2019-01-23 CC MINUTESCalhoun County Commissioners' Court—January 23, 2019
REGULAR 2019 TERM § JANUARY 23, 2019
BE IT REMEMBERED THAT ON JANUARY 23, 2015, THERE WAS BEGUN AND HOLDEN A
REGULAR TERM OF COMMISSIONERS' COURT.
1. CALL TO ORDER
This meeting was called to orderat;10:00 AM
2. ROLL CALL
THE FOLLOWING MEMBERS WERE PRESENT:
Richard Meyer
David Hall
Vern Lyssy
Clyde Syma
Gary Reese
Anna Goodman
Catherine Sullivan
County Judge
Commissioner, Precinct #1
Commissioner, Precinct #2
Commissioner, Precinct #3
Commissioner, Precinct #4
County Clerk
Deputy County Clerk
3. INVOCATION & PLEDGE OF ALLEGIANCE (AGENDA ITEM NO. 2 & 3)
Invocation — Commissioner David Hall
Pledge to US Flag & Texas Flag — Commissioner Gary Reese/Vern Lyssy
4. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 4)
On the proposal from G&W Engineers, Inc., on engineering fees for the rebid
of roof repairs for the Calhoun County Adult Detention Center and authorize
the County Judge to sign the proposal. (RM)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Clyde Syma, Commissioner Pct 3
SECONDER:
Gary Reese, Commissioner Pct 4
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
Page I of 7
Calhoun County Commissioners' Court — January 23, 2019
S. Discuss Community Development Block Grant -Disaster Recover Funds as
administered by the General Land Office and take any action deemed
necessary. (RM)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vern Lyssy, Commissioner Pet 2
SECONDER:
David Hall; Commissioner Pet 1
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
6. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 6)
On request by EMS Director to purchase a mascot suit for use in the EMS
Public Education and Outreach Program. (RM)
Vern Lyssy made the motion that the suit should be purchased via Donations to
EMS.
RESULT: APPROVED [UNANIMOUS]
MOVER: Vern Lyssy, Commissioner Pet 2
SECONDER: David Hall, Commissioner Pet 1
AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
7. CONSIDER AND TAKE NECESSARY ACTION: (AGENDA ITEM NO. 7)
On Proposed EMS Charge rate increase schedule for 2019. (RM)
Dustin Jenkins, EMS Director, spoke on this matter.
RESULT: APPROVED [UNANIMOUS]
MOVER: Vern Lyssy, Commissioner Pet 2
SECONDER: Gary Reese, Commissioner Pet 4
AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
Page 2 of 7
Calhoun County Cornmissioners' Court— January 23, 2019
8. Accept 2018 Certificate of Completion for Continuing Education Hours from
County Clerk and enter into official Court Records. (RM)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vein Lyssy, Commissioner Pet 2
SECONDER:
Gary Reese, Commissioner Pet 4
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
9. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 9)
To accept resignation from Rhonda Cummins, CEA -Marine Agent. (RM)
RESULT: APPROVED [UNANIMOUS]
MOVER: Richard Meyer, County Judge
SECONDER: Vern Lyssy, Commissioner Pet 2
AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
10. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 10)
On request by Justice of the Peace Precinct #3 to lease Kyocera 307CL
S/N R9V8800822 copier from Dewitt Poth & Son and authorize Judge Dimak
to sign 3 year agreement. (CS)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vern Lyssy, Commissioner Pct 2
SECONDER:
David Hall, Commissioner Pet 1
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
Page 3 of 7
Calhoun County Commissioners' Court—January 23, 2019
11. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 11)
On Contract No. HHS000371500003 under the 2017 Hurricane Public Health
Crisis Response Cooperative Agreement Grant with the Department of State
Health Services in the amount of $232,425 and authorize County Judge to
to sign electronically. (RM)
RESULT: APPROVED [UNANIMOUS]
MOVER: David Hall, Commissioner Pet I
SECONDER: Vern Lyssy, Commissioner Pet 2
AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
12. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 12)
To accept a check in the amount of $819.15 from Texas Association of
Counties for employee participation in the Health County Incentives to
be used for the Calhoun County Health and Wellness Program. (VL)
RESULT: APPROVED [UNANIMOUS]
MOVER: Vern Lyssy, Commissioner Pet 2
SECONDER: David Hall, Commissioner Pet 1
AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
13. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 13)
To authorize County Judge to sign Tax Resale Deed and Commissioners' Court
to sign Resolution providing for the sale of property acquired by the County
of Calhoun at Delinquent Tax Sale. Property is as follows:
PROPERTY: .14 acre, more or less, being Lots 12 & 13, Block I, Bayside Beach
Unit #2, Calhoun County, Texas (Instrument #145966 of the Deed Records,
Calhoun County, Texas). Tax Account No. 000000034668
PROPERTY: .14 acre, more or less, being Lot 6, Block 146, Bayside Beach,
Unit #2, Calhoun County, Texas (Instrument #145966 of the Deed Records,
Calhoun County, Texas). Tax Account No. 000000036027
PROPERTY: Lot 23, Block 50, Bayside Beach, Calhoun County, Texas (Instru-
ment #145966 of the Deed Records, Calhoun County, Texas). Tax Account
No.000000036292
PROPERTY: Lot 5, Block 66, Bayside Beach, Calhoun County, Texas (Instru-
ment #145966 of the Deed Records, Calhoun County, Texas). Tax Account
No.000000036612
Page 4 of 7
Calhoun County Commissioners' Court—January 23, 2019
PROPERTY: Lot 21, Block 57, Bayside Beach, Calhoun County, Texas (Instru-
ment #145966 of the Deed Records, Calhoun County, Texas). Tax Account
No. 000000036852
PROPERTY: Lot 13, Block 70, Bayside Beach, Calhoun County, Texas (Instru-
ment #145966 of the Deed Records, Calhoun County, Texas). Tax Account
No. 000000371
RESULT: APPROVED [UNANIMOUS]
MOVER: Vern Lyssy, Commissioner Pet 2
SECONDER: Gary Reese, Commissioner Pet 4
AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
14. ACCEPT REPORTS OF THE FOLLOWING COUNTY OFFICES: (AGENDA ITEM
NO. 14)
i. Calhoun Tax Assessor/ Collector
ii. County Treasurer
iii. County Sheriff
iv. District Clerk — December 2018 (Amended)
v. County Clerk — December 2018 (Amended)
vi. Justices of Peace
vii. County Auditor
viii. Floodplain Administration
ix. Extension Service
x. Adult Detention Center SHP Medical
RESULT: APPROVED [UNANIMOUS]
MOVER: Vern Lyssy, Commissioner Pet 2
SECONDER: David Hall, Commissioner Pet 1
AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
Page 5 of 7
Calhoun County Commissioners' Court—January 23, 2019
15. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 15)
To declare carpet, Inventory #570-077 in the office of Adult Probation as
Waste and authorize Disposal of Same. (RM)
RESULT: APPROVED [UNANIMOUS]
MOVER: Vern Lyssy, Commissioner Pet 2
SECONDER: Gary Reese, Commissioner Pet 4
AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
16. Consider and take action on any necessary budget adjustments.
2018 BUDGET ADJUSTMENTS
RESULT: APPROVED [UNANIMOUS]
MOVER: Vern Lyssy, Commissioner Pet 2
SECONDER: David Hall, Commissioner Pet 1
AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
2019 BUDGET ADJUSTMENTS
RESULT: APPROVED [UNANIMOUS]
MOVER: Vern Lyssy, Commissioner Pet 2
SECONDER: David Hall, Commissioner Pet 1
AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
Page 6 of 7
Calhoun County Commissioners' Court—January 23, 2019
17. Approval of bills and payroll.
MMC BILLS
RESULT: APPROVED [UNANIMOUS]
MOVER: Vern Lyssy, Commissioner Pet 2
SECONDER: David Hall, Commissioner Pct I
AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
COUNTY BILLS 2018
COUNTY BILLS 2019
RESULT: APPROVED [UNANIMOUS]
MOVER: Vern Lyssy, Commissioner Pet 2
SECONDER: David Hall, Commissioner Pet 1
AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
PAYROLL
RESULT:
MOVER:
SECONDER:
AYES:
APPROVED [UNANIMOUS]
Vern Lyssy, Commissioner Pet 2
David Hall, Commissioner Pet 1
Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
18. Public discussion of County matters.
Adjourned: 10:27 a.m.
Page 7 of 7
Calhoun County Commissioners' Court—January 23, 2019
CA L]H OUN COUNTY C®MlY[i ISSIO ]ERS➢ C®1CTRT
REGULAR 2019 TERM
0
JANUARY 23, 2019
BE IT REMEMBERED THAT ON JANUARY 23, 2018, THERE WAS BEGUN AND HOLDEN A
REGULAR TERM OF COMMISSIONERS' COURT.
1. CALL TO ORDER
This meeting was called fo order at -10:00 AM
2. ROLL CALL
THE FOLLOWING MEMBERS WERE PRESENT:
Richard Meyer
David Hall
Vern Lyssy
Clyde Syma
Gary Reese
Anna Goodman
Catherine Sullivan
County Judge
Commissioner, Precinct #1
Commissioner, Precinct #2
Commissioner, Precinct #3
Commissioner, Precinct #4
County Clerk
Deputy County Clerk
3. INVOCATION & PLEDGE OF ALLEGIANCE (AGENDA ITEM NO. 2 & 3)
Invocation — Commissioner David Hall
Pledge to US Flag & Texas Flag — Commissioner Gary Reese/Vern Lyssy
Page 1 of 16
Calhoun County Commissioners' Court—January 23, 2019
4. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 4)
On the proposal from G&W Engineers, Inc., on engineering fees for the rebid
of roof repairs for the Calhoun County Adult Detention Center and authorize
the County Judge to sign the proposal. (RM)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Clyde Syma, Commissioner Pet 3
SECONDER:
Gary Reese, Commissioner Pet 4
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
Page 2 of 16
Agenda Item for
Commissioners' Court — Wednesday, January 23, 2019
Consider and take necessary action on the proposal from G&W Engineers, Inc., on
engineering fees for the rebid of Roof Repairs for the Calhoun County Adult
Detention Center and authorize the County Judge to sign the proposal.
Z
rW ENGINEERS, INC.
Texas Firm RegistrationNo. z_
January 17, 2019
Everett Wood
Calhoun County
211 S. Ann Street
Port Lavaca, Texas 77979
VIA: Everett woo& caihouncotx.-"
RE: Proposal — Specification for Rebid of Roof Repairs for Detention Center
G&W Engineers, Inc. appreciates the opportunity to provide professional engineering services for the
specification, bid and construction phases of the project as follows:
Proposed Scope of Work: Provide technical specifications consisting of manufacturer recommendation(s) for a
complete roof system for the Detention Center.
1. Prepare technical specification (manufacturer recommendation), bid and contract documents;
2. Coordinate with Calhoun County Auditor's office to advertise for competitive bids;
3. Conduct a Pre -Bid conference;
4. Assist County with opening of Bids;
5. Prepare Bid Tabulation and Recommendation for Award;
6. Issue Notice of Award and Notice to Proceed;
7. Submit windstorm documentation to the Texas Department of Insurance;
8. Perform construction observations and inspections as necessary for Windstorm certification and to generally
determine if the Work is proceeding in accordance with the specification.
9. Perform a Final Inspection and collect closeout documentation.
G&W Engineers, Inc. proposes to perform this additional Scope of Work for Re -bid of Roof Repairs for
Detention Center on a time and material basis for a total estimated cost not to exceed of $6,000.00, paid based
upon the percentage of completion of each of the following phases on a monthly basis.
Scope Items
Fee
Re -bid
Revised Total Fee
Develop Technical Specification
$ 5,800
$2,000
$ 7,800
Bid and Contract Phase
$ 2,250
$2,500
$ 4,750
Construction Phase (including Windstorm inspections)
$ 8,400
$ 750
$ 9,150
Final Closeout Phase
$ 1,000
$ 750
TOTAL:
$17,450
$6,000
$23,450
Engineering Consulting Planning Surveying
z � s
If you concur with this proposal, please sign below and return to G&W Engineers, Inc. as aclmowledgement to
Proceed with the project.
Thank You.
G&W Engineers, Inc.
Calhoun County: Richard H. Meyer County
Printed Name
G&W File Number: 5310.010
Judge
Title Signa
Date
CERTIFICATE OF INTERESTED PARTIES 1295
FORM
loft
Complete Nos. 1- 4 and 6 if there are interested parties. _
OFFICE USE ONLY
Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties.
CERTIFICATION OF FILING
Certificate Number:
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
2019-442504
G&W Engineers, Inc.
Port Lavaca, TX United States
Date Filed:
01/17/2019
2 Name of governmental entity or state agency that is a party to the contract for which the form is
being filed.
Calhoun County, Texas
Date Acknowledged:
3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a
description of the services, goods, or other property to be provided under the contract.
5310
Technical Services
Nature of interest
4
Name of Interested Party
City, State, Country (place of business)
(check applicable)
Controlling
Intermediary
Novian, Brian
Port Lavaca, TX United States
X
r
Sappington, Michial
Port Lavaca, TX United States
X
Danysh, Henry
Port Lavaca, TX United States
X
Gohike, Anthony
Port Lavaca, TX United States
X
Gann, David
Port Lavaca, TX United States
X
Tuch, Elton
Port Lavaca, TX United States
X
5 Check only if there is NO Interested Party. ❑
6 UNSWORN DECLARATION
Mynameis bifct^ Noyl0.YN and my date of birth is
My address is .&5 Live fia k t. _,porfQVa , /V—_� � 72Z�� RSA—.
(street) (city) (state) (zip code) (country)
I declare under penalty of perjury that the foregoing is true and correct.
/1 r
ealboli County, State of IFIA(; on the day of , 2019 .
Executed in �+ ,
(year)
Signature of authorized agent of contracting business entity
(Declarant)
Forms provided by Texas Ethics Commission www.etmcs.state.tx.us Velban
CERTIFICATE OF INTERESTED PARTIES
1295
FORM
lofl
Complete Nos, 1- 4 and 6 if there are interested parties.
OFFICE USE ONLY
Complete Nos, 1, 2, 3, 5, and 6 if there are no interested parties.
CERTIFICATION OF FILING
Certificate Number:
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
2019-442504
G&W Engineers, Inc.
Port Lavaca, TX United States
Date Filed:
01/17/2019
2 Name of governmental entity or state agency that is a party to the contract for which the form is
being filed.
Calhoun County, Texas
Date Acknowledged:
02/07/2019
Provide the identification number used by the governmental entity or state agency to track or identify
the contract, and provide a
3
description of the services, goods, or other property to be provided under the contract.
5310
Technical Services
Nature of interest
4 Name of Interested Party
City, State, Country (place of business)
(check applicable)
Controlling
Intermediary
Novian, Brian
Port Lavaca, TX United States
X
Sappington, Michial
Port Lavaca, TX United States
X
Danysh, Henry
Port Lavaca, TX United States
X
Gohlke, Anthony
Port Lavaca, TX United States
X
Gann, David
Port Lavaca, TX United States
X
Tuch, Elton
Port Lavaca, TX United States
X
5 Check only if there is NO Interested Party. ❑
6 UNSWORN DECLARATION
My name is and my date of
birth is
My address is
(street) (city) (state)
(zip code) (country)
I declare under penalty of perjury that the foregoing is true and correct.
Executed in County, State of , on the
_day of , 20_
(month) (year)
Signature of authorized agent of contracting business entity
(Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx. us version v1.1.28auoiou
Calhoun County Commissioners' Court—January 23, 2019
5. Discuss Community Development Block Grant -Disaster Recover Funds as
administered by the General Land Office and take any action deemed
necessary. (RM)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vern Lyssy, Commissioner Pet 2
SECONDER:
David Hall, Commissioner Pet 1
AYES:
Judge Meyr, Commissioner Hall, Lyssy, Syma, Reese
Page 3 of 16
0
Suan Riley
From: brute@grantworks.net (Bruce Spitzengel) <bruce@grantworks.net>
Sent: Thursday, January 10, 2019 10:27 AM
To: Susan Riley; richard.meyer@calhouncotx.org
Cc: Katie Dushkin
Subject: Calhoun County -Harvey Procurement Agenda Item
Judge,
T and -you or taking my call this morning. As discussed, below is a suggested agenda item for the Wednesday,
anuary 23rd m
omissioners' Court meeting. This items provides the tool for the Court to discuss the counties
interest "in proceeding to apply for or not for the Hurricane Harvey grant funds as follows:
County
Buyout
Infra -
structure
77979 Calhoun County
(Excluding City of Port Lavaca)
$ 1,858,095
$ 3,740,301
Calhoun County
$ 2,124,398
$ 2,196,247
$ 3,982,493
$ 5,936,548
Suggested Agenda Item: Consider approval to issue requests for proposals and qualifications for services
related to CDBG-Disaster Recovery funds as administered by the General Land Office.
Please let me know if you have any questions.
Bruce
Bruce Spitzengel ) President ) (512) 420-0303 x 3091 Mobile (713) 252-5872 1 bruce@grantworks.net
GrantWorks, Inc. ) 2201 Northland Drive Austin TX 78756 ) www.�rantworks.net
Follow GrantWorks on Facebook!
Calhoun County Commissioners' Court — January 23, 2019
6. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 6)
On request by EMS Director to purchase a mascot suit for use in the EMS
Public Education and Outreach Program. (RM)
Vern Lyssy made the motion that the suit should be purchased via Donations to
EMS.
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vern Lyssy, Commissioner Pet 2
SECONDER:
David Hall, Commissioner Pet 1
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
Page 4 of 16
Suan Riley
From: Dustin.Jenkins@calhouncotx.org (Dustin Jenkins) <Dustin.Jenkins@calhouncotx.org>
Sent: Thursday, January 17, 2019 11:56 AM
To: Susan Riley
Cc: Cindy Mueller; Lori McDowell
Subject: For Commissioners Court
Attachments: RAC Member INFO &_Objectives.pdf
Susan,
I would like for the court to take action on the EMS purchase of a mascot suit to deem an appropriate expenditure as
meeting public purpose through use in the EMS public education and outreach program as a tool for children's
education.
I know it sounds a little different, but it makes a huge difference in our public education program. When a child has had
previous contact with EMS, on a "Fun" basis, and has been able to relate to EMS with the Mascot suit, our job is so much
easier and patient outcomes can be improved. This can alleviate future fear and anxiety with these patient
populations within our county. below you will find the various ways we can utilize the suit in the different public
education programs in which we are involved. Also, you will find documentation about our requirements to provide this
type of public education as members of the local RAC (Regional Advisory Council).
Calhoun County EMS Mascot Uses:
NOTE: These classes and programs become much less daunting and learning retention increase for children when they
see a fun character dressed up as an EMT assisting and even playing one of the "Victims".
Child Passenger Safety Seat Program — need for car seats, seat belts, etc.
CPR/First Aid Classes- emphasis has been made lately on teaching children CPR and First Aid with the recent school
shootings.
Injury Prevention — making homes safer for kids; elderly
Bystander Care for the Injured — first aid; heat exhaustion recognition; etc
Stop the Bleed — emphasis has been made lately on teaching children CPR and First Aid with the recent school
shootings, this class teaches application of tourniquets and wound packing.
Make the Right Call — when to call 911 and what to know when you call
School Functions — read books with kids; meet the Special Needs children (Autism, etc.), Fair demonstrations;
standbys; career days with high school kids
Walmart — summer safety; hurricane preparedness; first aid
Girl Scout field trips- to station
County Fair Days- During the fair all elementary schools come and are given a tour of the ambulance and a short
educational program is presented about what we do.
As you can see, this mascot outfit is simply a very useful tool that we utilize in EMS public education.
Respectfully,
J. Dustin Jenkins, DMin, MBA, LP
Director of Emergency Medical Services
705 Henry Barber Way
Calhoun County, TX
dustin.jenkins@calhouncotx.org
(361)571-0014
Calhoun County Texas
1/15/2019 DSHS RAC - Texas Department of State Health Services. EMS & Trauma Systems
TEXAS Texas Department ofState
G' ��x Serviesth ndHuman Health Services
Regional Advisory Councils
What is a RAC?
Regional Advisory Councils (RACs) are the administrative bodies responsible for trauma system
oversight within the bounds of a given Trauma Service Area in Texas. Each of the 22 RACs is
tasked with developing, implementing, and monitoring a regional emergency medical service
trauma system plan. Generally, RAC stakeholders are comprised of healthcare entitles and other
concerned citizens with an interest in improving and organizing trauma care. As such, not every
Regional Advisory Council is structured the same. However, each RAC has the same objectives -
to reduce the incidence of trauma through education,data colieetion, data analysis and
motive to reduce the
RAC Operation Guidelines
ery provider guidance and
res of trauma patients.
• History and Overview
• Texas Regional Advisory Council System Essential Criteria Defined (2009).
• RA-CLRvlaws
$ggional Trauma System Plans
Glossary of Terms
Contact your local Regional Advisory Council
View RAC Contacts
Trauma Service Area Map
https://dshs.texas.gov/smstFaumasystems/etrarac.shim 119
RAC Operation Guidelines
Regional Advisory Councils (History/Overview)
I. Purpose: The purpose of a Regional Advisory Council (RAC) is to develop, implement
and monitor a regional emergency medical services (EMS) trauma system plan to facilitate
trauma system networking within its TSA or group of TSAs. A RAC is an organized group of
healthcare entities and other concerned citizens who have an interest in improving and organizing
trauma care within a specified Trauma Service Area (TSA). RAC membership may include
hospitals, physicians, nurses, EMS providers, rehabilitation facilities, dispatchers, as well as other
community groups.
H. Omnibus Rural Health Care Rescue Act: The Texas legislature wanted trauma care
resources to be available to every Texan. The Omnibus Rural Health Care Rescue Act, passed in
1989, directed the Bureau of Emergency Management of the Texas Department of Health to
develop and implement statewide emergency medical services (EMS) and trauma care system,
designate trauma facilities, and develop a trauma registry to monitor the system and provide
statewide cost and epidemiological statistics.
III. Implementation of the trauma system: The trauma system was initially adopted by the
Texas Board of Health in accordance with Senate Bill 530, Health & Safety Code, Chapter 773
(Emergency Medical Services), whereby the state was divided into twenty-two regions called
Trauma Service Areas (Texas Administrative Code § Rule 157.122), provided for the formation
of a Regional Advisory Council (Texas Administrative Code § Rule 157.123). In each area, a
regional trauma system plan was developed and implemented, delineating the trauma facility
designation process, and provided for the development of a state trauma registry. A Regional
Advisory Council, an organization of healthcare entities and individuals such as hospitals,
physicians, nurses, EMS providers and other individuals interested in trauma care and injury
prevention thus provides a vital link in implementing the regional trauma system plan.
IV. Functions: The functions of Regional Advisory Councils (RAC) were to:
A. Develop and implement a regional EMS/trauma system plan
B. Provide public information and education about prevention of trauma and a trauma
system
C. Provide a forum for EMS providers and hospitals to address trauma service area
issues
D. Network with other regional advisory councils
E. Document and report trauma system data that meets trauma service criterion
(Rev. 06/2008)
RAC Operation Guidelines
Regional Advisory Councils (History/Overview)
V. Demographics: The geographic demographics of the twenty-two regional advisory councils
A.
RAC A
Amarillo
Panhandle RAC TSA -A
B.
RAC B
Lubbock
TSA -B RAC BRAC
C.
RAC C
Wichita Falls
NTRAC TSA -C Inc.
D.
RAC D
Abilene
Big Country RAC Inc
E.
RAC E
Dallas/Ft Worth
North Central Texas Trauma RAC
F.
RAC F
Texarkana
Northeast Texas RAC
G.
RAC G
Tyler
Piney Woods RAC
H.
RAC H
Lulkin/Nacogdoches
TSA -H RAC
I.
RAC I
EI Paso
Far West Texas & Southern New Mexico Trauma
RAC
J.
RAC J
Midland/Odessa
Texas J RAC
K.
RAC K
San Angelo
Concha, Valley RAC TSA -K
L.
RAC L
Belton
Central Texas Regional Trauma RAC
M.
RAC M
Waco
Heart of Texas RAC
N.
RAC N
Bryan/College Station
Brazos Valley RAC
O.
RAC O
Austin
Capital Area Trauma RAC
P.
RAC P
San Antonio
Southwest Texas RAC
Q.
RAC Q
Houston
Southeast Texas Trauma RAC
R.
RAC R
Galveston/Beaumont
East Texas Gulf Coast Regional Trauma RAC
S.
RAC S
Victoria
Golden Crescent RAC TSA -S
T.
RAC T
Laredo
Seven Flags RAC on Trauma TSA -T
U.
RAC U
Corpus Christi
Coastal Bend RAC on Trauma TSA -U Inc
V.
RAC V
Harlingen
Lower Rio Grande Valley RAC on TSA -V Inc
(Rev. 06/2006) 2
RAC Operation Guidelines
Regional Advisory Councils (History/Overview)
VI. Trauma Facilities: The trauma facilities are an integral component in a well-developed trauma
system. An essential part of the trauma care plan (discussed in greater detail in following sections) is the
designation of definitive care facilities. (Trauma facility development discussed in greater detail in
following section)
VII. Trauma Funding: During the 751" Legislative Session, Senate Bill 102 (SB -120) was enacted
creating the Emergency Medical Services (EMS) and Trauma Care System Fund. During the 7e
Legislative Session, the EMS and Trauma Care System Fund was changed, with the enactment of HB -
2085. During the 1999 Legislative Session, the Department of Health was empowered to distribute
funding directly to regional advisory council if the councils was an IRS 501 (c)(3) organization.
Additional funding sources, such as extraordinary emergency allotment (SEF), uncompensated care
allotment and tobacco endowment has significantly enabled regional advisory councils and providers to
impact trauma care.
VIII. RAC Structure: As approval for RAC development occurred, among the essential events to
happen was the select of leadership. The following components were and remain essential in selecting
RAC leadership.
A. Composition of the officers (mix of geographic areas or professions)
B. Title and number of officers (chairman, president, twelve, etc.)
C. Method of selection (by appointment or by vote)
D. Length of term for each officeholder (number of years)
E. Responsibilities of each officeholder (duties and functions)
Group support and agreement among the members is enhanced if the "key" people were representative of
the membership across a broad spectrum. Limiting the number of leadership positions of those in the
same profession or that live in the same county was and is a critical. It was and is suggested that at least
one position be from the pre -hospital discipline.
Without saying, the history and development of a Regional Advisory Council has moved rapidly over the
course of several years. They have not been static since their inception, neither should they. No one RAC
is the same; each has components that are unique. The remaining sections of this manual will highlight
the essential elements and criteria of a RAC and with the intent being to provide basic guidance for
success.
IX. What is a RAC? The Regional Advisory Councils are responsible for developing, implementing,
and monitoring a regional emergency medical service trauma system plan. They are an organized group
of healthcare entities and other concerned citizens who have an interest in improving and organizing
trauma care within a specific TSA. As such, not every Regional Advisory Council will be structured the
same but each must have the same objectives — to reduce the incidence of trauma through education, data
collection and analysis and performance improvement. This is accomplished by providing educational'
initiatives, looping data back into those initiatives as well as conducting performance improvement that
provides each and every provider guidance and motive to reduce the incidence of trauma as well as
improve the outcome of trauma patients.
(Rev. 06/2008)
Mascot Use
Child Passenger Safety Seat — need for car seats, seatbelts, etc.
CPR/First Aid
Injury Prevention — making homes safer for kids; elderly
Bystander Care for the Injured — first aid; heat exhaustion recognition; etc
Stop the Bleed —application of tourniquets and wound packing
Make the Right Call — when to call 911 and what to know when you call
School Functions— read books with kids; meet the Special Needs children (Autism, etc.), Fair
demonstrations, standbys; career days with high school kids
Walmart—summer safety; hurricane preparedness, first aid
Girl Scout field trip to station
(--ail-ioun County Commissioners" Court—January 23, )019
7. CONSIDER AND TAKE NECESSARY ACTION: (AGENDA ITEM NO. 7)
On Proposed EMS Charge rate increase schedule for 2019. (RM)
Dustin Jenkins, EMS Director, spoke on this matter.
RESULT: APPROVED [UNANIMOUS]
MOVER: Vern Lyssy, Commissioner Pet 2
SECONDER: Gary Reese, Commissioner Pet 4
AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
Page 5 of 16
Suan Riley
From: Dustin.Jenkins@calhouncotx.org (Dustin Jenkins) <Dustin.Jenkins@calhouncotx.org>
Sent: Tuesday, January 15, 2019 12:07 PM
To: Susan Riley, Cindy Mueller
Cc: Lori McDowell
Subject: Fwd: [WARNING -Remote attachments, verify sender] Draft Rate Analysis and
Recommendation
Attachments: CCEMSSummary(010919)v1.pdf, CCEMS 2019 Proposed charges.xls
Susan,
I would like to propose an EMS Charge rate increase Schedule for 2019 to the commissioners court for approval.
Kevin Coyle with Revenue Optimization Solutions, LLC., the company that performs our yearly cost reports, suggested we
raise our charge schedule by at least 20.13% across all charges to optimize revenue from the Texas Ambulance
Supplemental Payment Program (TASPP), as noted in the forwarded email and attachment
"CCEMSSummary(010919)v1.pdP' below.
Further, Travis Autery, from Emergicon our billing company, has suggested a fee schedule that would put us more in line
with providers in our specific area, as noted in the other Forwarded Email from EMERGICON below.
I have also attached our proposed rate increase in the attachment "CCEMS 2019 Proposed charges.x[s" below. The
rate increases take into account these recommendations, and follows a "middle road," as you will see. Also, in this
document, you will find the rates with increases from the past several years along with the Cost Report and Emergicon
proposed numbers.
Respectfully,
From: "kcoyle@revopsllc.com (Kevin Coyle)" <kcoyle@revopsllc.com>
To: "Dustin Jenkins" <Dustin.Jenkins@calhouncotx.org>
Date: Wed, 9 Jan 2019 09:16:22 -0600
Subject: [WARNING -Remote attachments, verify sender] Draft Rate Analysis and Recommendation
Dustin — I am attaching the rate/charge analysis based on the 2017 TASPP Cost Report.
Since I do not have the rates that went into effect in January 2018, the recommendation section tries to take that into
account as we recommend percentage increases in rates/charges.
Please review and let's talk to make sure it makes sense for your purposes.
Thanks.
Kevin Coyle
REYENUE OPTIMIZATION SOLUTIONS, LLC
1 000 HERITAGE CENTER CIRCLE
ROUND ROCK. TX 78664
DIRECT: 512-537-9588
CELL: 512-585-2129
KCOYLE@REVOPSLLC.COM
WWW.REVOPSLLC.COM
From: "tautery(&emergicon.com (Travis Autery)" <tautery(&emergicon.com>
Date: January 11, 2019 at 10:56:49 AM CST
To: Lori McDowell <Lori.McDowe[Wcalhouncotx.ora >
Cc: Christopher Turner <cturneo emergicon.com>, Michael Iglio <mig1io(0)emergicon.com>
Subject: [WARNING -Remote attachments, verify sender] Fee Schedule Recommendation
Good morning Ms. McDowell,
I am following up on a request that was relayed to me by Christopher. I have put together a fee
schedule comparison for your agency. With the recent influx in rising deductibles and premiums,
commercial plans have become skinnier across the industry. Over the last year, we have seen higher fee
schedule updates for many agencies. These higher fee schedules have effectively mitigated any
commercial payment decrease. The below comparison contains examples of some recent fee schedule
updates from the coastal region.
0 c:
To maximize commercial insurance payments going forward, we propose the following fee schedule
update. This update would not need to be updated again for a good while.
U
On our end, any fee schedule update is simple. Once you are ready, all that we need is an email
approval. Any update can go into effect as early as the following day.
If you have any questions or need anything at all, please let me know. Thank you very much.
Respectfully,
Travis Autery — Manager of QA/QI
tauterV(o emerg icon. corn I p. 972-602-2060 ext. 430
IHI
This email and any files transmitted with it are confidential and intended solely for the use of the
individual or entity to whom they are addressed. This document may contain information covered under
the Privacy Act (5 USC 552(a)), the Health Insurance Portability and Accountability Act (PL 104-191)
and/or the Texas Medical Privacy Act (Tex. Health & Safety Code §181) and the various implementing
regulations and must be protected in accordance with those provisions. Healthcare information is
personal and sensitive and must be treated accordingly. If this correspondence contains healthcare
information it is being provided to you after appropriate authorization from the patient or under
circumstances that don't require patient authorization. You, the recipient, are obligated to maintain it in
a safe, secure and confidential manner in accordance with applicable law. Disclosure without patient
consent as permitted by law is prohibited. Unauthorized disclosure or failure to maintain confidentiality
subjects you to application of appropriate sanction. If you have received this correspondence in error,
please notify the sender at once, delete this email from your system and destroy any copies you have
made. If you are not the intended recipient you are notified that disclosing, copying, distributing or
taking any action in reliance on the contents of this information is strictly prohibited.
J. Dustin Jenkins, DMin, MBA, LP
Director of Emergency Medical Services
705 Henry Barber Way
Calhoun County, TX
dustin.jenkins@calhouncotx.org
(361)571-0014
Calhoun County Texas
Revenue Optimization SolutionS, LLC
f 1pli...W", Reomwe fi,rA,,d,0 uec Seroices Prmnders
MEMORANDUM
TO:
Dustin Jenkins EMS Director, Calhoun County EMS
FROM:
Kevin Coyle, RevOPS
(512)537-9588
kcoyle@revopsllc.com
RE:
Calhoun County EMS Cost Report Comparison
DATE:
January 9, 2019
Below is a comparative analysis of provider billing rates/charges, average charges per transport, and
average costs per transport. The analysis includes information from 26 ambulance services providers in
Texas, including twenty fire departments and six P service providers. The data was gathered from the
2017 Texas Ambulance Supplemental Payment Program (TASPP) Cost Reports.
Please keep in mind that the TASPP Cost Reports, and the analysis contained herein, only account for the
Medicaid and Uninsured transports. That represents 25% of the Calhoun County EMS patient mix;
however, given uniform billing requirements and the nature of rate/charge structures, this analysis can
be considered representative of the broader patient mix.
RECOMMENDATIONS
Overall, based on the analysis below, Calhoun County EMS's rates/charges are in line with the other
providers studied, and we do not see any immediate issues with the existing rate/charge structure that
may cause concerns with the Texas Health and Human Services Commission (HHSC).
To optimize revenue from the Texas Ambulance Supplemental Payment Program (TASPP), we recommend
a rate/charge increase. The recommendation is in two parts:
A) If the rate/charge increase that went into effect in January 2018 was not at least 6.5% above
the rates identified in the analysis below, then we recommend increasing rates/charges by a
percentage that will take you to an overall 6.5% increase. By doing this, your new average charge
per transport ($1,498.99) will be slightly above your 2017 TASPP Cost Report average cost per
transport ($1,495.46). Having rates/charges per transport at, or slightly above the cost per
transport is an advantageous position to be in for optimizing TASPP revenue.
B) We also recommend an additional percentage increase in your rates/charges equal to the
percentage increase in Calhoun County EMS expenses from fiscal year 2017 to fiscal year 2019
(13.63% based on 2017 Actual vs. 2019 Budgeted expenses in the "2019 Final Budget" document).
This additional increase to your rates/chares will ensure that the rates/charges are keeping pace
with your expenses.
1
Revenue Optimization Solutions, LLC
Opti n.mma) sm, s Nmdd,"
DATA ANALYSIS
Base Transport and Mileage Charges:
Below are tables that provide an overview of the existing base transport and mileage charges of the
providers studied.
As the tables show, Calhoun County EMS is slightly above the average rates/charges when looking at a
breakdown for all providers studied (both 31 Service Providers and Fire Departments), 3'd Service
Providers only, and in comparison to Fire Departments.
Overall, the existing rate/charge structure is well within the ranges (min/max) of the providers studied;
therefore, we do not see any immediate concerns with how your rates/charges are structured.
Total Charges Per Transport:
Calhoun County EMS's average total charge per transport is slightly above the average of all providers
studied (Fire Departments and 3`d Service providers)
ALL PROWDERS Charge Per Transport
Average -ALL Providers $ 1,209.67
Minimum -ALL Providers $ 602.63
Max -ALL Providers $ 2,082.77
CaOwun CauMy EMS' .. $ - ifW7.50
2
Revenue Optimization Solutions, LLC
O,1ww ,, Ro..cu uGfl,r An,hu&wce tiemices Prmddc,,
When comparing the average charges per transport for 3`d service providers, Calhoun County EMS comes
in slightly below the average.
3RD SERVICE PROVIDERS Charge Per Transport
Average - 3rd Service Providers$ 1,461.85
Minimum - 3rd Service Providers $ 781.00
Max - 3rd Service Providers $ 2,082.77
GalhounCo4ntyEMS�-.$..-. '1,407;50
Calhoun County EMS's average total charges per transport are in the top 30% when comparing them to
fire department providers.
FIRE DEPARTMENTS
Average- Fire Departments
Charge
$
Per Transport
1,134.02
Minimum- Fire Departments
$
602.63
Max -Fire Departments
$
1,614.67
t eBmudCouMyEMS
$,=
1;495:96`
Having a high charge per transport is typical for 311 service providers as these types of providers tend to
operate on a cost -based, or cost-plus type of rate structure.
Total Cost Per Transport:
Calhoun County EMS's total cost pertransport is in the top third of all providers studied (Fire Departments
and EMS Providers).
AU PROVIDERS
Average -ALL Providers
Cost
$
Per Transport
1,711.91
Minimum - ALL Providers
$
625.59
Max - ALL Providers
$
3,063.27
ls0ioun'Cou' .EMS =:
$,=
1;495:96`
When comparing the cost per transport of 3`d service providers only, Calhoun County EMS comes in at the
high end.
3RID SERVICE PROVIDERS Cost Per Transport
Average -3rd Service Providers $ 1,143.46
Minimum - 3rd Service Providers $ 625.59
Max - 3rd Service Providers $ 1,495.46
t:a0iouiiCountyEMS ° $�'" 1,495`A6?
Calhoun County EMS's cost per transport is 80% of the average cost per transport of fire departments
studied.
FIRE DEPARTMENTS Cost Per Transport
Average - Fire Departments $ 1,882.44
Minimum - Fire Departments $ 879.82
Max- Fire Departments $ 3,063.27
CelhaunCountyEMS' i; S 1;49SAIS
3
Suan Riley
From: Dustin.Jenkins@calhouncotx.org (Dustin Jenkins) <Dustin.Jenkins@calhouncotx.org>
Sent: Tuesday, January 15, 2019 12:07 PM
To: Susan Riley, Cindy Mueller
Cc: Lori McDowell
Subject: fwd: [WARNING -Remote attachments, verify sender] Draft Rate Analysis and
Recommendation
Attachments: CCEMSSummary(010919)v1.pdf, CCEMS 2019 Proposed charges.xls
Susan,
I would like to propose an EMS Charge rate increase Schedule for 2019 to the commissioners court for approval.
Kevin Coyle with Revenue Optimization Solutions, LLC., the company that performs our yearly cost reports, suggested we
raise our charge schedule by at least 20.13% across all charges to optimize revenue from the Texas Ambulance
Supplemental Payment Program (TASPP), as noted in the forwarded email and attachment
"CCEMSSummary(010919)v1.pdf' below.
Further, Travis Autery, from Emergicon our billing company, has suggested a fee schedule that would put us more in line
with providers in our specific area, as noted in the other Forwarded Email from EMERGICON below.
I have also attached our proposed rate increase in the attachment "CCEMS 2019 Proposed charges.xls" below. The
rate increases take into account these recommendations, and follows a "middle road," as you will see. Also, in this
document, you will find the rates with increases from the past several years along with the Cost Report and Emergicon
proposed numbers.
