K - Kosher • H - Halal • C - Clear • D - Diabetic • R - Resealable • G - Gluten Free • S - Soy Free
Total Total Total
Order Form Sumter County Qtr. 1 2017 Package Program Ordering Dates: February 20 - March 21, 2017Please complete all info on reverse (print clearly).
ITEM DESCRIPTION PRICE ITEM # QTY TOTALPRICE
DRINKS
Coffee, Cappuccino & Cocoa
Folger’s 4 oz. 100% Colombian Coffee K H R $6.25 / EA 10961
Folger’s 4 oz. Traditional Roast Coffee K H R $5.50 / EA 10963
Keefe 10 oz. French Vanilla Cappuccino $2.45 / EA 80002268
Keefe 3 oz. 100% Colombian Coffee K H C R $3.15 / EA 7022
Swiss Miss 4.38 oz. Hot Cocoa w/Marshmallows (6 Pk.)
$2.40 / BX 80001146
Drink Mixes
Hawaiian Punch .94 oz. SF Green Berry Rush Drink Mix (8 Pk.)
$2.10 / BX 7178
Hawaiian Punch 0.91 oz. Singles To Go Berry Blue Typhoon (8 Pk.) G S
$2.10 / BX 7809
Jolly Rancher 0.57 oz. Singles To Go Cherry (6 Pk.) G S
$2.10 / PK 80000723
Sweet Fusions 12 oz. Watermelon Strawberry Drink Mix R
$2.15 / EA 10924
Wyler’s Light .80 oz. SF Singles To Go Strawberry Lemonade Drink Mix (8 Pk.) K
$4.30 / BX 80001731
Wyler’s SF .89 oz. Singles To Go Raspberry Drink Mix (8 Pk.)
$2.10 / BX 10733
FOOD & SNACKS
Cereal & Cereal Bar
Golden Valley 1.3 oz. Strawberry Cereal Bar K $0.40 / EA 6045
Kellogg’s 1.5 oz. Froot Loops Cereal (Single Serve) K
$1.00 / EA 10954
ITEM DESCRIPTION PRICE ITEM # QTY TOTALPRICE
Kellogg’s 12.2 oz. Apple Jacks Cereal K C R $5.00 / EA 10809
Quaker 15.1 oz. Maple Brown Sugar Instant Oatmeal (10 Pk.)
$5.55 / BX 5518
Sweet Home Farm 12 oz. French Vanilla Granola K $4.85 / EA 80001215
Pastries & Snack Cakes
JJ’s Tid-Bits 2 oz. Mini Snack Pie - Apple (6 Pk.) $3.95 / BX 80002090
JJ’s Tid-Bits 2 oz. Mini Snack Pie - Cherry (6 Pk.) $3.95 / BX 80002081
Kellogg’s 14.1 oz. Cinnamon Roll Pop Tarts (8 Pk.) $3.50 / BX 80002282
Kellogg’s 14.7 oz. Frosted Blueberry Pop Tarts (8 Pk.)
$3.75 / BX 10548
Market Square Bakery 4.75 oz. Chocolate Iced Honey Bun K C
$0.80 / EA 6540
Market Square Bakery 4 oz. Iced Swirl Cinnamon Roll K C
$1.15 / EA 6057
Market Square Bakery 4 oz. Strawberry ZuZus (2 Pk. Donuts) K
$1.05 / EA 6046
Mrs. Freshley’s 4.5 oz. Apple Fruit Pie $1.15 / EA 9739
Otis Spunkmeyer 3.5 oz. Marble Loaf Cake K $1.05 / EA 80003171
Otis Spunkmeyer 4 oz. Lemon Loaf Cake with Lemon Icing K
$1.05 / EA 80003169
Chips
“The Whole Shabang” 6 oz. Original Potato Chips K H
$2.30 / EA 5114
“The Whole Shabang” 9.5 oz. Extreme Crunchies K H
$2.75 / EA 80001670
ITEM DESCRIPTION PRICE ITEM # QTY TOTALPRICE
Cactus Annie’s 11 oz. “The Whole Enchilada” Party Mix K H C
$2.75 / EA 902
Cheetos 8 oz. Flamin’ Hot Crunchy C G $2.80 / EA 7687
Cheetos 9 oz. Crunchy C G $2.95 / EA 7683
Doritos 8 oz. Nacho Cheese Chips C $2.90 / EA 10514
Fritos 4 oz. Regular Corn Chips $1.55 / EA 6378
Lays 5.5 oz. Mesquite BBQ Stax Potato Chips $3.05 / EA 80003227
Lays 5.5 oz. Sour Cream & Onion Stax Potato Chips K G
$3.05 / EA 80003228
Moon Lodge 1.5 oz. Buffalo Wing Blue Cheese Potato Chips K
$0.65 / EA 80000963
Snacks & Nuts
“The Whole Shabang” 5 oz. Popcorn K H G $1.50 / EA 80002294
Combos 6.3 oz. Pepperoni Pizza H G S $3.80 / EA 6905
Cracker Jack 4 oz. Popcorn $1.50 / EA 80003277
Fiddle Faddle 6 oz. Butter Toffee Popcorn with Peanuts K
$2.00 / EA 6607
Good Sense 8 oz. Chipotle BBQ Mix C R $5.35 / EA 7864
Hormel 7.5 oz. Snackers Bacon & Jalapeno Dip G S
$5.75 / EA 80002277
Hormel 7.5 oz. Snackers Spinach Artichoke Dip G S $5.75 / EA 80002276
Kar’s 6 oz. Sweet ‘N Spicy Mix C $2.85 / EA 9674
Keebler .952 oz. Gripz Chocolate Chip Grahams $0.75 / EA 80002334
K - Kosher • H - Halal • C - Clear • D - Diabetic • R - Resealable • G - Gluten Free • S - Soy Free
Total Total Total
Order Form Sumter County Qtr. 1 2017 Package Program Ordering Dates: February 20 - March 21, 2017Please complete all info on reverse (print clearly).
