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					                      MSI PRINT SHOP FORMS INDEX USERS


The yellow tab "Recent Changes":
This sheet contains most of the information about changes, etc.

YARD PASSES AND PHYSICIAN'S ORDERS:
Please note the difference between the form numbers for these forms - they both have
two listings. Ordering the correct form number will help us get your order out quicker -
and no one will have to keep pestering you about which format you want.
   YARD PASSES: CAX-850 = Continuous feed - with pinholes for tractor
                                      feed printers.
                         CAJ-850 = LASER PRINTER forms. 3 ea / 8 1/2 x 11sheet.
           NOTE: Passes are priced per PASS, not by 8 1/2 x 11 sheet.

   PHYSICIAN'S ORDERS: CHX-122 = Form with tear-off strip on the bottom                                                                      ABBREVIATIONS
                         CHJ-122 = Form is glued at bottom with NO
                                     tear-off strip.                                                COLOR             UNIT OF ISSUE                  QTY / Unit or Special Paper                     Paper Weights
                                                                                           ABBREV      COLOR    ABBREV            UNIT               STANDARD DISTRIBUTION
Who prints it?
The column labelled "Vendor" indicates who/where it's printed. We try to keep track of                                                           2 PT
all MDOC forms even if we don't print them. And now that quite a few forms are             W        WHITE       PD          PAD          2 NCR   CARBONLESS      White, Canary                 20#      20 POUND
"electronic" and available on the "P" (Public) Drive, you'll see that indicated, also.                                                           3 PT
We've had a few questions about these forms so we will try to explain:                     C        CANARY      EA          EACH         3 NCR   CARBONLESS      White, Canary, Pink           60#      60 POUND
                                                                                                                                                 4 PT
ELEC or ELECT = The form is an "Electronic Only" form. It is available from the
                                                                                           P        PINK        ST          SET          4 NCR   CARBONLESS      White, Canary, Pink, Goldenrod 80#     80 POUND
Public Drive ONLY.                                                                                                                               5 PT            White, Canary, Pink, Green,
                                                                                           GR       GREEN       BK          BOOK         5 NCR   CARBONLESS      Goldenrod                      110#    110 POUND
ELEC~MSI; MSI~ELEC = The form is available from the Public Drive and is also              G        GOLDENROD   SH          SHEET
available from the MSI Print Shop. Please note: The MAJORITY of Electronic forms                                PG          PAGE
will be printed on white bond paper and will come in pads. There are only a few            CH       CHERRY      PKG         PACKAGE
exceptions! This includes forms that used to be multi-part carbonless sets.                BL       BLUE        BX          BOX
                                                                                           S        SALMON
DMB-PG = These must be ordered from DMB Print & Graphics. It's usually a matter
of security that we don't print these forms. Please NOTE: this is "...not the DMB-
Warehouse. When the vendor is listed as DMB that means the vendor mail code on
the PO should be for DMB instead of MSI. Please have your procurement tech place
an order in MAIN and have the PO sent to Central Office Forms Control."

ROTARY; RMI = Rotary Multiforms prints these, but we usually order them and
distribute them. We do NOT print continuous feed forms and special forms in-house.

As always, feel free to contact us with any questions.


The Print Shop
517-780-5806
          CAJ                                    MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                                      QTY /
                                                                                                                                               Unit
                                                                                                                                                      Unit or
 Vendor      Comm#           Form#                                 Title/Description                           Rev.      Color     Size          of
                                                                                                                                                     *Special
                                                                                                                                               Issue
                                                                                                                                                      Paper
MSI        4835-0001     CAJ-001      Certificate of Completion                                                                  8 1/2 - 11   SH                  $0.058
MSI        4835-0002     CAJ-002      Certificate of Achievement                                               05/97   Blue      8 1/2 - 11   SH                  $0.083
MSI        4835-0003     CAJ-003      Certificate of Appointment                                                                 8 1/2 - 11   SH                  $0.066
MSI        4835-0004     CAJ-004      Certificate of Promotion                                                                   8 1/2 - 11   SH                  $0.066
MSI        4835-0005     CAJ-005      Certificate of Recognition(formerly CCR-005)                             03/86             8 1/2 - 11   SH                  $0.050
MSI        4835-0006     CAJ-006      Certificate - Narcotics Anonymous (Pending Approval)                     06/03   White     8 1/2 - 11   SH                  $0.000
                                      Certificate of Achievement (Certificate + cover) Career & Technical
MSI        4835-0010     CAJ-010      Certificate                                                              06/00   Chmpne    8 1/2 x 11 ST                    $0.083

MSI        4835-0010     CAJ-010CVR   Certificate of Achievement (COVER ONLY) Career & Technical Certificate   06/00   Chmpne    8 1/2 x 11 EA                    $0.033
MSIELEC    4835-0011     CAJ-011      Tool Audit Reports                                                       11/10
MSI        4835-0015     CAJ-015      Progress Plotter - Technical Math Student (2-sided)                      07/02   white     8 1/2 x 11   PD          100     $3.405
MSI        4835-0016     CAJ-016      Rifle Zero Target Form                                                   08/00   white     8 1/2 x 11   EA          SH      $0.040
MSI        4835-0018     CAJ-018      Progress Plotter - Introduction to Computers - Student                   07/02   white     8 1/2 x 11   PD          100     $2.711
MSI        4835-0020     CAJ-020      Relocation Approval                                                      02/02   white     8 1/2 x 11   PD          100     $2.711
MSI        4835-0021     CAJ-021      Request to Move Household Goods                                          02/02   white     8 1/2 X 11   PD          100     $2.711
MSI        4835-0022 A   CAJ-022 A    Master Count Board - SMT(1A,2A,3A,4A)                                    05/07   manilla      11 x 17   SH         TAG      $0.397
MSI        4835-0022 B   CAJ-022 B    Master Count Board - SMT(1B,2B,3B,4B)                                    05/07   manilla      11 x 17   SH         TAG      $0.397
MSI        4835-0022     CAJ-022      Count Sheet - SMT - 1A(1-80)                                             05/07   White     2 1/8 x 17   PD          100     $4.536
MSI        4835-0023     CAJ-023      Count Sheet - SMT - 2A(1-80)                                             05/07   White     2 1/8 x 17   PD          100     $4.536
MSI        4835-0024     CAJ-024      Count Sheet - SMT - 3A(1-80)                                             05/07   White     2 1/8 x 17   PD          100     $4.536
MSI        4835-0025     CAJ-025      Count Sheet - SMT - 4A(1-80)                                             05/07   White     2 1/8 x 17   PD          100     $4.536
MSI        4835-0026     CAJ-026      Count Sheet - SMT - 1B(1-80)                                             05/07   White     2 1/8 x 17   PD          100     $4.536
MSI        4835-0027     CAJ-027      Count Sheet - SMT - 2B(1-80)                                             05/07   White     2 1/8 x 17   PD          100     $4.536
MSI        4835-0028     CAJ-028      Count Sheet - SMT - 3B(1-80)                                             05/07   White     2 1/8 x 17   PD          100     $4.536
MSI        4835-0029     CAJ-029      Count Sheet - SMT - 4B(1-80)                                             05/07   White     2 1/8 x 17   PD          100     $4.536
MSI        4835-0030     CAJ-030      MASTER COUNT - PUGSLEY 4 Block - Wings A & B                             05/03             8 1/2 x 14   SH        Index     $0.066
MSI        4835-0031     CAJ-031      MASTER COUNT - PUGSLEY 4 Block - Wings C & D                             05/03             8 1/2 x 14   SH        Index     $0.066
MSI        4835-0032     CAJ-032      Count Sheet - Pugsley 4 Block - Wings A & B                              05/03             8 1/2 x 14   PD          100     $4.530
MSI        4835-0033     CAJ-033      Count Sheet - Pugsley 4 Block - Wings C & D                              05/03             8 1/2 x 14   PD          100     $4.530

MSI        4835-0034     CAJ-034      MASTER COUNT - PUGSLEY 1 - 2 - 3 Blocks - All Wings Beds 1 - 68          05/03             8 1/2 x 14 SH          Index     $0.066

MSI        4835-0035     CAJ-035      MASTER COUNT - PUGSLEY 1 - 2 - 3 Blocks - All Wings Beds 1 - 68          05/03             8 1/2 x 14   SH        Index     $0.066
MSI        4835-0036     CAJ-036      Count Sheet - Pugsley 1 - 2 - 3 Blocks - All Wings Beds 1 - 68           05/03             8 1/2 x 14   PD          100     $4.530
MSI        4835-0037     CAJ-037      Count Sheet - Pugsley 1 - 2 - 3 Blocks - All Wings Beds 69 - 134         05/03             8 1/2 x 14   PD          100     $4.530
MSI        4835-0040     CAJ-040      Employee Award Nomination Form(Valor/Lifesaving/Citizenship) 3 page      11/99             8 1/2 x 11   BK          EA      $0.132
                                      Employee Award Nomination Form(Professional Excellence/Director's) 5
MSI       4835-0041      CAJ-041      page                                                                     11/99             8 1/2 x 11   BK          EA      $0.198
MSI       4835-0044      CAJ-044      Privilege Modification Form (I onia Max)                                 04/02             8 1/2 x 11   ST            5     $0.132
MSI       4835-0045      CAJ-045      30 day General Population Review                                         04/02             8 1/2 x 11   ST            3     $0.083
MSI       4835-0046      CAJ-046      Florence Crane Building 44/45 Long Wing Count Sheet 1-66                 07/10             2 3/4 x 17   PD          100     $4.530
MSI       4835-0047      CAJ-047      Florence Crane Building 44/45 Short Wing Count Sheet 67-102              07/10             2 3/4 x 17   PD          100     $4.530
 2/24/2012                                                                                                                                             2 of 267   CAJ
          CAJ                                  MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                                QTY /
                                                                                                                                         Unit
                                                                                                                                                Unit or
 Vendor      Comm#          Form#                                Title/Description                      Rev.     Color      Size           of
                                                                                                                                               *Special
                                                                                                                                         Issue
                                                                                                                                                Paper
MSI        4835-0048    CAJ-048     Florence Crane M-Unit Count Sheet 1-80                              07/10              3 1/4 x 17   PD          100     $4.530
MSI        4835-0049    CAJ-049     Florence Crane Building 58 Count Sheet 1-80                         07/10              3 1/4 x 17   PD          100     $4.530
MSI        4835-0050    CAJ-050     Florence Crane Building 58 Count Sheet 81-160                       07/10              3 1/4 x 17   PD          100     $4.530
MSI        4835-0064    CAJ-064     Count Strips for J Block- Floor One                                 09/97              5 1/2 x 17   PD          100     $3.405
MSI        4835-0065    CAJ-065     Count Strips for J Block- Floor Two                                 09/97              5 1/2 x 17   PD          100     $3.405
MSI        4835-0066    CAJ-066     Count Strips For J Block-Floor Three, Four, and Five                09/97              5 1/2 x 17   PD          100     $3.405
MSI        4835-0070    CAJ-070     MASTER COUNT SHEET - JMF 4 BLOCK                                    06/03   White         11 - 17   SH        Index     $0.132
MSI        4835-1071    CAJ-070A    Count Sheet - JMF 4 Block - Pod A                                   06/03              5 1/8 - 17   PD          100     $4.463
MSI        4835-1071    CAJ-070B    Count Sheet - JMF 4 Block - Pod B                                   06/03              5 1/8 - 17   PD          100     $4.463
MSI        4835-1073    CAJ-070C    Count Sheet - JMF 4 Block - Pod C                                   06/03              5 1/8 - 17   PD          100     $4.463
MSI        4835-1074    CAJ-070D    Count Sheet - JMF 4 Block - Pod D                                   06/03              5 1/8 - 17   PD          100     $4.463
MSI        4835-0071    CAJ-071     MASTER COUNT SHEET - JMF 5 BLOCK                                    06/03   White         11 - 17   SH        Index     $0.132
MSI        4835-1171    CAJ-071A    Count Sheet - JMF 5 Block - Pod A                                   06/03              5 1/8 - 17   PD          100     $4.530
MSI        4835-1172    CAJ-071B    Count Sheet - JMF 5 Block - Pod B                                   06/03              5 1/8 - 17   PD          100     $4.530
MSI        4835-1173    CAJ-071C    Count Sheet - JMF 5 Block - Pod C                                   06/03              5 1/8 - 17   PD          100     $4.530
MSI        4835-1174    CAJ-071D    Count Sheet - JMF 5 Block - Pod D                                   06/03              5 1/8 - 17   PD          100     $4.530
MSI        4835-0072    CAJ-072     MASTER COUNT SHEET - JMF - 6 Block                                  06/03   White         11 - 17   SH        Index     $0.132
MSI        4835-1072    CAJ-072A    Count Strip - JMF 6 Block - Pod A                                   06/03   white    2 5/16 X 17    PD          100     $4.530
MSI        4835-1073    CAJ-072B    Count Strip - JMF 6 Block - Pod B                                   06/03   white    2 5/16 X 17    PD          100     $4.530
MSI        4835-1074    CAJ-072C    Count Strip - JMF 6 Block - Pod C                                   06/03   white    2 5/16 X 17    PD          100     $4.530
MSI        4835-1075    CAJ-072D    Count Strip - JMF 6 Block - Pod D                                   06/03   white    2 5/16 X 17    PD          100     $4.530
MSI        4835-1076    CAJ-072E    Count Strip - JMF 6 Block - Pod E                                   06/03   white    2 5/16 X 17    PD          100     $4.530
MSI        4835-0079    CAJ-079     Count Sheet -" Egeler"                                              01/02   White                   SH        Index     $0.132
MSI        4835-0080    CAJ-080     Count Strips-(LRF) Level IV--A Wing (1T --- 24B)                    02/06   White      2 1/2 - 17   PD          100     $2.265
MSI        4835-1080    CAJ-080A    Master Count Board Sheet (LRF) Level IV (1T--24B)                   02/06   white      5 1/2 - 17   SH        Index     $0.132
MSI        4835-0081    CAJ-081     Count Strips-(LRF) Level IV, B-Wing, 25T - 48B                      02/06   White      2 1/2 - 17   PD          100     $2.265
MSI        4835-1081    CAJ-081A    Master Count Board Sheet (LRF) Level IV, B-Wing, 25T - 48B          02/06   white      5 1/2 - 17   SH        index     $0.132
MSI        4835-0082    CAJ-082     Count Strips-{LRF}Level IV--C Wing 49T-72B                          02/06   White      2 1/2 - 17   PD          100     $2.265
MSI        4835-1082    CAJ-082A    Master Count Board Sheet (LRF) Level IV, C-Wing, 49T - 72B          02/06   White      5 1/2 - 17   SH        Index     $0.132
MSI        4835-0083    CAJ-083     Count Strips{LRF}-Level IV-- D Wing (73 --- 96)                     02/06   White      2 1/2 - 17   PD          100     $2.265
MSI        4835-1083    CAJ-083A    Master Count Board Sheet (LRF) Level IV D-Wing, 73T---96B           02/06   White      5 1/2 - 17   SH        Index     $0.132
MSI        4835-0084    CAJ-084     Count Strips-Level I & II-- A Wing(LRF) 1T - 30B                    02/06   White      2 1/2 - 17   PD          100     $2.265
MSI        4835-1084    CAJ-084A    Master Count Board Sheet (LRF), level I & II, A-Wing, IT - 30B      02/06   White      5 1/2 - 17   SH        Index     $0.132
MSI        4835-0085    CAJ-085     Count Strips(LRF)-Level I & II-- B Wing, 31T-- 60B                  02/06   White      2 1/2 - 17   PD          100     $2.265
MSI        4835-1085    CAJ-085A    Master Count Sheet(LRF) level I & II, B-wing, 31T -- 60B            02/06   white      5 1/2 - 17   SH        index     $0.132
MSI        4835-0086    CAJ-086     Count Strips(LRF)-Level I & II - C-wing, 61 T -- 90 B               02/06   White      2 1/2 - 17   PD          100     $2.261
MSI        4835-1086    CAJ-086A    Master Count Sheet (LRF) level I & II, C-wing, 61T --- 90B          02/06   white      5 1/2 - 17   SH        index     $0.132
MSI        4835-0087    CAJ-087     Count Strips(LRF)-Level I & II-- D Wing, 91 T -- 120 B              02/06   White      2 1/2 - 17   PD          100     $2.261
MSI        4835-1087    CAJ-087A    Master Count Board Sheet (LRF) level I & II, D-wing, 91T --- 120B   02/06   white      5 1/2 - 17   SH        Index     $0.132
MSI/ELEC   4835-0088    CAJ-088     EXIT INTERVIEW SURVEY                                               11/09                                               $0.000
MSI        4835-0089    CAJ-089     MASTER COUNT BOARD-MCF Unit #1 (101-150 & 116-143)                  04/05   White      8 1/2 - 17 EA          Index     $0.132
                                                                                                                           5 1/2 - 15
MSI        4835-0089A   CAJ-089A    Count Strip - MCF Unit# 1 (101-150 & 116-143)                       04/05   White             1/2 PD        100/pd      $4.629
 2/24/2012                                                                                                                                       3 of 267   CAJ
          CAJ                                  MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                               QTY /
                                                                                                                                        Unit
                                                                                                                                               Unit or
 Vendor      Comm#          Form#                                Title/Description                      Rev.     Color       Size         of
                                                                                                                                              *Special
                                                                                                                                        Issue
                                                                                                                                               Paper
MSI        4835-0090    CAJ-090     MASTER COUNT BOARD - MCF Unit #1 (200-232 & 233-262)                04/05   White       8 1/2 - 17 EA        Index      $0.132
                                                                                                                            5 1/2 - 15
MSI        4835-0090A   CAJ-090A    Count Strip - MCF Unit# 1 (200-232 & 233-262)                       04/05   White              1/2 PD       100/pd      $4.629
MSI        4835-0091    CAJ-091     MASTER COUNT BOARD - MCF General Unit (100-153)                     04/05   White       8 1/2 - 17 EA        Index      $0.132
                                                                                                                            5 1/2 - 15
MSI        4835-0091A   CAJ-091A    Count Strip - MCF General Unit (100-153)                            04/05   White              1/2 PD       100/pd      $4.629
MSI        4835-0092    CAJ-092     MASTER COUNT BOARD - MCF General Unit (200-264)                     04/05   White       8 1/2 - 17 EA        Index      $0.132
                                                                                                                            5 1/2 - 15
MSI        4835-0092A   CAJ-092A    Count Strip - MCF General Unit (200-264)                            04/05   White              1/2 PD       100/pd      $4.629
MSI        4835-0093    CAJ-093     MASTER COUNT BOARD - MCF Unit #6 (101-140)                          04/05   White       8 1/2 - 17 EA        Index      $0.132
                                                                                                                            5 1/2 - 15
MSI        4835-0093A   CAJ-093A    Count Strip - MCF Unit #6 (101-140)                                 04/05   White              1/2 PD       100/pd      $4.629
MSI        4835-0094    CAJ-094     MASTER COUNT BOARD - MCF Unit #6 (201-240)                          04/05   White       8 1/2 - 17 EA        Index      $0.132
                                                                                                                            5 1/2 - 15
MSI        4835-0094A   CAJ-094A    Count Strip - MCF Unit #6 (201-240)                                 04/05   White              1/2 PD       100/pd      $4.629
MSI                     CAJ-095A    IBC LEVEL 2 A-WING                                                  05/11   White       4 1/4X17 PD         100/pd      $4.629
MSI                     CAJ-095B    IBC LEVEL 2 B-WING                                                  05/11   White       4 1/4X17 PD         100/pd      $4.629
MSI                     CAJ-095C    IBC LEVEL 4 A-WING                                                  05/11   White       4 1/4X17 PD         100/pd      $4.629
MSI                     CAJ-095D    IBC LEVEL 4 B-WING                                                  05/11   White       4 1/4X17 PD         100/pd      $4.629
MSI                     CAJ-095E    IBC HOUSING UNIT2 A-WING                                            05/11   White       4 1/4X17 PD         100/pd      $4.629
MSI                     CAJ-095F    IBC HOUSING UNIT 2 B-WING                                           05/11   White       4 1/4X17 PD         100/pd      $4.629
MSI        4835-0101    CAJ-101     Warehouse Delivery Receipt                                          08/96   NCR      5 1/2 - 8 1/2 ST              3    $0.083
MSI/ELEC   4835-0102    CAJ-102     Requisition - Supplies                                              02/98   NCR         8 1/2 - 11 ST              4    $0.116
MSI/ELEC   4835-0103    CAJ-103     MDOC Visiting Application                                           06/11   NCR         8 1/2 - 11 ST              4    $0.119
MSI        4835-0104    CAJ-104     Room Roster                                                         09/89   white       8 1/2 - 11 PD          100      $2.711
MSI        4835-0105    CAJ-105     Daily Report on Food service                                        09/89   white       8 1/2 - 11 PD          100      $2.711
MSI        4835-0109    CAJ-109     Shipping and Delivery Report                                        01/90   NCR      5 1/2 - 8 1/2 ST              5    $0.083
MSI        4835-0110    CAJ-110 A   OJT Evaluation - Weekly - Secure Custody - All Prisons              01/90   white       8 1/2 - 11 PD          100      $3.405
MSI        4835-1110    CAJ-110 B   OJT Evaluation - Weekly - Community/Residential Programs            01/90   white       8 1/2 - 11 PD          100      $3.405
MSI        4835-2110    CAJ-110 C   OJT Evaluation - Weekly - Camps                                     01/90   white       8 1/2 - 11 PD          100      $3.405
MSI        4835-0112    CAJ-112     Pick-Up Order                                                       12/89               8 1/2 - 11 SH                   $0.017
MSI        4835-0113    CAJ-113     Loss of Privileges                                                  12/90   NCR         8 1/2 - 11 ST              3    $0.083
MSI        4835-0117    CAJ-117     Prisoner's / Inmate Issue Record(F&B, 2-forms) Same on both sides   12/89   white      8 1/2 X 11 EA         Index      $0.050
MSI        4835-0118    CAJ-118     Employment Preference                                               07/84   NCR         8 1/2 - 11 ST              2    $0.066
ELECT      4835-0119    CAJ-119     Cross Training Credit                                               04/06                                               $0.000
MSI        4835-0120    CAJ-120     CMC Inventory                                                                          8 1/2 - 11 SH                    $0.017
MSI        4835-0121    CAJ-121     Time Card - KCF Food service                                                            3 1/2 - 7 EA          Index     $0.050
OBS        4835-0122    CAJ-122     Vacation Notification (OBSOLETE) See CAJ-180                                                                            $0.000
OBS        4835-0122    CAJ-122 A   Laundry - Bag Verification Report (OBSOLETE 3/27/02)                                                                    $0.000
OBS        4835-1122    CAJ-122 B   Laundry - Bulk Verification Report (OBSOLETE 3/27/02)                                                                   $0.000
MSI        4835-0123    CAJ-123     Proof Slip - Bureau of Health Care Services                         08/89            5 1/2 - 8 1/2 ST             2     $0.050
MSI        4835-0124    CAJ-124     Request for Administrative Hearing - Special Education Services     05/94               8 1/2 - 11 ST             3     $0.083

 2/24/2012                                                                                                                                       4 of 267   CAJ
          CAJ                                  MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                             QTY /
                                                                                                                      Unit
                                                                                                                             Unit or
 Vendor      Comm#          Form#                               Title/Description    Rev.     Color       Size          of
                                                                                                                            *Special
                                                                                                                      Issue
                                                                                                                             Paper
ELECT      4835-0125    CAJ-125     Shipping Order (DMB Warehouse)                   01/90                                               $0.000
MSI        4835-0126    CAJ-126     Classification Record Inventory                  04/90              8 1/2 - 11 PD            100     $2.711
MSI        4835-0128    CAJ-128     Postal Account Card                              04/91   White    7 1/2 - 3 1/4   EA       Index     $0.017
MSI        4835-0129    CAJ-129     Count Sheet - Master (101-156B)                  01/97   White     10 1/4 - 17    EA       Index     $0.116
MSI        4835-0130    CAJ-130     Count Sheet - Master (200T-262B)                 01/97   White     10 1/4 - 17
                                                                                                         2 3/4 15     EA       Index     $0.116
MSI        4835-0131    CAJ-131     Count Sheet - Muskegon (200-264)                                            3/4   PD         100     $2.038
MSI        4835-0132    CAJ-132     Count Sheet - Hiawatha (1-70) Individual         01/08   White       2 1/2 - 17   PD         100     $4.530
MSI        4835-0132A   CAJ-132A    Count Sheet - Hiawatha (1-80)                    06/07   White       2 1/8 - 17   PD         100     $4.536
MSI        4835-0133    CAJ-133     Vehicle Inspection Report                        06/91               8 1/2 - 11   PD         100     $2.711
MSI        4835-0134    CAJ-134     Inventory/Revolving Fund - Stock Item Request    09/84               8 1/2 - 11   ST           3     $0.083
MSI        4835-0135    CAJ-135     Biweekly Detail                                  09/89               8 1/2 - 11   SH                 $0.017
MSI        4835-0136    CAJ-136     Security Unit Grievance Form                     03/90               8 1/2 - 11   PD                 $3.405
OBS        4835-0137    CAJ-137     Hearing Division Statistics - Monthly Report                                                         $0.000
MSI        4835-0138    CAJ-138     Meals Served                                     05/94               8 1/2 - 14   PD         100     $4.530
MSI        4835-0139    CAJ-139     New Classification or Reclassification           02/90               8 1/2 - 11   PD         100     $2.711
MSI        4835-0140    CAJ-140     Offender Financial Status Report                 01/97               8 1/2 - 11   ST           4     $0.116
MSI        4835-0141    CAJ-141     Count Sheet - Carson (Level 1) 1 - 60            05/05   white       2 1/2 - 14   PD         100     $2.711
MSI        4835-0142    CAJ-142     Count Sheet - Carson (Level 111) 61 - 120        05/05   white       2 1/2 - 14   PD         100     $2.711
MSI        4835-0143    CAJ-143     Count Sheet - Carson - Level IV (1-48)           01/92               2 1/2 - 14   PD         100     $2.711
MSI        4835-0144    CAJ-144     Count Sheet - Carson - Level IV (49-96)          01/92               2 1/2 - 14   PD         100     $2.711
MSI        4835-0145    CAJ-145     Contraband Log                                                       8 1/2 - 11   PD         100     $2.711
MSI        4835-0146    CAJ-146     Amp Reading - Hourly                             06/90               8 1/2 - 14   PD         100     $4.530
MSI        4835-0147    CAJ-147     Delivery Slip and Receipt                        07/91            5 1/2 - 8 1/2   ST           4     $0.066
OBS        4835-0148    CAJ-148     Prisoner Store Order - Short                     08/89                                               $0.000
MSI        4835-0149    CAJ-149     Room Check - Employees                           10/89            4 1/4 - 5 1/2   ST           3     $0.017
MSI        4835-2150    CAJ-150 A   Meal Ticket Official - Paid                      02/96   Salmon   2 1/2 - 4 1/4   EA       Index     $0.017
MSI        4835-2151    CAJ-150 B   Meal Ticket Guest - No Charge                            Green    2 1/2 - 4 1/4   EA       Index     $0.017
MSI        4835-0151    CAJ-151     Room/Cell Check - Prisoner                       10/89            4 1/4 - 5 1/2   PD         100     $1.356
MSI        4835-0152    CAJ-152     Contraband Disposition Log                       11/90   NCR         8 1/2 - 11   ST           3     $0.083
MSI        4835-0153    CAJ-153     Hobby craft Card                                 04/84   yellow      8 1/2 - 14   SH           1     $0.017
MSI        4835-0154    CAJ-154     Facility Inspection Report - Monthly             04/91               8 1/2 - 11   PD         100     $2.711
MSI        4835-0155    CAJ-155A1    Lakeland Master Count Board A1-A4               02/11   110            11x17     EA           1     $0.200
MSI        4835-0155    CAJ-155A2    Lakeland Master Count Board A2-A3               02/11   110            11x17     EA           1     $0.200
MSI        4835-0155    CAJ-155B1    Lakeland Master Count Board B1                  02/11   110            11x17     EA           1     $0.200
MSI        4835-0155    CAJ-155B2    Lakeland Master Count Board B2                  02/11   110            11x17     EA           1     $0.200
MSI        4835-0155    CAJ-155B3    Lakeland Master Count Board B3                  02/11   110            11x17     EA           1     $0.200
MSI        4835-0155    CAJ-155B4    Lakeland Master Count Board B4                  02/11   110            11x17     EA           1     $0.200
MSI        4835-0155    CAJ-155B5    Lakeland Master Count Board B5                  02/11   110            11x17     EA           1     $0.200
MSI        4835-0155    CAJ-155C1    Lakeland Master Count Board C1                  02/11   110            11x17     EA           1     $0.200
MSI        4835-0155    CAJ-155C2    Lakeland Master Count Board C2                  02/11   110            11x17     EA           1     $0.200
MSI        4835-0155    CAJ-155C3    Lakeland Master Count Board C3                  02/11   110            11x17     EA           1     $0.200
MSI        4835-0155    CAJ-155C4    Lakeland Master Count Board C4                  02/11   110            11x17     EA           1     $0.200
 2/24/2012                                                                                                                    5 of 267   CAJ
          CAJ                                        MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                                          QTY /
                                                                                                                                                   Unit
                                                                                                                                                          Unit or
 Vendor      Comm#         Form#                                           Title/Description                     Rev.     Color       Size           of
                                                                                                                                                         *Special
                                                                                                                                                   Issue
                                                                                                                                                          Paper
MSI        4835-0155   CAJ-155E1       Lakeland Master Count Board E1(160)                                       02/11   110            11x17     EA              1    $0.200
MSI        4835-0155   CAJ-155E2       Lakeland Master Count Board E2(160)                                       02/11   110            11x17     EA              1    $0.200
MSI        4835-0155   CAJ-155F1       Lakeland Master Count Board F1(160)                                       02/11   110            11x17     EA              1    $0.200
MSI        4835-0155   CAJ-155F2       Lakeland Master Count Board F2(160)                                       02/11   110            11x17     EA              1    $0.200
MSI        4835-0156   CAJ-155U        Lakeland Master UTILITY Count Board                                       02/11   110            11x17     EA              1    $0.200
MSI        4835-0156   CAJ-156A1       Count Sheet - Lakeland A1                                                 02/11   white        2 1/2-17    PD          100      $2.711
MSI        4835-0156   CAJ-156A2       Count Sheet - Lakeland A2                                                 02/11   white        2 1/2-17    PD          100      $2.711
MSI        4835-0156   CAJ-156A3       Count Sheet - Lakeland A3                                                 02/11   white        2 1/2-17    PD          100      $2.711
MSI        4835-0156   CAJ-156A4       Count Sheet - Lakeland A4                                                 02/11   white        2 1/2-17    PD          100      $2.711
MSI        4835-0156   CAJ-156B1LOW    Count Sheet - Lakeland B1LOW                                              02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156B2LOW    Count Sheet - Lakeland B2LOW                                              02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156B3LOW    Count Sheet - Lakeland B3LOW                                              02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156B4LOW    Count Sheet - Lakeland B4LOW                                              02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156B5LOW    Count Sheet - Lakeland B5LOW                                              02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156B1HIGH   Count Sheet - Lakeland B1HIGH                                             02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156B2HIGH   Count Sheet - Lakeland B2HIGH                                             02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156B3HIGH   Count Sheet - Lakeland B3HIGH                                             02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156B4HIGH   Count Sheet - Lakeland B4HIGH                                             02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156C1LOW    Count Sheet - Lakeland C1LOW                                              02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156C2LOW    Count Sheet - Lakeland C2LOW                                              02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156C3LOW    Count Sheet - Lakeland C3LOW                                              02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156C4LOW    Count Sheet - Lakeland C4LOW                                              02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156C1HIGH   Count Sheet - Lakeland C1HIGH                                             02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156C2HIGH   Count Sheet - Lakeland C2HIGH                                             02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156C3HIGH   Count Sheet - Lakeland C3HIGH                                             02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156C4HIGH   Count Sheet - Lakeland C4HIGH                                             02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156E1LOW    Count Sheet - Lakeland E1LOW160                                           02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156E2LOW    Count Sheet - Lakeland E2LOW160                                           02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156E1HIGH   Count Sheet - Lakeland E1HIGH160                                          02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156E2HIGH   Count Sheet - Lakeland E2HIGH 160                                         02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156F1LOW    Count Sheet - Lakeland F1LOW160                                           02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156F2LOW    Count Sheet - Lakeland F2LOW160                                           02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156F1HIGH   Count Sheet - Lakeland F1HIGH160                                          02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156F2HIGH   Count Sheet - Lakeland F2HIGH160                                          02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0156   CAJ-156U        Count Sheet - Lakeland UTILITY                                            02/11   white        2 1/2-17    PD           100     $2.711
MSI        4835-0157   CAJ-157         Laundry Receipt/Prisoner Personal                                         07/89            5 1/2 - 8 1/2   ST             3     $0.066
OBS        4835-0158   CAJ-158         Cash Report - Daily                                                       10/84                                                 $0.000
MSI        4835-0159   CAJ-159         Inventory Checklist SEE CAH-159                                                                                                 $0.000
ELECT                  CAJ-160         Data Processing Equipment Request                                         10/01                                                 $0.000
OBS        4835-0161   CAJ-161         Out-of-State Travel Request for Approval(Replaced with DMB-34 rev.3/98)                                                         $0.000
MSI        4835-0162   CAJ-162         Special Alternative Incarceration Public Works Agreement                  10/91             12 1/2 - 18 ST
                                                                                                                                    8       11                   3     $0.083
MSI        4835-0163   CAJ-163         Traffic - Daily Log                                                       06/90                     1/2 PD              100     $4.530