Respectfully,
From: "kcoyle@revopslic.com (Kevin Coyle)" <kcoyle@revopslic.com>
To: "Dustin Jenkins" <Dustin.Jenkins@calhouncotx.org>
Date: Wed, 9 Jan 2019 09:16:22 -0600
Subject: [WARNING -Remote attachments, verify sender] Draft Rate Analysis and Recommendation
Dustin — I am attaching the rate/charge analysis based on the 2017 TASPP Cost Report.
Since I do not have the rates that went into effect in January 2018, the recommendation section tries to take that into
account as we recommend percentage increases in rates/charges.
Please review and let's talk to make sure it makes sense for your purposes.
Thanks.
Kevin Coyle
REVENUE OPTIMIZATION SOLUTIONS, LLC
1000 HERITAGE CENTER CIRCLE
ROUND ROCK, TX 78664
DIRECT: 512-537-9588
CELL: 512-585-2129
KCOYLE@REVOPSLLC,COM
WWW.REVOPSLLC.COM
From: "tautery(&emergicon,com (Travis Autery)" <tautery( emergicon.com>
Date: January 11, 2019 at 10:56:49 AM CST
To: Lori McDowell<Lori.McDowe11(@calhouncotx.org>
Cc: Christopher Turner <cturner(0emerg1con.com>, Michael Iglio <miglio(@emergicon,com>
Subject: [WARNING -Remote attachments, verify sender] Fee Schedule Recommendation
Good morning Ms. McDowell,
I am following up on a request that was relayed to me by Christopher. I have put together a fee
schedule comparison for your agency. With the recent influx in rising deductibles and premiums,
commercial plans have become skinnier across the industry. Over the last year, we have seen higher fee
schedule updates for many agencies. These higher fee schedules have effectively mitigated any
commercial payment decrease. The below comparison contains examples of some recent fee schedule
updates from the coastal region.
E
To maximize commercial insurance payments going forward, we propose the following fee schedule
update. This update would not need to be updated again for a good while.
H1
On our end, any fee schedule update is simple. Once you are ready, all that we need is an email
approval. Any update can go into effect as early as the following day.
If you have any questions or need anything at all, please let me know. Thank you very much.
Respectfully,
Travis Autery — Manager of QA/QI
tauterv@emergicon.com I p. 972-602-2060 ext. 430
=:
This email and any files transmitted with it are confidential and intended solely for the use of the
individual or entity to whom they are addressed. This document may contain information covered under
the Privacy Act (5 USC 552(a)), the Health Insurance Portability and Accountability Act (PL 104-191)
and/or the Texas Medical Privacy Act (Tex. Health & Safety Code §181) and the various implementing
regulations and must be protected in accordance with those provisions. Healthcare information is
personal and sensitive and must be treated accordingly. If this correspondence contains healthcare
information it is being provided to you after appropriate authorization from the patient or under
circumstances that don't require patient authorization. You, the recipient, are obligated to maintain it in
a safe, secure and confidential manner in accordance with applicable law. Disclosure without patient
consent as permitted by law is prohibited. Unauthorized disclosure or failure to maintain confidentiality
subjects you to application of appropriate sanction. If you have received this correspondence in error,
please notify the sender at once, delete this email from your system and destroy any copies you have
made. If you are not the intended recipient you are notified that disclosing, copying, distributing or
taking any action in reliance on the contents of this information is strictly prohibited.
J. Dustin Jenkins, DMin, MBA, LP
Director of Emergency Medical Services
705 Henry Barber Way
Calhoun County, TX
dustinjenkins@calhouncotx.org
(361) 571-0014
Calhoun County Texas
Proposed 2019 EMS CHARGES - CALHOUN COUNTY EMS
Service Refused
2018
2019
% Increase
Service Refused
$91.75
$150.00
63.49%
BLS Non -Emergency
$628.39
$1,000.00
59.14%
BLS Emergency
$1,000.57
$1,100.00
9.94%
ALS Non -Emergency
$763.42
$1,200,00
57.19%
ALS Emergency
$1,182.34
$1,300.00
9.95%
ALS 2
$1,718.98
$20000.00
16.35%
SCT Transport
$1,855.47
$2,250.00
21.26%
BLS Disposables
$200.00
$250.00'
25.00%
ALS Disposables
$275.00
$350.00
27.27%
Oxygen
$125.00
$130.00
4.00%
Mileage
$19.06
$22.87
20.00%
COST REPORT 2013 2014 2015 2016
Service Refused
$64.28
$67.49
$70.86
$77.95
BLS Non -Emergency
$440.23
$462.24
$485.35
$533.89
BLS Emergency
$700.97
$736.02
$772.82
$850.10
ALS Non -Emergency
$534.83
$561.57
$589.65
$648.62
ALS Emergency
$828.31
$869.73
$913.22
$1,004.54
ALS 2
$1,204.27
$1,264.48
$1,327.70
$1,460.47
SCT Transport
$1,290.37
$1,364.89
$1,433.13
$1,576.44
BLS Disposables
-
-
-
-
ALS Disposables
-
-
-
-
Oxygen
-
-
-
-
Mileage
$13.351
$14.02
$14.72
$16.19
Emergicon- Proposed
2013
2014
2015
2016
Service Refused 1
$64.281
$67.491
$70.861
$77.95
BLS Non -Emergency
$440.23
$462.24
$485.35
$533.89
BLS Emergency
$700.97
$736.02
$772.82
$850.10
ALS Non -Emergency
$534.83
$561.57
$589.65
$648.62
ALS Emergency
$828.31
$869.73
$913.22
$1,004.54
ALS 2
$1,204.27
$1,264.48
$1,327.70
$1,460.47
SCT Transport
$1,290.37
$1,364.89
$1,433.13
$1,576.44
BLS Disposables
-
-
-
-
ALS Disposables
-
-
-
-
Oxygen
-
-
-
-
Mileage
$13.35
$14.02
$14.72
$16.19
CCEMS- Proposed 2013 2014 2015 2016
Service Refused
$64.28
$67.49
$70.86
$77.95
BLS Non -Emergency
$440.23
$462.24
$485.35
$533.89
BLS Emergency
$700.97
$736.02
$772.82
$850.10
ALS Non -Emergency
$534.83
$561.57
$589.65
$648.62
ALS Emergency
$828.31
$869.73
$913.22
$1,004.54
ALS 2
$1,204.27
$1,264.48
$1,327.70
$1,460.47
SCT Transport
$1,290.37
$1,364.89
$1,433.13
$1,576.44
BLS Disposables
-
-
-
-
ALS Disposables
-
-
-
-
Oxygen
-
-
-
-
Mileage
$13.35
$14.02
$14.72
$16.19
2017 2018
COST REPORT Proposed
2019 '
% Increase
$85.75
$91.75
$110.22
20.13%
$587.28
$628.39
$754.88'
20.13%
$935.11
$1,000.57
$1,201.98'
20.13%
$713.48
$763.42
$917.10
20.13%
$1,104.99
$1,182.34
$1,420.35
20.13%
$1,606.52
$1,718.98
$2,065.01
20.13%
$1,734.08
$1,855.47
$2,228.98'
20.13%
-
$200.00
$240.26'
20.13%
-
$275.00
$330.36
20.13%
-
$125.00
$150.16'
20.13%
20.13%
$17.811
$19.06
$22.90
2017 2018
EMERGICON Proposed 2019
% Increase
172.48%
$85.75
$91.75
$250.00'
$587.28
$628.39
$1,500.00:
138.71
$935.11
$1,000.57
$1,500.00
49.91
109.58
$713.48
$763.42
$1,600.00
$1,104.99
$1,182.34
$1,600.00
35.32
$1,606.52
$1,718.98
$2,000.00
16.35
34.74
$1,734.08
$1,855.47
$2,500.00'
-
$200.00
$325.00
62.50
54.55
20.00
25.92
-
$275.00
$425.00
-
$125.00
$150.00'
$17.81
$19.06
$24.001
2017 2018
CCEMS Proposed
2019
% Increase
63.49%
$85.75
$91.75
$150.00'
$587.28
$628.39
$11000.00
59.14%
9.94%
$935.11
$1,000.57
$1,100.00'
$713.48
$763.42
$1,200.00
57.19%
9.95%
16.35%
$1,104.99
$1,182.34
$1,300.00
$1,606.52
$1,718.98
$2,000.00`
$1,734.081
$1,855.47
$2,250.00
21.26%
-
$200.00
$250.00
25.00%
-
$275.00
$350.00
27.27%
4.00%
-
$125.001
$130.00
$17.81
$19.061
$22.87;
20.00%
Calhoun County Commissioners' Court --January 23, 2019
8. Accept 2018 Certificate of Completion for Continuing Education Hours from
County Clerk and enter into official Court Records. (RM)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vern Lyssy, Commissioner Pet 2
SECONDER:
Gary Reese, Commissioner Pet 4
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
Page 6 of 16
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Calhoun County Commissioners' Court—January 23, 2019
9. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 9)
To accept resignation from Rhonda Cummins, CEA -Marine Agent. (RM)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Richard Meyer, County Judge
SECONDER:
Vern Lyssy, Commissioner Pet 2
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
Page 7 of 16
Sea'emt
Texas
Science At {York For Texans
TO: Calhoun County fudge Meyer
Commissioners Hall, Lyssy, Syma, and Reese
Agril_ife Extension Administration
Texas Sea Grant Administration
FROM: Rhonda Cummins, CEA -Marine
DATE: January 9, 2019
SUBJECT: Retirement/resignation
.Joe Surovik was right. Calhoun County is the best county in Texas to be a Marine Agent. I have loved serving the
residents and visitors to this county through a wide variety of programs that I was given the freedom to create and
grow. From building boats with middle school students, kayaking with adults like Veva Saylor, operating the aquarium at
the Hardhead Derby, working with the commercial fishermen, conducting the popular Cooking with Seafood program,
creating the Outdoor Classroom at Little Chocolate Bayou Park, coordinating the Magnolia Beach cleanups, and so much
more, you gave me the opportunity to raise the awareness of Calhoun County's coastal and marine resources.
I have been honored to work with many local and statewide partners over the years including Big Bear shrimp and
Seafood, TPWD Coastal Fisheries, the General land Office, and Our Lady of the Gulf Catholic School, just to name a few.
Hundreds of youth and adult volunteers have donated their time and talents to help rnake my programs successful. I
will be forever grateful to those partners, volunteers, program participants, my dedicated Marine Advisory Committee
members, and this court.
When I interviewed for this position 11 years ago, Kenny Finster asked me "How long are you going to stay?" I told him
"until I retire," Well, that time has come. The last few months have been a different time of service and reflection for me
as I have used Family Medical Leave to help my mother. I know my greater calling is to remain by her side during her
recovery, rehabilitation and beyond. My retirement/resignation will be effective on .January 31, 2019.
Thank you again for this amazing opportunity.
Sea Vrant
Texas
Science At Work For Texans
TO: Calhoun County Judge Meyer
Commissioners Hall, Lyssy, Syma, and Reese
AgriLife Extension Administration
Texas Sea Grant Administration
FROM: Rhonda Cummins, CEA -Marine �-
DATE: January 9, 2019
SUBJECT: Retirement/resignation
Joe Surovik was right. Calhoun County is the best county in Texas to be a Marine Agent. 1 have loved serving the
residents and visitors to this county through a wide variety of programs that I was given the freedom to create and
grow. From building boats with middle school students, kayaking with adults like Veva Saylor, operating the aquarium at
the Hardhead Derby, working with the commercial fishermen, conducting the popular Cooking with Seafood program,
creating the Outdoor Classroom at Little Chocolate Bayou Park, coordinating the Magnolia Beach cleanups, and so much
more, you gave me the opportunity to raise the awareness of Calhoun County's coastal and marine resources.
I have been honored to work with many local and statewide partners over the years including Big Bear Shrimp and
Seafood, TPWD Coastal Fisheries, the General Land Office, and Our Lady of the Gulf Catholic School, just to name a few.
Hundreds of youth and adult volunteers have donated their time and talents to help make my programs successful. I
will be forever grateful to those partners, volunteers, program participants, my dedicated Marine Advisory Committee
members, and this court.
When I interviewed for this position 11 years ago, Kenny Finster asked me "How long are you going to stay?" I told him
"until I retire." Well, that time has come. The last few months have been a different time of service and reflection for me
as I have used Family Medical Leave to help my mother. I know my greater calling is to remain by her side during her
recovery, rehabilitation and beyond. My retirement/resignation will be effective on January 31, 2019.
Thank you again for this amazing opportunity.
Calhoun County Commissioners' Court—January 23, 2019
10. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 10)
On request by Justice of the Peace Precinct #3 to lease Kyocera 307CL
S/N R9V8800822 copier from Dewitt Poth & Son and authorize Judge Dimak
to sign 3 year agreement. (CS)
RESULT: APPROVED [UNANIMOUS]
MOVER: Vern Lyssy, Commissioner Pet 2
SECONDER: David Hall, Commissioner Pet 1
AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
Page 8 of 16
/0
Clyde Syma.
Calhoun County Commissioner, Precinct 3
24627 State llxy. J72—Olivia, Port Lavaca, Texas 77979 Office (361) 893-63,16 —Fax (361) 893.5309
Email: cl cv Ie.svi i�rrlcalltotmcotx orz
January 16, 2019
Honorable Richard Meyer
Calhoun County Judge
211 S. Alm
Port Lavaca, TX 77979
RE: Agenda Item
Dear Judge Meyer:
Please place the following item on the Commissioner's Court Agenda for January 23, 2019.
Please Consider and Take Necessary Action on request by Justice of the Peace, Pct. 3 to lease newer
copier from Dewitt Poth & Son. Product Kyocera 307CI. S/N R9V8800822 and authorize Judge Dimak
to sign 3 year contract agreement,
Sincerely,
Clyde Syma
Commissioner Pct. 3
dewitt poth
1,0MD000W-S 01)5114E55
COMPANY NAME: Calhoun County JP 3
ADDRESS: 112 Jones Str
i', 0.1x 5LI a
Point Comfort, Texas 77978
-%o�nuac�.. di mak
EMAIL: v C p lhounr nhr �r�
EQUIPMENT: KYOCERA 307ci
son
WT919
1111NAI.O roewY
LOCATION
CONTACT: Judge Dimak
PHONE: 361-987-2930
FAX:.. 3U i -Dq I -IC)
SERIAL #: R9V8800822
SYSTEM #: 9848
CONTRACT TERM: January 16, 2.0.19, -.January 16, 2022
MONTHLY COST OF CONTRACT: $0,0125 per Black copy. $0.075 per Color copy.
EXCLUDES: Paper and Staples
TERMS AND CONDITIONS:
1. All copies will be billed monthly in. arrears.
2. Copy count will be taken monthly.
3. No credit will be given on bad copies.
4. Maintenance does not include service resulting from negligence, accident, misuse, acts of nature,
vandalism, theft, changes in the specifications of the equipment or use of supplies not recommended by
manufacturer.
5. The stated maintenance rate will be held for 3 years from the contract start date,. At the 3 year mark stated in
the contract, the service rate may increase ycatly at a rate of no more than I0"/o.per year..
6. There will be a minimum charge of $30.00 per month on cost per copy contracts
CUSTOMER DATE
DEWITT:POTH & SON DATE
102 West Street I P:O. Box 487 I Yoakum, TX 77995
(361) 293-3791 i toll free (800) 242-0162 I fox (361) 293-7553
wwW..clewittpoth. corn
MISSING ITEMS
COMMISSIONERS
COURT DATE AGENDA ITEM # NOTES
t 20)77-t 1W f , �r
Calhoun County Commissioners' Court—January 23, 2019
11. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 11)
On Contract No. HHS000371500003 under the 2017 Hurricane Public Health
Crisis Response Cooperative Agreement Grant with the Department of State
Health Services in the amount of $232,425 and authorize County Judge to
to sign electronically. (RM)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
David Hall, Commissioner Pet 1
SECONDER:
Vern Lyssy, Commissioner Pet 2
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
Page 9 of 16
Suan Riley "
From: Richard.Meyer@calhouncotx.org (Richard Meyer) <Richard.Meyer@calhouncotx.org>
Sent: Friday, January 11, 2019 11:34 AM
To: susan.riley@calhouncotx.org
Subject: FW: New $232,425; HHS000371500003; Calhoun County; CMS/CoAg LHD
From: DocuSign System [mailto:dse_na2@docusign.net]
Sent: Tuesday, January 8, 2019 12:56 PM
To: Richard Meyer <richard.meyer@calhouncotx.org>
Subject: New $232,425; HHS000371500003; Calhoun County; CMS/CoAg LHD
TEXAS
Health and Human
Services
Texas Health and Human Services Commission
PCS DocuSign(a)hhSC.State.tx.us
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2
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
SIGNATURE DOCUMENT FOR
DEPARTMENT OF STATE HEALTH SERVICES
CONTRACT No. MS000371500003
UNDER THE
2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOPERATIVE AGREEMENT GRANT
I. PURPOSE
The DEPARTMENT OF STATE HEALTH SERVICES ("DSHS" or "System Agency"), a pass-through
entity, and CALgomCOUNTY("Grantee" or "Contractor") (each a 'Party" and collectively the
"Parties") enter into the following grant contract to provide funding for the Hurricane Harvey
Crisis Project (the "Contract'), as described in Attachment A, Statement of Work.
II. LEGAL AUTHORITY
This Contract is made in accordance with awards by the Centers for Disease Control and
Prevention (CDC-RFA-TP18-1802 — Cooperative Agreement for Emergency Response: 2017
Hurricane Public Health Crisis Response, Funding Opportunity Number: CDC -RFA -TPI 8-1802,
CFDA 493.354), which is incorporated herein by reference, and is authorized by and in compliance
with the provisions of Texas Health and Safety Code Chapter 12 or 1001 or Texas Government
Code Chapter 531, 771, 791 or 2155.
III. DURATION
This Contract is effective on the signature date of the latter of the Parties to sign this Contract and
terminates on June 30, 2020, unless renewed, extended, or terminated pursuant to the terms and
conditions of the Contract. The System Agency, at its own discretion, may extend this Contract
subject to terms and conditions mutually agreeable to both Parties.
IV. BUDGET
The total amount of this Contract will not exceed ($232,425.00). All expenditures under the
Contract will be in accordance with ATTACHMENT B, BUDGET.
V. CONTRACT REPRESENTATIVES
The following will act as the Representative authorized to administer activities under this
Contract on behalf of their respective Party.
System Mency
Samiyah Bailey
1100 West 49t1i Sheet, MC 1990
Austin, Texas 78756
(512) 776-2614
samiyah.bailey(c�r dshs.texas.gov
System Agency Contract No. III-IS000371500003 Under the Page I of 62
2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOPERATIVE AGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
Contractor
Name: Calhoun County
Address: 202 S. Ann, Port Lavaca, Texas 77979
Phone: 361-552-9242
Email: david.hall@calhouncotx.org
Either Party may change its designated Representative by providing written notice to the other
Party.
VI. LEGAL NOTICES
Any legal notice required under this Contract shall be deemed delivered when deposited by the
System Agency either in the United States mail, postage paid, certified, return receipt requested; or
with a common carrier, overnight, signature required, to the appropriate address below:
System Agency
Department of State Health Services
1100 West 49th Street, MC 1911
Austin, Texas 78756
Attention: General Counsel
Grantee
Name: Calhoun County
Address: 202 S. Ann, Port Lavaca, Texas 77979
Attention: County Judge
Notice given by Grantee will be deemed effective when received by the System Agency. Either Parry
may change its address for notice by written notice to the other Parry.
VII. ADDITIONAL GRANT INFORMATION
Federal Award Identification Number (FAIN): 1 NU90TP921945-01-00
Federal Award Date: 7/3/2018
Name of Federal Awarding Agency: Centers for Disease Control and Prevention
CFDA Number: 93.354
Awarding Official Contact Information:
Yull Celestin
1600 Clifton Rd
Atlanta, GA 30333
Phone: 404-639-7690
SIGNATURE PAGE FOLLOWS
System Agency Contract No. IIHS000371500003 Under the Page 2 of 62
2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOPERATIVE AGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
SIGNATURE PAGE FOR
DEPARTMENT OF STATE HEALTH SERVICES
CONTRACT No. HHS000371500003
DSHS
Name: Imelda Garcia
Title: Associate Commissioner
Date of execution:
GRANTEE
Name: Richard Meyer
Title: Calhoun county judge
Date of execution:
THE FOLLOWING ATTACHMENTS TO SYSTEM AGENCY CONTRACT NO. HHS000371500003 ARE
HEREBY INCORPORATED BY REFERENCE:
ATTACHMENT A - STATEMENT OF WORK
ATTACHMENT B — BUDGET
ATTACHMENT B-1—INDIVIDUAL PROJECT BUDGET(S)
ATTACHMENT C - HHSC UNIFORM TERMS AND CONDITIONS - GRANT
ATTACHMENT D - CONTRACT AFFIRMATIONS
ATTACHMENT E - DSHS SUPPLEMENTAL AND SPECIAL CONDITIONS
ATTACHMENT F - FEDERAL ASSURANCES AND LOBBYING FORM
ATTACHMENT G - FFATA CERTIFICATION
ATTACHMENT H - DATA USE AGREEMENT
ATTACHMENTSFOLLOW
System Agency Contract No. I-IHS000371500003 Under the Page 3 of 62
2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOPERATIVE AGREEMENT GRANT
DocuSlgn Envelope ID: 9CE59EOC-198A-4052-8461-93136FE88CD71D
ATTACHMENT A
STATEMENT OF WORK
I. GRANTEE RESPONSIBILITIES
Grantee will:
A. Complete the Hurricane Harvey Crisis Project (HHCP) by performing activities for this
project that support the Public Health Crisis Response Cooperative Agreement for
Emergency Response (Funding Opportunity Number CDC-RFA-TPI8-1802) from the
Centers for Disease Control and Prevention (CDC).
B. Work to improve or strengthen one or more of the following objectives in accordance with
their approved workplan (See para. C, below, for more information on Grantee's workplan
requirements):
1. Traditional and Novel Vector Control
Enhance mosquito surveillance (to jurisdictions with initial low capacity or damaged
surveillance systems).
Grantee will:
a. Traditional Methods
i. Implement traditional vector control strategies (larvicide/insecticide).
ii. Enhance mosquito control capacity through:
1. Initiating and augmenting mosquito surveillance (purchase of
equipment, supplies, etc.);
2. Purchasing adulticide, larvicide, or application equipment;
3. Addition of temporary employees;
4. Paying for trainings or licensing;
5. Paying for vector control contracts; and
6. Submitting monthly progress reports on the personnel, equipment,
material, and other supplies that have been purchased and their
implementation within the mosquito control program.
C. Implement approved workplan. Grantee's workplan has been approved by DSHS prior to
DSHS's entering into this Contract with Grantee. Grantee will adhere to the approved
workplan. The workplan must include a description of the project(s) and activities to be
addressed by the HHCP and measurable objective(s) for addressing each issue. The
workplan must also describe a clear method for evaluating the services that will be
provided. Any proposed changes to the approved workplan are not effective unless and
until Grantee has received written approval to the revised workplan from DSHS.
D. Submit monthly and final performance reports that describe progress toward achieving
the objectives contained in Grantee's approved workplan and any written revisions.
Grantee will submit the performance reports by the 5th business day following the last
day of the last month of each month, in a format to be provided by DSHS. Failure to
submit a required report or additional requested information by the due date specified in
System Agency Contract No. HHS000371500003 Under the Page 4 of 62
2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE CcoPERATrvE AGREEMENT GRANT
DocuSign Envelope to: 9CE59EOC-198A-4052-8461-93BBFE88CD7D
this Contract or upon request constitutes breach of contract, and may result in delay of
payment. Reports should be sent electronically to coayLcMshs.texas.aov and to
croscri si scoa2�L),,dshs.texas. Qov.
E. Comply with all applicable regulations, standards, and guidelines in effect on the
beginning date of this Contract and as amended.
F. The following documents and resources are incorporated herein by reference and made a
part of this Contract as if fully set forth therein:
DSHS and CDC Public Health Crisis Response Cooperative Agreement, Funding
Opportunity Number: CDC-RFA-TP18-1802;
Project workplan; and
Local Health Department Hurricane Crisis Discretionary Project — Monthly Project
Report(s).
IL PERFORMANCE MEASURES
DSHS will develop performance measures in collaboration with the Grantee. DSHS will monitor
the Grantee's performance of the requirements in this Statement of Work and compliance with
the Contract's terms and conditions.
I11. REPORTING REQUIREMENTS
Grantee at the request of the System Agency, may be required to submit additional reports
determined necessary to accomplish the objectives and monitor the compliance of this contract.
Grantee must submit reports in a format specified by the System Agency. Grantee will provide
System Agency financial reports as System Agency determines necessary to accomplish the
objectives of this Contract and to monitor compliance. If Grantee is legally prohibited from
providing any report under this Contract, Grantee will immediately notify System Agency in
writing.
Grantee will provide and submit written reports; by electronic mail in the format specified by
System Agency. Grantee will complete and submit the Local Health Department Hurricane Crisis
Discretionary Project — Monthly Project Report by the 5th business day of each month and a Final
Performance Report by the 15th business day of the end of the contract term. These reports need to
be completed for each HHCP for which the Grantee receives funding from System Agency.
Grantee shall maintain the source documentation used to develop the reports. All written reports
should be titled with the Grantee name, address, email address, vendor identification number,
telephone number, program name, contract or purchase order number, dates services were
completed and/or products were delivered, the time period of the report, total invoice amount, and
invoices paid to subgrantees for services received.
IV. INVOICING AND PAYMENTS
Grantee will request payments by submitting the State of Texas Purchase Voucher (Form B-13)
at httD://www.texas.2ov/erants/foi,i ns/b I 3form.doc no later than fifteen (15) business days after
the end of the preceding month. Voucher and any supporting documentation will be mailed or
submitted by fax or electronic mail to the address/number below.
System Agency Contract No. HHS000371500003 Under the Page 5 of 62
2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOPERATIVEAGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-9386FEMGM
Department of State Health Services
Claims Processing Unit, MC 1940
1100 West 49"' Street
P.O. Box 149347
Austin, TX 78714-9347
FAX: (512) 458-7442
EMAIL: invoicesna dshs.texas.aov and crosinvoices(a)dshs.texas.Zov
Grantee will be paid on a cost reimbursement basis and in accordance with the Budget in
Attachment B of this Contract.
With prior written notification to, and approval from, the System Agency Contract Manager,
Contractor may transfer money between budget categories, other than the equipment and indirect
cost categories, not to exceed 25% of the total contract value during a contract budget period. If
the budget transfer(s) exceeds 25% of the total contract value, alone or cumulatively, a formal
contract amendment is required.
Contractor shall provide notification of the budget transfer by submission of a revised
Categorical Budget Form to the System Agency Contract Manager, highlighting the areas
affected by the budget transfer. After review, the System Agency Contract Manager shall
provide notification of acceptance to Contractor via email, upon receipt of which, the revised
budget shall be incorporated into the Contract.
System Agency reserves the right, where allowed by legal authority, to redirect funds in the
event of financial shortfalls. System Agency Program will monitor Grantee's expenditures on a
quarterly basis. If expenditures are below Grantee's total Contract amount, Grantee's budget
may be subject to a decrease for the remainder of the Contract term. Vacant positions existing
after ninety (90) days may result in a decrease in funds.
System Agency Contract No. HHS000371500003 Under the Page 6 of 62
2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOPERATIVE AGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
ATTACHMENT B
BUDGET
Contract No. HHS000371500003
Categorical Budget:
PERSONNEL
$0.00
FRINGE BENEFITS
$0.00
TRAVEL'
EQUIPMENT
$41,648.00
SUPPLIES'
$186;302.00
CONTRACTUAL
$3,600.00
OTHER
$875.00
TOTAL DIRECT CHARGES
$232,425.00 `
INDIRECT CHARGES
$0.00
TOTAL
$232,425.00
System Agency Contract No. HHS000371500003 Under the Page 7 of 62
2617 HunnicANE PUBLIC HEALTH CRISIS RESPONSE COOPERATIVE AGREEMENT GRANT
DocuSlgn Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
Attachment B-1 Individual Project Budget(s)
System Agency Contract No. HHS000371500003 Under the Page 8 of 62
2017 HURRICANE PUBLIC HEALTII CRISIS RESPONSE COOPERATIVE AGREEMENT GRANT
Personnel Fr n%e
'11'nel
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S 232,425.00
Nm1Vector
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232425.00' S -
S, 232 ,425.00
System Agency Contract No. HHS000371500003 Under the Page 8 of 62
2017 HURRICANE PUBLIC HEALTII CRISIS RESPONSE COOPERATIVE AGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
ATTACHMENT C
HHSC UNIFORM TERMS AND CONDITIONS - GRANT
System Agency Contract No. HHS000371500003 Under the Page 9 of 62
2017 HURRICANE PURLw HEALTH CRISIS RESPONSE COOPERATrVE AGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
HHSC Uniform Terms and Condltlons Version 2.15
Published and Effective: September 1, 2017
Responsible Office: Chief Counsel
Wealth and Human Services
Health and Human Services Commission
HHSC Uniform Terms and Conditions - Grant
Version 2.15
System Agency Contract No. HHS000371500003 Under the Page 10 of 62
2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOPERATIVE AGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
TABLE OF CONTENTS
ARTICLE I. DEFINITIONS AND INTERPRETIVE PROVISIONS .................................... 4
1.01 Definitions..........................................................................................................................4
1.02 Interpretive Provisions........................................................................................................ 5
ARTICLE II Payment Methods and Restrictions..................................................................... 6
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
2.05 Application of Payment Due............................................................................................ 7
2.06 Use of Funds ..................................................................................................................... 7
2.07 Use for Match Prohibited.................................................................................................7
- I ........1.........a_.............................................................................________-____..
ARTICLE IV Allowable Costs and Audit Requirements......................................................... 9
4.01 Allowable Costs............................................................................................................... 9
4.02 Independent Single or Program -Specific Audit............................................................. 10
4.03 Submission of Audit....................................................................................................... 10
Article V AFFIRMATIONS, ASSURANCES AND CERTIFICATIONS ............................ 10
5.01 General AfPmnations...................................................................................................... 10
5.02 Federal Assurances......................................................................................................... 10
5.03 Federal Certifications..................................................................................................... 10
ARTICLE VI OWNERSHIP AND INTELLECTUAL PROPERTY ................................... 11
6.01 Ownership...................................................................................................................... 11
6.02 Intellectual Property....................................................................................................... 11
ARTICLE VII RECORDS, AUDIT, AND DISCLOSURE.................................................... 11
7.01 Books and Records......................................................................................................... 11
7.02 Access to records, books, and documents...................................................................... 11
Grantee Uniform Terms and Conditions
Page 2 of 19
v. 9.1.17
System Agency Contract No. IIHS000371500003 Under the Page 11 of 62
2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOPERATIVE AGREENI ENT GRANT
DocuSlgn Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
7.03
Response/compliance with audit or inspection findings ................................................
12
7.04
SAO Audit......................................................................................................................
12
7.05
Confidentiality... ................................ .... ...... ....... .................. . ....... ...... ... .
... 12
7.06
Public Information Act...................................................................................................
12
ARTICLE VIII CONTRACT MANAGEMENT AND EARLY TERMINATION .............
12
8.01
Contract Management....................................................................................................
12
8.02
Termination for Convenience... ........................... ..........................................................
13
8.03
Termination for Cause....................................................................................................
13
8.04
Equitable Settlement......................................................................................................
13
ARTICLE IX MISCELLANEOUS PROVISIONS.................................................................
13
9.01
Amendment....................................................................................................................
13
9.02
Insurance........................................................................................................................
13
9.03
Legal Obligations...........................................................................................................
14
9.04
Permitting and Licensure...............................................................................................
14
9.05
Indemnity.......................................................................................................................
14
9.06
Assignments...................................................................................................................
15
9.07
Relationship of the Parties ..............................................................................................
15
9.08
Technical Guidance Letters............................................................................................
15
9.09
Governing Law mud Venue............................................................................................
16
9.11
Survivability...................................................................................................................
16
9.12
Force Majeure................................................................................................................
16
9.13
No Waiver of Provisions................................................................................................
16
9.14
Publicity.........................................................................................................................
16
9.15
Prohibition on Non -compete Restrictions......................................................................
17
9.16
No Waiver of Sovereign Immunity................................................................................
17
9.17
Entire Contract and Modification...................................................................................
17
9.18
Counterparts...................................................................................................................
17
9.19
Proper Authority.............................................................................................................
17
9.20
Employment Verification..............................................................................................
17
9.21
Civil Rights...................................................................................................................
17
Grantee Uniform Terms and Conditions
Page 3 of 19
v.9.1.17
System Agency Contract No. HHS000371500003 Under the Page 12 of 62
2017 HBmucANE PUBLIC HEALTH Cffi91S RESPONSE COOPERATIVE AGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
ARTICLE L DEFINITIONS AND INTERPRETIVE PROVISIONS
1.01 Definitions
As used in this Contract, unless the context clearly indicates otherwise, the following terms and
conditions have the meanings assigned below:
"Amendment" means a written agreement, signed by the patties hereto, which documents
changes to the Contract other than those permitted by Work Orders or Technical Guidance
Letters, as herein defined.
"Attachment" means documents, terms, conditions, or additional information physically added
to this Contract following the Signature Document or included by reference, as if physically,
within the body ofthis Contract.
"Contract" means the Signature Document, these Uniform Terms and Conditions, along with any
Attachments, and any Amendments, or Technical Guidance Letters that may be issued by the
System Agency, to be incorporated by reference herein for all purposes if issued.
"Deliverable" means the work product(s) required to be submitted to the System Agency
including all reports and project documentation.
"Effective Date" means the date agreed to by the Parties as the date on which the Contract takes
effect.
"Federal Fiscal Year" means the period beginning October 1 and ending September 30 each
year, which is the annual accounting period for the United States government.
"GAAP" means Generally Accepted Accounting Principles.
"GASH" means the Governmental Accounting Standards Board.
"Grantee" means the Patty receiving funds under this Contract, if any. May also be referred to as
"Contractor" hh certain attachments.
"Health and Human Services Cominission" or "HHSC" means the administrative agency
established under Chapter 531, Texas Government Code or its designee.
"HUB" means Historically Underutilized Business, as defined by Chapter 2161 of the Texas
Government Code.
"Intellectual Property" means inventions and business processes, whether or not patentable;
works of authorship; trade secrets; trademarks; service marks; industrial designs; and creations
that are subject to potential legal protection incorporated in any Deliverable and first created or
developed by Grantee, Grantee's contractor or a subcontractor in performing the Project.
"Mentor Protege" means the Comptroller of Public Accounts' leadership program found at:
http://www.wiiidow.state.tx.us/prociirennentiprog/hub/lnentoiprotege/.
Grantee Uniform Terms and Conditions
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2017 HURRICANE PUBLIC HEALTH Ciusis RESPONSE COOPERATIVE AGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
"Parties" means the System Agency and Grantee, collectively.
"Earff" means either the System Agency or Grantee, individually.
"Program" means the statutorily authorized activities of the System Agency under which this
Contract has been awarded.
"Proiect'means specific activities of the Grantee that are supported by funds provided under this
Contract.
"Public hnfomiation Act" or "PIA" means Chapter 552 ofthe Texas Government Code.
"Statement of Work" means the description of activities performed in completing the Project, as
specified in the Contract and as may be amended.
"Signature Document' means the document executed by both Parties that specifically sets forth
all of the documents that constitute the Contract.
"Solicitation or "RFA"" means the document issued by the System Agency under which
applications for Program funds were requested, which is incorporated herein by reference for all
purposes in its entirety, including all Amendments and Attachments.
"Solicitation Resnonse" or "Application" means Grantee's full and complete response to the
Solicitation, which is incorporatedherein by reference for all purposes in its entirety, including
any Attachments and addenda.
"State Fiscal Tear" means the period beginning September 1 and ending August 31 each year,
which is the amoral accounting period for the State of Texas.
"State of Texas Tectravel" means Texas Administrative Code, Title 34, Part 1, Chapter 5,
Subchapter C, Section 5.22, relative to travel reimbursements under this Contract, if any.
"System Agency' means HHSC or any of the agencies of the State of Texas that are overseen by
HHSC under authority granted under State law and the officers, employees, and designees of
those agencies. These agencies include: HHSC and the Department of State Health Services.
"Technical Guidance Letter" or "TGL' means an instruction, clarification, or interpretation of
the requirements of the Contract, issued by the System Agency to the Grantee.
1.02 Interpretive Provisions
a. The meanings of defined terms are equally applicable to the singular and plural forms of the
defined terms.
b. The words "hereof," `9nerein," "hereunder," and similar words refer to this Contract as a
whole and not to guy particular provision, section, Attachment, or schedule of this Contract
unless otherwise specified.
c. The tern "including" is not limiting and means "including without linrfation" and, unless
otherwise expressly provided in this Contract, (i) references to contracts (including this
Contract) and other contractual instruments shall be deemed to include all subsequent
Amendments mrd other modifications thereto, but only to the extent that such Amendments
and other modifications are not prohibited by the terms of this Contract, and (ii) references to
Grantee Uniform Tums and Conditions
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2017 HURRICANE PUBLIC HEALTH Ousts RESPONSE COOPERATIVE AGREEMENT GRANT
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any statute or regulation are to be construed as including all statutory and regulatory
provisions consolidating, amending, replacing, supplementing, or interpreting the statute or
regulation.
d. Any references to "sections," "appendices," or "attachments" are references to sections,
appendices, or attachments of the Contract.
e. Any references to agreements, contracts, statutes, or administrative rules or regulations in the
Contract are references to these documents as amended, modified, or supplemented from
time to time daring the tern of the Contract.
f. The captions acrd headings of this Contract are for convenience of reference only and do not
affect the interpretation of this Contract.
g. All Attachments within this Contract, including those incorporated by reference, and any
Amendments are considered part ofthe terns of this Contract.
h. 'Ibis Contract may use several different limitations, regulations, or policies to regulate the
same or similar matters. All such limitations, regulations, and policies are cumulative mid
each will be performed in accordance with its terns.
i. Unless otherwise expressly provided, reference to any action of the System Agency or by the
System Agency by way of consent, approval, or waiver will be deemed modified by the
phrase "in its sole discretion."
j. Time is ofthe essence inthis Contract.
ARTICLE II PAYMENT METIIODS AND
2.01 Payment Methods
Except as otherwise provided by the provisions of the Contract, the payment method will be one
or more of the following:
a. cost reimbursement. This payment method is based on an approved budget and submission
of a request for reimbursement of expenses Grantee has incurred at the £nue of the request;
b. unit rate/fee-for-service. This payrnent method is based on a fixed price or a specified rate(s)
or fee(s) for delivery of a specified unit(s) of service and acceptable submission of all
required documentation, fomes mid/or reports; or
c. advance payment. This payment method is based on disbursal of the minimum necessary
Rinds to carry out the Program or Project where the Grantee has implemented appropriate
safeguards. This payment method will only be utilized in accordance with governing law
and at the sole discretion of the System Agency.
Grantees shall bill the System Agency in accordance with the Contract. Unless otherwise
specified in the Contract, Grantee shall submit requests for reimbursement or payment monthly
by the last business day of the month following the month in which expenses were incurred or
services provided. Grantee shall maintain all documentation that substantiates invoices and make
the documentation available to the System Agency Upon request.
2.02 Final Billbrg Submission
Unless otherwise provided by the System Agency, Grantee shall submit a reimbursement or
payment request as a final close-out invoice not later than forty-five (45) calendar days following
the end of the term of the Contract. Reimbursement or payment requests received in the System
Grantee Uniform Terms and Conditions
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Agency's offices more than forty-five (45) calendar days following the termination of the
Contract may not be paid.
2.03 Financial Status Reports (FSRs)
Except as otherwise provided in these General Provisions or in the terms of any Program
Attachment(s) that is incorporated into the Contract, for contracts with categorical budgets,
Grantee shall submit quarterly FSRs to Accounts Payable by the last business day of the month
following the end of each quarter of the Program Attactnnent term for System Agency review
and firnaneial assessment. Grantee shall submit the final FSR no later than forty-five (45)
calendar days following the end of tile applicable term.