ITEM DESCRIPTION PRICE ITEM # QTY TOTALPRICE
Keebler 1 oz. Chocolate Elf Grahams $0.75 / EA 80002332
Kellogg’s 1.3 oz. Original Rice Krispies Treats $1.00 / EA 2381
Kellogg’s 1.76 oz. Crunchmania Cinnamon Bun $0.85 / EA 80002330
Kellogg’s 1.76 oz. Crunchmania French Toast $0.70 / EA 80002331
Kellogg’s 3 oz. Rice Krispies Treats Double Choco-latey Chunk
$2.10 / EA 10572
Kings Nut 3 oz. Roasted & Salted Peanuts $0.95 / EA 80003354
Kings Nut 3 oz. Roasted Unsalted Peanuts $1.00 / EA 80003355
Snyder’s 2.25 oz. Honey Mustard and Onion Pretzel Pieces
$1.25 / EA 9553
Crackers
Austin 1.38 oz. Grilled Cheese on Saltines (8 Pk.) K $3.25 / BX 80000109
Austin 1.38 oz. Pepperjack on Saltines (8 Pk.) K $3.25 / BX 80000110
Cheez-It 1.5 oz. Cheddar Crackers K $0.60 / EA 9590
Cheez-It 7 oz. Cheddar Jack Crackers R $4.00 / EA 7452
Wheat Thins 1.75 oz. Crackers $0.75 / EA 9461
Cookies
Bud’s Best 6 oz. Candy ‘n Cookies - Butterfinger Mini Cookies K G S
$1.75 / EA 6386
Bud’s Best 6 oz. Chocolate Peanut Butter Mini Cookies K
$1.75 / EA 6384
Bud’s Best 6 oz. Orange Bite Delight Cookies $1.80 / EA 7924
ITEM DESCRIPTION PRICE ITEM # QTY TOTALPRICE
Checkers 8 oz. Raspberry Shortbread Cookies $2.35 / EA 7314
Delicious Bakery 12.4 oz. Chocolate Chip Cookies w/Candy Gems
$4.50 / EA 80001496
Famous Amos 2 oz. Chocolate Chip Cookies $0.60 / EA 850
Keebler 11.6 oz. Chips Deluxe Triple Chocolate Cookies K
$6.35 / EA 80000616
Lil Dutch Maid 5 oz. Duplex Creme Cookies $2.15 / EA 80002230
Market Square Bakery 6 oz. Chocolate Chip Cookies K H
$1.20 / EA 6072
Oven Baked 13 oz. Fudge Striped Shortbread Cookies
$3.00 / EA 80001120
Oven Baked 9.4 oz. Crispy Fudge Mint Cookies K C $2.90 / EA 6580
Candy
Atkinson’s 3.75 oz. Sugar Free Chick-O-Stick K G S $2.50 / EA 9765
Bit-O-Honey 4.2 oz. Bag $2.25 / EA 80000736
Chewy Lemonhead 4 oz. - Redrific $1.00 / EA 80000871
Cinamo Candy Stick .7 oz (10 Pk.) $2.60 / KIT 80002888
GoLightly 2.75 oz. Sugar Free Starlight Mints K C G $2.50 / EA 6330
GoLightly 2.75 oz. Sugar Free Vanilla Caramels K C $2.65 / EA 6331
Hot Tamales 5 oz. Candy Bag $2.25 / EA 80002269
Jolly Rancher 10 oz. Assorted Soft Chews $6.65 / EA 80002238
M&M’s 1.48 oz Mega Candies $0.65 / EA 80002242
ITEM DESCRIPTION PRICE ITEM # QTY TOTALPRICE
Old Dominion 6 oz. Peanut Brittle $2.80 / EA 80003030
Rainbow Candy (10 Pk.) $2.60 / KIT 80003433
Red Hots 4 oz. Cinnamon Flavored Hard Candy $1.00 / EA 80000869
Sathers 4 oz. Gummy Bears $1.00 / EA 80000867
Sathers 4 oz. Sour Neon Worms $1.00 / EA 80000868
Sathers 7.5 oz. Butterscotch Discs $1.40 / EA 40666
Select Sweets 8 oz. Jelly Beans $1.75 / EA 80002185
Starburst 2.07 oz. Fruit Chews $1.75 / EA 953
Werther’s 5.5 oz Candy $3.95 / EA 603
Zachary 5 oz. Double Dipped Chocolate Peanuts $2.35 / EA 3975
Pickle
Van Holten’s 9.6 oz. Dill Pickle K G S $0.80 / EA 381
Cheese
Cactus Annie’s 2 oz. Jalapeno Cheese Squeeze Snack G
$0.40 / EA 2585
