Business and Finance Division

C

DESTINATION

PREPAID

ITEM          DESCRIPTION                 QTY       U/M        UNIT PRICE       EXTENSION
001  952-07-490076                         1.0000    EA          34.000000          34.00
     OFFENDER:           MARTIN, TRAVONTE
     TDCJ #:             2283582
     CONFIRMATION TEST:  FENTANYL
     SPECIMEN ID:        A00347-2034
     UNIT:               COFFIELD/CO
     REQUESTOR:          C HERNANDEZ
     CONFIRMATION TESTING FOR FENTANYL TESTING
     FENTANYL CONFIRMATION TESTING
     DONE BY LIQUID CHROMATOGRAPHY-TANDEM MASS SPECTROMETRY
     (LC-MS/MS)
     VENDOR MUST PROVIDE CHAIN OF CUSTODY FORMS, COLLECTION CUPS AND
     SHIPPING MATERIALS.  PRICE MUST INCLUDE SHIPPING COSTS TO THE LAB.
     SHIPPING MUST BE NEXT DAY AIR.
     SAMPLES MUST BE TESTED FOR DILUTION VIA CALORIMETRIC TESTING OF
     CREATINE LEVELS. THE TEST RESULTS MUST IDENTIFY SAMPLES THAT ARE
     IDENTIFIED AS DILUTE, THE TESTING METHOD (CALORIMETRIC), THE PRECISE
     CREATINE LEVEL DETECTED AND THE REFERENCE RANGE UTILIZED TO ESTABLISH
     DILUTION.
     RESULTS MUST CLEARLY IDENTIFY THE TESTING LABORATORY, ADDRESS AND
     CONTACT INFORMATION. RESULTS MUST CLEARLY IDENTIFY THE DATE COLLECTED
     AND DATE RECEIVED AT THE LABORATORY. RESULTS MUST CLEARLY IDENTIFY
     POSITIVE OR NEGATIVE FOR EACH ANALYTE AND THE TESTING METHOD
     (LCMS CUT OFF LEVEL). RESULTS MUST IDENTIFY THE SENDING REGION, OFFICE
     AND IDENTIFIER (TDCJ OR SID NUMBER) FOR THE CLIENT.
     RESULTS MUST BE FAXED OR EMAILED TO SPECIALIZED PROGRAMS FOR THE
     PAROLE DEPARTMENT AND PLANS AND OPERATIONS FOR SECURITY OPERATIONS
     UPON COMPLETION OF TESTING AND MADE AVAILABLE VIA AN INTERNET BASED
     PORTAL WITH A SECURE SIGN IN AND ADMINISTRATOR ACCESS.
     AVERAGE TURNAROUND TIME SHOULD BE 7 DAYS.
     4-ANPP 1 NG/ML
     4'-METHYLACETYL FENTANYL 0.5 NG/ML
     ACETYL FENTANYL 0.5 NG/ML
     ACETYL NORFENTANYL 5 NG/ML
     ACRYL FENTANYL 0.5 NG/MLL
     ALFENTANYL 0.5 NG/ML
     ALPHA-METHYLACETYL FENTANYL 0.5 NG/ML
     ALPHA-METHYL FENTANYL 0.5 NG/ML
     BETA-HYDROXYTHIO FENTANYL 0.5 NG/ML
     BUTYRYL FENTANYL 0.5 NG/ML
     BUTYRYL NORFENTANYL 0.5 NG/ML
     CARFENTANIL 0.5 NG/ML
     CIS-3-METHYL FENTANYL 0.5 NG/ML
     CYCLOPENTYL FENTANYL 0.5 NG/ML
     CYCLOPROPYL FENTANYL 0.5 NG/ML
     PARA-FLUOROBUTYRYL FENTANYL 0.5 NG/ML
     FENTANYL 0.5 NG/ML
     FLUOROISOBUTYRYL FENTANYL 0.5 NG/ML
     FLUORO FENTANYL 0.5 NG/ML
     FURANYL FENTANYL 0.5 NG/ML

