 |
CONTRACT PURCHASE ORDER
In accordance with the contract between the Contractor
and the Texas Comptroller of Public Accounts |
Agency to Invoice
NORTH TEXAS STATE HOSPITAL 656 Purchase Order Number 3 0 2 1 9 5
PO BOX 2231 001 Requisition 53701-0-16737
VERNON TX 76385
11/6/09 1
Destination if Different
NORTH TEXAS STATE HOSPITAL 656
WICHITA FALLS CAMPUS 002
6515 KEMP BLDG
WICHITA FALLS TX 76308
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.
| 37237 | Contractor
VID#: 1-74-220-5722-8000
GROVES INDUSTRIAL SUPPLY CORP
7301 PINEMONT DRIVE
HOUSTON TX 77040-6607
|
FOR AGENCY USE ONLY: MIM1004734 LINE 6
**** ENTERED BY 29SINGLETON FLOR ****
CONTACT AT AGENCY: FLORENCE SINGLETON, PHONE: 512-206-5122
PAYMENT CONTACT: PEGGY JONES, PHONE: 940-552-4026
VENDOR CONTACT: RALPH COSTA, PHONE: 713 675-4747
AGENCY DELIVERY CONTACT INFORMATION:
NAME: SHARON PETTIT
TELEPHONE NO: 940-689-5585
EMAIL: SHARON.PETTIT@HHSC.STATE
VENDOR TO PROVIDE DELIVERY CONTACT INFORMATION TO
SHIPPING/FREIGHT PROVIDER
ORDERING ENTITY/PURCHASER CONTACT INFORMATION:
EMAIL: FLORENCE.SINGLETON@HHSC.STATE
FAX NUMBER: 512-206-4711
Description Quantity Unit Unit Extended
Price Amount
200-45 PONCHO RAINWEAR. APPROX. 10MM UNSUPPORTED SINGLE
PLY PVC, APPROX. 50 X 80, LIGHTWEIGHT, ATTACHED
HOOD WITH POUCH FOR STORAGE, SIDE SNAP CLOSURE
20010-0 ONE SIZE FITS ALL. COLOR: CLEAR, RIVER CITY, #042 200 EA 1.04 208.00
DELIVERY IN 30 DAYS.
TOTAL THIS ORDER $208.00