Date: 06/01/14 Superseding: N/A Product Specification Buena Vista Food Products, 823 W. 8th Street, Azusa, CA 91702 626.815.8859 Buena Vista is a Peanut Free and Tree Nut free plant. Product Information WG Pumpkin Cookie 1.1 oz. 72820 IW Product Name: Item Number: USDA Meal Contribution/Formulation Statement: Does product meet Whole Grain Rich criteria? (at least 50% or 1st ingredient?) Yes, Whole Wheat Does product contain non-creditable grains? Yes, Corn Starch (0.528 g.) Description of Creditable Grain Ingredient? Whole Wheat Flour Enriched Wheat Flour Grams of Creditable Gram Standard of Grain ingredient Creditable Grain per oz equivalent? (B) per Portion? (A) 6.74 Description of Product Group C Whole Grain Grams per serving: Cookie-plain 6.74 Creditable Amount (A/B) 16 g 6.47 16 g Total Creditable Amount By Weight: .75 Exhibit A: Group (A-I) Units per Case: Case Cube: Case Gross Weight: Pallet Tie: UPC Case Code: Grain crediting Exhibit A: .75oz eq. 0.42 0.4 oz grain eq. Portion Size of product as purchased (A) Weight of one ounce equivalent as listed in SP-30-2012 (B) 1.1 oz 1.2 oz Packaging 150 IW 0.74 11.31 # 10 x 5 711341728200 Ingredients: Whole Wheat Flour, Enriched Wheat Flour, Sugar, Vegetable Shortening, Water. Contains less than 2% of Eggs, Corn Starch, Baking Powder, Salt, Natural Flavor, Food Color Nutritional Information: Contains: Egg, Soy, Wheat Storage Requirements: Store Frozen at 0°F I certify the above is true and correct. Shelf Life: 12 months Case Coding System Example: Manufacture Date/ Julian Date/Year MD/249/14 Laura Trujillo, RD, SNS President, Buena Vista Foods DAVE’S BAKING COMPANY 1158 26th Street, Suite 463 . Santa Monica . CA 90403 . Tel (310) 630-5873 . Fax (310) 630-5865 Quality Baked Products Since 1960 Product Formulation Statement Product Name: Fudge Brownie-Reduced Fat Manufacturer: Dave’s Baking Co. Case Weight and Pack/Count: Item number: 225 9.9 lbs; 72 servings per case Weight of one Serving of Product: 2.2 oz, 62 gm Grain Ingredients per serving: Whole grain wheat flour (8.3gm), Enriched wheat flour (7.9gm). Description of Creditable Grain Ingredient Grams of Creditable Grain Ingredient per Portion A Gram Standard of Creditable Grain per oz equivalent B Creditable Amount A÷B Whole Grain Wheat Flour Enriched Wheat Flour Total Creditable Amount 8.3 7.9 16 16 0.51 0.5 1 I certify that the above information is true and correct and that one serving of the above product (ready to eat) contains one serving of Grain. I further certify that non-creditable grains are not above 0.24 oz eq. per portion. Name: David Aframian Title: Vice President Date: May 26, 2013 Chocolate Cupcake - 2oz SBI CODE # - 9480 UPC ITEM# - 091464948007 Nutrition Facts PRODUCT CONTRIBUTION Serving Size 2oz (57g) Servings Per Container 1 Amount Per Serving Calories 200 Calories from Fat 60 % Daily Value* Total Fat 7g 10% 12% Saturated Fat 2.5g Trans Fat 0g Polyunsaturated Fat 2g Monounsaturated Fat 2g Cholesterol 10mg 3% 13% Sodium 300mg Total Carbohydrate 35g 12% 4% Dietary Fiber less than 1g Sugars 25g Protein 2g Vitamin A 0% Calcium 15% • • GRAIN CREDIT: ¼ oz grain equivalent GRAMS OF FLOUR: 5.82 GRAMS OF WHOLE GRAIN: 0 GRAMS OF ENRICHED: 5.82g PERCENT OF TOTAL GRAINS THAT ARE WHOLE GRAIN: NA DOES THIS PRODUCT QUALIFY AS WHOLE GRAIN RICH: NO PRODUCT HIGHLIGHTS • Menu or Ala Carte • Great for Classroom Parties • Increase Participation Vitamin C 0% Iron 4% *Percent Daily Values are based on a 2,000 calorie diet. INGREDIENTS: SUGAR, WATER, CORN SYRUP, ENRICHED FLOUR (WHEAT FLOUR, MALTED BARLEY FLOUR, NIACIN, REDUCED IRON, THIAMINE MONONITRATE, RIBOFLAVIN, FOLIC ACID), HIGH FRUCTOSE CORN SYRUP, EGGS, PALM OIL, SOYBEAN OIL, COCOA (NATURAL AND PROCESSED WITH ALKALI). CONTAINS 2% OR LESS OF THE FOLLOWING: MODIFIED CORNSTARCH, DEXTROSE, LEAVENING (SODIUM ACID PYROPHOSPHATE, BAKING SODA, MONOCALCIUM PHOSPHATE), CORNSTARCH, CALCIUM CARBONATE, MONOAND DIGLYCERIDES, CHOCOLATE , SALT, CALCIUM SULFATE, AGAR, SOY LECITHIN, DATEM, SODIUM