27001719-0.pdf

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Attached to
TX|615-C1|27001719
Contract number
27001719
Issued by
Texas

About this file

Purchase Order Summary

This is a Purchase Order (PO No. 27001719) issued by the State of Texas Department of State Health Services (DSHS) to Staples Contract & Commercial LLC, dated September 16, 2026. The order is directed to DSHS's Laboratory L114 location at 1100 West 49th Street in Austin, Texas. The purchase was processed through the Texas Comptroller of Public Accounts – Statewide Procurement Division by Clarence Perry. Virginia Flores serves as the agency contact for this transaction.

The purchase order covers four line items totaling $3,373.44 with a delivery date of September 21, 2026 (3 days after order placement). Items include 20 Lexmark 55B1000 black standard yield toner cartridges ($1,734.80), one pack of Staples thermal laminating pouches in letter size ($22.00), two Lexmark 55B0Za0 photoconductor units ($152.54), and ten HP 89A black standard yield toner cartridges ($1,464.10). All items are procured under Contract 615-C1, a term contract. The State of Texas claims exemption from federal excise taxes and state and city sales taxes under Texas Tax Code Section 151.309(4).

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Text version

Purchase Order PO No. 27001719

Order Date: 9/16/2026

Internal Tracking No.: HHSTX-7-0000414836

Contractor Info Bill To Ship To Staples Contract & Commercial LLC 10433908166 500 Staples Drive Framingham, MA 01702

(888) 212-7219

1100 West 49th Street

MC: 3063

Austin TX 78756

Virginia Flores

(512) 776-7587

1100 W 49TH ST

Laboratory L114 FLOOR: 2nd

AUSTIN, TX 78756-3101

DEPARTMENT OF STATE HEALTH SERVICES

1100 W 49th St (DBGL) PO Box 149347 Austin, TX 78756 Attention To Flores,Virginia

NOTE TO CONTRACTOR: PO#: 0000414836

AGENCY CONTACT:

Virginia Flores 512-776-7587 Virginia.Flores@dshs.texas.gov INVOICING: invoices@dshs.texas.gov

DSHS ATTN: FISCAL DIVISION/ACCOUNTS PAYABLE

DELIVERY: Delivery hours are from 8:00-11:30 AM and 1:00-4:30 PM Monday – Friday except designated State Holidays Invoice per 34 TAC §20.487, amended effective 5-1-22

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 Purchaser Email Phone

Dept Of State Health Services -

Clarence Perry Clarence.Perry2@hhs.texas.gov (512) 776-6012

Purchase Order PO No. 27001719

Order Date: 9/16/2026

Internal Tracking No.: HHSTX-7-0000414836

Line

NIGP

Code

Commodity Code/ Supplier Part #

Item QTY UOM Unit Price Extended Price

1 20772 24439779 Lexmark 55B1000 Black Standard Yield Toner Cartridge Contract: 615-C1 Contract Type: Term Delivery ARO (days): 3 Delivery Date: 9/21/2026

MPN: 55B1000

Manufacturer Name: LEXMARK

INTERNA

20 EACH 86.74 $1,734.80

2 70010 24568049 Staples Thermal Laminating Pouches, Letter Size, 9 X 11.5 Inches, 3 Mil, 100/Pack, For Office & School Use Contract: 615-C1 Contract Type: Term Delivery ARO (days): 3 Delivery Date: 9/21/2026

MPN: 24568049-1855753

Manufacturer Name: Worklife Brands

1 PACK 22.00 $22.00

3 57547 24445418 Lexmark 55B0Za0 Photoconductor Unit Contract: 615-C1 Contract Type: Term Delivery ARO (days): 3 Delivery Date: 9/21/2026

MPN: 24445418-1855753

Manufacturer Name: LEXMARK

INTERNA

2 EACH 76.27 $152.54

4 20772 24394160 Hp 89A Black Standard Yield Toner Cartridge, Prints Up To 5,000 Pages (Cf289A) Contract: 615-C1 Contract Type: Term Delivery ARO (days): 3 Delivery Date: 9/21/2026

MPN: CF289A

Manufacturer Name: HEWLETT

PACKARD

10 EACH 146.41 $1,464.10

Total $3,373.44

File details come from the government source that posted it. Updated .