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<br />~ <br /> <br />TEXAS DEPARTMENT OF HEALTH <br />1100 WEST 49TH STREET <br />AUSTIN, TEXAS 78756-3199 <br /> <br />STATE OF TEXAS <br /> <br />TDH Document No.7560022067 97 <br />CONTRACT CHANGE NOTICE NO. QJ. <br /> <br />COUNTY OF TRAVIS <br /> <br />The Texas Department of Health, hereinafter referred to as RECEIVING AGENCY, did heretofore enter into a contract in writing with <br />PARIS-LAMAR COUNTY HEALTH DEPARTMENT hereinafter referred to as PERFORMING AGENCY. The panies thereto now <br />desire to amend such contract attachment(s) as follows: <br /> <br />SUMMARY OF TRANSACTION: <br />ATT. NO. 04: PHR 4&5 - EPSDT <br /> <br />All terms and conditions not hereby amended remain in full force and effect. <br /> <br />EXECUTED IN DUPLICATE ORIGINALS ON THE DATES SHOWN. <br /> <br />Authorized Contracting Entity (type above if different <br />from PERFORMING AGENCY) for and in behalf of: <br /> <br />PERFORMING AGENCY: <br /> <br />RECEIVlNG AGENCY: <br /> <br />PARIS-LAMAR COUNTY HEALTH DEPARTMENT <br /> <br />(Signature of person authorized to sign contracts) <br /> <br /> <br />N <br /> <br />By: <br /> <br />MIKE MALONE, CITY MANAGER <br />(Name and Title) <br /> <br />Linda Farrow, Chief <br />Bureau of Financial Services <br />(Name and Title) <br /> <br />Date: <br /> <br />Date: <br /> <br />11- 15"-9(:, <br /> <br />RECOMMENDED: <br /> <br />APPROVED AS TO FORM: <br /> <br />By: <br /> <br /> <br />By~iJ~iiP IIrt a 1m <br /> <br />DM GMD - Rev. 12/95 <br /> <br />" <br /> <br />EXHIBIT A <br />Cover Page 1 <br />