 2/24/2012                                                                                                                                                  6 of 267   CAJ
          CAJ                                  MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                                    QTY /
                                                                                                                                             Unit
                                                                                                                                                    Unit or
 Vendor      Comm#          Form#                               Title/Description                           Rev.     Color       Size          of
                                                                                                                                                   *Special
                                                                                                                                             Issue
                                                                                                                                                    Paper
ELECT      4835-0164    CAJ-164     Weekly Fire Safety Inspection Check List                                10/09                                               $0.000
ELECT      4835-0165    CAJ-165     Monthly Fire Safety Inspection Check List                               08/04                                               $0.000
ELECT      4835-0166    CAJ-166     Evacuation Drill Report                                                 05/92                                               $0.000
OBS        4835-0167    CAJ-167     Application for Pardon and Commutation of Sentence                      03/88              8 1/2 - 11    PD         100     $2.943
MSI        4835-0168    CAJ-168     Major Misconduct Hearing Summary                                        03/85              8 1/2 - 11    PD         100     $2.711
MSI        4835-0169    CAJ-169     Count Sheet - MR - Weekend Checkouts                                    02/90              4 1/4 - 11    PD         100     $2.381
MSI        4835-0170    CAJ-170     Count Sheet - MR - I Block                                              01/97              5 1/2 - 17    PD         100     $3.405
MSI        4835-0171    CAJ-171     Count Sheet - MR - J Block                                              01/97              5 1/2 - 17    PD         100     $3.405
MSI        4835-0172    CAJ-172     Daily Personnel Reconciliation                                          12/91   white      8 1/2 - 11    PD         100     $2.711
OBS        4835-0173    CAJ-173     Biweekly Summary Addendum - Camps Only                                                                                      $0.000
MSI        4835-0174    CAJ-174     Bus Transportation Authorization - SAI                                  12/92              8 1/2 - 11    SH                 $0.017
MSI        4835-0175    CAJ-175     Application/Referral/Decision Sheet - Tech. Rule Viol. Center           10/91              8 1/2 - 11    SH                 $0.017
MSI        4835-0176    CAJ-176     Custodial Staff Assignment (5 pages)                                    09/88              8 1/2 - 11    SH[s]              $0.116
MSI/ELE    4835-0177    CAJ-177     Public Works Agreement -State Department or Agency (2 page)             10/08   NCR        8 1/2 - 11    ST           5     $0.132
MSI/ELE    4835-1177    CAJ-177 A   Public Works Agreement -Non -State Department or Agency ( 2 PAGE)       10/08   NCR        8 1/2 - 11    ST           5     $0.132
MSI        4835-1178    CAJ-177 B   Prisoner Labor - Invoice Statement - Camp                               05/84              8 1/2 - 11    ST           4     $0.116
MSI        4835-1179    CAJ-177 C   Operation Expenses - Invoice Statement - Camp                           05/84              8 1/2 - 11    ST           4     $0.116
ELECT      4835-1177D   CAJ-177 D   Community Works Agreement-State Department or Agency                    09/08              8 1/2 - 11                       $0.000
ELECT      4835-1177E   CAJ-177 E   Community Works Agreement-Non-State Department or Agency                09/08              8 1/2 - 11                       $0.000
MSI        4835-0178    CAJ-178     Count Sheet - Muskegon Temporary (1t-40b)                               11/08   white     3 1/2 X 17     PD         100     $4.682
MSI        4835-0178A   CAJ-178A    Master Count Board - Muskegon Temporary(1t-40b)                         06/06   White     5 1/2 x 16     EA       Index     $0.104
MSI        4835-0179    CAJ-179     Count Sheet - Muskegon Temporary (41t-80b)                              11/08   white     3 1/2 X 17     PD         100     $4.682
MSI        4835-0179B   CAJ-179B    Master Count Board - Muskegon Temporary(41t-80b)                        06/06   White     5 1/2 x 16     EA       Index     $0.104
OBS        4835-0180    CAJ-180     Laundry Bag Verification (obsolete 5/23/06)                                                                                 $0.000
MSI        4835-0181    CAJ-181     Ten Questions and Answers for Volunteers                                04/02               8 1/2 - 16   BK                 $0.083
MSI        4835-0183    CAJ-183     Hobby craft Card                                                        01/92                3 1/2 - 2   EA       Index     $0.017
ELECT      4835-0184    CAJ-184     Emergency Notification - Personnel                                      06/09            5 1/2 - 8 1/2   PD         100     $1.356
MSI        4835-0185    CAJ-185     File Recharge                                                                            5 1/2 - 8 1/2   PD         100     $1.356
                                    Flammable, Combustible, Toxic & Corrosive Materials-Monthly Inventory
MSI        4835-0186    CAJ-186     Sheet                                                                   04/97              8 1/2 - 11    PD         100     $2.711
ELECT      4835-0187    CAJ-187     Pre-Employment Application (2 sided)                                    08/07              8 1/2 - 11                       $0.000
MSI/ELE    4835-0188    CAJ-188     Application for Leave (Electronic Form is 8 1/2 X 11)                   06/03   NCR         5 1/2 x 8    ST           3     $0.083
MSI        4835-0189    CAJ-189     Count Sheet - Mid Michigan (1-60)                                       07/90              2 1/2 - 18    PD         100     $4.530
MSI        4835-0190    CAJ-190     Count Sheet - Mid Michigan (61-120)                                     07/90              2 1/2 - 18    PD         100     $4.530
MSI        4835-0191    CAJ-191     Furniture and Equipment Locations Take Sheet                            10/89              8 1/2 - 14    SH                 $0.017
MSI        4835-0192    CAJ-192     Count Sheet - Marquette (1-54)                                          11/90              2 1/2 - 17    PD         100     $4.530
MSI/ELE    4835-0193    CAJ-193     LEIN Information                                                        12/06   white      8 1/2 - 11    PD         100     $2.711
ELECT      4835-0194    CAJ-194     Quality Assurance Audit Elements                                        02/08              8 1/2 - 11                       $0.000
MSI        4835-0195    CAJ-195     Count Sheet                                                                                                                 $0.000
ELECT      4835-0196    CAJ-196     Driver License Verification Form                                        04/03              8 1/2 x 11 PD            100     $2.711
MSI        4835-0197    CAJ-197     Packing List                                                            05/88            5 1/2 - 8 1/2 ST             3     $0.066
MSI        4835-0198    CAJ-198     Fire Extinguisher Record                                                                    8 1/2 - 11 PD           100     $2.711
 2/24/2012                                                                                                                                           7 of 267   CAJ
          CAJ                                  MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                                         QTY /
                                                                                                                                                  Unit
                                                                                                                                                         Unit or
 Vendor      Comm#          Form#                                Title/Description                                Rev.      Color       Size        of
                                                                                                                                                        *Special
                                                                                                                                                  Issue
                                                                                                                                       7 1/4 - 10        Paper
MSI        4835-0199    CAJ-199     Special Consideration Referral                                                                            1/2ST              2        $0.050
MSI        4835-0200    CAJ-200     Count Sheet - Standish (123-244) A Wing                                     12/90                      4 x 14PD          100          $4.530
MSI        4835-0201    CAJ-201     Count Sheet - Standish (101-222) B Wing                                     12/90                      4 - 14PD          100          $4.530
ELECT      4835-0202    CAJ-202     Offender Contact Exception Request                                          01/06 white           8 1/2 X 11 SH                       $0.000
MSI        4835-0203    CAJ-203     Daily Work Pass Travel and Payroll Log                                      02/90 white            8 1/2 - 11PD          100          $2.711
ELECT      4835-0204    CAJ-204     Request for Approval of Outside Employment                                  06/04                                                     $0.000
MSI        4835-0205    CAJ-205     Receiving Report                                                            11/89 NCR           5 1/2 - 8 1/2 ST            3         $0.050
MSI        4835-0206    CAJ-206     Appointment Calendar                                                        12/94                  8 1/2 - 11 EA        Index         $0.050
MSI        4835-0207    CAJ-207     Count Sheet - Ryan Regional                                                 11/91                  4 1/2 - 14 PD          100         $2.711
MSI        4835-0207R   CAJ-207R    Master Count Board-Ryan                                                     03/10 manilla              11x14 EA        200tag         $0.200
MSI        4835-0207C   CAJ-207C    Count Board Face Sheet                                                      03/10 manilla              11x14 EA        200tag         $0.200
MSI        4835-1207    CAJ-207A    Count Sheet - Mound(See CAJ-452)                                            06/95                  4 1/2 - 14 PD          100         $2.711
MSI        4835-9207    CAJ-207M    Master Count Board - Mound                                                  07/03 white               11 - 14 SH        Index         $0.116
MSI        4835-0208    CAJ-208     Racial Composition Report                                                   02/91                  8 1/2 - 11 PD          100         $2.711
MSI        4835-0209    CAJ-209     Property Disposition Sheet                                                  06/90                  8 1/2 - 11 ST            4         $0.116
MSI        4835-0210    CAJ-210     Weapons and Restraint Authorization                                         04/91               5 1/2 - 8 1/2 ST            2         $0.060
MSI        4835-0211    CAJ-211     Outside Vehicle or Official Visitor Pass                                    07/89                  8 1/2 - 11 PD          100         $2.711
MSI        4835-0212    CAJ-212     Hobby craft Transfer Between Prisoners                                      09/89               4 1/4 - 5 1/2 SH                      $0.017
MSI        4835-0213    CAJ-213     Telephone Addition/Deletion Work Sheet                                      06/95               8 1/2 - 5 1/2 ST            3         $0.066
MSI        4835-0214    CAJ-214     Inventory Report - Monthly                                                  02/85                  8 1/2 - 11 ST            3         $0.083
MSI        4835-0215    CAJ-215     Laundry Bulk Verification Report                                            02/98                  8 1/2 - 11 ST            4         $0.116
MSI        4835-0216    CAJ-216     Add Sheet for CAJ-217                                                       07/88                  8 1/2 - 11 SH                      $0.017
MSI        4835-0217    CAJ-217     Procedure Sheet                                                             09/89                  8 1/2 - 11 SH                      $0.017
OBS        4835-0218    CAJ-218     SEE CAR-218                                                                                                                           $0.000
MSI        4835-0219    CAJ-219     Request to Hire Worker                                                      06/91               5 1/2 - 8 1/2 ST            2         $0.017
MSI        4835-0220    CAJ-220     Classification Change Request                                               06/91               5 1/2 - 8 1/2 ST            2         $0.017
MSI        4835-0221    CAJ-221     Outside Group Admittance Request                                            12/86                  8 1/2 - 11 PD          100         $2.711
MSI        4835-0222    CAJ-222     Out of Uniform Notice                                                       02/85               5 1/2 - 8 1/2 ST            2         $0.017
MSI        4835-0223    CAJ-223     Memorandum                                                                  06/00                  8 1/2 - 11 PD          100         $2.711
OBS        4835-0224    CAJ-224      OBSOLETE 08/29/03         Replaced with CFJ-411      Health Review for Community Residential Programs Application               $0.000
ELECT      4835-0225    CAJ-225     Employee Departure Check-off List                                           11/03                                                     $0.000
                                    MDOC Non-Exclusively Represented Employee Preference Plan
ELECT      4835-0226    CAJ-226     Questionnaire                                                               07/05                                                     $0.000
                                    MDOC Notice of Intent to Conduct A Parole Board Interview For Prisoners
ELECT      4835-0227    CAJ-227     Serving A Life Sentence                                                     04/09                  8 1/2 - 11                         $0.000
MSI        4835-0229    CAJ-229     Pay Warrant Error Notification (2 pages)                                    06/89                  8 1/2 - 11 SH[s]                   $0.083
MSI        4835-0230    CAJ-230     Employee Monthly Rating Form - New                                          03/88                  8 1/2 - 11 ST            4         $0.116
ELECT      4835-0231    CAJ-231     Employee Disciplinary Report                                                05/07                                                     $0.000
ELECT      4835-0232    CAJ-232     UAW Employee Transfer Request                                               01/10
MSI        4835-0234    CAJ-234     Prisoner Receipt                                                            10/96               3 1/2 - 8 1/2 ST            4         $0.050
MSI        4835-0235    CAJ-235     Visitor Call-Out Sheet                                                      06/86                  8 1/2 - 11 SH                      $0.017
MSI        4835-0236    CAJ-236     Count Sheet - Carson - Segregation Count Sheet (1-22)                       01/92                   3 - 8 1/2 PD          100         $2.711
 2/24/2012                                                                                                                                                 8 of 267     CAJ
          CAJ                                 MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                               QTY /
                                                                                                                                        Unit
                                                                                                                                               Unit or
 Vendor      Comm#         Form#                                Title/Description                     Rev.     Color       Size           of
                                                                                                                                              *Special
                                                                                                                                        Issue
                                                                                                                                               Paper
MSI        4835-0237   CAJ-237     Returned Uniform Release Receipt                                   02/92               8 1/2 - 11   ST              3    $0.083
ELECT      4835-0238   CAJ-238     Firearms Use Evaluation                                            05/92               8 1/2 - 11   SH                   $0.050
MSI        4835-0239   CAJ-239     Teacher and Chapter I Teacher Aide Utilization                     10/91               8 1/2 - 11   SH                   $0.017
MSI        4835-0240   CAJ-240     Computer Services Processing Request                                                   8 1/2 - 11   SH                   $0.017
MSI        4835-0241   CAJ-241     Evidence Record                                                    09/89            5 1/2 - 8 1/2   PD          100      $1.356
MSI        4835-0242   CAJ-242     Visitor Services Questionnaire (POSTCARD)                          02/02                4 1/2 - 6   EA        Index      $0.050
MSI        4835-0243   CAJ-243     Visitor Accident Report                                            02/87               8 1/2 - 11   PD          100      $2.711
MSI        4835-0244   CAJ-244     Driver Log Work - Pass                                             12/85 white         8 1/2 - 11   PD          100      $2.711
MSI        4835-1245   CAJ-245 A   Group Volunteer Form - Confidential                                07/89               8 1/2 - 11   PD          100      $2.711
MSI        4835-1246   CAJ-245 B   Request for Volunteer Services - Position Description              02/86               8 1/2 - 11   SH                   $0.017
MSI        4835-1247   CAJ-245 C   Volunteer Memo Information                                         02/86               8 1/2 - 11   SH                   $0.017
ELEC       4835-0246   CAJ-246     MPRI Facility Transition Team Member Application                   08/08              8 1/2 x 11                         $0.000
MSI        4835-0247   CAJ-247     Academic/Vocational Monthly Report - Pages 1 & 2                   01/90 REV??         8 1/2 - 11 ST[s]            3     $0.182
MSI        4835-0248   CAJ-248     Volunteer Service Application (Former CSO-407 is on back)          04/93               8 1/2 - 11 PD                     $3.405
OBS                    CAJ-249     Biweekly Summary of Daily Overtime Reconciliation - Pages 1 & 2   OBSOLE                                                 $0.000
                                                                                                                                                 4 PT
MSI/ELEC                                                                                                                                       NCR 1
T          4835-2249   CAJ-249A    Biweekly Summary of Overtime Reconciliation - Camps (2 PAGES)      11/04   NCR        8 1/2 - 11 ST          SET =       $0.231
OBS        4835-0250   CAJ-250     Daily Assignment Sheet - Pages 4 & 5 SEE CSJ-375                  OBSOLE                                                 $0.000
MSI        4835-0251   CAJ-251     Volunteer Services Summary                                         05/88               8 1/2 - 14   SH                   $0.050
MSI/ELEC   4835-0253   CAJ-253     SAI Program Eligibility Screen                                     09/06   NCR         8 1/2 - 11   ST             4     $0.116
MSI        4835-0254   CAJ-254     Grievance Report - Quarterly                                       10/82   white       8 1/2 - 11   PD           100     $2.943
MSI        4835-0255   CAJ-255     Facility Personnel Requisition                                     11/90   NCR         8 1/2 - 11   ST             5     $0.132
MSI        4835-0256   CAJ-256     Consent to Strip Search                                            01/86   white    5 1/2 - 8 1/2   PD           100     $1.356
MSI        4835-0257   CAJ-257     Assignment or Housing Unit Pass Record                             08/89   white       8 1/2 - 11   PD           100     $2.711
MSI        4835-0258   CAJ-258     Victim’s Rights Notification                                       12/92   white       8 1/2 - 11   PD           100     $2.711
DMB-PG     4835-0260   CAJ-260                                                                        08/95            3 1/4 - 7 3/8   EA           100     $0.000
MSI        4835-0262   CAJ-262     Toplock Notice to Control Master                                   02/85   NCR      5 1/2 - 8 1/2   ST             5     $0.083
MSI        4835-0263   CAJ-263     SAI Voluntary Agreement and Waiver - Pages 1 & 2                   01/01   NCR         8 1/2 - 11   ST[s]          4     $0.231
MSI        4835-0264   CAJ-264     SAI Voluntary Termination                                          04/92   NCR         8 1/2 - 11   ST             4     $0.116
PHOTO      4835-0265   CAJ-265     GED Accommodations Referral                                        06/03                                                 $0.000
MSI        4835-0266   CAJ-266     Cumulative School Record (Please specify: Right or Left Tab)       02/89   Cherry    18 1/2 - 11 EA            Index     $0.231
OBS        4835-0265   CAJ-267     Prisoner Cleanup Sheet (OBSOLETE)                                                                                        $0.000
OBS        4835-0269   CAJ-269     Information Release Authorization (OBSOLETE)                                                                             $0.000
MSI        4835-0270   CAJ-270     Assignment Posting                                                 10/89              8 1/2 - 11    PD           100     $2.711
MSI        4835-0271   CAJ-271     Weekly Menu                                                        06/93              8 1/2 - 14    SH                   $0.050
MSI        4835-0273   CAJ-273     SAI Health Questionnaire                                           04/92              8 1/2 - 11    ST             4     $0.116
MSI        4835-0274   CAJ-274     Smoking Cessation Benefits Reimbursement Form                      01/95              8 1/2 - 11    PD           100     $3.405
MSI        4835-0275   CAJ-275     Respiratory Protection Medical Evaluation Questionnaire            11/94              8 1/2 - 11    PD           100     $3.405
MSI        4835-0276   CAJ-276     SAI Count Sheet                                                    05/92              8 1/2 - 11    PD           100     $2.711
MSI        4835-0277   CAJ-277     Key Register                                                       01/95                   5-8      EA         Index     $0.017
MSI        4835-0278   CAJ-278     Special Housing Unit Record                                        01/90              8 1/2 - 11    PD           100     $2.711
MSI        4835-0279   CAJ-279     Cash Receipt - Personal - Prisoner                                 11/90              8 1/2 - 11    ST             2     $0.066
 2/24/2012                                                                                                                                       9 of 267   CAJ
          CAJ                                 MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                                         QTY /
                                                                                                                                                  Unit
                                                                                                                                                         Unit or
 Vendor      Comm#         Form#                                Title/Description                               Rev.     Color       Size           of
                                                                                                                                                        *Special
                                                                                                                                                  Issue
                                                                                                                                                         Paper
MSI        4835-0281   CAJ-281     SAI Camp Movement Log                                                        05/92   white       8 1/2 - 11   PD          100      $2.711
MSI        4835-0282   CAJ-282     Special Education Record - Confidential Student Record                       07/90   Green       9 1/2 - 11   EA        Index      $0.331
MSI        4835-0283   CAJ-283     Community Residential Program Call Sheet                                                         8 1/2 - 11   SH                   $0.053
MSI        4835-0284   CAJ-284     Memo of Telephone Calls for Community Programs                               01/91               8 1/2 - 11   PD          100      $2.711
MSI        4835-0285   CAJ-285     Property Security                                                            02/75            4 1/4 - 5 1/2   PD          100      $2.711
MSI        4835-0286   CAJ-286     Food service Requisition                                                     05/92            5 1/2 - 8 1/2   ST              3    $0.066
MSI        4835-0287   CAJ-287     Work Request/Job Control Sheet - Desktop Publishing Unit                                         8 1/2 - 11   ST              2    $0.066
MSI        4835-0288   CAJ-288     Payment Authorization for Local Goods & Services - Camp                      03/93               8 1/2 - 11   ST              3    $0.066
                                   Clothed Body Search of Visitor - Waiver - Pages 1 & 2 (Page 1 + Page 2 = 1
MSI        4835-0290   CAJ-290     set)                                                                         02/95               8 1/2 - 11   ST             3     $0.132
MSI        4835-0290   CAJ-290P1   Clothed Body Search of Visitor - Waiver - Page 1 only                        02/95               8 1/2 - 11   ST             3     $0.066
MSI        4835-0290   CAJ-290P2   Clothed Body Search of Visitor - Waiver - Page 2 only                        02/95               8 1/2 - 11   ST             3     $0.066
ELECT      4835-0291   CAJ-291     Prisoner Receipt                                                             08/10            5 1/2 - 8 1/2   ST
MSI        4835-0292   CAJ-292     Power Plant Log - Daily                                                      03/90   white       8 1/2 - 11   PD           100     $2.711
ELECT      4835-0293   CAJ-293     Notification of Detainer                                                     09/06                                                 $0.000
MSI        4835-1294   CAJ-294 A   Count Sheet - Temporary (1-80)                                               07/07              2 3/4 - 14    PD           100     $2.711
MSI        4835-1295   CAJ-294 B   Count Sheet - Temporary (81-160)                                             07/07              2 3/4 - 14    PD           100     $2.711
MSI        4835-1296   CAJ-294 C   Count Sheet - Temporary Master (1-80)                                        07/07   White      4 1/4 - 14    EA         Index     $0.050
MSI        4835-1297   CAJ-294 D   Count Sheet - Temporary Master (81-160)                                      07/07   White      4 1/4 - 14    EA         Index     $0.050
MSI        4835-0295   CAJ-295     Evidence Record/Analysis Report/Contraband Disposition Record                08/92              8 1/2 - 11    SH                   $0.017
ELECT      4835-0296   CAJ-296     Application for Temporary Policy Variance - Pages 1 & 2                      09/09                                                 $0.000
MSI        4835-0298   CAJ-298     Sequence of Events for First Responder                                       06/94                2 - 3 1/4   EA         Index     $0.050
MSI        4835-0299   CAJ-299     Monthly Idleness Report                                                      10/94               8 1/2 - 11   PD           100     $2.711
MSI        4835-0301   CAJ-301     Shakedown Report                                                             02/90               8 1/2 - 11   PD           100     $2.711
MSI        4835-0302   CAJ-302     Memo Pad (Small with orange on side)                                         09/92            5 1/2 - 8 1/2   PD           100     $1.703
MSI        4835-0303   CAJ-303     Shift/Department Request                                                     09/92               8 1/2 - 11   ST             3     $0.083
MSI        4835-0304   CAJ-304     Employee Attendance/Count Information                                        09/92               8 1/2 - 11   ST             2     $0.066
MSI        4835-0305   CAJ-305     Token Distribution - Camps                                                   12/93               8 1/2 - 11   ST             4     $0.116
MSI        4835-0306   CAJ-306     Public Works Count Sheet - Prisoners                                         06/96            5 1/2 - 8 1/2   ST             3     $0.050
ELECT      4835-0307   CAJ-307     Complaint Against Employee                                                   10/04               8 1/2 - 11                        $0.000
MSI        4835-0309   CAJ-309     Conduct Record - F & B                                                       04/86   white       8 1/2 - 15   SH                   $0.050
MSI        4835-0310   CAJ-310     Work Release                                                                 05/85            5 1/2 - 8 1/2   ST             3     $0.050
MSI        4835-0311   CAJ-311     Count Sheet - SPSM Farms                                                                             5 - 12   PD           100     $2.711
MSI        4835-0313   CAJ-313     Intra-Agency Requisition                                                     04/90            5 1/2 - 8 1/2   ST             3     $0.050
MSI        4835-0314   CAJ-314     Uniform Record - Employee                                                    09/93            5 1/2 - 8 1/2   EA         Index     $0.017
MSI        4835-0315   CAJ-315     Student Intern Confidentiality Statement                                     03/98               8 1/2 - 11   ST             2     $0.066
MSI        4835-0319   CAJ-319     Request for L.E.I.N. Clearance                                               04/98               8 1/2 - 11   PD           100     $2.711
ELECT                  CAJ-320     Lunch Program - Monthly Report                                                                                                     $0.000
MSI        4835-0324   CAJ-324     Food service Time/Temperature Sheet                                          10/92            5 1/2 - 8 1/2 ST               2     $0.050
ELECT      4835-0325   CAJ-325     Sharps Injury Log                                                            07/08                                                 $0.000
ELECT      4835-0326   CAJ-326     Contact Form - Harassment Reporting and Prevention                           07/02               8 1/2 - 11 ST               3     $0.083
MSI        4835-0327   CAJ-327     Official Receipt - State Money                                               04/91            5 1/2 - 8 1/2 ST               4     $0.066
ELECT      4835-0328   CAJ-328     Prisoner Computer Use Registration Form                                      12/01               8 1/2 - 11 ST               4     $0.116
 2/24/2012                                                                                                                                                10 of 267   CAJ
          CAJ                                 MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                                         QTY /
                                                                                                                                                  Unit
                                                                                                                                                         Unit or
 Vendor      Comm#         Form#                               Title/Description                             Rev.     Color          Size           of
                                                                                                                                                        *Special
                                                                                                                                                  Issue
                                                                                                                                                         Paper
MSI/ELE    4835-0329   CAJ-329     Professional/Vistor LEIN Request                                          12/07                  8 1/2 - 11   ST              2    $0.066
MSI        4835-0330   CAJ-330     Count Sheet - Riverside - Control Center                                                         3 1/2 - 11   SH                   $0.017
MSI        4835-0331   CAJ-331     Count Sheet - Riverside - Out Count                                       08/93                  3 1/2 - 11   PD          100      $2.381
MSI        4835-0332   CAJ-332     Security Unit Shift Transfer/RUO Reallocation Request                     04/93                  8 1/2 - 11   SH                   $0.017
MSI        4835-0333   CAJ-333     Progress Plotter - Pre-GED/GED Developmental Plotter                                             8 1/2 - 11   PD          100      $2.711
MSI        4835-0334   CAJ-334     Visitor List                                                              05/11                  8 1/2 - 11   ST              3    $0.083
MSI        4835-0335   CAJ-335     After Hours Property Room Quartermaster Issue                             05/87               4 1/4 - 5 1/2   PD          100      $1.356
MSI        4835-0336   CAJ-336     Major Misconduct Committee Action                                         12/92               5 1/2 - 8 1/2   ST              4    $0.066
MSI        4835-0337   CAJ-337     Legal Assistance Request and Agreement                                    01/91                  8 1/2 - 11   ST              5    $0.132
MSI        4835-0338   CAJ-338     DOC Appointment Approved (12 Level and Above)                             10/87                  8 1/2 - 11   ST              3    $0.083
                                   Complaint Form for Discriminatory Harassment Reporting and Prevention -
ELECT      4835-0339   CAJ-339     Page 1                                                                    06/07                 8 1/2 - 11                         $0.000
                                   Complaint Form for Discriminatory Harassment Reporting and Prevention -
ELECT      4835-1339   CAJ-339-2   Page 2                                                                    06/07                 8 1/2 - 11                         $0.000
MSI        4835-0340   CAJ-340     After Hours Report                                                        01/97                 8 1/2 - 11 PD              100     $2.711
ELECT      4835-0342   CAJ-342     Voluntary Alternative Work Schedule Request                               10/08                                                    $0.000
MSI/ELEC   4835-0345   CAJ-345     Tool Receiving Report                                                     10/06                 8 1/2 - 11    SH                   $0.017
MSI/ELEC   4835-0346   CAJ-346     Tool Report                                                               10/06                 8 1/2 - 11    PD           100     $2.711
MSI/ELEC   4835-0347   CAJ-347     Tool Turn-In Report                                                       10/06                 8 1/2 - 11    PD           100     $2.711
MSI/ELEC   4835-0348   CAJ-348     Tool Report - Lost                                                        10/06                 8 1/2 - 11    PD           100     $2.711
OBS        4835-0349   CAJ-349     Prisoner Declaration of Rcv'd Clothing & Linen - Female (OBSOLETE see                                                              $0.000
MSI        4835-0350   CAJ-350     Postage Meter Reading                                                     05/87                 8 1/2 - 11 SH                      $0.017
MSI        4835-0351   CAJ-351     Count Sheet - Master Generic                                              10/89   White        13 - 19 1/2 EA            Index     $0.132
OBS        4835-0353   CAJ-353     Release of Information - Drug Screening OBSOLETE 08/11/03                                                                          $0.000
MSI        4835-0354   CAJ-354     MDOC INFORMATION FOR OUTREACH VOLUNTEERS                                  12/99                  8 1/2 - 11   EA                   $0.050
MSI/ELEC   4835-0355   CAJ-355     Prisoner Declaration of Received Clothing & Linen                         06/10                  8 1/2 - 11   ST             3     $0.083
MSI        4835-0356   CAJ-356     Outreach Volunteer Application                                            09/95                  8 1/2 - 11   ST             2     $0.066
MSI        4835-0357   CAJ-357     Account Summary                                                           04/93   Buff           8 1/2 - 11   SH                   $0.050
MSI        4835-0358   CAJ-358     Memorandum - Half Sheet                                                   08/00               5 1/2 - 8 1/2   PD           100     $1.356
MSI        4835-0359   CAJ-359     Cell Inventory - R&GC                                                     12/93                  8 1/2 - 11   ST             2     $0.066
MSI        4835-0360   CAJ-360     Daily Work Schedule - Food service Supervisors                            08/86   white          8 1/2 - 11   PD           100     $2.711
MSI        4835-0361   CAJ-361     Application for Concealed Weapons Authorization                           04/88               5 1/2 - 8 1/2   PD           100     $1.356
MSI        4835-0362   CAJ-362     Notice of Discharge                                                       04/87               5 1/2 - 8 1/2   ST             4     $0.066
MSI        4835-0363   CAJ-363     Emergency Control Exercise Notice                                         02/88               5 1/2 - 8 1/2   EA         Index     $0.017
MSI        4835-0364   CAJ-364     Deposit Into Prisoner Account                                             12/97               5 1/2 - 8 1/2   ST             4     $0.066
MSI        4835-0367   CAJ-367     Stock Control Card                                                                Buff                5-8     EA         Index     $0.017
MSI        4835-0368   CAJ-368     Prisoner Declaration of Received Clothing & Linen - Male                  10/98                  8 1/2 - 11   ST             4     $0.116
MSI        4835-0369   CAJ-369     Prisoner Benefit Fund Requisition                                         11/86               5 1/2 - 8 1/2   ST             4     $0.066
MSI        4835-0370   CAJ-370     Telephone Agreement & Number List                                         12/01                  8 1/2 - 11   ST             4     $0.116
MSI        4835-0371   CAJ-371     Application for Medical Waiver                                            12/01                                                    $0.000
MSI        4835-0373   CAJ-373     Ticket Sanction Card                                                      02/98   Gr; Ch; Y     8 1/2 - 11 EA            Index     $0.017
PHOTO      4835-0376   CAJ-376     Security Report - Weekly "PHOTO COPY ONLY"                                                                                         $0.000
MSI        4835-0377   CAJ-377     Programming Monthly Report - Page 1-4                                     04/98                 8 1/2 - 11                   4     $0.364

 2/24/2012                                                                                                                                                11 of 267   CAJ
          CAJ                                 MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                             QTY /
                                                                                                                                      Unit
                                                                                                                                             Unit or
 Vendor      Comm#         Form#                                Title/Description                   Rev.     Color       Size           of
                                                                                                                                            *Special
                                                                                                                                      Issue
                                                                                                                                             Paper
MSI        4835-0378   CAJ-378     Visiting Room Report                                             11/96               8 1/2 - 11   PD          100      $2.711
MSI        4835-0380   CAJ-380     Band Room Property Card                                          02/87   Salmon   5 1/4 - 9 1/2   EA        Index      $0.050
MSI        4835-0383   CAJ-383     Time Sheet - Prisoner                                            08/86                3 - 8 1/2   PD          100      $1.356
MSI        4835-0384   CAJ-384     Count Sheet - Scott (1A-48B)                                     08/93               4 1/4 - 14   PD          100      $2.381
MSI        4835-0385   CAJ-385     Count Sheet - Scott (49A-96B)                                    08/93               4 1/4 - 14   PD          100      $2.381
MSI        4835-0386   CAJ-386 A   Count Sheet - Boyer Road Correctional Facility (1-60)            08/04   white      5 1/2 x 17    PD          100      $4.530
MSI        4835-1386   CAJ-386 B   Count Sheet - Boyer Road Correctional Facility (61-120)          08/04   white      5 1/2 x 17    PD          100      $4.530
MSI        4835-1387   CAJ-387     MDOC Weapons Score Sheet/Range Rules (FRONT & BACK)              02/02   white       8 1/2 - 11   SH                   $0.050
MSI        4835-0388   CAJ-388     Arsenal - Ammunition Inventory Sheet                             12/86               8 1/2 - 14   PD          100      $3.405
MSI        4835-0389   CAJ-389     Official Contract for Intramural Players                         11/93   Pink         3 - 5 1/2   EA        Index      $0.017
MSI        4835-0391   CAJ-391     Parolee Loan Card                                                02/86   Yellow       4 - 5 3/4   EA        Index      $0.050
MSI        4835-0392   CAJ-392     Arsenal Equipment Sign-Out Sheet                                 08/95            5 1/2 - 8 1/2   ST              2    $0.050
MSI        4835-0393   CAJ-393     Outpatient Referral Sheet - R&GC                                 09/88               8 1/2 - 11   SH                   $0.017
MSI        4835-0394   CAJ-394     After Hours - Quartermaster Turn-In Slip                         10/88            4 1/4 - 5 1/2   PD          100      $1.356
MSI        4835-0395   CAJ-395     Count Sheet - Mound Facility                                     05/96               4 1/2 - 14   PD          100      $2.711
OBS        4835-0396   CAJ-396     Procurement Request (SEE CAR-396)                                                                                      $0.000
MSI        4835-0399   CAJ-399     Purchase Order Log Sheet                                         04/87               8 1/2 - 14   SH                   $0.083
MSI/ELEC   4835-0400   CAJ-400     Security Threat Group (STG) Informational Report                 11/96               8 1/2 - 11   PD           100     $2.711
MSI        4835-0401   CAJ-401     Purchase Order Log                                               03/90               8 1/2 - 11   PD           100     $2.711
MSI        4835-1402   CAJ-402 A   Paid Document Log                                                11/85               8 1/2 - 11   PD           100     $2.711
MSI        4835-1403   CAJ-402 B   Purchase Order Log - Department                                  06/86               8 1/2 - 11   PD           100     $2.711
MSI/ELEC   4835-0403   CAJ-403     Gang Involvement Questionnaire                                   02/02               8 1/2 - 11   PD           100     $2.711
MSI        4835-0404   CAJ-404     Discharge Receipt                                                08/94                3 1/4 - 8   PD           100     $1.356
MSI        4835-0405   CAJ-405     Prisoner Property Transfer Form                                  04/89               8 1/2 - 11   ST             4     $0.116
MSI        4835-0406   CAJ-406     Auditor’s Comment Sheet                                          09/93               8 1/2 - 14   PD           100     $4.530
MSI        4835-0407   CAJ-407     Audit Work Paper (With Tab)                                      09/93   Blue        8 1/2 - 14   EA         Index     $0.050
MSI        4835-0408   CAJ-408     Reduced Custody/Waiver for College Enrollment                                        8 1/2 - 11   ST             3     $0.083
MSI        4835-0409   CAJ-409     College Enrollment Eligibility Questionnaire                                         8 1/2 - 11   ST             2     $0.066
MSI        4835-0410   CAJ-410     Motor Vehicle Operator’s Monthly Report                          01/87               8 1/2 - 11   PD           100     $2.711
MSI        4835-0411   CAJ-411     Reclassification Notice                                          03/86            5 1/2 - 8 1/2   PD           100     $1.356
ELECT      4835-0412   CAJ-412     Operations Inspection Form(county jail services unit) (24-pgs)   07/06                                                 $0.000
MSI        4835-0413   CAJ-413     Library Card                                                     01/88   Yellow       4 1/2 - 6   EA         Index     $0.050
MSI        4835-0414   CAJ-414     RMI Informal Count                                               01/97               8 1/2 - 14   PD           100     $4.530
MSI        4835-0415   CAJ-415     Property Record                                                  01/87            5 1/2 - 8 1/2   ST             3     $0.050
MSI        4835-0416   CAJ-416     Daily Movement Sheet - RDC                                       01/87   Green       8 1/2 - 11   PD           100     $2.711
MSI        4835-0417   CAJ-417     Control Master’s Office                                          08/86            4 1/4 - 5 1/2   PD           100     $1.356
ELECT      4835-0418   CAJ-418     Plan Review / Progress Task Form(14pg)-county jail serv. unit    07/03              8 1/2 X 11                         $0.000
MSI        4835-0419   CAJ-419     Job Control Document                                             07/90            5 1/2 - 8 1/2   PD           100     $1.356
MSI        4835-0420   CAJ-420     Student Locator                                                  09/88   Yellow   3 1/2 - 5 1/2   EA         Index     $0.083
OBS        4835-0422   CAJ-422     Internet Access Request                                          05/08               8 1/2 - 11                        $0.000
MSI        4835-0425   CAJ-425     Escape Notice                                                    02/88               8 1/2 - 11   PD           100     $2.711
MSI        4835-0426   CAJ-426     Law Library Card Checkout Memo                                   10/90            4 1/4 - 5 1/2   PD           100     $1.356

 2/24/2012                                                                                                                                    12 of 267   CAJ
          CAJ                                 MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                                  QTY /
                                                                                                                                           Unit
                                                                                                                                                  Unit or
 Vendor      Comm#         Form#                                 Title/Description                          Rev.     Color      Size         of
                                                                                                                                                 *Special
                                                                                                                                           Issue
                                                                                                                                                  Paper
MSI        4835-0429   CAJ-429     Employee Reference Check                                                 07/86              8 1/2 - 11 ST              2      $0.066
MSI        4835-0433   CAJ-433     Requisition for Files from Record Storage                                01/87                   3 - 5 PD          100        $1.356
ELECT      4835-0434   CAJ-434     Legal Writer Monthly Report and Log                                      03/10
                                   Prisoner Request for Assistance from a Legal Writer-Physical or Mental
ELECT      4835-0435   CAJ-435     Impairment                                                               03/10
ELECT      4835-0436   CAJ-436     Prisoner Request for Assistance from a Legal Writer                      03/10
ELECT      4835-0437   CAJ-437     Legal Writer Client Return of Document (s) Receipt                       03/10
MSI        4835-0439   CAJ-439     Auto Repair Work Order                                                   06/89               8 1/2 - 11   ST           4      $0.116
MSI        4835-0440   CAJ-440     Receiving Unit Day Book                                                  01/87                  11 - 14   PD          50      $2.711
MSI        4835-0442   CAJ-442     Vehicle Checklist                                                        09/93               8 1/2 - 11   SH                  $0.017
MSI        4835-0443   CAJ-443     Demarse Training Academy Staff Key Control Sheet                         08/99   White      11 X 81/2     PD         100      $2.711
MSI        4835-0445   CAJ-445     Driver Application                                                       05/88            4 1/4 - 5 1/2   SH                  $0.017
MSI        4835-0447   CAJ-447 A   Inspection Report/Food Service - Operations (pg. 15)                     10/97               8 1/2 - 11   BK                  $0.182
MSI        4835-1447   CAJ-447 B   Inspection Report/Food Service - Physical Report                         10/97               8 1/2 - 11   BK                  $0.000
MSI        4835-0450   CAJ-450     After Hours Critical Incident Telephone/Fax Notification Worksheet       04/97               8 1/2 - 11   PD         100      $3.405
                                   Count Sheet - Egeler - "C" Unit (A, B & Chronic; C & D wing) (No
MSI        4835-0451   CAJ-451     chipboard)                                                               06/02                            PD         100      $2.711
MSI        4835-0452   CAJ-452     Count Sheet - Mound Regional(Also CAJ-207A)                              08/94               4 1/4 - 14   PD         100      $2.711
MSI        4835-0453   CAJ-453     Count Sheet - S.H. of C. & B.P.                                          11/81            5 1/2 - 8 1/2   PD         100      $1.356
MSI        4835-0454   CAJ-454     Prisoner Package List                                                    08/86               8 1/2 - 11   ST           3      $0.083
MSI        4835-0455   CAJ-455     Control Center Call-Out                                                  04/93                8 1/2-11    PD         100      $2.711
OBS        4835-0456   CAJ-456     Prisoner Store Order - Long                                                                                                   $0.000
MSI        4835-1457   CAJ-457 A   Count Sheet - Master - Huron Valley Men’s                                12/86               4 1/4 - 11   PD         100      $1.356
MSI        4835-1458   CAJ-457 B   Count Sheet 1 - Huron Valley Men’s                                       12/86               4 1/4 - 14   PD         100      $2.711
MSI        4835-1459   CAJ-457 C   Count Sheet 2 - Huron Valley Men’s                                       12/86               4 1/4 - 14   PD         100      $2.711
MSI        4835-1460   CAJ-457 D   Count Sheet 3 - Huron Valley Men’s                                       12/86               4 1/4 - 14   PD         100      $2.711
MSI        4835-0458   CAJ-458     Hazard Communication - Right-to-Know Training Certification              02/88               8 1/2 - 11   SH                  $0.017
MSI        4835-0459   CAJ-459     Request for Shipping Order                                               02/90            5 1/2 - 8 1/2   PD         100      $1.356
MSI        4835-0460   CAJ-460     Evaluation of Religious Programming (4 Pages)                            07/87               8 1/2 - 11   SH[s]               $0.083
MSI        4835-0461   CAJ-461     Count Sheet - Master - A-Wing (1T-30B)                                   01/97               5 1/2 - 14   EA       Index      $0.066
MSI        4835-0462   CAJ-462     Count Sheet - Master - B-Wing (31T-60B)                                  01/97               5 1/2 - 14   EA       Index      $0.066
MSI        4835-0463   CAJ-463     Count Sheet - Master - C-Wing (61T-90B)                                  01/97               5 1/2 - 14   EA       Index      $0.066
MSI        4835-0464   CAJ-464     Count Sheet - Master - D-Wing (91T-120B)                                 01/97               5 1/2 - 14   EA       Index      $0.066
MSI        4835-0465   CAJ-465     Count Sheet - Levels I & II - A-Wing (1T-30B)                            11/96               2 3/4 - 14   PD         100      $2.711
MSI        4835-0466   CAJ-466     Count Sheet - Levels I & II - B-Wing (31T-60B)                           03/91               2 3/4 - 14   PD         100      $2.711
MSI        4835-0467   CAJ-467     Count Sheet - Levels I & II - C-Wing (61T-90B)                           03/91               2 3/4 - 14   PD         100      $2.711
MSI        4835-0468   CAJ-468     Count Sheet - Levels I & II - D-Wing (91T-120B)                          11/96               2 3/4 - 14   PD         100      $2.711
MSI        4835-0469   CAJ-469     Count Sheet - Level IV - A-Wing (1T-30B)                                 11/96               2 3/4 - 14   PD         100      $2.711
MSI        4835-0470   CAJ-470     Count Sheet - Level IV - B-Wing (31T-60B)                                11/96               2 3/4 - 14   PD         100      $2.711
MSI        4835-0471   CAJ-471     Count Sheet - Level IV - C-Wing (61T-90B)                                11/96               2 3/4 - 14   PD         100      $2.711
MSI        4835-0472   CAJ-472     Count Sheet - Level IV - D-Wing (91T-120B)                               11/96               2 3/4 - 14   PD         100      $2.711
MSI        4835-0473   CAJ-473     Count Sheet - Gus Harrison - Level IV - C-Wing                           11/93               3 1/2 - 14   SH                  $0.050
MSI        4835-0474   CAJ-474     Count Sheet - Gus Harrison - Level IV - D-Wing                           11/93               3 1/2 - 14   SH                  $0.050
 2/24/2012                                                                                                                                           13 of 267   CAJ
          CAJ                                 MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                              QTY /
                                                                                                                                       Unit
                                                                                                                                              Unit or
 Vendor      Comm#         Form#                               Title/Description                     Rev.     Color       Size           of
                                                                                                                                             *Special
                                                                                                                                       Issue
                                                                                                                                              Paper
MSI        4835-0475   CAJ-475     Count Sheet - Saginaw Regional - A-Wing                           08/94              2 3/4 - 17    PD          100      $2.711
MSI        4835-0476   CAJ-476     Count Sheet - Saginaw Regional - B-Wing                           08/94              2 3/4 - 17    PD          100      $2.711
MSI        4835-0477   CAJ-477     Count Sheet - Saginaw Regional - C-Wing                           08/94              2 3/4 - 17    PD          100      $2.711
MSI        4835-0478   CAJ-478     Count Sheet - Saginaw Regional - D-Wing                           08/94              2 3/4 - 17    PD          100      $2.711
MSI        4835-0479   CAJ-479     Count Sheet - Saginaw Regional                                    08/94                            PD          100      $2.711
MSI        4835-0480   CAJ-480     Count Sheet - Saginaw Regional ( A-wing, 1 thru 60)               02/00   white     2 3/4 X 17     PD          100      $2.711
MSI        4835-0481   CAJ-481     Count Sheet - Saginaw Regional (B-wing, 61 thru 120)              10/05   white     2 3/8 X 17     PD          100      $2.711
MSI        4835-0482   CAJ-482     Count Sheet - Saginaw Regional                                                                     PD          100      $2.711
MSI        4835-0483   CAJ-483     Count Sheet - Saginaw Regional                                                                     PD          100      $2.711
MSI        4835-0484   CAJ-484     Count Sheet - Cotton                                              04/97   White       2 7/8 - 21   PD          100      $3.405
MSI        4835-0485   CAJ-485     Count Sheet                                                       04/86               2 1/2 - 13   PD          100      $2.711
MSI        4835-0486   CAJ-486     Housing Unit Master Roster                                        04/86   White       8 1/2 - 11   SH        Index      $0.017
MSI        4835-0486   CAJ-486     Housing Unit Master Roster - CRANE - 120 BED                      12/03   White       8 1/2 - 11   SH        Index      $0.050
MSI        4835-0487   CAJ-487     Monthly Work Pass Report                                          05/87               8 1/2 - 11   PD          100      $2.711
MSI        4835-0488   CAJ-488 A   Count Sheet- Unit#7- A Wing,101--225,St Louis                     07/05             41/4 x 81/2    PD          100      $2.711
MSI        4835-1488   CAJ-488 B   Count Sheet- Unit#7- B Wing                                       07/05   white    4 1/4 x 81/2    PD          100      $2.711
MSI        4835-0489   CAJ-489 A   Count Sheet- Unit#6- A Wing                                       11/99                   4 - 14   PD          100      $2.711
MSI        4835-1489   CAJ-489 B   Count Sheet- Unit#6- B Wing                                       11/99                   4 - 14   PD          100      $2.711
MSI        4835-0490   CAJ-490 A   Count Sheet- Unit#1- A Wing                                       11/99                   4 - 14   PD          100      $2.711
MSI        4835-1490   CAJ-490 B   Count Sheet- Unit#1- B Wing                                       11/02                   4 - 14   PD          100      $2.711
MSI        4835-0491   CAJ-491 A   Count Sheet- A Wing                                               11/99                   4 - 14   PD          100      $2.711
MSI        4835-1491   CAJ-491 B   Count Sheet- B Wing                                               11/99                   4 - 14   PD          100      $2.711
MSI        4835-0492   CAJ-492     Count Sheet - Cotton Facility 1 - 120 (no chipboard)              06/02              4 3/4 x 16    PD          100      $3.405
MSI        4835-0493   CAJ-493     Count Sheet - Generic (104 count) (no chipboard)                  02/04               2 1/8 - 17   PD          100      $2.943
MSI        4835-0494   CAJ-494     Property Control Room Receipt                                     08/86            5 1/2 - 8 1/2   PD          100      $1.356
MSI        4835-0496   CAJ-496     Credit Card Purchase Approval Request-Michigan State Industries   04/00              11 X 8 1/2    PD          100      $2.711
MSI        4835-0497   CAJ-497     Commissary Check Sheet                                            07/86            5 1/2 - 8 1/2   ST              3    $0.050
MSI        4835-0498   CAJ-498     Employee Request - Personnel                                      05/01               8 1/2 - 11   ST              2    $0.066
MSI/ELEC   4835-0499   CAJ-499     Procurement Card Log                                              02/06               8 1/2 - 11   PD          100      $3.405
MSI        4835-0500   CAJ-500     Pat Down Searches                                                 01/98               8 1/2 - 11   PD          100      $2.711
MSI        4835-0501   CAJ-501     Practice Pack Ups                                                 01/98               8 1/2 - 11   PD          100      $2.711
MSI        4835-0502   CAJ-502     Pat Down or Clothed Body Search for Male Staff                    06/99               8 1/2 - 11   ST              3    $0.083
ELECT      4835-0503   CAJ-503     Fire Detector/Alarm System Annual Test/Maint. Inspection Report   03/11                                                 $0.000
MSI        4835-0504   CAJ-504     Cooking Appl. Suppression System Semi-Annual Inspection Report    11/88               8 1/2 - 11   PD           100     $3.405
MSI        4835-0508   CAJ-508     Property Registration Card                                        06/88                    3-5     EA         Index     $0.017
MSI        4835-0509   CAJ-509     Authorization to Sign Manifest                                    05/88            5 1/2 - 8 1/2   PD           100     $1.356
MSI        4835-0510   CAJ-510     Sexual Harassment Complaint - Page 1 thru 3                       01/97   NCR         8 1/2 - 11   ST[s]          3     $0.272
MSI        4835-0511   CAJ-511     Daily Report                                                      08/86               8 1/2 - 11   PD           100     $3.405
MSI        4835-0512   CAJ-512     Cell Searches 1st Through 15th                                    01/98               8 1/2 - 11   PD           100     $2.711
MSI        4835-0513   CAJ-513     Cell Searches 16th Through 31th                                   01/98               8 1/2 - 11   PD           100     $2.711
ELECT      4835-0514   CAJ-514     Livescan Fingerprint Request                                      11/06              8 1/2 X 11                         $0.000
ELECT      4835-0515   CAJ-515     Fire Safety Deficiencies and Plans for Correction                 09/05                                                 $0.000
ELECT      4835-0516   CAJ-516     Open Flame Permit                                                 08/07                                                 $0.000
 2/24/2012                                                                                                                                     14 of 267   CAJ
          CAJ                                       MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                                            QTY /
                                                                                                                                                     Unit
                                                                                                                                                            Unit or
 Vendor      Comm#          Form#                                     Title/Description                               Rev.     Color      Size         of
                                                                                                                                                           *Special
                                                                                                                                                     Issue
                                                                                                                                                            Paper
MSI      4835-0517     CAJ-517          Employee Transfer Request                                                     04/89              8 1/2 - 11 ST              3    $0.083
ELECT    4835-0518     CAJ-518          Leave of Absence Request                                                      09/03                                              $0.000
         4835-0520     CAJ-520                                                                                                                                           $0.000
MSI      4835-0521     CAJ-521          RESTART Prisoner Voluntary Agreement And Waiver(2-pages)                      05/01   white     8 1/2 X 11                       $0.000
         4835-0522     CAJ-522                                                                                                                                           $0.000
MSI/ELEC 4835-0523     CAJ-523          Certification of ACA Files Review                                             11/09   NCR        8 1/2 - 11                4     $0.116
                                        Notice of Cessation of Special Education Programs and Services in Response
ELECT      4835-0524   CAJ-524          to Revocation of Consent                                                      10/09
MSI        4835-0525   CAJ-525          Prosecuting Attorney Notification Letter                                      06/88              8 1/2 - 11 SH                   $0.017

ELECT      4835-0526   CAJ-526          Revocation of Prisoner Consent for Special Education Programs and Services    10/09
MSI        4835-0528   CAJ-528          Count Sheet - Master - Chippewa Regional and Temporary 1-70                   06/07               8.5 x 17 EA          Index     $0.132
MSI        4835-0529   CAJ-529          Contact - Sexual Harassment Reporting and Prevention                          08/96              8 1/2 - 11 ST             3     $0.083

MSI        4835-0530   CAJ-530          Count Sheet - Chippewa/Kinross Regional and Temporary (60 beds)               08/02              2 1/2 - 18 PD           100     $4.530
                       CAJ-530 (short
MSI        4835-0530   form)            Count Sheet - (22 beds)                                                                            2 1/2 - 8   PD        100     $4.530
MSI        4835-0531   CAJ-531          Property Envelopes - Prisoner                                                 07/01            4 1/2 - 6 3/4   EA                $0.132
ELECT      4835-0532   CAJ-532          Security Agreement - Data Processing                                          12/07               8 1/2 - 11                     $0.000
MSI        4835-0533   CAJ-533          Civil Service Rules                                                           01/92               8 1/2 - 11   SH                $0.050
ELECT      4835-0534   CAJ-534          Title II of the Americans with Disabilities Act Complaint Form and Instruct   08/06              8 1/2 X 11    SH                $0.000
MSI        4835-0536   CAJ-536          Progress Plotter - Pre-GED Math                                                N/A                8 1/2 - 11   SH                $0.017
MSI        4835-0537   CAJ-537          Custodial Maintenance Technology Core-pages 1-3                               05/98               8 1/2 - 11   SH                $0.017
MSI        4835-0538   CAJ-538          Progress Plotter - GED Math                                                    N/A                8 1/2 - 11   SH                $0.017
MSI        4835-0539   CAJ-539          Progress Plotter - Pre-GED Reading in Content Areas                            N/A                8 1/2 - 11   SH                $0.017
MSI        4835-0540   CAJ-540          Progress Plotter - Pre-GED Developmental Reading                                                  8 1/2 - 11   SH                $0.017
MSI        4835-0541   CAJ-541          Progress Plotter - Pre-GED Writing Skills                                      N/A                8 1/2 - 11   SH                $0.017
MSI        4835-0543   CAJ-543          Athletic Department Property Card                                             03/87   Salmon           5-9     EA      Index     $0.050
ELECT      4835-0544   CAJ-544          Special Problem Offender Notice(Prints on Red Mark Paper)-MSI/MISC            09/89               8 1/2 - 11   ST          3     $0.149
MSI        4835-0545   CAJ-545          Progress Plotter - GED Writing Skills                                          N/A                8 1/2 - 11   PD        100     $2.711
MSI        4835-0546   CAJ-546          Special Problem Offender Notice - Victim Notification                         07/91                                              $0.000
MSI        4835-0548   CAJ-548          Security Classification Committee Worksheet                                   08/94               8 1/2 - 11   SH                $0.017
MSI        4835-0549   CAJ-549          Overtime Work Slip                                                            08/01            5 1/2 - 8 1/2   ST          4     $0.066
MSI        4835-0550   CAJ-550          Group Overtime Summary                                                        04/89               8 1/2 - 11   PD        100     $2.711
MSI        4835-0551   CAJ-551          Returning Officer's Statement                                                 09/99               8 1/2 - 11   PD        100     $2.711
MSI        4835-0553   CAJ-553          Substance Abuse Program Agreement                                             02/86               8 1/2 - 11   ST          2     $0.066
ELECT      4835-0554   CAJ-554          Case Review Form                                                              06/08               8 1/2 - 11                     $0.000
MSI/ELEC   4835-0555   CAJ-555          Employee Medication Request                                                   11/05   white      8 1/2 X 11    SH        EA      $0.013
MSI        4835-0559   CAJ-559          Unlock Sheet                                                                  01/92               8 1/2 - 11   PD        100     $2.711
MSI        4835-0561   CAJ-561          Special Alternative Incarceration Absconder Report                            06/89               8 1/2 - 11   PD        100     $2.711
ELECT      4835-0562   CAJ-562          Sexual Assault Interview                                                      06/10
ELECT      4835-0563   CAJ-563          Psychological Report of Prisoner Miscoonduct                                  06/10

 2/24/2012                                                                                                                                                   15 of 267   CAJ
          CAJ                                 MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                               QTY /
                                                                                                                                        Unit
                                                                                                                                               Unit or
 Vendor      Comm#         Form#                               Title/Description                      Rev.     Color       Size           of
                                                                                                                                              *Special
                                                                                                                                        Issue
                                                                                                                                               Paper
MSI        4835-0564   CAJ-564     Telephone Agreement                                                08/86                    4-4     PD          100      $1.356
MSI        4835-0565   CAJ-565     Monthly Report of Hearing Statistics - Major Misconducts           03/89               8 1/2 - 11   ST              2    $0.066
MSI        4835-0566   CAJ-566     Evacuation Drill Log                                               06/90               8 1/2 - 11   PD          100      $2.711
MSI        4835-0568   CAJ-568     Special Deposit Account - Cashier’s Copy (Numbered if Requested)   04/87            8 1/2 - 8 1/2   ST              3    $0.050
MSI        4835-0569   CAJ-569     Count Sheet - MR Dormitory                                         05/95               4 1/4 - 13   PD          100      $2.711
MSI        4835-1569   CAJ-569 A   Dormitory Count Sheet A-Wing                                       05/97               4 1/4 - 13   PD          100      $2.711
MSI        4835-2569   CAJ-569 B   Dormitory Count Sheet B-Wing                                       05/97               4 1/4 - 13   PD          100      $2.711
MSI        4835-3569   CAJ-569 C   Dormitory Count Sheet C-Wing Front & Back                          01/98               4 1/4 - 13   PD          100      $2.711
MSI/ELEC   4835-0570   CAJ-570     Critical Incident Report (3 pages in 2 separate pads)              12/04   white       8 1/2 - 11   PD          100      $6.117
MSI/ELEC   4835-0571   CAJ-571     Critical Incident Participation Report                             07/91               8 1/2 - 11   PD          100      $2.711
MSI        4835-0572   CAJ-572     Critical Incident Witness Report                                   04/91               8 1/2 - 11   PD          100      $2.711
MSI        4835-0573   CAJ-573     Non-Critical Event Monthly Report                                  07/91               8 1/2 - 11   PD          100      $2.711
MSI        4835-0575   CAJ-575     Visitor’s Token and Photo Reconciliation                           07/86               8 1/2 - 11   ST              2    $0.066
ELECT      4835-0576   CAJ-576     Corrections Officer OJT Report                                     04/05               8 1/2 - 11   SH                   $0.000
MSI        4835-0577   CAJ-577     Records Requisitions - Telephone                                   06/89   white       8 1/2 - 11   PD          100      $2.711
MSI        4835-0578   CAJ-578     Property Transferred - Short                                       04/89               5 1//2 - 8   ST              4    $0.066
MSI        4835-0579   CAJ-579     Property Transferred - Long                                        04/88               8 1/2 - 11   ST              4    $0.116
MSI        4835-0581   CAJ-581     New Employee - School Information                                  02/89   Blue     5 1/2 - 8 1/2   EA        Index      $0.050
MSI        4835-0583   CAJ-583     Count Sheet - Control Center                                       07/89               3 1/2 - 10   PD          100      $2.711
MSI        4835-0587   CAJ-587     Training Record - N.E.S.                                           10/89   Blue        8 1/2 - 11   EA        Index      $0.116
MSI        4835-0588   CAJ-588     Non-Institutional Personnel Daily Pass                             11/96            5 1/2 - 8 1/2   ST              3    $0.066
MSI        4835-0591   CAJ-591     Travel Voucher Corrections Slip                                    10/89            4 1/4 - 5 1/2   ST              2    $0.017
MSI        4835-0594   CAJ-594     Key Entry Daily Activity Log                                       02/86               8 1/2 - 11   SH                   $0.017
MSI        4835-0597   CAJ-597     Conflict of Interest and Disclosure                                08/87               8 1/2 - 11   PD          100      $2.711
ELECT                  CAJ-599     Software Review Form (Electronic Only)                                                                                   $0.000
ELECT                  CAJ-600     New Position/Replacement Authorization                             02/08                                                 $0.000
ELECT                  CAJ-601     Request for Hiring Approval                                        06/03                                                 $0.000
MSI        4835-0603   CAJ-603     New Employee Training Waiver                                       09/93              8 1/2 - 11 PD              100     $2.711
ELECT      4835-0604   CAJ-604     Lockout/Tagout Machine Specific Procedure(2 pages)                 08/07                                                 $0.000
MSI        4835-0605   CAJ-605     Service Car Request                                                02/87   Yellow     8 1/2 - 11 PD              100     $2.943
ELECT      4835-0606   CAJ-606     Job Safety Analysis                                                09/07                                                 $0.000
MSI        4835-0607   CAJ-607     Count Sheet (1-52)                                                 08/89                                                 $0.000
MSI        4835-0608   CAJ-608     Typewriter Registration - Prisoner                                 02/87                    3 - 5 EA           Index     $0.017
MSI        4835-0609   CAJ-609     Resident Dorm and Assignment Roster                                10/89                                                 $0.000
ELECT      4835-0610   CAJ-610     Lockout/Tagout Periodic Inspection Certification                   08/07                                                 $0.000
ELECT      4835-0611   CAJ-611     Lockout/Tagout Employee Training Certification                     08/07                                                 $0.000
ELECT      4835-0612   CAJ-612     Lockout/Tagout Energy Source Evaluation                            08/07                                                 $0.000
ELECT      4835-0613   CAJ-613     Supervisor's Accident Investigation Report(2 page)                 09/07                                                 $0.000
ELECT      4835-0614   CAJ-614     Report of Hazard                                                   10/07                                                 $0.000
MSI        4835-0615   CAJ-615     Shipping Order                                                     10/89            5 1/2 - 8 1/2 ST               4     $0.066
MSI        4835-0616   CAJ-616     LEGAL MAIL & COURT FILING FEE LOGBOOK - BUS. OFFICE                12/01   white       81/2 x 11 PD              100     $2.711


