Common use of INVOICE AND PAYMENT Clause in Contracts

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System AgencyDSHS. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx DSHS. Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency DSHS will reduce the reimbursement request by one- one-third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee will request payment monthly using the State of Texas Purchase Voucher (Form B-13B- 13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the The Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, and Financial Status Reports, and Match Certification Forms Reports should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 AustinX.X. Xxx 000000 Xxxxxx, TX XX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, B-13s and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx XXXXxxxxxxx@xxxx.xxxxx.xxx. FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx. B. Subject to submission of required and appropriate documentation, and in accordance with applicable law and governing regulations, Grantee will be paid on a reimbursed monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfallsARTICLE I. DEFINITIONS AND INTERPRETIVE PROVISIONS 5 1.1 DEFINITIONS 5 1.2 INTERPRETIVE PROVISIONS 7 ARTICLE II. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basisPAYMENT PROVISIONS 8 2.1 PROMPT PAYMENT 8 2.2 ANCILLARY AND TRAVEL EXPENSES 8 2.3 NO QUANTITY GUARANTEES 8 2.4 TAXES 8 ARTICLE III. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- third of the remaining balance of the advance.STATE AND FEDERAL FUNDING 8 3.1 EXCESS OBLIGATIONS PROHIBITED 8

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System AgencyDSHS. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx DSHS. Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency DSHS will reduce the reimbursement request by one- one-third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee will request monthly payment using the Excel version of the State of Texas Purchase Voucher (Form B-13) on a monthly basis and Support Document including any acceptable additional supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Excel version of the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, documentation and Financial Status Reports, and Match Certification Forms Reports should be mailed or emailed e-mailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with Attachment B, Budget.the Budget in C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- third of the remaining balance of the advance. E. For the purposes of this Contract, the Grantee may not use funds for fundraising activities, lobbying, research, construction, major renovations and reimbursement of pre-award costs, clinical care, purchase of vehicles of any kind, funding an award to another party or provider who is ineligible, backfilling costs for staff or the purchase of incentive items.

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the The Grantee will submit the Financial Status Report (FSR-269A) and ). Additionally, the Grantee will submit the Match Certification Form (B-13A), as requested by DSHS. Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 AustinX.X. Xxx 000000 Xxxxxx, TX XX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, B-13 and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor XxxxxxxGrantee’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, XxxxxxxGrantee’s budget may be subject to a decrease for the remainder of the Term term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx D. Grantee may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx E. Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee X. Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis at xxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm. Voucher and acceptable supporting documentation for reimbursement of will be mailed or submitted by fax or electronic mail to the required servicesaddress/deliverablesnumber below. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed mailed, faxed, or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with the Budget in Attachment B, BudgetB of this Contract. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfallsshortfall. System Agency Program will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amountamount as approved for this Contract, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds.the X. Xxxxxxx may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee X. Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis at xxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm. Voucher and acceptable supporting documentation for reimbursement of will be mailed or submitted by fax or electronic mail to the required servicesaddress/deliverablesnumber below. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed mailed, faxed, or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with the Budget in Attachment B, BudgetB of this Contract. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfallsshortfall. System Agency Program will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amountamount as approved for this Contract, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the ContractContract term. Vacant positions existing after ninety (90) days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- third of the remaining balance of the advance.at

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the The Grantee will submit the Financial Status Report (FSR-269A) and ). Additionally, the Grantee will submit the Match Certification Form (B-13A), as requested by DSHS. Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, B-13 and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx . Grantee may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box X.X. Xxx 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx D. Grantee may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx E. Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the The Grantee will submit the Financial Status Report (FSR-269A) and FSR- 269A). Additionally, the Grantee with submit the Match Certification Form (B-13A), as requested by DSHS. Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, B-13 and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee X. Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis at xxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm. Voucher and acceptable supporting documentation for reimbursement of will be mailed or submitted by fax or electronic mail to the required servicesaddress/deliverablesnumber below. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed mailed, faxed, or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with the Budget in Attachment B, BudgetB of this Contract. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfallsshortfall. System Agency Program will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amountamount as approved for this Contract, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the ContractContract term. Vacant positions existing after ninety (90) days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee will request monthly payment using the Excel version of the State of Texas Purchase Voucher (Form B-13) on a monthly basis and Support Document including any acceptable additional supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Excel version of the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, documentation and Financial Status Reports, and Match Certification Forms Reports should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with Attachment B, Budget.the Budget in C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance. E. For the purposes of this Contract, the Grantee may not use funds for fundraising activities, lobbying, research, construction, major renovations and reimbursement of pre-award costs, clinical care, purchase of vehicles of any kind, funding an award to another party or provider who is ineligible, backfilling costs for staff or the purchase of incentive items.

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will submit separate and distinct invoices for the two Contract Grant Funding Allocations. Separate monthly invoices will be submitted for the base HAZARDS grant activities and a separate one-time invoice will be submitted for the NACCHO application process. Comingling of these federal funds is prohibited. C. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. D. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System AgencyDSHS. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx DSHS. Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency DSHS will reduce the reimbursement request by one- one-third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee X. Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis at xxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm. Voucher and acceptable supporting documentation for reimbursement of will be mailed or submitted by fax or electronic mail to the required servicesaddress/deliverablesnumber below. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx B-13, B-13A, and supporting documentation should be sent emailed to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSR should be sent emailed to: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxxXXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid reimbursed on a monthly basis and in accordance with Attachment B, Budget.the Budget in C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfallsshortfall. System Agency Program will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amountcontract amount as approved for this Contract, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the ContractContract term. Vacant positions existing after ninety (90) days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System AgencyDSHS. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx DSHS. Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency DSHS will reduce the reimbursement request by one- one-third of the remaining balance of the advance.. Personnel $74,650.00 Fringe Benefits $32,106.00 Travel $6,190.00 Equipment $0.00 Supplies $5,225.00 Contractual $0.00 Other $23,341.00 Sum of Direct Costs $141,512.00 Indirect Costs $0.00 Sum of Total Direct Costs and Indirect Costs $141,512.00 Less Match (Cash or In-Kind) $12,862.00 Grantee shall provide match funds in the amount of $12,862.00. HHSC Uniform Terms and Conditions Version 2.14 Published and Effective: March 1, 2017 Responsible Office: Chief Counsel 1.01 Definitions 4 1.02 Interpretive Provisions 5 2.01 Payment Methods 6 2.02 Final Billing Submission 6 2.03 Financial Status Reports (FSRs) 7 2.04 Debt to State and Corporate Status 7

INVOICE AND PAYMENT. A. Grantee X. Xxxxxxx will request payment payments in accordance with the schedule outlined in Attachment B, Budget, of this Grant Agreement. Payments must be requested using the State of Texas Purchase Voucher (Form B-13) on a monthly basis at xxxx://xxx.xxxx.xxxxx.xx.xx/grants/forms/b13form.doc. Voucher and acceptable any supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed submitted by fax or electronic mail to the addresses address/number below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 AustinX.X. Xxx 000000 Xxxxxx, TX XX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, xxxxxxxx@xxxx.xxxxx.xxx and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx and XxxxxxxxXxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid on a monthly basis and in accordance with the schedule outlined in Attachment B, Budget, of this Grant Agreement. The Grantee can request a delay in the submission of a milestone report, if necessary. DSHS will consider reasonable requests and respond within five business days to the request. Non-delivery or non-acceptance of milestone reports/services under this Grant Agreement and Statement of Work may result in non- payment, delayed, or reduced payment. All milestone reports outlined below will be submitted to DSHS electronically via email to xxxx@xxxx.xxxxx.xxx; Xxxxxxx.Xxxxxxxxx@xxxx.xxxxx.xxx, Xxxxx.Xxxxx@xxxx.xxxxx.xxx, and XxxxxxxxXxxxxx@xxxx.xxxxx.xxx for review and approval prior to releasing payment and subject to receipt and approval of corresponding invoice. C. System Agency reserves 1. Project Work Plan, developed in coordination with and for approval by DSHS, including goals; milestones for progress and data sources; activities; tasks; key partners; and resources for serving as the rightSelected Pilot Site (in fulfillment of clauses 1-8 of Section II(B) of Attachment A, where allowed by legal authorityStatement of Work) during the FY22 and FY23 project term Within 45 days of contract execution $7,000 2. HRMCCS-PP Pilot Site Progress Report describing Xxxxxxx’s efforts to date toward meeting work plan milestones, barriers, needs, learning to redirect funds in date, and recommendations 6/15/2022 $10,000 3. HRMCCS-PP Pilot Site Progress Report describing Xxxxxxx’s efforts to date toward meeting work plan milestones, barriers, needs, learning to date, and recommendations 7/15/2022 $10,000 4. HRMCCS-PP Pilot Site Progress Report describing Xxxxxxx’s efforts to date toward meeting work plan milestones, barriers, needs, learning to date, and recommendations 8/15/2022 $10,000 Not to exceed: $37,000 1. HRMCCS-PP Pilot Site Progress Report describing Xxxxxxx’s efforts to date toward meeting work plan milestones, barriers, needs, learning to date, and recommendations By or before 9/15/2022 $10,000 2. HRMCCS-PP Pilot Site Progress Report describing $25,000 Xxxxxxx’s efforts to date toward meeting work plan milestones, barriers, needs, learning to date, and recommendations 12/15/2023 3. HRMCCS-PP Pilot Site Progress Report describing Xxxxxxx’s efforts to date toward meeting work plan milestones, barriers, needs, learning to date, and recommendations 3/15/2023 $25,000 4. HRMCCS-PP Pilot Site Progress Report describing Xxxxxxx’s efforts to date toward meeting work plan milestones, barriers, needs, learning to date, and recommendations 6/15/2023 $25,000 5. HRMCCS-PP Pilot Site Progress Report describing Xxxxxxx’s efforts to date toward meeting work plan milestones, barriers, needs, learning to date, and recommendations 8/31/2023 $25,000 Not to exceed: $ 110,000 _C_ CONTRACT AFFIRMATIONS For purposes of these Contract Affirmations, HHS includes both the event Health and Human Services Commission (HHSC) and the Department of financial shortfallsState Health Services (DSHS). System Agency refers to HHSC, DSHS, or both, that will monitor Xxxxxxx’s expenditures on be a quarterly basisparty to this Contract. If expenditures are below that projected in Grantee’s total These Contract amountAffirmations apply to all Contractors and Grantees (referred to as “Contractor”) regardless of their business form (e.g., Xxxxxxx’s budget may be subject individual, partnership, corporation). By entering into this Contract, Contractor affirms, without exception, understands, and agrees to a decrease for comply with the remainder of following items through the Term life of the Contract: 1. Vacant positions existing after ninety days Contractor represents and warrants that these Contract Affirmations apply to Contractor and all of Contractor's principals, officers, directors, shareholders, partners, owners, agents, employees, subcontractors, independent contractors, and any other representatives who may result provide services under, who have a financial interest in, or otherwise are interested in a decrease in fundsthis Contract and any related Solicitation. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid on a monthly cost-reimbursement basis and in accordance with Attachment B, Budget.the Budget in C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the ContractContract term. Vacant positions existing after ninety (90) days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget.. DRAFT C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee X. Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis at xxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm. Voucher and acceptable supporting documentation for reimbursement of will be mailed or submitted by fax or electronic mail to the required servicesaddress/deliverablesnumber below. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed mailed, faxed or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with the Budget in Attachment B, BudgetB of this Contract. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfallsshortfall. System Agency Program will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amountamount as approved for this Contract, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the ContractContract term. Vacant positions existing after ninety (90) days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency DSHS will reduce the reimbursement request by one- one-third of the remaining balance of the advance. I. GRANTEE RESPONSIBILITIES Grantee will: A. Perform activities in Wise County (hereinafter the "Jurisdiction") in support of the Public Health Emergency Preparedness Cooperative Agreement from the Centers for Disease Control and Prevention (CDC) and further the Strategic National Stockpile (SNS) program to comply with the Public Health Emergency Preparedness (PHEP) Cooperative Agreement’s capabilities-based approach. The Cities Readiness Initiative (CRI) requirements support the Medical Countermeasure Dispensing and Medical Materiel Management and Distribution capabilities. The CRI supports medical countermeasure distribution and dispensing for all-hazards events. B. Coordinate activities and response plans within the Jurisdiction with the state, regional and other local jurisdictions, among local agencies, and with hospitals and major health care entities, jurisdictional Metropolitan Medical Response Systems, and Councils of Government. X. Xxxxxxxxx with System Agency to coordinate all planning, training, and exercises performed under this Contract with the State of Texas, Texas Division of Emergency Management of the State of Texas, or other points of contact at the discretion of the Division for Regional and Local Health Operations, to ensure consistency and coordination of requirements at the local level and eliminate duplication of effort between the various domestic preparedness funding sources in the state. D. Utilize the Texas Medical Countermeasure (MCM) Strategy Document, as amended, to develop and execute plans, thus preparing the Metropolitan Statistical Area (MSA) to provide medical countermeasures to the identified population during a large-scale public health emergency. The Texas MCM Strategy Document is available at: xxxxx://xxx.xxxx.xxxxx.xxx/commprep/sns.aspx or by contacting the Strategic National Stockpile (SNS) Central Office Team at XXX@xxxx.xxxxx.xxx. To accomplish this, Grantee will meet the planning and operational standards as outlined in Sections I(B)-(X) of this Contract, and the current Operational Readiness Review (XXX) Tool, as amended, that applies to the following Public Health Emergency Preparedness Capabilities:

INVOICE AND PAYMENT. A. Grantee X. Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report Reports (FSR-269A) and the Match Certification Form (B-13A)on a quarterly basis. Vouchers, supporting documentation, and Financial Status Reports, and Match Certification Forms Reports should be mailed or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13xxx@xxxx.xxxxx.xx.xx, B-13A, and Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx B-13 and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx xxx@xxxx.xxxxx.xx.xx, and Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxxxxx@xxxx.xxxxx.xx.xx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxxand XXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid reimbursed on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed twelve (12% %) percent of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if If the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.. DocuSign Envelope ID: BE05D74F-E84D-4C4D-970E-CB5AE478E70A *UDQWHH 'DOODV &RXQW\ +HDOWK DQG +XPDQ 6HUYLFHV 3HUVRQQHO )ULQJH %HQHILWV 7UDYHO (TXLSPHQW 6XSSOLHV &RQWUDFWXDO 2WKHU 6XP RI 'LUHFW &RVWV ,QGLUHFW &RVWV 6XP RI 7RWDO 'LUHFW &RVWV DQG ,QGLUHFW &RVWV *UDQWHH PXVW H[SHQG IXQGV ZLWKLQ WKH DSSOLFDEOH VSHFLILHG WLPH SHULRG QRWHG DERYH HHSC Uniform Terms and Conditions Version 2.14 Published and Effective: March 1, 2017 Responsible Office: Chief Counsel 1.01 Definitions 4 1.02 Interpretive Provisions 5 2.01 Payment Methods 6 2.02 Final Billing Submission 6 2.03 Financial Status Reports (FSRs) 7 2.04 Debt to State and Corporate Status 7

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box X.X. Xxx 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxxXXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx funds D. Grantee may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System AgencyDSHS. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx DSHS. Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency DSHS will reduce the reimbursement request by one- one-third of the remaining balance of the advance.. Personnel $456,106.00 Fringe Benefits $165,567.00 Travel $5,309.00 Equipment $0.00 Supplies $4,601.00 Contractual $0.00 Other $0.00 Sum of Direct Costs $631,583.00 Indirect Costs $0.00 Sum of Total Direct Costs and Indirect Costs $631,583.00 Less Match (Cash or In-Kind) $57,417.00 Grantee shall provide matching funds in the amount of $57,417.00. HHSC Uniform Terms and Conditions Version 2.13 Published and Effective: July 15, 2016 Responsible Office: Chief Counsel

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx D. Grantee may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx E. Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. B. The Parties agree to cooperate by submitting separate and distinct invoices for each of the two Contract Grant Funding Allocations. Separate monthly invoices will be submitted for the base Hazards Grant Activities and for the 2019 All Hazards Conference Grant Activities. Comingling of these federal funds is prohibited. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 AustinX.X. Xxx 000000 Xxxxxx, TX XX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. C. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. D. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-one third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one third of the remaining balance of the advance. 3. For the Contract period beginning July 1, 2018 and ending June 30, 2019, the Categorical Budget is deleted in its entirety and replaced with the following: Personnel $437,256.00 $0.00 Fringe Benefits $166,245.00 $0.00 Travel $9,851.00 $0.00 Equipment $0.00 $0.00 Supplies $4,263.00 $0.00 Contractual $0.00 $0.00 Other $13,968.00 $100,000.00 Sum of Direct Costs $631,583.00 $100,000.00 Indirect Costs $0.00 $0.00 Sum of Total Direct Costs and Indirect Costs $631,583.00 $100,000.00 Less Match (Cash or In-Kind) $57,417.00 $0.00 TOTAL $574,166.00 $100,000.00 Grantee shall provide matching funds in the amount of Fifty-Seven Thousand Four Hundred Seventeen Dollars ($57,417.00). 4. This Amendment No. 02 shall be effective on the first date on which it has been executed by both Parties. 5. Except as amended and modified by this Amendment No. 02, all terms and conditions of the Contract shall remain in full force and effect. 6. Any further revisions to the Contract shall be by written agreement of the Parties.

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. B. The Parties agree to cooperate by submitting separate and distinct invoices for each of the three Contract Grant Funding Allocations. Separate monthly invoices will be submitted for the base Hazards Grant Activities and for the 2018 All Hazards Conference Grant Activities. In addition, a separate one-time invoice will be submitted for the NACCHO application process. Comingling of these federal funds is prohibited. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 AustinX.X. Xxx 000000 Xxxxxx, TX XX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. C. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. D. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx . Grantee may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System AgencyDSHS. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System AgencyDSHS. X. Xxxxxxx will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency DSHS will reduce the reimbursement request by one- third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis at xxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm. Voucher and acceptable supporting documentation for reimbursement of will be mailed or submitted by fax or electronic mail to the required servicesaddress/deliverablesnumber below. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed mailed, faxed or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box X.X. Xxx 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with the Budget in Attachment B, BudgetB of this Contract. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfallsshortfall. System Agency Program will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amountamount as approved for this Contract, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the ContractContract term. Vacant positions existing after ninety (90) days may result in a decrease in funds. X. Xxxxxxx D. Grantee may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency DSHS will reduce the reimbursement request by one- one-third of the remaining balance of the advance. I. GRANTEE RESPONSIBILITIES Grantee will: A. Perform activities in Parker County (hereinafter the "Jurisdiction") in support of the Public Health Emergency Preparedness Cooperative Agreement from the Centers for Disease Control and Prevention (CDC) and further the Strategic National Stockpile (SNS) program to comply with the Public Health Emergency Preparedness (PHEP) Cooperative Agreement’s capabilities-based approach. The Cities Readiness Initiative (CRI) requirements support the Medical Countermeasure Dispensing and Medical Materiel Management and Distribution capabilities. The CRI supports medical countermeasure distribution and dispensing for all-hazards events. B. Coordinate activities and response plans within the Jurisdiction with the state, regional and other local jurisdictions, among local agencies, and with hospitals and major health care entities, jurisdictional Metropolitan Medical Response Systems, and Councils of Government. C. Cooperate with System Agency to coordinate all planning, training, and exercises performed under this Contract with the State of Texas, Texas Division of Emergency Management of the State of Texas, or other points of contact at the discretion of the Division for Regional and Local Health Operations, to ensure consistency and coordination of requirements at the local level and eliminate duplication of effort between the various domestic preparedness funding sources in the state. D. Utilize the Texas Medical Countermeasure (MCM) Strategy Document, as amended, to develop and execute plans, thus preparing the Metropolitan Statistical Area (MSA) to provide medical countermeasures to the identified population during a large-scale public health emergency. The Texas MCM Strategy Document is available at: xxxxx://xxx.xxxx.xxxxx.xxx/commprep/sns.aspx or by contacting the Strategic National Stockpile (SNS) Central Office Team at XXX@xxxx.xxxxx.xxx. To accomplish this, Grantee will meet the planning and operational standards as outlined in Sections I(B)-(X) of this Contract, and the current Operational Readiness Review (XXX) Tool, as amended, that applies to the following Public Health Emergency Preparedness Capabilities:

INVOICE AND PAYMENT. A. Grantee X. Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis at xxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm. Voucher and acceptable supporting documentation for reimbursement of will be mailed or submitted by fax or electronic mail to the required servicesaddress/deliverablesnumber below. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed mailed, faxed, or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with the Budget in Attachment B, BudgetB of this Contract. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfallsshortfall. System Agency Program will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amountamount as approved for this Contract, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the ContractContract term. Vacant positions existing after ninety (90) days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- third of the remaining balance of the advance.at

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. B. The Parties agree to cooperate by submitting separate and distinct invoices for each of the three Contract Grant Funding Allocations. Separate monthly invoices will be submitted for the base Hazards Grant Activities and for the 2018 All Hazards Conference Grant Activities. In addition, a separate one-time invoice will be submitted for the NACCHO application process. Comingling of these federal funds is prohibited. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 AustinX.X. Xxx 000000 Xxxxxx, TX XX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. C. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. D. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor XxxxxxxGrantee’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, XxxxxxxGrantee’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx . Grantee may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System AgencyDSHS. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System AgencyDSHS. X. Xxxxxxx E. Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency DSHS will reduce the reimbursement request by one- one-third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee will request monthly payment using the Excel version of the State of Texas Purchase Voucher (Form B-13) on a monthly basis and Support Document including any acceptable additional supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Excel version of the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, documentation and Financial Status Reports, and Match Certification Forms Reports should be mailed or emailed e-mailed to the addresses below. Claims Processing Unit, MC1940 Texas Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. PO Box 149347 Austin, TX 0000078714-0000 FAX9347 B-13: (000) 000-0000 EMAILxxxxxxxx@xxxx.xxxxx.xx.xx and xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx Support Document: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, xxxxxxxx@xxxx.xxxxx.xx.xx and xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx B-13A, : xxxxxxxx@xxxx.xxxxx.xx.xx and supporting documentation should be sent toxxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSR: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx and xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx and XXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid reimbursed on a monthly basis and in accordance with the Budget in Attachment B, BudgetB of this Contract. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.. Grantee: Tarrant County Personnel $164,105 Fringe Benefits $68,924 Travel $1,844 Equipment $0 Supplies $10,867 Contractual $0 Other $6,075 Sum of Direct Costs $251,815 Indirect Costs $0 Sum of Total Direct Costs and Indirect Costs $251,815 Less Match (Cash or In-Kind) $22,892 HHSC Uniform Terms and Conditions Version 2.12 Published and Effective: November 30, 2015 Responsible Office: Chief Counsel

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxxXXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. funds X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- third of the remaining balance of the advance.. Grantee: City of Brownwood Personnel $67,539 Fringe Benefits $16,701 Travel $5,714 Equipment $0 Supplies $7,147 Contractual $0 Other $13,225 Sum of Direct Costs $110,326 Indirect Costs $0 Sum of Total Direct Costs and Indirect Costs $110,326 Less Match (Cash or In-Kind) $10,030 Grantee shall provide matching funds in the amount of $10,030.00. HHSC Uniform Terms and Conditions Version 2.13 Published and Effective: July 15, 2016 Responsible Office: Chief Counsel

INVOICE AND PAYMENT. A. Grantee will request monthly payment using the Excel version of the State of Texas Purchase Voucher (Form B-13) on a monthly basis and Support Document including any acceptable additional supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Excel version of the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, documentation and Financial Status Reports, and Match Certification Forms Reports should be mailed or emailed e-mailed to the addresses below. Claims Processing Unit, MC1940 Texas Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. PO Box 149347 Austin, TX 00000-0000 FAXB-13: (000) 000-0000 EMAILxxxxxxxx@xxxx.xxxxx.xx.xx and xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx Support Document: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, xxxxxxxx@xxxx.xxxxx.xx.xx and xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx B-13A, : xxxxxxxx@xxxx.xxxxx.xx.xx and supporting documentation should be sent toxxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSR: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx and xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx and XXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid reimbursed on a monthly basis and in accordance with the Budget in Attachment B, BudgetB of this Contract. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.. Personnel $96,660.00 Fringe Benefits $39,940.00 Travel $14,096.00 Equipment $0.00 Supplies $19,567.00 Contractual $0.00 Other $50,973.00 Sum of Direct Costs $221,236.00 Indirect Costs $0.00 Sum of Total Direct Costs and Indirect Costs $221,236.00 Less Match (Cash or In-Kind) $20,113.00 HHSC Uniform Terms and Conditions Version 2.13 Published and Effective: July 15, 2016 Responsible Office: Chief Counsel

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxxXXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. funds X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System AgencyDSHS. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx DSHS. Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency DSHS will reduce the reimbursement request by one- one-third of the remaining balance of the advance.. Personnel $126,899.00 Fringe Benefits $54,567.00 Travel $10,600.00 Equipment $0.00 Supplies $239.00 Contractual $20,400.00 Other $9,780.00 Sum of Direct Costs $222,485.00 Indirect Costs $0.00 Sum of Total Direct Costs and Indirect Costs $222,485.00 Less Match (Cash or In-Kind) $20,400.00 Grantee shall provide matching funds in the amount of $20,400.00. HHSC Uniform Terms and Conditions Version 2.12 Published and Effective: November 30, 2015 Responsible Office: Chief Counsel ARTICLE I. DEFINITIONS AND INTERPRETIVE PROVISIONS 4

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx D. Grantee may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System AgencyDSHS. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx DSHS. Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency DSHS will reduce the reimbursement request by one- one-third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box X.X. Xxx 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxxXXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx funds D. Grantee may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System AgencyDSHS. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx DSHS. Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency DSHS will reduce the reimbursement request by one- one-third of the remaining balance of the advance.. Grantee: Collin County Personnel $374,957 Fringe Benefits $140,027 Travel $14,538 Equipment $0 Supplies $35,370 Contractual $0 Other $34,950 Sum of Direct Costs $599,842 Indirect Costs $0 Sum of Total Direct Costs and Indirect Costs $599,842 Less Match (Cash or In-Kind) $54,515 Grantee shall provide match funds in the amount of $54,515.00. HHSC Uniform Terms and Conditions Version 2.13 Published and Effective: July 15, 2016 Responsible Office: Chief Counsel

INVOICE AND PAYMENT. A. Grantee Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A)on a quarterly basis. Vouchers, supporting documentation, and Financial Status Reports, and Match Certification Forms Reports should be mailed or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box X.X. Xxx 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, xxxxxxxx@xxxx.xxxxx.xx.xx and xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx B-13 and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx xxx@xxxx.xxxxx.xx.xx, and Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxxxxx@xxxx.xxxxx.xx.xx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxxand XXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid reimbursed on a monthly basis and in accordance with Attachment BC, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx D. Grantee may request a one-time working capital advance not to exceed twelve (12% %) percent of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if If the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.. DocuSign Envelope ID: D9A3FB21-8D40-43EB-8D07-1786909C7BD2 Grantee: Collin County Personnel $0.00 $52,800.00 $0.00 $52,800.00 Fringe Benefits $0.00 $0.00 $0.00 $0.00 Travel $2,968.00 $0.00 $0.00 $2,968.00 Equipment $0.00 $0.00 $0.00 $0.00 Supplies $7,306.00 $1,000.00 $5,000.00 $13,306.00 Contractual $30,000.00 $56,500.00 $32,000.00 $118,500.00 Other $0.00 $0.00 $0.00 $0.00 Sum of Direct Costs $40,274.00 $110,300.00 $37,000.00 $187,574.00 Indirect Costs $0.00 $0.00 $0.00 $0.00 Sum of Total Direct Costs and Indirect Costs $40,274.00 $110,300.00 $37,000.00 $187,574.00 Grantee must expend funds within the applicable specified time periods noted above. HHSC Uniform Terms and Conditions Version 2.13 Published and Effective: July 15, 2016 Responsible Office: Chief Counsel

INVOICE AND PAYMENT. A. Grantee will request monthly payment using the Excel version of the State of Texas Purchase Voucher (Form B-13) on a monthly basis and Support Document including any acceptable additional supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Excel version of the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, documentation and Financial Status Reports, and Match Certification Forms Reports should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box X.X. Xxx 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with Attachment B, Budget.the Budget in C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx D. Grantee may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance. E. For the purposes of this Contract, the Grantee may not use funds for fundraising activities, lobbying, research, construction, major renovations and reimbursement of pre-award costs, clinical care, purchase of vehicles of any kind, funding an award to another party or provider who is ineligible, backfilling costs for staff or the purchase of incentive items.

INVOICE AND PAYMENT. A. Grantee Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis at xxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm. Voucher and acceptable supporting documentation for reimbursement of will be mailed or submitted by fax or electronic mail to the required servicesaddress/deliverablesnumber below. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed mailed, faxed, or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with the Budget in Attachment B, BudgetB of this Contract. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfallsshortfall. System Agency Program will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amountamount as approved for this Contract, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds.the X. Xxxxxxx D. Grantee may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, and Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX Texas 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & xxxxxxxx@xxxx.xxxxx.xxx and XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, B-13 and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx and XXXXxxxxxxx@xxxx.xxxxx.xxx CC: xxxxx.xxxxx@xxxx.xxxxx.xxx ,xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx cc assigned contract manager FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxxXXXXxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxxXXXXxxxxxxx@xxxx.xxxxx.xxx & CC: xxxxx.xxxxx@xxxx.xxxxx.xxx , XXXXxxxxx@xxxx.xxxxx.xxx xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxxcc assigned contract manager B. Grantee will be paid on a monthly cost-reimbursement basis and in accordance with Attachment BC-2, BudgetRevised Budget of this Contract. C. System Agency DSHS reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency DSHS will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the ContractContract term. Vacant positions existing after ninety 90 days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce Contract No. 537-18-0276-00001 Further information for completing the reimbursement request by one- third of the remaining balance of the advanceWork Plan can be obtained at Public Health Preparedness and Response Capabilities: National Standards for State, Local, Tribal and Territorial Public Health, and Local Planning, October 2018 (updated January 2019): Public Health Emergency Preparedness and Response Capabilities: National Standards for State, Local, Tribal, and Territorial Public Health—October 2018 (xxx.xxx) P = Planning, S/T = Skills and Training, and E/T = Equipment and Technology.

