Common use of Certification Regarding Public Access to Compensation Information Clause in Contracts

Certification Regarding Public Access to Compensation Information. Does the public have access to information about the compensation of the senior executives in your business or organization (including parent organization, all branches, and all affiliates worldwide) through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986? Yes No If your answer is “Yes” to this question, where can this information be accessed? If your answer is “No” to this question, you must provide the names and total compensation of the top five highly compensated officers below. For example: Xxxx Xxxx:500000;Xxxx Xxxx:50000;Xxxx Xxxx:400000;Xxxx Xxxxx:300000; Xxxxx Xxx:300000 Provide compensation information here: REQUEST DOCUMENT XXXXX Contract Change Request Requestor 00000242250 - Xxxxx,Xxxxxxxx Requisition ID 0000067138 Document ID ADH0000000000000000066540 Document Owner 00000242250 - Xxxxx,Xxxxxxxx Contract change request header Agency lead contact for contract changes 00000242250 - Xxxxx,Xxxxxxxx Desired amendment effective date March 12, 2019 Amendment contract number 537-18-0146-00001 Request amendment description Contract Description: The contractor provides activities in their service area in support of the Public Health Emergency Preparedness Cooperative Agreement from the Centers for Disease Control and Prevention and further Strategic National Stockpile program to comply with the Public Health Emergency Preparedness Cooperative Agreements Capabilities-based approach. The Cities Readiness Initiative requirements support the Medical Countermeasure Dispensing, Medical Material Management and Distribution capabilities, and supports medical countermeasure distribution and dispensing for all-hazards events. Contractor Name: Wise County (located in Decatur, TX) Purpose of Amendment: Amendment #2 (Renewal)-The purpose of the amendment is revise current language to the SOW and to renew the contract by adding funding for an additional year through June 30, 2020 to continue the activities for the Public Health Emergency Preparedness Cooperative Agreement for their service area. **This is a $0.00 requisition using FY19 chart field to start the XXXXX contract collaboration process with PCS. This contract crosses fiscal years. Once the FY20 organizational budget is loaded, additional requisitions will be entered to encumber the FY20 funds for the contract. ** Contract amount change: Original Contract Amount: $36,381.00 + Amendment #1 Amount: $36,381.00 + Amendment #2 Amount: $36,381.00 = (TotalAmount: $109,143.00 + Total Match Amount: $10,914.00) = NEW TOTAL CONTRACT VALUE: $120,057.00 Contract change request details Does the amount change Yes New requested changed amount $ 120,057.000 Does the date change Yes New request contract end date June 30, 2020 Does the scope change Yes New change in scope There are not any significant changes to the scope. The amendment will update language in the SOW, update contractual requirement reporting dates, and include additional contractual requirements for FY20 contract REQUEST DOCUMENT XXXXX Contract Change Request term (July 1, 2019 ¿ June 30, 2020). Supplemental information and comments **See Line Comments for contract related supporting documentation** Contract Statement of Work (SOW) description: To perform activities in support of the Cities Readiness Initiative under the Public Health Emergency Preparedness Cooperative Agreement. **This is a $0.00 requisition using FY19 chart field to start the XXXXX contract collaboration process with PCS. Once the FY20 organizational budget is loaded, requisitions will be entered to encumber the FY20 funds for the contract. ** Vendor (Supplier) Name: Wise County Vendor/TIN (Supplier ID): 17560012035 Vendor (Supplier) Mail Code: 002 Contract ID: 537-18-0146-00001 Current Purchase Order Number: 0000027643 Vendor/Subrecipient Determination: Subrecipient Contract Term: 07/01/2017 thru 06/30/2020 Original Contract Amount: $36,381.00 + Amendment #1 Amount: $36,381.00 + Amendment #2 Amount: $36,381.00 = (Total Amount: $109,143.00 + Total Match Amount: $10,914.00) = NEW TOTAL CONTRACT VALUE: $120,057.00 Contract Manager Name/Phone: Xxxxxxxx Xxxxx / 000-000-0000 Contract Manager Email: Xxxxxxxx.Xxxxx@xxxx.xxxxx.xxx DSHS Program ID (SCOR Other Subject): CPS/CRI SCOR Division: Regional & Local Health Operations (RLHO) REQUESTOR INFORMATION Name: Xxxxxxxx Xxxxx Phone Number: 000-000-0000 E-mail address: Xxxxxxxx Xxxxx@xxxx.xxxxx.xxx DocuSign Envelope ID: 31DCD8B9-15BB-443E-BEB2-9750FFA0BA10 Requisition Date: 02/26/2019 Purchase Order #: Origin: ZR2 - 537-Emergency Prep GSC Purchase Order: Business Unit: HHSTX Date Issued: Document Status: Approved Header Description: Requestor: Xxxxx,Xxxxxxxx Requestor Phone: 512/000-0000 Header Comments Line Sched Class / Item or Commodity REQUISITION DETAIL Database: FSPRD Description Due Date Qty UOM Price Extended Amount 1 1 990 / 29 FY19 DSHS CPS/CRI- Wise County -Amendment- To perform activities in support of the CRI under the Public Health Emergency Preparedness Cooperative Agreement. Term: 7/1/19-6/30/20 03/12/2019 1 EA 0 0 Distrib Acct Dept ID Fund Class Prog Project Amount 1 761200 R20000 0273 71242 J97 9Y531FFBI 0 OT Buyer: Vendor: 00000164981 1756001203 - WISE COUNTY Buyer Phone: Vendor Item:

Certification Regarding Public Access to Compensation Information. Does the public have access to information about the compensation of the senior executives in your business or organization (including parent organization, all branches, and all affiliates worldwide) through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986? Yes No If your answer is “Yes” to this question, where can this information be accessed? If your answer is “No” to this question, you must provide the names and total compensation of the top five highly compensated officers below. For example: Xxxx Xxxx:500000;Xxxx Xxxx:50000;Xxxx Xxxx:400000;Xxxx Xxxxx:300000; Xxxxx Xxx:300000 Provide compensation information here: DocuSign Envelope ID: 7E16DFEF-8D5D-4F17-A65C-E7630F71D691 REQUEST DOCUMENT XXXXX Contract Change Request Requestor 00000242250 - Xxxxx,Xxxxxxxx Requisition ID 0000067138 0000069171 Document ID ADH0000000000000000066540 ADH0000000000000000068495 Document Owner 00000242250 - Xxxxx,Xxxxxxxx Contract change request header Agency lead contact for contract changes 00000242250 00000256514 - XxxxxXxxxxx,Xxxxxxxx Xxxxxx Xxxxxxx Desired amendment effective date March 1225, 2019 Amendment contract number 537-18-01460187-00001 Request amendment description Contract Description: The contractor provides activities in their service area in support of the Public Health Emergency Preparedness Cooperative Agreement from the Centers for Disease Control and Prevention and further Strategic National Stockpile program to comply with the Public Health Emergency Preparedness Cooperative Agreements Capabilities-based approach. The Cities Readiness Initiative requirements support the Medical Countermeasure Dispensing, Medical Material Management and Distribution capabilities, and supports medical countermeasure distribution and dispensing for all-hazards events. Contractor Name: Wise Fort Bend County (located in DecaturRichmond,, TX) Purpose of Amendment: Amendment #2 (Renewal)-The purpose of the amendment is revise current language to the SOW and to renew the contract by adding funding for an additional year through June 30, 2020 to continue the activities for the Public Health Emergency Preparedness Cooperative Agreement for their service area. **This is a $0.00 requisition using FY19 chart field to start the XXXXX contract collaboration process with PCS. This contract crosses fiscal years. Once the FY20 organizational budget is loaded, additional requisitions will be entered to encumber the FY20 funds for the contract. ** Contract amount change: Original Contract Amount: $36,381.00 142,618.00 + Amendment #1 Amount: $36,381.00 142,618.00 + Amendment #2 Amount: $36,381.00 142,618.00 = (TotalAmountTotal Amount: $109,143.00 427,854.00 + Total Match Amount: $10,914.0042,786.00) = =NEW TOTAL CONTRACT VALUE: $120,057.00 470,640.00 Contract change request details Does the amount change Yes New requested changed amount $ 120,057.000 470,640.000 Does the date change Yes New request contract end date June 30, 2020 Does the scope change Yes New change in scope There are not any significant changes to the scope. The amendment will update language in the SOW, update contractual requirement reporting dates, and include additional includeadditional contractual requirements for FY20 contract REQUEST DOCUMENT XXXXX Contract Change Request term (July 1, 2019 ¿ June 30, 2020). Supplemental information and comments **See Line Comments for contract related supporting documentation** Contract Statement of Work (SOW) description: To perform activities in support of the Cities Readiness Initiative under the Public Health Emergency Preparedness Cooperative Agreement. **This is a $0.00 requisition using FY19 chart field to start the XXXXX contract collaboration process with PCS. Once the FY20 organizational budget is loaded, requisitions will be entered to encumber the FY20 funds for the contract. ** Vendor (Supplier) Name: Wise Fort Bend County Vendor/TIN (Supplier ID): 17560012035 0000000000 Vendor (Supplier) Mail Code: 002 055 Contract ID: 537-18-01460187-00001 Current Purchase Order Number: 0000027643 0000024185 Vendor/Subrecipient Determination: Subrecipient Contract Term: 07/01/2017 thru 06/30/2020 Original Contract Amount: $36,381.00 142,618.00 + Amendment #1 Amount: $36,381.00 142,618.00 + Amendment #2 Amount: $36,381.00 142,618.00 = (Total Amount: $109,143.00 427,854.00 + Total Match Amount: $10,914.0042,786.00) = NEW TOTAL CONTRACT VALUE: $120,057.00 470,640.00 Contract Manager Name/Phone: Xxxxxxxx Xxxxx Xxxxxx Xxxxxx / 000-000-0000 Contract Manager Email: Xxxxxxxx.Xxxxx@xxxx.xxxxx.xxx Xxxxxx.Xxxxxx@xxxx.xxxxx.xxx DSHS Program ID (SCOR Other Subject): CPS/CRI SCOR Division: Regional & Local Health Operations (RLHO) REQUESTOR INFORMATION Name: Xxxxxxxx Xxxxx Xxxxxx Xxxxxx Phone Number: 000-000-0000 E-mail address: Xxxxxxxx Xxxxx@xxxx.xxxxx.xxx DocuSign Envelope ID: 31DCD8B9-15BB-443E-BEB2-9750FFA0BA10 Xxxxxx.Xxxxxx@xxxx.xxxxx.xxx Requisition Date: 02/26/2019 03/11/2019 Purchase Order #: Origin: ZR2 - 537-Emergency Prep GSC Purchase Order: Business Unit: HHSTX Date Issued: Document Status: Approved Header Description: Requestor: Xxxxx,Xxxxxxxx Requestor Phone: 512/000-0000 Header Comments Line Sched Class / Item or Commodity REQUISITION DETAIL Database: FSPRD REQUISITION DETAIL Description Due Date Qty UOM Price Extended Amount 1 1 990 / 29 FY19 DSHS CPS/CRI- Wise County -Amendment- Fort Bend County-Amendment- To perform activities in support of the CRI under the Public Health Emergency Preparedness Cooperative Agreement. Term: 7/1/19-6/30/20 03/12/2019 03/25/2019 1 EA 0 0 Distrib Acct Dept ID Fund Class Prog Project Amount 1 761200 Xxxxxx 0 000000 R20000 0273 71242 J97 9Y531FFBI 0 OT Buyer: Vendor: 00000164981 1756001203 0000000000 - WISE FORT BEND COUNTY Buyer Phone: Vendor Item:

Certification Regarding Public Access to Compensation Information. Does the public have access to information about the compensation of the senior executives in your business or organization (including parent organization, all branches, and all affiliates worldwide) through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986? Yes No If your answer is “Yes” to this question, where can this information be accessed? If your answer is “No” to this question, you must provide the names and total compensation of the top five highly compensated officers below. For example: Xxxx Xxxx:500000;Xxxx Xxxx:50000;Xxxx Xxxx:400000;Xxxx Xxxxx:300000; Xxxxx Xxx:300000 Provide compensation information here: DocuSign Envelope ID: 7E16DFEF-8D5D-4F17-A65C-E7630F71D691 DocuSign Envelope ID: 7E16DFEF-8D5D-4F17-A65C-E7630F71D691 DocuSign Envelope ID: 7E16DFEF-8D5D-4F17-A65C-E7630F71D691 REQUEST DOCUMENT XXXXX Contract Change Request Requestor 00000242250 - Xxxxx,Xxxxxxxx Requisition