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2019-06-19 CC MINUTES.pdfCalhoun County Commissioners' Court—JUNE 19, 2019 CALH OUN COUNTY COMMISSIONERS'COURT REGULAR 2019 TERM A JUNE 19, 2019 BE IT REMEMBERED THAT ON JUNE 19, 2019, THERE WAS BEGUN AND HOLDEN A REGULAR TERM OF COMMISSIONERS' COURT. 1. CALL TO ORDER This meeting was called to order at 10:00 A.M by Judge Richard Meyer. 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 8 Calhoun County Commissioners' Court—JUNE 19, 2019 4. General Discussion of Public matters and Public Participation. N/A S. Approve minutes of May 22, 2019 and May 29, 2019 meetings. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 6. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 17) On insurance proceeds from TAC in the amount of $2,113.52 ($4,613.52 minus $2,500 deductible) for damages to a Sheriff Office vehicle from an accident on May 16, 2019. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 7. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 18) On Sheriff Vickery's request to create deputy/jailer positions for the Calhoun County Jail. (RM) Sheriff Bobby Vickery spoke on this matter. No Action Taken At This Time. 8. Hear report from Memorial Medical Center. (AGENDA ITEM NO. 06) Diane Moore and Jason Anglin presented report. Page 2 of 8 ICalhoun County Commissioners' Court — IUNE 19, 2019 9. Public Hearing regarding the proposed adoption of Guidelines and Criteria of of the Commissioners' Court of Calhoun County for Granting Tax Abatememt as a Business Incentive in Reinvestment Zones created in Calhoun County. (RM) Sandra Witte spoke on this matter. Commenced: 10:14 a.m. Adjourned: 10:18 a.m. 10. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 8) To adopt Guidelines and Criteria of the Commissioners' Court of Calhoun County for Granting Tax Abatement as a Business Incentive in Reinvest- ment Zones created in Calhoun County. (RM) RESULT: APPROVED[UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 11. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 9) To vacate and abandon a portion of public road in Alamo Beach described as a 0.26 of an acre shown as Alamo Street on the plat of Alamo Beach Townsite further described in the application. Property owner is CMP Development, LLC, Matt Wetzig, President. (DH) David Hall and Sandra Witte spoke on this matter. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 3 of 8 I Calhoun County Commissioners' Court — JUNE 19, 2019 12. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 10) On request from Calhoun County Museum to use donations funds to Purchase various promotional items for distribution to schools and other tour groups. George Ann Cormier spoke on this matter. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 13. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 11) To award bids for Road Materials for period beginning July 1, 2019 and ending December 31, 2019. (RM) The lowest bid was rejected due to previous quality. Quality Hot Mix accepted at this time. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 14. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 12) To award vids for Asphalts, Oils and Emulsions for period beginning July 1, 2019 and ending December 31, 2019. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 4 of 8 Calhoun County Commissioners' Court —JUNE 19, 2019 15. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITME NO. 13) To award the RFP for Property, Equipment Breakdown, Inland Marine and Crime Insurance for Calhoun County for the period beginning July 1, 2019. (RM) Don Gray, Gray & Co., spoke on this matter. TAC was accepted as insurance provider. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 16. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 14) On Port Alto FNI Project No. CCY17350 and authorize Commissioner Syma to sign the Professional Service Agreement with Freese and Nichols. (CS) Pass 17. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 15) To transfer $25,212.50 from GOMESA funds to the Port Alto Beach Nourishment FNI Project No. CCT17350 for the engineering scope of services provided by Freese and Nichols post Hurricane Harvey. (CS) Pass 18. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 16) On submittal of CEPRA Grant utilizing GOMESA funds as matching funds if approved (estimated to be $70,000) for a solution for Magnolia Beach erosion and authorize Commissioner Hail to sign. (DH) RESULT. APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 5 of 8 Calhoun County Commissioners' Court—JUNE 19, 2019 19. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 19) On request from Port O'Connor Chamber of Commerce to install a plaque at the pavilion at King Fisher Beach. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 20. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 20) To accept a donation of $4,200 from the Port O'Connor Service Club for the repair of existing picnic tables/benches at King Fisher Park. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Clyde Syma, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 21. CONSIDER AND TAKE NECESSARY ACITON (AGENDA ITEM NO. 21) To set dates and times for budget workshops. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 22. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 22) To declare items located in the Calhoun County Public Library declared as Surplus/Salvage and authorize the Librarian to dispose of same. (see list) (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 6 of 8 I Calhoun County Commissioners' Court—JUNE 19, 2019 23. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 23) To declare items located in the Calhoun County Public Library declared as Waste and authorize the Librarian to dispose of same. (see list) (RM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 24. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 24) To accept donations to the Calhoun County Public Library. (see list) (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 25. Accept reports of the following County Offices: L County Clerk's Office — April 2019 ii. County Sheriff's Office — May 2019 iii. Justice of the Peace PCT #3 — May 2019 iv. Justice of the Peace PCT #5 — May 2019 v. County Extension Office — May 2019; June 2019 RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 7 of 8 Calhoun County Conrimissioners' Court --JUNE 19, 2019 26. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 26) On any necessary budget adjustments. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 27. APPROVAL OF BILLS AND PAYROLL. (RM) MMC RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese COUNTY RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judqe Meyer, Commissioner Hall, Lvssv, Syma, Reese PAYROLL RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese ADJOURNED: 11:15 A.M. Page 8 of 8 Calhoun County Commissioners' Court—JUNE 19, 2019 CA L]H OUN COUNTY C®MMISSION ERS' C®URT REGULAR 2019 TERM § JUNE 19, 2019 BE IT REMEMBERED THAT ON JUNE 19, 2019, THERE WAS BEGUN AND HOLDEN A REGULAR TERM OF COMMISSIONERS' COURT. 1. CALL TO ORDER This meeting was called to order at 10:00 XM by Judge Richard Meyer. 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 25 Calhoun County Cornmissioners' Court—JUNE 19, 2019 4. General Discussion of Public matters and Public Participation. N/A Page 2 of 25 ICalhoun County Commissioners' Court — JUNE 19, 2019 S. Approve minutes of May 22, 2019 and May 29, 2019 meetings. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 3 of 25 The Commissioners' Court of Calhoun County, Texas met on Wednesday, May 22, 2019 at 10:00 a.m. in the Commissioners' Courtroom in the County Courthouse at 211 S. Ann Street, Suite 104, Port Lavaca, Calhoun County, Texas. Attached are the true and correct minutes of the above referenced meeting. µ--- --j - , Calhoun County, Anna Goodman, County Clerk Deputy Clerk' Calhoun County Commissioners' Court — MAY 22, 2019 CALHOUN COUNTY COMMISSIONERS' CURT REGULAR 2019 TERM MAY 22, 2019 BE IT REMEMBERED THAT ON MAY 22, 2019, THERE WAS BEGUN AND HOLDEN A REGULAR TERM OF COMMISSIONERS' COURT. 1. CALL TO ORDER This meeting was called to order at 10:00 A.M by Judge Richard Meyer. 2. ROLL CALL THE FOLLOWING MEMBERS WERE PRESENT: Richard Meyer CountyJudge David Hall Commissioner, Precinct #1 Vern Lyssy Commissioner, Precinct #2 Clyde Syma Commissioner, Precinct #3 Gary Reese Commissioner, Precinct #4 Anna Goodman County Clerk Catherine Sullivan 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 6 Calhoun County Commissioners' Court— MAY 22, 2019 4. General Discussion of Public matters and Public Participation. N/A S. Approve Minutes of May 08, 2019 Meeting. RESULT: APPROVED [UNANIMOUS] MOVER: David Hail, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 6. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 6) To declare two (2) nonfunctioning Llfepak 1000 Automatic External Deflbrillators located in EMS as Surplus/Salvage. (see list) (RM) RESULT: APPROVED [UNANIMOUS]'', MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 7. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 7) To authorize Dusting Jenkins, EMS Director, to trade in the above two (2) Defibrillators (see #6) to Physlo-Control Inc. for two (2) new Lifepak 1000 Automatic External Defibrillators. (see attached) (RM RESULT: APPROVED [UNANIMOUS] MOVER: Clyde Syma, Commissioner Pct 3 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 8. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 8) On Non -Federal Government Radio Frequency Use Agreement and authorize County Judge to sign. (DH) RESULT: APPROVED[UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 2 of 6 Calhoun County Commissioners' Court— MAY 22, 2019 9. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 9) To authorize Dustin Jenkins, EMS Director, to sign the Services Payment Agreement with ESO to provide report writing software required by Magnolia Beach VFD as an ambulance provider. Funds will be provided by the Volunteer ambulance budget. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 10. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 10) To amend the agreement for Air Medical Transport Services with PHI Air Medical, LLC (agenda Item #10 approved at the April 3, 2019 Commissioner's Court Meeting) with the addition of Exhibit A and authorize the County Judge to sign. (CS) Jeremy Thomason of PHI spoke on this matter. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 7 SECONDER: Clyde Syma, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 11. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 11) To place funds from Texas Port Recycling for a total amount of $117.00 to be placed into 2019 Precinct 1 budget account #540-53510 Road and Bridge Supplies. (DH) RESULT, APPROVED[UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 3 of 6 Calhoun County Commissioners' Court—MAY 22, 2019 12. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO, 12) To place funds from GOVPLANET, for the auction of a sweeper ($2,992.00) and a mower ($561.00) for a total amount of $3,553.00 to be placed into the 2019 Precinct 1 budget account #540-53510 Road and Bridge Supplies. (DH) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 13. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 13) To accept a donation of property from Melissa Sterling consisting of Lot 1, Block 80, Bayside Beach Subdivision. (DH) RESULT: APPROVED[UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 14. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 14) On Utility Easement and Covenant of Access with Victoria Electric Coop at Magnolia Beach VFD and authorize Commissioner Hall to sign. (DH) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 15. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 15) To transfer $25,212.50 from GOMESA funds to the Port Alto Beach Nourishment Project, Port Alto, TX. (CS) No Action Taken — Contract to be prepared Page 4 of 6 I Calhoun County Commissioners' Court—MAY 22, 2019 16. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 16) To accept the 2018 Calhoun County Roof Repairs as complete and release the retainage. (RM) RESULT: APPROVED[UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 17. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 17) To declare certain items of County Property In the Emergency Management Office as waste and authorize disposal of some. (see list) (RM) RESULT: APPROVED[UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 18. Accept Reports of the following County Offices: 1. County Treasurer 8. County Sheriff ill. District Clerk iv. County Clerk v. Justices of Peace vi. County Auditor vii. Floodplain Administration viii. Extension Service ix. Tax Accessor-Collector—Apr 2019 RESULT: APPROVED[UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese '.. Page 5 of 6 Calhoun County Commissioners' Court— MAY 22, 2019 19. CONSIDER AND TAKE ACTION ON NECESSARY BUDGET ADJUSTMENTS. 2019 RESULT: APPROVED[UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 20. APPROVAL OF BILLS AND PAYROLL. (AGENDA ITEM NO. 20) MMC Bills RESULT: APPROVED[UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese County Bills RESULT: APPROVED[UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese COURT ADJOURNED: 10:20 A.M. Page 6 of 6 The Commissioners' Court of Calhoun County, Texas met on Wednesday, May 29, 2019 at 10:00 a.m. in the Commissioners' Courtroom in the County Courthouse at 211 S. Ann Street, Suite 104, Port Lavaca, Calhoun County, Texas. the true and correct minutes of the above referenced meeting. t Calhoun County, Anna Goodman, County Clerk � f Deputy Clerk , Calhoun County Commissioners' Court—MAY 29, 2019 REGULAR 2019 TERM V MAY 29, 2019 41S BE IT REMEMBERED THAT ON MAY 29, 2019, THERE WAS BEGUN AND HOLDEN A REGULAR TERM OF COMMISSIONERS' COURT. 1. CALL TO ORDER This meeting was called to order at 10:00 A.M by Judge Richard Meyer. 2. ROLL CALL THE FOLLOWING MEMBERS WERE PRESENT: Richard Meyer County Judge David Hall Commissioner, Precinct #1 - ABSENT Vern Lyssy Commissioner, Precinct #2 Clyde Syma Commissioner, Precinct #3 Gary Reese Commissioner, Precinct #4 Anna Goodman County Clerk Catherine Sullivan Deputy County Clerk 3. INVOCATION & PLEDGE OF ALLEGIANCE (AGENDA ITEM NO. 2 & 3) Invocation — Commissioner Clyde Syma Pledge to US Flag & Texas Flag — Commissioner Gary Reese/Vern Lyssy Page 1 of 5 , Calhoun County Cornmissioners' Court-- MAY 29, 2019 4. General Discussion of Public matters and Public Participation. N/A S. Hear Veteran Services Report, (RM) Ron Langford, Veterans Services, gave report. 6. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 6) On the Tax Resale Deed and Resolution for the sale of a property previously bid in trust to Calhoun County. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Clyde Syma, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Lyssy, Syma, Reese 7. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 7) On a request by Memorial Medical Center to draw $1,000,000,000 (one million dollars) from line of credit for participation in QIPP, DSH, Waiver and UHRIP programs. (RM) Jason Anglin, Diane Moore, and Terry Sizer (Board Chairman) spoke on this. matter. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Clyde Syma, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Lyssy, Syma, Reese Page 2 of 5 Calhoun County Commissioners' Court - MAY 29, 2019 8. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 8) To approve the specifications for the RFP for Administration/ Professional Services in support of Calhoun County State and Federal Grants and authorize the County Auditor to advertise for these services. The RFP will be due by 2 pm, Wednesday, June 19, 2019 and considered for award on Wednesday, June 26, 2019. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Clyde Syma, Commissioner Pct 3 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Lyssy, Syma, Reese 9. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 9) To approve the specifications for the RFQ for Engineering Services in support of Calhoun County State and Federal Grants and authorize the County Auditor to advertise for these services. The RFP will be due by 2 pm, Wednesday, June 19, 2019 and considered for award on Wednesday, June 26, 2019. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Lyssy, Syma, Reese 10. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 10) To appoint a committee to score the RFO for Administration/ Professional Services and the RFQ for Engineering Services for the Community Development Block Grant. (RM) Commissioner Hall; Commissioner Lyssy; Cindy Mueller; Peggy Hall; and LaDonna Thigpen were appointed. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 7 SECONDER: Clyde Syma, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Lyssy, Syma, Reese Page 3 of 5 . Calhoun County Commissioners' Court — MAY 29, 2019 11. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO, 11) On accepting G & W Engineers' proposal — Phase 2 Engineering Services Dredging at Magnolia Beach Boat Ramp, authorize Commissioner Hall to sign the proposal and utilize GOMESA Funds for Projects for the purposes of coastal protection. (DH) RESULT: APPROVED[UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Clyde Syma, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Lyssy, Syma, Reese 12. Accept Reports of the following County Offices: i. County Auditor — Dec. 2018; Jan. 2019; Feb. 2019; Mar. 2019 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Lyssy, Syma, Reese 13. CONSIDER AND TAKE ACTION ON NECESSARY BUDGET ADJUSTMENTS. 2019 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 4 of 5 (, Calhoun County Commissioners' Court— MAY 29, 2019 14. APPROVAL OF BILLS AND PAYROLL. (AGENDA ITEM NO. 14) MMC Bills RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Lyssy, Syma, Reese County Bilis RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER., Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Lyssy, Syma, Reese Payroll RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Lyssy, Syma, Reese COURT ADJOURNED: 10:36 A.M. Page 5 of 5 I Calhoun County Commissioners' Court—JUNE 19, 7.019 6. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 17) On insurance proceeds from TAC in the amount of $2,113.52 ($4,613.52 minus $2,500 deductible) for damages to a Sheriff Office vehicle from an accident on May 16, 2019. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 4 of 25 TEXAS ASSOCIATION OF COUNTIES RISK MANAGEMENT POOL -CLAIMS 0/4/2019 411 37592 TEXAS ASSOCIATION OF COUNTIES RISK MANAGEMENT POOL -CLAIMS Calhoun County 202 S Ann St Ste B Port Lavaca, TX 779794204 37592 1 TO REORDER CALL: (708)327-9550 W14SFOO1014M 10114 Date: 6/31/2019 12:20 PM Estimate 10: 8759050049 Estimate Veralon: 0 Committed Profile ID: 'PDATX Quote ID: 48816408 Property Damage Appraisers (PDA Victoria) PO Box 3894, Vlctods, TX 77903 (361) 6824732 Fax: (361)582-0044 Email: pdadctoda@pdaorg.net *Not An Authorization For repair* Read disclaimers following appraisal calculations. Damage Assessed By. Rudy Llanes Classification: Condition Code: Good Date of Loss: 5116/2019 Contact Date: 5/30/2019 Deductit9w 0.00 File Number. 8759050049 Claim Number. APD20196368-1 Insured: Calhoun County Owner: Calhoun County Address; 211 S Ann SL PortLavaca, TX Telephone; Work Phone: (361)553-4846 Appraised For. Mary Bdseno Typeof Loss: Collision Accident Date: 5116/2019 Mitchell Service: 911675 Description: 2018 Cheololet Tahoe LS Vehicle Produc0on Date: 12116 Body Style: 4D Ut Drive Traln: 5.3L Inj 8 CyI2WD VIN: IGNLCOECXGR263824 License: 1317842 TX Mileage: 72,036 OEM/ALT: A Parts Profile: Victoria 'Parts Pro0le Version: 4 Color. Patrol Options: PASSENGER AIRBAG, POWER DRIVER SEAT, POWER LOCK, POWER WINDOW, POWER STEERING REAR WINDOW DEFOGGER, AIR CONDITION, CRUISE CONTROL, TILT STEERING COLUMN AM/FM STEREO, DRIVER AIRBAG, HEATED EXTERIOR MIRROR, REAR (DUAL-ZONE)AC POWER PASSENGER SEAT, FRONT SIDE AIRBAG WITH HEAD PROTECTION ANTI-LOCK BRAKE SYS., TRACTION CONTROL, RUNNING BOARDS, ALUMIALLOY WHEELS REARVIEW CAMERA, REMOTE IGNITION, TIRE INFLATIONIPRESSURE MONITOR ANTI -THEFT SYSTEM, AUXILIARY INPUT, BLUETOOTH WIRELESS CONNECTIVITY, HD RADIO LEATHER STEERING WHEEL, SATELLITE RADIO, CD PLAYER, TOW HITCH RECEIVER POWER ADJUSTABLE EXTERIOR MIRROR, PRIVACY GLASS, AUTO AIR CONDITION FIRST ROW BUCKET SEAT, TELEMATIC SYSTEMS REAR HEATING, VENTILATION &AIR CONDITIONING, CLOTH SEAT, SIDE AIRBAGS AUTOMATIC HEADLIGHTS, SECOND ROW SIDE AIRBAG WITH HEAD PROTECTION, MP3 PLAYER DAYTIME RUNNING LIGHTS, DRIVER SEAT WITH POWER LUMBAR SUPPORT ELECTRONIC PARKING AID, ELECTRONIC STABILITY CONTROL FRONT SEATS WITH POWER LUMBAR SUPPORT, KEYLESS ENTRY SYSTEM LIMITED SLIP DIFFERENTIAL, RAIN SENSING WIPERS, STEERING WHEEL AUDIO CONTROLS Line Entry Labor Line Item Part Type/ Dollar Labor Item Number Type Operation Description Part Number Amount Units 1 AUTO BOY OVERHAUL FR Bumper Cover Assy - 2.8 If 2 100788 BOY REMOVE/REPLACE Fd Bumper Cover Remsnufactured 537.00 INC # 3 AUTO REF REFINISH Frt Bumper Cover C 2.6 4 100809 BOY REMOVE/REPLACE FrtLwrBumper Moulding "QUAL REPL PART 88.00 INC# 5 AUTO BOY REMOVEIINSTALL Frt Bumper Cover INC # 6 100813 BOY REMOVE/REPLACE LFrt OV Bumper Trim "QUAL REPL PART 24.00 INC# 7 AUTO BOY REMOVEINSTALL LFrt Fog Lamp INC # 8 100814 BOY REMOVE/REPLACE Frt Lw Bumper Air Deflector ­QUAL REPL PART 99.00 INC # 9 100793 BOY REMOVEIREPLACE L Fri OV Bumper Filler ••QUAL REPL PART 28,00 INC # 10 100795 BOY REMOVE02EPLACE LFrt Bumper Brace ••QUAL REPL PART 16.00 INC ESTIMATE RECALL NUMBER: 05/31/201912:20:36 8759050049 Mitchell Data Version: OEM: MAY 19 V0530 Aftemate Parts: 051311201912:07:21 Copyright(C)1994- 2019 Mitchell International Page i of 4 Software Version: 7.1.236 All Rights Reserved 11 100797 BOY REMOVEIREPLACE LFrt Bumper Guide 12 100801 BOY REMOVE/REPLACE L Frt Bumper Fog Lamp Opening Cow 13 100768 BOY REMOVEIREPLACE Grille Assembly 14 101501 BOY REMOVEIREPLACE L Frt Combination Lamp Assembly 15 AUTO BOY CHECKIADJUST Headlamps 16 100587 BOY REPAIR Hood Panel (Alum) 17 REF REFINISHIREPAIR Hood Panel (Alum) 18 16.00 MODIFIED REFINISH WITH FULL CLEAR COAT 19 100641 BOY REMOVE/REPLACE LFender Panel 20 AUTO REP REFINISH LFender Outside 21 AUTO REF REFINISH L Add To Edge Fender 22 100652 BOY REMOVE/REPLACE LFender Support 23 100656 BOY REMOVEIREPLACE LFentlo Brace 24 936012 ADD'L COST Hazardous Waste Dlsposal 25 AUTO REF ADD'L OPR Clear Coat 26 AUTO ADD'L COST Palnt/Matedals "- Judgment Rem It - Labor Note Applies QRP Certifled - Quality Replacement Parts - Certified QUAL REPL PART - Quality Replacement Parts C - Included In Clear Coat Calc KEYSTONE -INS QUALITY PRT KEYSTONE KEYSIQ Addt 1721 TANCAHUA ST, 1721 TANCAHUA ST. Labor CORPUS CHRISTI CORPUS CHRISTI Amount TX 78401 TX 78401 0.00 (888) 272-8901 (361) 855.7121 (866) 272.8901 (361) 855-7121 0.00 2 '• GM1000973R 537.00 4 '" GM1044135 86.00 Labor Summery 6 "GM1046105 24.00 28.00 8 "GM1095201C 99.00 539.00 9 "GM1088182 20.00 1,062.00 10 "dM1068202 16.00 11 "GM1042148 18.00 12 ••GM1038188 28.00 13 "GM1200703 539.00 14 "• GM2602406R 1,062.00 19 "' GM7240388C 557.00 Remarks VEHICLE REPAIRABLE Estimate Totals Sublet 5131/201912:20 PM Addt Totals 0.00 Labor L Labor Subtotals Units Rate Amount Body 8.6 58.00 0.00 Refinish 11.4 68.00 0.00 48816408 Non -Taxable Labor "QUAL REPL PART Labor Summery 20.0 "QUAL REPL PART Estimate Totals Sublet 5131/201912:20 PM Amount Totals 0.00 498.80 0.00 661.20 Committed 1,160.00 1,160.00 Data: 5131/201912:20 PM Estimate ID; 8759050049 Estimate Version: 0 Committed Profile ID: " PDA TX Quote to: 48816408 "QUAL REPL PART 18.00 INC # "QUAL REPL PART 28.00 INC # "•DUAL REPL PART 539.00 INC It Remanufactured 1,062.00 INC # 0.4 Ezisgng 2.0• C 2.8' •' QRP Certified 22805765 22814873 II. Part Replacement Summary Non -Taxable Parts Total Replacement Parts Amount 667.00 3.2 # C 2.6 C 1.2 14.17 INC 7.15 0.2 5.00 2.3 433.20 Amount 3,015.32 3,015.32 ESTIMATE RECALL NUMBER: 05131/201912:20:36 8759050049 Mitchell Data Version: OEM: MAY 19_V0530 Alternate Parts: 0501/201912:07:21 Copyright(C)1994- 2019 Mitchell international Page 2 of 4 Software Veralon: 7.1.236 All Rights Reserved THIS ESTIMATE HAS BEEN PREPARED BASED ON THE USE OF REPLACEMENT PARTS SUPPLIED BY A SOURCE OTHER THAN THE MANUFACTURER OF YOUR MOTOR VEHICLE. WARRANTIES APPLICABLE TO THESE REPLACEMENT PARTS ARE PROVIDED BY THE MANUFACTURER OR DISTRIBUTOR OF THESE PARTS RATHER THAN THE MANUFACTURER OF YOUR VEHICLE. Point(s) of Impact 11 Left Front Comer (P) Insurance Co: TEXAS ASSOCIATION OF COUNTIES Address: 1204 SAN ANTONIO AUSTIN, TX 78701 Inspection Site: CALHOUN COUNTY SO Address: 211 S ANN PORT LAVACA, TX 77979 (361) 553-0045 Inspection Date: 5/31/2019 Body Shop: PORT LAVACA COLLISION Address: 2228 STATE HWY 35 N PORT LAVACA, TX 77979 Telephone: (361)552-9989 ESTIMATE RECALL NUMBER: 05131/20191220:36 8759050049 Mitchell Data Version: OEM: MAY 19_V0530 Allemate Parts: 05/31/201912:07:21 Copy0ght(C)1994-2019MHchelllntema9onal Page 3 of 4 Sofhvare Verslon: 7.1.236 All Rights Reserved Date; 5/31/201912;20 PM Estimate 10: 8759050049 Estimate Version: 0 Committed Profile ID: ' PDA TX Quote ID: 48818408 III. Additional Costs Amount IV. Adjustments Amount NomTwble Costs 438.20 Insurance Deductible 0.00 Total Additional Costs 438.20 Customer Responsiblltiy 0.00 Paint Material Method: Rates Init Rate = 38.00 , Ing Max Hours = 99.9, Addl Rate= 0.00 I. Total Labor. 1,160.00 If. Total Replacement Parts: 3,015.32 III. Total Additional Costs: 438.20 Gross Total: 4,613.52 IV. Total Adjustments: 0Z Net Total: 4,613.52 THIS ESTIMATE HAS BEEN PREPARED BASED ON THE USE OF REPLACEMENT PARTS SUPPLIED BY A SOURCE OTHER THAN THE MANUFACTURER OF YOUR MOTOR VEHICLE. WARRANTIES APPLICABLE TO THESE REPLACEMENT PARTS ARE PROVIDED BY THE MANUFACTURER OR DISTRIBUTOR OF THESE PARTS RATHER THAN THE MANUFACTURER OF YOUR VEHICLE. Point(s) of Impact 11 Left Front Comer (P) Insurance Co: TEXAS ASSOCIATION OF COUNTIES Address: 1204 SAN ANTONIO AUSTIN, TX 78701 Inspection Site: CALHOUN COUNTY SO Address: 211 S ANN PORT LAVACA, TX 77979 (361) 553-0045 Inspection Date: 5/31/2019 Body Shop: PORT LAVACA COLLISION Address: 2228 STATE HWY 35 N PORT LAVACA, TX 77979 Telephone: (361)552-9989 ESTIMATE RECALL NUMBER: 05131/20191220:36 8759050049 Mitchell Data Version: OEM: MAY 19_V0530 Allemate Parts: 05/31/201912:07:21 Copy0ght(C)1994-2019MHchelllntema9onal Page 3 of 4 Sofhvare Verslon: 7.1.236 All Rights Reserved Dale: 51311201912:20 PM Estimate ID; 8759050049 Estimate Version: 0 Committed Profile ID: ' PDA TX Quote ID: 48816408 This is not an authorization for repair. All costs of repairs are the sole responsibility of the vehicle owner, who must authorize all repairs. Failure to deliver a copy of this appraisal to the repair shop by the vehicle owner may result in out of pocket expense to the vehicle owner. Providing a copy of this appraisal is not an acceptance of coverage or liability and all issues of coverage or liability are to be determined by the insurance carrier. Deductibles may or may not be addressed or included in this appraisal. If applicable, the repairer should collect the deductible from the vehicle owner prior to the release of the repaired vehicle. ********************Supplement Procedure Notice********************* It is the repairer's responsibility to send notification of the supplement via fax or email to PDA, including a statement whether the repairs have been halted on the vehicle. PDA will respond to your request within 24 hours. Please allow 49 hours to complete supplement processing from the date of request to ensure timely release of the vehicle. This appraisal is subject to the complete review and approval by the assigning insurance company to assure accuracy, cost effectiveness, and that accepted industry repair standards are met. The insurance company listed has the right to accept or reject any part or all of this appraisal or make any changes they feel necessary. Any person who knowingly presents a false or fraudulent claim for the payment of a loss is guilty of a crime and may be subject to Eines and confinement in state prison. ESTIMATE RECALL NUMBER: 0513112019 1 2:20:36 8759050049 Mitchell Data Veralon: OEM: MAY_19_V0530 Altemate Pads: 051311201912-.07:21 Copyright(C)1994- 2019 Mitchell international Page 4 of 4 Software Version: 7.1.236 All Rights Reserved ICalhoun County Commissioners' Court —JUNE 19, 2019 7. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 18) On Sheriff Vickery's request to create deputy/jailer positions for the Calhoun County Jail. (RM) Sheriff Bobby Vickery spoke on this matter. No Action Taken At This Time. Page 5 of 25 COUNTY OF CALHOUN lg SHERIFF'VICKERY 211 SOUTH ANN STREET PORT LAVACA, TEXAS 77979 committed to community cJ&Jisa To: Calhoun County Judge Richard Meyer From: Sheriff BJ Vickery Ref: Deputy/Jailer Position Dear Judge and Commissioners, As you know, I have been looking at the ability to utilize my jailers that are also certified Peace Officers to help alleviate some of the burden on our law enforcement duties within the county. TCOLE rules mandate that a jailer, regardless of the fact that he/she is certified to work as a full time Peace Officer, is not allowed to engage in those duties unless they are paid as a deputy. Many of my partner Texas Sheriffs utilize a rule from TCOLE that allows us to pay a jailer as a Deputy/Jailer, which allows them to then engage in those duties. They need only make what an entry [ever deputy makes. Due to the hugely lowered turnover rate and the fact that I do have jailers who would rather stay with this department and wait for a chance to work here says a lot and I believe part of keeping good people is doing everything you can to keep that sentiment. This action would allow those deputy/jailers to work security and make extra money, be utilized on the street in the event of an emergency as well as during times of other needs such as assist with transports, civil service paperwork, large events, and many other areas where we are in great need. Due to a recent incident in Lavaca County, our District Court Judge has "requested" that we double the courtroom security. That takes place every two weeks and does not cover the other courts in session. That is a separate need which I do not have the manpower to fill. This would help. Dealing with the huge traffic issue at Formosa and Dow as well as the other three plants in Calhoun County that affects the entire county, already puts me in need of more officers simply due to the multitude of calls answered on a daily basis that also must be answered. I know this will not solve all of these other issues but in order to solve the big problems, I believe it is imperative that we sometimes must start by fixing small issues and work our way up. Included is a breakdown showing where the money would come from and I would mostly just need the ability to create a new line item for Deputy/Jailer salary. Please don't hesitate to call me with any additional questions. Thank you for your time and consideration in this matter. �rlffick*e y Main Office (361) 553-4646 Facsimile (361) 553-4668 Deputy/Jailer Breakdown Position Salary SS Ret WCmp Enemp Total -per year Staring Deputy $48,293.00 3,695 5,308 706 73 58,075 Jailer $45,776 3,502 5,031 669 69 55,047 5 - Deputy/Jailers $12,585 965 1,385 185 20 15,140 e',sl to ImNI man n6w - (--monlh Q0 0 To) O O - ¢l n N 0 0 v w O O n m N . N w O A m n N - o w m O n m w w n v (» n m a> m rn N m NN O O m d' y b M N m b n d' N m r c V O M W Yml lnfl N m N m N Vi (V lV m O V w N (9 U! lO f9 V3 fR N •fl K z Z tu Z ¢ w z E �- _ a O w a a O V ¢ ¢ J w } O O a z g W m LL ¢ ¢ O J rc Z¢ q YO Z 4 g t~U ¢ U W ¢Q Q Q KF 1' pW -¢i W > > O O W q O p m ¢ W. W W W w Q K ¢ m a 0 0¢ o�> 3 m c9 a 61 0 0 0 o io n T T e e n m m m `rn� w m wMNv m - N Z le, To) O O - ¢l n N 0 0 v w O O n m N . N w O A m n N - o w m O n m w w n v (» n m a> m rn N m NN O O m d' y b M N m b n d' N m r c V O M W Yml lnfl N m N m N Vi (V lV m O V w N (9 U! lO f9 V3 fR N •fl K z Z tu Z ¢ w z E �- _ a O w a a O V ¢ ¢ J w } O O a z g W m LL ¢ ¢ O J rc Z¢ q YO Z 4 g t~U ¢ U W ¢Q Q Q KF 1' pW -¢i W > > O O W q O p m ¢ W. W W W w Q K ¢ m a 0 0¢ o�> 3 m c9 a 61 0 0 0 o io n T T e e n m m m `rn� w m wMNv m - N Z I m O N i A aNVJ O pO O O nO O O CCi O O O. O O W O O O � eh{ O O pOH O M N M m 0 n YI m V9 m f9 N bi eY f9 f9 e) tR m fR m N m f9 m (T m ON m T � m � N � w m0 O M N M m W tWp O O W W 6 W 1n b O A m O N � W O O m m m Vm M o � 4 r } N � J � O z o o a > 0 5 ¢ 6w z a a wo m U m o a z w Q 0 (!34 ° jaa W tQ- o O z Z w w Fpa_ a m n D O K ¢ W m. y}m O K K K d - z 2 ow Q' fL ¢ O m z W a z Q � o x 0 V Q V � V ICalhoun County Commissioners' Court—JUNE 19, 2019 8. Hear report from Memorial Medical Center. (AGENDA ITEM NO. 06) Diane Moore and Jason Anglin presented report. Page 6 of 25 Calhoun County Commissioners' Court —JUN1 19, 2019 9. Public Hearing regarding the proposed adoption of Guidelines and Criteria of of the Commissioners' Court of Calhoun County for Granting Tax Abatememt as a Business Incentive in Reinvestment Zones created in Calhoun County. (RM) Sandra Witte spoke on this matter. Commenced: 10:14 a.m. Adjourned: 10:18 a.m. Page 7 of 25 Calhoun County Commissioners' Court—JUNE 19, 2019 10. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 8) To adopt Guidelines and Criteria of the Commissioners' Court of Calhoun County for Granting Tax Abatement as a Business Incentive in Reinvest- ment Zones created in Calhoun County. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 8 of 25 M GUIDELINES AND CRITERIA OF THE COMMISSIONERS' COURT OF CALHOUN COUNTY FOR GRANTING TAX ABATEMENTAS A BUSINESS INCENTIVE IN REINVESTMENT ZONES CREATED IN CALHOUN COUNTY (For the period June 25, 2019 through June 24, 2021) 1_Wt4W. u13B11 WHEREAS, the Commissioners' Court of Calhoun County by resolution adopted on March, 18, 1988 declared its eligibility to grant tax abatement; and WHEREAS, by subsequent resolutions the Commissioners' Court of Calhoun County adopted and extended Guidelines and Criteria for granting tax abatement in reinvestment zones created in Calhoun County; and WHEREAS, as a direct result of being eligible to grant tax abatement, Calhoun County, the Calhoun County Independent School District, Calhoun County Navigation District and other taxing jurisdictions in the county have been able to compete for and obtain expansion projects of the Union Carbide Corporation Seadrift Plant, with projects exceeding one hundred million dollars, and the Formosa Plastics Corporation, Texas facilities of approximately 1.3 billion dollars; and WHEREAS, pursuant to the PROPERTY REDEVELOPMENT AND TAX ABATEMENT ACT, TEX. TAX CODE ANN. Chapter 312, it is necessary to adopt Guidelines and Criteria for granting tax abatement agreements as a business incentive for the next two year period commencing June 25, 2019 through June 24, 2021, inclusive, said Guidelines and Criteria to be unchanged for the two year period, unless amended by three-quarters vote; and NOW, THEREFORE, BE IT RESOLVED that the Commissioners' Court of Calhoun County does hereby adopt the following Guidelines and Criteria for granting tax abatement as a business incentive in reinvestment zones created within Calhoun County, Texas for the period June 25, 2019 through June 24, 2021, inclusive. Section i (a) "ABATEMENT" means the exemption from ad valorem taxation of a portion or all of the eligible value of the real property or of tangible personal property located on the real property, or both, as limited by these Guidelines and Criteria and the provisions of TEX. TAX CODE ANN. §312.204. (b) "AGREEMENT" means a written contractual agreement between a property owner and/or lessee and an eligible taxing jurisdiction for the purposes of a business incentive. (c) "AQUACULTURE FACILITY" means buildings, structures and major earth structure improvements, including fixed machinery and equipment, the primary purpose of which is the hatching or incubation or nursing or maturing or processing to marketable size aquatic culture in commercially marketable quantities. (d) "APPLICANT" means the legal entity seeking tax abatement as a business incentive. (e) "APPRAISED VALUE" means the last certified property value as approved by the Calhoun County Appraisal Review Board. (f) "BASE YEAR VALUE" means the appraised value of all property owned by the Taxpayer/applicant in the reinvestment zone as most recently determined by the Calhoun County Appraisal District immediately preceding the application, plus the agreed upon value of all property improvements made in the reinvestment zone since the last appraisal, but before the execution of the agreement. (g) `BUSINESS INCENTIVE" means an item offered of value to a business that induces the business to locate in a particular jurisdiction. (h) "COMMENCEMENT OF CONSTRUCTION" means the placement or construction of any improvements that are part of the project in the reinvestment zone. The storage of building materials in the reinvestment zone that are to be used in construction of the improvements does not constitute commencement of construction. Engineering, site preparation and similar activity shall not be considered commencement of construction so long as permanent improvements that are part of the project have not been constructed and placed in the reinvestment zone. 2 (i) "COMMISSIONERS" or "COMMISSIONERS' COURT" means the Commissioners' Court and governing body of Calhoun County, Texas. 0) "COUNTY" means Calhoun County, Texas, a political subdivision of the State of Texas. (k) "DEFERRED MAINTENANCE" means improvements necessary for continued operations which do not improve the productivity or alter the process technology. (1) "DESIGNATING AUTHORITY" means the taxing unit that has the authority to designate the reinvestment zone in which the proposed project is located. (m) "DESIGNEE" unless otherwise indicated, means any person or entity authorized by the Commissioners' Court to act on behalf of the County. (n) "ECONOMIC LIFE" means the number of years a property improvement is expected to be in service in a facility, and will continue to have value for ad valorem tax purposes throughout such term. (o) "ELIGIBLE JURISDICTION" includes Calhoun County and any navigation district, any drainage district, and municipal utility district, any water quality improvement district, any municipality, and the Calhoun County Independent School District, that levies ad valorem taxes upon property located within the proposed or existing reinvestment zone. (p) "EXPANSION" means the addition of building, structures, fixed machinery or equipment for purposes of increasing production capacity. (q) "FACILITY" means property improvements proposed, completed, or in the process of construction which together comprise an integral whole. (r) "INFRASTRUCTURE" means a system of public works installed in a residential subdivision, whether public or private, to include, but not be limited to, roadways, utility service including water, sewer and electrical service, and bulk heading. (s) "MANUFACTURING FACILITY" means building and structures, including fixed machinery and equipment, the primary purpose of which is or will be the manufacture of tangible goods or materials or the processing of such goods or materials by physical or chemical change. (t) "MATERIAL MISREPRESENTATION" means a false statement about a material matter which induced the Commissioners' Court to take any specific action on 3 an application for tax abatement as a business incentive, and without such misrepresentation, the Commissioners' Court would either not have designated a reinvestment zone, or granted tax abatement as a business incentive or would have taken some action different than it actually did. (u) "MODERNIZATION" means the replacement or upgrading of existing facilities which increases the productivity input or output, updates the technology, or substantially lowers the unit cost of the operation. Modernization may result from the construction, alteration, or installation of buildings, structures, fixed machinery or equipment. It shall not be for the purpose of reconditioning, refurbishing or repairing. (v) "NEW FACILITY" means a property previously undeveloped which is placed into service by means other than or in conjunction with expansion or modernization. (w) "OTHER BASIC INDUSTRY" means buildings and structures including fixed machinery and equipment not elsewhere described, used, or to be used for the production or products, and result in the creation of new permanent jobs within Calhoun County and inject new wealth into Calhoun County. (x) "PROJECT" is a reference to the entire proposal of work and improvements to be accomplished in the reinvestment zone as described in the application and tax abatement as a business incentive agreement. (y) "REGIONAL DISTRIBUTION CENTER FACILITY" means building and structures, including machinery and equipment, used or to be used primarily to receive, store, service or distribute goods or materials owned by the facility operator. (z) "REGIONAL ENTERTAINMENT" means buildings and structures, including fixed machinery and equipment, used or to be used to provide entertainment through the admission or the general public. (aa) "REGIONAL SERVICE FACILITY" means buildings and structures, including fixed machinery and equipment, used or to be used to service goods. (bb) "REINVESTMENT ZONE -COUNTY DESIGNATED" means any area of Calhoun County which has been designated a reinvestment zone for tax abatement as a business incentive and which is not within the taxing jurisdiction of any incorporated municipality. It is the province of the Calhoun County Commissioners' Court to designate Reinvestment Zones - County Designated on a case-by-case basis in order to 4 maximize the potential incentives for eligible enterprises to locate or expand within Calhoun County. (cc) "REINVESTMENT ZONE - MUNICIPALITY DESIGNATED" means an area of Calhoun County which lies within the taxing jurisdiction of a municipality and has been designated a reinvestment zone by that municipality for tax abatement as a business incentive. It is the province of the City Council of any eligible municipality to designate Reinvestment Zones Municipality Designated on a case-by-case basis in order to maximize the potential incentives for eligible enterprises to locate or expand within the City. (dd) "RENOVATION" is a repair or improvement of an existing facility or structure. (cc) "REPAIR" means any improvement or betterment of an existing facility or structure. (ff) "REPLACEMENT" means the substitution of something new or different for an existing facility or structure, or portion thereof, when the replacement facility or structure is to be used for the same general purpose as the old facility or structure that is being replaced. (gg) "RESEARCH FACILITY" means buildings and structures, including fixed machinery and equipment, used or to be used primarily for research or experimentation to improve or develop or develop the production processes thereto. (hh) "SCHOOL DISTRICT" or "DISTRICT", unless otherwise indicated, means the Calhoun County Independent School District. (ii) "SUBSTANTIAL COMPLIANCE" means that any estimate or prediction that comes within eighty-five percent of a stated amount shall be construed as compliance, but only when estimates are expressly authorized. Unless expressly authorized, strict compliance with a statement or representation shall be required. Oj) "TAXPAYER" means the legal entity that seeks, or who has been approved for tax abatement as a business incentive. It also is a reference to the owner of the property constituting the reinvestment zone and the improvements and tangible personal property to be located therein. Section 2 5 ELIGIBILITY CRITERIA GENERALLY (a) General Eligibility Subject to the limitations and exceptions contained in these Guidelines and Criteria, TEX. TAX CODE ANN. §312.204 shall govern to what extent real property and tangible personal property located in a reinvestment zone are eligible for tax abatement as a business incentives. (b) Commencement of Construction. If the reinvestment zone is designated by a municipality, the applicant shall not commence construction until after it and the municipality have both executed an agreement on similar terms for the same project then under consideration by the County. Any property otherwise eligible for abatement that is placed or constructed in the reinvestment zone before the agreement is executed with the municipality shall not be eligible for tax abatement as a business incentive. However, any eligible improvements made or property placed in the reinvestment zone after executing the agreement with the municipality shall be eligible for abatement with the County, even though such improvements or property are placed in the reinvestment zone prior to filing the application or executing the agreement with the County, provided that a municipality is the designating authority. If the reinvestment zone is County designated, applicant shall not commence construction until the County executes the agreement. (c) Property Value Eligible for Abatement Subject to the limitations and other eligibility requirements contained in these guidelines, the County may abate the value of tangible personal property located on the real property in the reinvestment zone in each year covered by the agreement, other than tangible personal property that was located on the real property at any time before the period covered by the agreement. The value of real property to the extent its value for each year during the agreement exceeds its value for the year in which the agreement was executed is eligible for abatement. (d) New and Existing Facilities A business incentive may be granted for both eligible new facilities and structures, as well as for expansion or modernization of existing facilities and structures. (e) Eligible Property to be Described The application for tax abatement as a business incentive or any other business incentive and any agreement must describe the project and improvements with such detail and certainty as required by the County in order to identify the property that is declared to be eligible for business incentives. Any 6 property, even though otherwise eligible for business incentives, that is not sufficiently described in the application, as determined by the Commissioners' Court, or their designee, shall not be eligible for business incentives under such agreement. (f) Exclusions. (1) This policy is mutually exclusive of existing Industrial District Contracts. The real property cannot be in an improvement project financed by tax increment bonds. (2) Any business incentive agreement granted is subject to the rights of holders of outstanding bonds of the County. (3) When any project that otherwise satisfies the eligibility criteria for tax abatement as a business incentive is for the purpose of repairing, replacing, modernizing, or upgrading an existing facility, if, prior the commencement of the project, or upon completion of the project the value of the existing facility is reduced or deleted from the tax rolls, then, in such event, the applicant shall only be eligible for tax abatement as a business incentives to the extent of the difference in the last appraised value of the property value that is being dropped or reduced from the tax rolls and the project cost. Section 3 ELIGIBILITY CRITERIA AND TERMS FOR FACILITIES/INDUSTRY (a) Eligible Facilities. A facility may become eligible for abatement if it is located in a designated Reinvestment Zone, and is a: (1) Manufacturing Facility; or (2) Research Facility; or (3) Aquaculture Facility; or (4) Regional Distribution Center Facility; or (5) Regional Service Facility; or (6) Regional Entertainment Facility; and, (7) Other Basic Industry. (b) Economic Qualifications In addition to satisfying the other eligibility criteria, in order to be eligible for business incentives, the new facility or structure, or the expanded or modernized existing facility or structure must meet the following qualifications: 7 (1) The project must cost at least Five Million Dollars ($5,000,000.00); and (2) Be expected to retain or create employment for at least 10 persons of the eligible facility on a full time and permanent basis in Calhoun County; and (3) Not be expected to solely or primarily have the effect of transferring employment from one part of Calhoun County to another; and (4) Be expected to attract major investment in the reinvestment zone that would be a benefit to the property to be included in the zone; and (5) That development anticipated to occur in the proposed reinvestment zone would contribute to the economic development of the County. (6) The County reserves the right to grant abatements up to the state maximum of 100% for 10 years. (c) Term of Abatement. The term of tax abatement as a business incentive granted by the County shall be six (6) years, and shall be applied commencing January 1 following the effective date of the agreement. (d) Effective Date. (1) If the County is the designating authority, the effective date of the agreement shall be the date that the County executes the agreement. (2) If a municipality is the designating authority, the effective date of any agreement that the County approves shall be same date as that of the agreement entered into for the same project by the municipality. (3) Abatement applies to all eligible improvements placed in the reinvestment zone after the designating authority and Taxpayer execute their agreement. Taxes will be abated on eligible property for the number of years approved by the County, commencing January 1 immediately following the effective date of the agreement. Property otherwise eligible for abatement under the agreement shall be eligible for abatement only if the property is placed or constructed in the reinvestment zone after the effective date of the agreement, but on or before December 31 immediately preceding the beginning of the last full tax year that taxes are to be abated. 