05-A Health Dept CO #7
DRAFT
F:ALICEIRESWORKICURRENTI Health Contract Change Order No.7 - 2005
March 7, 2005
RESOLUTION NO.
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF PARIS,
PARIS, TEXAS, APPROVING AND AUTHORIZING THE EXECUTION OF
CONTRACT CHANGE ORDER NOTICE NO.7 FOR PUBLIC HEALTH
SERVICES, TDH DOCUMENT NO. 7560022067-2005 (ATTACHMENT NO.
02A) CHS - PRIMARY HEALTH CARE; 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 Contract for Public Health Services, Contract Change Notice No.7,
TDH Document No. 7560022067-2005 (Attachment No. 02A) CHS - Primary Health Care, is
the conduit through which the state funds are received; and,
WHEREAS, it is appropriate that the form of said Contract Change Notice No.7,
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 form of the Contract for Public Health Services, Contract Change
Notice No.7 DH Document No. 7560022067-2005 (Attachment No. 02A) CHS - Primary
Health Care, attached hereto as Exhibit A, be, and the same is 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, the Contract for Public Health
Services, Contract Change Notice No. 07, 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 14th day of March, 2005.
Curtis Fendley, Mayor
ATTEST:
Janice Ellis, City Clerk
APPROVED AS TO FORM:
Larry W. Schenk, City Attorney
'.
DEPARTMENT OF STATE HEALTH SERVICES
1100 WEST 49TH STREET
AUSTIN, TEXAS 78756-3199
STATE OF TEXAS
COUNTY OF TRAVIS
DSHS Document No. 75600220672005
Contract Change Notice No. 07
The Department of State Health Services, hereinafter referred to as RECEIVING AGENCY, did heretofore enter into a contract in
,:"riting with PARIS-LAMAR COUNTY HEALTH DEPARTMENT hereinafter referred to as PERFORMING AGENCY. The
arties thereto now desire to amend such contract attachment(s) as follows:
SUMMARY OF TRANSACTION:
ATT NO. 02A: CHS - PRIMARY HEALTH CARE
All terms and conditions not hereby 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 HEALTH DEPARTMENT
DEPARTMENT OF STATE HEALTH SERVICES
By:
(Signature of person autlDrized to sign)
By:
(Signature of person autOOrized to sign)
Tony N. Williams. City Manager
(Name and Title)
Bob Burnette, Director
Procurement and Contracting Services Division
(Name and Title)
Date:
MarclLJ4. 20.05
Date:
KR
PCSD - Rev. 6/04
Cover Page 1
EXHIBIT A.
DETAILS
OF
A TT ACHMENTS-
Att/ DSHS Program ID/ Term Financial Assistance Direct Total Amount
Amd DSHS Purchase Assistance (DSHS Share)
No. Order Number Begin End Source of Amount
Funds.
01C IMM/LOCALS 0 I/O 1/04 08/31/05 State 93.268 83,433.00 0.00 83,433.00
00000o1782
02A CHS/PHC 09/01/04 08/31/05 State 179,463.00 0.00 179,463.00
C038917000
03 OPHP/LPHS 09/01/04 08/31/05 State 93.991 120,519.00 0.00 120,519.00
C03 9254000
04 BNS/WIC-CARD 10/01/04 09/30/05 10.557 93.268 0.00 0.00 0.00
C039512000
DSHS Document No.7560022067 2005 Totals $383,415.00 $ 0.00 $383,415.00
Change No. 07
. .
*Federal funds are indicated by a number from the Catal~ of Federal Domestic Assistance (CFDA), if applicable. REFER TO
BUDGET SECTION OF ANY ZERO AMOUNT ATTACHMENT FOR DETAILS.
Cover Page 2
.~
.
DEPARTMENT OF STATE HEALTH SERVICES
RECEIVING AGENCY PROGRAM: COMMUNITY HEALTH SERVICES SECTION
PERFORMING AGENCY: PARIS-LAMAR COUNTY HEALTH DEPARTMENT
CONTRACT TERM: 09/01/04 THRU: 08/31/05 BUDGET PERIOD: 09/01/04 THRU 08/31/05
DSHS DOC. NO. 7560022067 200502A CHG.07
REVISED CONTRACT BUDGET
FINANCIAL ASSISTANCE
OBJECT CLASS CATEGORIES CURRENT APPROVED CHANGE NEW OR REVISED
BUDGET (A) REQUESTED (B) BUDGET (C)
Personnel $80,160.00 $0.00 $80,160.00
Fringe Benefits 19,840.00 0.00 19,840.00
Travel 1,477.00 0.00 1,477.00
Equipment 0.00 0.00 0.00
Supplies 10,940.00 20,546.00 31,486.00
Contractual 30,500.00 0.00 30,500.00
Other 8,641.00 7,359.00 16,000.00
Total Direct Charges $151,558.00 $27,905.00 $179,463.00
Indirect Charges 0.00 0.00 0.00
TOTAL $151,558.00 $27,905.00 $179,463.00
PERFORMING AGENCY SHARE:
Program Income 0.00 0.00 0.00
Other Match 0.00 0.00 0.00
RECEIVING AGENCY SHARE $151,558.00 $27,905.00 $179,463.00
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 contract to provide more services to current clients. .
Form No. GC-9 ECPS - Rev. 10/04
Financial status reports are due the 30th of December, 30th of March, 30th of June, andtle 30th of November.