 2/24/2012                                                                                                                                      16 of 267   CAJ
          CAJ                                MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                              QTY /
                                                                                                                                       Unit
                                                                                                                                              Unit or
 Vendor      Comm#         Form#                             Title/Description                        Rev.     Color       Size          of
                                                                                                                                             *Special
                                                                                                                                       Issue
                                                                                                                                              Paper
                                   LEGAL MAIL & COURT FILING FEE LOGBOOK - Mail Room/Control
MSI        4835-0617   CAJ-617     Center                                                             03/02   white      81/2 x 11 PD             100      $2.711
ELECT      4835-0618   CAJ-618     Close Call/Near Miss Accident Report                               10/07                                                $0.000
MSI        4835-0621   CAJ-621     ADP Trouble Report                                                 12/01               8 1/2 - 11   ST           2      $0.066
MSI        4835-0625   CAJ-625     Quarterly Legislative Report on College Programs                   05/87               8 1/2 - 11   ST           3      $0.083
MSI        4835-0626   CAJ-626     Mail Order                                                         10/89               8 1/2 - 11   PD         100      $2.711
MSI        4835-0627   CAJ-627     Payroll Summary - Prisoner                                         02/90               8 1/2 - 11   PD         100      $2.711
MSI        4835-0633   CAJ-633     Inter-School Transfer                                              09/89            5 1/2 - 8 1/2   ST           4      $0.066
MSI        4835-0635   CAJ-635     Prisoner Property Record Card                                      07/89   Buff        8 1/2 - 11   EA       Index      $0.066
MSI        4835-0636   CAJ-636     Procurement Log                                                    01/89               8 1/2 - 11   PD         100      $2.711
MSI        4835-0637   CAJ-637     ADP Computer Service and Repair Call                               12/90            5 1/2 - 8 1/2   PD         100      $2.711
MSI        4835-0638   CAJ-638     Vocational Programs Registration                                   01/89               8 1/2 - 11   ST           3      $0.083
MSI        4835-0639   CAJ-639     Vocational Certificate Renewal - Annual                            01/89            5 1/2 - 8 1/2   ST           3      $0.050
MSI        4835-0640   CAJ-640     Vocational Certificate Application - Annual                        01/89               8 1/2 - 11   ST           3      $0.083
OBS        4835-0641   CAJ-641     Escape/Extradition Notification                                    08/93               8 1/2 - 11   ST           2      $0.000
ELECT      4835-0649   CAJ-649     Equipment, Supplies and Forms Requisition                          07/05               8 1/2 - 11   ST           2      $0.066
MSI        4835-1650   CAJ-649 A   Equipment, Supplies and Forms Requisition (No Bill to Info.)       08/89               8 1/2 - 11   ST           3      $0.083
MSI        4835-0650   CAJ-650     Count Sheet to Control Master                                      12/90               4 1/4 - 11   PD         100      $2.711
MSI        4835-0653   CAJ-653     Food Guide Comparison Sheet                                        04/93               8 1/2 - 11   PD         100      $2.711
MSI        4835-0654   CAJ-654     Store Card                                                         02/90   Canary   5 1/2 - 8 1/2   EA       Index      $0.050
ELECT      4835-0655   CAJ-655     Re-Entry Discharge Plan                                            08/10
MSI        4835-0658   CAJ-658     Employee Personnel Notice                                          05/94            5 1/2 - 8 1/2 ST             3      $0.066
MSI        4835-0659   CAJ-659     Vehicle Pass - MSI                                                 01/90   Yellow           3 - 6 EA         Index      $0.017
ELECT      4835-0660   CAJ-660     Pre-Release Information Request                                    04/08                                                $0.000
ELECT      4835-0661   CAJ-661     Supplemental Sex Offender Registration Information(Front & Back)   01/07                                                $0.000
ELECT      4835-0662   CAJ-662     Transfer Out/In Checklist                                          10/06                                                $0.000
MSI        4835-0663   CAJ-663     Receipt - Prisoner Personal Cash                                   06/96               8 1/2 - 11   ST           2      $0.066
MSI        4835-0664   CAJ-664     Receipt - Returned Clothing and Property                           07/89               8 1/2 - 11   ST           5      $0.132
MSI        4835-0666   CAJ-666     Applicant History (4 Pages)                                        04/93               8 1/2 - 11   SH[s]               $0.083
MSI        4835-0667   CAJ-667     Leave Record                                                       01/88               8 1/2 - 11   PD         100      $2.711
MSI        4835-0668   CAJ-668     Employee Medical Leave of Absence                                  10/88               8 1/2 - 11   ST           3      $0.083
MSI        4835-0669   CAJ-669     Return from Medical Leave of Absence                               01/90               8 1/2 - 11   ST           3      $0.083
MSI        4835-0679   CAJ-679     Vendor Invoice                                                     03/86               8 1/2 - 11   ST           3      $0.083
MSI/ELEC   4835-0681   CAJ-681     Hearing Investigation Report (ROLL-OUT 10/01/04)                   02/90   white       8 1/2 - 11   PD         100      $2.711
MSI        4835-0682   CAJ-682     Transfer Inquiry                                                   01/86               8 1/2 - 11   PD         100      $2.711
MSI        4835-0684   CAJ-684     Initial Application of Restraints                                  09/89               8 1/2 - 11   ST           3      $0.083
MSI        4835-0685   CAJ-685     Close Observation Status                                           03/95               8 1/2 - 11   ST           5      $0.132
MSI        4835-0686   CAJ-686     School Detail                                                      05/87            5 1/2 - 8 1/2   ST           5      $0.083
MSI/ELEC   4835-0687   CAJ-687     Restriction of Segregation Property & Privileges                   06/06   NCR         8 1/2 - 11   ST           5      $0.132
MSI        4835-0688   CAJ-688     Attendance Cards (All Colors)                                      06/86            3 3/4 - 5 1/2   EA       Index      $0.017
MSI/ELEC   4835-0689   CAJ-689     Food Loaf Request Form                                             04/06   NCR         8 1/2 - 11   ST           6      $0.372
MSI        4835-0690   CAJ-690     Level VI - Adjustment Report                                       09/89               8 1/2 - 11   ST           4      $0.116
MSI        4835-0691   CAJ-691     Initial Application of Restraint - Deputy’s Memo                   09/89               8 1/2 - 11   ST           3      $0.083
 2/24/2012                                                                                                                                     17 of 267   CAJ
          CAJ                                 MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                                    QTY /
                                                                                                                                             Unit
                                                                                                                                                    Unit or
 Vendor      Comm#         Form#                                 Title/Description                            Rev.     Color    Size           of
                                                                                                                                                   *Special
                                                                                                                                             Issue
                                                                                                                                                    Paper
MSI        4835-0694   CAJ-694     Per Capita Report - Monthly                                                01/90            8 1/2 - 11   PD          100       $2.711
MSI        4835-0695   CAJ-695     Per Capita Report - Quarterly                                              01/90            8 1/2 - 11   PD          100       $2.711
MSI        4835-0696   CAJ-696     Expenditure Projections - Monthly                                          01/88            8 1/2 - 11   PD          100       $2.711
MSI        4835-0697   CAJ-697     Physical Restraint Checklist - 24 Hour                                     09/89            8 1/2 - 11   ST              3     $0.083
MSI        4835-0699   CAJ-699     Performance Evaluation - On-the-Job                                        03/90            8 1/2 - 11   PD          100       $2.711

MSI/ELE    4835-0702   CAJ-702     Speech/Language Impairment Eligibility Recommendation                      04/07   NCR      8 1/2 - 11 ST               3      $0.079

ELECT      4835-0703   CAJ-703     Summary of Student Performance                                             11/07                                               $0.000
MSI        4835-0705   CAJ-705     Vehicle Repair Order                                                       09/89            8 1/2 - 11   ST             3      $0.099
MSI        4835-0706   CAJ-706     Daily Raw Stock Usage                                                              Cherry        5-6     EA         Index      $0.050
MSI        4835-0707   CAJ-707     Prisoner Accommodation Request                                             12/94            8 1/2 - 11   ST             3      $0.083
MSI        4835-0708   CAJ-708     Annual Goals & Short Term Instructional Objectives (4 Pages)               07/90            8 1/2 - 11                100     $10.878
MSI/ELE    4835-0709   CAJ-709     Multi disciplinary Evaluation Team Report - Visual Impairment              04/07   NCR      8 1/2 - 11   ST             3      $0.079
MSI        4835-0710   CAJ-710     Special Education Referral                                                 08/96            8 1/2 - 11   ST             4      $0.116
OBS        4835-0711   CAJ-711     Special Education Evaluation - Notice of Intent to Conduct                 12/96            8 1/2 - 11                         $0.000
MSI        4835-0712   CAJ-712     Parental Permission for Special Education Programs                         04/90            8 1/2 - 11   ST             4      $0.116
ELECT      4835-0713   CAJ-713     Special Education Department Multidisciplinary Evaluation Team(MET)        09/07            8 1/2 - 11                         $0.000
ELECT      4835-0714   CAJ-714     Multi disciplinary Evaluation Team Report - Emotional Impairment           11/07   NCR      8 1/2 - 11   ST             3      $0.079
MSI/ELEC   4835-0715   CAJ-715     Multi disciplinary Evaluation Team Report- Cognitive Impairment            04/07   NCR      8 1/2 - 11   ST             3      $0.079
MSI/ELE    4835-0716   CAJ-716     Multi disciplinary Evaluation Team Report - Specific Learning Disability   04/07   NCR      8 1/2 - 11   ST             3      $0.079
ELECT      4835-0717   CAJ-717     Individualized Educational Planning Comm. Meeting - Invitation to Attend   03/08            8 1/2 - 11                         $0.000
MSI/ELEC   4835-1718   CAJ-718     Individualized Educational Plan - Page 1-6(program -iep-report)            08/06            8 1/2 - 11   ST[s]    7 pages      $0.678
MSI        4835-0719   CAJ-719     Individualized Vocational Educational Plan                                 04/97            8 1/2 - 11   ST             4      $0.116
OBS        4835-0720   CAJ-720     Waiver of Special Education Programs and Services                          11/94                                               $0.000
MSI        4835-0721   CAJ-721     Short Test of Educational Ability                                          01/95            8 1/2 - 11 PD             100      $2.711
ELECT      4835-0722   CAJ-722     IEP ADDENDUM (individual education plan)                                   11/06             8 1/2-11                          $0.000
ELECT      4835-0723   CAJ-723     Legal Writer Eligibility Criteria                                          08/06                                               $0.000
MSI        4835-0724   CAJ-724     Out Card - SPSM                                                             N/A    Canary      13 - 18   EA         Index      $0.413
MSI        4835-0725   CAJ-725     Batch Control Sheet - Data Processing Division                             07/89            8 1/2 - 11   PD           100      $2.711
MSI/ELE    4835-0727   CAJ-727     Multi disciplinary Evaluation Team Report - Hearing Impairment             04/07   NCR      8 1/2 - 11   ST             3      $0.079
ELECT      4835-0728   CAJ-728     Request for Release of Information                                         09/07            8 1/2 - 11   ST             4      $0.116
MSI        4835-0729   CAJ-729     Student Record                                                             04/00            8 1/2 - 11   PD           100      $3.405
ELECT      4835-0730   CAJ-730     Parent Letter                                                              06/08            8 1/2 - 11                         $0.000
MSI        4835-0731   CAJ-731     Log of Telephone Calls - Toll                                              12/93            8 1/2 - 11   PD           100      $2.711
MSI        4835-0732   CAJ-732     Handbook of Services for Special Education Prisoners                       08/96                         BK                    $0.562
MSI        4835-0735   CAJ-735     Apprenticeship Application - Prisoner                                      11/90            8 1/2 - 11   PD           100      $2.711
MSI        4835-0736   CAJ-736     Apprenticeship Prospect Evaluation                                         03/86            8 1/2 - 11   PD           100      $2.711
MSI        4835-0737   CAJ-737     Apprenticeship Applicant Evaluation                                        03/86            8 1/2 - 11   PD           100      $2.711
MSI        4835-0739   CAJ-739     Meals Served                                                               03/87            8 1/2 - 11   PD           100      $2.711
MSI        4835-0740   CAJ-740     Apprentice Time Record                                                      N/A             8 1/2 - 11   PD           100      $2.711
MSI        4835-0741   CAJ-741     Apprenticeship Agreement Between Apprentice & Joint Appr. Comm.            09/87            8 1/2 - 11   ST             3      $0.083

 2/24/2012                                                                                                                                           18 of 267   CAJ
          CAJ                                  MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                                    QTY /
                                                                                                                                             Unit
                                                                                                                                                    Unit or
 Vendor      Comm#           Form#                              Title/Description                          Rev.     Color       Size           of
                                                                                                                                                   *Special
                                                                                                                                             Issue
                                                                                                                                                    Paper
ELECT      4835-0742     CAJ-742     Pocket Book of MDOC’s Procedure Safeguards "Saddle Stitch BKLT" (16   05/06   White      4 1/4 x 11    BK                   $0.562
MSI        4835-0744     CAJ-744     Confidentiality & Protection Record                                   06/97               8 1/2 - 11   PD          100      $2.711
MSI        4835-0745     CAJ-745     Procedural Safeguards - Signature Page                                07/96               8 1/2 - 11   PD          100      $2.711
MSI        4835-0746     CAJ-746     Summary Sheet - Pre-Service Quality Check                             04/88               8 1/2 - 11   PD          100      $2.711
MSI        4835-0747     CAJ-747     Activities Group Pass                                                 03/86               8 1/2 - 11   PD          100      $2.711
MSI        4835-0748     CAJ-748     Telephone Messages - Pickups                                          08/86            5 1/2 - 8 1/2   PD          100      $1.356
MSI        4835-0750     CAJ-750     VAE Program Plan (pages 1 & 2)                                        05/02               8 1/2 - 11   ST[s]           4    $0.231
MSI        4835-0751     CAJ-751     CCA Visit Record                                                      07/86               8 1/2 - 11   PD          100      $2.711
MSI        4835-0753     CAJ-753     Telephone/Catalog Quotation                                            N/A                8 1/2 - 11   PD          100      $2.711
MSI        4835-0754     CAJ-754     Cell Changes                                                          02/91               8 1/2 - 11   PD          100      $2.711
MSI        4835-0755     CAJ-755     Squad Drill Card                                                      03/90                2 - 3 1/2   EA        Index      $0.050
ELECT      4835-0756     CAJ-756     Multi disciplinary Evaluation Team Report - Traumatic Brain Injury    04/07              8 1/2 X 11                         $0.000
OBS        4835-0758     CAJ-758     Special Good Time/Disciplinary Credits - Notice of Intent             06/89               8 1/2 - 11   ST             4     $0.116
MSI        4835-0760     CAJ-760     Parking Violation Notice                                              06/86            5 1/2 - 8 1/2   ST             2     $0.050
MSI        4835-0761     CAJ-761     Store Receiving Report - Prisoner                                     05/88               8 1/2 - 11   ST             3     $0.083
MSI        4835-0762     CAJ-762     System Flow                                                                               8 1/2 - 11   PD           100     $2.711
MSI        4835-0763     CAJ-763     Initial Central Registry Information                                  01/86   Green            4-6     EA                   $0.017
MSI        4835-0764     CAJ-764     Central Registry Form                                                 08/96               8 1/2 - 11   PD                   $2.711
ELECT      4835-0767     CAJ-767     Multi disciplinary Evaluation Team Report - Physical Impairment       10/09   NCR        8 1/2 X 11    ST             3
ELECT      4835-0768     CAJ-768     Multi disciplinary Evaluation Team Report - Other Health Impairment   10/09              8 1/2 X 11
MSI        4835-0771     CAJ-771     Special Education Teacher/Prisoner Contact Log                        02/97                                                 $0.000
MSI        4835-0774     CAJ-774     Prisoner Monthly Summary Pay Sheet                                    02/86   Canary      8 1/2 - 11   PD           100     $2.711
MSI        4835-0775     CAJ-775     Bakery Check Sheet                                                    06/82               8 1/2 - 11   SH                   $0.017
MSI        4835-0776     CAJ-776     Officers Dining Area                                                  03/86               8 1/2 - 11   SH                   $0.017
MSI        4835-0777     CAJ-777     Multi disciplinary Evaluation Team Report - Multiple Impairment       07/00              8 1/2 X 11    ST             3     $0.116
ELECT      4835-0778     CAJ-778     Multid Eval Team Report - Autism Spectrum Disorder(2 pgs.)            04/07              8 1/2 X 11                         $0.000
MSI        4835-0788     CAJ-788     Food service Inspection Sheet (front and back)                        03/86   white       8 1/2 - 11   PD           100     $3.405
ELECT      4835-0789     CAJ-789     GED Completion Exemption Form                                         09/05               8 1/2 - 11                        $0.000
MSI        4835-0790     CAJ-790     Boiler Log                                                            03/86               8 1/2 - 11   PD           100     $2.711
MSI        4835-0791     CAJ-791     Prisoner Funds Receipt                                                05/87            5 1/2 - 8 1/2   ST             3     $0.066
MSI        4835-0792 W   CAJ-792 W   Index Card                                                            06/82   White            3-5     EA         Index     $0.013
MSI        4835-0792 Y   CAJ-792 Y   Index Card                                                            06/82   Yellow           3-5     EA         Index     $0.013
MSI        4835-0792 B   CAJ-792 B   Index Card                                                            06/82   Blue             3-5     EA         Index     $0.013
MSI        4835-0792 C   CAJ-792 C   Index Card                                                            06/82   Cherry           3-5     EA         Index     $0.013
MSI        4835-0792 G   CAJ-792 G   Index Card                                                            06/82   Green            3-5     EA         Index     $0.013
MSI        4835-0793     CAJ-793     Warrant Receipt                                                       05/87            4 1/4 - 5 1/2   PD           100     $1.356
MSI        4835-0794     CAJ-794     Security Equipment Receipt                                            05/87            5 1/2 - 8 1/2   ST             2     $0.050
MSI        4835-1795     CAJ-795 A   Count Sheet - Regional Facilities (1-48)                               N/A                2 1/2 - 17   PD           100     $2.711
MSI        4835-1796     CAJ-795 B   Count Sheet - Regional Facilities (49-96)                              N/A                2 1/2 - 17   PD           100     $2.711
MSI        4835-1797     CAJ-796 A   Count Sheet - Ionia Max - C-Wing - Units 2-5                          01/99               4 1/4 - 14   PD           100     $2.711
MSI        4835-1798     CAJ-796 B   Count Sheet - Ionia Max - B-Wing - Units 2-5                          01/99               4 1/4 - 14   PD           100     $2.711
MSI        4835-1799     CAJ-796 C   Count Sheet - Ionia Max - B-Wing - Segregation                        01/99               4 1/4 - 14   PD           100     $2.711
MSI        4835-1800     CAJ-796 D   Count Sheet - Ionia Max - C-Wing - Segregation                        01/99               4 1/4 - 14   PD           100     $2.711
 2/24/2012                                                                                                                                           19 of 267   CAJ
          CAJ                                 MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                                        QTY /
                                                                                                                                                 Unit
                                                                                                                                                        Unit or
 Vendor      Comm#         Form#                                Title/Description                              Rev.     Color       Size           of
                                                                                                                                                       *Special
                                                                                                                                                 Issue
                                                                                                                                                        Paper
MSI        4835-1801   CAJ-796 E   Count Sheet - Ionia Max - Short                                             05/87               8 1/2 - 11   PD          100     $2.711
MSI        4835-0797   CAJ-797     Tunnel Inspection Report                                                    01/88               8 1/2 - 11   PD          100     $2.711
MSI        4835-0799   CAJ-799A    Count Sheet - Thumb Correctional - Franklin Unit                             9/01              2 1/2 x 17    PD          100     $2.711
MSI        4835-1799   CAJ-799B    Count Sheet - Central Control                                                9/01              2 1/2 x 17    PD          100     $2.711
MSI        4835-0800   CAJ-800     Demerit Card                                                                02/88                    3-5     EA        Index     $0.050
ELECT      4835-0801   CAJ-801     Release Clearance                                                           01/08               8 1/2 - 11                       $0.000
MSI        4835-0802   CAJ-802     Count Sheet to Control master - Riverside                                   06/99               4 1/4 - 11   PD          100     $2.711
MSI        4835-0803   CAJ-803     Work Report Daily - Work Camp Supervisor                                    07/89               8 1/2 - 11   PD          100     $3.405
MSI        4835-0804   CAJ-804     Count Sheet - Camp Program                                                  07/89               8 1/2 - 14   PD          100     $4.530
MSI        4835-0805   CAJ-805     Prison Property Rule Card - JMF                                             NEW              2 1/2 - 3 1/2   EA                  $0.111
MSI        4835-0806   CAJ-806     Work Pass Activity Report                                                   02/90               8 1/2 - 11   PD          100     $2.711
MSI        4835-0807   CAJ-807     Institution Stores Credit - To the Storekeeper                              09/92            8 1/2 - 5 1/2   ST            3     $0.066
MSI        4835-0808   CAJ-808     Prisoner Store Daily Sales Log                                              07/89               8 1/2 - 11   PD          100     $2.711
MSI        4835-0809   CAJ-809     Prisoner Store Weekly Sales Log                                             07/89               8 1/2 - 11   PD          100     $2.711
MSI        4835-0810   CAJ-810     Religious Record                                                            02/90   Buff             5-8     EA        Index     $0.017
MSI        4835-0811   CAJ-811     Visitor Information and Guidelines - Camp Program                           07/89   white       8 1/2 - 11   PD          100     $2.711
MSI        4835-0813   CAJ-813     Religious Report - Weekly                                                   01/90               8 1/2 - 11   PD          100     $2.711
MSI        4835-0814   CAJ-814     Meal Report - Monthly Summary                                               07/89            5 1/2 - 8 1/2   PD          100     $1.356
MSI        4835-1817   CAJ-817 A   Sanitation Inspection Response Report - Facility MDPH                       03/86               8 1/2 - 14   PD          100     $4.530
MSI        4835-1818   CAJ-817 B   Agriculture Inspection                                                      03/86               8 1/2 - 14   PD          100     $4.530
MSI        4835-0818   CAJ-818     Prisoner Materials Received Receipt                                         07/86            5 1/2 - 8 1/2   ST            3     $0.050
MSI        4835-0821   CAJ-821     Time Card                                                                   07/82                3 3/8 - 7   EA        Index     $0.017
MSI        4835-0822   CAJ-822     Time Cards - Camp Gilman - TRV                                              05/00   Manila      3 1/2 - 10   EA          Tag     $0.033
MSI        4835-0823   CAJ-823     Order Forms for Maintenance                                                 10/94               8 1/2 - 11   PD          100     $2.711
MSI        4835-0824   CAJ-824     Employee Vendor Invoice                                                      N/A                8 1/2 - 11   ST            3     $0.083
MSI        4835-0825   CAJ-825     Good Time Restoration Consideration                                         05/87               8 1/2 - 11   PD          100     $2.711
MSI        4835-0831   CAJ-831     Cell Shakedown                                                              08/89               8 1/2 - 11   PD          100     $2.711
MSI        4835-0840   CAJ-840     Misconduct Disposition Sheet                                                 N/A             5 1/2 - 8 1/2   ST            3     $0.050
MSI        4835-0841   CAJ-841     Driver’s Identification Card - Red                                          01/87   Pink     3 1/4 - 4 3/4   EA        Index     $0.017
MSI        4835-0846   CAJ-846     Inspection Report - Food Service (8 Pages)                                  07/88               8 1/2 - 11   SH[s]               $0.182
MSI        4835-0847   CAJ-847     Stamp Receipt and Transmittal Record                                        11/90               8 1/2 - 11   ST            2     $0.066
MSI        4835-0848   CAJ-848     Transmittal Slip - Deputy’s                                                 01/87            3 3/4 - 4 1/2   PD          100     $1.356
MSI        4835-0849   CAJ-849     Cell Move Request                                                           12/86            4 1/4 - 5 1/2   PD          100     $1.356

                                   Yard Pass (Non-Continuous Feed/ use with Laser Printer) (SEE CAX-850
                                                                                                                                                        (3 ea / 8
                                   FOR CONTINUOUS FEED WITH HOLES FOR TRACTOR PRINTER)                                           3 11/16 - 8
MSI        4835-0850   CAJ-850                                                                                 07/93                         EA         1/2 x 11    $0.020
                                   NOTE: Please order total number of passes you want. Do NOT order by the 8                            1/2
                                                                                                                                                             sh)
                                   1/2 x 11 size sheet. Each pass is considered ONE ea.

OBS        4835-0855   CAJ-855     Maintenance Record                                                          06/89            5 1/2 - 8 1/2   SH                  $0.017
MSI        4835-0856   CAJ-856     Stores Card - Accounting                                                    09/92   Buff            8 - 10   SH                  $0.017
MSI        4835-0857   CAJ-857     Driver’s License                                                            09/82                3 - 4 3/4   EA        Index     $0.017
MSI        4835-0860   CAJ-860     Overtime Computation Record - Officer                                       07/86   Canary      9 1/4 - 12   SH        Index     $0.066
 2/24/2012                                                                                                                                              20 of 267   CAJ
          CAJ                                 MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                      QTY /
                                                                                                                               Unit
                                                                                                                                      Unit or
 Vendor      Comm#         Form#                               Title/Description             Rev.     Color       Size           of
                                                                                                                                     *Special
                                                                                                                               Issue
                                                                                                                                      Paper
MSI        4835-0863   CAJ-863     Cash Advance Receipt - Prisoner                           10/84            4 1/4 - 5 1/2   ST              2    $0.050
MSI        4835-0864   CAJ-864     Hobby craft Wood Usage - Balance Permit                           NCR      5 1/2 - 8 1/2   ST              5    $0.083
MSI        4835-0869   CAJ-869     Property Issued at Intake                                 03/91               8 1/2 - 11   PD          100      $2.711
MSI        4835-0875   CAJ-875     Daily Postage Report                                                          8 1/2 - 11   ST              2    $0.053
MSI        4835-0879   CAJ-879     Classification Assignment Record - Secondary Occupation   03/90   Canary       4 - 7 1/2   EA        Index      $0.017
MSI/ELEC   4835-0881   CAJ-881     Hobbycraft Clearance Permit                               10/06   NCR         8 1/2 - 11   ST              4    $0.119
MSI        4835-0882   CAJ-882     Hobby craft Daily Sales Report                            08/89               8 1/2 - 11   ST              3    $0.083
MSI        4835-0883   CAJ-883     Leather Shop Sewing Receipt                                                5 1/2 - 8 1/2   SH                   $0.017
MSI        4835-0884   CAJ-884     Hobby craft Manifest to Salesroom                         09/92               8 1/2 - 11   ST              3    $0.083
MSI        4835-0885   CAJ-885     Hobby craft Monthly Report                                11/89               8 1/3 - 13   SH                   $0.017
MSI/ELEC   4835-0886   CAJ-886     Hobbycraft Card (materials list)                          10/06   NCR         8 1/2 - 11   ST              2    $0.066
MSI        4835-0887   CAJ-887     Hobby craft Sales                                         01/92               4 1/4 - 10   ST              4    $0.083
MSI        4835-0888   CAJ-888     Hobby craft Rules                                         09/89               8 1/2 - 11   ST              3    $0.083
MSI        4835-0889   CAJ-889     Hobby craft Sales Agreement                               09/89               8 1/2 - 11   ST                   $0.083
MSI        4835-0891   CAJ-891     Name Tents - Training                                     12/96   Yellow                   SH                   $0.116
OBS        4835-2893   CAJ-893     Disbursement Authorization - Prisoner (SEE CAR-893)                                                             $0.000
MSI        4835-1894   CAJ-894 B   Segregation Checklist - Blue                              10/96   Blue     5 1/2 - 8 1/2   EA         Index     $0.030
MSI        4835-1893   CAJ-894 C   Segregation Checklist - Canary                            10/96   Canary   5 1/2 - 8 1/2   EA         Index     $0.030
MSI        4835-1896   CAJ-894 G   Segregation Checklist - Green                             10/96   Green    5 1/2 - 8 1/2   EA         Index     $0.030
MSI        4835-1897   CAJ-894 P   Segregation Checklist - Pink/Cherry                       10/96   Pink     5 1/2 - 8 1/2   EA         Index     $0.030
MSI        4835-1895   CAJ-894 W   Segregation Checklist - White                             10/96   White    5 1/2 - 8 1/2   EA         Index     $0.030
MSI        4835-0895   CAJ-895     Receiving Clerk’s Daily Report                            04/89               8 1/2 - 11   ST             2     $0.066
MSI        4835-0896   CAJ-896     Cell Inventory Check List                                 06/96   NCR         8 1/2 - 11   ST             3     $0.079
MSI        4835-0897   CAJ-897     Unit/Room Inventory                                       06/96               8 1/2 - 11   ST             2     $0.066
ElECT      4835-0900   CAJ-900     MDOC Prisoner Worker Safety Training Record               03/07               8 1/2 - 11                        $0.000
MSI        4835-0904   CAJ-904     Food service Master Control Sheet                         03/90            8 1/2 - 8 1/2   PD           100     $2.711
MSI        4835-0905   CAJ-905     Barber Shop List                                          10/89            5 1/2 - 8 1/2   PD           100     $1.356
MSI        4835-0906   CAJ-906     TV Schedule                                               10/89               8 1/2 - 11   SH                   $0.017
MSI        4835-0909   CAJ-909     Hearing Schedule - Nonbondable                            01/87            5 1/2 - 8 1/2   SH                   $0.017
MSI        4835-0910   CAJ-910     Hearing Schedule - Bondable                               01/87               8 1/2 - 11   PD           100     $2.711
MSI        4835-0917   CAJ-917     Hobby craft Order Blank                                   09/91            5 1/2 - 8 1/2   ST             3     $0.050
MSI        4835-1919   CAJ-918 B   Volunteer Services Monthly Report - Group Report          09/89               8 1/2 - 11   PD           100     $2.711
MSI        4835-0919   CAJ-919     Miranda Warning                                           03/86   White    2 1/2 - 3 1/2   EA         Index     $0.017
MSI        4835-0926   CAJ-926     Individual Record of Prisoner Locking in Seg. Blocks      04/90   White       4 3/4 - 10   EA         Index     $0.050
MSI        4835-0927   CAJ-927     Count Sheet - Central Control                             10/94               4 1/4 - 11   PD           100     $2.711
MSI        4835-0929   CAJ-929     Maintenance Service Request                               10/89               8 1/2 - 11   ST             3     $0.083
ELECT      4835-0930   CAJ-930     MDOC Computer Application Access Request                  02/10               8 1/2 - 11
ELECT      4835-0931   CAJ-931     MDOC RA-931 Screen Access Form                            12/09               8 1/2 - 11
ELECT      4835-0932   CAJ-932     MDOC MIPC Usercode Request Form                           12/09               8 1/2 - 11
MSI        4835-0937   CAJ-937     Abandoned Property                                         N/A                8 1/2 - 11   PD           100     $2.711
OBS        4835-0941   CAJ-941     Catalog Order Form (See CAR-100)                                                                                $0.000
ELECT      4835-0943   CAJ-943     Monthly Job Safety Inspection Checklist                   12/05              8 1/2 x 11
ELECT      4835-0944   CAJ-944     Job Safety Inspection Checklist Weekly-Random Monthly     04/07              8 1/2 x 11
 2/24/2012                                                                                                                             21 of 267   CAJ
          CAJ                                 MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                 QTY /
                                                                                                                          Unit
                                                                                                                                 Unit or
 Vendor      Comm#         Form#                                Title/Description          Rev.     Color      Size         of
                                                                                                                                *Special
                                                                                                                          Issue
                                                                                                                                 Paper
MSI        4835-0945   CAJ-945     Purchase Order - Prisoner                               04/88              8 1/2 - 11 ST              5    $0.132
MSI        4835-0946   CAJ-946     Monthly Fire Incident Summary                            N/A               8 1/2 - 11 PD          100      $2.711
MSI        4835-0947   CAJ-947     Payroll Revision Request - Prisoner                     08/87              8 1/2 - 11 ST              2    $0.066
ELECT      4835-0948   CAJ-948     Fire Incident Report                                    05/07
MSI/ELEC   4835-0950   CAJ-950     Medical Gas Mask Exemption Request by Employee          11/05              8 1/2 x 11    PD        100     $2.711
MSI/ELEC   4835-0951   CAJ-951     Response to Medical Gas Mask Exemption Request          11/05              8 1/2 x 11    PD        100     $2.711
MSI        4835-0952   CAJ-952     Visitor’s Book Register                                 12/91                 11 - 15    SH                $0.050
MSI        4835-0954   CAJ-954     Time Card - Food Service - Prisoner - HMTU              06/89   White    3 3/4 - 7 1/2   EA      Index     $0.050
ELECT      4835-0955   CAJ-955     Physical Fitness Test                                   03/07
MSI        4835-0956   CAJ-956     Meal Forecasting                                        03/90              8 1/2 - 11 PD           100     $2.711
MSI        4835-0957   CAJ-957     Prisoner Accommodation Response                         12/94              8 1/2 - 11 ST             3     $0.083

ELECT      4835-0959   CAJ-959     Prisoner Detail for Inter-Institution Transfer          11/04              8 1/2 - 11    ST
MSI        4835-1959   CAJ-959 B   Prisoner Detail for Inter-Camp Transfer                 05/94              8 1/2 - 11    ST          5     $0.132
MSI        4835-0963   CAJ-963     Boiler Steam Plant Operating Log - Monthly              05/83             11 - 17 1/2    SH                $0.050
MSI        4835-0965   CAJ-965     Store Inventory                                         05/91              8 1/2 - 11    PD        100     $2.711
MSI        4835-0967   CAJ-967     New Employee Training - Final Recommendation            02/90              8 1/2 - 11    ST          2     $0.066
ELECT      4835-0968   CAJ-968     Officer Recruit On-The-Job Manual Approval              04/03                                              $0.000
MSI        4835-0970   CAJ-970     Grievance Appeal Request Denial                         10/94               8 1/2 - 11   PD        100     $2.711
REV                    CAJ-972     Daily On-the-Job Evaluation (SEE CAH-972)                                   8 1/2 - 11   PD        100     $2.711
MSI        4835-0976   CAJ-976     First Step Grievance Receipt                            11/94            5 1/2 - 8 1/2   PD        100     $1.356
MSI        4835-0977   CAJ-977     Grievance Coordinator Log Sheet                          N/A                8 1/2 - 14   SH                $0.050
MSI        4835-0978   CAJ-978     Grievance Appeal Receipt - Step II (use with CAH-978)   11/94   white       8 1/2 - 11   PD        100     $2.711
MSI        4835-0979   CAJ-979     Grievance Investigation Delay Letter                    11/94               8 1/2 - 11   PD        100     $2.711
MSI        4835-0986   CAJ-986     Daily A-60 Supply Requisition Log                       10/88               8 1/2 - 11   ST          2     $0.066
MSI        4835-0990   CAJ-990     Crime Victim Phone/Correspondence Log                   11/03               8 1/2 - 11   PD        100     $2.711
MSI        4835-0994   CAJ-994     Monthly Grievance Report                                10/94               8 1/2 - 11   PD        100     $2.711
MSI        4835-0996   CAJ-996     Visit Token Card                                        10/92                4 - 4 1/2   EA      Index     $0.017
MSI        4835-0997   CAJ-997     Request for Resident Subsistence Funding                12/91               8 1/2 - 11   ST          2     $0.066
MSI        4835-0999   CAJ-999     Video Conferencing Log                                  11/02              8 1/2 x 11    PD        100     $2.711




 2/24/2012                                                                                                                        22 of 267   CAJ
         CAJ                MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                               QTY /
                                                                                        Unit
                                                                                               Unit or
Vendor      Comm#   Form#               Title/Description         Rev.   Color   Size     of
                                                                                              *Special
                                                                                        Issue
                                                                                               Paper
                                                                                                           $0.000
                                                                                                           $0.000
                                                                                                           $0.000
                                                                                                           $0.000




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   CSJ                                            MSI FORMS INDEX ( Revised 9/1/2011)

                                                                                                                                                         QTY / Unit
                                                                                                                                                 Unit of
  Vendor       Comm#       Form#                                   Title/Description                                                 Size                or *Special
                                                                                                                                                 Issue
                                                                                                                  Rev.     Color                            Paper
MSI/ELECT    4835-3100   CSJ-100   Request for Prisoner to Prisoner Mail                                          04/10   NCR      8 1/2 - 11    ST                4
MSI          4835-3101   CSJ-101   Prisoner Issue Record                                                           N/A    White    8 1/2 - 11    EA            Index
                                                                                                                                                             100 (2-
MSI          4835-3102   CSJ-102   Security Threat Group Member Identification                                    04/03   White    8 1/2 - 11    PD           sides)
MSI/ELECT    4835-3103   CSJ-103   RSAT Prisoner Assessment Form                                                  08/04            8 1/2 - 11    PD              100
MSI          4835-3104   CSJ-104   Basic Information - Page 1 of 3                                                06/00            8 1/2 - 11    ST                5
MSI          4835-4104   CSJ-104   Basic Information - Page 2 of 3                                                06/00            8 1/2 - 11    ST                5
MSI          4835-5104   CSJ-104   Basic Information - Page 3 of 3                                                06/00               1/2 11
                                                                                                                                   851/2 - x 8   ST                5
MSI          4835-3105   CSJ-105   Prisoner Kite                                                                  07/05   white           1/2    SH               EA
MSI/ELECT    4835-3106   CSJ-106   Memorandum of Interviews and Telephone Calls                                   08/89            8 1/2 - 11    PD              100
MSI/ELECT    4835-3107   CSJ-107   RSAT Applicant Eligibility Screen                                              08/09            8 1/2 x 11    PD              100
                                                                                                                                     4 1/2 - 5
MSI          4835-3108   CSJ-108   Prisoner Move                                                                   N/A                    1/2    PD              100
MSI/ELECT    4835-3109   CSJ-109   Substance Abuse Treatment - Admission and Consent                              04/09            8 1/2 - 11    ST                3
MSI          4835-3110   CSJ-110   Prisoner Stationery                                                             N/A    white    8 1/2 - 11    SH               EA
MSI/ELECT    4835-3111   CSJ-111   Substance Abuse Client Discharge - Treatment Program Use                       01/06   NCR      8 1/2 - 11    ST                4
MSI          4835-3112   CSJ-112   Fingerprint Card (Please send or fax sample)                                   08/86            8 1/2 - 11    EA            Index
OBS          4835-3113   CSJ-113   State Issue Clothing Request (OBSOLETE SEE CSJ-251)
MSI          4835-3114   CSJ-114   Parole Board Request for Information                                           12/86            8 1/2 - 11    ST                4
MSI          4835-3115   CSJ-115   Case Notes                                                                     03/90            8 1/2 - 11    PD              100
MSI          4835-3116   CSJ-116   Index Card                                                                     02/87                 5-8      EA            Index
MSI          4835-3117   CSJ-117   Basic Information Sheet                                                        09/89            8 1/2 - 11    ST                4
MSI          4835-3118   CSJ-118   Visitor Record                                                                 03/93            8 1/2 - 15    EA            Index
ELECT        4835-3119   CSJ-119   Wanted - Reward, Escape Notice Reward                                          06/06
MSI          4835-3120   CSJ-120   Lay-In Notice                                                                  12/89            8 1/2 x 11 ST                   3
MSI          4835-3121   CSJ-121   Custody Reduction Application                                                  01/86            8 1/2 - 11 PD                 100
MSI          4835-3122   CSJ-122   Deputy File Folder                                                             07/86   Canary   9 - 12 1/2 EA               Index
ELECT        4835-4123   CSJ-123   Parole Eligibility Report                                                      08/08
                                                                                                                                    5 1/2 - 8
MSI          4835-3124   CSJ-124   Probation Detainer                                                             05/92                   1/2    SH
MSI          4835-3125   CSJ-125   Suicide Attempt Referral                                                       05/00   NCR      8 1/2 - 11    ST                5
MSI          4835-3126   CSJ-126   Assignment Waiver                                                              05/00            8 1/2 - 11    ST                5
MSI/ELECT    4835-3127   CSJ-127   Administrative Manifest (was Deputy Warden's Manifest )                        01/06   White         3x5      EA            Index
MSI          4835-3128   CSJ-128   Security Threat Group Renunciation/Removal/Reduction                           02/00            8 1/2 - 11    PD              100
MSI          4835-3129   CSJ-129   Disposition of Property Received                                               09/89            8 1/2 - 11    ST           3 NCR
                                   Certificate of Discharge/Termination of Sentence/Sentence Discharge by Court
MSI/ELECT    4835-3130   CSJ-130   Order                                                                          05/99   NCR      8 1/2 X 11 ST                   4
                                                                                                                                     5 1/2 - 8
MSI          4835-3132   CSJ-132   South Complex Trip Ticket                                                      01/86                    1/2 ST                  2
MSI/ELECT    4835-3133   CSJ-133   Parole Violation Arraignment (Notice and Plea)                                  6/10             8 1/2 - 11 ST                  4

 2/24/2012                                                                                                                                       46 of 267   CSJ
      CSJ                                            MSI FORMS INDEX ( Revised 9/1/2011)

                                                                                                                                                          QTY / Unit
                                                                                                                                                  Unit of
  Vendor       Comm#       Form#                                      Title/Description                                               Size                or *Special
                                                                                                                                                  Issue
                                                                                                                     Rev.    Color                           Paper
MSI          4835-4134   CSJ-134     Transfer Order                                                                  03/91           8 1/2 - 11   ST                  4
MSI          4835-3135   CSJ-135     Substance Abuse Client Discharge Form - DOC Use                                 05/89           8 1/2 - 11   ST                  5
MSI          4835-3136   CSJ-136     Intake Screening Sheet                                                          10/92           8 1/2 - 11   ST                  2
MSI          4835-3137   CSJ-137     OPS Take Sheet                                                                  01/86           8 1/2 - 14   PD                100
MSI          4835-3138   CSJ-138     Prisoner Declaration                                                            10/90           8 1/2 - 11   ST                  4
MSI          4835-3139   CSJ-139     Academic Record/Report                                                          09/89           8 1/2 - 11   ST                  4
MSI          4835-4140   CSJ-140 A   Indeterminate Sentence Record - Circuit Court                                   09/89           8 1/2 - 11   SH
MSI          4835-4141   CSJ-140 B   Indeterminate Sentence Record - Recorder’s Court                                09/89           8 1/2 - 11   SH
MSI          4835-3141   CSJ-141     Pre-Parole Planning                                                             10/89           8 1/2 - 11   PD                100
MSI          4835-3142   CSJ-142     Substance Abuse Treatment Consent- In-Prison Residential                        08/09           8 1/2 - 11   ST                  3
MSI          4835-3143   CSJ-143     Package Notification                                                            04/90           8 1/2 - 11   SH
ELECT        4835-3144   CSJ-144     Administrative Hearing Report                                                   12/01
ELECT        4835-3146   CSJ-146     Release Certification                                                           07/98
                                                                                                                                      4 1/4 - 5
MSI          4835-3147   CSJ-147     Special Token Draw Request                                                      04/88                  1/2   PD                100
MSI          4835-3148   CSJ-148     Public Works Application                                                        10/91           8 1/2 - 11   ST                  3
MSI          4835-3149   CSJ-149     Community Health Care Referral                                                  11/92           8 1/2 - 11   ST                  2
MSI          4835-3150   CSJ-150     Special Escape Data Review                                                      04/93           8 1/2 - 11   ST                  5
OBS          4835-4152   CSJ-152     Community Residential Program Application Replaced by CFJ-410
MSI/ELECT    4835-3153   CSJ-153     Administrative Hearing Report - Formal                                          02/91   NCR     8 1/2 - 11   ST                  5
MSI          4835-3154   CSJ-154     Funeral or Sick Bed Visit                                                       04/88           8 1/2 - 11   ST                  3
MSI          4835-3155   CSJ-155     Work Pass Application                                                            N/A            8 1/2 - 11   PD                100
MSI/ELECT    4835-3156   CSJ-156     Prisoner Accident Report                                                        10/89           8 1/2 - 11   ST                  4
ELECT        4835-3157   CSJ-157     Authorization for Release of Substance Abuse Information                        04/05
ELECT        4835-3158   CSJ-158     Michigan Prison Reentry Initiative Authorization for Release of Information     12/09
ELECT        4835-3159   CSJ-159     Parole Loan Agreement                                                           02/00
                                                                                                                                      5 1/2 - 8
MSI          4835-3160   CSJ-160     Room Inventory Card                                                             01/87                 1/2 SH
MSI          4835-3161   CSJ-161     Individual Program Plan - Phase I (2 Pages)                                     05/93           8 1/2 - 11 ST[s]                 3
MSI          4835-3162   CSJ-162     Individual Program Plan - Phase II (2 Pages)                                    05/93           8 1/2 - 11 ST[s]                 3
MSI          4835-3163   CSJ-163     Special Education Complaint Form
MSI          4835-3164   CSJ-164     Special Education Due Process Hearing Form
ELECT        4835-3165   CSJ-165     Administrative Warrant for Return of Escaped Prisoners                          06/06
                                     Prisoner Guidebook - English (Cover revised 09/03 for Director's name only)No
MSI/ELECT    4835-3166   CSJ-166     Director's Name on 8/09 version                                                 08/09           8 1/2 - 11 BK