2.04 Debt to State and Corporate Status
Pursuant to Tex. Gov. Code § 403.055, the Department will not approve and the State
Comptroller will not issue payment to Grantee if Grantee is indebted to the State for any reason,
including a tax delinquency. Grantee, if a corporation, certifies by execution of this Contract that
it is current and will remain current in its payment of franchise taxes to the State of Texas or that
it is exempt from payment of franchise taxes under Texas law (Tex. Tax Code §§ 171.001 or
seq.). If tax payments become delinquent during the Contract tern, all or part of the payments
under this Contract may be withheld until Grantee's delinquent tar is paid in full.
2.05 Application of Payment Dae
Grantee agrees that any payments due under this Contract will be applied towards any debt of
Grantee, including but not limited to delinquent taxes and child support that is owed to the State
of Texas.
2.06 Use of Funds
Grantee shall expend funds provided mnder this Contract only for the provision of approved
services and for reasonable and allowable expenses directly related to those services.
2.07 Use for Match Prohibited
Grantee shall not use fiends provided under this Contract for nnatching purposes Ln securing other
frulding without the written approval of the System Agency.
2.08 Program Income
Income directly generated from funds provided under this Contract or eared only as a result of
such fiends is Program Income. Unless otherwise required under the Program, Grantee shall use
the addition alternative, as provided in UGMS § _.25(g)(2), for the use of Project income to
flether the Program, and Grantee shall spend the Program Intone on the Project. Grantee shall
identify and report this income in accordance with the Contract, applicable law, and any
programmnatic guidance. Grantee shall expend Program Income during the Contract tenn and
may not carry Program Income forward to any succeeding tern. Grantee shall refund progrann
income to the System Agency if line Program Income is not expended in the temp in which it is
earned. The System Agency may base fature funding levels, in part, upon Grantee's proficiency
in identifying, billing, collecting, and reporting Program Income, and in using it for the purposes
and under the conditions specified in this Contract.
Grantee Unifonn Terms and Conditions
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2.09 Nonsupplanting
Grantee shall not use funds from this Contract to replace or substitute for existing finding from
other but shall use funds front this Contract to supplement existing state or local finds currently
available. Grantee shall make a good faith effort to maintain its current level of support.
Grantee may be required to submit documentation substantiating that a reduction in state or local
binding, if any, resulted for reasons other than receipt or expected receipt of funding under this
Contract.
ARTICLE III. STATE AND FEDERAL. FUNDING
3.01 Funding
This Contract is contingent Upon the availability of sufficient and adequate funds. If finds
become unavailable through lack of appropriations, budget cats, transfer of funds between
programs or agencies, amendment of the Texas General Appropriations Act, agency
consolidation, or any other disruptions of current funding for this Contract, the System Agency
may restrict, reduce, or temninate finding under this Contract. This Contract is also subject to
immediate cancellation or tennination, without penalty to the System Agency, if sufficient and
adequate fitnds are not available. Grantee will have no right of action against the System Agency
if the System Agency cannot perform its obligations under this Contract as a result of lack of
funding for any activities or functions contained within the scope of this Contract. In the event of
cancellation or termination Under this Section, the System Agency will not be required to give
notice and will not be liable for any damages or losses caused or associated with such
termination or cancellation.
3.02 No debt Against the State
The Contract will not be construed as creating any debt by or on behalf of the State of Texas,
3.03 Debt to State
If a payment law prohibits the Texas Comptroller of Public Accounts from making a payment,
the Grantee acknowledges the System Agency's payments under the Contract will be applied
toward eliminating the debt or delinquency. This requirement specifically applies to any debt or
delinquency, regardless of when it arises.
3.04 Recapture of Funds -
The System Agency may withhold all or part of any payments to Grantee to offset overpayments
made to the Grantee. Overpayments as used ht this Section include payments (i) made by the
System Agency that exceed the nnaxirnum allowable rates; (u) that are not allowed under applicable
laws, rules, or regulations; or (iii) that are otherwise inconsistent with this Contract, including any
unapproved expenditures. Cnantee understands and agrees that it will be liable to the System
Agency for any costs disallowed pursuant to financial and compliance audit(s) of fiords received
under this Contract. Grantee further understands and agrees that reimbursement of such
disallowed costs will be paid by Grantee from funds which were not provided or otherwise made
available to Grantee tinder this Contract.
Grantee Uniform Terms and Conditions
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ARTICLE IV ALLOWABLE COSTS AND AUDIT REQUIREMENTS
4.01 Allowable Costs.
System Agency will reimburse the allowable costs incurred in performing the Project that are
sufficiently documented. Grantee must have incurred a cost prior to claiming rei nbumenua t and
within the applicable tear to be eligible for reimbursement under this Contract. The System
Agency will determine whether costs submitted by Grantee are allowable and eligible for
reimbursement. If the System Agency has paid favids to Grantee for unallowable or ineligible
costs, the System Agency will notify Grantee in writing, and Grantee shall return the funds to the
System Agency within thirty (30) calendar days of the date of this written notice. The System
Agency may withhold all or part of any payments to Grantee to offset rehnbrusement for any
unallowable or ineligible expenditure that Grantee has not refunded to the System Agency, or if
financial status report(s) required under the Financial Status Reports section are not submitted by
the due date(s). The System Agency may take repayment (recoup) from fiords available under
this Contract in amounts necessary to fulfill Grantee's repayment obligations. Applicable cost
principles, audit requirements, mid administrative requirements include -
Applicable Entity
Applicable Cost
Audit
Administrative
Principles
Requirements
Requirements
State, Local and
2 CFR, Part 225
2 CFR Part 200,
2 CFR Part 200 and
Tribal Governments
Subpart F and
UGMS
UGMS
Educational
2 CFR, Part 220
2 CFR Part 200,
2 CFR Part 200 and
Institutions
Subpart F mrd
UGMS
UGMS
Non -Profit
2 CPR, Part 230
2 CFR Part 200,
2 CFR Part 200 and
Organizations
Subpart F mrd
UGMS
UGMS
For-profit
48 CFR Part 31,
2 CFR Part 200,
2 CFR Part 200 and
Organization other
Contract Cost
Subpart F and
UGMS
than a hospital mid an
Principles
UGMS
organization named in
Procedures, or
OMS Circular A-122
uniform cost
(2 CFR Part, 230) as
accounting
not subject to that
standards that
circular
comply with cost
principles
acceptable to the
federal or state
awarding agency
Grantee Uniform Terms and Conditions
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2017 HURRICANE PUBLIC DEALT 11 CRISIS RESPONSE COOPERATIVE AGREEMENT GRANT
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OMB Circulars will be applied with the modifications prescribed by UGMS with effect given to
whichever provision imposes the more stringent requirement ih the event of a conflict.
4.02 Independent Single or Program -Specific Audit
if Grantee, within Grantee's fiscal year, expends a total amount of at least SEVEN HUNDRED
FIFTY THOUSAND DOLLARS ($750,000) in federal fiords awarded, Grantee shall have a
single audit or program -specific audit in accordance with 2 CFR 200. The $750,000 federal
threshold amount includes federal Rinds passed through by way of state agency awards. If
Grantee, within Grantee's fiscal year, expends a total amount of at least $750,000 in state fiords
awarded, Grantee must have a single audit or program -specific audit in accordance with UGMS,
State of Texas Single Audit Circular. The audit must be conducted by an independent certified
public accountant and in accordance with 2 CFR 200, Government Auditing Standards, and
UGMS. For-profit Grantees whose expenditures meet or exceed the federal or state expenditure
thresholds stated above shall follow the guidelines in 2 CFR 200 or UGMS, as applicable, for
their program -specific audits. HHSC Single Audit Services will notify Grantee to complete the
Single Audit Determination Form. If Grantee fails to complete the Single Audit Determination
Form within thirty (30) calendar days after notification by HHSC Single Audit Services to do so,
Grantee shall be subject to the System Agency sanctions and remedies for non-compliance with
this Contract. Each Grantee that is required to obtain a single audit must competitively re -
procure single audit services once every six years. Grantee shall procure audit services in
compliance with this section, state procurement procedures, as well as with One provisions of
UGMS.
4.03 Submission of Audit
Due the earlier of 30 days after receipt of the independent certified public accountant's report or
nine months after the end of the fiscal year, Grantee shall submit electronically, one copy of the
Single Audit or Program -Specific Audit to the System Agency as directed in this Contract and
another copy to: single_ audit_repoti@hhsc.state.tx.us
ARTICLE V AFFIRMATIONS, ASSURANCES AND CERTIFICATIONS
5.01 General Affirmations
Grantee certifies that, to the extent General Affirmations are incorporated into the Contract under
the Signature Document, the General Affimmtions have been reviewed and that Grantee is in
compliance with each of the requirements reflected therein.
5.02 Federal Assurances
Grantee further certifies that, to the extent Federal Assurances are incorporated into the Contract
under the Signature Document, the Federal Assurances have been reviewed and that Grantee is
in compliance with each of the requirements reflected therein.
5.03 Federal Certifications
Grantee finther certifies, to the extent Federal Certifications are incorporated into the Contract
under the Signature Document, that the Federal Certifications have been reviewed, and that
Grantee is is compliance with each of the requirements reflected therein. In addition, Grantee
certifies that it is in compliance with all applicable federal laws, rules, or regulations, as they
may pertain to this Contract.
Grantee Uniform Terms and Conditions
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ARTICLE VI OWNERSHIP AND INTELLECTUAL PROPERTY
6.01 Ownership
The System Agency will own, and Grantee hereby assigns to the System Agency, all right, title,
and interest in all Deliverables.
6.02 Intellectual Property
a. The System Agency and Grantee will retain ownership, all rights, title, and interest in and to,
their respective pre-existing intellectual Property. A license to either Party's pre-existing
Intellectual Property must be agreed to under this or another contract.
h. Grantee grants to the System Agency and the State of Texas a royalty -free, paid up,
worldwide, perpetual, non-exclusive, non -transferable license to use any Intellectual Property
invented or created by Grantee, Grantee's contractor, or a subcontractor in the performance of
the Project. Grantee will require its contractors to grant such a license under its contracts.
ARTICLE VII RECORDS, AUDIT, AND DISCLOSURE
7.01 Books and Records
Grantee will keep and maintain Under GAAP or GASB, as applicable, full, true, and complete
records necessary to fully disclose to the System Agency, the Texas State Auditor's Office, the
United States Goverment, and their authorized representatives sufficient information to
determine compliance with the terms and conditions of this Contract and all state and federal
rules, regulations, and statutes. Unless otherwise specified in this Contract, Grantee will
maintain legible copies of this Contract and all related documents for a minimum of seven (7)
years after the termination of the contract period or seven (7) years after the completion of any
litigation or dispute involving the Contract, whichever is later.
7.02 Access to records, books, and documents
III addition to any right of access arising by operation of law, Grantee and any of Grantee's
affiliate or subsidiary organizations, or Subcontractors will permit fire System Agency or any of
its duly authorized representatives, as well as duly authorized federal, state or local authorities,
unrestricted access to and the right to examine any site where business is conducted or Services
are performed, and all records, which includes but is not limited to financial, client mrd patient
records, books, papers or documents related to this Contract. If the Contract includes federal
finds, federal agencies that will have a right of access to records as described in this section
include: the federal agency providing the finds, the Comptroller General of the United States,
the General Accounting Office, the Office of the Inspector General, mrd any of their authorized
representatives. In addition, agencies of the State of Texas that will have a right of access to
records as described in this section include: the System Agency, HHSC, HHSC's contracted
examiners, the State Auditor's Office, the Texas Attorney General's Office, mrd. any successor
agencies. Each of these entities may be a duly authorized authority. If deemed necessary by the
System Agency or any duly authorized authority, for the purpose of investigation or herring,
Grantee will produce original documents related to this Contract. The System Agency mid any
duly authorized authority will have the right to audit billings both before and after payment, and
all documentation that substantiates the billings. Grantee will include this provision contemning
Grantee Uniform Terms and Conditions
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the right of access to, and examination of, sites and information related to this Contract in any
Subcontract it awards.
7.03 Response/compliancewith audit or inspection findings
a. Grantee most act to ensure its and its Subcontractor's compliance with all corrections
necessary to address any finding of noncompliance with any law, regulation, audit
requirement, or generally accepted accounting principle, or any other deficiency identified in
any audit, review, or inspection of the Contract and the goods or services provided
hereunder. Any such connaction will be at Grantee or its Subcontractor's sole expense.
Whether Grantee's action corrects the noncompliance will be solely the decision of the
System Agency.
b. As part of the Services, Grantee must provide to HHSC upon request a copy of those portions
of Grantee's and its Subcontractors' internal audit reports relating to the Services and
Deliverables provided to the State under the Contract.
7.04 SAO Audit
Grantee understands that acceptance of funds directly under the Contract or indirectly through a
Subcontract under the Contract acts as acceptance of the authority of the State Auditor's Office
(SAO), or any successor agency, to conduct an audit or investigation in connection with those
funds. Under the direction of the legislative audit committee, an entity that is the subject of an
audit or investigation by the SAO most provide the SAO with access to any information the SAO
considers relevant to the investigation or audit. Grantee agrees to cooperate fully with the SAO
or its successor in the conduct of the audit or investigation, including providing all records
requested. Grantee will ensure that this clause concerning the authority to audit funds received
indirectly by Subcontractors through Grantee and the requirement to cooperate is included in any
Subcontract it awards.
7.05 Confidentiality
Any specific confidentiality agreement between the Parties takes precedent over the terns of this
section. To the extent permitted by law, Grantee agrees to keep all information confidential, in
whatever foram produced, prepared, observed, or received by Grantee. The provisions of this
section remain in full force and effect following termination or cessation of the services
performed under this Contract.
7.06 Public Information Act
Information related to the performance of this Contract may be subject to the PIA and will be
withheld from public disclosure or released oily in accordance therewith. Grantee must make all
information not otherwise excepted from disclosure under the PIA available in portable
document file (".pdf') formal or any other format agreed between the Parties.
ARTICLE VIII CONTRACT MANAGEMENT AND EARLY TERMINATION
8.01 Contract Management
To ensure full performance of the Contract and compliance with applicable law, the System
Agency may take actions including:
a. Suspending all or part ofthe Contract;
Grantee Uniform Terms and Conditions
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b. Requiring the Grantee to take specific corrective actions ht order to remain in compliance
with term ofthe Contract;
c. Recouping payments made to the Grantee found to be in error;
d. Suspending, limiting, or placing conditions on the continued performance of the Project;
e. Imposing any other remedies authorized under this Contract; and
f. imposing any other remedies, sanctions or penalties permitted by federal or state statute, law,
regulation, or role.
8.02 Termination for Convenience
The System Agency may terminate the Contract at any time when, in its sole discretion, the
System Agency determines that termination is in the best interests of the State of Texas. The
termination will be effective on the date specified in HHSC's notice of termination.
8.03 Termination for Cause
Except as otherwise provided by the U.S. Bankruptcy Code, or any successor law, the System
Agency may terminate the Contract, in whole or in part, upon either of the following conditions:
a. Material Breach
The System Agency will have the right to terminate the Contract in whole or in part if the
System Agency determines, at its sole discretion, that Grantee has materially breached the
Contract or has failed to adhere to any laws, ordinances, rules, regulations or orders of any public
authority having jurisdiction and such violation prevents or substantially impairs performance of
Grantee's duties under the Contract. Grantee's misrepresentation in any aspect of Grantee's
Solicitation Response, if any or Grantee's addition to the Excluded Parties List System (EPLS)
will also constitute a material breach of the Contract.
b. Failure to Maintain Financial Viability
The System Agency may terminate the Contract if, in its sole discretion, the System Agency has
a good faith belief that Grantee no longer maintains the financial viability required to complete
the Services and Deliverables, or otherwise fully perform its responsibilities under the Contract.
8.04 Equitable Settlement
Any early termination under this Article will be subject to the equitable settlement of the
respective interests of the Parties up to the date of termination.
ARTICLE IX MISCELLANEOUS PROVISIONS
9.01 Amendment
The Contract may only be amended by an Amendment executed by both Parties.
9.02 Insurance
Unless otherwise specified in this Contract, Grantee will acquire and maintain, for the duration of
this Contract, insurance coverage necessary to ensure proper fulfillment of this Contract and
potential liabilities thereunder with financially sound and reputable insurers licensed by the
Texas Department of Insurance, in the type and amount customarily carried within the industry
as determined by the System Agency. Grantee will provide evidence of insurance as required
Grantee Uniform Terms and Conditions
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tinder this Contract, including a schedule of coverage or underwriter's schedules establishing to
the satisfaction of the System Agency the nature and extent of coverage granted by each Such
policy, Upon request by One System Agency. In the event that any policy is determined by the
System Agency to be deficient to comply with the terns of this Contract, Grantee will secure
such additional policies or coverage as the System Agency may reasonably request or that are
required by law or regulation. If coverage expires during the tern of this Contract, Grantee must
produce renewal certificates for each type of coverage.
These and all other insurance requirements under the Contract apply to both Grantee and its
Subcontractors, if any. Grantee is responsible for ensuring its Subcontractors' compliance with all
requirements.
9.03 Legal Obligations
Grantee will comply with all applicable federal, state, and local laws, ordinances, and
regulations, including all federal and state accessibihly laws relating to direct and indirect use of
information and communication technology. Grantee will be deemed to have knowledge of all
applicable laws and regulations and be deemed to understand them. In addition to any other act
or omission that may constitute a material breach of the Contract, failure to comply with this
Section may also be a material breach ofthc Contract.
9.04 Peranitting and Licensure
At Grantee's sole expense, Grantee will procure and maintain for the druation of this Contract
any state, comity, city, or federal license, authorization, insurance, waiver, permit, qualification
or certification required by statute, ordinance, law, or regulation to be held by Grantee to provide
the goods or Services required by Oris Contract. Grantee will be responsible for payment of all
taxes, assessments, fees, premiums, permits, and licenses required by law. Grantee agrees to be
responsible for payment of any such government obligations not paid by its contactors or
subcontractors during performance of this Contract.
9.05 Imlemmity
TO THE EXTENT ALLOWED RY LAW, GRANTEE WILL DEFEND, INDEMNIFY, AND HOLD
HARMLESS THE STATE OF TEXAS AND ITS OFFICERS AND EMPLOYEES, AND THE SYSTEM
AGENCY AND ITS OFFICERS AND EMPLOYEES, FROM AND AGAINST ALL CLAIMS, ACTIONS,
SUITS, DEMANDS, PROCEEDINGS, COSTS, DAMAGES, AND LIABILITIES, INCLUDING ATTORNEYS'
FEES AND COURT COSTS ARISING OUT OF, OR CONNECTED WITH, OR RESUL'T'ING FROM:
a. GRANTEE'S PERFORMANCE OF THE CONTRACT, INCLUDING ANY NEGLIGENT ACTS OR
OMISSIONS OF GRANTEE, OR ANY AGENT, EMPLOYEE, SUBCONTRACTOR, OR SUPPLIER OF
GRANTEE, OR ANY THIRD PARTY UNDER THE CONTROL OR SUPERVISION OF GRANTEE, IN
THE EXECUTION OR PERFORMANCE OF THIS CONTRACT; OR
h. ANY BREACH OR VIOLATION OF A STATUTE, ORDINANCE, GOVERNMENTAL REGULATION,
STANDARD, RULE, OR BREACH OF CONTRACT BY GRANTEE, ANY AGENT, EMPLOYEE,
SUBCONTRACTOR, OR SUPPLIER OF GRANTEE, OR ANY THIRD PARTY UNDER THE CONTROL
OR SUPERVISION OF GRANTEE, IN THE EXECUTION OR PERFORMANCE OF THIS CONTRACT;
OR
C. EMPLOYMENT OR ALLEGED EMPLOYMENT, INCLUDING CLAIMS OF DISCRIMINATION
AGAINST GRANTEE, ITS OFFICERS, OR ITS AGENTS; OR
Grantee Uniform Tenns and Conditions
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2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOPERATIVE AGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
d. WORK UNDER THIS CONTRACT THAT INFRINGES OR MISAPPROPRIATES ANY RIGHT OF ANY
THIRD PERSON OR ENTITY BASED ON COPYRIGHT, PATENT, TRADE SECRET, OR OTHER
INTELLECTUAL PROPERTY RIGHTS.
GRANTEE WILL COORDINATE I'T'S DEFENSE WITH THE SYSTEM AGENCY AND ITS COUNSEL.
THIS PARAGRAPH 1S NOT INTENDED TO AND WILL NOT BE CONSTRUED TO REQUIRE GRANTEE
TO INDEMNIFY OR HOLD HARMLESS THE STATE OR THE SYSTEM AGENCY FOR ANY CLAIMS OR
LIABILITIES RESULTING SOLELY FROM THE GROSS NEGLIGENCE OF THE SYSTEM AGENCY OR
ITS EMPLOYEES. THE PROVISIONS OF THIS SECTION WILL SURVIVE TERAIINATION OF THIS
CONTRACT.
9.06 Assigmmrrents
Grantee may not assign all or any portion of its rights Bader, interests in, or duties required under
this Contract without prior written consent of the System Agency, which may be withheld or
granted at the sale discretion of the System Agency. Except where otherwise agreed in writing
by the System Agency, assignment will not release Grantee from its obligations under the
Contract.
Gratrtee understands and agrees the System Agency may in one or more transactions assign,
pledge, or transfer the Contract. This assignment will only be made to another State agency or a
non -state agency that is contracted to perform agency support.
9.07 Relationship of the Parties
Grantee is, and will be, as independent contractor and, subject only to the terms of this Contract,
will have the sole right to supervise, manage, operate, control, and direct performance of the
details incident to its duties under this Contract. Nothing contained in this Contract will be
deemed or construed to create a partnership or joint venture, to create relationships of an
employer-employee or principal -agent, or to otherwise create for the System Agency any
liability whatsoever with respect to the indebtedness, liabilities, and obligations of Grantee or
any other Party.
Grantee will be solely responsible for, mid the System Agency will have no obligation with
respect to:
a. Payment of Grantee's employees for all Services performed;
b. Ensuring each of its employees, agents, or Subcontractors who provide Services or
Deliverables under the Contract are properly licensed, certified, or have proper permits to
perform any activity related to the Work;
c. Withholding of income taxes, FICA, or any other taxes or fees;
d, Industrial or workers' compensation insurance coverage;
e. Participation in any group insurance plans available to employees of the Stale of Texas;
f Participation or contributions by the State to the State Employees Retirement System;
g. Accumulation of vacation leave or sick leave; or
Ira. Unemployment compensation coverage provided by the State.
9.08 Technical Guidance Letters
In the sole discretion of the System Agency, and in conformance with federal mid state law, the
System Agency may issue instructions, clarifications, or interpretations as may be required
during Work performance in the form of a Technical Guidance Letter. A TGL must be in
Grantee Uniform Terms and Conditions
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2017 HUmHCANE PUBLIC HEALTH CRISIS RESPONSE COOPERATIVE AGREEMENT GRANT
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writing, and may be delivered by regular snail electronic mail or facsimile transmission. Any
TGL issued by the System Agency will be incorporated into the Contract by reference herein for
all purposes when it is issued.
9.09 Governing Law and Venue
This Contract and the rights and obligations of the Patties hereto will be governed by, and
construed according to, the laws of the State of 'Texas, exclusive of conflicts of law provisions.
Venue of any suit brought under this Contract will be in a court of competent jurisdiction in
Travis County, Texas unless otherwise elected by the System Agency. Grantee irrevocably
waives any objection, including any objection to personal jurisdiction or the laying of venue or
based on the grounds of forum non conveniens, which it may now or hereafter have to the
bringing of my action or proceeding in such jurisdiction in respect of this Contract or any
document related hereto.
9.10 Severability
If any provision contained in this Contract is held to be unenforceable by a court of law or
equity, this Contract will be construed as if such provision did not exist and the non -
enforceability of such provision will not be held to render any other provision or provisions of
this Contract unenforceable.
9.11 Survivability
Termination or expiration of this Contract or a Contract for any reason will not release either
patty from my liabilities or obligations in this Contract that the parties have expressly agreed
will survive any such termination or expiration, remain to be performed, or by their nature would
be untended to be applicable following may such termination or expiration, including maintaining
confidentiality of information and records retention.
9.12 Force Majeure
Except with respect to the obligation of payments under this Contract, if either of the Parties,
after a good faith effort, is prevented front complying with any express or implied covenant of
this Contract by reason of war; terrorism; rebellion; riots; strikes; acts of God; any valid order,
role, or regulation of govermnental authority; or similar events that are beyond the control of the
affected Party (collectively referred to as a "Force Majeure), then, while so prevented, the
affected Party's obligation to comply with such covenant will be suspended, mid the affected
Party will not be liable for damages for failure to comply with such covenant. Int any such event,
tine Party claiming Force Majeure will promptly notify the other Party of the Force Majeure
event in writing and, if possible, such notice will set forth the extent mud duration thereof.
9.13 No Waiver of Provisions
Neither failure to enforce any provision of this Contract nor payment for services provided under
it constitute waiver of any provision of the Contract.
9.14 Publicity
Except as provided in the paragraph below, Grantee must not use the name of, or directly or
indirectly refer to, the System Agency, the State of Texas, or any other State agency in any
media release, public announcement, or public disclosure relating to the Contract or its subject
Grantee Uniform Terms and Conditions
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System Agency Contract No. HHS000371500003 Under the Page 25 of 62
2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOPERATIVE AGREEMENT GRANT
DocuSlgn Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
matter, including in any promotional or marketing materials, customer lists, or business
presentations.
Grantee may publish, at its sole expense, results of Grantee performance under the Contract with
the System Agency's prior review and approval, which the System Agency may exercise at its
sole discretion. Any publication (written, visual, or sound) will acknowledge thesupport
received from the System Agency mid any Federal agency, as appropriate.
9.15 Prohibitimr on Non -compete Restrictions
Grantee will not require any employees or Subcontractors to agree to any conditions, such as
non -compete clauses or other contractual arrangements that would limit or restrict such persons
or entities from employment or contracting with the State of Texas.
9.16 No Waiver of Sovereign Immunity
Nothing in the Contract will be construed as a waiver of sovereign immunity by the System
Agency.
9.17 Entire Contract and Modification
The Contract constitutes the entire agreement of the Parties and is intended as a complete and
exclusive statement of the promises, representations, negotiations, discussions, and other
agreements that may have been made in connection with the subject matter hereof. Any
additional or conflicting terns in any future document incorporated into the Contract will be
harmonized with this Contract to the extent possible by the System Agency.
9.18 Counterparts
This Contract may be executed in any number of counterparts, each of which will be an original,
and all such counterparts will together constitute but one and the same Contract.
9.19 Proper Authority
Each Party hereto represents and warrants that One person executing this Contract on its behalf
has full power and authority to enter into this Contract. Any Services or Work performed by
Graintee before this Contract is effective or after it ceases to be effective are performed at the sole
risk of Grantee with respect to compensation.
9.20 Employment Verification
Grantee will conform the eligibility of all persons employed during One contract term to perform
duties within Texas and all persons, including subcontractors, assigned by the contractor to
perform work pursuant to the Contract.
9.21 Civil Rights
a. Grantee agrees to comply with state and federal anti-discrinimation laws, including:
1. Title VI of the Civil Rights Act of 1964 (42 U.S.C. §2000d et seq.);
2. Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. §794);
3. Americans with Disabilities Act of 1990 (42 U.S.C. §12101 et seq.);
4. Age Discrimination Act of 1975 (42 U.S.C. §§6101-6107);
5. Title IX of the Education Amendments of 1972 (20 U.S.C. §§1681-1688);
6. Food mud Nutrition Act of 2008 (7 U.S.C. §2011 et seq.); mid
Grantee Uniform Terms and Conditions
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7. The System Agency's administrative rules, as set forth in the Texas Administrative Code,
to the extent applicable to this Agreement.
Grantee agrees to comply with all amendments to the above -referenced laws, and all
requirements imposed by the regulations issued pursuantto these laws. These laws provide in
part that no persons in the United States may, on the grounds of race, color, national origin,
sex, age, disability, political beliefs, or religion, be excluded from participation in or denied
any aid, care, service or other benefits provided by Federal or State funding, or otherwise be
subjected to discrimination.
b. Grantee agrees to comply with Title VI of the Civil Rights Act of 1964, and its implementing
regulations at 45 C.F.R. Part 80 or 7 C.F.R. Part 15, prohibiting a contractor from adopting
and implementing policies and procedures that exclude or have the effect of excluding or
limiting the participation of clients in its programs, benefits, or activities on the basis of
national origin. State and federal civil rights laws require contractors to provide alternative
methods for ensuring access to services for applicants and recipients who cannot express
themselves fluently in English. Grantee agrees to take reasonable steps to provide services
and information, both orally and in writing, in appropriate languages other than English, in
order to ensure that persons with limited English proficiency are effectively informed and
can have meaningful access to programs, benefits, and activities.
c. Grantee agrees to post applicable civil rights posters in areas open to the public informing
clients of their civil rights and including contact information for the HHS Civil Rights Office.
The posters are available onthe HHS website at: litti)�//hbsex hhsc texas aov/system-support-
servi ces/civil-rights/publications
d. Grantee agrees to comply with Executive Oder 13279, and its implementing regulations at
45 C.F.R. Part 87 or 7 C.F.R. Part 16. Tllese provide in part that any organization that
participates in programs fimded by direct financial assistance from the United States
Department of Agriculture or the United States Department of Health and Human Services
shall not discriminate against a program beneficiary or prospective program beneficiary on
the basis of religion or religious belief.
e. Upon request, Grantee will provide HHSC Civil Rights Office with copies of all of the
Grantee's civil rights policies and procedures.
f Grantee must notify HHSC's Civil Rights Office of any civil rights complaints received
relating to its performance Under this Agreement. 'Ibis notice must be delivered no more than
ten (10) calendar days after receipt of a complaint. Notice provided pursuant to this section
must be directed to:
HHSC Civil Rights Office
701 W. 51't Street, Mail Code W206
Austin, Texas 78751
Phone Toll Free: (888) 388-6332
Phone: (512) 438-4313
Grantee Uniform Terms and Conditions
Page 18 of 19
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System Agency Contract No. IIHS000371500003 Under the Page 27 of 62
2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOPERATIVE AGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-9386FE88CD7D
TTY Toll Free: (877) 432-7232
Fax: (512) 438-5885.
Grantee Uniform Terms and Conditions
Page 19 of 19
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2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOPERA'PIVE AGREEMENT GRANT
DocuSlgn Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
ATTACHMENT D
CONTRACT AFFIRMATIONS
By entering into this Contract, Contractor affirms, without exception, as follows:
1, 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 provide services under, who have. a financial interest in,. or othenvise are
interested in this Contract and auyrelated Solicitation -
2. Contractor represents and warrants that all statements and information provided to HHSC
are current complete, and accurate. This includes all statements and information in this
Contract and any related Solicitation Response.
3. Contractor understands that HHSC will comply with the Texas Public Information Act
,(Chapter 552 of the Texas Government Code) as interpreted by judicial ndings and
opinions of the Attorney General of the State of Texas. Information, documentation, and
other material prepared and submitted in connection with this Contract or any related
Solicitation may be subject to public disclosure pursuant to the Texas Public Information.
Act. In accordance with Section 2252.907 of the Texas Government Code, Contractor is
required to make any information created or exchanged with the State pursuant to the
Contract, and not otherwise excepted from disclosure under the Texas Public Information
Act; available in a format that is accessible by the public at no additional charge to the
State.
4, Contractor accepts the Solicitation terms and conditions unless specifically noted by
exceptions advanced in the form and manner directed in the Solicitation, if any, under
which this Contract was awarded, Contractoragreesthat all exceptions to the Solicitation,
if any, are rejected unless expressly accepted by HHSC in nritnmg.
5. Contractor agrees that HHSC has the right to use, produce, and distribute copies of and to
disclose to HHSC employees, agents, and contractors and other governmental entities all
or part of this Contract or any related Solicitation Response as HHSC deems necessary to
complete the procurement process or comply with state or federal laws..
6. Contractor generally releases from liability and waives all claims against any party
providing information about the Contractor at the request of HHSC.
'7. Contractor has not given, has.. not offered to give, and does not intend to, give at any time
discount trip, favor, or senice to a public servant in comiection with this Contract or any.
related Solicitation, or related: Solicitation Response.:
S. Under Section 2155,004, Texas Government Code (relating to financial participation in
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System Agency Contract No. HUS000371500003 Under the Page 29 of 62
2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOPERATIVE AGREEMENT GRANT
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Contract and acknowledges that this Contract may he terminated and payment withheld if
this certification isinaccurate.
-9. Under Sections 2155.006 and 2261.033 of the Tems Government Code_(relating to
convictions and penalties regarding Hurricane Rita. Hurricane Katrina, and other
disasters), the Contractor certifies that the individual or business entity named in this
Contract and any related Solicitation Response is not ineligible to receive this Contract
and acknowledges that this Contract may be terminated and payment withheld if this
"certification is inaccurate.
10: Under Section 231.006(d),of the Texas Family Code regarding child support,: Contractor
certifies that the individual orbusiness entity named in this Contract and any related
Solicitation Response is not ineligible to receive the specified payment and acknowledges
that the Contract may be terminated and payment may be withheld if this certification is
inaccurate.
11. Contractor certifies that it and its principals are not suspended or debarred from doing
business with the state or federal government as listed on the State of Texas Debarred
Vendor List maintained by the Texas Comptroller of Public Accounts and the System for
Alvard 11hriagement (M14 maintained by the General Services Administration. This
certification is made purmaut to the regulations implementing Executive Order 12549
and Executive Order 126$9; Debarment and Suspension, 2 C.F.R Part 376, and any
relevant regulationspromulgated by the Department or Agency funding this project This
provision shall be included in its entirety in Contractor'a subcontracts,if airy, if payment
in whole or in part. is from federal funds.
12. Contractor certifies that it is not listed on the federal government'sterrorisrn watch list as
described in Executive Order 13224.
13. Contractor represents and warrants that it is not engaged in business with Iran, Sudan, or
a foreign terrorist organization, as prohibited by Section 2252.152 ofthe Texas
Government Code.
14. In accordance with Section 669.003 of the Texas Governmeut Code, relating to
contracting with the executive head of a state agency, Contractor certifies that it is not (1)
the executive head of an HHS agency, (2) a person who at any time during the four years.
before the date of this Contract was the executive head of an HITS. agency, or (3) a person
who employs a current or former executive head of an HHS agency.
15,Contractor represents and warrants that. it is not currently delinquent in the payment of
any franchise taxes owed the State of Texas under Chapter 171 of the Teras Tax Code.
16. Contractor agrees that any payments due under this Contract shall be, applied towards any
debt or delinquency that is orved to the State of Texas.
17. Contractor represents and warrants that payments to Contractor and Contractor's receipt
of appropriated or other funds under this Contract or my related Solicitation are not
prohibited by Sections 556.005, 55 6.0055, or 556.003 of the Texas Government Code
(relating to use of appropriated money or state funds to employ or pay lobbyists, lobbying
V. L3
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18. Contractor agrees to comply with Section 2155.4") of the Texas Government. Code,
requiring the purchase of products and materials produced in the State of Texas is
performing service contracts.
19. Contractor agrees that. upon request of HHSC,'Contractor shall provide copies of its most
recent business continuity and disasterrecoveryy plans.
20. Contractor expressly acknowledges that state funds may not be expended in connection
withthepurchase of an automated information system unless that system meets certain
statutory requirements relating to accessibility by persons with visual impairments.
Accordingly, Contractor represents and warrants to HHSC that the technology provided
to HHSC for purchase (if applicable under this Contractor any related Solicitation) is
capable, either by virtue of features included within the technology or because it is
readily adaptable by use x6th.other technology, of.-
-
£• providing equivalent access for effective use by both visual and non -visual
means'
•.presenting information, including prompts used for interactive communications,
in formats intended for non -visual use-, and
. being integrated into networks for obtaining, retrieving; and disseminating
information used by individuals who are not blind or visually impaired.
For purposes ofthis Section, the phrase "equivalent access" means a substantially similar
ability to communicate with or make use of the technology, either directly by features
incorporated within the technology or by other reasonable means such as assistive
devices or services which would constitute reasonable accommodations under the
Americans With Disabilities Act or similar state or federal laws. Examples of methods by
whichequivalent access may provided include, but are not limited to, keyboard
alternatives to mouse commands and other means of navigating graphical displays, acid
customizable display appearance.
In accordance with Section 2157.005 of the Texas Governmeni.Code, the Technology.
Access Clause contract provision remains in effect for any contract entered into before
.September 1; 2006.
21. If this Contract is for the purchase or lease of computer equipment, then Contractor
certifies that it is in compliance with Subchapter 1, Chapter 361 of tine Texas Health and
Safety Code related to the Computer Equipment Recycling Program and the Texas.
Commission on Environmental Quality riles in 30 TAC Chapter :328.
22. If this Contract is for the purchase or lease of covered television equipment then
Contractor certifies that it is compliance with Subchapter. Z. Chapter 361 of the Texas
Health and Safety Code related to the Television Equipment Reeycling Program.
23. Contractor represeats and Warrants, during the twelve (12) month period immediately
prior to the date of the execution of this Contract, none of its employees including, but
not limited to those will provide services under the Contract; was an employee of as HHS
Agency Pursuant to Section 2252.901, Texas Government Code (relating to prohibitions
regarding contracts with and Involving farmer and retired state agency: employees),
Contractor willnot allowanyformer employee ofihe System Agency to perform services
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under this Contract during the twelve (12) month period immediately following the
employee's last dateof employment at the System Agency.
24. Contractor aelmouiedges that, pursuant to Section 572.069 of the Texas Government
Code, a firmer state officer or employee of a state agency who during the period of state
service or employment pachcipated on behalf of a state agency in a procurement or
contract negotiation invoking Contractor may not accept employment from Contractor
before the second anniversary of the date the Contract is signed or the procurement is
terminated or withdtanm.
25, If this Contract is for consulting services under Chapter 2254 ofthe Texas Government
Code, in accordance with Section 2254.033 of the Texas Government Code; Contractor
certifies that it does not employ anindividual who was employed by System Agency or
another agency at any time during the two years preceding the submission of any related
Solicitation Response related to this Contract or, in the alternative, Contractor has
disclosed in any related Solicitation Response the following: (i) the nature of the precious
employment with System Agency or the other agency; (ii):the date the employment was
terminated; and (iii) the annual rate of compensation at the time of the employment was
terminated.
26. Contractor represents and wairantsthat it has no actual or potential conflicts of interest in
providing the requested goods or sen=ices to HHSC under this Contract or any related
Solicitation and that Contractor's provision of the requested goods andtor services under
this Contract and any, related Solicitation tivill not constitute an actual or potential conflict
of interest or reasonably create an appearance ofimpropziety.
27. Contractor understands that HHSC does not tolerate my type of fraud. The agency
policy' is to promote: consistent, legal, and ethical organizational behavior by assigning
responsibilities and providing guidelines to enforce controls. Violations of law, agency
policies, or standards of ethical conduct will be investigated; and appropriate actions will
be taken_ All employees or contractors who suspect fraud, H=aste or abuse (including.
emolovee misconduct that would constitute fraud, waste, or abuse) are required to
Office. Contractor agrees to comply with all :applicable laws, rules, regulations, and
HHSC policies regarding fraud including, but not limited to, HHS Circular.0-027.
28. The undersigned affirms underpenalty of perjury of the laws of the State of Texas that
rat in rnn»crtinn n4h thik t:rintrAct and AItV related Solicitation Response: neither I nor
Enterprise and Antitrust Act Tex, Bus;& Con
with this Contract and any related Solicitation
of the Contractor has Violated any federal antil
representative of the Contractor has directly of
contents of this Contract and any related Solic
Contractor or any other company.. corporation.
the same line of business as the Comractor.