0 (e) Percent of Tax Abatement as a Business Incentive. The percent of tax abatement as a business incentive of eligible property value to be granted each year shall be as follows: (f) Taxability. From the execution of the agreement to the end of the agreement period taxes shall be payable as follows: (1) the value of ineligible property as provided in Section 2 shall be fully taxable. (2) the base year value of existing eligible property as determined each year shall be fully taxable; and (3) the unabated value of eligible property shall be taxable. (g) Limitations. If, during the term of the business incentive period the taxpayer should close, cease production, or demolish any or all of a facility that was in existence on the effective date of the business incentives agreement, or take any other similar action that would have the effect of reducing or deleting the value of the facility, or portion thereof from the tax rolls that was in existence on the effective date of the business incentives agreement regardless of the reason, then the eligible value for abatement allowed in the business incentives agreement shall be reduced by the amount of existing property value owned by the taxpayer that is reduced or deleted from the tax roll. Depreciation, agreed to by the Chief Appraiser, or Appraisal Review Board, shall not be construed as a reduction or deletion of value for purposes of this limitation. Section 4 9 Year Taxable Investment (Millions) 1 2 3 4 5 6 Up to 5.00 5.00 to 9.99 90 50 25 10.00 to 14.99 90 75 50 25 15.00 to 19.99 90 90 75 50 25 20.00 or more 90 90 85 75 50 25 (f) Taxability. From the execution of the agreement to the end of the agreement period taxes shall be payable as follows: (1) the value of ineligible property as provided in Section 2 shall be fully taxable. (2) the base year value of existing eligible property as determined each year shall be fully taxable; and (3) the unabated value of eligible property shall be taxable. (g) Limitations. If, during the term of the business incentive period the taxpayer should close, cease production, or demolish any or all of a facility that was in existence on the effective date of the business incentives agreement, or take any other similar action that would have the effect of reducing or deleting the value of the facility, or portion thereof from the tax rolls that was in existence on the effective date of the business incentives agreement regardless of the reason, then the eligible value for abatement allowed in the business incentives agreement shall be reduced by the amount of existing property value owned by the taxpayer that is reduced or deleted from the tax roll. Depreciation, agreed to by the Chief Appraiser, or Appraisal Review Board, shall not be construed as a reduction or deletion of value for purposes of this limitation. Section 4 9 ELIGIBILITY CRITERIA AND TERMS FOR REAL ESTATE DEVELOPMENT (a) Eligible Development. A development may become eligible for abatement if it is located in a designated Reinvestment Zone, and is a: (1) New single family residential housing project; (2) Multi -family housing project; and/or, (3) Apartment project. (b) Duration of Abatement as a Business Incentive. Any Agreement under this section shall not exceed three (3) years. (c) Economic Qualification. To be eligible to receive tax abatement as a business incentive, the developer must expend a minimum of two million dollars ($2,000,000.00) in infrastructure costs for the development. (d) Taxability. From the initial application to the end of the abatement period, taxes shall be paid as follows: (1) All ineligible property shall be fully taxable during the term of the abatement. (2) Any property within the reinvestment zone that is sold, transferred, conveyed, occupied or otherwise no longer part of the developer's inventory shall be taxed at the appraised value determined by the Calhoun County Appraisal District beginning January 1 of the year following the sale, transfer, conveyance, or occupation. (3) At the end of the abatement period, all property subject to the Agreement shall be subject to full taxation. APPLICATION (a) Filing. Any property owner of taxable property in Calhoun County located in a designated or proposed reinvestment zone may request tax abatement as a business incentive by filing a written application with the Commissioners' Court, or their designee. When appropriate, the application may combine a request for designation of a reinvestment zone with an application for tax abatement as a business incentive. (b) Contents. The application shall include all information contemplated by these Guidelines and Criteria in order for the Commissioners' Court to evaluate the applicant's eligibility and to determine whether to grant any business incentives. The application 10 shall be submitted on a form provided by the County, or alternatively, if unavailable, the contents of the application shall be in order of this subsection and respond to each element of this subsection, and shall contain such other information as required by the County, or it representative. Specifically, the application shall include the following: (1) A list of the kind, number and location of all proposed improvements of the property, including a general written description of the general nature and extent of modernization, expansion or new improvements to be undertaken. (2) A statement of the current and proposed uses of the property showing that planned usage is consistent with the general purpose of encouraging development or redevelopment of the reinvestment zone during the period that the property tax exemptions are in effect. (3) A map showing locations of existing and proposed improvements. The map should also show general uses and conditions of the real property in the reinvestment zone. (4) A legal description of the property. (5) An estimate of the project cost and new value that will result from the modernization, expansion or new improvements to be undertaken. A statement of the base year value separately stated for land and existing improvements located in the reinvestment zone, plus any improvements or changes in value in the reinvestment zone after the last appraisal and prior to the application. In any case where the value of an existing facility will be deleted or diminished as a result of the project, the application must contain verification from the Chief Appraiser of the last appraised value of any portion or all of a facility whose value will be reduced or removed from the tax rolls. (6) An estimate of the number of jobs that will be created or retained by the modernization, expansion or new improvements. (7) Estimated date of start of construction, length of construction, estimated value of new improvements to be completed during each year of construction and estimated date of completion. (8) An estimate of what the property value subject to abatement will be on January 1 immediately following the end of the abatement period. (9) In the case of applicants unknown to the Commissioners' Court, a financial statement of the individual or corporation filing the application, complete with letters of credit and other documents which the County may request in order that the Commissioners' Court can appropriately evaluate the financial capacity and other factors of the applicant. (10) The Taxpayer shall make the following assurances in the application: (a) That all the information contained in the application is true and correct. (b) That the person signing the application on behalf of the Taxpayer/Applicant has unrestricted authority to execute the application and the contract documents on behalf of the Taxpayer/Applicant, and has the unrestricted authority to obligate the Taxpayer/Applicant to all the terms, covenants and conditions that will be contained in the agreement. (c) That construction will not commence on any of the eligible improvements until an agreement has been executed with the designating authority, whether the designating authority is the County, or a municipality. (d) That the project will not be constructed without first obtaining all necessary local, state and federal environmental and construction permits, and that the Taxpayer will abide by all conditions of the permits, laws and ordinances, rules and regulations governing the operation of the project throughout its economic life. (e) That the Taxpayer/applicant will abide by all conditions of the agreement and the Guidelines and Criteria adopted by the Commissioners' Court applicable to the agreement. (f) That the planned use of the property will not constitute a hazard to public health or safety throughout the economic life of the project. (g) That the applicant will make the specific improvements to the property as described in its application. (h) That although estimates of the cost of the project and the number of jobs retained or created as a result of the project that are within 85 % of actual cast and/or number of jobs may be construed to be substantial compliance, 12 the actual total cost of the project and actual number of jobs retained or created shall not be less than the minimum amounts required in the County's Guidelines required to qualify for tax abatement as a business incentive. (I1) The applicant will identify the type of legal entity making the application, such as corporation, partnership, etc. If a corporation, the statement should include the home state of incorporation, the name and address of the registered agent for service in Texas, and a commitment to notify the County within sixty days of any change of the registered agent or status of the corporation. Similar information will be required of a general or limited Partnership or other legal entity. (12) The application shall contain the name, title and address of the Taxpayer's local and corporate representatives for the purposes of giving notice. (13) In its application, the applicant shall include a statement that it waives all rights of confidentiality with regard to the contents of its application for tax abatement as a business incentive otherwise granted under TEX. TAX CODE ANN. §312 .003. (14) The applicant shall agree to reimburse the County for all legal fees and any other expenses that the County incurs in establishing eligibility for granting business incentives and for reviewing, processing and acting on its application. Further, applicant shall agree to pay for the costs of an economic impact assessment, if the County requires one in connection with its application for business incentives. In the event the County determines an economic impact assessment is required, the Taxpayer shall be given notice and the opportunity to withdraw its application prior to commencement of the economic impact assessment, if applicant is unwilling to pay the total cost of the economic impact assessment. In its application, the Taxpayer shall agree to pay for all fees and expenses incurred by the County in establishing eligibility to grant business incentives and processing the application, even though the Commissioners' Court ultimately denies the application. (15) Any other information that the Commissioners' Court or Applicant may deem appropriate to assist the Commissioners' Court in determining whether to enter into a business incentives agreement with the Applicant. (16) If a variance from any provision in these Guidelines and Criteria is 13 requested, a statement describing the variance, and a detailed statement supporting the Applicant's reasons for the requested variance must be included. (c) Completed Application. Upon receipt of a completed application, the Commissioners' Court shall mail written notice to the presiding officer of the governing body of each taxing unit that includes in its boundaries real property that is included in the application. Such notice shall be mailed at least seven (7) days before the Commissioners' Court takes any action on the application. The notice shall include a copy of the proposed agreement, if the County is the designating authority. There shall be a $1,000 nonrefundable fee payable the County at the time the application is submitted. (d) Economic impact assessment. After receipt of an application for business incentives, the Commissioners' Court may cause to have prepared an economic impact assessment setting forth the impact of the proposed agreement. The study shall include, but not necessarily be limited to, an assessment of the economic effects of the abatement of taxes. The County shall give at least ten (10) days written notice to the Applicant of its intent to conduct an economic impact assessment, which notice shall include a description of the scope of the study. If the Applicant is unwilling to pay for the economic impact assessment, it may give notice to the County within seven (7) calendar days from the date it received notice of the proposed economic impact assessment that the Applicant is withdrawing its application. The economic impact assessment may include any other issue that the Commissioners' Court determines to be appropriate in considering the application, including, without limitation by enumeration, environmental issues, short term/long term effect on issues of adequacy of existing physical plants, need to increase number of employees in the County, and the impact on the County of any resulting increased costs as a result of the project and the County's ability to pay such costs during the abatement period. Section 5 DESIGNATION OF REINVESTMENT ZONE (a) Authority to Designate Reinvestment Zones. Reinvestment zones may be designated by either the Commissioners' Court for property located outside the jurisdiction of any municipality in the County, or by a municipality, if the property is 14 located within the jurisdiction of such municipality. (b) Application for County Designated Reinvestment Zone. An application to the County for designation of a Reinvestment Zone may be combined with the application for business incentives. The application must include information to support the required findings in subsection (c), inclusive of this section. It must also include a map showing the boundaries of the proposed reinvestment zone and a legal description of the proposed reinvestment zone. Any information contained in the application for business incentives that answers the requirements for designation of a reinvestment zone does not need to be duplicated, if the application for designation of a reinvestment zone and business incentives are combined in one application. (c) Designation. The Commissioners' Court may not designate an area as a reinvestment zone until: (1) The Commissioners' Court has held a public hearing on the designation at which time interested persons shall be entitled to speak and present evidence for or against the designation; and (2) The Commissioners' Court must make the following findings in order to designate an area as a reinvestment zone: (a) The designation would contribute to the retention or expansion of primary employment; or, (b) The designation would attract major investment in the zone that would be a benefit to the property to be included in the zone; and, (c) The designation would contribute to the economic development of the county. (d) Notice of Hearing. Notice of the hearing shall be clearly identified on the Commissioners' Court agenda. In addition, notice shall issue as follows: (1) Notice of the hearing must be published in a newspaper of general circulation in the County not later than the 7th day before the date of the hearing; and (2) Written notice of the hearing shall be delivered to the presiding officer of the governing body of each taxing unit that includes in its boundaries real property that is included in the proposed reinvestment zone. Such notice 15 shall be delivered at least 7 days before the hearing. Pursuant to Tex Tax Code Ann. §312.2O1(e) this notice shall be presumed delivered when placed in the mail postage paid and properly addressed to the appropriate presiding officer. (e) Municipality Designated Reinvestment Zones. If the reinvestment zone is designated by a municipality, to be eligible for tax abatement as a business incentive with the County, the property must be located in a reinvestment zone and the municipality must have entered into an agreement for the same project with the applicant no more than ninety days before the County enters into an agreement with the same applicant for the same project. (f) Date of Expiration. The designation of a reinvestment zone shall expire five (5) years after the date of designation. However, the designation of a reinvestment zone that has expired may be renewed by the County or municipality for periods not to exceed five (5) years. The expiration of the designation of a reinvestment zone shall not affect existing agreements made under these Guidelines and Criteria. Section 6 AGREEMENTS (a) Resolution of Commissioners' Court. After approval, the Commissioners' Court shall formally pass a resolution and execute an agreement with the owner of the facility and lessee as required, which shall include those matters contained in Texas Tax Code §312.205 and any other terms and conditions in the best interests of the County. (b) Notice to Other Taxing Jurisdictions. If the County is the designating authority, it shall deliver written notice to the presiding officer of the governing body of each other taxing unit in which the property that is the subject of the agreement is located that the County intends to enter into an agreement. The notice must be delivered at least 7 days before the County enters into the agreement. The notice must also include a copy of the proposed agreement. The notice shall be presumed to be delivered when placed in the mail postage paid and properly addressed to the appropriate presiding officer. (c) Execution/Effective Date. After giving the notices required above, and after making 16 the necessary findings, the County may, in its discretion, approve and execute the agreement. The effective date of the agreement shall be the date that the County's designated representative or official executes the agreement if the County is the designating authority. If a municipality is the designating authority, the effective date of the agreement shall be the date that the City's designated representative or official executes the agreement. Section 7 RECAPTURE (a) Conditions of Default. Cure and Termination. Should the Commissioners' Court determine that the Taxpayer is in default according to the terms and conditions of its agreement, the Commissioners' Court shall notify the Taxpayer in writing at the address stated in the agreement, and if such default is not cured within sixty (60) days from the date of such notice ("Cure Period"), then the agreement may be terminated by the Commissioners' Court. Provided, that upon proof of a curative effort commencing within sixty (60) days, if construction is required, the Commissioners' Court may extend the time to complete the curative work, based upon reasonable construction requirements. (b) Elements of Default. The following shall be considered elements of default, in the event that the Taxpayer: (1) Allows its ad valorem taxes owed to Calhoun County to become delinquent without timely and proper protest and/or contest; or (2) Violates any of the terms and conditions of the abatement agreement, or any prior- or subsequent agreement with the County, or any other taxing jurisdiction that has granted an agreement to the Taxpayer for any project that the Commissioners' Court has also granted business incentives; or (3) Discontinues producing product or service at the improvements subject to abatement and described in the application, for any reason excepting fire, explosion or other casualty or accident or natural disaster for a period of one year during the abatement period after the facility is completed and begins producing product or service. 17 (4) Violates any written term, covenant, condition, agreement, or promise of a gift or donation made by the taxpayer to the County, although such may be extraneous to the agreement, and even though same might be otherwise legally unenforceable; or (5) Makes any material misrepresentations, either in the application or agreement. (c) Termination. If, after written notice, the Taxpayer fails to cure within the prescribed period any specified default, such failure shall be grounds for termination for cause. Termination of the agreement for cause shall be retroactive to the beginning of the agreement. Termination shall be effected by resolution of the Commissioners' Court and written notice mailed to the Taxpayer. (d) Non Waiver. In the event the County fails to act on or enforce any element or breach that is identified as a default, such failure to act shall not be a waiver of the County's right to subsequently enforce the same default or any other prior or subsequent default. (e) Recapture. On termination for cause, the Taxpayer shall then become liable for the payment of all taxes that would have otherwise become due but for the abatement agreement for all calendar years during which the abatement agreement was in effect. Said taxes shall be paid to the Calhoun County Consolidated Tax Office for the credit of Calhoun County within sixty (60) days from the date of receipt of notice of termination. All such taxes due shall include statutory penalty and interest from the date they would otherwise have become delinquent but for the agreement, until the date they are actually paid. Section 8 ADMINISTRATION (a) Duties of Chief Appraiser. The Chief Appraiser of the County shall, as a normal consequence of his duties, annually determine an assessment of the real and personal property comprising the reinvestment zone. Each year, on or before April 1, the Taxpayer receiving abatement shall furnish the Chief Appraiser with such information as may be IN reasonably requested. Once value has been established, the Chief Appraiser shall notify the affected taxing jurisdictions, which have granted tax abatement as a business incentive in the reinvestment zone, of the amount of the appraisal. (b) Compliance Inspections. All compliance inspections will be made only after giving twenty-four (24) hours notice and will only be conducted in such manner as not to unreasonably interfere with the construction and/or operation of the facility. All inspections will be made with one or more representatives of the company or individual and in accordance with its safety standards. (c) Annual Evaluations Upon completion of construction, the Commissioners' Court of Calhoun County, or their designees, shall annually evaluate each facility receiving abatement to ensure compliance with the agreement. (d) Notice Requirements. Any notice required to be given to Calhoun County hereunder shall be in writing, and mailed or personally delivered to the County Judge. Notices to the Taxpayer shall be in writing, and addressed to its designated representative at the address provided in its application or the agreement. Section 9 MISCELLANEOUS (a) Variance. An application for a variance from the provisions of these Guidelines and Criteria may be made in written form to the Commissioners' Court. The total duration of abatement shall in no instance exceed ten (10) consecutive tax years commencing January I following the effective date of the agreement, including any extension. Such request shall include a complete description of the circumstances explaining why the applicant should be granted such variance. Approval of a request for variance requires at least a three-fourths (3/4) vote of the Commissioners' Court. (b) Assignments. An abatement agreement may be transferred and assigned by the holder to a new owner or lessee of the same facility, subject to obtaining written approval by resolution of the Commissioners' Court. Approval shall be conditioned upon the assignee providing whatever proof the Commissioners' Court may require to show the assignee's financial capability to carry out all the terms and conditions of the agreement. 19 The County reserves the right to require such additional information as it may deem appropriate to determine not only the assignee's financial capability to carry out the terms and conditions of the agreement, but also its experience and historical record to determine that it is in fact capable of operating the project subject to the abatement in such a manner that it can reasonably be expected to strictly comply with every term, covenant, condition and assurance contained in the agreement Further, the assignee shall agree in writing by amendment to the original agreement that it shall be bound by all the terms, covenants and conditions contained in the original agreement. No assignment or transfer shall be approved if the parties to the existing agreement, the new owner or new lessee are liable to Calhoun County or any other taxing unit affected by the agreement for delinquent taxes, or otherwise in default of any of the terms, covenants or conditions contained in the agreement. Subject to the foregoing conditions, the Commissioners' Court shall not unreasonably withhold approval of any proposed assignment. Any approval of assignment of the agreement shall not release any previous Taxpayer who has been a party to the agreement from its obligations under the agreement. (c) Application for Exemption. It shall be the responsibility of the Taxpayer to perfect any right of exemption as a result of any agreements entered into with the County. For each year in which abatement has been authorized by the County under the agreement, it shall be the responsibility of the Taxpayer to file its annual application with the Calhoun County Appraisal District for property exemption in accordance with the Texas Tax Code and related administrative regulations. (d) Effective Date. These Guidelines and Criteria shall be effective for two (2) years, from June 25, 2019 through June 24, 2021, inclusive. (e) Sunset Provision. At the end of the two year effective period of these Guidelines and Criteria, all agreements created pursuant to these provisions will be reviewed by the Calhoun County Commissioners' Court to determine whether the goals have been achieved. Based upon that review, the Guidelines and Criteria may be modified, renewed or eliminated. In the event that these Guidelines and Criteria are not modified or renewed, they shall automatically terminate effective June 24, 2021. 20 (f) Effect of Modification or Termination. The modification or termination of these Guidelines and Criteria shall have no effect upon existing agreements entered into while these Guidelines and Criteria are in effect. (g) Subtitles. The use of subtitles in these Guidelines and Criteria is strictly for convenience, and shall have no legal significance whatsoever. The use of the singular shall include the plural and the use of plural shall include the singular when appropriate. The use of any reference to gender shall include any and all other genders when appropriate. (h) Severability. In the event any paragraph, clause, phrase or other provision of these Guidelines and Criteria should be declared to be unconstitutional, void or otherwise unenforceable the remaining provisions shall remain in full force and effect as if the unconstitutional, void or otherwise unenforceable provisions had not been included. Section 10 ADOPTION i Upon motion by Commissioner, ° cit .r' -, seconded by Commissioner 1i i i the foregoing resolution to amend these Guidelines and Criteria of the Commissioners' Court of Calhoun County for Granting Business incentives in Reinvestment Zones Created in Calhoun County was approved by a vote of 5 for and 0 against. PASSED, ADOPTED AND APPROVED on this day of j , , , 2019. ATTEST: Annna,Goo�man,-County Clerk / r By: �! lr 'r 7r ��` ,MJ > Deputy 21 ONERS' COURT OF COUNTY, TEXAS County, Calhoun County Commissioners' Court—JUNE 19, 2019 11. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 9) To vacate and abandon a portion of public road in Alamo Beach described as a 0.26 of an acre shown as Alamo Street on the plat of Alamo Beach Townsite further described in the application. Property owner is CMP Development, LLC, Matt Wetzig, President. (DH) David Hall and Sandra Witte spoke on this matter. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 9 of 25 PRE VACATE AND ABANDON A PORTION OF PUBLIC ROAD IN ALAMO BEACH, CALHOUN COUNTY, TEXAS A Motion was. }fade bY` om��}issioner n and seconded by Commissioner [ (S>S to Vacate and Abandon a portion of a public road in Alamo Beach, Calhoun County, Texas as shown on the following Order with exhibits attached. e CY�L voted in favor of the motion. ORDER DECLARING CLOSURE OF A PORTION OF PUBLIC ROAD IN ALAMO BEACH, CALHOUN COUNTY, TEXAS WHEREAS, on the 12t1i day of June, 2019, the Commissioner's Court of Calhoun County, Texas considered the request of CMP Development, LLC, being a property owner in Precinct 1 of Calhoun County, Texas, to abandon and vacate the following portion of a public road in Alamo Beach, Calhoun County, Texas more fully hereinafter described and as shown on the Exhibit "A" which is attached to this order and incorporated by reference. WHEREAS, Texas Transportation Code §251.051 vest in the Commissioner's Court the authority to abandon and vacate a portion of the road; and WHEREAS, the Commissioners have not previously classified the subject road as either a first class or second class road; and WHEREAS, the Commissioner's actions to abandon or vacate the road have not been enjoined or sought to be enjoined by any party; and WHEREAS, proper notice of the petition to abandon and vacate the road has been posted at the Courthouse door of Calhoun County, Texas and at other places in the vicinity of the affected route, being at the Indianola Fishing Center and on the property at 1 ®m FA 6M the portion of the road to be abandoned and vacated, for at least twenty (20) days before the date the application was made to the Court; and WHEREAS, the Commissioners have voted unanimously to abandon and vacate the portion of the road described on the attached Exhibit "A"; and WHEREAS, all requirements of Texas Transportation Code §251.051 and §251.052 have been complied with in declaring said road to be abandoned and vacated. NOW, THEREFORE, ON MOTION DULY MADE BY Commissioner p 0& L and SECONDED by CommissionerY Ly�y , and upon said Motion having been approved by the Commissioner's Court in a properly posted public meeting; IT IS ORDERED AND DECREED, that Calhoun County does hereby CLOSE, ABANDON and VACATE that portion of road described on the attached Exhibit "A". IT IS FURTHER ORDERED AND DECREED that on the date this Order is signed, title to the portion of road closed by this Order is vested in CMP Development, LLC, pursuant to Texas Transportation Code §251.058(b). IT IS FURTHER ORDERED AND DECREED that a copy of this Order is to be filed in the Official Records of Calhoun County, Texas and a duly filed copy of the Order shall serve as the official instrument of conveyance of the closed portion of the road, Alamo Beach, Calhoun County, Texas from CALHOUN COUNTY to the respective owners of the abutting property as set forth hereinabove, pursuant to Texas Transportation Code §251.058(b). 2 SIGNED this 12" day of June, 2019. COUNTY, TEXAS CALHOUN COUNTY ATTESTED TO BY: ANNA GOODMAN CALHOUN COUNTY CLERK By Deputy Clerk 0.26 OF AN ACRE` FIELONOTE DESCRIPTION STATE OF TEXAS COUNTY OF CALHOUN Bemg 0.26 of an aa.e situated in and a part of the Narca5o Cabazos Survey, Abstract No. 3, Calhoun County, Texas, as is a portion of that certain property shown as Alamo Street on the plat of Alamo Beach Townsite, recorded in Volume V, Page 01 ( also in Volume Z, Page 13 ) of the Plat Records of Calhoun County, Texas. This 0.26 of an acre is more fully described by metes and bounds as follows: BEGINNING at a 518 inch iron rod found at the intersection of the platted East line of Calhoun 5trest undeveloped ) and the platted South line of Alamo Street ( undeveloped ) for the Southwest corner of this 0.2G of an acre, also bmng the Northwest corner of Lot I , Block 3. Alamo Townsite; THENCE , N 02 degrees, 47'13" W crossmg said Alamo Street in projection of the East line of Calhoun Street , at 37.72 feet passing a Wood bulkhead, continumg on the same course a TOTAL D15TANCE of 42.72 feet to the existing waters edge for the Northwest corner of this 0.2G of an acre; THENCE, 5 89 degrees, 13'40" E still crossmg Alamo Street with the, existing waters edge a distance of 350,68 feet to the Northeast corner of this 0.26 of an acre; THENCE, 5 02 degrees, 47' 13' E still crossmg Alamo Street, at 5.00 feet passing an existing wood bulkhead, eonbnumg on the same course a TOTAL DISTANCE of 20.95 feet to a 518 inch iron rod found for the Southeast corner of this 0.2G of an acre, also Bemg the common corner of Lot 4 and Lot 5. Block 3, Alamo Beach Town5ite; THENCE, 5 87 degrees, 1 2'47" W with the common line of Lots 4,3,2 and I , Block 3, Alamo Beach Townsite and the South line of Alamo Street a distance of 350.00 feet to the PLACE OF BEGINNING, CONTAINING within these metes and bounds 0.26 of an acre, and beanngs are based on a deed recorded in Instrument Number 2018.03606 of the Official Records of Calhoun County, Texas. The, foregoing FIEDNOTE DE5CRITION was prepare from an on the ground survey made under my direction and supervision on April 20, 2019. A",7 Denms J. IffI11561Date Registered Professional Land Surveyor Texas No. 4736 Job No. 4803 Q' Firm Registration Number 10194034�(Q//1,ytt ovNN16 J ...41Sa .e....�Iao o¢ �. ^f9. alis FILED AND RECORDED OFFICIAL PUBLIC RECORDS 2019-02110 VAC Fee: $38.00 06/21/2019110:122 AM /r�'_J/csullivan }y� Anna Goodman, County Clerk Calhoun County, Texas Calhoun County Anna Goodman, County Clerk 211 South Ann Street Port Lavaca, Texas 77979 (361) 553-9911. www.calhouncoclerk.org _ Receipt: 19-2982 Product Name VAC VACATE If Pages Document If Document Info: File Page Non Standard Missing Grantee Address Recording Fee - $5 1st Page, $9 add pages LGC 9118.011 Records Management Preservation LGC § 118.011(b)(2) Records Archive LGC 9118.011(£) Courthouse Security LGC § 291.008(d) Total Tender (CHECK) Check Number 1054 Paid By ROBERTS ODEFEY WITTE & WALL LLP Thank You for Your Business 6/21/19 10:12 AM esullivan Extended $38.00 9 2019-02110 ROBERTS ODEFEY WITTE & WALL LLP false false false $17.00 $10.00 $10.00 $1.00 $38.00 $38.00 Calhoun County Commissioners' Court — JUN[ 19, 2019 12. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 10) On request from Calhoun County Museum to use donations funds to Purchase various promotional items for distribution to schools and other tour groups. George Ann Cormier spoke on this matter. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 10 of 25 Consider and take necessary action on request from Museum to use Donations Fund to purchase various promotional items for distribution to schools and other tour groups. Calhoun County Commissioners' Court—JUNE 19, 2019 13. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 11) To award bids for Road Materials for period beginning July 1, 2019 and ending December 31, 2019. (RM) The lowest bid was rejected due to previous quality. Quality Hot Mix accepted at this time. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 11 of 25 CIN R 411 PEGGY HALL CRISTINA P TUAZON 202 S ANN ST, STE B DEMI CABRERA CANDICE VILLARREAL PORT LAVACA, TENAS 71979 ERICA PEREZ 13TASSISTANTAUDITOR TELEPHONE (3611553-4610FAX [3611553-4614 ASSISTANT AUDITORS June 12, 2019 TO: Honorable Richard H. Meyer Calhoun County Judge RE: Agenda Item for Commissioners' Court Wednesday, June 19, 2019 Please place the following item on the Commissioners' Court Ag nda for June 19, 2019. • Consider and take necessary action to award bids for A mus s for the period beginning July 1, 2019 and ending December 31, 2019. Thank you, Peggy Haff Assistant Auditor PEGGY HAIL CRISTINA P TOUGH 202 S ANN ST, STE R DEMI CARRERA CANDICE VILLARREAL PORT LAVACA, TERAS 71979 ERICA PEREZ 1nASSISTANTAUDITOR TELEPHONE (36115534610 W 136115B346114 ASSISTANT AUDITORS RECAP OF BID TABULATION ROAD MATERIALS For the period beginning July 1, 2019 and ending December 31, 2019 Contract Number: 2019.07-12.RM The County received bids on the following Road Materials: • PE 5 Aggregate • Limestone -3/4 Inch to Dust • Item 247, Type A Limestone, Grade 2 [1 % Inch] • Item 247, Type A Limestone, Grade 3 [1'/ Inch] • Item 302, Type PE (Topping Rock), Grade 3, LRA (Limestone Rock Asphalt) *Material Source out of • Item 302, Type PE (Topping Rock), Grade 4, LRA (Limestone Rock Asphalt) *Material Source out of • Item 330, Type D (Pre -Mix Limestone) • Item 330 D, Pothole Repair, Limestone Rock Asphalt (LRA) • Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement • Item 432 Riprap, Section 2.3 Stone Riprap, 12" Limestone The County did not receive any bids on the following Road Materials: • Item 247, Type B (Flexible Processed Base), Grade 2 • Item 247, Type B (Flexible Processed Base), Grade 3 • Item 275-2.1, Hydraulic Cement Type 1 The County received one bid that did not meet specifications: • K -C Lease Service Inc., dba Matagorda Construction & Materials The vendor did not return the entire Invitation To Bid Form (pages 1-9 with page 9 being the signature page) Only pages 1, 2 and 3 were returned The bids that met specifications are attached. Please review each bid to confirm the low bid. CALHOUN COUNTY, TEXAS BID TABULATION ROAD MATERIALS For the Period Beginning July 1, 2019 and Ending December 31, 2019 Page i of 7 PE 5 AGGREGATE County County Department Cost per Unit Low Bid Minimum Load/Order and Minimum Load/Order and Type of Delivery Returned All Returned All Required Information Cost per Unit Low Bid Vendor Quality Hot Mix Inc Exceptions Required Department Precinct 2 $28.70/Ton X Type of Delivery $28.70/Ton Information Precinct 1 $61.47/Ton X Precinct 4-5 $28.70/Ton X Pages 1-9 of Precinct 1 $30.00/Ton Precinct 2 $62.25/Ton X Vulcan Construction 24 Tons $30.00/Ton the Bid Form J 12954 Precinct 3 $30.00/Ton Precinct 3 $63.80/Ton I I Materials LLC End Dump Delivery Info Form) nffidavitJ W-9 J Precinct 4-P $62.25/Ton X Brauntex Materials Inc 24 Tons End Dump or Belly Dump Delivery Precinct 4-S $62.25/Ton X Precinct 3 $30.75/Ton Precinct 4-P Precinct 1 $63.00/Ton Precinct 4-S Brauntex Materials Inc 24 Tons End Dump Delivery Pages 1-9 of the Bid Form4 12951 Info Form 4 Affidavit) W-9 4 Precinct $63.00/Ton Precinct 3 $63.00/Ton X Precinct 4-P $63.00/Ton Fp--S $63.00/Ton LIMESTONE -3/4 INCH TO DUST County Department Cost per Unit Low Bid Vendor Minimum Load/Order and Type of Delivery Exceptions Returned All Required Information Precinct 1 $28.70/Ton X Quality Hot Mix Inc 24 Tons Either End Dump or Belly Dump Delivery Pages 1-9 of the Bid Form 4 12954 Info Form 4 Affidavit W-9 q Precinct 2 $28.70/Ton X Precinct 3 $28.70/Ton X Precinct 4-P T $28.70/Ton on X Precinct 4-5 $28.70/Ton X Precinct 1 $30.00/Ton Midtex Materials LLC Pages 1-9 of the Bid Form 4 12954 Info Form 4 Affidavit) W-9 J Precinct 2 $30.00/Ton Precinct 3 $30.00/Ton Precinct 4-P $31.75/Ton Precinct 4-S $30.00/Ton Precinct 1 $30.75/Ton Brauntex Materials Inc 24 Tons End Dump or Belly Dump Delivery Pages 1-9 of the Bid Form J 12954 Info Form 4 Affidavit) W-9 J Precinct 2 $30.75/Ton Precinct 3 $30.75/Ton Precinct 4-P $30.75/Ton Precinct 4-S $30.75/Ton BID TABULATION -ROAD MATERIALS -FOR THE PERIOD BEGINNING JULY 1, 2019 AND ENDING DECEMBER 31, 2019 Page 2 of 7 ITEM 247,TYPE 'A LIMESTONE, GRADE 2 [13/4 INCH] County Department Cost per Unit Low Bid Vendor Minimum Load/Order and Type of Delivery Exceptions Returned All Required Information Precinct 1 $28.70/Ton X Quality Hot Mix Inc 24 Tans Either End Dump or Belly Dump Delivery Pages 1-9 of the Bid Form 4 129s J Info Form) Affidavit) W-9 J Precinct 2 $28.70/Ton X Precinct 3 $28.70/Ton X Precinct 4-P $28.70/Ton X Precinct 4-S $28.70/Ton X Precinct 1 $30.00/Ton Midtex Materials LLC Pages 1-9 of the Bid Form) 12954 Info form J Affidavit) W-9 J Precinct $30.00/Ton Precinct 3 $30.00/Ton Precinct 4-P $31.75/Ton Precinct 4-S $30.00/Ton Precinct 1 $30.75/Ton Brauntex Materials Inc 24 Tons End Dump Dump or Belly Dump Delivery Pages 1-9 of the Bid Form 12954 Info Form J Affidavit) W-9 4 Precinct $30.75/Ton Precinct 3 $30.75/Ton Precinct 4-P $30.75/Ton Precinct 4-S $30.75/Ton Precinct 1 $40.00/Ton Vulcan Construction Materials LLC 22 Tons Belly Dump Delivery Pages 1-9 of the Bid Form) 12954 Info Form J Affidavit) W-9 J Precinct $41.00/Ton Precinct 3 $42.00/Ton Precinct 4-P $42.00/Ton Precinct 4-S $40.00/Ton BID TABULATION -ROAD MATERIALS -FOR THE PERIOD BEGINNING JULY 1, 2019 AND ENDING DECEMBER 31, 2019 Page 3 of 7 ITEM 247,TYPE A LIMESTONE, GRADE 3 [13/4 INCH] County De anrtment p Cost per Unit Low Bid Vendor Minimum Load/order and Type of Deliver y Exceptions Returned All Required Information Precinct 1 $28.70/Ton X Quality Hot Mix Inc 24 Tons Either End Dump or Belly Dump Delivery Pages 1-9 of the Bid Form 4 12954 Info Form 4 Affidavit) w-9 J Precinct 2 $28.70/Ton X Precinct 3 $28.70/Ton X Precinct 4-P $25.70/Ton X Precinct 4-S $28.70/Ton X Precinct 1 $30.00/Ton Midtex Materials LLC Pages 1-9 of the Bid Form 4 12954 Info Form J Affidavit) W-9 J Precinct 2 $30.00/Ton Precinct 3 $30.00/Ton Precinct 4-P $31.75/Ton Precinct 4-S $30.00/Ton Precinct 1 $30.75/Ton Brauntex Materials Inc 24 Tons End Dump or Belly Dump Delivery Pages 1-9 of the Bid Form 4 Info J Info Form J Affidavit) W-9 J Precinct 2 $30.75/Ton Precinct 3 $30.75/Ton Precinct 4-P $30.75/Ton Precinct 4-S $30.75/Ton Precinct 1 $40.00/Ton Vulcan Construction Materials LLC 22 Tons Belly Dump Delivery Pages 1-9 of the Bid Form) 1295 Info Form 4 Affidavit4 W-9 J Precinct $41.00/Ton Precinct 3 $42.00/Ton Precinct 4-p $42.00/Ton Precinct 4-S $40.00/Ton BID TABULATION -ROAD MATERIALS -FOR THE PERIOD BEGINNING JULY 1, 2019 AND ENDING DECEMBER 31, 2019 Page 4 of 7 ITEM 247, TYPE B (FLEXIBLE PROCESSED BASE), GRADE 3' 247, TYPE B (FLEXIBLE PROCESSED BASE), GRADE 2 County Department Cost per Unit Low Bid Vendor Minimum Load/Order and Type of Delivery Exceptions Returned all Required Information Precinct 1 NO BIDS RECEIVED Precinct 2 Precinct 3 Precinct 4-P Precinct 4-S ITEM 247, TYPE B (FLEXIBLE PROCESSED BASE), GRADE 3' County De artment P Cost per Unit Low Bid Vendor Minimum Load/Order and Type of Deliver y Exceptions Returned all Required Information Precinct 1 NO BIDS RECEIVED Precinct 2 Precinct 3 Precinct 4-P Precinct 4-S ITEM 275, ITEM 275-2.1, CEMENT (ROAD MIXED) HYDRAULIC CEMENT TYPE 1 County Department Cost per Unit Low Bid Vendor Minimum Load/Order and Type of Delivery Exceptions Returned all Required Information Precinct 1 NO BIDS RECEIVED Precinct 2 Precinct 3 Precinct 4-13 Precinct 4-S BID TABULATION -ROAD MATERIALS -FOR THE PERIOD BEGINNING JULY 1, 2019 AND ENDING DECEMBER 31, 2019 Page 5 of 7 ITEM 302, TYPE PE (TOPPING ROCK), GRADE 3 LRA (LIMESTONE ROCK ASPHALT),; * Material Source out of County Minimum Load/Order and Returned All Department Cost per Unit Low Bid Vendor Type of Delivery Exceptions Required Information Precinct 1 $59.47/Ton X Vulcan Construction 24 Tons * Material Source out of Pages 1-9 of the Bid Form J 1295) Precinct 2 $60.25/Ton X $61.80 Ton X Precinct 3 $62.80 Ton X Materials LLC End Dump Delivery Uvalde (Dabney) * Info Form J Affidavit W-9 J Precinct 4-P $60.25/Ton X Precinct 4-S $60.25/Ton X ITEM 302, TYPE PE (TOPPING ROCK), GRADE 4 LRA (LIMESTONE ROCK ASPHALT), * Material Source out of County Minimum Load/Order and Returned All Department Cost per Unit Low Bid Vendor Type of Delivery Exceptions Required Information Precinct 1 $60.47/Ton X Vulcan Construction 24 Tons * Material Source out of Pages 1-9 of the Bid Form J 1295 J Precinct 2 $61.25/Ton X Precinct 3 $62.80 Ton X Materials LLC End Dump Delivery Uvalde (Dabney) * Info Form J AffidavitJ W-9 J Precinct 4-P $61.25/Ton X Precinct 4-S $61.25/Ton X ITEM 330, TYPE D (PRE -MIX LIMESTONE) County Minimum Load/Order and Returned All Department Cost per Unit Low Bid Vendor Type of Delivery Exceptions Required Information Precinct 1 $77.47/Ton X Vulcan Construction 24 Tons Pages 1-9 of the Bid Form J 1295 Precinct 2 $78.25/Ton X Precinct 3 $79.60/Ton X Materials LLC End Dump Delivery Info Form J AffidavitJ W-9 J Precinct 4 -Pi $78.25/Ton X Precinct 4-S $78.25/Ton X BID TABULATION -ROAD MATERIALS -FOR THE PERIOD BEGINNING JULY 1, 2019 AND ENDING DECEMBER 31, 2019 Page 6 of 7 ITEM 330 D, POTHOLE REPAIR, LIMESTONE ROCK ASPHALT (LRA) County County Minimum Load/Order and Minimum Load/Order and Returned All Department Cost per Unit Low Bid Vendor Type of Delivery Exceptions Required Required Department Type of Delivery Information Precinct 1 $96.98/Ton X X $107.37/cu yd We have $11.00/50 Ib bag changed oil Precinct 2 $96.58/Ton X $106.91/cu yd $11.00/501b bag suppliers for the $80.00/Ton X Blades Group LLC 22 Tons manufacturing Pages 1-9 of the Bid Form 4 12954 Precinct 2 $100.76/Ton Precinct 3 $11.00/50 Ib bag X dba Road Rescue Asphalt 62 Bags (1 Pallet) $111.55/cu yd 24 Tons Type D Hot Mix the Bid Form J End Dump Delivery avisForm Affidavit q ffidavit4 W-9 4 $80.00/Ton X Brauntex Materials Inc End Dump or Precinct 4-P $99'55/Ton $11.00/50 Ib bag X $110.20/cu yd Bell DumpDelivery spat Affidavit) Precinct 4-$ $99.55/Ton $11.00/50 lb bag X $110.20/cu yd W_9 J Precinct 4-P $80.00/Ton X has enhanced the quality of ITEM 334, TYPE D, HOT MIX COLD LAID ASPHALT CONCRETE PAVEMENT County Minimum Load/Order and Returned All Cost per Unit Low Bid Vendor Exceptions Required Department Type of Delivery Information Precinct 1 $80.00/Ton X We have changed oil suppliers for the $80.00/Ton X manufacturing Precinct 2 of Item 334, Pages 1-9 of 24 Tons Type D Hot Mix the Bid Form J $80.00/Ton X Brauntex Materials Inc End Dump or Cold Laid 1295 Info Form 4 Precinct 3 Bell DumpDelivery spat Affidavit) Concrete, which W_9 J Precinct 4-P $80.00/Ton X has enhanced the quality of $80.00/Ton X the finished Precinct 4-S product. Precinct 1 $84.00/Ton Pages 1-9 of 4 Precinct 2 $84.00/Ton Quality Hot Mix Inc 25 Tons Either End Dump or Belly Dump Delivery the Bid Form 12954 Info Form J Affidavit) Precinct 3 $84.00/Ton Precinct 4-13 $84.00/Ton W-9 J Precinct 4-S $84.00/Ton BID TABULATION -ROAD MATERIALS -FOR THE PERIOD BEGINNING JULY 1, 2019 AND ENDING DECEMBER 31, 2019 Page 7 of 7 ITEM 432, RIPRAP, SECTION 23 STONE RIPRAP, 12" LIMESTONE County Minimum Load/Order and Returned All Department Cost per Unit Low Bid Vendor Type of Delivery Exceptions Required Information Precinct 1 $50.00/Ton X Brauntex Materials Inc 24 Tons End Dump Delivery Only Pages 1-9 of the Bid Form 12954 info Form 4 Affidavit W-9 J Precinct $50.00 Ton / X Precinct 3 $50.00/Ton X Precinct 4-P $50.00/Ton X Precinct 4-S $50.00/Ton X Precinct 1 $69.00/Ton Midtex Materials LLC 25 Tons End Dump Delivery Pages 1-9 of the Bid Form 4 12954 Info Form 4 Affidavit) W-9 4 Precinct 2 $69.00/Ton Precinct 3 $69.00/Ton Precinct 4-13 $73.00/Ton Precinct 4-51$69.00/Ton CALHOUN COUNTY, TEXAS For the period beginning July 1, 2019 and ending December 31, 2019 Vendor's Name and Address: YOU ARE INVITED TO SUBMIT A BID ON THE FOLLOWING ROAD MATERIALS TO: Honorable Richard H. Meyer, Calhoun County Judge Calhoun County Courthouse 211SAnn St 3rd Floor, Suite 301 Port Lavaca, TX 77979 SEALED BIDS DUE: 2:00 PM, Wednesday, June S, 2019 Sealed bids are due at the above address. The outside of the 9 x 12 or larger envelope must be marked: Sealed Bid - Road Materials If you send your bid by UPS, FEDEX, etc, the outside of this envelope must be clearly marked: Sealed Bid - Road Materials All charges must be included in bid price or clearly stated on the bid form or on a separate attachment to the bid and labeled as such. -11. Invitation To Bid Form (Pages 1- 9) ° 42. Form 1295 Vi. Vendor and Order Information Form ✓4. Affidavit V'S. W-9 Upon acceptance and approval by Calhoun County Commissioners' Court, this bid will be the working contract between the County and the successful bidder for the period designated. Page 1 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 2 of 9 PE 5 AGGREGATE Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ Per Ton Minimum Tons Precinct $ Per Ton Minimum Tons Precinct 3 $ Per Ton Minimum Tons Precinct 4-P $ Per Ton Minimum Tons Precinct 4-S $ Per Ton Minimum Tons Page 2 of 9 LIMESTONE -3/4 INCH TO DUST Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct $ Per Ton Minimum Tons Precinct $ Per Ton Minimum Tons Precinct 3 $ Per Ton Minimum Tons Precinct 4-P $ Per Ton Minimum Tons Precinct 4-S $ Per Ton Minimum Tons Page 2 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 3 of 9 ITEM 247, TYPE A LIMESTONE GRADE 2 [13/4 INCH] Cost Per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precincts $ Per Ton Minimum Tons Precinct 2 $ Per Ton Minimum Tons Precinct 3 $ Per Ton Minimum Tons Precinct 4-P $ Per Ton Minimum Tons Precinct 4-S $ Per Ton Minimum Tons Page 3 of 9 ITEM 247, TYPE A LIMESTONE, GRADE 3 [13/4 INCH] Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ Per Ton Minimum Tons Precinct 2 $ Per Ton Minimum Tons Precinct 3 $ Per Ton Minimum Tons Precinct 4-P $ Per Ton Minimum Tons Precinct 4-S $ Per Ton Minimum Tons Page 3 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 4 of 9 ITEM 247, TYPE B (FLEXIBLE PROCESSED BASE), GRADE 2 Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ Per Ton Minimum Tons Precinct $ Per Ton Minimum Tons Precinct 3 $ Per Ton Minimum Tons Precinct 4-P $ Per Ton Minimum Tons Precinct 4-S $ Per Ton Minimum Tons Page 4 of 9 ITEM 247, TYPE B (FLEXIBLE PROCESSED BASE), GRADE 3 Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ Per Ton Minimum Tons Precinct 2 $ Per Ton Minimum Tons Precinct 3 $ Per Ton Minimum Tons Precinct 4-P $ Per Ton Minimum Tons Precinct 4-S $ Per Ton Minimum Tons Page 4 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE - NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 5 of 9 ITEM 275, CEMENT (ROAD MIXED) ITEM 2752.1, HYDRAULIC CEMENT TYPE 1 Cost per Unit Minimum Load/Order Type of Delivery Precinct 1 $ Per Ton $ Per 47 Ib Bag Minimum Tons Minimum Bags Per Pallet Spreader Bar Needed, Pneumatic Tankers Precinct 2 $ Per Ton $ Per 47 Ib Bag Minimum Tons Minimum Bags Per Pallet Spreader Bar Needed, Pneumatic Tankers Precinct 3 $ Per Ton $ Per 47 Ib Bag Minimum Tons Minimum Bags Per Pallet Spreader Bar Needed, Pneumatic Tankers Precinct 4-P $ Per Ton $ Per 47 Ib Bag Minimum Tons Minimum Bags Per Pallet Spreader Bar Needed, Pneumatic Tankers Precinct 4-$ $ Per Ton $ Per 47 Ib Bag Minimum Tons Minimum Bags Per Pallet Spreader Bar Needed, Pneumatic Tankers Page 5 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE - NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 6 of 9 ITEM 302, TYPE PE (TOPPING ROCK), GRADE 3, LRA (LIMESTONE ROCK ASPHALT), *Material Source out of Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ Per Ton Minimum Tons Precinct 2 $ Per Ton Minimum Tons Precinct 3 $ Per Ton Minimum Tons Precinct 4-P $ Per Ton Minimum Tons Precinct 4-S $ Per Ton Minimum Tons Page 6 of 9 ITEM 302, TYPE PE (TOPPING ROCK), GRADE 4, LRA (LIMESTONE ROCK ASPHALT), *Material Source out of Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ Per Ton Minimum Tons Precinct 2 $ Per Ton Minimum Tons Precinct 3 $ Per Ton Minimum Tons Precinct 4-P $ Per Ton Minimum Tons Precinct 4-S $ Per Ton Minimum Tons Page 6 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INKAND LEGIBLE - NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 7 of 9 ITEM 330, TYPE D (PRE -MIX LIMESTONE) Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct $ PerTon Minimum Tons �- Vfr, V 7 1C'; Precinct 2 $ PerTon Minimum Tons Precinct 3 $ PerTon Minimum Tons Precinct 4-P $ PerTon Minimum Tons Minimum Tons 64 Minimum Bags ?vz, Precinct 4-S $ PerTon Minimum Tons 7 _ Minimum Tons Minimum Bags Page 7 of 9 ITEM 330 D, POTHOLE REPAIR, LIMESTONE ROCK ASPHALT (LRA) Cost Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 (p>er $ Vi� PerTon $ k� i Per 501b Bag -)" Minimum Tons 4V Minimum Bags �- Vfr, V 7 1C'; Precinct $ F�d PerTon $ ,C Per 50 Ib Bag ')4)- Minimum Tons !'Minimum Bags i Ezb4z. Precinct 3 $PerTon_ $ O Q Per 50 Ib Bag Minimum Tons gy Minimum Bags Precinct 4-P $ "'S PerTon $ k�.6'0 Per 50IbBag Minimum Tons 64 Minimum Bags ?vz, /'Cir ' Precinct 4-S $ Yk �5 �0 PerTon $ C,O Per 50lb Bag 7 _ Minimum Tons Minimum Bags �k o Cu - Page 7 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INKAND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 8 of 9 ITEM 334, TYPE D, HOT MIX COL® LAI® ASPHALT CONCRETE PAVEMENT Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ Per Ton Minimum Tons Precinct $ Per Ton Minimum Tons Precinct 3 $ Per Ton Minimum Tons Precinct 4-P $ Per Ton Minimum Tons Precinct 4-S $ Per Ton Minimum Tons Page 8 of 9 ITEM 432 RIPRAP, SECTION 2.3 STONE RIPRAP, 12" LIMESTONE Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct $ Per Ton Minimum Tons Precinct 2 $ Per Ton Minimum Tons Precinct 3 $ Per Ton Minimum Tons Precinct 4-P $ Per Ton Minimum Tons Precinct 4-S $ Per Ton Minimum Tons Page 8 of 9 Invitation To Bid Form - Road Materials The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation To Bid Package and fully understands and has complied with all instructions, specifications, and general conditions. Authorized Signature & Printed Name & Title: Exceptions and or Variations from Specifications or Date: f Page 9 of 9 Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.A.391`8039c CERTIFICATE OF INTERESTED PARTIES FORM 1.295 loll 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 1 Name of business entity filing form, and the city, state and country of the business entity's place Certificate Number: of business. 2019-491071 Blades Group LLC UVALDE, TX United States Date Filed: 2 Name of governmon4a entity or state agency that is a party tot ®contract for which the forms 05/1512019 being filed. Calhoun County Date Acknowledged: g Provide the identification number used by the governmentmI entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to he provided under the contract. 207.9.07-12.rm packaged and bulk rock asphalt 4 Name of Interested Part Y City, State, Count lace of business Y, Country (P ) Nature of interest check applicable) 1 Np ) _ Controlling Intermediary 5 Check only if there is NO Interested Party. X 6 UNSWORN DECLAR TIO �! s My name is Y ,h.. l)� �'t��%-� 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. �q- Executed in Ui414 County, State of l z') , on theI6> day of'ffip�PY_, 20—OL , (month) (year) Signatures of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.A.391`8039c Forms provided by Texas Ethics Commission www.ethlcs.state.tx.us version V1.1.398039c CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 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. 2019-491071 Blades Group LLC UVALDE, TX United States Date Filed: 05/15/2019 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 07/02/2019 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. 2019.07-12.rm packaged and bulk rock asphalt Nature of interest 4 Name of Interested Party City, State, Country (Place of business) (check applicable) Controlling I Intermediary 5 Check only if there is NO Interested Party. X 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.ethlcs.state.tx.us version V1.1.398039c Please Type. If handwritten, must be in ink and legible p Vendor Name: Poo R -L Q �. 0 ������� Address: Remittance Address: ?7 Y M Signature of Authorized Representative: w .y Printed name of Authorized Rep: Order Contact Name & Title: 1 hvzw\t\c> V JO N I $�1 Order Contact Telephone: Order Contact Fax: Order Contact Email: • � j BEFORE ME, the undersigned authority, on this day personally appeared known to me to be the person whose name is subscribed to the following, who, upon oath says: I am the Manager, Secretary, or other Agent or Officer or the Principal of the Bidder in the matter of the bids to which this affidavit is attached, and I have full knowledge of the relations of the Bidder with the other firms in this same line of business, and the Bidder is not a member of any trust, pool or combination to control the price of supplies bid on, or to influence any person to bid or not to bid thereon. I further affirm that the Bidder has not given, offered to give, nor intends to give at any time hereafter any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to a public servant in connection with the submitted bid. SWORN TO AND SUBSCRIBED BEFORE ME by the above Affiant, who, on oath states that the facts contained in the above are true and correct, this day of _ 20 =ssm MONICAA. GONZALEStary Pnbllc, State of Texasmm. Expires 12.26-2020No47ry ID 125153741 Name of Bidder Signed By Title Address Phone Number Fax Number Email Address Notary Public in and for 3 NOTE: BIDS NOT ACCOMPANIED BY THIS AFFIDAVIT WILL NOT BE CONSIDERED The County of Calhoun does not discriminate on the basis of race, color, national origin, sex, religion, age, or disability in employment or the provision of services. Enter your TIN in the appropriate box. Tile TIN provided must match the name given on line 1 to avoid ^.r .... TI � backup withholding. For individuals, this Is generally your social security number (SSN). However, fora resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entitles, it is your employer identification number (EIN). If you do not have a number, see How to get a FUI _ _ 7/N, later. or Note: If the account Is In more than one name, see the instructions for line 1. Also see What Name and em Io er identification number Number To Give the Requesterfor guidelines on whose number to enter. 1 Under penalties of perjury, I certify that: 1. The number shown on this form Is my correct taxpayer identification number (or I am waiting for a number to be Issued to me); and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) Indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply, For mortgage Interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an Individual retirement arrangement (IRA), and generally, payments other than Interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part 11, later. cry^Signature of Here U.S.person� General Ins#ri Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest Information about developments related to Form W-9 and Its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9. Purpose of Form An individual or entity (Form W-9 requester) who is required to file an Information return with the IRS must obtain your correct taxpayer Identification number (TIN) which may be your social security number (SSN), Individual taxpayer Identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (FIN), to report on an Information return the amount paid to you, or other amount reportable on an Information return. Examples of Information returns include, but are not limited to, the following. • Form 1099 -INT (interest earned or paid) Date ®.- e Form 1099 -DIV (dividends, Including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan Interest), 1098-T (tuition) • Form 1099-0 (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231 X Form W-8 (Rev. 10-2018) WMM9 Request for Taxpayer Give Form to the =arm Idenflfloai'Ior1 Number and Certification requester. Do not ;Rev. October 2018) send to the IRS. Department eternal of the Treasury Revenue Service d Go to www.irs.gov/FormW9 for Instructions and the latest information. I Name (as shown on your income tax return). Name Is required on this line; do not leave this tine blank. Blades Group, LLC dba Road Rescue Asphalt Patch 2 Business name/disregarded entity name, if different from above 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the 4 Exemptions (codes apply only to rn o. following seven boxes. certain entities, not individuals; see instructions on page 3): p ❑ Individual/sole proprietor or ❑ C Corporation ❑ S Corporation ❑ Partnership ❑ Trust/estate 0 single -member LLD Exempt payee code (if any) Z ❑✓ Limited [lability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) b P o Note; Check the appropriate box In the line above for the tax classification of the single -member owner. Do not check Exemption from FATCA reporting S Ci LLC if the LLC is classified as a single-membor LLC that is disregarded from the owner unless the owner of the LLC is code (if any) another LLC that Is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that w Is disregarded from the owner should check the appropriate box for the tax classification of its owner. m ❑ Other (see Instructions) (as+>a=merc•vr,r:,rn�.,i�moawisas na ust W 5 Address (number, street, and apt. or suite no,) see instructions. Requester's name and address (optional) 1E1403 6 City, state, and ZIP code Uvalde, TX 78801 7 List account number(s) here (optlonal) Taxpayer Identification dumber (TIN) Enter your TIN in the appropriate box. Tile TIN provided must match the name given on line 1 to avoid ^.r .... TI � backup withholding. For individuals, this Is generally your social security number (SSN). However, fora resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entitles, it is your employer identification number (EIN). If you do not have a number, see How to get a FUI _ _ 7/N, later. or Note: If the account Is In more than one name, see the instructions for line 1. Also see What Name and em Io er identification number Number To Give the Requesterfor guidelines on whose number to enter. 1 Under penalties of perjury, I certify that: 1. The number shown on this form Is my correct taxpayer identification number (or I am waiting for a number to be Issued to me); and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) Indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply, For mortgage Interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an Individual retirement arrangement (IRA), and generally, payments other than Interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part 11, later. cry^Signature of Here U.S.person� General Ins#ri Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest Information about developments related to Form W-9 and Its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9. Purpose of Form An individual or entity (Form W-9 requester) who is required to file an Information return with the IRS must obtain your correct taxpayer Identification number (TIN) which may be your social security number (SSN), Individual taxpayer Identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (FIN), to report on an Information return the amount paid to you, or other amount reportable on an Information return. Examples of Information returns include, but are not limited to, the following. • Form 1099 -INT (interest earned or paid) Date ®.- e Form 1099 -DIV (dividends, Including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan Interest), 1098-T (tuition) • Form 1099-0 (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231 X Form W-8 (Rev. 10-2018) CALHOUN COUNTY, TEXAS For the period beginning July 1, 2019 and ending December 31, 2019 Vendor's Name and Address: Brauntex Materials, Inc. 1504 Wald Rd., New Braunfels TX 76132 YOU ARE INVITED TO SUBMIT A BID ON THE FOLLOWING ROAD MATERIALS TO: Honorable Richard H. Meyer, Calhoun County Judge Calhoun County Courthouse 2115 Ann St 3rd Floor, Suite 301 Port Lavaca, TX 77979 SEALED BIDS DUE: 2:00 PM, Wednesday, June S, 2019 Sealed bids are due at the above address. The outside of the 9 x 12 or larger envelope must be marked: Sealed Bid - Road Materials If you send your bid by UPS, FEDEX, etc, the outside of this envelope must be clearly marked: Sealed Bid - Road Materials All charges must be included in bid price or clearly stated on the bid form or on a separate attachment to the bid and labeled as such. To be a valid bid, the following forms must be returned: A. Invitation To Bid Form (Pages 1 - 9) v12. Form 1295 ✓ 3, Vendor and Order Information Form 4. Affidavit A W-9 Upon acceptance and approval by Calhoun County Commissioners' Court, this bid will be the working contract between the County and the successful bidder for the period designated. Page 1 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INKAND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 2 of 9 LIMESTONE -3/4 INCH TO DUST PE 5 AGGREGATE Cost per Unit Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ 63.00 Per Ton 24 Minimum Tons End Dump $ Precinct 2 $ 63.00 Per Ton 24 Minimum Tons End Dump 30.75 Precinct 3 $ 63.00 Per Ton 24 Minimum Tons End Dump Per Ton Precinct 4-P $ 63.00 Per Ton 24 Minimum Tons End Dump 24 Minimum Tons Precinct 4-S $ 63.00 Per Ton 24 Minimum Tons End Dump Page 2 of 9 LIMESTONE -3/4 INCH TO DUST Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ 30.75 Per Ton 24 Minimum Tons End Dump or Belly Dump Precinct 2 $ 30.75 Per Ton 24 Minimum Tons End Dump or Belly Dump Precinct 3 $ 30.75 Per Ton 24 Minimum Tons End Dump or Belly Dump Precinct 4-P $ 30.75 Per Ton 24 Minimum Tons End Dump or Belly Dump Precinct 4-S $ 30.75 Per Ton 24 Minimum Tons End Dump or Belly Dump Page 2 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations -See Contact Information for County Precincts Page 3 of 9 ITEM 242, TYPE A LIMESTONE GRADE 2 [13/4 INCH] Cost Per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ 30.75 Per Ton 24 Minimum Tons End Dump or Belly Dump Precinct 2 $ 30.75 Per Ton 24 Minimum Tons End Dump or Belly Dump Precinct 3 $ 30.75 Per Ton 24 Minimum Tons End Dump or Belly Dump Precinct 4-P $ 30.75 per Ton 24 Minimum Tons Enc{ Dump or Belly Dump Precinct 4-5 $ 30.75 Per Ton 24 Minimum Tons End Dump or Belly Dump Page 3 of 9 ITEM 247, TYPE A LIMESTONE, GRADE 3 [13/4 INCH] Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ 30.75 Per Ton 24 Minimum Tons E'•nd Dump or Belly Dump Precinct 2 $ 3 0. 75 Per Ton 24 Minimum Tons End Dump or Belly Dump Precinct 3 $ 30.75 Per Ton 24 Minimum Tons End Dump or Belly Dump Precinct 4-P $ 30.75 Per Ton 24 Minimum Tons End Dump or Belly Dump Precinct 4-S $ 30.75 Per Ton 24 Minimum Tons End Dump or Belly Dump Page 3 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 4 of 9 ITEM 247, TYPE B (FLEXIBLE PROCESSED BASE), GRADE 2 Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct $ Per Ton Minimum Tons Precinct 2 $ Per Ton Minimum Tons Precinct 3 $ Per Ton Minimum Tons Precinct 4-P $ Per Ton Minimum Tons Precinct 4-S $ Per Ton Minimum Tons Page 4 of 9 ITEM 247, TYPE B (FLEXIBLE PROCESSED BASE), GRADE 3 Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ Per Ton Minimum Tons Precinct 2 $ Per Ton Minimum Tons Precinct 3 $ Per Ton Minimum Tons Precinct 4-P $ Per Ton Minimum Tons Precinct 4-S $ Per Ton Minimum Tons Page 4 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 5 of 9 ITEM 275, CEMENT (ROAD MIXED) ITEM 275-2.1, HYDRAULIC CEMENT TYPE 1 Cost per Unit Minimum Load/Order Type of Delivery Precinct 1 $ Per Ton $ Per 47 Ib Bag Minimum Tons Minimum Bags Per Pallet Spreader Bar Needed Pneumatic Tankers Precinct $ Per Ton $ Per 47 Ib Bag Minimum Tons Minimum Bags Per Pallet Spreader Bar Needed, Pneumatic Tankers Precinct 3 $ Per Ton $ Per 47 Ib Bag Minimum Tons Minimum Bags Per Pallet Spreader Bar Needed, Pneumatic Tankers Precinct 4-13 $ Per Ton $ Per 47 Ib Bag Minimum Tons Minimum Bags Per Pallet Spreader Bar Needed, Pneumatic Tankers Precinct 4-S $ Per Ton $ Per 47 Ib Bag Minimum Tons Minimum Bags Per Pallet Spreader Bar Needed, Pneumatic Tankers Page 5 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 6 of 9 ITEM 302, TYPE PE (TOPPING ROCK), GRADE 3, LRA (LIMESTONE ROCK ASPHALT), *Material Source out of Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ Per Ton Minimum Tons Precinct 2 $ Per Ton Minimum Tons Precinct 3 $ Per Ton Minimum Tons Precinct 4-P $ Per Ton Minimum Tons Precinct 4-S $ Per Ton Minimum Tons Page 6 of 9 ITEM 302, TYPE PE (TOPPING ROCK), GRADE 4, LRA (LIMESTONE ROCK ASPHALT), *Material Source out of Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct $ Per Ton Minimum Tons Precinct $ Per Ton Minimum Tons Precinct $ Per Ton Minimum Tons Precinct 4-P $ Per Ton Minimum Tons Precinct 4-S $ Per Ton Minimum Tons Page 6 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -1F HANDWRITTEN, MUST BE IN INKAND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 7 of 9 ITEM 330, TYPE D (PRE -MIX LIMESTONE) Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ Per Ton Minimum Tons Precinct $ Per Ton Minimum Tons Minimum Tons Minimum Bags Precinct $ Per Ton Minimum Tons $ Per Ton $ Per 50 lb Bag Minimum Tons Minimum Bags Precinct 4-P $ Per Ton Minimum Tons Precinct 4-P $ Per Ton $ Per 50 Ib Bag Precinct 4-S $ Per Ton Minimum Tons Precinct 4-S Page 7 of 9 ITEM 330 D, POTHOLE REPAIR, LIMESTONE ROCK ASPHALT (LRA) Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ Per Ton $ Per 50 lb Bag Minimum Tons Minimum Bags Precinct 2 $ Per Ton $ Per 50 Ib Bag Minimum Tons Minimum Bags Precinct 3 $ Per Ton $ Per 50 lb Bag Minimum Tons Minimum Bags Precinct 4-P $ Per Ton $ Per 50 Ib Bag Minimum Tons Minimum Bags Precinct 4-S $ Per Ton $ Per 50 lb Bag Minimum Tons Minimum Bags Page 7 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INKAND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations -See Contact Information for County Precincts Page 8 of 9 ITEM 334, TYPE D, HOT MIX COLD LAID ASPHALT CONCRETE PAVEMENT Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ 80.00 Per Ton 24 Minimum Tons End Dump or Belly Dump Precinct 2 $ 80.00 Per Ton 24 Minimum Tons End Dump or Belly Dump Precinct 3 $ 80.00 Per Ton 24 Minimum Tons End Dump or Belly Dump Precinct 4-P $ 80.00 per Ton 24 Minimum Tons End Dump or Belly Dump Precinct 4-S $ 80.00 Per Ton 24 Minimum Tons End Dump or Belly Dump Page 8 of 9 ITEM 432 RIPRAP, SECTION 2.3 STONE RIPRAP, 12" LIMESTONE Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ 50.00 per Ton 24 Minimum Tons End Dump Only Precinct 2 $ 50.00 per Ton 24 Minimum Tons End Dump Only Precinct 3 $ 50.00 per Ton 24 Minimum Tons End Dump Only Precinct 4-P $ 50.00 per Ton 24 Minimum Tons End Dump Only Precinct 4-S $ 50.00 per Ton 24 Minimum Tons End Dump Only Page 8 of 9 Invitation To Bid Form - Road Materials The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation To Bid Package and fully understands and has complied with all instructions, specifications, and general conditions. Authorized Signature & Printed Name & William D. Fischer, Vice President/General Manager Date: 6/3/19 Exceptions and or Variations from Specifications or Notes: We have changed oil suppliers for the manufacturing of Item 334 Type D Hot Mix Cold Laid Asphalt Concrete, which has enhanced the quality of the finished product. Page 9 of 9 `5 0!!�7 1 of 1 Complete Nos, 1- 4 and 6 if there are interested parties. OFFICE LISE ONLY Comple Nos, 1, 2, 3, 5, and 6 if there an e no interested parties. q CER if Or ;UHG ta 0, 15 1) --::s ef , ii,y f];ia, ff , :r., .,k-1? me coy, s,ate and co4mif y of the business anti ky's place Certificate Number: 2019-498980 Braurnex Niatenals, inc. NEW BRAUNFELS, TX United States Nnate tiled: 2 Name ofgovarncucnb1 rM1,11 or state agency tha;F, a party to the contract for which the form is I 06103!00—�) being flhad, ii Da'e Aokf�&,Vleagaa: . I - th. montfm tion number used by the governmental enthyor state lgcncyto aock or W8.1 -rov;d description of the services, goods, or other property to be provided under the contract. goad Materials fd,inra of interest 4 Ata ne 'fln£srest-d P,)Iy (check i ControWng sniermediary ;G UNSWORN 0F.t' I -A RATION 1 MV name ls d m date of birth Mly 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 r4,, of 20_ � (month) (year) tura6thori hld'agent of contracting business entity Sign A4f' (Declarant) Forms provided by Texas Ethics Commission Aww.etlnics.scate.tY..us Version. V1.1.39f8039c Forms provided by Texas Ethics Commission www,ethics.state.tx.us version v1.l.59f8039c CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 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. 2019-498980 Brauntex Materials, Inc. NEW BRAUNFELS, TX United States Date Filed: 2 Name of governmental entity or state agency that is a party to the contract for which the form is 06/03/2019 being filed. Calhoun County Date Acknowledged: 07/02/2019 g 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. 2019.07-12.RM Road Materials Nature of interest 4 Name of Interested Party City, State, Country (place of business) (check applicable) Controlling I Intermediary 5 Check only if there is NO Interested Party. ❑ X 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.l.59f8039c (T1AWfail Tiii►_l'�CSI�I Please Type. if handwritten, must be in ink and legible Vendor Name: Brauntex Materials, Inc. Address: 1504 Wald Rd. New Braunfels, TX 78132 Remittance Address: PO Box 312522 Tele Fax: Emai New Braunfels, TX 78131 Signature of Authorized Representative: Printed name of Authorized Rep: William D. Fischer Order Contact Name &Title: Austin Deen, Sales Manager Order Contact Tele Order Contact Fax: Order Contact Ema STATE OF TEXAS 0 AFFIDAVIT • � s BEFORE ME, the undersigned authority, on this day personally appeared known to me to be the person whose name is subscribed to the following, who, upon oath says: I am the Manager, Secretary, or other Agent or Officer or the Principal of the Bidder in the matter of the bids to which this affidavit is attached, and I have full knowledge of the relations of the Bidder with the other firms in this same line of business, and the Bidder is not a member of any trust, pool or combination to control the price of supplies bid on, or to influence any person to bid or not to bid thereon. I further affirm that the Bidder has not given, offered to give, nor intends to give at anytime hereafter any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to a public servant in connectj,6n with the submitted bid. Affiant SWORN TO AND SUBSCRIBED BEFORE ME by the above Affiant, who, on oath, states that the facts contained in the above are true and correct, this 3 day of 20 L. EM H KADERLI ELDRESTARY PUBLICIDH 10648187tate of Texasm. Exp, 11-07-2020 Name of Bidder Brauntex Materials, Inc. Signed By Title Vice President/General Address Phone Number Fax Number Email Address Notary Public in and for lid. County, Texas NOTE: BIDS NOT ACCOMPANIED BY THIS AFFIDAVIT WILL NOT BE CONSIDERED The County of Calhoun does not discriminate on the basis of race, color, national origin, sex, religion, age, or disability in employment or the provision of services. Enter your TIN in the appropriate box. The TIN provided must match the name given online 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN. However, fora resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other W-9Request for 'taxpayer Give Form to the Farm entities, it is your employer Identification number (EIN). If you do not have a number, see How to get a Identification Number and Certification requester. Do not (Rev. October 2018) oepadment of the Treasury TIN, later. Send to the IRS. Internal Revenue Service b Go to www.1rs.gov/FormW9 for instructions and the latest information. 1 Name (as shown on your Income tax return). Name Is required on this line; do not leave this line blank. Brauntex Materials, Inc. 2 Business name/disregarded entity name, If different from above cO3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the 4 Exemptions (codes apply only to rn is following seven boxes. certain entities, not Individuals; see Instructions on page 3): o Q IndividuaVsole proprietor or ❑ C Corporation H 8 Corporation ❑ Partnership ❑ Trustlestate M single -member LLC Exempt payee code (if any) d c Limited liability company. Enter the tax classification IC -0 corporation, S=S corporation, P=Partnership) ► a 2 Note: Check the appropriate box in the line above for the tax classification of the single -member owner. Co not check Exemption from FATCA reporting cy LLC if the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner or the LLC is code (if any) •C a another LLC that Is not disregarded from the owner for U.S, federal tax purposes. Otherwise, a single -member LLC that IL o is disregarded from the owner should check the appropriate box for the tax classification of Its owner. c y ❑Other (see instructions)® O's 'l. e•m:m. m�US) In 5 Address (number, street, and apt. or suite no.) See Instructions. Requester's name and address ptlonel) 1504 Wald Road a City, state, and ZIP code New Braunfels, TX 78132 7 List account number(s) here(optionai) Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given online 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN. However, fora resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other ) Social security nu,vuur —m entities, it is your employer Identification number (EIN). If you do not have a number, see How to get a TIN, later. or Note: If the account is In more than one name, see the Instructions for line 1. Also see What Name and Employer fdentilicatlon , Number To Give the Requester for guidelines on whose number to enter. Under penalties of perjury, I certify that: 1. The number shown on this form Is my correct taxpayer Identification number (or I am waiting for a number to be issued to me); and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U.S. citizen or other U.S, person (defined below); and 4. The FATCA code(s) entered on this form (if any) Indicating that I am exempt from FATCA reporting is correct. Certification Instructions. You must cross out Item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, Item 2 does not apply. For mortgage Interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an Individual retirement arrangement (IRA), and generally, payments other than interest and dividen%xou are not required to sign the certification, but you must provide your correct TIN See the Instructions for Part II, later. Sign Signature of 0 Here u.a.person► bate► General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and Its Instructions, such as legislation enacted after they were published, go to wwwdirs.gov/FonnW9. Purpose of Form An individual or entity (Form W-9 requester) who Is required to file an Information return with the IRS must obtain your correct taxpayer Identification number (TIN) which may be your social security number (SSN), individual taxpayer Identification number (ITIN), adoption taxpayer Identification number (ATIN), or employer identification number (EIN), to report on an Information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following. • Form 1099 -INT (interest earned or paid) • Form 1099 -DIV (dividends, Including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-8 (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage Interest), 1098-E (student loan interest), 1098-T (tul0on) • Form 1099-0 (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231X Form (Rev. 10-2010) CALHOUN COUNTY, TEXAS For the period beginning July 1, 2019 and ending December 31, 2019 Vendor's Name and Address: o, YOU ARE INVITED TO SUBMIT A BID ON THE FOLLOWING ROAD MATERIALS TO: Honorable Richard H. Meyer, Calhoun County Judge Calhoun County Courthouse 211SAnn St 3rd Floor, Suite 301 Port Lavaca, TX 77979 SEALED BIDS DUE: 2:00 PM, Wednesday, June 5, 2019 Sealed bids are due at the above address. The outside of the 9 x 12 or larger envelope must be marked: Sealed Bid - Road Materials if you send your bid by UPS, FEDEX, etc, the outside of this envelope must be clearly marked.- Sealed arked:Sealed Bid - Road Materials All charges must be included in bid price or clearly stated on the bid form or on a separate attachment to the bid and labeled as such. To be a valid bid, the following forms must be returned: V1. Invitation To Bid Form (Pages 1 - 9) 2. Form 1295 7 3. Vendor and Order Information Form 4. Affidavit 5. W-9 Upon acceptance and approval by Calhoun County Commissioners' Court, this bid will be the working contract between the County and the successful bidder for the period designated. Page 1 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -1F HANDWRITTEN, MUST BE IN INKAND LEGIBLE - NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 2 of 9 PE 5 AGGREGATE Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct $ Per Ton Minimum Tons Precinct $ /Per Ton /Per Minimum Tons Precinct 3 s..z. Ton M'nimum Tons Precinct 4-P $ Per Ton Minimum Tons Precinct 4-S $ Per Ton Minimum Tons Page 2 of 9 LIMESTONE -3/4 INCH TO DUST Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $, Per Ton Minimum Tons Precinct 2 roc Per Ton Minimum Tons Precinct �? $:.%�„ Per Ton Minimum Tons Precinct 4-P $ Per Ton Minimum Tons Precinct 4-S $3i9w Per Ton Minimum Tons Page 2 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INKAND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 3 of 9 ITEM 247, TYPE A LIMESTONE GRADE 2 [13/4 INCH] Cost Per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct $.,m Per Ton Minimum Tons Precinct 2 Per Ton Minimum Tons Precinct 3 e1 $ 7/I Per Ton Minimum Tons Precinct 4-P i� $PerTon Minimum Tons Precinct 4-S $ . C Per Ton Minimum Tons Page 3 of 9 ITEM 247, TYPE A LIMESTONE, GRADE 3 [13/4 INCH] Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 {4 Q $ "3o' Per Ton Minimum Tons Precinct cSGs $ Xf'. Per Ton Minimum Tons Precinct �r $,%' Per Ton Minimum Tons Precinct 4-P $,] 7, Per Ton Minimum Tons Precinct 4-$$ Per Ton Minimum Tons Page 3 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INKAND LEGIBLE - NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 4 of 9 ITEM 247, TYPE B (FLEXIBLE PROCESSED BASE), GRADE 2 Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ Per Ton Minimum Tons Precinct 2Per Ton 4z/ Minimum Tons Precinct 3 $ Per Ton / Mi i - m Tons Precinct 4-P $ Per Ton Minimum Tons Precinct 4-S $ Per Ton Minimum Tons Page 4 of 9 ITEM 247, TYPE B (FLEXIBLE PROCESSED BASE), GRADE 3 Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ Per Ton Minimum Tons Precinct 2 $ Per Ton /) Minimum Tons Precinct 3 $ P Ton d Mini m Tons Precinct 4-P $ Per Ton Minimum Tons Precinct 4-S $ Per Ton Minimum Tons Page 4 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 5 of 9 ITEM 275, CEMENT (ROAD MIXED) ITEM 2752.1, HYDRAULIC CEMENT TYPE 1 Cost per Unit Minimum Load/Order Type of Delivery Precinct 1 $ Per Ton $ Per 47 Ib Bag Minimum Tons Minimum Bags Per Pallet Spreader Bar Needed Pneumatic Tankers Precinct 2 -;;-; Per Ton $ Per 47 Ib Bag -Minimum Tons M r'inum B gs Per Pale spreader Bar Needed, Pneumatic Tankers Precinct $ Per Ton $ Per 47 Ib Bag Minimumons Minimum Bags Per Pallet Spreader Bar Needed, Pneumatic Tankers Precinct 4-P $ Per Ton $ Per 47 Ib Bag Minimum Tons Minimum Bags Per Pallet Spreader Bar Needed, Pneumatic Tankers Precinct 4-S $ Per Ton $ Per 47 Ib Bag Minimum Tons Minimum Bags Per Pallet Spreader Bar Needed, Pneumatic Tankers Page 5 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE 1N INKAND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 6 of 9 ITEM 302, TYPE PE (TOPPING ROCK), GRADE 3, LRA (LIMESTONE ROCK ASPHALT), *Material Source out of Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ Per Ton Minimum Tons Precinct 2 $ Per Ton Minimum Tons Precinct $` (-" Per Ton Minimum Tons/ Precinct 4-P $ Per Ton Minimum Tons Precinct 4-S $ Per Ton Minimum Tons Page 6 of 9 ITEM 302, TYPE PE (TOPPING ROCK), GRADE 4, LRA (LIMESTONE ROCK ASPHALT), *Material Source out of Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ Per Ton Minimum Tons Precinct 2 $ Per Ton Minim7/ns Precinct 3 f � ' PerTon� ifimum Tons Precinct 4-P $ Per Ton Minimum Tons Precinct 4-S $ Per Ton Minimum Tons Page 6 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 7 of 9 ITEM 330, TYPE D (PRE -MIX LIMESTONE) Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct $ Per Ton Minimum Tons j Precinct 2 Precinct 3 $ Per Ton $ Per Ton Minimurp ons Miq'mum Tons `4,Minimum Tons t irai'm Q" s Precinct 4-P $ Per Ton Minimum Tons Minimum Tons Minimum Bags Precinct 4-S $ Per Ton Minimum Tons $ Per Ton $ Per 50 lb Bag Minimum Tons Minimum Bags Page 7 of 9 ITEM 330 D, POTHOLE REPAIR, LIMESTONE ROCK ASPHALT (LRA) Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct $ PetTon $ "t er y Ib Bag j Minimum Tons Minimum Bags j Precinct 2 �r $ / PrerTon $ j 0 lb Bag `4,Minimum Tons t irai'm Q" s Precinct 3 $ Per Ton $ Per 50 Ib Bag Minimum Tons Minimum Bags Precinct 4-P $ Per Ton $ Per 50 lb Bag Minimum Tons Minimum Bags Precinct 4-S $ Per Ton $ Per 50 Ib Bag Minimum Tons Minimum Bags Page 7 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INKAND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 8 of 9 ITEM 334, TYPE D, HOT MIX COLD LAID ASPHALT CONCRETE PAVEMENT Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct $;l> /j PerTon Minimum Tons Precinct $.%A; 3 J PerTon Minimum Tons r ry-j Precinct 3$ % 13,e PerTon Minimum Tons ; Precinct 4-P Precinct 4-P r $ '; 131Z PerTon Minimum Tons Precinct 4-S Precinct 4-S $,,11 /3W Per Ton Minimum Tons Page 8 of 9 ITEM 432 RIPRAP, SECTION 2.3 STONE RIPRAP, 12" LIMESTONE Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ Per Ton > Minimum Tons, Precinct 2 ,lr_le! $ PerTon i Minimum Tons r ry-j Precinct 3 00 $ A. PerTon c}_5 Minimum Tons ; Precinct 4-P $ PerTon '' Minimum Tons e"41 Precinct 4-S $ ellPerTon 9,5Minimum Tons Page 8 of 9 Invitation To Bid Form - Road Materials The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation To Bid Package and fully understands and has complied with all instructions, specifications, and general conditions. Authorized Signature & Title: F' 4, 18 Printed Name &Title:$/' �� �'f ,t,,�,�,,' t Date: �� Exceptions and or Variations from Specifications or N Page 9 of 9 CERTIFICATE OF INTERESTED PARTIES FORM 1295 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 1 Name of business entity filing form, and the city, state and country of the business entity's place Certificate Number: of business. 