Texas State Seal

CONTRACT PURCHASE ORDER

In accordance with the contract between the Contractor
and the Texas Comptroller of Public Accounts
         Agency to Invoice    
      DEPT OF ASSISTIVE AND REHAB                    Purchase Order Number  3 0 0 8 7 4
      ACCOUNTS PAYALBE                                         Requisition  538-0-14164
      4900 N LAMAR
      AUSTIN             TX 78741                                            09/9/09         1


         Destination if Different  
      DEPT OF ASSISTIVE AND REHAB
      DDS
      6101 E OLTORF
      AUSTIN TX 78741

THE STATE OF TEXAS IS EXEMPT FROM ALL FEDERAL EXCISE TAXES
STATE AND CITY SALES TAX EXEMPTION CERTIFICATE: The State of Texas claims an exemption from taxes under Texas Tax Code § 151.309(4), for purchase of tangible personal property described in this numbered order, purchased from contractor and/or shipper listed here, as this property is being secured for the exclusive use of the State of Texas.
73448
         Contractor
 VID#: 1-36-175-0680-6  COMP
 SEARS COMMERCIAL ONE
 SEARS CONTRACT SALES
 6216 CLARION DRIVE
 AUSTIN TX 78749

                      **** ENTERED BY 29LAINO DONNA    ****
              CONTACT AT AGENCY: DEBBIE BRADSHAW, PHONE: 512-487-8471
              VENDOR CONTACT: GAIL CAIRNIE OR SHELIA BRYANT , PHONE: 888-329-7327
              ORDERING ENTITY/PURCHASER CONTACT INFORMATION:
              EMAIL: DONNA.LAINO@HHSC.STATE.TX.
              FAX NUMBER: 512-206-4711


                   Description                                  Quantity  Unit      Unit    Extended
                                                                                   Price      Amount

      045-66  REFRIGERATOR, NO FROST:
                (1.1)  2 DOOR CABINET
                (1.2)  TOP MOUNT FREEZER
                (1.3)  GENERAL FEATURES
                  (A)  DAIRY/BUTTER BIN
                  (B)  CRISPER(S)
                  (C)  DOOR SHELVES
                  (D)  FREEZER SHELF
                  (E)  ADJUSTABLE LEVELERS OR ROLLERS
                  (F)  ADJUSTABLE TEMPERATURE CONTROL
                  (G)  REVERSABLE DOORS
                  (H)  MOISTURE CONTROL (EXCEPT 045-66-13-0037)
               (REFER TO SECTION 2 -CONTRACT SPECIFICATION 2.1)

     13013-6  ONE MINIMUM 16 CU.FT., FACTORY INSTALLED                10  EA      555.00     5550.00
              AUTOMATIC ICE MAKER, ADJUSTABLE SHELVES
              IN REFRIGERATOR, WHEELS ACTUAL
              TOTAL CU.FT.: 16.5 OVERALL
              DIMENSIONS: 65-1/8 H X 28 W X 31-1.8
              WHITE OR BISQUE, SEARS KENMORE, 46-71752-WHITE
              COLOR:  WHITE

              DELIVERY IN  14 DAYS.

                                                                   TOTAL THIS ORDER        $5,550.00