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29. Contractor represents and warrants that it is not aware of and has received no notice of
any court or govenuueutal agency proceeding, investigation, or other action pending or
threatened against Contractor or any ofthe individuals or entities included in numbered
paragraph 1 of these Contract Affirmations within the five (5) calendar years immediately
preceding execution of this Contract or the submission of any related Solicitation
Response that would or could impair Contractor's performance under this Contract, relate
to the contracted or similar goods or services, or otherwise be relevant to HHSC's
consideration of entering into this Contract. If Contractor is unable to make the preceding
representation and warranty, then Contractor indeed represems and warrants that it has
provided to HHSC a complete, detailed disclosure of any such court or governmental
agency proceeding, investigation, or other action that mould or could impair Contractor's
performance under this Contract relate to the contracted or similar goods or services, or
otherwise be relevant to HHSC's consideration of entering into this. Contract. In addition,
Contract"acknotvledges this is a continuing disclosure requirement Contractor
represents and warantsthat Contractor shall notify HHSC in writing within five (5)
business days of any changes to the representations or warranties in this. clause: and
understands -that failure to so timely update HRSC shall constitute breach of contract and
may result in immediatecontract termination.
30. Contractor represents and. warrants that, pursuant to Section 2270.002 of the Texas
Government Code, Contractor does not boycott Israel and will not boycott Israel during
the term of this Contract.
31. Contractor certifies that for contract, for services, Contractor shall utilize the U.S.
Department of Homeland Security's E -Verify system during the term of this Contract to
determine the eligibility of:
(a) all persons employed by Contractor to perform duties within Texas; and
(b) all persons, including subcontractors, assigned by Contractor to perform work
pursuant to this Contract within the United States ofAmerica.
32. Contractor understands; acknowledges, and agrees that any false representation or any
failure to comply with a representation; warranty; or certification made by Contractor is
.subject to all civil and criminal consequences provided at lady or in equity including, but
not limited to, immediate termination of this, Contract
33, Contractor represents and warrants that it will comply with all. applicable laws and
maintain all permits and licenses required by applicable city-, county, state, and federal
rules, regulations, statutes, codes, and other lain that pertain to this Contract
34. Contractor represents and warrants that aO statements and information prepared and.
submitted by Contractor in this. Contract andany related Solicitation Response are
current, complete, true, and accurate. Contractor acknowledges any false statement or
material misrepresentationmade by Contractor during the performance of this Contract
or any related Solicitation is material breach of contract and may void this Contract -
Further,
ontractFurther,. Contractor understands; acknowledges, and agrees that any false representation
or any failure to comply with a representation, warranty; or certification made by
Contractor is subject to all civil and criminall consequences provided at law or in equity
including, but not limited to, immediate termination of this Contract.
e-1.3
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35. Contractor represents and warrants that the individual signing this Contract is authorized
to sign on behalf of Contractor and to bind the Contractor.
Authorized representatke on behalf of Contractor must complete and sign the following:
Legal Name of Contractor. Richard
Signature of Authorized
Representative
Calhoun county judge
Printed Name and Title of
Authorized Representative
74-6001923
Federal Employer Identification
Number
087309324
DINS Number
211 5 Ann St., Stuite 301
Physical Street Address
Mailing Address, if different
¢13
Augmt 2618
Date Signed
361-553-4600
Phone Number
Fax
richard.meyer@calhouncotx.org
Email Address
Port Lavaca, TX 77979
City, State, Zip Code
City, State, Zip Code
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ATTACHMENT E
SUPPLEMENTAL AND SPECIAL CONDITIONS
SUPPLEMENTAL CONDITIONS
There are no Supplemental Conditions for this Contract that modifies this Contract's HHS
Uniform Terms and Conditions.
SPECIAL CONDITIONS
SECTION 1.01 NOTICE OF CONTRACT ACTION
Grantee shall notify their assigned contract manager if Grantee has had any contract suspended or
terminated for cause by any local, state or federal department or agency or nonprofit entity within
five days of becoming aware of the action and include the following:
a. Reason for such action;
b. Name and contact information of the local, state or federal department or agency or
entity;
c. Date of the contract;
d. Date of suspension or termination; and
e. Contract or case reference number.
SECTION 1.02 NOTICE OF CRIMINAL ACTIVITY AND DISCIPLINARY ACTIONS
a. Grantee shall immediately report in writing to their contract manager when Grantee
has Imowledge or any reason to believe that they or any person with ownership or
controlling interest in the organization/business, or their agent, employee, contractor or
volunteer that is providing services under this Contract has:
I. Engaged in any activity that could constitute a criminal offense equal to or greater
than a Class A misdemeanor or grounds for disciplinary action by a state or federal
regulatory authority; or
2. Been placed on community supervision, received deferred adjudication, or been
indicted for or convicted of a criminal offense relating to involvement in any
financial matter, federal or state program or felony sex crime.
b. Grantee shall not permit any person who engaged, or was alleged to have engaged, in
any activity subject to reporting under this section to pet -form direct client services or
have direct contact with clients, unless otherwise directed in writing by the System
Agency.
Section 1.03 Grantee's Notification of Change of Contact Person or Key Personnel
The Grantee shall notify in writing their contract manager assigned within ten days of any change
to the Grantee's Contact Person or Key Personnel.
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SECTION 1.04 DISASTER SERVICES
In the event of a local, state, or federal emergency, including natural, man- made, criminal,
terrorist, and/or bioterrorism events, declared as a state disaster by the Governor, or a federal
disaster by the appropriate federal official, Grantee may be called upon to assist the System
Agency in providing the following services:
a. Community evacuation;
b. Health and medical assistance;
c. Assessment of health and medical needs;
d. Health surveillance;
e. Medical care personnel;
f. Health and medical equipment and supplies;
g. Patient evacuation;
IL In-hospital care and hospital facility status;
L Food, drug and medical device safety;
j. Worker health and safety;
k. Mental health and substance abuse;
1. Public health information;
In. Vector control and veterinary services; and
n. Victim identification and mortuary services.
SECTION 1.05 CONSENT BY NON -PARENT OR OTHER STATE LAw TO MEDICAL CARE OF A
MINOR
Unless a federal law applies, before a Grantee or its contractor can provide medical, dental,
psychological or surgical treatment to a minor without parental consent, informed consent must be
obtained as required by Texas Family Code Chapter 32.
SECTION 1.06 TELEMEDICINE/TELEPSYCHIATRY MEDICAL SERVICES
If Grantee or its Contractor uses telemedicine/telepsychiatry, these services shall be in accordance
with the Grantee's written procedures. Grantee must use a protocol approved by Grantee's medical
director and equipment that complies with the System Agency equipment standards, if applicable.
Grantee's procedures for providing telemedicine service must include the following
requirements:
a. Clinical oversight by Grantee's medical director or designated physician
responsible for medical leadership;
b. Contraindication considerations for telemedicine use;
c. Qualified staff members to ensure the safety of the individual being served by
telemedicine at the remote site;
d. Safeguards to ensure confidentiality and privacy in accordance with state and federal
laws;
C. Use by credentialed licensed providers providing clinical care within the scope of their
licenses;
f. Demonstrated competency in the operations of the system by all staff members who
are involved in the operation of the system and provision of the services prior to
initiating the protocol;
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g. Priority in scheduling the system for clinical care of individuals;
It. Quality oversight and monitoring of satisfaction of the individuals served; and
i. Management of information and documentation for telemedicine services that ensures
timely access to accurate information between the two sites. Telemedicine Medical
Services does not include chemical dependency treatment services provided by
electronic means under 25 Texas Administrative Code Rule § 448.911.
SECTION 1.07 SERVICES AND INFORMATION FOR PERSONS WITH LimITED ENGLISH
PROFICIENCY
a. Grantee shall take reasonable steps to provide services and information both orally
and in writing, in appropriate languages other than English, to ensure that persons
with limited English proficiency are effectively informed and can have meaningful
access to programs, benefits and activities.
b. Grantee shall identify and document on the client records the primary language/dialect
of a client who has limited English proficiency and the need for translation or
interpretation services and shall not require a client to provide or pay for the services
of a translator or interpreter.
c. Grantee shall make every effort to avoid use of any persons under the age of 18 or
any family member or friend of the client as an interpreter for essential
communications with a client with limited English proficiency, unless the client has
requested that person and using the person would not compromise the effectiveness of
services or violate the client's confidentiality and the client is advised that a free
interpreter is available.
SECTION 1.08 THIRD PARTY PAYORS
Except as provided in this Contract, Grantee shall screen all clients and may not bill the System
Agency for services eligible for reimbursement fiom third party payors, who are any person or entity
who has the legal responsibility for paying for all or part of the services provided, including
commercial health or liability insurance carriers, Medicaid, or other federal, state, local and private
funding sources.
As applicable, the Grantee shall:
a. Enroll as a provider in Children's Health Insurance Program and Medicaid if providing
approved services authorized under this Contract that may be covered by those
programs and bill those programs for the covered services;
b. Provide assistance to individuals to enroll in such programs when the screening process
indicates possible eligibility for such programs;
c. Allow clients that are otherwise eligible for System Agency services, but cannot pay a
deductible required by a third party payor, to receive services up to the amount of the
deductible and to bill the System Agency for the deductible;
d. Not bill the System Agency for any set -vices eligible for third party reimbursement until all
appeals to third party payors have been exhausted;
e. Maintain appropriate documentation from the third party payor reflecting
attempts to obtain reimbursement;
f Bill all third party payors for services provided under this Contract before submitting any
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request for reimbursement to System Agency; and
g. Provide third party billing functions at no cost to the client.
SECTION 1.09 HIV/AIDS MODEL WORKPLACE GUIDELINES
Grantee shall implement System Agency's policies based on the Human Immunodeficiency
Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS), AIDS Model Workplace Guidelines
for Businesses at littp://www.dshs,state.tx.us/hivstd/policv/policies.shtili, State Agencies and
State Grantees Policy No. 090.021.
Grantee shall also educate employees and clients concerning HIV and its related conditions,
including AIDS, in accordance with the Texas. Health & Safety Code §§ 85.112-114.
SECTION 1.10 MEDICAL RECORDS RETENTION
Grantee shall retain medical records in accordance with 22 TAC §165.1(b) or other applicable
statutes, rules and regulations governing medical information.
SECTION 1.11 NOTICE OF A LICENSE ACTION
Grantee shall notify their contract manager of any action impacting its license to provide services
under this Contract within five days of becoming aware of the action and include the following:
a. Reason for such action;
b. Name and contact information of the local, state or federal department or agency or
entity;
c. Date of the license action; and
d. License or case reference number.
SECTION 1.12 INTERIM EXTENSION AMENDMENT
a. Prior to or on the expiration date of this Contract, the Parties agree that this Contract
can be extended as provided under this Section.
b. The System Agency shall provide written notice of interim extension amendment to
the Grantee under one of the following circumstances:
1. Continue provision of services in response to a disaster declared by the governor; or
2. To ensure that services are provided to clients without interruption.
c. The System Agency will provide written notice of the interim extension amendment
that specifies the reason for it and period of time for the extension.
d. Grantee will provide and invoice for services in the same manner that is stated in the
Contract.
e. An interim extension under Section (b)(1) above shall extend the term of the contract
not longer than 30 days after governor's disaster declaration is declared unless the
Patties agree to a shorter period of time.
f An interim extension under Section (b)(2) above shall be a one-time extension for
a period of time determined by the System Agency.
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SECTION 1.13 ELECTRONIC AND INFORMATION RESOURCES ACCESSIBILITY AND SECURITY
STANDARDS
a. Applicability:
The following Electronic and Information Resources (EIR) requirements apply to the
Contract because the Grantee performs services that include EIR that the System
Agency's employees are required or permitted to access or members of the public are
required or permitted to access.
This Section does not apply to incidental uses of EIR in the performance of the
Agreement, unless the Parties agree that the EIR will become property of the State of
Texas or will be used by HHSC's clients or recipients after completion of the Agreement.
Nothing in this section is intended to prescribe the use of particular designs or
technologies or to prevent the use of alternative technologies, provided they result in
substantially equivalent or greater access to and use of a Product.
b. Definitions:
"Accessibility Standards" means accessibility standards and specifications for Texas
agency and institution of higher education websites and EIR set forth in 1 TAC Chapter
206 and/or Chapter 213.
"Electronic and Information Resources" means information resources, including
information resources technologies, and any equipment or interconnected system of
equipment that is used in the creation, conversion, duplication, or delivery of data or
information. The term includes telephones and other telecommunications products,
information kiosks, transaction machines, Internet websites, multimedia resources, and
office equipment, including copy machines and fax machines.
"Electronic and Information Resources Accessibility Standards" means the
accessibility standards for electronic and information resources contained in I Texas
Administrative Code Chapter 213.
"Product" means information resources technology that is, or is related to EIR.
"Web Site Accessibility Standards/ Specifications" means standards contained in
Volume 1 Tex. Admin. Code Chapter 206(c) Accessibility Requirements.
Under Tex. Gov't Code Chapter 2054, Subchapter M, and implementing rules of the
Texas Department of Information Resources, the System Agency must procure Products
and services that comply with the Accessibility Standards when those Products are
available in the commercial marketplace or when those Products are developed in
response to a procurement solicitation. Accordingly, Grantee must provide electronic
and information resources and associated Product documentation and technical support
that comply with the Accessibility Standards.
c. Evaluation, Testing, and Monitoring
1. The System Agency may review, test, evaluate and monitor Grantee's Products and
services, as well as associated documentation and technical support for compliance
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with the Accessibility Standards. Review, testing, evaluation and monitoring may be
conducted before and after the award of a contract. Testing and monitoring may
include user acceptance testing. Neither the review, testing (including acceptance
testing), evaluation or monitoring of any Product or service, nor the absence of
review, testing, evaluation or monitoring, will result in a waiver of the State's right to
contest the Grantee's assertion of compliance with the Accessibility Standards.
2. Grantee agrees to cooperate fully and provide the System Agency and its
representatives timely access to Products, records, and other items and
information needed to conduct such review, evaluation, testing, and
monitoring.
d. Representations and Warranties
1. Grantee represents and warrants that:
i. As of the Effective Date of the Contract, the Products and associated
documentation and technical support comply with the Accessibility Standards
as they exist at the time of entering the Agreement, unless and to the extent
the Parties otherwise expressly agree in writing; and
ii. If the Products will be in the custody of the state or a System Agency's client or
recipient after the Contract expiration or termination, the Products will continue
to comply with Accessibility Standards after the expiration or termination of the
Contract Term, unless the System Agency or its clients or recipients, as
applicable, use the Products in a manner that renders it noncompliant.
2. In the event Grantee becomes aware, or is notified that the Product or service
and associated documentation and technical support do not comply with the
Accessibility Standards, Grantee represents and warrants that it will, in a timely
manner and at no cost to the System Agency, perform all necessary steps to
satisfy the Accessibility Standards, including remediation, replacement, and
upgrading of the Product or service, or providing a suitable substitute.
3. Grantee actmowledges and agrees that these representations and warranties
are essential inducements on which the System Agency relies in awarding
this Contract.
4. Grantee's representations and warranties under this subsection will survive the
termination or expiration of the Contract and will remain in full force and effect
throughout the useful life of the Product.
e. Remedies
1. Under Tex. Gov't Code § 2054.465, neither the Grantee nor any other person has
cause of action against the System Agency for a claim of a failure to comply with
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Tex. Gov't Code Chapter 2054, Subchapter M, and rules of the Department of
Information Resources.
2. In the event of a breach of Grantee's representations and warranties, Grantee
will be liable for direct, consequential, indirect, special, or liquidated damages
and any other remedies to which the System Agency may be entitled under this
Contract and other applicable law. This remedy is cumulative of any other
remedies to which the System Agency may be entitled under this Contract and
other applicable law.
SECTION 1.14 CHILD ABUSE REPORTING REQUIREMENT
a. Grantees shall comply with child abuse and neglect reporting requirements in Texas Family
Code Chapter 261. This section is in addition to and does not supersede any other legal
obligation of the Grantee to report child abuse.
b. Grantee shall develop, implement and enforce a written policy that includes at a minimum
the System Agency's Child Abuse Screening, Documenting, and Reporting Policy for
Grantees/Providers and train all staff on reporting requirements.
c. Grantee shall use the System Agency's Child Abuse Reporting Form located at
www.dshs.state.tx.us/cliildabuserep,ottin as required by the System Agency. Grantee
shall retain reporting documentation on site and make it available for inspection by the
System Agency.
SECTION 1.15 GRANTEE'S CERTIFICATION OF MEETING OR EXCEEDING TOBACCO -FREE
WORKPLACE POLICY MINIMUM STANDARDS.
Grantee certifies that it has adopted and enforces a Tobacco -Free Workplace Policy that
meets or exceeds all of the following minimum standards of:
a) Prohibiting the use of all forms of tobacco products, including but not limited to
cigarettes, cigars, pipes, water pipes (hookah), bidis, kreteks, electronic cigarettes,
smokeless tobacco, snuff and chewing tobacco;
b) Designating the property to which this Policy applies as a "designated area," which
must at least comprise all buildings and structures where activities funded under this
Contract are taking place, as well as Grantee owned, leased, or controlled sidewalks,
parking lots, walkways, and attached parking structures immediately adjacent to this
designated area;
c) Applying to all employees and visitors in this designated area; and
d) Providing for or referring its employees to tobacco use cessation services.
If Grantee cannot meet these minimum standards, it must obtain a waiver from the System
Agency.
SECTION 1.16 PROGRAMEQUIPMENT PROGRAM SUPPLIES PROPERTY MANAGEMENT AND
REPORTING.
a. Grantee shall initiate the purchase of all Equipment approved in writing by the System
Agency in the first quarter of the Contract term, as applicable. Failure to timely initiate the
purchase of Equipment may result in the loss of availability of funds for the purchase of
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Equipment. Requests to purchase previously approved Equipment after the first quarter in
the Contract must be submitted to the assigned System Agency contract manager.
b. Controlled Assets include firearms, regardless of the acquisition cost, and the following
assets with an acquisition cost of $500 or more, but less than $5,000: desktop and laptop
computers (including notebooks, tablets and similar devices), non-portable printers and
copiers, emergency management equipment, communication devices and systems, medical
and laboratory equipment, and media equipment. Controlled Assets are considered
Supplies.
c. Grantee shall maintain an inventory of Equipment, supplies defined as Controlled Assets,
and real property and submit an annual cumulative report of the equipment and other
property on HHS System Agency Grantee's Property Inventory Report to the assigned
System Agency contract manager by e-mail not later than October 15 of each year.
d. System Agency funds must not be used to purchase buildings or real property without prior
written approval from the System Agency. Any costs related to the initial acquisition of
the buildings or real property are not allowable without written pre -approval.
e. At the expiration or termination of this Contact for any reason, title to any remaining
equipment and supplies purchased with funds under this Contract reverts to System Agency.
Title may be transferred to any other party designated by System Agency. The System
Agency may, at its option and to the extent allowed by law, transfer the reversionary interest
to such property to Grantee.
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ATTACHMENT F
FEDERAL, ASSURANCES AND LOBBYING FORM
OMB Number: 4040.0007
Expiration Date: 01!312019
ASSURANCES• NON -CONSTRUCTION PROGRAMS
Public reporting burden for this collection of information is estimated to average 15 minutes per response, including time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send comments regarding the burden estimate or any other aspect of this collection of information, Including suggestions for
reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0040), Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET. SEND
IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
NOTE: Certain of these assurances may not be applicable to your projector program. If you have questions, please contact the
awarding agency. Further, certain Federal awarding agencies may require applicants to cer ify to additional assurances.
If such is the case, you will be notified.
As the duly authorized representative of the applicant, I certify that the applicant:
1. Has the legal authority to apply for Federal assistance
and the institutional, managerial and financial capability
(including funds sufficient to pay the non -Federal share
of project cost) to ensure proper planning, management
and completion of the project described in this
application.
2. Will give the awarding agency, the Comptroller General
of the United States and, if appropriate, the State,
through any authorized representative, access to and
the right to examine all records, books, papers, or
documents related to the award; and will establish a
proper accounting system in accordance with generally
accepted accounting standards or agency directives.
3. Wil establish safeguardsto prohibit employeesfrom
using their positions for a purpose that constitutes or
presents the appearance of personal or organizational
conflict of interest, or personal gain.
4. Will initiate and complete the work within the applicable
time forme after receipt of approval of the awarding
agency.
5. Wit comply with the Intergovernmental Personnel Act of
1970 (42 U.S.C. §§4728-4763) relating to prescribed
standards for merit systems for programs funded under
one of the 19 statutes or regulations specified In
Appendix A of OPM's Standards for a Merit System of
Personnel Administration (5 C.F.R. 900, Subpart F).
6. Wit comply with all Federal statutes relating to
nondiscrimination. These Include but are not limited to:
(a) Title A of the Civil Rights Act of 1984 (P.L. 88-352)
which prohibits discrimination on the basis of race, color
or national origin; (b) Title IX of the Education
Amendments of 1972, as amended (20 U,S.C.§§l681-
1683, and 1685-1686), which prohibits discrimination on
the basis of sex; (c) Section 504 of the Rehabilitation
Act of 1973, as amended (29 U.S.C. §794), winch
prohibits discrimination on the basis of handicaps; (d)
the Age Discrimination Act of 1975, as amended (42 U.
S.C. §§8101.6107), which prohibits discrimination on
the basis of age; (e) the Drug Abuse Office and
Treatment Act of 1972 (P.L. 92-255), as amended,
relating to nondiscrimination an the basis of drug
abuse; (f) the Comprehensive Alcohol Abuse and
Alcoholism Prevention, Treatment and Rehabilitation
Act of 1970 (P.L. 91-616), as amended, relating to
nondiscrimination on the basis of alcohol abuse or
alcoholism (g) §§523 and 527 of the Public Health
Service Act of 1912 (42 U.S.C. §§290 dd-3 and 290
ee-3), as amended, relating to confidentiality of alcohol
and drug abuse patient records; (h) Title VIII of the Civil
Rights Act of 1968 (42 U.S.C. §§3601 at seq.), as
amended, relating to nondiscrimination in the sale,
rental or financing of housing; (i) any other
nondiscrimination provisions in the specific statute(s)
under which application for Federal assistance is being
made; and, 0 the requirements of any other
nondiscrimination insatiate) which may apply to the
application.
W11 comply, or has already complied, with the
requirements of Titles 11 and 111 of the Uniform
Relocation Assistance and Real Property Acquisition
Policies Act of 1970 (P. L. 91-646) which provide for
fair and equitable treatment of persons displaced or
whose property is acquired as a result of Federal or
federally -assisted programs. These requirements
apply to all interests in real property acquired for
project purposes regardless of Federal participation in
purchases.
8. Will comply, asapplicabie, with provisions of the
Hatch Act (5 U.S.C. §§1501-1508 and 7324-7328)
which limit the political activities of employees whose
principal employment activities are funded in Whole
or in partvith Federal funds.
Previous Edition Usable standard Farm 4248 (Rev. 7.97)
Authorized for Local Reproduction Prescribed by oche etraularA-192
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9. Will comply, as applicable, with the provisions of the Davis -
Bacon Act (40 U.S.C. §§276a to 276a-7), the Copeland Act
(40 U.S.C. §276c and 18 U.S.C. §874), and the Contract
Work Hours and Safety Standards Act (40 U.S.C. §§327-
333), regarding labor standards for f rdemily-assisted
construction subagreements.
10. Wil comply, 9 applicable, with flood insurance purchase
requirements of Section 102(a) of the Flood Disaster
Protection Act of 1973 (P.L. 93-234) which requires
recipients in a special flood hazard area to participate In the
program and to purchase flood insurance if the total cost of
insurable construction and acquisition Is $10,000 or more.
11. Will comply with environmental standards Which may be
prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National
Environmental Policy Act of 1969 (P.L. 91-190) and
Executive Order (EO) 11514; (b) notification of violating
facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in
floodplains in accordance with EO 11988; (e) assurance of
project consistency With the approved State management
program developed under the Coastal Zone Management
Act of 1972 (16 U.S.C. §§1451 at seq.); (f) conformity of
Federal actions to State (Clean Air) Implementation Plans
under Section 176(c) of the Clean Air Act of 1955, as
amended (42 U.S.C. §§7401 at seq.); (g) protection of
underground sources of drinking water under the Safe
Drinking Water Act of 1974, as amended (P. L. 93-523);
and, (h) protection of endangered species under the
Endangered Species Act of 1973, as amended (P. L. 93-
205).
12. Will comply with the Wild and Scenic Rivers Act of
1968 (16 U.S.C. §§1271 at seq.) related to protecting
components or potential components of the national
wild and scenic rivers system.
13. Will assistthe awarding agency in assuring compliance
with Section 106 of the National Historic Preservation
Act of 1966, as amended (16 U.S.C. §470), EO 11593
(identification and protection of historic properties), and
the Archaeological and Historic Preservation Act of
1974 (16 U.S.C. %469a-1 at seq.).
14. Will comply with P.L. 93-348 regarding the protection of
human subjects involved in research, development, and
related activities supported by this award of assistance.
15. Wit comply with the Laboratory Animal Welfare Act of
1966 (P.L. 89-544, as amended, 7 U.S.C. §§2131 at
seq.) pertaining to the care, handling, and treatment of
warm blooded animals held for research, teaching, or
other activities supported by this award of assistance.
10. Will comply with the Lead -Based Paint Poisoning
Prevention Act (42 U.S.C. §§4801 at seq.) which
prohibits the use of lead-based paint in construction or
rehabilitation of residence structures.
17. Will cause to be performed the required financial and
compliance audits in accordance with the Single Audit
Act Amendments of 1995 and OMB Circular No. A-133,
"Audits of States, Local Governments, and Non -Profit
Organizations."
18. WII complywith all applicable requirements of all other
Federal laws, executive orders, regulations, and policies
governing this program.
19. Will comply with the requirements of Section 106(g) of
the Trafficking Victims Protection Act (IVPA) of 2000, as
amended (22 D.S.G. 7104) which prohibits grant award
recipients or a sub -recipient from (1) Engaging in severe
forms of trafficking in persons during the period of time
that the award is in effect (2) Procuring a commercial
sex act during the period of time that the award Is In
effect or (3) Using forced labor in the performance of the
award or subawards under the award.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL
TITLE
Pal oun oun y Juclge
APPLICANT ORGANIZATION
DATE SUBMITTED
lCalhoun county
standard Forth 424B(Rev. r-97)Back
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CERTIFICATION REGARDING LOBBYING
Certification for Contracts, Grants, Loans, and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that
(1) No Federal appropriated funds have been paid a will be paid, by a on beh sit of the undersigned, to any
person for influencing or attempting to influence an officer or employee of an agency, a Member of
Congress, an officer or employee of Congress, a an employee of a Member of Congress in connection with
the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the
entering Into of any cooperative agreement, and the extension, continuation, renewal, amendment, or
modification of any Federal contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid a will be paid to any person for
Influencing or attempting to Influence an orccer or employee of any agency, a Member of Congress, an
officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal
contract, grant, loan, a cooperative agreement, the undersigned shall complete and submit Standard
Form -LLL, "Disclosure of Lobbying Activities," In accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included In the award documents
for all subawards at all tiers (including subcontracts, subgrents, and contracts under imide, loans, and
cooperative agreements) and that all subreclpienls shell certify and disclose accordingly. This certification
Is a material representation of fact upon which reliance was placed when this transaction was made or
entered into. Submission of this certification Is a prerequisite fa making or entering Into this transaction
Imposed by section 1352, litle 31, V.S. Coda. Any person who falls to file the required certification shall be
subject to a civil penalty of not less than $10,000 and not more than $100,000 fa each such failure.
Statement fa Loan Guarantees and Loan Insurance
The undersigned slates, to the best of his or her knowledge and belief, that
If any funds have been paid or will be paid to any person for influencing or attempting to influence an officer
or employee of any agency, a Member of Cangress, an officer or employee of Congress, or an employee of
a Member of Congress in connection with this commitment prodding for the United States to insure or
guarantee a loan, the undersigned shall complete and submit Standard Form-LLL,'Disclosure of Lobbying
Activities," In accordance with Its instructions. Submission of this statement is a prerequisite for making or
entering Into this tmneaclion Imposed by section 1352, title 31, U.S. Code. Any person who fails to file the
required statement shall be subject to a civil penalty of not less than $10,000 and net more than $100,000
for each such failure.
'PRINTED NAME AND TITLE OF AUTHORI$EP REPRESENTATIVE
C dl d
Prefix. B ' First Name:
Middle No.:
' Last Neme. Suffix. �—
.11,1,1CRIhoun Minty ju ge
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ATTACHMl•,NT G
FFATA CERTIFICATION
Fiscal Federal Funding Accountability and Transparency Act
(FFATA) CERTIFICATION
The certifications enumerated below represent material facts upon which DSHS relies when reporting
information to the federal government required under federal law. If the Department later determines
that the Contractor -knowingly rendered an erroneous certification, DSHS may pursue all available
remedies in accordance with Texas and U.S. law. Signor further agrees that it will provide immediate
written n otice to DSHS If at any time S Ignor learn s th at any of the certifications provided for below were
erroneous when submitted or have since become erroneous by reason of changed circumstances.! the
Legal Name of contractor:
FFATA Contact #1 Name, Email and Phone Number:
Primary Address of Contractor.
FFATA Contact #2 Name Snail and Phone Number:
ZIP Code: 9-digit5 Required www.usps.com
DUNS Number: 9 -digits Required www.sam.gov
Calhoun county judge
State of Texas Comptroller Venda Identification Number (VIN) 1.4 Digits
Printed Name of Authorized Representative
Signature' of Authorized Representative
Richard Meyer
Title of Authorized Representative
Date
Calhoun county judge
-1-
Departmert of State Beath Services Form 4734 -June 2013
System Agency Contract No. HHS000371500003 Under the Page 46 of 62
2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOP6RATrvE AGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
Fiscal Federal Funding Accountability and Transparency Act
(FFATA) CERTIFICATION
Asthe duty authorized representative (Signor) of the Contractor, I hereby certify that
the statements made by mein this certification form are true, completeand correctto
the best of my knowledge.
Did your organization have a gross income, from all sources, of less than $300)000 in
your previous tax year?[:] Yes F] No
if your answer Is "Yes", skip questions "A", "B", and "C" andfinish the certification.
If your answer Is "No", answer questions "A" and "B".
A. Certification Regarding e,6 of Annual Grossfrom Federal Awards.
Did your organization receive M or more of Its annual gross revenue from federal
awards during the preceding fiscal year? ❑Yes F] No
B. Certification Regarding Amount of Annual Grossfrom Federal Awards.
Did your organization receive $25 million or more in annual gross revenues from federal
awards in the preceding fiscal year? ❑ Yes ❑ No
If your answer is "Yes" to both question"A" and "B", you must answer question "C
If your answer is "No" to either question "A" or "B", skip question "C" and finish the
certification.
C Certification Regarding Public Access to Compensation Information.
Does the public have access to Information about the compensation of the senior
executives in your business cr organization {Including parent organization, all branches,
and all affiliates worldwide) through periodic reports filed under section 13(a) or 15(d)
of the5ecurlties Exchange Act of 1934 (15 U.S.C. 78m(a); 78o(d)) or section 6104 of the
Internal RevenueCodeof1986?❑Yes F1 No
Ifyouranswer is"Yeetrothis question, where canthis information beaccessed?
If your answer is "No" to this question, you must provide the names and total
compensation, of the top five highly compensated officers below.
Provide compensation Information here:
- 2-
Departmert of State fkafth Serrlces Form 4734-Jrne 2013
System Agency Contract No. 1IHS000371500003 Under the Page 47 of 62
2017 HORmCANE PUBLIC HEALTH CRISIS BBSPONSE COOPERATIVE AGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
ATTACHMENT H
HHS DATA USE AGREEMENT
This Data Use Agreement ("DUA'); effective as of the date the Base Contract into which
it is incorporated is signed ("Effective Da&'), is, entered into by and beti een a Texas Health and
Human Services Enterprise agency ("HHS"), and the Contractor identified in the Base Contmot .ii
political subdivision of the State of Texas ("CONTRACTOR.
ARTICLE 1.
PURPOSE; APPLICABILITY; ORDEROFPRECEDENCE
The purpose of this DUA is to facilitate creation, receipt maintenance, use, disclosure of
access to Confidential h0orrnation with CONTRACTOR, and describe CONTRACTOR'S rights
and obligations withrespect to the Confidential Information. 45 CFR 164.504(e)(I)43): This DUA
also describes HHS's remedies in the event of CONTRACTOR's noncompliance with its
obligations under this DUA. This DUA. applies to both Business Associates and contractors who
are not Business Associates who create, receive, maintain, use, disclose or have access to
Confidential Informal on behalf of HHS, its programs or clients as described in the Base
Contract.
As of the Effective Date of this DUA, if any provision of the Base Contract including any
Geneva Provisions crUniform Terms and Conditions, conflicts vvith this DUA; this DUA controls.
ARTICLE 2.
DEFINITIONS
For the: purposes of this DUA, capitalized, underlined terns have the meanings set forth in
the following: Health Insurance Portability and Accountability Act of 1996, Public Law 104-191(42
U.&C. §1320d, et seq.) and regulations thereunder in 45 CFR Parts 160 and 164, including all
amendments, regulation, and guidance issued thereafter, The Social Security Act including Section
1.13 7 (42 U.S.C. §§ 1320b-7), Title XVI of the Act; The Privacy Act of 1974, as amended by the
Computer Matching and Privacy Protection Act of 1988, 5 U.S.C. § 552aand regulations and
guidance: thereunder, Internal Revenue Code, Title 26 ofthe United States Code aid regulations and
publications adopted under that code,. including IRS Publication 1075; Obffi Memorandum 07-18;
Texas Business and Commerce Code Ch. 521; Texas Government Code, CIL 552, and Texas
Government Code §2054-1125. In addition, the following term si in this DUA are defined as follows:
"Authorised Purpose" -means the specific purpose or purposes described in the Statement
of [Work ofthe Base Coutract for CONTRACTOR to fulfill its obligations under the Base Contract,
or any otherpurpose expressly authorized by HHS is writing in advance.
"Authorized User" means a Person:
(1) Who is authorized to create, receive, maintain; have access to, process, view,
handle, examine, interpret, or analyze Confidential Information pursuant to this DUA,
IMSData U a _3.g ommnt 97' 11315111PAA ChmalbE - Compliant Getolra, 2015
TACO 0 VEX3I011T -
Pzee 1 of 15
System Agency Contract No. HHS000371500003 Under the Page 48 of 62
2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOPERATrvr, AGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
(2) For whom, CONTRACTOR warrants and represents has a. demonstrable need to
create, receive, maintain; use, disclose or have access to the Confidential Information; and
(3) JVho has agreed in writing to be bound by the disclosure and use limitations
pertaining to the Confidential Information as required by this DUA.
"Confidential Information" means any communication or record (whether oraL written,
electronically stored or transmitted, or in any other form) provided to or made available to
CONTRACTOR, or thatCONTRACTOR may, foraaAuthorizedPurpose: create, receive, maintain,
use, disclose or have access to, that consists of ar includes any or all of the following:
(1) Client Informatioa;
(2) Protected Health Information in any form including without limitation, Electronic
Protected Health Information or Unsecured Protected HealthInfibrmation (herein `PHI'');
(3) Sensitive Peronal Information defined by Texas Business and Commerce Code
Ch. 521;
(4) Federal Tax Information;
(5) Individually Identifiable Health Information as related to HIPAA, Texas HIPAA
and Personal Identifying Information muter the Texas Identity Theft Enforcement and Protection
Act:
(6) Social Securih, Administration Data. including, without limitation, Medicaid
information;
(7) All privileged work product;
(S) Allinformation designated as confidential under the constitution and laws of the
State of Texas and of the United States, including the Texas Health & Safety Code and the Texas
Public Information Act; Texas Government Code, Chapter 552.
"Legally Authorized Representative" of the Individual, as defined by Texas law, including
as provided in 45 CFR 435.923 (Medicaid); 45 CFR 164.502(8)(1) (I-IIPAA); Tex Occ. Code §
151.002(6); Tex. R & S. Code § 166.164; and Fstates Code Ch. 752 -
ARTICLE 3.
CONTRACTOR'S DUTIES REGARDING CONFIDENTIAL INFORINiATI01\
3.01 Obligations of CONTRACTOR
CONTRACTOR agrees that:
(A) CONTRACTOR will exercise reasonable care and no. less their the same
degree of care CONTRACTOR uses to protectitsown confidential, proprietary and trade
secret information to prevent any portion ofthe Confidential Information from being used in
flli.S Mc, U= -e Ageemwt 0't1015MP.4.a' 0mad i. Compliant October, ?915
TACCHO VERSION
P_._e 2 of 15
System Agency Contract No. HHS000371500003 Under the Page 49 of 62
2017 HURRICANE PUBLIC HEALTn Cmsis RESPONSE COOPERATIVE AGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
a nlatmer that is not empressly an Authorized Purpose under this DUAor as Required byI.acy:
45 CFR 164503(6)(1); 45 CFR 164.514(d),
(B) Except wReguiredbyLa�r,:CONTRACTORivillnotdisclose orallowaccess
to any portion of the Confidential Information to any Pers or other entity; other than
Authorized Us WoMorce or Subcontractors (as. defined in 45. CFA .160.103) of
CONTRACTOR who have completed training in confidemiality, privacy, security and the
importance of promptly reporting -any EyaM or Breach to CONTRACTOR's management;to
carry. out CONTR4CTOR's obligations in connection niththeAuthorized Purpose..
HHS, at its election, may assist CONTRACTOR in training and education on specific or
unique HHS processes, systems and+or requirements. CONTRACTOR will produce
evidence of completed training to HHS upon request. 45 CF.R 164.308(a)(5)r); Texas
health & Safety Code§181.101
(C) CONTRACTOR will establish, implement and maintain appropriate
sanctions against any member of its Workforce or Subcontractor who fails to comply with this
DUA the Base Contract or'apl)licable law. CONTRACTOR %till maintain evidence of
sanctions and produce it to HHS upon request4S CFA 164308(a)(1)(9)(C); 164.530(e);
164410(b); I6453o(b)(2)
(D) CONTRACTOR will not except as otherwise permitted by this DUA,
disclose or provide accessto any Confidential Information on the basis that such act is
Required by Latr withoutawtifying either FM or CONTRACTOR's-own legal counsel to
deterruine v%bether. CONTRACTOR should abject to the disclosure or access and seek
appropriate relief CONTRACTOR win maintain an accounting of all such requests for
disclosure and responses and.. provide such accounting to BHS within 4S hours of HHS'
regaest 45 CFR I" 504(e)(2)(rt)(A)
(E) CONTRACTOR %rill not attempt to re -identify or further identify
Confidential Information orDe-identitiedlnformation: or attenrptm contact any Individuals
those records are 'contained in the Confidential Information; except for an Authorized
Pumose, without express written authorization from IM or as expressly permitted by the
Base. Contract 45 CFR 164.303(d)(2)fJ and (Y) CONTRACTOR will not engage in
prohibited marketing or sale of Confidential hgommtior 45 CFR 164 501, 164 508(a)(3)
and (4); Texas Reahk & Safety Code Cls.18I.002
(F) CONTRACTOR aril not permit, or eater into any .agreement with. a
Sbbeouhactor to, create, receive, maintain, use, disclose, have access to or transmit
Confidential Information to carry mut COITRACTOWs obligations in connection with the
Authorized Entine on behalf of CONTRACTOR, unless Subconfractor agrees to comply
with all applicable laws, rules; and regulations. 45 CFR 164S02(e)(1)(6); 164.504(e)(i)(i)
and (2).
(0) CONTRACTOR is directly responsible for compliance with, and enforcement
of all conditions for creation, maintenance, use, disclosure, transmission and Destruction of
IRIS Data Uea Ag -Ment 071015H PAA Oranibustsmpliant October, 2015
TAC%HO VE9SI014. .
