24020484-1.pdf

PDF 20 KB Posted Oct 20, 2023

Attached to: Term TX|405-S1|17419760511|24020484
Contract number: 24020484
Issued by: Texas

About this file

Written by GovTribe AI · Aug 1, 2025

This document is a Purchase Order Change Notice (PO No. 24020484) issued by the Texas Health & Human Services Commission (HHSC), specifically the HHSC-Mexia SSLC Warehouse, dated 10/20/2023. The primary contractor is WorkQuest, Inc., located in Austin, Texas. The purchase order involves multiple state contract terms and is processed through the Texas Comptroller of Public Accounts' Statewide Procurement Division.

The purchase order covers a diverse range of office and operational supplies, including soft drink mix, shredder oil, batteries (Rayovac Ultra Pro and High Energy), correction tape, self-stick note pads, binders, pens, highlighters, and transparent tape. The total order value is $5,017.70, with quantities ranging from 1 to 96 units across 15 line items. Each item is sourced through specific state term contracts (e.g., 393-S1, 405-S1, 615-S1), with consistent delivery dates around early to mid-November 2023 and delivery times of 14-30 days after receipt of order. The purchase order includes a transportation and freight charge of $13.38 and follows Texas state tax exemption guidelines.

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Purchase Order Change Notice PO No. 24020484

Order Date: 10/20/2023

Internal Tracking No.: 0000331414

Contractor Info Bill To Ship To WorkQuest, Inc.

17419760511 1011 East 53 1/2 Street Austin, TX 78751

(512) 451-8145

Health & Human Services Commission 424 Mesquite Dr Mexia SSLC PO Box 1132 Mexia TX 76667

Health & Human Services Commission - 529

HHSC -MEXIA SSLC WHSE

424 Mesquite Dr

MEXIA TX 76667

NOTE TO CONTRACTOR:

PO#: HHSTX-4-0000331414

AGENCY CONTACT:

Warehouse Supervisor: Ricky Salazar

P: (254) 562-1372

F: (254) 562-1344

E: ricky.salazar@hhs.texas.gov

Reg Manager: Taylor Gain

ACCOUNTS PAYABLE:

E: 718accounting@hhs.texas.gov

HHSC BUYER:

Desiree Alvarez, CTCD

P: (512) 776-2033

E: Desiree.Alvarez@hhs.texas.gov

DELIVERY: Delivery hours are from 8:00-11:30 AM and 1:00-4:30 PM Monday through Friday except for designated State Holidays when the Warehouse is closed.

Please call the Agency Delivery Contact to schedule delivery 24 hours prior to arrival.

Invoice per 34 TAC §20.487, amended effective May 1, 2022.

Please follow the Texas Comptroller's Invoicing standards as seen below. Include the PO Number on invoices, bills, receipts, bill lading, packing slips, and backorder. (a) To receive payment, a contractor must submit an invoice to the State Agency receiving the goods or services. The invoice should include but is not limited to include:(1) the contractor's mailing and e-mail (if applicable) address;(2) the contractor's telephone number;(3) the name and telephone number of a person designated by the contractor to answer questions regarding the invoice;(4) the state agency's name, agency number, delivery address;(5) the state agency's purchase order number, if applicable;(6) the contract number or other reference number, if applicable;(7) a valid Texas identification number (TIN) issued by the Comptroller;(8) a description of the goods or services, in sufficient detail to identify the order which relates to the invoice;(9) unit numbers corresponding to the amount of the invoice;(10) if submitting an invoice after receiving an assignment of a contract, the TIN of the original contractor and the TIN of the successor vendor;(11) other relevant information supporting and explaining the payment requested.

REVISION HISTORY:

PO Revision #: 1 PO Change Reasons (Aggregated):7/31/2024 3:25 pm-Item Option added for: 40573731755

Order Date: 10/20/2023

Internal Tracking No.: 0000331414

Disclaimer The State of Texas is exempt from all Federal Excise Taxes except as noted in each contract.

STATE AND CITY SALES TAX EXEMPTION CERTIFICATE:

The undersigned claims an exemption from taxes under Texas Tax Code, Section 151.309(4), for purchase of tangible personal property described in this numbered order, purchased from contractor and/or shipper listed above, as this property is being secured for the exclusive use of the State of Texas, or a Texas County, City, Special District, or Other Political Subdivision.