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxxXXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. funds X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System AgencyDSHS. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx DSHS. Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency DSHS will reduce the reimbursement request by one- one-third of the remaining balance of the advance.. Personnel $66,984.00 Fringe Benefits $32,085.00 Travel $6,205.00 Equipment $0.00 Supplies $2,112.00 Contractual $0.00 Other $2,940.00 Sum of Direct Costs $110,326.00 Indirect Costs $0.00 Sum of Total Direct Costs and Indirect Costs $110,326.00 Less Match (Cash or In-Kind) $10,030.00 TOTAL $100,296.00 Grantee shall provide matching funds in the amount of $10,030.00. HHSC Uniform Terms and Conditions Version 2.13 Published and Effective: July 15, 2016 Responsible Office: Chief Counsel

INVOICE AND PAYMENT. A. Grantee Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report Reports (FSR-269A) and the Match Certification Form (B-13A)on a quarterly basis. Vouchers, supporting documentation, and Financial Status Reports, and Match Certification Forms Reports should be mailed or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, xxxxxxxx@xxxx.xxxxx.xx.xx and xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx B-13 and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxxXXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid reimbursed on a monthly basis and in accordance with Attachment BC, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx funds D. Grantee may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx will repay all or part of advance funds at any time Agency during the Contract’s term. However, if If the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee X. Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis at xxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm. Voucher and acceptable supporting documentation for reimbursement of will be mailed or submitted by fax or electronic mail to the required servicesaddress/deliverablesnumber below. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed mailed, faxed or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with the Budget in Attachment B, BudgetB of this Contract. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfallsshortfall. System Agency Program will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amountamount as approved for this Contract, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the ContractContract term. Vacant positions existing after ninety (90) days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- third of the remaining balance of the advance.at

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxxXXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. funds X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System AgencyDSHS. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx DSHS. Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency DSHS will reduce the reimbursement request by one- one-third of the remaining balance of the advance.. Grantee: Sweetwater-Nolan County Health Department Personnel $72,864 Fringe Benefits $7,286 Travel $3,087 Equipment $0 Supplies $5,844 Contractual $0 Other $22,270 Sum of Direct Costs $111,351 Indirect Costs $0 Sum of Total Direct Costs and Indirect Costs $111,351 Less Match (Cash or In-Kind) $10,123 Grantee shall provide matching funds in the amount of $10,123. HHSC Uniform Terms and Conditions Version 2.12 Published and Effective: November 30, 2015 Responsible Office: Chief Counsel

INVOICE AND PAYMENT. A. Grantee will request monthly payment using the Excel version of the State of Texas Purchase Voucher (Form B-13) on a monthly basis and Support Document including any acceptable additional supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Excel version of the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, documentation and Financial Status Reports, and Match Certification Forms Reports should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with Attachment B, Budget.the Budget in C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance. E. For the purposes of this Contract, the Grantee may not use funds for fundraising activities, lobbying, research, construction, major renovations and reimbursement of pre-award costs,

INVOICE AND PAYMENT. A. Grantee X. Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report Reports (FSR-269A) and the Match Certification Form (B-13A)on a quarterly basis. Vouchers, supporting documentation, and Financial Status Reports, and Match Certification Forms Reports should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx : P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, xxxxxxxx@xxxx.xxxxx.xx.xx and xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx B-13 and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxxXXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid reimbursed on a monthly basis and in accordance with Attachment BC, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. funds X. Xxxxxxx may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx will repay all or part of advance funds at any time Agency during the Contract’s term. However, if If the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxxXXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. funds X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System AgencyDSHS. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx DSHS. Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency DSHS will reduce the reimbursement request by one- one-third of the remaining balance of the advance.. Grantee: Dallas County Personnel $1,120,225 Fringe Benefits $432,755 Travel $20,291 Equipment $0 Supplies $37,864 Contractual $0 Other $130,010 Sum of Direct Costs $1,741,145 Indirect Costs $174,114 Sum of Total Direct Costs and Indirect Costs $1,915,259 Less Match (Cash or In-Kind) $174,114 Grantee shall provide matching funds in the amount of $174,114.00. HHSC Uniform Terms and Conditions Version 2.13 Published and Effective: July 15, 2016 Responsible Office: Chief Counsel

INVOICE AND PAYMENT. A. Grantee will request monthly payment using the Excel version of the State of Texas Purchase Voucher (Form B-13) on a monthly basis and Support Document including any acceptable additional supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Excel version of the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, documentation and Financial Status Reports, and Match Certification Forms Reports should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with Attachment B, Budget.the Budget in C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance. E. For the purposes of this Contract, the Grantee may not use funds for fundraising activities, lobbying, research, construction, major renovations and reimbursement of pre-award costs, clinical care, purchase of vehicles of any kind, funding an award to another party or

INVOICE AND PAYMENT. A. Grantee X. Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13B- 13) on a monthly basis at xxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm. Voucher and acceptable supporting documentation for reimbursement of will be mailed or submitted by fax or electronic mail to the required servicesaddress/deliverablesnumber below. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed mailed, faxed, or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with the Budget in Attachment B, BudgetB of this Contract. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfallsshortfall. System Agency Program will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amountamount as approved for this Contract, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the ContractContract term. Vacant positions existing after ninety (90) days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- third of the remaining balance of the advance.funds

INVOICE AND PAYMENT. A. Grantee X. Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis at xxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm. Voucher and acceptable supporting documentation for reimbursement of will be mailed or submitted by electronic mail to the required servicesaddress/deliverablesnumber below. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, and Financial Status Reports, and Match Certification Forms Reports should be mailed or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 ATTACHMENT A STATEMENT OF WORK EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, B-13 and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx XXXXxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxxXXXXxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with the Budget in Attachment B, BudgetB of this Contract. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfallsshortfall. System Agency Program will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amountcontract amount as approved for this Contract, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the ContractContract term. Vacant positions existing after ninety (90) days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.. SYSTEM AGENCY CONTRACT NO. HHS000145800001 XXXXXXX COUNTY Personnel $9,000.00 Fringe Benefits $0.00 Travel $1,000.00 Equipment $0.00 Supplies $0.00 Contractual $0.00 Other $0.00 Sum of Direct Costs $10,000.00 Indirect Costs $0.00 Sum of Total Direct Costs and Indirect Costs $10,000.00 Less Match (Cash or In-Kind) $0.00 TOTAL $10,000.00 HHSC Uniform Terms and Conditions Version 2.15 Published and Effective: September 1, 2017 Responsible Office: Chief Counsel ARTICLE I. DEFINITIONS AND INTERPRETIVE PROVISIONS 4

INVOICE AND PAYMENT. A. Grantee X. Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis at h ttp://xxx.xxxx.xxxxx.xxx/xxxxxx/xxxxx.xxxx. Voucher and acceptable supporting documentation for reimbursement of will be mailed or submitted by fax or electronic mail to the required servicesaddress/deliverablesnumber below. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed mailed, faxed, or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxxi xxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxxi xxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx P xx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxxi xxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxxP xx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx F XXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxxC XXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with the Budget in Attachment B, BudgetB of this Contract. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfallsshortfall. System Agency Program will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amountamount as approved for this Contract, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the ContractContract term. Vacant positions existing after ninety (90) days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- third of the remaining balance of the advance.at

INVOICE AND PAYMENT. A. Grantee X. Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis at xxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm. Voucher and acceptable supporting documentation for reimbursement of will be mailed or submitted by fax or electronic mail to the required servicesaddress/deliverablesnumber below. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed mailed, faxed or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with the Budget in Attachment B, BudgetB of this Contract. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfallsshortfall. System Agency Program will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amountamount as approved for this Contract, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the ContractContract term. Vacant positions existing after ninety (90) days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency DSHS will reduce the reimbursement request by one- one-third of the remaining balance of the advance. I. GRANTEE RESPONSIBILITIES Grantee will: A. Perform activities in Fort Bend County (hereinafter the "Jurisdiction") in support of the Public Health Emergency Preparedness Cooperative Agreement from the Centers for Disease Control and Prevention (CDC) and further the Strategic National Stockpile (SNS) program to comply with the Public Health Emergency Preparedness (PHEP) Cooperative Agreement’s capabilities-based approach. The Cities Readiness Initiative (CRI) requirements support the Medical Countermeasure Dispensing and Medical Materiel Management and Distribution capabilities. The CRI supports medical countermeasure distribution and dispensing for all-hazards events. B. Coordinate activities and response plans within the Jurisdiction with the state, regional and other local jurisdictions, among local agencies, and with hospitals and major health care entities, jurisdictional Metropolitan Medical Response Systems, and Councils of Government. X. Xxxxxxxxx with System Agency to coordinate all planning, training, and exercises performed under this Contract with the State of Texas, Texas Division of Emergency Management of the State of Texas, or other points of contact at the discretion of the Division for Regional and Local Health Operations, to ensure consistency and coordination of requirements at the local level and eliminate duplication of effort between the various domestic preparedness funding sources in the state. D. Utilize the Texas Medical Countermeasure (MCM) Strategy Document, as amended, to develop and execute plans, thus preparing the Metropolitan Statistical Area (MSA) to provide medical countermeasures to the identified population during a large-scale public health emergency. The Texas MCM Strategy Document is available at: xxxxx://xxx.xxxx.xxxxx.xxx/commprep/sns.aspx or by contacting the Strategic National Stockpile (SNS) Central Office Team at XXX@xxxx.xxxxx.xxx. To accomplish this, Grantee will meet the planning and operational standards as outlined in Sections I(B)-(X) of this Contract, and the current Operational Readiness Review (XXX) Tool, as amended, that applies to the following Public Health Emergency Preparedness Capabilities:

