Minnesota WIC Vendor Shelf Price Survey
March 2012
Vendor Stamp Number:
Store Name:
Store Address:
Store City:
Store County:
EXPLANATION AND INSTRUCTIONS:
This survey is used to determine average shelf prices for the current WIC foods and will also provide
us with important information regarding the availability of specific WIC food items. Submission of
this survey is required by WIC Program Rules and your current WIC Vendor Agreement.
1.
2.
3.
4.
5.
6.
7.
8.
9.
If you would like to receive an electronic version of this survey, please contact Theresa
Graham at [email protected] or go to the WIC website at:
http://www.health.state.mn.us/divs/fh/wic/vendor/rqrmnts/survey.html
Complete the entire survey.
Not all WIC-allowed products are listed in this survey. For a list of WIC-allowed products, refer
to the WIC website at
http://www.health.state.mn.us/divs/fh/wic/vendor/fpchng/upc/download/allpdf.cfm
Where applicable, UPC codes are listed.
If no brand or manufacturer is specified, write the price of your most expensive brand.
Please do not include sale prices. Write in your store’s usual price (what you would charge
non-WIC customers), even if this is more than the maximum price allowed by WIC.
Remember, though, that even if you write a price on this survey that is higher than the
maximum WIC price, the price you charge on WIC vouchers cannot exceed the maximum WIC
price.
If you do not stock the item or size listed, leave the line blank.
If you have any questions, please call (651) 201-4417.
Send your completed survey by April 25, 2012.
Minnesota WIC Price Survey
CSC
13401 West 98th Street
Lenexa, KS 66215
1
WIC Program Shelf Price Survey
MILK
Skim or Fat Free Milk
(multiple brands)
$
/ quart
Skim or Fat Free Milk
(multiple brands)
$
/ half gallon
Skim or Fat Free Milk
(multiple brands)
$
/ gallon
1% Milk
(multiple brands)
$_______/ quart
1% Milk
(multiple brands)
$_______/ half gallon
1% Milk
(multiple brands)
$_______/ gallon
2% Milk
(multiple brands)
$_______/ quart
2% Milk
(multiple brands)
$_______/ half gallon
2% Milk
(multiple brands)
$_______/ gallon
(multiple brands)
$_______/half gallon
(multiple brands)
$_______/ quart
(multiple brands)
$_______/half gallon
(multiple brands)
$_______/ quart
Nonfat Dry Powdered Milk
(multiple brands)
$_______/3 quart
Nonfat Dry Powdered Milk
(multiple brands)
$_______/8 quart
Nonfat Dry Powdered Milk
(multiple brands)
$_______/20 quart
Evaporated Milk
(multiple brands)
$_______/12 oz.
Fat Free or Lowfat (1%)
Lactose Free Milk
Fat Free or Lowfat (1%)
Lactose Free Milk
Fat Free or Lowfat (2%)
Lactose Free Milk
Fat Free or Lowfat (2%)
Lactose Free Milk
GOAT MILK
Myenberg whole
0 72904 00003 5
$
/ quart
Myenberg low-fat
0 72904 00015 5
$
/ quart
Nanny’s Pride whole
0 41483 00105 4
$
/ quart
Poplar Hill whole
0 19433 00001 3
$
/ quart
Meyenberg evaporated milk
0 72904 00012 7
$
/ 12 oz.
