Business and Finance Division

Contracts and Procurement Department

Details of Purchase Order - 696-2-EA001214

Purchase Order
Texas Department of Criminal Justice
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Title Table

PURCHASE ORDER

TEXAS DEPARTMENT OF CRIMINAL JUSTICE
Tax Exempt Agency of Texas State Government

Table
Order Table
ORDER DATE:
09-01-21
INVITATION/REQUEST NO:
PURCHASE ORDER NO:
696-2-EA001214
Agency Table
AGENCY NAME AND ADDRESS
TEXAS DEPT. OF CRIMINAL JUSTICE    
ACCOUNTS PAYABLE / 696-2-EA001214  
P.O. BOX 4018                      
HUNTSVILLE, TX 77342-4018          
DESTINATION OF GOODS
TDCJ                                   
HUMAN RESOURCES DIVISION               
TWO FINANCIAL PLAZA, SUITE 600         
HUNTSVILLE, TX  77340                  
Vendor Table
VENDOR NAME AND ADDRESS
BEEVILLE MEDICAL CLINIC WALK IN
301 S HILLSIDE DR STE 4

BEEVILLE, TX 78102 5324
Vendor Data Table
VENDOR PHONE NO.
361-226-1126
VENDOR ID NO.
1811890349
PERSON CONTACTED:
AMANDA GIBSON
CASH DISCOUNT:
NET
%
DAYS OR NET 30
Data Table
Order Type:
E
F.O.B.:
DESTINATION
Freight Terms:
PREPAID
Table
Detail Table
ITEM          DESCRIPTION                 QTY       U/M        UNIT PRICE       EXTENSION
     IN ACCORDANCE WITH THE SPECIFICATIONS AND THE TERMS AND CONDITIONS
     INCLUDED HEREIN, THIS IS FOR THE PROCUREMENT OF DOT PHYSICALS FOR THE
     TDCJ DRIVERS IN THE BEEVILLE AREA.
     THE TERMS OF SUCH PO WILL BE SEPTEMBER 01, 2021 THROUGH AUGUST
     31, 2022.
     ESTIMATED QUANTITIES:
     THE QUANTITIES INDICATED HERE ARE ESTIMATES ONLY AND SHALL NOT BE
     CONSTRUED AS A MINIMUM OR MAXIMUM THAT THE AGENCY MAY ORDER.  ORDERS
     WILL BE PLACED ON AN AS NEEDED BASIS.  ANY QUANTITIES NOT ORDERED OR
     NOT DELIVERED BY AUGUST 31 OF EACH CONTRACT YEAR WILL AUTOMATICALLY
     BE CANCELLED.
     THE TDCJ RESERVES THE RIGHT TO INCREASE OR DECREASE THIS PO, INCLUDING
     ANY EXTENSION OPTIONS, AS DETERMINED TO BE IN THE BEST INTEREST OF THE
     STATE.
     VENDOR SHALL HONOR THE PRICE FOR ANY INCREASE OR DECREASE IN THE
     NUMBER OF DOT PHYSICALS THAT MAY BE NEEDED.
     THE TDCJ RESERVES THE RIGHT TO INCREASE, DECREASE, CHANGE OR CANCEL
     THIS ORDER VIA PURCHASE ORDER CHANGE NOTICE (POCN).
     DO NOT PROVIDE SERVICE IF THERE IS NO QUANITY REMAINING ON CONTRACT.
     PRE-AUTHORIZATION FORM SIGNED BY THE TDCJ SCO'S OFFICE IS REQUIRED
     FROM THE INDIVIDUAL COMING IN FOR THE PHYSICAL BEFORE PERFORMING THE
     SERVICE.
     PLEASE DO NOT PERFORM THE PHYSICAL WITHOUT A PRE-AUTHORIZATION FORM
     SIGNED BY BRENDA LENORMAN OR TONI ZAVALA.
     SERVICE IS TO BE PROVIDED ON AN AS NEEDED BASIS. TDCJ DRIVERS OR
     THEIR SUPERVISORS WILL SET UP THEIR OWN APPOINTMENTS.
     IN ADDITION TO ACCOUNTS PAYABLE, PLEASE SEND A COPY OF THE INVOICE TO
     HR HEADQUARTERS
     2 FINANCIAL PLAZA, SUITE 600
     HUNTSVILLE, TX 77340
     SUBSTANCE ABUSE COORDINATOR: BRENDA LENORMAN 936-437-3171