     FURANYL NORFENTANYL 5 NG/ML
     ISOBUTYRYL FENTANYL 0.5 NG/ML
     METHOXYACETYL FENTANYL 0.5 NG/ML
     NORFENTANYL 0.5 NG/ML
     OCFENTANIL 0.5 NG/ML
     PARA-CHLOROISOBUTYRYL FENTANYL 0.5 NG/ML
     PARA-METHOXYBUTYRYL FENTANYL 0.5 NG/ML
     TETRAHYDROFURANYL FENTANYL 0.5 NG/ML
     VALERYL FENTANYL 0.5 NG/ML
     DELIVER TO:
       TDCJ COFFIELD UNIT SUPPLY
       2661 FM 2054
       TENNESSEE COLONY, TX 75884
     PAYMENT:
      PAYMENT SHALL BE MADE THIRTY CALENDAR DAYS AFTER THE LATTER OF
      (1) THE DATE AN UNCONTESTED INVOICE IS RECEIVED, (2) THE DATE
      GOODS ARE RECEIVED, AND (3) THE DATE SERVICES ARE COMPLETED.
      REFER TO TEXAS GOVERNMENT CODE, CHAPTER 2251.
     AWARDED VENDOR AGREES THAT ANY PAYMENTS DUE UNDER THE PURCHASE
     ORDER OR CONTRACT SHALL BE DIRECTLY APPLIED TOWARDS ELIMINATING
     ANY DEBT OR DELINQUENCY IT HAS TO THE STATE OF TEXAS INCLUDING,
     BUT NOT LIMITED TO, DELINQUENT TAXES, DELINQUENT STUDENT LOAN
     PAYMENTS, AND DELINQUENT CHILD SUPPORT.
     VENDOR MAINTENANCE DIRECT DEPOSIT AND SUBSTITUTE W-9 FORM
     (ELECTRONIC FUNDS TRANSFER):
     GOVERNMENT CODE 403.016 (C) (3) ENCOURAGES STATE AGENCIES TO
     TRANSMIT PAYMENTS TO VENDORS THROUGH ELECTRONIC FUNDS TRANSFER
     (DIRECT DEPOSIT). TO SET UP YOUR ACCOUNT, CONTACT AGENCY ACCOUNTS
     PAYABLE AT (936)437-8761 OR (936)437-6357.
     REGARDLESS AS TO WHETHER DIRECT DEPOSIT IS CHOSEN, THE AWARDED
     VENDOR SHALL SUBMIT A COMPLETED VENDOR MAINTENANCE DIRECT
     DEPOSIT AND SUBSTITUTE W-9 FORM TO TDCJ ACCOUNTS PAYABLE. VENDORS
     WHO HAVE ALREADY SUBMITTED A FORM FOR ANOTHER SEPARATE PURCHASE
     ORDER ARE NOT REQUIRED TO SUBMIT ANOTHER FORM. THE VENDOR FORM AND
     INSTRUCTIONS ARE FOUND AT THE FOLLOWING LINK ON THE TDCJ WEBSITE:
     WWW.TDCJ.STATE.TX.US/DIVISIONS/BFD/ACCT_ACCTS_PAY.HTML
     TO ENROLL FOR ADVANCE NOTIFICATION OF ELECTRONIC FUNDS TRANSFER TO
     YOUR ACCOUNT, PLEASE CONTACT THE NUMBERS LISTED ABOVE. PAYMENT
     INFORMATION MAY BE OBTAINED BY CALLING THE COMPTROLLER OF PUBLIC
     ACCOUNTS TOLL FREE AT (800) 531-5441, EXT. 3-3660 OR IN AUSTIN, TEXAS
     CALL (512) 936-3461, SELECT OPTION 3 (PIN NOT REQUIRED) AND ENTER
     THEIR VENDOR IDENTIFICATION NUMBER AND 696 FOR THE AGENCY NUMBER.
     INFORMATION IS AVAILABLE VIA THE INTERNET AT:
     HTTPS://FMX.CPA.TEXAS.GOV/FMX/PAYMENT/INDEX.PHP
     (NOTE: THIS ADDRESS MUST BE IN LOWER CASE LETTERING WHEN ENTERED
     IN THE ADDRESS BAR OF YOUR BROWSER.)
     SHIPPING AND INVOICING INSTRUCTIONS:
     FAILURE TO FOLLOW THESE SHIPPING AND INVOICE INSTRUCTIONS MAY RESULT
     IN MERCHANDISE BEING REJECTED AT THE RECEIVING DOCK AND RETURNED TO
     THE VENDOR WITHOUT NOTICE.