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxxXXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. funds X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System AgencyDSHS. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx DSHS. Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency DSHS will reduce the reimbursement request by one- one-third of the remaining balance of the advance.. Grantee: San Xxxxxx-Xxx Xxxxx County Health Department Personnel $67,806 Fringe Benefits $25,454 Travel $5,164 Equipment $0 Supplies $0 Contractual $0 Other $1,872 Sum of Direct Costs $100,296 Indirect Costs $10,030 Sum of Total Direct Costs and Indirect Costs $110,326 Less Match (Cash or In-Kind) $10,030 Grantee shall provide match funds in the amount of $10,030. HHSC Uniform Terms and Conditions Version 2.13 Published and Effective: July 15, 2016 Responsible Office: Chief Counsel ARTICLE I. DEFINITIONS AND INTERPRETIVE PROVISIONS 4

INVOICE AND PAYMENT. A. Grantee will request monthly payment using the Excel version of the State of Texas Purchase Voucher (Form B-13) on a monthly basis and Support Document including any acceptable additional supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Excel version of the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, documentation and Financial Status Reports, and Match Certification Forms Reports should be mailed or emailed e-mailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAXB-13: (000) 000-0000 EMAILxxxxxxxx@xxxx.xxxxx.xx.xx and xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx Support Document: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, xxxxxxxx@xxxx.xxxxx.xx.xx and xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx B-13A, : xxxxxxxx@xxxx.xxxxx.xx.xx and supporting documentation should be sent toxxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSR: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx and xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx and XXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid reimbursed on a monthly basis and in accordance with Attachment B, Budget.the Budget in C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.. Personnel $86,075.00 Fringe Benefits $31,961.00 Travel $9,371.00 Equipment $0.00 Supplies $29,316.00 Contractual $8,722.00 Other $78,632.00 Sum of Direct Costs $244,077.00 Indirect Costs $24,408.00 Sum of Total Direct Costs and Indirect Costs $268,485.00 Less Match (Cash or In-Kind) $24,408.00 TOTAL $244,077.00 HHSC Uniform Terms and Conditions Version 2.13 Published and Effective: July 15, 2016 Responsible Office: Chief Counsel

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxxXXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx funds Grantee may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System AgencyDSHS. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System AgencyDSHS. X. Xxxxxxx will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency DSHS will reduce the reimbursement request by one- one-third of the remaining balance of the advance.. Personnel $234,604.00 Fringe Benefits $98,084.00 Travel $6,513.00 Equipment $0.00 Supplies $4,667.00 Contractual $0.00 Other $46,765.00 Sum of Direct Costs $390,633.00 Indirect Costs $0.00 Sum of Total Direct Costs and Indirect Costs $390,633.00 Less Match (Cash or In-Kind) $35,633.00 HHSC Uniform Terms and Conditions Version 2.13 Published and Effective: July 15, 2016 Responsible Office: Chief Counsel

INVOICE AND PAYMENT. A. Grantee will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis at xxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm. Voucher and acceptable supporting documentation for reimbursement of will be mailed or submitted by fax or electronic mail to the required servicesaddress/deliverablesnumber below. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed mailed, faxed, or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 AustinX.X. Xxx 000000 Xxxxxx, TX XX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with the Budget in Attachment B, BudgetB of this Contract. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfallsshortfall. System Agency Program will monitor XxxxxxxGrantee’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amountamount as approved for this Contract, XxxxxxxGrantee’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds.the X. Xxxxxxx D. Grantee may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee will request payment monthly payments using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverableslocated at xxxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm. Additionally, the Grantee will submit the Financial Status Report (FSR-269Aa Voucher Support Form(s) with each B-13. Voucher and the Match Certification Form (B-13A). Vouchers, any supporting documentation, Financial Status Reports, and Match Certification Forms should documentation required or requested will be mailed or emailed submitted by fax or electronic mail to the addresses address/number below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, xxxxxxxx@xxxx.xxxxx.xxx and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. xxxxxxxxxxx@xxxx.xxxxx.xxx Grantee will be paid on a monthly cost reimbursement basis and in accordance with Attachment B, BudgetBudget of this Contract. One Contract advance may be requested in an amount not to exceed 1/12th of the total Contract amount. B. Grantee will bill according to the following activity codes and amounts defined in the 2022-2023 Allocation by Code document located at xxxx://xxx.xxxx.xxxxx.xxx/hivstd/funding/default.shtm: 1. Administration: H25; 2. Planning and Evaluation: 079; and 3. Quality Management: K18. C. System Agency reserves the rightIf no funds were expended for a month of service, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency Grantee will monitor Xxxxxxx’s expenditures submit a zero-dollar B-13. D. Grantee will submit Financial Status Report (FSR) Form #GC-4a (269) located at xxxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm on a quarterly basis. If expenditures are below All FSR reports will be sent via email to XXXXxxxxx@xxxx.xxxxx.xxx. PERSONNEL $379,001.00 FRINGE BENEFITS $101,193.00 TRAVEL $35,920.00 EQUIPMENT $0.00 SUPPLIES $0.00 CONTRACTUAL $4,671,673.00 OTHER $20,670.00 TOTAL DIRECT CHARGES $5,208,457.00 INDIRECT CHARGES $50,258.00 Contract Number _H_HS0011222000_03 Attachment _C_ CONTRACT AFFIRMATIONS For purposes of these Contract Affirmations, HHS includes both the Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS). System Agency refers to HHSC, DSHS, or both, that projected in Grantee’s total will be a party to this Contract. These Contract amountAffirmations apply to all Contractors and Grantees (referred to as “Contractor”) regardless of their business form (e.g., Xxxxxxx’s budget may be subject individual, partnership, corporation). By entering into this Contract, Contractor affirms, without exception, understands, and agrees to a decrease for comply with the remainder of following items through the Term life of the Contract: 1. Vacant positions existing after ninety days Contractor represents and warrants that these Contract Affirmations apply to Contractor and all of Contractor's principals, officers, directors, shareholders, partners, owners, agents, employees, subcontractors, independent contractors, and any other representatives who may result provide services under, who have a financial interest in, or otherwise are interested in a decrease in fundsthis Contract and any related Solicitation. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee X. Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis at xxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm. Voucher and acceptable supporting documentation for reimbursement of will be mailed or submitted by fax or electronic mail to the required servicesaddress/deliverablesnumber below. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed mailed, faxed or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with the Budget in Attachment B, BudgetB of this Contract. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfallsshortfall. System Agency Program will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amountamount as approved for this Contract, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the ContractContract term. Vacant positions existing after ninety (90) days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency DSHS will reduce the reimbursement request by one- one-third of the remaining balance of the advance. I. GRANTEE RESPONSIBILITIES Grantee will: A. Perform activities in Xxxxxxxxxx County (hereinafter the "Jurisdiction") in support of the Public Health Emergency Preparedness Cooperative Agreement from the Centers for Disease Control and Prevention (CDC) and further the Strategic National Stockpile (SNS) program to comply with the Public Health Emergency Preparedness (PHEP) Cooperative Agreement’s capabilities-based approach. The Cities Readiness Initiative (CRI) requirements support the Medical Countermeasure Dispensing and Medical Materiel Management and Distribution capabilities. The CRI supports medical countermeasure distribution and dispensing for all-hazards events. B. Coordinate activities and response plans within the Jurisdiction with the state, regional and other local jurisdictions, among local agencies, and with hospitals and major health care entities, jurisdictional Metropolitan Medical Response Systems, and Councils of Government. X. Xxxxxxxxx with System Agency to coordinate all planning, training, and exercises performed under this Contract with the State of Texas, Texas Division of Emergency Management of the State of Texas, or other points of contact at the discretion of the Division for Regional and Local Health Operations, to ensure consistency and coordination of requirements at the local level and eliminate duplication of effort between the various domestic preparedness funding sources in the state. D. Utilize the Texas Medical Countermeasure (MCM) Strategy Document, as amended, to develop and execute plans, thus preparing the Metropolitan Statistical Area (MSA) to provide medical countermeasures to the identified population during a large-scale public health emergency. The Texas MCM Strategy Document is available at: xxxxx://xxx.xxxx.xxxxx.xxx/commprep/sns.aspx or by contacting the Strategic National Stockpile (SNS) Central Office Team at XXX@xxxx.xxxxx.xxx. To accomplish this, Grantee will meet the planning and operational standards as outlined in Sections I(B)-(X) of this Contract, and the current Operational Readiness Review (XXX) Tool, as amended, that applies to the following Public Health Emergency Preparedness Capabilities:

INVOICE AND PAYMENT. A. Grantee will request monthly payment using the Excel version of the State of Texas Purchase Voucher (Form B-13) on a monthly basis and Support Document including any acceptable additional supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Excel version of the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, documentation and Financial Status Reports, and Match Certification Forms Reports should be mailed or emailed e-mailed to the addresses below. Claims Processing Unit, MC1940 Texas Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. PO Box 149347 Austin, TX 0000078714-0000 FAX9347 B-13: (000) 000-0000 EMAILxxxxxxxx@xxxx.xxxxx.xx.xx and xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx Support Document: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, xxxxxxxx@xxxx.xxxxx.xx.xx and xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx B-13A, : xxxxxxxx@xxxx.xxxxx.xx.xx and supporting documentation should be sent toxxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSR: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx and xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx and XXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid reimbursed on a monthly basis and in accordance with Attachment B, Budget.the Budget in C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance. E. For the purposes of this Contract, the Grantee may not use funds for fundraising activities, lobbying, research, construction, major renovations and reimbursement of pre-award costs, clinical care, purchase of vehicles of any kind, funding an award to another party or provider who is ineligible, backfilling costs for staff or the purchase of incentive items. Grantee: Dallas County Health and Human Services Personnel $97,632 Fringe Benefits $42,862 Travel $0 Equipment $0 Supplies $31,642 Contractual $0 Other $40,070 Sum of Direct Costs $212,206 Indirect Costs $21,221 Sum of Total Direct Costs and Indirect Costs $233,427 Less Match (Cash or In-Kind) $21,221 HHSC Uniform Terms and Conditions Version 2.13 Published and Effective: July 15, 2016 Responsible Office: Chief Counsel

