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<br />. .. <br /> <br />TEXAS DEPARTMENT OF HEALTH <br /> <br />RECEIVING AGENCY PROGRAM: IMMUNIZATION DIVISION <br />PERFORMING AGENCY: PARIS-LAMAR COUNTY HEALTH DEPARTMENT <br />CONTRACT TERM: 01/01/04 THRU: 12/31/04 BUDGET PERIOD: 01/01/04 THRU 12/31/04 <br />TDH DOC. NO. 7560022067 200501B CHG.05 <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 $19,539.00 $9,770.00 $29,309.00 <br />Fringe Benefits 6,850.00 3,425.00 10,275.00 <br />Travel 667.00 333.00 1,000.00 <br />Equipment 0.00 0.00 0.00 <br />Supplies 4,000.00 2,000.00 6,000.00 <br />Contractual 333.00 167.00 500.00 <br />Other 2,000.00 1,000.00 3,000.00 <br />Total Direct Charges $33,389.00 $16,695.00 $50,084.00 <br />Indirect Charges 0.00 0.00 0.00 <br />TOTAL $33,389.00 $16,695.00 $50,084.00 <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 $33,389.00 $16,695.00 $50,084.00 <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 to budget remainder of funds to enable contractor to continue services through the end of the <br />contract term. <br /> <br />Form No. GC-9 <br /> <br />Financial status reports are due the 30th of April, 30th of July, 30th of October, and the 30th of March. <br />