MSI          4835-3167   CSJ-167     Prisoner Guidebook - Spanish (Cover revised 09/03 for Director's name only)     07/05           8 1/2 - 11 BK
ELECT        4835-3168   CSJ-168     Community Residential Program Processing Checklist (2 pgs)RESCINDED             06/08           8 1/2 - 11

 2/24/2012                                                                                                                                        47 of 267   CSJ
      CSJ                                            MSI FORMS INDEX ( Revised 9/1/2011)

                                                                                                                                                              QTY / Unit
                                                                                                                                                      Unit of
  Vendor       Comm#       Form#                                      Title/Description                                                   Size                or *Special
                                                                                                                                                      Issue
                                                                                                                       Rev.     Color                            Paper
ELECT        4835-3169   CSJ-169     Parole Processing Checklist (3 pages)                                             08/10            8 1/2 X 11
ELECT        4835-3170   CSJ-170     Discharge Processing Checklist (3 pgs)                                            08/10             8 1/2 - 11
ELECT        4835-3171   CSJ-171     Parole Reinstaement Processing Checklist( 2 pages)                                08/10
MSI          4835-3172   CSJ-172     Security Report Release on Writ or Court Order                                    04/88            8 1/2 - 11 PD                   100
                                                                                                                                        8 1/2 - 13
MSI          4835-3173   CSJ-173     Inmate Payroll Sheet                                                              08/88   white           1/2 PD                   100
ELECT        4835-3174   CSJ-174     Co-Occurring Disorders Classification Screening Form                              10/05
ELECT        4835-3175   CSJ-175     Program Classification Report                                                     04/09
                                                                                                                                          5 1/2 - 8
MSI          4835-3176   CSJ-176     Prisoner Mail Restriction                                                         08/89                    1/2   ST                  3
MSI/ELECT    4835-3177   CSJ-177     Declaration of Religious Preference                                               03/98             8 1/2 - 11   ST                  2
                                                                                                                                          4 1/4 - 5
MSI          4835-3183   CSJ-183     Prisoner Pass(Can be other colors for different levels)                           09/92                    1/2   PD                100
                                                                                                                                          5 1/2 - 8
MSI          4835-3191   CSJ-191     Visitor Pass                                                                      04/89                    1/2   ST                  2
MSI/ELECT    4835-3195   CSJ-195     Application For Correspondence Course                                             04/07   white    8 1/2 X 11    SH                  1
MSI          4835-3200   CSJ-200     FTA/FTR Verification Form (f/b)                                                   02/00              8 1/2-11    ST                  4
ELECT        4835-3202   CSJ-202     Notice of Escape or Attempt to Escape                                             06/06            8 1/2 X 11
                         CSJ-204
MSI          4835-3204   A&B         Furlough Application and Investigation- Front & Back                               N/A             8 1/2 - 11    PD                100
MSI          4835-3205   CSJ-205     Token Receipt Roster                                                              10/86            8 1/2 - 11    SH
MSI          4835-3223   CSJ-223     Waiver of Extradition                                                             10/86            8 1/2 - 11    SH
MSI          4835-3224   CSJ-224     Health Review for CRPA - See CAJ-224 !                                             N/A             8 1/2 - 11    ST                  3
ELECT        4835-3225   CSJ-225     Offender Work Area Inspection Registration Form                                   05/01
                                                                                                                                         4 1/2 - 5
MSI          4835-3226   CSJ-226     Work Assignment Pass                                                              09/94                   1/2    ST                3
MSI          4835-3227   CSJ-227     Dep. Director Manifest (ordered by Ruth Clark, C.O.)                              01/02   white         3x5      EA            Index
MSI/ELECT    4835-3228   CSJ-228     Misconduct Report                                                                 10/10   NCR      8 1/2 - 11    ST                5
ELECT        4835-3229   CSJ-229     Class II and Class III Misconduct Hearing Reports                                 10/10   NCR      8 1/2 - 11    ST                3
OBS          4835-4240   CSJ-240 A   Major Misconduct Report SEE CSJ-228                                               03/07   NCR      8 1/2 - 11    ST                5
MSI/ELECT    4835-5241   CSJ-240 B   Major Misconduct Hearing Report SEE CSJ-228 , CSJ-229                             10/11   NCR      8 1/2 - 11    ST                5
OBS          4835-5242   CSJ-240 C   Minor Misconduct Violation and Hearing Report SEE CSJ-228                         06/07   NCR      8 1/2 - 11    ST                4
OBS          4835-5243   CSJ-240 D   Major Misconduct Hearing Report - Continuation Page SEE CSJ-228 , CSJ-229         12/90   NCR      8 1/2 - 11    ST                5
                                     Prisoner Personal Property Receipt (Use when prisoner's property is transferred
MSI/ELECT    4835-3241   CSJ-241 A   or stored by MDOC)                                                                06/09   NCR      8 1/2 - 11 ST                     3
                                     Prisoner Personal Property Receipt (Used when a prisoner is received at a Level
                                     IV, V, VI due to a custody increase & has property not allowed at the receiving
MSI/ELECT    4835-4241   CSJ-241 B   facility)                                                                         06/09   NCR      8 1/2 - 11 ST                     3
MSI/ELECT    4835-5241   CSJ-241 R   Prisoner Personal Property Receipt - Reception Facility                           06/09   NCR      81/2 x 11 ST                      3

 2/24/2012                                                                                                                                            48 of 267   CSJ
      CSJ                                            MSI FORMS INDEX ( Revised 9/1/2011)

                                                                                                                                                       QTY / Unit
                                                                                                                                               Unit of
  Vendor       Comm#       Form#                                      Title/Description                                           Size                 or *Special
                                                                                                                                               Issue
                                                                                                               Rev.     Color                             Paper
MSI          4835-3242   CSJ-242     Quartermaster Issue Pack-up Receipt                                       03/99   NCR      8 1/2 - 11 ST                      3
MSI          4835-3243   CSJ-243     Offender work area Inspection Request Form                                12/01            8 1/2 - 11 ST                      4
                                                                                                                                 5 1/2 - 8
MSI          4835-3244   CSJ-244     Request to Have Legal Mail Read                                           06/89   white           1/2 SH
                         CSJ-245
MSI/ELECT                CSJ-246     Special Handeling of Incoming Legal Mail                                  03/11   white     8 1/2 - 11    SH
MSI          4835-4247   CSJ-247 A   Prisoner/Parolee Grievance Form                                           10/94   NCR       8 1/2 - 11    ST                  5
MSI/ELECT    4835-4248   CSJ-247 B   Prisoner/Parolee Grievance Appeal                                         05/09   NCR       8 1/2 - 11    ST                  5
                                                                                                                                   5 1/2 - 8
MSI          4835-3250   CSJ-250     Transportation Request                                                    09/89                    1/2    ST                  2
MSI/ELECT    4835-3251   CSJ-251     Prisoner Request for State Issued Items (Clothing)                        12/01             8 1/2 - 11    PD                100
                                                                                                                                   3 1/8 - 5
MSI          4835-3252   CSJ-252     Prisoner Property Receipt                                                 08/89                    1/2    ST                  3
MSI/ELECT    4835-3254   CSJ-254     Prisoner Receipt For State Issued Items on Transfer                       10/04   NCR         8 1/2-11    ST                  4
                                                                                                                                   4 1/4 - 5
MSI          4835-7263   CSJ-263     Court Order Release Notice GOS                                            01/86   White            1/2    PD
MSI          4835-7268   CSJ-268     Computer Usage Log Sheet                                                  12/01             8 1/2 - 11
                                                                                                                                   5 1/2 - 8
OBS          4835-3269   CSJ-269     Information Release Authorization(See CSJ-158)                            01/06                    1/2    PD                100
MSI/ELECT    4835-3270   CSJ-270     Prisoner Computer Background Investigation                                12/01              8 1/2- 11    ST                  4
MSI/ELECT    4835-3271   CSJ-271     Employee Accident Report (2-SIDED)                                        07/04            8 1/2 X 11     PD                100
OBS          4835-3272   CSJ-272     Client Appeal of Minor Misconduct (replaced by CSJ-274)                   02/91             8 1/2 - 11    ST                  3
ELECT        4835-3273   CSJ-273     Replaced by CFJ-485                                                       05/05
MSI/ELECT    4835-3274   CSJ-274     Class II and Class III Misconduct Appeal                                  10/10            8 1/2 - 11     ST                  2
                                                                                                                                 5 1/2 - 8
OBS          4835-4276   CSJ-275     Summary Disciplinary Action - Minor Rule Infraction(see CSJ-228)          01/07                   1/2     ST                  4
ELECT        4835-3276   CSJ-276     Cert. of Pris. Account Activity & Affidavit Regarding Suspension of....   07/07            8 1/2 - 11
ELECT        4835-3277   CSJ-277     Certificate of Prisoner Institutional/Trust Fund Account Activity         07/07            8 1/2 - 11
                                                                                                                                 4 1/4 - 5
MSI          4835-3278   CSJ-278     Daily Check Sheet - South Complex                                         01/86                   1/2     ST                  2
MSI/ELECT    4835-3282   CSJ-282     Notice of Intent to Conduct an Administrative Hearing                     06/06   NCR      8 1/2 - 11     ST                  3
ELECT        4835-3283   CSJ-283     Administrative Segregation Behavior Review                                09/10                                               5
OBS          4835-4283   CSJ-283 A   Confinement in Segregation in Excess of 30 Days                           02/06
ELECT        4835-5283   CSJ-283 B   Request For RPA Approval to Reclassification From AD-SEG                  09/10                                               4
MSI          4835-3284   CSJ-284     Contraband Removal Record                                                 12/01             81/2 x 11 ST                      4
ELECT        4835-3286   CSJ-286     Escape Warrant Entry Information                                          06/06
ELECT        4835-3287   CSJ-287     Escape Warrant Cancellation Information                                   06/06            8 1/2 X 11
MSI          4835-0289   CSJ-289     Strip Search/Body Cavity Search                                           06/88             8 1/2 - 11 ST                     2
MSI/ELECT    4835-3290   CSJ-290     Prisoner Pre-Release Notice                                               04/09   NCR      8 1/2 x 11 ST                      2

 2/24/2012                                                                                                                                     49 of 267   CSJ
   CSJ                                                 MSI FORMS INDEX ( Revised 9/1/2011)

                                                                                                                                                    QTY / Unit
                                                                                                                                            Unit of
   Vendor      Comm#         Form#                                      Title/Description                                       Size                or *Special
                                                                                                                                            Issue
                                                                                                             Rev.     Color                            Paper
MSI          4835-3301     CSJ-301     In-State Detainer Processing                                          04/94            8 1/2 - 11    PD                100
MSI          4835-4303     CSJ-303 A   Information to Families of Reduced Custody Prisoners                  06/89            8 1/2 - 11    SH
MSI          4835-4304     CSJ-303 B   Information to Reduced Custody Prisoners                              06/89            8 1/2 - 11    PD                100
MSI          4835-3305     CSJ-305     Photography and Interview Release Form                                04/01            8 1/2 - 11    ST                  2
MSI          4835-3306     CSJ-306     Physical Fitness and Health Affidavit (2 pages)                       11/84            8 1/2 - 11    PD[s]             100
MSI          4835-3307     CSJ-307     Medical Examination Record - Employee (2 pages)                       04/93            8 1/2 - 11    SH[s]
MSI          4835-3315     CSJ-315 A   Notice of Proposed Visitor Restriction                                12/90            8 1/2 - 11    ST                  5
MSI          4835-4315     CSJ-315 B   Notice of Visitor Restriction                                         01/02            8 1/2 - 11    ST                  5
MSI          4835-3316     CSJ-316     Notice of Mail/Package Rejection                                      11/02            8 1/2 - 11    ST                  4
MSI          4835-3317     CSJ-317     Notice of Property Shipment/Mailing                                   08/98            8 1/2 - 11    ST                  2
MSI          4835-3318     CSJ-318     Legal Mail Disbursement                                               05/02            8 1/2 - 11    ST                  4
MSI          4835-3319     CSJ-319     MDOC Elections Ballot                                                 04/98            8 1/2 - 11    ST                  2
MSI /ELECT   4835-3320     CSJ-320     Notice of Prisoner-to-Prisoner Mail Rejection                         09/09            8 1/2 - 11    PD                100
MSI/ELECT    4835-3330     CSJ-330     Misconduct Sanction Screening Form                                    07/09            8 1/2 - 11
MSI/ELECT    4835-3331     CSJ-331     Misconduct Sanction Assessment                                        07/09            8 1/2 - 11
MSI          4835-3349     CSJ-349     Parole Board Disposition Inquiry                                      01/87            8 1/2 - 11    PD                100
MSI/ELECT    4835-3350     CSJ-350     Notice of Risk Classification                                         04/09            8 1/2 - 11    ST                  5
MSI/ELECT    4835-3351     CSJ-351     Notice of Sexual Predator Designation                                 08/07            8 1/2 - 11    ST                  5
ELECT        4835-3352     CSJ-352     Property Risk Screening Sheet (Definitions on Back - CSJ-353A)        09/88            8 1/2 - 11    ST                  4
ELECT        4835-3353     CSJ-353     Assaultive Risk Screening Sheet (Definitions on Back)                 07/98            8 1/2 - 11    ST                  4
OBS          4835-4353 A   CSJ-353 A   Definitions of Property Risk Classification Factors- Back             03/87            8 1/2 - 11
ELECT        4835-3354     CSJ-354     Definitions of Property Risk/Assaultive Risk Classification Factors   10/08            8 1/2 - 11
ELECT        4835-3355     CSJ-355     VASOR Worksheet                                                       11/09
ELECT        4835-3356     CSJ-356     Vermont Assessment of Sex Offender Risk(VASOR)                        11/09
MSI/ELECT    4835-3363     CSJ-363     Program and Work Assignment Evaluation                                09/06   NCR       8 1/2 - 11 ST                    5
ELECT        4835-4363     CSJ-363 A   Educational Program Plan                                              06/07            8 1/2 X 11
                                                                                                                                                        ST = 1 of
MSI          4835-4375     CSJ-375     Daily Assignment Sheet pages 4-5 (Replaces CAJ-250)                   06/97            8 1/2 - 11 ST                ea pg
MSI          4835-3377     CSJ-377     Prisoner Driver Permit                                                07/86   White     4 - 5 1/2 EA                Index
MSI          4835-3382     CSJ-382     Personal Property Receipt - Women                                     08/90            8 1/2 - 11 ST                     3
ELECT        4835-3392     CSJ-392     Transition Team Recommendations                                       05/06
MSI          4835-3401     CSJ-401     Request for Parole Board Psychological Evaluation                     07/88             8 1/2 - 11 ST                    3
OBS          4835-3403     CSJ-403     Gate Manifest Logsheet                                                01/06   white    8 1/2 X 11 PD                   100
OBS          4835-3403A    CSJ-403A    Instructions for Gate Manifest Logsheet                               01/06
MSI/ELECT    4835-3404     CSJ-404     Gate/Load Manifest - Numbered/Unnumbered                              08/11   NCR        4 3/4 11
                                                                                                                              8 1/2 X - 8   ST                 4
MSI          4835-4405     CSJ-404 A   Gate/Load Manifest - Supplement Sheet                                 01/92                    1/2   ST                 4
MSI                        CSJ-404P    Gate/Load Manifest -Pilot Form                                        05/11   NCR      8 1/2 X 11    ST                 4
MSI          4835-3405     CSJ-405     Pre-Sentence Investigation Report Disclosure                          04/84             8 1/2 - 11   PD               100
MSI          4835-3407     CSJ-407     Prisoner’s Hobby craft Account                                        03/87   White     8 1/2 - 11   EA             Index

 2/24/2012                                                                                                                                  50 of 267   CSJ
      CSJ                                             MSI FORMS INDEX ( Revised 9/1/2011)

                                                                                                                                                        QTY / Unit
                                                                                                                                                Unit of
  Vendor       Comm#        Form#                                      Title/Description                                            Size                or *Special
                                                                                                                                                Issue
                                                                                                                  Rev.     Color                           Paper
MSI/ELECT    4835-3418    CSJ-418     Request for Rehearing                                                       10/10            8 1/2 - 11   ST                  2
                                                                                                                                    5 1/2 - 8
MSI          4835-3419    CSJ-419     Notice of Hearing                                                           03/86                   1/2   ST                  3
MSI          4835-3420    CSJ-420     Witness Question Sheet                                                      11/93            8 1/2 - 11   PD                100
                                                                                                                                    4 1/4 - 5
MSI          4835-3421    CSJ-421     MDOC Segregation Admit-Release Authorization - MCF Form                     01/08   NCR             1/2   ST                  3
MSI/ELECT    4835-3423    CSJ-423     Administration Segregation Classification Notice                            06/11            8 1/2 - 11   ST                  5
MSI          4835-3429    CSJ-429     Personal Property Claim                                                     10/89            8 1/2 - 11   ST                  3
OBS          4835-3432    CSJ-432     CAIN Issues
MSI          4835-3446    CSJ-446     Segregation Classification Hearing Report                                   09/91            8 1/2 - 11   ST                  5
ELECT        4835-3447    CSJ-447     Notice of Intent to Classify to Segregation                                 07/08            8 1/2 - 11   ST                  5
                                                                                                                                    4 1/4 - 5
MSI          4835-3460    CSJ-460     Cell Changes                                                                12/86                   1/2   PD               100
MSI          4835-3461    CSJ-461     Assignment Detail Card                                                      02/84   White         3-5     EA             Index
ELECT        4835-3465    CSJ-465     Voluntary Classification to Protective Segregation                          07/08            8 1/2 - 11   ST                 5
ELECT        4835-3465a   CSJ-465a    Protective Segregation Investigation Report                                 07/08                                            2
OBS          4835-3467    CSJ-467     Parole Process Information (OBSOLETE 12/00)
                                                                                                                                    3 1/2 - 5
MSI          4835-3468    CSJ-468     Daily Prisoner Shakedown Report                                             04/93   White          1/2 PD                   100
OBS          4835-3473    CSJ-473     Parole Reminder (OBSOLETE 12/00)
MSI          4835-3478    CSJ-478     Employee Grievance - Security Unit                                          11/83            8 1/2 - 11   PD                100
MSI          4835-3480    CSJ-480     Security Classification Screen - Initial                                    08/02            8 1/2 - 11   ST                  4
MSI          4835-3481    CSJ-481     Security Classification Screen - Review                                     08/02            8 1/2 - 11   ST                  4
MSI          4835-4481    CSJ-481 A   Computation of Credits for Six Month Misconduct-Free Periods                10/88            8 1/2 - 11   PD                100
MSI          4835-3482    CSJ-482     Security Class Screen-Initial - Female Pris Only                            01/00            8 1/2 - 11   ST                  4
MSI          4835-3483    CSJ-483     Security Classification Screen - Review - Female Prisoners Only             01/00            8 1/2 - 11   ST          4 pt NCR
Rotary       4835-3485    CSJ-485     Parole Board Referral Sheet                                                                  8 1/2 - 11   SH
Rotary       4835-4485    CSJ-485 A   Parole Board Referral Sheet
MSI/ELECT    4835-3487    CSJ-487     Witness Statement                                                           02/88            8 1/2 - 11 PD                  100
MSI          4835-3488    CSJ-488     Document Record                                                             02/86            9 1/2 - 18 PD                  100
MSI/ELECT    4835-3489    CSJ-489     Documentation Verification Request                                          05/08            8 1/2 - 11 ST                    3
ELECT        4835-3490    CSJ-490     MDOC Prisoner Application For A Certified Copy of A Michigan Birth Record   05/08            8 1/2 - 11
ELECT        4835-3491    CSJ-491     Michigan Marriage Record                                                    05/08
ELECT        4835-3492    CSJ-492     Michigan Divorce or Annulment Record                                        05/08
ELECT        4835-3493    CSJ-493
ELECT        4835-3494    CSJ-494
ELECT        4835-3495    CSJ-495     Forfeiture Information Sheet                                                06/08            8 1/2 - 11
MSI/ELECT    4835-3500    CSJ-500     Offender work area Inspection Request Form                                  12/01            8 1/2 - 11 ST                    4
MSI          4835-3525    CSJ-525     MDOC - Computer Usage Log Sheet                                             04/02            8 1/2 x 11 PD                  100

 2/24/2012                                                                                                                                      51 of 267   CSJ
   CSJ                                            MSI FORMS INDEX ( Revised 9/1/2011)

                                                                                                                                           QTY / Unit
                                                                                                                                   Unit of
  Vendor       Comm#       Form#                                   Title/Description                                   Size                or *Special
                                                                                                                                   Issue
                                                                                                     Rev.    Color                            Paper
ELECT        4835-3540   CSJ-540   Consideration for Granting/Restoring Credits
ELECT                    CSJ-541   Assurance Letter To ICE Pursuant To PA 223                        03/11
MSI          4835-3550   CSJ-550   Screening Sheet For the Change Program                            04/02
OBS          4835-3600   CSJ-600   Access to Courts - Flash Kite
MSI/ELECT    4835-3601   CSJ-601   Segregation Law Library Resource Request                          11/03            8 1/2 - 11   PD                100
MSI/ELECT    4835-3602   CSJ-602   Legal Photocopy Disbursement Authorization                        01/08            8 1/2 - 11   ST                  4
MSI          4835-3681   CSJ-681   Affidavit and Petition for Appt. of Counsel for Appel. Rev.       08/87            8 1/2 - 14   SH
MSI          4835-3682   CSJ-682   Affidavit of Indigency                                            08/87            8 1/2 - 14   SH
ELECT        4835-3683   CSJ-683   Adult Learning Plan                                               06/07           8 1/2 X 11
ELECT        4835-3684   CSJ-684   Record Storage File Request                                       12/06           8 1/2 X 11
ELECT        4835-3685   CSJ-685   Letter Requesting Department of Attorney General Representation   08/07            8 1/2 - 11
ELECT        4835-3686   CSJ-686   Request For Protection/Investigation Report                       09/10                                             4
ELECT        4835-3687   CSJ-687   Protective Housing Quarterly Review                               09/10                                             3
                                                                                                                       4 1/2 - 8
MSI          4835-3866   CSJ-866   Cashier’s Token Receipt                                           07/86                  1/2 ST                     4
ELECT                    CSJ-536   Restoration Information Sheet
ELECT                    CSJ-537   Review/Grand Special Credits Information Sheet
ELECT                    CSJ-538   Dead Time Information Sheet
ELECT                    CSJ-539   Reduction/Reapplication of Disciplinary Time Information Sheet
ELECT                    CSJ-540   Certification of Release Dates
ELECT                    CSJ-541   Assurance Letter To ICE Pursuant To PA 223                        03/11




 2/24/2012                                                                                                                         52 of 267   CSJ
            $0.101
            $0.043
            $2.961
            $2.358
            $0.115
            $0.115
            $0.115
            $0.020
            $2.961
            $2.358

            $1.179
            $0.069
            $0.030
            $0.101
            $0.014

            $0.101
            $2.358
            $0.014
            $0.101
            $0.058

            $0.069
            $2.358
            $0.072


            $0.014
            $0.115
            $0.115
            $0.014
            $2.954
            $0.072

            $0.101

            $0.043
            $0.101

2/24/2012            53 of 267   CSJ
            $0.101
            $0.115
            $0.058
            $2.961
            $0.101
            $0.101
            $0.043
            $0.043
            $2.358
            $0.072
            $0.014



            $1.179
            $0.072
            $0.058
            $0.115


            $0.115
            $0.072
            $2.961
            $0.101




            $0.014
            $0.158
            $0.158




            $2.550

            $2.550


2/24/2012            54 of 267   CSJ
            $2.358

            $2.961



            $0.072
            $0.058

            $1.179

            $0.043
            $0.012
            $0.144


            $2.961
            $0.014
            $0.012
            $0.072


            $0.014
            $0.014
            $0.180
            $0.120
            $0.160
            $0.158
            $0.120
            $0.158

            $0.080


            $0.072
            $0.069

2/24/2012            55 of 267   CSJ
            $0.072
            $0.104

            $0.014

            $0.014
            $0.160
            $0.158

            $0.043
            $2.358

            $0.058
            $0.110

            $1.179
            $2.358


            $0.101
            $2.961
            $0.072

            $0.100

            $0.081



            $0.014
            $0.072



            $0.101


             $0.066
            $0.058

2/24/2012             56 of 267   CSJ
            $2.961
            $0.014
            $2.358
            $0.058
            $4.729
            $0.072
            $0.115
            $0.115
            $0.101
            $0.058
            $0.110
            $0.058
            $2.961


            $2.358
            $0.115
            $0.115
            $0.144
            $0.144




            $0.160


            $0.043
            $0.014
            $0.072

            $0.072
            $2.358

            $0.120
            $0.058
            $0.200
            $2.358
            $0.043

2/24/2012            57 of 267   CSJ
            $0.100

            $0.058
            $2.358

            $0.035
            $0.115
            $0.072

            $0.115


            $0.719
            $0.014




            $0.719

            $2.961
            $0.101
            $0.101
            $2.358
            $0.101
            $0.101
            $0.014
            $0.012
            $2.358
            $4.830
            $0.069




            $0.101
            $2.358

2/24/2012            58 of 267   CSJ
            $2.358
            $0.110
            $0.014
            $0.014




            $0.043




2/24/2012            59 of 267   CSJ
        CFJ                                   MSI FORMS INDEX ( Revised 9/1/2011)

                                                                                                               Unit of
   Vendor      Comm#      Form#                                                     Rev.    Color     Size
                                                                                                               Issue

ELECT         4835-6101 CFJ-101    Basic Information Report (4-pgs)                 12/06
ELECT         4835-6102 CFJ-102A   L.E.I.N. Warrant Entry                           09/03
ELECT                   CFJ-102B   L.E.I.N. Warrant Cancellation
ELECT         4835-6103 CFJ-103    Pass Permit                                      01/90
ELECT         4835-6104 CFJ-104    Case Report                                      02/99
ELECT~WHSE    4835-6105 CFJ-105    Offender Supervision Report                      03/98 Canary    8 1/2 - 11 PD
ELECT         4835-6106 CFJ-106    Order for Parole Extension                       02/02
              4835-
ELECT         6107A     CFJ-107A   Notice of Arrival                                10/06
              4835-
ELECT         6107B     CFJ-107B   Notice of Departure                              10/06
ELECT         4835-6108 CFJ-108    Parole Detainer                                  03/99
ELECT         4835-6109 CFJ-109    Petition Affidavit & Bench Warrant - Mc229       06/05
ELECT         4835-6110 CFJ-110    Parole Violation Report                          05/99
ELECT         4835-6111 CFJ-111    Parole Viol War W/ Notice 4par                   06/11
OBS                     CFJ-113    OBSOLETE
ELECT         4835-6114 CFJ-114    Order Warrant Rev & Parole Reinstatement         07/10
ELECT         4835-6115 CFJ-115    Notice of Special Designation
ELECT         4835-6116 CFJ-116    Transfer Investigation Report                    12/05
ELECT         4835-6117 CFJ-117    EMS Equip Inventory Log                          01/90
ELECT         4835-6118 CFJ-118    Travel Permit                                    11/97
Obsolete                CFJ-119    Obsolete                                         03/90
ELECT         4835-6120 CFJ-120    Interstate Compact Communication
ELECT         4835-6121 CFJ-121    Field Agent Daily Report                         07/10
Obsolete                CFJ-122    Obsolete                                         10/97
ELECT         4835-6123 CFJ-123    Parole Guidelines Data Entry                     01/04
ELECT         4835-6124 CFJ-124    Special Conditions of Parole                     04/02
Obsolete                CFJ-125    Permit To Drive (obsolete)
ELECT         4835-6126 CFJ-126    Workload Report                                  01/00
OBSOLETE                CFJ-127    USE CFJ-231
ELECT         4835-6129 CFJ-129    Client Health Questionnaire                      12/05
ELECT         4835-6130 CFJ-130    45 Day Waiver                                    04/09
OBSOLETE      4835-6132 CFJ-132    CRP Prisoner Restitution Payments                09/00
ELECT         4835-6133 CFJ-133    Notice to Appear Before Parole Board             04/09
REV           4835-6134 CFJ-134     SEE CFX-134                                     09/00            4 1/8 - 7 BK
ELECT         4835-6135 CFJ-135    Curfew Schedule Form                             12/98
ELECT         4835-6136 CFJ-136    Progress Report                                  10/06
  2/24/2012                                                                                                  60 of 267   CFJ
        CFJ                                  MSI FORMS INDEX ( Revised 9/1/2011)

                                                                                                                      Unit of
  Vendor       Comm#        Form#                                                          Rev.    Color     Size
                                                                                                                      Issue

ELECT         4835-6140   CFJ-140   Offender Referral /Enrollment /Termination             09/10
ELECT         4835-6141   CFJ-141   Report of Nonpayment of Restitution                    05/07
ELECT         4835-6142   CFJ-142   Petition To Revoke Warrant & Cont Probation            12/89
ELECT         4835-6144   CFJ-144   FOA Critical Incident Notification ( 2-pages )         09/05
ELECT         4835-6145   CFJ-145   Pre-Sentence Investigation Report                      10/09
OBSOLETE      4835-6146   CFJ-146   TRV Voluntary Term Request -Parole                     02/92
OBSOLETE      4835-6147   CFJ-147   TRV Center(Program Description)/Rights and Agreement   04/98
ELECT         4835-6149   CFJ-149   Motion For Discharge From Probation MC245              05/07
ELECT         4835-6150   CFJ-150   Outstate Sex Off. Notification                         09/95
ELECT         4835-6151   CFJ-151   Transfer Order CRP Only                                09/00
ELECT         4835-6153   CFJ-153   Transfer Request(2 page)                               03/07
ELECT         4835-6154   CFJ-154   Petition and Order Amend Of Probation MC244            03/01
ELECT         4835-6156   CFJ-156   Motion & Order To Show Cause MC230                     06/04
ELECT         4835-6159   CFJ-159   Monitoring Equipment Form                              05/09
OBSLETE       4835-6160   CFJ-160   Community Corrections Center Orientation               01/00
OBSLETE       4835-6161   CFJ-161   Mo Facility Fire Inspection Report                     06/99
OBSLETE       4835-6162   CFJ-162   Emergency Drills Record Crp                            04/99
OBSLETE       4835-6163   CFJ-163   Community Programs Med Log-Restricted                  05/99
ELECT         4835-6164   CFJ-164   EMS Orientation                                        01/00
ELECT         4835-6165   CFJ-165   PSI Recommendation Guidelines                          12/05
OBSOLETE      4835-6166   CFJ-166   Offender's App For ISC Transfer                        03/10
ELECT         4835-6167   CFJ-167   Referral: Parole Action Ordered                        03/11
ELECT         4835-6168   CFJ-168   Parole Violation Charges                               04/09
ELECT         4835-6171   CFJ-171   New Fee Case Report                                    10/94
ELECT         4835-6172   CFJ-172   Receiptless Processing - Daily B                       06/99
ELECT         4835-6173   CFJ-173   Supervision Fee Offender Income                        10/94
ELECT         4835-6174   CFJ-174   CRP Reclassification Decision Guide(RESCINDED)         02/85           8 1/2 - 11 ST
ELECT         4835-6175   CFJ-175   Parole Viol Response Guideline                         04/09           8 1/2 - 11 ST
OBSOLETE                  CFJ-176   USE CFJ-180
ELECT         4835-6177   CFJ-177   Prisoner Detainer                                      02/89
ELECT         4835-6178   CFJ-178   Order of Prob. Judicial Court MC243 A                  06/05
ELECT         4835-6180   CFJ-180   Interstate Compact Supervision Fee Notice(2 page)      01/10
OBSOLETE                  CFJ-184   USE CFJ-180
ELECT         4835-6185   CFJ-185   Preliminary Parole Violation Hearing                   12/89
ELECT         4835-6186   CFJ-186   Notice of Prelim Par Viol Hear                         10/98
ELECT         4835-6189   CFJ-189   Michigan Conditions of Parole                          08/04
ELECT         4835-6190   CFJ-190   Supervision Fee Notice                                 06/05
  2/24/2012                                                                                                         61 of 267   CFJ
         CFJ                                     MSI FORMS INDEX ( Revised 9/1/2011)

                                                                                                                                    Unit of
   Vendor       Comm#        Form#                                                                          Rev.    Color   Size
                                                                                                                                    Issue

OBSOLETE       4835-6192   CFJ-192     Road Book Face Sheet - Continuation                                  06/96
OBSOLETE       4835-6193   CFJ-193     Road Book Face Sheet - Intense                                       07/99
OBSOLETE       4835-6194   CFJ-194     Road Book Face Sheet - Average                                       07/99
OBSOLETE       4835-6195   CFJ-195     Road Book Face Sheet - Min                                           08/99
OBSOLETE                   CFJ-196     USE CFJ-190
OBSOLETE                   CFJ-197     USE CFJ-190
ELECT          4835-6199   CFJ-199     EMS Offender Enrollment                                              11/05
ELECT          4835-6200   CFJ-200     EMS Termination Form                                                 06/99
ELECT          4835-6202   CFJ-202     EMS Home Confine Agreement                                           05/99
ELECT          4835-6203   CFJ-203     Equipment Inventory Report                                           10/97
ELECT          4835-6204   CFJ-204     Immigration Notice                                                   08/00
OBSOLETE       4835-6205   CFJ-205     Sign-Out Log REP                                                     12/89
ELECT          4835-6206   CFJ-206     Offender Financial Record                                            07/99
ELECT          4835-6207   CFJ-207     Parole Board Action - Executive Session
               4835-
ELECT          6207A       CFJ-207A    Parole Board Action - Exec. Session Lifer
ELECT          4835-6208   CFJ-208     Prisoner Employment Data Sheet                                       01/90
OBS            4835-6209   CFJ-209     BIR Interview Sheet Offender I                                       10/02
OBS            4835-6210   CFJ-210     BIR Interview Sheet Offense In                                       10/02
OBS            4835-6211   CFJ-211     SAI Progress Report                                                  04/00
MSI / ELECT    4835-6212   CFJ-212     Special Alternative Incarceration - Health Questionnaire/Screening   01/90
ELECT          4835-6213   CFJ-213     CRP Escape, Apprehend, Reclass                                       09/01
ELECT                      CFJ-213     Instructions to complete 213
OBSOLETE       4835-6215   CFJ-215     Special Cond. Of Comm Placement                                      10/04
OBSOLETE       4835-6217   CFJ-217     Community Correction Rules                                           01/99
ELECT          4835-6218   CFJ-218     Request for Reporting Instruc-Interstate(2page)                      03/07
ELECT          4835-6219   CFJ-219     Parole and Commutation Board Request for Infromation                 03/10
ELECT          4835-6221   CFJ-221     Prob Risk Class Score Sheet                                          08/99
               4835-6221
ELECT          A           CFJ-221 A Agreement on Detainers-Notice of Untried Indictment-(2 forms
               4835-6221
ELECT          B           CFJ-221 B Agreement on Detainers-Notice of Place of Imprisonment
               4835-6221
ELECT          C           CFJ-221 C Agreement on Detainers-Certificate of Inmate Status
               4835-6221
ELECT          D           CFJ-221 D Agreement on Detainers-Offer to Deliver Temporary Custody


   2/24/2012                                                                                                                       62 of 267   CFJ
        CFJ                                    MSI FORMS INDEX ( Revised 9/1/2011)

                                                                                                                              Unit of
   Vendor      Comm#        Form#                                                                     Rev.    Color   Size
                                                                                                                              Issue

              4835-6221
ELECT         E           CFJ-221 E Agreement on Detainers-Request for Temporary Custody
              4835-6221
ELECT         F           CFJ-221 F Agreement on Detainers-Evidence of Agents Authority
              4835-6221
ELECT         G           CFJ-221 G Agreement on Detainers-Prosecutors Accept./Prisoners Request
              4835-6221
ELECT         H           CFJ-221 H Agreement on Detainers-Prosecutors Accept./Another Prosecutor
              4835-6221
ELECT         I           CFJ-221 I   Agreement on Detainers-Prosecutors Report on Disposition        01/86
              4835-6221               Agreement on Detainers-Prisoners Agreement to Temp. Trans. Of
ELECT         J           CFJ-221 J   Custody                                                         01/86
ELECT         4835-6222   CFJ-222     FOA Pre-release investigation                                   03/10
ELECT         4835-6223   CFJ-223     Employment Verification                                         03/90
ELECT         4835-6224   CFJ-224     Policy & Procedure Review                                       03/01
ELECT         4835-6225   CFJ-225     Field Services Performance Evaluation                           04/00
              4835-
ELECT         6225B     CFJ-225b      Field Services Performance Eva Update                           04/00
ELECT         4835-6226 CFJ-226       Par Viol Worksheet & Decision                                   04/02
ELECT         4835-6227 CFJ-227       Case Movement Report- Parole                                    06/95
ELECT         4835-6228 CFJ-228       Case Movement Report- Probation                                 08/99
ELECT         4835-6230 CFJ-230       Parole Violation Hearing Notice                                 04/02
OBSOLETE      4835-6231 CFJ-231       TRV Eligibility Screening                                       08/02
ELECT         4835-6232 CFJ-232       Parole Violator Div Prg Scrn & Plcmt                            05/03
ELECT         4835-6233 CFJ-233       Parole Vio Div Prg. Scrn & Plcmt Waiver
ELECT         4835-6236 CFJ-236       Investigative Assignment Log                                    07/99
ELECT         4835-6237 CFJ-237       Case Supervision Review                                         12/02
ELECT                   CFJ-237-0     OMNI Version of Case Supervision Reviews
ELECT         4835-6238 CFJ-238       Completed Pre-Parole                                            04/09
ELECT                   CFJ-239       Comp Plans & Services
ELECT                   CFJ-240       Criminal History Check (Emplymnt)                               07/99
ELECT                   CFJ-241       Waiver to Contact Present/Prev Employers                        07/99
ELECT         4835-6242 CFJ-242       Witness Statement                                               07/99
ELECT                   CFJ-243       ARU Case Activity Sheet                                         08/05
ELECT                   CFJ-244       ARU Case Activity Sheet Continue Sheet                          08/05
ELECT                   CFJ-245       ARU Min Stds Case Review Sheet (2 pages)                        03/10
ELECT                   CFJ-246       ARU Incident Report                                             08/05
  2/24/2012                                                                                                                  63 of 267   CFJ
         CFJ                                   MSI FORMS INDEX ( Revised 9/1/2011)

                                                                                                                        Unit of
   Vendor       Comm#        Form#                                                           Rev.    Color     Size
                                                                                                                        Issue

ELECT                      CFJ-247   Polygraph Referral and Fee Notice                       12/09
ELECT                      CFJ-248   Community Corrections - Financial Review
ELECT                      CFJ-249   CCP&S Mo Expenditure Report                             05/02
ELECT          4835-6250   CFJ-250   LEIN Information Form                                   05/02
ELECT/ Omni                CFJ-252   Parole Violation Formal Hearing Sum & Re
ELECT/OCC                  CFJ-253   Probation Residential Services Rr
ELECT/ OCC                 CFJ-254   Probation Residential Service Vic                       06/02
WHSE                       CFJ-256   Offender Bar Code Label (OMNI)                          09/99
ELECT / OCC                CFJ-257   OCC Payment Authorization
ELECT / OCC                CFJ-259   Proposal For Comm Corr Funds
ELECT / OCC    4835-6260   CFJ-260   Order Delaying Sentencing                               03/00
ELECT / OCC    4835-6261   CFJ-261   Warrant Recall                                          07/00
ELECT / OCC    4835-6262   CFJ-262   Notice Of Approved Placement                            10/97
ELECT / OCC                CFJ-263   Failure To Report Notice                                09/02
Elect / OCC    4835-       CFJ-264   Vendor Expense Report                                   11/84
ELECT-OCC      4835-6265   CFJ-265   Level I/Level II Probation Violation                    02/99
ELECT          4835-6266   CFJ-266   Probation Violation Decision Guide                      02/99
ELECT          4835-6267 CFJ-267     Probation Violation Response Guide                      03/99           8 1/2 - 11 PD
ELECT          4835-6268 CFJ-268     Probation Violation Departure Request                   03/99
ELECT          4835-6269 CFJ-269     Substance Abuse Test Record                             08/99
OBSOLETE                 CFJ-270     Corrections Center Parolee Placement                    05/00
OBSOLETE       4835-6271 CFJ-271     Corrections Center Parolee Plmt Revision                05/00
ELECT                    CFJ-272     Office Audit
ELECT                    CFJ-273     Caseload Audit Instructions
ELECT                    CFJ-274     Caseload Audit Sheet
OBSOLETE                 CFJ-274A    Agent Caseload Audit-Annual
ELECT                    CFJ-275     Audit Continuation Sheet
ELECT                    CFJ-276     Caseload Audit Reconcil Rpt
ELECT                    CFJ-278     Caseload Audit Follow Up
ELECT                    CFJ-279     Parole Bd Notice Of Decision
ELECT/OMNI               CFJ-280     User Profile Design-Omni
ELECT/OMNI               CFJ-281     Emply Info Fax Sheet-Omni
ELECT                    CFJ-282     Request For User ID/Password-Omni
ELECT/OMNI               CFJ-284     PSI Narrative-Omni
ELECT~WHSE     4835-6287 CFJ-287     PSI Questionnaire - OMNI Combined(33-pgs)               11/09 White     8 1/2 x 11 EA
ELECT~WHSE     4835-6288 CFJ-288     OMNI Pre-Sentence Interview - Data Collection(19-pgs)   11/09 White     8 1/2 x 11 EA

   2/24/2012                                                                                                          64 of 267   CFJ
         CFJ                                 MSI FORMS INDEX ( Revised 9/1/2011)

                                                                                                           Unit of
   Vendor       Comm#      Form#                                                   Rev.    Color   Size
                                                                                                           Issue

ELECT/OMNI               CFJ-289   PSI Traffic Record                              04/02
ELECT                    CFJ-290   Form In Process
OBSOLETE       4835-6291 CFJ-291   Roadbook Face Sheet - Parole                    11/01
OBSOLETE       4835-6292 CFJ-292   Roadbook Face Sheet - Probation                 12/99
OBSOLETE       4835-6293 CFJ-293   Roadbook Face Sheet - CRP                       12/99
ELECT                    CFJ-300   Form In Process
ELECT                    CFJ-301   MDOC Sex Offense Questionnaire(12 pages)        07/10
ELECT                    CFJ-303   Polygraph Testing Orientation                   11/01
ELECT                    CFJ-304   Polygraph Admission Sheet(2 Parts)              07/10
OBSOLETE                 CFJ-305   Stop li Program Eligibility Screening           11/02
ELECT                    CFJ-306   Residential Treatment Referral                  05/05
ELECT                    CFJ-307   FOA GED Completion Exemption                    08/02
ELECT                    CFJ-308   Prob Voluntary Termination (SAI)
ELECT                    CFJ-309   P.V. Case Supervision Sheet                     10/05
ELECT                    CFJ-310   Parole Loan Request                             10/02
ELECT/OCC                CFJ-311   OCC Case Notes
ELECT/OCC                CFJ-312   OCC On-Site Visits
ELECT/OCC                CFJ-313   OCC Technical Assistance Plan
ELECT                    CFJ-314   Misconduct Referral Sheet
ELECT-OMNI               CFJ-315   OMNI Form
ELECT-OMNI               CFJ-316   OMNI Form
ELECT                    CFJ-317   Order For Vehicle Immoblization                 06/03
OBSOLETE                 CFJ-318   Writ Of Haveas Corpus                           11/85
OBSOLETE                 CFJ-319   Restitution Contacts(Available in DAS)
ELECT                    CFJ-320   Workload Analysis Quarterly
ELECT                    CFJ-321   Quarterly Personnel Workload
OBSOLETE                 CFJ-322   Parole Re-Entry Program Eligibility Screening   05/05
ELECT                    CFJ-401   Cancellation Of Discharge
ELECT                    CFJ-402   Parole Cischarge Processing Checklist
ELECT                    CFJ-403   Sentencing Record                               10/05
OBSOLETE                 CFJ-410   Crp Assessment                                  06/04
OBSOLETE                 CFJ-411   Crp Health Review                               11/04
ELECT                    CFJ-413   PreSentence Case Report                         10/03
ELECT                    CFJ-414   Response to Violation Report                    10/06
ELECT                    CFJ-415   Case Closure Notice                             10/06
ELECT                    CFJ-416   Consent To Random Testing/Searches              10/06
ELECT                    CFJ-417   Offender Violation Report(2 page)               04/08
   2/24/2012                                                                                              65 of 267   CFJ
        CFJ                                MSI FORMS INDEX ( Revised 9/1/2011)

