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<br />DOCUMENT NO. 7560022067-2005 <br />ATTACHMENT NO. 04 <br />PURCHASE ORDER NO. C039512000 <br /> <br />PERFORMING AGENCY: PARIS-LAMAR COUNTY HEALTH DEPARTMENT <br /> <br />RECEIVING AGENCY PROGRAM: BUREAU OF NUTRITION SERVICES <br /> <br />TERM: October 01,2004 THRU: September 30,2005 <br /> <br />SECTION I. SCOPE OF WORK: <br /> <br />PERFORMING AGENCY shall administer RECEIVING AGENCY'S Special Supplemental <br />Nutrition Program for Women, Infant, and Children (WIC) to provide supplemental food <br />instruments, nutrition education and counseling to enhance good health care at no cost to 10w- <br />income pregnant and postpartum women, infants and children identified to be at nutritional risk. <br />PERFORMING AGENCY shall complete the following: it <br /> <br />A. Perform professional, administrative and clerical services necessary to determine <br />eligibility, provide food instruments, and provide appropriate nutrition education and <br />counseling to qualified women, infants and children in a specified geographic area. <br />PERFORMING AGENCY shall ensure adequate staff coverage and uninterrupted <br />delivery of services. Services shall be performed according to the terms and <br />specifications of RECEIVING AGENCY'S Special Supplemental Nutrition Program for <br />Women, Infants, and Children (WIC) and/or the United States Department of Agriculture <br />(USDA) as referenced in this contract Attachment. During the term of this contract <br />Attachment, USDA will issue regulations, instructions, policies and/or directives, which <br />may be incorporated into the RECEIVING AGENCY'S WIC Program Policy and <br />Procedures Manual and program rules. <br /> <br />PERFORMING AGENCY shall provide services in the authorized geographic service <br />area(s) described in PERFORMING AGENCY'S application and agreed to by <br />RECEIVING AGENCY'S WIC Program. PERFORMING AGENCY can change the <br />authorized geographic service area(s) with written approval from RECEIVING <br />AGENCY'S WIC Program. If RECEIVING AGENCY'S WIC Program disagrees on <br />change of geographic service area(s), PERFORMING AGENCY may terminate this <br />contract Attachment with at least thirty (30) days written notice. <br /> <br />B. Assist in the collection of data that will identify benefits of this nutrition intervention <br />program and furnish financial, health, nutrition education and any other special reports in <br />a timely manner as required by RECEIVING AGENCY'S WIC Programs written rules <br />and policies for the compilation of such data. <br /> <br />C. Determine eligibility of applicants through assessment of their income, residence and <br />nutritional status, and provide nutrition education and counseling to eligible applicants. <br /> <br />A TT ACHMENT - Page 1 <br />