Page 3 of 15
System Agency Contract No. HHS000371500003 Under the Page 50 of 62
2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOPERATIVE AGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
Confidential Information and the acts or omissions of Subcontractors as may be reasonably
necessary to prevent unauthorized use. 45 CFR 164.504(q)(S);.42 CFR 431.340, et seq.
(H) If CONTRACTOR maintains PHI in: a Designated Record Set which is
Confidential Infoimatrorr and subject to this Agreement, CONTRACTOR Will make PIR
available to HHS in aDesignatedRec<)rd Setuponrequest. CONTRACTORwill proiidePHI
to an Individual, or LegaflcAuthorized Representative of the Individual who is requesting
PHI in compliance with the requirements of the HIPAA Privacy Regulations.
CONTRACTOR will release PHI in accordance width the RIMA Privacy Regulations upon
receipt of a valid written authorization. CONTRACTOR will male other Confidential
Information in CONTRACTOR's possession available pursuant to the requirements of
HIPAA_ or other applicable law upon a determination ofa Breach ofUnsecuredPHI as defined
in HIPAA: CON`IRACTOR1rill maintain an accounting of all such disclosures and provide
it to HHS Ivithin 48 hours ofHHV request 45 CFR 164.524and 164.504(e)(2)(d)(E).
(1) If PHI is subject to this Agreement, CONTRACTOR will make PHI as
required by HIPAA available to HEIS for review subsequent to CONTRACTOR'a
incorporation of any amendments requested pursuant to HIPAA. 45 CFR
144.504(e)(2)(E)(E) and M.
(J) IfPHIissubject tothisAgreement,CONTRACTORwitldocument andmake
available to HHS the PHI required to provide access,, an accounting of disclosures or
amendmentia compliance withthe.requirements ofthe lEPAAPrivacy Reeulatioas. 45 CFR
1 64.504(e)(2)(d)(G) and164.5 28.
;(I) IfCONTRACTOR receives arequest -for access, amendment oraccounting
of PIH from an individual with a -right of access to information subject to this DUA, it will
respond to :such request :in compliance with the HWAA Pdyacy Regulations -
CONTRACTOR will maintain an accounting of all responses to requests for access to or
amendment of PHI and provide it to HHS within 48 hours of HHS' request. 45 CFR
I64.504(e)(1)•
(L
) CONTRACTOR will protide, and will cause its Subcontractors and agents
to provide, to HHS periodic written certifications of compliance with controls and
provisions relating to information privacy, security :and breach notification, including.
without limitation information related to data transfer% -and the handling and disposal of
(Ni) Except as otherwise limited by this DUA, the Base Contract or lawn
applicable to the Confidential 'oration, CONTRACTOR may use PHI fat the proper
management and administration of CONTRACTOR or to carry out CONTRACTOR's
legal responsibilities. Except as otherwise limited by this DUA, the Base Contract, or law
applicable to the Confidential Information. CONTRACTOR may disclose I'M for the
proper management and administration of CONTRACTOR, or to carry out
CONTRACTOR's legal respomibiliiie% if: 45 CFTt 164.504(e)(4)(A).
I-10. Data LLe Agement0 t415fit'Pr:A OemuFna ti.uv liazt Getater,^_{}]5
^a AL'CHO L'HK5l01'T
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System Agency Contract No. RHS000371500003 Under the Page 51 of 62
2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOPERKHVE AGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
(1) Disclosure is Required byLavc,. provided did CONTRACTOR compliesLcrith
Section 3.01(D); or
(2) CONTRACTOR obtains reasonable assurances from the person or entity to
which the information is disclosed that the person or entity will:
(a)Ivlaintain the confidentiality. of the Confidential Information in accordance
with this DUA;
(b) Use orfurtherdisclmethe information only asRge uiredbyi:au'nafor
the Authorized Pumose for which it was disclosed to the Person; and
(c)Notify CONTRACTOR in accordance with Section 4.01 ofany° Event or
Breac of ConfidentiallufixmationofwhichthePersondiscoversorshouldhave
discovered with the. exercise of reasonable diligence. 45 CFR
164.504(e)(4)(iO(B)•
(N) Except as otherwise limited b3' this DUA, CONTRACTOR iAdtL if required
by lain and requestedbyHHS,use commercially reasonable efforts to use PHI to provide data
aggregation services to HHS, as that term is defined in the HIPA.A; 45 CFR y§164.501 and
perp ittedbyRMAA. 49 CFR 164.504(8)(3)0($)
(0) CONTRACTOR utill, on the termination or expiration of this DUA or the
Base Contract, at its expense, send to HHS or Destroy" at HHS's election and to the extent
reasonably feasible and permissible by lata; all Confidential Information received from HHS
or created or maintained by CONTRACTOR or any of CONfRACTOR's agents or
Subcontractors on HHS's behalf if that data contains Confidential Information.
CONTRACTOR will certify in writing to HHS that all the ConfidentialInformation that has
been created, received, maintained, used by,or disclosed to CONTRACTOR, has been
Destroyed or seat to HHS, and that CONTRACTOR and its agents and Subcontractorshave
retained no copies thereof. Nohiithstanding the foregoing, HMS aclmowledges and agrees
ion schedule, .andlor a litigation hold notice prohibit such aenvei}' or
'such deliveyorDestruction is notreasonably feasible, oris impermissible by
ACTOR wV immediately notify HHS of the reasons such delivery or
not feasible, and agree to extend indefinitely the protections of this DUAto the
afommation and limit its further uses and disclosures to the purposes thatmake
rery oresitvction ofthe Confidential Information not feasible for as longus
lRmaintains such Confidential lnformatton 45 CTR 164.504(e)(2)(it)(J)
(P) CONTRACTOR will create, maintain; use, disclose, transmit or Deatroy
Confidential In$immation in secure fashion that protects against any reasonably anticipated
threats or hazards to the security or integrity of such information or unauthorized uses. 45
CFR 164.306;-:1"530(c)
14H- DxtaIha A}ee eut 07141:HiP AOtmabu.Compirim Oct013--r,"05
eACG"tlO- fE"10N
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System Agency Contract No. 14HS000371500003 Under the Page .52 of 62
2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOPERAxrvE AGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
(Q) If CONTRACTOR accesses, timmits,.stores, and/ormaintaius Confidential
Issfermation, CONTRACTOR will complete andreturn to HITS of
iafbsecu1ily@hhso.ftte,ts.us the HHS information security and privacy initial inquiry (SP1)
at Attachment 1 . The SPI identifies basic privacy and security controls with which.
CONTRACTOR must comply to protect HEIS Confidential Informatioss. CONTRACTOR
will comply with periodic security controls compliance assessment and monitoring by HITS
as required by state and federal law, based on the type. of Confidential Information.
CONTRACTOR creates, receives, maintains, uses,. discloses or has access toand the
Authorized Pumose and level of risk CONTRACTOR'ssecurity controls will be based on
the National Institute of Standards and Technology (RAST) Special Publication 500-3.
CONTRACTOR will update its security controls assessment Whenever there are significant
changes in security controls for HHS Confidential Inform and wilt provide the updated
document to HITS. HHS also reserves the right to request updates as needed to satisfy state
and federal monitoring requirements.. 45 CFR 164.306,
(R) CONTRACTOR will establish, :implement and maintain reasonable
procedural, administrative, physical and technical safeguards to preserve and maintain the
confidentiality, integrity, and availability ofthe Confidential Information, and with respectto.
PHL as described in the HIP.AA Privacy and Security Regulations: or other applicable laurs
or regulations relating to Confidential Infrnmation to: present any unauthorized use or
disclosure of Confidential Information as long as CONTRACTOR has such "Confidential
Information in its actual or constructive possession. 45 CFR 164.308 (adrrdrds"a vIs
safeguards); 164.310 (physical safeguards); 164.312 (technI wl safeguards);
(S) CONTRACTOR will designate and
Official 45 CFS 164.530(a)(1) and Information Secs
to act on behalf of CONTRACTOR and is
.implementation of the privacy and security requires
provide name and current address, phone number.
HEI
officials to S. upon wtecutioR of this DUAand p
develop and implement the requirements of the D
upon IM, request. .45 CFR 164,308(a)(2).
and
e-mail address for such designated
:o any change. If such persons fail to
CONTRACTOR will replace them
(T) CONTRACTOR represents and warrants thatAsAuthorized Users each have
a demonstrated need to koory and have access to Confidential Information solely to the
minimum extent necessary to accomplish the Authorized Purpose pursuant to this DUA and
the Base Contracr.aad further that each has agreed in writing to be bound by the disclosure
and use limitations pertaining to the Confidential Information contained in this DU -A- 45
CFR 164.502,164.514(d).
agreed to be 1
upon request
itractors will maintain, an _updated, complete,
is, their signatures;titles and the date they
at all times and supply it to HHS; as directed,
HHS Dala Une hp�-,new 071015H€PAA O? nbm Compli it Oetaber, 2015
ZriCCHO VFASION
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System Agency Contract No. I-IHS000371500003 Under the Page 53 of 62
2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOPERATIVE AGREEarCNT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
OD CONTRACTOR nvill implement, update as necessaq•, and document
reasonable and appropriate policies and Procedures .for privacy, security and of
Confidential. Information and as incident response plan for an Event or Breach; to comply
with the privacy security and breach notice requirements of this DUA prior to conducting
n•ork under the Statement of Work 4S CFR 164.308;164816;164.514(d); 164.530(i)(1).
(M .CONTRACTOR will produce copies of its information security and privacy
policies and procedures and records relating to the use or disclosure of Corlfldeutial
Information received from, created by; or received,. used or disclosed by CONIRACTORfor
an Authorized Purpose for HHS's-review and approval within 30 days of execution of this.
DUAL and uponrequest by HHS thefollowing business day or otheragreed upon time frame.,
45 GFR 164.308;164.514(d).
(X) CONTRACTOR will make available to HHS any information HHS requires
to fulfill HHS's obligations to provide access to, of copies of, PIR in accordance with HIPAA
and other applicable lavas and regulations relating to Confidential Information.
CONTRACTOR«^ill provide such information in atime and manner reasonably agreed upon
or as designated by the SecreW of the U.S.. Department of Health and Hunan Services, or
other federal or state law. 45 CFR 164.504(e)(2)ri)(I).
(I) CONTRACTOR will only conduct secure transmissions of Confidential
Information whether in paper, oral or electronic form,. in accordance kith applicable rules,
regulations and laws. A secure transmission of electronic Confidential Information in motion
includes, but isnot lin ited to. Secure File Transfer Protocol (SF1P) or Encryption at an
appropriate Im el. Ifrequired byrule, regulation or law, HHS Confidential hlfomiatioa at rest
requires Engr,mtiau unless there _is other adequate administrative, technical. and physical
hrough secure systems. Proof ofsystem, media or device security sadlorEneryptionmust'
)reduced to HHS:no later than 48 he= after HHS's witten request in response to
:ompliance investigation, audit or the Disc over• ofarlEvent or Breach: Othenviserequest,
rroductiono 'suchfiproofwill be made as agreeduponby theparties. pe -identification of Hl
confidential Infamlation is a means of security. R itli respect to de -identification _ of PF
(Z) Foreaclitypeof Cenfidentiallaform CONTRACTOR creates, receives,
maintains, uses. discloses; has access to or transmits in the performance ofthe Statement of
Work, CONTRACTOR will comply with the following tans rules and regulations; only to.
the extent applicable and required by lam
Title 1, Part 10, Chapter 202, Subehapter B. Texas Administrative. Code;
The Privacy Act of 1974;
Obl$ Memorandum 07-16;
HISS D,,b C-.iupliant tacsba, 2015
TACC'HO iTERSION
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System Agency Contract No. ITHS000371500003 Under the Page 54 of 62
2017 HURRICANE PUBLIC HEALTH CmSIS RESPONSE COOPERATIVE AGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93BGFE88CD7D
• The Federal Information Security Management Act of 2002 (FFISX•LA);
• The Health Insurance Portability and Accountability Act of 1996 (HIPAA)
as defined in the DUA;
• Internal Revenue Publication 1075 — Tax Information Security Guidelines
for Federal, State and Local Agencies;
• National Institute of Standards and Technology (NIST) Special Publication
800-66 Revision 1—An Introductory- Resource Guide for Implementing the
Health Insurance Portability and Accountability Act (HIPAA) Security
Rule;
• NIST Special Publications 800-53 and 800-53A—Recommended Security
Controls for Federal Information Systems and Organizations, as currently
revised:
• NIST Special Publication 800-47 — Security Guide for Interconnecting
Information Technology Systems;
• MST Special Publication 800-88, Guidelines for Media Sanitization;
• NIST Special Publication 800-111, Guide to Storage of Encryption
Technologies for End User Devices containing PHI; and
Any other State or Federal law, regulation, or administrative rule relating to the specific HHS
program area that CONTRACTOR supports on behalf of HHS.
(AA) INohvithstanding anything to the contrary herein, CONTRACTOR u°i11 treat
any Personalldwhfving Information it creates, receives, maintains, uses; transmits, destroys
and/or discloses in accordance pith Texas Business and Commerce Code, Chapter 521 and
other:. applicable regulatory standards identified in Section 3.01(1), and Whilmu
Identifiable Health Information CONTRACTOR creates, receives, maintains, uses,
traminits, destroys and/or discloses in accordance with HIPAA and other applicable
regulatory standards identified in Section 3.01(2).
ARTICLE 4.
BREACH NOTICE, REPORTING AND CORRECTION REQUIREhIENTS
4.41 Breach or Event Notification to HEIS. 45 CFR 164.409414.
(A) CONTRACTORwill cooperate fultyxvithHHSinmvestigating,mitigating to
the extent practicable and issuing notifications directed by HES, for any Event or Breach of
Confidential Infomtatior to the extent and inthe manner determined by HHS.
HHS Dat, -Ute Apeua mt 07101_` WA-40=bu=_ Compliant Odol6 , 2015
'£ACCHO VERSION
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2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOPERATIVE AGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
(B) CONTRACTOR'S obligationbegins at the DiscovelyofanEventorBreach
and continues as long as related activity continue,. until all effects of the Event are mitigated
to HHS`s reasonable satisfaction (the "incident response period"). 45 CFR 264.404
(C) Breach Notice:
(1) Initial Notice.
(a) For federal information, including without limitation, Federal
Tax Inform Social Security Administration Data. and Medicaid Client
Information vtdthin the first, consecutive clock hour of Discovery, and for
all othertypes of Confidential Information not more than 24 hours after
Discolrety. or in atimefrarne otherwise appro-,ed by HHS intLTAing, initially
report to HHS's Privacy and Security _ Officers via email at:
privacy@HHSC.state tx.us and to the HHS division responsible for this
DUA; and IRS Publication 1075; Privacy Act of 1974, as amended by the
Computer Matching and Privacy Protection Act of 1985, 5 U.S.C. § 552a;
OISB Memorandum 07-16 as cited in HHSC-CMS Contracts for
information exchange.
(b) Report all information reasonably available to
CONTRACTOR about the Event or Breach of the privacy or security of
Confidential Information. 45 CFR 164.910.
(c) Name, and provide contact information to HHS for,
CONTRACTOR's single point of contact i0w will communicate ivithHHS
both on and offbusiness hours during the incident response period..
(2) Formal Notice. No later than two business days after the Initial Notice
above, provide Format notification to privacy@HHSC.state-taus .andto the HHS
division responsible for this DUA; including all reasonably available informvation
about the Event or Bre and CONTRACTOR's investigation, including urythout
Imitation and to the extent available: For (a) - (pro below: 45 CFR 164.400-414.
(a) The date the Ewn
I or Breach occurred;
(b) The date of CONTRACTOR's and, if applicable,
Subcontractor's Discover;
(c) A brief description of the Event or Breach; including how• it
occurred and who is responsible (or hypotheses, if not yet determined);
(d) Abrief description of COINTRACTOR's investigation and the
status of the investigation;
(e) A description of the types and amount of Confidential
Information involved;
HHS Data Use Agreement 071015H1PAA. Oa=lm: Compliant Qctobu, 2015
TACCHO F&RSION
pase 9 a# 1_
System Agency Contract No. IHIS000371500003 Underthe Page 56 of 62
2017 HuRmcANE Pimmc HEALTH CRISIS RESPONSE COOPERATIVE AGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
(f) Identification. of and number of all Individuals reasonably
believed to be affected, including first and lastuame ofthe Individual and if
applicable the, Leg0j Authorized Representative, last known address,
W. telephonenumber, and email address if itis apreferred contact method,
tothe exteatknovn or can be reasonably deteruned by CONTRACTOR at
that time;
(g) CONTRACTOR's initial risk assessment of the Event or
Breach demonstrating whether individual or other notices are required by
applicable law or this DUA for HHS approval, including an analysis of
whether there is a lore probability of compromise of the Confidential
Information or whether any legal exceptions to notification apply;
(h) CONTRACTOR's recommendation for HHS's.approval as to
the steps Individuals and,or CONTRACTOR on behalf of Individuals,
should take to protect the Individuals from potential harm, includingixdthout
[imitation CONIRACTOR's provision of notifications, credit protection,
claims monitoring, and any specific protections for a Legally Authorized
Representatitire to take on behalf of an Individual Ecnth special capacity or
circumstances;
(i) The steps CONTRACTOR has taken to mitigate the hann or
potential baro caused (including vtdthout limitation the provision of
sufficient resources to mitigate),
0) The steps CONTRACTOR has taken, or will take, to prevent
or reduce the likelihood of recurrence of a similar Event or Breach,
(k) Identi€}, describe or estimate the Persons. Workforce
Subcontractor, or Individuals and any lav enforcememthatmay be involved
in theF ent or Breach;
0) Areasonable schedule for CONTRACTOR to provide regular
updates during normal business hours to the foregoing in the future for
response to the Event or reach, but no less than every three (3) business
days or as otherwise directed by HHS; including information about risk
estimations. reporting, notification, if any, mitigation, corrective action, root
cause analysis sad when such activities arra expected to be completed; and
(in) Any reasonablyayaihmble, pertinent information,documents or
reports related to an &_eat or Breach that HHS requests felloiving
Discovery.
4.02 7rrvestigatiou, Response and Afftigation.45CFR 164308,310and 312;164.530
(A) CONTRACTORwill immediately conduct a full and complete investigation,
respond to the Event or Brea commit necessary and appropriate staff and resources to
HHS Data UR.: Aereerneut 071019HL AA 0arrubw Compliant October, 2015
TACCHO HEAaION
Fag=_ 10 ePt5
System Agency Contract No. H14S000371500003 Under the Page 57 of 62
2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOPERATIVE AGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
expeditiously respond and report as required to and by HHS for. incident response purposes
and for purposes of HHS's compliance with report and notificationrequirements, tothe
reasonable satisfaction of HHS.
(B) CONTRACTOR will complete or participate in a risk assessment as directed
by HHS following an Event or Breach. and provide the final assessment, corrective actions
and mitigations to HHS fcrreview and approval.
,(C) CONTRACTOR -will fully cooperate with HHS to respond to inquiries andlor
proceedings by state and federal authorities, Persons andforludividuals about the Er_entor
Breach..
(D) CONTRACTOR will fully cooperate with MS's efforts to seek appropriate
injunctive relief or otherwise prevent or curtail such Event or$reacll; or to recover or protect
any Confidential Information, including complying with reasonable corrective action or
measures, as specified by HHS ina Corrective ActionPlan if directed by1M under theBase
Contract
4.03 Breach Notification to Individuals and Reporting to Authorities. Tex. Bus. &
Comm. Code §§521.053; 45 CFR 164.404 (Individuals), 164.406 (Afedia); 164.408.
(Authorities)
(A) HHS may direct CONTRACTOR to. provide Breach notification to
Individuals; regulators or third -parties; as specified by HHS following a Breach.
(B) CONTRACTOR shall. give HHS an opportunity to review and provide
feedback to CONTRACTOR and to confirm that COMIRAGTOR's nohce meets all
regulatory requirements regarding, thetime, manner and content of my notification to
Individuals: regulators or third -parties, orany notice. required byother state or federal
authorities. HHS shall line ten (10) business days to provide said feedback to
CONTRACTOR- Notice letters will be in CONTRACTOR's name and on CONTRACTOR's
letterhead, unless otherwise directed by HHS and will contain contact information, including
the name and title of CONTRACTOR's representative, an entail address and atoll -free
telephonenumber,ifrequiredbyapplicable law, rule. orreb Iation,fortheIndiciduattoobtain
additional information:
(C) CONTRACTOR will provide HHS with copies of distributed and: approved
communications..
will have. the burden of: demonstrating tothereasor
ACTOR's control, CONTRACTORwill provideitritten documentation of
delay.
(E) If HHS delegates notice requirement to CONTRACTOR, HHS shall, in the.
time and manner reasonably requested by CONTRACTOR, cooperate and assist Aith
CONTRACTOR's information requests in order to make such notifications and reports.
[itis DaL= Use AueEu>Frit 071015; OAA.0znnlbm Comp! ' Oetabe , 2015
TACC'HO VEM101I
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Systern Agency Contract No. HBS000371500003 Under the Page 58 of 62
2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOPERATIVE AGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93BBFE88CD7D
ARTICLE S.
STATEMENT OF WORK
"Statrtment of work" means the sen -ices and deliverables to be performed or provided by
CONTRACTOR, or on behalf of CONTRACTOR by its Subcontractors cr agents for HHS that are
described in detail in the Base Contract. The Statement of Work, including any future amendments
thereto, is incorporated by reference in this DUA as if set out word -for -cord herein.
ARTICLE 6.
GENERAL PROVISIONS
6.01 Oversight of Confidential Information
CONTRACTOR acknowledges and agrees that HHS is entitled to oversee and monitor
CONIRACTORN access to and creation, receipt, maintenance, use, disclosure of the Confidential
Information to confirm that CONTRACTOR is in compliance with this DUA.
6.02 HHS Commitment and Obligations
HHS will notrequest CONTRACTOR to create, maintain, transmit, use or disclose PHI in
any mannerthat would not be permissible under applicable law if done by HHS.
6.03 HHS Right to Inspection
At any time upon reasonable notice to CONTRACTOR, or if HHS determines that
CONTRACTOR has violated this DUA. HHS, directly or through its agent, will have the right to
inspeetthe facilities, systems, books and records of CONTRACTOR to monitor compliance with this
DUA. Forpurposes of this subsection, HHS's agent(s) include, «<ithout limitation, the HHS Office of
the Inspector General or the Office of the Attorney General of Texas, outside consultants or legal
counsel or other designee.
6.41 Term; Termination of DUA; Sundval
This DUA will be effective on the date on which CONTRACTOR executes the DUA, and
will terminate upon termination of the Base Contract and as set forth herein. If the Base Contract is
extended or amended: this DUA shall be extended or amended concurrent with such extension or
amendment
(A) HHS may immediatelytemamatethis DUA and Base Contract upon amaterial
violation of this DUA
(B) Termination or Expiration of this DUAwill notrelieve CONTRACTORofits
obligation to return or Destroy the Confidential Information as set forth in this DUA and to.
continue to safeguard the Confidential Infonnation unfil such time as determined by HHS.
(C) If HHS. determines: that CONTRACTOR has violateda material term of this
DUA; HHS may in its sole discretion:
HFS DzLUee Aa eanneni 071015MAA Chtnubus Cempliaut October, 2015
TACCHO VERSION
Page 12 of 35.
System Agency Contract No. HHS000371500003 Under the Page 59 of 62
2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOPERATLVE AGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
(1) Exercise any of its rights including but not limited to reports, access
and rnspectionunder this DUA and!otthe Base Contract; or
(2) Require CONTRACTOR to submit to a Corrective Action Pian,
including. a plan for monitoring. and plan for reporting, as HHS may determine
necessary to maintain compliance troth this DUA; or
(3) Provide CONTRACTOR with a reasonable period to cure the
violation as determined by HHS; or
(4) Terminate the DUA and Base Contract immediately, and seek relief in
a court of competent jurisdiction in Texas.
Before exercising any of these options, HHS will provide %,written notice to
CONTRACTOR describing the violation, the requested corrective action CONTRACTOR
may take to cure the alleged violation, and the action HHS intends to take if the alleged
violated is not timely cured by CONTRACTOR.
(D) Ifneither terminatiou nor cure is feasible, HHS shall reportthe violation to the
SeuetaZ of the U.S. Department of Health and Human Services.
(E) The duties of CONTRACTOR or its Subcontractor under this DUA survive
the expiration or termination of this DUA until all the Confidential Infomration is Destroyed
or returned to HHS, as required by this DUA-
6.05
UA6.05 Governing Law, Venue and Litigation
(A) The validity, construction and performance ofthis DUAandthe legal relations
amongthe Parties to this DUAivill be governed by and construed in accordance nith the laws
of the State of Texas.
(B) The Parties agree thatthe courts of Texas, will be the exclusive venue for any
litigation, special proceeding or other proceeding as between the parties that may be brought;
or arise out of or in connection with, or by reason of this DUA
6.06 Injunctive Relief
(A) CONTRACTOR acknowledges and agrees that HHS. may suffer irreparable
injury if CONTRACTOR or its Subconhactor fails to comply with arty of the terms of this
DUAwith respect to the Confidential Information or a provision of HIPAA or other laws or
regulations applicable to Confidential Information.
(B) CONTRACTOR further agrees that monetary damages may be inadequate to
compensate HHS for CONTRACTORS or i6 Subcontractor's failure to comply. AccorditW_ y,
CONTRACTOR agrees that HHS will. in addition to any other remedies available to it at Im-
or in equity, be entitled to seek injunctive relief without posting a bond and nithout the
necessity of demonstrating actual damages, to enforce the term ofthis DUA
H1IS Data Uee AgremiEw 071015MPAA Onuubw Cetnphant OetobE ; 2015
TACCHO VEM1018
Page 34 of it
System Agency Contract No. ITHS000371500003 Under the Page 60 of 62
2617 HURRICANR PUBLIC HEALTH CRISIS RESPONSE COOPERATIVE AGREEMENT GRANT
DocuSign Envelope ID: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
6.07 Responsibility.
To the extent. permitted by the Texas Constitution, laws and rules, .and without -waiving any
immunities or defenses available to CONTRACTOR as a governmental entity, CONTRACTOR
.shall be solely responsible for its ouni acts and omissions :and the acts and omissions of its
employees, directors, officers, Subcontractors and agents. HHS shall be solely responsible for its
oum acts and omissions.
6.08 Insurance
(-A) As a govenunental entity and in accordance with the limits of the Texas Tort
Claim. Act, Chapter 101 of the Texas Civil Practice and Remedies Code, CONTRACTOR
either maintains commercial insurance or self-imsures %itll policy limits in an amount
sufficient to cover CONTRACTOR's liability arising under this DUA CONTRACTOR will
request that HHS be named as an additional insured. HHSC reserves the right to consider
alternative means for CONTRACTOR to satisfy CONTRACTOR'S financial responsibility
under this DUA Nothing herein shall relieve CONTRACTOR of its financial obligations set
forth in this DUA if CONTRACTOR faits to maintain insurance.
(B) CONTRACTORurillprovideHHSwith urittenproofthatrequiredinsurance
coverage is in effect. at the request ofHHS..
6.08 Fees and Costs
Except as otherwise specified in this DUA or the Base Contract, if any legal action or other
proceeding is brought for the enforcement of this DUA, or because of an alleged dispute; contract
violation, Event, Preack default, misrepresentation, or mimnctive action, in connection with any of
the provisions of this DUA, each party,/rill bear thein. own legal. expenses and the other cost incurred
in that action or proceeding.
6.09 Entirety of the Contract
This DUA is incorporated by: reference into the Base Contract as an amendment thereto
and, together with the Base Contract; constitutes the entire agreement between the parties. No
change, waiver, or discharge of obligations arising under those documents will be valid unless in
writing and executed by thepartyagainst whom such change, waiver, or discharge is sought to be
enforced. .If -any provision of the Base Contract, including any General. Provisions or Uniform
Terms and Conditions, conflicts with this DUA, this DUA controls.
6.10 Automatic Amendment and Interpretation
If there is (i) a change in any lain, regulation or rule, state or federal, applicable to HIPPA andfor
Confidential information- or (ii) any change in the judicial or administrative interpretation of anv
such law, regulation or role,, upon the effective date of such change, this DUA shall be deemed fo
have been automatically wended, interpreted and read so that the obligations imposed on HHS
and/or CONTRACTOR remain incompliance with such changes. Any ambiguity in this DUA will
HHS Data U) e Agaeineut O..toL�, 2015
TACCHO VE.C9I01•1
pagx 13 of 15
System Agency Contract No. HHS000371500003 Under the Page 61 of 62
2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOPERATIVE AGREEMENT GRANT
DocuSign Envelope lD: 9CE59EOC-198A-4052-8461-93B6FE88CD7D
be resolved in favor of a meaning that pelnlits HHS and CONTRACTOKto comply with H[FAA
or any other law applicable to Confidential Information.
HHS Dat_ll=e Aweement07101: IPA -4.0n -bu: Compliant Octobei, 2615
TACf-M VERSION
Page 15, of 13
System Agency Contract No. IIHS000371500003 Under the Page 62 of 62
2017 HURRICANE PUBLIC HEALTH CRISIS RESPONSE COOPERATIVE AGREEMENT GRANT
Docu
6 secukkn
.....__......... .
Certificate Of Completion
Envelope Id: 9CE59EOC198A4052846193B6FE88CD7D Status: Sent
Subject: New $232,425; HHS000371500003; Calhoun County; CMS/CoAg LHD
Source Envelope
Document Pages: 78 Signatures: 4
Envelope Originator:
Certificate Pages: 2 Initials: 0
Texas Health and Human Services Commission
AutoNav: Enabled
1100 W. 49th St.
Envelopeld Stamping: Enabled
Austin, TX 78756
Time Zone: (UTC -06:00) Central Time (US & Canada)
PCS_DocuSign@hhsc.state.lx.us
Status
IP Address: 167.137.1.14
Record Tracking
Status: Original Holder: Texas Health and Human Services Location: DocuSign
1/8/2019 12:44:52 PM Commission
PCS—DocuSign@hhsc.state.tx.us
Signer Events Signature Timestamp
Richard Meyer Sent: 1/8/2019 12:56:24 PM
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Security Level: Email, Account Authentication
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imeldam.garcia@dshs.texas.gov
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Sent: 1/8/201912:56:23 PM
elisha.wiley@hhsc.stale.tx. us
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sara.mosqueda@dshs.texas.gov COR+� v Viewed: 1/8/2019 7:20:35 PM
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Calhoun County Commissioners' Court—January 23, 2014
12. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 12)
To accept a check in the amount of $819.15 from Texas Association of
Counties for employee participation in the Health County Incentives to
be used for the Calhoun County Health and Wellness Program. (VL)
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vern Lyssy, Commissioner Pet 2
SECONDER:
David Hall, Commissioner Pet 1
AYES,
Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
Page 10 of 16
i�
Vern Lyssy
Calhoun County Commissioner, Precinct #2
5812 FM 1090C'06-�4"
(361) 552-9656
Port Lavaca, TX 77979 Fax (361) 553-6664
January 17, 2019
Honorable Richard Meyer
Calhoun County Judge
211 S. Ann
Port Lavaca, TX 77979
RE: AGENDA ITEM
Dear Judge Pfeifer:
Please place the following item on the next Commissioners' Court Agenda
Consider and take necessary to accept a Texas Association of Counties check
in the amount of $819.15 for employee participation in the Healthy County
Incentives to be used for the Calhoun County Health & Wellness Program
Sincerely,
Vern Ly
ssy
V,Ltlj
I
TAG -HEALTH and EMPLOYEE BENEFITS POOL
12/31/2018 2018 CALHOU,N
1/9/2019 1 004644
4b44
$819.16
TAC-HEALTF) and EMPLOYEE BENEFITS POOL
Calhoun County
TO REORUER CALL: 0001327 9550 W MF001015M 05114
Calhoun County Commissioners' Court—January 23, 2019
13. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 13)
To authorize County Judge to sign Tax Resale Deed and Commissioners' Court
to sign Resolution providing for the sale of property acquired by the County
of Calhoun at Delinquent Tax Sale. Property is as follows:
PROPERTY: .14 acre, more or less, being Lots 12 & 13, Block I, Bayside Beach
Unit #2, Calhoun County, Texas (Instrument #145966 of the Deed Records,
Calhoun County, Texas). Tax Account No. 000000034668
PROPERTY: .14 acre, more or less, being Lot 6, Block 146, Bayside Beach,
Unit #2, Calhoun County, Texas (Instrument #145966 of the Deed Records,
Calhoun County, Texas). Tax Account No. 000000036027
PROPERTY: Lot 23, Block 50, Bayside Beach, Calhoun County, Texas (Instru-
ment #145966 of the Deed Records, Calhoun County, Texas). Tax Account
No.000000036292
PROPERTY: Lot 5, Block 66, Bayside Beach, Calhoun County, Texas (Instru-
ment #145966 of the Deed Records, Calhoun County, Texas). Tax Account
No. 000000036612
PROPERTY: Lot 21, Block 57, Bayside Beach, Calhoun County, Texas (Instru-
ment #145966 of the Deed Records, Calhoun County, Texas). Tax Account
No. 000000036852
PROPERTY: Lot 13, Block 70, Bayside Beach, Calhoun County, Texas (Instru-
ment #145966 of the Deed Records, Calhoun County, Texas). Tax Account
No. 000000371
RESULT: APPROVED [UNANIMOUS]
MOVER: Vern Lyssy, Commissioner Pet 2
SECONDER: Gary Reese, Commissioner Pet 4
AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
Page 11 of 16
MCCREARY, VESELKA, BRAGG & ALLEN, P.C.
ATTORNEYS AT LAW
426 W. Main
Port Lavaca, Texas 77979
(361) 552-4560 ext. 206
January 10, 2019
Mr. Richard Meyer
Calhoun County Judge
211 S. Ann
Port Lavaca, Texas 77979
Dear Mr. Meyer:
I
Enclosed please find a Tax Resale Deed and Resolution providing for the sale of a property
previously bid in trust to the County of Calhoun.
The subject properties were put up for sale at a public auction for delinquent taxes on December
4, 2018. There has not been much interest in these properties and we believe it is advisable to
accept the bid to put the properties back on the tax rolls.
Please place the resolution on your agenda for your governing body to consider and, if approved,
please sign and return to us for proper filing.
Sincerely,
Noe Reyes
nr/RXC
Enclosures
TAX RESALE DEED
NOTICE OF CONFIDENTIALITY RIGHTS: IF YOU ARE A NATURAL PERSON, YOU MAY REMOVE OR STRIKE
ANY OF THE FOLLOWING INFORMATION FROM THIS INSTRUMENT BEFORE IT IS FILED FOR RECORD IN
THE PUBLIC RECORDS: YOUR SOCIAL SECURITY NUMBER OR YOUR DRIVER'S LICENSE NUMBER.
DATE: January3, 2019
GRANTOR: County of Calhoun, in trust for the use and benefit of itself and the Calhoun Independent
School District and the Calhoun County Port Authority
GRANTOR'S MAILING ADDRESS: 426 W. Main, Port Lavaca, Texas, 77979
GRANTEE: Thomas Hunt
GRANTEE'S MAILING ADDRESS: 8565 Real Road, San Antonio, Texas 78263-1908
CONSIDERATION: One Thousand Three Hundred Fifty -Five and No Hundredths Dollars ($2,355.00)
PROPERTY: .14 acre, more or less, being Lots 12 & 13, Block 1, Bayside Beach, Unit 92, Calhoun
County, Texas (Instrument #145966 of the Deed Records, Calhoun County, Texas) Tax Account No.
000000034668
PROPERTY: .14 acre, more or less, being Lot 6, Block 146, Bayside Beach, Unit #2, Calhoun County,
Texas (Instrument #145966 of the Deed Records, Calhoun County, Texas) Tax Account No.
000000036027
PROPERTY: Lot 23, Block 50, Bayside Beach, Calhoun County, Texas (Instrument #145966 of the
Deed Records, Calhoun County, Texas) Tax Account No. 000000036292
PROPERTY: Lot 5, Block 66, Bayside Beach, Calhoun County, Texas (instrument #145966 of the Deed
Records, Calhoun County, Texas) Tax Account No. 000000036612
PROPERTY: Lot 21, Block 57, Bayside Beach, Calhoun County, Texas (Instrument #145966 of the
Deed Records, Calhoun County, Texas) Tax Account No. 000000036852
PROPERTY: Lot 13, Block 70, Bayside Beach, Calhoun County, Texas (instrument #145966 of the
Deed Records, Calhoun County, Texas) Tax Account No. 000000037129
TAX FORECLOSURE LAWSUIT: Cause No. 2013-09.6392; Calhoun County Appraisal District v. Robert
Alexander
GRANTOR, for and in consideration of the amount set out above, and subject to the reservations from
and exceptions to conveyance, and other good and valuable consideration paid by the GRANTEE, the
receipt and sufficiency of which are acknowledged by GRANTOR, has GRANTED, SOLD AND CONVEYED,
and by these presents does GRANT, SELL AND CONVEY to the GRANTEE all of the right, title and interest,
of GRANTOR in the PROPERTY acquired by the tax foreclosure sale held under the TAX FORECLOSURE
LAWSUIT referenced above.
TO HAVE AND TO HOLD all of its right, title and interest in and to the PROPERTY unto the said
GRANTEE, the GRANTEE'S successors and assigns forever without warranty of any kind, so that neither
the GRANTOR, nor any person claiming under it and them, shall at any time hereafter have, claim or
demand any right or title to the PROPERTY, premises or appurtenances, or any part thereof.
GRANTOR excludes and excepts any warranties, express or implied, regarding the PROPERTY,
Including, without limitation, any warranties arising by common law or Section 5.023 of the Texas
Property Code or its successor.
GRANTOR has not made, and does not make any representations, warranties or covenants of any kind
or character whatsoever, whether express or implied, with respect to the quality or condition of the
PROPERTY, the suitability of the PROPERTY for any and all activities and uses which GRANTEE may
conduct thereon, compliance by the PROPERTY with any laws, rules, ordinances or regulations of any
applicable governmental authority or habitability, merchantability or fitness for a particular purpose,
and specifically, GRANTOR does not make any representations regarding hazardous waste, as defined by
the Texas Solid Waste Disposal Act and the regulations adopted thereunder, or the U.S. Environmental
Protection Agency regulations, or the disposal of any hazardous or toxic substances in or on the
property.
The PROPERTY is hereby sold, transferred, and assigned to GRANTEE "as is" and "with all faults".
This conveyance is expressly made subject to property taxes for the tax year 2017 and subsequent
years.
This conveyance is expressly subject to any existing right or redemption remaining to the former
owner of the PROPERTY under the provisions of law.
This conveyance is expressly subject to all easements and restrictions of record.
When the context requires, singular nouns and pronouns include the plural.
IN TESTIMONY WHEREOF the GRANTOR, pursuant to Section 34.05 of the Texas Property Tax Code,
has caused these presents to be executed on the date set forth in the acknowledgement attached
hereto, to be effective as of DATE.
County t i al un
BY
Richard Meyer, County Judge
THE STATE OF TEXAS
COUNTY OF CALHOUN 9
Before me, the undersigned authority on this day personally appeared Richard Meyer, County Judge
of Calhoun County, known to me to be the person whose name is subscribed to the foregoing document
and acknowledged to me that he executed the same for the purposes and consideration therein
expressed.
GIVEN UNDER MY HAND AND SEAL OF OFFICE this the 23 day of January 2019
e
SUSAN RILEY Notary Public, State of Texas
Lvtary rob' Sia(e of Texas
EXPCes 04 1 ,-2020
M CaBir4-7 k3- 11gs$L❑oP ex fres:
Plolafy IU 7424044 Y 0
RESOLUTION PRDVIDING FOR THE SALE
OF PROPERTY ACQUIRED BY THE COUNTY OF CALHOUN
AT DELINQUENT TAX SALE
WHEREAS, .14 acre, more or less, being Lots 12 & 13, Block 1, Bayside Beach, Unit 92, Calhoun County,
Texas (Instrument #145966 of the Deed Records, Calhoun County, Texas) Tax Account No.
