VF0001 D 145th MOCK Order.pdf

REPORT DATES

1. REQUESTOR UNIT, ADDRESS AND BUILDING 2. TO VENDOR 3. DATE (YYYMMDD)

PAGE ___ OF ___

VEGETARIANISM:

4. REPORT DATES

9a. SIGNATURE 9b. RANK 9c. DATE (YYYYMMDD)

BREAKFAST:1.____2.____3.____

8. ACTIVTY LEVEL

Light (850 Cal) Moderate (950 Cal)

Heavy (1067 Cal) Ex Heavy (1283 Cal)

Lacto-ovo-vegetarianism (includes eggs, dairy, and honey):

Lacto-vegetarianism (includes dairy, no eggs):

Ovo-vegetarianism (includes eggs, no dairy):

Pescatarianism (includes fish and other forms of seafood):

LUNCH:1.____2.____3.____

DINNER:1.____2.____3.____

UNIT PAGE: MEAL INFORMATION PROVIDED BY UNIT TO COMMERCIAL VENDOR

7. GRAND TOTAL MEALS

REQUESTED

MEALS REQUESTED BY CATEGORY

Total SIK Stock Meals (without dietary accomodations)

Vegan (no animal product or by-product; no eggs, dairy, or honey):

Gluten-free (no wheat, barley, rye, or oats):

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Light (850 Cal) Moderate (950 Cal)

Heavy (1067 Cal) Ex Heavy (1283 Cal)

Light (850 Cal) Moderate (950 Cal)

Heavy (1067 Cal) Ex Heavy (1283 Cal)

NOTE: (V - Vegan, P - Pescatarian, GF - Gluten-free, LV - Lacto-veg, OV - Ovo-veg, LOV - Lact-ovo-veg)

GF: _____

P: _____ LOV:

V: _____ OV: ____

Reg: _____ LV: ____

GF: _____

P: _____ LOV:

V: _____ OV: ____

Reg: _____ LV: ____

GF: _____

P: _____ LOV:

V: _____ OV: ____

Reg: _____ LV: ____

GF: _____

P: _____ LOV:

V: _____ OV: ____

Reg: _____ LV: ____

GF: _____

P: _____ LOV:

V: _____ OV: ____

Reg: _____ LV: ____

GF: _____

P: _____ LOV:

V: _____ OV: ____

Reg: _____ LV: ____

GF: _____

P: _____ LOV:

V: _____ OV: ____

Reg: _____ LV: ____

GF: _____

P: _____ LOV:

V: _____ OV: ____

Reg: _____ LV: ____

GF: _____

P: _____ LOV:

V: _____ OV: ____

Reg: _____ LV: ____

10. CASH MEALS

CALORIC REQUIREMENT PER MEAL: 850 Calories

MEAL DATE:

Regular Meals without dietary restrictions Vegan (no animal product or by-products) Pescatarian (includes fish and other forms of seafood) Gluten-free (no wheat, barley, rye, or oats) Lacto-vegetarian (includes dairy, no eggs) Ovo-vegetarian (includes eggs, no dairy) Lacto-ovo-vegetarian (includes eggs, dairy, and honey)

LUNCH DINNERBREAKFAST

TOTAL MEALS FOR THE DAY:

950 Calories 1067 Calories 1283 Calories

CALORIC REQUIREMENT PER MEAL: 850 Calories

MEAL DATE:

Regular Meals without dietary restrictions Vegan (no animal product or by-products) Pescatarian (includes fish and other forms of seafood) Gluten-free (no wheat, barley, rye, or oats) Lacto-vegetarian (includes dairy, no eggs) Ovo-vegetarian (includes eggs, no dairy) Lacto-ovo-vegetarian (includes eggs, dairy, and honey)

LUNCH DINNERBREAKFAST

950 Calories 1067 Calories 1283 Calories

CALORIC REQUIREMENT PER MEAL: 850 Calories

MEAL DATE:

Regular Meals without dietary restrictions Vegan (no animal product or by-products) Pescatarian (includes fish and other forms of seafood) Gluten-free (no wheat, barley, rye, or oats) Lacto-vegetarian (includes dairy, no eggs) Ovo-vegetarian (includes eggs, no dairy) Lacto-ovo-vegetarian (includes eggs, dairy, and honey)

LUNCH DINNERBREAKFAST

950 Calories 1067 Calories 1283 Calories

PAGE ___ OF ___

TOTAL MEALS FOR THE DAY:

TOTAL MEALS FOR THE DAY:

1. REQUESTOR UNIT, ADDRESS AND BUILDING 2. TO VENDOR 3. DATE (YYYMMDD)1. REQUESTOR UNIT, ADDRESS AND BUILDING 2. TO VENDOR 3. DATE (YYYMMDD)

10a. SIGNATURE: 11b. RANK: 11c. DATE:

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10a. Print (First, Last, M.I.):

VENDOR PAGE: MEAL INFORMATION PROVIDED BY UNIT TO COMMERCIAL VENDOR

4690 N. Range Road Las Vegas, NV 89165