ID 0000067138 0000069171 Document ID ADH0000000000000000066540 ADH0000000000000000068495 Document Owner 00000242250 - Xxxxx,Xxxxxxxx Contract change request header Agency lead contact for contract changes 00000242250 00000256514 - XxxxxXxxxxx,Xxxxxxxx Xxxxxx Xxxxxxx Desired amendment effective date March 1225, 2019 Amendment contract number 537-18-01460187-00001 Request amendment description Contract Description: The contractor provides activities in their service area in support of the Public Health Emergency Preparedness Cooperative Agreement from the Centers for Disease Control and Prevention and further Strategic National Stockpile program to comply with the Public Health Emergency Preparedness Cooperative Agreements Capabilities-based approach. The Cities Readiness Initiative requirements support the Medical Countermeasure Dispensing, Medical Material Management and Distribution capabilities, and supports medical countermeasure distribution and dispensing for all-hazards events. Contractor Name: Wise Fort Bend County (located in DecaturRichmond,, TX) Purpose of Amendment: Amendment #2 (Renewal)-The purpose of the amendment is revise current language to the SOW and to renew the contract by adding funding for an additional year through June 30, 2020 to continue the activities for the Public Health Emergency Preparedness Cooperative Agreement for their service area. **This is a $0.00 requisition using FY19 chart field to start the XXXXX contract collaboration process with PCS. This contract crosses fiscal years. Once the FY20 organizational budget is loaded, additional requisitions will be entered to encumber the FY20 funds for the contract. ** Contract amount change: Original Contract Amount: $36,381.00 142,618.00 + Amendment #1 Amount: $36,381.00 142,618.00 + Amendment #2 Amount: $36,381.00 142,618.00 = (TotalAmountTotal Amount: $109,143.00 427,854.00 + Total Match Amount: $10,914.0042,786.00) = =NEW TOTAL CONTRACT VALUE: $120,057.00 470,640.00 Contract change request details Does the amount change Yes New requested changed amount $ 120,057.000 470,640.000 Does the date change Yes New request contract end date June 30, 2020 Does the scope change Yes New change in scope There are not any significant changes to the scope. The amendment will update language in the SOW, update contractual requirement reporting dates, and include additional contractual requirements for FY20 contract REQUEST DOCUMENT XXXXX Contract Change Request term (July 1, 2019 ¿ June 30, 2020). Supplemental information and comments **See Line Comments for contract related supporting documentation** Contract Statement of Work (SOW) description: To perform activities in support of the Cities Readiness Initiative under the Public Health Emergency Preparedness Cooperative Agreement. **This is a $0.00 requisition using FY19 chart field to start the XXXXX contract collaboration process with PCS. Once the FY20 organizational budget is loaded, requisitions will be entered to encumber the FY20 funds for the contract. ** Vendor (Supplier) Name: Wise Fort Bend County Vendor/TIN (Supplier ID): 17560012035 0000000000 Vendor (Supplier) Mail Code: 002 055 Contract ID: 537-18-01460187-00001 Current Purchase Order Number: 0000027643 0000024185 Vendor/Subrecipient Determination: Subrecipient Contract Term: 07/01/2017 thru 06/30/2020 Original Contract Amount: $36,381.00 142,618.00 + Amendment #1 Amount: $36,381.00 142,618.00 + Amendment #2 Amount: $36,381.00 142,618.00 = (Total Amount: $109,143.00 427,854.00 + Total Match Amount: $10,914.0042,786.00) = NEW TOTAL CONTRACT VALUE: $120,057.00 470,640.00 Contract Manager Name/Phone: Xxxxxxxx Xxxxx Xxxxxx Xxxxxx / 000-000-0000 Contract Manager Email: Xxxxxxxx.Xxxxx@xxxx.xxxxx.xxx Xxxxxx.Xxxxxx@xxxx.xxxxx.xxx DSHS Program ID (SCOR Other Subject): CPS/CRI SCOR Division: Regional & Local Health Operations (RLHO) REQUESTOR INFORMATION Name: Xxxxxxxx Xxxxx Xxxxxx Xxxxxx Phone Number: 000-000-0000 E-mail address: Xxxxxxxx Xxxxx@xxxx.xxxxx.xxx DocuSign Envelope ID: 31DCD8B9-15BB-443E-BEB2-9750FFA0BA10 