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<br />DEPARTMENT OF STATE HEALTH SERVICES <br /> <br />RECEIVING AGENCY PROGRAM: REGIONAL AND LOCAL SERVICES SECTION <br />PERFORMING AGENCY: PARIS-LAMAR COUNTY HEALTH DEPARTMENT <br />CONTRACT TERM: 09/01/05 THRU: 08/31/06 BUDGET PERIOD: 09/01/05 THRU 08/31/06 <br />DSHS DOC. NO. 7560022067 200601A CHG.04 <br /> <br />REVISED CONTRACT BUDGET <br /> <br /> FINANCIAL ASSISTANCE <br />OBJECT CLASS CATEGORIES CURRENT APPROVED CHANGE NEW OR REVISED <br /> BUDGET (A) REQUESTED (B) BUDGET (C) <br />Personnel $45,200.00 $42,798.00 $87,998.00 <br />Fringe Benefits . 15,059.50 6,940.50 22,000.00 <br />Travel 0.00 0.00 0.00 <br />Equipment 0.00 0.00 0.00 <br />Supplies 0.00 0.00 0.00 <br />Contractual 0.00 0.00 0.00 <br />Other 0.00 0.00 0.00 <br />Total Direct Charges $60,259.50 $49,738.50 $109,998.00 <br />Indirect Charges 0.00 0.00 0.00 <br />TOTAL $60,259.50 $49,738.50 $109,998.00 <br />PERFORMING AGENCY SHARE: <br />Program Income 0.00 0.00 0.00 <br />Other Match 0.00 0.00 0.00 <br />RECEIVING AGENCY SHARE $60,259.50 $49,738.50 $109,998.00 <br />PERFORMING AGENCY SHARE $0.00 $0.00 $0.00 <br />Detail on Indirect Cost Rate Type: <br />Rate 0.00 Base $0.00 Total $0.00 <br />Budget Justification: Amendment is to extend end term from 02/28/06 to 08/31/06 and budget funds for additional 6 months. <br />Revised Number to be Served/Units of Service: 2,216 <br /> <br />Financial status reports are due the 30th of December, 30th of March, 30th of June, and the 30th of November. <br /> <br />Form No. GC-9 ECPS - Rev. 10104 <br />