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<br /> <br />CONTRACT FOR PUBLIC HEALTH SERVICES <br /> <br />Contract ~ssued by: <br />(RECEIVING AGENCY) <br /> <br />DEPARTMENT OF STATE HEALTH SERVICES <br />1100 WEST 49TH STREET <br />AUSTIN, TEXAS 78756-3199 <br /> <br />DSHS DOCUMENT NO. 7560022067A2006 <br />KR <br /> <br />Legal Authority to Contract: <br /> <br />Chapters 12 and 121, Health and Safety Code. <br /> <br />Venue: The provisions of this Contract shall be interpreted in accordance with Texas law. Venue for any court disputes shall be in Travis County, <br />Texas. <br /> <br />PERFORMING AGENCY NAME: PARIS-LAMAR COUNTY HEALTH DEPARTMENT <br /> <br />MAILING ADDRESS: PO BOX 938 PARIS TX 75460-0938 <br /> <br />STREET ADDRESS: 740 6TH ST SW <br /> <br />PARIS TX 75460-8530 <br /> <br />NAME OF AUTHORIZED <br />CONTRACTING ENTITY: CITY OF PARIS <br />(If different from PERFORMING AGENCY) <br /> <br />PA YEE DATA (If not the same as PERFORMING AGENCY or AUTHORIZED CONTRACTING ENTITY; must be on file with the Texas State <br />Comptroller's Office.): <br /> <br />NAME: PARIS-LAMAR COUNTY HEALTH DEPARTMENT <br /> <br />ADDRESS: PO BOX 938 PARIS TX 75460-0938 <br />(City, State, Zip) <br /> <br />State of Texas Vendor Identification No. (14 digits) <br />17560022067001 <br /> <br />PAYEE AGENCY Fiscal <br />Year Ending Month: <br /> <br />September <br /> <br />. <br /> <br />PA YEE BUSINESS INFORMATION FOR STATISTICAL REPORTING: <br /> <br />Please check the categories that apply to your business. <br /> <br />- <br /> <br />Small Business - A corporation, sole proprietorship, or other legal entity formed for the purpose of making a profit which is <br />independently owned and operated and has fewer than 100 employees or has less than $1,000,000 in annual gross receipts. <br /> <br />- <br /> <br />Historically Underutilized Business (HUB) - A corporation, sole proprietorship, or joint venture formed for the purpose of making a <br />profit in which at least 51 % of all classes of the shares of stock or other equitable securities are owned by one or more persons who <br />have been historically underutilized (socially disadvantaged) because of their identification as members of certain groups: Black <br />American, Hispanic American, Asian Pacific American, Native American, and Women. The HUB must be certified by Texas <br />Building and Procurement Commission or another entity. <br /> <br />- <br /> <br />For Profit Organization <br /> <br />SUMMARY OF CONTRACT DOCUMENTATION: <br />COVER PAGE 1 - Receiving and Performing Agency Data <br />COVER PAGE 2 - Details of Attachment(s) <br />COVER PAGE 3 - Authorized Signatures <br /> <br />GENERAL PROVISIONS - 6/ 2004 <br />A ITA CHMENT(S) <br />EXHIBITS, IF APPLICABLE <br /> <br />Cover Page 1 <br /> <br />T <br /> <br />I <br />