HomeMy WebLinkAboutC2015-354 - 6/9/2015 - Approved ,
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TEXAS HEALTH AND HUMAN SERVICES COMMICRk.ARY'S OFFICE,
KYLE L.JANEK,M.D.
G EXECUTIVE COMMISSIONER
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July 10, 2015 ikSC° \3
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Dear Contractor: OM
Enclosed is an approved copy of your Department of State Health Services (DSHS)contract amendment.
Please file it with the office of record for your agency.
DSHS will not pay for reimbursements submitted/postmarked more than 45 days after the end of the
contract term. Additional information regarding this policy is available on the DSHS website at
http://www.dshs.state.tx.us.
Please reference the DSHS contract and attachment number in all future correspondence. If you have
questions, contact Marguerite St. Germain at 512 406-2403, or, via email at
Marguerite.StGermain @hhsc.state.tx.us.
Sincerely,
dirl
A - IL
Marguerite St.Germain,Contract Specialist
Procurement and Contracting Services
Enclosures
2015-354
6/09/15
Ord. 030517 exas 78711 • 4900 North Lamar,Austin,Texas 78751 • (512)424-6500
Texas Health and Human Service INDEXED
DEPARTMENT OF STATE HEALTH SERVICES
/
Amendment
The Department of State Health Services (DSHS) and CORPUS CHRISTI-NUECES COUNTY PUBLIC
HEALTH DISTRICT(CITY) (Contractor)agree to amend the Program Attachment# 001 (Program
Attachment)to Contract# 2015-047290 (Contract) in accordance with this Amendment No. OO1A : NSS/WIC
LOCAL AGENCY, effective 01/01/2015 .
The purpose of this Amendment is due to rate increase effective 1/1/15; which also requires additional funding
than initially established on initial contract.
This Amendment has a retroactive effective date because: Initial FY 15 contract was in Mailed status in Source
previously and has recently been executed by all parties - 02/24/15; which will now allow an amendment to be
created in Source screen.
It is mutually agreed by and between the contracting parties to amend the terms and conditions of Document No.
2015-047290 as written below. All other terms and conditions not hereby amended are to remain in full force
and effect. In the event of a conflict between the terms of this contract and the terms of this Amendment, this
Amendment shall control.
Therefore,DSHS and Contractor agree as follows:
Change Program Attachment Number as follows:
PROGRAM ATTACHMENT NO.-004 OO1A
SECTION.VII. BUDGET is revised as follows:
Total reimbursements will not exceed:49W69407$1,052,271.00.
PARTICIPANTS SERVED PER MONTH MAXIMUM REIMBURSEMENT is revised as follows:
During the term of the Program Attachment, Contractor shall earn administrative funds at the rate of$12.71
$13.23 for each participant served as defined above.
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All other terms and conditions not hereby amended are to remain in full force and effect. In the event of a
conflict between the terms of the Contract and the terms of this Amendment,this Amendment shall control.
Department of State Health Services Contractor
. J3V)e.joao
..41
Signature of Au orized Qffici. Signature of Authorized Official
Date: Date: • 11- 15
Evelyn Delgado Name: Jl14jtO C. Ase/
dy
Assistant Commissioner for Family and Title: e0 momajer
Community Health Services
1100 WEST 49TH STREET Address: IO I Leopa rd
AUSTIN, TEXAS 78756
COrfous elvish' 7'6 781101
512.776.7321
Phone: NOP I• I • 3 220
Evelyn.Delgado@dshs.state.tx.us
Email: Mit vvrQ ccIe %4S.co 1
Airpread se b bon: �°
Cly , /
Lisa Aguilar
Assistant City •ttomey
For City Attorney
CILL L\351r-1
CN$CIL k C/
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ATTEST: I -LeX-42.&
REBECCA HU&RTA
CITY SECRETARY
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