Customer order form (updated 12/2012) Ordering 2 Ways to Place Your Order (choose one): 1. Email completed form to: ANA.MEorders@aryzta.com 2. Fax completed form to: 866-733-6844 Payment 2 Ways to Pay for Your Order (choose one): 1. If you buy indirect via a distributor, you can charge the order to your credit card—by completing a recurring Credit Card Authorization form 2. Establish credit by completing a Credit Application Oven Replacement/Return Requests 1. 2. 3. 4. Oven Serial Number: ___________________ How long has oven been in use: __________________________ What is wrong with the oven: _____________________________ Email completed form to: ANA.MEorders@aryzta.com or Call 1-888-ASK –OTIS, Option 4 ***Please box up the broken oven in the new oven box, have it ready for UPS to pick up in approximately two weeks. They will bring the return label when they arrive. Customer Information Please print clearly and fill in all information for prompt and accurate processing Business Name: Owner/Contact at location: Address: City/State/Zip: Phone #: Email: Customer # : Distributor Name: *Loan Agreement Signature: X *By signing, I acknowledge that the Ovens and/or Displays I am accepting are the property of Otis Spunkmeyer, Inc., and are intended to support the sale of Otis Spunkmeyer products only. Any sale or other use of these items is strictly prohibited. As such, if I choose to no longer participate in the Otis Spunkmeyer program, I am obligated to return the oven to Otis Spunkmeyer. Business Type: FS – Business Dining FS – Caterers FS – Colleges FS – Correctional Institution FS – Dist C-Stores FS – Distributor Food Serv FS – Dist Vending FS – Healthcare FS – Hotels FS – Quick Casual Rest FS – Quick Service Rest FS – Recreation FS – Vending FS – Military FS – Schools FS - Transportation Questions? Please Call 1-888-ASK-OTIS (275-6847), option 4 12/2012tml 1 Business Name: Date: Customer order form (updated 12/2012) SKU UOM Description # Merchandising & Equipment 96200 Each Cookie Oven, Triple Rack 120v w/ Starter Kit-For replacement see Page1 92158 Each Cookie Display – 2 Drawer Narrow Slanted 92188 Each Cookie Display – 3 Level Operator Serve 92189 Each Cookie Display – 3 Level Self-Serve 92184 Each Cookie Display C-Store – 3 Level Bulk Acrylic 92271 Each Cookie Display C-Store Multi Pack Counter Register Display 92183 Each Counter Wire Rack w/ Header (IW) 93106 Each Counter Wire Rack w/ Header (Euro) 92175 Each Counter Display Large Bakery Self-Serve 92176 Each Counter Display Large Bakery Operator Serve 99758 Each Supreme Indulgence Bulk Display 17547 Each Pennant Sweet Bites Cini Mini Tabletop Display Carton Accessories & Smallware 92151 Each Cookie Bag Rack 93107 Each Cooling Rack 96150 Each Baking Pan 96160 Each Pot Holder 96170 Each Timer 99522 Each Tongs Paper & Packaging 94100 Each Pan Liners, Small (500 Sheets per Pack) 94100 Case Pan Liners, Small (10 Packs per Case) 94120 Each Pick-up Tissues (1,000 Sheets per Pack) 99286 Each Napkins 5”x5” (100 per Pack) 94227 Case Cookie Bag w/ Tin Tie (250 per Case) 94228 Case Gold Bottom Bite Size Gift Bags w/ Twist Tie Bow (100 per Case) 94208 Case Small Clear Bag w/ Pre-attached Label (1,000 per Case) 94232 Case Cookie Pop Kit - White Stick, Clear Bag & Twist Tie Bows (100 per Case) 94237 Case Standard Clear Bag w/ Label (1,000 per Case) 94239 Case Small Cookie Paper Bag (1,000 per Case) 94270 Case Warm Wishes Cookie Jar (4 per Case) 94271 Case Warm Wishes Cookie Box (25 per Case) 17528 Each Brownie Square, Bottomless Silicon Form (2 per Pack) 17562 Each Otis Spunkmeyer Brownie Cup Liners (250 cups Per Sleeve) Point of Purchase Materials COOKIES AND BARS 99531 Each Cookie Just Right Baking Guide 99306 Each Cookie Counter Card 94257 Each Cookie Crew Button (20 per Pack) 99309 Each Cookie Dangler 99310 Each Cookie Poster 94260 Each Cookie Window Cling 99342 Each Cookie Time Promo Kit 17507 Each Tasty Grains Bakery Cards (2 Flavors per Pack) 17508 Each Tasty Grains Table Tents (5 per Pack) MUFFINS 92148 Each Supreme Muffin Flavor Cards (5 Flavors per Pack) Supreme Muffin POP Kit – Blueberry Crumbcake (Contains 5 each: Table Tents & 17560 Each Posters, and 3 Low Tack Stickers) 99244 Each Muffin Counter Card – Blueberry 99304 Each Proudly Serving Otis Poster DAYPART PLATFORMS 17525 Each Breakfast Poster – Get a Jump Start on Breakfast (18x24) 17526 Each Breakfast Table Tent – Get a Jump Start on Breakfast (5 per Pack) 17522 Each Snack Poster – Treat Yourself (18x24) 17523 Each Snack Table Tent – Treat Yourself (5 per Pack) Grand Total 12/2012tml Price Order Qty Total SKU/ UPC Code NC NC NC NC NC NC NC NC NC NC NC NC 0-13087-96200-7 0-13087-92158-5 0-13087-92188-2 0-13087-92189-9 0-13087-92184-4 0-13087-92271-1 0-13087-92183-7 0-13087-93106-5 0-13087-92175-2 0-13087-92176-9 0-13087-99758-0 0-13087-17547-9 NC $22.58 $6.30 $4.46 $10.50 $2.00 0-13087-92151-6 0-13087-93107-2 0-13087-96150-8 0-13087-96160-4 0-13087-96170-3 0-13087-99522-7 $8.93 $89.25 $4.46 $11.55 $49.61 $51.45 $26.25 $23.10 $26.25 $13.13 $7.00 $14.00 $20.00 $6.00 0-13087-94100-2 0-13087-94100-2 0-13087-94120-0 0-13087-99286-8 0-13087-94227-6 0-13087-94228-3 0-13087-94208-5 0-13087-94232-0 0-13087-94237-5 0-13087-94239-9 0-13087-94270-2 0-13087-94271-9 0-13087-17528-8 0-13087-17562-2 NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC $ 2