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TEXAS DEPARTMENT OF tIEALTH <br />1100 WEST 49TH ST~ET <br />AUSTIN, TEXAS 78756- 199 <br />STATE OF TEXAS <br />TDH Document No. 7560022067 2005 <br />COUNTY OF TRAVIS Contract Change Notice No. 0 1 <br />The Texas Department of Health, hereinafter referred to as RECEIVING AGENCY, did heretofore enter into a contract in writing <br />with PARIS-LAMAR COUNTY HEALTH DEPARTMENT hereinafter referredl to as PERFORMING AGENCY. The parties thereto <br />now desire to amend such contract attachment(s) as follows: ' <br />SLJMMARY OF TRANSACTION: ° <br />ATT NO.OIA : IMMUNIZATION DIVISION - LOCALS <br />All terms and conditions not hereby amended remain in full force and effect. <br />EXECUTED IN DUPLICATE ORIGINALS ON THE DATES SHOWN. <br />CITY OF PARIS ' <br />Authorized Contracting Entity (type above if different <br />from PERFORMING AGENCY) for and in behalf of: ' <br />PERFORMING AGENCY: RECEIVING AGENCY : <br />PARIS-LAMAR COUNTY HEALTH DEPARTMENT TEXAS DtPARTMENT OF HEALTH' <br />By: By'- - - ..s - . 12 <br />(Signature of person authorized to sign) (Signature of person authorized to sign) <br />Bob Blurnette. Director <br />(Name and Title) (Name and Title) <br />Date: Date: <br />RECOM E • <br />By: <br />(P ORMING AGENCY Director, if different <br />IM ~ <br />fro ~on authorized to sign contract <br />JC PCSD - Rev. 6/04 <br />Cover Page 1 E X H I B IT A <br />