2
CHEESE
Cheddar
(multiple brands)
$_______/8 oz block
Colby
(multiple brands)
$
/8 oz block
Co-Jack (Colby/Monterey Jack)
(multiple brands)
$
/8 oz block
Farmer Cheese
(multiple brands)
$
/8 oz block
Monterey Jack Cheese
(multiple brands)
$
/8 oz block
Mozzarella Cheese
(multiple brands)
$
/8 oz block
Muenster Cheese
(multiple brands)
$
/8 oz block
Provolone Cheese
(multiple brands)
$
/8 oz block
Swiss Cheese
(multiple brands)
$
/8 oz block
SOY BEVERAGE
8th Continent- Plain Original Label
0 53859 07066 3
$
/ half gallon
Pacific Natural Foods
0 52603 08200 6
$
/ quart
TOFU
WIC Allowed Tofu
(multiple brands)
$
/ 12 to 16 ounce package
EGGS
Large Eggs
(multiple brands)
$
/ dozen
CANNED FISH
Tuna Fish
(multiple brands)
$_______/5-6 oz
Pink Salmon
(multiple brands)
$_______/_____ oz
PEANUT BUTTER
Peanut Butter
(multiple brands)
3
$
/15 to 18 oz
TORTILLAS
Corn Tortillas
Carlita’s corn tortillas
0 41130 27082 6
$_______/16 ounce package
Chi-Chi’s white corn tortillas
0 37600 08595 3
$_______/16 ounce package
Don Pancho soft white corn tortillas
0 79341 01386 4
$_______/16 ounce package
Food Club white corn tortillas
0 36800 30093 4
$_______/16 ounce package
HyVee White corn tortillas
0 75450 01722 9
$_______/16 ounce package
La Banderita 100% natural soft corn tortillas
0 27331 00049 3
$_______/16 ounce package
La Burrita soft corn tortillas
0 37232 00104 8
$_______/16 ounce package
La Perla soft corn tortillas
6 75674 92645 3
$_______/16 ounce package
Los Maizales corn tortillas
7 93573 84639 6
$_______/16 ounce package
Mission extra-thin soft yellow corn tortillas
0-73731 00328-2
$_______/16 ounce package
Shurfresh corn tortillas
0 11161 40251 0
$_______/16 ounce package
Tortillas Gloria soft corn tortillas
8 92697 00004 9
$_______/15 ounce package
Chi-Chi’s whole wheat tortillas
0 43354 00790 5
$_______/16 ounce package
Don Pancho whole wheat tortillas
0 79341 02628 4
$_______/16 ounce package
Food Club whole wheat tortillas
36800 220829
$_______/16 ounce package
Frescados whole wheat tortillas
29630 50018
Wheat Tortillas
$_______/15.5 oz package
Hy-Vee Authentic 8 whole wheat tortillas
0 7545001745 8
$_______/16 ounce package
La Banderita whole wheat tortillas
0 27331 00048 6
$_______/16 ounce package
Mission whole wheat tortillas
0 73731 07107 6
$_______/16 ounce package
Ortega whole wheat tortillas
0 41501 00922 2
$_______/14.3 oz package
Reser’s Baja Café whole wheat tortillas
0-74177 00114-6
$_______/15 ounce package
Roundy’s whole wheat tortillas
0 11150 08337 9
$_______/16 ounce package
Shurfresh whole wheat tortillas
11161 40121
$_______/16 ounce package
4
WHOLE GRAIN BREAD
Bimbo - 100% Whole Wheat
0 74323-09230 1
$_______/16 ounce loaf
Cub - 100% Whole Wheat
0 41130 02669 0
$_______/16 ounce loaf
Family Choice -100% whole wheat bread
76057 00427
$_______/16 ounce loaf
Food Club -100% whole wheat bread
36800 30087
$_______/16 ounce loaf
HyVee 100% whole wheat bread
75450 10138
$_______/16 ounce loaf
Our Family -100% whole wheat bread
70253 75151
$_______/16 ounce loaf
0 14100 07101 3
$_______/16 ounce loaf
0 14100 07132 7
$_______/16 ounce loaf
14100 09140
$_______/16 ounce loaf
Sara Lee - Classic 100% Whole Wheat
0 72945 61103 0
