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<br />TEXAS DEPARTMENT OF HEALTH <br /> <br />RECEIVING AGENCY PROGRAM: IMMUNIZATION DIVISION <br />PERFORMING AGENCY: PARIS-LAMAR COUNTY HEALTH DEPARTMENT <br />CONTRACT TERM: 09/01/2002 THRU: 12/31/2003 BUDGET PERIOD: 09/01/2002 THRU 12/31/2003 <br />TDH DOC. NO. 7560022067 2oo304A 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 $29,081.00 $9,694.00 $38,775.00 <br />Fringe Benefits 8,724.00 2,908.00 11,632.00 <br />Travel 2,180.00 726.00 2,906.00 <br />Equipment 0.00 0.00 0.00 <br />Supplies 6,928.00 2,309.00 9,237.00 <br />Contractual 500.00 167.00 667.00 <br />Other 2,610.00 870.00 3,480.00 <br />Total Direct Charges $50,023.00 $16,674.00 $66,697.00 <br />Indirect Charges 0.00 0.00 0.00 <br />TOTAL $50,023.00 $16,674.00 $66,697.00 <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 $50,023.00 $16,674.00 $66,697.00 <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: Increase in funds and number to be served due to extending contract end date from 8/31/03 to 12/31/03. <br />Revised Number to be ServedlUnits of Service: 6,474 <br /> <br />Form No. GC-9 <br /> <br />Financial status reports are due the 30th of December, 30th of March, 30th of June, 30th of September, and the 30th of March. <br />