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TEXAS DEPARTMENT OF HEALTH <br />1100 WEST 49TH STREET <br /> AUSTIN, TEXAS 78756-3199 <br /> <br />64. <br /> <br />STATE OF TEXAS <br /> <br />COUNTY OF TRAVIS <br /> <br />TDH Document No. 7460022381 2003 <br /> <br /> Contract Change Notice No. 0kl <br /> <br />The Texas Department of Health, hereinafter referred to as RECEIVING AGENCY, did heretofore enter into a contract in writing <br />with CITY OF SAN MARCOS hereinafter referred to as PERFORMING AGENCY. The parties thereto now desire to amend such <br />contract attachment(s) as follows: <br /> SUMMARY OF TRANSACTION: <br /> ATT NO. 0lA: BNS - WIC CARD PARTICIPATION <br /> <br />All terms and conditions not hereby amended remain in full rome and effect. <br /> <br />EXECUTED IN DUPLICATE ORIGINALS ON THE DATES SHOWN. <br /> <br />Authorized Contracting Entity (type above if different <br />tom PERFORMING AGENCY) for and in behalf off <br /> <br />'ERFORMING AGENCY: <br /> <br />CITY OF SAN MARCOS <br /> <br />By: <br /> (Signature of person at/~horized to sign) <br /> <br /> Dan O'Leary, Ci~cy Manager <br />(Name and Title) <br /> <br />Date: AuGust 26, 2003 <br /> <br />RECOMMENDED: <br /> <br />(PERFORMING AGENCY Director, if~gifferent <br /> from person authorized to sign contract <br /> <br />RECEIVING AGENCY: <br /> <br />TEXAS DEPARTMENT OF HEALTH <br /> <br />By: ~~ <br /> (Signature of person authorized to sign) <br /> <br /> Bob Burnette, Director <br /> Procurement and Contractin~ Services Division <br /> (Name and Title) <br /> <br />Date: ~' ?°/' ~3 <br /> <br />TP PCSD-Rev. 2~3 <br /> <br />Cover Page 1 <br /> <br /> <br />