2019-490210 Midtex Materials, LLC Fayetteville, TX United States Date Filed: 2 Name of governmental entity or state agency that is a party to the contract for which the form is 05/13/2019 being filed. Calhoun County 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. 2019.07-12.RM Road Materials 4 Nature of interest Name of Interested Party City, State, Country (place of business) (check applicable) I Midtex Materials, LLC 5 Check only if there is NO Interested Party. 6 UNSWORN DECLARATION C Fayetteville, TX United States I X My name is JY el , -� f�.r t a �/`� and my date of birth My address is (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in Gt r' [I._.. County, State of on the--- / —Say of 20. (mont) (year) ped agent of contracting business entity (Declarant) =nrms nrrwided by Texas Please Type. If handwritten, must be in ink and legible Vendor Name: 1Z -" Address: Remittance Address: L;)rZv) Z-wy LI'l-, Tele Fax: Email: Signature of Authorized Representative: Printed name of Authorized Rep: Order Contact Name & Tit] Order Contact Telephone: Order Contact Fax: Order Contact Email: STATE OF TEXAS 0 AFFIDAVIT BEFORE ME, the undersigned authority, on this day personally appeared g` ` �f � ' ?�--4 �. nd. Civ known to me to be the person whose name is subscribed to the following, who, upon oath says: I am the Manager, Secretary, or other Agent or Officer or the Principal of the Bidder in the matter of the bids to which this affidavit is attached, and I have full knowledge of the relations of the Bidder with the other firms in this same line of business, and the Bidder is not a member of any trust, pool or combination to control the price of supplies bid on, or to influence any person to bid or not to bid thereon. I further affirm that the Bidder has not given, offered to give, nor intends to give at any time hereafter any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to a public servant in connection with the submitted bid. SWORN TO AND SUBSCRIBED BEFORE ME by the abo g Affiant, w , on oath, states that the a Its contained in the above are true and correct, this day of ,��1 20 � . J MEGAN COOPER COMM. EXPIRES 8-28-2022 'ham NOTARY ID 125813841 Name of Bidder Signed By Title Address Phone Number Fax Number Email Address Notary Public in arid for ,✓/ � r 7" `.., Texas NOTE: BIDS NOT ACCOMPANIED BY THIS AFFIDAVIT WILL NOT BE CONSIDERED The County of Calhoun does not discriminate on the basis of race, color, national origin, sex, religion, age, or disability in employment or the provision of services. Number Enter your TIN in the appropriate box. The TIN provided must match the name given online 1 to avoid backup withholding. For Individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer Identification number (EIN). if you do not have a number, see How to get TIN, later. Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter. Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be Issued to me); and 2.1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all Interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3.1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that 1 am exempt from FATCA reporting is correct. Certification Instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, hem 2 does not apply. For mortgage Interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than Interest and dividends, you are not required to sign the certification, but you must provide your correct DN. Seethe instructions for Part 11, later. Signature of U.S. personD � - � Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.im gov1FormW9. Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number ([TIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an Information return the amount paid to you, or other amount reportable on an Information return. Examples of information returns include, but are not limited to, the following. • Form 1099 -INT Qnterest earned or paid) Date ID • Form 1099 -DIV (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of Income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-8 (proceeds from real estate transactions) • Form 1099-K (merchant card and third parry network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-7 (tuition) • Form 1099-0 (canceled debt) • Farm 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding, See What is backup withholding, later. Cat. No. 10231X Form W9 (Rev. 10-2018) ® Request for Taxpayer Give Form to the (ReFarm (Rev. October 2818) identification Number and Certification requester. Do not q OepadmsntoftheTrmury send to the IRS. Intemal Revenue Service ® Go to wimmirs govifFormW9 for instructions and the latest information. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. 2 Businessname/disregwdedentityna ifdifferentfromabove m 3 Check appmpdate box forfederal tax classification of the person whose name is entered an line 1. Check only one of the 4 Exemptions (codes apply only to M following seven boxes. certain entitles, not Individuals; see a o ❑ C Cor El IndividuaVsole proprietor or potation El El ❑TrusVestate Instructions an pia a; w Z single -member LLC Exempt payee code Of any) �'0� _t ❑"'Clmited liability company. Enierihe tax classification (C=C corporation, 8=5 corporation, P=Partnership) �- `0 2 m Note: Check the appropriate box In the line above forthe tax classification slue single -member owner. Donotcheck Exemption tram FATCA reporting LLC if the LLC is classified as a single -member LLC that Is disregarded from the owner unless the owner of the LLC is another LLC that Is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a singie-member LLC that eoda fanY) Q a 0 Is disregarded from the owner should check the appropriate box far the tax classification of Its owner. m ❑ Other (see Instructions)b Wyss ro•xow,tsm xmsaawmxvuwvs) W 5Adgdress(numbepr', seeat, and apt, orsuita na.)See inshuctions. Rem:} AddrSS5 Requester's name and address(optional) P 11 d e City, state, and ZIP code 7 UR number(s)here(optIana0 Number Enter your TIN in the appropriate box. The TIN provided must match the name given online 1 to avoid backup withholding. For Individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer Identification number (EIN). if you do not have a number, see How to get TIN, later. Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter. Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be Issued to me); and 2.1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all Interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3.1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that 1 am exempt from FATCA reporting is correct. Certification Instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, hem 2 does not apply. For mortgage Interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than Interest and dividends, you are not required to sign the certification, but you must provide your correct DN. Seethe instructions for Part 11, later. Signature of U.S. personD � - � Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.im gov1FormW9. Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number ([TIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an Information return the amount paid to you, or other amount reportable on an Information return. Examples of information returns include, but are not limited to, the following. • Form 1099 -INT Qnterest earned or paid) Date ID • Form 1099 -DIV (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of Income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-8 (proceeds from real estate transactions) • Form 1099-K (merchant card and third parry network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-7 (tuition) • Form 1099-0 (canceled debt) • Farm 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding, See What is backup withholding, later. Cat. No. 10231X Form W9 (Rev. 10-2018) CALHOUN COUNTY, TEXAS I,I I►T/li���l�Ii�'�TiT: , :� tip, :;1e/ For the period beginning July 1, 2019 and ending December 31, 2019 Vendor's Name and Address: Rol Nix -Ing, V)o X U U CL,6() `hX 7—?y37 YOU ARE INVITED TO SUBMITA BID ON THE FOLLOWING ROAD MATERIALS TO: Honorable Richard H. Meyer, Calhoun County Judge Calhoun County Courthouse 211SAnn St 3rd Floor, Suite 301 Port Lavaca, TX 77979 SEALED BIDS DUE: 2:00 PM, Wednesday, June 5, 2019 Sealed bids are due at the above address. The outside of the 9 x 12 or larger envelope must be marked: Sealed Bid - Road Materials if you send your bid by UPS, FEDEX, etc, the outside of this envelope must be clearly marked: Sealed Bid - Road Materials All charges must be included in bid price or clearly stated on the bid form or on a separate attachment to the bid and labeled as such. To be a valid bid, the following forms must be returned: /1. Invitation To Bid Form (Pages 1- 9) 1/2. Form 1295 ./ 3. Vendor and Order Information Form ✓4 4. Affidavit V 5. W-9 Upon acceptance and approval by Calhoun County Commissioners' Court, this bid will be the working contract between the County and the successful bidder for the period designated. Page 1 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE 1N INK AND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 2 of 9 PE 5 AGGREGATE Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct $ _Per To 0 �� c Minimum Tons J `AA, Precinct 2 $ Per Ton Minimum Tons r+i Precinct 3 $ Per Ton \� Minimum Tons 7�7 r eP Precinct 4-P $ Per Ton Minimu Tons 1 Precinct 4-S $ Per Ton Minimum Tons < wvq Page 2 of 9 LIMESTONE -3/4 INCH TO DUST Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ Per Ton Minimum Tons J `AA, Precinct ${,.70 Per Ton Minimum Tons r+i Precinct $ x,70 Per Ton Minimum Tons r eP Precinct 4-P $,70 Per Ton d 11 Minimum Tons 1 Precinct 4-S $ ,7U Per Ton 911 Minimum Tons < wvq Page 2 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 3 of 9 ITEM 247, TYPE A LIMESTONE GRADE 2 [13/4 INCH] Cost Per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ J ! - 0 Per Ton P1 Minimum Tons Precinct $ � i-70 Per Ton )q Minimum Tons 1 he P Precinct 3 $ A,70 Per Ton -_� Minimum Tons Precinct 4-P $ l' 10, Per Ton Minimum Tons i 41x Precinct 4-S $ QF .70 Per Ton Minimum Tons Page 3 of 9 ITEM 247, TYPE A LIMESTONE, GRADE 3 [13/4 INCH] Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ cL.7M Per Ton 9q Minimum Tons Precinct 2 $ 99-76 Per Ton i Minimum Tons 1 he P Precinct $ 4'&'70 Per Ton Minimum Tons Precinct 4-P $ X0.70 Per Ton Minimum Tonsi1��i Precinct 4-S $ 70 Per Ton Minimum Tons Page 3 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INKAND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 4 of 9 ITEM 247, TYPE B (FLEXIBLE PROCESSED BASE), GRADE 2 Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct $ PerT n Minimum Tons Precinct $ Per Ton Minimum Tons Precinct 3 $ Per Ton Minim Tons Precinct 4-P $ Per Ton Minimum Tons Precinct 4-S $ Per Ton Minimum Tons \ Page 4 of 9 ITEM 247, TYPE B (FLEXIBLE PROCESSED BASE), GRADE 3 Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ Per Ton Minimum Tons L' Precinct $ Per Ton Minimum Tons Precinct $ Per Ton nimumTons Precinct 4-P $ Per Ton Minimu Tons Precinct 4-S $ Per Ton Minimum Tons —� Page 4 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 5 of 9 ITEM 275, CEMENT (ROAD MIXED) ITEM 275-2.1, HYDRAULIC CEMENT TYPE 1 Cost per Unit Minimum Load/Order Type of Delivery Precinct $ Per To $ 07 Ib Bag, Minimum Tons Minimum Bags Per Pallet Spreader Bar Needed, Pneumatic Tankers Precinct $ Per Ton $� 'Per Ib Bag Minimum Tons Minimum Bags Per Pallet Spreader Bar Needed, Pneumatic Tankers Precinct 3 $ Per Ton $ Per 47 Ib Bag inimum Tons Mini um Bags Per Pallet Spreader Bar Needed, Pneumatic Tankers Precinct 4-P $ Per Ton $ Per 47 Ib Bag Minimum Tons Minimum B gs Per Pallet Spreader Bar Needed, Pneumatic Tankers Precinct 4-S $ Per Ton $ Per 47 Ib Bag Minimum TonsT Minimum Bags Per Pallet L�rBaX eeded Pneumatic Tankers Page 5 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -1F HANDWRITTEN, MUST BE 1N INK AND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 6 of 9 ITEM 302, TYPE PE (TOPPING ROCK), GRADE 3, LRA (LIMESTONE ROCK ASPHALT), *Material Source out of Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ Per T Minimum Tons Precinct $ Per Ton Minimum Tons Precinct 3 $ Per Ton inimum Tons Precinct 4-P $ Per Ton Mini um Tons Precinct 4-S $ Per Ton Minimum Tons Page 6 of 9 ITEM 302, TYPE PE (TOPPING ROCK), GRADE 4, LRA (LIMESTONE ROCK ASPHALT), *Material Source out of Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $� Per Minimum Tons Precinct 2 $ Per Ton Minimum Tons Precinct 3 $ Per Ton Minimum Tons Precinct 4-P $ Per Ton Mini mTons Precinct 4-S $ Per Ton Minimum Tons Page 6 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 7 of 9 ITEM 330, TYPE D (PRE -MIX LIMESTONE) Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ Per To Minimum Tons Precinct 2 $ Per Ton Minimum Tons Minimum Tons Minimum Bags Precinct 3 $ i Per Ton Minimum Tons $ Per Ton $ Per 50 Ib Bag Minimum Tons mmum Bags Precinct 4-P $ Per Ton Min um Tons Precinct 4-P $ Per Ton $ Per 50 Ib Bag Precinct 4-S $ Per Ton Minimum Tons Precinct 4-S Page 7 of 9 ITEM 330 D, POTHOLE REPAIR, LIMESTONE ROCK ASPHALT (LRA) Cost per Unit Minimum Load/Order Type of Delivery (end or Belly Dump) Precinct $ Per T, $_ lb B \ Minimum Tons ( Minimum Bags r Precinct 2 $ Per Ton $ Per 50 lb Bag Minimum Tons Minimum Bags Precinct 3 $ Per Ton $ Per 50 Ib Bag Minimum Tons mmum Bags Precinct 4-P $ Per Ton $ Per 50 Ib Bag Minimu Tons Minimum Bags -- Precinct 4-S $ Per Ton $ Per 50 Ib Bag Minimum Tons Minimum Bags Page 7 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INKAND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 8 of 9 ITEM 334, TYPE D, HOT MIX COLD LAID ASPHALT CONCRETE PAVEMENT Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ 3q.00 Per Ton d.5 Minimum Tons Precinct 2 $ $L'• VO Per Ton 9Y- Minimum Tans r amu; Precinct 3 $ Per Ton :9r Minimum Tons ('}-(•ut' Precinct 4-P $ 0 L ,GfS Per Ton } - Minimum Tons Precinct 4-S $ Per Ton Minimum Tonsi Page 8 of 9 ITEM 432 RIPRAP, SECTION 2.3 STONE RIPRAP, 12" LIMESTONE Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ Per f Minimum Tons Precinct 2 $ Per Ton Minimum Tons Precinct 3 $ Per Ton Minimu Tons Precinct 4-P $ Per Ton Minimum Tons Precinct 4-S $ Per Ton Minimum Tons Page 8 of 9 Invitation To Bid Form - Road Materials The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation To Bid Package and fully understands and has complied with all instructions, specifications, and general conditions. Authorized Signature & Printed Name & Title: Exceptions and or Variations from Specifications or Notes: /Uu Date: �j 3 c 111 Page 9 of 9 Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.391-8U39C CERTIFICATE OF INTERESTED PARTIES FORM 1295 left Complete Nos. 1- 4 and 6 if there are interested parties. Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY 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. 2019-496965 Quality Hot Mix, Inc. EI Campo, TX United States Date Filed: 05/29/2019 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County 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. 2019.07-12.RM Road Materials Nature of interest 4 Name of Interested Party City, State, Country (place of business) (check applicable) Controlling I Intermediary Snyder, Jeffrey EI Campo, TX United States X 5 Check only if there is NO Interested Party. EJ 6 UNSWORN DECLARATION(} j) I My name is �� r�i � :L` S a, t) 1. C and my date of birth is _ II z �t My address is P u k'I � i tM Qij I // /l r? q .3 % �� CCA L / (street) (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. '' ryry Executed in it �c C t6A County, State of �k , on the G day of fu2-y_, 201 (month) (year) Signature of authorize&4gentWcontrakefing business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.391-8U39C Forms provided by Texas Ethics Commission www.ethics.state.tx.us version v1.1.3918039c CERTIFICATE OF INTERESTED PARTIES FORM 3.295 10f1 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. 2019-496965 Quality Hot Mix, Inc. EI Campo, TX United States Date Filed: 05/29/2019 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 07/02/2019 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. 2019.07-12.RM Road Materials Nature of interest 4 Name of Interested Party City, State, Country (place of business) (check applicable) Controlling I Intermediary Snyder, Jeffrey EI Campo, 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 v1.1.3918039c Please Type. If handwritten, must be in ink and legible Vendor Name: (u I i %aF M) T4(.. Address: �L—1 Lir vn4,( I x ty31 Remittance Address: Q Q V3uK ()- `j Tele Fax: E�. Campo i X `77y 37 Signature of Authorized Representative: Printed name of Authorized Rep: Tk 9 ' njer' Order Contact Name & Title:' Son ig 9:i Order Contact Telephone: __MMMK_ Order Contact Fax: Order Contact Emai STATE OF TEXAS {} COUNTY OF CALHOUN {} BEFORE ME, the undersigned authority, on this day personally appeared -a t 'p �NV dCr known to me to be the person whose name is subscribed to the following, who, upon oath says: I am the Manager, Secretary, or other Agent or Officer or the Principal of the Bidder in the matter of the bids to which this affidavit is attached, and I have full knowledge of the relations of the Bidder with the other firms in this same line of business, and the Bidder is not a member of any trust, pool or combination to control the price of supplies bid on, or to influence any person to bid or not to bid thereon. I further affirm that the Bidder has not given, offered to give, nor intends to give at any time hereafter any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to a public servant in connection with the submitted bid. Affiant SWORN TO AND SUBSCRIBED BEFORE ME by the above Affiant, who, on oath, states that the facts contained in the above are true and correct, this 26tv, , day of MF4 20_. o Y PioARNETT _ " COMM. EXPIRES 92.99.2022 v-- =t _ �4haSflp NOTARY ID 9934552-8 I — " Notary Public in and for 1/ill��OA� County, Texas Phone Number Fax Number Email Address NOTE: BIDS NOT ACCOMPANIED BY THIS AFFIDAVIT WILL NOT BE CONSIDERED The County of Calhoun does not discriminate on the basis of race, color, national origin, sex, religion, age, or disability in employment or the provision of services. a� Request for Taxpayer Give Form to the Fonn (Rev. Octad '2078) Identification filuea�ber af1C@ Certification requester. Do not Depanm¢nt of the Treasury send to the IRS. Internal Revenue Service P- Go to www.frs9ov1FbmnW9 for instructions and the latest information. 7ameff(as sho nop your mem tax retum,),7e is requir oont'a line; do not leave this fine blank or 2 Business trameldisregfrded entity name, it different from above `. m 3 Check appropriate box for federal tax classification ofthe person whose name Is entered on line 1. Check only one of the 4 Exemptions (codes apply only to On following seven boxes. certain entities, not individuals; see a o ElIndivlduallsole proprietor or 9C Corporation ❑SCorporation ❑ Partnership ❑TrusUestate instructions on page 3): w or c single -member LLC Exempt payee code (if any) o Unnited liability company. Enter the tax classification C=C corporation, S=S corporation, P=Padnomhl P `o Note: Check the appropriate box In the line above for the tax classification of the single -member owner. Donotcheck Exemption from FATCA reporting e H LLC if the LLC is classified as a single -member LLC that is disregarded from the owner unlessihe ownerof the LLC is codeen) (it Y a Ia another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that Is dlsregarr ed from the owner should check the appropriate box for the tax classificatlon of Its owner. re w ❑ Other (see Instructions)> Wyt•:ma nsmaxr+wuowueuwus)- y5Address umber, street, andits no.) See instructions,Remi Address apt. or u I Requester's name and addess(aptionall m r t 9 6�WPtR 6 Casae, dZlP coda r,�,.., --,57 tber(s) Ust account numItem(op (optional) MRM Taxpayer Identification Number (TIN) Enteryour TIN in the appropriate box. The TIN provided most matchthe name given on line 1 to avoid Social security number security numberISSN).However, fora backup withholding. For Individuals,etrordisregarded seeInst resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entity, 111 entities, it is your employer identification number (EIN). If you do not have a number, see How to gate TIN, later. or Note: if the account is In more than one name, seethe Instructions for line 1. Also see What Name and i - E toerdentification nu i Number To Give the Requester for guidelines on whose number to enter. .. 1. The number shown on this form is my correct taxpayer identification number (or I am waiting fora number to be issued to me); and 2.1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report ail interest d dividends on your ax return. For real estate transactions, Rem 2 does not apply, For mortgage interest paid, acquisition or abandonment ofs ud property, conceit ti nqf debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividend y are not required tq si r, e certification, but you must provide your correct TIN. See the instructions for Part II, later. of n General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.fcs.gcw1FonnW9. Purpose of Form An Individual or entity (Form W-9 requester) who is required to file an Information return with the IRS must obtain your correct taxpayer Identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an Information return. Examples of information returns Include, but are not limited to, the following. • Form 1099 -INT interest earned or paid) Code> '-) I'Ji, . •f • Form 1099 -DN (dividends, including those from stocks or mutual funds) • Form 1099-MISO (various types of income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Farm W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TM, you might be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231X Form W-9 (Rev, 10.2018) CALHOUN COUNTY, TEXAS For the period beginning July 1, 2019 and ending December 31, 2019 Vendor's Name and Address: 25 T YOU ARE INVITED TO SUBMIT A BID ON THE FOLLOWING ROAD MATERIALS TO: Honorable Richard H. Meyer, Calhoun County Judge Calhoun County Courthouse 211SAnn St 3rd Floor, Suite 301 Port Lavaca, TX 77979 SEALED BIDS DUE: 2:00 PM, Wednesday, June 5, 2019 Sealed bids are due at the above address. The outside of the 9 x 12 or larger envelope must be marked: Sealed Bid - Road Materials if you send your bid by UPS, FEDEX, etc, the outside of this envelope must be clearly marked: Sealed Bid - Road Materials All charges must be included in bid price or clearly stated on the bid form or on a separate attachment to the bid and labeled as such. To be a valid bid, the following forms must be returned: /1. Invitation To Bid Form (Pages 1- 9) v2. Form 1295 ✓3. Vendor and Order Information Form Z4. Affidavit V,5. W-9 Upon acceptance and approval by Calhoun County Commissioners' Court, this bid will be the working contract between the County and the successful bidder for the period designated. Page 1 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 2 of 9 PE S AGGREGATE Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct I $ t 4 . _ Per Ton L� Minimum Tons e n Precinct $�0 c PerTon > L Minimum Tons , Precinct $>> f3 Per Ton 4 Minimum Tons Minimum Tons Precinct 4-P Per Ton `� Minimum Tons ( ' Precinct 4-S $ .c Per Ton 1 `4 A MinimumTons Minimum Tons Page 2 of 9 LIMESTONE -3/4 INCH TO DUST Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ i\,)s Per Ton Minimum Tons Precinct 2 $ Ii_. Per Ton Minimum Tons Precinct 3 $ i C Per Ton Minimum Tons Precinct 4-P $ (it Per Ton Minimum Tons Precinct 4-S $ Per Ton Minimum Tons Page 2 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 3 of 9 ITEM 247, TYPE A LIMESTONE GRADE 2 [13/4 INCH] Cost Per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ ' . e PerTon s Minimum Tonsgc>t t ,g I Precinct 2 PerTon Minimum Tons` _ Precinct 3 $ " • C) PerTon Minimum Tons ...8 1 Precinct 4-P e. C "i�_�� $ PerTon Minimum Tons -A Precinct 4-S $ % PerTon Minimum Tons C` Page 3 of 9 ITEM 247, TYPE A LIMESTONE, GRADE 3 [13/4 INCH] Cost per Unit Minimum Load/Order Type of (End or Belly Dump) Precinct $t i PerTon Minimum Tons €Dielivery �V�4Ak _1 I Precinct 2 $ « PerTon ° Minimum Tons Precinct 3 PerTon Minimum Tonsr ...8 Precinct 4-P $L-[, ~> PerTon, Minimum Tons Precinct 4-$ $Ll) ° f ti) PerTon. Minimum Tons l �, Page 3 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE - NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 4 of 9 ITEM 247, TYPE B (FLEXIBLE PROCESSED BASE), GRADE 2 Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ WS Per Ton Minimum Tons Precinct $ S Per Ton Minimum Tons Precinct 3 $ 4Vy Per Ton Minimum Tons Precinct 4-P $ N y Per Ton Minimum Tons Precinct 4-S $ PerTon Minimum Tons Page 4 of 9 ITEM 247, TYPE B (FLEXIBLE PROCESSED BASE), GRADE 3 Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ Per Ton Minimum Tons Precinct 2 $ Per Ton Minimum Tons Precinct 3 $ Per Ton Minimum Tons Precinct 4-P $ it Gy Per Ton Minimum Tons Precinct 4-S $ Per Ton Minimum Tons Page 4 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 5 of 9 ITEM 275, CEMENT (ROAD MIXED) ITEM 275-2.1, HYDRAULIC CEMENT TYPE 1 Cost per Unit Minimum Load/Order Type of Delivery Precinct 1 $ Per Ton Per 47 Ib Bag Minimum Tons Minimum Bags Per Pallet Spreader Bar Needed, Pneumatic Tankers Precinct 2 r� $ Per Ton $ _ Per 47 Ib Bag Minimum Tons Minimum Bags Per Pallet Spreader Bar Needed, Pneumatic Tankers Precinct 3 $ Per Ton $ `t.. Per 47 Ib Bag Minimum Tons Minimum Bags Per Pallet Spreader Bar Needed, Pneumatic Tankers Precinct 4-P $ 5' Per Ton $ .i Per 47 Ib Bag Minimum Tons Minimum Bags Per Pallet Spreader Bar Needed, Pneumatic Tankers Precinct 4-S $ Per Ton $ Per 47 Ib Bag Minimum Tons Minimum Bags Per Pallet Spreader Bar Needed, Pneumatic Tankers Page 5 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INKAND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 6 of 9 ITEM 302, TYPE PE (TOPPING ROCK), GRADE 3, LRA (LIMESTONE ROCK ASPHALT), *Material Source out of UVAkAe C * Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct .� PerTon. Minimum Tons -0' Precinct 2 $ , c PerTon �� Minimum Tons ("'AA Precinct 3 Precinct $(CPerTon Minimum Tons r=C)�'_\ Precinct 4-P Precinct 4-P $ t> a PerTon a r Minimum Tons -0,1A Precinct 4-S Precinct 4-S $ 1e C}., < PerTon = 0 Minimum Tons (A Page 6 of 9 ITEM 302, TYPE PE (TOPPING ROCK) GRADE 4, LRA (LIMESTONE ROCK ASPHALT), *Material Source out of �TU Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct $�DO,'A'_A PerTon t Minimum Tons �'i Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INKAND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 7 of 9 ITEM 330, TYPE D (PRE -MIX LIMESTONE) Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ \ C Per Ton A Minimum Tons C' -C\ Precinct 2 $ t •. Per Ton Minimum Tons ' `A Minimum Tons Minimum Bags Precinct 3 $ 4 t' Per Ton_ Minimum Tons t1 $ -S Per Ton $$! Per 50 Ib Bag Precinct 4-P $ Per Ton b Minimum Tons . Precinct 4-S $� t1 �`. Per Ton tA'A Minimum Tons Page 7 of 9 ITEM 330 D, POTHOLE REPAIR, LIMESTONE ROCK ASPHALT (LRA) Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 - Per Ton $ fAa 5 Per 50 lb Bag Minimum Tons Minimum Bags Precinct 2 $ IN 1�5N Per Ton $ MA Per 50 lb Bag Minimum Tons Minimum Bags Precinct $ -S Per Ton $$! Per 50 Ib Bag Minimum Tons Minimum Bags Precinct 4-P $ &Z Per Ton $ NS Per 501b Bag Minimum Tons Minimum Bags Precinct 4-S $ i -s Per Ton $ % Per 50 lb Bag Minimum Tons Minimum Bags Page 7 of 9 Invitation To Bid Form - Road Materials PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 8 of 9 ITEM 334, TYPE D, HOT MIX COLD LAID ASPHALT CONCRETE PAVEMENT Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 hu $ 1_� Per Ton Minimum Tons Precinct $ ' 9 Per Ton Minimum Tons Precinct 3 $ V�S Per Ton Minimum Tons Precinct 4-P k, $ ` Per Ton Minimum Tons Precinct 4-S $ Per Ton Minimum Tons Page 8 of 9 ITEM 432 RIPRAP, SECTION 2.3 STONE RIPRAP, 12" LIMESTONE Cost per Unit Minimum Load/Order Type of Delivery (End or Belly Dump) Precinct 1 $ i 1 Per Ton Minimum Tons Precinct 2 $ 1 t Per Ton Minimum Tons Precinct 3 $ Per Ton Minimum Tons Precinct 4-P $ - Per Ton Minimum Tons Precinct 4-S $ ,f,> Per Ton Minimum Tons Page 8 of 9 Invitation To Bid Form - Road Materials The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation To Bid Package and fully understands and has complied with all instructions, specifications, and general conditions. Authorized Signature & Printed Name & Title:_ Exceptions and or Variations from Specifications or Notes: Date:''A�)t Y 46(-11 Page 9 of 9 CERTIFICATE OF INTERESTED PARTIES FORM 1295 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 Name of business entity filing form, and the city, state and country of the business entity's place Certificate Number: of business. 2019-499009 Vulcan Construction Materials LLC San Antonio, TX United States Date Filed: --- _. __.._-__.._._, _,_... .............r....... - +h- —+—+ f— ... k;,k a6m a..,.. ,. 06/03/2019 being filed. Calhoun County 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. 2019.07-12.RM Road Materials Name of Interested Party Vulcan Construction Materials LLC Check only if there is NO Interested Party. UNSWORN My name is My address City, State, Country (place of business) Birmingham, AL United States Fol of I declare under penalty of perjury that the foregoing is true and correct. meq+ \ Executed in _ County, State of ` �, , on the�day of fr� f/ (month) (year) Signature of authorizetl agent of contracting business entity (Declarant) Forms Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.. f8039c CERTIFICATE OF INTERESTED PARTIES FORM 1295 loll 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. 2019-499009 Vulcan Construction Materials LLC San Antonio, TX United States Date Filed: 06/03/2019 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 07/02/2019 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. 2019.07-12.RM Road Materials Nature of interest 4 Name of Interested Party City, State, Country (Place of business) (check applicable) Controlling I Intermediary Vulcan Construction Materials LLC Birmingham, AL 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.. f8039c Please Type. If handwritten, must be in ink and legible Vendor Name: � C.f .i�; � sty S L� C� \ li)�� f� f c ti rj Address: 3�'tc"oR\(>i ; Remittance Address: Telephone: Fax: Email: Signature of Authorized Representative: `a1i Printed name of Authorized Rep: L '\J "� vA Order Contact Name & Tit] Order Contact Telephone: Order Contact Fax: Order Contact Email: •* • STATE OF TEXAS {} 41yyI7_1T/ COUNTY OF CALHOUN {} BEFORE ME, the undersigned authority, on this day personally appeared r\ known to me to be the person whose name is subscribed to the following, who, upon oath says: I am the Manager, Secretary, or other Agent or Officer or the Principal of the Bidder in the matter of the bids to which this affidavit is attached, and I have full knowledge of the relations of the Bidder with the other firms in this same line of business, and the Bidder is not a member of any trust, pool or combination to control the price of supplies bid on, or to influence any person to bid or not to bid thereon. I further affirm that the Bidder has not given, offered to give, nor intends to give at any time hereafter any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to a public servant in connection with the submitted bid. F-IT10 T SWORN TO AND SUBSCRIBED BEFORE ME by the above Affiant, who,,.on oath, states that the facts contained in the above are true and correct, this _ day of .Lj;a r, e- 200 io�wvroa� AMY NICOLE CONAGHAN NOTARY PUBLIC " * STATE OF TEXAS MY COMM. EXP. 5/22/2021 NOTARY ID# 13113878-5 Name of Bidder ° , A Signed By Title Address Phone Number Fax Number Email Address Notary Public in and for C,<1°; County, Texas NOTE: BIDS NOT ACCOMPANIED BY THIS AFFIDAVIT WILL NOT BE CONSIDERED The County of Calhoun does not discriminate on the basis of race, color, national origin, sex, religion, age, or disability in employment or the provision of services. Enter your TlN in the appropriate box. The TIN provided must match the name given online 1 to avoid ( Social security number Request for 'taxpayer backup withholding. For individuals, this is dgenerallyentity, your social security ebony number (SSN). However, for a resident ellen, sole proprietor, or disregarded entity, see the Instructions for Pert I, later, For, Give Farm to the Form (Rev. October 2015) Identification Number and Certification 1 — m requester. Do not Depprimont of the Treasury Internal Revenue service Y Go to www.trs.go r/FarmW9 for Instructions and the latest informatlon. send to the IRS. 1 Name (as shown on your Income tau return). Name Is required on this line; do not leave this line blank. TIN, later. or J� U G ; _ V�LC4 �✓/ t _L,j @V�iTCC 2 89alness nametdisregarded entry name. it different from above I v' dP 3 Check appropriate box for federal tax classification of the person whose name is entered on lined 1. Check only one of the Y following seven boxes./ 4 Exemptions codes apply only to P ( PPY Y certain entitles, trot Individuals; sae o• o L_�,( ElIndividual/sole proprietor or C Corporation ❑ S Corporation ❑ Partnership ❑ TrusNestate inatrucdona on page 3j: a, single -member LLC Exempt payea code (if any) 0 ❑ Limited liability company. Enter ihB tax classification (C=C corporation, 8=9 corporation, P=Partnership) D `p t NOW Check the appropriate box in the line above for the tax classification of the single -member owner. Do not check LLC If the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is Exemption from FATCA reporting aT U another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a singlo-member LLC that code Of any) Is disregarded from the owner should check the appropriate box for the tax classification of its owner. y ❑ Other (see Instructions) U.S.) 5 Address (number, street, and apt. or suite no.) See Instructions. -- Requester's name and address (optional) Cor i i A) , x 3 -Mo J4� l Zva i)r� ltv �n v Q �ic� e City, state, and ZIP code Ic -t,�SZ39'-SO/L� ,ka✓w 7 List account numb r(e here (o tior ao - Bin Taxpayer Identification Number (TiN) Enter your TlN in the appropriate box. The TIN provided must match the name given online 1 to avoid ( Social security number backup withholding. For individuals, this is dgenerallyentity, your social security ebony number (SSN). However, for a resident ellen, sole proprietor, or disregarded entity, see the Instructions for Pert I, later, For, — m r _� entities, it is your employer Identification number (EIN). If you do not have, a number, see Now [o gala TIN, later. or Note: if the account Is in more than one name, see the Instructions for line 1. Also see What Name and CEmployer identification number Number To Give the Requester for guidelines on whose number to enter. Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer Identification number (or I am wafting for a number to be Issued to me); and 2. 1 am not subject to backup withholding because; (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form of any) indicating that I am exempt from FATCA reporting Is correct. Cartifloation instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributfons to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part fl, later, Fe signstureor C` Nere U.5. parson■ General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest Information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov1FormW9. Purpose of Form An Individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer Identification number (ITIN), adoption taxpayer Identification number (ATIN), or employer identification number (EIN), to report on an Information return the amount paid to you, or other amount reportable on an Information return. Fxampies of Information returns Include, but are not limited to, the following. • Form 1099 -INT (interest earned or paid) Date), /(/) • Form 1099 -DIV (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-5 (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-8 (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage Interest), 1090-E (student loan Interest), 1095-T (tuition) • Form 1099-0 (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (Including a resident alien), to provide your correct TIN. Ifyou do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What Is backup withholding, later. Cat. No. 10231X Forth VMJI (Rev, 10-2018) Calhoun County Commissioners' Court—LUNE 19, 2019 14. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 12) To award vids for Asphalts, Oils and Emulsions for period beginning July 1, 2019 and ending December 31, 2019. (RM) RESULT: APPROVED[UNANIMOUS] MOVER, Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 12 of 25 C=TOR LER � �z Im PEGGY HALL CRISTINA P TUAZON 202 S ANN ST, STE B DEMI CABRERA CANDICE VILLARREAL PORT LAVACA, TEXAS 71979 ERICA PEREZ 11TASSISTANTAUDITOR TELEPHONE 13611553-4610FAX (36115534614 ASSISTANT AUDITORS June 12, 2019 TO: Honorable Richard H. Meyer Calhoun County Judge RE: Agenda Item for Commissioners' Court Wednesday, June 19, 2019 Please place the following item on the Commissioners' Court Agenda for June 19, 2019. • Consider and take necessary action to award bids for Asphalts, Oils and Emulsions for the period beginning July 1, 2019 and ending December 31, 2019. Thank you, Peggy Haff Assistant Auditor C PEGGY HAIL CRISTINA P TUMOR 202 S ANN ST, STE R DEMI CADRERA CANDICE VILLARREAL PORT LAVACA, TENAS 77979 ERICA PEREZ 1" ASSISTANT AUDITOR TELEPHONE 13 611 553-4610 FAHL36115534614 ASSISTANT AUDITORS RECAP OF BID TABULATION ASPHALTS, OILS & EMULSIONS For the period beginning July 1, 2019 and ending December 31, 2019 Contract Number: 2019.07-12.AOE The County received bids on the following: Primer Oil AC -5 RC250 CRS -2 CRS -2P The actual bids are attached. Please review each bid to confirm the low bid. CALHOUN COUNTY, TEXAS BID TABULATION ASPHALTS, OILS AND EMULSIONS For the period beginning July 1, 2019 and ending December 31, 2019 Page 1 of 2 PRIMER OIL Minimum Returned All Returned All County Cost per Gallon Demurrage Low Bid Vendor Minimum Exceptions Required Department Order Order Information Information Precinct 1 Pages 1-4 of Pages 1-4 of All prices based on minimum 5,000 Bid Form 4 Precinct 2 $20.00/Hour $60.00/Hour Martin Asphalt Cleveland Asphalt gallon load. For smaller quantities 1295 q Precinct 3 $2.65/Gallon After 2 Free Hours X Products Inc 5,000 Gallons please call. Diluted loads can not Info Form) Precinct 4-P be returned for credit. Affidavit J Precinct 4-S W-9 4 w-9 d ------------- Precinct 1 '----------------------------------- .-------------------------------- ._________ -"""--------------- _________------ ----------------__-------------'___ _________--' Pages 1-4 of All prices based on minimum 5,000 Bid Form Bid Form q Precinct 2 $60.00/Hour $20.00/Hour Cleveland Asphalt Martin Asphalt gallon load. For smaller quantities 1295) 1295' Precinct 3 $3.01/Gallon After 2 Free Hours Products Inc Company 5,000 Gallons Info Form4 Info Form'q Precinct 4-P returned for credit. Affidavit Affidavit Precinct 4-S w-9 4 w-9 q AC -5 Minimum Returned All County Cost per Gallon Demurrage Low Bid Vendor Exceptions Required Department Order Information Precinct 1 Pages 1-4 of Bid Form q Precinct 2 $20.00/Hour Martin Asphalt 12954 Precinct 3 $2.14/Gallon After 2 Free Hours X Company 5,000 Gallons Info Form'V Precinct 4-P Affidavit V Precinct 4-5 W-9 4 ___-------"- Precinct 1 --------------- ------------------- .-------------------------------- ---_______"'__ -___------------------------------- ------------ Pages 1-4 of All prices based on minimum 5,000 Bid Form Precinct 2 $60.00/Hour Cleveland Asphalt gallon load. For smaller quantities 1295) Precinct3 $3.00/Gallon After 2 Free Hours Products Inc S,000Gallons please call. Diluted loads can not be Info Form4 Precinct 4-P returned for credit. Affidavit Precinct 4-S w-9 4 RC250 Minimum Returned All County Cost per Gallon Demurrage Low Bid Vendor Exceptions Required Department Order Information Precinct 1 Pages 1-4 of Bid Form Precinct 2 $20.00/Hour Martin Asphalt J Precinct 3 $2.91/Gallon After 2 Free Hours X Company 5,000 Gallons Info Form Info Precinct 4-P Affidavit Precinct 4-S w-9 q -------------'--------------- Precinct 1 ------------------- .-------------------------------- --------------------------------------------------- ------------- Pages 1-4 of All prices based on minimum 5,000 Bid Form 4 Precinct 2 $80.00/Hour Cleveland Asphalt gallon load. For smaller quantities 1295') Precinct 3 $3.55/Gallon After 2 Free Hours Products Inc 5,000 Gallons please call. Diluted loads can not be Info Form) Precinct 4-P returned for credit. Affidavit J Precinct 4-S w-9 4 BID TABULATION -ASPHALTS, OILS AND EMULSIONS -FOR THE PERIOD BEGINNING JULY 1, 2019 AND ENDING DECEMBER 31, 2019 Page 2 of 2 CRS -2 Minimum Returned All County Cost per Gallon Demurrage Low Bid Vendor Exceptions Required Department Order Information Precinct 1 Pages 1-4 of All prices based on minimum 5,000 Bid Form J Precinct 2 $60.00/Hour Cleveland Asphalt gallon load. For smaller quantities 1295 J Precinct 3 $2.15/Gallon After 2 Free Hours X Products Inc 5,000 Gallons please call. Diluted loads can not Info Form) Precinct 4-P be returned for credit. Affidavit) Precinct 4-5 W-9 4 ------------- Precinct 1 '----------------------------------- .--------' -------------------------------- __------------- ----------------_______________"" -_---------- Pages 1-4 of Bid Form J Precinct 2 $70.00/Hour Martin Asphalt 12954 Precinct $2.16/Gallon After 2 Free Hours Company 5,000 Gallons Info Form) Precinct 4-P Affidavit J Precinct 4-5 W-9 J CRS -2P Minimum Returned All County Cost per Gallon Demurrage Low Bid Vendor Exceptions Required Department Order Information Precinct 1 Pages 1-4 of Bid Form 4 Precinct 2 $70.00/Hour Martin Asphalt 1295 J Precinct 3 $2.61/Gallon After 2 Free Hours X Company 5,000 Gallons Info Form) Precinct 4-P Affidavit J Precinct 4-5 W-9 4 ------------- Precinct 1 '----------------------------------- .____""- ---------------------- ---_________"' ---------------------------""-"' -____------- Pages 1-4 of All prices based on minimum 5,000 Bid Form J Precinct 2 $80.00/Hour Cleveland Asphalt gallon load. For smaller quantities 1295 J Precinct 3 $2.75/Gallon After 2 Free Hours Products Inc 5,000 Gallons please call. Diluted loads can not be Info Form) Precinct 4-P returned for credit. Affidavit) Precinct 4-5 W-9 4 CALHOUN COUNTY, TEXAS Fivi a M F.410 c6 O For the period beginning July 1, 2019 and ending December 31, 2019 Vendor's Name and Address: Cleveland Asphalt Products, INC. PO Box 1449 Shepherd, TX 77371 YOU ARE INVITED TO SUBMIT A BID ON THE FOLLOWING ASPHALTS OILS & EMULSIONS TO: Honorable Richard H. Meyer, Calhoun County Judge Calhoun County Courthouse 211SAnn St 3rd Floor, Suite 301 Port Lavaca, TX 77979 SEALED BIDS DUE: 2:00 PM, Wednesday, June 5, 2019 Sealed bids are due at the above address. The outside of the 9 x 12 or larger envelope must be marked: Sealed Bid - Asphalts, Oils & Emulsions If you send your bid by UPS, FEDEX, etc, the outside of this envelope must be clearly marked: Sealed Bid -Asphalts, Oils & Emulsions All charges must be included in bid price or clearly stated on the bid form or on a separate attachment to the bid and labeled as such. To be a valid bid the following forms must be returned: J� Invitation To Bid Form (Pages 1- 4) ✓ 2. Form 1295 �1. Vendor and Order Information Form 4. Affidavit 5, W-9 Upon acceptance and approval by Calhoun County Commissioners' Court, this bid will be the working contract between the County and the successful bidder for the period designated. Page 1 of 4 Invitation to Bid Form - Asphalts, Oils and Emusions PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE - NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 2 of 4 PRIMER OIL Cost per Gallon Demurrage Minimum Order Precinct 1 $ 2.65 Per Gallon $ $80.00 Per Hour After 2 Free Hours 5000 Gallons Precinct 2 $ 2.65 Per Gallon $ 80.00 Per Hour After 2 Free Hours 5000 Gallons Precinct 3 $ 2.65 Per Gallon $ $80.0 Per Hour After 2 Free Hours 5000 Gallons Precinct 4-P $ 2.65 per Gallon $ 80.00 Per Hour After 2 Free Hours 5000 Gallons Precinct 4-S $ 2.65 Per Gallon $ $80.00 Per Hour After 2 Free Hours 5000 Gallons Page 2 of 4 AC -5 Cost per Gallon Demurrage Minimum Order Precinct 1 $ 3.00 Per Gallon $_J80.00 Per Hour After 2 Free Hours 5000 Gallons Precinct 2 $__1.00 Per Gallon $ $80.0 Per Hour After 2 Free Hours 5000 Gallons Precinct 3 $_.3.00 Per Gallon $_$80.00 Per Hour After 2 Free Hours 5000 Gallons Precinct 4-P $ 3.00 Per Gallon $_$80.00 Per Hour After 2 Free Hours 5000 Gallons Precinct 4-S $ 3.00 Per Galion $ $80.0 Per Hour After 2 Free Hours 5000 Gallons Page 2 of 4 Invitation to Bid Form -Asphalts, Oils and Emusions PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 3 of 4 RC250 Cost per Gallon Demurrage Minimum Order Precinct 1 $ 3.55 Per Gallon $ $80.0 Per Hour After 2 Free Hours 5000 Gallons Precinct 2 $ 3.55 Per Gallon $ $80.00 Per Hour After 2 Free Hours 5000 Gallons Precinct 3 $ 3.55 Per Gallon $ $80.00 Per Hour After 2 Free Hours 5000 Gallons Precinct 4-P $ 3.55 Per Gallon $ $80.0 Per Hour After 2 Free Hours 5000 Gallons Precinct 4-S $ 3.55 Per Gallon $ $80.0 Per Hour After 2 Free Hours 5000 Gallons Page 3 of 4 CRS -2 Cost per Gallon Demurrage Minimum Order Precinct 1 $ 2.15 Per Gallon $$80,0 Per Hour After 2 Free Hours 5000 Gallons Precinct 2 $ 2.15 Per Gallon $$80.0 Per Hour After 2 Free Hours 5000 Gallons Precinct 3 $ 2.15 Per Gallon $ $80.00 Per Hour After 2 Free Hours 5000 Gallons Precinct 4-P $ 2.15 Per Gallon $_19.0.00 Per Hour After 2 Free Hours 5000 Gallons Precinct 4-S $ 2.15 Per Gallon $ 80.00 Per Hour After 2 Free Hours 5000 Gallons Page 3 of 4 Invitation to Bid Form - Asphalts, Oils and Emusions PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INKAND LEGIBLE - NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation To Bid Package and fully understands and has complied with all instructions, specifications, and general conditions. Authorized Signature & Printed Name & Title: Clayton Moore Sales Rep. Date; 5/29/2019 Exceptions and or Variations from Specifications or Notes: All prices based on minimum 5000 gallon load. For smaller quantities please call. Diluted loads can not be returned for credit. Page 4 of 4 CRS -2P Cost per Gallon Demurrage Minimum Order Precinct 1 $ 2.75 Per Gallon $ $80.00 Per Hour After 2 Free Hours 5000 Gallons Precinct 2 $ 2.75 Per Galion $ $80.0 Per Hour After 2 Free Hours 5000 Gallons Precinct 3 $ 2.75 Per Gallon $ $80.0 Per Hour After 2 Free Hours 5000 Gallons Precinct 4-P $ 2.75 Per Gallon $ $80.00 Per Hour After 2 Free Hours 5000 Gallons Precinct 4-S $ 2.75 Per Gallon $ 80.00 Per Hour After 2 Free Hours 5000 Gallons The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation To Bid Package and fully understands and has complied with all instructions, specifications, and general conditions. Authorized Signature & Printed Name & Title: Clayton Moore Sales Rep. Date; 5/29/2019 Exceptions and or Variations from Specifications or Notes: All prices based on minimum 5000 gallon load. For smaller quantities please call. Diluted loads can not be returned for credit. Page 4 of 4 Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.39f8039c CERTIFICATE OF INTERESTED PARTIES FORM 1295 10f1 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. .. 