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<br />TEXAS DEPARTMENT OF HEALTH CONTRACT <br />1100 West 49th Street <br />Austin, Texas 78756-3199 <br /> <br />STATE OF TEXAS <br />COtnITY OF TRAVIS <br /> <br />TOH Document No. C3000897-01 <br /> <br />This contract is between the Texas Department of Health, hereinafter referred to <br />as RECEIVING AGENCY, and the party listed below as PERFORMING AGENCY and <br />includes general provisions and attachments detailing scope(s) of work and <br />special provisions. <br /> <br />PERFORMING AGENCY: CITY OF PARIS <br />(PRINT OR TYPE) <br />Mailing Address: P. O. Box 9037 Paris TX 7<;461 i017 <br /> (City) (St) (Z p) <br />Street Address: 135 First St,. N.E. Paris TX 75461 <br /> (If different) (City) (St) (Zip) <br />Authorized <br />Contracting Entity: from <br /> (If different PERFORMING AGENCY) <br />Payee Name: CITY OF PARIS <br /> (Must match with vendor identification number shown below) <br />Payee Address: P. O. Box 9037, Paris, TX 75461-9037 <br /> (Must match with vendor identification number shown below) <br />State of Texas Vendor Identification Number (14 digits): 17560006359000 <br />Finance Officer/Contact: Michael E. Malone. Cit:v M;tn;t~p.:r <br />Type of Organization: city . <br />Designate: Elmentary/secondary school, junior college, senJ.or college/ <br />university, city, county, other political subdivision, council of <br />governments, judicial district, community services proqram, individual, <br />or other (define) . <br />Is this a small businessNo (Yes/No) and/or minority/woman owned~(Yes/No) <br />Is this a non-profit business ~ (Yes/No) <br />PAYEE AGENCY Fiscal Year Ending Month: SeDtember <br />SUMMARY OF TRANSACTION: <br />Dental Care Program contract for water fluoridation project. <br /> <br />Revised 9/92 <br /> <br />1 <br /> <br />EXHIBIT A <br />