HOLIDAY BASKET & ORDER FORM **ALL ORDERS MUST BE CONFIRMED AT LEAST 24 HOURS BEFORE DESIRED PICK UP TIME ** Please email completed form to [email protected] All below serve 6 – 8 guests. PRICE QTY $17 $14 LOG , hazelnut, raspberry $65

BERRY TRES LECHES $56

FRUIT CREAM – CHECK ONE BANANA CARAMEL PASSIONFRUIT-RASPBERRY $44

SALTED CARAMEL $89

BASQUE $50

FAIRHILL FARMS CARAMEL $44 FRUIT TARTS – CHECK ONE DARK CHOCOLATE RASPBERRY APPLE-CRANBERRY $52 PUDWILL FARMS BERRY CREAM SARI SARI STORE’S FAMOUS BUKO PIE $36 young pastry cream, streusel

CLASSIC SWEET RÉPUBLIQUE GIFT BASKET

granola, verve coffee, shortbread cookies, almond toffee, stollen, and house jam, presented in a wicker basket $75

SIGNATURE SWEET RÉPUBLIQUE HOLIDAY GIFT BASKET ‘baking at république’ cookbook by margarita manzke, granola, verve coffee, cookies, shortbread cookies, almond toffee, stollen, house jam and ingredients to bake margarita’s cranberry white chocolate scones, presented in a wicker basket $125

CLASSIC SAVORY RÉPUBLIQUE GIFT BASKET dried fresh pasta, riviera ligure olive oil, apple balsamic , balinese salt, verve coffee, dried porcini mushrooms, presented in $150 a wicker basket

SIGNATURE SAVORY RÉPUBLIQUE GIFT BASKET dried fresh pasta, riviera ligure olive oil, apple balsamic vinegar, balinese salt, verve coffee, dried porcini mushrooms, plantin truffle paste, $250 acquerello risotto, basque cherry jam and weiss dark chocolate bar, presented in a wicker basket

ADD GIFT CARD(S): DENOMINATION $ ______

ADD ‘BAKING AT RÉPUBLIQUE’ COOKBOOK BY CHEF MARGARITA MANZKE $30

*Payment will be processed at the time of order. All sales are final.* PAYMENT INFORMATION CARD TYPE: ___ VISA ___ AMEX ___ MASTERCARD

NAME (as it appears on card): ______

BILLING ADDRESS: ______

CARD NUMBER: ______

EXPIRATION DATE: ______SECURITY CODE: ______BILLING ZIP: ______

CONTACT TELEPHONE: ______

SIGNATURE: ______DATE: ______

I, the above signed, certify that all the information is complete and accurate. I hereby authorize Republique, LLC to collect payment for all the charges indicated herein, including sales tax, by processing a charge to the credit card listed above. I certify that I am the authorized signer of the credit card listed above. A 4% charge will be added to your check to help cover the cost of health care benefits we offer to our full-time employees. Thank you for supporting our staff. If you would like this 4% charge removed, please let us know. By signing above, I understand that payment will be processed at the time of order and that all sales are final. The order will be available for pick up only at Republique on date listed below. Signatory agrees to fully inspect bakery items at time of pick up. Republique is not responsible for any damage that occurs outside the restaurant's premises, e.g. during transport.

PICK-UP INFORMATION: PLEASE NOTE THAT WE ARE CLOSED ON DEC 25, DAY. PICK- UP DATE: ______PICK- UP TIME: ______