2019-497282 Cleveland Asphalt Products, INC. Shepherd, TX United States Date Filed: 05/29/2019 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County 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. 2019.07-12.AOE Asphalts, Oils & Emulsions Nature of interest 4 Name of Interested Party Ci ty,State, Country (place of business)(check applicable) Controlling I Intermediary 5 Check only if there is NO Interested Party. X 6 UNSWORN DECLARATION My name is Clayton Moore and my date of birth is b{ My address is PO Box 1449 Shepherd TX 77371 USA (street) (city) (state) (zip code) (country) 1 declare under penalty of perjury that the foregoing is true and correct. Executed in San Jacinto County, State of Texas , on the 29th day of May .20 19 . (month) (year) Signature of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.39f8039c CERTIFICATE OF INTERESTED PARTIES FORM 1295 loft Complete Nos. 1- 4 and 6 if there are interested parties. Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2019-497282 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Cleveland Asphalt Products, INC. Shepherd, TX United States Date Filed: 05/29/2019 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 07/02/2019 g 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. 2019.07-12.AOE Asphalts, Oils & Emulsions Nature of interest 4 Name of Interested Party City, State, Country (place of business) (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. Lai 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) .. va a on<nnon.. Forms provided by Texas Ethics Commission www.emics.state.Ec.us V M,U„ Please Type. If handwritten, must be in ink and legible Vendor Name: Cleveland Asphalt Products, INC. Address: PO Box 1449 Shepherd, TX 77371 Remittance Address: Department Number 936 PO Box 4652, Houston Texas 77210-4652 Telephone: Fax: Email: Signature of Authorized Representative: - Printed name name of Authorized Rep: Clayton Moore •' �c' �,• . t S order Contact Name & Title: Freida Ortiz, Office Manager Order Contact Telephone: Order Contact Fax: Order Contact Email: BEFORE ME, the undersigned authority, on this day personally appeared Clayton Moore known to me to be the person whose name is subscribed to the following, who, upon oath says: I am the Manager, Secretary, or other Agent or Officer or the Principal of the Bidder in the matter of the bids to which this affidavit is attached, and I have full knowledge of the relations of the Bidder with the other firms in this same line of business, and the Bidder is not a member of any trust, pool or combination to control the price of supplies bid on, or to influence any person to bid or not to bid thereon. I further affirm that the Bidder has not given, offered to give, nor intends to give at anytime hereafter any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to a public servant in connection with the submitted bid. SWORN TO AND SUBSCRIBED BEFORE ME by the above Affiant, who, on oath, states that the facts contained in the above are true and correct, this day of May 20 19 v AMIE FEARRINCT®r1 � � NOTARYPUBUC = STATE OF TEXAS a.-- * m 1®# 93133526-0 '�� °MycAmre,,Expiresto39-2029 Notary Public in and fo San Jacinto County, Texas Name of Bidder Cleveland Asphalt Products, INC. Signed By Title Address Phone Numbei Fax Number Email Address Clayton Moore 4 Sales Rep The County of Calhoun does not discriminate on the basis of race, color, national origin, sex, religion, age, or disability in employment or the provision of services. Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid I Social security number i backup withholding. For individuals, this is generally your social security form(Sate). However, fora [—M _ m ` resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer Identification number (EIN). if you do not have a number, see How to get a TIN, later. or Note: If the account is in more than one name, see the Instructions for line 1. Also see What Name and Employer idemification number Number To Give the Requester for guidelines on whose number to enter. Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be Issued to me); and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all Interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this toren (if any) Indicating that I am exempt from FATCA reporting Is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all Interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Pad 11, later. 01tir• Signature ofx. '" 5/29/2019 Her® U.S. person► � ra _ -- Dai General Instrt Section references are to t6eA&nal Revenue Code unless otherwise noted. Future developments. For the latest Information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to wWw.frs.gov/FormW9. Purpose of Form An Individual or entity (Form W-9 requester) who is required to file an Information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer Identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following. • Form 1099 -INT (interest earned or paid) • Fonn 1099 -DIV (dividends, Including those from stooks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (billion) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only If you are a U.S. person (including a resident alien), to provide your correct TIN. it you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) ® Request for Taxpayer Give Form to the Farm Identification Number and Certification requester. Do not (Rev. October 20181 "apartment of the Treasury send to the IRS. Internal Revenue Service 0- Go to www.irs.gov/FormW9 for instructions and the latest Information. I Name (as shown on your Income tax return). Name is required on this line; do not leave this line blank. Cleveland Asphalt Products INC. 2 Business name/disregarded entity name, it different from above w 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the 4 Exemptions (codes apply only to Ce following seven boxes. certain entities, not Individuals; see Instructions on page 3): p ❑ Individual/soler proprietor or Q C Corporation EIS Corporation ElPartnership ❑ Tms loslate a 2 single -member LLC Exempt payee code (ti any) � ❑ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership)► 0 2 Note: Check the appropriate box in the line above for the tax classification of the single -member owner, Do not check Exemption from FATCA reporting h LLC if the LLC Is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is LLC code (if any) .� another LLC that Is not disregarded front the owner for US. federal lax purposes. Otherwise, a single -member that n o w Is disregarded from the owner should check the appropriate box for the tax classification of Its owner. - y El Older (see instructions)► Nta'r•smxrwnsrnsnrxaa mrn,l•n,au S) m 5 Address (number, street, and apt, or supe no.) See instructions. Requester's name and address (optional) We PO Box 1449 _ S City, stale, and ZIP code Shepherd, Texas 77371 7 List account number(s) here (optional) Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid I Social security number i backup withholding. For individuals, this is generally your social security form(Sate). However, fora [—M _ m ` resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer Identification number (EIN). if you do not have a number, see How to get a TIN, later. or Note: If the account is in more than one name, see the Instructions for line 1. Also see What Name and Employer idemification number Number To Give the Requester for guidelines on whose number to enter. Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be Issued to me); and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all Interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this toren (if any) Indicating that I am exempt from FATCA reporting Is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all Interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Pad 11, later. 01tir• Signature ofx. '" 5/29/2019 Her® U.S. person► � ra _ -- Dai General Instrt Section references are to t6eA&nal Revenue Code unless otherwise noted. Future developments. For the latest Information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to wWw.frs.gov/FormW9. Purpose of Form An Individual or entity (Form W-9 requester) who is required to file an Information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer Identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following. • Form 1099 -INT (interest earned or paid) • Fonn 1099 -DIV (dividends, Including those from stooks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (billion) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only If you are a U.S. person (including a resident alien), to provide your correct TIN. it you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) CALHOUN COUNTY, TEXAS rLM110 ZfA • , _ • For the period beginning July 1, 2019 and ending December 31, 2019 Vendor's Name and Address: YOU ARE INVITED TO SUBMIT A BID ON THE FOLLOWING ASPHALTS OILS & EMULSIONS TO: Honorable Richard H. Meyer, Calhoun County Judge Calhoun County Courthouse 211SAnn St 3rd Floor, Suite 301 Port Lavaca, TX 77979 SEALED BIDS DUE: 2:00 PM, Wednesday, June 5, 2019 Sealed bids are due at the above address. The outside of the 9 x 12 or larger envelope must be marked: Sealed Bid - Asphalts, Oils & Emulsions If you send your bid by UPS, FEDEX, etc, the outside of this envelope must be clearly marked: Sealed Bid - Asphalts, Oils & Emulsions All charges must be included in bid price or clearly stated on the bid form or on a separate attachment to the bid and labeled as such. To be a valid bid, the following forms must be returned: 1. Invitation To Bi Form (Pages 1- 4) I/ 2. Form 1295 V J 3. Vendor and prder Information Form/ 4. Affidavit f 5. W-9 Upon acceptance and approval by Calhoun County Commissioners' Court, this bid will be the working contract between the County and the successful bidder for the period designated. Page 1 of 4 Invitation to Bid Form -Asphalts, Oils and Emusions PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 2 of 4 PRIMER OIL Cost per Gallon Demurrage Minimum Order Precinct 1 $ 3-01 Per Gallon $ ry 0 Per Hour After Free Hours 5zvo Gallons Precinct 2 $ 3.0' Per Gallon $-f2Q— Per Hour After $ Free Hours .5Zbo Gallons Precinct 3 $ �' Per Gallon $�iZ Per Hour After � Free Hours Ab Gallons Precinct 4-P $ ©� Per Gallon $10 Per Hour After $a Free Hours `Dy_X) Gallons Precinct 4-S $ J • Per Gallon $2_ Per Hour After A Free Hours 5 -ODD Gallons Page 2 of 4 AC -5 Cost per Gallon Demurrage Minimum Order Precinct 1 $ G• I Per Gallon $ `70 Per Hour After Free Hours O WD Gallons Precinct 2 $ 2• N Per Gallon $ W Per Hour After o% Free Hours ` O Gallons Precinct 3 $a Per Gallon $ 10 Per Hour After a Free Hours Gallons Precinct 4-P $% ' 1 Per Gallon $ '90 Per Hour After oZ Free Hours Gallons 10 5L Precinct 4-S $ v Per Gallon $ Per Hour After —1 Free Hours Gallons Page 2 of 4 Invitation to Bid Form - Asphalts, Oils and Emusions PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INKAND LEGIBLE -NOT RESPOSIBLE FOR ERRORS IF NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts Page 3 of 4 RC250 Cost Gallon Demurrage Minimum Order Precinct 1 /aper $ Per Gallon $ Per Hour After Free Hours 5CL70 Gallons Precinct 2 $ per Gallon $ Per Hour After 9" Free Hours Gallons Precinct 3 $ 2 ql Per Gallon $ Per Hour After Free Hours Gallons Precinct 4-P $ Per Gallon Per Hour After Free Hours TC100 Gallons Precinct 4-S $ Per Gallon $ /D Per Hour After Free Hours Ute/ Gallons Page 3 of 4 CRS -2 Cost per Galion Demurrage Minimum Order Precinct 1 $ `• % Per Gallon yn� $ !D Per Hour After orl� Free Hours nbD Gallons Precinct 2 $% Per Gallon $JID Per Hour After Free Hours 57,E Gallons Precinct 3 $ Per Gallon $ Per Hour After Free Hours Gallons Precinct 4-P $�� Per Gallon $ Per Hour After _C9 Free Hours Gallons Precinct 4-S $ Per Gallon $ Per Hour After a_ Free Hours - ()Ut/ Gallons Page 3 of 4 Invitation to Bid Form -Asphalts, Oils and Emusions PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INKAND LEGIBLE -NOT RESPOSIBLE FOR ERRORS 1F NOT LEGIBLE For Precinct Locations - See Contact Information for County Precincts The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation To Bid Package and fully understands and has complied with all instructions, specifications, and general conditions. Authorized Signature & Title: v Printed Name & Exceptions and or Variations from Specifications or Date: S -4/y/9 y/9 Page 4 of 4 CRS -2P Cost per Gallon Demurragen Minimum Order Precinct 1 $ o�� Per Gallon �7 $ dd Per Hour After d Free Hours Gallons Precinct 2 $�__ per Gallon $—qo Per Hour After Free Hours Gallons Precinct 3 $_ Per Gallon $ �b Per Hour Afteroz Free Hours _ Gallons Precinct 4-113 $� Per Gallon $ Per Hour After Free Hours Gallons Precinct 4-S $_ Per Gallon $ 10 Per Hour After Free Hours Gallons The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation To Bid Package and fully understands and has complied with all instructions, specifications, and general conditions. Authorized Signature & Title: v Printed Name & Exceptions and or Variations from Specifications or Date: S -4/y/9 y/9 Page 4 of 4 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 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 1 Name of business entity filing form, and the city, state and country of the business entity's place Certificate Number; of business. 2019-497368 Martin Asphalt Company Houston, TX United States Date Filed: 2 Name of governmental entity or state agency that is a party to the contract for which the form is 05/29/2019 being filed. CALHOUN COUNTY 3 Provide the identification number used by the governmental description of the services, goods, or other property to be p 2019.07-12.AOE ASPHALT OILS AND EMULSIONS Name of Interested Party 15 Check only If there is NO Interested Party. 16 UNSWORN DECLARATION My name is My address ME Date Acknowledged: or state agency to track or identify the contract, and provide a I under the contract. Nature City, State, Country (place of business) (check (stale) (zip code) (country) I declare under pe II�t�y of perjury that the foregoing is true and correct. Executed in �Ll�'J County, Stale of _—� on theta / q/��r�/�� day of 20 ` (m 1 (year) or amnonzeo nrnvidpd by Texas Version V1.1.39f8039c Forms provided by Texas Ethics Commission www.etnics.state.tx.us V ero o, . . .--- CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 Complete Nos. 1- 4 and 6 if there are interested parties. Complete Nos, 1, 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2019-497368 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Martin Asphalt Company Houston, TX United States Date Filed: 05/29/2019 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. CALHOUN COUNTY Date Acknowledged: 07/02/2019 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. 2019.07-12.AOE ASPHALT OILS AND EMULSIONS Nature of interest 4 Name of Interested Party City, State, Country (place of business) (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. Lij 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) naonon,. Forms provided by Texas Ethics Commission www.etnics.state.tx.us V ero o, . . .--- 11 : 11,4. •• k 11 1 0, Please Type. If handwritten, must be in ink and legible Vendor Name: Address: 3 k` Remittance Address Tele Fax: cS1rLt � / ASO P®30X 9`,310 -1-te YN —UO Order Contact Nam Order Contact Tele Order Contact Fax: ORDER INFORMATION Order Contact Email: COUNTY OF CALHOUN {} BEFORE ME, the undersigned authority, on this day personally appeared 1%1c A- �)n known to me to be the person whose name is subscribed to the following, who, upon oath says: I am the Manager, Secretary, or other Agent or Officer or the Principal of the Bidder in the matter of the bids to which this affidavit is attached, and I have full knowledge of the relations of the Bidder with the other firms in this same line of business, and the Bidder is not a member of any trust, pool or combination to control the price of supplies bid on, or to influence any person to bid or not to bid thereon. I further affirm that the Bidder has not given, offered to give, nor intends to give at any time hereafter any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to a public servant in connection with the submitted bid. Affiant SWORN TO AND SUBSCRIBED BEFORE ME by the above Affiant, who, on oath, states that the facts contained in the above are true and correct, this qY4 day of J rine 20ift—. STMANIE AGUIRRE -74 Notary PUNIC State of Texas -"' % My commission Expires $Optervibet 17, 2019 Notary Public in and for 0 �°3zpl'S County, Texas Name of Bidder Signed By Title Address Phone Number Fax Number Email Address NOTE: BIDS NOT ACCOMPANIED BY THIS AFFIDAVIT WILL NOT BE CONSIDERED The County of Calhoun does not discriminate on the basis of race, color, national origin, sex, religion, age, or disability in employment or the provision of services. Enter your TIN In the appropriate box. The TIN provided must match the name given on line 1 to avoid I social security number backup withholding, For individuals, this Is generally your social security number (SSN. However, lora resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, It is your employer identification number (EIN). If you do not have a number, see How to got a TIN, later. or Note: If the account Is In more than one name, see the instructions for line 1. Also see What Name and idonuncedon number Number To Give the Requester for guidelines on whose number to enter. Under penalties of perjury, I certify that: 1. The number shown on this form Is my correct taxpayer Iderthficatlon number (or I am waiting for a number to be Issued to me); and 2. 1 am not subject to backup withholding because: (a) i am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all Interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3.1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA codes) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification Instructions. You must crass out item 2 above If you have been notified by the IRS that you are currently subject to backup wilhholding because you have failed to report all interest and dividends on your tax return. For real estate transact ons, Item 2 does not apply, For mortgage Interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than Interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the Instructions for Part 11, later. Aer I U.S. Signature �/1% '/9//,7 Here f us.paraon► ��,,,,r� Date 0. General Instructions Section references are to the Internal Revenue Code unless otherwise noted. future developments. For the latest Information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9, Purpose of Form An Individual or entity (Form W-9 requester) who is required to file an Information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), Individual taxpayer Identification number (ITIN), adoption taxpayer Identification number (ATIN), or employer Identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an Information return. Examples of Information returns Include, but are not limited to, the following. • Form 1099 -INT (Interest earned or paid) • Form 1099 -DIV (dividends, Including those from stocks or mutual funds) • Form 1099-MISO (various types of Income, prizes, awards, or gross proceeds) • Farm 1099.8 (stock or mutual fund sales and certain other transactions by brokers) • Form 1099.5 (proceeds from real estate transactions) • Forth 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage Interest), 1098-E (student loan Interest), 1096-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only It you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. Sae What Is backup withholding, later. Cat. No, 10231x Form W-8 (Rev, 10.2018) W-9 Request far Taxpayer Give Form to the Forth ;flet. October 2018) Identification Number and Certification requester, Do not 3epanment of the Treasury send to the IRS. ntemal Revanue Service 1- Go to wwwits.gov/FormK'9 for instructions and the latest Information. 1 Name (as shown on your Income tax return). Name Is required on this line; do not leave this line blanH. MARTIN PRODUCT SALES LLC 2 Business name/disregarded entity name, If different from above MARTIN ASPHALT v 3 Check appropriate box for federal tax classification of the person whose name is entered on tine 1. Check only one of the 4 Exemptlons(codel apply only to g+ following seven boxes. certain entitles, not Individuals; see 3 Instructions an page 3): c ❑ IndiulduaUsole proprietor or C1C Corporation ❑ S Corporation ElPartnership ❑ Trusuestate ai c singlo-mombor LLC Exempt payee code (I any) 4a �' ❑J Umlled liability Company. Einar the tax classification (C=C corporation, S=S corporation, P=Padnarshlp)► S `o Note: Check the appropriate box in the line above for the tax classification of the single -member owner. Do not check Exemption from FATCA reporting ; G c LLC If the LLC Is classified as a sl lamombor LLC that Is disregarded from the owner unless the Owner 01 the LLC Is code (f an y) another LLC that Is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that o.` Is disregarded from the owner should check the appropriate box for the lax classification of Its Owner, ❑ Other(smi lnstructlons)► 4bowrroxca,nn,,,w,w,rd ouutrro inaual to 5 Address (number, street, and apt. or suite no.) See Instructions. Requostoes name and address (optional) N 3 RIVERWAY ST E 1250 s City, slate, and ZIP coda HOUSTON TX 77056 9 UN account numbor(s) here (oplional) Tax ayer Identification Number IN Enter your TIN In the appropriate box. The TIN provided must match the name given on line 1 to avoid I social security number backup withholding, For individuals, this Is generally your social security number (SSN. However, lora resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, It is your employer identification number (EIN). If you do not have a number, see How to got a TIN, later. or Note: If the account Is In more than one name, see the instructions for line 1. Also see What Name and idonuncedon number Number To Give the Requester for guidelines on whose number to enter. Under penalties of perjury, I certify that: 1. The number shown on this form Is my correct taxpayer Iderthficatlon number (or I am waiting for a number to be Issued to me); and 2. 1 am not subject to backup withholding because: (a) i am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all Interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3.1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA codes) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification Instructions. You must crass out item 2 above If you have been notified by the IRS that you are currently subject to backup wilhholding because you have failed to report all interest and dividends on your tax return. For real estate transact ons, Item 2 does not apply, For mortgage Interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than Interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the Instructions for Part 11, later. Aer I U.S. Signature �/1% '/9//,7 Here f us.paraon► ��,,,,r� Date 0. General Instructions Section references are to the Internal Revenue Code unless otherwise noted. future developments. For the latest Information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9, Purpose of Form An Individual or entity (Form W-9 requester) who is required to file an Information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), Individual taxpayer Identification number (ITIN), adoption taxpayer Identification number (ATIN), or employer Identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an Information return. Examples of Information returns Include, but are not limited to, the following. • Form 1099 -INT (Interest earned or paid) • Form 1099 -DIV (dividends, Including those from stocks or mutual funds) • Form 1099-MISO (various types of Income, prizes, awards, or gross proceeds) • Farm 1099.8 (stock or mutual fund sales and certain other transactions by brokers) • Form 1099.5 (proceeds from real estate transactions) • Forth 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage Interest), 1098-E (student loan Interest), 1096-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only It you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. Sae What Is backup withholding, later. Cat. No, 10231x Form W-8 (Rev, 10.2018) ICalhoun County Commissioners' Court—JUNE 19, 2019 15. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITME NO. 13) To award the RFP for Property, Equipment Breakdown, Inland Marine and Crime Insurance for Calhoun County for the period beginning July 1, 2019. (RM) Don Gray, Gray & Co., spoke on this matter. TAC was accepted as insurance provider. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 13 of 25 CANDICEVILLARREAL V ASSISTANT AUDITOR June 12, 2019 CIN 202 S ANN ST, STE B PORT LAVACA,TEXAS 71979 TELEPHONE [3 611 5 5 3-4 610 FAX (3611553-4614 TO: Honorable Richard H. Meyer Calhoun County Judge RE: Agenda Item for Commissioners' Court Wednesday, lune 19, 2019 1 PEGGY HAIL CRISTINA P TUAZON DEIYII CABRERA ERICA PEREZ ASSISTANT AUDITORS Please place the following item on the Commissioners' Court Agenda for June 19, 2019. • Consider and take necessary action to award the RFP for Property, Equipment Breakdown, Inland Marine and Crime Insurance for Calhoun County for the period beginning July 1, 2019. Thank you, Peggy Haff Assistant Auditor IL COMPANY, LLC fmurau ce Gousdta ucs &Managers June 13, 2019 Ms. Cynthia Mueller Calhoun County Auditor 202 South Ann, Suite B Port Lavaca, TX 77979 Re: 7/1/2019-2020 Property Insurance renewal proposal Dear Ms. Mueller: This letter and the accompanying Exhibits A -D provide you with my commentary about the property insurance renewal effort that you, your staff, and I have been engaged with since March 12. Fortunately, the process has worked out much better for the County than we initially thought it might have. Through this process we have learned the following 1. In March, TAC initially notified the County of a possible premium rate increase in the range of 30%-40% that when combined with an 8% increase in replacement cost values (as called for by the 2018 appraisal) had the potential to increase the County's 2018/2019 property insurance premium of $345,290 by 50% (an increase of $173,022) to reach $518,312. 2. Of the more than 50 insurers who were approached through the County's RFP process, the best pricing was near $600,000. That agent (McGriff) opted to not submit a proposal in light of the pricing being so far out of line with the 2018/2019 pricing of $345,290. 3. TAC, who was the only proposer, quoted a 21% rate increase (far less than the initial 30%-40% rate increase indication). When combined with an 8% increase in the County's appraised values, TAC proposed a premium of $448,765 ($103,475 greater than the 2018/2019 premium and $69,547 less than the potential renewal premium of $518,312). 4. As requested in the RFP, TAC has quoted options to increase the "crime" limits (theft of County funds and property) and the "business income' limits (loss of revenues following an insured property damage loss). PO Box 1099, Mason, Texas 76856 • phone 512-496-3583 donaldkgray(o)g mail.com Attached you will find Exhibits A, B, C and D for your review. Exhibit A provides the County's annual property insurance loss ratios for the most recent six policy periods (losses as a percent of premium). Exhibit B provides a synopsis of the RFP project. Exhibit C compares the expiring premium, premium "rates" and insured values to those proposed for the renewal of coverage. Exhibit D points out the areas where coverage will be changing for the renewal period and details the options to increase the crime limit and business income limit mentioned above. Recommendation After reviewing TAC's insurance renewal proposal, I recommend that Calhoun County approve its renewal for coverage to become effective 7/1/19 and that the Commissioners Court "consider" the options to increase the crime insurance limits and business income limits as mentioned above. I look forward to presenting this material to the Commissioners Court on June 19 and invite questions by phone in the interim. Sincerely, J)oil amy Don Gray, ARM Exhibit B - RFP Project Synopsis Page 1 Calhoun County Auditor Cindy Mueller received phone call from TAC advising the County's property insurance renewal proposal for the period of 7/1/19-20 may include a "premium rate" increase in the range of 30%-40%. This means that premiums could be expected to increase by the same percentages prior to consideration of any increases in the replacement cost values for 7/1/19-20. Further, premiums could be expected to increase by an additional 8% as a result of the increased replacement cost values being applied that were the result of the 2018 3/12/2019 property value appraisal. A 40% rate increase coupled with an 8% value increase could be expected to increase premiums by 50% ($173,022). The rate increase is being driven by the "hardening" of the commercial reinsurance market resulting in higher reinsurance premiums being paid by TAC and other insurers to purchase reinsurance. Reinsurance costs are increasing due to the impact of large natural disasters around the world in 2018/2019 which increased property insurance losses far beyond anticipated levels. Consultant Don Gray provided the County Auditor with a memo recommending that a property insurance RFP be prepared and released in order to solicit property 3/14/2019 insurance proposals from TAC as well as other sources. The Commissioners Court later approved the recommendation and the consultant and Auditor's office worked together to create the RFP and pull together the required underwriting data. Emails were sent to sources listed on the County's insurance bidder's list to verify the 5/6/2019 accuracy of email addresses and contact information Emails were simultaneously sent to sources who responded to the 5/6/19 email informing them that an insurance RFP had been posted on the County's website this date and asking them to reply to the consultant if they were interested in receiving 5/8/2019 the underwriting exhibits that were referenced in the RFP. The posted RFP contained RFP Parts I, II and III. The posted positions of the RFP did not include the underwriting exhibits to the RFP (information such as the County's loss history, premium history, underwriting information, 2018 appraisal, property schedule, etc.). Emails were simultaneously sent to sources who responded to the 5/8/19 email to provide them with the underwriting exhibits to the RFP. This included GSM (Port 5/9/2019 Lavaca & Rockport); TAC (Austin); McGriff, Siebals and Williams (Houston) ; Deep East Texas WC Fund (Jasper); Higginbotham (Denton, Fort Worth and Victoria). Page 1 Page 2 Received email from McGriff advising they were not able to present a competitive proposal for submission to the County by the 2 PM deadline on 6/5/19. They advised that the absolute best premium they could obtain from standard insurance companies is almost $600,000 and no where near the expiring premium of $345,290. McGriff advised they had solicited quotes from the following 51 insurers: Chubb, Alteris, AmRisc, Arch, Arrowhead, Aspen, AWAC, Axis, Beazley, Berkshire, Brit, 6/4/2019 Broadvision, CNA, Canopius, CNA, CM Vantage, Commonwealth, Continental, Crum & Forster, CV Starr, Diamond States, Endurance, Ethos, Everest Re, Gen Star, Global Excess, Great American, Hallmark, Hartford, HDI Global, Hiscox, IFG, Ironshore, James river, Kemah, KinsdaAle, Lexington, London - BMS, Markel, Mitsui, Navigators, One Beacon, Pioneer Risks, QBE Specialty, Rivington Partners, RLI/Mt Hawley, RSUI, Scottsdale, Swiss Re, Travelers, Velocity, XL, and Zurich vroposais were received at Z rivi in Ine County juagee only proposer. Instead of proposing a premium rate increase in the range of 30%-40% that had been indicated on 3/12/19, TAC proposed a premium rate increase of 21% and a premium of $448,765. The quoted premium includes both the 21% rate increase and 6/5/2019 an 8% increase in replacement cost property values. TAC's premium is far less than the "absolute best premium of $600,000" that McGriff reported. In the past two weeks the consultant also reviewed property insurance renewal proposals at two other counties. For a "hill country" county with no hurricane exposure and favorable loss history, TAC quoted a 23% renewal rate. For a "north Texas" county with poor In response to inquiry from consultant, GSM advised they had sent the RFP to many insurance companies who might have an interest in quoting but then learned that those insurance companies were not able to quote through GSM inasmuch as other agents had already submitted the RFP material to those insurers (property insurers typically operate on a "fist submission received" protocol in determining which retail agency they will release their quotes through). 6/7/2019 GSM also advised that they do have access to a property insurance source who can provide coverage through an interlocal agreement (like TAC does, making their quote exempt from the RFP process). GSM also advised that their source does not offer quotes in a "bidding" situation. GSM advised that the source is competitive and that the source performed very well in response to Hurricane Harvey claims. The consultant and County Auditor's staff are trying to arrange a meeting with GSM on 6/19 to learn more about this source and its potential benefit for Calhoun County. Consultant will meet with the Commissioners Court on 6/19 to discuss the RFP 6/19/2019 process and TAC's renewal proposal, to include options to increase certain limits as presented in Exhibit C. Page 2 2 F ƒ F / F E \E\E a « f o@-®- j « CJI ® * A 2 99j§\ # ®{ƒ_\® \ ® $ S \ & EG ® E ' OD ) \/}\ n y / CL C: U) = / m0 \ 3§ \ �( $ -4 \ \ > 0 : ® M. / % CL Qm3/ / zg »& a 7 C: C-0 $ ® @ o @ ' a ®�0 \ \ A / \§\ƒ) * M 2 w 2 F *\ /2 / Pw \ // § \ /} / \ m m ƒ/ o ! % \ / . / / ) \ { G / / \ \ t g k $ \ / f § / 2 ® ° j ; \ 0 , 0 / j wo \CD / ƒ a j « CJI ® * A e E § # \ o $ S \ » ' OD ® \ n y a a j § \ \ / $ -4 > : ® # / % \ 6. -4 Cl) k $ @ C-0 $ ® @ o @ ' \ \ A § * M 2 w 2 F wo Exhibit B - RFP Project Synopsis Page 1 Calhoun County Auditor Cindy Mueller received phone call from TAC advising the County's property insurance renewal proposal for the period of 7/1/19-20 may include a "premium rate" increase in the range of 30%-40%. This means that premiums could be expected to increase by the same percentages prior to consideration of any increases in the replacement cost values for 7/1/19-20. Further, premiums could be expected to increase by an additional 8% as a result of the increased replacement cost values being 3/12/2019 applied that were the result of the 2018 property value appraisal. A 40% rate increase coupled with an 8% value increase could be expected to increase premiums by 50% ($173,022). The rate increase is being driven by the "hardening" of the commercial reinsurance market resulting in higher reinsurance premiums being paid by TAC and other insurers to purchase reinsurance. Reinsurance costs are increasing due to the impact of large natural disasters around the world in 2018/2019 which increased property insurance losses far beyond anticipated levels. Consultant Don Gray provided the County Auditor with a memo recommending that a property insurance RFP be prepared and released in order to solicit property insurance 3/14/2019 proposals from TAC as well as other sources. The Commissioners Court later approved the recommendation and the consultant and Auditor's office worked together to create the RFP and pull together the required underwriting data. Emails were sent to sources listed on the County's insurance bidder's list to verify the 5/6/2019 accuracy of email addresses and contact information Emails were simultaneously sent to sources who responded to the 5/6/19 email informing them that an insurance RFP had been posted on the County's website this date and asking them to reply to the consultant if they were interested in receiving the 5/8/2019 underwriting exhibits that were referenced in the RFP. The posted RFP contained RFP Parts I, II and III. The posted positions of the RFP did not include the underwriting exhibits to the RFP (information such as the County's loss history, premium history, underwriting information, 2018 appraisal, property schedule, etc.). Emails were simultaneously sent to sources who responded to the 5/8/19 email to provide them with the underwriting exhibits to the RFP. This included GSM (Port Lavaca 5/9/2019 & Rockport); TAC (Austin); McGriff, Siebals and Williams (Houston) ; Deep East Texas WC Fund (Jasper); Higginbotham (Denton, Fort Worth and Victoria). Page 1 Page 2 Received email from McGriff advising they were not able to present a competitive proposal for submission to the County by the 2 PM deadline on 6/5/19. They advised that the absolute best premium they could obtain from standard insurance companies is almost $600,000 and no where near the expiring premium of $345,290. McGriff advised they had solicited quotes from the following 51 insurers: Chubb, Alteris, 6/4/2019 AmRisc, Arch, Arrowhead, Aspen, AWAC, Axis, Beazley, Berkshire, Brit, Broadvision, CNA, Canopius, CNA, CM Vantage, Commonwealth, Continental, Crum & Forster, CV Starr, Diamond States, Endurance, Ethos, Everest Re, Gen Star, Global Excess, Great American, Hallmark, Hartford, HDI Global, Hiscox, IFG, Ironshore, James river, Kemah, KinsdaAle, Lexington, London - BMS, Markel, Mitsui, Navigators, One Beacon, Pioneer Risks, QBE Specialty, Rivington Partners, RLI/Mt Hawley, RSUI, Scottsdale, Swiss Re, Travelers, Velocity, XL, and Zurich Proposals were received at 2 PM in the County Judge's office. TAC was the only proposer. Instead of proposing a premium rate increase in the range of 30%-40% that had been indicated on 3/12/19, TAC proposed a premium rate increase of 21% and a premium of $448,765. The quoted premium includes both the 21% rate increase and an 8% increase 6/5/2019 in replacement cost property values. TAC's premium is far less than the "absolute best premium of $600,000" that McGriff reported. In the past two weeks the consultant also reviewed property insurance renewal proposals at two other counties. For a "hill country" county with no hurricane exposure and favorable loss history, TAC quoted a 23% renewal rate. For a "north Texas" county with poor loss history due to hail losses, In response to inquiry from consultant, GSM advised they had sent the RFP to many insurance companies who might have an interest in quoting but then learned that those insurance companies were not able to quote through GSM inasmuch as other agents had already submitted the RFP material to those insurers (property insurers typically operate on a "fist submission received" protocol in determining which retail agency they will release their quotes through). 6/7/2019 GSM also advised that they do have access to a property insurance source who can provide coverage through an interlocal agreement (like TAC does, making their quote exempt from the RFP process). GSM also advised that their source does not offer quotes in a "bidding" situation. GSM advised that the source is competitive and that the source performed very well in response to Hurricane Harvey claims. The consultant and County Auditor's staff are trying to arrange a meeting with GSM on 6/19 to learn more about this source and its potential benefit for Calhoun County. Consultant will meet with the Commissioners Court on 6/19 to discuss the RFP process 6/19/2019 and TAC's renewal proposal, to include options to increase certain limits as presented in Exhibit C. Page 2 4� m c "6 o w a w v v -I m -I G w -i m 0. o O O N (D C O m �. O e�rrt N 0 N van 'O (D 30. N N C ~ N s 3 3 o o o m o 3 W -n O O(D L 7 lT �^ V of N 3 N O (D 3 N N rt O N O O rt w O L0 w O O O N d C (D ..n (D = (D N w (D (D N O h (D N N G V `y' N ..+ W l0 A (D pl lD C = (D n (D E (D m \ 00 to w to 00 o t0 ~ N co N w O N l0 N cn W m w w tT l0 0 m wA N V O N LO VT LT LO W w 00 w N Lo N W An N m co ALON N W N A N i/ iO LO W W 'W A ~ O 00 00 N O ~ V O LO N 00 A ? N N <0tD N O u p O O O O 0N0 A co .p p C n co co V V 0 0 0 o a N (D t t eW .� O W ih a0 a 90 O O W V .P N. I� V!9 A w O 00 0 N V m 3,: F IP o N d N 111 14 li Ool to O w O V ry o o c N D! N V 4Pll i j� 01 tD .. et In Ln W n �, O to r W V C In v V N n w N 00 Exhibit D - Options and Changes in Coverage for 7/1/19 Page 1 Expiring Coverage Proposed Coverage Consultant's (7/1/18-19) (7/1/19-20) Comment Crime (refer to the bottom Limit can remain @ of this Exhibit $250,000 per occurrence for a ($1,000 deductible) or 1) summary of the limit can be increased the County's $250,000 per occurrence to $500,000 per occurrence crime ($1,000 deductible). This limit @ $1,000 deductible for insurance had been $100,000 until $2,986 additional premium For discussion coverages 7/1/18, or 2) the limit can be with the provided by increased to $500,000 per Commissioners the TAC occurrence @ $10,000 C � Property deductible for $1,942 O insurance policy) additional premium 6/119 Loss of Limit can remain @ $1 Revenues per occurrence or be and Extra $1M per occurrence increased to $5M per PC Expenses occurrence for $2,639 additional premium. For MMC only, reduce the Named Windstorm deductible from the current 2% of MMC's Requested in the RFP, but total not available from TAC replacement cost value (2% of est. @ $42.8M which is $860,000) to $100,000 Page 1 Accounts Receivables $500,000 $2.5M limit Electronic $1M $2.5M Data Positive Spoilage @ $250,000, Extra Spoilage @ $500,000, Extra Expense @ $500,000, Expense @ $500 improvements, but Equipment Expediting Expense @ Expediting Expense @ likely not Breakdown $250,000, Hazardous $1M, Hazardous Substance significant. Substance cleanup @ cleanup @ $M, Ammonia $125,000, Ammonia Contamination @ $125,000 Contamination @ $500,000 Property while in $500,000 $2.5M Transit Crime insurance description: Crime insurance provides protection for 1) ,beT,,, pft of�Ca nty?mon.ey anFl�^ ptidlYM bVt%tntyuoffieialg;.and the failure of any officials or employee to faithfully perform their duties as prescribed by law, 2) fof'ger, dl rrJation ofnCounty h1&ks drawn by or drawn upon the County; 3)&Tb1e°the) rdlsappeaganpe�andV ' ,,, - J n of money and stcurltl-`sXfr m inside County premises, from banking premises andsgi Jdihen in the care of a County officia o employee or an armored motor vehicle company, 4) Tlehokibefy�CoLThyl4ptV, Ch�h Ghanftii'oi� And seGV, 011 motor vehicles, and trailers from a County employee or officials (other than from a 1 watchperson or janitor) while inside County premises, @'%q Mi,pt�x 6 J'.l&_gtdhe tmheft�3fCaonpdp6C,y) „fTahrerdacceptance cceptance eof money that ney that is not paid upon presentation or counterfeit currency orders. $1,000 deductible per occurrence. Page 2 Calhoun County Commissioners' Court—JUNE 1% 2019 16. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 14) On Port Alto FNI Project No. CCY17350 and authorize Commissioner Syma to sign the Professional Service Agreement with Freese and Nichols. (CS) Pass Page 14 of 25 Clyde Syma Calhoun County Commissioner, Precinct 3 24627 Stale Hwy, 172—Olivia, Port Lavaca, Texas 77979 —Office (367) 593-5346 —rax (3G7) 593-6309 Email: clydc symaRoalhouncotx.org June 10, 2019 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: Agenda Item Dear Judge Meyer, Please place the following item on the Commissioner's Court Agenda for June 19, 2019 • Please Consider and take Necessary Action on Port Alto FNI Project No. CCY17350 and authorized Commissioner Syma to sign the Professional Service Agreement with Freese and Nichols. Sincerely, (3`/C429,_ 0429 Clyde Syma Commissioner Pct. 3 FREESE ?NICHOLS Clyde Syma, Precinct 3 Commissioner Calhoun County 24627 State Highway 172 Part Lavaca, TK 77979 PROFESSIONAL SERVICES AGREEMENT— ATTACHMENT A TASK AUTHORIZATION Calhoun County Task Authorization No. 3 FNI Project No. CCY17350 Master Agreement Executed on May 13, 2016 and expires on December 31, 2020 Project Name: Port Alto Shoreline Restoration Construction Services Description of Services: See Attachment SC. Deliverables: See Attachment SC, Schedule: See Attachment SC. Compensation shall be: Not -to -Exceed $25,212.50 In accordance with Attachment CO AI/ other provis/ons, terms and conditions of the Professional Services Agreement which ore not expressly amended shall remain in full force and effect. FREESE AND N HOLS, IN BY: Robert W Chambers PG Print Name TITLE: Vice PPreesIddeent DATE: tl 7 �/ / CALHOUN COUNTY BY: Print Name TITLE: DATE: SCOPE OF SERVICES AND RESPONSIBILITIES OF CLIENT PROJECT UNDERSTANDING ATTACHMENT SC In response to our telephone conversation with you on May 23, 2019, we are pleased to submit this scope for providing professional services to Calhoun County (CLIENT) for Port Alto Shoreline Restoration Construction Services, It Is our understanding that the CLIENT Is requesting FNI to update design documents dated March 1, 2018 and entitled "Port Alto Emergency Beast Restoration". The purpose of this project is to harvest sand for the areas to be excavated and place it along the fill areas as noted In Figure 1. It is FNI's understanding that the Client was unable to obtain acceptable bids during the 2018 bid process. This purpose of this Scope of Services Is to update the construction documents In an attempt to obtain acceptable construction bids and complete construction of the project, FNI will utilize the services of a subcontractor, Scheibe Consulting, Inc„ to complete this Scope of Services ARTICLE I BASIC SERVICES: FNI shall render the following professional services In connection with the development of the Project: A. PRELIMINARY PHASE: FNI shall provide professional services in this phase as follows; 1. Study Phase a. FNI shall conduct a site visit to the project area to verify that existing conditions have not changed since the original construction documents were prepared. b. FNI shall conduct a detailed review of the original construction documents, c. FNI shall prepare a technical memo documenting our findings from the site visit and any recommended changes to the original construction documents that might be Identified. The design review memo will identify any additional data collection needs that are not Included In this scope of services. d. FNI shall advise Client as to the necessity of Client's providing or obtaining data or services from others and assist Client in connection with any such services. Geotechnlcal Investigation or topographic, boundary, or bathymetrlc surveying Is not Included in Basic Services. B. DESIGN PHASE: FNI shall provide professional services In this phase as follows: 1. Update drawings, specifications, Construction Contract Documents, designs, and layouts of improvements to be constructed (if surveys are to be furnished, they are Additional Services, pursuant to Article 111). FNI anticipates that updates maybe required to; a. Temporary erosion control plan b. Cut/fill quantities c, Project control (post survey) d. Bid specifications SC -1 2. Furnish such information necessary to utility companies whose facilities may be affected or services may be required for the Project. 3. Prepare revised opinion of probable construction cost. 4. Prepare bidder's proposal forms (project quantities) of the improvements to be constructed. 5. Provide design submittals at 90% and loo%design milestones. 6. Furnish Client three (3) sets of printed copies and one (1) electronic copy (.pdf format) of drawings, specifications, and bid proposals marked "Preliminary" for approval by Client, foreach design submittal as described above. Upon final approval by Client, FNI will provide Client one (1) set of reproducible "Final" drawings and one (1) loose set of specifications for reproduction by Client. 7. FNI staff shall attend meetings with County or their representatives. This Scope of Services Includes weekly half-hour meetings for a 4 -week period, plus two additional one-hour meetings. If additional meetings are required, those meetings will constitute an Additional Service. C. BID OR NEGOTIATION PHASE: Upon completion of the design services and approval of "Final" drawings and specifications by Client, FNI shall provide professional services in this phase as follows: 1. Assist Client in securing bids. Issue a Notice to Bidders to prospective contractors and vendors listed in FNI's database of prospective bidders; and to selected plan rooms. Provide a copy of the notice to bidders for Client to use in notifying construction news publications and publishing appropriate legal notice. The cost for publications shall be paid by Client. 2. Print Bid Documents and distribute to selected plan rooms, and to prospective bidders that respond to the Notice to Bidders. 3. Assist Client by responding to questions and In bid documents. Prepare and Issue addenda to the bid documents to plan holders if necessary. 4. At Client request, FNI will assist Client Inthe opening, tabulating, and analyzing the bids received. Review the qualification information provided by the apparent low bidder to determine if, based on the information available, they appear to be qualified to construct the project. Recommend award of contracts or other actions as appropriate to be taken by Client. Pre -qualification of all prospective bidders and issuing a list of eligible bidders prior to the bid opening is an additional service. S. Assist the Client in conducting a pre-bld conference for the construction projects and coordinate responses with Client. Response to the pre-bid conference will be In the form of addenda Issued afterthe conference. Attend the tour of the project site after the pre-bid conference. 6. Assist Client in the preparation of Construction Contract Documents for construction contracts. Provide ten (10) sets of Construction Contract Documents which Include Information from the apparent low bidders bid documents, legal documents, and addenda bound in the documents for execution by the client and construction contractor, Distribute five (5) copies of these documents SC -2 to the contractor with a notice of award that Includes directions for the execution of these documents by the construction contractor. Provide Client with the remaining five (5) copies of these documents for use during construction. Additional sets of documents can be provided as an Additional Service. 7. Furnish contractor copies of the drawings and specifications for construction pursuant to the General Conditions of the Construction Contract. D. CON5TRUCTION PHASE GENERAL REPRESENTATION: Upon completion of the bid or negotiation phase services, FNI will proceed with the performance of construction phase general representation services as described below. FNI will endeavor to protect Client in providing these services. However, it Is understood that FNI does not guarantee the Contractor's performance, nor Is FNI responsible for supervision of the Contractor's operation and employees. FNI shall not be responsible for the means, methods, techniques, sequences or procedures of construction selected by the Contractor, or any safety precautions and programs relating In any way to the condition of the premises, the work of the Contractor or any Subcontractor.. FNI shall not be responsible for the acts or omissions of any person (except its own employees or agents) at the Project site or otherwise performing any of the work of the Project. These services are based on the use of FNI standard General Conditions for construction projects. Modifications to these services required by use of other general conditions or contract administration procedures are an additional service. If general conditions other than FNI standards are used, the Client agrees to Include provisions In the construction contract documents that will require the construction contractor to include FNI and their subconsultants on this project to be listed as an additional Insured on contractor's Insurance policies. 1. Assist Client in conducting pre -construction conference with the Contractor, review construction schedules prepared by the Contractor pursuant to the requirements of the construction contract, and prepare a proposed estimate of monthly cash requirements of the Project from Information provided by the Construction Contractor, 7. Establish communication procedures with the Client and contractor. Submit monthly reports of construction progress. Reports will describe construction progress in general terms and summarize project costs, cash flow, construction schedule and pending and approved contract modifications. 3. Establish and maintain a project documentation system consistent with the requirements of the construction contract documents, Monitor the processing of contractor's submittals and provide for filing and retrieval of project documentation. Produce monthly reports indicating the status of all submittals In the review process. Review contractor's submittals, including, requests for Information, modification requests, shop drawings, schedules, and other submittals in accordance with the requirements of the construction contract documents for the projects. Monitor the progress of the contractor in sending and processing submittals to see that documentation Is being processed In accordance with schedules. 4. Based on FNI's observations as an experienced and qualified design professional and review of the Payment Requests and supporting documentation submitted by Contractor, determine the SC -3 amount that FNI recommends Contractor be paid on monthly and final estimates, pursuant to the General Conditions of the Construction Contract. 5. Assist Client in conducting construction progress meetings with the Contractor and Client, Including preparing and circulating copies of the meeting minutes. Construction progress meetings will be coordinated by FNI on a monthly basis and be conducted via teleconference. 6. Make eight visits to the construction site (as distinguished from the continuous services of a Resident Project Representative) to observe the progress and the quality of work and to attempt to determine in general If the work Is proceeding in accordance with the Construction Contract Documents. In this effort FNI will endeavor to protect the Client against defects and deficiencies In the work of contractors and will report any observed deficiencies to Client. Visits to the site in excess of the specified number are an Additional Service. 7. Notify the Client of nonconforming work observed on site visits. Review quality related documents provided by the contractor such as test reports, equipment installation reports or other documentation required by the Construction contract documents. S, Coordinate the work of testing laboratories and Inspection bureaus required for the testing or Inspection of materials, witnessed tests, factory testing, etc. for quality control of the Project. The cost of such quality control shall be paid by Client and is not Included in the services to be performed by FNI. 9, Interpret the drawings and specifications for Client and Contractor(s), Investigations, analyses, and studies requested by the Contractor(s) and approved by Client, for substitutions of equipment and/or materials or deviations from the drawings and specifications is an additional service. 10, Establish procedures for administering constructive changes to the construction contracts. Process contract modifications and negotiate with the contractor on behalf of the Client to determine the cost and time impacts of these changes. Prepare change order documentation for approved changes for execution by the Client. Documentation off laid orders, where costto Client Is not Impacted, will also be prepared. Investigations, analyses, studies or design for substitutions of equipment or materials, corrections of defective or deficient work of the contractor or other deviations from the construction contract documents requested by the contractor and approved by the Client are an additional service. Substitutions of materials or equipment or design modifications requested by the Client are an additional service, 11, Prepare documentation for contract modifications required to Implement modifications in the design .of the project, Receive and evaluate notices of contractor claims and make recommendations to the Client on the merit and value of the claim on the basis of Information submitted by the contractor or available In project documentation. Endeavor to negotiate a settlement value with the Contractor on behalf of the Client if appropriate. Providing these services to review or evaluate construction contractor(s) clalm(s), supported by causes notwlthin the control of FNI are an additional service. 12. Conduct, in company with Client's representative, a final review of the Project for conformance with the design concept of the Project and general compliance with the Construction Contract Documents, Prepare a list of deficiencies to be corrected by the contractor before recommendation of final payment. Assist the City In obtaining legal releases, permits, warranties, SC -4 spare parts, and keys from the contractor. Review and comment on the certificate of completion and the recommendation for final payment to the Contractor(s). Visiting the site to review completed work In excess of one trip Is an Additional Service, ARTICLE 11 SPECIAL SERVICES: FNI shall render the following professional services, which are not included In the Basic Services described above, In connection with the development of the Project: 1. None identified ARTICLE 11 ADDITIONAL SERVICES: Any services performed by FNI that are not Included in the Basic Services or Special Services described -above are Additional Services. Additional Services to be performed by FNI, If authorized by Client, may Include the following: • Geotechnical investigation • Field Survey (boundary, topographic, magnetometer, and as -built); easement designation • Floodplain Study • Structural design (Including Site Retaining Walls, foundations, breakaway wall design, and anchoring analysis) • Design services necessary to relocate the borrow site due to conflicts with gas pipelines, conflicts with property boundaries, conflicts with project access due to existing Infrastructure, and/or maintaining compliance with existing Section 10/404 permits, • Permit Fees • Storm water Pollution Prevention Pian Development and Permitting • Environmental studies including endangered species investigation, wetland determination, archeological Investigation, Section 10/404 CWA permitting, and Phase 1 ESAs • Construction staking • Unanticipated engineering services associated with Issues that may arise during construction. Should any of these services be desired or required, an additional scope and fee proposal may be necessary. • Once design is reviewed and approved by owner, any modifications to such plans may be considered as additional services. ARTICLE IV TIME of COMPLETION: FNI Is authorized to commence work on the Project upon execution of this Agreement and agrees to complete the services In accordance with the following schedule: • Review Existing Bid Documents -30 days from notice -to -proceed. • Update Construction Documents — 30 days from completion Client approval of Design Review Memo unlesA additional data collection is required. If additional data collection is required, updated construction documents will be submitted for Client review within 30 days of completion'of data collection. Final construction documents will be submitted to Client within 14 days of receipt of comments or approval from Client. • Construction Phase services and project management will occur from notice -to -proceed for the full duration of construction activities $C-5 If FNI's services are delayed through no fault of FNI, FNI shall be entitled to adjust contract schedule consistent with the number of days of delay. These delays may Include but are not limited to delays in Client or regulatory reviews, delays on the flow of information to be provided to FNI, governmental approvals, etc. These delays may result In an adjustment to compensation as outlined on the face of this Agreement and In Attachment CO. ABLE V RESPONSIBILITIES OF CLIENT: Client shall perform the following in a timely manner so as not to delay the services of FNI: A. Client recognizes and expects that change orders may be required to be Issued during construction. The responsibility for the costs of change orders will be determined on the basis of applicable contractual obligations and professional liability standards. FNI will not be responsible for any change order costs due to unforeseen site conditions, changes made by or due to the Client or Contractor, or any change order costs not caused by the negligent errors or omissions of FNI. Nothing In this provision creates a presumption that, or changes the professional liability standard for determining If, FNI is liable for change order costs, It is recommended that the Client budget a minimum of 5% for new construction and a minimum of 10% for construction that Includes refurbishing existing structures. B. Designate In writing a person to act as Cllent's representative with respect to the services to be rendered under this Agreement. Such person shall have contract authority to transmit instructions, receive information, Interpret and define Client's policies and decisions with respect to FNI's services for the Project. C. Provide all criteria and full information as to Client's requirements for the Project, Including design objectives and constraints, space, capacity and performance requirements, flexibility and expandability, and any budgetary limitations; and furnish copies of all design and construction standards which Client will require to be Included in the drawings and specifications, D. Assist FNI by placing at FNI's disposal all available information pertinent to the Project including previous reports and any other data relative to design or construction of the Project. E. Arrange for access to and make all provisions for FNI to enter upon public and private property as required for FNI to perform services under this Agreement. F. Examine all studies, reports, sketches, drawings, specifications, proposals and other documents presented by FNI, obtain advice of an attorney, insurance counselor and other consultants as Client deems appropriate for such examination and render in writing decisions pertaining thereto within a reasonable time so as not to delay, or cause rework in, the services of FNI. G, Client shall make or arrange to have made all subsurface Investigations, Including but not limited to borings, test pits, soil resistivity surveys, and other subsurface explorations. Client shall also make or arrange to have made the Interpretations of data and reports resulting from such Investigations. All costs associated with such investigations shall be paid by Client. H. Provide such accounting, Independent cost estimating and Insurance counseling services as may be required for the Project, such legal services as Client may require or FNI may reasonably request with SC -6 regard to legal issues pertaining to the Project Including any that maybe raised by Contractor(s), such auditing service as Client may require to ascertain how or for what purpose any contractor has used the moneys paid under the construction contract, and such Inspection services as Client may require to ascertain that Contractor(s) art complying with any law, rule, regulation, ordinance, code or order applicable to their furnishing and performing the work. If Client designates a person to serve In the capacity of Resident Project Representative who is not FNI or FNI's agent or employee, the duties, responsibilities and limitations of authority of such Resident Project Representative(s) will he set forth In an Attachment attached to and made a part of this Agreement before the Construction Phase of the Project begins. Said attachment shall also set forth appropriate modifications of the Construction Phase General Representation services as defined In Attachment SC, Article I, D, together with such adjustment of compensation as appropriate. J. Attend the pre-bid conference, bid opening, preconstruction conferences, construction progress and other job-related meetings and substantial completion inspections and final payment Inspections. K. Give prompt written notice to FNI whenever Client observes or otherwise becomes aware of any development that affects the scope or timing of FNI's services, or ant efect or nonconformance of the work of any Contractor. L. Furnish, or direct FNI to provide, Additional Services as stipulated In Attachment SC, Article III of this Agreement or other services as required. M. Bear all costs incident to compliance with the requirements of this Article V. ARTICLEYJ DESIGNATED REPRESENTATIVES: FNI and Client designate the following representatives: Client's Designated Representative Clyde Syme Calhoun County Commissioner Precinct 3 24627 State Highway 172 Port Lavaca, TX 77979 Phone: 961.893.5346 Email: Clyde.Syma@caihouncotx.org Client's Accounting Representative FNI's Designated Representative— Cynthia Mueller 202 S. Ann, Suite B Port Lavaca, TX 77979 361,553.4610 cindy.mueller@calhouncotx.org Juan Moya 10431 Morado Circle BS -S 300 Austin, Texas 78759 512.617-3184 Juan,moya@freese.com SC -7 FNI'sAccountingRepresentative— Kelly Shriver 4055 International Plaza, Ste, 200 Fort Worth, TX 76109 817-735-7351 KJS@freese.com SC -8 Attachment CO COMPENSATION Compensation to FNI far services shall be based upon the following rates as outlined in the Scope of Servlces for a not exceed fee of Twenty five Thousand Two Hundred Twelve Dollars and Fifty Cents ($25,212.50). If FNI sees the Scope of Services changing so that Additional Services are needed, Including but not limited to those services described as Additional Services, FNI will obtain CLIENT'S approval before proceeding. Schedule of Charges: Position - Rete Professional -1 107 Professional • 2 130 Professional -3 146 Professional -4 169 Professional -5 197 Professional -6 225 Construction Manager -1 85 Construction Manager -2 111 Construction Manager- 3 131 Construction Manager- 4 164 CAD Techniclon/Design er-1 91 CAD Technlclan/Design or -2 117 CAD Technician/Designer-3 145 Corporate Project Support -1 87 Corporate Project Support- 2 105 Corporate Project Support -3 139 Intern/Coop 53 Senior Advisor 175 Rates for In -House Services Technology Charge Bulk Printing and Reproduction $8,50 per hour B&W color Small format (per cop $0.10 $0.25 Travel Large Format (per sq. ftJ Standard IRS Rates Bond $0.25 $0,75 Glossy/Mylar $0.75 $1.25 Vinyl/Adhesive $f.S9 $2.00 Mounting {persq. ft.) $2.00 Binding (per binding) $0.25 OTHER DIRECT EXPENSES: other direct expenses are reimbursed at actual cost times a multiplier of 1.00. They Include outside printing and reproduction expanse, communication expense, travel, transportation and subsistence away from the FNI office and other miscellaneous expenses directly related to the work, including costs of laboratory analysis, test, and otherwork required to be done by Independent persons other than staff members. For Resident Representative services performed by non-FNI employees and CAD services performed In-house by non-FNI employees where FNI provides workspace and equlpmentto perform such services, these serviceswlll be billed atcost times a muitlpllerof 2,0. This markup approxlmates the cost to FNI if an FNI employee was performingthe same orsimilarservices, These rateswlll be adjusted annually In February. 1022025 CO -1 04-13 ATTACHMENT TC TERMS AND CONDITIONS OF AGREEMENT 1. DEFINITIONS: The term Client as used herein refers to the Calhoun County Texas , Theterm FNI as used herein refers to Freese and Nichols, Inc„ Its employees and agents; also Its subcontractors and their employees and agents, As used herein, Services refers to the professional services performed by Freese and Nichols pursuant to the Agreement, 2. CHANGES:Client, without invalidating the Agreement, may order changes within the general scope ofthe work required by the Agreement by altering, adding to and/or deducting from the work to be performed. If any change under this clause causes an Increase or decrease In FNI's cost of, or the time required for, the performance of any part of the Services under the Agreement, an equitable adjustment will be made by mutual agreement and the Agreement modified In writing accordingly. 3. TERMINATION: The obligation to provide services underthis Agreement maybe terminated byelther party upon te" days' writtennotice, In the event of termination, FNI will be paid for all services rendered and reimbursable expenses Incurred to the date of termination and, In addition, all reimbursable expenses directly attributable to termination. 4. CONSEQUENTIAL DAMAGES: In no event shall FNI or Its subcontractors he liable In contract, tort, strict liability, warranty, or otherwise for any special, Indirect, Incidental or consequential damages, such as loss of product, loss of use of the equipment or system, loss of anticipated profits or revenue, non -operation or Increased expense of operation or other equipment or systems. S. INFORMATION FURNISHED BY CLIENT: Cllent will assist FNI by placing at FNI's disposal all available Information pertinent to the project Including previous reports and any otherdatarelative todesign orconstructlonofthe Project, FNlshallhave no liability for defects or negligence In the Services attributable to FNI's reliance upon or use of data, design criteria, drawings, specifications or other Information furnished by Client and Client agrees to Indemnify and hold FNI harmless from any and all claims and judgments, andal0asses, costs and expenses arising therefrom, FNI shall disclose toClient, priorto use thereof, defects or omissions In the data, design criteria, drawings, specifications or other Information furnished by Cllent to FNI that FNI may reasonably discover in Its review and Inspection thereof. 6. INSURANCE: FNI shall provide to Client certificates of Insurance which shall contain the following minimum coverage: commercial General Liability Workers' compensation General Aggregate $2,000,000 As required by Statute Automobile Liability (Any Auto) Professional Liability CSL $1,000,000 $3,0OO,000Annual Aggregate 7. SUBCONTRACTS: If, for any reason, at any time during the progress of providing Services, Client determines that any subcontractor for FNI is incompetent or undesirable, Client will notify FNI accordingly and FNI shall take Immedlatesteps for cancellation of such subcontract. Subletting by subcontractors shall be subject to the same regulations. Nothing contained In the Agreement shall create any contractual relation between any subcontractor and Client. 8. OWNERSHIP OF DOCUMENTS: All drawings, reports data and other project Information developed In the execution of the !ervlcas provided under this Agreement shall he the property of the Client upon payment of FNIs fees for services. FNlmay retain copies for record purposes. Client agrees such documents are not Intended or represented to be suitable for reuse by Client or others, Any reuse by Client or by those who obtained said documents from Client without written verification or adaptation by FNI will he at Client's sole risk and without liability or legal exposure to FNI, or to FNI's Independent associates or consultants, and Client shall indemnify and hold harmless FNI and FNI's Independent associates and consultants from all claims, damages, losses and expenses including attorneys' fees arising outof or resulting therefrom. Any such verification or adaptation will entitle FNI to further reasonable compensation. FNI may reuse all drawings, report data and other project Information in the execution of the Services provided underthis Agreement In FNI's otheractivities. Any reuse by FNI will beat FNI's sole riskand without liability or legal exposure to Client, and FNI shall indemnify and hold harmless Client from all claims, damages, losses and expenses including attorneys' fees arisingout of or resulting therefrom. Page 1 of 2(- FNI CLIENT 9. POLLUTANTS AND HAZARDOUSWASTES:ItisunderstoodandagreedthatFNihasneithercreatednorcontributedtothe creation or existence of any hazardous, radioactive, toxic, Irritant, pollutant, or otherwise dangerous substance or condition at the site, If any, and its compensation hereunder Is In noway commensurate with the potential risk of Injury or loss that maybe caused by exposures to such substances or conditions. The parties agree that in performing the Services required by this Agreement, PNI does not take possession or control of the subject site, but acts as an fnvltee in performing the services, and Is not therefore responsible for the existence of any pollutant present on or migrating from the site. Further, FNI shall have no responsibility for any pollutant during clean-up, transportation, storage or disposal activities. 10. OPINION OF PROBARLE COSTSi FNI will furnish an opinion of probable project development cost based on present day cost, but does not guarantee the accuracy of such estimates. opinions of probable cost, financial evaluations, feasibility studies, economic analyses of alternate solutions and utilitarian considerations of operations and maintenance costs prepared by FNI hereunderwlil be made on the basis of FNI's experience and qualifications and represent FNI'sjudgment as an experienced and qualified design professional. It is recognized, however, that FNI does not have control over the cost of labor, material, equipment or services furnished by others or over market conditions or contractors' methods of determining their prices, 11. CONSTRUCTION REPRESENTATION: If required by the Agreement, FNI will furnish Construction Representation according to the defined scope forthese services. FNI will observe the progress and the quality of work to determine in general If the work is proceeding In accordance with the Contract Documents, in performing these services, FNI will endeavortoprotect Client against defects and deficiencies In the work of Contractors; FNI will report any observed deficiencies to Client, however, It is understood that FNI does not guarantee the Contractor's performance, nor Is FNI responsible for the supervision of the Contractor's operation and employees. PHI shall notbe responsible for the means, methods, techniques, sequences or procedures of construction selected bythe Contractor, arthe safety precautions and programs Incident to the work of the Contractor. FNI shall not be responsible for the acts oromisslons of any person (except his own employees or agent) at the Project site or otherwise performing any of the work of the Project. If Client designates a person to serve In the capacity of Resident project Representative who Is not a FNI's employee or FNI's agent, the duties, responsibilities and limitations of authority of such Resident Project Representativets) will be set forth in writing and made a part of this Agreement before the Construction Phase of the Project begins, 12, PAYMENT: Progress payments maybe requested by FNI based on the amount of services completed. Paymentforthe services of FNI shall be due and payable upon submission of a statement for services to CLIENT and in acceptance of the services assatlsfactory by the CLIENT. Statements forservices shall not be submitted more frequently than monthly. Any applicable new taxes Imposed upon services, expenses, and charges by any governmental body after the execution of this Agreement will be added to FNI's compensation. If CLIENT falls to make any payment due FNI for services and expenses within thirty (30) days after receipt of FNI's statement for services therefore, the amounts due FNI will he Increased at the rate of one percent (1%) per month from sold thirtieth (30th) day, and, In addition, FNI may, after giving seven (7) days'written neticeto CLIENT, suspend services underthis Agreement until FNI has been paid In full, all amounts due for services, expenses and charges. 13. ARBITRATION: No arbitration arising out of, or relating to, this Agreement involving one party to this Agreement may Include the other party to this Agreement without their approval, 14. SUCCESSORS AND ASSIGNMENTS: CLIENT and FNI each are hereby bound and the partners, successors, executors, administrators and legal representatives of CLIENT and FNI are hereby bound to the other party to this Agreement and to the partners, successors, executors, administrators and legal representatives (and sold assigns) of such other party, in respect of all covenants, agreements and obligations of this Agreement. Neither CLIENT nor FNI shall assign, sublet or transfer any rights under or Interest In (Including, but without limitation, moneys that may become due or moneys that are due) this Agreement without the written consentof the other, exceptto the extent that any assignment, subletting or transfer is mandated by law or the effect of this limitation may be restricted by law, Unless specifically stated to the contrary In any written consent to an assignment, no assignment will release or discharge the assignor from any duty or responsibility under this Agreement. Nothing contained In this paragraph shall prevent FNI from employing such Independent associates and consultants as FNI may deem appropriate to assist in the performance of services hereunder. 15. PURCHASEORDERS: It a Purchase order Is used to authorize FNI's Services, only the terms, condltlons/Instructions typed on the face of the Purchase Order shall apply to this Agreement, should there be any conflict between the Purchase Order and the terms of this Agreement, then this Agreement shall prevail and shall be determinative of the conflict. Page 2 of 2L FNI CLIENT Calhoun County Coinmissioners' Court —JUNE 19, 2019 17. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 15) To transfer $25,212.50 from GOMESA funds to the Port Alto Beach Nourishment FNI Project No. CCT17350 for the engineering scope of services provided by Freese and Nichols post Hurricane Harvey. (CS) Pass Page 15 of 25 Clyde Syma Calhoun County Commissioner, Precinct 3 24627 Slate 1Iwy. 172—Olivia, Fort Iavaca, Texas 77979 —office (3G1) 993-5346 — Fax (3(31) 593-5309 Email: clvdc symaQr'calllotaucolx.orz 40 June 10, 2019 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: Agenda Item Dear Judge Meyer, Please place the following item on the Commissioner's Court Agenda for June 19, 2019 • Please Consider and take Necessary Action on transfer of $25,212.50 from the GOMESA Funds to the Port Alto Beach Nourishment FNI Project No. CCY17350. For the engineering scope services provided by Freese and Nichols post Hurricane Harvey. Sincerely,,Jtl (�'- - ettQ3-"�" kk Clyde Syma Commissioner Pct. 3 10431 Morado Circle, Suite 300 • Austin, Texas 78759 • 512-617-3100 • FAX 817-735-7491 www.freese.com Date: March 18, 2019 Clyde Syrna Calhoun County Corninissioner Precinct 3 24627 State Highway 172 Pori. Lavaca, TX. 77979 Re: Pott Alto Construction Management Scope of Services Dear Commissioner, Syma : Freese and Nichols, Inc. (FNI) is providing the Engineering Services Scope for Port Alto Beach Nourishment Project, Port Alto, TX Scope of Work The purpose of this project is to harvest sand for the areas to be excavated and place it along the fill areas as noted in Figure 1. A. This project area is located near Port Alto, TX. To accomplish the goals of this project, it is recommended that the following tasks be conducted, 1. Project Management 2. Review of Existing Bid Documents 3. Survey (By Others) 4. Update Construction Documents 5. Construction Phase Services 6. Expenses Services excluded from this proposal are structural design (including Site Retaining Walls, foundations, breakaway wall design, and anchoring analysis); Geotechnical Investigation; Field Survey (boundary, topographic, magnetometer, and as -built); easement designation; Floodplain Study; construction staking; Permit Fees; SWPPP; environmental assessments including endangered species investigation, wetland determination, archeological investigation, Section 10/404, and Phase 1 ESAs; and unanticipated engineering services associated with issues that may arise during construction. Should any of these services be desired or required, an additional scope and fee proposal may be necessary. Freese and Nichols will subcontract with Scheibe Consulting, LLC (SC) for the construction oversight process needed for this project. Following is a detailed explanation of each service for: Port Alto Date: April 1.8, 2019 Page 2 of 4 1. Project Management — FNI-SC staff will attend meetings with FNI, County, and additional consultants, as necessary. Meetings are billed at an hourly rate and we have estimated an average of 0.5 hour of meetings every 1 week for a 4 -week period, plus two (2) 1 -hour meeting with the County Staff. Client will be notified if meetings exceed the provided estimate, in addition, the task will include general project management of this effort, administrative assistance, and genera[ oversight. 2. Review of Existing Bid Documents -• FNI-SC will conduct a detailed review of the bid documents, will conduct a site visit, and will review the construction documents. FNI- SC staff will provide a technical memo documenting the results of this review to FNI, and provide recommended changes. Depending on the results of this review, additional services may be needed to ensure a successful end product for FNI and the client. FNI- SC staff will also provide required data collection needs that have been identified as pari of this initial effort. Figure 1: Project Location Map. 3. Survey (Provided by Others) —A survey should be utilized to assist with locating existing easements, property boundaries, proposed easements, and general site topographic/bathymetric conditions in and around this project. This effort will also require a magnetometer survey and probing to field locate all existing gas mains in proximity to the project area. Geotechnical W be required to provide a detailed examination of the existing sediment borrow areas relative to the placement areas. This effort will provide depth and quality of borrow [Project Number: CCY17350j Port Alto Date: April 18, 2019 Page 3 of 4 material, and how it compares to areas of placement. This may be avoided with written permission from FNI and owner with a full understanding of the risks. 5. Update Construction Documents — FNI-SC staff will provide updated construction documents based on the results of the field survey and possibly the results of the geotechnical investigation. This effort will include the following: a. Updates to the temporary erosion control plan; b. Updates to the cut/fill quantities; c. Updates to the project control (post survey); & d. Updates to the bid specifications. It is possible that post survey data collection, and review of construction documents/bid package (noted in Tasks 2 and 3 above) that additional services may be required in the form of relocating the borrow site due to conflicts with gas pipelines, conflicts with property boundaries, conflicts with project access due to existing infrastructure, and/or maintaining compliance with existing Section 101404 permits. 6. Construction Phase Services — FNI-SC staff will assist the owner with construction phase RFIs, submittal reviews, one (1) construction kick-off meeting, up to eight (8) site inspections, final walk-thru/punch-list check, and final sign -off letter. 7. Expenses — Printing, reproduction, and other non -labor charges that are directly related to this project will be billed at cost plus 5%. In-house printing charges will be based on competitive rates of local reproduction companies. Filing fees, permit fees, and other City/County/State/Federal fees are not included and shall be paid by the client. The total fee provided in this task is an estimate only. Should expenses exceed this limit, then additional fee will be required. Fee Schedule: The following is a fee schedule for services noted in this proposal (See also Exhibit 1 for an hourly breakdown): Services: 1 — Project Management: $3,437.50 [Hourly] 2 — Review of Existing Bid Documents: $1,435.00 3 — Survey (Provided by Others) 4 — Update Construction Documents: $8,705.00 5—Construction Phase Services: $11,135.00 6 — Reimbursables: $500.00 Total [excluding services provided by others]: $25,212.50 If additional services are required, these services shall be billed at the following hourly rates: 1. Principal Engineer - $215/hr [Project Number: CCY173501 i Port Alto Date: April 1.8, 2019 Page 4 of 4 2. Senior Engineer - $180/hr 3. Engineer 1 - $120/hr 4. EIT 2 - $105/hr 5. EIT 1 - $97/hr Notes: 1.'T'his engineering fee does not include permit fees to the city, county, TCEQ, USACE, FEMA, or other unanticipated review/permitting authorities. 2. Once design is reviewed and approved by owner, any modifications to such plans may be considered as additional services. NOTE: FNI-SC recommends a new survey in the fill area to reduce the volume uncertainties with the contractors. This survey will need to be contracted directly by the County. FNI-SC recommends using Naismith Marine as the surveying services provider since they are recognized as a good provider by the Texas General Land Office. The point of contact is Mr. Jim Naismith. His email is: jim@naismithmarine.com, phone number: (361) 945-0248. FNI-SC already communicated with Mr. Jim Naismith and attached is his survey proposal. FNI-SC will review of the scope and will pass a letter to the County with comments on the proposal. Sincerely, Juan Moya PG Freese and Nichols Coastal Program cc: Anthony Risko, Eric Scheibe. Attachments Naismith Scope for Survey [Project Number: CCY17350]: (Project Number: CCY173501 I Calhoun County Corurnissioners' Court —JUNE 19, 2019 18. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 16) On submittal of CEPRA Grant utilizing GOMESA funds as matching funds if approved (estimated to be $70,000) for a solution for Magnolia Beach erosion and authorize Commissioner Hall to sign. (DH) RESULT: APPROVED[UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 16 of 25 David E. Hall 61 - Calhoun County Commissioner, Precinct #1 202 S. Ann Port Lavaca, TX 77979 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer, (361)552-9242 Fax(361)553-8734 Please place the following item on the Commissioners' Court Agenda for June 19th, 2019. • Consider and take necessary action on submittal of CEPRA Grant utilizing GOMESA funds asma ing funds if approved (estimated to be $70,000)for solution for Magnolia Beach r- n and all Commissioner Hall to sign. Sincer y, David E. Hall DEH/apt Calhoun County Commissioners' Court --JUNE 19, 2019 19. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 19) On request from Port O'Connor Chamber of Commerce to install a plaque at the pavilion at King Fisher Beach. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 17 of 25 June 12, 2019 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: Gary A Reese County Commissioner County of Calhoun Precinct 4 Please place the following item on the Commissioners' Court Agenda for June 19, 2019. Discuss and take necessary action on request from Port O'Connor Chamber of Commerce to install a plaque at the pavilion at King Fisher Beach. Sincerely, Gary D. Reese GDR/at P.O. Box 177 — Seadrift, Texas 77983 — email: Qarv.reese®calhouncotx.org — (361) 785-3141 — Fax (361) 785.5602 In appreciation to the directors of the Port O'Connor Chamber of Commerce who by their dedicated efforts and loyal service made this pavilion a reality. Mary Jo Walker - President Donnie Klesel -V-President Secretaries - Beverly Clifton & Darla Parker Treasurers - Donnie Pyle & Carolyn Garrison Ann Brownlee Linda Bomar Sylvia Rodriguez Don Haynes Donna Vuichard Laurie Junek Agnes Valigura Patti Elkins IN GRATITUDE TO EACH AND EVERYONE WHO SUPPORTED THIS PROJECT DEMONSTRATING A SPIRIT OF GIVING WHICH HAS SUSTAINED AND IMPROVED LIFE IN THIS COMMUNITY Special recognition of the outstanding generosity of these major contributors : Sharilyn & Larry Carroll Gary Cunningham Frances Alexander Debbie & Doug Wuest DEDICATED SEPTEMBER, 2015 Calhoun County Commissioners' Court — JUNE 19, 2019 20. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 20) To accept a donation of $4,200 from the Port O'Connor Service Club for the repair of existing picnic tables/benches at King Fisher Park. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Clyde Syma, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 18 of 25 June 12, 2019 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 Dlkt• VM k) Dear Judge Meyer: Gary A Reese County Commissioner County of Calhoun Precinct 4 Please place the following item on the Commissioners' Court Agenda for June 19, 2019. • Discuss and take necessary action to accept donation of $4,200 from the Port O'Connor Service Club for the repair of existing picnic tables/benches at King Fisher Park. Sincerely, Gary D. Reese GDR/at P.O. Box 177 - Seadrift, Texas 77983 - email: ¢arv.reese@calhouncotx.ore - (361) 785-3141 - Fax (361) 785-5602 RESOLUTION Whereas, the Board of Directors and Membership of the Port O'Connor Community Service Club have approved implementation of a project for improvement of Kingfisher Park in a regular meeting held on June 6, 2019. Funding was approved not to exceed $7,000.00 for this project. RESOLVED that: Funding will be provided to Calhoun County Precinct #4 for purchase of material to repair eleven (11) existing picnic tables/benches. RESOLVED that: Funding will be provided to replace existing flagpole and new and future flags. RESOLVED that: Funding will be provided to purchase new volley -ball net. Date: June 7, 2019 Secretary: d� Do _ g a 00 ex Q gS co o 4 1 cc rm r. o� O 0 .a v ( ru V ` � ru ru LD z c z rm z ru viz m c 0 � � �+ a rA Calhoun County Commissioners' Court—JUNE 19, 2019 21. CONSIDER AND TAKE NECESSARY ACITON (AGENDA ITEM NO. 21) To set dates and times for budget workshops. (RM) RESULT: APPROVED[UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 19 of 25 { � � } . S h CF) / o Q m { ` C }_ - ` CD k ( k - � � %00 # ' ° m \ N ( % O � � % (.0 / e \ r m CL . %CA) }© �_ � CD . U) % - ~ ca m Calhoun County Commissioners' Court—JUNE 19, 2019 22. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 22) To declare items located in the Calhoun County Public Library declared as Surplus/Salvage and authorize the Librarian to dispose of same. (see list) (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 20 of 25 422 - Calhoun 22Calhoun County Public Library "M-"1ibMN'0rg 200 W. Mahan I Port Lavaca, TX 77979 Ph: 361.552.7323 Fax: 361.552.5218 APRIL - MAY 2019 I would like the following items to be declared Surplus/Salvage 376 Books 282 Paperbacks 1131 Magazines 9 DVD's Other 11 Music CD 19 VHS 5 Color Books I Calhoun County Commissioners' Court—JUNE 19, 2019 23. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 23) To declare items located in the Calhoun County Public Library declared as Waste and authorize the Librarian to dispose of same. (see list) (RM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 21 of 25 VIAL Calhoun County Public Library w ."Ilbrary.org 200 W. Mahan I Port Lavaca, TX 77979 Ph: 361.552.7323 Fax: 361.552.5218 APRIL - MAY 2019 I would like the following items to be declared Waste Laminator Xyron 850 Monitor Dell Monitor Dell Keyboard Dell Keyboard Dell Keyboard Dell Keyboard HP Keyboard Dell Keyboard HP Barcode Scanner Voyager Keyboard Gigaware Water Cooler Sunbeam Keyboard Dell Keyboard Dell Keyboard Dell Mouse Logitech Mouse HP Mouse HP Mouse Dell Mouse Dell Mouse Dell Mouse Microsoft 850-B LCD 1570NX-BK E176FPc E145614 SK -8115 SIC -8115 KB -0316 L100 SIC2880 MS9520 YLR2-5-87H3 SK -8115 SK -8115 SK -8115 M-BZ96C M-UAE96 M-UV96 M-UVDELl M-UVDELl Mouse Dell M -VAR DEL71 Mouse Dell Router Linksys G WRT54GL Router Linksys G WRT54GL Switch Bay Networks FS 108 Wireless Access U.S. Robotics USR5451 Wireless Access U.S. Robotics USR5451 Ethernet Switch CentreCom FS724i Cordless Phone Vtech CS6649 Cordless Phone Vtech CPU HP Pro 3000 M 9716 68D221IOTA CN-OMC040-64180-5BC-2 W VS CN-OJ4628-71616-623-OP55 CN-OJ4628-71616-624-OJ44 CN-OJ4628-71616-624-OMOM BAUDROJVBYN3RS CNORH6597357182M09RG BDAEBOBCP5M5YE 3500332432 12A07 20030503636 CN-ODJ3 3 1 -71 616 -75H -OP W 8 CN-OJ4628-71616-624-ODL5 CN-OJ4628-71616-627-ODSX PID:HS72711 CT:FATSKOLN30A959 265986-003 OC8639 HCS55219272 F0304610 X802382-017 HS908133E4A\ F030460B CL71KA00328 CL7C1KA01269 FS18E7066606 1 WBK18EF005U 1 WBK19CFOOAM M09P03131 A QA813859949 MXLO341JSL bA6- Calhoun County Public Library wviw"ibmry.orH 200 W. Mahan I Port Lavaca, 7X 77979 Ph: 361.552.7323 Fax: 361.552.5218 APRIL - MAY 2019 I would like the following items to be declared Waste 147 Books 542 Paperbacks 5 DVD's 211 Magazines Others 1 VHS I Calhowi County Commissioners' Court — JUNE 19, 2019 24. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 24) To accept donations to the Calhoun County Public Library. (see list) (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 22 of 25 Calhoun County Public Library w Xclibmry.org 200 W. Mahan I Port Lavaca, TX 77979 Ph: 361.552.7323 Fax: 361.552.5218 The following materials have been donated to the Calhoun County Public Library System during the month of APRIL - MAY 2019 Books Donor 115 Books Unknown 34 Books Holly Leopald 15 Books Markayla Quirey 18 Books Donna Pyle 4 Books Kim Hall 16 Books Michelle Lippold 19 Books Cherise Bludau 2 Books Araceley Avelar 2 Books Alane Haardt 1 Book Barbara Willoughby 2 Books Mikoela Overton 6 Books Angelica Lara 1 Book Joseph Smith 6 Books Ed Carroll 1 Book Sarah Peavy 54 Books Georgia Hawes 1 Book Brigid Berger 1 Book Amy Severson 147 Books David Marion Paperbacks 78 Paperbacks Unknown 28 Paperbacks Barbara Conitz 28 Paperbacks Holly Leopold 4 Paperbacks Donna Pyle 6 Paperbacks Kim Hall 2 Paperbacks Steve Serrill 47 Paperbacks Michelle Lippold 52 Paperbacks Cherise Bludau 1 Paperback Dennis Crane 5 Paperbacks Tommy Bailey 7 Paperbacks Charles Willoughby 1 Paperback Alane Haardt 4 Paperbacks Mikoela Overton 3 Paperbacks Angelica Lara 3 Paperbacks Markayla Quirey 3 Paperbacks Luis De La Garza 5 Paperbacks Sarah Peavy 1 Paperback Georgia Hawes 1 Paperback Brigid Berger 547 Paperbacks David Marion Magazines 28 Magazines Unknown 225 Magazines Dolores Schneider 13 Magazines Markayla Quirey 2 Magazines Barry Hunter DVD'S 18 DVD's Unknown 18 DVD's Bo Warren 1 DVD Aracely Avelar 36 DVD's Mark Yang Others 11 Puzzles Unknown 1 Audio Book Unknown 5 Color Books Unknown 1 Package Legos Patti Roeder 19 VHS Jessamy Reed 2 Boxes Hanging Files Letter Size Treasurer's Office 3 Boxes Hanging Files Legal Size Treasurer's Office 2 Pictures Treasurer's Office 5 3 -Ring Binders Treasurer's Office 20 Bags of Snacks Advantage Loan Co. 3 Boxes Capri Sun Advantage Loan Co. 1 Plastic File Holder Anna Goodman 1 Plastic Pamphlet Holder Anna Goodman 1 Box of Stationary Anna Goodman 167 File Folders Anna Goodman 5 1" Binders Anna Goodman 1 Package Address Labels Anna Goodman 2 Packages Tri -Fold Brochure Paper Anna Goodman 1 Package Construction Paper Anna Goodman 1 Spiral Notebook Anna Goodman 2 Packages Photo Paper Anna Goodman 2 Packages Crazy Felt Anna Goodman 1 Package Business Cards Anna Goodman 1 Package Rolodex Printer Cards Anna Goodman 2 Packages Decorative Computer PaperAnna Goodman 3 3" Binders Anna Goodman 2 Packages Dividers Anna Goodman 1 Magazine Anna Goodman 10 State Maps Anna Goodman $ 27.06 From Debbie Stovall for Port O'Connor Signage $ 25.00 From Christina Arroyo -Diaz For Summer Reading Program $ 79.82 For Seadrift Branch Library $ 500.00 From H.E.B. For Summer Reading Program $ 500.00 From Seadrift Coke For Summer Reading Progam $ 200.00 From Sutherland Family For Summer Reading Program $ 40.00 From Angelica Lara For Summer Reading Program $ 500.00 From Friends of POC Library For Summer Reading Program $ 27.15 Donation Bucket Point Comfort Library $ 40.68 Donation Bucket POC Library $ 4.11 Donation Bucket Seadrift Library $ 1000.00 From City of Point Comfort To Point Comfort Library $ 25.00 From Betty Morgenroth Memorial for Helen Morgenroth $ 6.00 Cartridge Recyling ICalhoun County Commissioners' Court—JUNE 19, 2019 25. Accept reports of the following County Offices: i. County Clerk's Office — April 2019 ii. County Sheriff's Office — May 2019 iii. Justice of the Peace PCT #3 — May 2019 iv. Justice of the Peace PCT #5 — May 2019 v. County Extension Office — May 2019; June 2019 RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 23 of 25 .42 55 CALHOUN COUNTY CLERK MONTHLY REPORT RECAPITUATION APRIL2019 DOC > DECODE CIVIL CRIMINAL OFFICIAL PUBLIC RECORDS PRODATE TOTAL OISTRICTATTORNEY FEES 100044020 $ 519.32 $ 519,32 BEER LICENSE 10042010 $ 5.00 $ 6.00 COUNTY CLERK FEES 100944030 S 441.20 $ 821.27 $ 9,664.25 $ 516.00 $ 11,442.72 APPEAL FROM JP COURTS 1000-44030 $ - $ - COUNTY COURT AT LAW 41 JURY FEE 300044140 $ - IURYFEE 100044140 $ - $ - $ - ELECTRONICFILING FEES FOR &FILINGS 100044058 IF 60.00 $ - $ - $ 02,00 $ 142.00 JUDGE'S EDUCATION FEE 100044160 $ - $ - $ - $ 46,00 $ 45.00 JUDGE'S ORDER/SIGNATURE 100044190 $ 6.00 $ - IS - $ 54.00 $ 60.00 SHERIFF'SFEES 100044190 $ - $ 541.50 $ - $ 225.00 $ 760.50 VISUAL RECORDER FEE 100044250 $ 100.30 $ 100.30 COURT REFPORTER FEE 100044270 $ GOOD $ - $ - S 135.00 $ 195.00 RESTITUTION DUE TO OTHERS 1000.49D20 $ - AlTORNEYFEES -COURT APPOINTED 100049030 $ - $ - APPELLATE FUND OGC)FEE 262044030 $ 20.00 $ 45.00 IF 05.00 TECHNOLOGY FUND 266344030 $ 82.13 $ 82.13 COURTHOUSE SECURITY FEE 267044030 $ 20.00 $ 61.62 $ 340,00 $ 45.00 $ 468,62 COURT INITIATED GUARDIANSHIP FEE 2672-44030 $ 100.00 $ 100.00 COURT RECORD PRESERVATION FUND 2673.44030 $ 40,00 IS - $ 90.00 $ 130,00 RECORDS AROINE FEE 267544030 $ 3,260.00 $ 3,260.00 DRUG & ALCOHOL COURT PROGRAM 2698.44030005 $ 360.94 $ 360.94 JUVENILE CASE MANAGER FUND 2699.44033 $ - $ - FAMILY PROTECTION FUND 270644030 $ - $ - IUVENILECRIME & DELI NQUENCY FUND 2715-44030 $0.00 $ - PRE-TRIAL DIVERSON AGREEMENT 2729-44034 $ 300,00 $ 300.00 LAW UDARY FEE 2731.44030 $ 140.00 $ 315.00 $ 455.00 RECORDS MANAGEMENT FEE -COUNTY CLERKK 2738-44380 $ 49.33 $ 3,340.00 $ 3,389.33 RECORDS MANGEMENT FEE - COUNTY 2739.44030 $ 20,00 $ 443.95 $ 45.00 $ 50B.95 FINES COUNTY COURT 274045040 $ 8,856.21 $ 8,058.21 DONDFORFEITURE 2740-45050 $ ' STATE POLICE OFFICER FEES - STATE (DPS)(20%) 702020740 $ 7.02 $ 7.02 CONSOUDATED COURT COSTS - COUNTY 707040610 $ 169.97 $ 169.97 CONSOLIDATED COURT COSTS - STATE 7070-20740 $ 1,629.74 IS 1,529,74 JUDICIAL AND COURT PERSONNEL TRAINING ,M(100%) 7502-20740 $ 20.00 $ - $ 45,00 $ 65,00 DRUG & ALCOHOL COURT PROGRAM -COUNTY 7390-20610 $ 72.19 $ 72.19 DRUG ALCOHOL COURT PROGRAM - STATE 730020740 $ 288.75 $ 208,75 STATE ELECTRONIC FILING FEE - CIVIL 740332607 $ 120,00 $ - $ 270.00 $ 390.00 STATE ELECTRONIC FILING FEE CRIMINAL 7403.22990 $ 102.69 $ 102.69 EMS TRAUMA -COUNTY DOV.) 7405.20610 IS 704.80 $ 704,68 EMS TRAUMA-STATE(909) 7405-20740 $ 78.30 $ 70.30 CIVIL INDIGENT FEE -COUNTY 7400.20610 $ 2.00 $ 4,50 $ 6.50 CIVIL INDIGENT FEE -STATE 740020740 $ 30.OD $ 85.60 $ 123.50 JUDICIAL FUND COURT COSTS 7495-20740 $ 307.99 $ 307.89 JUDICIAL SALARY FUND - COUNTY (10%) 750520610 $ 12.30 $ 12.30 JUDICIAL SALARY FUND - STATE 190%) 7505.20740 $ 110.68 $ 110.06 JUDICIAL SALARY FUND (CIVIL & PROBATE) -STATE 7505-20740 005 $ 100,08 $ 378.00 $ 540.00 TRAFFIC LOCAL(ADMINISTRATIVE FEES) 7538-22684,1000.44359 $ 6.65 $ 6.65 COURTCOST APPEAL OFTRAFFIC REG RP APPEAL) 753032885 $ - BUITH-STATE 7655-20780 $ 120.00 $ 126.00 INFORMAL MARRIAGES - STATE 785530782 $ - $ - JUOICIALFEE 7855-20786 $ 160.00 $ - $ 360.00 $ 520.00 FORMAL MARRIAGES - STATE 7855-20788 $ 360.00 $ 300.00 NONDISCLOSURE FEE - STATE 7855.20790 $ - $ - $ - IS - FOLIOSE COURT COST - COON" (10%) 7856-20610 $ 0,11 $ 0.11 TCLEGSE COURT COST - STATE (90%) 7856-20740 $ 1.00 $ 1.00 JURY REIMBURSEMENT FEE -COUNTY 00% 7857.20610 $ 8.19 $ 6.19 BURY REIMBURSEMENT FEE -STATE (90%) 7857-20740 $ 73.75 $ 73.75 STATE TRAFFIC FINE. COUNTY (5%) 7860.20610 $ 3,02 $ 3.02 STATE TRAFFIC FINE - STATE (95%) 786030740 $ 57.31 $ 57.31 INDIGENT DEFENSE LEE - CRIMINAL - COUNTY (10%) 786530610 $ 4.28 $ 4.28 INDIGENT DEFENSE FEE - CRIMINAL - STATE (90%) 7865.20740 $ 30.48 $ 38.40 TIME PAYMENT -COUNTY (50%) 7950.20610 $ 232.02 $ 232.02 TIME PAYMENT -STATE (50%) 7950-20740 S 232.02 S 232.02 BAIL JUMPING AND FAILURE TO APPEAR -COUNTY 797020610 $ ' BAIL JUMPING AND FAILURE TO APPEAR - STATE 7970-20740 $ ' DUE PORT LAVACA PO 9990-99991 $ 49.60 $ 49.60 DUE SEADRIFT PD 999099992 $ - $ - DUE TOPOINT COMFORT PD 999099993 $ 0.60 $ 0.66 DUE TO TEXAS PARKS & WILDLIFE 999099994 $ 21000.00 $ 2,000.00 DUE TO TEXAS PARKS& WILDLIFE WATER SAFETY 999099995 $ - OUETOTABC 999099996 $ - DUETOATTORNEYADLITEMS 999089997 $ ' DUE TO OPERATING/NSF CHARGES/DUE TO OTHERS $ $ 6.001$ 698,00 $ 1$ 701.00 S 1,315.20 B 10,240,90 4 17,791.26 $ 2,920,00 S 40,28736 TOTAL FUNDS COLLECTED $ 40,267.36 - PONDS HELD INESCROW: IS - AMOUNT DUE TO TREASURER: $ 37,61609'. TOTAL RECEIPTS' $ -00,247.36:'. AMOUNT DUE TO OTHERS: $ 2,751.26 I OF U W REPORTANOUTIF.MUDKOR AND TREASURER REPORT&VOIV 13019 TREACURER REPORTS As &SR019 CALHOUN COUNTY CLERK MONTHLY REPORT RECAPITUATION APRIL2019 CASH ON HANG REGISTRY OF COURT FUNDS(PROSPERITYI BEGINNING ROOK BALANCE 3/31/3019 S 134.741.99 FUND RECEIVED $ 3.900.00 DISBURSEMENTS $ 128,684.79 ENDING BOOK BALANCE 4/30/2019 4 $ 110,057.20 BANK RECONCILIATION REGISTRY OF COURT FUNDS ENDING BANK BALANCE 4/30/2019 $ 134,013.10 OUTSTANDING DEPOSITS" $ 475.00 OUTSTANDING CHECKS" $ (24,430.90 RECONCILED BANK BALANCE 4/30/2019 $ 110,057.20 S Hart um n Iu T.1111. PROSPERITY RANK -CUES Date Issued Balance Purchesssl Withdrawals Balance 313112019 Interest 04/3049 10440 1/24/2010 $ 1050.77 $ 3.90 $ $ 1,862.67 10441 1/24/2010 $ 10,065.16 $ 20.64 $ 10,093.70 10442 1/24/2010 $ 1.256.26 $ 2.63 $ 1260.69 10443 1/25/2018 $ 1,256.20 $ 2.63 $ 1,258,09 10444 12512018 $ 9,400.98 1 1988. $ 9,508.86 10445 1/25/2018 $ 9,406,90 $ 19.00 $ 9,506.06 10440 1/26/2018 $ 9.488.98 $ 19.88 $ 9.500.06 10449 212/2010 $ 19,910.73 $ 10,910.73 10464 132/2010 $ 3,643.97 $ 3,543.97 10465 3/2/2010 $ 3,843.87 $ 3,543,97 $ $ TOTALS: $ 09,904.08 $ 01.3A $ E 70,001.40 /It 2er2 U\OAEPORTSWOURILYNUUITOR ANO TREASURER REPORTS0010041010 TREASURER REPORTS As 0162010 m SHERIFF'S OFFICE MONTHLY REPORT May -19 BAIL BOND FEE $ 1,365.00 CIVIL FEE $ 1,174.00 JP#1 $ 914.00 JP#2 $ 1,468.00 JP#3 $ 2,301.50 JP#4 $ - JP#5 $ 494.00 PL MUN. $ COUNTY COURT $ SEADRIFT MUN. $ - PC MUN. $ 1,814.80 OTHER $ - PROPERTY SALES $ 176,100.00 DISTRICT $ CASH BOND $ - TOTAL: $ 185,631.30 1,811.50 181.15 4.23 30.00 30.00 90.57 230.00 181.14 `62.78 5.00 158.65 1,261-43 181.15 134.34 88.57 50.00 91.50 19.80 934.20 75.00 18.00 271.75 ''.75.00 '.3,907.60 297.00 102.00 15.00 z�s�eL DR REQUESTING DISBURSEMENT MO.REPORT MO. REPORT U,UU PLEASE INCLUDE D. R. REQUESTING DISBURSEMENT 0.00 PLEASE INCLUDE DR. REQUESTING DISBURSEMENT O,OD PLEASEINCLUDE D.R. REQUESTING DISBURSEMENT 0,00; PLEASEINCLUDE D REQUESTING DISBURSEMENT(IF REQUIRED) MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 6/5/2019 COURT NAME: JUSTICE OF PEACE NO. 3 MONTH OF REPORT: MAY YEAR OF REPORT: 2019 Page 1 of 2 ACCOUNT NUMBER ACCOUNT NAME AMOUNT CR 1000-001-45013 FINES 4,003.15 CR 1000-001-44190 SHERIFF'S FEES 233.70 ADMINISTRATIVE FEES: DEFENSIVE DRIVING 19.80 CHILD SAFETY 0.00 TRAFFIC 126.14 ADMINISTRATIVE FEE 934.20 EXPUNGEMENT FEES 0.00 MISCELLANEOUS 0.00 CR 1000-001-44363 TOTAL ADMINISTRATIVE FEES 1,080.14 CR 1000-001-44010 CONSTABLE FEES -SERVICE 75.00 CR 1000-001-44063 JP FILING FEES 75.00 CR 1000-001-44090 COPIES / CERTIFIED COPIES 0.00 CR 1000-001-49110 OVERPAYMENTS (LESS THAN $10) 0.00 CR 1000-001-44145 SCHOOL CROSSING/CHILD SAFETY FEE 0.00 CR 1000-999-20741 DUE TO STATE -DRIVING EXAM FEE 0.00 CR 1000-999-20744 DUE TO STATE -SEATBELT FINES 51.00 CR 1000-999-20745 DUE TO STATE -CHILD SEATBELT FEE 0.00 CR 1000-999-20746 DUE TO STATE -OVERWEIGHT FINES 0.00 CR 1000-999-20770 DUE TO JP COLLECTIONS ATTORNEY 91.50 TOTAL FINES, ADMIN. FEES & DUE TO STATE $5,609.49 CR 2670-001-44063 COURTHOUSE SECURITY FUND $135.86 CR 2720-001-44063 JUSTICE COURT SECURITY FUND $45.29 CR 2719-001-44063 JUSTICE COURT TECHNOLOGY FUND $181.15 CR 2699-001-44063 JUVENILE CASE MANAGER FUND $230.00 STATE ARREST FEES DPS FEES 41.73 P&W FEES 1.00 TABC FEES 0.00 CR 7020-999-20740 TOTAL STATE ARREST FEES 42.73 CR 7070-999-20610 CCC -GENERAL FUND 181.15 CR 7070-999-20740 CCC -STATE 1,630.35 DR 7070-999-10010 1,811.50 CR 7860-999-20610 STF/SUBC-GENERAL FUND 63.07 CR 7860-999-20740 STF/SUBC-STATE 1,198.36 DR 7860-999-10010 1,261.43 CR 7950-999-20610 TP -GENERAL FUND 67.17 CR 7950-999-20740 TP -STATE 67.17 DR 7950-999-10010 134.34 CR 7480-999-20610 CIVIL INDIGENT LEGAL -GEN. FUND 0.90 CR 7480-999-20740 CIVIL INDIGENT LEGAL -STATE 17.10 DR 7480-999-10010 18.00 Page 1 of 2 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 6/5/2019 COURT NAME: JUSTICE OF PEACE NO. 3 MONTH OF REPORT: MAY YEAR OF REPORT: 2019 CR 7865-999-20610 DA - RESTITUTION CRIM-SUPP OF IND LEG SVCS -GEN FUND 9.06 CR 7865-999-20740 0.00 CRIM-SUPP OF IND LEG SVCS -STATE 81.51 PARKS & WILDLIFE FII 252.45 DR 7865-999-10010 90.57 CR 7970-999-20610 TL/FTA-GENERAL FUND 10.00 CR 7970-999-20740 TL/FTA-STATE 20.00 DR 7970-999-10010 30.00 CR 7505-999-20610 JPAY - GENERAL FUND 27.18 CR 7505-999-20740 JPAY - STATE 244.57 DR 7505-999-10010 271.75 CR 7857-999-20610 JURY REIMB. FUND- GEN. FUND 18.11 CR 7857-999-20740 JURY REIMB. FUND- STATE 163.03 150 DR 7857-999-10010 181.14 CR 7856-999-20610 CIVIL JUSTICE DATA REPOS.- GEN FUND 0.42 CR 7856-999-20740 CIVIL JUSTICE DATA REPOS.- STATE 3.81 DR 7856-999-10010 4.23 CR 7502-999-20740 7998-999-20701 CR 7998-999-20740 CR 7403-999-22889 REVISED 03/04/16 JUD/CRT PERSONNEL TRAINING FUND -STAT 15.00 DR 7502-999-10010 15.00 JUVENILE CASE MANAGER FUND 44.29 TRUANCY PREVENT/DIVERSION FUND- STAT 44.29 DR 7998-999-10010 88.57 ELECTRONIC FILING FEE 30.00 DR 7403-999-10010 30.00 TOTAL (Distrib Reg to OperAcct) $10,181.05 DUE TO OTHERS (Distrib Reg Attchd) CALHOUN COUNTY IS 0.00 DA - RESTITUTION 0.00 REFUND OF OVERPAI 0.00 OUT -OF -COUNTY SER 0.00 CASH BONDS 0.00 PARKS & WILDLIFE FII 252.45 WATER SAFETY FINE: 0.00 TOTAL DUE TO OTHERS $252.45 TOTAL COLLECTED -ALL FUNDS $10,433.50 LESS: TOTAL TREASUER'S RECEIPTS $10,433.50 Z'_ OVER/(SHORT) $0.00 Page 2 Grp 06-07-19;18:59 ;From:Calhoun County Pot. 5 To:5534444 ;3619832461 # 2/ 9 CHS 2.00 11AP 5.00 WRNT 50.00 2173.00 HERBER, CARL AARON *2 1. b t V IF 4.00 JCSF 1.00 JPAY 6.00 TOP 2.00 TPDF 2.00 CreC14 card OMNC 4.00 OMND 20.00 OMNO CALHOUN CO. 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'Txmr 376706 1500.0300A 05-21-2019 JSY 4.00 CCC 40.00 CBS 3.00 LAF 5.00 TF 4.00 494.10 MILLER, DYLAN DP$C 30.00 JCSF 1.00 JPAY 6.00 TDF 2.00 TPDP 2,00 Credit Card FINE 260.00: CSRV 107.10 3.767Q7:_:: -:L$00-0300 S J I 1. F' .4.,00 TCC.,3 :3 01) CCC 4:60.6':' CBi;:: :06:;.:: ii7j� 299..0:0 . ....::::i . Ob, 0 0 P. '01,4-10 0, PISC 30:::0a.':: JCSF -*'U.00: A-: P ..G...00, ..:'Credit Card: TDF .16 ..... 0 MVF T 0 1 "0*0! t�' 00 .. Y V ...... 376708 1505-0231 05-30-2019 T$F 4.00 TPC 3.00 COO 40.00 CBS 3.00 LAP 5.00 190,00 CABRERA, MARLON TF 4.00 JCSF 1.00 JPAY 9.00 JDF 2.00 MVP 0.10 Money Order SUBC 30.00 TPDP 2.00 FINE 84.90 -TCMF 5.00 �'C : 70 376709:: 9 J..*:.::X9.1D.4:�0'�97 ;Q . 1. - 4-00 1: i: - 'CCC 40 06 I CHS:. " 6'6! �". X ...:TFL : r . , 00- 7 00 . . . ..... 'I p ENTER f:. RODR GUZZ-�.WaRAM, 0 :JCSF . .... )r JPAY : o. .. 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J.P. 5, MAX 2019 REPORT Type Code Donaription Count Retained Dinburaed Money -Totals Tho following totals represent - Caeb and Chcoka Collocted COST CCC CONSOLIDATED COURT COSTS 21 75.49 679.39 754.08 COST CHS COURTHOUSE SECURITY 21 58.12 0.00 58.12 COST DPSC DPS FAILURE TO APPEAR /OMNI FEES 0 0.00 0.00 0.00 COST IDF INDIGENT DEFENSE FUND 21 3.87 34.88 30.75 COST JCSF JUSTICE COURT SECURITY FUND 21 19.37 0,00 19.37 COST JPAY JUDGE PAY RAISE FEE 21 11162 104.61 116,23 COST JSF JUROR SERVICE FUND 21 7.75 69,72 77,47 COST IAP SHERIFF'S FEE 13 61.87 0,00 61.87 COST MVP MOVING VIOLATION FEE 11 0.10 0.90 1,00 COST OMNC DPS OMNI FEE - COUNTY 1 4.00 0.00 4.00 COST OMNI) DPS OMNI FEE - DPS 1 0.00 20.00 20,00 COST OMNO DPS OMNI FEE - OMNIDASE 1 0100 6.00 6.00 COST PWAF TEXAS PARKS & WILDLIFE 3 12,00 3,00 15.00 COST SAF DPS 4 12.00 3.00 15.00 COST SUBC SUR TITLE C 5 239.97 0.00 239.97 COST TF TECHNOLOGY FUND 21 77,49 0.00 77,49 COST TFC TFC 9 24.00 0.00 24,00 COST TIME TIME PAYMENT FEE 1 12.50 12.50 25.00 COST TPDF TRUANCY PREVENTION & DIVERSION FUND 21 0.00 38.75 38.75 COST WENT WARRANT FEE I 50,00 0.00 50,00 FEES CSRV COLLECTION SERVICES PER 1 65.50 0.00 85.50 FEES DDC DRIVER SAFETY COURSE - 2013 3 14.70 0.00 14.70 FEES OFF DEFERRED FEE 1 24.00 0.00 24.90 FEES EFF ELECTRONIC FILING FEE 1 0,06 10,00 10,00 FEES EXRF EXPIRATION RENEWAL FEE 1 20,00 0,00 20,00 FEES FILI FILING FEE 1 25.00 0.00 25,00 FEES IFEE INDIGENT FEE 1 0.30 5.70 6.00 FEES JCMF JUVENILE CASE MANAGER FEE 17 55.00 0.00 85.00 FEES JPTF JUDICIAL & COURT PERSONNEL TRNG FEE -CV 1 0,00 5.00 5.00 FEES SFEE SERVICE FEE 1 75.06 0.00 75.00 FINE FINE FINE 11 1,015.50 0,00 1,015.50 FINE PWF PARKS & WILDLIFE FINE 5 129,30 732,70 062.00 OTHR OVNC OVERPAYMENT 1 20.00 0.00 20.00 Money Tota10 25 2,165.35 1,726.15 31891.50 Tho following totals ropronont - Trann Pera Collected COST CCC CONSOLIDATED COURT COSTS 0 0.00 0.00 0.00 COST CHS COURTHOUSE SECURITY 0 0.00 0.00 0,00 COST DPSC DPS FAILURE TO APPEAR /OMNI FEES 0 0.00 040 0.00 COST IDF INDIGENT DEFENSE FUND 0 0.00 0.00 0.00 COST JCSF JUSTICE COURT SECURITY FUND 0 0.00 0.00 0.00 COST JPAY JUDGE PAY RAISE FEE 0 0,00 0.00 0.00 COST .ISP JUROR SERVICE FUND 0 0.00 0.00 0.00 COST LAP SHERIFF'S FEE 0 0.00 0,00 0.00 COST MVP MOVING VIOLATION FEE 0 0100 0.00 0,00 COST OMNO DPS OMNI PGE - COUNTY 0 0.00 0.00 0.00 COST OMND DP$ OMNI FEE - DPS 0 D.00 0.00 0.00 COST OMNO DPS OMNI FEE - OMNIEASE 0 0.00 0.00 0.00 C09T PWAP TEXAS PARKS & WILDLIFE 0 0.00 0.00 0.00 COST SAF DPS 0 0.00 0,00 0.00 COST SUED SUR TITLE C 0 0.00 0.00 0.00 COST TF TECHNOLOGY FUND 0 0,00 0.00 0.00 COST TFC TFC 0 0.00 0.00 0.00 COST TIME TIME PAYMENT FEE D 0.00 0.00 0.00 COST TPOF TRUANCY PREVENTION & DIVERSION FUND 0 0.00 0.00 0.00 COST WRNT WARRANT FEE 0 0.00 0.00 0.00 FEES CSRV COLLECTION SERVICES FEE 0 0.00 0.00 0.00 FEES DDC DRIVER SAFETY COURSE - 2013 0 0.00 0,00 0.00 FEES OFF DEFERRED FEE 0 0.00 0.00 0.00 PECS EPP ELECTRONIC FILING FEE 0 0.00 0.00 0.00 FEES EXRF EXPIRATION RENEWAL FEE 0 0.00 0100 0.00 PEES PILI FILING FEE D 0.00 0.00 0.00 FEES TFEE INDIGENT FEE 0 0.00 0.00 0.00 FEES JCMF JUVENILE CASE MANAGER FEE 0 0,00 0.00 0.00 FEES JPTF JUDICIAL & COURT PERSONNEL TRNG PEE -CV 0 0.00 0.00 0.00 FEES SFEE SERVICE PEE 0 0.00 0100 0,00 06-05-2019 Eege 3 06-07-19;18:59 ;From:Calhoun County Pct. 5 To:5534444 ;3619832461 # 5/ 9 Money Distribution RoDort Transfer Totals 0 0.00 0.00 0.00 The following totals regreuent - .Tail Credit And Community Service COST CCC CONSOLIDATED COURT COSTS 3 12.00 CALHOUN 00, J.P. Sr MAY 2019 REPORT 3 Type Cade peacription Count Retained Dioburoed Mone-Totala PING FINE FINE 0 0.00 0.00 0.00 FINE PEP PARKS & WILDLIFE FINE 0 0.00 0,00 0.00 OTHR OVNC OVERPAYMENT 0 0.00 0.00 0100 Transfer Totals 0 0.00 0.00 0.00 The following totals regreuent - .Tail Credit And Community Service COST CCC CONSOLIDATED COURT COSTS 3 12.00 108.00 120.00 COST CHS COURTHOUSE SECURITY 3 9.00 0.00 9.00 COST DPSC DPS FAILURE TO APPEAR /OMNI FEES 0 0.00 0.00 0.00 COST TDF INDIGENT DEFENSE FUND 3 0.60 5.40 6.00 COST JCSF JUSTICE COURT SECURITY FUND 3 3,00 0.00 3.00 COST JPAY JUDGE PAY RAISE FEE 3 1.80 16.20 18.06 COST JSF JUROR SERVICE POND 3 1.20 10.80 12.00 COST LAP SHERIFF'S FEE 1 5.00 0.00 5,00 COST MVP MOVING VIOLATION FEE 2 0.02 0.18 0.20 COST OMNC DPS OMNI PRE - COUNTY 2 8.00 0.00 8.00 COST OMND DPS OMNI FEE - DPS 2 0.00 40.00 40.00 COST OMNO DPS OMNI FEE - OMNIBASE 2 0.00 12.00 12.00 COST PWAF TEXAS PARKS & WILDLIFE 0 0.00 0.00 0.00 COST SAP DPS 1 4.00 1.00 5.00 COST SUSC SUB TITLE C 1 30.00 0.00 30.00 COST TP TECHNOLOGY FUND 3 12.00 0.00 12.00 COST TFC TFC 1 3.00 0.00 3.00 COST TIME TIME PAYMENT FEE 0 0.00 0.00 0.00 COST TPDF TRUANCY PREVENTION & DIVERSION FUND 2 0.00 4.00 COST WRNT WARRANT PRE 2 100.00 0.00 4.00 100.00 FEES CSRV COLLECTION SBRVTCES FEE 0 0.00 0.00 FBES DDC DRIVER SAFETY COURSE - 2013 0 0.00 0,00 0.00 0.00 PEES OFF DEFERRED FEE 1 84,90 0.00 84.90 PEES EFF ELECTRONIC FILING FEE 0 0.00 0.00 0.00 FEES EXRP EXPIRATION RENEWAL PEE 0 0.00 0.00 0,00 FEES FILT PILING PEE 0 0.00 0,00 0.00 FEES IFEE INDIGENT PEE 0 0.00 0.00 0.00 PPES JCMF JUVENILE CASE MANAGER FEE 3 15.00 0.00 15.00 FEES JPTF JUDICIAL & COURT PERSONNEL TRNG FEE -CV 0 0.00 0.00 0.00 FEES SFBE SERVICE FEE 0 0.00 0.00 0.00 FINE FINE FINE 2 257.90 0.00 257.90 FINE PWF PARKS & WILDLIFE FINE 0 0.00 0.00 0.00 OTHR OVNC OVERPAYMENT 0 0.00 0.00 0.00 Credit Totals 3 547.42 197.50 745.00 The following ental0 represent - Credit CAVd Payments COST CCC CONSOLIDATED COURT COSTS g 29.00 261.03 290.03 COST CHS COURTHOUSE SECURITY 8 21.75 0.00 21.75 COST DPSC DPS FAILURE TO APPEAR /OMNI PEES 2 19.80 40.20 60.00 COST IDF INDIGENT DBFRNSE FUND 0 1.45 13.08 14.50 COST JCSF JUSTICE COURT SECURITY FUND 8 7.25 0.00 7.25 COST JPAY JUDGE PAY RAISE FEE E 4.35 39.15 43.50 COST SSP JUROR SERVICE FUND 0 2.90 26.12 29.02 COST LAP SHERTFP'S FEE 6 26.25 0.00 26.25 COST MVF 14OVING VIOLATION FEE 5 0,04 0.39 0.43 COST OMNC DPS OMNI FEB - COUNTY 2 8.00 0.00 0.00 COST OMND DPS OMNI FEE - DPS 2 0.00 40.00 40.00 COST OMNO DPS OMNI FEE - OMNIBASE 2 0.00 12.00 12.00 COST PWAP TEXAS PARKS & WILDLIFE 0 0.00 0.00 0.00 COST SAF DPS 2 8.00 2.00 10.00 COST SUSC SUB TITLE C 4 97,52 0.00 97,52 COST TP TECHNOLOGY FUND 8 29.00 0,00 29.00 COST TFC TFC 4 9.75 0.00 9.75 COST TIME TIME PAYMENT FEF. 0 0.00 0.00 0.00 COST TPDF TRUANCY PREVENTION & DIVERSION POND 8 0.00 14.50 14.50 COST WRNT WARRANT FEE 3 180.00 0.00 150.00 FEES CSRV COLLECTION SERVICES FEE 4 346.20 0.00 346.20 FEES DDC DRIVER SAFBTY COURSE - 2013 0 0.00 0.00 0.00 FEES DPP DEFERRED FEE 0 0.00 0.00 0.00 FEES EFF ELECTRONIC FILING PEE 0 0.00 0.00 0.00 FEES EXRF EXPIRATION RENEWAL FEE 0 0.00 0.00 0.00 06.05-2019 Page 4 06-07-19;18:59 ;From:Calhoun County Pct. 5 To:5534444 ;3619832461 # 6/ 9 Money Distribution Report 2019 FEES PILI FILING FEE 0 0.00 0.00 0.00 FEES IFEE INDIGENT FEE 0 0.00 0.00 0.00 FEES JCMF JUVENILE CASE MANAGER FEE 4 20.00 0.00 20,00 FEES JPTF JUDICIAL & COURT PERSONNEL TRNG FEE -CV 0 0.00 0100 0.00 FEES $FEE SERVICE FEE 0 0.00 0.00 0.00 FINE FINE FINE 7 002,60 0.00 002.60 FINE PWF PARKS & WILDLIFE FINE 0 0.00 0.00 0.00 OTPIR OVNC OVERPAYMENT 0 0.00 0.00 0.00 Credit Card Totals 0 1,583.86 448.44 2,032.30 The tQllowing totals represent - Combined Money COST CCC CONSOLIDATED COURT COSTS 29 104.49 940.42 1,044.91 COST CHS COURTHOUSE SECURITY 29 79,07 0.00 79.87 COST OPSC DPS FAILURE TO APPEAR /OMNI FEES 2 19.80 40.20 60.00 COST TDF INDIGENT DEFENSE FUND 29 5.32 47,93 S3.25 COST JCSF JUSTICE COURT SECURITY FUND 29 26.62 0.00 26.62 COST JPAY JUDOS PAY RAISE FEE 29 15.97 143.76 159.73 COST JSF JUROR SERVICE FUND 29 10.65 95.04 106.49 COST LAP SHERIFF'S FEE 19 00.12 0.00 80.12 COST MVP MOVING VIOLATION FEE 16 0.14 1.29 1.43 COST OMNC DPS OMNI FEE - COUNTY 3 12.00 0100 12.00 COST OMNO DPS OMNI FEE - DPS 3 0.00 60.00 60.00 COST OMNO DPS OMNI FEE - OMNIBASE 3 0.00 10.00 18.00 COST PWAF TEXAS PARKS & WILDLIFE 3 12,00 3100 15.00 COST SAF DPS 6 20.00 5.00 25.00 COST SUBC SUB TITLE C 13 337.49 0.00 337,49 COST TF TECHNOLOGY FUND 29 106.49 0.00 106,49 COST TFC TFC 13 33.75 0,00 33.75 COST TIME TIME PAYMENT PEE 1 12,50 12.50 25.00 COST TPDF TRUANCY PREVENTION & DIVERSION FUND 29 0.00 53.25 53.25 COST WRNT WARRANT FEE 4 200.00 0.00 200.00 FEES CSRV COLLECTION SERVICES FEE 5 431.70 0.00 431.70 FEES DDC DRIVER SAFETY COURSE - 2013 3 14.70 0.00 14.70 FEES OFF DEFERRED FEE 1 24,90 0.00 24.90 FEES CFF ELECTRONIC FILING FEE 1 0.00 10.00 10.00 FEES EXRF EXPIRATION RENEWAL FEE 1 20.00 0.00 20.00 FEES FILI PILING FEE 1 25.00 0.00 25.00 FEES IFEE INDIGENT FEE 1 0.30 5.70 6.00 FEES JCMF JUVENILE CASE MANAGER FEE 21 105.00 0.00 105.00 FEES JPTF JUDICIAL & COURT PERSONNEL TRNG PEC -CV 1 0,00 5.00 S.DO FEES OPEN SERVICE FEE 1 75.00 0.00 75.00 FINE FINE FINE 10 11010,10 0.00 1,818.10 PINE PWF PARKS & WILDLIFE FINE 5 129.30 732.70 862.00 OTHR OVNC OVERPAYMENT 1 20.00 0,00 20.00 Money Totals 33 3,749.21 21174.59 5,923.80 The following totals represent - Combined Money and credits COST CCC CONSOLIDATED COURT COSTS 32 116,49 1,048.42 1,164.91 COST CHS COURTHOUSE SECURITY 32 88.87 0.00 08.87 COST DP80 DPS FAILURE TO APPEAR /OMNI FEES 2 19.80 40.20 60.00 COST IDF INDIGENT DEFENSE FUND 32 5.92 $3.33 59.25 COST JCSF JUSTICE COURT SECURITY FUND 32 29.62 0.00 29.62 COST JPAY JUDGE PAY RAISE FEE 32 17,77 159,96 177,73 COST JSF JUROR SERVICE FUND 32 11.05 106,64 118.49 COST LAP SHERIFF'S FEE 20 93.12 0.00 93.12 COST MVP MOVING VIOLATION FOE 19 D. la 1.47 1.63 COST OMNC DPS OMNI FEE - COUNTY 5 20.00 0.00 20.00 COST OMND UPS OMNI FEE - DPS 5 0.00 100.00 100.00 COST OMNO DPS OMNI FEE - OMNYSASE 5 0.00 30.00 30.00 COST PWAF TEXAS PARKS & WILDLIFE 3 12.00 3.00 15.00 COST SAF DPS 7 24,00 6.00 30.00 COST SUBC SUB TITLE C 14 367.49 0.00 367,49 COST TF TECHNOLOGY FUND 32 118.49 0.00 118.49 COST TFC TFC 14 36.75 0.00 36.75 COST TIME TIMR PAYMENT FEE 1 12.50 12.$0 25.00 :OST TPDP TRUANCY PREVENTION & DIVERSION FUND 31 D.00 57.25 57.25 :OST WRNT WARRANT FEE 6 300.00 0.00 300.00 e6-05-2019 Page .5 06-07-19;18:59 ;From:Calhoun County Pot. 5 To:5534444 ;3619832461 Money DiatributioA RepOXt CALHOUN CO. J.P. 5. MAX 2019 REPORT # 7/ 9 FEES CSRV COLLECTION SERVICES FEE 5 431.70 0.00 431.70 FEES DDC DRIVER SAPETY COURSE - 2013 3 14.70 0.00 14.70 FEES OFF DEFERRED FEE 2 109.00 0.00 109.80 FEL^S EPP ELECTRONIC FILING FEE 1 0.00 10.00 10.00 FEES EXRF EXPIRATION RENEWAL FEE 1 20.00 0.00 20.00 FEES FILI FILING FEE 1 25.00 0.00 25.00 FEES IEEE INDIGENT FEE 1 0.30 5.70 6.00 FEES JCMF JUVENILE CASE MANAGER FEE 24 120.00 0.00 120.00 FEES JPTF JUDICIAL & COURT PERSONNEL TRNG FEF. -CV 1 0.00 5.00 5.00 FEES EPEE SERVICE FEE 1 75.00 0.00 75.00 FINE FINE FINE 20 2,076.00 0.00 21076.00 FINE PWP PARKS & WILDLIFE FINE 5 129.30 732.70 062.00 OTHR OVNC OVERPAYMENT 1 20.00 0.00 20.00 Report Totals 36 4,296.63 2,372.17 6,668.80 06-05-2019 Ease ', 6 06-07-19;18;59 ;From:Calhoun County Pct. 5 To:5534444 ;3619832461 # 8/ 9 Money Distribution Report CALHOUN CO. J.P. 5, MAY 2019 REPORT Data Payment Type Picea Court Costa rood Dondo Restitution Other Total 00-00-0000 Cava & Checks Collected 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Jail Credits & Comm Service 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Credit Cards & Transfers 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total of all Collections 0.00 O.OD 0.00 0.00 0.00 0.00 0.00 09-01-1991 Cash & Checks Collected 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Jail Credits & Comm Service 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Credit Cards & Transfers 0.00 0.00 0.00 0.00 0.00 0,00 0,00 Total of all Collections 0.00 0.00 0.00 0.00 0.00 0.00 0.00 09-01-1993 Cash & Checks Collected 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Jail Credits & Comm Service 0.00 0.00 0.00 0.00 0100 0.00 0.00 Credit Cards & Transfers 0.00 0.00 0,00 0.00 0.00 0,00 0,00 Total of all Collections 0.00 0100 0.00 0.00 0,00 0.00 0,00 09.01.1995 Cash & Checks Collected 0.00 0.00 0.00 0.00 0,00 0.00 0.00 Jail Credito & Comm Service 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Credit Cards & TronoRers 0.00 0.00 0.00 0.00 0.00 0,00 0.00 Total of all Collections 0.00 0.00 0.00 0.00 0.00 0.00 0.00 09-01-1997 Cash & Checks Collected 0.00 0.00 6.00 0.00 0.00 0.00 0100 Jail Credits & Comm Service 0.00 0.00 0.00 0.00 0,00 0.00 0.00 Credit Cards & Tranoters 0.00 0.00 0.00 0.00 0.00 0.00 0,00 Total of all Collections 0.00 0.00 0.00 0.00 0.00 0.00 0.00 09-01-1999 Cash & Checks Collected 0100 0.00 0.00 0.00 0.00 0.00 0.00 Jail Credits & Comm Service 0.00 0.00 0.00 0.00 0,00 0.00 O.DO Credit Cards & Transfers 0.00 0.00 0.00 0.00 0.00 0.00 0,00 Total of all Collections 0.00 0.00 0.00 0.00 0.00 0.00 0,00 09.01.2001 Cash & Checks Collected 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Jail Credits & Comm Service MO 0.00 0.00 0.00 0,00 0.00 0.00 Credit Cards & Transfers 0.00 0,00 0100 0.00 0.00 0.00 0.00 Total Ol all Collections 0.00 0,00 0.00 0.00 0.00 0,00 0.00 09.01.2003 Cash & Checks Collected 0.00 0,00 0.00 0.00 0.00 0.00 0.00 Jail Credits & Comm Service 0.00 0.00 0.00 0.00 0.00 0100 0.100 Credit Cards & Transfers 0.00 O.OD 0.00 0100 0.00 0.00 0100 Total of all Collections 0.00 0.00 0.00 0.00 0.00 0.00 0.00 01-01-2004 Cash & Checks Collected 1,877.50 1,642.90 351.10 0.00 0.00 20.00 3,091.30 Nail Credits & Comm Service 257.90 387,20 99.90 0.00 0.00 0.00 745.00 Credit Cards & Tranofero 802.60 063.50 366.20 0.00 0.00 0.00 2,032.30 Total of all Collections 21930.00 2,893.60 817.20 0.00 0.00 20,00 6,668.180 TOTALS Ca Oh & Chocks Collected 1,877.50 1,642.90 351.10 0.00 0.00 20.00 31891.30 Jail Credits & Comm Servioo 257.90 307.20 99.90 0.00 0.00 0.00 745.1)0 Credit Cards & Transfers 802.60 063.50 366.20 0.00 0.00 0.00 2,032.30 Total of all Collections 2,930.00 21893.60 817.20 0.00 O.DO 20.00 6,668.80 06-05-2019 Pnga 7 06-07-19;18:59 ;From;Calhoun County Pct, 5 To:5534444 ;3619832461 # 9/ 9 Money D,iotribution Report Section 11: As Applicable Peace Officer Foes CALHOUN CO. J.P. 5, MAY 2019 REPORT 1 Daocriytion Count Collected Retained Disbursed State of Texan Quarterly Reporting Totals 0 0.00 0100 0.i State Comptroller Cost and Foes Report 0 0,00 0.00 0.i Section I: Report for Offenses Committed 0 0.00 0.00 0.i 01-01-04 Forward 42 11302.40 441,98 940.42 09.01-01 - 12-31-03 0 0.00 0.00 0.0i0 00-31-99 - 06-31-01 0 0.00 0.00 0.00 09-01-97 - 00-30-99 0 0.00 0.00 0.010 09-01-91 - 08.31.97 0 0.00 0.00 0.010 Pail pond Fee 0 0,00 0.00 0.00 DNA Testing Fee - Convictions 0 0.00 0.00 0100 DNA Testing Fee - Comm Supvn 0 0.00 0.00 0.010 DNA Tasting Fee - Juvenile 0 0.00 0.00 0.00 EMS Trauma Fund (EMS) 0 0,00 0.00 0.00 Juvenile Probation Diversion Fees 0 0100 0.00 0.00 Jury Reimburaement Fee 29 106.49 10.65 95.81 Indigent Defense Fund 29 53.25 5.32 47,9 Moving Violation Paco 16 1,43 0.14 1,2 State Traffic Pine 0 0.00 0.00 O.4 Section 11: As Applicable Peace Officer Foes 9 40.00 32.00 8.i Failure to Appear/Pay Foeu 5 120.00 19.00 100.: Judicial Fund - Const County Court 0 0.00 0100 0.i Judicial Fund - Statutory County Court 0 0,00 0.00 0.i Motor Carrier Weight Violations 0 0.00 0.00 0.i Time Payment Fees 1 25.00 12.50 12.1 Driving Record Fee 0 0.00 0.00 0.i Judicial Support Fee 29 159,73 15.97 143.' Truancy Prevention and Diversion Fund 0 0,00 0.00 0.i Report dub Total 160 1,888.30 530.36 1,349.'. State Comptroller Civil Fees Report CF: Birth Certificate Foes 0 0.00 0.00 0.i CF: Marriage License Fees 0 0.00 0.00 0.1 CF: Declaration of Informal Marriage 0 0.00 0.00 0.1 Cr! Nondisclosure Fees 0 0100 0.00 O,i CF: Juror Donations 0 0.00 0.00 0.1 CF: Justice Court Indig Filing Fees 1 6,00 0.30 5.' CF: Stat Prob Court Indig Filing Fees 0 0.00 0.00 0.1 CF; Stat Prob Court Judic Piling Fees 0 0.00 0.00 0.1 CF: Stat Cnty Court Indig Filing Face 0 0.00 0.00 OJ CPI Stat Cnty Court Judic Filing Paco 0 0.00 0.00 0.1 CF: Cast Cnty Court Indig Filing Fees 0 0.00 0.00 0.1 CF: Cast Cnty COUrt Judic Filing Pees 0 0.00 0.00 0.1 CF: Disc Court Divorce & Family Law 0 0.00 0.00 0.1 CF; Dist Court Other Divorce/Gamily Law 0 0.00 0.00 0.1 CPI Diet Court Indig Legal Services 0 0.00 0.00 0.1 CF: Judicial Support Fee 0 0,00 0.00 0.1 CPI Judicial & Court Perri. Training Gee 0 0.00 0.00 0.1 Report Sub Total 1 1 6,00 0..30 5.' Total Due For This Period 1 161 1,894.30 530.66 1,355 TI4E STATE OF TEXAS Before m , the underoigned Authority, thin day County of Calhoun County par aenal y appeared Nancy Pomykal, Justice of the Peace, F ecinct No 5, Calhoun County, Texas, who being du y sworn, deposon and says that the above _qg foregoing rep t is true and correct, Witness my hand thin _.�._,�oe �A>�� Justice a ttn p4ace, PNi%�-inat No 5 Calhoun o t Texas D-738 REPORT OF OFFICE CONFERENCES Date 6-6-19 County: Calhoun Agent Presiding: Karen Lvssv Date of Next Conference: 6-26-19 at 8:30 Evaluation/Discussion of Events Since Last Conference: Karen: ► May 20 Dinner Tonight -Mexican Makeover ► May 21-22 Brenham Meeting and Assignments 4-H ► May 23 Orion Marine Lunch and Learn and met with Wesley Nurse for Planning ► May 24 Victoria Food Handler class at OLV ► May 28 FSITY at food Pantry Final Class and Child Care Monthly Class ► May 29-30 Mental Health Classes ► June 3-4 Food Manger class Victoria and Calhoun ► June 3 & 5 Walk and Talk. Point Comfort Pool is now closed so Wednesday only until fixed ► June 3 Commissioner's Court will be talking at the Republican Meeting. Reservations required Dinner $11 Gree ► May 21 Spring Faculty Conference - Brenham ► May 22 Meet with Texas A and M Vet Response Team — Matagorda County ► May 23 Mentor/ Mentee training with Matt Bochat CEA /ANR — Victoria County ► May 30 Mental Health First Aid Training - Victoria ► June 3 Commissioner's Court at Republican Meeting. ► June 5 District 11 4-H Horse Show Emilee ► May 21-22 Spring Faculty Conference in Brenham ► May 23 4-H helped with Challenger League ► May 29-30 Mental Health First Aid Training in Victoria ► June 3 PALA meeting ► June 5 District 11 4-H Horse Show Il. Discussion of Items from District, State, etc.: Karen: ► Regional Meeting ► Budget ► HST Meeting(s) Victoria July 18'x' and Corpus July 19"i. We think all are planning on the 18°' ► Greg needs to contact Barbara Moretich for Floating Holidays ► Commissioners out Monday -Thursday next week Gree: ► Texas 4-H Roundup in College Station Emilee: ► Texas 4-H Roundup in College Station III. Civil Rielrts/Affirmative Action ► Discussed age of people allowed to use equipment (lawn mower, weed eater) in county is 18 and above. IV. Agents Weekly Schedule: Karen: ► Walk and Talk in the Pool Every Wednesday in June and July ► Point Comfort Pool Closed for big leak and possible other problems. May not have WAT there Mondays ► June 6`h Worksite Wellness conference Cancelled ► At YMCA Fridays in June and July 9:00-11:00 ► Karen off Friday June 711i ► Cooking Camp with YMCA June 10-14 -10:00 tol2:00 ► May 17 Dinner Tonight Italian Healthy Makeovers ► June 24 and 27 Victoria Cooking Camp ► June 25 Child Care Class with Jodi Nerrin ► June 25-27 Calhoun Public Libraries talk about Nutrition and Healthy Recipes June 12 Texas 4-H Roundup — College Station June 13 Calhoun County Crop Tour June 17 Major Show Steer/Heifer tag -in June 18 Victoria County Row Crop Tour June 20 Calhoun County Fair Board Meeting June 25 Meeting with Dr. Shackelford June 26 Calhoun County Jr Livestock Board Meeting Emilee: ► June 7 Video interview for Star Award with 4-H member who will not be in town on interview date o Presentation at YMCA ► June 10-14 Texas 4-H Roundup in College Station ► June 14 Video interview for Star Award with 4-H member who will not be in town on interview date ► June 17 Helping with Jackson County Star Award interviews o Major Show Steer/Heifer tag -in ► June 18 Calhoun County Star Award interviews ► June 19-21 Leadership Lab in Bastrop ► June 24 Helping with Matagorda County Star Award interviews ► June 25 Meeting with Dr. Shackelford o Calhoun County Fair Sheep/Goat/Swine tag -in ► June 26 Calhoun County Jr. Livestock Board meeting ► July 5 - Vacation Katherine ► June 13 — Calhoun County Crop Tour ► June 25 - Calhoun County Fair Sheep/Goat/Swine tag -in ► July 5 - Vacation SIGNATURES OF COUNTY STAFF MEMBERS ATTENDING: hbmliemipv,.11M Iexa. ASM Agri. Fx ;ry R — open to allpeopkwilM1M regwdb--I-Mipion.—,_fie ,a.ig M, ug, in(oem .... f vn rk,Th, U11, AOM Un,,n SySt M US. Vepu.enenl It Agrk,IWr oM ILe C—lyC,W, .... Caehi al Taxa. Ca,ml, C� y Calhoun County Commissioners' Court—JUNE 19, 2019 26. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 26) On any necessary budget adjustments. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 24 of 25 O N W m 3 o� z v 3 o 3 Cl) 5 z z z y N � o N T m mm 3 O C- � c c N m o m o O q z� 3 n 0 (n Im Iy � R1 v m 'o m z -1 N V O 00 C = m C 'u Fn r m m z0 w c m a Z D 7d z MM M A m m z = m m cn O = m E -4 n��= z 3 e 0 600 w 3 O O O y 0 z�� = z o z o = o n n co re r r = 0 000 a _ o ooa w ww = fp t0 (O T o 0 0 0 = o 0 0 0 i 0 000 m 3 O c m m m 0 D r M .IM 3 3 0 z 2 m; a a m m Z y m: X Z: z b Z: 3 m mi ic n m O, NZ m i 1 c 10m Z: H n i o rn Z n H O 0 C O c C X A 2 � ( Calhoun County Commissioners' Court —JUNE 19, 2019 27. APPROVAL OF BILLS AND PAYROLL. (RM) MMC RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese COUNTY RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judqe Meyer, Commissioner Hall, Lvssv, Syma, Reese PAYROLL RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese ADJOURNED: 11:15 A. Page 25 of 25 a MEMORIAL MEDICAL CENTER TOTALS TO BE APPROVED - TRANSFERRED FROM ATTACHED PAGES MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---June 19 2019 PAYABLES AND PAYROLL 6/14/2019 Weekly Payables 268,631.44 6/7/2019 McKesson -340B Prescription Expense 5,213.26 6/14/2019 McKesson -340B Prescription Expense 9,750.66 6/7/2019 Amerisource Bergen -340B Prescription Expense 1,752.38 6/1 412 01 9 Amerisource Bergen -3406 Prescription Expense 884.90 6/14/2019 Crescent -Nursing home insurance payment sent to MMC in error 4,626.80 Prosperity Electronic Bank Payments 6/10/2019 Credit Card & Lease Fees 4,248.36 6/10/2019 UHC Community Insurance Payment -reversal of duplicate deposit 171.36 6/10/2019 UHC Community Insurance Payment -reversal of duplicate deposit 433.44 6/7/-6/14/19 Pay Plus -Patient Claims Processing Fee 24.21 TOTAL TRANSFERS BETWEEN FUNDS $ NURSING HOME UPL EXPENSES 6/17/2019 Nursing Home UPI 6/17/2019 Nursing Home UPI CREDIT CARD & LEASE FEES 6/10/2019 Golden Creek 451,726.02 66,793.56 23.02 TOTAL NURSING HOME UPL EXPENSES $ 518,542.60 TOTAL INTER -GOVERNMENT TRANSFERS $ GRAND TOTAL DISBURSEMENTS APPROVED June 19, 2019 $ 814,279.41' #D IRECEIJUN Page 1 of 13 13 2019 (`(Qp(t�/(7JttEL�tiatt{tlt3r MEMORIAL MEDICAL CENTER 0 AP Open Invoice List 10:34 o en invoice.tem ap_ p P late Due Dales Through: 06/2612019 Vendor# Vendor Name Class Pay Code 10995 ABILITY NETWORK (SHIFTHOUND) I/ Inv ice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No-Pay Net 40093200 1 06/10/20 06/07/20 06/07/20 SCHEDULING SERVICES(411tt9- 4I3411q) 558.00 0.00 0.00 558.00 Vendor Totals Number Name Gross Discount No-Pay Net 10995 ABILITY NETWORK (SHIFTHOUND) 558.00 0.00 0.00 558.00 Vendor# Vendor Name Class Pay Code 11283 ACE HARDWARE 15521 Invoice# Comment Tran Dt Inv Ot Due Dt Check DPay Gross Discount No-Pay Net 134627 / 05/30/20 05/31/20 06/25/20 99.99 0.00 0.00 99.99 SUPPLIES (Wk(AV V,) Vendor Totals Number Name Gross Discount No-Pay Net 11283 ACE HARDWARE 15521 99.99 0.00 0.00 99.99 Vendor# Vendor Name Class Pay Code A1680 AIRGAS USA, LLC - CENTRAL DIV ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No-Pay Net 9960978008 05/31/20 03/31/20 06120120 642.44 0.00 0.00 642.44 ✓ OXYGEN 9960978009 V1 05/31/20 04/30/20 06/20/20 107.85 0.00 0.00 107.851/ OXYGEN 9962445558 v1 06/12/20 05/31/20 06/25/20 489.86 0.00 0.00 489.86 </ CYLINDER RENTAL 9962445560 ✓ 06/12/20 05/31/20 06/25/20 79.36 0.00 0.00 79.36 CYLINDER RENTAL 9962445559 06/12/20 05131/20 06/25/20 661.69 0.00 0.00 661.69 V/ CYLINDER RENTAL 9089333545 �/ 06/1312005/31/2006125/20 2,183.26 0.00 0.00 2,183.26 OXYGEN Vendor Totals Number Name Gross Discount No-Pay Net A1680 AIRGAS USA, LLC -CENTRAL DIV 4,164.46 0.00 0.00 4,164.46 Vendor# Vendor Name Class Pay Code A1690 ALCON LABORATORIES, INC. M Invoice# Comment Tran Dt Inv Dt Due Dt Check D- Pay Gross Discount No-Pay Net 9655798192 06107/2005/20/2006/19/20 1,594.15 0.00 0.00 1,594.15 ✓ SUPPLIES Vendor Total: Number Name Gross Discount No-Pay Net A1690 ALCON LABORATORIES, INC. 1,594.15 0.00 0.00 1,594.15 Vendor# Vendor Name/ Class Pay Code 10958 ALLYSON SWOPE ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No-Pay Net 060619 06/11/20 06/11/20 06/11/20 2,198.25 0.00 0.00 2,198.25 t/ CONTRACT EMPLOYEE (6J 4B1iR-1l((e11 ) Vendor Totals Number Name Gross Discount No-Pay Net 10958 ALLYSON SWOPE 2,198.25 0.00 0.00 2,196.25 Vendor# Vendor Name Class Pay Code M2485 BAYER HEALTHCARE ✓/ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No-Pay Net file:///C:/Usershnmckissack/opsi/memmed.cpsinct.coni/tt88150/data 5/tmp_cw5report27... 6/13/2019 Page 2 of 13 6044358151 ✓ 05/31/2005/22/2006/22/20 1,245.00 0.00 0.00 1,245.00 INVENTORY PHARMACY 5,425.00 0.00 0.00 5,425.00 Vendor Totals Number Name Gross Discount No -Pay Net M2485 BAYER HEALTHCARE 1,245.00 0.00 0.00 1,245.00 Vendor# Vendor Name Class Pay Code 0.00 0.00 5,425.00 B1220 BECKMAN COULTER INC ✓ M Pay Code Invoice# Comment Tran DI Inv Dt Due Dt Check DPay Gross Discount No -Pay Net 5407453 05131/2005/3012006/24/20 3,507.27 0.00 0.00 3,507.27 ✓ MAINT CONTRACT 19,166.67 0.00 0.00 19,166.67 ✓ Vendor Totals Number Name Gross Discount No -Pay Net 81220 BECKMAN COULTER INC 3,507.27 0.00 0.00 3,507.27 Vendor# Vendor Name Class Pay Code 81800 BRIGGS HEALTHCARE v/ M Invoice# Comment Tran Dt Inv Dt Due DI Check D Pay Gross Discount No -Pay Net B204300J 231.99 0.00 0.00 231.99 a0611112005/31/2006/25120 SUPPLIES SvVi -nn- a.1.1q Vendor Totals Number Name V Gross Discount No -Pay Net B1800 BRIGGS HEALTHCARE 231.99 0.00 0.00 231.99 Vendor# Vendor Name Class Pay Code C1048 CALHOUN COUNTY ✓ w Invoice# Comment Tran Dt Inv Dt Due Ot Check D' Pay Gross Discount No -Pay Net 060419 06/12/20 06/04/20 06/04/20 382.00 0.00 0.00 382.00 ✓ AUTO INS'03 FOROP03 DODG (11(l14•11 -131(1a) Vendor Totals Number Name Gross Discount No -Pay Net C1048 CALHOUN COUNTY 382.00 0.00 0.00 382.00 Vendor# Vendor Name Class Pay Code L1629 CHRISTINA ZAPATA-ARROYO Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 042019 06/12/20 04/01/20 04101/20 412.50 0.00 0.00 412.50 ✓ SPEECH THERAPY ANaI ypicl 052019 06/12/20 05/01/20 05/01/20 165.00 0.00 0.00 165.00 ✓ SPEECH THERAPY jkl J CI Vendor Totals Number Name Gross Discount No -Pay Net L1629 CHRISTINA ZAPATA-ARROYO 577.50 0.00 0.00 577.50 Vendor# Vendor Name Class Pay Code C1970 CONMED CORPORATION ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 890400 ✓ 06/07/20 05/28/20 06/07/20 125.52 0.00 0.00 125.52 ✓ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net C1970 CONMED CORPORATION 125.52 0.00 0.00 125.52 Vendor# Vendor Name Class Pay Code 12612 DASHBOARD MD ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 8403 ✓ 06/13/20 06/12/20 06/12/20 5,425.00 0.00 0.00 5,425.00 NIGHTLY DATA LOAD Vendor Totals Number Name Gross Discount No -Pay Net 12612 DASHBOARD MD 5,425.00 0.00 0.00 5,425.00 Vendor# Vendor Name Class Pay Code 11011 DIAMOND HEALTHCARE CORP Invoice# Comment Tran Dt Inv Dt Due Ot Check D Pay Gross Discount No -Pay Net IN20052872 ✓ 05/31/2005/31/2006/25/20 19,166.67 0.00 0.00 19,166.67 ✓ file:///C:/Users/mmckissack/cpsi/mcmmed.cpsinet.com/u88150/data_5/tmp_cw5report27... 