INVOICE AND PAYMENT. A. Grantee X. Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis at xxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm. Voucher and acceptable supporting documentation for reimbursement of will be mailed or submitted by fax or electronic mail to the required servicesaddress/deliverablesnumber below. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed mailed, faxed, or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 AustinX.X. Xxx 000000 Xxxxxx, TX XX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with the Budget in Attachment B, BudgetB of this Contract. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfallsshortfall. System Agency Program will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amountamount as approved for this Contract, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds.the X. Xxxxxxx may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report Reports (FSR-269A) and the Match Certification Form (B-13A)on a quarterly basis. Vouchers, supporting documentation, and Financial Status Reports, and Match Certification Forms Reports should be mailed or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13xxx@xxxx.xxxxx.xx.xx, B-13A, and Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx B-13 and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx xxx@xxxx.xxxxx.xx.xx, and Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxxxxx@xxxx.xxxxx.xx.xx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxxand XXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid reimbursed on a monthly basis and in accordance with Attachment BC, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx D. Grantee may request a one-time working capital advance not to exceed twelve (12% %) percent of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if If the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.. DocuSign Envelope ID: 8B27C5F5-5D18-4045-B183-A71AB001AA84 Grantee: Fort Bend County Health and Human Services Personnel $ 0.00 $ 0.00 $ 0.00 $ 0.00 Fringe Benefits $ 0.00 $ 0.00 $ 0.00 $ 0.00 Travel $ 7,935.00 $ 0.00 $ 0.00 $ 7,935.00 Equipment $ 0.00 $ 0.00 $ 45,030.00 $ 45,030.00 Supplies $ 30,000.00 $ 12,000.00 $ 23,000.00 $ 65,000.00 Contractual $ 455,138.00 $ 25,500.00 $ 30,000.00 $ 510,638.00 Other $ 0.00 $ 0.00 $ 1,850.00 $ 1,850.00 Sum of Direct Costs $ 493,073.00 $ 37,500.00 $ 99,880.00 $ 630,453.00 Indirect Costs $ 0.00 $ 0.00 $ 0.00 $ 0.00 Sum of Total Direct Costs and Indirect Costs $ 493,073.00 $ 37,500.00 $ 99,880.00 $ 630,453.00 Grantee must expend funds within the applicable specified time periods noted above. HHSC Uniform Terms and Conditions Version 2.13 Published and Effective: July 15, 2016 Responsible Office: Chief Counsel ARTICLE I. DEFINITIONS AND INTERPRETIVE PROVISIONS 4

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx D. Grantee may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx E. Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 AustinX.X. Xxx 000000 Xxxxxx, TX XX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx . Grantee may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee X. Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis at xxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm. Voucher and acceptable supporting documentation for reimbursement of will be mailed or submitted by electronic mail to the required servicesaddress/deliverablesnumber below. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, and Financial Status Reports, and Match Certification Forms Reports should be mailed or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 ATTACHMENT A STATEMENT OF WORK EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, B-13 and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx XXXXxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxxXXXXxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with the Budget in Attachment B, BudgetB of this Contract. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfallsshortfall. System Agency Program will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amountcontract amount as approved for this Contract, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the ContractContract term. Vacant positions existing after ninety (90) days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.. Personnel $9,000.00 Fringe Benefits $0.00 Travel $1,000.00 Equipment $0.00 Supplies $0.00 Contractual $0.00 Other $0.00 Sum of Direct Costs $10,000.00 Indirect Costs $0.00 Sum of Total Direct Costs and Indirect Costs $10,000.00 Less Match (Cash or In-Kind) $0.00 TOTAL $10,000.00 HHSC Uniform Terms and Conditions Version 2.15 Published and Effective: September 1, 2017 Responsible Office: Chief Counsel ARTICLE I. DEFINITIONS AND INTERPRETIVE PROVISIONS 4

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 AustinX.X. Xxx 000000 Xxxxxx, TX XX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor XxxxxxxGrantee’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, XxxxxxxGrantee’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx . Grantee may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx D. Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- third of the remaining balance of the advance.. AMENDMENT XX. 00 XXXX XXXXXXXX XX. 000-00-0000-00000 XXXXXXX XXXXXX Personnel $445,562.00 $437,256.00 $882,818.00 Fringe Benefits $162,630.00 $166,245.00 $328,875.00 Travel $6,797.00 $9,851.00 $16,648.00 Equipment $0.00 $0.00 $0.00 Supplies $15,994.00 $4,263.00 $20,257.00 Contractual $0.00 $0.00 $0.00 Other $96,600.00 $13,968.00 $110,568.00 Sum of Direct Costs $727,583.00 $631,583.00 $1,359,166.00 Indirect Costs $0.00 $0.00 $0.00 Sum of Total Direct Costs and Indirect Costs $727,583.00 $631,583.00 $1,359,166.00 Less Match (Cash or In-Kind) $65,917.00 $57,417.00 $123,334.00 TOTAL $661,666.00 $574,166.00 $1,235,832.00

INVOICE AND PAYMENT. A. Grantee will request payment monthly payments using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverableslocated at xxxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm. Additionally, the Grantee will submit the Financial Status Report (FSR-269Aa Voucher Support Form(s) with each B-13. Voucher and the Match Certification Form (B-13A). Vouchers, any supporting documentation, Financial Status Reports, and Match Certification Forms should documentation required or requested will be mailed or emailed submitted by fax or electronic mail to the addresses address/number below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, xxxxxxxx@xxxx.xxxxx.xxx and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. xxxxxxxxxxx@xxxx.xxxxx.xxx Grantee will be paid on a monthly cost reimbursement basis and in accordance with Attachment B, BudgetBudget of this Contract. One Contract advance may be requested in an amount not to exceed 1/12th of the total Contract amount. B. Grantee will bill according to the following activity codes and amounts defined in the 2022-2023 Allocation by Code document located at xxxx://xxx.xxxx.xxxxx.xxx/hivstd/funding/default.shtm: 1. Administration: H25; 2. Planning and Evaluation: 079; and 3. Quality Management: K18. C. System Agency reserves the rightIf no funds were expended for a month of service, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency Grantee will monitor Xxxxxxx’s expenditures submit a zero-dollar B-13. D. Grantee will submit Financial Status Report (FSR) Form #GC-4a (269) located at xxxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm on a quarterly basis. If expenditures are below All FSR reports will be sent via email to XXXXxxxxx@xxxx.xxxxx.xxx. PERSONNEL $337,622.00 FRINGE BENEFITS $87,782.00 TRAVEL $6,824.00 EQUIPMENT $0.00 SUPPLIES $1,158.00 CONTRACTUAL $2,026,464.00 OTHER $500.00 TOTAL DIRECT CHARGES $2,460,350.00 INDIRECT CHARGES $0.00 _C_ CONTRACT AFFIRMATIONS For purposes of these Contract Affirmations, HHS includes both the Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS). System Agency refers to HHSC, DSHS, or both, that projected in Grantee’s total will be a party to this Contract. These Contract amountAffirmations apply to all Contractors and Grantees (referred to as “Contractor”) regardless of their business form (e.g., Xxxxxxx’s budget may be subject individual, partnership, corporation). By entering into this Contract, Contractor affirms, without exception, understands, and agrees to a decrease for comply with the remainder of following items through the Term life of the Contract: 1. Vacant positions existing after ninety days Contractor represents and warrants that these Contract Affirmations apply to Contractor and all of Contractor's principals, officers, directors, shareholders, partners, owners, agents, employees, subcontractors, independent contractors, and any other representatives who may result provide services under, who have a financial interest in, or otherwise are interested in a decrease in fundsthis Contract and any related Solicitation. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee will request monthly payment using the Excel version of the State of Texas Purchase Voucher (Form B-13) on a monthly basis and Support Document including any acceptable additional supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Excel version of the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, documentation and Financial Status Reports, and Match Certification Forms Reports should be mailed or emailed e-mailed to the addresses below. Claims Processing Unit, MC1940 Texas Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. PO Box 149347 Austin, TX 0000078714-0000 FAX9347 B-13: (000) 000-0000 EMAILxxxxxxxx@xxxx.xxxxx.xx.xx and xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx Support Document: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, xxxxxxxx@xxxx.xxxxx.xx.xx and xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx B-13A, : xxxxxxxx@xxxx.xxxxx.xx.xx and supporting documentation should be sent toxxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSR: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx and xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx and XXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid reimbursed on a monthly basis and in accordance with Attachment B, Budget.the Budget in C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.. Grantee: Texas Tech Personnel $84,664 Fringe Benefits $30,471 Travel $4,120 Equipment $0 Supplies $16,449 Contractual $0 Other $39,625 Sum of Direct Costs $175,328 Indirect Costs $45,585 Sum of Total Direct Costs and Indirect Costs $220,913 Less Match (Cash or In-Kind) $20,116 HHSC Uniform Terms and Conditions Version 2.14 Published and Effective: March 1, 2017 Responsible Office: Chief Counsel 1.01 Definitions 4 1.02 Interpretive Provisions 5 2.01 Payment Methods 6 2.02 Final Billing Submission 6 2.03 Financial Status Reports (FSRs) 7 2.04 Debt to State and Corporate Status 7

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxxXXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. funds X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System AgencyDSHS. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx DSHS. Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency DSHS will reduce the reimbursement request by one- one-third of the remaining balance of the advance.. Personnel $456,106.00 Fringe Benefits $165,567.00 Travel $5,309.00 Equipment $0.00 Supplies $4,601.00 Contractual $0.00 Other $0.00 Sum of Direct Costs $631,583.00 Indirect Costs $0.00 Sum of Total Direct Costs and Indirect Costs $631,583.00 Less Match (Cash or In-Kind) $57,417.00 Grantee shall provide matching funds in the amount of $57,417.00. HHSC Uniform Terms and Conditions Version 2.13 Published and Effective: July 15, 2016 Responsible Office: Chief Counsel ARTICLE I. DEFINITIONS AND INTERPRETIVE PROVISIONS 4

