6” x 4.5” C $2.80 / EA 20281
Cereal Bowl w/Lid 24 oz. $0.75 / EA 20580
Deluxe White Quarter Socks (1 Pair) $1.35 / EA 5023701099
Hinged Soap Dish (Soap Not Included) C $0.50 / EA 20272
Mesh Orange Laundry Bag 24” x 36” $4.85 / EA 20842
Penn Racquetball (1 Pk.) $1.50 / EA 5019801007
Soup Spoon $0.40 / EA 21091
Toothbrush Holder (Toothbrush Not Included) $0.60 / EA 20275
Inmate’s Name ID#
Institution/Dorm/Housing#
Street Address
City State Zip
Sender’s Name
Street Address
City State Zip
Phone Number
Email (You will receive confirmation emails when the order is placed and shipped)
SHIP TO:
SENDER:
We cannot send orders from one inmate to another.
REQUIRED for order fulfillment.
WAYS TO ORDER Online: phillypackages.comPhone: 1-800-546-6283Mail: Access Securepak (PA), 10880 Linpage Place, St. Louis, MO 63132
ACCEPTABLE FORMS OF PAYMENT: • Credit/Debit Cards—VISA, MasterCard, Discover• Prepaid Account• Prepaid cards that have a verifiable United States address• Cashier’s check• Money orderWe do not accept personal checks and will return them to the sender. Credit/debit and pre-paid cards will be charged on the day the order is placed. Re-funds or credits will be applied to the card used for the order (allow additional time for refunds/credits on pre-paid 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 Pennsylvania to collect 8% sales tax on select items. These items are identified on the order form as taxable items.
Tax calculation example: $63.52 non-taxable items = $63.52 subtotal$21.47 taxable items x 1.08 (8% sales tax) tax rate = $23.19 taxable items subtotal$63.52 non-taxable items subtotal + $23.19 taxable items subtotal = $86.71 total due ELIGIBILITY: Access Securepak verifies inmate eligibility before shipping packages, if applicable.
LIMITS: maximum $75 of product per inmate per order.
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 specifica-tions without prior notice. We regret any changes that might occur and will make every effort to minimize these occurrences. Inadvertent errors in product descrip-tions, 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 phillypackages.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:phillypackages.comAutomated system is available 24 hours a day, seven days a week1.800-546-6283 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.
MANERAS DE ORDENAR: Internet: phillypackages.comTeléfono: 1-800-546-6283Correo: Access Securepak® (PA), 10880 Lin Page Pl, St. Louis, MO 63132
FORMAS DE PAGO ACEPTABLES: • Tarjetas de Crédito/Débito—VISA, MasterCard, Discover• Tarjetas Prepagadas con domicilio registrado en los EU • Cheque Cajero• Giro de DineroNo aceptamos cheques personales y serán retornados al remitente. Las tarjetas de Crédito/Débito y Prepagadas serán cobradas el día en que la orden es puesta. Reembolsos o créditos serán aplicados a la tarjeta usada en la orden (permita tiempo adicional para procesar reembolsos / créditos a tarjetas prepagadas). Access Securepak® se reserva el derecho a re-mover uno o más artículos de la orden debido a fondos insuficientes
IMPUESTOS DE VENTA: Access Securepak® es requerido por el estado de Pennsylvania en cobrar 8% de impuestos de venta en ciertos artículos. Estos artículos están identificados en la forma para ordenar.
EJEMPLO PARA CÁLCULO DE IMPUESTO:$63.52 artículos sin impuesto= $63.52 subtotal$21.47 artículos con impuesto x 1.08 (8% impuestos de venta) = $23.19 subtotal de artículos con impuesto$63.52 subtotal de artículos sin impuesto + $23.19 subtotal de artículos con impuesto = $86.71 total a deber
LIMITES: $75 por preso, por orden.
CAMBIOS AL CATALOGO: Todo el esfuerzo se ha hecho en demostrar y describir la mercancía y toda la información lo más correctamente posible. Varias compañías hacen cambios en diseño, color, tamaño del paquete y estilo después de producir el catálogo , por consecuente, nos reservamos el derecho a descontinuar ó cambiar especificaciones del producto sin notificación previa. Lamentamos cualquier cambio que pueda ocurrir y haremos todo el esfuerzo en minimizar estas ocurrencias. Errores inad-vertidos en la descripción de productos, precios y ofertas especiales no son obligatorias a Access Securepak y pueden ser ajustadas por Access Securepak en cualquier momento. Además, varios de nuestros produc-tos pueden contener alergenos comunes como leche, huevos, trigo y cacahuates. Por favor consulte el empaquetado antes de consumirlo para información específica en los ingredientes contenidos en cada producto. Precios y ofertas son sujetas a cambios y son disponibles hasta agotar mercancía. Siempre consulte nuestra página phillypackages.com para las actualizaciones más recientes en este programa.
En caso de que algún artículo no esté disponible, podemos sustituirlo con un artículo similar de igual o más valor? Nota: al menos que elija “NO”, podemos sustituir los artículos no disponibles o restringidos.
___SI ___NO SERVICIO AL CLIENTE: phillypackages.comTeléfono: 1-800-546-6283• Sistema Automático: 24 horas al día / 7 días a la semana• Representante de Servicio al Cliente: Lunes a Viernes 8:30 a.m.– 11:59 pm Hora Este y Sábados 11:00 am – 5:00 pm Hora Este
Order Form Philadelphia - PA Effective December 2017Please complete all info on reverse (print clearly). / Por favor complete toda la información al reverso (escriba claramente)
CALCULATE AMOUNT DUE: CALCULE TOTAL A DEBER:
SUBTOTALS TAX TOTALS
Non-Taxable ItemsArtículos no imponibles:
x =
Taxable Items:Elementos gravables:
x 1.08 =
TOTAL AMOUNT DUE : Total Cantidad a Deber :
Credit Card Number / Número de Tarjeta
/
Expiration Date Fecha de Expiración
Security Code Código de Seguridad
Security Code Código de Seguridad
SELECT PAYMENT METHOD: SELECCIONE MÉTODO DE PAGO:
¨ Cashier’s Check ¨ Money Order Cheque Cajero Giro de Dinero
Make check or money order payable to ACCESS SECUREPAK / Escriba los Cheques y Giro de Dinero a ACCESS SECUREPAK
¨ VISA ¨ MasterCard ¨ Discover ¨ Prepaid
Cardholder Name / Nombre del tarjetahabiente
Cardholder Signature / Firma del tarjetahabiente
Daytime Phone Number Número de Teléfono Date / Fecha mm/dd/yyyy/ /
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