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<br />~ <br /> <br />CONTRACT FOR PUBLIC HEALTH SERVICES <br /> <br />TDH DOCUMENT NO 75600220672005 <br /> <br />Contract Issued by: TEXAS DEPARTMENT OF HEALTH LF <br />(RECEIVING AGENCY) 1100 WEST 49TH STREET <br /> AUSTIN, TEXAS 78756-3199 <br />Legal Authority to Contract: Chapters 12 and 121, Health and Safety Code. <br />Venue: The provisions of this Contract shall be interpreted in accordance with Texas law. Venue for any court disputes shaH be in Travis County, <br /> Texas. <br />PERFORMING AGENCY NAME: PARIS-LAMAR COUNTY HEALTH DEPARTMENT <br />MAILING ADDRESS: PO BOX 938 PARIS TX 75460-0938 <br />STREET ADDRESS: 740 SOUTHWEST 6TH PARIS TX 75460-0000 <br />NAME OF AUTHORIZED <br />CONTRACTING ENTITY: CITY OF PARIS <br />(If difr,re", &om PERFORMING AGENCY) <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 />NAME: <br />ADDRESS: <br />State of Texas Vendor Identification No. (14 digits) I PAYEE AGENCY Fiscal <br />17560022067001 Year Ending Month: September <br />PAYEE BUSINESS INFORMATION FOR STATISTICAL REPORTING: Please check the categories that apply to your business. <br />- Small Business - A corporation, sole proprietorship. or other legal entity formed for the purpose of making a profit whkh is <br />independently owned and operated and has fewer than 100 employees or has less than $1,000,000 in annual gross receipts. <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 o.wned 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 />- For Profit Organization <br />SUMMARY OF CONTRACT DOCUMENTATION: <br />COVER PAGE I - Receiving and Performing Agency Data GENERAL PROVISIONS - 1112003 <br />COVER PAGE 2 - Details of Attachment(s) ATTACHMENT(S) <br />COVER PAGE 3 - Authorized Signatures EXHIBITS, IF APPLICABLE <br /> <br />EXHIBIT A. <br /> <br />Cover Page 1 <br />