STEAROYL LACTYLATE, POLYSORBATE 60, GUAR GUM, CELLULOSE GUM, ARTIFICIAL FLAVORS, SODIUM HEXAMETHAPHOSPHATE, LACTIC ACID, SORBITAN MONOSTEARATE, CITRIC ACID, XANTHAN GUM, CARAMEL COLOR, PRESERVED WITH POSTASSIUM SORBATE, SORBIC ACID AND SODIUM PROPIONATE.. CONTAINS: WHEAT, SOY, MILK & EGG MANUFACTURED ON SHARED EQUIPMENT THAT ALSO PROCESSES PRODUCTS CONTAINING WALNUTS & COCONUT. PEANUT/PEANUT DERIVATIVES ARE PRESENT IN THE FACILTY SUGGESTED BID SPEC Goodyman Happy Birthday Cupcake (Chocolate) code/ 9480- 72 - 2 oz. Frozen, individually wrapped Thaw & Serve cupcake. Must conform to USDA Child Nutrition Program specifications and meet ¼ oz grain equivalent. Student preferred brand Super Bakery’s Goodyman product #9480. Must meet 31% or fewer calories from fat. Made in the USA, Peanut Free Product. Product analysis required. cs/ct case dimensions case cube case weight cases per pallet TiHi shelf life CASE SPECS 72 (12 iw cc per tray - 6 trays per case) 14.75” L x 10.875” W x 10.625” H .98 10.8 lbs 88 11 x 8 frozen: 12 months / ambient: 16 days days PRESIDENT, SUPER BAKERY, INC. 1•800•722•6841 – Customer Service Updated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’S BAKING COMPANY 1158 26th Street, Suite 463 . Santa Monica . CA 90403 . Tel (310) 630-5873 . Fax (310) 630-5865 Quality Baked Products Since 1960 Product Formulation Statement Product Name: Whole Grain Brownie Cup Manufacturer: Dave’s Baking Co. Case Weight and Pack/Count: Item number: 126 9.55 lbs; 90 servings per case Weight of one Serving of Product: 1.5 oz, 43 gm Grain Ingredients per serving: Whole grain wheat flour (4.15gm), Enriched wheat flour (3.95gm). Description of Creditable Grain Ingredient Grams of Creditable Grain Ingredient per Portion A Gram Standard of Creditable Grain per oz equivalent B Creditable Amount A÷B Whole Grain Wheat Flour Enriched Wheat Flour Total Creditable Amount 4.15 3.95 16 16 0.259 0.25 0.5 I certify that the above information is true and correct and that one serving of the above product (ready to eat) contains half serving of Grain. I further certify that non-creditable grains are not above 0.24 oz eq. per portion. Name: David Aframian Title: Vice President Date: May 26, 2013 PDF 1oz Honey Graham 51% Whole Grain Pre-Packaged Belly Bears - 200 ct Manufacturer's Product Code 056071 Nutrition Facts Serving Size: 1 package (28 G) Serving Per Container: 1 Calories Calories from Fat 130 35 Per Serving % Daily Value* Total Fat 4g 6% Saturated Fat 0g 0% Trans Fat 0g Cholesterol 0mg 0% 100mg 4% 20g 7% Dietary Fiber 1g 5% Sugars 8g Protein 2g Sodium Total Carbohydrate Vitamin A Calcium 0% 10% Vitamin C Iron 0% 6% Ingredients: Whole wheat (graham) flour, enriched flour (wheat flour, niacin, reduced iron, thiamine mononitrate, riboflavin, folic acid), sugar, canola oil, honey, calcium carbonate, leavening (baking soda, monocalcium phosphate), salt, natural flavor. Allergen Information: Contains: Wheat Kosher Type: OU - DAIRY Child Nutrition Statement: The listed serving size contains 18.36g creditable grains of which 9.42g are whole grains. This provides 1 servings of breads/grains under the Child Nutrition Program using the 16g calculator. Storage/ Handling: Product Specifications: Storage at ambient temperature will give 6 months shelf life. UPC SCC/GTIN Case Pack 073321560713 10073321560710 1 200 Preparation Instruction: Open package and serve as is. Case Length Case Width 20.07 15.47 Case Dimensions Case Case Net Weight Height Cube (Lbs) 8.94 1.6063 Gross Weight (Lbs) 12.5 14.5 Pallet Tier 6 Pallet Dimensions Pallet High 9 Pallet Count 54 I certify that the nutritional information contained on this page is true and correct to the best of my knowledge. Kathleen Wong Research and Development Director J&J Snack Foods Corp. • 6000 Central Highway, Pennsauken, NJ 08109 • (800) 486-9533 x6140 • www.jjsnack.com 06/30/2014 PDF 1 oz Chocolate Graham 51% Whole Grain Pre-Packaged Belly Bears - 200 ct Manufacturer's Product Code 056070 