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CONTRACT FOR PUBLIC HEALTH SERVICES <br /> Contract Issued by: <br /> (RECEIVING AGENCY) <br /> <br /> TEXAS DEPARTMENT OF HEALTH <br /> 1100 WE, ST 49TM STREET <br /> AUSTIN, TEXAS 78756-3199 <br /> <br />Legal Authority to Contract: 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: P. O. BOX 938 PARIS TX 754604}938 <br /> <br />STREET ADDRESS: 740 SOUTHWEST 6TH. PARIS TX 754604)000 <br /> <br />TDH DOCUMENT NO. 7560022067 200203 <br /> CN <br /> <br />NAMIg OF AUTHORIZED <br />CONTRACTING ENTITY: <br />(If different from PERFORMING AGENCY) <br /> <br />PAYEE DATA (If not the same as PERFORMING AGENCY or AUTHORIZED CONTRACTING ENTITY; must be on file with thc Texas State <br />Comptroller's Office.): <br /> <br />ADDRESS: <br /> <br />State of Texas Vendor Identification No. (14 digits) <br />17560022067001 <br /> <br />PAYEE AGENCY Fiscal <br />Year Ending Month: September <br /> <br />PAYEE BUSINESS INFORMATION FOR STATISTICAL REPORTING: Please check the categories that apply to your business. <br /> <br />Small Business - A corporation, ~o1¢ 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 />Historically Underutilized Business (HUB) - A corporation, sole proprietorship, or joint vemure formed for the purpose of making <br />a profit in which at least 51% of all classes of the shares of stock or oth6r equitable securities are owned by one or more persons <br />who have been historically underutilized (socially disadvantaged) because of their identification as members of certain groups: <br />Black American, Hispanic American, Asian Pacific American, Native American, and Women. The HUB must be certified by <br />General Services Commission or another entity. <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 <br />ATtACHMENT(S) <br />EXHIBITS, IF APPLICABLE <br /> <br /> Cover Page <br />EXHIBIT <br /> <br /> <br />