Xxxxxx.Xxxxxx@xxxx.xxxxx.xxx Requisition Date: 02/26/2019 03/11/2019 Purchase Order #: Origin: ZR2 - 537-Emergency Prep GSC Purchase Order: Business Unit: HHSTX Date Issued: Document Status: Approved Header Description: Requestor: Xxxxx,Xxxxxxxx Requestor Phone: 512/000-0000 Header Comments Line Sched Class / Item or Commodity REQUISITION DETAIL Database: FSPRD REQUISITION DETAIL Description Due Date Qty UOM Price Extended Amount 1 1 990 / 29 FY19 DSHS CPS/CRI- Wise County -Amendment- Fort Bend County-Amendment- To perform activities in support of the CRI under the Public Health Emergency Preparedness Cooperative Agreement. Term: 7/1/19-6/30/20 03/12/2019 03/25/2019 1 EA 0 0 Distrib Acct Dept ID Fund Class Prog Project Amount 1 761200 Xxxxxx 0 000000 R20000 0273 71242 J97 9Y531FFBI 0 OT Buyer: Vendor: Ship To: 00000164981 1756001203 0000000000 - WISE FORT BEND COUNTY Location: Buyer Phone: Vendor Item:: Austin : 0000 X Xxxxx Xxxx Xxxxxx : 0000 X 00xx Xx HEALTH & HUMAN SERVICES COMMISSION Program Operations: Contract M 0000 X Xxxxx Xxxx Xxxxxx, XX 00000 Line Comments Attached Documents BASE Amendment 1 PCS 515 Requisition Grand Total: 0.00 Approved By Approver Phone (Area + Number) Approved By Approver Phone (Area + Number) 00000242250 Database: FSPRD Date Approved Entered In HHSAS By 03/11/2019 Date Approved Date Entered In HHSAS From: Xxxxxx,Xxxxxx (DSHS) To: Xxxxxxxxx,Xxxxx (HHSC) Cc: Xxxxxx,Xxxxx (DSHS) Subject: DSHS/CPS/CRI Fort Bend County Date: Thursday, April 11, 2019 1:34:53 PM Attachments: Cities Readiness Initiative Contract.msg CRI FY20 Signature Doc_Fort Bend County.xml Attachment A-3 FY20 CRI SOW_Fort Bend.doc Attachment C-FFATA Certification DSHS.pdf image001.jpg

Certification Regarding Public Access to Compensation Information. Does the public have access to information about the compensation of the senior executives in your business or organization (including parent organization, all branches, and all affiliates worldwide) through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986? Yes No If your answer is “Yes” to this question, where can this information be accessed? If your answer is “No” to this question, you must provide the names and total compensation of the top five highly compensated officers below. For example: Xxxx Xxxx:500000;Xxxx Xxxx:50000;Xxxx Xxxx:400000;Xxxx Xxxxx:300000; Xxxxx Xxx:300000 Provide compensation information here: REQUEST DOCUMENT XXXXX Contract Change Request Requestor 00000242250 - Xxxxx,Xxxxxxxx Requisition ID 0000067138 Document ID ADH0000000000000000066540 Document Owner 00000242250 - Xxxxx,Xxxxxxxx Contract change request header Agency lead contact for contract changes 00000242250 - Xxxxx,Xxxxxxxx Desired amendment effective date March 12, 2019 Amendment contract number 537-18-0146-00001 Request amendment description Contract Description: The contractor provides activities in their service area in support of the Attachment G Individual Work Plan Public Health Emergency Preparedness Cooperative Agreement from the Centers for Disease Control Work Plan and Prevention and further Strategic National Stockpile program to comply with the Public Health Emergency Preparedness Cooperative Agreements Capabilities-based approach. The Cities Readiness Initiative requirements support the Medical Countermeasure Dispensing, Medical Material Management and Distribution capabilities, and supports medical countermeasure distribution and dispensing for all-hazards events. Contractor Name: Wise County Vulnerable Populations Plan Template Budget Period (located in Decatur, TXBP) Purpose of Amendment: Amendment #2 (Renewal)-The purpose of the amendment is revise current language to the SOW and to renew the contract by adding funding for an additional year through June 30, 2020 to continue the activities for the Public Health Emergency Preparedness Cooperative Agreement for their service area. **This is a $0.00 requisition using FY19 chart field to start the XXXXX contract collaboration process with PCS. This contract crosses fiscal years. Once the FY20 