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CONTRACT PURCHASE ORDERIn accordance with the contract between the Contractorand the Texas Comptroller of Public Accounts |
Agency to Invoice
HHSC Purchase Order Number 3 0 3 0 3 6
PO Box 960 Requisition 529-0-47239
EDINBURG TX 78540-0960
01/11/10 1
Destination if Different
HHSC
2412 E Richardson St
EDINBURG TX 78539
THE STATE OF TEXAS IS EXEMPT FROM ALL FEDERAL EXCISE TAXES | 63124 | Contractor VID#: 3-69-669-6696-6007 TEXAS CORRECTIONAL INDUSTRIES CUSTOMER SERVICE REPRESENTATIVE PO BOX 4013 HUNTSVILLE TX 77342-4013 |
**** ENTERED BY STATE OFFICE ****
CONTACT AT AGENCY: Paul Ebrom, PHONE: 956-316-8255
VENDOR CONTACT: CUSTOMER SERVICE, PHONE: 903-928-3112
ORDERING ENTITY/PURCHASER CONTACT INFORMATION:
EMAIL: amy.fitzgerald@hhsc
FAX NUMBER: 512-206-4711
AGENCY DELIVERY CONTACT INFORMATION:
NAME: PAUL EBROM
TELEPHONE NO: 956-316-8255
EMAIL: paul.ebrom@hhsc
VENDOR TO PROVIDE DELIVERY CONTACT INFORMATION TO
SHIPPING/FREIGHT PROVIDER
Description Quantity Unit Unit Extended
Price Amount
420-60 STACKING CHAIR, DAKOTA, WITHOUT ARMS - STANDARD
WITH CHROME FRAME FINISH AND WITHOUT GLIDES
ALL CHAIR COMPONENTS MEET ANSI/BIFMA SEATING
PERFORMANCE STANDARDS AND CAL 133 TEST REQUIRE-
MENTS.
SEAT: 17.4" WIDE AND 18.4" DEEP
BACKREST: 17.4" WIDE AND 12/1" HIGH
**AGENCY MUST SPECIFY FRAME FINISH IF OTHER
THAN CHROME**
30001-1 F.O.B. DESTINATION; RECEIVING DOCK 30 EA 60.00 1800.00
90 DAY DELIVERY AFTER RECEIPT OF ORDER
SHELL COLOR: SH Splash
FRAME FINISH-CHROME OR OTHER: CHROME
TOTAL THIS ORDER $1,800.00