2004-185-RES CONTRACT CHANGE NOTICE NO. 05 (ATTACHMENT NO. 01B) TDH DOC. NO. 7560022067-2005
RESOLUTION NO. 2004-185
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF PARIS,
PARIS, TEXAS, APPROVING AND AUTHORIZING THE EXECUTION OF
CONTRACT CHANGE NOTICE NO. 05 (ATTACHMENT NO. 01B) TO
THE CONTRACT FOR PUBLIC HEALTH SERVICES, TDH DOCUMENT
NO. 7560022067-2005; MAKING OTHER FINDINGS AND PROVISIONS
RELATED TO THE SUBJECT; AND PROVIDING AN EFFECTIVE DATE.
WHEREAS, the State of Texas is a funding partner with the County of Lamar and the City
of Paris for the Paris-Lamar County Health Department; and,
WHEREAS, the City Council of the City of Paris did heretofore, on the 12th day of July,
2004, in Resolution No. 2004-126, authorize the execution of a Contract for Public Health
Services, TDH Document No. 7560022067-2005, which is the conduit through which the state
funds are received; and,
WHEREAS, the City Council of the City of Paris did heretofore, on the 12th day of July,
2004, in Resolution No. 2004-127, authorize the execution of Contract Change Notice No. 01
(Attachment No. 0IB); and,
WHEREAS, the City Council of the City of Paris did heretofore, on the 9th day of
August, 2004, in Resolution No. 2004-139, authorize the execution of Contract Change Notices
No.2 (Attachment No. 02) and No.3 (Attachment 03); and,
WHEREAS, the City Council of the City of Paris did heretofore, on the 13th day of
September, 2004, in Resolution No. 2004-158, authorize the execution of Contract Change Notice
No. 4(Attachment No. 04); and,
WHEREAS, said contract is in need of further amendment, and it is deemed appropriate
that the forms of Contract Change Notice No. 05 (Attachment No. 01B) attached hereto as Exhibit
A, be approved, and that the City Manager be authorized to execute the same on behalf of the City
of Paris, which is the authorized contracting entity for the performing agency, the Paris-Lamar
County Health Department; NOW, THEREFORE,
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF PARIS, PARIS,
TEXAS:
Section 1. That the findings set out in the preamble to this resolution are hereby in all
things approved.
Section 2. That the forms for the Contract for Public Health Services, TDH Document
No. 7560022067-2005, Contract Change Notice No. 05 (Attachment No. OlB) attached hereto as
Exhibit A be, and the same are hereby, approved.
Section 3. That the City Manager be, and he is hereby, authorized and directed to execute,
on behalf of the City of Paris, which is the authorized contracting entity for the performing
agency, the Paris-Lamar County Health Department, Contract Change Notice No. 05 (Attachment
No. 0IB), under the terms and conditions and in the form shown in Exhibit A, attached hereto.
Section 4. That this resolution shall be effective from and after its date of passage.
PASSED AND APPROVED this 11th day of October, 2004.
ATTEST:
tJ~ t1/~
Sherian Dixon, Assistant City Clerk
.
TEXAS DEPARTMENT OF HEALTH
1100 WEST 49TH STREET
AUSTIN, TEXAS 78756-3199
STATE OF TEX~S
COUNTY OF TRAVIS
TDH Document No. 75600220672005
Contract Change Notice No. 05
The Texas Department of Health, hereinafter referred to as RECEIVING AGENCY, did heretofore enter into a contract in writing
with PARIS-LAMAR COUNTY HEALTH DEPARTMENT hereinafter referred to as PERFORMING AGENCY. The parties
thereto now desire to amend such contract attachment(s) as follows:
SUMMARY OF TRANSACTION:
ATT NO. OlB: IMMUNIZATION DIVISION - LOCALS
All terms and conditions not hereb amended remain in full force and effect.
EXECUTED IN DUPLICATE ORIGINALS ON THE DATES SHOWN.
CITY OF PARIS
Authorized Contracting Entity (type above if different
from PERFORMING AGENCY) for and in behalf of:
PERFORMING AGENCY:
RECEIVING AGENCY:
PARIS-LAMAR COUNTY BEALm DEPARTMENT
By:
(Signature of person au
By:
(Signature of person authorized to sign)
(Name and Title)
Bob Burnette, Director
Procurement and Contracting Services Division
(Name and Title)
Date:
Date:
'6\~l()4
DL peSD - Rev. 6/04
EXHIBIT Ii-
Cover Page 1
DETAILS OF ATTACHMENTS
AttI TDH Program 10/ Term Financial Assistance Direct Total Amount
Amd TDH Purchase Order Assistance (TDH Share)
No. Number Begin End Source of Amount
Funds'"
01B IMM/LOCALS 01/01/04 12/31/04 State 93.268 50,084.00 0.00 50,084.00
o00ooo1782
02 ACFH/PHC 09/01/04 08/31/05 151,558.00 0.00 151,558.00
C038917000
03 OPHP/LPHS 09/01/04 08/31/05 120,519.00 0.00 120,519.00
C039254000
04 BNS/WIC-CARD 10/01/04 09/30/05 0.00 0.00 0.00
C039512000
TDH Document No.7560022067 2005 Totals $322,161.00 $ 0.00 $322,161.00
Change No. 05 .
"'Federal funds are indicated by a number from the Catalog of Federal Domestic Assistance (CFDA), if applicable. REFER TO
BUDGET SECTION OF ANY ZERO AMOUNT ATTACHMENT FOR DETAILS.
Cover Page 2
. ..
TEXAS DEPARTMENT OF HEALTH
RECEIVING AGENCY PROGRAM: IMMUNIZATION DIVISION
PERFORMING AGENCY: PARIS-LAMAR COUNTY HEALTH DEPARTMENT
CONTRACT TERM: 01/01/04 THRU: 12/31/04 BUDGET PERIOD: 01/01/04 THRU 12/31/04
TDH DOC. NO. 7560022067 200501B CHG.05
REVISED CONTRACT BUDGET
FINANCIAL ASSISTANCE
OBJECT CLASS CATEGORIES CURRENT APPROVED CHANGE NEW OR REVISED
BUDGET (A) REQUESTED (B) BUDGET (C)
Personnel $19,539.00 $9,770.00 $29,309.00
Fringe Benefits 6,850.00 3,425.00 10,275.00
Travel 667.00 333.00 1,000.00
Equipment 0.00 0.00 0.00
Supplies 4,000.00 2,000.00 6,000.00
Contractual 333.00 167.00 500.00
Other 2,000.00 1,000.00 3,000.00
Total Direct Charges $33,389.00 $16,695.00 $50,084.00
Indirect Charges 0.00 0.00 0.00
TOTAL $33,389.00 $16,695.00 $50,084.00
PERFORMING AGENCY SHARE:
Program Income 0.00 0.00 0.00
Other Match 0.00 0.00 0.00
RECEIVING AGENCY SHARE $33,389.00 $16,695.00 $50,084.00
PERFORMING AGENCY SHARE $0.00 $0.00 $0.00
Detail on Indirect Cost Rate Type:
Rate 0.00 Base $0.00 Total $0.00
Budget Justification: Increase to budget remainder of funds to enable contractor to continue services through the end of the
contract term.
Form No. GC-9
Financial status reports are due the 30th of April, 30th of July, 30th of October, and the 30th of March.