Nutrition Facts Serving Size: 1 package (28 G) Serving Per Container: 1 Calories Calories from Fat 120 35 Per Serving % Daily Value* Total Fat 4g 6% Saturated Fat 0g 0% Trans Fat 0g Cholesterol 0mg 0% 85mg 3% 20g 7% Dietary Fiber 2g 6% Sugars 7g Protein 2g Sodium Total Carbohydrate Vitamin A Calcium 0% 10% Vitamin C Iron 0% 6% Ingredients: Whole wheat (graham) flour, enriched flour (wheat flour, niacin, reduced iron, thiamine mononitrate, riboflavin, folic acid), sugar, canola oil, cocoa (alkalized), unsweetened chocolate, calcium carbonate, natural flavor, baking soda, salt. Allergen Information: Contains: Wheat Kosher Type: OU - DAIRY Child Nutrition Statement: The listed serving size contains 17.68g creditable grains of which 9.36g are whole grains. This provides 1 servings of breads/grains under the Child Nutrition Program using the 16g calculator. Storage/ Handling: Product Specifications: Storage at ambient temperature will give 6 months shelf life. UPC SCC/GTIN Case Pack 073321560706 10073321560703 1 200 Preparation Instruction: Open package and serve as is. Case Length Case Width 20.07 15.47 Case Dimensions Case Case Net Weight Height Cube (Lbs) 8.94 1.6063 Gross Weight (Lbs) 12.5 14.5 Pallet Tier 6 Pallet Dimensions Pallet High 9 Pallet Count 54 I certify that the nutritional information contained on this page is true and correct to the best of my knowledge. Kathleen Wong Research and Development Director J&J Snack Foods Corp. • 6000 Central Highway, Pennsauken, NJ 08109 • (800) 486-9533 x6140 • www.jjsnack.com 06/30/2014 PDF Manufacturer's 56073 Ingredients: Whole Wheat (Graham) Flour, Enriched Flour (Wheat Flour, Malted Barley Flour, Niacin Reduced Iron, Thiamine Mononitrate, Riboflavin, Folic Acid), Sugar, High Oleic Canola Oil, Natural Flavor, Invert Sugar, Calcium Carbonate, Salt, Baking Soda, Monocalcium Phosphate, Mixed Tocopherols (Vitamin E Added to Preserve Freshness). Allergen Information: Contains: Wheat Kosher Type: OU - DAIRY Child Nutrition Statement: The listed serving size contains 17.50g creditable grains of which 8.98g are whole grains. This provides 1 servings of breads/grains under the Child Nutrition Program using the 16g calculator. Storage/ Handling: Product Specifications: Storage at ambient temperature will give 6 months shelf life. UPC SCC/GTIN Case Pack 073321560737 10073321560734 1 200 Preparation Instruction: Open package and serve as is. Case Length Case Width 20.07 15.47 Case Dimensions Case Case Net Weight Height Cube (Lbs) 8.94 Pallet Tier 6 1.6063 Pallet Dimensions Pallet High 9 Gross Weight (Lbs) 12.5 14.5 Pallet Count 54 I certify that the nutritional information contained on this page is true and correct to the best of my knowledge. Kathleen Wong Research and Development Director J&J Snack Foods Corp. 6000 Central Highway, Pennsauken, NJ 08109 (800) 486-9533 x6140 07/01/2014 www.jjsnack.com PDF 1oz 51% Whole Grain Pre-Packaged Jungle Crackers - 200 ct Manufacturer's Product Code 039085 Nutrition Facts Serving Size: 1 package (28 G) Serving Per Container: 1 Calories Calories from Fat 130 35 Per Serving % Daily Value* Total Fat 4g 6% Saturated Fat 0g 0% Trans Fat 0g Cholesterol 0mg 0% 95mg 4% 20g 7% Dietary Fiber 1g 4% Sugars 8g Protein 2g Sodium Total Carbohydrate Vitamin A Calcium 0% 15% Vitamin C Iron 0% 4% Ingredients: Whole wheat flour, enriched flour (wheat flour, niacin, reduced iron, thiamine mononitrate, riboflavin, folic acid), sugar, canola oil, invert syrup, calcium carbonate, leavening (baking soda, monocalcium phosphate), salt, natural flavors. Allergen Information: Contains: Wheat Kosher Type: OU - DAIRY Child Nutrition Statement: The listed serving size contains 17.38g creditable grains of which 8.93g are whole grains. This provides 1 servings of breads/grains under the Child Nutrition Program using the 16g calculator. Storage/ Handling: Product Specifications: Keep at ambient temperature. Shelf life is 6 months ambient temperature. UPC SCC/GTIN Case Pack 073321390853 