INVOICE Page 1 of 5

ACCOUNT NUMBER INVOICE NUMBER INVOICE DATE CUSTOMER NUMBER PURCHASE ORDER # SALES LOCATION SALES REP DATE ORDERED

71286918 2738958 08/30/2021 51381663 3147 397 08/29/2021

FREIGHT TERMS ORDER NUMBER PAYMENT TERMS ROUTE NUMBER SPECIAL INSTRUCTIONS
908752 NET 30 DAYS 1133

BILL TO SHIP TO REMIT TO

HRA HOLDINGS LLC HARBORCHASE CORDOVA US Foods, Inc.
958 20TH PLACE 2ND FLOOR 1600 APPLING RD BOX 281834
VERO BEACH, FL 32960 CORDOVA, TN 38016-4906 IL EGG INSPECTION FEE PD
ATTN: MANAGER Dept.: 0 ATLANTA, GA 30384-1834
(000) 000-0000 (901) 250-1195 (800) 858-6108

SHIPPED FROM: 5900 HOLMES ROAD,MEMPHIS, TN DRIVER NAME: Tevin Atkins ROUTE NUMBER: 1133
SHIPPED DATE: 08/30/2021 DRIVER ID: 315670 STOP NUMBER: 6

INVOICE LINE DETAILS

QUANTITY SALES PRODUCT DESCRIPTION LABEL PACK SIZE CODE WEIGHT PRICING UNIT EXTENDED
ORD SHP ADJ UNIT NUMBER UNIT PRICE PRICE

DRY
1 1 0 CS 42192 MAYONNAISE, REAL SHLF STABL KRAFT 4/1 GA T CS $24.5700 $24.57
1 1 0 EA 760819 SPICE, CHILI PWDR MILD PLST MONARCH 5 LB T EA $31.7700 $31.77
1 1 0 EA 760884 SPICE, GRLC PWDR PLST JUG SHLF MONARCH 6 LB T EA $35.9400 $35.94
1 1 0 CS 1682798 TOPPING, PNAPL CRSD TFF SHLF MONARCH 6/#5 CN T CS $36.3600 $36.36
1 1 0 EA 3555034 TOPPING, CHOC HOT FUDGE LIQ MONARCH 10 CN TB EA $8.3700 $8.37
1 1 0 CS 3746252 CRUMB, BRD PLN FINE BAG AMER KRUSTEAZ 20 LB T CS $21.4000 $21.40
1 1 0 CS 4000246 JAM, STWBY SS CUP SHLF STABL SMUCKERS 200/.5 OZ T CS $12.9600 $12.96
1 1 0 CS 4263668 CREAMER, LIQ FRNCH VNL SHLF GLNVW FRMS 288 EA T CS $18.7200 $18.72
1 1 0 EA 6494538 SPICE, ONION PWDR PLST JUG MONARCH 6 LB T EA $25.4900 $25.49
1 1 0 CS 7327695 TOPPING, MMALO CRM RTU MONARCH 6/#5 CN T CS $28.2900 $28.29
1 1 0 CS 8000572 TOMATO, CRSD UNPLD IN PUREE ANGELA MIA 6/#10 CN T CS $30.0500 $30.05
1 1 0 CS 8027161 MIX, BRWNE ADD WATER HOSPITALTY 6/6 LB T CS $31.7300 $31.73
1 1 0 CS 9064080 JUICE, APPL 100% PLST BTL SHLF OCEANSPRAY 8/60 OZ T CS $20.0900 $20.09

Page 1 of 5
 INVOICE Page 2 of 5

ACCOUNT NUMBER INVOICE NUMBER INVOICE DATE CUSTOMER NUMBER PURCHASE ORDER # SALES LOCATION SALES REP DATE ORDERED

71286918 2738958 08/30/2021 51381663 3147 397 08/29/2021

FREIGHT TERMS ORDER NUMBER PAYMENT TERMS ROUTE NUMBER SPECIAL INSTRUCTIONS
908752 NET 30 DAYS 1133

INVOICE LINE DETAILS

QUANTITY SALES PRODUCT DESCRIPTION LABEL PACK SIZE CODE WEIGHT PRICING UNIT EXTENDED
ORD SHP ADJ UNIT NUMBER UNIT PRICE PRICE