     REQUISITIONER: KATHY HARMON: 936-437-3664
001  948-74                               27.0000    EA          65.000000        1755.00
     DOT PHYSICALS FOR THE TDCJ DRIVERS IN THE BEEVILLE AREA.
     PLEASE ADD THE FOLLOWING STIPULATIONS TO THE PURCHASE ORDER:
     DO NOT PROVIDE SERVICE IF THERE IS NO QUANITY REMAINING ON CONTRACT.
     PRE-AUTHORIZATION FORM SIGNED BY THE TDCJ SCO'S OFFICE IS REQUIRED
     FROM THE INDIVIDUAL COMING IN FOR THE PHYSICAL BEFORE PERFORMING THE
     SERVICE.
     PLEASE DO NOT PERFORM THE PHYSICAL WITHOUT A PRE-AUTHORIZATION FORM
     SIGNED BY BRENDA LENORMAN OR TONI ZAVALA.
     SERVICE IS TO BE PROVIDED ON AN AS NEEDED BASIS.
      TDCJ DRIVERS OR THEIR SUPERVISORS WILL SET UP THEIR OWN APPOINTMENTS.
      IN ADDITION TO ACCOUNTS PAYABLE, PLEASE SEND A COPY OF THE INVOICE TO
      HR HEADQUARTERS
      2 FINANCIAL PLAZA, SUITE 600
      HUNTSVILLE, TX 77340
     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 INVOICE 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.
     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.
     BIDDER AGREES THAT ANY PAYMENTS DUE UNDER THIS CONTRACT WILL BE
     APPLIED TOWARDS ANY DEBT, INCLUDING BUT NOT LIMITED TO DELINQUENT
     TAXES AND CHILD SUPPORT THAT IS OWED TO THE STATE OF TEXAS.
     RIGHT TO OFFSET:
     IN THE EVENT TDCJ DETERMINES THAT THE BIDDER OWES MONEY TO TDCJ UNDER
     ANY CONTRACT OR PURCHASE ORDER, TDCJ UPON PROVIDING THE BIDDER WITH
     WRITTEN NOTICE OF ITS INTENT TO OFFSET, SHALL HAVE THE RIGHT TO
     WITHHOLD MONIES DUE VENDOR WITH RESPECT TO ANY CONTRACT OR PURCHASE
     ORDER RESULTING FROM THIS SOLICITATION OR WITH RESPECT TO ANY
     CONTRACT OR PURCHASE ORDER WITH TDCJ AND APPLY SUCH MONIES TO THE
     MONEY DUE TDCJ.
     FOR QUESTIONS OR INQUIRIES CONTACT:
     KRISTIE ROBERTSON, CTCD, CTCM
     TDCJ CONTRACTS AND PROCUREMENT
     TWO FINANCIAL PLAZA, SUITE 703
     HUNTSVILLE, TX 77340
     PH:  936-437-3805
     EMAIL: KRISTIE.ROBERTSON@TDCJ.TEXAS.GOV
ORDER TOTAL:$      1,755.00

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Authorization Table
Name of Authorized Purchaser Signature of Authorized Purchaser
All terms and conditions set forth in the referenced Invitation/Request become a part of this purchase order. In accordance with your bid/offer, item(s) must be received at the destination address on or before 08/31/2022
Seller agrees that any payments due under this contract will be applied towards any debt, including but not limited to delinquent taxes and child support that is owed to the State of Texas.
STATE AND CITY SALES TAX EXEMPTION: The undersigned claims an exemption from taxes under Chapter 151, Section 309, Texas Tax Code, for the purchase of services/tangible personal property purchased from the contractor and/or shipper listed above, as these are being secured for the exclusive use of the State of Texas.
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