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Product Specification/Formula Statement Product Specification/Formula Statement Current as of: 07/01/16 310 W. Alondra Blvd. Version #: 07/29/15 Gardena, CA 90248 Supersedes Version #: 09/02/14 (310) 523-3664 - Office (310) 523-1619- Fax Commodity Code #: C34260B-BQ Commodity UPC#: 007219391 3462 7 Brand: Hot Off The Grill Commercial Code #: N34260B-BQ Commercial UPC#: 007219391 3463 4 Product Name: BBQ Rib Shaped Patty, with BBQ Sauce - Bulk Pack Packaging: CN Label: N.A. Case Count: 148 Case Cube: 0.90 Cases/Pallet: 84 Portion Size: 3.25 oz. Net Wt./Case: 30.05 LBS. Case Dimensions: 19.44 x 13.88 x 5.5 Pallet Config: 7 x 12 EQUIVALENT GRAIN CALCULATIONS Does product meet Whole Grain Rich criteria? No (at least 50% or 1st ingredient?) Grain crediting from Exhibit "A" School Lunch and Breakfast Does product contain non-creditable grains? No Description of Creditable Grams of Creditable Grain Gram Standard of Creditable Grain Creditable Grain Ingredient: ingredient in each portion? per ounce equivalent? Amount (A/B) Whole Wheat/Grain Flour (grams) 0.00 16 grams 0.00 Enriched Wheat Flour (grams) 0.00 16 grams 0.00 TOTAL CREDITABLE GRAINS BY WEIGHT TOTAL CREDITABLE GRAINS BY WEIGHT: 0.00 0.00 ROUNDED TO NEAREST 1/4: EQUIVALENT GRAINS CALCULATIONS PER FOOD BUYING GUIDE (GROUP B) Description of Product per Food Portion size of product Weight of one ounce equivalent Creditable Buying Guide: as purchased as listed in SP 30-2012 Amount Bread or Buns 0.00 oz. 0.00 oz. 0.00 TOTAL CREDITABLE GRAINS BY WEIGHT ROUNDED TO NEAREST 1/4: 0.00 MEAT/ MEAT ALTERNATIVE CALCULATIONS Description of Creditable Ingredients Ounces of Raw Portion FBG Yield/Servings Multiply Creditable Amount per Food Buying Guide (FBG) in Creditable Ingredient per Unit 0.00 oz. X 0.00 0.00 oz. 0.00 oz. X 0.00 0.00 oz. 0.00 oz. X 0.00 0.00 oz. 0.00 oz. X 0.00 0.00 oz. A. Total Creditable Cheese or M/MA 0.00 Commodity Beef, Ground, 20% fat 2.43 oz. X 0.74 1.80 oz. Commercial Beef, Ground, 24% fat 2.43 oz. X 0.73 1.77 oz. B. Total Creditable Beef amount 1.80 Description of APP, Manufacturer's Name and Code # Oz. Dry APP per Portion Multiply % of Protein As-Is Divide by 18 Creditable Amount Ultra Soy 3000 C 0.18 X 50.00 18 0.50 oz. C. Total Creditable APP amount 0.50 D. Total Creditable Amount (A + B + C, rounded down to nearest 1/4 ounce) 2.25 TOTAL CREDITABLE MEAL CONTRIBUTION: EQUIVALENT GRAINS: 0.00 MEAT/ MEAT ALTERNATE: 2.25 Product Specification/Formula Statement Current as of: 07/01/16 310 W. Alondra Blvd. Version #: 07/29/15 Gardena, CA 90248 Supersedes Version #: 09/02/14 (310) 523-3664 - Office (310) 523-1619- Fax Commodity Code #: C34260B-BQ Commodity UPC#: 007219391 3462 7 Brand: Hot Off The Grill Commercial Code #: N34260B-BQ Commercial UPC#: 007219391 3463 4 Product Name: BBQ Rib Shaped Patty, with BBQ Sauce - Bulk Pack Product Description: 100154- Beef Coarse Ground USDA Commodities used: Handling and Cooking Instructions: Shelf Life: 18 Months Frozen Conventional Oven (Frozen): 350 F 18 - 22 Minutes Convection Oven (Frozen): 325 F 16 - 20 Minutes Conventional Oven (Thawed): 350 F 14 - 17 Minutes Convection Oven (Thawed): 325 F 11 - 14 Minutes Ingredients: Fully Cooked BBQ Flavor Beef Rib Shaped Patty: Ground Beef, Water, Textured Vegetable Protein (Soy Flour, Caramel Color), Seasoning (Sugar, Tomato Powder, Salt, Brown Sugar, Natural Flavors (Including Smoke), Onion & Garlic Powder, Worcestershire Sauce Powder (Maltodextrin, Worcestershire Sauce (Distilled Vinegar, Molasses, Corn Syrup, Salt, Caramel Color, Garlic Powder, Sugar, Spices, Tamarind, Natural Flavor and Sulfiting Agents)), Molasses Powder (Refinery Syrup, Cane Molasses, Cane Caramel Color), Spices, Extractives of Paprika), Tomato Paste, Sugar, Vinegar, Sodium Phosphate, Caramel Color. Sweet and Smokey BBQ Sauce: Brown Sugar, Water, Tomato Puree (Tomatoes and Citric Acid), Molasses, Red Wine and Distilled Vinegar, Sugar, Salt, Starch and Guar Gum, Smoke Flavor, Worcestershire Sauce (Distilled Vinegar, Molasses, Corn Syrup, Water, Salt, Caramel Color, Garlic Powder, Sugar, Spices, Tamarind, and Natural Flavor), Spices and Natural Flavors. Wheat Eggs Tree Nuts Fish/Shellfish Allergen Statement (Product Contains): Milk Peanuts Soy Gluten Nutritional Information: Weight 92.10 g Dietary Fiber 0.97 g Sugar 12.34 g Calories 201.88 Fat (total) 9.58 g Calcium 31.04 mg % Calories Fat 42.71 % Fat (saturated) 3.71 g Iron 0.15 mg % Calories Sat Fat 16.54 % Trans Fat 0.00 g Vitamin C 1.68 mg Protein 14.41 g Cholesterol 42.82 mg Vitamin A 3.98 IU Carbohydrate 13.89 g Sodium 473.54 mg Riboflavin 0.00 mg Niacin 0.00 mg Thiamine 0.00 mg Potassium 249.91 mg Case Coding Example: (Manufacture Date/ Production Line #) (Example: January 1st 2013 Product produced on Line A) I certify that the above information is true and correct and that a 3.25 ounce serving of the above product (ready for serving) contains 2.25 ounces of equivalent meat/ meat alternate when prepared according to directions. I further certify that any APP used in the product conforms to the Food and Nutrition Service Regulations (7 CFR Parts 210,220,225,226, Appendix A) Signature David J. Watzke, V.P. of Operations 7/1/2016 (310) 523-3664 Printed Name Date Phone Number.
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