000000034668 AND .14 acre, more or less, being Lot 6, Block 146, Bayside Beach, Unit #2, Calhoun
County, Texas (Instrument #145966 of the Deed Records, Calhoun County, Texas) Tax Account No.
000000036027 AND Lot 23, Block 50, Bayside Beach, Calhoun County, Texas (Instrument #145966 of
the Deed Records, Calhoun County, Texas) Tax Account No. 000000036292 AND Lot 5, Block 66,
Bayside Beach, Calhoun County, Texas (Instrument #145966 of the Deed Records, Calhoun County,
Texas) Tax Account No. 000000036612 AND Lot 21, Block 57, Bayside Beach, Calhoun County, Texas
(instrument #145966 of the Deed Records, Calhoun County, Texas) Tax Account No. 000000036852
AND Lot 13, Block 70, Bayside Beach, Calhoun County, Texas (Instrument #145966 of the Deed
Records, Calhoun County, Texas) Tax Account No. 000000037129, according to the map or plat thereof
recorded as assessed on the tax rolls under the jurisdiction of Calhoun County, Texas, was offered for
sale by the Sheriff of Calhoun County, Texas at a public auction pursuant to a judgment of foreclosure
for delinquent taxes by the District Court; Cause No 2018-cv-6989-dc; Calhoun County et al vs. David F.
Bone and
WHEREAS, no sufficient bid was received and the property was struck off to the County of Calhoun,
Texas, for the use and benefit of itself and Calhoun County Independent School District and Calhoun
County Port Authority, pursuant to TEX. PROP. TAX CODE §34.01(j); and
WHEREAS, TEX. PROP. TAX CODE §34.05(x), (h) and (1) provide that a taxing unit may accept a sufficient
bid. A bid of ONE THOUSAND THREE HUNDRED FIFTY-FIVE HUNDRED AND No HUNDREDTHS DOLLARS
($1,355.00) having been received from Thomas W. Hunt WOULD be a sufficient bid for this property;
THEREFORE, BE IT HEREBY RESOLVED by the County of Calhoun, that the Judge is hereby authorized to
convey .14 acre, more or less, being Lots 12 & 13, Block I, Bayside Beach, Unit #2, Calhoun County,
Texas (Instrument #145966 of the Deed Records, Calhoun County, Texas) Tax Account No.
000000034668 AND .14 acre, more or less, being Lot 6, Block 146, Bayside Beach, Unit #2, Calhoun
County, Texas (Instrument #145966 of the Deed Records, Calhoun County, Texas) Tax Account No.
000000036027 AND Lot 23, Block 50, Bayside Beach, Calhoun County, Texas (Instrument #145966 of
the Deed Records, Calhoun County, Texas) Tax Account No. 000000036292 AND Lot 5, Block 66,
Bayside Beach, Calhoun County, Texas (instrument 9145966 of the Deed Records, Calhoun County,
Texas) Tax Account No. 000000036612 AND Lot 21, Block 57, Bayside Beach, Calhoun County, Texas
(Instrument 0145966 of the Deed Records, Calhoun County, Texas) Tax Account No. 000000036852
AND Lot 13, Block 70, Bayside Beach, Calhoun County, Texas (Instrument #145966 of the Deed
Records, Calhoun County, Texas) Tax Account No. 000000037129, according to the map or plat thereof
recorded as assessed on the tax rolls under the jurisdiction of Calhoun County, Texas, according to the
map or plat thereof recorded as assessed on the tax rolls under the jurisdiction of Calhoun County,
Texas for the sum of SIX THOUSAND SIX HUNDRED TWENTY NINE AND NO HUNDREDTHS DOLLARS
($1,355.00) payable to the Calhoun County Appraisal District for distribution as provided by law and to
execute a deed to Thomas W. Hunt.
PASSED, APPROVED AND ADOPTED THIS 23 day of January, 20189.
County Judge
David pall, County Commissioner, Precinct 1
lyssy, County Commissioner, Precinct 2
Clyde Sgma, County Commissioner, Preclnct 3
Gary Reese Co my Commissioner, Precinct 4
Calhoun County Commissioners' Court -January 23, 2019
14. ACCEPT REPORTS OF THE FOLLOWING COUNTY OFFICES: (AGENDA ITEM
NO. 14)
i. Calhoun Tax Assessor/ Collector
ii. County Treasurer
iii. County Sheriff
iv. District Clerk — December 2018 (Amended)
v. County Clerk — December 2018 (Amended)
vi. Justices of Peace
vii. County Auditor
viii. Floodplain Administration
ix. Extension Service
x. Adult Detention Center SHP Medical
RESULT: APPROVED [UNANIMOUS]
MOVER: Vern Lyssy, Commissioner Pet 2
SECONDER: David Hall, Commissioner Pet 1
AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
Page 12 of 16
)q
FIRST AMENDED
Treasurer Receipt Numbers: P2018DrC003,013,
021,031,035
MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS
1/1,512019 .COURT NAME: DISTRICT CLERK
MONTH OF REPORT: DECEMBER
YEAR OF REPORT: 2018
ACCOUNT NUMBER ACCOUNTNAME DEBIT CREDIT
1000-001-44190
SHERIFF'S SERVICE FEES
$639.03
1000-001-44140
JURY FEES
$120.00
1000-001-44045
RESTITUTION FEE
$0.00
1000-001-44020
DISTRICT ATTORNEY FEES
$0.00
1000-001-49010
REBATES -PREVIOUS EXPENSE
$4.61
1000-001-49030
REBATES -ATTORNEY'S FEES
$539.39
1000-001-44058
DISI RICT CLERK ELECTRONIC FILING FEES
$188.00
1000-001-43049
STATE REIMB- TITLE IV -D COURT COSTS
$0.00
DISTRICT CLERK FEES
CERTIFIED COPIES
$375.00
CRIMINAL COURT
$112.30
CIVIL COURT
$1,650.49
STENOGRAPHER
-$264,30
CIV FEES DIFF
$0.00
1000-001-44050
DISTRICT CLERK FEES- -
$2,402.09
1000-999-10010
CASH AVAILABLE
$3,893, 12
2706-001-44055
FAMILY PROTECTION FEE
$30.00
2706-999-10010
CASH - AVAILABLE
$30.00
2740-001-45055
FINES - DISTRICTCOURT
$1,308.02
2740-999-10010
CASH - AVAILABLE
$1,308.02
2620-001.44055
APPELLATE JUDICIAL SYSTEM
$88.11
2620-999-10010
CASH - AVAILABLE
$88.11
2670-001-44055
COURTHOUSE SECURITY
.$118.88
2670-999-10010
CASH - AVAILABLE
$118,88
2673-001-44055
CRT RECS PRESERVATION FUND- CO
$198.48:
2673-999-10010
CASH - AVAILABLE.
$198.48
2739-001-44055
RECORD MGMT/PRSV FUND -COUNTY
$102.96
2739-999-10010
CASH - AVAILABLE
$102.96
2737-001-44055
RECORD MGMTlPRSV FUND -DIST CLRK
$216.10
2737-999-10010
CASH - AVAILABLE
$215.10
2731-001-44055
LAW LIBRARY
$616.70
2731-999-10010
.CASH - AVAILABLE
$616.70
2663-001-44050
CO & DIST CRT TECHNOLOGY FUND
$11.22
2663-999-10010
CASH - AVAILABL
$1122
7040-999-20740
BREATH ALCOHOL TESTING --:STATE
$0.00
7040-999.10010
CASH - AVAILABLE
$0.00
2667-001-44055
CO CHILD ABUSE PREVENTION FUND
$2.74
2667-999-10010
CASH - AVAILABLE
$2-74
7502-990-20740
JUDICIAL & COURT PERSONNEL TRAINING
FUND -STATE
$116.82
7502-999-10010
CASH-AVAILABE
$116.82
7383-999-20610
DNA TESTING FEE - County
$1.65
7383-999-20740
DNA TESTING FEE - STATE
$14.83
7383-999-10010
CASH - AVAILABLE
$16.48
7405-.999-20610
EMS TRAUMA FUND -COUNTY
$1.84
7405-999-20740
EMS TRAUMA FUND - STATE
$16.55
7405-999-10010.
CASH - AVAILABLE
$1.8.39
7070-999-20610
CONSOL. COURT COSTS - COUNTY
$9477
7070-999-20740
CONSOL. COURT COSTS - STATE
$852.90
7070-999-10010
CASH - AVAILABLE
$947.67
2696-001-44030-010
DRUG CRT FROG FEE - COUNTY (PROGRAM)
$102.57
2698-999-10010-010
CASH AVAILABLE
$102.57
7390-999-20610-999
DRUG COURT FROG FEE -COUNTY (SVC FEE)
$20.51
7390-999-20740-999
DRUG COURT PROG FEE - STATE
$8205
7390-999-10010-999
CASH - AVAILABLE
$102.56
7865=999-20610-999
CRIM - SUPP OF IND LEGAL SVCS - COUNTY
$1.42
7865-999-20740-999
CRIM - SUPP OF IND LEGAL SVCS -STATE
$12.73
7865-999-10010-999
CASH - AVAILABLE
$14.15
7950-999-20610
TIME PAYMENT- COUNTY
$47.19
7950-999-20740
TIME PAYMENT - STATE
$47.18
7950-999-10010
CASH - AVAILABLE
$94.37
7505-999-20610
JUDICIAL SUPPORT -GRIM - COUNTY
$6.34
7505-999-20740
JUDICIAL SUPPORT=CRIM- STATE
$35.90
7505.999-10010
-CASH - AVAILABLE
$42.24
7505-999.20740-010
JUDICIAL SALARIES-CIVIL-STATE(42)
$866.03
7505-999-10010-010
CASH AVAILABLE
$866.03
2740-001-45050
BOND FORFEITURES
$0.00
2740-999.10010
CASH - AVAILABLE
$0.00
2729-001-44034
PRE-TRIAL DIVERSION FUND
$0.00
2729-999-10010
CASH - AVAILABLE
$0.00
7857-999-20610
JURY REIMBURSEMENT FUND- COUNTY
$2.82
7857-999-20740
JURY REIMBURSEMENT FUND- STATE
$25.37
7857-999-10010
CASH - AVAILABLE
$2819
7403-999-22888
DIST CRT - ELECTRONIC FILING. FEE - CIVIL
$710.28
7403-999-22991
DIST CRT - ELECTRONIC FILING FEE - CRIMINAL
$13.88
CASH - AVAILABLE
$724.16
7855-999-20784-010
DIST CRT DIVORCE & FAMILY LAW - STATE
$208.75
7855-999-20657-010
DIST CRT DIVORCE & FAMILY LAW -COUNTY
$5.50
7855-999-20792-010
DIST CRT OTHER THAN DIVORCEIFAMILY LAW - STATE-
$97.50
7855-999-20658-010
DIST CRT -OTHER THAN DIVORCE/FAMILY LAW - COUNTY
$2.50
7855-999-20740-010
DIST CRT - OTHER CIVIL PROCEEDINGS STATE
$944.18
7855-999-20610-010
DIST CRT - OTHER CIVIL PROCEEDINGS COUNTY
$49.69
7855-999-10010-010
CASH - AVAILABLE
$1,308.12
TOTAL (Distrib Req to Oper Acct)
$10,967.08
$10,967.08.
DUE TO OTHERS (Distrib Req(s) attached)
ATTORNEY GENERAL (RESTITUTION)
0.00
OUT -OF -COUNTY SERVICE. FEES
0.00
REFUND OF OVERPAYMENTS I
0.00
.DUE TO OTHERS
0:00
TOTALDUETO
OTHERS
'$0.00
REPORT TOTAL - ALL FUNDS
10,967.08
PLUS AMT OF RETURNED CKS
0.00
LESS: TOTAL TREASURER'S RECEIPTS
(10,967.08)
Revised 03/18/14
OVER / (SHORT)
$0.00
DISTRICT COURT
STATE. COURT COSTS REPORT
SECTION I: REPORT FOR OFFENSES COMMITTED
01/01/04FORWARD
09/01/01 - 12/31/03
09/01/99 - 08/31/01
09/01197 - 08/31/99
DNA TESTING FEES
EMS TRAUMA FUND
JUV, PROB, DIVERSION FEES
JURY REIMBURSEMENT FEE
STATE TRAFFIC FEES
DRUG CRT PROG FEE
SECTION II. AS APPLICABLE
STATE POLICE OFFICER FEES
FAILURE TO APPEAR/PAY FEES
JUD. FUND -CONST. CO. CRT:
J UD. FUND -STATUTORY CO. CRT -
MOTOR CARRIER WEIGHT VIOLATIONS
TIME PAYMENT FEE
DRIVING RECORD FEE
JUDICIAL SUPPORT FEES
ELECTRONIC FILING: FEE - CR
TOTAL STATE COURT COSTS
CIVIL FEES REPORT
BIRTH CERTIFICATE FEES
16.46'
MARRIAGE LICENSE FEES
16.55.
DECL.:OF INFORMAL MARRIAGE
25.37
ELECTRONIC FILING FEE -CV
82.05.
NONDISCLOSURE FEES
- $116.82
JUROR. DONATIONS
JUSTICE CRT, INDIG FILLING FEES
STAT PROB CRT INDIG. FILING FEES
STAT PROB CRT JUDIC FILING FEES
STAT CNTY CRT INDIG FILING FEES
STAT CNTY CRT JUDIC FILING FEES
-STAT CNTY CRT -JUDICIAL SUPPORT
CONST CNTY CRT INDIG FILING: FEES
CNST CNTY CRT JUDIC FILING FEES
_
DIST CRT DIV & FAMILY LAW
_2.2
DIST CRT OTHER THAN DIV/FAM LAW
5
DIST CRT OTHER CIVIL FILINGS
52
FAMILY PROTECTION FEE
JUDICIAL SUPPORT FEE _
_24
JUDICIAL & COURT PERSONNEL TRANING FEE
`48.
TOTAL CIVIL FEES REPORT
DECEMBER
2018
DECEMBER
0.44 3.'
0.42 3.'
16.48
16.46'
18.39 1.84
16.55.
$28.19 2.82
25.37
$205.13 $123.08
82.05.
$94.37 47.19 47.18
$42.24 6.34 35.90
$13.88 $13.88'
$1,366.35 $ 276.04 $ 1,090.31
DECEMBER
COLLECTED .COUNTY STATE
$710.26 $710.28.
$214.25
5,50 208,75
$100.00
2,50 9750
$993.87
4969 -944,18
.$866.03
$866.03..
$116.82
- $116.82
$ 3,00125 $ 57.69 $ 2,943.56.
TOTAL BOTH REPORTS $ 4,367.60 $ 333.73 $ 4,033.87
MONTHLY REPORT
COURT NAME: DISTRICT CLERK
MONTH OF REPORT: DECEMBER
YEAR OF REPORT: 2018
CIVIL FEES
District Clerk's. Fees:
Certified Copies 375.00
Civil Court 1,650.49
Stenographer 264,30
Courthouse Security Fund:
Civil Filings:
Sheriffs Fees:
civil Court.
Civil Jury
Jury Fees:
Law Library Fees:.
Appellate Judicial System. Fund (AJSF):
Judicial Salaries Fund (JSF):
511.17
7.73
& Court Personae] Training Fee (JCPT)
t Management Fees:
strict Clerk 208.09
wnty _ .39.84
Bond Forfeitures
Adoption/Bureau of Vital Statistics Fee
State Electronic Filing Fee -_ CV
County Electronic Filing Fee, CV
CRIMINAL FEES
Consolidated Court Costs:
Criminal Justice Planning (CJPF)
Crime Victims Comp (CVCF)
JCPT
CJPT
Crime Stoppers(CS)
Fugitive Apprehension (FA)
Consol Cd Costs (CCC)
Juv Crime Prevention (JCD)
CMI
Clerk's Fees.
Records Management:
Restitution Fee:
Bono Forfeitures:
Pretrial Diversion Fund
Law Enforcement Edu Fund(LEOS);
Breath Alcohol Testing (BAT):
Child Abuse Prevention Fund
Drug Court Program Fee
DNA Testing
EMS Trauma Fund
Time Payment Fee:
State Electronic Filing Fee - CR:
County Electronic Filing Fee- CR:
Reimume.Crt Appt Ally Fees:
Jury Reimbursement Fee.(JRF)r
Judicial Support Fund (JSF):
Fines:
Courthouse Security:
Sheriffs Fees:
District Attorney Fees:
Civil Fees:
0.00
0.18
0.01
0,00
0.68
002
046.78
0.00
0.00
Criminal Fees:
2,289,79
104.84
1,308.12
518.90
120,00
616.70
88.11
866,03
30.00
188.48
116.82
247:93
0.00
0:00
710.28
180:00
7,404.00
947.67
112.30
70.13
0.00
0.00
0.00
0.00
0.00
2.74
205.13
98.48
18.39
94.37
13.88
0.00
539.39
28.19
42,24
1,308.02
14.04
120:t3
0.00
$3 533.10
Due to Others: $0.00
TOTAL COLLECTED: $10,937:10
Less Returned checks 0.00
Suan Riley
From: anna.goodman@calhouncotx.org (Anna Goodman) <anna.goodman@calhouncotx.org>
Sent: Wednesday, January 16, 2019 9:20 AM
To: susan.riley@calhouncotx.org
Subject: Emailing: 2018.123118.000NTY CLERK REPORT.00012319 - CORRECTED
Attachments: 2018.123118.000NTY CLERK REPORT.00012319.pdf
Good morning!
Will you please add to next available agenda? I had to correct an error on December's report.
Thanks!
Your message is ready to be sent with the following file or link
attachments:
2018.123118.000NTY CLERK REPORT.00012319
Note: To protect against computer viruses, e-mail programs may prevent sending or receiving certain types of file
attachments. Check your e-mail security settings to determine how attachments are handled.
Calhoun County Texas
CALHOUN COUNTY CLERK
MONTHLY REPORT RECAPITUATION
'- DECEMBER 2018
DESC
GLCODE
CML
CRIMINAL
OFFICIAL
PUBLIC
RECORDS
PROBATE
TOTAL
DISTRICT ATTORNEY FEES
1000-44020
$ 395.47
$ 396.47
BEER LICENSE
1000-42010
$ -
$ -
COUNTY CLERK FEES
1000-44030
$
287.00
$ 634.43
$ 10,381.65
$ 203.00
$ 11,506.08
APPEAL FROM IP COURTS
1000-44030
$ -
$ -
COUNTY COURT ATLAW 41JURY FEE
1000-44140
$
JURY FEE
1000-44140
$
-
$ -
$ -
ELECTRONICFILINGFEESFORE-FIONGS
1000-44058
$
48.00
$ -
$ -
$ 34.00
$ 82.00
JUDGE'S EDUCATION FEE
1000-04160
$
-
$ -
$ -
$ 20.00
$ 20.00
JUDGE'S ORDER/SIGNATURE
300044180
$
6.00
$ -
$ -
$ 36.00
$ 42.00
SH ERIFF'S FEES
1000-04190
$
-
$ 416.97
$ -
$ 150.00
$ 566.97
VISUAL RECORDER FEE
LOGO 44250
$ 60.17
$ 60.17
COURT REFPORTER FEE
100044270
$
60.00
$ -
$ -
$ 60.00
$ 120.00
RESTITUTION DUE TO OTHERS
100049020
$ -
ATTORNEY FEES -COURT APPOINTED
1OW49030
$ 116.01
$ 116.01
APPELLATE FUND (TGC) FEE
2620-04030
$
20.00
$ 20.00
$ 40.00
TECHNOLOGY FUND
2663-44030
$ 59.48
$ 59.48
COURTHOUSE SECURITY FEE
267044030
$
20.00
$ 47.56
$ 327.00
$ 20.00
$ 414.56
COURT INITIATED GUARDIANSHIP FEE
2672-44030
$ 80.00
$ 80.00
COURT RECORD PRESERVATION FUND
2673-44030
$
40.00
$ -
$ 40.00
$ 80.00
RECORDS ARCHIVE FEE
2675-44030
$ 3,160.00
$ 3,160.00
DRUG& ALCOHOL COURT PROGRAM
2698-44030-005
$ 214.34
$ 214.34
JUVENILE CASE MANAGER FUND
269944033
$ -
$
FAMILY PROTECTION FUND
2706-44030
$
15.00
$ 15.00
JUVENILE CRIME& DELINQUENCY FUND
2715-44030
$0.00
$ -
PRE-TRIAL DIVERSON AGREEMENT
2729-44034
$ 32.14
$ 32.14
LAW LIBARY FEE
2731-44030
$
140.00
$ 140.00
$ 280.00
RECORDS MANAGEMENT FEE - COUNTYCLERKK
2738-44380
$ 39.03
$ 3,210.00
$ 3,249.03
RECORDS MANGEMENT FEE - COUNTY
2739-44030
$
20.00
$ 351.24
$ 20.00
$ 391.24
FINES -COUNTY COURT
2740-45040
$ 3,602.13
$ 3,602.13
BOND FORFEITURE
2740-45050
$ -
STATEPOLICEOFFICERFEES - STATE (DPS)(20%)
7020-20740
$ 4.35
$ 4.35
CONSOLIDATED COURT COSTS -COUNTY
7W0-20610
$ 136.89
$ 136.89
CONSOLIDATED COURT COSTS - STATE
7070-20740
$ 1,232.00
$ 1,232.00
JUDICIAL AND COURT PERSONNEL TRAINING - ST (100%)
7502-20740
$
20.00
$ -
$ 20.00
$ 40.00
DRUG& ALCOHOL COURT PROGRAM -COUNTY
7390-20610
$ 42.87
$ 42.87
DRUG& ALCOHOL COURT PROGRAM - STATE
7390-20740
$ 171.47
$ 171.47
STATE ELECTRONIC FILING FEE - CIVIL
7403-22887
$
120.00
$ -
$ 120.00
$ 240.00
STATE ELECTRONIC FILING FEE CRIMINAL
7403-22990
$ 74.26
$ 74.26
EMS TRAUMA -COUNTY (10%)
7405-20610
$ 358.38
$ 368.38
EMS TRAUMA -STATE 190%)
7405-20740
$ 40.93
$ 40.93
CIVIL INDIGENT FEE -COUNTY
7480-20610
$
2.00
$ 2.00
$ L00
CIVIL INDIGENT FEE -STATE
7480-20740
$
38.00
$ 38.00
$ 76.00
JUDICIAL FUN D COURT COSTS
7495-20740
$ 237.93
$ 237.93
JUDICIAL SALARY FUND - COUNTY (10%)
7505-20610
$ 9.67
$ 9.67
JUDICIAL SALARY FUND - STATE (90%)
7505-20740
$ 87.03
$ 87.03
JUDICIAL SALARY FUND (CIVIL & PROBATE) -STATE
7505-20740-005
$
168.00
$ 168.00
$ 336.00
TRAFFIC LOCAL (ADMINISTRATIVE FEES)
7538-22884,1000-04359
$ 10.45
$ 10.45
COURT COST APPEAL OF TRAFFIC REG DP APPEAL)
7538-22885
$ -
BIRTH - STATE
7855-20780
$ 66.60
$ 66.60
INFORMAL MARRIAGES - STATE
7855-20782
$ 25.00
$ 25.00
JUDICIAL FEE
7855-20786
$
160.00
$ -
$ 160.00
$ 320.00
FORMAL MARRIAGES -STATE
7855-20788
$ 450.00
$ 450.00
NONDISCLOSURE FEE - STATE
7855-20790
$
-
$ -
$ -
$
TCLEOSE COURT COST - COUNTY (10%)
7856-20610
$ 0.08
$ 0.08
TCLEOSE COURT COST - STATE (90%)
7856-20740
$ 0.76
$ 0.76
JURY REIMBURSEMENT FEE -COUNTY (10%
7857-20610
$ 6.57
$ 6.57
JURY REIMBURSEMENT FEE -STATE (90%)
7857-20740
$ 59.10
$ 59.10
STATE TRAFFIC FINE - COUNTY (5%)
7860-20610
$ 6.32
$ 6.32
STATE TRAFFIC FINE - STATE (95%)
7860-20740
$ 120.15
$ 120.15
INDIGENT DEFENSE FEE - CRIMINAL - COUNTY (10%)
7865-20610
$ 3.32
$ 3.32
INDIGENT DEFENSE FEE - CRIMINAL - STATE (90%)
7865-20740
$ 29.89
$ 29.89
TIME PAYMENT - COUNTY (50%)
7950-20610
$ 202.22
$ 202.22
TIME PAYMENT -STATE (50%)
7950-20740
$ 202.22
$ 202.22
SAIL JUMPING AND FAIW RE TO APPEAR - COUNTY
7970-20610
$ -
SAIL JUMPING AND FAILURE TOAPPEAR -STATE
7970-20740
$ -
DUE PORT IAVACA PD
x.999099991
$ 29.79
$ 29.79
DUE SEADRIFT PIT
.9990-99992
$ 212
$ .:2.12
DUE TO POINT COMFORT PD
9990-99993
$ 0.17
$ -'0.17.
DUE TO TEXAS PARKS & WILDLIFE ,
9990-99994
$ 28800
$ -288.00
DUE TO TEXAS PARKS IS WILDLIFE WATER SAFETY
9990-99995
$
DUETOTABC
9990-99996
$
DUE TO ATTORNEY AO( ITEMS
999099997
$
DUE TO OPERATING/NSF CHARGES/DUE TO OTHERS
$
$ 275.00
1 $ 1,696.00
$ -
$ 1,971.00
$
1,164.00
$ 9,611.90
$ 19,316.25
$ 1,331.00
$ 31,423.15
TOTAL FUNDS COLLECTED
$
31,423.15
-
FUNDSHELDINESCROW:
$
-
AMOUNT
DU E TO TREASURER:
$':"'' 29,132.07
TOTAL RECEIPTS:
$ L
'iJ31,42115
AMOUNT DUE TO
OTHERS:
$ 2,291.08
1 aF2
ANO TREASURER REPORT512018120118 TREA611RER REPORTS.carrec1e Fu.d 2620 1tl52019
CALHOUN COUNTY CLERK
MONTHLY REPORT RECAPITUATION
DECEMBER 2018
_ `BALANCE MOVED TO NEW PROSPERITY ACCOUNT"
.GINNING BOOK BALANCE r ' `I 11/30/2017 - $ -
FUND RECEIVED $ -
DISBURSEMENTS
ENDING BOOK BALANCE 12/31/201] >: $ -
iNDING BANK BALANCE 12/31/2017 $
OUTSTANDING DEPOSITS" $
OUTSTANDING CHECKS`
"BALANCE MOVED TO NEW PROSPERITY ACCOUNT"
GINNING BOOK BALANCE >11/30/2017 $
FUND RECEIVED $
DISBURSEMENTS $
ENDING BOOK BALANCE 212/31/2017:::5; $
iNDiNG BANK BALANCE 12/31/2017 $
OUTSTANDING DEPOSITS" $
OUTSTANDING CHECKS` $
RECONCILED BANK BALANCE 12/31/2017 $
IEGINNING BOOK BALANCE +'-<11/30/2018
1'.'.
`. $
82,192.20
FUND RECEIVED
Balance
$
3,500.00
DISBURSEMENTS
Interest
$
(3,730.00
ENDING BOOK BALANCE dhi
12/31/2018 EI'.
$
81,962.20
$
$
IANK RECONCILIATION REGISTRY OF COURT FUNDS
1/30/2013
$
10441
!LADING BANK BALANCE
12/31/2018
$
107,125.60
OUTSTANDING DEPOSITS"
$
475.00
OUTSTANDING CHECKS`
1/15/2015
$
(25,638.40
CD'S
'Data tssued
-Balance
Purchases/
Withdrawals
Balance
11/30/2018
Interest
Interest
12/31/18
74925
11/19/2009
$
$
$
$
49466
1/30/2013
$
10441
1/24/2018
$
50782
1/15/2015
$
10642
$
50790
1/15/2015
$
$ 1,254.68
$
50804
1/15/2015
$
$ 1,254.68
$
50863
212/2015
$
$
50871
2/2/2015
$
$ 9,475.04
$
51134
5/28/2015
$
$
$-
$ -
TOTALS:
$ -'
$
,.:$
$
••c0 n]a awas casnev Is mammyaeuueposNa To ne9rsry nccraunuur a T.I.I. r n,un,y w.
r�aT[ClfaTT< PRDPI[IT[ MFI n IN TRI IR. PROCPFRITY RANK
-CD's
-Date Issued
Balance
Purchases/
Withdrawals
Balance
11130/2018
Interest
12/31118
10440
1/24/2018
$ 1,856.43
$
$ 1,856.43
10441
1/24/2018
$ 10,048.70
$ 10,048.70
10642
1/24/2018
$ 1,254.68
$ 1,254.68
10443
1/25/2018
$ 1,254.68
$ 1,254.68
10444
1/25/2018
$ 9,475.04
$ 9,475.04
10445
1/25/2018
$ 9,475.04
$ 9,475.04
10446
1/25/2018
$ 9,475.04
$ 9,475.04
10449
2!2/2018
$ 79,886.15
$ 19,886.15
10456
3/2/2018
$ 3,535.20
$ 4.41
$ 3,539.61
10455
3/2/2018
$ 3,535.20
$ 4.41
$ 3,539.61
$
$
TOTALS:
$ 69,796.16
$ 8.82.
$
$ 69,804.98
> ve,Pvw.av
620" 1/15/2019
( Submitted by: Anna M Goodman, County Clerk Date
g
V k,
REPORTS. mrrxlM Fund M20
2 OF
1 KNM
Calhoun County Commissioners' Court — January 23, 2019
15. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 15)
To declare carpet, Inventory #570-077 in the office of Adult Probation as
Waste and authorize Disposal of Same. (RM)
RESULT: APPROVED [UNANIMOUS]
MOVER: Vern Lyssy, Commissioner Pet 2
SECONDER: Gary Reese, Commissioner Pet 4
AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
Page 13 of 16
Calhoun County, Texas
WASTE DECLARATION REQUEST FORM
Department Name: ACIL-If-Prohaffo^/C5cb
Requested By: Tam.,, mRtUla 1 Efn f SUPprvj Sor
Inventory
Number Description Serial No. Reason for Waste Declaration
5y0Dt��1 r e 1994 a e atec�
Cal Iioun County Commissioners' Court—January 23, 2019
16. Consider and take action on any necessary budget adjustments.
2018 BUDGET ADJUSTMENTS
RESULT: APPROVED [UNANIMOUS]
MOVER: Vein Lyssy, Commissioner Pet 2
SECONDER: David Hall, Commissioner Pet 1
AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
2019 BUDGET ADJUSTMENTS
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vern Lyssy, Commissioner Pet 2
SECONDER:
David Hall, Commissioner Pet 1
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
Page 14 of 16
Calhoun County Commissioners' Court—January 23, 2019
16. Consider and take action on any necessary budget adjustments.
2018 BUDGET ADJUSTMENTS
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vein Lyssy, Commissioner Pet 2
SECONDER:
David Hall, Commissioner Pet 1
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
2019 BUDGET ADJUSTMENTS
RESULT:
APPROVED [UNANIMOUS]
MOVER:
Vern Lyssy, Commissioner Pet 2
SECONDER:
David Hall, Commissioner Pet 1
AYES:
Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
Page 14 of 16
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Calhoun County Commissioners' Court—January 23, 2019
17. Approval of bills and payroll.
MMC BILLS
RESULT: APPROVED [UNANIMOUS]
MOVER: Vern Lyssy, Commissioner Pet 2
SECONDER: David Hall, Commissioner Pet 1
AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
COUNTY BILLS 2018
COUNTY BILLS 2019
RESULT: APPROVED [UNANIMOUS]
MOVER: Vern Lyssy, Commissioner Pet 2
SECONDER: David Hall, Commissioner Pet 1
AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
PAYROLL
RESULT: APPROVED [UNANIMOUS]
MOVER: Vern Lyssy, Commissioner Pet 2
SECONDER: David Hall, Commissioner Pet 1
AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese
Page 15 of 16
r
TOTAL PAYABLES, PAYROLL AND ELECTRONIC BANK PAYMENTS $ 752,834.03
TOTAL TRANSFERS BETWEEN FUNDS $
TOTAL NURSING HOME URL EXPENSES $ 446,726.70
TOTAL INTER -GOVERNMENT TRANSFERS $ 151,920.00
GRAND TOTAL DISBURSEMENTS APPROVED January 23, 2019 $ 7,351,480:73
MEMORIAL . C: CENM
PAYABLES AND PAYROLL
1/17/2019 Weekly Payables
354,036.27
1/22/2019 McKesson -3408 Prescription Expense
4,328.78
1/22/2019 Amerisource Bergen -3406 Prescription Expense
2,683.03
1/22/2019 Pfizer Inc -340B Repayment
57.33
1/22/2019 AstaZeneca-3048 Repayment
1,403.09
1/22/2019 Novo Nordisk Inc -3408 Repayment
3,685.41
1/22/2019 Mission Pharmacal Co -3408 Repayment
3.32
1/22/2019 Sandoz Inc -340B Repayment
17.53
1/22/2019 Taro Pharmaceutical USA, Inc -3408 Repayment
49.50
1/22/2019 Sun Pharmaceuticals Industry Inc -3408 Repayment
1,773.72
1/22/2019 Payroll Liabilities (Payroll Taxes)
94,816.19
1/22/2019 Payroll
289,889.29
Prosperity Electronic Bank Payments
1/22/2019 Pay Plus -Patient Claims Processing Fee
90.57
NURSING HOME UPL EXPENSES
1/22/2019 Nursing Home UPI
381,978.57
QIPP/INTEREST CHECKS TO MMC
1/22/2019 Ashford
1/22/2019 Solera
22,547.04
10,057.50
1/22/2019 Crescent
1/22/2019 Broadmoor
6,839.10
1/22/2019 Fort Bend
10,861.92
...._ -
INTER -GOVERNMENT TRANSFERS
9 IGT DY8 UC Advance to be paid February 04, 2019 151
I
Page 1 of 16
F
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A MEMORIAL MEDICAL CENTER
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01/17{2 7 � '
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:`+5 AP Open Invoice List
11:28
ap_open_invoice.template
Due Dates Through: 01/30/2019
/ e do endo1,„ x� rx_ e § Class Pay Code
Vi 1rif� r a e
/
11283 ACE HARDWARE 15521 y/
Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross
Discount
No -Pay
Net
130256 ✓ 12/31/2012/24/2001/26{20 15.99
0.00
0.00
15.99 e�
SUPPLIES (KW VLQ
130282 12/31/2"012/26/2001/26/20 $9.51
0.00
0.00
39.51 u/
SUPPLIES [ MU,1Al}.1
130266 12/31/20 12{26/20 01/26/20 12.98
0.00
0.00
12.98 y
SUPPLIES C MIAIAQ
130307 V/ 12/31/20 12/27/20 01/27/20 24.58
0.00
0.00
24.58 t�
SUPPLIES L JA,�)
130312 V/ 12/31/20 12/27/20 01/27/20 17.99
0.00
0.00
17.99
SUPPLIES C LAI6,
130335 ✓ 12/31/2012/28/2001/28120 6.99
0.00
0.00
6.99 a/
SUPPLIES ( M(ij Vk V.
Vendor Totals Number Name Gross
Discount
No -Pay
Net
11283 ACE HARDWARE 15521 118.04
0.00
0,00
118.04
Vendor# Vendor NameClass Pay Code
10950 ACUTE CARE INC V/
Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross
Discount
No -Pay
Net
24167 ,�/ 01{16/2001/20/2001/20/20 1,400.00
0.00
0.00
/
1,400.00
RFID
Vendor Totals Number Name Gross
Discount
No -Pay
Net
10950 ACUTE CARE INC 1,400.00
0.00
0.00
1,400,00
Vendor# Vendor Name / Class Pay Code
A1680 AIRGAS USA, LLC - CENTRAL DIV V M
Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross
Discount
No -Pay
Net
9958796207 ✓ 12/31/20 12/31/20 01/25/20 77.04
0.00
0.00
77.04 v1
CYLINDER RENTAL
9958796206 12/31/2012/31/2001/25/20 439.58
0.00
0.00
439.58
RENTAL
CYLINDER
9958796205 V1 12/31120 12/31/20 01/25/20 750.29
0.00
0.00
750.29 v1
CYLINDER RENTAL
9083808394 d 01/16/20 12/20/20 01/14/20 90.11
0.00
0.00
/
90.11 r/
CO2
Vendor Totals Number Name Gross
Discount
No -Pay
Net
A1680 AIRGAS USA, LLC -CENTRAL DIV 1,357.02
0.00
0.00
1,357,02
Vendor# Vendor Name Class Pay Code
/
10814 ALLIED BENEFIT SYSTEMS y
Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross
Discount
No -Pay
Net
011519 01/16/20 01/15/20 01/15/20 16,104.40
0.00
0.00
16,104.40
ADMIN FEE L-41ILI- q( 61 1,;0 -fwu%ln� f da!" -Pw dn.A✓t1a-t pnw 10
'
Vendor Totals Number Name C KU-lLaHot ate. ) Gross
Discount
No -Pay
Net
10814 ALLIED BENEFIT SYSTEMS 16,104.40
0.00
0.00
16,104.40
Vendor# Vendor Name Class Pay Code
A1360 AMERISOURCEBERGEN DRUG CORP ✓ W
Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross
Discount
No -Pay
Net /
947791731 v/ 01/16/20 01/14/20 01/20/20 131.42
0.00
0.00
131.42 ✓
file:///C:/Users/cclevenger/cpsi/Memmed. cpsinet. com/u82227/data_5/tmp_cw5report830...