City Cow 4 oz. Mozzarella Cheese Stick C G $1.85 / EA 5645
City Cow 4 oz. White Queso Dip C R G $1.85 / EA 6017
Painted Cow 2 oz. Dippins Cream Cheese C G $1.00 / EA 9655
Philly 2 oz. Cream Cheese w/Jalapenos $1.00 / EA 10911
Velveeta 2 oz. Sharp Cheddar Spread G $0.65 / EA 7739
K - Kosher • H - Halal • C - Clear • D - Diabetic • R - Resealable • G - Gluten Free • S - Soy Free
Total Total Total
Order Form Sumter County Qtr. 1 2017 Package Program Ordering Dates: February 20 - March 21, 2017Please complete all info on reverse (print clearly).
ITEM DESCRIPTION PRICE ITEM # QTY TOTALPRICE
Velveeta 4 oz. Nacho Cheese Dip w/Jalapenos Snack Spread Tub C R G
$1.60 / EA 9398
Velveeta 8 oz. Spicy Jalapeno Cheese Snack Spread Tub C R G
$2.30 / EA 9397
Meat Snacks
Brookfield Farms 2.1 oz. Fully Cooked Hickory Bacon (15 slices)
$5.70 / EA 5885
Brushy Creek 1.6 oz. Regular Summer Sausage $1.65 / EA 80001715
Brushy Creek 5 oz. Beef & Chicken Hot Sau-sage H G
$3.20 / EA 80003317
Brushy Creek 5 oz. Beef & Chicken Sausage H G $3.20 / EA 80003316
Brushy Creek 5 oz. Beef Salami Stick G S $3.20 / EA 80001739
Carmela 10 oz. Vienna Sausage Bites $2.40 / EA 80001054
Jack Link’s 4 oz. Deli Cuts Sausage Bites $5.40 / EA 6354
O’Brien’s 1.125 oz. Beef Sticks Hickory Smoked G $1.25 / EA 5379
O’Brien’s Double Barrel 1.125 oz. Spicy Meat & Jalapeno Cheese
$1.15 / EA 80001205
Seafood
Bumble Bee 5 oz. Tuna in Pouch K $4.00 / EA 9768
Chicken of the Sea 3.53 oz. Sardines in Louisiana Hot Sauce K
$2.00 / EA 10358
Chicken of the Sea 5 oz. Pink Salmon K $4.00 / EA 4179
Fresh Catch 3.53 oz. Fillets of Mackerel in Soybean Oil K H G
$1.95 / EA 4385
ITEM DESCRIPTION PRICE ITEM # QTY TOTALPRICE
Fresh Catch 3.53 oz. Yellowfin Tuna Steak in Spicy Thai Chili Sauce K H G
$4.00 / EA 5696
Fresh Catch 4.23 oz. Chunk Light Tuna in Water K H G
$2.50 / EA 4317
Starkist 3 oz. Ready-to-Eat Tuna Salad $4.95 / EA 10705
Ready-To-Eat Meals
Brushy Creek 11.25 oz. Beef Stew G $2.50 / EA 1715
Brushy Creek 11.25 oz. Chili with Beans G $2.40 / EA 1711
Brushy Creek 11.25 oz. Hot Chili with Beans (HOT) G
$2.20 / EA 1712
Brushy Creek 11.25 oz. Lasagna with Beef $2.00 / EA 1721
Brushy Creek 11.25 oz. Low Fat Spicy Chili w/Beans $2.75 / EA 10274
Brushy Creek 11.25 oz. Sloppy Joe Sauce with Beef $3.65 / EA 1723
Brushy Creek 5 oz. Chicken Vienna Sausage G S $1.75 / EA 80002944
Brushy Creek 5 oz. Spicy Chicken Vienna Sausage $1.75 / EA 80002945
Brushy Creek 7 oz. Chunk Ham with Natural Juices $4.30 / EA 80002117
Brushy Creek 8 oz. Southwestern Style Black Beans and Beef
$3.10 / EA 80000266
Brushy Creek 8 oz. Chicken Chili w/White Beans $2.50 / EA 80001465
Brushy Creek 8 oz. Mexican Style Chicken Stew G $3.30 / EA 80003085
Rice & Beans
Brushy Creek 10 oz. Black Beans G $1.90 / EA 4915
ITEM DESCRIPTION PRICE ITEM # QTY TOTALPRICE
Brushy Creek 10 oz. Seasoned Pinto Beans in Sauce $2.10 / EA 80002106
Sevilla 4.4 oz. HOT Chili Flavor Refried Beans & Rice K H C