REFRIGERATED
1 1 0 CS 706945 MILK, WHL UHT VITMN D CTN REF GLNVW FRMS 24/.5 PT T CS $14.9800 $14.98
1 1 0 CS 882373 EGG, LIQ WHL PSTRD CTNGBLE REF GLNVW FRMS 15/2 LB T CS $28.1700 $28.17
3 3 0 EA 1205582 STRAWBERRY, CLMSHL FRESH REF PACKER 1 LB TB EA $3.7200 $11.16
1 1 0 CS 1757244 HAM, CNTRY SLCD STK BI RNDM BURGERS 14-16 LBA T 16.43 LB $4.4500 $73.11
READY TO EAT - Please refer to return policy
CS: 1 16.43 lbs
1 1 0 EA 2016152 BANANA, SNGL FRESH REF PACKER 10 LB TB EA $6.9200 $6.92
1 1 0 CS 2641892 POTATO, RED B SZ #2 GRD FRESH PACKER 50 LB T CS $33.4400 $33.44
1 1 0 CS 2761791 SOUR CREAM, CLTD ALL NTRL SS GLNVW FRMS 100/1 OZ T CS $11.3100 $11.31
1 1 0 CS 4289443 POTATO, YUKON GLD A SZ FRESH PACKER 50 LB T CS $37.9800 $37.98
1 1 0 CS 4326419 SPINACH, FLAT LEAF CLND & CROSS VALY 4/2.5 LB TB CS $23.7000 $23.70
READY TO EAT - Please refer to return policy
1 1 0 CS 4488805 SALAD MIX, MESCLUN SPRG BAG CROSS VALY 4/3 LB T CS $25.0400 $25.04
READY TO EAT - Please refer to return policy
1 1 0 CS 4725586 CELERY, STALK FRESH REF CROSS VALY 36 EA T CS $26.4400 $26.44
1 1 -1 CS 5888599 SHORTENING, FRYG LARD PORK HARVEST VL 50 LB T CS $49.5200 $0.00
1 1 0 CS 8340978 CREAM, WHPG HVY 40% BUTRFT UHT GLNVW FRMS 12/1 QT T CS $47.2300 $47.23
1 1 0 CS 9502089 BLUEBERRY, FRESH REF PACKER 12/6 OZ T CS $31.0600 $31.06
1 1 0 CS 9922765 EGG, SHL LG GRD A BRN CG/FR GLNVW FRMS 15 DZ T CS $35.6800 $35.68

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 INVOICE Page 3 of 5

ACCOUNT NUMBER INVOICE NUMBER INVOICE DATE CUSTOMER NUMBER PURCHASE ORDER # SALES LOCATION SALES REP DATE ORDERED

71286918 2738958 08/30/2021 51381663 3147 397 08/29/2021

FREIGHT TERMS ORDER NUMBER PAYMENT TERMS ROUTE NUMBER SPECIAL INSTRUCTIONS
908752 NET 30 DAYS 1133

INVOICE LINE DETAILS

QUANTITY SALES PRODUCT DESCRIPTION LABEL PACK SIZE CODE WEIGHT PRICING UNIT EXTENDED
ORD SHP ADJ UNIT NUMBER UNIT PRICE PRICE

FROZEN
1 1 0 CS 1104439 PORK, BBQ PLLD CKD FZN BYRONBBQ 2/5 LB T CS $50.0900 $50.09
1 1 0 CS 1240652 DOUGH, CKY PNT BUTR RSP FILLD RICH'S 96/3 OZ T CS $62.0100 $62.01
1 1 0 CS 1327592 PEA, BLKEYE DMSTC IQF FZN MONARCH 20 LB T CS $26.0700 $26.07
1 1 0 CS 3852753 GINGER, PUREE PLST TUB FZN IMP SUPHERB FM 4/1 LB T CS $28.9800 $28.98
1 0 0 CS 3934353 BREAD, FLAT NAAN RSTD GRLC CHEFS LINE 6/8/4.4 OZ $0.0000 $0.00
*SUB* 0 0 CS 3934320 BREAD, FLAT NAAN TANDR 4.4 Z CHEFS LINE 6/8/4.4 OZ $0.0000 $0.00
1 1 0 CS 4251930 DONUT, FRITR APPL FLNG TRAY PK CHEFPIERRE 8/6/3.25 OZ T CS $25.3100 $25.31
1 1 0 CS 4340303 BREAD, WHT 26 SLCD LOAF FZN HILLTOP HR 10/24 OZ T CS $22.5200 $22.52
1 1 0 CS 5195557 PEA, BUTR GRD A FZN PICTSWEET 20 LB T CS $30.4900 $30.49
1 1 0 CS 6284012 GREEN, CLRD CHPD GRD A IQF FZN PICTSWEET 6/3 LB T CS $18.5400 $18.54
1 0 0 CS 6332290 ONION RING, BTRD BEER 3/8" MOLLYS KIT 4/2.5 LB $0.0000 $0.00
*SUB* 1 0 CS 2332526 ONION RING, BTRD BEER 5/8" TFF MOLLYS KIT 4/2.5 LB T CS $24.2700 $24.27
1 1 0 CS 7685415 SAUSAGE, PORK PTY 2 Z 3" MILD KEITHS FRM 8 LB T CS $19.3900 $19.39
1 1 0 CS 7882749 PORK, CUTLT BRDD FRITR 5-8Z HOLTEN 50/6.4 OZ T CS $27.0600 $27.06
1 1 0 CS 7901804 BREAD, FLAT 5X12" OVAL BKD FZN RICH'S 48/4.8 OZ T CS $41.8100 $41.81
1 0 0 CS 8333361 CATFISH, 5-7 Z SHANK FIL BND HARBOR BNK 15 LB $0.0000 $0.00
*SUB* 1 0 CS 96842 CATFISH, 5-7Z FIL BLSL RAW FZN SIMMONS 15 LB T CS $84.7100 $84.71
3 3 0 CS 8638280 CHICKEN, BRST SNGL 6 Z BLSL HARVSTLAND 2/5 LB T CS $34.8400 $104.52
1 1 0 CS 8829681 HUSH PUPPY, CORN SWT WHL GRAIN SAVANNAH 2/5 LB T CS $20.1900 $20.19
2 2 0 CS 9039561 PEA, PRPL HULL FZN PICTSWEET 20 LB T CS $22.8300 $45.66
1 1 0 CS 9047267 BEAN, BUTR SPKLD FZN PICTSWEET 12/3 LB T CS $44.9700 $44.97