1/17/2019
INVENTORY
Vendor Totals Number Name Gross
A1360 AMERISOURCEBERGEN DRUG CORP 131.42
Vendor# Vendor Name Class Pay Code
A2218 AQUA BEVERAGE COMPANY,/ M
Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross
884820 01/09/2012/31/20+01/300/20 46.95
WATER VrlrU Cllig V_ 0f $b,00
Vendor Totals Number Name '" 8" Gross
A2218 AQUA BEVERAGE COMPANY 46.95
Vendor# Vendor Name / Class Pay Code
A2271 ARTHREX, INC d W
Invoice# Co ment Tran Dt Inv Dt Due Dt Check D' Pay Gross
AR8400CDS vT 01/16/2012/13/2001/13/20 66.00
DISSECTOR
Vendor Totals Number Name Gross
A2271 ARTHREX, INC 66.00
Vendor# Vendor NameClass Pay Code
12252 ASCEND NATIONAL LLC /
Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross
27106 12/31/2012/29/2001/18/20 2,966.66
SURGERY STAFFING(.Pad(.ch IX1 atgj I�--�12^�7.tj1,`)i
Vendor Totals Number Name Gross
12252 ASCEND NATIONAL LLC 2,966.66
Vendor# Vendor Name / Class Pay Code
B1800 BRIGGS HEALTHCARE e/ M
Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross
/
B152959 q! 12/31/20 12/26/20 01/25/20 156.24
SUPPLIES hWVVivl j XI, Igq
Vendor Totals Number Name Gross
81800 BRIGGS HEALTHCARE 156.24
Vendor# Vendor Name / Class Pay Code
A1825 CARDINAL HEALTH 414,LLC M
Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross
8001828631 V/ 12/31/2012/22/2001/25/20 210.43
SUPPLIES M1 Jtft� -19.00
Vendor Totals Number Name Gross
A1825 CARDINAL HEALTH 414,LLC 210.43
Vendor# Vendor Name Class Pay Code _
12028 CASE MANAGEMENT INNOVATIONS
Invoice# Comment Tran Dt Inv Dt Due Dt Check D* Pay Gross /
236 ✓ 01/15/20 12/31/20 01/18/20 60.00
ADMISSION REVIEW
Vendor Totals Number Name Gross
12028 CASE MANAGEMENT INNOVATIONS 60.00
Vendor# Vendor Name / Class Pay Code
L1629 CHRISTINA ZAPATA-ARROYO V
Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross
IPOCT2018 01/16/20 10/31/20 10/31/20 220.00
SPEECHTHERAPY "W
IPNOV2018A 01/16/2012/31/20 1,815.00
SPEECH THERAPY W d j( Ak(,tr 1WL((
Discount No -Pay
0.00 0.00
Page 2 of 16
Net
131.42
Discount
No -Pay
Net
0.00
0.00
/
46,95 a✓
Discount
No -Pay
Net
0.00
0.00
46.95
Discount
No -Pay
Net
0.00
0.00
66.00
Discount
No -Pay
Net
0.00
0.00
66.00
Discount
No -Pay
Net
0.00
0.00
2,966,66 d
Discount
No -Pay
Net
0.00
0.00
2,966.66
Discount
No -Pay
Net
0.00
0.00
/
156,24 y
Discount
No -Pay
Net
0.00
0.00
156.24
Discount
No -Pay
Net
0.00
0.00
210.43
Discount
No -Pay
Net
0,00
0.00
210.43
Discount
No -Pay
Net
0.00
0.00
60.00
Discount
No -Pay
Net
0.00
0.00
60.00
Discount
No -Pay
Net
0.00
0.00
220.00 ✓
0.00
0.00
1,815.00
file:///C:/Users/eclevenger/cpsi/memmed.cpsinet.com/u82227/data 5/tmp_cw5report830... 1/17/2019
11291 DOWELL PEST CONTROL V1
Invoice# / Comment Tran Dt Inv Dt Due Dt Check D Pay Gross
10464 ./ 12/31/20 12/31/20 01/25/20 580.00
/ PEST CONTROL WK(,
10566 a/ 12/31/2012/31/2001/25/20 105.00
PEST CONTROL
Vendor Totals Number Name Gross
11291 DOWELL PEST CONTROL 685.00
Discount No -Pay Net /
0.00 0.00 580.00 ✓
0.00 0.00 105.00 ✓
Discount No -Pay
0.00 0.00
Net
685.00
file:///C:/Users/cclevenger/cpsi/memmed, cpsinet.coni/u82227/data_5/tmp_cw5report830... 1/17/2019
Page 3 of 16
IPDEC2018
v/ 01/16/20 12/31/20 12/31/20
330.00
0.00
0.00
330.00
SPEECH THERAPY
IPNOV2018 / 01/16/20 12/31/20 12131/20
247.50
0.00
0.00
247.50
SPEECH THERAPY
IPDEC2018A 01116/2012/31/2012131/20
1,141.25
0.00
0.00
1,141.25 ✓/
SPEECH THERAPY
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
L1629 CHRISTINA ZAPATA-ARROYO
3,753.75
0.00
0.00
3,753.75
Vendor# Vendor Name Class Pay Code
/
11720 CLINICAL COMPUTER SYSTEMS INC ✓
Invoice# /Comment Tran Dt Inv Dt Due Dt Check D Pay Gross
Discount
No -Pay
Net
IN128597v 01/16/2012/27/2001/27/20
5,775.00
0.00
0.00
5,775.00 /
OBIX HOSTING QRTRLY C 01114- 0 -61 LR )
V
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
11720 CLINICAL COMPUTER SYSTEMS INC
5,775.00
0,00
0.00
5,775.00
Vendor# Vendor Name Class Pay Code
10368 DEWITT POTH & SON /
Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay
Gross
Discount
No -Pay
Net
5585650 01/15/20 01/02/20 01/27/20
185.94
0.00
0.00
185.94
SUPPLIES
5585470 01/15/20 01/02/20 01/27/20
267.30
0.00
0.00
267.30 ✓ /
SUPPLIES
5587800, 01/16/20 01/03/20 01/28/20
56.07
0.00
0.00
56.07 1/
SUPPLIES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
10368 DEWITT POTH & SON -
509.31
0.00
0.00
509.31
Vendor# Vendor Name Class Pay Code
11011 DIAMOND HEALTHCARE CORP
Invoice# Comment omment Tran Dt Inv Dt Due Dt Check D' Pay Gross
Discount
No -Pay
Net
IN20052499 d 01/16/20 12/28/20 01/22/20
19,166.67
0.00
0.00
/
19,166.671/
CPR SERVICES
IN20052498v,/ 01/1612012/28/2001/22/20
31,144.58
0.00
0.00
31,144.58 v1
BEH. HLTH SERVICES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
11011 DIAMOND HEALTHCARE CORP
50,311.25
0.00
0.00
50,311.25
Vendor# Vendor Name Class Pay Code
10892 DIANE MOORE
Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay
Gross
Discount
No -Pay
Net
011619 01/16/2001/16/2001/16/20 I�rJ��1j((
6672
0.00
0.00
!/
6672 (i5�
TRAVEL Y
Vendor Totals Number Name
Discount
No -Pay
Net
10892 DIANE MOORE I�,c! "Gross
667#
0.00
0.00
6672 �7p �jle
�y
Vendor# Vendor Name Class Pay
11291 DOWELL PEST CONTROL V1
Invoice# / Comment Tran Dt Inv Dt Due Dt Check D Pay Gross
10464 ./ 12/31/20 12/31/20 01/25/20 580.00
/ PEST CONTROL WK(,
10566 a/ 12/31/2012/31/2001/25/20 105.00
PEST CONTROL
Vendor Totals Number Name Gross
11291 DOWELL PEST CONTROL 685.00
Discount No -Pay Net /
0.00 0.00 580.00 ✓
0.00 0.00 105.00 ✓
Discount No -Pay
0.00 0.00
Net
685.00
file:///C:/Users/cclevenger/cpsi/memmed, cpsinet.coni/u82227/data_5/tmp_cw5report830... 1/17/2019
Page 4 of 16
r'
Vendor# Vendor Name Class Pay Code
12040 DREISSEN WATER INC. t/
Invoice# / Comment Tran Dt Inv Dt Due Dt Check D Pay Gross
Discount
No -Pay
Net
C187671 d/ 01/16/2012/31/2001/22/20 191.50
0.00
0.00
/
191.50 Y
WATER
Vendor Totals Number Name Gross
Discount
No -Pay
Net
12040 DREISSEN WATER INC. 191.50
0.00
0.00
191.50
Vendor# Vendor Name Class Pay Code
/
D1785 DYNATRONICS CORPORATION
Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross
Discount
No -Pay
Net
IN1921023 y/ 12/31/20 12/27/20 01/27/20 88.56
0.00
0.00
88.56 /
SUPPLIES fvciyt.I
Vendor Totals Number Name J Gross
Discount
No -Pay
Net
D1785 DYNATRONICS CORPORATION 88.56
0.00
0.00
86.56
Vendor# Vendor Name Class Pay Code
11284 EMERGENCY STAFFING SOLUTIONS/
Invoice#Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross
Discount
No -Pay
Net
37366,/f 01/15/2001/15/2001/25/20 40,062.50
0.00
0.00
/
40,062.50 ✓
ER STAFFING
Vendor Totals Number Name Gross
Discount
No -Pay
Net
11284 EMERGENCY STAFFING SOLUTIONS 40,062.50
0.00
0.00
40,062.50
Vendor# Vendor NameClass Pay Code
C2510 EVIDENT ✓/ M
Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross
Discount
No -Pay
Net
WALGREENS340B 01/16/20 06/25/20 07/20/20 2,500.00
0.00
0.00
2,500.00
WALGREENS340B-LkAi_,A(VccA )�ivt-{u tt_
Vendor Totals Number Name Gross
Discount
No -Pay
Net
C2510 EVIDENT 2,500.00
0.00
0.00
2,500.00
Vendor# Vendor Name Class Pay Code
F1050 FASTENAL COMPANY
V// M
Invoice#Gj Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross
���'°�
Discount
No -Pay
Net
TXPOT0059 12/31/20 12/28/20 01/27/20 27.05
0.00
0.00
27.05
SUPPLIES
Vendor Totals Number Name Gross
Discount
No -Pay
Net
F1050 FASTENAL COMPANY 27.05
0.00
0.00
27.05
Vendor# Vendor Name Class Pay Code
10689 FASTHEALTH CORPORATION v/
Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross
Discount
No -Pay
Net
01A19MMC✓ 01/15/2001/01/2001/16/20 495.00
0.00
0.00
495.00
WEBSITE
Vendor Totals Number Name Gross
Discount
No -Pay
Net
10689 FASTHEALTH CORPORATION 495.00
0.00
0.00
495.00
Vendor# Vendor Name / Class Pay Code
11037 FIRST CLEARING ✓
Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross
Discount
No -Pay
Net
010319 01/16/2001/03/2001/03/20 75.00
0.00
0.00
75.00
PAYROLLDED
Vendor Totals Number Name Gross
Discount
No -Pay
Net
11037 FIRST CLEARING 75.00
0.00
0.00
75.00
Vendor# Vendor Name Class Pay Code
F1400 FISHER HEALTHCARE V1
M
Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross
Discount
No -Pay
Net
file:///C:/Users(cclevenger/cpsi/memmed.cpsinet.com/u82227/data_5/tmp_cw5report830... 1/17/2019
Page 5 of 16
3
f
8249190 12/31/20 12/31/20 01/25/20
535.99
0.00
0.00
535.99
/ SUPPLIES
/
8451801✓ 01 /15/20 01/03/20 01/28/20
407.20
0.00
0.00
407.20 V
SUPPLIES �Ik ppj i'l V.1�
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
F1400 FISHER HEALTHCARE
943.19
0.00
0.00
943.19
Vendor# Vendor Name Class
Pay Code
11184 FLDR DESIGNS LLC y1/
Invoice# / Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
15260 f 12/31/20 12/14/20 01/25/20
363.77
0.00
0.00
363.77 y�
BROCHURES y6VOVL.J jl�.-J j (,j�Op
p)"^Ra,dl.cirp
Vendor Total: Number Name
Gross
Discount
No -Pay
Net
11184 FLDR DESIGNS LLC
363.77
0.00
0.00
363.77
Vendor# Vendor Name Class
Pay Code
11149 GARDNER & WHITE, INC.,
Invoice# Comment Tran Dt Inv Dt Due Dt
Check DPay Gross
Discount
No -Pay
Net
010119 01/16/2001/01/2001/01/20
3,216.83
0.00
0.00
3,216.83
INSURANCE
Vendor Total: Number Name
Gross
Discount
No -Pay
Net
11149 GARDNER & WHITE, INC.
3,216.83
0.00
0.00
3,216.83
Vendor# Vendor Name Class
Pay Code
10283 GE HEALTHCARE V1
Invoice# Co ment Tran Dt Inv Dt Due Dt
Check D' Pay Gross
Discount
No -Pay
Net
6001187659 01/16/2012/01/2012/26/20
5,665.83
0.00
0.00
5,665.83 V/
MMAINT CONTRACT
60012096284 01 /16/20 01/01/20 01/26/20
5,665.83
0.00
0.00
/
5,665.83
AINT CONTRACT
6001209594 01/16/20 01/01/20 01/26/20
3,588.58
0.00
0.00
/
3,588.58 V/
TINT CONTRACT
3
600120951 01/16/2001/01/2001/26/20
3,236.62
0.00
0.00
3,236.62 V1
RAD SERVICES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
10283 GE HEALTHCARE
18,156.86
0.00
0.00
18,156.86
Vendor# Vendor Name Class
Pay Code
10901 GENESIS DIAGNOSTICS /
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D' Pay Gross
Discount
No -Pay
Net
49430 12/31/20 12/28/20 01/27/20
122.96
0.00
0.00
122.96
SUPPLIES C)AIVI) 00
,J
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
10901 GENESIS DIAGNOSTICS
122.96
0.00
0.00
122.96
Vendor# Vendor Name / Class
Pay Code
G1210 GULF COAST PAPER COMPANY ✓ M
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net /
4/
1607266 12/31/20 12/26/20 01/25/20
533.54
0.00
0.00
533.54 V/
SUPPLIES
1607267 V1 12/31/20 12126/20 01/25/20
557.00
0.00
0.00
/
557.00 ✓
SUPPLIES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
G1210 GULF COAST PAPER COMPANY
1,090.54
0.00
0.00
1,090.54
Vendor# Vendor Name / Class
Pay Code
H0031 HEB CREDIT RECEIVABLES DEPT308 v
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a
Page 6 of 16
Invoice#
Comment
Tran Dt Inv Dt Due Dt
Check DPay Gross
Discount
No -Pay
Net
091053 J
01/17/20 11/28/20 11/28/20
23.81
0.00
0.00
23.81 v
/
FOOD
/
18.69
082152
01 /17120 11129120 11/29120
18.69
0.00
0.00
/
FOOD
091931 d
01/17/20 12/03/20 12/03/20
54.08
0.00
0.00
54.08
FOOD
/
023632.(
01/17/20 12/03/2012/03/20
16.63
0.00
0.00
16.63 V1
FOOD
/
094295
01/17/20 12/04/20 12/04/20
25.16
0.00
0.00
25.16
FOOD
/
093881
01/17/20 12/04/20 12/04/20
20.20
0.00
0.00
20.20 ✓
FOOD
029742 ✓
01/17/20 12/04/20 12/04/20
22.92
0.00
0.00
22.92 V/ -
1
FOOD
D"151 /
.1.20518 d
01/17/20 12/05/20 12/05/20
4.86
0.00
0.00
4.86 f
A
Oil
30.14
033902./
01/17/20 12/05/20 12/05/20
30.14
0.00
0.00
/
FOOD
098875 ✓
01/17/20 12/06/20 12/06/20
25.98
0.00
0.00
25.98 1/
/
FOOD
0.00
53.70
043212 `v
01/17/20 12/06/20 12106120
53.70
0.00
v1
FOOD
/
0.00
25.65,✓
003343 ✓
01/17/20 12107/20 12/07120
25.65
0.00
/
FOOD SUPPLIES
070233 d
01/17/20 12110/2012110/20
45.54
0.00
0.00
45.54 y/
/
V
FOOD
19.30 t✓/
009865
01/17/20 12/10/20 12/10120
19.30
0.00
0.00
FOOD
012627✓
01/17/20 12111/20 12/11/20
15.29
0.00
0.00
15.29
FOOD
/
083073 ,/
01/17/20 12/12/20 12/12/20
8.94
0.00
0.00
8.94
/
FOOD
/
37.02
015099
01/17/20 12/12/20 12/12/20
37.02
0.00
0.00
v/
FOOD
024610 v1/
01/17/20 12/16/20 12116/20
21.16
0.00
0.00
/
21.16r/
FOOD
0.00
27.86
012512 v/
01/17/20 12/16/20 12/16/20
27.86
0.00
/FOOD
/
✓
020001 v
01/17/20 12/17/20 12/17/20
31.47
0.00
0.00
31.47
OOD
030816
01/1712012/18/2012/18/20
51.75
0.00
0.00
/
51.75 ✓
/
FOOD
0.00
42.50
038198 ✓
01/17/2012120/2012120/20
42.50
0.00
/
FOOD
035880
01/17/20 12120/20 12/20/20
18.95
0.00
0.00
18.95 ✓�
FOOD
0.00
/
4.56 ✓
043787
01/17/20 12123/20 12/23120
4.56
0.00
/
FOOD
048936 e/'
01/17/20 12/2412012/24120
38.68
0.00
0.00
38.68 d�
/FOOD
OC44105 V/
01/17/20 12/26/20 12/26/20
13.36
0.00
0.00
13.36
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a
Page 7 of 16
FINANCE CHARGE
OC44104 ✓ 01/17/2012/26/2012/26/20
4.15
0.00
0.00
4.15
FINANCE CHARGE
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
H0031 HEB CREDIT RECEIVABLES DEPT308 702.35
0.00
0.00
702.35
Vendor# Vendor Name Class
Pay Code
/
10922 HUNTER PHARMACY SERVICES d
Invoice# Comment Tran Ot Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
3230 ✓ 01/16/20 12/31/20 01/20/20
14,476.35
0.00
0.00
14,476.35
PHARMACY SERVICES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
10922 HUNTER PHARMACY SERVICES 14,476.35
0.00
0.00
14,476.35
Vendor# Vendor Name/ Class
Pay Code
12196 ICU MEDICAL, INC V
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D* Pay Gross
Discount
No -Pay
Net
/
1918924r/ 01/16/2001/03/20
11.25
0.00
0.00
11.25 V/
SRVC CONTRACT
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
12196 ICU MEDICAL, INC
11.25
0.00
0.00
11.25
Vendor# Vendor Name Class
/
Pay Code
12332 INFINITE SOFTWARE SOLUTIONS �/
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D' Pay Gross
Discount
No -Pay
Net
/
INV5064% 01/16/20 01/01/20 01/01/20
1,470.00
0.00
0.00
1,470.00 V/
REPORT WRITER
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
12332 INFINITE SOFTWARE SOLUTIONS 1,470.00
0.00
0.00
1,470.00
Vendor# Vendor Name Class
Pay Code
/
11200 IRON MOUNTAIN �/
Invoiice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
AKJ031,// 12/31/20 12/31/20 01/30/20
341.29
0.00
0.00
/
341.29 r/
SERVICE
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
11200 IRON MOUNTAIN
341.29
0.00
0.00
341.29
Vendor# Vendor Name Class
Pay Code
11285 ITA RESOURCES INC v//
Invoice# Comment Tran Dt Inv Dt Due Dt
Check DPay Gross
Discount
No -Pay
Net
/
/
MMC12019 ,/ 01/15/2001/14/2001/14/20
23,458.20
0.00
0.00
23,458.20
RESPIRATORY SERVICES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
11285 ITA RESOURCES INC
23,458.20
0.00
0.00
23,458.20
Vendor# Vendor Name Class
Pay Code
11600 LEGAL SHIELD V
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D' Pay Gross
Discount
No -Pay
Net
011519 01 /15/20 01/15/20 01/15/20
1,005.95
0.00
0.00
1,005.95
PAYROLL DED
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
11600 LEGAL SHIELD
1,005.95
0.00
0.00
1,005.95
Vendor# Vendor Name Class
Pay Code
L1640 LOWE'S HOME CENTERS INC W
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D' Pay Gross
Discount
No -Pay
Net
90270 ,/ 01/17/2012/14/2012/14/20
190.24
0.00
0.00
190.24
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DOOR
010219
01/17/20 01/02/20 01/02/20
LATE FEE
Vendor Totals Number Name
L1640 LOWE'S HOME CENTERS INC
Vendor# Vendor NameClass Pay Code
V/
10972 M G TRUST
Page 8 of 16
35.00
0.00
0.00
35.00 J
Gross
Discount
No -Pay
Net
225.24
0.00
0.00
225.24
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
010319 01/16/20 01/03/20 01/03/20
1,295.00
PAYROLL DED
1,295.00
Vendor Totals Number Name
Gross
10972 M G TRUST
1,295.00
Vendor# Vendor Name Class
Pay Code
11099 MARLIN BUSINESS BANK r//
No -Pay
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
16628219 V// 01/15/20 01/14/20 01/14/20
663.27
LEASE
Discount
Vendor Totals Number Name
Gross
11099 MARLIN BUSINESS BANK
663.27
Vendor# Vendor Name Class
Pay Code
/
Net
11760 MARVELOUS GARDENS, INC f
0.00
Invoice# Comment Tran Dt Inv Dt Due Dt
Check DPay Gross
0.00
379.17
1288 J 01115/20 01/15/20 01/15/20
205.83
LAWN CARE KWkL, �d v p,L\A_11j
Discount
No -Pay
Net
1301 J 01/15/20 01/15/20 01/15/20
379.17
LAWN CARE WWtL,
Discount
1302 01/15/2001/15/2001/15/20
433.33
LAWN CARE KWL' WVwt/
Vendor Total: Number Name
Gross
11760 MARVELOUS GARDENS, INC
1,018.33
Vendor# Vendor Name Class
Pay Code
M2181 MATTHEW BENDER & CO.,INC. ✓ W
0.00
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D' Pay Gross
Discount
No -Pay
08095299✓ 01/16/20 12/22/20 01/22/20
68.08
SUPPLIES (db t° i1 j t1-0�
�/
9.74 J
Vendor Totals Number Name
Gross
M2181 MATTHEW BENDER & CO., INC.
68.08
Vendor# Vendor Name Class
Pay Code
M2178 MCKESSON MEDICAL SURGICAL INC J
No -Pay
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D' Pay Gross
0.00
217.81 J
5517217 J 01/16/20 12/31/20 01/30/20
9.74
FINANCE CHARGES
0.00
Vendor Totale Number Name
Gross
M2178 MCKESSON MEDICAL SURGICAL INC 9.74
Vendor# Vendor Name Class
Pay Code
M2470 MEDLINE INDUSTRIES INC J M
Invoice# Tran Dt Inv Dt Due Dt
Check D' Pay Gross
Comment
1867072332 / 01ry/09/20 02/03/20
217.81
(01/15/20
SUPPLIES fj65VYdCJGn
,t
1866701539V1 01/15/2001/03/2001/28/20
80.38
SUPPLIES �y�y�,.� t(/,(�
1866701537 J 01/1 /20 01/03/20 01/28/20
317.85
Discount
No -Pay
Net
J
0.00
0.00
1,295.00
Discount
No -Pay
Net
0.00
0.00
1,295.00
Discount
No -Pay
Net
0.00
0.00
663.27 v�
Discount
No -Pay
Net
0.00
0.00
663.27
Discount
No -Pay
Net
0.00
0.00
205.83 J
0.00
0.00
379.17
0.00
0.00
433.33
Discount
No -Pay
Net
0.00
0.00
1,018.33
Discount
No -Pay
Net
J
0.00
0.00
68.08
Discount
No -Pay
Net
0.00
0.00
68.08
Discount
No -Pay
Net
0.00
0.00
9.74 J
Discount
No -Pay
Net
0.00
0.00
9.74
Discount
No -Pay
Net
0.00
0.00
217.81 J
0.00
0.00
80.38 J
0.00
0.00
317.85 J
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Page 9 of 16
r'
PPLIES
i01 Y /1
5/20
t . 1866701541 V
011.03/0/28/20
21.74
0.00
0.00
21.74
SUPPLIES
}}
Yr1.�DW 111,gI M I'1(M
1866701533 v1
01/15/2001/0312001/28/20
70.66
0.00
0.00
/
70.66 r/
SUPPLIES
/
1866701538 V//
fifi
01 /15/20 01/03120 01/28/20
22.47
0.00
0.00
22.47/
SUPPLIES
p
flf lJ Kg.14.tl on 4,' i
18667015310/
01/15/2001/0312001128/20
77.06
0.00
0.00
77.06
SUPPLIES
/
82.92✓
18667015341//
01/15/2001/03/2001/28/20
82.92
0.00
0.00
SUPPLIES
1866701536 /
01/15/2001/03/2001/28/20
3,825.07
0.00
0.00
3,825.07
SUPPLIES
1866701540 a//
25.96
0.00
0.00
/
25.96
SUPPLIES
(01/16/2yy001//0312001/28/20
}}
�.'hI 1LYA
18667015351//
i'Y(a u�,t l"I'��
01/15/2001/03/2001/28/20
415.67
0.00
0.00
415.67 v�
SUPPLIES
18667829444
01/15/2001/04/2001/29/20
30.95
0.00
0.00
30.95
SUPPLIES
1866782941
01/15/20 01/04/20 01/29/20
160.88
0.00
0.00
160.88
SUPPLIES
1866782945✓
01 /15/20 01/04/20 01/29/20
156.44
0.00
0.00
156.44
S PPLIES
102.53
1866782942✓/
01/15/2001/0412001/29/20
102.53
0.00
0.00
SUPPLIES
/01/15/2001/04/2001/29/20
/
1866782962
89.14
0.00
0.00
89.14V
SUPPLIES
�f, kjV[4,1.1.I.
/
179.92
0.00
0.00
179.92
1866782953 �/
01/15//20V011/404/2001/29/20
SUPPLIES
1866782946 V1
01/15/20 01/04/20 01/29/20
469.32
0.00
0.00
/
469.32V/
SUPPLIES
1866782947 y
01/1512001/04/2001/29/20
110.35
0.00
0.00
110.35
SUPPLIES
1866782957 V/
01 /15/20 01/04/20 01/29/20
97.07
0.00
0.00
97.07
SUPPLIES
1866782961 V
/2001/29/20
01/115/2001/0041
30.83
0.00
0.00
30.83
PPLIES
1 /
'l/
V'155/
1866782963 V/1
O 0 01/04/2001/29/20
35.54
0.00
0.00
35.54,/
SUPPLIES
�V611ll.I'
1866782959
01 /15/20 01/04/20 01/29/20
231.04
0.00
0.00
231.04
SUPPLIES
�l ti%vl
1866782949
1' l,ig
10,1/15/2001/04/2001/29120
113.50
0.00
0.00
113.50>/
SUPPLIES
fV�j4KI
0.00
✓
1866306683
01/16/2012/27/2001/21/20
-58.63
0.00
-58.63
CREDIT
Vendor Total: Number Name
Gross
Discount
No -Pay
Net
M2470 MEDLINE INDUSTRIES INC
6,906.47
0.00
0.00
6,906.47
Vendor# Vendor Name
Class Pay Code
M2550 MELSTAN, INC. ✓
w
Invoice# Comment
Tran Dt Inv Dt Due Dt Check D Pay
Gross
Discount
No -Pay
Net
/
33278 t/
01116/2001/02/2001/12/20
70.60
0.00
0.00
70.60 r/
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Page 10 of 16
SUPPLIES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
M2550 MELSTAN, INC.
70.60
0.00
0.00
70.60
Vendor# Vendor Name Class
Pay Code
10963 MEMORIAL MEDICAL CLINIC
Invoice# Comment Tran Dt Inv Dt Due Dt
Check DPay Gross
Discount
No -Pay
Net
010319 01/16/2001/03/20
15.00
0.00
0.00
15.00 V�
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
10963 MEMORIAL MEDICAL CLINIC
15.00
0.00
0.00
15.00
Vendor# Vendor Name Class
Pay Code
/
M2621 MMC AUXILIARY GIFT SHOP w
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D' Pay Gross
Discount
No -Pay
Net
011019 01/16/2001/10/20
132.18
0.00
0.00
132.18
PAYROLLDED
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
M2621 MMC AUXILIARY GIFT SHOP
132.18
0.00
0.00
132.18
Vendor# Vendor Name Class
Pay Code
10810 MMC EMPLOYEE BENEFIT PLAN
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
011419 01/15/2001/14/2001/14/20
55,246.45
0.00
0.00
/
55,246.45 V/
INSURANCE
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
10810 MMC EMPLOYEE BENEFIT PLAN 55,246.45
0.00
0.00
55,246.45
Vendor# Vendor Name/ Class
Pay Code
10536 MORRIS & DICKSON CO, LLC ✓
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D' Pay Gross
Discount
No -Pay
Net
3713514 V/ 01/15/2001/08/2001/18/20
1,650.00
0.00
0.00
1,650.00
INVENTORY
3721498 ✓/ 01/15/2001/09/2001/19/20
159.98
0.00
0.00
159.98
INVENTORY
3721497 ✓ 01 /15/20 01/09/20 01/19/20
381.82
0.00
0.00
381.82
INVENTORY
f
CM20702 V/ 01/15/20 01/09/20 01/19/20
-148.65
0.00
0.00
-148.65
CREDIT
9347✓ 01/15/2001/09/2001/19/20
-10.00
0.00
0.00
-10.00 ✓
/ CREDIT
3721499 ✓ 01/15/20 01/09/20 01/19/20
294.42
0.00
0.00
/
294.42 ✓
INVENTORY
3727031 01/15/20 01/10/20 01/20/20
205.60
0.00
0.00
205.60
INVENTORY
0076 01/15/2001/10/2001/20/20
-4.99
0.00
0.00
-4.99✓/
CREDIT
37271480/ 01 /15/20 01/10/20 01/20/20
21.67
0.00
0.00
21.67
INVENTORY
3727030✓ 01/15/20 01/10/20 01/20/20
935.19
0.00
0.00
935.19✓
INVENTORY
3727029 / 01/15/20 01/10/20 01/20/20
1,343.73
0.00
0.00
1,343.73 6/
V
/ INVENTORY
3725499 ✓ 01/15/20 01/10/20 01/20/20
211.36
0.00
0.00
211.36,/
JNVENTORY
3725079 ✓ 01 /15/20 01/10/20 01/20/20
268.06
0.00
0.00
268.06
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A
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Page I 1 of 16
I VENTORY
CM21377
01!15/2001/11/2001121!20
-71.21
0.00
0.00
-71.21
CREDIT
/
3738645 ✓
01/15/20 01/14/20 01/24/20
9.28
0.00
0.00
9,28
INVENTORY
/
3740931
01/15/20 01/14/20 01/24/20
170.51
0.00
0.00
170.51 ✓
/ INVENTORY
37386474
01/15/2001/14/2001/24/20
23.40
0.00
0.00
23.40
INVENTORY
/
3738646V
01 /15/20 01/14/20 01/24/20
13.56
0.00
0.00
13.56
/INVENTORY
1,280.53
3737259V
01115/2001/14/2001/24/20
1,280.53
0.00
0.00
INVENTORY
3738410 ✓
01/15/20 01/14/20 01/24/20
3,190.96
0.00
0.00
3,190.96 ✓
INVENTORY
3738409 s%
01/15/20 01/14/20 01/24/20
5,545.11
0.00
0.00
5,545.11
INVENTORY
3738514 V1
01115/2001/14/2001/24/20
66.59
0.00
0.00
66.59
INVENTORY
3737258 ✓
01/15/20 01114/20 01/24/20
94.09
0.00
0.00
94.09
INVENTORY
/
3738408
01/15/2001!14/2001/24/20
9,746.28
0.00
0.00
9,746.28
INVENTORY
/
3740930
01/15/20 01114/20 01/24/20
154.13
0.00
0.00
154.13
INVENTORY
3745300 ✓
01/16/2001/15/2001/25!20
499.01
0.00
0.00
499.01
/INVENTORY
/
3742778,/
01/16/2001/15/2001125120
1,746.38
0.00
0.00
1,746.38 ✓
INVENTORY
3745299 �/
01!16/20 01/15/20 01/25120
47.46
0.00
0.00
47.46
INVENTORY
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
10536 MORRIS & DICKSON CO, LLC
27,824.27
0.00
0.00
27,824.27
Vendor# Vendor Name
Class
Pay Code
11472 OCCUPRO LLC V/
Invoice#/ Comment
Tran Dt Inv Dt Due Dt
Check D' Pay Gross
Discount
No -Pay
Net
12044 ✓
01/16/20 01/07/20 01/07/20
844.92
0.00
0.00
844.92
PROVIDER LICENSE
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
11472 OCCUPRO LLC
844.92
0.00
0.00
844.92
Vendor# Vendor NameClass
Pay Code
OM425 OWENS & MINOR ✓/
Invoice#
Tran Dt Inv Dt Due Dt
Check D' Pay Gross
Discount
No -Pay
Net
Comment
2043830149 ✓
12/22/20 12/26/20 01/25/20
732.44
0.00
0.00
/
732.44
SUPPLIES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
OM425 OWENS & MINOR
732.44
0.00
0.00
732.44
Vendor# Vendor Name /
Class
Pay Code
P0706 PALACIOS BEACON r,/
W
Invoice# Comment
Tran Dt Inv Dt Due Dt
Check DPay Gross
Discount
No -Pay
Net
33056018
12/31!2012/27/2001/27/20
187.50
0.00
0.00
187.50
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AD
Net
Vendor Totals Number Name
Vendor Totals Number Name
Gross
Discount
No -Pay
P0706 PALACIOS BEACON
187.50
0.00
0.00
Vendor# Vendor Name Class
Pay Code
Invoice#Comment Tran Dt Inv Dt Due Dt
Check D' Pay Gross
Discount
76432 d/ 01/15/2001/15/2001/15/20
75.89
P1800 PITNEY BOWES INC t// W
/ PT REFUND
Invoice# Co ment Tran Dt Inv Dt Due Dt
Check DPay Gross
Discount
No -Pay
1010798420 12/31/2012/27/2001/26/20
295.00
0.00
0.00
POSTAGE
12328 RAWLINGS FINANCIAL SERVICES 151.78
0.00
Vendor# Vendor Name Class
1010779943 v// 01/15/20 12/27/20 01/26/20
207.00
0.00
0.00
POSTAGE
R1200 RED HAWK FIRE AND SECURITY ✓
Vendor Totals Number Name
Gross
Discount
No -Pay
P1800 PITNEY BOWES INC
502.00
0.00
0.00
Vendor# Vendor Name Class
Pay Code
/
P2100 PORT LAVACA WAVE J W
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
123118 01/16/20 12/31/20 01/25/20
393.20
0.00
0.00
SUPPLIES
Vendor Totals Number Name
Gross
Discount
No -Pay
P2100 PORT LAVACA WAVE
393.20
0.00
0.00
Vendor# Vendor Name Class
Pay Code
P2200 POWER HARDWARE V W
Invoice# / Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
A50088 ✓ 01/16/20 01/15/20 01/25/20
22.38
0.00
0.00
SUPPLIES
Vendor Totals Number Name
Gross
Discount
No -Pay
P2200 POWER HARDWARE
22.38
0.00
0.00
Vendor# Vendor Name Class
Pay Code
/
11932 PRESS GANEY ASSOCIATES, INC. ,/
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
IN000364007 J 12/31/20 12/31/20 01/30/20
1,950.00
0.00
0.00
PT SURVEYS
Vendor Totals Number Name
Gross
Discount
No -Pay
11932 PRESS GANEY ASSOCIATES,
INC. 1,950.00
0.00
0.00
Vendor# Vendor Name Class
Pay Code
12260 QUALITY CONTROL TESTING, INC
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
20181741 ,/ 01/16/20 11/21/20 12/21/20
125.00
0.00
0.00
PEARS CLASS
Net
Vendor Totals Number Name
Gross
Discount
12260 QUALITY CONTROL TESTING,
INC 125.00
0.00
Vendor# Vendor Name/ Class
Pay Code
12328 RAWLINGS FINANCIAL SERVICES ✓
151.78
Invoice#Comment Tran Dt Inv Dt Due Dt
Check D' Pay Gross
Discount
76432 d/ 01/15/2001/15/2001/15/20
75.89
0.00
/ PT REFUND
76520 ✓ 01 /15/20 01/15/20 01/15/20
75.89
0.00
PT REFUND
Vendor Totals Number Name
Gross
Discount
12328 RAWLINGS FINANCIAL SERVICES 151.78
0.00
Vendor# Vendor Name Class
Pay Code
/
R1200 RED HAWK FIRE AND SECURITY ✓
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D' Pay Gross
Discount
Page 12 of 16
Net
187.50
Net /
295.00 ✓
207.00
Net
502.00
Net
393.20 V
Net
393.20
Net
22.38
Net
22.38
Net
1,950.00
Net
1,950.00
Net /
125.00 ✓
No -Pay Net
0.00 125.00
No -Pay
Net
0.00
75.89
0.00
75.89
/
✓
No -Pay
Net
0.00
151.78
No -Pay Net
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382465 J 01 /15/20 01/01/20 01/26/20
45.47
0.00
0.00
45.47 r/
FIRE MONITORING
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
R1200 RED HAWK FIRE AND SECURITY
45.47
0.00
0.00
45.47
Vendor# Vendor Name Class
Pay Code
/
10987 REVCYCLE+, INC. I/
Invoice# Corr/�ment Tran Ot Inv Dt Due Dt
Check D' Pay Gross
Discount
No -Pay
Net
/
MLVAC45074 ✓ 01/16/2001/03/2001/28/20
2,059.10
0.00
0.00
2,059.10
CODING SERVICES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
10987 REVCYCLE+, INC.
2,059.10
0.00
0.00
2,059.10
Vendor# Vendor NameClass
Pay Code
11764 ROBERT RODRIQUEZ d/
Invoice# Comment Tran Dt Inv Dt Due Dt
Check DPay Gross
Discount
No -Pay
Net
010819 01 /16/20 01/08/20 01/08/20
13.96
0.00
0.00
13.96)
FOOD SUPPLIES
011019 01/16/20 01/10/20 01/10/20
24.99
0.00
0.00
/
24.99
FOOD SUPPLIES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
11764 ROBERT RODRIQUEZ
38.95
0.00
0.00
38.95
Vendor# Vendor Name Class
Pay Code
11164 RS CLARK & ASSOCIATES, INC
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
20181130 v/ 12/31/2011/30/2001/25/20
49.27
0.00
0.00
49.27
COLLECTION
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
11164 RS CLARK & ASSOCIATES, INC 49.27
0.00
0.00
49.27
Vendor# Vendor Name Class
Pay Code
11252 RX WASTE SYSTEMS LLC
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
1921 12/31/20 01/01/20 01/26/20
235.00
0.00
0.00
235.00
/
✓ DISPOSAL SERVICE
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
11252 RX WASTE SYSTEMS LLC
235.00
0.00
0.00
235.00
Vendor# Vendor Name Class
Pay Code
10625 SARA RUBIO �/
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D' Pay Gross
Discount
No -Pay
Net
011019 01 /15/20 01/10/20 01/10/20
33.41
0.00
0.00
33.41
TRAVEL 0dldL6v-/Yr(cu,- i" MMt+A`I
11 loll,"
(uJ
.
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
10625 SARA RUBIO
33.41
0.00
0.00
33.41
Vendor# Vendor Name Class
Pay Code
/
51800 SHERWIN WILLIAMS ✓ W
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
80341 01/15/2001/10/2001/25/20
4.58
0.00
0.00
4.58
SUPPLIES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
S1800 SHERWIN WILLIAMS
4.58
0.00
0.00
4.58
Vendor# Vendor Name / Class
Pay Code
10699 SIGN AD, LTD. ✓
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D' Pay Gross
Discount
No -Pay
Net
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✓
233370 ✓ 12/31/2001/05/2001/25/20
775.00
0.00
0.00
775.00
AD
/
231326 ✓/ 01/15/2011/01/2011/11/20
775.00
0.00
0.00
775.00 r/
AD
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
10699 SIGN AD, LTD.
1,550.00
0.00
0.00
1,550.00
Vendor# Vendor Name Class
Pay Code
T2539 T -SYSTEM, INC ✓/ W
Invoice# C/o�nment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
205EV44447 ✓ 12/31/20 12/31/20 01/30/20
4,555.00
0.00
0.00
4,555.00
ER SERVICES
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
T2539 T -SYSTEM, INC
4,555.00
0.00
0.00
4,555.00
Vendor# Vendor Name/ Class
Pay Code
T2050 TEXAS HOSPITAL INS EXCHANGE ✓ W
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
16195513 ✓/ 01/16/20 12/27/20 01/27/20
28,496.00
0.00
0.00
28,496.00
PREMIUM
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
T2050 TEXAS HOSPITAL INS EXCHANGE 28,496.00
0.00
0.00
28,496.00
Vendor# Vendor Name Class
Pay Code
/
T2204 TEXAS MUTUAL INSURANCE CO W
Invoice# Comment Tran Dt Inv Dt Due Dt
Check DPay Gross
Discount
No -Pay
Net
1000657756 01/16/2001/06/2001/06/20
5,688.00
0.00
0.00
5,688.00
INSURANCE
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
T2204 TEXAS MUTUAL INSURANCE CO 5,688.00
0.00
0.00
5,688.00
Vendor# Vendor Name Class
Pay Code
/
T2250 THYSSENKRUPP ELEVATOR CORP v M
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net
/
5001000863 ✓ 12/31/2012/31/2001/25/20
768.00
0.00
0.00
768.00
ELEVATOR CONTRACT
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
T2250 THYSSENKRUPP ELEVATOR CORP 768.00
0.00
0.00
768.00
Vendor# Vendor Name Class
Pay Code
/
11067 TRIZETTO PROVIDER SOLUTIONS V
Invoice# Tran Dt Inv Dt Due Dt
Check D' Pay Gross
Discount
No -Pay
Net
Comment
35FK011900✓ 01/15/2001/01/2001/26/20
1,010.00
0.00
0.00
1,010.00
PT STATEMENTS
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
11067 TRIZETTO PROVIDER SOLUTIONS 1,010.00
0.00
0.00
1,010.00
Vendor# Vendor Name / Class
Pay Code
U1064 UNIFIRST HOLDINGS INC ✓
Invoice# Comment Tran Dt Inv Dt Due Dt
Check D Pay Gross
Discount
No -Pay
Net /
8400290892 `/ 12/31/2012/3112001/25/20
125.74
0.00
0.00
125.74
LAUNDRY
8400290953 V/ 12/31/2012/31/2001/25/20
47.51
0.00
0.00
47.51 ✓
LAUNDRY
8400290921 12/31/2012/31/2001/25/20
76.42
0.00
0.00
76.42✓
LAUNDRY
8400290893 V/ 12/31/2012/31/2001/25/20
47.15
0.00
0.00
47.15
LAUNDRY
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8400290894 ) 12/31/20 12/31/20
01/25/20
56.21
0.00
0.00
56.21
LAUNDRY
/
/
8400290890 ✓ 12/31/20 12131/20
01/25120
120.39
0.00
0.00
120.39 ✓/
L UNDRY
8400290928 12/31/20 12/31/20
01/25/20
928.06
0.00
0.00
928.06 ✓ l
�UNDRY
8400290891 d 12/31/20 12/31/20
01/25/20
115.15
0.00
0.00
115,15
LAUNDRY
8400291218 c/ 01/15/2001/03/2001/28/20
168.62
0.00
0.00
168.62
LA�JNDRY
8400291252 �// 01/1512001/03/2001/28/20
1,260.48
0.00
0.00
1,260.48 V/
L UNDRY
8400291216 01/15/20 01/03/20
01/28/20
17.00
0.00
0.00
17.00 V/
LAUNDRY
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
U1064 UNIFIRST HOLDINGS
INC
2,962.73
0.00
0.00
2,962.73
Vendor# Vendor Name
Class
Pay Code.