organizational budget is loaded, additional requisitions will be entered to encumber the FY20 funds for the contract. ** Contract amount change: Original Contract Amount: $36,381.00 + Amendment #1 Amount: $36,381.00 + Amendment #2 Amount: $36,381.00 = (TotalAmount: $109,143.00 + Total Match Amount: $10,914.00) = NEW TOTAL CONTRACT VALUE: $120,057.00 Contract change request details Does the amount change Yes New requested changed amount $ 120,057.000 Does the date change Yes New request contract end date June 30, 2020 Does the scope change Yes New change in scope There are not any significant changes to the scope. The amendment will update language in the SOW, update contractual requirement reporting dates, and include additional contractual requirements for FY20 contract REQUEST DOCUMENT XXXXX Contract Change Request term (July 1, 2019 ¿ June 30, 2020). Supplemental information and comments **See Line Comments for contract related supporting documentation** Contract Statement of Work (SOW) description: To perform activities in support of the Cities Readiness Initiative under the Public Health Emergency Preparedness Cooperative Agreement. **This is a $0.00 requisition using FY19 chart field to start the XXXXX contract collaboration process with PCS. Once the FY20 organizational budget is loaded, requisitions will be entered to encumber the FY20 funds for the contract. ** Vendor (Supplier) Name: Wise County Vendor/TIN (Supplier ID): 17560012035 Vendor (Supplier) Mail Code: 002 Contract ID: 537-18-0146-00001 Current Purchase Order Number: 0000027643 Vendor/Subrecipient Determination: Subrecipient Contract 4- FY23 Term: 07/01/2017 thru 06/30/2020 Original Contract Amount7/1/2022 – 6/30/2023 Due: $36,381.00 + Amendment #1 AmountJanuary 25, 2022 Jurisdiction: $36,381.00 + Amendment #2 AmountFort Bend County Report Completed by: $36,381.00 = (Total Amount: $109,143.00 + Total Match Amount: $10,914.00) = NEW TOTAL CONTRACT VALUE: $120,057.00 Contract Manager Name/Phone: Xxxxxxxx Xxxxx / 000-000-0000 Contract Manager Xxxx Xxxxxx Email: Xxxxxxxx.Xxxxx@xxxx.xxxxx.xxx DSHS Program ID (SCOR Other Subject): CPS/CRI SCOR Division: Regional & Local Health Operations (RLHO) REQUESTOR INFORMATION Name: Xxxxxxxx Xxxxx Phone Numberxxxx.xxxxxx@xxxxxxxxxxxxxxxx.xxx Phone: 000-000-0000 E-mail addressInstructions: Xxxxxxxx Xxxxx@xxxx.xxxxx.xxx DocuSign Envelope IDThis template should be used to outline the work plan for Budget Period (BP) 4 – FY23 and provide a general summary of planned activities. Jurisdiction should: 31DCD8B9-15BB-443E-BEB2-9750FFA0BA10 Requisition Date• Select three (3) or more capabilities to work on in BP4– FY23. • Develop the work plan by identifying jurisdictional needs within a capability, assessing current resources, and developing a plan to address identified gaps. Work Plan tasks and activities may be linked to the ongoing COVID-19 response. • Carrying capabilities forward from previous budget periods: 02/26/2019 Purchase Order #Capabilities for BP4– FY23 may be the same as prior year selections. If the jurisdiction intends to carry work forward from BP3 – FY22 to BP4 – FY23, please mark this on page 3. • Changing capabilities: Origin: ZR2 - 537-Emergency Prep GSC Purchase Order: Business Unit: HHSTX Date Issued: Document Status: Approved Header Description: Requestor: Xxxxx,Xxxxxxxx Requestor Phone: 512/000-0000 Header Comments Line Sched Class / Item or Commodity REQUISITION DETAIL Database: FSPRD Description Due Date Qty UOM Price Extended Amount 1 1 990 / 29 FY19 DSHS CPS/CRI- Wise County -Amendment- To perform activities in support of Capabilities can be changed during the CRI under budget period. If there is a change to capabilities, please email a notification to the Public Health Emergency Preparedness Cooperative Agreement. Term: 7/1/19-6/30/20 03/12/2019 1 EA 0 0 Distrib Acct Dept ID Fund Class Prog Project Amount 1 761200 R20000 0273 71242 J97 9Y531FFBI 0 OT Buyer: Vendor: 00000164981 1756001203 - WISE COUNTY Buyer Phone: Vendor Item:PHEP email inbox (XXXX@xxxx.xxxxx.xxx).