STORAGE LOCATION RECAP(N)

STORAGE LOCATION TOTAL PIECES TOTAL PIECES TOTAL PIECES TOTAL PIECES TOTAL ITEMS TOTAL WEIGHT TOTAL EXTENDED
ORDERED SHIPPED ADJUSTED DELIVERED SHIPPED SHIPPED PRICE
DRY 13 13 0 13 13 233.09 $325.74

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 INVOICE Page 4 of 5

ACCOUNT NUMBER INVOICE NUMBER INVOICE DATE CUSTOMER NUMBER PURCHASE ORDER # SALES LOCATION SALES REP DATE ORDERED

71286918 2738958 08/30/2021 51381663 3147 397 08/29/2021

FREIGHT TERMS ORDER NUMBER PAYMENT TERMS ROUTE NUMBER SPECIAL INSTRUCTIONS
908752 NET 30 DAYS 1133

STORAGE LOCATION RECAP(N)

STORAGE LOCATION TOTAL PIECES TOTAL PIECES TOTAL PIECES TOTAL PIECES TOTAL ITEMS TOTAL WEIGHT TOTAL EXTENDED
ORDERED SHIPPED ADJUSTED DELIVERED SHIPPED SHIPPED PRICE
REFRIGERATED 17 17 1 16 15 307.78 $406.22
FROZEN 21 20 0 20 17 298.15 $676.59
DELIVERY SUMMARY TOTALS 51 50 1 49 45 839.02 $1,408.55

DELIVERY SUMMARY

AS SHIPPED DELIVERY AMOUNT $1,556.47

Product Total Adjustments $49.52 CR
Total Charges Adjustment $0.00
Total Allowance Adjustment $0.00
Sales Tax Adj: Rate: VAR $3.34 CR

TOTAL ADJUSTMENT 52.86

DELIVERED AMOUNT $1,503.61

INVOICE SUMMARY

Product Total $1,408.55

Sales Tax Rate: 6.75 $95.06
PLEASE REMIT THIS AMOUNT BY 09/29/2021 $1,503.61

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 INVOICE Page 5 of 5

ACCOUNT NUMBER INVOICE NUMBER INVOICE DATE CUSTOMER NUMBER PURCHASE ORDER # SALES LOCATION SALES REP DATE ORDERED

71286918 2738958 08/30/2021 51381663 3147 397 08/29/2021

FREIGHT TERMS ORDER NUMBER PAYMENT TERMS ROUTE NUMBER SPECIAL INSTRUCTIONS
908752 NET 30 DAYS 1133

CUSTOMER ACCEPTANCE
Interest shall accrue on all unpaid balances exceeding established credit terms at a rate equal to the lesser of (a) 1-1/2% per month or (b) the maximum rate that the customer may lawfully contract to pay, and in
all events calculated in accordance with applicable law.

CUSTOMER SIGNATURE: . MANAGER

SIGNED AT: 08/30/2021 04:33 PM (UTC)

**We appreciate your business. Please visit our website www.usfoods.com/order for a fast and easy way to order or contact customer service at: (800) 253-0277.
**You agree with respect to any dispute arising out of your purchases from US Foods: (i) you are giving up your right to serve in any representative capacity, or to participate as a member of a class,
in any lawsuit; (ii) you also agree, at US Foods sole option, to submit to binding, individual arbitration of all claims; (iii) such arbitration shall be governed by the Federal Arbitration Act, 9 U.S.C. § 1 and
conducted in accordance with the Commercial Rules of the American Arbitration Association; and (iv) each party shall pay half the costs of arbitration, and separately pay its own attorneys’ fees and costs.
For more information about the fuel surcharge, go to: http://www.usfoods.com/terms/fuelsurcharge/StandardGridEIAAreaMidwest
If you have an agreement with US Foods that expressly addresses the calculation of the fuel surcharge, please refer to that agreement.
**The perishable agricultural commodities listed on this invoice are sold subject to the statutory trust authorized by section 5(c) of the Perishable Agricultural Commodities Act, 1930 (7 U.S.C. 499e(c)).
The seller of these commodities retains a trust claim over these commodities, all inventories of food or other products derived from these commodities, and any receivables or proceeds from the sale of
these commodities until full payment is received.

US Foods is committed to the safety of our associates, customers and communities. Our associates are expected to follow COVID-19 safety protocols, including daily wellness checks, wearing masks,
practicing social distancing, and regular hand washing / sanitizing.

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