Court filing — No. 1:20-cv-00658 (Dkt. 130-7, E.D. Va.)

Summary

Exhibit 7, filed May 6, 2021 as Document 130-7 in Case 1:20-cv-00658-LMB-IDD. It is a State of California purchase order, STD. 65, dated Mar 25, 2020, number M12948-T6619, from the Department of General Services to Blue Flame Medical LLC. The order covers 100,000 units of N95 masks at $4,760.00 each, a total of $476,000,000.00 before sales tax, and $513,961,000.00 with tax. It bears a defendant's exhibit sticker, 43.

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Case 1:20-cv-00658-LMB-IDD Document 130-7 Filed 05/06/21 Page 1 of 2 PageID# 1489
EXHIBIT 7
Case 1:20-cv-00658-LMB-IDD Document 130-7 Filed 05/06/21 Page 2 of 2 PageID# 1490
EXHIBIT Defendant's 43 exhibitsticker.com
STATE OF CALIFORNIA - GENERAL SERVICES PROCUREMENT DIVISION
PURCHASING AUTHORITY PURCHASE ORDER
STD. 65 (Rev. 10/2019)
Page 1 of 1
DATE: Mar 25, 2020 | AMENDMENT NO.: | PURCHASE ORDER NUMBER: M12948-T6619
SHIP TO: [redacted]
BILL TO: CA Dept. Of General Services, ATTN: OBAS, 707 Third Street, 2nd Floor, West Sacramento, CA 95605
AGENCY BILLING CODE: 030100 | PURCHASING AUTHORITY NO.:
LEVERAGED PROCUREMENT AGREEMENT NUMBER:
INFORMATION TECHNOLOGY PROJECT IDENTIFICATION NUMBER:
AGENCY OR BUYER INFORMATION
AGENCY TRACKING/REQUISITION NUMBER (Optional):
AGENCY NAME: Department of General Services
CONTACT NAME: Michael Wong
CONTACT E-MAIL ADDRESS: michael.wong@dgs.ca.gov
CONTACT PHONE NUMBER: (916) 441-9619 | CONTACT FAX NUMBER:
TO SUPPLIER ADDRESS: Blue Flame Medical LLC, 499 South Capitol St., SW Suite 420, Washington, DC 20003 US
SUPPLIER CONTACT NAME: John Thomas | SUPPLIER PHONE NUMBER: (818) 636-6522 | SUPPLIER FAX NUMBER: | SUPPLIER E-MAIL ADDRESS: john@blueflame.agency
PAYMENT TERMS: Net 45 | CERTIFICATION NUMBER: | ☐ Certified Small Business ☐ Certified Microbusiness EXPIRATION DATE: | ☐ Certified DVBE EXPIRATION DATE:
SHIPPING INSTRUCTIONS: REQUIRED DELIVERY DATE: Apr 3, 2020 | ☒ F.O.B. Destination FRT. PPD | ☐ F.O.B. Destination FRT. PPD/ADD. Freight not to exceed cost stated on P.O. | ☐ F.O.B. Origin | CITY OF ORIGIN: | STATE: | ZIP CODE:
TERMS AND CONDITIONS
A-1 ☒ General Provisions are incorporated herein by reference to:
☒ Form GSPD - 401 Non-IT Commodities Revision Date: 6/8/2010 OR ☐ Form GSPD - 401IT Revision Date: ______
☐ Attached OR ☐ Published at: www.dgs.ca.gov/pd
A-2 ☐ This order is issued under a Department of General Services (DGS) Leveraged Procurement Agreement (LPA). Terms and Conditions set forth in that agreement (LPA number referenced in the block titled Leveraged Procurement Agreement No.) are incorporated herein by reference as if set forth in full text.
B ☐ Agency Special Provisions are attached and titled ______
C ☐ Any other attachments, such as specifications, Statement of Work, or Information Technology Model Language Modules, are identified in the product or services description area or on continuation pages.
TAXABLE SUBTOTAL: $476,000,000.00
TAX RATE: 7.975%
SALES TAX: $37,961,000.00
INSTALLATION:
SHIPPING FREIGHT:
OTHER NON-TAXABLE:
GRAND TOTAL: $513,961,000.00
PROCUREMENT METHODS
☐ COMPETITIVE: Solicitation Number (if applicable) ______ ☐ LEVERAGED ☐ DVBE / SMALL BUSINESS (GC 14838.5(a)) ☐ NON-COMPETITIVELY BID ☒ EXEMPT
PROGRAM / CATEGORY (Code / Title): | FUND TITLE: | VERIFIED NO STATE SURPLUS AVAILABLE: ☒ YES ☐ NO | PAID BY CAL-CARD: ☐ YES ☒ NO
ITEM | CHAPTER | STATUTE | FISCAL YEAR | OBJECT OF EXPENDITURE (Code and Title) | ☐ Original Equipment ☐ Operating Expense
CERTIFICATION AND APPROVAL OF EXECUTIVE OFFICER
I HEREBY CERTIFY, on personal knowledge, that this order for purchasing the items specified below is issued in accordance with the procedure prescribed by law governing the purchase of such items for the State of California; and that all such legal requirements have been fully complied with.
UNENCUMBERED REMAINDER AFTER POSTING THIS ORDER TO ALLOTMENT EXPENDITURE LEDGER:
ADJUSTMENT INCREASING ENCUMBRANCES:
ADJUSTMENT DECREASING ENCUMBRANCES:
AUTHORIZING NAME: MICHAEL WONG | AUTHORIZING TITLE: Contracts Administrator
AUTHORIZING SIGNATURE: [signature] | CERTIFIED CORRECT SIGNATURE:
ITEM NUMBER | QUANTITY | UNIT | UNSPSC | RECYCLED PRODUCT | PRODUCT OR SERVICE DESCRIPTION | CATEGORY | UNIT PRICE | EXTENSION TOTAL
1 | 100,000 | | | | N95 Masks Model Numbers | Taxable | $4,760.00 | $476,000,000.00
DTC 3B, DTX 3X, L-288, SEKURA-321
QTY 100,000,000, Cost $4.76/ea
COVID19 Prepayment (75%)
CONFIDENTIAL BFM000095501


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