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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 2004 <br /> COUNTY OF TRAVIS Contract Change Notice No. 01 <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. 02 : BNS - WIC CARD PARTIC~ATION <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 /> f~om PERFORMING AGENCY) for and in behalf of.' <br /> <br /> PERFORMING AGENCY: RECEIVING AGENCY: <br /> <br /> TEXAS DEPARTMENT <br /> PARIS-LAMAR COUNTY HEALTH DEPARTMENT ~, ~,~F HEA~___~ <br /> By: By: <br /> (Signature of person authorized to sign) (Signature of person authorized to sign) <br /> <br /> Bob Burnette, Director <br /> Procurement and Contractin~ Services Division <br /> (Name and Title) (Name and Title) <br /> <br /> Date: Date: <br /> <br /> (~L~OI~hMJNG ,~G~I~ICY Dtr'~'~ctor, if different <br /> fx, d~m person authorized to sign contract <br /> <br /> SC PCSD - Rev. 2/03 <br /> <br /> Cover Page ! <br /> EXHIBIT . <br /> <br /> <br />