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CONTRACT FOR PUBLIC HEALTH SERVICES TDH DOCUMENT NO. 7560022067 2004 <br /> Contract Issued by: TEXAS DEPARTMENT OF HEALTH SC <br /> (RECEIVING AGENCY) 1100 WEST 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: PO BOX 938 PARIS TX 75460-0938 <br /> <br /> STREET ADDRESS: 740 SOUTHWEST 6TH PARIS TX 75460-0000 <br /> <br /> NAME OF AUTHORIZED <br /> CONTRACTING ENTITY: CITY OF PARIS <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 the Texas State <br /> Comptroller's Office.): <br /> <br /> NAME: <br /> <br /> ADDRESS: <br /> <br /> State of Texas Vendor Identification No. (14 digits) IPAYEE AGENCY Fiscal <br /> 17560022067001 IYear 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, 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 /> __ 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 have <br /> been historically underutilized (socially disadvantaged) because of their identification as members of certain groups: Black American <br /> Hispanic American, Asian Pacific American, Native American, and Women. The HUB must be certified by General Services <br /> Commission or another entity. <br /> <br /> __ For Profit Organization <br /> <br /> SUMMARY OF CONTRACT DOCUMENTATION: <br /> COVER PAGE I - Receiving and Performing Agency Data GENERAL PROVISIONS - 11/2001 <br /> COVER PAGE 2 - Details of Attachment(s) ATFACHMENT(S) <br /> COVER PAGE 3 - Authorized Signatures EXHIBITS, IF APPLICABLE <br /> <br /> Cover Page 1 <br /> EXHIBIT <br /> <br /> <br />