INVOICE AND PAYMENT. A. Grantee will request monthly payment using the Excel version of the State of Texas Purchase Voucher (Form B-13) on a monthly basis and Support Document including any acceptable additional supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Excel version of the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, documentation and Financial Status Reports, and Match Certification Forms Reports should be mailed or emailed e-mailed to the addresses below. Claims Processing Unit, MC1940 Texas Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAXB-13: (000) 000-0000 EMAILxxxxxxxx@xxxx.xxxxx.xx.xx and xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx Support Document: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, xxxxxxxx@xxxx.xxxxx.xx.xx and xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx B-13A, : xxxxxxxx@xxxx.xxxxx.xx.xx and supporting documentation should be sent toxxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSR: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx and xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx and XXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid reimbursed on a monthly basis and in accordance with the Budget in Attachment B, BudgetB of this Contract. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.. Grantee: UT Health Science Center-Tyler-Public Health Laboratory of East Texas Personnel $135,560 Fringe Benefits $43,379 Travel $2,611 Equipment $0 Supplies $7,430 Contractual $0 Other $48,443 Sum of Direct Costs $237,423 Indirect Costs $23,742 Sum of Total Direct Costs and Indirect Costs $261,165 Less Match (Cash or In-Kind) $23,742 HHSC Uniform Terms and Conditions Version 2.13 Published and Effective: July 15, 2016 Responsible Office: Chief Counsel

INVOICE AND PAYMENT. A. Grantee X. Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report Reports (FSR-269A) and the Match Certification Form (B-13A)on a quarterly basis. Vouchers, supporting documentation, and Financial Status Reports, and Match Certification Forms Reports should be mailed or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13xxx@xxxx.xxxxx.xx.xx, B-13A, and Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx B-13 and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx xxx@xxxx.xxxxx.xx.xx, and Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxxxxx@xxxx.xxxxx.xx.xx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxxand XXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid reimbursed on a monthly basis and in accordance with Attachment BC, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed twelve (12% %) percent of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if If the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.. DocuSign Envelope ID: 8B27C5F5-5D18-4045-B183-A71AB001AA84 Grantee: Fort Bend County Health and Human Services Personnel $ 0.00 $ 0.00 $ 0.00 $ 0.00 Fringe Benefits $ 0.00 $ 0.00 $ 0.00 $ 0.00 Travel $ 7,935.00 $ 0.00 $ 0.00 $ 7,935.00 Equipment $ 0.00 $ 0.00 $ 45,030.00 $ 45,030.00 Supplies $ 30,000.00 $ 12,000.00 $ 23,000.00 $ 65,000.00 Contractual $ 455,138.00 $ 25,500.00 $ 30,000.00 $ 510,638.00 Other $ 0.00 $ 0.00 $ 1,850.00 $ 1,850.00 Sum of Direct Costs $ 493,073.00 $ 37,500.00 $ 99,880.00 $ 630,453.00 Indirect Costs $ 0.00 $ 0.00 $ 0.00 $ 0.00 Sum of Total Direct Costs and Indirect Costs $ 493,073.00 $ 37,500.00 $ 99,880.00 $ 630,453.00 Grantee must expend funds within the applicable specified time periods noted above. HHSC Uniform Terms and Conditions Version 2.13 Published and Effective: July 15, 2016 Responsible Office: Chief Counsel ARTICLE I. DEFINITIONS AND INTERPRETIVE PROVISIONS 4

INVOICE AND PAYMENT. A. Grantee Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report Reports (FSR-269A) and the Match Certification Form (B-13A)on a quarterly basis. Vouchers, supporting documentation, and Financial Status Reports, and Match Certification Forms Reports should be mailed or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box X.X. Xxx 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, xxxxxxxx@xxxx.xxxxx.xx.xx and xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx B-13 and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxxXXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid reimbursed on a monthly basis and in accordance with Attachment BC, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx funds D. Grantee may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx will repay all or part of advance funds at any time Agency during the Contract’s term. However, if If the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 0000 Xxxx 00xx Xxxxxx P.O. Box X.X. Xxx 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx D. Grantee may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx E. Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee X. Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis at xxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm. Voucher and acceptable supporting documentation for reimbursement of will be mailed or submitted by fax or electronic mail to the required servicesaddress/deliverablesnumber below. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed mailed, faxed or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with the Budget in Attachment B, BudgetB of this Contract. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfallsshortfall. System Agency Program will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amountamount as approved for this Contract, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the ContractContract term. Vacant positions existing after ninety (90) days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency DSHS will reduce the reimbursement request by one- one-third of the remaining balance of the advance. I. GRANTEE RESPONSIBILITIES Grantee will: A. Perform activities in Collin County (hereinafter the "Jurisdiction") in support of the Public Health Emergency Preparedness Cooperative Agreement from the Centers for Disease Control and Prevention (CDC) and further the Strategic National Stockpile (SNS) program to comply with the Public Health Emergency Preparedness (PHEP) Cooperative Agreement’s capabilities-based approach. The Cities Readiness Initiative (CRI) requirements support the Medical Countermeasure Dispensing and Medical Materiel Management and Distribution capabilities. The CRI supports medical countermeasure distribution and dispensing for all-hazards events. B. Coordinate activities and response plans within the Jurisdiction with the state, regional and other local jurisdictions, among local agencies, and with hospitals and major health care entities, jurisdictional Metropolitan Medical Response Systems, and Councils of Government. X. Xxxxxxxxx with System Agency to coordinate all planning, training, and exercises performed under this Contract with the State of Texas, Texas Division of Emergency Management of the State of Texas, or other points of contact at the discretion of the Division for Regional and Local Health Operations, to ensure consistency and coordination of requirements at the local level and eliminate duplication of effort between the various domestic preparedness funding sources in the state. D. Utilize the Texas Medical Countermeasure (MCM) Strategy Document, as amended, to develop and execute plans, thus preparing the Metropolitan Statistical Area (MSA) to provide medical countermeasures to the identified population during a large-scale public health emergency. The Texas MCM Strategy Document is available at: xxxxx://xxx.xxxx.xxxxx.xxx/commprep/sns.aspx or by contacting the Strategic National Stockpile (SNS) Central Office Team at XXX@xxxx.xxxxx.xxx. To accomplish this, Grantee will meet the planning and operational standards as outlined in Sections I(B)-(X) of this Contract, and the current Operational Readiness Review (XXX) Tool, as amended, that applies to the following Public Health Emergency Preparedness Capabilities:

INVOICE AND PAYMENT. A. Grantee X. Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis at xxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm. Voucher and acceptable supporting documentation for reimbursement of will be mailed or submitted by electronic mail to the required servicesaddress/deliverablesnumber below. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, and Financial Status Reports, and Match Certification Forms Reports should be mailed or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 ATTACHMENT A STATEMENT OF WORK EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, B-13 and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx XXXXxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxxXXXXxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with the Budget in Attachment B, BudgetB of this Contract. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfallsshortfall. System Agency Program will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amountcontract amount as approved for this Contract, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the ContractContract term. Vacant positions existing after ninety (90) days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.. SYSTEM AGENCY CONTRACT NO. HHS000145900001 XXXXXX COUNTY Personnel $9,000.00 Fringe Benefits $0.00 Travel $1,000.00 Equipment $0.00 Supplies $0.00 Contractual $0.00 Other $0.00 Sum of Direct Costs $10,000.00 Indirect Costs $0.00 Sum of Total Direct Costs and Indirect Costs $10,000.00 Less Match (Cash or In-Kind) $0.00 TOTAL $10,000.00 HHSC Uniform Terms and Conditions Version 2.15 Published and Effective: September 1, 2017 Responsible Office: Chief Counsel ARTICLE I. DEFINITIONS AND INTERPRETIVE PROVISIONS 4

INVOICE AND PAYMENT. A. Grantee will request payment monthly payments using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverableslocated at xxxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm. Additionally, the Grantee will submit the Financial Status Report (FSR-269Aa Voucher Support Form(s) with each B-13. Voucher and the Match Certification Form (B-13A). Vouchers, any supporting documentation, Financial Status Reports, and Match Certification Forms should documentation required or requested will be mailed or emailed submitted by fax or electronic mail to the addresses address/number below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box X.X. Xxx 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, xxxxxxxx@xxxx.xxxxx.xxx and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. xxxxxxxxxxx@xxxx.xxxxx.xxx Grantee will be paid on a monthly cost reimbursement basis and in accordance with Attachment B, BudgetBudget of this Contract. One Contract advance may be requested in an amount not to exceed 1/12th of the total Contract amount. B. Grantee will bill according to the following activity codes and amounts defined in the 2022-2023 Allocation by Code document located at xxxx://xxx.xxxx.xxxxx.xxx/hivstd/funding/default.shtm: 1. Administration: H25; 2. Planning and Evaluation: 079; and 3. Quality Management: K18. C. System Agency reserves the rightIf no funds were expended for a month of service, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency Grantee will monitor Xxxxxxx’s expenditures submit a zero-dollar B-13. D. Grantee will submit Financial Status Report (FSR) Form #GC-4a (269) located at xxxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm on a quarterly basis. If expenditures are below All FSR reports will be sent via email to XXXXxxxxx@xxxx.xxxxx.xxx. PERSONNEL $522,944.00 FRINGE BENEFITS $180,431.00 TRAVEL $81,228.00 EQUIPMENT $0.00 SUPPLIES $2,750.00 CONTRACTUAL $6,964,952.00 OTHER $180,016.00 TOTAL DIRECT CHARGES $7,932,321.00 INDIRECT CHARGES $164,127.00 _C_ CONTRACT AFFIRMATIONS For purposes of these Contract Affirmations, HHS includes both the Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS). System Agency refers to HHSC, DSHS, or both, that projected in Grantee’s total will be a party to this Contract. These Contract amountAffirmations apply to all Contractors and Grantees (referred to as “Contractor”) regardless of their business form (e.g., Xxxxxxx’s budget may be subject individual, partnership, corporation). By entering into this Contract, Contractor affirms, without exception, understands, and agrees to a decrease for comply with the remainder of following items through the Term life of the Contract: 1. Vacant positions existing after ninety days Contractor represents and warrants that these Contract Affirmations apply to Contractor and all of Contractor's principals, officers, directors, shareholders, partners, owners, agents, employees, subcontractors, independent contractors, and any other representatives who may result provide services under, who have a financial interest in, or otherwise are interested in a decrease in fundsthis Contract and any related Solicitation. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis at xxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm. Voucher and acceptable supporting documentation for reimbursement of will be mailed or submitted by fax or electronic mail to the required servicesaddress/deliverablesnumber below. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed mailed, faxed, or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box X.X. Xxx 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with the Budget in Attachment B, BudgetB of this Contract. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfallsshortfall. System Agency Program will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amountamount as approved for this Contract, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the ContractContract term. Vacant positions existing after ninety (90) days may result in a decrease in funds. X. Xxxxxxx D. Grantee may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- third of the remaining balance of the advance.at