U1056 UNIFORM ADVANTAGE J
W
Invoice# Comment Tran Dt Inv Dt
Due Dt
Check DPay
Gross
Discount
No -Pay
Net
9333530 / 01 /15/20 01/07/20
01/22/20
205.32
0.00
0.00
/
205.32✓
UNIFORMS K GOFF
9340348,// 01/15/2001/09/2001/24/20
261,86
0.00
0.00
261.86
UNIFORMS
9333485 f 01/16/20 01/07120
01/22/20
144.92
0.00
0.00
144.92
UNIFORMS M. RECTOR
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
U1056 UNIFORM ADVANTAGE
612.10
0.00
0.00
612.10
Vendor# Vendor Name
Class
Pay Code
10450 UNIT DRUG CO, LLC
Invoice#/Comment Tran Dt Inv Dt
Due Dt
Check D' Pay
Gross
Discount
No -Pay
Net
/
24009 V 12/31/2012/272001/27120
51.60
0.00
0.00
51.60
SUPPLIES e')6l j KL 6 jZ
Vendor Totals Number Name 11'' VV
Gross
Discount
No -Pay
Net
10450 UNIT DRUG CO, LLC
51.60
0.00
0.00
51.60
Vendor# Vendor Name /
Class
Pay Code
V1471 VICTORIA RADIOWORKS, LTD ✓
W
Invoice# Comment Tran Dt Inv Dt
Due Dt
Check D' Pay
Gross
Discount
No -Pay
Net/
18120216✓ 12/31/2012131/2001/25/20
210.00
0.00
0.00
210.00
AD
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
V1471 VICTORIA RADIOWORKS, LTD
210.00
0.00
0.00
210.00
Vendor# Vendor Name
Class
Pay Code
10793 WAGEWORKS
Invoice# Comment Tran Dt Inv Dt
Due Dt
Check D Pay
Gross
Discount
No -Pay
Net
010319 01/16/2001/03/20
2,329.33
0.00
0.00
2,329.33
PAYROLL DED
Vendor Totals Number Name
Gross
Discount
No -Pay
Net
10793 WAGEWORKS
2,329.33
0.00
0.00
2,329.33
Vendor# Vendor Name/
Class
Pay Code
12208 WAGEWORKS ✓
Invoice# Comment Tran Dt Inv Dt
Due Dt
Check D' Pay
Gross
Discount
No -Pay
Net
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INV1158919 V// 01/16/2001/15/2001/15/20
370.25
0,00
0.00
370.25 ✓
MONTHLY FEE
Vendor Total=Number Name
Gross
Discount
No -Pay
Net
12208 WAGEWORKS
370.25
0.00
0.00
370.25
Vendor# Vendor Name Class Pay Code
W1040 WATERMARK GRAPHICS INC ✓ M
Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay
Gross
Discount
No -Pay
Net /
122-11 8, 01/16/2012/21/2001/20/20
349.65
0.00
0.00
349.65 "
R.3 �'�'� UNIFORMS
Vendor Total: Number Name
Gross
Discount
No -Pay
Net
W1040 WATERMARK GRAPHICS INC
349.65
0.00
0.00
349.65
Vendor# Vendor Name Class Pay Code
10556 WOUND CARE SPECIALISTS,//
Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay
Gross
Discount
No -Pay
Net
WCS00002572 l/ 01/16/20 01/01/20 01/01/20
11,125.00 0.00
0.00
11,125.00 ✓/
WOUND CARE
Vendor Total: Number Name
Gross
Discount
No -Pay
Net
10556 WOUND CARE SPECIALISTS
11,125.00 0.00
0.00
11,125.00
Report Summary
Grand Totals: Gross Discount
No -Pay
Net
354,044.93 0.00
0.00
354,044.93
n c
35�t, o ��e • a—�
35 t044�5,., f'
66V t
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Discount
MEMORIAL MEDICAL CENTER
01/18/2019
0.00
0.00
AP Open Invoice List
08:48
No -Pay
Net
Dates Through:
Vendor# Vendor Name
Class Pay Code
No -Pay
12336 PFIZER INC /
0.00
Invoice# Comment Tran Dt
Inv Dt Due Dt Check DPay Gross
340BREPAYMENT 01/18/20
01/18/20 01118/20 57.33
3408 REPAYMENT
Vendor Totals Number Name
Gross
12336 PFIZER INC
57.33
Report Summary
Grand Totals: Gross
Discount
57.33
0.00
ON W3 q
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Discount
No -Pay
Net
0.00
0.00
57.33
Discount
No -Pay
Net
0.00
0.00
57.33
No -Pay
Net
0.00
57.33
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MEMORIAL MEDICAL CENTER
01!18/2019
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AP Open Invoice List
08:49
ap_open_invoice.template
Dates Through:
Vendor# Vendor Name/
Class Pay Code
12340 ASTRAZENECA ,,
Invoice# Comment Tran Dt Inv Dt
Due Dt Check pPay Gross
Discount
No -Pay
Net
340BREPAYMENT 01/18/2001/18/2001/18/20 1,403.09
0.00
0.00
l/
1,403.09
340B REPAYMENT
Vendor Total: Number Name
Gross
Discount
No -Pay
Net
12340 ASTRAZENECA
1,403.09
0.00
0.00
1,403.09
Report Summary
Grand Totals: Gross
Discount
No -Pay
Net
1,403.09
0.00
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1,403.09
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Page I of 1
MEMORIAL MEDICAL CENTER
01118/2019
0
AP Open Through List
08:50
ap_open_invoice.template
Dates Through:
Vendor# Vendor Name
Class Pay Code
12344 NOVO NORDISK INC.:
Invoice# Comment Tran Dt Inv Dt
Due Dt Check DPay
Gross
Discount
No -Pay
Net
3408 REPAYMENT 01/18/2001/18/2001/18/20
3,685.41
0.00
0.00
3,685.41
3408 REPAYMENT
Vendor Total: Number Name
Gross
Discount
No -Pay
Net
12344 NOVO NORDISK INC.
3,685.41
0.00
0.00
3,685.41
Report Summary
Grand Totals: Gross
Discount
No -Pay
Net
3,685.41
0.00
0.00
3,685.41
x;' 31P1
('oum1 , A:4JF9A.'.b.'dJ:R
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MEMORIAL MEDICAL CENTER
01/18/2019
0
AP Open Invoice List
13:13
ap_open_invoice.template
Dates Through:
Vendor# Vendor Name
Class Pay Code
12348 MISSION PHARMACAL CO /
Invoice# Comment Tran Dt
Inv Dt Due Dt Check DPay Gross
Discount
No -Pay
Net i
3408 REPAYMENT 01/1812001/1812001/18/20
3.32
0.00
0.00
3.32;1
34013 REPAYMENT
Vendor Total: Number Name
Gross
Discount
No -Pay
Net
12348 MISSION PHARMACAL
CO 3.32
0.00
0.00
3.32
Report Summary
Grand Totals: Gross
Discount
No -Pay
Net
3.32
0.00
0.00
3.32
N
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Oki
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MEMORIAL MEDICAL CENTER
01/18/2019
0.00
0.00
AP Open Invoice List
13:16
No -Pay
Net
Dates Through:
Vendor# Vendor Name
Class Pay Code
12352 SANDOZ INC
Invoice# Comment Tran Dt
Inv Dt Due Dt Check DPay Gross
340BREPAYMENT 01/18/2001/18/2001/18/20
17.53
340B REPAYMENT
Vendor Total: Number Name
Gross
12352 SANDOZ INC
17.53
Report Summary
Grand Totals: Gross
Discount
17.53
0.00
Oki
JAN 2 21319
d,'WJM' OI xaiJ7PfTOU
i:.r L"k3€ 0-H CJ6,'8'€ NI' Y_, TZ^ X6j
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0.00
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17.53
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0.00
0.00
17.53
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0.00
17.53
file:///C:/Usersleclevenger/cpsilmemmed.cpsinet.com/u82227/data_5/tmp_ew5report777... 1/18/2019
01/18/2019 MEMORIAL MEDICAL CENTER
13:18 AP Open Invoice List
Dates Through:
Vendor# Vendor Name Class Pay Code
12350 TARO PHARMACEUTICAL USA, INC
Invoice# Comment Tran Dt Inv Dt Due Dt Check 0Pay Gross
340BREPAYMENT 01/18/2001/18/2001/18/20 49.50
3408 REPAYMENT
Vendor TotalE Number Name Gross
12360 TARO PHARMACEUTICAL USA, INC 49.50
Report Summary
Grand Totals: Gross Discount
49.50 0.00
i
Page 1 of 1
0
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0.00
0.00
49.50 ,
Discount
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0.00
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0.00
49.50
file:///C:/Users/eclevenger/cpsi/memmed.cpsinet.com/u82227/data_5/tmp_cw5report268... 1/18/2019
01118!2019 MEMORIAL MEDICAL CENTER
AP Open Invoice List
13:17
Dates Through:
Vendor# Vendor Name / Class Pay Code
12356 SUN PHARMACEUTICALS INDUSTRY J
Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross
340BREPAYMENT 01/18/2001/18/2001/18/20 1,773.72
3408 REPAYMENT
Vendor Total: Number Name Gross
12356 SUN PHARMACEUTICALS INDUSTRY 1,773.72
Report Summary
Grand Totals: Gross Discount
1,773.72 0.00
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1,773.72
file:///C:/Userslcclevenger/cpsi/memmed.cpsinet.com/u82227/data_5/tmp_cw5report523... 1/18/2019
TOLL FEE PHONE NUMBER: 1-600-555-3453
(EFTPS TUTORIAL SYSTEM: 1-800-572-8683)
"ENTER 9 -DIGIT TAXPAYER IDENTIFICATION NUMBER"
"ENTER YOUR 4 -DIGIT PIN"
"MAKE A PAYMENT, PRESS 1"
"ENTER THE TAX TYPE NUMBER FOLLOWED BY THE # SIGN"
E]"IF FEDERAL TAX DEPOSIT ENTER 1"
"ENTER 2 -DIGIT TAX FILING YEAR"
"ENTER 2 -DIGIT TAX FILING ENDING MONTH"
IST QTR - 03 (MARCH) - Jan, Feb, Mar
2ND QTR - 06 (JUNE) - Apr, May, June
3RD QTR - 09 (SEPTEMBER) - July, Aug, Sept
4TH QTR - 12 (DECEMBER) - Oct, Nov, Dec
"ENTER AMOUNT OF TAX DEPOSIT - FOLLOWED BY # SIGN"
"1 TO CONFIRM"
"ENTER W/CENTS AMOUNT OF SOCIAL SECURITY"
"ENTER W/CENTS AMOUNT OF MEDICARE"
"ENTER W/CENTS AMOUNT OF FEDERAL WITHHOLDING"
CHECK
"6 -DIGIT SETTLEMENT DATE"
"1 TO CONFIRM"
ACKNOWLEDGEMENT NUMBER
CALLED IN BY:
CALLED IN DATE:
CALLED IN TIME:
K:\Finance Share\AP-Payroll Files\Payroll Taxes\2019\#2 MMC TAX DEPOSIT WORKSHEET 01.17.19 R1
#### ENTER:
El
G
$
94,616.19
1
$
46,241.04
$
11,262.30
$
35,292.65
S -
1
1120/2019
Run Date: 01/20/19 MEMORIAL MEDICAL CENTER Page 106
Time: 16:36 Payroll Register ( Bi -Weekly 1 P2REG
Pay Period 01/04/19 - 01/17/19 Rung 1
Final Summary
*-- P ay
Y C o d e S u m m a r-----------------------------------------
*-- D e d u c t i o
n s S
-
u m m a r y-----------*
PayCd
Description
His IOTISHIWEIHOIC31
Gross
( Code
Amount
i--------------------------------------------------------..
- _f
-
_R
1
REGULAR PAY -S1
9303.00
N
N N
100990.16
A/R
969.47
A/R2
140.53
A/R3
1
REGULAR PAY -Si
2064.25
N
N N N
87113.46
ADVANC
AWARDS
BOOTS
1
REGULAR PAY -Si
256.00
Y
N N
6013.47
CAFE H
CAFE -1
CAFE -2
2
REGULAR PAY -S2
2151,75
N
N N
61369.46
CAFE -3
CAFE -4
CAFE -5
2
REGULAR PAY -82
101,00
Y
N N
2912,56
CAFE -C
CAFE -D
1599.29
CAFE -F
3
REGULAR PAY -S3
1650.25
N
N N
43794.82
CAFE -H
18564.28
CAFE -I
CAFB-L
3
REGULAR PAY -S3
104.75
Y
N N
4451.26
CAFE -P
217,30
CANCER
CHILD
C
CALL PAY
2163.50
N 1
N N
4327.00
CLINIC
418.43
C014BIN
592.07
CREDUN
E
EXTRA WAGES
N
N N N
3732.69
DO ADV
DENTAL
DBP -LF
E
EXTRA WAGES
N I
N N N
760.00
DIS -LF
EAT
EATCSH
F
FUNERAL LEAVE
36,00
N I
N N
695,28
FEDTAX
35292.85
FICA -M
5641,15
FICA -0
24120.52
N
HOLIDAY PAY
26.00
N
N N N
315,09
FIRSTC
75.00
FLEX S
2329.33
FIX FE
I
INSERVICE
118.25
N 1
N N
3116.17
FORT D
FUTA
GIFT S
410,68
1
INSERVICE
5.50
Y 1
N N
224.29
GRANT
GRP -IN
65.76
GTL
J
JURY LEAVE
8,00
N 1
N N
290.80
HOSP-I
ID TFT
LEAF
K
EXTENDED -ILLNESS -BANK
116,00
N I
N N
2679.28
LEGAL
420.18
IMSA
546.00
MEALS
182.26
P
PAID -TIME -OFF
89.67
N
N N N
1050.79
MISC
MISC/
VDICGHR
P
PAID -TIME -OFF
483.00
N 1
N N
8715.44
NATFM1I6
359.3D
OTHER
PHI
X
CALL PAY 2
140.00
N I
N N
280.00
PHI***
PR FIN
253.16
RELAY
Z
CALL PAY 3
96.00
N 1
N N
288.00
REPAY
GANG
SCRUBS
SIGNOR
ST -TX
STONDF
1295.00
STONE
SWN82
STUDEN
TSA -1
TSA -2
TSA -C
TSA -P
TSA -R
28912.58
TUTION
UNIFOR
825.59
UW/HOS
*------------------- Grand Totals: 19512,92 ------- ( Gross: 413120.02
Checks Count:- FT 199 PT 8 Other 36 Female 212 Male 30 Credit
*---------- _____-_.________..________________-_._____._-.___._-_
Deductions: 123230.73 Net: 289809.29
OverAmt 5 ZeroNet Term Total: 242 _ y.
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AmeenssourceBergen- STATEMENT
AMERISOURCEBERGEN DRUG CORP
12727 WEST AIRPORT BLVD
SUGAR LAND TX 77478-6101
866451-9655
UPO
RISOURCEBERGEN DRUG CORP
ox 905223
RLOTTE NC 28200-5223
Number: 57597902 Date: 01-18-2019 1 of 1
WALGREENS #12494 3408
Reference
Number
MEMORIAL MEDICAL CENTER
Activity
Type
-1302 N VIRGINIA ST
Rp
01-14-2019
IIIM PORT LAVACA
TX 77979-2509
ACCOUNT: 1001352841037028186
Invoice
16.61/
01-14-2019
Not Yet Due:
0.00
Current:
2,683.03
Past Due:
(.00
Total Due:
2,683.03
Account Balance:
2,683.03
Account Activity
Activity Due
Date Date
Reference
Number
Purchase Order
Number
Activity
Type
Amount
01-14-2019
01-25-2019
3018535565
141742
Invoice
16.61/
01-14-2019
01-25-2019
3018535566
141821
Invoice
98.74,
01-15-2019
01-25-2019
3018613944
141878
Invoice
,400.76-
01-162019
01-25-2019
3018613945
141879
Invoice
1/.49.`
01-16.2019
01-25-2019
3018663269
141954
Invoice
1413 23:"
01-16-2019
01-25-2019
3018663940
141955
Invoice
4.63/
01-17-2019
01-25-2019
3018718697
141979
Invoice
13.41/
01-18-2019
01-25-2019
3018759135
142007
Invoice
558.16
Thank You for Your Payment
Date Payment Number Amount
01-18-2019 (3,603.48)
Reminders
Due Date Amount
01-25-2019 2,683.03
Total Due: 0,683.03
Terms:
Monday - Friday due in 7 days
GL C) 0
JAN
L"f1t,7'Tt3€rr1 {:CitlTtd`4`l,'t'3�.",fF=
n�,.�nramee. eux,zss,z oowmonTvw. wm�a,suonom zmwnmsas�
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MEMORIAL MED;CAL CENTER
CHECK REQUEST
Memorial Medical Center Operating Date Requested: January 23, 2019
A
-- — ...._...__...
FOR ACCT, USE ONLY
y
— �t;+3.��i,3
�ImprestCash
�A/P Check
E
1RtI 2 fl
IlMail Check to Vendor
1, RN sf
Return Check to Dept
s Atra-st
iF ii1'i R.C)R➢1`I'd"Y.
AMOUNT $22,547.04
_ G/LNUMBER:
21400012
EXPLANATION: Ashford —To transfer funds for December Component 1—QIPP
REQUESTED BY: Andy De Los Santos AUTHORIZED BY:
MEMOMA!,, MEDICAL CENTER
CHECK REQUEST
Memorial Medical Center Operating Date Requested: January 23, 2019
FOR ACCT. USE ONLY
ElImprest Cash
IAl '? 2 'NI"I DA/P Check
[]Mail Check to Vendor
r, )rfq' ,t I Return Check to Dept
fN
AMOUNT�10,IJ57.50 G/LNUMBER: 21400011
_
EXPLANATION: Solera —To transfer funds for December Component I— QIPP Paymen
REQUESTED BY: —Andy De Los Santos AUTHORIZED
P
A
'i
E
E
MEMORIAL MEMCAL CENTER
CHECK REQUEST
Memorial Medical Center Operating Date Requested:
January 23, 2019
P'43rr� 2,v"t�
t9i?f
--- -- _.. _..
FOR ACCT. USE ONLY
_
OI m prest Cash
l_]A/P Check
r,x����a r urarac.re
fI Mail Check to Vendor
❑Return Check to Dept
AMOUNT $6,$39,10 G/L NUMBER: 21400010
EXPLANATION: Crescent—To transfer funds for December
REQUESTED BY: Andy De Los Santos
nent 1—QIPP Payments
AUTHORIZED BY:
M
11
e
MEMORIAL MEMCAL CENTER
CHECK REQUEST
Memorial Medical Center Operating Date Requested: January 23, 2014
FOR ACCT. USE ONLY
ulmprest Cash
[]A/P Check
Mail Check to Vendor
u Return Check to Dept
AMOUNT $10,Sfi1.92 G/L NUMBER: 21400009
EXPLANATION: Broadmoor—To transfer funds for December Component)—QIPP
REQUESTED BY: Andy De Los Santos AUTHORIZED BY: ^_
P
A
y
E
is
MEMORIAL MEDICAL CENTER
CHECK REQUEST
Memorial Medical Center Operating Date Requested: January 23, 2019
FOR ACCT. USE ONLY
�1V OImprestCash
J , 1 .]A/P Check
LMali Check to Vendor
LT�ilidrv?a7X�k'R'r�
DReturn Checkto Dept
AMOUNT $14,442.57 G/LNUMBER: 21400008
EXPLANATION: Fort Bend —To transfer funds for December Component 1— QIPP Payn
REQUESTED BY: Andy De Los Santos
AUTHORIZED 3Y:—
Memorial Medical Center
Nursing Nome UPL
Weekly Cantex Transfer
Prosperity Accounts
1/21/2019
Prevl4us
MWupt ae4lnnln0
ftHa, man -H !o &b1 dO rd
Ashford Heath CaKCento,Wfa,
JPMPr9on Chase3onk
ABA 11 -'--'
Accdun
Prevloua
H4aunt 4aginnln8
Num er BaNnw
.. 25,077.46..
ACH
AOi PeadlaBokt4
17,29434 ( 17,194,84 / 53,432,60
2!,266.69 ✓ 24,756.69 ,f 87,08184
14,634.83 J, 19,534.83 t/ 57,346.41
a„an ucsn r a de a,
CanfexHmlN ure 2nvrs IBLLG -
JPMorgon Omse Beek
ABA
Am
New Only bolaare ofover55000 will be bensJerredto the numlng home
Nah1: FoM o¢ountMsabosa6olante of$loBfhoeMMedeposlfedNopmormun4
46593°
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42a903 64
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p\NHWeeklyTmnsren\NHUPLTm.Ae,sonmary\2019\janvar\NH UPLTnnder5ummary01-21-19
Totlays Meow. ae
Amouotto Bo
TOWI.ed to
Bank Role..
137,137.84
Bank Balance
137,!37,84 i/,
Veda".
-
Leave ln Balance
100.00
MMCPorttaa NPPl
23,547.04 t�
MMCPortipn NFpl
-
MMCPorttonNPP2
-
MMCPonionNPP3
JanuaryBanklnterest
-
FebraaryBonk lnterest
-
McMbBanklntereet
101,820.75 a/
Adlast Belanw/rnnvFer Amt
114,490001
Amouotto Bo
TOWI.ed to
Bank Role..
111,970.25
Vadaat4
Leave In Balanw
10000
MMCPonion NPPI
9,410.00 ✓
MMCPapIon QIPP1
3,637.50
MMCporUan NFP2
-
MMCPonionNPP3
-
JanaaryBanklntere4e
February Bank Interest
Martis B.0huereet
/
AdJust BaWnce/rmMFetAmt
101,820.75 a/
53,532.68 / 46,59350
Beak BalaMe
53,532.68 t/
Vadaate
leave In Balance
200,00
MMC Panton NPP l
4,3650 .%
MMC par lon NPP 1
2A73.50
MMC Ponlon NPP2
-
MMCPardon NPP3
-
JanuatyBaakinterest
February Bank intense
-
Momh8aaklntarest
Adjust Bala6wfrnnsfar Atet
4605350
-
87,131.52 / 26,169.60
Bank BpIann
87,131.52'
V4danw.
LeavalnBalance
100.00
MMCP9rtl4n NPpi
3,99259
MMCP.M.n NPpi
2A8B,U5
MMCParOoa NPp1
4,391.28 t/
MMC Pomon NPP 2
MMC Portion NPP 3
W..orrBanklmerest
0.00
February Bank Interest
0
Match Bank Interest
0
A9Jat Bahmotrw0orAmt
78,169.60 �✓/
57A46A1 i 41,903.84
Bank Balance
57,446.41
Varianoe
Leavein Balanw
100.00
MMC PorOo a NPP 1
5,223A5
MMCPoruon NPP3
9,219.12
MMCPordoa NPP2
-
-P MMCPortion NPP3
-
Jonuary8ankinterest
FebruaryBankinterest
-
MarchBanklaterest
Adiust Balanea/caa*rAmt
4503.84a/
,- TOTAtT8AN5FFRLS
381970.57
73('•blone Moore, CFO
1/21/2019
VIN 2 2 2019
i"AVIX01jill11,{Ow7P4dI [flzz.k3
t ' KANH Weekly Transfer;\Contex Bank Dowl08d\2019Vsnuary\Caotex Prosperity Download 01.14-19 Thru 01-20-19 Pagel
AshfOtd gatclens
1/18/2019 Check#43
1/18/2019 ACH Deposit Amerleroup TKSC HCCLAIMPMT 3390300358 311000
1/18/2019 ACH Deposit AMERIGROUP CORPO EFPAYMENT FE51781452112000
1/18/2079 ACH Deposit UHC COMMUNITY PL HCCIAIMPMT 746003411910000
1/17/2019 ACH Deposit MANAGEANDNM718 MNS PMNT 00000000000009341
1/17/2019 ACH Deposit UHC COMMUNITY PL HCCLAIMPMT 746003411910000
1/17/2019 ACH Deposit UHC COMMUNITY PL HCCtAIMPMT746003411910000
i/16/2019 CM Wire Domestic WIRE OUTASHFORD HEALTH CARR CENTER LTD
1/16/2019 ACH Deposit UHC COMMUNITY PL HCCIAIMPMT746003411910000
1/15/2019 ACH Deposit Amerigroup TK5C HCCLAIMPMT 5900030315 121000
1/15/2019 ACH Deposit UHC COMMUNITY PL HCCLAIMPMT 746003411910000
V24/2019 -ACH Deposit HHP EFPAYMENT 39086091000012285665 DISDATA
1/14/2019 ACH Deposit Amerigroup TR5C HCCLAIMPMT 3989958606111000
1/14/2019 ACH Deposit UHC COMM UNITY PL HCCLAIMPMT 74BODS4119100D0
�L°.�tlm6ar;
1/28/3019 Check412
1/18/2029 ACH Deposit AMERIGROUP CORPO E -PAYMENT FES17814551=0
1/18/2039 ACH Deposit UnitedHeahhcare HCCLAIMPMT 746003411124384
1/38/2019 ACH Deposit UHC COMMUNITY PL HCCLAIMPMT 746003411 910DOG
3/38/2019 -ACH Deposit MNP EFPAYMENT 39066191000012300052 DISDATA
1/17/2039 ACM Deposit UHC COMMUNITY PL HCCLAIMPMT 746003411910000
1/17/2039 -ACH Deposit HHP EFPAYMENT 39086191000012297998 DISDATA
1/16/2019 CM Wire Domestic WIRE OUT CANTER HEALTHCARE CENTERS III
3/16/2019 ACH Deposit MOLINA HEALTHCAR MOLINAACH 0079989442000015
1/16/2039 ACH DepositAMERIGROUP CORPO EFPAYMENT E€51778362111000
1/16/2019 ACH Deposit UnitedHeeithcdre HCCMMPMT74600341112A384
1/16/2019 ACH Deposit UHC COMMUNITY PL HCCLAIMPMT 746OD3411910000
1/19/2019 -ACH Deposit HHP EFPAYMENT 39066191000012291178 DISDATA
1/15/2019 ACH Deposit UHC COMMUNITY PL HCCLAIMPMT 746003411910000
1/15/2019 ACH Deposit HUMANA INS CO EFPAYMENT 3908618300DO5920768
2/14/2019 -ACH Deposit HHP EFPAYMENT $9096191000012283689 DISDATA
1/14/2019 ACH Deposit UHC COMMUNITY PL HCCLAIMPMT 74 60 03411 910 0 0 0
1/14/2019 ACH Deposit HEALTH HUMAN SVC HCMIMPMTX74600342130042
1/18/2019 Check#39
1/18/2019 ACH DepositAMERIGROUP CORPO E -PAYMENT EE51781454111000
1/17/2019 ACH Deposit UHC COMMUNITY PL HCCtAIMPMT746003411910000
1/17/2019 ACH Deposit UHC COMMUNITY PL HCCtAIMPMT746003411910000
1/16/2019 CM Wire Domestic WIRE OUT CANTER HEALTH CARE CENTERS III
1/16/2019 ACH Deposit MOLINA HEALTHCAR MOLINAACH 0079987342000015
1/16/2019 ACH Deposit UnitedHealthcare HCCWMPMT746003421124384
1/15/2019 ACH Deposit UHC COMMUNITY PL HCCLAIMPMT 746003411910000
1/15/2019 ACH Deposit HUMANA INS CO EFPAYMENT 390864 8300005927372
1/15/2019 ACH Deposit HUMANA INS CO EFPAYMENT 39086483ODODS920769
1/14/2019 ACH Deposit UNC COMMUNITY PL HCCLAIMPMT 746003411910000
.:
1/18/2019 Check #37
1/18j2019 ACH DepositAMERIGROUP CORPO EFPAYMENT EE51781452111000
1/18/2019 ACH Deposit UHC COMMUNITY PL HCCLAIMPMT 746003411910000
1/17/2039 ACH Deposit UHC COMMUNITY PL HCCLAIMPMT 746003411910000
1/17/2019 ACH Deposit HEALTH HUMAN SVC HCCLAIMPMT 174600341130062
1/16/2019 CM Wire Domestic WIRE OUT CANTER HEALTH CARE CENTERS 111
1/16/2019 ACH Deposit MOLINA HEALTHCAR MOUNAACH 00799755 42000015
3/16/2019 ACH Deposit UHC COMMUNITY PL HCCUOMPMT746003411910000
1/15/2019 ACH Deposit UHC. COMMUNITY PL HCCIAIMPMT746003411910001)
1/35/2019 ACH Deposit HUMANA INS CO EFPAYMENT 390863 8300005920768
1/14/2019 ACH Deposit HUMANA INS CO EFPAYMENT 390863 8500005612683
2/14/2019 ACH Deposit HUMANA INS CO EFPAYMENT 39086383000DS616058
1/14/2019 ACH Deposit HEALTH HUMAN SVC HCCLAIMPMT 17460034123006 2
MMC PORTION
Transfer -Out 7 n r- QIPP/ComP1 WPP/Comp2 WPP/Comp9 0.100 17 NH PORTION
__. _... _
33,803.00 -
2,667.41 = 2,667.41
22,547.04 22,947.04 22,547.04 -
4,834.59 4,834.59
436.95 - 436.95
12,542.81 - 12,542.81
1,635.15 - 1,635.15
22,074.28 '
2,216.76 - 2,216.76
31.20 - 31.20
33,329,88 33,329.88
250.48 250AB
30,438.29 = 30,436.29
26,109.28 26,109.28
59877.28 197,037.84 22597,04 _ — 22,547.04 114,490.80
MMC PORTION
Tran _ _ t s er•I WPP/Comps 0gPP/Comp2 QIPP/ComP3 QIPPTI NN PORTION
6,583.50 '
4,39L28 4,991.28 4,381.28 -
5,670.00 5,67000
843.85 • 843.85
1,435.50 1,435.50
8,699.38 - 8,699.38
7,062.96 - 7,062.96
16,573.19
2,488.05 2,48305 2,488.06
3,982.59 3,982.59 8,982.58 -
3,780A0 3,780.00
1,322.16 = 1,322.16
594.76 - 594.76
18,881.95 - 18,881.95
6,357.51 6,357.51
3,251.19 3,251.19
4,170.60 4,170.60
14,099.74 - 14,099.74
23186.64
87 93152
10,883.82
- -
30,883.92
78,169.60
2,033.61
2,033.61
2,277.75
-_
2,277.75
14,430.79
-
__..
AiMCPORTI4N
•
-
TrapaL=Put
iTFgn�a sfar=In
WPP/Camp,
WPP/Camp2 Qlpp/Comp3
WPPTI
NH PORTION
6,545.00
5,050.68
731.31
-
5,320.66
4,365.60
4,365.60
3,329.46
4,365.60
-
2,211.19
1,472,70
2,211.19
1953483 57,346.41 14442.57 --
14,442.57
1,472.70
10,971.17
10,971.17
10,64934
'
-
2,473.50
2,47350
2,478.50
-
1,110.D0
1,110.00
11,058.98
11,058.98
318.18
•
128.18
11,665.90
11,665.90
10,186.65
10,186.65
1719434
53,43268
6839.10
6839.30
46,593.58
MMO PORTION
Transfer -Out
Transloo-in[CPP/C,,pI
QIPP/Camp2 WPP/Comps
WPPTI
NH PORTION
13,821.50
9,219.12 5,218,12
8,219.12
-
2,033.61
2,033.61
2,277.75
-
2,277.75
14,430.79
-
14,430.79
5,713.33
•
-
5,22BAS 5,225.45
5,229.45
-
7,528.39
-
7,518.39
5,050.68
5,050.68
731.31
731.31
5,320.66
-
5,320.65
3,329.46
-
3,329.46
2,211.19
-
2,211.19
1953483 57,346.41 14442.57 --
14,442.57
42,903.84
' K:\NH Weekly Transfers\Cent"Bank Dowioad\2019\lanuary\Camez prosperity Download 01-14-19 Thar 01-20-19 Paget
S, olera 0 West Houston
1/18/2019 Check 837
1/18/2019 ACH Deposit AMERIGROUP CORPO E -PAYMENT EES7781455111000
1/17/2019 ACH Deposit UHC COMMUNITY PI, HCCLAIMPMT746003411910000
1/17/2019 ACH Deposit UHC COMMUNITY PI,HCCIAIMPMT 746003411910000
1/17/2019 ACH Deposit HUMANA INS CO EFPAYMENT 3908628300005545330
1/17/2029 -ACH DeposR HHP EFPAYMENT 39086291000012297999 DISDATA
1/16/2019 CM Wire Domestic WIRE OUT CANTER HEALTH CARE CENTERS 111
1/16/2019 ACH Deposit MOLINA HEALTHCAR MOLINAACH 0079985842000015
1/16/2019 ACH Deposit AmerlBroupTRSC HCCLAIMPMT 33901_25383111000
1/16/202.9 ACH Deposit UHC COMMUNITY PL HCCIAIMPMT 746003411910000
1/15/2019 -ACH Deposit HHP EFPAYMENT 38066291600012289418 DISDATA
1/15/2019 ACH Deposit UHC COMM UNITY PL HCCIAIMPMT 746003411910000
1/15/2019 ACH Deposit HUMANA INS CO EFPAYMENT 390862830005920763
1/15/2039 ACH Deposit AARP Supplements HCCLAIMPMT74WMII 124984
1/14/2019 -ACH Deposit HHP EFPAYMENT 39086291000017283690 DISDATA
1/14/2019 -ACH Deposit HHP EFPAYMENT 89086291000012285666 DISDATA
1/14/2019 ACH Deposit Amedgroup TXSC HCCIAIMPMT33$995860731UN
1/14/2019 ACH Deposit UHC COMMUNITY PL HCCLAIMPMT746003411910000
1/14/2019 ACH Deposit NOVITAS SOLUTION HCCIAIMPMT675320420000116
1/14/2019 ACH Deposit HUMANA INS CO EPPAYMENT390862830005612683
7/14/2019 ACH Deposit HUMANA INS CO EFPAYMENT 390867830005616058
TOTAL$
MMC PORTION
Tranggo.4 Transfer -I QIPP/C9mP1 QIPP/Comp2 0PP/Comp3 QIPR TI NH PORTION
6,420,00 6,420.00
5,181,81
767.82
6,584.31
37480
16,152.46
3,637.50
2p81.35
13,888.97
1,710,67
9,956.59
7,939.68
5,025.00
2,986,20
7,678.97
4,893.54
3,$89.61
7,075.70
13,728.57
7,959.16
3,637.50
6,420.0
5,16L61
767.82
6,584.31
372.80
3,637.50
2,481.35
13,888.97
1,710.67
9,956.59
7,939.68
5,025.00
2,986.20
7,678.97
4,893.54
3,589.61
7,075.70
13,728.57
7,959.16
25,777.46 121,878,25 10,057.50 - - 10,057.50 101,820.75
}41540.60 446,726.70 64748.13 _ - 64,74813 381,978.57
, ,1!21/2019
r
Home
ALL ACCOUNTS FAVORITES *
Checking
MEMORIAL MEDICAL CENTER /
NH ASHFORD *Haat A
MEMORIAL MEDICAL CENTER /
NH 13ROADMOORw403*
MEMORIAL MEDICAL CENTER /
NH CRESCENT "4411 *
MEMORIAL MEDICAL CENTER /
SOLERA AT WEST HOUSTON
•4438 *
MEMORIAL MEDICAL CENTER /
NH FORT BEND +44464
Digital Banking
sort By: Account Number
Available Previous Day
$157,916.74 $137,137.84
$367,238.54 $87,131.52
$60,330,23 $53,532,6$
$124,552.01 $111,978,25
$64,498.27 $57,446.41
TOTAL $2,336,464,05 $1,896,657.99
https://pbsltx.secure.fundsxpress.com/fxweb/app/#/home 1/1
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1/18/2019 Checgp27
1/17/1019 ACH 0®p --h NPNTAMMION HCCIAIMPMT476097420800188
MMC PORTION
Transfer Q. Tra s r- OJPP/CamPi OPP/Camp2 QIPP/Com P3 gIPPTI NH PORTION
20,924.90 -
303.77
305.77
20,924.43 34$.)7 -_-.. -.. 305.])
1/21/2019
ALL ACCOUNTS
Checking
FAVORITES *
MEMORIAL MEDICAL/ NH
GOLDEN CREEK HEALTHCARE
"4454 *
Digital Banking
Avallable
Previous Pay
$1,238.16 $405.77
QUI
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TOTAL $2,336,464.05 $1,896,657.44
Sort By., Account Number
https://pbsltx.secure.fundsxpress.coWfxweb/app/#/home 1/1
January 23, 2019 2019 APPROVAL LIST - 2018 BUDGET
COMMISSIONERS COURT MEETING ON
BALANCE BROUGHT FORWARD FROM APPROVAL LIST REPORT PAGE
CENTERPOINT ENERGY
SAM'S CLUB
EMS- RENEWAL OF MEMBERSHIP
01/23/19
22 $165,317.01
A/P $ 40.59
A/P $ 50.04
TOTAL VENDOR DISBURSEMENTS: $ 165,407.64
TOTAL AMOUNT FOR APPROVAL: $ 165,407.64
January 23, 2019
2019 APPROVAL LIST- 2019 BUDGET
COMMISSIONERS COURT MEETING OF
01/23/19
BALANCE BROUGHT FORWARD FROM APPROVAL LIST REPORT PAGE
22
$1,736,981.80
CAHOUN COUNTY GENERAL FUND 4 QTR 2oi8- FEES & FINES
A/P
$
7,116.62
FRONTIER COMMUNICATIONS
A/P
$
105.39
RICHARD MEYER COUNTY JUDGE- REIMBURSEMENT FOR CONE EXPENSES
A/P
$
716.19
STATE COMPTROLLER 4111 QTR 2oi8 FEES & FINES
A/P
$
59,248.10
WHITE TRASH SERVICES
A/P
$
540.00
TOTAL VENDOR DISBURSEMENTS:
$
1,804,708.10
P/R $ 283,109.59
TOTAL AMOUNT FOR APPROVAL: $ 2,087,817.69
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Calhoun County Commissioners' Court —January 23, 2019
18. Public discussion of County matters.
Adjourned: 10:27 a.m.
Page 16 of 16