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<br />50. <br /> <br /> <br />CONTRACT FOR PUBLIC HEALTH SERVICES <br /> <br />TDH DOCUMENT NO. 746002238100 <br /> <br />Contract Issued by: <br />(RECEIVING AGENCY) <br /> <br />TEXAS DEPARTMENT OF HEALTH <br />1100 WEST 49TH STREET <br />AUSTIN, TEXAS 78756-3199 <br /> <br />GC <br /> <br />Legal Authority to Contract: <br /> <br />Chapter 12, Health and Safety Code. <br /> <br />"1(_1':__ HIP:: <br /> <br />The provisions of this Contract shall be interpreted in accordance with Texas law. Venue for any court disputes shall be in <br />Travis County, Texas. <br /> <br />~ <br />l"EKFORMING AGENCY NAME: CITY OF SAN MARCOS <br /> <br />MAILING ADDRESS: 630 EAST HOPKINS SAN MARCOS TX 78666-6397 <br />(City, State, Zip) <br /> <br />STREET ADDRESS: 630 EAST HOPKINS SAN MARCOS TX 78666-6397 <br />(City, State, Zip) <br /> <br />NAME OF AUTHORIZED <br />CONTRACTING ENTITY: <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) <br />17460022381000 <br /> <br />PAYEE AGENCY Fiscal <br />Year Endinsz 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 independently <br />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 profit <br />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 been <br />historically underutilized (socially disadvantaged) because of their identification as members of certain groups: Black American, Hispanic <br />American, Asian Paciflc American, Native American, and Women. The HUB must be certifled by General Services Commission or <br />another entity. <br /> <br />For Profit Orl!:anization <br /> <br />SUMMARY OF CONTRACT DOCUMENTATION: <br />COVER PAGE 1 - Receiving and Performing Agency Data <br />COVER PAGE 2 - Details of Attachment(s) <br />COVER PAGE 3 - Authorized Sil!:natures <br /> <br />GENERAL PROVISIONS <br />A TTACHMENT(S) <br />EXHIBITS, IF APPLICABLE <br /> <br />Cover Page 1 <br />