                                                                                                                      Unit of
   Vendor     Comm#     Form#                                                            Rev.    Color     Size
                                                                                                                      Issue

ELECT                 CFJ-418    Reply To Transfer Request                               10/06
ELECT                 CFJ-419    Author For Release Of Med/Psych Info                    10/06
ELECT                 CFJ-420    Parole Violation Charges-Interstate                     07/04

ELECT                 CFJ-423A   Interstate Agreement on Detainers - Form I              05/07           8 1/2 X 11

ELECT                 CFJ-423B   Interstate Agreement on Detainers - Form II             05/07           8 1/2 X 11

ELECT                 CFJ-423C   Interstate Agreement on Detainers - Form III            04/09           8 1/2 X 11

ELECT                 CFJ-423D   Interstate Agreement on Detainers - Form IV             05/07           8 1/2 X 11
ELECT                 CFJ-423E   Interstate Agreement on Detainers Form V                10/04
ELECT                 CFJ-423F   Interstate Agreement on Detainers Form VI               10/04
ELECT                 CFJ-423G   Interstate Agreement on Detainers Form VII              10/04
ELECT                 CFJ-423H   Interstate Agreement on Detainers Form VIII             10/04
ELECT           4835- CFJ-423I   Interstate Agreement on Detainers Form IV               10/04

ELECT                 CFJ-423J   Interstate Agreement on Detainers - Form V-a            05/07           8 1/2 X 11
ELECT-OMNI            CFJ-424    Parole Action Request                                   04/09
ELECT                 CFJ-425    Quarterly Personnel Wkld Report                         08/05
ELECT                 CFJ-426    Probaton violation Charges Interstate                   08/05
ELECT                 CFJ-427    Order For Assignment Of Wages MC 289                    02/04
OBSOLETE              CFJ-428    TRV Termination Report                                  10/04
ELECT                 CFJ-429    Parole Cond Authorization                               08/08
ELECT                 CFJ-430    Office Move Request For DIT                             11/04
ELECT                 CFJ-431    PSI Name Removal Request
ELECT                 CFJ-432    Motion,Affidavit & SummonsRegardingProbationViolation   06/04
OBSOLETE              CFJ-451    Crp Case Report                                         03/05
ELECT                 CFJ-452    PSI Communication Report                                03/05
OBSOLETE              CFJ-455    Re-Entry Screening Placement                            10/05
OBSOLETE              CFJ-456    IPRP Program Info And Prisoner Agreement                03/05
ELECT                 CFJ-457    Iru Updated Parole Placement Information                11/05
ELECT                 CFJ-458    Compact Action Request                                  10/06
ELECT                 CFJ-460    EMS Inventory Reconciliation                            09/09
ELECT                 CFJ-461    ScramAlcoholSupervisionProgramParticipantAgreement      06/05
Elect/OMNI            CFJ-465A   Notice Of Final Assessment
Elect/OMNI            CFJ-465B   Notice Of Final Assessment
  2/24/2012                                                                                                       66 of 267     CFJ
        CFJ                                MSI FORMS INDEX ( Revised 9/1/2011)

                                                                                                                               Unit of
   Vendor     Comm#     Form#                                                                          Rev.    Color   Size
                                                                                                                               Issue

ELECT                 CFJ-469    In Process
ELECT                 CFJ-471    FOA Offender Detail                                                   03/10
ELECT                 CFJ-480    Warrant Entry Form                                                    06/07
ELECT                 CFJ-481    Probation/ParoleOrientation Form & Checklist                          01/10
ELECT                 CFJ-482    Parolee Notice- Zero Tolerance                                        09/05
ELECT                 CFJ-485    Request To Governor For Denial Of Temporary Custody                   05/05
ELECT                 CFJ-490    Community Resource Program Listing(2 pages)                           02/07
ELECT                 CFJ-495    GPS User Access request form                                          05/09
ELECT                 CFJ-496    Attorney Appointment                                                  01/07
ELECT                 CFJ-497    Global Positioning System -Participant Agreement                      12/09
ELECT                 CFJ-498     Residentiol Reentry Program Eligibility Screening Form               04/11
OBSOLETE              CFJ-499    Community Placement Program Request for Stay Extension                06/07
ELECT                 CFJ-500    Special Conditions of Probation-Interstate                            07/07
MSI/ELECT             CFJ-502    Residential ReEntry Programs                                          03/10
ELECT                 CFJ-504    Travel Expense Voucher-Witness Fees-MDOC                              01/10
ELECT                 CFJ-505    Electronic Inventory Form                                             01/09
ELECT                 CFJ-506    Computer Use Agreement                                                01/09
ELECT                 CFJ-507    Right of Defendant to Petition the Court for Mod. of Rest. Payments   03/09
ELECT                 CFJ-509    Suplemental Sex Offender Registration Information                     04/09
ELECT                 CFJ-510    Case Management Review--Supervisor Worksheet                          05/09
ELECT                 CFJ-511    Probation/Parole Case Management Review                               05/09
ELECT                 CFJ-512    Case Management Review Guide                                          05/09
ELECT                 DD-4       Sex Offender Registry                                                 05/05
ELECT                 DD-4A      Sex Offender Registry Part 2                                          05/05
ELECT                 CFJ-515    Application for Pardon or Commutation of Sentence                     04/09
ELECT                 CFJ-515A   Application for Pardon After Probation,Parole or Discharge            06/10
ELECT                 CFJ-518    Case Management Team Member Confidentiality Agreement                 01/10
ELECT                 CFJ-519    Case Management Team Provationer/Parolee Case Staffing Report         03/10
ELECT                 CFJ-520    Fee Collection Program-Supervision Fees                               01/10
ELECT                 CFJ-521    Fee Collection Program-EMS, Polygraph and Other Fees                  01/10
ELECT                 CFJ-522    Parole to Detainer Notification and Adknowledgment                    01/10
ELECT                 CFJ-523    Questions for Student Safety Zone Exemption Guide                     04/10
ELECT                 CFJ-524    GPS Case Management Review                                            03/10
ELECT                 CFJ-525    MDOC Electronic Control Device (ECD) Use Report                       03/10
ELECT                 CFJ-526    Offender Self-Asseaament                                              04/10
ELECT/MSI             CFJ-527    Seized Property and Evidence Receipt                                  11/10
ELECT                 CFJ-528
  2/24/2012                                                                                                                   67 of 267   CFJ
        CFJ                              MSI FORMS INDEX ( Revised 9/1/2011)

                                                                                                                          Unit of
   Vendor     Comm#     Form#                                                                     Rev.    Color   Size
                                                                                                                          Issue

ELECT                 CFJ-529
ELECT                 CFJ-530   Telephone Reporting Program Information Form                      10/10
ELECT/MSI             CFJ-532   Required Information For Crime Victims Unit                       06/11
ELECT/MSI             CFJ-535   Residential ReEntry Programs Community Works Detail/Count sheet   06/11
ELECT                 CFJ-536   Restoration Information Sheet
ELECT                 CFJ-537   Review/Grand Special Credits Information Sheet
ELECT                 CFJ-538   Dead Time Information Sheet
ELECT                 CFJ-539   Reduction/Reapplication of Disciplinary Time Information Sheet    03/11
ELECT                 CFJ-540   Certification of Release Dates
ELECT                 CFJ-541   Lifetime Electronic Monitoring Program Participant Agreement      05/11
ELECT
ELECT
ELECT
ELECT
ELECT
ELECT




  2/24/2012                                                                                                              68 of 267   CFJ
QTY / Unit or
  *Special
   Paper




         100    $2.358




                $0.201


   2/24/2012             69 of 267   CFJ
QTY / Unit or
  *Special
   Paper




           2    $0.058
           2    $0.058




   2/24/2012             70 of 267   CFJ
QTY / Unit or
  *Special
   Paper




   2/24/2012    71 of 267   CFJ
QTY / Unit or
  *Special
   Paper




   2/24/2012    72 of 267   CFJ
QTY / Unit or
  *Special
   Paper




         100    $2.358




                $1.323
                $0.762

   2/24/2012             73 of 267   CFJ
QTY / Unit or
  *Special
   Paper




   2/24/2012    74 of 267   CFJ
QTY / Unit or
  *Special
   Paper




   2/24/2012    75 of 267   CFJ
QTY / Unit or
  *Special
   Paper




            4


   2/24/2012    76 of 267   CFJ
QTY / Unit or
  *Special
   Paper




   2/24/2012    77 of 267   CFJ
           CHJ                                   MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                                         QTY /
                                                                                                                                                 Unit of Unit or
  Vendor        Comm#     Form#                                   Title/Description                              Rev.     Color      Size
                                                                                                                                                 Issue *Special
                                                                                                                                                         Paper

MSI           4835-7101   CHJ-101   Post Anesthesia Care (DWH form) 2 HOLE PUNCH AT TOP                          11/04   NCR        8 1/2 - 11   ST         2 PT           $0.058
MSI           4835-7102   CHJ-102   Special Needs Identification Screening                                       01/96   White      8 1/2 - 11   PD          100           $2.961
MSI           4835-7103   CHJ-103   Information Concerning Surgical Removal of Teeth                             07/89   NCR        8 1/2 - 11   ST            2           $0.058
MSI           4835-7104   CHJ-104   Anesthetic Record                                                            09/95   NCR        8 1/2 - 11   ST            2           $0.043
MSI           4835-7105   CHJ-105   Medication Record                                                            03/89 White        8 1/2 - 11 PD            100           $2.559
MSI           4835-7106   CHJ-106   Intake Health Appraisal/Physical Examination                                 10/92 White        8 1/2 - 11 PD            100           $2.358
OBS           4835-7107   CHJ-107   Medical/Mental Health Parole Eval. (OBSOLETE)
MSI           4835-7108   CHJ-108   Discharge Instructions                                                       09/91   NCR        8 1/2 - 11   ST            3           $0.072
MSI           4835-7109   CHJ-109   Intake History/Screening                                                     11/94   White      8 1/2 - 11   PD          100           $2.961
MSI           4835-7110   CHJ-110   Medical History & Physical Examination                                       05/98   White      8 1/2 - 11
                                                                                                                                             7   PD          100           $2.559
MSI           4835-7111   CHJ-111   Nursing Care Plan (F & B)                                                    01/90   Buff     15/16X91/2     SH        Index           $0.101
OBS                       CHJ-112   Mental Health Nursing Care Plan--(OBSOLETE)                                  11/89
MSI           4835-7113   CHJ-113   Nutritional Assessment ( F & B )                                             01/90   White      8 1/2 - 11 PD            100           $2.559
MSI~ELEC      4835-7114   CHJ-114   Annual Health Screening                                                      10/03   White      8 1/2 - 11 PD            100           $2.358
MSI           4835-7115   CHJ-115   Dental Health History                                                        03/00   White      8 1/2 - 11   PD          100           $2.760
MSI           4835-7116   CHJ-116   Nurses' Operating Room Record                                                11/04   NCR        8 1/2 - 11   ST            2           $0.058
MSI           4835-7117   CHJ-117   Consent for Patient Photograph                                               11/89   White        1/2 - 11
                                                                                                                                    85 1/2 - 8   PD          100           $2.358
MSI           4835-7118   CHJ-118   Tissue Examination Request                                                   01/90   White             1/2   PD          100           $1.078
OBS           4835-7119   CHJ-119   Patient Care Plan (OBSOLETE)
MSI           4835-7120   CHJ-120   Patient Care Flow Sheet                                                      02/98   White     8 1/2 - 11    PD          100           $2.961
MSI/ELEC      4835-7121   CHJ-121   Patient's Authorization For Disclosure Of Health Record                      03/05   White     8 1/2 - 11    PD          100           $2.961
MSI           4835-7122   CHJ-122   Physicians Orders (No tear off strip at the bottom)                          01/97   NCR       8 1/2 - 11    ST            3           $0.201
MSI           4835-7123   CHJ-123   Face Sheet                                                                   01/90   White     8 1/2 - 11    PD          100           $2.358
MSI           4835-7124   CHJ-124   Reduced Custody Psychological Screening Form                                 01/90   NCR       8 1/2 - 11    ST            4           $0.101
MSI           4835-7125   CHJ-125   Radiology Request and Report                                                 05/90   NCR       8 1/2 - 11    ST            4           $0.101
MSI           4835-7126   CHJ-126   Receipt of Health Record Information                                         01/90   White     8 1/2 - 11    PD          100           $2.358
ELECT         4835-7127   CHJ-127   Certification of Health Record                                               08/09   White     8 1/2 - 11    PD          100
MSI           4835-7128   CHJ-128   Physical Therapy                                                             11/89   White     8 1/2 - 11    PD          100           $2.961
MSI           4835-7129   CHJ-129   Patient Contract                                                             01/90   NCR       81/2 X 11     ST            2           $0.058
MSI           4835-7130   CHJ-130   Progress Notes                                                               12/97   White     8 1/2 - 11    PD          100           $2.961
                                    Medication Administration Record (Printed on 2 sides; 2 holes top; 3 holes
MSI           4835-7131   CHJ-131                                                                                08/98 white        8 1/2 - 11 PD            100           $2.961
                                    left)
MSI           4835-7132   CHJ-132   Food Acceptance Record                                                       07/89 white       81/2 X 11 PD              100           $2.358
MSI           4835-7134   CHJ-134   INH Flow Sheet                                                               11/95   White      8 1/2 - 11   PD          100           $2.559
MSI           4835-7137   CHJ-137   Emergency Treatment ( has no perf. )                                         11/04   NCR        8 1/2 - 11   ST            2           $0.058
MSI           4835-7138   CHJ-138   Emergency Treatment - Continuation Page                                      02/98   NCR        8 1/2 - 11   ST            3           $0.072
MSI           4835-7139   CHJ-139   Graphic Chart                                                                03/90   white      8 1/2 - 11   PD          100           $2.559
MSI           4835-7140   CHJ-140   General Flow Sheet A                                                         06/93   white      8 1/2 - 11   PD          100           $2.559
MSI           4835-7141   CHJ-141   Health Review for MDOC Transfer                                              03/02   NCR        8 1/2 - 11   ST            3           $0.072
OBS           4835-7142   CHJ-142   T.B. Test (OBSOLETE 2/3/99) SEE CHJ-243 OR 256
MSI           4835-7143   CHJ-143   Inpatient Summary                                                            05/90 white        8 1/2 - 11 PD            100           $2.358
MSI           4835-7144   CHJ-144   Emergency Transfer Record                                                    02/91 NCR          8 1/2 - 11 ST              3           $0.072
MSI           4835-7146   CHJ-146   Dental Treatment                                                             09/99 white        8 1/2 - 11 PD            100           $2.961
  2/24/2012                                                                                                                                                        78 of 267   CHJ
           CHJ                                   MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                            QTY /
                                                                                                                                    Unit of Unit or
  Vendor        Comm#     Form#                                  Title/Description                      Rev.     Color    Size
                                                                                                                                     Issue *Special
                                                                                                                                            Paper
MSI           4835-7147   CHJ-147   Release from Responsibility for Medical Treatment                   01/90 NCR        8 1/2 - 11 ST              3       $0.072
MSI           4835-7148   CHJ-148   Information Released from this Record                               02/91 white      8 1/2 - 11 PD           100        $2.559
MSI/ELECT     4835-7149   CHJ-149   Informed consent to surgery, anesthetics, medical treatment and--   05/98 NCR        8 1/2 - 11 ST              2       $0.058
OBS           4835-7150   CHJ-150   Consent to INH Chemoprophylaxis (OBSOLETE)
                                                                                                                          8 1/4 - 3
MSI           4835-7151   CHJ-151   Urinalysis - Lab Report                                             10/79   NCR             1/4   ST           3        $0.058
MSI           4835-7155   CHJ-155   Patient Rights/Consent to Inpatient Psychiatric Treatment           04/86   white    8 1/2 - 11   PD         100        $2.559
MSI           4835-7156   CHJ-156   A Healthy Way to a Healthy Weight - Booklet                         05/93            8 1/2 - 11   BK                    $0.985
MSI           4835-7157   CHJ-157   Consent to Treatment with Psychotropic Medication                   10/89            8 1/2 - 11   ST           2        $0.058
MSI           4835-7158   CHJ-158   Intake and Output Record                                            08/89            8 1/2 - 11   PD         100        $2.961
MSI           4835-7159   CHJ-159   Psychiatric Treatment Team Misconduct Review                        08/94            8 1/2 - 11   ST           2        $0.058
MSI           4835-7160   CHJ-160   Problem List                                                        06/90   White    8 1/2 - 11   SH       Index        $0.043
MSI           4835-7161   CHJ-161   Off-Site Health Care Encounter                                      07/89            8 1/2 - 11   ST           2        $0.058
MSI           4835-7162   CHJ-162   Request for Off-Site Services                                       11/93            8 1/2 - 11   ST           3        $0.072
MSI           4835-7163   CHJ-163   Treatment Plan - MDOC                                               02/98            8 1/2 - 11   PD         100        $2.961
MSI           4835-7164   CHJ-164   Certification of Physical Examination                               11/89            8 1/2 - 11   PD         100        $2.358
MSI           4835-7166   CHJ-166   Nursing History and Assessment - Pages 1 & 2                        05/90            8 1/2 - 11   PD         100        $2.961
MSI           4835-7167   CHJ-167   Nursing History and Assessment - Pages 3 & 4                        12/89   white    8 1/2 - 11   PD         100        $2.961
MSI           4835-7168   CHJ-168   Psychiatric Assessment/Discharge Summary                            01/90   white    8 1/2 - 11   PD         100        $2.358
MSI           4835-7169   CHJ-169   Inpatient Screening                                                 07/89   white    8 1/2 - 11   PD         100        $2.961
OBS           4835-7170   CHJ-170   Medical Records Certification (OBSOLETE)
MSI           4835-7171   CHJ-171   Psychological Report - Page 1                                       01/98   NCR      8 1/2 - 11   ST           3        $0.072
MSI           4835-7172   CHJ-172   Psychological Report - Page 2                                       01/98   NCR      8 1/2 - 11   ST           3        $0.072
MSI/ELEC      4835-7173   CHJ-173   Diet History/Nutritional Evaluation (Page 1 & 2)                    08/06   white    8 1/2 - 11   PD         100        $2.961
MSI           4835-7174   CHJ-174   Consent to Contrast Injection Treatment                             06/90            8 1/2 - 11   ST           2        $0.058
MSI           4835-7175   CHJ-175   Psychiatric Medications and Their Side Effects                      05/90            8 1/2 - 11   PD         100        $2.559
ELECT         4835-7177   CHJ-177   Mental Health Management Plan                                       12/09            8 1/2 - 11   ST           4
MSI           4835-7178   CHJ-178   Attorney Cover Letter                                               11/95            8 1/2 - 11   PD         100        $2.358
MSI           4835-7179   CHJ-179   Suicide Prevention Screening(2-sided, 2-forms)                      03/94   NCR      8 1/2 - 11   ST           2        $0.072
MSI           4835-7180   CHJ-180   Evaluation of Suicide Risk Prisoners                                01/01            8 1/2 - 11   PD         100        $2.358
MSI           4835-7181   CHJ-181   Admission Consent (White copy only is two-sided.)                   08/03            8 1/2 - 11   ST           2        $0.086
OBS           4835-7182   CHJ-182   Cover Letter Litigation (OBSOLETE)
MSI           4835-7183   CHJ-183   Off-Formulary Medication Request (formerly called Non-Formulary)    10/97            8 1/2 - 11   PD         100        $2.358
MSI           4835-7184   CHJ-184   Abnormal Involuntary Movement Scale - AIM                           07/98            8 1/2 - 11   PD         100        $2.961
MSI           4835-7185   CHJ-185   Social Assessment                                                   07/89            8 1/2 - 11   PD         100        $2.961
MSI           4835-7186   CHJ-186   Psychiatric Evaluation/Initial Treatment Plan                       09/98            8 1/2 - 11   PD         100        $2.961
OBS           4835-7187   CHJ-187   Mental Health Nursing Assessment - Pages 1 & 2 (OBSOLETE)
OBS           4835-7188   CHJ-188   Mental Health Nursing Assessment - Pages 3 & 4 (OBSOLETE)
MSI           4835-7189   CHJ-189   Hypersensitivity Report                                             05/90            8 1/2 - 11   PD         100        $2.559
MSI           4835-7190   CHJ-190   Pre-Natal Record                                                    07/89            8 1/2 - 11   PD         100        $2.559
MSI           4835-7191   CHJ-191   Health History - Obstetric                                          01/90            8 1/2 - 11   PD         100        $2.358
MSI           4835-7192   CHJ-192   Nursing Orientation      (4 pages)                                  01/90            8 1/2 - 11   PD         100       $10.241
MSI           4835-7193   CHJ-193   Nursing Appraisal - Weekly Performance Evaluation                   01/90            8 1/2 - 11   PD         100        $2.358
MSI           4835-7194   CHJ-194   Mental Health Record                                                04/97            8 1/2 - 11   ST           2        $0.058
MSI           4835-7195   CHJ-195   Mental Health Nursing Care Plan - Continuation Page                 05/90            8 1/2 - 11   PD         100        $2.559


  2/24/2012                                                                                                                                         79 of 267   CHJ
           CHJ                                   MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                         QTY /
                                                                                                                                 Unit of Unit or
  Vendor        Comm#     Form#                                 Title/Description                  Rev.     Color    Size
                                                                                                                                 Issue *Special
                                                                                                                                         Paper
                                                                                                                     5 1/2 - 8
MSI           4835-7196   CHJ-196    Medical Record Deficiency Slip                                01/00                   1/2   ST            2           $0.043
MSI           4835-7198   CHJ-198    Record of On-Call Contact; 2-hole punch, top                  08/03 White      8 1/2 - 11   PD          100           $2.961
MSI           4835-7199   CHJ-199    Mental Health Summary Sheet                                   07/89            8 1/2 - 11   PD          100           $2.358
MSI           4835-7200   CHJ-200    Optometric/Vision Screening                                   08/89            8 1/2 - 11   PD          100           $2.961
MSI           4835-8200   CHJ-200A   Opthalmic Progress Notes                                      10/04 white      8 1/2 - 11   PD          100           $2.961
MSI           4835-7201   CHJ-201    Ophthalmic Evaluation                                         09/97 white      8 1/2 - 11   PD          100           $2.961
OBS           4835-7202   CHJ-202    Mental Health Treatment Plan (OBSOLETE)
OBS           4835-7203   CHJ-203    Mental Health Treatment Plan - Continuation Page (OBSOLETE)
MSI           4835-7204   CHJ-204    Restraint/Seclusion                                           10/00            8 1/2 - 11 PD            100           $3.348
OBS           4835-7205   CHJ-205    Restraint/Seclusion - Continuation Page (OBSOLETE)
MSI           4835-7206   CHJ-206    Restraint Monitoring Flow Sheet                               03/03            8 1/2 - 11   PD          100           $2.358
MSI           4835-7207   CHJ-207    Activity Participation Record                                 09/93            8 1/2 - 11   PD          100           $2.559
MSI           4835-7208   CHJ-208    Information and Consent for Epinephrine Injection Kit         02/91            8 1/2 - 11   PD          100           $2.358
MSI           4835-7209   CHJ-209    Certification When No Informed Consent                        10/89            8 1/2 - 11   PD          100           $2.358
MSI           4835-7210   CHJ-210    Inpatient Record Locator                                      10/89            8 1/2 - 11   PD          100           $2.358
MSI           4835-7211   CHJ-211    Personal Grooming Flow Sheet                                  10/89            8 1/2 - 11   PD          100           $2.559
MSI           4835-7213   CHJ-213    Activity Assessment                                           10/93            8 1/2 - 11   PD          100           $2.961
MSI           4835-7214   CHJ-214    Segregation/Detention Rounds                                  10/03            8 1/2 - 11   PD          100           $2.961
MSI           4835-7215   CHJ-215    Prenatal Education Record - Pages 1 & 2                       10/89            8 1/2 - 11   PD          100           $2.559
MSI           4835-7216   CHJ-216    Prenatal Education Record - Page 3                            10/89            8 1/2 - 11   PD          100           $2.358
MSI           4835-7217   CHJ-217    Consent to Routine, Non-Surgical Medical Care                 01/00            8 1/2 - 11   ST            3           $0.072
MSI/ELECT     4835-7218   CHJ-218    Transfer Assessment/Screening; 2-hole punch, top              08/03   White    8 1/2 - 11   PD          100           $2.961
MSI           4835-7219   CHJ-219    Mental Health Kardex                                          04/90   White     8 - 9 3/4   EA        Index           $0.072
MSI           4835-7220   CHJ-220    Mental Health Kardex - Med. Insert                            04/90   White         8-5     EA        Index           $0.014
MSI           4835-7221   CHJ-221    Psychological Screening - Pages 1 & 2                         05/90            8 1/2 - 11   PD          100           $2.559
MSI           4835-7222   CHJ-222    Psychological Screening - Page 3                              05/90            8 1/2 - 11   PD          100           $2.358
MSI/ELEC      4835-7223   CHJ-223    Confidentiality/Privileged Communication                      01/06   white    8 1/2 - 11   PD          100           $2.559
MSI           4835-7224   CHJ-224    Age - Appropriate Prevention Services                         12/92   White    8 1/2 - 14   EA        Index           $0.058
MSI/ELEC      4835-7225   CHJ-225    HIV Counseling - Negative Results                             08/90            8 1/2 - 11   ST            2           $0.058
OBS           4835-7226   CHJ-226    Outpatient Diabetic Flow Sheet (OBSOLETE)
MSI           4835-7227   CHJ-227    Amendment of Health Record Documentation                      02/91            8 1/2 - 11   PD          100           $2.358
MSI           4835-7228   CHJ-228    Mentally Ill - Discharge/Transfer Tracking                    06/91            8 1/2 - 11   PD          100           $2.358
MSI           4835-7229   CHJ-229    Facsimile Cover Letter                                        12/97            8 1/2 - 11   PD          100           $2.358
MSI           4835-7230   CHJ-230    Durable Power of Attorney for Health Care - Booklet           02/96            8 1/2 - 11   EA           BK           $0.072
OBS           4835-7231   CHJ-231    Point of Entry Screening (OBSOLETE)
OBS           4835-7232   CHJ-232    Arrival Screening (OBSOLETE)
ELECT         4835-7233   CHJ-233    Durable Power of Attorney - Page 1, 2, 3                      10/07            8 1/2 - 11
OBS           4835-7234   CHJ-234    Durable Power of Attorney - Page 2(CHJ -233 replaced this)    10/92            8 1/2 - 11
OBS           4835-7235   CHJ-235    Durable Power of Attorney - Page 3(CHJ-233 replaced this)     10/92            8 1/2 - 11
ELECT         4835-7236   CHJ-236    Acceptance of Patient Advocate Designation - Page 1           10/07            8 1/2 - 11
OBS           4835-7237   CHJ-237    Acceptance of Patient Advocate Designation - Page 2           10/94            8 1/2 - 11
MSI           4835-7238   CHJ-238    Crisis Stabilization Unit Referral                            09/92            8 1/2 - 11   PD          100           $2.559
MSI           4835-7239   CHJ-239    Combined Point of Entry and Arrival Screening                 12/92            8 1/2 - 11   PD          100           $2.358
MSI           4835-7240   CHJ-240    Certificate of Destruction                                    07/96            8 1/2 - 11   PD          100           $2.358
MSI           4835-7241   CHJ-241    County/State Medical Transfer Record                          05/05 NCR        8 1/2 - 11   ST            2           $0.058

  2/24/2012                                                                                                                                        80 of 267   CHJ
           CHJ                                    MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                              QTY /
                                                                                                                                      Unit of Unit or
  Vendor        Comm#     Form#                                    Title/Description                     Rev.    Color    Size
                                                                                                                                       Issue *Special
                                                                                                                                              Paper
MSI           4835-7242   CHJ-242   CSU Initial Assessment/Treatment Plan                                11/92           8 1/2 - 11   PD           100        $2.559
MSI/ELEC      4835-7243   CHJ-243   Tuberculosis Summary Record - Employees                              07/05 white     8 1/2 - 11   PD           100        $2.358
MSI           4835-7244   CHJ-244   Special Accommodation Notice                                         05/03           8 1/2 - 11   ST              4       $0.115
MSI           4835-7245   CHJ-245   Employee TB Screening Program                                        01/93           8 1/2 - 11   PD           100        $2.358
MSI           4835-7246   CHJ-246   Mental Health Referral/Evaluation Data Entry                         04/97           8 1/2 - 11   PD           100        $2.358
MSI           4835-7247   CHJ-247   Outpatient Pre-OP Assessment                                         10/94           8 1/2 - 11   PD           100        $2.358
MSI           4835-7248   CHJ-248   NIDDM Education Standards                                            07/02           8 1/2 - 11   PD           100        $2.961
MSI           4835-7249   CHJ-249   Confidentiality Statement                                            04/93           8 1/2 x 11   PD           100        $2.358
MSI           4835-7250   CHJ-250   General Flow Sheet B                                                 06/93           8 1/2 - 11   SH                      $0.043
MSI           4835-7251   CHJ-251   Notice of Sex Offender Program Screening                             10/93           8 1/2 - 11   ST              4       $0.101
MSI           4835-7252   CHJ-252   Social Assessment Addendum                                           09/93           8 1/2 - 11   SH                      $0.014
MSI           4835-7253   CHJ-253   Discharge Disposition (72-Hour Evaluation Only)                      11/93           8 1/2 - 11   PD           100        $2.358
MSI           4835-7254   CHJ-254   Medication Teaching                                                  10/93           8 1/2 - 11   PD           100        $2.358
MSI           4835-7255   CHJ-255   Patient Teaching                                                     02/94           8 1/2 - 11   PD           100        $2.358
MSI           4835-7256   CHJ-256   Immunizations                                                        05/96 white     8 1/2 - 11   PD           100        $2.358
MSI           4835-7257   CHJ-257   Inpatient Medication Administration Record                           10/94           8 1/2 - 11   PD           100        $2.559
MSI           4835-7258   CHJ-258   Daily Nursing Assessment and Care                                    10/94           8 1/2 - 11   PD           100        $2.559
MSI           4835-7259   CHJ-259   Nursing Patient Care Plan                                            10/94           8 1/2 - 11   PD           100        $2.559
MSI           4835-7260   CHJ-260   Fall Risk Evaluation Sheet                                           10/94           8 1/2 - 11   PD           100        $2.358
MSI           4835-7261   CHJ-261   Nursing Admission (3 pages)                                          10/94           8 1/2 - 11   PD           100        $4.931
OBS           4835-7262   CHJ-262    Daily Clinic Log. (OBSOLETE)
MSI           4835-7263   CHJ-263   Hepatitis B Declination Form - Employee                              10/94           8 1/2 - 11 PD             100        $2.358
MSI           4835-7264   CHJ-264   Medical Opinion for Hepatitis B Vaccine - Employee                   10/94           8 1/2 - 11 PD             100        $2.358
ELECT         4835-7265   CHJ-265   Hepatitis B Vaccination Consent/Declination                          05/11
MSI/ELEC      4835-7267   CHJ-267   Health Care Contact Worksheet                                        01/06           8 1/2 - 11 PD             100        $2.358
MSI           4835-7268   CHJ-268   Response to Request for Health Record Information                    07/05 NCR       8 1/2 - 11 ST               2        $0.058
ELECT         4835-7269   CHJ-269   DNA Sample - Collection Record                                       08/09           8 1/2 - 11 ST               2        $0.058
MSI           4835-7270   CHJ-270   Tuberculosis Symptoms & Health Screening-Emp/Prisoners               04/96 white     8 1/2 - 11 PD             100        $2.559
MSI           4835-7271   CHJ-271   Pulmonary Clinic Flowsheet                                           09/99           8 1/2 - 11 PD             100        $2.358
MSI           4835-7272   CHJ-272   Pulmonary Clinic Database                                            08/02           8 1/2 - 11 ST               2        $0.058
OBS           4835-7273   CHJ-273   Seizure Clinic Flowsheet (OBSOLETE - Replaced by CHJ-538A)
MSI           4835-7274   CHJ-274   Neurology Clinic Database                                            08/02           8 1/2 - 11   ST             2        $0.058
MSI           4835-7275   CHJ-275   Diabetic Clinic Flowsheet                                            06/98           8 1/2 - 11   PD           100        $2.358
MSI           4835-7276   CHJ-276   Endocrine Clinic Database                                            08/02           8 1/2 - 11   ST             2        $0.058
MSI           4835-7277   CHJ-277   Gastrointestinal Clinic Flowsheet                                    09/99           8 1/2 - 11   PD           100        $2.358
MSI           4835-7278   CHJ-278   Gastrointestinal Clinic Database                                     08/02           8 1/2 - 11   ST             2        $0.058
MSI           4835-7279   CHJ-279   Cardiac/Hypertension Clinic Flowsheet                                06/98           8 1/2 - 11   PD           100        $2.358
MSI           4835-7280   CHJ-280   Cardiac/Hypertension Clinic Database                                 08/02           8 1/2 - 11   ST             2        $0.058
OBS           4835-7282   CHJ-282   Hepatitis B Vaccine Questionnaire (obsolete-replaced with CHJ-265)
MSI           4835-7283   CHJ-283   Infectious Disease Clinic Flowsheet                                  06/98           8 1/2 - 11 PD             100        $2.358
MSI           4835-7284   CHJ-284   Infectious Disease Clinic Database                                   08/02           8 1/2 - 11 ST               2        $0.058
OBS           4835-7286   CHJ-286   Reception Intake Processing Log (OBSOLETE - 03/02)
OBS           4835-7287   CHJ-287   Telephone Log (OBSOLETE)
                                                                                                               Green
MSI           4835-7288   CHJ-288   Inter-Institutional Transfer Log / 2-sided; spiral bound             01/97 Cvr       8 1/2 x 14 BK          100 pg        $3.766
MSI           4835-7289   CHJ-289   Urgent/Emergency Log                                                 01/97           8 1/2 - 14 PK             100        $4.931
  2/24/2012                                                                                                                                           81 of 267   CHJ
           CHJ                                   MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                                        QTY /
                                                                                                                                                Unit of Unit or
  Vendor        Comm#     Form#                                  Title/Description                                Rev.     Color    Size
                                                                                                                                                Issue *Special
                                                                                                                                                        Paper
                                                                                                                        Canary
MSI           4835-7290   CHJ-290   Grievance Log                                                                 02/97 Cvr        8 1/2 - 14 BK         100 pg           $3.766
                                                                                                                        Purple
MSI           4835-7291   CHJ-291   Telephone Log - DWH - ER                                                      02/97 Cvr        8 1/2 - 14 BK         100 pg           $3.766
OBS           4835-7292   CHJ-292   Segregation Log         (OBSOLETE)
MSI           4835-7293   CHJ-293   Specialty/Referral Log                                                                         8 1/2 x 11   PK          200           $4.600
MSI           4835-7294   CHJ-294   Kite Log (PK of 200 SH)                                                       01/97            8 1/2 - 14   PK          200           $4.931
MSI           4835-7295   CHJ-295   Laboratory Log (PK of 200 SH)                                                 01/97            8 1/2 - 14   PK          200           $4.931
MSI           4835-7296   CHJ-296   Medication Log F&B (PK of 200 SH)                                             06/97            8 1/2 - 14   PK          200           $4.931
MSI           4835-7297   CHJ-297   Ambulatory Clinic Appointments                                                01/97            8 1/2 - 11   PK          200           $4.931
MSI           4835-7298   CHJ-298   Telemedicine Log (PK of 200 SH)                                               03/99            8 1/2 - 11   PK          200           $3.939
MSI           4835-7300   CHJ-300   Psychiatric Report - Proposed Plan of Service                                 10/94            8 1/2 - 11   PD          100           $2.358
MSI           4835-7301   CHJ-301   Notice of Intent to Terminate Formal Voluntary Admission                      08/94            8 1/2 - 11   ST            3           $0.072
MSI           4835-7302   CHJ-302   Physician’s Certificate                                                       10/94            8 1/2 - 11   PD          100           $2.559
MSI           4835-7303   CHJ-303   Educational Assessment                                                        10/94            8 1/2 - 11   PD          100           $2.559
MSI           4835-7304   CHJ-304   Outpatient/Residential Mental Health Treatment Plan Review                    09/98            8 1/2 - 11   PD          100           $2.559
MSI           4835-7305   CHJ-305   Nursing Admission Assessment (4 pages)                                        02/00            8 1/2 - 11   PD          100           $5.520
ELECT         4835-7306   CHJ-306   Medical Assessment DCH ONLY                                                           ELECTR
MSI           4835-7307   CHJ-307   Comprehensive Psychiatric Examination                                         12/97            8 1/2 - 11   PD          100           $2.559
MSI           4835-7308   CHJ-308   Aftercare Instructions                                                        04/98            8 1/2 - 11   PD          100           $2.559
MSI           4835-7309   CHJ-309   Comprehensive Individual Treatment Plan                                       10/00            8 1/2 - 11   PD          100           $5.118
MSI           4835-7310   CHJ-310   Comprehensive Individual Treatment Plan - Continuation Page                   08/94            8 1/2 - 11   PD          100           $2.961
ELECT         4835-7311   CHJ-311   Notice of Hearing - PA 252                                                    10/07            8 1/2 - 11
ELECT         4835-7312   CHJ-312   Proof of Service - PA 252                                                     10/07            8 1/2 - 11
ELECT         4835-7313   CHJ-313   Proof of Non-Medication PA 252                                                10/07            8 1/2 - 11
ELECT         4835-7314   CHJ-314   Waiver of Involuntary Treatment Hearing PA 252                                10/07            8 1/2 - 11
ELECT         4835-7315   CHJ-315   Report and Order of Hearing Committee PA 252                                  10/07            8 1/2 - 11
ELECT         4835-7316   CHJ-316   Appeal of Hearing Committee Decision PA 252                                   10/07            8 1/2 - 11
                                    Psychiatrist Report of Determination of Continuing Need for Services PA
ELECT         4835-7317   CHJ-317   252                                                                           10/07            8 1/2 - 11
MSI           4835-7318   CHJ-318   Request for Consultation with Office of Recipient Rights                      10/98            8 1/2 - 11   ST            3           $2.358
ELECT         4835-7319   CHJ-319   Notice of Opportunity for Hearing - PA 252                                    10/07            8 1/2 - 11
MSI           4835-7320   CHJ-320   Report of QMHP of Continuing Need for Service                                 10/94            8 1/2 - 11   PD          100           $2.559
MSI           4835-7321   CHJ-321   Admission/Rights/Consent for Mental Health Treatment - PA 252                 08/98            8 1/2 - 11   PD          100           $2.559
MSI           4835-7322   CHJ-322   QMHP Report - PA 252                                                          08/94            8 1/2 - 11   PD          100           $2.358
MSI           4835-7323   CHJ-323   QMHP Report - Continuation Page                                               08/94            8 1/2 - 11   PD          100           $2.358
MSI           4835-7324   CHJ-324   Religious Interest Questionnaire                                              07/96            8 1/2 - 11   PD          100           $2.559

MSI           4835-7325   CHJ-325   Outpatient/Residential Mental Health Treatment Plan (5 pg. form / 1 PD ea.)   06/98            8 1/2 - 11   PD[s]       100           $2.358
MSI           4835-7326   CHJ-326   Nursing Annual Assessment Pg. 1-5                                             02/00 White      8 1/2 - 11   PD          100           $2.961
MSI           4835-7327   CHJ-327   Special Consent Behavior Management                                           12/98            8 1/2 - 11   PD          100           $2.559
MSI           4835-7329   CHJ-329   RTP Nursing Admission Assessment F&B                                          09/98            8 1/2 - 11   PD          100           $2.559
MSI           4835-7330   CHJ-330   Nursing Reassessment                                                          02/00            8 1/2 - 11   PD          100           $5.514
MSI           4835-7331   CHJ-331   RTP Admission Activity Therapy Assessment                                     08/98            8 1/2 - 11   PD          100           $2.961
MSI           4835-7332   CHJ-332   Mental Health Evaluation/Admission Referral                                   03/99            8 1/2 - 11   PD          100           $2.961
MSI           4835-7333   CHJ-333   Outpatient/Residential Mental Health Treatment Plan                           09/98            8 1/2 - 11   PD          100           $2.559

  2/24/2012                                                                                                                                                       82 of 267   CHJ
           CHJ                                    MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                                   QTY /
                                                                                                                                           Unit of Unit or
  Vendor        Comm#     Form#                                   Title/Description                            Rev.     Color    Size
                                                                                                                                            Issue *Special
                                                                                                                                                   Paper
MSI           4835-7334   CHJ-334    Notice of Advance Medical Directive                                       02/00 White      8 1/2 - 11 PD           100       $2.961
MSI           4835-7335   CHJ-335    Close Observation DCH                                                     10/00 White      8 1/2 - 11 PD           100       $3.349
                                     Request for Regional Medical Officer Approval of Off-Guidelines Special
PHOTO                     CHJ-337    Accommodations & Medical Details
MSI           4835-7338   CHJ-338    Arrival Screening Health-Trained Review                                   10/04   White     81/2 x 11    PD       100        $2.961
ELEC/MSI      4835-7339   CHJ-339    Individual Management Plan for Gender Identity Disorder                   01/05   white    8 1/2 X 11    PD       100        $2.358
MSI           4835-7340   CHJ-340    Pre-operative Checklist (DWH form)                                        04/06   NCR      8 1/2 x 11    ST         2        $0.058
ELEC/MSI      4835-7343   CHJ-343    Durable Medical Equipment Contract                                        09/05   NCR      8 1/2 x 11    ST         2        $0.058
ELECT         4835-7340   CHJ-345    Review Of Record Disclosure                                               06/06
ELECT         4835-7347   CHJ-347    Medical Acuity Index Worksheet                                            07/07
OBS           4835-7348   CHJ-348    Nursing Assessment/Protocol(2 page)                                       07/07
ELECT         4835-7349   CHJ-349    Pneumococcal vaccine Consent and Record                                   02/09            8 1/2 x 11
ELECT                     CHJ-350    Transfer Medication Receipt                                               01/11
ELECT                     CHJ-350A   Transfer Medication Receipt Addendum                                      01/11
ELEC/MSI      4835-7351   CHJ-351    Letter Hepatitis C Antibody Positive Results                              08/09 NCR        8 1/2 x 11               2        $0.058
ELEC/MSI      4835-7352   CHJ-352    Letter Hepatitis C Antibody Negative Results                              08/09 NCR        8 1/2 x 11    ST         2        $0.058
ELEC/MSI      4835-7353   CHJ-353    Letter Hepatitis C Antibody Indeterminate Results                         08/09 NCR        8 1/2 x 11    ST         2        $0.058
MSI           4835-7401   CHJ-401    Offsite Inpatient Log                                                     01/97 White      8 1/2 - 14    PK       200        $4.931
MSI           4835-7402   CHJ-402    X-Ray Log (Guidelines on back)                                            01/97 White      8 1/2 - 14    PK       200        $4.931
                                                                                                                     Rose
MSI           4835-7403   CHJ-403    Observation Log / 2-sided; spiral bound                                   01/97 Cvr        8 1/2 - 14 BK       100 pg        $3.766
ELEC          4835-7404   CHJ-404    Medication Tracking Record                                                04/11            8 1/2 - 11 PD          100        $2.358

ELEC          4835-7405   CHJ-405    Employee Request for HIV/HBV/HCV Testing of Potential Exposure Source     04/04
MSI/ELEC      4835-7406   CHJ-406    Discharge Parole Checklist (1-side, 2-hole top)                           08/09 White      8 1/2 - 11 PD          100        $2.961

MSI           4835-7407   CHJ-407    CMS Authorization Request (two-side; two-hole punch, top)                 11/04 White       8 1/2 - 11   PD       100        $2.961
MSI           4835-7408   CHJ-408    CMS Decision Form                                                         11/04 White      8 1/2 x 11    PD       100        $2.961
MSI           4835-7409   CHJ-409    CMS Specialty Consulting Report                                           11/04 White      8 1/2 x 11    PD       100        $2.961
PILOT                     CHJ-410    Notice of Emergency Dept. (ED) Visit                                            white      8 1/2 X 11
ELECT         4835-7412   CHJ-412    Post Exposure Source Information                                          04/04 white      8 1/2 X 11    PD       100        $2.358
ELECT         4835-7413   CHJ-413    Pre-Test Counseling and Consent for Pre-Release HIV & Hep C               06/08            8 1/2 X 11
MSI           4835-7414   CHJ-414    Code Blue Record                                                          06/97             8 1/2 - 11   PD       100        $2.961
ELECT         4835-7415   CHJ-415    Response, Employee request for Hiv/Hbv testing(exposed)                   04/04 NCR        8 1/2 X 11    ST         2        $0.058
MSI           4835-7416   CHJ-416    Tuberculosis Symptoms Health Screening Questionnaire(rec/int)             12/97 white       8 1/2 - 11   PD       100        $2.559
ELECT         4835-7417   CHJ-417    Potential Exposure Follow-Up                                              04/04
MSI           4835-7418   CHJ-418    Tuberculosis Summary Record-Prisoners                                     12/97 white      8 1/2 - 11    PD       100        $2.358
MSI           4835-7423   CHJ-423    Treatment Plan - Diabetes                                                 09/99            8 1/2 - 11    PD       100        $2.961
MSI           4835-7424   CHJ-424    Treatment Plan - Seizure Disorder                                         02/98            8 1/2 - 11    PD       100        $2.961
MSI           4835-7425   CHJ-425    Treatment Plan - Cardiovascular Disease                                   02/98            8 1/2 - 11    PD       100        $2.961
MSI           4835-7426   CHJ-426    Treatment Plan - Gastrointestinal Disease                                 02/98            8 1/2 - 11    PD       100        $2.961
MSI           4835-7427   CHJ-427    Treatment Plan - Infectious Disease                                       02/98            8 1/2 - 11    PD       100        $2.961
MSI           4835-7428   CHJ-428    Treatment Plan - Pulmonary Disease                                        02/98            8 1/2 - 11    PD       100        $2.961
MSI           4835-7431   CHJ-431    Mortality Review Tracking Form                                            02/00            8 1/2 - 11    PD       100        $2.358
PHOTO         4835-7432   CHJ-432    Reg./Hospital Nursing Mortality (photocopy only) ELECTRONIC               10/05
MSI           4835-7433   CHJ-433    Ambulatory Instrument Pick-up                                             04/98            8 1/2 - 11 ST            4