10073321390850 1 200 Preparation Instruction: Serve as is. Case Length Case Width 20.07 15.47 Case Dimensions Case Case Net Weight Height Cube (Lbs) 8.94 1.6063 Gross Weight (Lbs) 12.5 14.5 Pallet Tier 6 Pallet Dimensions Pallet High 9 Pallet Count 54 I certify that the nutritional information contained on this page is true and correct to the best of my knowledge. Kathleen Wong Research and Development Director J&J Snack Foods Corp. • 6000 Central Highway, Pennsauken, NJ 08109 • (800) 486-9533 x6140 • www.jjsnack.com 07/01/2014 Date: 06/01/14 Superseding: N/A Product Specification Buena Vista Food Products, 823 W. 8th Street, Azusa, CA 91702 626.815.8859 Buena Vista is a Peanut Free and Tree Nut free plant. Product Information WG Shamrock Cookie 1.1 oz. 72920 IW Product Name: Item Number: USDA Meal Contribution/Formulation Statement: Does product meet Whole Grain Rich criteria? (at least 50% or 1st ingredient?) Yes, Whole Wheat Does product contain non-creditable grains? Yes, Corn Starch (0.528 g.) Description of Creditable Grain Ingredient? Whole Wheat Flour Enriched Wheat Flour Grams of Creditable Gram Standard of Grain ingredient Creditable Grain per oz equivalent? (B) per Portion? (A) 6.74 Description of Product Group C Whole Grain Grams per serving: Cookie-plain 6.74 Creditable Amount (A/B) 16 g 6.47 16 g Total Creditable Amount By Weight: .75 Exhibit A: Group (A-I) Units per Case: Case Cube: Case Gross Weight: Pallet Tie: UPC Case Code: Grain crediting Exhibit A: .75oz eq. 0.42 0.4 oz grain eq. Portion Size of product as purchased (A) Weight of one ounce equivalent as listed in SP-30-2012 (B) 1.1 oz 1.2 oz Packaging 150 IW 0.74 11.31# 10 x 5 711341729207 Ingredients: Whole Wheat Flour, Enriched Wheat Flour, Sugar, Vegetable Shortening, Water. Contains less than 2% of Eggs, Corn Starch, Baking Powder, Salt, Natural Flavor, Food Color Nutritional Information: Contains: Egg, Soy, Wheat Storage Requirements: Store Frozen at 0°F I certify the above is true and correct. Shelf Life: 12 months Case Coding System Example: Manufacture Date/ Julian Date/Year MD/249/14 Laura Trujillo, RD, SNS President, Buena Vista Foods Date: 07/1/13 Superseding: N/A Product Specification Buena Vista Food Products, 823 W. 8th Street, Azusa, CA 91702 626.815.8859 Buena Vista is a Peanut Free and Tree Nut free plant. Product Information Product Name: Item Number: WG Yellow Star Cookie 73910 bulk/73920 IW USDA Meal Contribution/Formulation Statement: Does product meet Whole Grain Rich criteria? (at least 50% or 1st ingredient?) Yes, Whole Wheat Does product contain non-creditable grains? No Description of Creditable Grain Ingredient? Whole Wheat Flour Enriched Wheat Flour Grams of Creditable Gram Standard of Grain ingredient Creditable Grain per oz equivalent? (B) per Portion? (A) 6.74 Description of Product Group C Whole Grain Grams per serving: Cookie-plain 6.74 Packaging Creditable Amount (A/B) 16 g 6.47 16 g Total Creditable Amount By Weight: Exhibit A: Group (A-I) Units per Case: Case Cube: Case Gross Weight: Pallet Tie: UPC Case Code: Grain crediting Exhibit A: .75oz eq. 0.42 0.4 .75 oz grain eq. Portion Size of product as purchased (A) Weight of one ounce equivalent as listed in SP-30-2012 (B) 1.1 oz 1.2 oz 300 b/150 IW 1.32 21.63 #/11.31 # 10 x 5 00711341739107/'00711341739206 Ingredients: WHOLE WHEAT FLOUR, ENRICHED WHEAT FLOUR, SUGAR, TRANSFAT-FREE SOY SHORTENING, WATER, EGG POWDER, MODIFIED FOOD STARCH, SALT, BAKING POWDER, NATURALFREE FLAVOR, YELLOW FOODWATER, COLORING. WHOLE WHEAT FLOUR, ENRICHED WHEAT FLOUR, SUGAR, TRANSFAT SOY SHORTENING, EGG POWDER, MODIFIED FOOD STARCH, CARAMEL COLOR, SALT, Nutritional Information: Allergens: Egg, Soy, Wheat Storage Requirements: Store Frozen at 0°F Shelf Life: 12 months Case Coding System Example: Manufacture Date/ Julian Date/Year MD/249/13 Laura Trujillo, RD, SNS President, Buena Vista Foods Date: 7.1.13 Date: 06/01/14 Superseding: N/A Product Specification Buena Vista Food Products, 823 W. 8th