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TEXAS DEPARTMENT OF HEALTH <br /> <br />RECEIVING AGENCY PROGRAM: IMMUNIZATION DIVISION <br />PERFORMING AGENCY: PARIS-LAMAR COUNTY HEALTH DEPARTMENT <br />CONTRACT TERM: 09101/2002 THRU: 12/31/2003 BUDGET PERIOD: 09~01/2002 THRU 12/31/2003 <br />TDH DOC. NO. 7560022067 200304A CHG. 04 <br />REVISED CONTRACT BUDGET <br />FINANCIAL ASSISTANCE <br /> OBJECT CLASS CATEGORIES CURRENT APPROVED CHANGE NEW OR REVISED <br /> BUDGET (A) REQUESTED (B) BUDGET (C) <br /> Personnel $2%081.00 $9,694.00 $38,775.00 <br /> Fringe Benefits 8,724.00 2,908.00 11,632.00 <br /> Travel 2,180.00 726.00 2,906.00 <br /> Equipment 0.00 0.00 0.00 <br /> ~ Supplies 6,928.00 2,309.00 9,237.00 <br /> Contractual 500.00 167.00 667.00 <br /> Other 2,610.00 870.00 3,480.00 <br /> Total Direct Charges $50,023.00 $16,674.00 $66,697.00 <br /> Indirect Charges 0.00 0.00 0.00 <br /> TOTAL $50,023.00 $16,674.00 $66,697.00 <br /> PERFORMING AGENCY SHARE: <br /> Program Income 0.00 0.00 0.00 <br /> Other Match 0.00 0.00 0.00 <br /> RECEIVING AGENCY SHARE $50,023.00 $16,674.00 $66,697.00 <br /> PERFORMING AGENCY SHARE $0.00 $0.00 $0.00 <br /> <br /> Detail on Indirect Cost Rate Type: <br /> Rate 0.00 Base $0.00 Total $0.00 <br /> Budget Justification: Increase in funds and number to be served due to extending contract end date from 8/31/03 to 12/31/03. <br /> Revised Number to be Served/Units of Service: 6,474 <br /> Form No. GCL9 <br /> Financial status reports are due the 30th of December, 30th of March, 30th of June, 30th of September, and the 30th of March. <br /> <br /> <br />