Business and Finance Division

Contracts and Procurement Department

Details of Purchase Order - 696-4-EC051062

Purchase Order

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Title Table

PURCHASE ORDER

TEXAS DEPARTMENT OF CRIMINAL JUSTICE

Tax Exempt Agency of Texas State Government

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Order Table

ORDER DATE:

10-11-23

INVITATION/REQUEST NO:

PURCHASE ORDER NO:

696-4-EC051062

Agency Table

AGENCY NAME AND ADDRESS

TEXAS DEPT. OF CRIMINAL JUSTICE    
ACCOUNTS PAYABLE / 696-4-EC051062  
P.O. BOX 4018                      
HUNTSVILLE, TX 77342-4018

DESTINATION OF GOODS

SEE BELOW

Vendor Table

VENDOR NAME AND ADDRESS

MAURO PSYCHOLOGICAL SERVICES PLLC
7500 RIALTO BLVD BLDG 1 STE 250

AUSTIN, TX 78735 8531

Vendor Data Table

VENDOR PHONE NO.

512 551 0601

VENDOR ID NO.

1462276714

PERSON CONTACTED:

CONSULTATION

CASH DISCOUNT:

NET

DAYS OR NET 30

Data Table

Order Type:

F.O.B.:

DESTINATION

Freight Terms:

PREPAID

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Detail Table

ITEM          DESCRIPTION                 QTY       U/M        UNIT PRICE       EXTENSION
     *** PAYMENT PURPOSES ONLY ***
     AGENCY CONTACT: ANGELA JETER 936-437-3351
001  961-50                                1.0000    EA        2681.250000        2681.25
     PSYCH EVALUATION, REVIEW OF RECORDS, DIAGNOSTIC AND
     OPINION FORMULAITONS.
     IN RE: ROBERT GROGAN
     CAUSE NO. 22069
     REQUEST DATE: 09/19/2023
     COMPLETION DATE: 09/19/2023
     INVOICE NO. 3987
     DELIVER TO:
       TDCJ
       STATE COUNSEL FOR OFFENDERS
       200 RIVER POINTE DR.
       SUITE 312 (3RD FLOOR)
       CONROE, TX 77304
     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.)
     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.
     FOR QUESTIONS OR INQUIRIES CONTACT:
     LAKESHIA SIMMS
     TDCJ CONTRACTS AND PROCUREMENT
     TWO FINANCIAL PLAZA STE. 703
     HUNTSVILLE, TX 77340
     PH:  936-437-3808
     EMAIL: LAKESHIA.SIMMS@TDCJ.TEXAS.GOV
     FOR QUESTIONS OR INQUIRIES CONTACT:
     JANICE WOOLEY, CTCD, CTCM
     TDCJ CONTRACTS AND PROCUREMENT
     TWO FINANCIAL PLAZA, SUITE 703
     HUNTSVILLE, TX 77340
     PH:  936-437-3842
     EMAIL: JANICE.WOOLEY@TDCJ.TEXAS.GOV
ORDER TOTAL:$      2,681.25

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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 11/19/2023

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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