Street, Azusa, CA 91702 626.815.8859 Buena Vista is a Peanut Free and Tree Nut free plant. Product Information WG Pink Heart Cookie 1.1 oz. 73820 IW Product Name: Item Number: USDA Meal Contribution/Formulation Statement: Does product meet Whole Grain Rich criteria? (at least 50% or 1st ingredient?) Yes, Whole Wheat Does product contain non-creditable grains? Yes, Corn Starch (0.528 g.) Description of Creditable Grain Ingredient? Whole Wheat Flour Enriched Wheat Flour Grams of Creditable Gram Standard of Grain ingredient Creditable Grain per oz equivalent? (B) per Portion? (A) 6.74 Description of Product Group C Whole Grain Grams per serving: Cookie-plain 6.74 Creditable Amount (A/B) 16 g 6.47 16 g Total Creditable Amount By Weight: .75 Exhibit A: Group (A-I) Units per Case: Case Cube: Case Gross Weight: Pallet Tie: UPC Case Code: Grain crediting Exhibit A: .75oz eq. 0.42 0.4 oz grain eq. Portion Size of product as purchased (A) Weight of one ounce equivalent as listed in SP-30-2012 (B) 1.1 oz 1.2 oz Packaging 150 IW 0.74 11.31# 10 x 5 711341738209 Ingredients: Wholw Wheat Flour, Enriched Wheat Flour, Sugar, Vegetable Shortening, Water. Contains less than 2% of Eggs, Corn Starch, Baking Powder,Salt, Natural Flavor, Food Color Nutritional Information: Contains: Egg, Soy, Wheat Storage Requirements: Store Frozen at 0°F I certify the above is true and correct. Shelf Life: 12 months Case Coding System Example: Manufacture Date/ Julian Date/Year MD/249/14 Laura Trujillo, RD, SNS President, Buena Vista Foods Date: 06/01/14 Superseding: N/A Product Specification Buena Vista Food Products, 823 W. 8th Street, Azusa, CA 91702 626.815.8859 Buena Vista is a Peanut Free and Tree Nut free plant. Product Information WG Christmas Tree Cookie 1.1 oz 71220 IW Product Name: Item Number: USDA Meal Contribution/Formulation Statement: Does product meet Whole Grain Rich criteria? (at least 50% or 1st ingredient?) Yes, Whole Wheat Does product contain non-creditable grains? Yes, Corn Starch (0.528 g.) Description of Creditable Grain Ingredient? Whole Wheat Flour Enriched Wheat Flour Grain crediting Exhibit A: .75oz eq. Grams of Creditable Gram Standard of Grain ingredient Creditable Grain per oz equivalent? (B) per Portion? (A) 6.74 16 g 6.47 Total Creditable Amount By Weight: Exhibit A: Group (A-I) Description of Product Group C Whole Grain Grams per serving: Cookie-plain 6.74 Units per Case: Case Cube: Case Gross Weight: Pallet Tie: UPC Case Code: Creditable Amount (A/B) 0.42 16 g .75 oz grain eq. 0.4 Portion Size of product as purchased (A) Weight of one ounce equivalent as listed in SP-30-2012 (B) 1.1 oz 1.2 oz Packaging 150 IW 0.74 11.31# 10 x 5 711341712209 Ingredients: Whole Wheat Flour, Enriched Wheat Flour, Sugar, Vegetable Shortening, Water. Contains less than 2% of Eggs, Corn Starch, Baking Powder, Salt, Natural Flavor, Food Color Nutritional Information: Contains: Egg, Soy, Wheat Storage Requirements: Store Frozen at 0°F I certify the above is true and correct. Shelf Life: 12 months Case Coding System Example: Manufacture Date/ Julian Date/Year MD/249/14 Laura Trujillo, RD, SNS President, Buena Vista Foods Gold Star Foods 3781 East Airport Way, Ontario, CA 91761 (909) 843-9600 Product: 51% Whole Grain 4” Wheat Hamburger Bun Pack Size: Fresh 2.07 oz/12 count Frozen: 2.07 oz/144 count Freund Code: #2176 Fresh# 600054 Frozen#112952 Don Lee #146 Case Weight: 22 lb Shelf Life of Product: Frozen: 12 months/ Refrigerated: 7 days USDA Meal Contribution: Does product meet Whole Grain Rich criteria? (at least 50% or 1st ingredient) Grams of whole grains per portion? yes Does product contain non-creditable grains? How many grams? No Exhibit A determination Description of Creditable Grain Grams of total grain per portion? Computed creditable amount by weight 17.882 g 2.0 Oz Grain Equivalent Group B Whole wheat flour, enriched wheat flour 35.06 g 2.0 Ingredients: Whole Wheat Flour, Enriched Wheat Flour (Flour, Malted barley Flour, Niacin, Reduced