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<br /> ... .';., <br /> ~. ~ 57 <br /> ~ <br /> CONTRACT FOR PUBLIC HEALTH SERVICES TDH DOCUMENT NO. 7460022381 97 <br /> Contract Issued by: TEXAS DEPARTMENT OF HEALTH SC <br /> (RECEIVING AGENCY) 1100 WEST 49TH STREET <br /> AUSTIN, TEXAS 78756-3199 <br /> Legal Authority to Contract: Chapter 12, Health and Safety Code. <br /> r~""J.ue: The provisions of this Contract shall be interpreted in accordance with Texas law. Venue for any colin disputes shall be in <br /> :. Travis County, Texas. <br /> ~ <br /> T .r.RFORMING AGENCY NAME: CITY OF SAN MARCOS <br /> MAILING ADDRESS: 630 EAST HOPKINS SAN MARCOS TX 78666-6397 <br /> (City, State, Zip) <br /> STREET ADDRESS: 630 EAST HOPKINS SAN MARCOS TX 78666-6397 <br /> (City, State, Zip) <br /> NA.L\1E OF AurHORIZED <br /> CONTRACTING ENTITY: <br /> (If different from 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) PAYEE AGENCY Fiscal <br /> 17460022381000 Year Ending Month: September <br /> PAYEE BUSINESS INFORJ.'YfATION FOR STATISTICAL REPOR-pNG: Please check the categories that apply to your business. <br /> ¡ Small Business - A corporation, sale proprietorship, or other legal entity formed for the purpose of making a profit which is independently <br /> t owned and operated and has fewer than 100 employees or has less than $1,000,000 in annual gross receiptS. <br /> : <br /> L' Historically Underutilized Business (HUB) - A corporation, sole proprietorship, or joint ventUre formed for the purpose of making a profit <br /> - <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 Pacific American, Native American, and Women. The HUB must be certified by General Services Commission or <br /> another entity. <br /> For Profit Organization <br /> SUMMARY OF CONTRACT DOCUMENTATION: <br /> COVER PAGE 1 - Receiving and Performing Agency Data GENERAL PROVISIONS <br /> COVER PAGE 2 - Details of Attachment(s) ATTACHMENT(S) <br /> COVER PAGE 3 - Authorized SignatUres EXHIBITS, IF APPLICABLE <br /> Cover Page 1 <br /> .,.- . -. , <br /> . . <br />