Business and Finance Division

C

DESTINATION

PREPAID

ITEM          DESCRIPTION                 QTY       U/M        UNIT PRICE       EXTENSION
001  952-07-390075                         1.0000    EA          30.000000          30.00
     OFFENDER:           OLIVAREZ, ARMANDO
     TDCJ #:             02401933
     CONFIRMATION TEST:  AMP
     SPECIMEN ID:        A00310-602
     UNIT:               SCOTT/J4
     REQUESTOR:          J. ALCINDOR
     CONFIRMATION TEST ONLY FOR ONE OF THE FOLLOWING DRUGS WITHIN A SINGLE
     URINE SPECIMEN COLLECTED BY THE CUSTOMER:
     1. AMP AMPHETAMINE (D-AMPHETAMINE, METH, MAMP, ECTASY)
     2. BARBITURATES (AMOBARBITAL, PENTOBARBITAL, SECOBARBITAL)
     3. BZO BENZODIAZEPINES (NORDIAZEPAM, XANAX, VALIUM, ATIVAN, ROHYPNOL,
        ETC.)
     4. COC COCAINE (BENZOYLECGONINE)
     5. THC CANNABINOIDS (11-NOR-9-CARBOXY-THC)
     6. OPI OPIATES (CODEINE, MORPHINE)
     7. PHENCYCLIDINE (PCP)
     CONFIRMATION TEST ONLY FOR ONE OF THE FOLLOWING DRUGS WITHIN A SINGLE
     URINE SPECIMEN COLLECTED BY THE CUSTOMER.
     1. AMP AMPHETAMINE (D-AMPHETAMINE)
     2. BZO BENZODIAZEPINES (NORDIAZEPAM)
     3. COC COCAINE (BENZOYLECGONINE)
     4. THC CANNABINOIDS (11-NOR-9-CARBOXY-THC)
     5. OPI OPIATES (MORPHINE)
     ZONES 1-5
     DELIVER TO:
       TDCJ SCOTT (FORMERLY JESTER IV) UNIT
       SUPPLY
       4 JESTER ROAD
       RICHMOND, TX 77406
     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.
     THE VENDOR AGREES NOT TO USE ANY ARTIFICIAL INTELLIGENCE IN THE
     PERFORMANCE OF THIS CONTRACT WITHOUT PRIOR WRITTEN CONSENT OF THE
     TDCJ.
ORDER TOTAL:$         30.00