2004-158-RES AUTHORIZING EXECUTION OF CONTRACT CHANGE NOTICE NO 04 (ATTACHMENT NO 04) TO THE CONTRACT FOR PUBLIC HEALTH SERVICES, TDH DOC. NO 7560022067-2005

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General Provisions, Equipment and Supplies Article, is replaced with the following: PERFORMING AGENCY shall accept responsibility and financial liability for all equipment and supplies purchased with RECEIVING AGENCY'S WIC Program funds, whether purchased locally by PERFORMING AGENCY or by RECEIVING AGENCY'S WIC Program and transferred to the care and custody of PERFORMING AGENCY. PERFORMING AGENCY shall conduct an annual physical inventory of all equipment purchased by RECEIVING AGENCY'S WIC Program and submit it at a time to be specified by RECEIVING AGENCY'S WIC Program. RECEIVING AGENCY'S WIC Program reserves the right to recover the cost of equipment or supplies purchased by RECEIVING AGENCY'S WIC Program and placed in the custody of PERFORMING AGENCY i(such articles are lost, stolen, or otherwise unaccounted for. General Provisions, Reports Article, second paragraph, second sentence, is replaced with the following: A final report, Financial Status Report, Federal form 269 (Form GC-3), shall be submitted no later than December 31,2005. General Provisions, Reports Article, third paragraph, is hereby modified to include the following: PERFORMING AGENCY shall submit vaccine report forms as required by RECEIVING AGENCY'S WIC Program. PERFORMING AGENCY shall comply with instructions from RECEIVING AGENCY'S WIC Program to transmit immunization activity at intervals specified by RECEIVING AGENCY'S WIC Program. SECTION III. BUDGET: All categories of costs billed to RECEIVING AGENCY'S WIC Program, and allocation of such costs, shall be in accordance with the "Plan to Allocate Direct Costs" (P ADC) submitted by PERFORMING AGENCY and approved by RECEIVING AGENCY'S WIC Program. This. document is incorporated herein by reference and made a part of this contract Attachment. A TT ACHMENT - Page 9