Iron, Thiamine Mononitrate, Riboflavin, Folic Acid), Water, Sugar, Contains less than 2% of: Soybean oil, Yeast, Wheat Gluten, Salt, Emulsifier, Enzymes, Calcium Propionate, Monoglyceride, Calcium Carbonate, Microcrystalline Cellulose, Cornstarch. Contains: Wheat I certify this information is true and correct: July 20, 2014 Stan Schaffer, Plant Manager Gold Star Foods 3781 East Airport Way, Ontario, CA 91761 (909) 843-9600 Product: 51% Whole Grain 6” Wheat Hotdog Bun Pack Size: 1.96 oz/12 Freund Code: #2179 GS# 600056 Case Weight: 1 lb Shelf Life of Product: Frozen: 12 months/ Refrigerated: 7 days USDA Meal Contribution: Does product meet Whole Grain Rich criteria? (at least 50% or 1st ingredient) Grams of whole grains per portion? yes Does product contain non-creditable grains? How many grams? No Exhibit A determination Description of Creditable Grain Grams of total grain per portion? Computed creditable amount by weight 17.24 g 1.75 Oz Grain Equivalent Group B Whole wheat flour, enriched wheat flour 33.81 2.0 Ingredients: Whole Wheat Flour, Enriched Wheat Flour (Flour, Malted barley Flour, Niacin, Reduced Iron, Thiamine Mononitrate, Riboflavin, Folic Acid), Water, Sugar, Contains less than 2% of: Soybean Oil, Wheat Gluten, Yeast, Salt, Monoglyceride, Emulsifier, Enzymes, Calcium Propionate, Calcium Carbonate, Microcrystalline Cellulose, Cornstarch. Allergens: Wheat I certify this information is true and correct: July 20, 2014 Stan Schaffer, Plant Manager FOR QUALIWAND SERVICE BE SURE TO GET ROMERO'S FOOD PRODUCTS, INC. 15155 Valley View Avenue . Santa Fe Springs, CA 90670 (562) 802-1858 . FAX (562\ 921-7240 . www.'romorosfood.com CORN & FLOUR TORTILLAS. TACO & TOSTADA SHELLS, MEXICAN SWEET BBEAD. TORTILLA CHIPS 210282UG ROMERO'S FLOUR TORTILLAS 10"-28ozldoz ULTRA GRAIN WHOLE WHEAT FLOUR TORTILLAS-PRESSED 612 DOZ. PKGS.-1 2 DOZ./CASE CODE PRODUGT NAME DESCRIPTION PAGK AM** SPECTF/CArrO'VS LABEL |NGREDTENJ WHOLE GRAIN WHEAT FLOUR (Ultra ENRICHED WHEAT FLOUR (wheat flour, malted ferrous sulfate, niacin, thiamine mononitrate, folic acid), WATER, VEGETABLE OIL (may contain cottonseed or palm oils), MARGARINE, (corn starch, sodium bicarbonate, sodium aluminum rice flour, monocalcium phosphate), CALCIUM PROPIONATE, POTASSIUM GUAR GUM, FUMARIC ACID, Gontains: Wheat, Grain), barley, riboflavin, soybean, LEAVENING sulfate, SALT, SORBATE, L-CYSTEINE. Soy General Manager NUTR|TION FACTS 1 T3rtills Calories 181 Calories From Fat Total Fat, gm Saturated Fat, gm Trans Fat, gm Cholesterol, mg Sodium, mg TotalCarbohydrate, gm 41 % D. V. * 57% 14% 0 0 168 31 3 Dietary Fiber, gm Sugars, gm Protein, gm 0o/o 7o/o 10% 12% n Vitamin A Vitamin C 0o/o Calcium lron 10% 10% 0% * Daily Values Based On 2,000 Calories/Day PHYSICAL WeighUDoz. Diameter Flavor Golor 28oz(+l-.25o2) 10" (+7- .5"; Fresh Baked Flour Tan-Light Toast Marks Meets USDA StandardEor "Whole Grain Rich" 1 Tortilla = 2.25o2 Equivalent Grains According To USDA Exhibit A:School Lunch/Breakfast-Group B. 1 Tortilla Contains 39.7 Grams (600/o) Whole crain/Enriched Wheat Flour Blend Of Which At Least 50% ls Whole Grain. CHEMTqAL Tortilla pH Tortilla Moisture SHELF l_tFE Room Temperature Refrigerated 5.50-5.90 MICROBIOLOGICAL Total Plate <50000/g 28o/o-32o/o TotalColiform <10019 E. Coli Staph Salmonella <25l1 009 15 Days 30 Days PACKAGING-BAG P"iy B"g G*g" Poly Bag Dimensions Type Of Seal Package Count Package Weight Package/Case SPECS.XLS. 1 0"x28oz .0015"-Plain 1 3"x14.5" Heat Seal 24 56oz (+7-.50o2) 6 U negative Yeasi & Mold negative <5og Listeria negative PACKAGING.CASE Case Dimensions Case Cube Case Gross Wt. 40"x48" Pallet Tie 40"x48" Pallet Tiers Cases/40"x48" Pallet ltra GTEiOFIERO'S FOOD PRODUCTS lNC. Confidentiat .5"x10.75"x4.5" 0.60 22.5 21 I 42 4t7t2014 Forrnulaton statoment fbr Documenting Gnai*s i* schoor lwenrs r^ |''' r e d". tr R.eq_uired Eeginning SV iOfS_ZOl+ t's st a,i;;,f;:,I:: i :;:f:i:."0, * ib tt A ) sohool Food Autho|ities (sFAs) shoulcl iriclude a copyr{'th., label