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: 2.10.13
(EZI W &EOMRK 'SQTER]
2986-8-32 %2%0=7-7 7,))8
463(9'8 2%1)
;LSPI +VEMR &VS[RMI 'YT
463(9'8 '3()
4368-32 7->)
S^ KQ
4%'/)(
'%7) 2)8 ;)-+,8
PFW
'%7) (-1)27-327
\ \
4%00)8->-2+
XMI < LM
1)%0 '3286-&98-32
)%', &63;2-) '94 463:-()7 WIVZMRK SJ FVIEH GSRXEMRW QMRMQYQ KQ
SJ JPSYV GSRXEMRW QMRMQYQ SJ XLI JPSYV EW [LSPI KVEMR
-2+6)(-)287
;LSPI [LIEX JPSYV IRVMGLIH JPSYV GSRXEMRW RMEGMR VIHYGIH MVSR XLMEQMRI QSRSRMXVEXI
VMFSJPEZMR JSPMG EGMH [EXIV WYKEV WS]FIER SMP GSGSE IKK [LMXI YRW[IIXIRIH ETTPIWEYGI GSVR
W]VYT GEVEQIP GSPSV EVXMJMGMEP JPEZSV WEPX
1ERYJEGXYVIH MR E 4IERYX *VII 4PERX
2YXVMXMSREP %REP]WMW
4IV 7IVZMRK
S^
&EWMG 'SQTSRIRXW
7IVZMRK HMVIGXMSRW 8LE[ EX VSSQ XIQTIVEXYVI LSYVW
4VMSV XS WIVZMRK
- GIVXMJ] XLEX XLI EFSZI MRJSVQEXMSR MW EGGYVEXI EX TVIWIRX SR XLMW
HEXI
2EQI (EZMH %JVEQMER
8MXPI :MGI 4VIWMHIRX
7MKREXYVI
(EXI 1E] 'EPSVMIW 4VSXIMR K
'EVFSL]HVEXIW K
(MIXEV] *MFIV K
7YKEV 8SXEP K
*EX 8SXEP K
7EXYVEXIH *EX K
8VERW *EX K
'LSPIWXIVSP QK
:MXEQMR % -9 -9
:MXEQMR ' QK
'EPGMYQ QK
-VSR QK
7SHMYQ QK
2MEGMR QK
8LMEQMR QK
6MFSJPEZMR QK
'EPSVMIW JVSQ *EX XL 7XVIIX WYMXI 7ERXE 1SRMGE '% 8IP *E\ 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:
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

Mcp-21/22(Granular) - Tazan Agro Limited