Contract - Texas DPS - 12/7/2017 INTERLOCAL COOPERATION CONTRACT
DPS GENERAL STORES
P.O.BOX 15999
AUSTIN,TEXAS 78761-5999
STATE OF TEXAS
TRAVIS COUNTY
THIS CONTRACT is entered into between the Department of Public Safety(DPS)and the
Local Governmental Entity listed in Section I(Contracting Parties)under the authorityof
the
Texas Government Code Chapter 791 (the Interlocal Cooperation Act)and in furthernce of the
responsibilities of DPS as provided in Texas Government Code Chapter 411.
I. CONTRACTING PARTIES
Department of Public Safety
and
Local Governmental Entity: City of Round Rock,Texas
Complete Address: 221 East Main Street
Round Rock,TX 7864
Street Address City and State Zip Code
Email Address: rwhite@roundrocktexas.gov
II. STATEMENT OF SERVICE
DPS will provide certain forms,manuals,gunshot residue kits,and other supplies for the
Local Governmental Entity to use in the Breath Testing and Laboratory Alcohol and
Drug Testing Program The purpose and objective of this Contract is to facilitate the use
of uniform and consistent procedures,paperwork,printed materials,and supplies.
III. BASIS FOR CALCULATING COSTS
Costs will be in accordance with the DPS General Stores'non-DPS users price sheet,
IV. PAYMENT FOR SUPPLIES
Local Governmental Entity must submit full payment to DPS at the time of order,
Payment will be made from the Local Governmental Entity's current revenues.
V. TERM OF CONTRACT
This Contract is effective as of the date of the last party to sign the contract and ends on
August 31,2021.
f&-gel1--4-994.
THE UNDERSIGNED CONTRACTING PARTIES bind themselves to the faithful
performances of this Contract and have full authority to enter into this Contract on behalf of the
respective parties.
If the governing body of a party is required to approve this Contract,it will not become effective
until approved by the governing body of that party.In that event,this Contract will be executed
by the duly authorized official of the party as expressed in the approving resolution or order of
the governing body of said party,a copy of which must be attached to this Contract.
•
CITY OF ROUND ROCK,TEXAS DEPARTMENT OF PUBLIC SAFETY
Name of Local Governmental Entity Name of Agency
By: _A/ li B : f ''�
By: W
Autho►zed Sig.- e A orized S:11.1 ature
Craig Moran / - / "'i
Morgan, Mayor Y / �di i /91),Z)
Title Title
Date: 12-4R Date: var a-` 2
INTRODUCTION
The Department of Public Safety stocks certain forms, manuals, gunshot residue kits, and
supplies for the Intoxilyzer Breath Testing Program and the Laboratory Alcohol and Drug
Testing Program for all Texas cities and counties.DPS performs this service to facilitate the use
of uniform and consistent procedures,paperwork,printed materials,and supplies.
DPS requires certain minimum quantities and packaging in order to be as efficient as possible.
The prices will differ between DPS and non-DPS users. The non-DPS users will be charged a
slightly higher price to cover administrative and handling expenses and will be required by law
to have an Interlocal Cooperation Contract on file with DPS General Services for any printed
materials or supply items, such as mouthpieces, alcohol blood test kits,gunshot residue kits, and
urine specimen kits.
DPS strongly urges entities to discuss and coordinate all purchases with its local Breath Test
Program Technical Supervisor or DPS Headquarters Laboratory Alcohol and Drug Testing
Program personnel. These individuals are familiar with the ordering procedure and should be
aware of any price changes. Your local Breath Test Program Technical Supervisor or our DPS
Laboratory Alcohol and Drug Testing personnel should also be able to advise the purchaser of
the quantities of supplies that may be needed.
(1)
INSTRUCTIONS FOR THE PURCHASE OF
INTOXILYZER BREATH TESTING AND LABORATORY ALCOHOL/DRUG TESTING
PRINTED MATERIALS/SUPPLIES AND GUN SHOT RESIDUE KITS
1. Submit your request on your department's letterhead using the sample on page 5.
This request must be signed by an authorized representative and the name and phone
number of a contact person.Also,furnish exemption number if tax exempt.
Attach pages 3 and 4 to include the requested items and total amount due.