$_______/16 ounce loaf
Shurfresh 100% whole wheat bread
0 11161 40303 6
$_______/16 ounce loaf
76057 00428
$_______/16 ounce loaf
83791 00001 2
$_______/16 ounce loaf
Wonder - Soft 100% Whole Wheat
0 45000 12100 3
$_______/16 ounce loaf
East African - Injera Bread
8 23264 00007 0
$_______/16 ounce package
Pepperidge Farms - Stone Ground 100%
Whole Wheat
Pepperidge Farms - Very Thin Sliced Soft
100% Whole Wheat
Pepperidge Farms - Whole Grain Rye,
Seeded
Village Hearth -100% whole wheat bread
Weight Watchers - Whole Wheat Bread
OATMEAL
Mom’s Best Natural Quick Oats
Mother’s Rolled Oats
0 42400 01692 2
$_______/16 ounces
30000 21641
$_______/16 ounces
- n/a -
$_______/16 ounces
Bulk oatmeal
BROWN RICE
Instant Brown Rice
(multiple brands)
$_______/14 ounce package
Brown Rice
(multiple brands)
$_______/16 ounce package
-n/a-
$_______/16 ounce package
Bulk Brown Rice
5
DRY BEANS, PEAS, LENTILS
Dry Beans
(multiple brands)
$
/14-16 oz bag
Lentils
(multiple brands)
$
/14-16 oz bag
Green or Yellow Split or Whole Peas
(multiple brands)
$
/14-16 oz bag
-na-
$
/14-16 oz bag
Bulk dry beans, peas or lentils
CANNED BEANS (no added fats, oils meat)
Azuki beans
(multiple brands)
$_______/14-16 ounce can
Black beans
(multiple brands)
$_______/14-16 ounce can
Chick peas (garbanzo beans)
(multiple brands)
$_______/14-16 ounce can
Great Northern beans
(multiple brands)
$_______/14-16 ounce can
Kidney beans
(multiple brands)
$_______/14-16 ounce can
Lima beans
(multiple brands)
$_______/14-16 ounce can
Mung beans
(multiple brands)
$_______/14-16 ounce can
Navy beans
(multiple brands)
$_______/14-16 ounce can
Pinto beans
(multiple brands)
$_______/14-16 ounce can
100% FRUIT JUICE
Apple
(multiple brands)
$
/64 oz non-refrigerated container
Grape (red, white, purple)
(multiple brands)
$
/64 oz non-refrigerated container
Pineapple
(multiple brands)
$
/64 oz non-refrigerated container
Orange
(multiple brands)
$
/59 oz REFRIGERATED container
Orange
(multiple brands)
$
/64 oz REFRIGERATED container
Tomato
(multiple brands)
$
/64 oz non-refrigerated container
Vegetable
(multiple brands)
$
/64 oz non-refrigerated container
Apple
(multiple brands)
$
/11.5-12 oz can of FROZEN concentrate
Grape
(multiple brands)
$
/11.5-12 oz can of FROZEN concentrate
Grapefruit
(multiple brands)
$
/11.5-12 oz can of FROZEN concentrate
Orange
(multiple brands)
$
/11.5-12 oz can of FROZEN concentrate
Pineapple
(multiple brands)
$
/11.5-12 oz can of FROZEN concentrate
6
CEREALS (note: this is not a complete list of all WIC-allowed cereals)
General Mills Cheerios (plain)
0 16000 27564 5
$
/14 oz
General Mills Cheerios (plain)
0 16000 27528 7
$
/ 18 oz
General Mills KIX
0 16000 27567 6
$
/12 oz
General Mills Multi-Grain Cheerios
0 16000 27562 1
$
/12.8 oz
General Mills Rice Chex
0 16000 27559 1
$_______/12.8 oz
General Mills Whole Grain Total
0 16000 27563 8
$
General Mills Wheat Chex
0 16000 27549 2
$_______/14 oz
General Mills Wheaties (plain)
0 16000 27565 2
$
/15.6 oz
Kellogg’s Corn Flakes
38000 00127
$
/12 oz
Kellogg’s Corn Flakes
38000 00120
$
/18 oz
Kellogg’s Crispix
38000 03530
$ _______/12 oz
Kellogg’s Frosted Mini-Wheats (Big Bite)
38000 02720
$
/16 oz
Kellogg’s Rice Krispies
38000 31846
$
