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TEXAS DEPARTMENT OF HEALTH <br /> 1100 WEST 49TH STREET <br /> AUSTIN, TEXAS 78756-3199 <br /> <br /> STATE OF TEXAS TDH Document No. 7560022067 2003 <br /> COUNTY OF TRAVIS Contract Change Notice No. 03 <br /> <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 referred to as PERFORMING AGENCY. The parties thereto <br />now desire to amend such contract attachment(s) as follows: <br /> SUMMARY OF TRANSACTION: <br /> ATT NO. 05A: BNS - WIC CARD PARTICIPATION <br /> <br /> All terms and conditions not hereby amended remain in full force and effect. <br /> <br /> EXECUTED IN DUPLICATE ORIGINALS ON THE DATES SHOWN. <br /> <br /> CITY OF PARIS <br /> <br /> Authorized Contracting Entity (type above if different <br /> from PERFORMING AGENCY) for and in behalf of: <br /> <br /> PERFORMING AGENCY: RECEIVING AGENCY: <br /> <br /> PARIS-LAMAR COUNTY HEALTH DEPARTMENT TEXAS DEPARTMENT OF HEALTH <br /> By:. By: __~~""~ <br /> (Signature of person authorized to sign) (Signature of person authorized to sign) <br /> <br /> Bob Burnette, Director <br /> ~_ehae! g. /,la'lone, C~_tv ~4anaee~: Procuremem and Contracting, Services Division <br /> (Name and Title) (Name and Title) <br /> <br /> Date: June 9. 2003 Date: <br /> <br /> By: <br /> (PE~I~(~R~G A~3~NCY D~e~-¥if~fferent <br /> ~,~r~fm person authorized to sign/contract <br /> <br /> CC PCSD - Rev. 2/03 <br /> <br /> Cover Page 1 <br /> EXHIBIT <br /> <br /> <br />