Health and Human Services Commission Purchase Order

Health and Human Services Commission

Purchase Order

Dispatch via Print

Payment Terms

Freight Terms

Ship Via

Net 30

N/A, Service, Pick up, etc.

NONE

If advertised by informal bid, Invitation for Offer, or Request for Proposal; all

specifications, terms, and conditions set forth in the advertisement and vendor's conforming responses become a part of this numbered purchase order. Contractor

guarantees goods or services delivered meet or exceed numbered purchase order

requirements.

All shipments, shipping papers, invoices, and correspondence must be identified

with our Purchase Order Number.

Purchase Order

Date

Revision

09/01/21

HHSTX-2-0000265830

Page 1

Ship To:

3273 - Hurst:625 Grapevine Hwy DEPT FAMILY AND PROTECTIVE SERVICES 625 Grapevine Hwy Hurst TX 76054 United States

Vendor:

1752363035 2 ALLIANCE FOR CHILDREN INC 908 SOUTHLAND AVE FORT WORTH TX 761043911 United States

Bill To:

Invoice-HHSC Financial Service HEALTH & HUMAN SERVICES COMMISSION 801 S State Highway 161 PO Box 532089 Grand Prairie TX 75051 United States

Fax: Email:

972/337-6257 Reg03_AP@hhsc.state.tx.us

Line-Sch Inventory Item ID - Line Description

Class/Item

Purchaser: Quantity UOM

Freeman,Lisa M

512/406-2567

PO Price

Extended Amt Due Date

SCOR-SYSTEM SUPPORT SERVICES FY22 RENEWAL FOR LEASE 3158-HURST : 12 MTHS @ $2,266.25 = $27,195.00 FY21 PO 1-227497 LOCATION: 3273 T125 625 GRAPEVINE HWY HURST VENDOR: ALLIANCE FOR CHILDREN VID: 17523630352002 SUPERUSER - JAN.SHAW@HHS. 972-337-6249 CONTRACT MANAGER - MARTIN.BYRAM@HHS. 972-337-6222 A/P CONTACT - REG03_AP@HHSC.STATE.TX.US PLEASE NOTIFY ALL WHEN PO ISSUED PO BILL TO INFO: HEALTH HUMAN SERVICES COMMISSION PO BOX 532089 GRAND PRAIRIE, TX 75053-2089 BILL TO CODE: 0125 EMAIL- REG03_AP@HHSC.STATE.TX.US FY22 Funding PO PO Expires 8/31/22 Region 3 TGC CHAPTER 2167. LEASE OF SPACE FOR STATE AGENCIES HHSC/PCS CONTACT: Lisa Freeman PHONE: 512-406-2567 EMAIL: lisa.freeman@hhsc.state.tx.us SUPERUSER - JAN.SHAW@HHS. 972-337-6249

Contract Manager Martin Byram MARTIN.BYRAM01@HHS. 972) 337-6222 PM/PCC: EX/0 Requisition:

1-1

971-45

R03 FY22 RENEWAL DFPS LEASE

3158 MC3273

1.00 LOT

27195.00000

Schedule Total Item Total for Line 1

$27,195.00 08/31/2021

$27,195.00 $27,195.00

Health and Human Services Commission

Purchase Order

Dispatch via Print

Payment Terms

Freight Terms

Ship Via

Net 30

N/A, Service, Pick up, etc.

NONE

If advertised by informal bid, Invitation for Offer, or Request for Proposal; all

specifications, terms, and conditions set forth in the advertisement and vendor's conforming responses become a part of this numbered purchase order. Contractor

guarantees goods or services delivered meet or exceed numbered purchase order

requirements.

All shipments, shipping papers, invoices, and correspondence must be identified

with our Purchase Order Number.

Purchase Order

Date

Revision

09/01/21

HHSTX-2-0000265830

Page 2

Ship To:

3273 - Hurst:625 Grapevine Hwy DEPT FAMILY AND PROTECTIVE SERVICES 625 Grapevine Hwy Hurst TX 76054 United States

Vendor:

1752363035 2 ALLIANCE FOR CHILDREN INC 908 SOUTHLAND AVE FORT WORTH TX 761043911 United States

Bill To:

Invoice-HHSC Financial Service HEALTH & HUMAN SERVICES COMMISSION 801 S State Highway 161 PO Box 532089 Grand Prairie TX 75051 United States

Fax: Email:

972/337-6257 Reg03_AP@hhsc.state.tx.us

Line-Sch Inventory Item ID - Line Description

Class/Item

Purchaser: Quantity UOM

Freeman,Lisa M

512/406-2567

PO Price

Extended Amt Due Date

Total PO Amount

$27,195.00

No substitutions or cancellations are permitted without prior approval by Health & Human Services Commission. If contractor fails to deliver by promised delivery date (or reasonable time thereafter) or fails to meet requirements, Health & Human Services Commission reserves the right to purchase elsewhere and charge an increased cost and handling to contractor.

Over shipments will not be accepted unless authorized by Buyer prior to shipment. The dispute resolution process provided for in Chapter 2260 of the Texas Government Code must be used by the Health & Human Services Commission and Contractor to attempt to resolve all disputes arising under the contract.

Performance under this purchase order is acceptance of the attached affirmations and terms and conditions.

Authorized By

06/24/2021

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