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<br /> TEXAS DEPARTMENT OF HEALTH CONTRACT
<br /> 1100 West 49th Street
<br /> Austin, Texas 78756-3199
<br /> STATE OF TEXAS
<br /> COUNTY OF TRAVIS TDH Docuaent No. C1000555
<br /> This contract is between the Texas De~rtaent of Health, hereinafter referred to
<br /> as RECEIVING AGENCY, and the par y listed below as PERFORMING AGENCY and
<br /> includes general provisions and attachaents detailing scope(s) of work and
<br /> special provisions.
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<br /> J PERFORMING AGENCY: CITY OF SAN MARCOS ,
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<br /> , (PRINT or TYPE) ,
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<br /> J Mailing Address: 630 East HoDkins San Marcos TX 78666 6397:
<br /> , (City) (St) (Zip) I
<br /> { Street Address: SAME I
<br /> {If d:l ff erent) {C:lty) (m) (Z1p) ,
<br /> , ,
<br /> ,-------------------------------------------------------------------------------------,
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<br /> , Authorized J
<br /> , Contracting Entity: .
<br /> , (If d1fferent froa PERFORMING AGENCY) t
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<br /> ~ Payee Naae: CITY OF SAN MARCOS ,
<br /> (Must .atch w1th vendor 1dent1f:lcat10n nuaber shown below) ,
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<br /> J Payee Address: 630 East H~ San Marcos TX 78666 6397:
<br /> I TfilUSt .atc w1t vendor identification nuaber shown below) I
<br /> ~ State of Texas Vendor Identification No. (14 digits): 17460022381000 '
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<br /> I Finance Officer/Contact: Williaa White ,
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<br /> , Type of Organization: City I
<br /> I Designate: Eleaentary/secondary school, junior college, senior colle5e/university ,
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<br /> , citi' county, other political subdivision, council of fovernaents, ju icial I
<br /> I dis rict, coaaunity services prograa, ind1vipual, or 0 her (define) ,
<br /> ~ Is this a saall business No {Yes/NOt and/or ainority/woaan owned. No (Yes/No) I
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<br /> I Is this a non-profit business Yes ( es/No) --- I
<br /> I PAYEE AGENCY Fiscal Year Ending Monti: SEPTEMBER I
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<br /> : SUMMARY OF TRANSACTION: I
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<br /> { Contract for public health services. ,
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<br /> COVER - Page 1
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