$1.30 / EA 5940
Velveeta 4 oz. Spicy, Cheesy Refried Beans & Rice K H C
$1.50 / EA 4941
Zatarain’s 8.8 oz. Big Easy Rice - Jambalaya $3.95 / EA 10453
Tortillas
Chi-Chi’s 9 oz. White Corn Tortillas (10 Pk.) K C G $1.55 / EA 6190
Nuevo Leon 13 oz. 8 inch Flour Tortillas (10 Pk.) $1.55 / EA 80002202
Ramen
Maruchan 3 oz. Cajun Chicken Flavor Ramen C $0.45 / EA 18
Maruchan 3 oz. Chili Flavor Ramen C $0.45 / EA 10
Maruchan 3 oz. Texas Beef Flavor Ramen C $0.45 / EA 13
Noodles
Barilla 16 oz. Angel Hair Pasta $3.65 / EA 9429
Cinch 7.25 oz. Macaroni & Cheese $1.05 / EA 764
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 shipped and received.)
SHIP TO:
SENDER:
We cannot send orders from one inmate to another.
REQUIRED for order fulfillment.
CALCULATE AMOUNT DUE:TAX TOTALS
Food Items Total: x 1.04 =
Processing Fee: $2.95 x 1.04 = $3.07
TOTAL AMOUNT DUE:
Credit Card Number
/
Expiration Date Security Code
Security code is last three digits of account number panel.
SELECT PAYMENT METHOD:
¨ Cashier’s Check ¨ Money OrderMake check or money order payable to ACCESS SECUREPAK
¨ VISA ¨ MasterCard ¨ Discover
Cardholder Name
Cardholder Signature
Daytime Phone Number Today’s Date mm/dd/yyyy/ /
Order Form Sumter County Qtr. 1 2017 Package Program Ordering Dates: February 20 - March 21, 2017Please complete all info on reverse (print clearly).
PROGRAM DATES:Ordering Begins: February 20, 2017Ordering Ends: March 21, 2017Postmark date for mail orders: March 14, 2017 Orders must be received by: March 21, 2017Delivery to facility: On or before April 1, 2017
WAYS TO ORDER Online: sumtercountypackages.comPhone: 1-855-768-0785Mail: Access Securepak (GA), 10880 Linpage Place St. Louis, MO 63132
ACCEPTABLE FORMS OF PAYMENT: • Credit/Debit Cards—VISA, MasterCard, Discover• 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 send-er. 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 Georgia to collect sales tax on all merchandise including the processing fee. Please see the tax calculation example below for more information.
Tax calculation example: $87.52 merchandise total x 1.04 (tax rate) = $91.02 merchandise subtotal$2.95 processing fee x 1.04 (tax rate) = $3.07 processing fee sub-total$91.02 merchandise subtotal + $3.07 processing fee subtotal = $94.09 total due
ELIGIBILITY: Access Securepak verifies inmate eligibility before shipping packages, if applicable.
LIMITS: Maximum $100 or 15 lbs. of product per inmate (whichev-er is reached first). Multiple packages can be ordered, and we will consolidate orders not to exceed the maximum $100 or 15 lbs. 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 discontin-ue 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 sumtercountypackages.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:sumtercountypackages.comAutomated system is available 24 hours a day, seven days a week1-855-768-0785 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.