fi,om the purchasecl product car.ton in the following in{bunarionon adclition to retrerheacr ,:llffi;v'r.pr_S"*rire, Grain pr.ocrn*s may be oredited basecl on Previous^standar,rt utroiiri io^tz-20,. rhe new.iffii;g Polioy Memo.anclum sP 30-2012) "irA$s,un.a'cls for.grains (as ourlined in sy zor:.zoi+, have rhe oprion ro crroose crediting method thar best fits the'specific-r;il;i;_ ;ttffi;;1:fff,-l bi "ili;;;;Jb.ginni'g menu ptanner,, I._ Docs the prorluct rncet ilre Whole Grain-t{ich Critoliar (llefer n sP 30'20 l2 Grain 'llec1'r'tire',,i,,1ii, iii 're ,-r-{rO* iutionot srhoctr t rnch pyo\,unr and sicLt.or r.Jreuffir,tt Xl, Doer thc protilurt contain uon- creditable grains: n*r=-= {.Iow rnany grflnrsi (Product,s t'pirh wore thart 0.2,/oz iqr;;r;;t;;,;:;; i:;; g,,on ---'* r.ffi,,ir,,,tu ,j-(; ))lrt o,tt gror,:t./br Grorp creclltable grahs mcty not u,eclit .i,, t,iil,,n iio"grlniin'riuqui,,,rrn"nr,t; Jbr schoctl mectts.l l,rogr*nt,) N"*d r_r o,non^ trtrx' use lPolicy Mlcnrol'anclum sjl' 30-2012 cJrai' ltetluin,emouts rbr r\ationar schoor {",uncrr progranr nnd school 'Breahlhst Prosrttn; fdxlribit t i;;-;;,rde ii'uro p.o,ru*i rii,thci,rio Lru-up, A-G (bakecr goorrs), Gnorp Id (cereaf grnins) or 61'o'p I (xtrll rr,'onrri*i.*,, to catculate s'e,virry,t ol als), (piase tun riri"tnot ,tq1ynrent b;;;;;;;';r"riititrtn gn i*r," oiiiir-n-c, ,use methoclologie,r tu,e apptiect the tttanclarcl o,/, I6 gra,m;t tt u,et ,nn ,,,,id)uta ii'zit ';:;,:'i:J'uf:7;:;,tr; f,,i,,,il,.iiio'iii'gn i, pu,, oz eq; anct (iroup t i,r ::,:1,,;;i;,,p Indicate whicll lixhibit.{(il;oup (A_I) the product l}elonssl .13 griirl comr)onent Portion Sizc oi' Doscription of procluct por Food triuying Guide Wcight of one oluncc oquivalcnt as listecl in n)roduct ns lPurchased sP 30-2012 'Iotll Croditnbic 'rotal Amou c*ctitar.rie@ffi.];ffi* () r,., r,ol iin,l#5X*i"J* Total weiglil (per por.tion) ol'procluct o, pu,:ol,osok*1'l"otal conrri buriou of pr.ochrc, f I fi''the'ce'tify thal the'atrove inlb'mation is true serving) pLovidegfl_jlz equivareni aucr ***&-br"ce po.tion of this product (reacry c;;i;;:"if;il; r".ri$,;;;;;"ir;Ai.oi_ grains are nor above 0,24 ozeq. per a*cr co.r'ect l..crr ,n:crectifbre gr.ains may llil,l.1l;,1_iii'lll,yJl,ly::l':::.1;:l :!;111,J,"i, ", 3 ee grams for Gr.oups A-G or 6,ee grams ror.Gror'r H or cr.eclirt"*-,*li,. eil;;;;il:#il,'i;,:::ifi: fr;?,|,6,ee crams ro'Group 'or /, _1/(:: '"r"-, 'f ifle l/- ;?e> ^ T' ly f !&:*\cl# "_/ &,5ff D*6-*-*--:- Phone Numbor FOR QUALITYAND SERVICE BE SURE TO GET ROMERO'S FOOD PRODUCTS, INC. 15155 Valley View Avenue . Santa Fe Springs, CA 90670 (562) 802-1858 . FAX (562) 921-7240 . www.romerosfood.com COFN & FLOUB TORTILLAS, TACO & TOSTADA SHELLS, MEXICAN SWEET BREAD. TORTILLA CHIPS 208182UG ROMERO'S FLOUR TORTILLAS 8"-11ozldoz ULTRA GRAIN WHOLE WHEAT FLOUR TORTILLAS-PRESSED 1212 DOZ. PKGS.-24 DOZ./CASE CODE PRODUCT NAME DESGRIPTION PACK Affi"^* SPECIFICA.TiONS- LAqEL INGREDIENT WHOLE GRAIN WHEAT FLOUR (Ultra ENRICHED WHEAT FLOUR (wheat flour, malted ferrous sulfate, niacin, thiamine mononitrate, folic acid), WATER, VEGETABLE OIL (may contain soybean, cottonseed or palm oils), MARGARINE, (corn starch, sodium bicarbonate, sodium aluminum rice flour, monocalcium phosphate), CALCIUM PROPIONATE, POTASSIUM GUAR GUM, FUMARIC ACID, Contains: Wheat, Grain), barley, riboflavin, LEAVENING sulfate, SALT, SORBATE, L-CYSTEINE. Soy General Manager NUTRITIQN FACTS 1 Calories Tqrtilla 7s D. V. * 116 26 Calories From Fat Total Fat, gm Saturated Fat, gm Trans Fat, gm Cholesterol, mg Sodium, mg TotatCarbohydrate, gm 35% 3% 1 Dietary Fiber, gm Sugars, gm Protein, gm 0 o 0% 108 4% ZU 7% 2 8o/o 0 2 Vitamin A Vitamin C 0% 0% Calcium 6% lron 6% * Daily Values Based On 2,000 Calories/Day PHYSTCAL WeighVDoz. Diameter Flavor Color qHEMTCLL Tortilla pH Tortilla Moisture 18oz (+l- .25o2) 8" (+/-.5") Fresh Baked Flour Tan-Light Toast Marks Tortilla Contains 25,5 crams (60%) Whole crain/Enriched <50000/g <100/g negative <2511 009 negative <5og