/12 oz
Kellogg’s Rice Krispies
38000 29121
$
/18 oz
Kellogg’s Special K
38000 01611
$
/12 oz
Malt-O-Meal (original hot)
42400 00105
$
/ 28 oz
Post Banana Nut Crunch
8 84912 11650 5
$_______/15.5 oz
Post Grape Nuts
8 84912 10521 9
$
Post Honey Bunches of Oats – Honey Roasted
8 8491201424 5
$_______/14.5 oz
Post Honey Bunches of Oats – Honey Roasted
8 84912 01426 9
$_______/18 oz
/16 oz
/24 oz
Quaker Life (Regular)
30000 06340
$
/15 oz
Quaker Oatmeal Squares (Blue box)
30000 06430
$
/14.5 oz
Quaker Instant Oatmeal
30000 01210
$
/11.8 oz
7
INFANT FORMULA
Similac Advance (concentrate)
70074-56974
$_______/13 oz can
Similac Advance (powder)
70074-55958
$_______/12.4 oz can
Similac Advance (ready to feed)
70074-55962
$_______/1 quart (32 oz) can
Similac Advance (powder)
70074-53360
$_______/1.45 lb. (23.2 oz) can
Similac Soy Isomil (concentrate)
70074-56976
$_______/13 oz can
Similac Soy Isomil (powder)
70074-55964
$
Similac Sensitive (concentrate)
70074-57536
$_______/13 oz can
Similac Sensitive (powder)
70074-57541
$_______/12.6 oz can
Similac Sensitive for Spit Up (powder)
70074-50960
$_______/12.3 oz can
Similac Go and Grow (powder)
70074-50828
$_______/22 oz can
Similac Go and Grow Soy (powder)
70074-50838
$_______/22 oz can
/12.4 oz can
INFANT CEREAL
Beech Nut
(multiple products)
$
/8 oz box
Gerber
(multiple products)
$
/8 oz box
INFANT FRUITS AND VEGETABLES
Beech Nut infant fruits
(multiple products)
$
/4 oz jar
Beech Nut infant vegetables
(multiple products)
$
/4 oz jar
Gerber infant fruits
(multiple products)
$
/4 oz jar
Gerber infant vegetables
(multiple products)
$
/4 oz jar
HyVee infant fruits
(multiple products)
$
/4 oz jar
HyVee infant vegetables
(multiple products)
$
/4 oz jar
Full Circle organic infant fruits
(multiple products)
$
/4 oz jar
Full Circle organic infant vegetables
(multiple products)
$
/4 oz jar
Wild Harvest organic infant fruits
(multiple products)
$
/4 oz jar
Wild Harvest organic infant vegetables
(multiple products)
$
/4 oz jar
8
INFANT MEATS
Beech Nut infant meats
(multiple products)
$
/2.5 oz jar
Gerber infant meats
(multiple products)
$
/2.5 oz jar
BANANAS
Regular (including organic)
(multiple brands)
$_______/16 ounce (pound)
FRESH VEGETABLES (white-fleshed potatoes are excluded)
Please mark with an “X” what fresh vegetables your store currently has in stock.
“X” if your
store stocks
this product
Fresh Vegetables
“X” if your
store stocks
this product
Fresh
Vegetables
Avocados
Plain Bagged salad
Beets
Broccoli
Cabbage
Carrots
Cauliflower
Celery
Chilies
“X” if your
store stocks
this product
Corn
Cucumbers
Green beans
Lettuce
Onions
Peppers
Radishes
Rutabaga
Fresh Vegetables
Spinach
Squash
Sweet Potatoes
Tomatoes
Yams
Zucchini
Other (note:
cannot include
white-fleshed
potatoes or
pumpkins)
FRESH FRUITS
Please mark with an “X” what fresh fruits your store currently has in stock.
“X” if your
store stocks
this product
Fresh Fruits
Apples
Apricots
Bananas
Blueberries
Cantaloupes
Cherries
Grapes
Lemons
“X” if your
store stocks
this product
Fresh Fruits
Limes
Mangos
Melons
Nectarines
Oranges
Papayas
Peaches
9
“X” if your
store stocks
this product
Fresh Fruits
Pears
Pineapples
Plums
Raspberries
Strawberries
Watermelons
Other