Texas Comptroller of Public Accounts – Statewide Procurement Division

Agency/CO-OP Member Purchaser Email Phone

Health & Human Services Commission - 529

Desiree Alvarez Desiree.Alvarez@hhs.texas.gov (361) 834-5588

Line

NIGP

Code

Commodity Code/ Supplier Part #

Item QTY UOM Unit Price

Extended Amount

1 39333 39333750501 Soft Drink Mix, Sugar Free, Packet Yields 2 Quarts, 24 Packets/CTN, 4 CTN/CS, Plus Freight Order Less Than $50 A t t r i b u t e 1 : A s s o r t e d Flavors-39333750501 Contract: 393-S1 Contract Type: Term Delivery ARO (days): 30 Delivery Date: 11/20/2023

MPN: BVA-1205B

Manufacturer Name: Wyler's

40 CASE 53.08 $2,123.20

2 40573 40573731755 Shredder Oil, 16 Oz. Bottle, 4/CS Plus Freight Contract: 405-S1 Contract Type: Term Delivery ARO (days): 30 Delivery Date: 11/20/2023

4 CASE 52.92 $211.68

3 45006 45006100100 Rayovac Ultra Pro ALAA-24 24/pack 1.35lbs/pack; 288 batteries / Case.Plus Freight Order Less Than $25 Contract: 615-S1 Contract Type: Term Delivery ARO (days): 14 Delivery Date: 11/3/2023

MPN: ALAA-24

Manufacturer Name: Rayovac

96 PACK 8.70 $835.20

Order Date: 10/20/2023

Internal Tracking No.: 0000331414

Line

NIGP

Code

Commodity Code/ Supplier Part #

Item QTY UOM Unit Price

Extended Amount

4 45006 45006100102 Rayovac High Energy 824-12k 12/ pack .32lbs/pack.Plus Freight Order Less Than $25 Contract: 615-S1 Contract Type: Term Delivery ARO (days): 14 Delivery Date: 11/3/2023

MPN: 824-12K

Manufacturer Name: Rayovac

96 PACK 4.75 $456.00

5 61529 61529301006 Correction Tape,Standard Tip, White, Single Line, Plus Freight Order Less Than $25 Contract: 615-S1 Contract Type: Term Delivery ARO (days): 14 Delivery Date: 11/3/2023

60 EACH 1.77 $106.20

6 61562 61562384000 Self Stick Note Pad, 3" x 3", Yellow, 100 Sheets/Pad, 12 Pads/Pkg, Plus Freight Order Less Than $25 Contract: 615-S1 Contract Type: Term Delivery ARO (days): 14 Delivery Date: 11/3/2023

12 PKG 13.02 $156.24

7 61573 61573175108 Binder, 3" Capacity, 3 Ring, Inside Front/Back Pockets, Plus Freight Order Less Than $25 Attribute 1: Blue-61573175108-3 Contract: 615-S1 Contract Type: Term Delivery ARO (days): 20 Delivery Date: 11/9/2023

24 EACH 6.04 $144.96

8 62080 62080230105 Pen, Gel Ink, 0.7mm, Retractable, Rubber Grip, Zebra Sarasa, 4 Pens/ Pack, Plus Freight Order Less Than $25 Attribute 1: Black-62080230105 Contract: 620-S1 Contract Type: Term Delivery ARO (days): 14 Delivery Date: 11/3/2023

48 PACK 6.08 $291.84

9 62090 62090361007 Highlighter, Wedge Tip, 12 Each, Plus Freight Order Less Than $25 Attribute 1: 62090361007–Blue Contract: 620-S1 Contract Type: Term Delivery ARO (days): 14 Delivery Date: 11/3/2023

8 DOZ 8.30 $66.40

Order Date: 10/20/2023

Internal Tracking No.: 0000331414

Line

NIGP

Code

Commodity Code/ Supplier Part #

Item QTY UOM Unit Price

Extended Amount

10 62090 62090361007 Highlighter, Wedge Tip, 12 Each, Plus Freight Order Less Than $25 Attribute 1: 62090362005–Green Contract: 620-S1 Contract Type: Term Delivery ARO (days): 14 Delivery Date: 11/3/2023

8 DOZ 8.30 $66.40

11 62090 62090361007 Highlighter, Wedge Tip, 12 Each, Plus Freight Order Less Than $25 Attribute 1: 62090363003-Yellow Contract: 620-S1 Contract Type: Term Delivery ARO (days): 14 Delivery Date: 11/3/2023

20 DOZ 8.30 $166.00

12 62090 62090361007 Highlighter, Wedge Tip, 12 Each, Plus Freight Order Less Than $25 Attribute 1: 62090364001-Pink Contract: 620-S1 Contract Type: Term Delivery ARO (days): 14 Delivery Date: 11/3/2023

15 DOZ 8.30 $124.50

13 62090 62090361007 Highlighter, Wedge Tip, 12 Each, Plus Freight Order Less Than $25 Attribute 1: 62090368002–Purple Contract: 620-S1 Contract Type: Term Delivery ARO (days): 14 Delivery Date: 11/3/2023

15 DOZ 8.30 $124.50

14 83220 83220112 Tape, Transparent, Refill, 3/4" x 1000", Core 1", Multi-Purpose, 6/ Pack, Freight Order Less Than $50 Contract: 832-S1 Contract Type: Term Delivery ARO (days): 14 Delivery Date: 11/3/2023

20 PKG 6.56 $131.20

15 40573 40573731755 ADDED TO ORDER FOR LINE: 2

DESC: Transportation and Freight Charge Notes: Work Quest sent an e-mail to add freight of $13.38. Invoice#:

PINV0241070

1 EACH 13.38 $13.38

Total $5,017.70

File details come from the government source that posted it. Updated Aug 1, 2025.