  2/24/2012                                                                                                                                               83 of 267   CHJ
           CHJ                                   MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                                           QTY /
                                                                                                                                                   Unit of Unit or
  Vendor        Comm#     Form#                                   Title/Description                               Rev.     Color       Size
                                                                                                                                                    Issue *Special
                                                                                                                                                           Paper
MSI           4835-7434   CHJ-434   Clinic Flowsheet                                                              06/98              8 1/2 - 11    PD           100        $2.358
ELECT         4835-7435   CHJ-435   Potential Exposure Incident Investigation                                     04/04 NCR          8 1/2 x 11    ST              3       $0.072
ELECT         4835-7436   CHJ-436   Offsite Health Care Provider Information                                      04/04 NCR          8 1/2 x 11    ST              2       $0.058
MSI           4835-7437   CHJ-437   Discharge Plan - Tuberculosis                                                 09/99              8 1/2 - 11    ST              3       $0.072
MSI           4835-7439   CHJ-439   Uniform Reporting System (URS) - Client Data Summary for MDOC                 06/98              8 1/2 - 11    ST              2       $0.058
MSI           4835-7440   CHJ-440   Uniform Reporting System (URS) - Activity Update Log for MDOC                 07/98              8 1/2 - 11    ST              2       $0.058
ELECT         4835-7446   CHJ-446   Guidelines for Universal/Standard Precautions - Health Care Staff             07/08              8 1/2 - 11

MSI           4835-7447   CHJ-447   Guidelines for Universal/Standard Precautions - Custody/Non-Health Care       03/99              8 1/2 - 11 ST                2        $0.058
MSI           4835-7449   CHJ-449   Dental Exam & Treatment                                                       03/00 White        8 1/2 - 11 PD              100        $2.961
OBS           4835-7450   CHJ-450   Community Health Care Referral                                                03/99              8 1/2 - 11 ST                4        $0.115
                                    Responsibility Determination for Reimbursement: Medical Cost of Self-
MSI/ELEC      4835-7451   CHJ-451   Injurious Behavior                                                            12/07              8 1/2 - 11 ST                2        $0.072
ELECT         4835-7452   CHJ-452   Influenza Vaccine Consent                                                     11/07              8 1/2 - 11 PD              100        $2.358
                                    Prisoner Acknowledgement of the Consequences of Refusing Food and/or
ELECT     4835-7459       CHJ-459   Liquid                                                                        11/07
MSI/ELECT 4835-7460       CHJ-460   Chronic Hepatitis "C" Treatment Evaluation Worksheet                          07/08              8 1/2 - 11 PD              100        $2.358
          4835-7461       CHJ-461   Hepatitis A Vaccine Consent                                                   09/99              81/2 x 11 PD               100        $2.358

MSI           4835-7464   CHJ-464   Intake Screening for History of Sexual or Physical Abuse; 2-hole punch, top   10/99   White       8 1/2 - 11   PD           100        $2.961
MSI           4835-7465   CHJ-465   HIV Positive Post-Text Counseling                                             01/00   NCR         8 1/2 - 11   ST             2        $0.072
MSI           4835-7470   CHJ-470   Dental Intake Examination                                                     03/00   White       8 1/2 - 11   PD           100        $2.961
ELECT                     CHJ-471   Hep C Treatment Flow Sheet Genotype 1, 4, 6                                   01/05   white        8 1/2 11    PD           100        $2.358
ELECT                     CHJ-472   Hep C Treatment Flow Sheet Genotype 2, 3                                      01/05   white      8 1/2 X 11    PD           100        $2.358
MSI           4835-7500   CHJ-500   Health Records for Transfer                                                   01/90               8 1/2 - 11   ST             2        $0.058
MSI           4835-7501   CHJ-501   Onsite Inpatient Log                                                          12/89               8 1/2 - 11   PD           100        $2.358
                                                                                                                                       5 1/2 - 8
MSI           4835-7502   CHJ-502   Physical Therapy Detail Request                                               11/89                      1/2   PD           100        $1.179
MSI           4835-7503   CHJ-503   Request For Health Records - Log                                              10/94 white         8 1/2 - 11   PD           100        $2.358
MSI           4835-7504   CHJ-504   Specialty Clinic Report                                                       07/89               8 1/2 - 11   PD           100        $2.358
MSI           4835-7505   CHJ-505   Medication Incident                                                           03/97               8 1/2 - 11   ST             4        $0.101
MSI           4835-7506   CHJ-506   Adverse Drug Reaction                                                         05/90               8 1/2 - 11   ST             3        $0.072
MSI           4835-7507   CHJ-507   Daily Census Sheet                                                            01/90               8 1/2 - 11   PD           100        $2.358
MSI           4835-7508   CHJ-508   Report of Patient’s Condition and Nursing Unit Activities                     01/90               8 1/2 - 14   PD           100        $2.760
MSI           4835-7509   CHJ-509   X-Ray File Card                                                               01/90 White              3-5     EA         Index        $0.014
MSI           4835-7510   CHJ-510   Medical Appointment Summary                                                   01/90               8 1/2 - 11   PD           100        $2.358
MSI           4835-7511   CHJ-511   Appointment Card                                                              01/90 White              3-5     EA         Index        $0.014
                                                                                                                                       4 1/4 - 5
MSI           4835-7512   CHJ-512   Property Release                                                              01/90                      1/2   PD           100        $1.179
MSI           4835-7513   CHJ-513   You and Your Teeth                                                            10/91               8 1/2 - 11   PD           100        $2.358
                                                                                                                                       4 1/4 - 5
MSI           4835-7514   CHJ-514   Office of the Physician (MCF Lay-In-Only)                                     10/85                      1/2   PD           100        $1.179
MSI           4835-7515   CHJ-515   Daily Non-Compliance Record                                                   01/90               8 1/2 - 11   ST             2        $0.058
MSI           4835-7516   CHJ-516   Laundry Roster                                                                01/90               8 1/2 - 11   ST             2        $0.058
MSI           4835-7517   CHJ-517   Meal Request                                                                  10/85            4 1/4 - 5- 11
                                                                                                                                      8 1/2        PD           100        $2.559
MSI           4835-7518   CHJ-518   Eye Glass Prescription                                                        10/85            1/2             PD           100        $1.185

  2/24/2012                                                                                                                                                        84 of 267   CHJ
           CHJ                                        MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                                          QTY /
                                                                                                                                                  Unit of Unit or
  Vendor        Comm#      Form#                                       Title/Description                            Rev.     Color    Size
                                                                                                                                                   Issue *Special
                                                                                                                                                          Paper
MSI           4835-7519    CHJ-519       Hospital Admitting Slip                                                    01/90                 3-5     ST              3       $0.014
MSI           4835-7520    CHJ-520       Patient Index Card                                                         09/90   White         4-6     EA        Index         $0.014
MSI           4835-7521    CHJ-521       Medication Card - T. I. D.                                                 01/90   Yellow    3 1/2 - 2   EA        Index         $0.046
MSI           4835-7522    CHJ-522       Medication Card - BID                                                      01/90   Pink      3 1/2 - 2   EA        Index         $0.043
MSI           4835-7523    CHJ-523       Medication Card - HS                                                       01/90   White     3 1/2 - 2   EA        Index         $0.043
MSI           4835-7524    CHJ-524       Medication Card - QID                                                      01/90   Green     3 1/2 - 2   EA        Index         $0.043
MSI           4835-7525    CHJ-525       Medication Card - Daily                                                    01/90   Blue      3 1/2 - 2   EA        Index         $0.043
OBS           4835-7526    CHJ-526       Request for Health Care Report (OBSOLETE)
OBS           4835-7527    CHJ-527       Req.for Notif.of Info. Sys. (OBSOLETE)
MSI           4835-7528    CHJ-528       Archive Locator Card                                                       10/90   White     5 1/2 - 8   EA         Index        $0.014
MSI           4835-7529    CHJ-529       Mental Health Inpatient Progress Notes                                     08/94   White    8 1/2 - 11   SH                      $0.043
MSI           4835-7530    CHJ-530       Notice of Mental Health Services                                           01/97            8 1/2 - 11   ST             5        $0.115
MSI           4835-7531    CHJ-531       Pre-Admission and Discharge Room Check                                     05/93   White    8 1/2 - 11   PD           100        $2.358
MSI           4835-7532    CHJ-532       Quality Improvement Mortality/Morbidity Review                             01/08   White    8 1/2 - 11   PD           100        $2.358
MSI           4835-7533    CHJ-533       Dental Monthly Review                                                      08/97   White    8 1/2 - 11   PD           100        $2.961
MSI           4835-7534    CHJ-534       Dental Daily Report                                                        08/97   White    8 1/2 - 11   PD           100        $2.961
MSI           4835-7535    CHJ-535       Daily Census                                                               08/90   White    8 1/2 - 11   PD           100        $2.358
MSI           4835-7536    CHJ-536       Admittance and Discharge Report                                            08/90   White         4-4     PD           100        $1.179

PHOTO         4835-7537    CHJ-537       Reg/Hospital Med. Directory. Mortality Review Summary (Photocopy only)     03/02
MSI           4835-7538    CHJ-538A      Chronic Care Flowsheet                                                     08/02            8 1/2 - 11   ST             2        $0.058
MSI           4835-8538    CHJ-538B      Chronic care Clinic Follow up form                                         08/02            8 1/2 - 11   ST             2        $0.058
                                                                                                                                      5 1/2 - 8
MSI           4835-7539    CHJ-539       Prosthetics Prescription - Camps                                           05/90                   1/2   ST             3        $0.043
MSI           4835-7540    CHJ-540       Narcotics Count Register                                                   10/85 White      8 1/2 - 11   PD           100        $2.358
MSI           4835-7541    CHJ-541       Inpatient Consultation Request/Report                                      10/93            8 1/2 - 11   ST             2        $0.058
MSI           4835-7542    CHJ-542       Infirmary Work Sheet                                                       01/90 White      8 1/2 - 14   PD           100        $3.939
MSI           4835-7543    CHJ-543       Mental Health Progress Notes                                               09/93 White      8 1/2 - 11   PD           100        $2.358
                                                                                                                                      6 3/4 - 7
MSI           4835-7544    CHJ-544       Dental Prosthetic Form                                                     01/90                   1/2   ST             5        $0.101
MSI           4835-7545    CHJ-545       Patient Index Cards                                                        12/89 Blue            3-5     EA         Index        $0.014
                                                                                                                                      5 1/2 - 8
MSI           4835-7546    CHJ-546       Full Dentures                                                              01/90 Green             1/2   PD            100       $1.179
MSI           4835-7547    CHJ-547       Notification to Health Care of Proposed Prisoner Transfer                  09/96 White      8 1/2 - 11   PD            100       $2.358
MSI           4835-7549    CHJ-549       Health Care Request                                                        11/05 NCR        8 1/2 - 11   ST      3 pt NCR        $0.110

MSI           4835-7549P   CHJ-549 Pilot Pilot Health Care Request (Only to be used at JCS)Perf page 2 at the top   03/08 NCR        8 1/2 - 11   ST             3        $0.138
MSI/ELEC      4835-7550    CHJ-550       Case Management Discharge                                                  11/07            8 1/2 - 11   ST             3        $0.072
MSI           4835-7551    CHJ-551       Segregation Psychological Screening                                        09/99            8 1/2 - 11   ST             2        $0.058
                                                                                                                                      5 1/2 - 8
MSI           4835-7552    CHJ-552       Clinic Call-Out List                                                       01/90                   1/2   ST             3        $0.072
MSI           4835-7553    CHJ-553       Infection Surveillance Monthly Review (4 Pages)                            01/90 Yellow     8 1/2 - 11   SH                      $0.046
OBS           4835-7554    CHJ-554       Infection Surveillance Quarterly Review (OBSOLETE:4/16/02)
MSI           4835-7555    CHJ-555       CQI/Critical Incident Report Review                                        08/98 White      8 1/2 - 11 PD             100        $2.358

MSI~ELECT 4835-7556        CHJ-556       Medical Detail                                                             06/90            8 1/2 - 11 ST               5        $0.115

  2/24/2012                                                                                                                                                       85 of 267   CHJ
          CHJ                                    MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                      QTY /
                                                                                                                              Unit of Unit or
 Vendor         Comm#     Form#                                  Title/Description              Rev.     Color    Size
                                                                                                                               Issue *Special
                                                                                                                                      Paper
MSI           4835-7558   CHJ-558   X-Ray File Card                                             01/90   White         3-5     EA        Index         $0.014
MSI           4835-7559   CHJ-559   Diabetic Flow Sheet                                         09/97   White    8 1/2 - 11   PD           100        $2.559
MSI           4835-7560   CHJ-560   Release from Responsibility/ Cardiovascular                 07/00            8 1/2 - 11   PK/25           2       $0.058
MSI           4835-7561   CHJ-561   Drug Distribution Card                                      09/89   Green        10 - 6   EA        Index         $0.058
MSI           4835-7562   CHJ-562   Release from Responsibility/ Endocrine                      07/00            8 1/2 - 11   ST              2       $0.058
MSI           4835-7563   CHJ-563   Treatment/Management Recommendations Aftercare Plan         01/90   White    8 1/2 - 11   PD           100        $2.358
MSI           4835-7564   CHJ-564   Release from Responsibility/ Gastrointestinal               07/00            8 1/2 - 11   ST              2       $0.058
MSI           4835-7565   CHJ-565   Seizure Report                                              12/89   White    8 1/2 - 11   PD           100        $2.358
OBS           4835-7566   CHJ-566   Comprehensive Care Unit Rules (OBSOLETE)
MSI           4835-7567   CHJ-567   Medical Care Evaluation - Audit Criteria - Page 1           10/91   White    8 1/2 - 11   PD           100        $2.358
MSI           4835-7568   CHJ-568   Medical Care Evaluation - Audit Criteria - Page 2           10/91   White    8 1/2 - 11   PD           100        $2.358
MSI           4835-7569   CHJ-569   Medical Care Evaluation - Audit Criteria - Page 3           10/91   White    8 1/2 - 11   PD           100        $2.358
MSI           4835-7570   CHJ-570   Medical Care Evaluation - Audit Criteria - Page 4           10/91   Yellow   8 1/2 - 11   PD           100        $2.358
MSI           4835-7571   CHJ-571   Medical Care Evaluation - Audit Criteria - Page 5           10/91   White    8 1/2 - 11   PD           100        $2.358
MSI           4835-7575   CHJ-575   Prisoner Insurance Information                              01/97   White    8 1/2 - 11   PD           100        $2.961
MSI           4835-7576   CHJ-576   Immunization Records & Consent                              05/97   White    8 1/2 - 11   PD           100        $2.358
MSI           4835-7577   CHJ-577   Permission for Dental Treatment                             05/97            8 1/2 - 11   ST             2        $0.058
MSI           4835-7578   CHJ-578   Juvenile Intake Screening                                   01/97   White    8 1/2 - 11   PD           100        $2.559
MSI           4835-7579   CHJ-579   Dental Prosthetics Log                                      01/97   White    8 1/2 - 14   PK           200        $4.931
MSI           4835-7580   CHJ-580   Dental Kite Log                                             01/97   White    8 1/2 - 14   PK           200        $4.931
MSI           4835-7581   CHJ-581   Dental Daily Log                                            01/97   White    8 1/2 - 14   PK           200        $4.931
MSI           4835-7582   CHJ-582   Dental Instrument Inventory Log                             01/97   White    8 1/2 - 14   PK           200        $4.931
MSI           4835-7583   CHJ-583   Dental Needle Inventory Log                                 01/97   White    8 1/2 - 11   SH           200        $0.014
MSI           4835-7584   CHJ-584   Dental Blade Inventory Log                                  01/97   White    8 1/2 - 11   SH           200        $0.014
MSI           4835-7585   CHJ-585   Dental Offsite Referral Log                                 01/97   White    8 1/2 - 14   SH           200        $0.014
MSI           4835-7587   CHJ-587   Biological Monitoring for Steam Sterilizers Log             01/97   White    8 1/2 - 11   SH           200        $0.014
MSI           4835-7588   CHJ-588   Release from Responsibility/ Infectious                     07/00            8 1/2 - 11   ST             2        $0.058
MSI           4835-7589   CHJ-589   Release from Responsibility/ Pulmonary                      07/00            8 1/2 - 11   ST             2        $0.058
MSI           4835-7590   CHJ-590   Release from Responsibility/ Neurology                      07/00            8 1/2 - 11   ST             2        $0.058
MSI           4835-7591   CHJ-591   Disability Clinic Flowsheet (2 sided)                        1/01            81/2 x 11    PD           100        $2.961
ELECT         4835-7598   CHJ-598   Electronic only - call Sue Coley @ BHC in Lansing
MSI           4835-7601   CHJ-601   Disability Clinic Database                                  02/01            8 1/2 - 11   PD           100        $2.961
MSI           4835-7602   CHJ-602   Disability Chronic Care- Chronic Care Follow-up (2-sided)   01/01            8 1/2 - 11   PD           100        $2.961
MSI           4835-7603   CHJ-603   Pulmonary Chronic Care Follow-up                            08/02            8 1/2 - 11   ST             2        $0.058
MSI           4835-7604   CHJ-604   Endocrine Chronic Care Follow-up                            08/02            8 1/2 - 11   ST             2        $0.058
MSI           4835-7605   CHJ-605   Gastrointestinal Chronic Care Clinic                        08/02            8 1/2 - 11   ST             2        $0.058
MSI           4835-7606   CHJ-606   Cardiovascular Chronic Care Clinic                          08/02   NCR      8 1/2 - 11   ST             2        $0.058
MSI           4835-7607   CHJ-607   Infectious Disease Follow-up                                08/02   NCR      8 1/2 - 11   ST             2        $0.058
MSI           4835-7608   CHJ-608   Neurologic Chronic Care Clinic                              08/02   NCR      8 1/2 - 11   ST             2        $0.058
MSI           4835-7615   CHJ-615   Mental Health Group Progress Notes                          02/01   white    8 1/2 - 11   PD           100        $2.358
ELECT                     CHJ-618   Reception Center Psychological Basic Information Sheet      03/02
ELECT                     CHJ-619   Reception Center Psychological Report                       03/02
ELECT                     CHJ-620   Therapy Nonadmission Report Confidential                    03/02
ELECT                     CHJ-621   Therapy Admission Report Confidential                       03/02
ELECT                     CHJ-622   Monthly Therapy Progress Note Confidential                  03/02
ELECT                     CHJ-623   Therapy Termination Report Confidential                     03/02

  2/24/2012                                                                                                                                   86 of 267   CHJ
           CHJ                                   MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                                  QTY /
                                                                                                                                          Unit of Unit or
  Vendor        Comm#     Form#                                  Title/Description                            Rev.    Color      Size
                                                                                                                                           Issue *Special
                                                                                                                                                  Paper
MSI           4835-7624   CHJ-624   Pris. Med. reorder form                                                   01/02 NCR        8 1/2 x 11 ST              3        $0.072
OBS           4835-7626   CHJ-626   Pre-Release ALT - OBSOLETE
PHOTO                     CHJ-627   Cognitive Assessment                                                      03/03
PHOTO                     CHJ-628   Extended Care Activity Assessment                                         03/03
ELECT         4835-7629   CHJ-629   EMR Log on Request Form                                                   03/11
                                    Hepatitis C Antibody Positive Post-Test Counseling Verification; 2-hole
MSI/ELEC      4835-7630   CHJ-630   punch, top                                                                08/03 NCR        8 1/2 - 11 ST     2 pt NCR          $0.069
                                    Hepatitis C Antibody Negative Post-Test Counseling Verification; 2-hole
MSI/ELEC      4835-7631   CHJ-631   punch, top                                                                08/03 NCR        8 1/2 - 11 ST     2 pt NCR          $0.069
ELECT                     CHJ-632   Psychosocial Rehabilitation Program -- CITP Intervention                  06/03
ELECT                     CHJ-633   Huron Valley Center Educational Assessment                                06/03
ELECT                     CHJ-634   Physician's Note for Seclusion/Restraint Order                            06/03
ELECT                     CHJ-635   Physician's Order for Seclusion and/or Restraint                          06/03
ELECT                     CHJ-636   Nursing Incidental Pain Assessment                                        06/03
ELECT                     CHJ-637   Nursing Modified Hendrich Fall Risk Assessment                            06/03
ELECT                     CHJ-638   Nursing Patient/Prisoner Teaching Record                                  06/03
MSI           4835-7639   CHJ-639   Viral Hepatitis Clinic Database; 2-hole punch, top                        08/03 W; C       8 1/2 - 11 ST     2 pt NCR          $0.058
MSI           4835-7640   CHJ-640   Viral Hepatitis Chronic Care Clinic Follow-Up Form; 2-hole punch, top     08/03 W; C       8 1/2 - 11 ST     2 pt NCR          $0.058
ELECT         4835-7642   CHJ-642   Non-Preferred Psychotropic Medication Review (HURON VALLEY CTR            12/05

MSI           4835-7643   CHJ-643   Pain Management Committee Patient History (2 side)                        10/04   White   8 1/2 x 11   PD       100         $2.961
                                    Pain Management Committee Pain Assessment (4pg) ONE SET = 1 PD pg                                             100/pd
MSI           4835-7644   CHJ-644   1-2 & 1 PD pg 3-4; 2 pds total                                            10/04   White   8 1/2 x 11   PD      2 pds        $5.923

                                    Pain Management Committee Patient Physical Exam (10 pages) 1 pad                                              100/pd
MSI/ELEC      4835-7645   CHJ-645   each of page 1, 2, 3, 4, 5, 6, 7, 8, 9, 10     10 pads total              08/05   White   8 1/2 x 11   ST     10 pds        $2.358
MSI           4835-7646   CHJ-646   Diagnostic Testing Result Notification                                    10/04   NCR     8 1/2 x 11   ST        2          $0.058
ELECT         4835-7647   CHJ-647   HVC Nutrition Assessment (HURON VALLEY CTR ONLY)
                                    Psychosocial Rehab Program - Progress Note (HURON VALLEY CTR
ELECT         4835-7648   CHJ-648   ONLY)
                                    Physician's Order for Patient/Prisoner on Security Admission Precaution
ELECT         4835-7649   CHJ-649   (HURON VALLEY CTR ONLY)

ELECT         4835-7651   CHJ-651   Incidental Pain Assessment (HURON VALLEY CTR ONLY)

ELECT         4835-7652   CHJ-652   Patient/Prisoner Management Preferences (HURON VALLEY CTR ONLY)
                                    Nursing Seclusion and/or Restraint Termination Note (HURON VALLEY
ELECT         4835-7653   CHJ-653   CTR ONLY)
MSI           4835-7654   CHJ-654   Emergency Treatment Medical MSP (DWH form)                                11/04   NCR     8 1/2 x 11   ST        2          $0.058
                                    Release of Responsibility for MDOC Diabetes Education        Self-
ELECT         4835-7655   CHJ-655   Management Program                                                        05/06

MSI           4835-7656   CHJ-656   Symptom Distribution Diagram                                              11/04   NCR     8 1/2 x 11   ST        2          $0.058

ELECT         4835-7657   CHJ-657   Health Work Assignment Clearance (2-sided/food service)                   06/05   NCR     81/2 X 11    ST        4          $0.144


  2/24/2012                                                                                                                                                87 of 267   CHJ
           CHJ                                   MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                                QTY /
                                                                                                                                        Unit of Unit or
  Vendor        Comm#     Form#                                  Title/Description                          Rev.    Color     Size
                                                                                                                                        Issue *Special
                                                                                                                                                Paper

MSI           4835-7658   CHJ-658   Physician Orders For Life-Sustaining Treatment(Pages 1 & 2)             07/05   NCR     81/2 X 11    ST       2            $0.144
dmb/dch                   CHJ-803   Hiv/Aids booklet (see memo)
                                                                                                                              5 1/2 x 8
MSI/ELEC      4835-7804   CHJ-804   Inmate Infection Control Guidelines(5 pages plus cover on blue index)   09/06 white             1/2 BK                        $0.150
MSI           4835-7802   DCH-675   Important Health Information Booklet                                    05/02 White     8 1/2 X 11 BK                         $0.288
ELECT                     CHJ-676   Emergency Box/Physician Dispensing Box Medication Removal/Addition
ELECT                     CHJ-677   Dentist Box Inventory                                                   03/11
ELECT                     CHJ-678   Physician Box Inventory                                                 03/11
ELECT                     CHJ-679   Emergency Medication Box Inventory
ELECT                     CHJ-680   Seal Log
ELECT                     CHJ-681   Box Inspection Form
ELECT                     CHJ-682   Seal Inventory Count Log
ELECT                     CHJ-683   HUM/NSG Supervisor Controlled Substance Master Inventory
ELECT                     CHJ-684   Controlled Substance/High Cost Medication Count Sheet                   03/11
ELECT                     CHJ-685   Medication Disposal Log
ELECT                     CHJ-686   Emergency Bag Inventory and Count
ELECT                     CHJ-687   Non-Disposable Critical Tools Inventory
ELECT                     CHJ-688   Removal and Return of Non-Disposable Critical Tool Log
ELECT                     CHJ-689   Disposable Critical Tool Inventory
ELECT                     CHJ-690   High Cost Medication Count Log
ELECT                     CHJ-691   Controlled Substance Count Log
ELECT                     CHJ-692   Critical Tool Count Log
ELECT                     CHJ-693   AMERICAN BIO MEDICA CORP ORDER FORM                                     08/09




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2/24/2012   90 of 267   CHJ
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2/24/2012   99 of 267   CHJ
           CAH                                     MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                      Unit QTY /
                                                                                                                                       of   Unit
Vendor              Comm#       Form#                              Title/Description                    Rev.    Color     Size
                                                                                                                                      Issu   or
                                                                                                                                        e *Spec
OBS               4835-0100   CAH-100   Tobacco-Free Housing                                            11/04   NCR     8 1/2 - 11    ST     ial 4     $0.101
MSI               4835-1104   CAH-104   Room Roster                                                     09/89           8 1/2 - 11    SH               $0.014
MSI               4835-0108   CAH-108   Report on Menu Changes                                          07/84   white   8 1/2 - 11    PD      100      $2.358
MSI               4835-0111   CAH-111   Intra-Institutional Moves                                       08/89           8 1/2 - 11    PD      100      $2.358
MSI               4835-0127   CAH-127   Substance Abuse Pilot Project Admission Document                08/89           8 1/2 - 11    ST         2     $0.058
                                                                                                                         3 1/4 - 6
MSI               4835-0130   CAH-130   GENERIC INSPECTION TAG                                          03/04   Green          1/4 EA       Index      $0.219
ELECT             4835-0135   CAH-135   PROJECT REVIEW AND APPROVAL                                     04/08
MSI               4835-0136   CAH-136   MDOC Sheriff's Questionnaire for Delivered Prisoners            12/09
ELECT             4835-0137   CAH-137   Call or Writ                                                    02/10
MSI               4835-0140   CAH-140   Motivational Cards                                              07/03             3 1/2 - 2   ST     47/st   $12.003
MSI               4835-0141   CAH-141   "LEDGE" Training Brochure                                       08/03   White    8 1/2 - 11   EA      80#     $0.359
MSI                           CAH-144   Prisoner Program Survey - (for JCF)                             11/05   white   8 1/2 X 11    BK              $0.092
MSI               4835-1146   CAH-146   Trip Sheet-MDOC                                                 11/99   White    8 1/2 - 11   PD      100     $2.358
ELECT             4835-1147   CAH-147   MDOC Hazard Communication Program Contractor Info Statement     01/08

ELECT             4835-0159   CAH-159   Hazardous Material Inventory Checklist (Formerly CAJ-159)       12/99
ELECT             4835-1160   CAH-160   Inventory of Hazardous Material                                 04/07
MSI               4835-1161   CAH-161   Inventory of Hazardous Material ( weekly )                      10/99   NCR      8 1/2 - 11 ST          2      $0.058
ELECT             4835-1162   CAH-162   Daily Inventory of Hazardous Material                           04/07           8 1/2 X 11
OBS               4835-1163   CAH-163   Hazardous Material Weekly Verification                          12/99
ELECT             4835-1164   CAH-164   Confined Space Entry Permit                                     04/07           8 1/2 X 11
ELECT             4835-1165   CAH-165   Confined Space Identification Matrix                            04/07           8 1/2 X 11
ELECT             4835-1166   CAH-166   Personal Protective Equipment Hazard Assessment Annual          04/07           8 1/2 X 11
ELECT             4835-1167   CAH-167   Certification                                                   04/07           8 1/2 X 11
ELECT             4835-1168   CAH-168   Contractor Checklist for Confined Space Entry                   04/07           8 1/2 X 11
ELECT                         CAH-170   Annual Fire Safety Inspection Checklist                         09/07
ELECT             4835-1171   CAH-171   Annual Safety Inspection Checklist                              10/07
ELECT             4835-0175   CAH-175   Fire Drill Log                                                  05/03
ELECT             4835-0180   CAH-180   Request for a New or Revised Form                               08/07
ELECT             4835-0181   CAH-181   Employee General Safety and Health Orientation Checklist        04/08
ELECT             4835-0182   CAH-182   Powered Industrial Truck (PIT) Equipment Inspection Checklist   04/08
ELECT             4835-0183   CAH-183   Powered Industrial Truck (PIT) Operator Skills Evaluation       04/08
ELECT             4835-0184   CAH-184   Respirator Fit Test Worksheet                                   10/08
ELECT             4835-0185   CAH-185   Respiratory Protection Training Certification                   04/08
ELECT             4835-0186   CAH-186   Driver's Weekly Truck Inspection Report                         04/08
ELECT             4835-0187   CAH-187   Pesticide Application Record                                    04/08
ELECT                         CAH-201   Consensus Interview Panel Rating Form                           08/04
ELECT                         CAH-202   Background Check Form                                           08/04
ELECT                         CAH-203   Background Check Form (Female Facilities Only)                  08/04
ELECT                         CAH-204   Final Applicant Pool Listing                                    08/04

      2/24/2012                                                                                                                            Page 100 of 267   CAH
           CAH                                     MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                         Unit QTY /
                                                                                                                                          of   Unit
Vendor              Comm#       Form#                              Title/Description                     Rev.    Color       Size
                                                                                                                                         Issu   or
                                                                                                                                           e *Spec
ELECT                         CAH-205   Appointment Approval Form                                        11/09                                  ial
ELECT                         CAH-206   Reference Authorization Form                                     11/09
ELECT                         CAH-207   Reference Check Form                                             01/10
MSI               4835-0272   CAH-272   Prisoner File Requisitions Processed                             04/84             8 1/2 - 11    PD     100       $2.358
msi / elect       4835-0280   CAH-280   Admission Document - Treatment Program Use                       05/07   NCR       8 1/2 - 11    ST       3       $0.069
MSI               4835-0300   CAH-300   Telephone Slip                                                                      4 1/4 - 7    SH               $0.014
MSI               4835-0312   CAH-312   Certification of Files and Records                               02/03   White     8 1/2 - 14    EA     20#       $0.101
MSI               4835-0320   CAH-320   Academic & Vocational Opportunities Brochure (RGC)               02/03   White     8 1/2 - 14    EA     20#       $0.101
County Jail                             Reimbursement for County Jail Reimbursement Program (Diverted
Serv. ELEC        4835-1334   CAH-334   Felons) E-Mailed to Users by County Jail Services ELECT. ONLY    10/05

                  4835-1334A CAH-334A

                  4835-1334B CAH-334B
                                                                                                                            5 1/2 - 8
MSI               4835-0342   CAH-342   Daily Check Sheet                                                05/88                    1/2 PD        100       $1.179
                                                                                                                            5 1/2 - 8
MSI               4835-0343   CAH-343   Daily Check Sheet - Big Gate                                                              1/2 SH                  $0.014
MSI               4835-0344   CAH-344   Daily Check Sheet - Trustee Division                                               8 1/2 - 14 SH                  $0.014
                                                                                                                 Buff/C
MSI               4835-0352   CAH-352   Count Sheet - Master - HVMF                                       N/A    anary        11 - 16 EA       Index      $0.115
ELECT             4835-0354   CAH-354   DCDS Security Request-Employee Entry Level-New User              08/10
MSI               4835-0355   CAH-355   Personnel Time Summary                                                              8 1/2 - 11 SH                 $0.014
ELECT             4835-0360   CAH-360   DCDS - Financial Approval                                        06/06             8 1/2 X 11
ELECT             4835-0361   CAH-361   DCDS - Timekeeper                                                06/06             8 1/2 X 11
ELECT             4835-0362   CAH-362   DCDS - Audit                                                     06/06             8 1/2 X 11
ELECT             4835-0363   CAH-363   DCDS - Certifier                                                 06/06             8 1/2 X 11
ELECT             4835-0364   CAH-364   DCDS - Financial Entry                                           06/06             8 1/2 X 11
ELECT             4835-0365   CAH-365   DCDS - Personnel Entry/Personnel Approval                        06/06             8 1/2 X 11
ELECT             4835-0366   CAH-366   DCDS - Releaser                                                  06/06             8 1/2 X 11
ELECT             4835-0372   CAH-372   Business Card Requisition                                        07/08             8 1/2 X 11
MSI               4835-0381   CAH-381   Call-Out Schedule                                                07/87              8 1/2 - 11 SH                 $0.014
PHOTO                         CAH-408   Pended or Denied form "Pilot"
MSI               4835-0421   CAH-421   Gas and Motor Oil Report - Daily                                N/A               8 1/2 - 11     PD   100   $2.358
MSI               4835-0424   CAH-424   Prisoner Wage Adjustment                                                            8 1/2 - 11   SH              $0.014
MSI               4835-0427   CAH-427   Criminal History Check                                           05/02              8 1/2 - 11   PD     100      $2.358
MSI               4835-0428   CAH-428   Telephone Reference Check                                        07/86              8 1/2 - 11   PD     100      $2.358
OBS               4835-0446   CAH-446   Documentation System Notice (Obsolete 4/01)
MSI               4835-0496   CAH-496   Block Locator Sheet                                              08/86              8 1/2 - 11   PD     100       $2.358
MSI               4835-0505   CAH-505   Grievance Investigation Report & Instructions                    07/88   white     8 1/2 X 11    SH      EA       $0.023
MSI               4835-0558   CAH-558   Early Warrant Request                                            09/91              8 1/2 - 11   PD     100       $2.358
MSI               4835-0580   CAH-580   Twenty-Four Hour Census                                          01/88   white      8 1/2 - 11   PD     100       $2.363

      2/24/2012                                                                                                                               Page 101 of 267   CAH
           CAH                                       MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                Unit QTY /
                                                                                                                                 of   Unit
Vendor              Comm#       Form#                               Title/Description              Rev.    Color    Size
                                                                                                                                Issu   or
                                                                                                                                  e *Spec
MSI               4835-0628   CAH-628     ADP Screen Routing                                                       8 1/2 - 11   SH     ial       $0.014
MSI               4835-0629   CAH-629     ADP Program Routing                                                      8 1/2 - 11   SH               $0.014
MSI               4835-0630   CAH-630     ADP Status Report                                                        8 1/2 - 11   SH               $0.014
MSI               4835-0631   CAH-631     Targeted Jobs Tax Credit (TJTC) for Ex-Offenders                         8 1/2 - 11   SH               $0.014
MSI               4835-0632   CAH-632     Driver Mileage Report - USDA Surplus Commodities                         8 1/2 - 11   ST         2     $0.058
MSI               4835-0652   CAH-652     Foodservice Department Inspections                       03/86           8 1/2 - 11   SH               $0.014
MSI               4835-0657   CAH-657     Salary Step Increases                                                    8 1/2 - 11   PD      100      $2.358
OBS                           CAH-681     Hearing Investigation Report     SEE CAJ-681
MSI               4835-0701   CAH-701     Weekly Employee Time Slip                                                8 1/2 - 11 SH                 $0.014
MSI               4835-0703   CAH-703     Partial Tuition Refund Application                       05/84           8 1/2 - 11 ST          5      $0.115
                                                                                                                    5 1/2 - 8
MSI               4835-0705   CAH-705     Discriminatory Harassment Complaint Reference Guide      04/03                  1/2 BK                 $0.029
MSI               4835-0771   CAH-711     Rules for Jails, Lockup and Security Camps                                          BK
MSI               4835-0726   CAH-726     Notification to Parole Violators                                         8 1/2 - 11 SH                 $0.014
MSI               4835-0743   CAH-743 A   Count Sheet - Huron Valley                               07/90           2 1/8 - 17 PD        100      $2.358
MSI               4835-0749   CAH-749     Evidence and Property Tag                                03/89                3 - 5 SH                 $0.014
MSI               4835-1766   CAH-766 A   Meal Tickets - Record of Sale                            01/92           8 1/2 - 11 PD        100      $2.358
MSI               4835-1767   CAH-766 B   Meal Sign Off                                                            8 1/2 - 11 PD        100      $2.358
MSI               4835-0769   CAH-769     Toplock Schedule                                         03/86           8 1/2 - 11 SH                 $0.014
                                                                                                                    5 1/2 - 8
MSI               4835-0770   CAH-770     RUM Unit 8 - Room Regulation                                                    1/2 SH                 $0.014
MSI               4835-0772   CAH-772     Recall List Preference Record                                            8 1/2 - 11 SH                 $0.014
MSI               4835-0799   CAH-799     Count Sheet - Michigan Reformatory - Adjustment Center   02/97           5 1/2 - 17 PD        100      $2.961
MSI               4835-0826   CAH-826     Lay-In/Medical Status List - Prisoner                    12/87           8 1/2 - 11 PD        100      $2.358
MSI               4835-0827   CAH-827     Meal Tally - Prisoner                                                    8 1/2 - 11 SH                 $0.014
MSI               4835-0828   CAH-828     Duty Charge                                                              8 1/2 - 11 PD        100      $2.358
MSI               4835-0829   CAH-829     Daily Status Off-Site                                                    8 1/2 - 11 SH                 $0.014
MSI               4835-0830   CAH-830     Call Log                                                                 8 1/2 - 11 PD        100      $2.358
MSI               4835-0858   CAH-858     Foodservice Operator’s Sanitation Check List             12/93           8 1/2 - 11 SH                 $0.014
                                                                                                                    5 1/2 - 8
MSI               4835-0859   CAH-859     Law Library Pass                                                                1/2 PD        100      $1.179
MSI               4835-0866   CAH-866     Grievance Record                                         01/92           8 1/2 - 11 PD        100      $2.358
MSI               4835-0876   CAH-876     Prisoner’s Personal Statement and Account of Charges     08/89           8 1/2 - 11 PD        100      $2.358
MSI               4835-0877   CAH-877     Chef Salad Sign-In Sheet                                                 8 1/2 - 11 SH                 $0.014
MSI               4835-0892   CAH-892     Apprentice Time Record                                                   8 1/2 - 11 SH                 $0.058
MSI               4835-0893   CAH-893     Mobile Radio Assignments                                                 8 1/2 - 11 PD        100      $2.358
MSI               4835-0899   CAH-899     In-Service Overtime Request                                              8 1/2 - 11 SH                 $0.014
                                                                                                                    5 1/2 - 8
MSI               4835-0900   CAH-900     Confinement Notice                                       02/90                  1/2 ST          2      $0.043
MSI               4835-0901   CAH-901     Flashlight Check-Out                                     03/86           8 1/2 - 11 PD        100      $2.358
MSI               4835-0902   CAH-902     Unit Daily Activity Log                                  02/90           8 1/2 - 11 PD        100      $2.358


      2/24/2012                                                                                                                      Page 102 of 267   CAH
           CAH                                       MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                 Unit QTY /
                                                                                                                                  of   Unit
Vendor              Comm#       Form#                                Title/Description            Rev.    Color      Size
                                                                                                                                 Issu   or
                                                                                                                                   e *Spec
                                                                                                                                        ial

                                                                                                          02/00?
MSI               4835-0903   CAH-903     Condition and Equipment Checklist for Towers            06/99   09/03?   8 1/2 - 11    PD     100       $2.358
                                                                                                                    5 1/2 - 8
MSI               4835-1903   CAH-903 A   Equipment Checklist and Post Receiving Sheet            03/86                   1/2    PD     100       $1.179
MSI               4835-0907   CAH-907     Notice of Boundaries                                    03/86            8 1/2 - 11    SH
MSI               4835-0908   CAH-908     Infirmary Sign-In Sheet                                 11/93            8 1/2 - 11    SH               $0.014
MSI               4835-0911   CAH-911     Chase Vehicle Checklist                                 07/89            8 1/2 - 11    PD     100       $2.358
ELECT             4835-0912   CAH-912     Minor Court Log                                         02/90
MSI               4835-0913   CAH-913     Unit/Room Shakedown                                     02/91            8 1/2 - 11    PD     100       $2.358
MSI               4835-0914   CAH-914     Daily Report on Prisoners in the Unit                   02/91            8 1/2 - 11    PD     100       $2.358
MSI               4835-1918   CAH-918 A   Volunteer Services Monthly Report - Individual Report   09/93   white    8 1/2 - 11    SH               $0.014
MSI               4835-1919   CAH-918 B   Volunteer Services Monthly Report - Group Report        09/89   white     8 1/2- 11    SH               $0.012
MSI               4835-0922   CAH-922     Public Works Indoctrination (7 Pages)                   03/86            8 1/2 - 11                     $0.144
MSI               4835-0938   CAH-938     Shift Announcement Log Sheet                                             8 1/2 - 11    PD     100       $2.358
                              CAH-941     Catalog Order Form SEE CAJ-941
MSI               4835-0942   CAH-942     Weapons Qualification                                                    8 1/2 - 11    PD     100       $2.358
MSI               4835-0943   CAH-943     Count Reconciliation                                                     8 1/2 - 11    SH               $0.014
MSI               4835-0944   CAH-944     Tool Issue Log                                          02/91            8 1/2 - 11    PD     100       $2.358
MSI               4835-0949   CAH-949     Receipts - Prisoner - Log                                                8 1/2 - 11    PD     100       $2.358
ELECT             4835-0950   CAH-950     Sanitation Inspection Weekly-Monthly                    07/03
                                                                                                                     5 1/2 - 8
MSI               4835-0951   CAH-951     Inventory Adjustment                                                            1/2    SH               $0.014
ELECT             4835-0972   CAH-972     Daily On-The-Job Evaluation(formerly CAJ-972)           04/06            8 1/2 x 11    SH
                                                                                                                     5 1/2 - 8
MSI               4835-0978   CAH-978     Grievance Appeal Receipt (use with CAJ-978)             11/94   white           1/2    PD     100       $2.358
MSI               4835-0980   CAH-980     Grievance Transfer                                      11/89            8 1/2 - 11    SH               $0.014
MSI               4835-1981   CAH-981 A   Grievance Investigation Request                         02/90            8 1/2 - 11    PD     100       $2.358
MSI               4835-1982   CAH-981 B   Grievance Investigation Request - Supervisor Reviewed   02/90            8 1/2 - 11    PD     100       $2.358
                                                                                                                     5 1/2 - 8
MSI               4835-2982   CAH-982 A Prisoner Health Status - PER Support Form                 05/88                   1/2    PD     100       $1.179
                                                                                                                     5 1/2 - 8
MSI               4835-2983   CAH-982 B   Prisoner Financial Status - PER Support Form            08/92                   1/2    PD     100       $1.179
MSI               4835-0983   CAH-983     Mobile Radio Assignments                                                 8 1/2 - 11    PD     100       $2.358
MSI               4835-0984   CAH-984     Weapons Qualification Certification                     01/92            8 1/2 - 11    PD     100       $2.358
ELECT/MSI         4835-0991   CAH-991     Major Misconduct Docket                                 09/89            8 1/2 - 11    PD     100       $2.358
MSI               4835-0998   CAH-998     Signature Sheet - Supplement to PD                      08/89            8 1/2 - 11    SH               $0.043
MSI               4835-0999   CAH-999     State of Michigan Transmittal (DMB-10575)               02/05   white         4X6      PD     100       $1.294




      2/24/2012                                                                                                                       Page 103 of 267   CAH
            CAH




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2/24/2012         Page 107 of 267   CAH
 CAO                                  MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                Unit QTY /
  Vendor

