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<br />EXECUTED IN DUPLICATE ORIGINALS ON THE DATES SHOWN. <br /> <br />CITY OF PARIS <br />Authorized Contracting Entity (type above if different <br />from PERFORMING AGENCY) for and in behalf of: <br /> <br />PERFORMING AGENCY NAME: <br /> <br />PARIS-LAMAR COUNTY HEALTH <br />DEPARTMENT <br /> <br />By: <br /> <br />(Signature of person authorized to sign contracts) <br /> <br />(Name and Title) <br /> <br />Date: <br /> <br />RECOMMENDED: <br /> <br />By: <br /> <br /> <br />( FORMING AGENC Director, if different <br />om person authorized to sign contract) <br /> <br />RECEIVING AGENCY NAME: <br /> <br />TEXAS DEPARTMENT OF HEALTH <br />~~~ <br /> <br />By: <br /> <br />(Signature of person authorized to sign contracts) <br /> <br />Bob Burnette, Director <br />Procurement and Contracting Services Division <br />(Name and Title) <br /> <br />Date: <br /> <br />8)'3)0~ <br /> <br />. <br /> <br />TDH Document No: 7560022067 2004 <br /> <br />Cover Page 3 <br />