INVOICE AND PAYMENT. A. Grantee X. Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis at xxxx://xxx.xxxx.xxxxx.xxx/grants/forms.shtm. Voucher and acceptable supporting documentation for reimbursement of will be mailed or submitted by fax or electronic mail to the required servicesaddress/deliverablesnumber below. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx B-13, B-13A, and supporting documentation should be sent emailed to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSR should be sent emailed to: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxxXXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid reimbursed on a monthly basis and in accordance with Attachment B, Budget.the Budget in C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfallsshortfall. System Agency Program will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amountcontract amount as approved for this Contract, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the ContractContract term. Vacant positions existing after ninety (90) days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System AgencyDSHS. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System Agency. X. Xxxxxxx DSHS. Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency DSHS will reduce the reimbursement request by one- one-third of the remaining balance of the advance.. Remainder of Page Intentionally Left Blank. Personnel $195,300.00 Fringe Benefits $85,733.00 Travel $11,836.00 Equipment $0.00 Supplies $44,650.00 Contractual $6,000.00 Other $132,510.00 Sum of Direct Costs $476,029.00 Indirect Costs $47,602.00 Sum of Total Direct Costs and Indirect Costs $523,631.00 Less Match (Cash or In-Kind) $47,602.00 Grantee shall provide match funds in the amount of $47,602.00. HHSC Uniform Terms and Conditions Version 2.14 Published and Effective: March 1, 2017 Responsible Office: Chief Counsel 1.01 Definitions 4 1.02 Interpretive Provisions 5 2.01 Payment Methods 6 2.02 Final Billing Submission 6 2.03 Financial Status Reports (FSRs) 7 2.04 Debt to State and Corporate Status 7

INVOICE AND PAYMENT. A. Grantee X. Xxxxxxx will request payment reimbursement using the State of Texas Purchase Voucher (Form B-13) on a monthly basis at h ttp://xxx.xxxx.xxxxx.xxx/xxxxxx/xxxxx.xxxx. Voucher and acceptable supporting documentation for reimbursement of will be mailed or submitted by fax or electronic mail to the required servicesaddress/deliverablesnumber below. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed mailed, faxed or emailed to the addresses below. : Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxxi xxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxxi xxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx P xx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxxi xxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx F XXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxxC XXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with the Budget in Attachment B, BudgetB of this Contract. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfallsshortfall. System Agency Program will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amountamount as approved for this Contract, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the ContractContract term. Vacant positions existing after ninety (90) days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed twelve percent (12% %) of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- third of the remaining balance of the advance.at

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 0000 Xxxx 00xx Xxxxxx P.O. Box X.X. Xxx 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx D. Grantee may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System AgencyDSHS. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx DSHS. Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency DSHS will reduce the reimbursement request by one- one-third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee will request monthly payment using the Excel version of the State of Texas Purchase Voucher (Form B-13) on a monthly basis and Support Document including any acceptable additional supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Excel version of the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, documentation and Financial Status Reports, and Match Certification Forms Reports should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 AustinX.X. Xxx 000000 Xxxxxx, TX XX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with Attachment B, Budget.the Budget in C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance. E. For the purposes of this Contract, the Grantee may not use funds for fundraising activities, lobbying, research, construction, major renovations and reimbursement of pre-award costs, clinical care, purchase of vehicles of any kind, funding an award to another party or

INVOICE AND PAYMENT. A. Grantee will request monthly payment using the Excel version of the State of Texas Purchase Voucher (Form B-13) on a monthly basis and Support Document including any acceptable additional supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Excel version of the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, documentation and Financial Status Reports, and Match Certification Forms Reports should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box X.X. Xxx 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid reimbursed on a monthly basis and in accordance with Attachment B, Budget.the Budget in C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx D. Grantee may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx . Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance. E. For the purposes of this Contract, the Grantee may not use funds for fundraising activities, lobbying, research, construction, major renovations and reimbursement of pre-award costs, clinical care, purchase of vehicles of any kind, funding an award to another party or

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxxxxxxxxxx@xxxx.xxxxx.xx.xx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xx.xx & XXXXxxxxxxx@xxxx.xxxxx.xxxXXXXxxxxx@xxxx.xxxxx.xx.xx B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx funds Grantee may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System AgencyDSHS. All advances must be expended by the end of the Contract contract term. Advances not expended by the end of the Contract contract term must be refunded to System AgencyDSHS. X. Xxxxxxx will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency DSHS will reduce the reimbursement request by one- one-third of the remaining balance of the advance.. Personnel $234,604.00 Fringe Benefits $98,084.00 Travel $6,513.00 Equipment $0.00 Supplies $4,667.00 Contractual $0.00 Other $46,765.00 Sum of Direct Costs $390,633.00 Indirect Costs $0.00 Sum of Total Direct Costs and Indirect Costs $390,633.00 Less Match (Cash or In-Kind) $35,633.00 HHSC Uniform Terms and Conditions Version 2.13 Published and Effective: July 15, 2016 Responsible Office: Chief Counsel ARTICLE I. DEFINITIONS AND INTERPRETIVE PROVISIONS 4

INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 Austin, TX 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx xxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx B. The Parties agree to cooperate by submitting separate and distinct invoices for each of the two Contract Grant Funding Allocations. Separate monthly invoices will be submitted for the base Hazards Grant Activities and for the 2019 All Hazards Conference Grant Activities. Comingling of these federal funds is prohibited. C. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget. C. D. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. X. Xxxxxxx will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- one-third of the remaining balance of the advance.

INVOICE AND PAYMENT. A. Grantee X. Xxxxxxx will request payment payments using the State of Texas Purchase Voucher (Form B-13) on a monthly basis at xxxx://xxx.xxxx.xxxxx.xx.xx/grants/forms.shtm. Voucher and acceptable any supporting documentation for reimbursement of the required services/deliverables. Additionallywill be mailed, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Voucherssubmitted by fax, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed submitted by electronic mail to the addresses addresses/number below. Department of State Health Services Claims Processing Unit, MC 1940 0000 Xxxx 00xx Xxxxxx P.O. Box 149347 AustinX.X. Xxx 000000 Xxxxxx, TX Xxxxx 00000-0000 FAX: (000) 000-0000 EMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & Xxxxxxxx@xxxx.xxxxx.xxx EMAIL: XXXXxxxxxxx@xxxx.xxxxx.xxx B-13, B-13A, and supporting documentation should be sent toEMAIL: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxx FSRs should be sent to: xxxxxxxx@xxxx.xxxxx.xxx, Xxx.xxxxxxxxxxxxxx@xxxx.xxxxx.xxx, XXXXxxxxx@xxxx.xxxxx.xxx & XXXXxxxxxxx@xxxx.xxxxx.xxxXXXXXxxxxxxxxx@xxxx.xxxxx.xxx B. Grantee will be paid on a monthly cost reimbursement basis and in accordance with Attachment B, Budget. C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event B-1 Revised Budget of financial shortfalls. System Agency will monitor Xxxxxxx’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, Xxxxxxx’s budget may be subject to a decrease for the remainder of the Term of the this Contract. Vacant positions existing after ninety days may result in a decrease in funds. X. Xxxxxxx may request a one-time working capital advance Travel costs must not to exceed 12% of General Services Administration (GSA) rates located at xxxxx://xxx.xxx.xxx/travel/plan-book/per-diem-rates unless the total amount of the Contract funded Grantee has an established travel policy that has been reviewed and approved by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System AgencyDSHS. X. Xxxxxxx will repay submit requests for reimbursement (Form B-13) and financial expenditure template monthly by the last business day of the month following the month in which expenses were incurred or services provided. Grantee shall maintain all or part of advance funds at any time during documentation that substantiate invoices and make the Contract’s term. However, if the advance has not been repaid prior documentation available to the DSHS upon request. In the event a cost reimbursed under the Contract is later determined to be unallowable then the Grantee will reimburse DSHS for that cost. X. Xxxxxxx will submit quarterly Financial Status Reports (FSR) located at xxxx://xxx.xxxx.xxxxx.xx.xx/grants/forms.shtm by email to XXXXxxxxx@xxxx.xxxxx.xxx and XXXXxxxxxxx@xxxx.xxxxx.xxx by the last three months business day of the month following the end of each quarter of the Contract term, for DSHS review and financial assessment. X. Xxxxxxx will submit request for reimbursement (B-13) as a final close-out invoice not later than forty- five (45) calendar days following the Grantee must deduct at least one-third end of the remaining advance from each term of the last three months’ reimbursement requestsContract. If Reimbursement requests received in the advance is not repaid prior to DSHS office more than forty-five (45) calendar days following the last three months termination of the Contract termmay not be paid. X. Xxxxxxx will submit a final FSR for the service period of September 1, System Agency 2021 through August 31, 2022 by October 20, 2022. Grantee will reduce submit a final FSR for the reimbursement request service period of September 1, 2022 through August 31, 2023 by one- third of the remaining balance of the advanceOctober 20, 2023.