                                                                                                                                 of   Unit or
                Form#                                  Title/Description                    Rev.     Color        Size
                                                                                                                                Issu *Special
                                                                                                                                  e   Paper
MSI           CAO-209    Cutting Ticket [ General ] No number                                N/A    NCR        5 1/2 X 8 1/2    ST           4      $0.092
MSI           CAO-209    Cutting Ticket [ General ] Numbered                                 N/A    NCR        5 1/2 X 8 1/2    ST           4      $0.086
MSI           CAO-209    Cutting Ticket [ CG ]                                              01/06   NCR        5 1/2 X 8 1/2    ST           4      $0.092
MSI           CAO-209    Cutting Ticket [ KC ]                                              01/00   NCR        5 1/2 X 8 1/2    ST           4      $0.092
MSI           CAO-209    Cutting Ticket [ KG ]                                              09/00   NCR        5 1/2 X 8 1/2    ST           4      $0.092
MSI           CAO-209    Cutting Ticket [WC] (Marquette Garment) Numbered                           NCR        5 1/2 X 8 1/2    ST           4      $0.086
MSI           CAO-210    MSI Dental Lab Delivery Report (Scott Facility)                    06/01   NCR           8 1/2 x 11    ST           5      $0.115
MSI           CAO-214    MSI Operating & Work Rule Manual                                   01/04   White         8 1/2 x 11    BK         BK       $0.244
MSI           CAO-216    Ware Washing Customer Service Report                               11/03   NCR           8 1/2 x 11    ST           3      $0.072
MSI           CAO-218    Laundry Tally Sheet (Lapeer)                                       05/02   NCR           8 1/2 X 11    ST           3      $0.072
MSI           CAO-219    Laundry Tally Sheet [ General ] No Number (Jackson Laundry; )      01/89   NCR           8 1/2 X 11    ST           2      $0.072
MSI           CAO-219    Laundry Tally Sheet [ General ] Numbered (Also see: CMR-157 )      01/89   NCR           8 1/2 X 11    ST           3      $0.086
MSI           CAO-219    Laundry Tally Sheet - Kinross [ KL ]                               01/00   NCR           8 1/2 X 11    ST           3      $0.086
MSI           CAO-219    Laundry Tally Sheet - Chippewa                                             NCR           8 1/2 X 11    ST           3      $0.086
MSI           CAO-220    Laundry Check List                                                 04/00   White         8 1/2 x 11    PD        100       $2.358
MSI           CAO-225    Laundry Tally Sheet (Chippewa for Cheyboygan Memorial Hospital)    05/04   NCR           8 1/2 X 11    ST           3      $0.072
                                                                                                    Canary /
MSI           CAO-228    Industrial Store Card                                               N/A    White             4X8       EA      Index       $0.029
MSI           CAO-233    Inmate Payroll Sheet                                               09/00   White        11 X 8 1/2     PD        100       $2.358
MSI           CAO-234    Miss Out                                                           06/99   NCR          4 1/4 X 11     ST          2       $0.058
MSI           CAO-235    Inmate Payroll Sheet(Can be pads of 100)                           03/07   White           11 X 17     EA          1       $0.058
MSI           CAO-329    MSI Prisoner Job Assignment File Card                                      White              8x5      EA      Index       $0.014
MSI           CAO-241    Optical Products Brochure                                          06/03   White         8 1/2 - 11    EA        80#       $0.129
MSI           CAO-242    Optical Lab Booklet (6 pg)                                                                             EA                  $0.359
MSI           CAO-248    MSI Bill of Lading                                                 06/05   NCR           8 1/2 X 11    ST          5       $0.144
MSI           CAO-255    Accounting Ledger (Fiscal Year)                                     N/A    White            11 X 17    EA     Ledger       $0.046
MSI           CAO-256    JMF-Meal Ticket(Thanksgiving-Canary)                               06/05   Canary     2 1/2 X 4 1/4    EA      Index       $0.029
MSI           CAO-257    JMF-Meal Ticket(Christmas-Green)                                   06/05   Green      2 1/2 X 4 1/4    EA      Index       $0.029
MSI           CAO-258    JMF-Meal Ticket(New Years-White)                                   06/05   White      2 1/2 X 4 1/4    EA      Index       $0.029
MSI           CAO-259    JMF-Meal Ticket(Memorial Day-Blue)                                 06/05   Blue       2 1/2 X 4 1/4    EA      Index       $0.029
MSI           CAO-260    JMF-Meal Ticket(July 4th-Cherry)                                   06/05   Cherry     2 1/2 X 4 1/4    EA      Index       $0.029
MSI           CAO-261    JMF-Meal Ticket(Labor Day-Salmon)                                  06/05   Salmon     2 1/2 X 4 1/4    EA      Index       $0.029
MSI           CAO-262    Summary of Labor, Overhead, Material                                N/A    NCR         5 1/2 - 8 1/2   ST          2       $0.043
                                                                                            04/81                                                   $0.000
MSI            CAO-270   Metal Furniture Shipping Report (MSI)                              06/94   NCR        4 1/4 x 5 1/2    ST          2       $0.043
MSI            CAO-271   MSI Metal Furnishings Brochure                                     09/03   White         8 1/2 - 11    SH        80#       $0.101
MSI            CAO-279   Intra-Industries Stores Requisition [ G ]                          05/93   NCR         8 1/2 5 1/2     ST          4       $0.101
MSI            CAO-279   Intra-Industries Stores Requisition - Chair Factory [ CF ]         05/93   NCR         8 1/2 5 1/2     ST          4       $0.101
MSI            CAO-279   Intra-Industries Stores Requisition [ F ]                          05/93   NCR         8 1/2 5 1/2     ST          4       $0.101
MSI            CAO-279   Intra-Industries Stores Requisition - Textile [ TF ]               05/93   NCR         8 1/2 5 1/2     ST          4       $0.101
MSI            CAO-279   Intra-Industries Stores Requisition - Carson City Garment [ CC ]   05/93   NCR         8 1/2 5 1/2     ST          4       $0.101
MSI            CAO-279   Intra-Industries Stores Requisition - Wood Furniture [FF]          05/93   NCR         8 1/2 5 1/2     ST          4       $0.101
      2/24/2012                                                                                                                                  108 of 267   CAO
 CAO                                   MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                   Unit QTY /
  Vendor

                                                                                                                                    of   Unit or
                  Form#                                Title/Description                       Rev.     Color        Size
                                                                                                                                   Issu *Special
                                                                                                                                     e   Paper
                                                                                                       110#
MSI           CAO-282     Chair Factory Bin Card (MSI stock# & Description Card )              10/05   white      4 1/8 X 9 1/8 EA         Index      $0.029
MSI           CAO-283     Daily Production Report                                              04/00   NCR         6 1/2 - 8 1/2 st            5      $0.072

MSI           CAO-293A    Cost Sheet/Materials Used- Sign Shop (MSI)                            N/A    NCR           11 X 8 1/2    ST          2      $0.043
MSI           CAO-309     Time Card ( 7 3/16 X 3 3/8 )                                          N/A    Manilla   18cm X 8.5cm      EA        Tag      $0.043
MSI           CAO-311     Packing Slip [ General ]                                              N/A    NCR           8 1/2 X 11    ST          4      $0.101
MSI           CAO-311     Packing Slip - Textile [ TF ]                                         N/A    NCR            7 X 8 1/2    ST          4      $0.101
MSI           CAO-316     Request for Shipping Order                                           01/93   NCR           11 X 8 1/2    ST          2      $0.043
MSI           CAO-325     Production Daily Floor Record                                        10/94   White       4 1/2 - 5 1/2   PD        100      $1.179
MSI           CAO-326     Textile Production Sheet                                              N/A    white      5 1/2 X 8 1/2    PD        100      $1.078
MSI           CAO-329     MSI Prisoner Job Assignment File Card                                 N/A    white               5X8     EA      Index      $0.014

MSI           CAO-338A P-Shipper for License Plate Factory                                     N/A     NCR        5 1/2 X 8 1/2 ST             5      $0.129
MSI           CAO-384 Production Spreadsheet                                                           White            11 x 14 SH                    $0.072
                                                                                                       60#
MSI           CAO-444     Contents Label (licence plate factory) (C1S stock)                   04/03   white      3 1/4 X 5 1/4    PD        100      $0.863
MSI           CAO-449     Start Up Checklist Gas, LP Gas                                       10/94   White       4 1/2 - 5 1/2   PD        100      $1.179
MSI           CAO-481     Factory Request for Purchase - Brook Laundry [ BL ]                  08/94   NCR           8 1/2 X 11    ST          3      $0.072
MSI           CAO-481     Factory Request for Purchase - Carson City [ CC ]                    08/94   NCR           8 1/2 X 11    ST          3      $0.072
MSI           CAO-481     Factory Request for Purchase - Chair [ CF ]                          09/94   NCR           8 1/2 X 11    ST          3      $0.072
MSI           CAO-481     Factory Request for Purchase - Vinyl [ VP ]                           N/A    NCR           8 1/2 X 11    ST          3      $0.072
MSI           CAO-482     DAIRY PROCESSING RECIEVING TICKET                                    03/00   NCR          8 1/2/ x 11    ST          3      $0.101
MSI           CAO-482     Receiving Ticket - Brooks Laundry [ BL ]                              N/A    NCR           8 1/2 X 11    ST          3      $0.101
MSI           CAO-482     Receiving Ticket - Chair [ CF ]                                       N/A    NCR            7 X 8 1/2    ST          3      $0.101
MSI           CAO-482     Receiving Ticket - Cotton Garment [ CG ]                              N/A    NCR           8 1/2 X 11    ST          3      $0.101
MSI           CAO-482     Receiving Ticket - Meat Processing [ MP]                              N/A    NCR           8 1/2 X 11    ST          3      $0.101
MSI           CAO-482     Receiving Ticket - Creamery [ CR ]                                   02/00   NCR           8 1/2 X 11    ST          3      $0.101
MSI           CAO-482     Receiving Ticket - Engineering [ ENG ]                                N/A    NCR            7 X 8 1/2    ST          3      $0.101
MSI           CAO-482     Receiving Ticket [ JP ]                                               N/A    NCR            7 X 8 1/2    ST          3      $0.101
MSI           CAO-482     Receiving Ticket - Kinross Garment [ KG ]                             N/A    NCR           8 1/2 X 11    ST          3      $0.101
MSI           CAO-482     Receiving Ticket [ PTE ]                                              N/A    NCR            7 X 8 1/2    ST          3      $0.101
MSI           CAO-482     Receiving Ticket - Vinyl [ VP ]                                       N/A    NCR           8 1/2 X 11    ST          3      $0.101
MSI           CAO-485     Payroll Time Sheet (Prisoner Payroll)                                04/04   White         8 1/2 x 14    PD        100      $3.939
MSI           CAO-486     Shoe Spec. for Style 2428/2429                                       03/04   White      6 1/2 x 7 1/2    EA      Index      $0.115

MSI           CAO-486A Shoe Spec. for Style 2425/2426                                          03/04   White      6 1/2 x 7 1/2 EA         Index      $0.115
MSI           CAO-487 Ortho Ticket (Shoe Factory)                                              05/04   Cherry     5 1/2 x 8 1/2 EA         Index      $0.036
MSI           CAO-488 Daily Finished Goods                                                     02/09   NCR        5 1/2 X 8 1/2 ST             3      $0.058

MSI           CAO-500     Inventory Tag (MSI Official) 1-SIDED, NUMBERED, PERFED, 1 HOLE TOP           Varies          3 1/4 x 8 EA                   $0.029

      2/24/2012                                                                                                                                    109 of 267   CAO
 CAO                                   MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                              Unit QTY /
  Vendor

                                                                                                                               of   Unit or
                  Form#                                 Title/Description                   Rev.     Color      Size
                                                                                                                              Issu *Special
                                                                                                                                e   Paper

MSI           CAO-501     Forklft Operators Daily Chcklist                                  04/00   NCR         8 1/2 x 11 ST             2      $0.115

MSI           CAO-507     Record of Purchase Requests (3-hole left)                          N/A    White          11 x 17 SH                    $0.043
MSI           CAO-600     Cut Ticket: (Blank) (Numbered) CARSON CITY GARMENT                05/04   NCR      5 1/2 X 8 1/2 ST         4 PT       $0.086

MSI           CAO-600A Cut Ticket: QS/JS (Numbered)            CARSON CITY GARMENT          05/04   NCR      5 1/2 X 8 1/2 ST         4 PT       $0.086

MSI           CAO-600B Cut Ticket: QSP (Numbered)            CARSON CITY GARMENT            05/04   NCR      5 1/2 X 8 1/2 ST         4 PT       $0.086

MSI           CAO-600C Cut Ticket: QS04 (Numbered) CARSON CITY GARMENT                      05/04   NCR      5 1/2 X 8 1/2 ST         4 PT       $0.086

MSI           CAO-600D Cut Ticket: QS68 (Numbered) CARSON CITY GARMENT                      05/04   NCR      5 1/2 X 8 1/2 ST         4 PT       $0.086

MSI           CAO-600E Cut Ticket: QSTT (Numbered) CARSON CITY GARMENT                      05/04   NCR      5 1/2 X 8 1/2 ST         4 PT       $0.086
MSI           CAO-600F Cut Ticket: QSTB (Numbered) CARSON CITY GARMENT                      05/04   NCR      5 1/2 X 8 1/2 ST         4 PT       $0.086

MSI           CAO-600G Cut Ticket QSPJ (numbered) Carson City Garment                       02/05   NCR      5 1/2 X 8 1/2 ST          4PT       $0.086
                                                                                                                                                 $0.000
                                                                                                                                                 $0.000
                          Inspection Table Cut Ticket Log: (Blank) (Numbered) CARSON CITY
MSI           CAO-601     GARMENT                                                           05/04   NCR      5 1/2 X 8 1/2 ST         3 PT       $0.058
                          Inspection Table Cut Ticket Log: QS/JS (Numbered) CARSON CITY
MSI           CAO-601A    GARMENT                                                           05/04   NCR      5 1/2 X 8 1/2 ST         3 PT       $0.058
                          Inspection Table Cut Ticket Log: QSP (Numbered) CARSON CITY
MSI           CAO-601B    GARMENT                                                           05/04   NCR      5 1/2 X 8 1/2 ST         3 PT       $0.058
                          Inspection Table Cut Ticket Log: QS04 (Numbered) CARSON CITY
MSI           CAO-601C    GARMENT                                                           05/04   NCR      5 1/2 X 8 1/2 ST         3 PT       $0.058
                          Inspection Table Cut Ticket Log: QS68 (Numbered) CARSON CITY
MSI           CAO-601D    GARMENT                                                           05/04   NCR      5 1/2 X 8 1/2 ST         3 PT       $0.058
                          Inspection Table Cut Ticket Log: QSTT (Numbered) CARSON CITY
MSI           CAO-601E    GARMENT                                                           05/04   NCR      5 1/2 X 8 1/2 ST         3 PT       $0.058
                          Inspection Table Cut Ticket Log: QSTB (Numbered) CARSON CITY
MSI           CAO-601F    GARMENT                                                           05/04   NCR      5 1/2 X 8 1/2    ST      3 PT       $0.058
MSI           CAO-646     Daily Production Report (MSI Metal Furniture)                      3/80   NCR         8 1/2 x 11    ST       2PT       $0.065
MSI           CAO-660     Work Ticket - Sign Shop                                           07/93   NCR         8 1/2 X 11    ST         2       $0.058
MSI           CAO-661     Work Ticket - Ionia (UNNUMBERED)                                  05/03   NCR          8 1/2 - 11   ST         5       $0.115
MSI           CAO-661     Work Ticket - Ionia [Furniture Refinishing] (NUMBERED)            05/03   NCR          8 1/2 - 11   ST         5       $0.129
MSI           CAO-662     Forms Master Jacket- Print Shop                                   08/80   Salmon         11 X 17    EA    Ledger       $0.000
MSI           CAO-683      ( see CRX-130 )                                                                                                       $0.000
MSI           CAO-687     Resident Interview Rejection Sheet (MSI)                          04/81   NCR      5 1/2 x 8 1/2 ST             2      $0.058

      2/24/2012                                                                                                                               110 of 267   CAO
 CAO                                   MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                         Unit QTY /
  Vendor

                                                                                                          of   Unit or
                  Form#                                Title/Description     Rev.     Color   Size
                                                                                                         Issu *Special
                                                                                                           e   Paper
MSI           CAO-690     Inspection Tag, Wood Furniture (4 perfs)           05/03   White     3 - 8 1/4 EA      Index      $0.072
?             CAO-950     MSI Rapid Order Form                               04/04                                          $0.000
?             CAO-955     MSI Installation Change Order Form                 03/03                                          $0.000
MSI           CAO-999     Web Notice Post Cards - MSI                                White     6 - 4 1/4 EA     Index       $0.029
                                                                                                                            $0.000
                                                                                                                            $0.000
                                                                                                                            $0.000
                                                                                                                            $0.000




      2/24/2012                                                                                                          111 of 267   CAO
            CAR                                MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                          QTY / Unit
                                                                                                                                Unit of       or
   Vendor         Comm#      Form#                             Title/Description                Rev.    Color     Size
                                                                                                                                Issue      *Special
                                                                                                                                            Paper
MSI/ELECT      4835-1100   CAR-100     Disbursement Authorization/Catalog Order Form            10/08 NCR         8 1/2 - 11 ST                     4     $0.110
MSI            4835-1101   CAR-101     Store Card                                               10/86                                                     $0.000
MSI            4835-0106   CAR-106     Prisoner Detail - Outside Gate                           11/85             8 1/2 - 11    PD               100      $2.358
MSI            4835-0182   CAR-182     Media Authorization                                      08/87              2 1/2 - 4    EA             Index      $0.014
MSI            4835-0202   CAR-202     Workflow Execution Request                                                 8 1/2 - 11    SH                        $0.014
MSI            4835-0218   CAR-218     Major Court Sanction Record                              06/92 Green        4 1/2 - 8    EA             Index      $0.014
outside?                   CAR-232     Dept. Employment Record (special cut)                                                                              $0.000
MSI            4835-0246   CAR-246     Daily Official Count - Michigan Reformatory                                 5 1/2 - 11   ST                 5      $0.985
MSI            4835-0252   CAR-252     Work Pass Checkout Report                                01/88              8 1/2 - 14   PD               100      $2.961
MSI            4835-0265   CAR-265     Money Receipt (Numbered or Unnumbered)                   09/89           5 1/2 - 8 1/2   ST                 4      $0.058
MSI            4835-0268   CAR-268     Food Production Worksheet                                09/89              8 1/2 - 11   PD               100      $2.358
MSI            4835-0271   CAR-271     Weekly Menu                                              06/93              8 1/2 - 11   SH                        $0.043
MSI            4835-0297   CAR-297     Arsenal Equipment Record                                 08/87 White         3 1/2 - 5   EA             Index      $0.014
MSI            4835-0308   CAR-308     Certificate of Eligibility for College Enrollment        08/89              8 1/2 - 11   ST                 4      $0.101
OBS            4835-0329   CAR-329     Prisoner Store Stock Request                                                                                       $0.000
MSI            4835-0354   CAR-354     Conviction Statement                                     02/89             8 1/2 x 11    SH                        $0.014
MSI            4835-0366   CAR-366     Notice of Classification                                 10/86           4 1/4 - 5 1/2   ST                 4      $0.043
MSI            4835-1370   CAR-370     Investigator’s Report                                    09/87              8 1/2 - 11   PD               100      $2.358
MSI            4835-0382   CAR-382     Record Office Notice of Release and Transfers            10/89              8 1/2 - 11   PD               100      $2.358
MSI            4835-0390   CAR-390     Adjustment Center Prisoner Location                      06/87 Blue      4 1/2 - 6 1/2   EA             Index      $0.014
MSI~ELECT      4835-0396   CAR-396     Procurement Request                                      01/96              8 1/2 - 11   ST                 3      $0.072
MSI            4835-0423   CAR-423     Delivery Slip and Receipt - Front Desk                   05/91           5 1/2 - 8 1/2   ST                 4      $0.058
MSI            4835-0448   CAR-448                                                              09/86              8 1/2 - 11   PD               100      $2.358
MSI            4835-1451   CAR-451 A   Computer Program Description Sheet                                          8 1/2 - 11   SH                        $0.014
MSI            4835-1452   CAR-451 B   Computer Program Description Sheet - Continuation Page                      8 1/2 - 11   SH                        $0.014
MSI            4835-1453   CAR-451 C   Computer Program Description Sheet - Continuation Page                      8 1/2 - 11   SH                        $0.014
MSI            4835-0521   CAR-521     Attendance Record - Year                                 06/86              8 1/2 - 11   SH                        $0.043
MSI            4835-0534   CAR-534     Report Distribution Sheet                                                   8 1/2 - 11   SH                        $0.014
MSI            4835-0535   CAR-535     Record Distribution Sheet                                05/89 Canary       8 1/2 - 11   SH             Index      $0.043
MSI            4835-0556   CAR-556     Stock Record Card - New Institutions                     05/89 Canary       8 1/2 - 11   SH             Index      $0.043
ELECT/MSI      4835-0560   CAR-560     Freedom of Information Act Request - Log                 02/86              8 1/2 - 11   PD               100      $2.358
PHOTO          4835-0561   CAR-561     MDOC FOIA Quarterly Statistics "Photo Copy only"         09/01                                                     $0.000
MSI            4835-0655   CAR-655     Hardware Problems                                                           8 1/2 - 11   SH                        $0.014
MSI            4835-0700   CAR-700     CMIS Manual Control                                      03/86              8 1/2 - 11   PD               100      $2.363
MSI            4835-0704   CAR-704     Project GNATT Chart                                                         8 1/2 - 14   SH                        $0.014
MSI            4835-0722   CAR-722     CMIS Security Change Request                             06/87              8 1/2 - 11   ST                 2      $0.058
MSI            4835-0723   CAR-723     Prisoner Employee Counseling and/or Warning Notice       03/93 NCR       5 1/2 - 8 1/2   ST                 2      $0.043
MSI            4835-0730   CAR-730     Discrepancy Memo                                         06/89           5 1/2 - 8 1/2   ST                 2      $0.043
MSI            4835-0738   CAR-738     Individual Training Record                               10/88 Buff         8 1/2 - 11   EA            Index       $0.058
MSI            4835-0765   CAR-765     Sales and Token Redemption Report - Prisoner Store       01/88           5 1/2 - 8 1/2   ST                 3      $0.058
MSI            4835-0833   CAR-833     Ex-Offender Clearance Request                                               8 1/2 - 11   PD              100       $2.358
MSI/ELEC       4835-0854   CAR-854     Training Program Report - Individual (2 sided)           07/04              8 1/2 - 11   PD              100       $2.961
   2/24/2012                                                                                                                                112 of 267   CAR
           CAR                               MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                              QTY / Unit
                                                                                                                                    Unit of       or
  Vendor         Comm#      Form#                           Title/Description                       Rev.    Color     Size
                                                                                                                                    Issue      *Special
                                                                                                                                                Paper
MSI/ELEC      4835-0855   CAR-855     Training Program Evaluation (1 sided)                         04/08              8 1/2 - 11   PD              100      $2.358
MSI           4835-0861   CAR-861     Prisoner Funds Receipt                                        09/89           4 1/4 - 8 1/2   ST                3      $0.058
MSI           4835-0865   CAR-865     Ad Hoc Selection Committee Worksheet                                             8 1/2 - 14   SH                       $0.014
MSI           4835-0878   CAR-878     Lock Count Sheet                                                                 8 1/2 - 14   SH                       $0.014
MSI           4835-2893   CAR-893     Disbursement Authorization Prisoner(SEE ALSO CAR-100)         06/09 NCR       5 1/2 - 8 1/2   ST                 2     $0.050
OBS           4835-2894   CAR-893 A   Disbursement Authorization - Prisoner Store(SEE CAR-100)                                                               $0.000
OBS           4835-2895   CAR-893 B   Token Order - Prisoner(SEE CAR-100)                                                                                    $0.000
OBS           4835-2896   CAR-893 C   Disbursement Authorization - Prisoner                         02/00 NCR       5 1/2 - 8 1/2 ST                   3     $0.043
MSI           4835-2897   CAR-893 D   Disbursement Authorization - Indigent Prisoner                02/00 NCR       5 1/2 - 8 1/2 ST                   3     $0.043
OBS           4835-2898   CAR-893 E   Disbursement Authorization - Care Package(SEE CAR-100)                                                                 $0.000
MSI           4835-2899   CAR-893 F   Disbursement Authorization (Prisoner) - R & G C               10/06 NCR       5 1/2 - 8 1/2   ST                3      $0.046
MSI           4835-0915   CAR-915     Assignment Record                                             11/89 Green             5-8     EA            Index      $0.014
MSI           4835-0924   CAR-924     Progress and Attendance Record - Weekly                       04/92              8 1/2 - 11   PD              100      $2.358
MSI           4835-0925   CAR-925     Class Schedule Card                                                 Canary            3-5     EA            Index      $0.043
MSI           4835-0931   CAR-931     Meals Served by Month                                                            8 1/2 - 14   SH                       $0.043
MSI           4835-0933   CAR-933     Language Clues - DA, EA, FA                                   03/86              8 1/2 - 11   PD              100      $2.961
MSI           4835-0939   CAR-939     Parole Eligibility Report (A [F&B], B,C,D)                    11/92              8 1/2 - 11   ST                5      $0.158
MSI           4835-0953   CAR-953     Automated Capital Outlay                                      07/89              8 1/2 - 11   ST                2      $0.058
MSI           4835-0958   CAR-958     Meal Ordering Form                                                               8 1/2 - 11   ST                2      $0.058
MSI           4835-0960   CAR-960     Report(s) Requested for Consideration by Parole Board         03/89              8 1/2 - 11   ST                2      $0.058
MSI/ELEC      4835-0961   CAR-961     Hobby craft Sales Receipt                                     10/06 NCR          8 1/2 - 11   ST                3      $0.069
MSI           4835- 962   CAR-962 B   Work Request                                                  05/84              8 1/2 - 11   ST                5      $0.115
MSI           4835-1975   CAR-975 A   Probational Employee Monthly Evaluation                       09/89              8 1/2 - 11   ST                4      $0.101

MSI           4835-1976   CAR-975 B Probational Employee Monthly Evaluation - Rating Factor Sheet                     8 1/2 - 11 SH                          $0.043
MSI           4835-0985   CAR-985   Library Due Date                                                09/89                  3 - 5 PD                 100      $1.179
                                                                                                                                                             $0.000
                                                                                                                                                             $0.000
                                                                                                                                                             $0.000
                                                                                                                                                             $0.000
                                                                                                                                                             $0.000
                                                                                                                                                             $0.000




  2/24/2012                                                                                                                                     113 of 267   CAR
      CFO                             MSI FORMS INDEX ( Revised 9/1/2011)

                                                                                                          QTY / Unit
                                                                                                  Unit of
Vendor       Comm#       Form#                        Title/Description     Rev.   Color   Size           or *Special     Price
                                                                                                  Issue
                                                                                                             Paper
OBS         4835-6249   CFO-249   Petition and Order to Show Cause




2/24/2012                                                                                                    114 of 267     CFO
            CFX                            MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                     QTY /
                                                                                                                             Unit of Unit or
    Vendor    Comm#        Form#                           Title/Description                        Rev.    Color    Size                      Price
                                                                                                                             Issue *Special
                                                                                                                                     Paper
   DMB-
   PG        4835-6131   CFX-131     Employee ID Card -Region III
   DMB-
   PG        4835-6132   CFX-132     Employee ID Card - BFS
   OBS       4835-6140   CFX-140     Referral Enrollment/Termination - Offender (OBSOLETE:12/21/01 See CFJ-140)
   DMB-
   PG        4835-6246   CFX-246 A   Employee ID Card
                                     Termination from Adult Field Caseload - Assessment of Client                     8 1/2 -
   MSI       4835-6252   CFX-252     Needs                                                                                11 ST
   MSI       4835-6134   CFX-134     Explanation of Parole Rules                                    09/00           4 1/8 - 7 BK                $0.207




2/24/2012                                                                                                                                  115 of 267    CFX
            CJO                       MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                              QTY / Unit
                                                                                                                    Unit of       or
   Vendor     Comm#       Form#                      Title/Description           Rev.     Color      Size
                                                                                                                    Issue      *Special
                                                                                                                                Paper
 MSI         4835-9266   CJO-268   Visiting Room Report                           N/A    Canary   5/ 1/2 X 8 1/2    PD               100      $1.179
 MSI         4835-9322   CJO-322   D.O. Tally Sheet                              07/96   NCR       4 1/4 X 5 1/2    ST                  2     $0.014
 MSI         4835-9341   CJO-341   Buck Sheet                                     N/A    Canary        8 1/2 - 11   PD               100      $2.358
 MSI         4835-9388   CJO-388   SPSM- Official Business Pass                  10/81   White     4 1/4 X 5 1/2    PD               100      $0.589
 MSI         4835-9510   CJO-510   SPSM-Main Prison Garage(Daily Stock Report)    N/A    NCR          11 X 8 1/2    ST                  2     $0.058
 MSI         4835-9516   CJO-516   SPSM-Receipt                                   N/A    Gray          4 1/4 X 8    EA
 MSI         4835-9516   CJO-516   SPSM-Receipt                                   N/A    Green         4 1/4 X 8    EA
 MSI         4835-9598   CJO-598   Personal Property Card                         N/A    White             5X8      Index                     $0.014
 MSI         4835-9810   CJO-810   Job Order Request (MSI Metal Furniture)       04/05   NCR          8 1/2 X 11    ST                 3      $0.122
 MSI         4835-9887   CJO-887   Job Jacket- Print Shop                        01/07                 8 1/2 - 11




2/24/2012                                                                                                                             116 of 267   CJO
      CHR                                 MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                       QTY / Unit
                                                                                                             Unit of       or
 Vendor       Comm#    Form#                              Title/Description     Rev.    Color     Size                                Price
                                                                                                             Issue      *Special
                                                                                                                         Paper
OBS       4835-7198   CHR-198   Report of On-Call Contact (SEE CHJ-198)
MSI       4835-8510   CHR-510   Medication Pass                                        White    3 1/2 - 2 1/2 EA           Index       $0.012




  2/24/2012                                                                                                              117 of 267   CHR
       CJT                                MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                     QTY / Unit
                                                                                                            Unit of      or
 Vendor       Comm#    Form#                              Title/Description     Rev.   Color      Size                               Price
                                                                                                            Issue     *Special
                                                                                                                       Paper
MSI                   CJT-177   Shipping Labels- Egeler                         06/99 White    3 1/2 X 4 1/2 PD(gum)        100       $1.300
                      CJT-531   See CAJ-531




  2/24/2012                                                                                                             118 of 267    CJT
  CMJ                              MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                        QTY / Unit
       Com                                                                                                    Unit of       or
Vendor          Form#                              Title/Description         Rev.     Color      Size
       m#                                                                                                     Issue      *Special
                                                                                                                          Paper
MSI          CMJ-102     Requisition - MSI                                   09/88   NCR         8 1/2 X 11   ST                  4        $0.101
MSI          CMJ-110     Record of Merchandise Returned                      06/84   NCR      5 1/2 X 8 1/2   ST                  4        $0.058
MSI          CMJ-116     Shipper [ BL ] Brooks Laundry                       06/94   NCR         8 1/2 X 11   ST                  5        $0.115
MSI          CMJ-116     Shipper [ CC ] Carson City Cotton Garment           03/96   NCR         8 1/2 X 11   ST                  5        $0.115
MSI          CMJ-116     Shipper [ CF ] Chair Factory                        03/96   NCR         8 1/2 X 11   ST                  5        $0.115
MSI          CMJ-116     Shipper [ CG ] Chippewa Garment                     03/96   NCR         8 1/2 X 11   ST                  5        $0.115
MSI          CMJ-116     Shipper [ ER ]                                       N/A    NCR         8 1/2 X 11   ST                  5        $0.115
MSI          CMJ-116     Shipper [ FF ] Wood Furniture                       03/96   NCR         8 1/2 X 11   ST                  5        $0.115
MSI          CMJ-116     Shipper [ G] License Plate Factory                  03/96   NCR         8 1/2 X 11   ST                  5        $0.115
MSI          CMJ-116     Shipper [ JL ] Jackson Laundry                      03/96   NCR         8 1/2 X 11   ST                  5        $0.115
MSI          CMJ-116     Shipper [ MP ] Meat Processing                      03/96   NCR         8 1/2 X 11   ST                  5        $0.115
MSI          CMJ-116     Shipper [ OP ] Optical Lab                           N/A    NCR         8 1/2 X 11   ST                  5        $0.115
MSI          CMJ-116     Shipper [ PF ] Potato Factory                       10/07   NCR         8 1/2 X 11   ST                  4        $0.115
MSI          CMJ-116     Shipper [ RC ]                                       N/A    NCR         8 1/2 X 11   ST                  5        $0.115
MSI          CMJ-116     Shipper [ S ] MSI Warehouse                          N/A    NCR         8 1/2 X 11   ST                  5        $0.115
MSI          CMJ-116     Shipper [ SG ] Sign Shop                            03/96   NCR         8 1/2 X 11   ST                  5        $0.115
MSI          CMJ-116     Shipper [ VP ] Vinyl Products                        N/A    NCR         8 1/2 X 11   ST                  5        $0.115
MSI          CMJ-116     Shipper [ FR ] Furniture Refinishing - 1240         03/96   NCR         8 1/2 X 11   ST                  5        $0.115
MSI          CMJ-117     Inventory Verification                              01/85   Canary           6X9     EA             Index         $0.046
MSI          CMJ-118     Intra-Industries Store Requisition                   N/A    NCR         8 1/2 X 11   ST                  4        $0.101
MSI          CMJ-119     Receiving Tickets                                   03/96   NCR         8 1/2 X 11   ST                  5        $0.115
MSI          CMJ-119CC   Receiving Tickets (Carson City)                     08/04   NCR         8 1/2 X 11   ST                  4        $0.101
MSI          CMJ-120     Daily Finished Goods                                01/85   NCR          3 1/2 X 5   ST                  2        $0.023
MSI          CMJ-121     Incentive Bonus Report                              03/85   White       8 1/2 X 11   PD               100         $2.358
MSI          CMJ-122     Textile Dye Plant Report                            03/85   White       8 1/2 X 11   PD               100         $2.358
MSI          CMJ-123     Mill - Cart Cards                                    N/A    Canary           4X5     EA             Index         $0.023
MSI          CMJ-124     Furniture Panel Requisition                         01/85   NCR         8 1/2 X 11   ST                  4        $0.101
MSI          CMJ-125     Inventory Store Card                                02/85   White    5 1/2 X 8 1/2   EA             Index         $0.035
MSI          CMJ-126     Standard Release Form                               02/85   White       8 1/2 X 11   PD               100         $2.358
MSI          CMJ-130     Recut Tickets                                       05/85   white        2 1/2 X 4   PD               100         $0.633
MSI          CMJ-131     Shipping Labels                                      N/A
MSI          CMJ-132     Shipping Labels (No # on labels)                     N/A    White           4X5      PD               100    $0.920
MSI          CMJ-142     Bill of Lading                                      09/88   NCR        8 1/2 X 11    ST                 5       $0.115
MSI          CMJ-166     Industrial Maintenance Sales Slips                   N/A    white         11 X 14    PD               100       $2.990
MSI          CMJ-167     Shoe Repair Sheet                                   02/87   White      8 1/2 X 11    PD               100       $2.358
MSI          CMJ-230     Weekly Fire Inspection Report (MSI) (3-page form)   03/87   NCR        8 1/2 X 11    ST                 4       $0.173
MSI          CMJ-231     Weekly Sanitation Inspection (MSI)                  03/87   NCR        8 1/2 X 11    ST                 4       $0.104




2/24/2012                                                                                                                     119 of 267    CMJ
      CMR                                MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                               QTY / Unit
                                                                                                                                     Unit of       or
 Vendor   Comm#     Form#                               Title/Description                          Rev.     Color       Size
                                                                                                                                     Issue      *Special
                                                                                                                                                 Paper
MSI               CMR-104     Employee Earnings Record                                             04/84   White     5 1/2 X 8 1/2   EA             Index      $0.000
MSI               CMR-105     Work Clothing Factory- Stockroom Report Card                         04/84   White        8 1/2 X 11   EA             Index      $0.000
MSI               CMR-107     Prisoner Application for Employment                                  05/88   White        8 1/2 X 11   PD               100      $2.961
MSI               CMR-127     Payroll Change Notice                                                10/88   White        8 1/2 X 11   PD               100      $2.358
MSI               CMR-128     White Stock Control                                                   N/A    White         8 1/2 X11   EA             Index      $0.000
MSI               CMR-129 A   Components Parts Control (M. Reform.)                                 N/A    White         8 1/2 X11   EA             Index      $0.000
MSI               CMR-131     Time Card (Shoe Factory)                                             07/85   Manilla   3 3/8 X 6 7/8   EA               Tag      $0.000
MSI               CMR-133     Prisoner Employee Counseling Memo (see CAR-723)                      06/85   NCR       5 1/2 X 8 1/2   ST                  2     $0.043
MSI               CMR-144     Truck Report                                                         06/86   White         8 1/2 X11   PD               100      $0.000
MSI               CMR-154     Inspectors Tag                                                       11/88   White     2 1/2 X 9 1/2   EA             Index      $0.000
MSI               CMR-157     Laundry Tally Sheet (Also see: CAO-218 & CAO-219 - Lapeer Laundry)   01/94   NCR           8 1/2 X11   ST                  3     $0.072
MSI               CMR-158     In-coming Weight Dist. (Central Laundry)                             09/87   White         8 1/2 X11   PD               100      $2.358
MSI               CMR-200     Production Card - Furniture Factory                                  05/88   White     5 1/2 X 8 1/2   PD               100      $0.000
MSI               CMR-214     Daily Production Summary                                             05/88   White     5 1/2 X 8 1/2   PD               100      $0.000
                                                                                                                                                               $0.000
                                                                                                                                                               $0.000
                                                                                                                                                               $0.000
                                                                                                                                                               $0.000




  2/24/2012                                                                                                                                       120 of 267   CMR
2/24/2012   121 of 267   CMR
2/24/2012   122 of 267   CMR
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2/24/2012   131 of 267   CMR
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2/24/2012   133 of 267   CMR
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2/24/2012   135 of 267   CMR
       CSH                                   MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                         QTY / Unit
                                                                                                               Unit of       or
  Vendor       Comm#     Form#                              Title/Description      Rev.   Color    Size
                                                                                                               Issue      *Special
                                                                                                                           Paper
MSI         4835-3103   CSH-103   Daily Official Count Sheet                       09/99           4 1/4 - 5   PD               100     $1.179
MSI/ELECT   4835-3107   CSH-107   Request for State Police Investigation           01/07          8 1/2 - 11   PD               100     $2.358
MSI         4835-3131   CSH-131   Personal Items Approved                          01/86          8 1/2 - 11   PD               100     $2.358
MSI         4835-4275   CSH-275   Block Report                                     10/89          8 1/2 - 11   PD               100     $2.358
MSI/ELECT   4835-3479   CSH-479   Response to Request for Public Records           08/09 Canary   8 1/2 - 11   PD               100     $2.961




   2/24/2012                                                                                                               136 of 267   CSH
       CSR                                MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                              QTY / Unit
                                                                                                                    Unit of       or
 Vendor      Comm#       Form#                             Title/Description        Rev.   Color      Size
                                                                                                                    Issue      *Special
                                                                                                                                Paper
MSI         4835-3133   CSR-133   Medical Lay-In                                    01/91           4 1/2 - 5 1/2   ST                  4         $0.072
MSI         4835-3206   CSR-206   Delivery Slip and Receipt - Mailroom              06/87          5 1/2 X 8 1/2    ST                  3         $0.043
MSI         4835-3294   CSR-294   Subscription Record                               12/85 Blue              3-5     EA             Index          $0.014
MSI         4835-3347   CSR-347   Program Pass                                      01/88 Yellow        3 1/2 - 5   EA             Index          $0.014
ELEC/MSI    4835-3472   CSR-472   Prisoner Record - Report Checkoff List            04/09              8 1/2 - 11   ST                  2         $0.058
MSI         4835-3484   CSR-484   Declaration and Disposition of Private Property   08/89              8 1/2 - 11   ST                  3         $0.069




2/24/2012                                                                                                                            137 of 267    CSR
2/24/2012   138 of 267   CSR
2/24/2012   139 of 267   CSR
2/24/2012   140 of 267   CSR
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2/24/2012   142 of 267   CSR
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2/24/2012   145 of 267   CSR
2/24/2012   146 of 267   CSR
2/24/2012   147 of 267   CSR
2/24/2012   148 of 267   CSR
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      CAX                                      MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                                       QTY /
                                                                                                                                               Unit of Unit or
 Vendor     Comm#       Form#                                  Title/Description                              Rev.     Color     Size
                                                                                                                                                Issue *Special
                                                                                                                                                       Paper
MSI        4835-0107   CAX-107   Charge Out Card                                                                      Buff       8 1/2 - 11    EA        Index         $0.043
MSI/ELE    4835-1114   CAX-114   Notice of Action / Parole Board                                              03/11              8 1/2 - 11    ST              6       $0.372
MSI        4835-1115   A         Notice of Action (Continuous Feed)                                                              8 1/2 - 11    ST              4
DMB        4835-0115   CAX-115   Order of Discharge from Sentence (Continuous Feed) 3/2007                    07/93              8 1/2 - 11    EA
MSI        4835-0116   CAX-116   Parole Board Hearing Comments (Continuous Feed)                                                 8 1/2 - 11    ST              2
ELECT      4835-1120   CAX-119   Parole Board Order for Parole (BACK)                                         03/01              8 1/2 - 11    ST
MSI        4835-1119   A         Parole Board Notice of Parole (Continuous Feed)                                                 8 1/2 - 11    ST              7
MSI        4835-1216   CAX-216   Add Sheet (Continuous Feed)                                                                     2 3/16 11
                                                                                                                                 8 1/2 - - 5   SH
MSI        4835-0225   CAX-225   Pass - Office of Deputy Warden                                                       Yellow          7/16     PD           100
MSI        4835-0226   CAX-226   Parole Interview Rights and Receipt (Continuous Feed)                                           8 1/2 - 11    ST              5
ELECT      4835-0227   CAX-227   Notice of Intent to Conduct a Parole Board Interview                         04/09              8 1/2 - 11
MSI        4835-0228   CAX-228   Review of Screening (Continuous Feed)                                                           8 1/2 - 11 SH
DMB-PG     4835-0259   CAX-259   Employee Pass - Temporary (Minimum order 100)
DMB PG     4835-0261   CAX-261   Employee Pass (Minimum order 100) Detail (Continuous feed forms - See CAJ-
                                 Public Works Count Sheet - Prisoner
MSI        4835-1306   CAX-306   306 for non-continuous feed forms)                                           06/96            5 1/2 - 8 1/2 ST                3       $0.129
DMB PG     4835-0325   CAX-325   Transportation Manual (26 page booklet) EXEMPT - ORDER FROM DMB!
           4835-9009   CAX-398   Pocket Guide for Prisoner Rule Violation(booklet)                            10/10   Green        3 1/2 - 5   BK            EA        $1.179
MSI                    CAX-431   EMERGENCY TAGS                                                               06/11   GREEN    3 1/4 - 6 1/4   EA         Index        $0.219
MSI        4835-0432   CAX-432   Sprinkler System Main Drain Test Record Tag                                  10/90   Blue     3 1/4 - 6 1/4   EA         Index
                                                                                                                                                          13 pt.       $0.219
MSI        4835-0433   CAX-433   Fire Extinquisher Inspection Record                                          12/08   Green    2 5/8 - 5 1/4   EA          C2S         $0.219
OBS        4835-0434   CAX-434   Fire Extinquisher Tag                                                                         3 1/4 - 6 1/4   EA         Index        $0.219
MSI        4835-0435   CAX-435   SCBA Inspection Tag                                                                Pink       3 1/4 - 6 1/4   EA         Index        $0.219
MSI        4835-0436   CAX-436   Fire and Emergency Key Record                                                03/99 Buff       3 1/4 - 6 1/4   EA         Index        $0.219
MSI        4835-0437   CAX-437   Fire Hose Standpipe Inspection Tag                                                 Yellow     3 1/4 - 6 1/4   EA         Index        $0.219
MSI        4835-0443   CAX-443   Time Cards (Continuous Feed)                                                 08/99 Buff           4 1/2 - 7   EA         Index
MSI        4835-0444   CAX-444   Time Card                                                                                                     EA         Index
MSI        4835-0492   CAX-492   Time Card - Employee - MR                                                                     3 1/4 - 7 1/2   EA         Index
MSI        4835-1492   A         Time Card                                                                                             4-7     EA         Index
MSI        4835-0495   CAX-495   Procurement Log                                                                    NCR                        ST             6
RMI                    CAX-589                                                                                      NCR                        ST             6
MSI        4835-0622   CAX-622   Arsenal Inventory Audit Worksheet(16 page book)                              06/97 white        8 1/2 - 11    BK            EA        $0.288
DMB-PG     4835-0642   CAX-642   Arsenal Inventory Audit Report                                               12/96              8 1/2 - 11    PD           100       $13.786
Cent Ofc
MSI/ELE    4835-0644   CAX-644   Conveying Convicts to Penal Institutions SUPPLIED BY CNT OFC FINANCE
C          4835-0773   CAX-773   Twenty Questions About Parole(1-9 pages)Part of the Prisoner Guide Book       04/09 white       8 1/2 x 11 BK               EA        $0.489
           4835-0819   CAX-819   Time Card - SPSM                                                                                  3 1/2 - 7 EA            Index       $0.014
MSI        4835-0850   CAX-850   Yard Pass (Continuous Feed) NOT FOR LASER PRINTER USE. See CAJ-850 08/98                      3 3/4 - 8 1/2 EA         (3 ea / 8      $0.014
OBS        4835-0890   CAX-890   Training Division Course Evaluation
                                 for Non cont. feed/laser printer. NOTE: Please order total number of passes                                 PASS       1/2 x 11
ELECT                  CAX-939   Parole Eligibility Report (Continuous Feed is OBSOLETE) Avail. Electronically




    2/24/2012                                                                                                                                            153 of 267    CAX
    CAX                  MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                             QTY /
                                                                                     Unit of Unit or
Vendor   Comm#   Form#              Title/Description          Rev.   Color   Size
                                                                                     Issue *Special
                                                                                             Paper




   2/24/2012                                                                                  154 of 267   CAX
    CAX                  MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                             QTY /
                                                                                     Unit of Unit or
Vendor   Comm#   Form#              Title/Description          Rev.   Color   Size
                                                                                     Issue *Special
                                                                                             Paper




   2/24/2012                                                                                  155 of 267   CAX
    CAX                  MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                             QTY /
                                                                                     Unit of Unit or
Vendor   Comm#   Form#              Title/Description          Rev.   Color   Size
                                                                                     Issue *Special
                                                                                             Paper




   2/24/2012                                                                                  156 of 267   CAX
    CAX                  MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                             QTY /
                                                                                     Unit of Unit or
Vendor   Comm#   Form#              Title/Description          Rev.   Color   Size
                                                                                     Issue *Special
                                                                                             Paper




   2/24/2012                                                                                  157 of 267   CAX
    CAX                  MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                             QTY /
                                                                                     Unit of Unit or
Vendor   Comm#   Form#              Title/Description          Rev.   Color   Size
                                                                                     Issue *Special
                                                                                             Paper




