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Interlocal Contract Form

Step 1

Check to see if you are already a member. If not, please follow the instructions below to fill out the ILC Form.

Complete all required fields in this form. Once completed, a PDF copy of the ILC document will be delivered via email.

Click here to review the contract terms and conditions (sample only, not for execution).

Step 2

Secure a signature by the individual identified as the Authorized Official to contractually bind your entity.

Step 3

Scan and email a copy of the contract to H-GAC at [email protected], or fax it to 713-993-2424.

The contract may also be mailed to:

H-GAC Cooperative Purchasing Program
PO Box 22777
Houston, TX 77227-2777

Step 4

H-GAC will execute the contract and return a copy to you electronically.

End User Agency Information

Required
Required

End User Agency Contact Information

Required

Mailing Address

Required
Required
Required
Required

Physical Address - (No P.O Box)

Required
Required
Required
Required

Contract Authorization and Fiscal Year Dates

Required
Required
Required

Official Contact (Point of contact for the HGACBuy Interlocal Contract)

Required
Required
Required

Mailing Address - (No P.O Box)

Authorized Contact Chief Elected or Appointed Official who will provide authorized signature

Mailing Address - (No P.O Box)

Additional Official Contact 1 (optional)

Mailing Address - (No P.O Box)

Additional Official Contact 2 (optional)

Mailing Address - (No P.O Box)

Additional Official Contact 3 (optional)

Mailing Address - (No P.O Box)

Additional Information for Non-Profit Entities

Functions/Services (all or part of a function or service)
Administrative Functions (functions normally associated with the routine operation of government)