This request should be addressed to the following. •
• DPS GENERAL STORES
. P.O.BOX 15999
AUSTIN,TEXAS 78761-5999
2. Prices will be subject to change on a periodic basis and include shipping and handling.
3. Submit check or money order made out to the Department of Public Safety,
General Stores,along with your request.
4. Our minimum stock quantities for non-DPS users of Intoxilyzer Breath Testing
and Alcohol/Drug testing supplies and printed materials are listed on pages 3 and 4.
Non-DPS users must adhere to minimum quantities.
5. If you have any questions,please contact the following.
DPS GENERAL STORES
512-424-2017
GSoutsidesales@dps.texas.gov
(2)
6
NON-DPS USERS PRICE SHEET
PRICES SUBJECT TO CHANGE WITHOUT NOTICE
THESE ITEMS MUST BE PRE-PAID
QUANTITY DESCRIPTION MINIMUM QUANTITY PRICES TOTAL AMOUNT
DIC 23 PEACE OFFICERS SWORN REPORT(Rev.9-01) PAD 50 SETS $2.50/PAD $0.00
DTC 23A SPECIMEN ROUTING REPORT PAD 50 SETS $2.50/PAD $0.00
• DIC 24 STATUTORY WARNING PAD 50 SETS $2.50/PAD $0.00
DIC 25 NOTICE OF SUSPENSION PAD 50 SETS $2.50/PAD $0_00
TEMPORARY DRIVING PERMIT
DIC 54 PEACE OFFICER'S SWORN PAD 50 SETS $2.50/PAD $0.00
REPORT COMM.MOTOR VEHICLE
DIC 55 STATUTORY WARNING PAD 50 SETS $2.50/PAD $0.00
COMMERCIAL MOTOR VEHICLE OPERATORS
DIC 56 BREATH TEST TECHNICAL PAD 50 SETS $2.50/PAD $0.00
SUPERVISOR AFFIDAVIT
DIC 57 NOTICE OF DISQUALIFICATION(Rev.9-01) PAD 50 SETS $2.50/PAD $0.00
DIC SPANISH FORMS:
DIC 249 DWI STATUTORY WARNING PAD 50 SETS $2.50/PAD $0.00
DIC 258 NOTICE OF SUSPENSION PAD 50 SETS $2.50/PAD $0.00
DIC 57S NOTICE OF DISQUALIFICATION PAD 50 SETS $2.50/PAD $0.00
THP FORMS:
THP I OFFENSE REPORT PAD OF 100 SHEETS $2.50/PAD $0.00
THP IA SFST SCORING SHEET PAD OF 100 SHEETS $2.50/PAD $0.00
(3)
THP 51 STATUTORY AUTHORIZATION PAD OF 100 SHEETS $2.50/PAD $0.00
MANDATORY BLOOD SPECIMEN
THP S1A AFFIDAVIT OF PERSON PAD OF 100 SHEETS $2.50/PAD $0,0(
WHO WITHDREW BLOOD
THP/BR 38 INTOXILYZER MANUAL (BINDER,TABS&CONTENTS) $8.75/EACH $0.00
SUPPLIES
*PBT(MOUTHPIECES) 1 PKG of 25 EACH $4.50/PKG. $0.Q0
(PORTABLE BREATH TESTING TUBE)
*INTOXILYZER MOUTHPIECES 1 PKG of 100 EACH $23.00/PKG. $0.00
*ALCOHOL BLOOD TEST KIT 1 EACH $6.50/EACH m, Q
*•URINE SPECIMEN TEST KIT I EACH $4.50/EACH _ $0.00
*SYRINGE TRANSPORT TUBES I EACH $3.50/EACH $0.00
*GUNSHOT RESIDUE KIT I EACH $8.50/EACH $0.00
TOTAL ENCLOSED $0.00
(Items from pages 3 and 4)
MAIL ORDERS AND PAYMENTS TO:
DPS GENERAL STORES
P.O.BOX 15999
AUSTIN,TEXAS 78761-5999
512-424-2017
(4)
USING YOUR LETTERHEAD,PRINT THIS PAGE,
ATTACH ORDER SHEETS,AND MAIL TO:
DPS GENERAL STORES
1
I P.O.BOX 15999
AUSTIN,TEXAS 78761-5999
DATE
Please enter our order for the attached supplies.My check is enclosed.
Sincerely,
Title
Tax exempt number
Contact person Phone number
Physical Address(City,State,Zip)
Email Address
(5)