   2/24/2012                                                                                  158 of 267   CAX
        CHX                                   MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                                       QTY /
                                                                                                                                                 Unit
                                                                                                                                                       Unit or
Vendor       Comm#      Form#                                 Title/Description                                Rev.    Color     Size             of
                                                                                                                                                      *Special
                                                                                                                                                Issue
                                                                                                                                                       Paper
                                 Physician's Orders (Standard Register - Tear Off at Bottom) See CHJ-122 for
MSI        4835-7122   CHX-122   Bottom glue but no tear-off strip)                                            01/97              8 1/2 - 11 ST               3
DMB-
PG         4835-7133   CHX-133   Laboratory Mounting Sheet (order from DMB whse??) Shrink Wrap in 100's        05/90 Blue 20#     8 1/2 x 11 PG            100
OBS        4835-7135   CHX-135   Hyperlipidemia - Diet Book (Obsolete)                                                          5 1/2 - 8 1/2 BK
MSI        4835-7136   CHX-136   Salt in Your Diet - Booklet                                                   01/90            5 1/2 - 8 1/2 BK
OBS                    CHX-137   Emergency Treatment (obsolete- see CHJ-137)
MSI        4835-7145   CHX-145   Dental Health Record - Envelope                                               09/99 Brown              9 - 12 EA
MSI      4835-7151     CHX-151   Urinalysis - Lab Report(SEE CHJ-151)
MSI      4835-7152     CHX-152   Hematology - Lab Report                                                       08/78 NCR        8 1/4 - 3 1/4   ST            3
         4835-7153     CHX-153   Chemistry - Lab Report                                                        08/78            8 1/4 - 3 1/4   ST            3
MSI      4835-7154     CHX-154   Miscellaneous - Lab Report                                                    07/96            8 1/4 - 3 1/4   ST            3
MSI      4835-7165     CHX-165   Request for Prisoner Transfer for Health Reasons                              11/90               8 1/2 - 11   ST            3
MSI      4835-7181     CHX-181   Admission Consent (SEE CHJ-181)                                               08/03
MSI      4835-7197     CHX-197   Psychological Test (Envelope)                                                 07/89 Brown            9 - 12 EA
msi/elec 4835-7212     CHX-212   Mental Health Services Referral                                               04/05 NCR          8 1/2 - 11 ST               3




      2/24/2012                                                                                                                                       159 of 267   CHX
$0.2013

$2.3575




$0.3306

$0.0719

$0.0719
$0.1150

$0.3306
$0.0863




2/24/2012   160 of 267   CHX
        CRX                                   MSI FORMS INDEX ( Revised 9/1/2011)


  Vendor       Comm#       Form#                                                      Title/Description

MSI           4835-9112   CRX-112   Summary of Reasons for Overtime                                          05/99 White   8 1/2 - 11 SH                 $0.014
                          CRX-113   Facility inspection Resp. Rpt.  "1 cut :1 Sided"                         04/91 White   8 1/2 x 11 SH                 $0.014
ELECT                     CRX-122   Nere Employment Preference Map                                           11/09 White    8 1/2x11 SH

MSI           4835-9130   CRX-130   Notice to Office of Enforcement Operations, Criminal Div US Dept of J.   06/90 white   8 1/2 X 11 PD       100       $2.358
MSI/ELECT     4835-9139   CRX-139   Fire Hydrant Test and Maintenance Data                                   07/06 White   8 1/2 x 11 PD       100       $2.358
MSI                       CRX-149   Evacuation Drill Log                                                     11/90          8 1/2 - 11 PD      100       $0.000
ELECT                     CRX-169   Req. For Hold/ Notification                                              05/94                                       $0.000
MSI           4835-9173   CRX-173   Court Order Collection Record                                            04/97 white   8 1/2 x 11 PD       100       $2.358
ELECT                     CRX-174   DOC QRS Initial Proposal Form (2 pages)                                                                              $0.000
OBS                       CRX-175   Application for Pardon or Commutation Sentence                                                                       $0.000
                                                                                                                                                         $0.000
                                                                                                                                                         $0.000
                                                                                                                                                         $0.000




  2/24/2012                                                                                                                                 161 of 267   CRX
      CSX                                     MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                             QTY / Unit
                                                                                                                                   Unit of       or
 Vendor       Comm#      Form#                               Title/Description                        Rev.    Color    Size
                                                                                                                                   Issue      *Special
                                                                                                                                               Paper
MSI       4835-4106   CSX-104   Basic Information (Continuous Feed)                                   11/95           8 1/2 - 11   ST                  5
MSI       4835-4117   CSX-117   Basic Information Sheet (Continuous Feed)                             09/89           8 1/2 - 11   ST                  4    $0.101
MSI       4835-4124   CSX-123   Parole Eligibility Report (Continuous Feed) (also see CSJ-123 )       06/89           8 1/2 - 11   ST                  6    $0.201
MSI       4835-4135   CSX-134   Transfer Order (Continuous Feed)                                      04/84           8 1/2 - 11   ST                  4    $0.201
                                Community Residential Program Application (Continuous
OBS       4835-3152   CSX-152   Feed)Replaced with CFJ-410                                            02/91           8 1/2 - 11   ST                 5
OMNI      4835-4175   CSX-175   Program Classification Report (Continuous Feed) OMNI ONLY             09/90   NCR     8 1/2 - 11   ST                 4
MSI       4835-3225   CSX-225WH Prisoner Detail (Continuous Feed) 700 sets per box = 1 box or case    09/88            5 1/2 - 8   ST                 5     $0.201
MSI       4835-3225   CSX-225BL Prisoner Detail; All copies are blue; (Continuous Feed) 700 per box   09/88            5 1/2 - 8   ST                 5     $0.288
DMB-PG    4835-3463   CSX-463   CRP Prisoner ID Card
DMB-PG    4835-4463   CSX-463 A Camera Insert Card
                                Time Review & Disposition (Available on Public drive or Continuous
ELEC~MSI 4835-4482    CSX-482   Feed from MSI Print Shop)                                             01/05           8 1/2 - 11 ST                   5     $0.201




  2/24/2012                                                                                                                                    162 of 267   CSX
2/24/2012   163 of 267   CSX
2/24/2012   164 of 267   CSX
2/24/2012   165 of 267   CSX
2/24/2012   166 of 267   CSX
2/24/2012   167 of 267   CSX
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2/24/2012   169 of 267   CSX
2/24/2012   170 of 267   CSX
2/24/2012   171 of 267   CSX
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2/24/2012   173 of 267   CSX
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2/24/2012   177 of 267   CSX
ENVELOPES                          MSI FORMS INDEX ( Revised 9/1/2011)

                                                                                                                                   QTY / Unit
                                                                                                                           Unit of
Vendor     Comm #     Form#                        Title/Description                     Rev.       Color      Size                or *Special
                                                                                                                           Issue
                                                                                                                                      Paper

MSI                 ENV-NW     Envelope, #10, White, Without Window                              White         4 1/8 x 9.5 BX
MSI                 ENV-WW     Envelope, #10, White, With Window                                 White         4 1/8 x 9.5 BX
MSI                 ENV-1015   Envelope, Kraft Brown, 10" x 15", with return address             Brown            10 x 15 EA

MSI      4835-0531 CAJ-531     Property Envelopes - Prisoner ( Brown kraft envelopes )   07/01   Brown       4 1/2 x 6 3/4 EA

         4805-0531 CAJ-531 W Proerty Envelopes - Prisoner (White envelopes)              07/01   White      4 5/8" x 6 3/4" EA




      2/24/2012                                                                                                         178 of 267   ENVELOPES
Price


$14.375
$21.563
  $0.288

  $0.115

  $0.138




  2/24/2012   179 of 267   ENVELOPES
            GOV                            MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                          QTY / Unit
                                                                                                                                Unit of       or
    Vendor    Comm#    Form#                               Title/Description                 Rev.     Color        Size
                                                                                                                                Issue      *Special
                                                                                                                                            Paper
  MSI                 Gov Job   A.B.E. Reading Progress Plotter                               N/A    White          81/2 x 11   EA             Index
  MSI                 Gov Job   Academic School- Assignment Cards                             N/A    White      4 1/4 X 8 1/2   PD               100
  MSI                 Gov Job   Academic School- Language Clues and Reading Strategies       10/91   White          81/2 x 11   PD               100
  MSI                 Gov Job   Academic School- Pay Log                                      N/A    White         8 1/2 X 11   PD               100
  MSI                 Gov Job   Action Pad- Things to Do Today(Block)                         N/A    White         8 1/2 X 11   PD               100
  MSI                 Gov Job   Attic and Basement Bi-Weekly Inspection Form                  N/A    White         8 1/2 X 11   PD               100
  MSI                 Gov Job   Authorization for Medical Treatment- Egeler to Foote Hosp.    N/A    White         8 1/2 X 11   PD               100
  MSI                 Gov Job   Basic Sanitation Program Test- Egeler                         N/A    Canary     5 1/2 X 8 1/2   BK
  MSI                 Gov Job   Batch Control Log- Accounting                                 N/A    White         8 1/2 X 11   PD                 100
  MSI                 Gov Job   Business Cards- Crime Victim Services (65# Natural white)    02/06   65# nat.       2 X 3 1/2   Box                500
  MSI                           Business Cards - ( see misc. section of index )
  MSI                 Gov Job   Call-outs Form (Block)                                        N/A    White         8 1/2 X 11   PD              100
  MSI                 Gov Job   Classification Card                                           N/A    Canary       51/2 x 81/2   EA            Index
  MSI                 Gov Job   College Students Need Identifying-JCF                         N/A    White      5 1/2 X 8 1/2   EA
  MSI                 Gov Job   Draper Picks-Pg.1 & 2                                         N/A    White         8 1/2 X 11   PD              100
  MSI                 Gov Job   Employee of the Month Award-Egeler                            N/A                   81/2 x 11   EA            Index
  MSI                 Gov Job   Employee Of The Month-Egeler (Certificate)                    N/A  Canary           81/2 X 11   EA            Index
  MSI                 Gov Job   Inspection Grader- Weave                                      N/A  White           8 1/2 X 11   PD              100
  MSI                 Gov Job   Iron Sign-up Sheet                                            N/A  White           8 1/2 X 11   PD              100
  MSI                 Gov Job   Notice of Cell Condition (CJO-541, CJO-857, or CKO-119)       N/A  White        5 1/2 X 8 1/2   PD              100
  MSI                 Gov Job   Operator's Log                                                N/A  White           8 1/2 X 11   PD              100
  MSI                 Gov Job   Oral Surgery Referral-Dr.Booth                                N/A  White        4 1/4 X 5 1/2   PD              100
  MSI                 Gov Job                                                                 N/A  White                3X5     EA            Index
  MSI                 Gov Job   Performance Evaluation-Egeler                                 N/A  White           8 1/2 X 11   PD              100
  MSI                 Gov Job   Photo Contract                                                N/A  NCR          5 1/2 X 8 1/2   ST                3
  MSI                 Gov Job   Plumbing Repairs(CIT-151)                                    09/87 White        4 1/4 X 5 1/2   PD              100
  MSI                 Gov Job   Prisoner Movement Log                                         N/A  White           8 1/2 X 11   PD              100
  MSI                 Gov Job   Prisoner Passes CSJ-183-Egeler QM (Deliver Bedrolls)               white           8 1/2 X 11   PD              100
  MSI                 Gov Job   Reasons for Downtime - Picks                                       white           8 1/2 X 11   PD              100
  MSI                 Gov Job   Prisoner Release and Receive Log-DWH                          N/A White             81/2 X 11   PD              100
  MSI                 Gov Job   Regional Quartermaster Uniform Requisition                    N/A NCR              8 1/2 X 11   ST                4
  MSI                 Gov Job   Regional Warehouse Receiving Report                           N/A White            8 1/2 X 11   PD              100
  MSI                 Gov Job   Reprint Order Form (Photo) - Egeler                           N/A White            5 5/8 X 11   PD              100
  MSI                 Gov Job   Schedule of Sales and Tax Rates                               N/A White            8 1/2 X 11   EA            Index
  MSI                 Gov Job   Sign in Sheet- Egeler                                         N/A White            8 1/2 X 11   PD              100
  MSI                 Gov Job   Standard Compliance Checklist- Egeler                         N/A White            8 1/2 X 11   PD              100
  MSI                 Gov Job   State Issued Clothing Log-Egeler QM                          07/96 White         51/2 X 81/2    EA            Index
  MSI                 Gov Job   Store Requisition- Egeler Pg.1 & 2                            N/A White            8 1/2 X 11   PD              100
  MSI                 Gov Job   Sulzer Daily Picks and Time Report                            N/A White            8 1/2 X 11   PD              100
  MSI                 Gov Job   Sulzer Picks                                                  N/A White            8 1/2 X 11   PD              100
  MSI                 Gov Job   Time and Temperature Control Sheet                            N/A NCR           5 1/2 X 8 1/2   ST                3
  MSI                 Gov Job   Time and Temperature Chart- Food Service                      N/A White            8 1/2 X 11   PD              100
  MSI                 Gov Job   Training Nomination/Confirmation Form                         N/A White            8 1/2 X 11   PD              100
2/24/2012                                                                                                                             180 of 267    GOV
            GOV                           MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                        QTY / Unit
                                                                                                              Unit of       or
    Vendor    Comm#    Form#                             Title/Description         Rev.    Color    Size
                                                                                                              Issue      *Special
                                                                                                                          Paper
  MSI                 Gov Job   Weaver Inspection                                  N/A    White     8 1/2 X 11 PD              100
  MSI                 Gov Job   Weekly Material Report- Draper Weave/Sulzer Room   N/A    White    51/2 x 81/2 PD              100




2/24/2012                                                                                                           181 of 267   GOV
                $0.043
                $1.294
                $2.559
                $2.559
                $2.559
                $2.559
                $2.559
                $0.000
                $2.559
              $28.750
                $0.000
                $2.559
                $0.014
                $0.014
                $2.559
                $0.043
                $0.043
                $2.559
                $2.559
                $1.294
                $2.559
                $1.179
                $0.014
                $2.559
                $0.072
                $1.179
                $2.559
                $2.559
            $2.559
                $2.559
                $0.101
                $2.559
                $2.358
                $0.043
                $2.559
                $2.559
                $0.029
                $2.961
                $2.559
                $2.559
                $0.072
                $2.559
                $2.358
2/24/2012                182 of 267   GOV
            $2.559
            $1.294
            $0.000
            $0.000
            $0.000
            $0.000
            $0.000
            $0.000
            $0.000
            $0.000
            $0.000
            $0.000
            $0.000
            $0.000




2/24/2012            183 of 267   GOV
MSI LABELS                   MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                             QTY / Unit
                                                                           Label                                     Unit of
     FACTORY     Form#                      Title/Description      Rev.               INK Color(s)      Size                 or *Special   Price
                                                                           Color                                     Issue
                                                                                                                                Paper
??                        Address Labels- Avery (MSI)              N/A    White    Black                1 X 1 3/4 EA          Gummed
JANITORIAL     LBL-8720   TABLE WARE DESTAINER                                     Blk/Cyan                  8-5     EA                         $0.060
JANITORIAL     LBL-8721   SANI HANDS                                               Blk/Mustard Gold          8-5     EA                         $0.060
JANITORIAL     LBL-8749   DIAMOND STRIP                                            Blk/Pantone Grn      10 1/2 - 5   EA                         $0.060
JANITORIAL     LBL-8750   MULTI-PURPOSE CLEANER                                    Blk/Purple               10 - 5   EA                         $0.060
JANITORIAL     LBL-8751   GLASS CLEANER                                            Blk/Purple                8-5     EA                         $0.060
JANITORIAL     LBL-8752   SPRAY & WIPE                                             Blk/Purple                8-5     EA                         $0.060
JANITORIAL     LBL-8754   CLEANER DEGREASER                                        Blk/Purple               10 - 5   EA                         $0.060
JANITORIAL     LBL-8756   DETERGENT-DISINFECTANT                                   Black                    11 - 5   EA                         $0.060
JANITORIAL     LBL-8757   DISHWASHING DETERGENT, MANUAL                            Blk/Cyan                 10 - 5   EA                         $0.060
JANITORIAL     LBL-8758   DISHWASHING DETERGENT, MACHINE                           Blk/Cyan                 10 - 5   EA                         $0.060
JANITORIAL     LBL-8759   DISINFECTANT-SANITIZER-DEODORIZER                        Blue                     15 - 5   EA                         $0.060
JANITORIAL     LBL-8760   RINSE AGENT                                              Blk/Cyan                 10 - 5   EA                         $0.060
JANITORIAL     LBL-8761   LIME SOLVENT SCALE REMOVER                               Blk/Cyan                 10 - 5   EA                         $0.060
JANITORIAL     LBL-8762   LIQUID TOILET BOWL CLEANER                               Blk/Cyan                 10 - 5   EA                         $0.060
JANITORIAL     LBL-8763   FLOOR WAX STRIPPER                                       Blk/Pantone Grn          10 - 5   EA                         $0.060
JANITORIAL     LBL-8764   FLOOR SEALER                                             Blk/Pantone Grn          10 - 5   EA                         $0.060
JANITORIAL     LBL-8765   GLOSS COAT                                               Blk/Pantone Grn          10 - 5   EA                         $0.060
JANITORIAL     LBL-8766   CARPET STEAM CLEANER                                     Blk/Pantone Grn          10 - 5   EA                         $0.060
JANITORIAL     LBL-8767   HAND & BODY SOAP                                         Blk/Mustard Gold          8-5     EA                         $0.060
JANITORIAL     LBL-8770   HIGH SPEED BURNISHABLE FLOOR WAX                         Blk/Pantone Grn          10 - 5   EA                         $0.060
JANITORIAL     LBL-8771   CITRUS MAGIC SUPER CLEANER                               Blk/Orange                8-5     EA                         $0.060
JANITORIAL     LBL-8772   CITRUS MAGIC GLASS CLEANER                               Blk/Orange                8-5     EA                         $0.060
JANITORIAL     LBL-8773    CITRUS MAGIC SPRAY DEGREASER                            Blk/Orange                8-5     EA                         $0.060
JANITORIAL     LBL-8774   QUARRY TILE CLEANER                                      Blk/Pantone Grn          10 - 5   EA                         $0.060
JANITORIAL     LBL-8776   SCOURING CLEANER                                         Blk/Pantone Grn          10 - 5   EA                         $0.060
JANITORIAL     LBL-8777   FLOOR CLEANING COMPOUND                                  Blk/Pantone Grn          10 - 5   EA                         $0.060
JANITORIAL     LBL-8778   MANUAL DISHWASHING DETERGENT                             Blk/Cyan                 10 - 5   EA                         $0.060
JANITORIAL     LBL-8780   LAUNDRY BUILT DETERGENT                                  Blk/Reflex Blue          10 - 5   EA                         $0.060
JANITORIAL     LBL-8781   LAUNDRY DETERGENT SYNTHETIC                              Blk/Reflex Blue          10 - 5   EA                         $0.060
JANITORIAL     LBL-8782   LAUNDRY BLEACH, GRANULATED                               Blk/Reflex Blue          10 - 5   EA                         $0.060
JANITORIAL     LBL-8786   OXYGEN BLEACH, GRANULATED                                Blk/Reflex Blue          10 - 5   EA                         $0.060
JANITORIAL     LBL-8788   LAUNDRY DETERGENT, NON-PHOSPHATE                         Blk/Reflex Blue          10 - 5   EA                         $0.060
JANITORIAL     LBL-8789   LAUNDRY BLEACH, NON-PHOSPHATE                            Blk/Reflex Blue          10 - 5   EA                         $0.060
JANITORIAL     LBL-8790   LAUNDRY DETERGENT, W/ OXYGEN BLEACH                      Blk/Reflex Blue          10 - 5   EA                         $0.060
JANITORIAL     LBL-8792   DIAMOND GLOSS                                            Blk/Pantone Grn          10 - 5   EA                         $0.060
JANITORIAL     LBL-8800   LAUNDRY DETERGENT LIQUID                                 Blk/Reflex Blue          10 - 5   EA                         $0.060
JANITORIAL     LBL-8801   LAUNDRY BLEACH, LIQUID                                   Blk/Reflex Blue          10 - 5   EA                         $0.060
JANITORIAL     LBL-8808   LIQUID LAUNDRY FRESH                                     Rflx Blu/Sapphire         8-5     EA                         $0.060
JANITORIAL     LBL-FLR    FLOOR CLEANER                                            Black               1/2 x 1-3/4
JANITORIAL     LBL-GLS    GLASS CLEANER                                            Black               1/2 x 1-3/4
JANITORIAL     LBL-SAN    DISINFECTANT SANITIZER                                   Black               1/2 x 1-3/4
JANITORIAL     LBL-APC    ALL PURPOSE CLEANER                                      Black               1/2 x 1-3/4
JANITORIAL     LBL-H2O    WATER                                                    Black               1/2 x 1-3/4

2/24/2012                                                                                                                          184 of 267    MISC
MSI LABELS                        MSI FORMS INDEX ( Revised 9/1/2011)
                                                                                                                                QTY / Unit
                                                                                    Label                               Unit of
    FACTORY           Form#                     Title/Description           Rev.            INK Color(s)      Size              or *Special   Price
                                                                                    Color                               Issue
                                                                                                                                   Paper
MATTRESS            MATTRESS SHIPPING LABELS; AVERY, WITH BORDER                                           4 X 2 15/16** EA                        $0.081
JXSN GARMENT        GARMENT SHIPPING LABELS; AVERY, WITH BORDER                                            4 X 2 15/16** EA                        $0.081
                             Label-Contents (License Plate Fac)(C1S Label   04/03
License Plate Fac   CAO-444  Stock)                                                                        3 1/4 x 5 1/4 PD            100         $0.092




2/24/2012                                                                                                                             185 of 267    MISC
  MISC                                         MSI FORMS INDEX ( Revised 9/1/2011)

                                                                                                                                              Unit of
   Vendor    Comm #     Form#                                  Title/Description                     Rev.            Color       Size
                                                                                                                                              Issue

 MSI                              Business Cards ( 1-sided & 1-color ) box of 500 ea
 MSI                              Business Cards ( 2-sided & 1-color ) box of 500 ea
 MSI        48f-WMP   WMP         Water Marked Paper                                                 N/A     Gilbert Lanc       8 1/2 x 11    SH
                                  Central Office Folder- Manilla                                     N/A     Manilla           19 X 12 1/4    EA
 MSI        48F-Blank             2-Part NCR----10 REAMS PER CASE                                            NCR                8 1/2 x 11    REAM
 MSI        48F-Blank             3-Part NCR----10 REAMS PER CASE                                            NCR                8 1/2 x 11    REAM
 MSI        48F-Blank             4-Part NCR----10 REAMS PER CASE                                            NCR                8 1/2 x 11    REAM
 MSI        48F-Blank             5-Part NCR----10 REAMS PER CASE                                            NCR                8 1/2 x 11    REAM
            48F-Blank-
 MSI        S                     3-Part NCR----10 REAMS PER CASE(Straight Sequence)                         NCR                 8 1/2 x 11 REAM
            48F-Blank-
 MSI        S                     4-Part NCR----10 REAMS PER CASE(Straight Sequence)                         NCR                 8 1/2 x 11 REAM
            48F-Blank-
 MSI        S                     5-Part NCR----10 REAMS PER CASE(Straight Sequence)                         NCR                 8 1/2 x 11   REAM
 MSI        4820-0001 MSI-001     Overtime Work Slip (MSI)                                           03/98   NCR                      4x7     ST
 MSI                   MSI-002    MSI Farms & Agri Business - Time Card                              09/05   150# Tag         3 3/8 x 6 3/4   EA
 MSI                   MSI-003    MSI Kinross Garment - Time Card                                    10/05   150# Tag             3 3/8 x 7   EA
 MSI                   MSI-004    Pick Up Order Forms (Numbered)                                             NCR              5 1/2 X 8 1/2   EA
 MSI                   MSI-004A   Pick Up Order Forms (Unnumbered)                                           NCR              5 1/2 X 8 1/2   EA
 MSI                   MSI-005    Metal Furniture Move Order                                         08/94   NCR              5 1/2 X 8 1/2   ST
 MSI                   MSI-006    MSI Price List                                                     09/06   book                8 1/2 x 11   EA
 MSI                   MSI-007    MSI Sawmill Cut Ticket Log                                         01/06
 MSI                   MSI-008    Prescription Order Form- Optical Laboratory (Egeler)                N/A    NCR                4 3/4 X 11 ST
 MSI                   MSI-009    Pricelist Evelope                                                          ENV.
 MSI                   MSI-010    MSI Sawmill Cut Ticket                                             01/06   NCR                 4 1/4 X 11 ST
 MSI                   MSI-011    Generic MSI timecard                                               02/06   200# Tag              3 3/8 x 7 EA
                                                                                                                                             Box/50
 MSI                  MSI-012     City of Durand business cards (Police Dept. with officer's name)   03/06   65# Nat. Felt         2 x 3 1/2 0
                                                                                                                                             Box/50
 MSI                  MSI-013     City of Durand business cards (Police Dept. with blank line)       03/06   65# Nat. Felt         2 x 3 1/2 0
 MSI                  MSI-014     Letterhead MI Airguard Historical Association                      03/06   Gilbert Lanc         8 1/2 x 11 EA
 MSI                  MSI-015     Letterhead Selfridge Air Museum                                    03/06   Gilbert Lanc         8 1/2 x 11 EA
 MSI                  MSI-016     #9 MAGHA return envelopes                                          03/06   Security tint          #9 env. Box/50
 MSI                  MSI-017     #9 Selfridge Air Museum return envelopes                           03/06   Security tint          #9 env. Box/50
 MSI                  MSI-018     #10 MAGHA envelope                                                 03/06   white                 #10 env. Box/50
 MSI                  MSI-019     #10 Selfridge envelope                                             03/06   white                 #10 env. Box/50
 MSI                  MSI-020     #10 MAGHA indicia envelopes                                        03/06   white                 #10 env. Box/50
 MSI                  MSI-020A    6"x9" MAGHA indicia envelopes                                      05/07   white                   6" x 9" Box/50
 MSI                  MSI-021     Crime Victim Services Brochure                                     04/06   60# white          8 1/2" x 11" EA
 MSI                  MSI-022     Selfridge Gate Pass                                                04/06   110# white       5 1/2 X 8 1/2 EA
 MSI                  MSI-023     Director's Stationary (printed in reflex)                          05/06   65# cover       5 1/2" x 8 1/2" EA
 MSI                  MSI-024     Director's Stationary - matching envelopes                         05/06   70# text A-2    5 1/2" x 4 1/4" EA
2/24/2012                                                                                                                          186 of 267     MISC
  MISC                                          MSI FORMS INDEX ( Revised 9/1/2011)

                                                                                                                                                                Unit of
   Vendor    Comm #       Form#                                  Title/Description                              Rev.            Color             Size
                                                                                                                                                                Issue

 MSI                    MSI-025    Tab sets (58 tabs per set) for the 2006/2007 Price List                      12/06   Green                    8 1/2" x 11" EA
 MSI                    MSI-026    Equipment Repair Inspection Tag - Muskegon Complex                           07/07   Blue                          3" x 6" EA
 MSI                    MSI-027    Wood Furniture Inpsection Tag (includes 4 perfs)                             10/07   White                     3" x 8 1/4" EA
 MSI                    MSI-028    Potato Factory Shipper                                                       10/07                                         EA
 MSI                    MSI-029    Education Dept. Note pads                                                    10/07   20# White             5 1/2" x 8 1/2" PD
 MSI                    MSI-030    Brooks Laundry Tally Sheet                                                   10/07   NCR                      8 1/2" x 11" ST
 MSI                    MSI-031    Imax Level V Guidebook - 13 pages w/110# canary cover (2 hole drill)         11/07   White&canary               8 1/2 x 11 BK
 MSI                    MSI-032    Handlon Guidebook - 44 pages w/110# green cover (2 hole drill)               11/07   White&green                8 1/2 x 11 BK
 MSI                    MSI-033    I-Max Unit II Rules - 13 pages w/110# blue cover/2 hole with plastic fast.   03/08   White&blue                 8 1/2 x 11 BK
 MSI                    MSI-034    Daily Finished Goods - Jackson Mattress Factory                              03/08   NCR                   5 1/2" x 8 1/2" ST
 MSI                    MSI-035    Daily Finished Goods - Jackson Garment Factory                               03/08   NCR                   5 1/2" x 8 1/2" ST
 MSI                    MSI-036    Education Pads - 3x5 Teacher Appreciation Week                               04/08   20# White                     3" x 5" PD
 MSI                    MSI-037    Carson City Garment Labels - with MSI Logo                                   05/08   White                         2" x 4" EA
 MSI                    MSI-038    Numerical Dividers                                                           08/08   110 White indx              8.5x11.5 LOT
 MSI                    MSI-039    Tab Dividers VA                                                              08/08   110 White indx              8.5x11.5 LOT
 ELECT                  MSI-040    Repair Order for MSI Eyewear                                                 11/09
 MSI                    MSI-041    DMVA LEGION OF MERIT CERTIFICATE                                             04/11   60#Ivory Astroparch        8.5x11.5     EA
 MSI                    BRO-001    Computer for Schools Advertising Brochure (4 color; 2-sided; Tri-Fold)       08/02   80# white                 8 1/2 x 11    EA
 MSI        4835-       CAO-444    Contents - Label ( License Plate Factory ) ( C1S paper stock )               04/03   60# white              3 1/4 X 5 1/4    PD
 MSI                               Cost of Sales- MSI                                                            N/A    NCR                      1/2 X 8 1/2
                                                                                                                                               5 2 1/4 - 7 (6   ST
 MSI                    HFH-001    Count Strip; Foote Hospital Secure Unit                                      07/96   white                            3/4)   PD
 MSI                    007A-MRF   Count Strips - MRF Unit 7 A Wing                                             08/02                                           PD
 MSI                    007B-MRF   Count Strips - MRF Unit 7 B Wing                                             08/02                                           PD
 MSI                    007C-MRF   Count Strips - MRF Unit 7 C Wing                                             08/02                                           PD
 MSI                    007D-MRF   Count Strips - MRF Unit 7 D Wing                                             08/02                                           PD
 MSI                    SMT-001    Count Strip - SMT Laundry Count Strip (8 1/2 x 11) 1-84                      02/09   NCR                       8 1/2 x 11    ST
 MSI                    SMT-002    Count Strip - SMT Laundry Count Strip (8 1/2 x 11) 1-96                      02/09   NCR                       8 1/2 x 11    ST
 MSI                    SMT-003    Count Strip - SMT Laundry Count Strip (8 1/2 x 11) 1-76                      02/09   NCR                       8 1/2 x 11    ST
 MSI                               Cutting Ticket- Factory 1242 (Carson City)                                   08/96   NCR                    5 1/2 X 8 1/2    ST
 MSI                               Daily Production Report                                                       N/A    NCR                    6 1/2 X 8 1/2    ST
 MSI                               Document Record                                                               N/A    White                       11 X 17     PD
 MSI                    URF-001    Chippewa Garment Factory(Store Card)                                         04/06   White Index                    5X8      EA
 MSI                    KCF-010    Finished Goods Control Card (Kinross)                                        08/05   White Index                5 1/4 x 8    EA
 MSI                    KCF-011    Store Card (Form A61)                                                        09/05   White Index                5 1/4 x 8    EA
 MSI        4835-8111              Door Card-Regular (blue)                                                             blue                         2" X 8"    EA
 MSI        4835-8112              Door Card-Regular (orange/salmon)                                                    salmon                       2" X 8"    EA
 MSI        4835-8113              Door Card-Regular (pink/cherry)                                                      pink                         2" X 8"    EA
 MSI        4835-8114              Door Card-Regular (red)                                                              red                          2" X 8"    EA
 MSI        4835-8115              Door Card-Regular (white)                                                            white                        2" X 8"    EA
 MSI        4835-8116              Door Card-Regular (yellow/canary)                                                    yellow                       2" X 8"    EA
 MSI        4835-8117              Door Card- Special (manilla) 150#                                                    manilla                     3" X 12"    EA

2/24/2012                                                                                                                                           187 of 267       MISC
  MISC                                          MSI FORMS INDEX ( Revised 9/1/2011)

                                                                                                                                                      Unit of
   Vendor    Comm #       Form#                                Title/Description                            Rev.             Color       Size
                                                                                                                                                      Issue

 MSI        4835-8118               Door Card- Special (manilla) 150#                                              manilla               3" X 8.5"    EA
 MSI                    LRF-166     GUIDEBOOK, Brooks Facility Section(20 pages)                            08/04 White & Green         8 1/2 x 11    BK
 MSI                    MCF-166     GUIDEBOOK, Muskegon Facility Section(67 pages)                          01/08 White &Yellow         8 1/2 x 11    BK
 MSI                    MRF-166     GUIDEBOOK, Macomb Facility Section                                      08/04 White & Blue          8 1/2 x 11    BK
 MSI                    RGC-166     GUIDEBOOK, Egeler Facility Section                                      02/06                       8 1/2 X 11    BK
 MSI                    SMT-166     GUIDEBOOK, Parnall Facility Section                                     08/04?                                    BK
 MSI                    SMT-166     FACILITY SECTION OF GUIDEBOOK                                                  Canary               8 1/2 X 11    BK
 MSI                    NCF-166     GUIDEBOOK, Newberry Facility(7 sheets 2 sided)                          10/10 White                 8 1/2 X 11    BK
 MSI                    MSI-031     GUIDEBOOK, Imax Level V - 13 pages w/110# canary cover (2 hole drill)   11/07 White & canary        8 1/2 x 11    BK
 MSI                    MSI-032     GUIDEBOOK, Handlon - 44 pages w/110# green cover (2 hole drill)         11/07 White & green         8 1/2 x 11    BK
 MSI                    MSI-033     GUIDEBOOK, I-Max Unit II Rules - 13 pages w/110# blue cover/2 hole      03/08 White & blue          8 1/2 x 11    BK
 MSI                    RMP         CAJ-544 Special Problem Offender Notice(Red Mark Paper Only)                   White Bond           8 1/2 x 11    500
 MSI                    ENV-NW      Envelope, #10, White, Without Window                                                                              BX
 MSI                    ENV-WW      Envelope, #10, White, With Window                                                                                 BX
                                    Explanation of Duties to Register as a Sex Offender (MSI DOES NOT
 ELECT                  DD4         PRINT)
 MSI                                                                                                         N/A    NCR              5 1/2 X 8 1/2    ST
 MSI                                Horticulture/Plant ID Booklet                                           07/99   White               8 1/2 X 11    BK
 MSI        4835-7802 DCH-675       Important Health Information Booklet                                    05/02   White               8 1/2 X 11    BK
 MSI                  JCF-003       JCF Blood Spill Kit (Weekly Check)                                      05/03   White            2 1/2 - 4 7/16   EA
 MSI                  JCF-001       JCF Eyewash Station (Weekly Check)                                      05/03   White            2 1/2 - 4 7/16   EA
 MSI                  JCF-002       JCF First Aid Kit (Weekly Check)                                        05/03   White            2 1/2 - 4 7/16   EA
 MSI                                Laundry Checklist- Brooks                                               04/00   White               4 1/4 X 11    PD
 MSI        4835-6001               Locater Cards/Count Board Tags (blue)                                           blue                    2" X 8"   EA
 MSI        4835-6002               Locater Cards/Count Board Tags (pink/cherry)                                    pink                    2" X 8"   EA
 MSI        4835-6003               Locater Cards/Count Board Tags (red)                                            red                     2" X 8"   EA
 MSI        4835-6004               Locater Cards/Count Board Tags (yellow/canary)                                  yellow                  2" X 8"   EA
 MSI        4835-6005               Locater Cards/Count Board Tags (blue) Lakeland Coldwater                        blue                  3" X 10"    EA
 MSI                                Master Count Strips- Waterloo                                           08/00   White               2 3/4 X 13    PD
 ELECT                  DD4-A       Michigan Sex Offender Registration (MSI DOES NOT PRINT THIS)
 MSI                    MAP-025     Minority Advisory Panel                                                 07/05   white            4 1/4 X 5 1/2 PD
                        MPPOA-      MPPOA Annual Membership Directory (Revised Annually - Cost varies
  MSI                   Directory   according to total pages)                                               04/04   White               8 1/2 x 11    BK
  MSI                   A-324       MSI Official Inventory Tag                                                                            3 1/4 - 8   EA
  MSI                               Official Daily Travel Log                                                N/A    White            5 1/2 X 8 1/2    PD
  MSI                   see CAR-    Parnall Visiting Guidelines                                             01/02   White               8 1/2 x 11    BK
  MSI                   723         Prisoner Counseling/Warning Notice                                      01/87   White            8 1/2 X 5 1/2    PD
  MSI                   CAH-144     Prisoner Program Survey- (for JCF)                                      11/06   White               8 1/2 X 11    BK
  MSI                               Quartermaster Laundry Sheet-Egeler                                       N/A
  MSI                               Regional Warehouse Receiving Ticket-2 Page Form                          N/A    White               8 1/2 X 11
  MSI                               Request for Pick-up                                                      N/A    NCR              8 1/2 X 5 1/2 ST
2/24/2012                                                                                                                                  188 of 267 MISC
  MISC                                         MSI FORMS INDEX ( Revised 9/1/2011)

                                                                                                                                                  Unit of
   Vendor    Comm #       Form#                                Title/Description                         Rev.             Color      Size
                                                                                                                                                  Issue

 OBS                             Rule Booklet- MSI (Obsolete: included in Operating Manual now)
 MSI                    MISC     S.A.I. General Rules Card                                               12/97   White                   3 X 5 EA
 MSP/SCAO               SIR88-1  Sentencing Information Rpt (NOT PRINTED AT MSI)
 MSI                             Time Card- General (Employee)                                            N/A
 MSI                             Time Card-Gilman TRV - [Similar to Tops Form 1276]                       N/A    Canary            3 X 10 7/16 EA
 DMBwh      4835-7803            Tuberculosis - Get the Facts (100 per shrink wrapped pack)              07/99   Goldenrod           8 1/2 - 11 PK
 DMBwh      4835-7804            AIDS Information for Parolees                                                                                  EA
 DMBwh      4835-7805            AIDS Information for Prisoners                                                                                 EA
 DMBwh      4835-7807            Tuberculosis - Get the Facts - Spanish Version (200 per)                                                       PK
 DMBwh      4835-7808            Tuberculosis - The Connection Between TB & HIV (200 per)                                                       PK
                                 Tuberculosis - The Connection Between TB & HIV - Spanish Version (200
 DMBwh      4835-7809            per)                                                                                                             PK
 DMBwh      4835-7812            About Tuberculosis - Spanish Version
                                 Photo Tickets - SLF                                                     11/00   Yellow               2.5 - 4.4 EA
 MSI                    PT-SRF   Photo Tickets - SRF                                                     11/00   Green                2.5 - 4.4 EA
                                 Photo Tickets - STF                                                     11/00   Blue                 2.5 - 4.4 EA
 OBS                     CSO-102                                SEE CAJ-223
 OBS                     CSO-407                                SEE CAJ-248
 MSI        4835-7810   CN-001   Contact Notice ( Used by the Agents making home calls)($.081 each)      04/05   Neon Green       3 1/2 X 8 1/2   EA
 MSI        4835-7811   ICF-100  Arsenal Inventory Door Card                                             04/05   Canary              8 1/2 X 11   EA
 MSI        4835-7813   RGC-001 Westshore 2 color letterhead                                             04/05   specialty           8 1/2 X 11   Sh
 MSI        4835-7814   RGC-002 Westshore 2 color #10 Envelopes                                          04/05   White                      #10   box
 MSI        4835-7815   RGC-003 Westshore 2 color business cards (500 per box)                           04/05   White                  2 X3/12   box
 MSI        4835-7816   RGC-004 Westshore 2 color 9 X 12 Envelopes (250 per box)                         04/05   White                   9 X 12   box
 MSI        4835-7817   RGC-005 Receipt of Oreintation Form                                              09/07   NCR                  8 1/2X11    ST
 MSI                    RGC-006 PREA Verification                                                        01/11   NCR                  8 1/2X11    ST
 MSI        4835-7825   MAP-025 Michigan Department of Corrections Minority Advisory Panel               07/05   White            4 1/4 x 5 1/2   PD
 MSI        4835-       CAH-999  State of Michigan Transmittal (DMB-10575)                               02/05   white                    4X6     PD

 OBS                    CHG-422    Internet Access Change Notification                                   06/05
 MSI                    RW-001     Shipping/Load Invoice(Numbered upper right hand corner)               04/06   NCR                  4 1/2 X 8   ST
 MSI                    SAI-1      Parenting from Prison(11 page front and back)                         06/08   white              8 1/2 X 11    book
 MSI                    SAI-2      Family Reunification(6 page, front only)                              06/08   white              8 1/2 X 11    book
 MSI                    MID-1      MOTOR VEHICLE PERMIT(Hang from mirror)                                08/08                     2 3/4 x5 1/2   ea
 MSI                    CAMA-1     CAMA Brochure
 MSI                    CC-Bus     Charlevoix County Sheriff's -- Business Cards                         05/09   white                2 X 3 1/2   500
 MSI                    CC-1       Charlevoix County Sheriff's -- Return Envelopes(Black/PMS871)         05/09   white                      #10   500
 MSI                    CC-2       Charlevoix County Sheriff's -- Letterhead(Black/PMS871)               05/09                       8 1/2 X 11   ea
 MSI                    CC-3       Charlevoix County Sheriff's -- Report Card                            05/09   white index      3 1/2 X 5 1/4   ea
 MSI                    CC-4       Charlevoix County Sheriff's -- Vehicle Sticker                        05/09   orange           4 1/4 X 5 1/2   ea
 MSI                    CC-5       Charlevoix County Sheriff's -- Door Hanger                            05/09   solar yellow     3 5/8 X 8 1/2   ea
 MSI                    CC-6       Charlevoix County Sheriff's -- No Trespassing Sign(Warm Red)          05/09   white index         8 1/2 X 11   ea
2/24/2012                                                                                                                              189 of 267       MISC
  MISC                                    MSI FORMS INDEX ( Revised 9/1/2011)

                                                                                                                              Unit of
   Vendor   Comm #    Form#                               Title/Description                Rev.            Color     Size
                                                                                                                              Issue

 MSI                 CC-7     Charlevoix County Sheriff's -- Search Warrant Return Items   05/09   NCR              8 1/2 X 11 ST
 MSI                 CC-8     Charlevoix County Sherrif's-- Bad Check Notice               06/09   white           5 1/2X8 1/2 ea




2/24/2012                                                                                                             190 of 267    MISC
  QTY / Unit or
*Special Paper

                  $28.750
                  $31.510
              1    $0.038
            Tag
              2    $6.981
              3    $7.452
              4    $7.935
              5    $8.142

              3    $8.315

              4    $8.798

              5    $9.005
              3    $0.035
            Tag    $0.058
            Tag    $0.058
              4    $0.058
              4    $0.046
              2    $0.023
                   $4.669

              5    $0.086

              4    $0.046
            Tag    $0.058

      Nat. Felt   $32.200

      Nat. Felt   $32.200
        20 lb.     $0.058
        20 lb.     $0.081
          Env.    $34.500
          Env.    $34.500
          Env.    $28.750
          Env.    $40.250
          Env.    $28.750
          Env.    $36.800
                   $0.127
         Index     $0.058
      H. Linen     $0.115
      H. Linen     $0.092
2/24/2012                   191 of 267   MISC
      QTY / Unit or
    *Special Paper

       110# Index      $0.081
        110# Blue      $0.115
       110# Index      $0.092
                 4     $0.092
              100      $0.575
                 3     $0.058
      20# & 110#       $1.438
      20# & 110#       $3.163
      20# & 110#       $1.438
                 2     $0.038
                 2     $0.038
              100      $0.483
      Peel & Stick     $0.058
       110#White      $40.250
       110#White      $40.250

60#AstroparchIvory     $0.300
                       $0.072
               100     $0.863
                 2
               100     $2.156
               100     $2.358
               100     $2.358
               100     $2.358
               100     $2.358
                 2     $0.058
                 2     $0.058
                 2     $0.058
                 4
                 5
               100
             Index     $0.035
             Index     $0.029
             Index     $0.029
             Index     $0.012
             Index     $0.012
             Index     $0.012
             Index     $0.012
             Index     $0.012
             Index     $0.012
             Index     $0.023

    2/24/2012                   192 of 267   MISC
  QTY / Unit or
*Special Paper

        Index      $0.023
   20# & 110#      $1.750
   20# & 110#      $2.610
   20# & 110#      $4.672
           EA      $1.538
                   $0.417
                   $2.458
           20#     $0.750
   20# & 110#      $1.438
   20# & 110#      $3.163
   20# & 110#      $1.438
     500/ream      $6.900
                  $14.375
                  $21.563



             5

                   $0.288
                   $0.014
                   $0.014
                   $0.014
           100
         Index     $0.058
         Index     $0.058
         Index     $0.058
         Index     $0.058
         Index     $0.069
           100

            100    $2.300

    20# White      $0.575
                   $0.029
           100
         15 pg     $0.345
           100
            EA     $0.092


             4
2/24/2012                   193 of 267   MISC
  QTY / Unit or
*Special Paper


         Index     $0.023


         Index
           100     $4.744




         Index     $0.014
         Index     $0.014
         Index     $0.014



         Index     $0.081
         Index     $0.058
     Cla Crest     $0.115
          Env.    $35.938
           80#    $28.750
          Env.    $35.938
             2     $0.058
             3     $0.072
     20# bond      $1.438
           100     $1.300


             4     $0.090
     20# bond      $0.460
     20# bond      $0.115
     110 index     $0.104

                  $30.000
 #10 envelope     $40.250
    watermark      $0.173
   110# index      $0.138
  crack-n-peel     $0.207
     65# cover     $0.253
   110# index      $0.173
2/24/2012                   194 of 267   MISC
  QTY / Unit or
*Special Paper

         NCR      $0.196
     20# bond     $0.058




2/24/2012                  195 of 267   MISC
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2/24/2012   226 of 267   MISC
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2/24/2012   245 of 267   MISC
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2/24/2012   248 of 267   MISC
2/24/2012   249 of 267   MISC
2/24/2012   250 of 267   MISC
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2/24/2012   252 of 267   MISC
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2/24/2012   260 of 267   MISC
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2/24/2012   263 of 267   MISC
2/24/2012   264 of 267   MISC
2/24/2012   265 of 267   MISC
      OUT                         MSI FORMS INDEX ( Revised 9/1/2011)

                                                                                                                           QTY / Unit
                                                                                                                   Unit of
 Vendor   Comm #     Form#                          Title/Description                     Rev.   Color      Size           or *Special
                                                                                                                   Issue
                                                                                                                              Paper

                              Notice of Seizure and Intention to Forfeit and Dispose of
MSI       N/A      OUT-1243   Property (City of Durand)                                   03/04 NCR      8 1/2 X 11 ST    3 PT NCR
MSI       N/A      OUT-1244   Notice of Ordinance Violation (Durand Police)               03/04 NCR      8 1/2 X 14 ST    3 PT NCR
Price



  $0.092
  $0.092

				
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