     SHIPPING INSTRUCTIONS:
     1. ENSURE ITEM(S) IS SENT TO THE CORRECT UNIT/DEPARTMENT WITHIN THE
        TDCJ AS LISTED ON THE PURCHASE ORDER.
     2. DO NOT OVERSHIP. OVERAGES SHALL BE RETURNED AT THE VENDOR'S EXPENSE
        UNLESS ITEMS ARE OF INDETERMINABLE QUANTITY SUCH AS SAND OR GRAVEL.
     3. SHIP INDIVIDUAL LINE ITEMS COMPLETE.
     4. EACH PART SHIPPED SHALL HAVE A PART NUMBER OR BE TAGGED WITH A PART
        NUMBER AS IT APPEARS ON THE PURCHASE ORDER. IF ITEMS ARE SHIPPED
        WITHOUT A PART NUMBER, THEY WILL BE RETURNED TO THE VENDOR AT
        VENDOR'S EXPENSE.
     5. INCLUDE OR MARK PURCHASE ORDER NUMBER ON ALL PACKING SLIPS,
        CARTONS, PACKAGES, BUNDLES, ETC.
     INVOICING INSTRUCTIONS:
     1. THE INVOICE MUST BE ITEMIZED WITH THE DESCRIPTION, UNIT PRICE, UNIT
        OF MEASURE AND EXTENSION EXACTLY AS LISTED ON THE PURCHASE ORDER.
     2. ONLY ITEMS LISTED ON THE PURCHASE ORDER MAY BE BILLED AND PAID FOR
        BY THE TDCJ.
     3. ANY CHANGES TO THE PURCHASE ORDER ARE ONLY VALID UPON RECEIPT OF A
        PURCHASE ORDER CHANGE NOTICE (POCN) FROM THE AUTHORIZED PURCHASER.
     4. INVOICES MUST REFERENCE THE PURCHASE ORDER NUMBER.  ONLY ONE
        PURCHASE ORDER NUMBER ON AN INVOICE. (PURCHASE ORDER NUMBER ALWAYS
        BEGINS WITH AN 'E', EXAMPLE - EX000123)
     5. VENDOR MUST SUPPLY A VALID PAYEE IDENTIFICATION NUMBER (PIN) ON
        EACH INVOICE.
     6. INVOICES MUST BE SENT TO ACCOUNTS PAYABLE, P.O. BOX 4018
        HUNTSVILLE, TX 77342-4018.
        *ONLY DISCOUNTED INVOICES MAY BE EMAILED.
     7. DISCOUNTED INVOICES MUST BE EMAILED TO
        TDCJ.AP-INVSVS@TDCJ.TEXAS.GOV.
     8. SUBMIT SEPARATE INVOICES FOR EACH SHIPMENT/PER LOCATION.
     9. INCORRECT INVOICES WILL BE RETURNED TO THE VENDOR FOR CORRECTION.
     IN ACCORDANCE WITH SECTION 2252.907, GOVERNMENT CODE, THE VENDOR
     ACKNOWLEDGES THAT THIS CONTRACT AND INFORMATION CREATED OR
     MAINTAINED IN CONNECTION WITH THIS CONTRACT IS PUBLIC INFORMATION
     AND SUBJECT TO DISCLOSURE AS PROVIDED BY CHAPTER 552, GOVERNMENT
     CODE (TEXAS PUBLIC INFORMATION ACT).  THE PUBLIC INFORMATION ACT
     MAY REQUIRE THE VENDOR TO MAKE INFORMATION RELATED TO THIS CONTRACT
     AVAILABLE TO THE PUBLIC PURSUANT TO A REQUEST FOR PUBLIC INFORMATION.
     THE VENDOR AGREES, UPON REQUEST, TO MAKE INFORMATION RELATED TO THIS
     CONTRACT THAT IS NOT OTHERWISE EXCEPTED FROM RELEASE BY THE PUBLIC
     INFORMATION ACT AVAILABLE TO THE PUBLIC IN HARD COPY, UNLESS THE
     REQUESTOR OF THE INFORMATION CONSENTS TO RECEIVE THE INFORMATION IN
     ANOTHER MUTUALLY AGREEABLE FORMAT. THE VENDOR ACKNOWLEDGES THAT THE
     AGENCY SHALL NOT PROVIDE LEGAL COUNSEL RELATED TO THE VENDOR'S
     COMPLIANCE WITH THE PUBLIC INFORMATION ACT.
ORDER TOTAL:$         34.00