negative 28o/o-32o/o TotalPlate TotalColiform 15 Days 30 Days E. Coli Staph Salmonella Yeast & Mold Listeria ,0015"-Plain 10"x12" Heat Seal 24 36oz (+1- .50o2) Case Dimensions Case Cube Case Gross Wt. 40"x48" Pallet Tie 40"x48" Pallet Tiers 17"x8.5"x10.5" 0.88 28.5 12 Cases/40"x48" Pallet 60 PACKAGING-BAG Poly Bag Gauge Poly Bag Dimensions Type Of Seal Package Count Package Weight Package/Case 1 Wheat Flour Blend Of Which At Least 50% ls Whole Grain. MrqRoBroLQGrcAL 6.20-6.60 SHELF UEE Room Temperature Refrigerated Meets US_DA Standard For "Whole Grain RiSh" I Tortilla = 1.50o2 Equivalent Grains According To USDA Exhibit A:School Lunch/Breakfast-Group B. PACKAGING-CASE sP Ecs.xLS. 8"x1 8oz ultra GraR@l0ERo's FooD PRoDUcrs lNc. confidential 10 4t7t2014 ,,io{k II I It R-- tt'ormuration statement for Docunnenting Gl.ains in scnrootr Mears Required Beginning SV 20X.3-2014 (crerriting standards gased on Grams of creitkable Grains) \oc" school Food Autholities (SFAs) should inclucie of the label from the purchasecl product pactrage in adclition to the following information.on letferhead signed19opy by an official company repiesentative. Grain proclucts may be thlougf,sv. zotz-zon, rnr ni* Ireriiiing stancrarcrs for grains (as ourlined in ;'"-,*:*T:*:f:""t:1t"tt:ll::ds i ti ;;;; ;;;;:r i'y il ;:; fi:t'ijf,lTi.l1il li1,3fil'.ffi:ii[l?0 1*:1y1i:liirl11 :i : Qh"i,; crediti*g method that best fitgqhe specific neeclq.ofihe menu'lannel,. ^ ,.r producr r^,",,fr ,t",*-"fr1 Eii"* g".-U ?,0,^,., t tffi"t) G , /! ft Manuraorurer: tl ofi R WW>#n*\ ,L servipg size (raw dough weight urny bo uscd atc cledita[rle grnin aurount) yrr-{./No-* uotiiiiiirn'oiffii'i@rnrn and schort tlreag:ast program,) lI' Doos the product contailt.non- cretlltablc grains; yes.- Nu--i./l.ln* rnany grams:(Products tuith more than 0,24,o2 eclttivcilent or-3.99 g'ron ,r,for Groffi-(i or 6,gg grams.for Grp.up l,l o/'*onc:redltable grctin,s 1.. Does the procluct meet the Whole Grain-ltich Critorin, (tLelbr to sP 30-2012 Grain Requirenentsfor m, rnay not creclit tott,arcr,s the grain req,ir'ments.fttr schoctl nt.'ars.) III' ljsc Pollcy Momorandutn sP 30'2012 Grain Roquirom€uts for the National school Lunch lrrogranr aucl school tlrealilhst Proglam: lJxhibit A to dstcrminc irtne product lits into broups .d-G (bakcd goorls), Group {d (cereal grains) or Group I (RTE breakthst .ut'toh). (Difibrent methoclologie,s are applied ut calcllate servmgs oJ grain companent based on credltable grains. Groups A-G" use the sranctarct' ry l6grams cr(rclitabla grnin per oz eq; Group rI usrt's the standarcl ol'28grails ueclitable grain par oz ec1; and Grot4t I i,r reported by volunte or taeight.) trndicatc to which Exhibit A Group (.4..n) the Frocluct mctongs: Grnms ofl Description of Croditablc Grnin Pt lngrcdiont* \ a*e drwam) S Cledltnblo Cirain lngredlcnt pcr Grnm Stnnclard of Credii;able Grnin pcr or equivalent Portionr (l69 rtr 2Bg)' Total Creclitable A _ grnins rrr .rrvqr/ rruur uilq gllruOne(t nleal/I.loul,, .e.l..l are whole-gr:aii size) X (% ofcreditoble glain in for'rnula), Please be awalc rhat scrving sizes other.thau gramri nlust be colverted to .--itablo -- r'lsei'vtng , .--" ^ gfallls, 2 t,, olcleditabte ,;51::ld::l-g:llls - roial ul'cdltablo gr.ains fi.om rhe cor,r,csponcling Group in i"lxhibit A. Anlolult must be t'ouuded down to the noallgst quar.ter 10,25; oz eq. Do /rol louncl up, T'otal weiglrt (p.er portion) of pr.oduct as purchaso,tr-/, 'fotal contribution ofproduct (per portion) ) *.qffi.nt j t:11 of^;ff{or^utiou is true r'l'ancr ancl correor and (_ {un.. por.rion of rhis procluct (Leacly for andlhai thai oo4:-]un.. ::::'11 111 :A:^',ffi:yyl: :j:ltjy\*i::n I,further certify thatirori"cr.eclitable grains nro nor above 0,24 oz eq, per :iYi:f, $,Tl:K:Y;::Yiv-alentGrains. pol'tion. turore than 0 equivalentor not 3.99 grams for Croups A,C or 6,9g grams fbr Croup H the grain requil.enleuts for school nreals, '7* Date {* !-j of
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