6/13/2019 CPR SERVICES IN20052871 w/ 05131/2005/31/2006/25/20 BEHAVIORAL HEALTH SERVIC Vendor Total: Number Name 11011 DIAMOND HEALTHCARE CORP 31,144.58 0.00 Gross Discount 50,311.25 0.00 Vendor# Vendor Name Class Pay Code 11291 DOWELL PEST CONTROL 0.00 Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 12326 06/11/20 05/31/20 06/25/20 105.00 PEST CONTROL C,%1 N.( t+ 0.00 Vendor Total: Number Name Gross 11291 DOWELL PEST CONTROL 105.00 Vendor# Vendor Name Class Pay Code 11284 EMERGENCY STAFFING SOLUTIONS / 40,062.50 ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross Net 0.00 37977 06/12/20 06/25/20 06/25/20 40,062.50 ER STAFFING No -Pay Vendor Totals Number Name Gross 11284 EMERGENCY STAFFING SOLUTIONS 40,062.50 Vendor# Vendor Name Class Pay Code / 10042 ERRE USA INC SURGICAL SYSTEMS ✓ 0.00 Invoice# Comment Tran Dl Inv Dt Due Dt Check D Pay Gross Discount No -Pay 547996 06/07/20 05/20/21I0// 06/07/20 155.98 SUPPLIES 61{PV YV W-0 4,500.00 Vendor Totals Number Name Gross 10042 ERBE USA INC SURGICAL SYSTEMS 155.98 Vendor# Vendor Name Class Pay Code C2510 EVIDENT vl' M Discount Invoice# Comment Tran Dl Inv Dt Due Dt Check D' Pay Gross / 0.00 957589 �/ 06/11/20 05/31/20 06/25/20 4,500.00 SURVEY HCAHPS OAS Net Vendor Totals Number Name Gross C2510 EVIDENT 4,500.00 Vendor# Vendor Name Class Pay Code 10689 FASTHEALTH CORPORATION 0.00 Invoice# Co ment Tran Dt Inv Dt Due Dt Check D Pay Gross 06A19MMC 06/11/2006/01/2006/16/20 495.00 WEBSITE No -Pay Vendor Totals Number Name Gross 10689 FASTHE ALTH CORPORATION 495.00 Vendor# Vendor Name Class Pay Code F1100 FEDERAL EXPRESS CORP. ✓ W Invoice# Comment Tran Dt Inv Dt Due Dt Check D- Pay Gross 656771536 / 06/10/20 05/30/20 06/24/20 54.70 S/ryIPPING 657510218 y 06/11/2006/0612006/21/20 24.00 SHIPPING Vendor Totals Number Name Gross F1100 FEDERAL EXPRESS CORP. 78.70 Vendor# Vendor Name / Class Pay Code F1400 FISHER HEALTHCARE �/ M Page 3 of 13 0.00 31,144.58 V1 No -Pay Net 0.00 50,311.25 Discount No -Pay Net 0.00 0.00 105.00 Discount No -Pay Net 0.00 0.00 105.00 Discount No -Pay Net 0.00 0.00 / 40,062.50 ✓ Discount No -Pay Net 0.00 0.00 40,062.50 Discount No -Pay Net 0.00 0.00 155.98 ✓ Discount No -Pay Net 0.00 0.00 155.98 Discount No -Pay Net 0.00 0.00 4,500.00 Discount No -Pay Net 0.00 0.00 4,500.00 Discount No -Pay Net 0.00 0.00 495.00 Discount No -Pay Net 0.00 0.00 495.00 Discount No -Pay Net 0.00 0.00 54.70 0.00 0.00 24.00 Discount No -Pay Net 0.00 0.00 78.70 file:///C:/Users/mmckissack/cpsi/memmed.cpsinet.com/u88150/data_5/tmp_cw5report27... 6/13/2019 a Page 4 of 13 Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 5525686 t/ 05/31/20 05/21/20 06/20/20 -363.00 0.00 0.00 -363.00 CREDIT 6458528 V/ 05/31/20 05/29/20 06/23/20 232.00 0.00 0.00 232.00 SUPPLIES 6458529 ✓ 05/31/20 05/29/20 06/23/20 65.64 0.00 0.00 65.64 ✓ / SUPPLIES ✓ 6605980 ✓ 06/07/20 05/30/20 06/24/20 746.35 0.00 0.00 746.35 SUPPLIES 6605969 06/07/20 05/30120 06/24/20 44.33 0.00 0.00 44.33 SUPPLIES Stappi ilh'�•t/.% UU Vendor Total: Number Name Gross Discount No -Pay Net F1400 FISHER HEALTHCARE 725.32 0.00 0.00 725.32 Vendor# Vendor Name Class Pay Code 10901 GENESIS DIAGNOSTICS -1// Invoice# Comment Tran Dt Inv Dt Due Dt Check D- Pay Gross Discount No -Pay Net / 49926 V/ 05/31/20 05/24/20 06/23/20 122.93 0.00 0.00 122.93 v SUPPLIES SWypmn "/0 -Do Vendor Total: Number Name 0 Grass Discount No -Pay Net 10901 GENESIS DIAGNOSTICS 122.93 0.00 0.00 122.93 Vendor# Vendor Name Class Pay Code 10642 GLAXOSMITHKLINE PHARMACUETICAL,/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 8252810670 v11 05131/20 05/23/20 06/23/20 468.56 0.00 0.00 468.56 INVENTORY 61+ip OT wDo Vendor Total: Number Name Gross Discount No -Pay Net 10642 GLAXOSMITHKLINE PHARMACUETICAL 468.56 0.00 0.00 468.56 Vendor# Vendor Name Class Pay Code G1210 GULF COAST PAPER COMPANY V M Invoice# comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 1675381 V/ 05/29/20 05/14/20 06/14/20 643.29 0.00 0.00 643.29 ✓ SUPPLIES 1678835 05/29/20 05/21/20 06/20120 28.96 0.00 0.00 28.96 ✓ SUPPLIES 1679565 ✓ 05/29/2005/22/2006/21120 1,331.74 0.00 0.00 1,331.74 SUPPLIES Vendor Total Number Name Gross Discount No -Pay Net G1210 GULF COAST PAPER COMPANY 2,003.99 0.00 0.00 2,003.99 Vendor# Vendor Name Class Pay Code 1-11100 HAYES ELECTRIC SERVICE.// W invoice# Co ment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net A219051703 05/31/20 05/20/20 06/20/20 449.80 0.00 0.00 449.80 SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net H1100 HAYES ELECTRIC SERVICE 449.80 0.00 0.00 449.80 Vendor# Vendor Name Class Pay Code H3400 HUBERT COMPANY M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 509677 V 06/12/20 05/21/20 06/20/20 582.65 0.00 0.00 582.65 ✓ CROWD CONTROL CHAIN svar'AYt� gro,0 ( [3tw(,r tat) Vendor Totak Number Name Gross Discount No -Pay Net H3400 HUBERT COMPANY 582.65 0.00 0.00 582.65 file:///C:/Usershnmckissack/epsi/nieuniied.cpsinct.con3/u88150/data 5/ttnp_cw5report27... 6/13/2019 Vendor# Vendor Name Class Pay Code Net Discount 10922 HUNTER PHARMACY SERVICES V/ 0.00 Invoice# Comment Tran Dt Inv Dl Due Dt Check D Pay Gross Discount No -Pay 3441 �// 06/11/20 05/31/20 06/20/20 14,539.19 PHARM SERVICES 0.00 Vendor Total: Number Name Gross 10922 HUNTER PHARMACY SERVICES 14,539.19 Vendor# Vendor Name Class Pay Code 11200 IRON MOUNTAIN 0.00 Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross BSHX298V 05/31/2005/2812006/25/20 713.56 SHRED SERVICES Net Vendor Totals Number Name Gross 11200 IRON MOUNTAIN 713.56 Vendor# Vendor Name Class Pay Cade / Net 11108 ITERSOURCE CORPORATION ,/ 0.00 Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 5173 / 06/11/20 06/01/20 06/01/20 250.00 SUPPORT SERVICES Net Vendor Totals Number Name Gross 11108 ITERSOURCE CORPORATION 250.00 Vendor# Vendor Name Class Pay Code J0150 J & J HEALTH CARE SYSTEMS, INC w/ Net Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 0.00 1,243.60 920960662 05/31/20 05/22/20 06/21/20 1,243.60 Page 5 of 13 Discount No -Pay Net Discount 0,00 0.00 14,539.19 ✓ Discount No -Pay Net Discount 0.00 0.00 14,539.19 0.00 Discount No -Pay Net 0.00 0.00 0.00 713.56 V/ Discount No -Pay Net 0.00 0.00 0.00 713.56 PRO FEESICRAWFORD --- W&L t". Discount No -Pay Net 11230 JACKSON & COKER LOCUM TENENS, 19,936.53 0.00 0.00 250.00 Discount No -Pay Net Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 0.00 0.00 250.00 Discount No -Pay Net 0.00 0.00 1,243.60 SUPPLIES Net/ 8,880.00 Vendor Total; Number Name Gross Discount J0150 J &J HEALTHCARE SYSTEMS, INC 1,243.60 0.00 Vendor# Vendor Name Class Pay Code 8,880.00 11230 JACKSON & COKER LOCUM TENENS, 0.00 Invoice#/ Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount 418122 05/31/2005/23/2006/25/20 8,880.00 ✓ 0.00 PROFEESCLINIC TJv.Cvxk4wtt s�SI-5 �to �Iq-�Y✓ir¢S 2029527 05/31/20 ✓ 05/31/20 05/23/20 06/25/20 1,858.04 0.00 PRO FEES Dr. C4,ww4�4 -lywr,t <0. 416953 ✓ 06/10/20 05/03/20 05/03/20 -900.00 0.00 PRO FEES/PAPAPETROU 418819/ 06/10/20 06/05/20 05/05/20 8,880.00 0.00 PRO FEES/CRAWFORD- fi jzljl't ScWItQS VaKd-r ck 2030292 '/ 06/10/20 06/06/20 06/06/20 1,218.49 0.00 PRO FEESICRAWFORD --- W&L t". Vendor Totals Number Name Gross Discount 11230 JACKSON & COKER LOCUM TENENS, 19,936.53 0.00 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 80432 06/10/20 05/06/20 06/25/20 341.30 0.00 SUPPLIES 53580A 06/10/20 05/28/20 06/25/20 378.07 0.00 SUPPLIES 060219 06/10/20 06/02/20 06/25/20 16.41 0.00 No -Pay Net 0.00 1,243.60 No -Pay 0.00 Net/ 8,880.00 0.00 1,858.04 r/ 0.00 -900.00 0.00 8,880.00 0.00 1,218.49 L/ No -Pay Net 0.00 19,936.53 No -Pay Net 0.00 341.30 / 0.00 378.07 0.00 16.41 file:///C:[Usei-s/mmckissack/cpsi/memmed.cpsinct.com/u88150/data_5/tmp_cw5report27... 6/13/2019 Page 6 of 13 INTEREST CHARGED Vendor Total: Number Name Gross Discount No -Pay Net L1640 LOWE'S HOME CENTERS INC 735.78 0.00 0.00 735.78 Vendor# Vendor Name Class Pay Code 10972 M G TRUST V1 Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net 060619 06112/2005/24/2006106/20 1,095.00 0.00 0.00 1,095.00"/ PAYROLL CLEARING Vendor Total: Number Name Gross Discount No -Pay Net 10972 MGTRUST 1,095.00 0.00 0.00 1,095.00 Vendor# Vendor Name Pay Code /Class M2178 MCKESSON MEDICAL SURGICAL INC V Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 053119 06/07/20 05/31/20 06/15/20 5.30 0.00 0.00 5.30 v �CHARGEBACK/FINANCE CHAT 54673138 ✓ 06111/20 05/20/20 06/04/20 253.90 0.00 0.00 253.90 'UPPLIES 6049465 t// 06/11/20 05/31/20 06/15/20 -9.74 0.00 0.00 -9.74 CHARGEBACK Vendor Total: Number Name Gross Discount No -Pay Net M2178 MCKESSON MEDICAL SURGICAL INC 249.46 0.00 0.00 249.46 Vendor# Vendor Name Class Pay Code 11141 MEDICAL DATA SYSTEMS, INC. Involce# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 135048 05/31/20 05/31/20 06/25/20 996.58 0.00 0.00 / 996.58 COLLECTION EXP 135046 05/31/20 05/31/20 06/25/20 844.05 0.00 0.00 844.05 V1 / COLLECTION FEES 135047 05/31/2005131/2006125/20 2,018.62 0.00 0.00 2,018.62 V/ COLLECTION FEES Vendor Total; Number Name Gross Discount No -Pay Net 11141 MEDICAL DATA SYSTEMS, INC. 3,859.25 0.00 0.00 3,859.25 Vendor# Vendor Name Class Pay Code 12588 MEDICAL TECHNOLOGY ASSOCIATES Invoice# C mment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net 500.00 INV157236 05/31/20 05131/20 06/25120 500.00 0.00 0.00 VF�NT TESTING INV157235 ✓ 05131120 05/31/20 06/25120 693.40 0.00 0.00 693.40 DIAGNOSE LEAK Vendor Totals Number Name Gross Discount No -Pay Net 12588 MEDICAL TECHNOLOGY ASSOCIATES 1,193.40 0.00 0.00 1,193.40 Vendor# Vendor Name Class Pay Code M2470 MEDLINE INDUSTRIES INC M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 1878202777 ✓/ 05/31120 05/29/20 06/23/20 196.34 0.00 0.00 196.34 v1 SU PLIES / 1878202778 05/31/20 05/29/20 06/23/20 469.98 0.00 0.00 469.98 s/ SUPPLIES 1878243029 ✓/ 05/31120 05/30/20 06/24120 1,888.43 0.00 0.00 1,888.43 SUPPLIES / 1878243033 V/ 05131/20 05/30/20 06/24/20 33.40 0.00 0.00 33.40 ✓ SUPPLIESJgVjK� U -16M ia,UV file:///C:/Users/mmckissack/cpsi/memmed.cpsinet.coin/u88150/data_5/tmp_cw5report27... 6/13/2019 Page 7 of 13 file:///C:/Users/mmekissack/cpsi/memmed.cpsinet.corn/u88150/data_5/tmp_cw5report27... 6/13/2019 1878243025 ✓ 05/31/20 05/30/20 06/24/20 204.24 0.00 0.00 204.24 SUPPLIES f IjSjt1 q1.6( Vendor Total; Number Name Gross Discount No -Pay Net M2470 MEDLINE INDUSTRIES INC 2,792.39 0.00 0.00 2,792.39 Vendorll Vendor Name Class Pay Code 10963 MEMORIAL MEDICAL CLINIC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 060619 06/12/20 05/24/20 06/06/20 45.00 0.00 0.00 45.00 y� PAYROLL DEDUCT - Oiao VIIj J4 Vendor Total: Number Name Gross Discount No -Pay Net 10963 MEMORIAL MEDICAL CLINIC 45.00 0.00 0.00 45.00 Vendor# Vendor Name Class Pay Cade 10182 MERCEDES SCIENTIFIC ✓/ Invoice# pomment Tran Dl Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net 2169492 ✓/ 05/21/20 05/30/20 06/24120 76.13 0.00 0.00 76.13 SUPPLIES SWrrin� 1%,111 ' 2181904 v// 06112/20 06/04/20 06/24/20 76.21 0.00 0.00 76.21 ✓ SUPPLIES SwNpinI I t4l Vendor Totak Number Name Gross Discount No -Pay Net 10182 MERCEDES SCIENTIFIC 152.34 0.00 0.00 152.34 Vendodt Vendor Name Class Pay Code M2659 MERRY X-RAY/SOURCEONE HEALTHCA ✓ M Invoice# C/olnment Tran Dt Inv Ot Due Dt Check D- Pay Gross Discount No -Pay Net 8800458545x/ 05131/2005/21/2006/20/20 159.09 0.00 0.00 159.09 ✓ SUPPLIES '(/j,jSr Vendor Total: Number Name Gross Discount No -Pay Net M2659 MERRY X-RAY/SOURCEONE HEALTHCA 159.09 0.00 0.00 159.09 Vendor# Vendor Name Class Pay Code 11976 MID -COAST ELECTRIC SUPPLY, INC V/ Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 181184600 v// 06/11/20 03/18/20 04/17/20 42.14 0.00 0.00 42,14 SUPPLIES FPUVjkl1JIq ' 181355600 06/11/2003/21/2004/20/20 283.50 0.00 0.00 283.50 ✓ SUPPLIES / 182859500 ✓ 06/11/20 05/21/20 06/20/20 180.75 0.00 0.00 100.75 SUPPLIES �691kt X0.15 Vendor Total; Number Name Gross Discount No -Pay Net 11976 MID -COAST ELECTRIC SUPPLY, INC 506.39 0.00 0.00 506.39 Vendor# Vendor Name Class Pay Code / 10810 MMC EMPLOYEE BENEFIT PLAN t/ Invoice# Comment Tran Dt Inv Dt Due Dl Check D Pay Gross Discount No -Pay Net 061019 06/12120 000/20 06/10/20 1,954.36 0.00 0.00 1,954.36 ✓ INSURANCE Vendor Total Number Name Gross Discount No -Pay Net 10810 MMC EMPLOYEE BENEFIT PLAN 1,954.36 0.00 0.00 1,954.36 Vendor# Vendor Name Class Pay Code 10536 MORRIS & DICKSON CO, LLC V1 Invoice# / Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net j 4307154 V 06/10/20 06/05/20 06/15/20 18.28 0.00 0.00 18.28 ✓ INVENTORY l 2089 ✓ 06/10/20 06/05/20 06/15/20 -0.45 0.00 0.00 -0.45 file:///C:/Users/mmekissack/cpsi/memmed.cpsinet.corn/u88150/data_5/tmp_cw5report27... 6/13/2019 I Page 8 of 13 CREDIT 4308163 ✓ 06110/20 06/05/20 06/15/20 24.32 0.00 0.00 24.32 INVENTORY 2091 06/10/20 06/05/20 06/15/20 -1.82 0,00 0.00 -1.82 CREDIT / 4307155 ✓ 06/10/20 06/05/20 06/15/20 19,30 0.00 0.00 19.30 ✓ INVENTORY 43073001/ 06/10120 06/05/20 06/15/20 43.73 0.00 0.00 43.73 ✓ INVENTORY 4307301 / 06/10/20 06/05/20 06/15/20 212.16 0.00 0.00 212.16 ✓ INVENTORY 4307299 06110/20 06105120 06/15/20 1,203.03 0.00 0.00 1,203.03 INVENTORY 2090 ✓ 06/10/20 06/05/20 06/15/20 -0.44 0.00 0.00 -0.44 ✓ CREDIT 2088 v1 06/10/20 06/05/20 06/15/20 -1.05 0.00 0.00 -1.05 ✓ CREDIT / 4308164 ✓ 06/10/20 06/05/20 06115/20 24.32 0.00 0.00 24.32 ✓ INVENTORY 4312442 Y/ 06/10/20 06/06/20 06/16/20 69.58 0.00 0.00 69.58,/ INVENTORY � 4312444 06/10/20 06/06/20 06/16/20 2,548.06 0.00 0.00 2,548.06 INVENTORY / 4313671'v"06/101200610612006116/20 75.38 0.00 0.00 75.38 r/ INVENTORY 4310714 ✓ 06/10!20 06/06/20 06116/20 98.76 0.00 0.00 98.76 /INVENTORY 4312443 t/ 06/10/20 06/06/20 06/16/20 39.72 0.00 0.00 39.72 INVENTORY 4312174 06/10/20 06/06/20 06/16/20 41.42 0.00 0.00 41.42 ✓ /INVENTORY / 4310716 ,/ 06/10/20 06/06/20 06/16/20 19.30 0.00 0.00 19.30✓ INVENTORY / 4310717 06/10/20 06/06/20 06/16!20 710.94 0.00 0.00 710.94 INVENTORY 43107151/ 06/10/20 06/06/20 06/16/20 67.55 0.00 0.00 67.55 ✓ /INVENTORY ✓ 4313670 ✓ 06/10120 06/06/20 06/16/20 44.86 0.00 0.00 44.86 / INVENTORY ✓ 4317341 ✓ 06/11/20 06/07/20 06/17/20 383.47 0.00 0.00 383.47 /INVENTORY 4317340 ✓ 06/11/20 06107/20 06/17/20 3,863.65 0.00 0.00 3,863.65 /INVENTORY 4324859 V 06/11/20 06/10/20 06/20/20 149.21 0.00 0.00 149.21 INVENTORY 4324861 ✓ 06/11/20 06/10/20 06/20/20 34.94 0.00 0.00 34.94 I VENTORY 4324860 06/11/20 06/10/20 06/20/20 2,978.55 0.00 0.00 2,978.55 NVENTORY 4315753 06/13/20 06/07/20 06/17/20 408.13 0.00 0.00 408.13 INVENTORY Vendor Total; Number Name Gross Discount No -Pay Net file:///C:/Users/mmekissack/epsi/memmed.cpsinet.com/u88150/data_5/tmp_cw5report27... 6/13/2019 e 10536 MORRIS & DICKSON CO, LLC 13,074.90 0.00 Vendor# Vendor Name Class Pay Code 11069 PABLO GARZA Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 06119 06/11/20 06/111/I20 06/11/20 2,302.50 CONTRACT EMPLOYEE (1511f 11 fl" U ! 101 Il?) Vendor Totals. Number Name Gross 11069 PABLO GARZA 2,302.50 Vendor# Vendor Name Class Pay Code P0706 PALACIOS BEACON ✓ W No -Pay Invoice# Tran Dt Inv Dt Due Dt Check D Pay Gross /Comment 0.00 33056370 06/11/20 05/30/20 06/25/20 ✓ 187.50 AD Net 187.50 Vendor Total: Number Name Gross P0706 PALACIOS BEACON 187.50 Vendor# Vendor Name Class Pay Code / Net 10152 PARTSSOURCE, LLC �/ 0.00 Invoice# C mment Tran Dt Inv Dt Due Dt Check D Pay Gross 03159468 06/10/20 05/22/20 06/21/20 295.00 SUPPLIES Net 0,00 03161029 V 06/10/20 05/23/20 06/22/20 518.82 SUPPLIES 0.00 Vendor Totals Number Name Gross 10152 PARTSSOURCE, LLC 813.82 Vendor# Vendor Name Class Pay Code 0.00 12544 PATRICK OCHOA V/ 813,82 M Page 9 of 13 13,074.90 Discount No -Pay Net No -Pay MMC05 06/12/20 05/25/20 05/25/20 500.00 0.00 0.00 0.00 0.00 2.302.50 Discount No -Pay Net No -Pay 0.00 0.00 2,302.50 Discount 0.00 No -Pay 0.00 Net 187.50 Pay Code R1200 RED HAWK FIRE AND SECURITY P2200 POWER HARDWARE ✓ W Invoice# Comment Tran Dt Inv Ot Due Dt Check D- Pay Gross Discount No -Pay Net Discount 0.00 0.00 187.50 0.00 Discount No -Pay Net 0,00 0.00 295.00 0.00 0.00 518.82 Discount No -Pay Net 0.00 0.00 813,82 Invoice# Comment Tran Ot Inv Dt Due Ot Check D Pay Gross Discount No -Pay MMC05 06/12/20 05/25/20 05/25/20 500.00 0.00 0.00 LAWN CARE TRIM 30CREPE MI r ,7 'fiimwct do "'Lki (-Kd 1'"IL of uV'(_ Vendor Totals Number Name Gross Discount No -Pay 12544 PATRICK OCHOA 500.00 0.00 0.00 Vendor# Vendor Name Class Pay Code Pay Code R1200 RED HAWK FIRE AND SECURITY P2200 POWER HARDWARE ✓ W Invoice# Comment Tran Dt Inv Ot Due Dt Check D- Pay Gross Net Invoice# Comment Tran Dl Inv Dt Due Dt Check D Pay Gross Discount No -Pay A53839 r/ 06/11120 06/05/20 06/15/20 19.94 0.00 0.00 SUPPLIES No -Pay Vendor Totals Number Name Gross P2200 POWER HARDWARE 19.94 Vendor# Vendor Name Class Pay Code 11932 PRESS GANEY ASSOCIATES, INC. No -Pay Invoice# Cc ant Tran Dt Inv Dt Due Dt Check D Pay Gross IN000386707 �/ 06/10/20 05/31/20 06/25120 2,028.00 PT SURVEYS Vendor Total: Number Name Gross 11932 PRESS GANEY ASSOCIATES, INC. 2,028.00 Vendor# Vendor Name Class Pay Code R1200 RED HAWK FIRE AND SECURITY Invoice# Comment Tran Dt Inv Ot Due Dt Check D- Pay Gross Net 401758 ,/ 06/11/2006/01/2006/26/20 45.47 FIRE MONITORING / Vendor Total: Number Name Gross Net 500.00 Net 500.00 Net 19.94 Discount No -Pay Net 0.00 0.00 19.94 Discount No -Pay Net 0.00 0.00 2,028.00 Discount No -Pay Net 0.00 0.00 2,028.00 Discount No -Pay Net 0.00 0.00 45.47 / Discount No -Pay Net fi le:///C:/Users/mmekissack/epsi/memmed.epsinet.con>/u88150/data_5/tmp_cw5 report27... 6/13/2019 R1200 RED HAWK FIRE AND SECURITY 45.47 0.00 0.00 Vendor# Vendor Name Class Pay Code Vendor# Vendor Name Class Pay Code 11240 REMI CORPORATION t/ Net Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay / 0.00 Vendor Totals Number Name Gross 985414 ✓ 05131/2005/31/2006125/20 19,295.67 0.00 0.00 S1850 SHIP SHUTTLE TAXI SERVICE >/ W Discount Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross EQUIPMENT MAINTAGREEME (Aft(kk t) 733462 ,/ 06/12/20 06/10/20 06/10/20 6.00 Vendor Totals Number Name Gross Discount No -Pay 11240 REMI CORPORATION 19,295.67 0.00 0.00 Vendor# Vendor Name Class Pay Code K0536 SHIRLEY KARNEI V/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 061119 06/11/20 06/11/20 06/11/20 352.44 10645 REVISTA de VICTORIA (/ 1-1 Vendor Totals Number Name Gross Invoice# Comment Tran Dt Inv Dt Due Dt Check D- Pay Gross Discount No -Pay 05201921 05/29/20 05/22/20 06/22/20 240.00 0.00 0.00 AD Check D Pay Gross Vendor Totals Number Name Gross Discount No -Pay 10645 REVISTA de VICTORIA 240.00 0.00 0.00 Vendor# Vendor Name Class Pay Code / G0425 ROBERTS, ODEFEY, WITTE & WALL v - W Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay 169 06110/20 06/07/20 06/17/20 1,856.25 0.00 0.00 LEGAL 96 06/10/20 06/07/20 06/17/20 137.50 0.00 0.00 LEGAL No -Pay Vendor Totals Number Name Gross G0425 ROBERTS, ODEFEY, WITTE & WALL 1,993.75 Vendor# Vendor Name Class Pay Code 11252 RX WASTE SYSTEMS LLC r/ Net Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross 352.44 t/ Discount 2069./ 06/01/20 06/01/20 06/26/20 235.00 PHARM WASTE SERVICE 0.00 Vendor Totals Number Name Gross 11252 RX WASTE SYSTEMS LLC 235.00 Vendor# Vendor Name Class Pay Code S1850 SHIP SHUTTLE TAXI SERVICE >/ W Discount Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross / 0.00 733462 ,/ 06/12/20 06/10/20 06/10/20 6.00 TRASNPORTPT Vendor Totals Number Name Gross S1850 SHIP SHUTTLE TAXI SERVICE 6.00 Vendor# Vendor Name Class Pay Code / K0536 SHIRLEY KARNEI V/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 061119 06/11/20 06/11/20 06/11/20 352.44 CONTRACT EMPLOYEE (61744 11-'1 - (/ 1-1 Vendor Totals Number Name Gross K0536 SHIRLEY KARNEI 352.44 Vendor# Vendor Name Class Pay Code / 10699 SIGN AD, LTD. ✓ Invoice# Comment Tran Dt Inv DI Due DI Check D Pay Gross 238533 0611112006101/2006111/20 390.00 AD Vendor Totals Number Name Gross 10699 SIGN AD, LTD. 390.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 Page 10 of 13 45.47 Net 19,295.67 Net 19,295.67 Net 240.00 Net 240.00 Net 1,856.25 137.50 Net 1,993.75 Net 235.00 Net 235.00 Net / 6.00 ✓ Discount No -Pay Net 0.00 0.00 6.00 Discount No -Pay Net 0.00 0.00 352.44 t/ Discount No -Pay Net 0.00 0.00 352.44 Discount No -Pay Net 0.00 0.00 390.00 Discount No -Pay Net 0.00 0.00 390.00 file:///C:/Users/nunckissacl(/cpsi/memmed.cpsinet.com/u88150/data 5/tmp_cw5report27... 6/13/2019 I Vendor# Vendor Name/ Class Pay Code S2362 SMITH & NEPHEW % Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 93702426 06/07/20 05/15/20 06107/20 265.03 0.00 0.00 5 PPLIES �n(u ,j' aJ,/k 921368645 06/07/2010101/20 12/17/20 266.43 0.00 0.00 SUPPLIES � 6u llk.V ' �V4 j/ 921381984 t/ 06/07/20 10105/20 10105/20 284.93 0.00 0.00 SUPPLIES WA1 A 401 j 921452455 V1 06/07/20 10/30/20 06/07/20 2,287.68 0.00 0.00 S�dPPLIES fyUJV,. 921473024 �/ 06/07/20 11/03/20 11/03/20 7,970.80 0.00 0.00 S PPLIES 921506139 06/07/2011/15/2006/07/20 1,012.77 0.00 0.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay S2362 SMITH & NEPHEW 12,087.64 0.00 0.00 Vendor# Vendor Name Class Pay Code 52353 SMITHS MEDICAL ASD INC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 15552617 V/ 06/07/20 05/21/20 06/07/20 332.48 0.00 0.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay 52353 SMITHS MEDICAL ASD INC 332.48 0.00 0.00 Vendor# Vendor Name Class Pay Code S2830 STRYKER SALES CORP V1 M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 653058a 06/07/20 05/21/20 06/15/20 680.00 0.00 0.00 SUPPLIES 653052A 06/07/20 05/21/20 06/15/20 580.00 0.00 0.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay S2830 STRYKER SALES CORP 1,260.00 0.00 0.00 Vendor# Vendor Name Class Pay Code T2539 T -SYSTEM, INC W Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay 205EV49133 J 05/31/2005131/2006/25120 4,555.00 0.00 0.00 TRACKING 205EV49136 V/ 05/31120 05/31/20 06/25/20 1,144.00 0.00 0.00 CLOUD HOSTING Vendor Totals Number Name Gross Discount No -Pay T2539 T -SYSTEM, INC 5,699.00 0.00 0.00 Vendor# Vendor Name Class Pay Code / 11944 TALX CORPORATION ✓ Invoice# Co%�ment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 1000481188 ✓ 05/31/20 05/08/20 06/20/20 306.09 0.00 0.00 EMP VERIFICATION Vendor Totals Number Name Gross Discount No -Pay 11944 TALX CORPORATION 306.09 0.00 0.00 Vendor# Vendor Name/ Class Pay Code T1880 TEXAS DEPARTMENT OF LICENSING V A/P Page I I of 13 Net / 265.03 t/ 266.43 �/ 284.93 t/ 2,287.68 ✓ 7,970.80 �// 1,012.77 ✓ Net 12,087.64 Net 332.48 Net 332.48 Net 680.00 580.00 Net 1,260.00 Net / 4,555.00 t/ 1,144.00 Net 5,699.00 Net 306.09 V1 Net 306.09 file:///C:/Users/nmickissack/cpsi/inennned.cpsinet.com/u8 8150/data_5/tmp_cw5report27... 6/13/2019 Page 12 of 13 Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 10092667 V1 05/31/2005/21/2006/20/20 140.00 0.00 0.00 140.00 ✓ OPERATION FEE Vendor Total Number Name Gross Discount No -Pay Net T1880 TEXAS DEPARTMENT OF LICENSING 140.00 0.00 0.00 140.00 Vendor# Vendor Name / Class Pay Code T3334 TRINITY PHYSICS CONSULTING LLC ✓ W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 034399 / 05131/2005/23/2006/22120 450.00 0.00 0.00 450.00 CT TUBE ELALUATION Vendor Total; Number Name Gross Discount No -Pay Net T3334 TRINITY PHYSICS CONSULTING LLC 450.00 0.00 0.00 450.00 Vendor# Vendor NameClass Pay Code 11067 TRIZETTO PROVIDER SOLUTIONS ✓/ Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net / 35FK061900 �/ 06111/20 06101/20 06/26/20 1,010.00 0.00 0.00 1,010.00 t/ PTSTATEMENTS Vendor Totak 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 W-0 84003O05/29/20 05/27/20 06/21/20 47.15 0.00 0.00 47.15 UNDRY 8400302271 05/29/20 05/27/20 06/21/20 57.35 0.00 0.00 57.35 LAUNDRY 8400302301 a/ 05129/20 05127/20 06/21/20 1,156.01 0.00 0.00 1,156.01 UNDRY 8400302592 05/30/20 05/30/20 06/24/20 17.00 0.00 0.00 17.00 LAUNDRY 8400302597 V/ 05/30/20 05/30/20 06/24/20 158.74 0.00 0.00 158.74 V/ LA NDRY 8400302663 05/30/20 05/30/20 06/24/20 132.65 0.00 0.00 132.65 LA NDRY 8400302596 05/30/20 05/30/20 06/24/20 123.47 0.00 0.00 / 123.47 UNDRY / 8400302595 05/30/20 05/30/20 06/24/20 120.39 0.00 0.00 120.39 Y LA NDRY / 8400302598 05/30/20 05130/20 06/24/20 176.58 0.00 0.00 176.58 ✓ L.F�UNDRY . 8400302819 �/ 05!30/20 05/30/20 06/24/20 80.83 0.00 0.00 60.83 ✓ LA NDRY 8400302634 05/30/20 05/30/20 06/24/20 821.80 0.00 0.00 821.80// LAUNDRY Vendor Total: Number Name Gross Discount No -Pay Net U1064 UNIFIRST HOLDINGS INC 2,891.97 0.00 0.00 2,891.97 Vendor# Vendor Name / Class Pay Code U1056 UNIFORM ADVANTAGE ✓ W Invoice# Comment Tran Dl Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 9790874 ✓ 06/11/20 05/31/20 06/15/20 10.97 0.00 0.00 10.97 U IFORMS 9803984 06/11/20 06/06/20 06/21/20 140.92 0.00 0.00 140.92 file:///C:/Usershnmckissack/cpsi/menuned.cpsinet.coni/u88150/data_5/tmp_cw5report27... 6/13/2019 0 Page 13 of 13 UNIFORMS Vendor Total: Number Name Gross Discount No -Pay Net U1056 UNIFORM ADVANTAGE 151.89 0.00 0.00 151.89 Vendor# Vendor Name Class Pay Code 01200 UNITED AD LABEL CO INC M Invoice# comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 444900903 V 06/07/20 05/16120 06/01/20 81.72 0.00 0.00 81.72 ✓ SUPPLIES Vendor Total- Number Name Gross Discount No -Pay Net 01200 UNITED AD LABEL CO INC 81.72 0.00 0.00 81.72 Vendor# Vendor Name Class Pay Code V0564 VCS SECURITY SYSTEMS W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 204857 ✓ 06/07/20 02/28/20 03/30/20 450.00 0.00 0.00 450.00 TROUBLE SHOOT CAMERAS I / 206933,/ / 06/07/2005/0812006/05/20 9,982.00 0.00 0.00 9,982.00 ✓ CAMERA SYSTEM UPGRADE Vendor Total: Number Name Gross Discount No -Pay Net V0554 VCS SECURITY SYSTEMS 10,432.00 0.00 0.00 10,432.00 Vendor# Vendor Name Class Pay Code 10793 WAGEWORKS t/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D- Pay Gross Discount No -Pay Net 060619 06/12/20 05/24/20 06/06/20 3,786.37 0.00 0.00 3,786.37-f PAYROLLDEDUCT Vendor Total: Number Name Gross Discount No -Pay Net 10793 WAGEWORKS 3,786.37 0.00 0.00 3,786.37 Vendor# Vendor Name Pay Code /Class 11166 WEST INTERACTIVE SERVICES CORP ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net INV002102205 / 05/31/20 04/30/20 06/20/20 496.14 0.00 0,00 496.14 HOUSE CALLS Vendor TotalE Number Name Gross Discount No -Pay Net 11166 WEST INTERACTIVE SERVICES CORP 496.14 0.00 0.00 496.14 Vendor# Vendor Name Class Pay Code 10556 WOUND CARE SPECIALISTS Invoice# earnnt Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net WGS00002892 06/10/20 06/01/20 06/25/20 18,425.00 0.00 0.00 18,425.00 WOUND CARE Vendor Total. Number Name Gross Discount No -Pay Net 10556 WOUND CARE SPECIALISTS 18,425.00 0.00 0.00 18,425.00 Report Summary Grand Totals: Gross Discount No -Pay Net 268,631.44 0.00 0.00 268,631.44 APPROVED ON JUN 14 2019 COUNTY AUDiTO]t CALHOUN COUNTY, ,j"AIi file:///C:/Users/lnmckissack/cpsi/menuned.cpsinct.coin/u88150/data_5/tmp_cw5report27... 6/13/2019 Vi m m m M NO 0o � �VVVJ �z 0 om L ® Y G 3.0 nd U �a 0 3j dp Sr F «� U Qo W= Y 6 Qc NN S yi O A s o N O M m O N N C � jc mo QU) y�N Q �L U ❑ Vi m m m M g � N ry O N �z m r h M p N mr m o q VO N m U y ,IA 8¢ Q y {9ha' y J > Q � H U Oxx b 6 E S yi O 00 L g � Z �z m r Or m o r N m U y ,IA 8¢ Q y uli �L m0 J > Ul> b 6 d S m 00 L Ci 0 o M 0 0 �? O O N a N !77 � N > 7 m o N m 6v M Of 0404 ® N M Q y N m b 6 d M m Ci 0 o M 0 0 �? O O N a N !77 � N �cpp� {q} 6v 6 0404 ® 6 d a oz )t � !; §| LU \j \/ �\ k\) .� ,k ■ ! | | § §\ ®° \ k k k [\ §<1 )�§{ !§! !2 ` \) u 2 J� \ � � 0 ° tz \ ) § � | � - LU ) >2 � §) . ® - W r1 | �( ) &° : j\ \2 ! Z /\ ` ! 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LOL , /§ % \$ / // ;) m M M M N M M M 2� M 000 M m o 0 0 r o m m N m M E� r E m E y y U 0 z; N m 0o F Q p m m U O .� Ola �O � IIl a =0 O m O ,,,GgGgGq� O ST UO � yy Qo W= pti rip No S r m m m o .r x x x x E N Yl m 1(I d d m � a m m Fmid �n_ �1D 6f yYo V O m M M M N M M M 2� M 000 M m o 0 0 r o m m N m M E� r E m E y y U 0 N m N O O O O m m p m d m UO m m � M a O m O ,,,GgGgGq� O 7 11 Q y a e r o c m M YI m N rip m in m m r m m m M M M M .r x x x x E N Yl m 1(I d d W 2 W Q F- (1) U k m 5 O n m n o O N m g U ®N Z U R O � Z TZMz>gmR S z > m N SN N m o 0 m N N O M O O N N M o O M1 o 0 0 0 o m r a E y y U 0 U U O N O O O O m m N M m iri m m � M a N UC 7 11 Q y a e r o c m M YI m N rip m in m m r m m m M M M M x x x x E N Yl m 1(I d m � a N LL 0 0 0 a o m o 0 o e 0 o E LL m y r t� M1 r S4 0 19 x � m m m m 0 N O O O O u N N N 6 aN m m m m m a io �o �o io 0 0 0 0 Z m m m m N N N 5 (D t0 1p (O i1 o O M1 o 0 0 0 o m r a 0 m m O N m m N M m iri m m � M a N M M 7 � Q y M N rip M o O M1 o 0 0 0 o m r a m m O N O ORZ On O O On E E `m E 7 m � Q y tCy � g rip o O M1 o 0 0 0 o m r a Q ORZ Z 0 00 V U Atne�n ourceBergen• STATEMENT AMERISOURCEBERGEN DRUG CORP • 12727 WEST AIRPORT BLVD Activity Due SUGAR LAND TX 77478.6101 866-451.9655 Amount - AMERISOURCEBERGEN DRUG CORP Number PO Box 905223 0.00 CHARLOTTE NC 28290.5223 Number: 58033556 Date: 06-07-2019 1 of 1 WALGREENS #12494 3400 MEMORIAL MEDICAL CENTER 1302 N VIRGINIA ST Activity Due PORT LAVACA TX 77979.2509 ACCOUNT: 1001352841037028186 Amount Date Date Number Not Vet Due: 0.00 Current: 1,752.38 Past Due: 0.00 Total Due: 1,752.38 Account Balance: 1,752.38 Account Activity Activity Due Reference Purchase Order Activity Amount Date Date Number Number Type 06.03.2019 06-14.2019 3023588287 147234 Invoice 1,071.03 06.03.2019 06.14-2019 3023568288 147235 Invoice 246,23 0604.2019 06.14-2019 3023597905 147382 Invoice 70.48 06.05.2019 06-14-2019 3023651478 147417 Invoice 64.60 v/ 06.06.2019 06.14-2019 3023699181 147456 Invoice 3.45 06.06.2019 06.14-2019 3023699182 147457 Invoice 33.47 06.07.2019 06.14-2019 3023737498 147467 Invoice 263.12 ✓ Thank You for Your Payment Reminders Date Payment Number Amount Due Date Amount 06.07-2019 (1,218.17) 06.14.2019 Total Due: 1,752.38 Terms: Monday - Friday due in 7 days L F-0 APPROVED ON 500,00 JUN 17 2019 COUNTY AUDTTOIt %1_L- 4 I_ o j t coo CALHOUN COUNTY, TEXAS grv���N ��• O#K:I, H"�'ur p-„mivfM Cuum.,,v�++ .y,PM:1„Nll Number. 58049093 Date: 06-14-2019 1 of 1 WALGREENS 412404 340B AmensourceBergen- STATEMENT AMERISOURCEBERGEN DRUG CORP Activity Due • 12727 WEST AIRPORT BLVD TX 77979.2509 SUGAR LAND TX 77478-6101 866.451-9655 Number AMERISOURCEBERGEN DRUG CORP 0.00 PO Bou 905223 884.90 CHARLOTTE NC 28290-5223 Number. 58049093 Date: 06-14-2019 1 of 1 WALGREENS 412404 340B MEMORIAL MEDICAL CENTER 1302 N VIRGINIA ST Activity Due PORT LAVACA TX 77979.2509 ACCOUNT: 100135284 /037028186 Amount Date Date Number Not Yet Due: 0.00 Current: 884.90 Past Due: 0.00 Total Due: 884.90 Account Balance: 884.90 Account Activity Activity Due Reference Purchase Order Activity Amount Date Date Number Number Type 06-10-2019 06.21-2019 3023775063 147517 Invoice 31,65 OG -10-2019 06-21-2019 3023775064 147519 Invoice 203.13 ✓ 06-10-2019 06-21-2019 3023813433 147566 Invoice 21.55 06-11-2019 06.21.2019 3023846429 147577 Invoice 575.41 v/ 06-12-2019 06-21-2019 3023901264 147590 Invoice 27.20 06.13-2019 06-21-2019 3023941961 147615 Invoice 1.981/ 06-14.2019 06.21-2019 3023990827 147639 Invoice 23.98 Thank You for Your Payment Reminders Date Payment Number Amount Due Date Amount 06-14-2019 (1,752.38) 06-21-2019 0 Total Due: 864.90 Terms: Mondav - Fridav due in 7 dans i C`A fS0DOmH CA U0,250000 bµ '-�-. (FU APPROVED ON JUN 17 2019 COUNTYAUpffOR CALHOUN COUNTY, OTi XAB r 6/131 1_ EU P7 E tmp_cw5report3129759007015165458.html MEMORIAL 0 APOpen Invoice Le st 11:09 ap_open_invoice.template tilegJ�gg63, as�PB$ >pY6 &tlr 'd'i?t a - Dates Through: Pay Code n o Vendor NameClass 11824 THE CRESCENT ✓/ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 060719 06/07/2019 06/05/2019 06/27/2019 4,626.80 0.00 0.00 4,626.80 TRANSFER gftn� keML /.i&t "itl wwc- .1A f.VVUr Vendor Totals: Number Name Gross Discount No -Pay Net 11824 THE CRESCENT 4,626.80 0.00 0.00 4,626.80 f-:eport Summary Grand Totals: Gross Discount No -Pay Net 4,626.80 0.00 0.00 4,626.80 APPROVED ON JUN 1 4 20N COUNTY AUDITOR CALHOUN COUNTY, TEXAS fie://IC:/Users/mmokissack/cpsitmemmed,cpsinet.com/u88150/data_5/tmp_cw5report3i 29759007015165458.html 1/1 4*4 �`-+y roi�Sp" baba po po po pg pS rpo'po po `b po p� R d H O O O O O O O O 0 0 0 0 0$ 0 O P v n o 0 o m P ry m m m v m m' fl fll M '� P N OI r rl fN m �O r N N N N l0 E Z d d d a d a 'o u 'o c u u u u u u o y v n n y 0 'a 'a o 0 o a o o m a o uuuu t u +ry�p _o a a m m m a a m m` m` N p N P b b 1p y1 M rl p. rl N O M N P r rl M M M ei P W Ol O ri Of T M N m V1 m N M N 1p M P b OI M M P P � tp N M b b n m� pr P N '1 01 pN N Om N N opy n m m M �0 m� b m m m m m u Z N N M M P P P d a a a N N N Z N A W ^ n Q m m O O O O O O W W O m m m¢ m a f°w ¢z Gza pjooSSoda a1z-lz-czc�pzr- p G F C_ a K _r a N Z>Z K lx! U U U z u. u. LL > p O¢¢ z Z z z z la- i- C C C C C C C C C C C C C C C C C C C a a a a a d d a d d d d a d d d d a a E E E E E E E E EE E EE E E U u u u u u u u u u v u u u v u u u u a a a a a a a a a a a a a a a¢ a a a 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 b b 0 N ti M V V V V b b b b b b b b 10 b b b b b tO 4- 4- ns 'ns O O m J 0 d E 3 O f tv �F I l l i k J] ., b O m �' � d a1 tl J `D .O J J •- '� O t o o ,- In O .L. 4- 4- ns 'ns O O m J 0 d E 3 O f tv �F Memorial Medical Center Nursing I-lome OR Weekly Cantex Transfer Prosperity Accounts 6/17/2019 Prevldus kiddy, Amount to Be Asmunt Beginning ACH Beginning lramterred to Nouslo Homo NumberBalance Tnmfer-0ut Transler-In Pondin De colt, Balance couture Hem. 144,708.6 14].539.30 191,335.21 - 188,504.17 / 188,294.81 Bank Balance 188,504.17 k] Variance Leave In Balance 100.00 Faulted Jnformatlan ler ACMmd Gardens: MMC Portion QIPP 1 Ath/ard Nealth Core Center Qd Co MMC Portion QIPP 2,3,tapse Jp Morgan Chose Bank April interest 40.71✓/ ABA may interest 68.64 s/ Acro._. _ ..___ .__. Pending QIPP Ck to MMC Adjust BalancefTransler Amt 188,294.81V walffiJANNUM, 142,63821 J 142,417.69 ✓ 79.365.53 ✓ - 79,586.05 / 79,365.53 Bank Balance 79,586.05 v' Variance - Lee" lnBalance 100.00 MMC Portion QIPP 1 MMC Portion QIPP 2,3,tapse ✓ April Interest Maylnterest 59.21 61.31 ✓ Pending QIPP Ck to MMC Adjust Balance/Transfer Amt 79,365.53 ✓ t g 97.809.15 ✓ 91,602.29 ✓ 53,508.96 ✓ - 53,715.82 / 53,508.96 Bank Balance 53.715.82✓ Variance Leave In D2tento 100.00 MMC Portion QIPP 1 MMC Portion QIPP 2,3,Lapse ✓ April Interest Maylnterest 51.89 54.97. Pending QIPPCk to MMC Adjust Balance/Transler Amt 53,508,96 / 25,952.50 v/ 25,801.72 7,418.92 / - 7,569.70 / 7.418.92 ✓ ✓ Bank Balance 7,569.70 Variance Leave In Balance 100.00 MMC Portion QIPP 1 MMC Portion QIPP 2,3,tapse April interest 25.47 May Interest 25.31 ✓ Pending QIPPCk to MMC Adjust Balancefransfer Amt 7,418.92 / 59,786.31 v/ 59,599.82 123,137.80 ✓ 123,324.29 123,137.80 Bank Balance 123,324.29ov/ Variance Leave In Balance 100100 Feunna WeInn.d on lar beaeent/sa4.a at We,, Jreusnn /Fort Bend /Breadmc, MMC Porti0n QIPP 1 Comex Health Can Centers no 11C MMC Portion QIPP 2,3,Lepse 1P Magan Chose Bank April Interest 41.585/ ABA I f3 v r r) It CS Maylnterest 44.91 ✓ A. Pending QIPPCk to MMC J+ J U y Adjust BalancefTransfer Amt 123,137.80 Li t TOTALTeANOtO 451.726.02 "CN New Dory bolan4e o/over 55," wluoe rramJernata me nuumq Approved: � � AVE111 Note2:Coch account hma base ba1nnaa/5IO0Iha1MAfcdepwlh 4 J 1 * l L L 'J G Diane C. Moore, CFO UN 6/17/2019 JUN 17 2019 J:\NH W..klV Transfea\NH UPL Ttamfer Summery\2019\lune\NH UPL Transfer Summary 0617.19,eHe COUNTY AUDITOR CALHOUN COUNTY, TEXAS _ I \ND WeeklyT 1 \0 kUslad LV ksINels\2019\lune\C4nl.a Plymellty Oowlom67-19Hirt 616-19111, Paget MMC PORTON ❑ansler47ut MMCPDR71ON QIPP/Comps tA#{�O19)1{SlY�sS1L4 NH PORTION 6/7/2019 AM Deposit UHC COMMUNITY PL HCCLAWVMT)4EW34II910000 41042 - - i^"�x-, a�?�"..,-,� ,c� .. lwnflpr4741 tlans�n QIPP/Comp] QIPP/Comp2 QIPPIComp3 QIPP/Ups. QIPP❑ NH PORTION 617/2019 ACH Deposit Amerignoup TXSC HCCLAIMPM1310169306611IW0 / 3,404.50 - 3,404.56 ' 6110/2019 6110/1019 Chetka59 CM Wire Domestic WIRE OUT ASHFORD HEALTH CARE CENTER LTD 22.659.33 ✓ 12I,B3457� ACH Deposit NOVITAS SOLUTION HCCLAIMPMT 675663420000139 ' 6/10/2019 ACH Payment UHC COMMUNITY PL REVERSAL 74600341191000016 ..3,040.40 / ' 611012019 ACHOeposlt UHCCOMMUNIIYPLHCCIAIMPMT)46003411910000 6114/2019 �. 3,MOA01// - 3,04040 613012019 ACH Deposit LIFINUNe4lthcare HCCLAIMPMT 746003411124384 6/14/2019 7,380.ODsa - 7,380.00 6/10/2019 MH Deposit UNC COMMUNITY PLHCCNIMPMT746003411910000 3,04040/ - 3.040.40 6/4/2019 ACH Deposit MANAGEANDNET17111 MN5 PMNT11000C0000W009341 12,905.00 - 12,905.00 6112/2019 ACH Depo0t Ameogmup TXSC HCCLAIMPMT 310198035811DOE) 25,691.28✓ 25,691.28 6/12120%9 ACH Deposit UnlledXeaRheare HCCIAWFM T 746003411124394 QIPP/CpmP2 QIPP/Comp; QIPP/lapse QIPPTI 1,430.00 I/ - 1.43006 6/12/2919 ACH Deposit HEALTH HUMAN SVC HCCLAIMPMT 174GW341120052 IQ6) :0 - 14677.61 6/13/2019 Deposit 61,043.87 - 61,04387 6/14/2019 ACHOeposit UHCCOIdMUNITYPLHCCNIMPMT7J6W3411910W0 13,794.56 - 13,794.56 6/14/1019 ACHDePOsit UHCCOMNIUNITYPLIICCNIMPMT]46003411910000 - 24,242.35 6/11/2019 24,242.35 6114/2019 ACH Oeposit UHC COMMUNITY PL HCCNIMPMT 746003411910000 - 16,037.39 ✓ 6/11/2019 16,03739 6/14/1019 AM Deposit HEALTH HUMAN SVC HCCWMPMT 174600341130052 8,647.79 6/11/2019 6/12/2019 8.647.79 4.092.00 147,539.30 191,335.11 191,33511 10.979.08 5/ 10,979.08 6/12/2019 MMC PORTION 1,229.9 - j7pOsLU081 Tron51eJ9 I QIPP/C-, Pl QIPP/Comp2 QIPP/Comp; QIPPIUPsa QIPPTI N14PORTION 6/712019 ACH Deposit UHCCOMMVNIWPLHCCIAIMPMT746W3411910100 6/13/2019 189.30 / - 389.30 6/7/2019 ACH Deposit UHC COMMUNITY PL HCCIAIMPMt 74SM3411910000 6/13/1019 7.14 a/ ),14 6/1012019 Check 1,25 4AI6.03 ✓ ACH Deposit UHC COMMUNITY PL HCCWMPMT 746W34119I0000 ' 6/1012019 CM Wire Domestic WIRE OUT CAnTEX HEALTH CARE CENTERS III 138.001.66 ACH Oepo0t UHC COMMUNITY PL HCCWMPMT 746W3411910000 24,254.66 6/11/2019 ACH Deposit UHC COMMUNITY PL HCCNIMPMT 7450111910000 6/14/2019 10.294/ 7,789.99/ 6/12/2019 ACH Deposit HEALTH HUNAN SVC HCCLAIMPMT174600341130042 6/14/2019 4,880.57 - 4.080.57 6/13(1019 Deposit 6/14/2019 5)•601.53 ✓ - 57,601.53 6/1411019 ACH Deposit UnitedHeaith4are HCCNIMPMT 74GW3411124384 3,646.00 - 2,646E 6/14/2019 ACH Deposit UHCCONIMUN17Y PL HCCNIMPMT 746003411950000 5.713.))1/ - 5,713.77 6/1412019 ACH Deposit UHC COMMUNITY PL HCCNIMPMT 7460034119100004,158.00 472960.82 45476642 - MISLED ACH Deposit UHC COMMUNITY PL HCCLAIMPMT 746W3411950GW 4,03129 - 4,03129 6114/2019 ACH Deppatt NOVITAS SOLUTION HCCLAIMPMT 67639420000184 / 123.24 Z 123.64 342,49.69 )9365.53 71,365.53 MMCPORTION T..Mfc,-C.TUamienitl QIPP/ComP1 QIPP/CpmP2 QIPP/Cemp3 QIPP/UPle QIPPTI NH PORTION 6/712019 ACH Deposit UnitedHealthnre HCCNIMPMT 746033411124384 7,810923% - 7.010.92 6/10/2019 Check454 4,388.]0 - 6/10/2019 CM WIN Domestic WIRE OUT CANTEX HEALTH CARE CENTERS 111 93,213.59 ' 6/11/1019 ACH Deposit UnitedHealihetre HCCLAIMPMT )46W3411124384 93000/ - 930.0 6/12/2019 ACH Oeposit MANAGEAN ONET1718 MN5 PMNT000000000W326841 1,408.00/ - 1,403.00 6/12/1019 ACH Deposit NOVITAS SOLUTION HCCNIMPMT 676323 420M)l 20 360.]0// 360.10 6/13/2019 Depp5lt 14.7)6.14] 14,776.14 6/1412019 ACH Deposit UHC COMMUNITY PL HCCLAIMPMT )46003411910000 729.70 729.70 6/14/2019 ACH Deposit UHC COMMUNITY PL HCCNIMPMT)46003411910000 8,56&59 r7// 3.569,59 6/14/2019 ACH Deposit UHC COMMUNITY PL IICCLAIMPMT 746003411910000 9.090,55✓ - 17,090.56 6/14/2019 AOI Deposit HEALTH HUMAN SVC HCCNIMPMT 1746034113002 1.833.95 ✓ 1.833.95 _ MMC PORTON ❑ansler47ut a lo•In QIPP/Comps QIPP/CpmP2 QIPP/Comp; QIPP/Uple QIPP71 NH PORTION 6/7/2019 AM Deposit UHC COMMUNITY PL HCCLAWVMT)4EW34II910000 41042 - 410.42 6/10/2019 Check 952 9,260.11 6/30/2019 CIA Wire 0omestic WIRE OUT CANTEX HEALTH CARE CENTERS 11; 16,521.61 ✓ / - - 6/11/2019 ACH Deposit NOVITAS SOLUTION HCCLAIMPMT 675663420000139 80.32✓ - 80.32 6/13/2019 Deposit 136.71 136.71 6114/2019 ACH Deposit UHC COMMUNITY PL HCCLAIMPMT 746003411910000 5,74186 5,741.86 6/14/2019 ACH DepmIt HUMANA INS CO EPPAYMENT 3908638300005638162 1,049.61 ✓ 1,049.61 15,801.1E ),438.92 7,418.92 MMC PORTION Tra len tLTO}lePln_ QIPP/Camps QIPP/CpmP2 QIPP/Comp; QIPP/lapse QIPPTI NIIPORTION 6/10/2019 Check052 6.451.90 �// - 6/10/2019 CM Wire Domesllt WIRE OUTCANIEX HEALTHCARE CENTERSIR 53.147.92 ✓ 6/10/2019 ACH Deposit UHCCOMMUNITYPLHCCNIMPMT 746W342191DOW 272 27 272.27 6/11/2019 ACH Depotll UnitedHeallhcare HCCLAIMPMT746W3411124384 18,791.94/ - 18,791.94 6/11/2019 ACH OeposltNOVITA550LUTIONHCCLAIMPMT 676310420000139 210.15! - 210.15 6/11/2019 ACH Deposit 14EALTH HUMAN SVC HCCNIMPMt 174SM34113007 215,876.41 15,87641 6/11/2019 6/12/2019 ACH Deposit AARP Supplement. HCCLAIMPMT 74603411124184 ACH Oeposlt Ameriproup TXSC HCCNIMPMT 3101980159111000 4.092.00 - 4,092.00 10.979.08 5/ 10,979.08 6/12/2019 ACH Deposit HEALTH HUMAN SVC HCCNIMPMT 1746003411300)2 1,229.9 - 1,229.57 6/13/2019 Deposit 8,017.84 - 8,017.84 6/13/2019 Deposit 990.00 990.00 6/13/1019 AM Deposit HEALTH HUMAN SVC HCCLAIMPMT 17460034113072 18,227.70/ 18,227.70 6/1412019 ACH Deposit UHC COMMUNITY PL HCCWMPMT 746W34119I0000 4,112.81 ✓ 4.112.81 6/1412019 ACH Oepo0t UHC COMMUNITY PL HCCWMPMT 746W3411910000 24,254.66 - 24,254,86 6/14/2019 ACH Oeposit UHC COMMUNITY PL HCCNIMPMT 746W3412 9100M 7,789.99/ - 7,789.98 6/14/2019 AM Deposit HUMANA INS CO EIPAYMENt 39086283ONS638162 1,066.31 ✓ - 1.066.31 6/14/2019 ACH OeposN HEALTH HUMAN SVC HCCLAIMPMT 174600341130072 7836.88 ✓ 7,}}6.81 59599.82 123137.80 12313] BO TOTALS 472960.82 45476642 454.76642 6/17/2019 Digital Banking Home ALL ACCOUNTS FAVORITES * Reorder Favorites Favorite Accounts Available Previous Day MEMORIAL MEDICAL CENTER- MEMORIAL MEDICAL CENTER / $108,504.17 8180,504.17 NH ASHFORD '43e1* MEMORIAL MEDICAL CENTER / $79,586.05 $79,506.05 NH BROADMOOR `4403* MEMORIAL MEDICAL CENTER / $53,715.82 $53,715.82 NH CRESCENT -"11 * MEMORIAL MEDICAL CENTER / $123,324.29 $123,324.29 SOLERA AT WEST HOUSTON '4438* MEMORIAL MEDICAL CENTER / $19,622.13 $7,569.70 NH FORT BEND '4446* MEMORIAL MEDICAL / NH MMC -NH GULF POINTE PLAZA MMNH GULF POINTE PLAZA IC �-1_...-� https://pbsltx.secure.fundsxpress.com/txveb/app/N/home 111 Memorlal Medical Center Nursing Home UPL Weekly Nezlon Transfer Prosperity Accounts 6/17/2019 Previous Amount to Be All ount Beginning Pending Newlon Portion• Tram/erred to Navin It... .Number_ Front. Traroileeut Tratnfon]n CW Cleared ba adb federal Mmdl Todds 6egi.nl.g gala... Nuning Nome 121,011.92y 120,907.35 66,816.58 66,941,15 /66,793.56 Bank Behnee 66,941.15 ✓/ laaVrti.Balanee Set.. 100.00 MMC Portion QIPP.lap 1 MMC Portion UIPP earn 1.lapfe APtll lnlereft 19.911 doutlna ln7ormoflon7or Golden Creek. May interest 3).9! ✓ Healon Health at Golden Creek Pending MPP Ck to MMC Wells Eoroo Bank. N.A APA. Aeeov..... ._.. .. Adient 8.1...e/TramEer Amt 66793.56✓ Nate: Only balonrr+o/ovn$S,NO will be Horst ..ed a the nuMnp home. Note l: Earh ottaunl has a bete belen@atSICO that lfhiC d,.,,Ied to ner'n enaunr. V `�J Aae 01ane C. Moura,,, CFO 6/11/2019 APPROVED ON JUN 17 2015 COUNTY AUDPPOR CALHOUN cOtMY, TNXAq LXtel Warki, TraudentNll UPL Transfer Summa1\2019V..ANll UPL lomfer Summary 0617 19 .lµ 672/)019 ACM Deposit l$Y5/fMN$FlA9 BKCO SilldT 543684555826917 9 6/10/2019 Opol,437 6/10/2019 Chi VA16 Dpme3lle ME OD3 NEKION HEAUR AT GOWEN CREEK 6/10/2019 ACH P4Ymenl TSYS/THANSRHST OISCOUN1543684555076017 910 6/13/2019 Depo0t 6/13/2019 ACH Deposit lSVS/TIIAHSiIB51 BKCD 6 Mly 543684555876917 9 6/14/2019 ACH Oepotit T5V5/TRAN52185T OCC05TMIT 543694555876917 9 6/14/2019 ACH Dupont Amedliys Holding CCD+55S380828 210000288123 6/14/2019 ACH Depollt AETHA H09 HCCNIMPMT 1588025964 3110020$1834 MM[ PORTION NN j Transfer -Out Transf d IPP/Campl QIPP/Comp2 QIPP/Camp3 QIPP/bpse QIPPTI PORTION I, 19450 V 1,194.50 18,101.85 ' 102,782.48 ' 23.02 55,155.05 55,155.05 5,624.00 5.02400 141,10 241,10 476.93 476.93 ,4 125.00 4,125.00 110901.35 66 616.50 3.190.50 e 6/17/2019 Home ALL ACCOUNTS FAVORITES * Favorite Accounts MEMORIAL MEDICAL CENTER - MEMORIAL MEDICAL CENTER / MEMORIAL MEDICAL CENTER / MEMORIAL MEDICAL CENTER / NH CRESCENT` MEMORIAL MEDICAL CENTER / SOLERA AT WEST HOUSTON Isaw MEMORIAL MEDICAL CENTER / MEMORIAL MEDICAL / NH GOLDEN CREEK HEALTHCARE '4454* MMC -NH GULF POINTE PLAZA MMC -NH GULF POINTE PLAZA - MEDICARE/MEDICA�i Digital Banking Available Previous Day $66,941.15 $66,941.15 Reorder Favorites https:Upbsltx.secure.(uiidsxpress.wni/f vreb/app/q/home 1I7 Erica Perez From: DMinton@Nexion-Health.com (Minton, Donna) <DMinton@Nexion-Health.com> Sent: Monday, June 17, 2019 4:36 PM To: 'Sarah Henderson'; Hartner, Beth L Cc: Erica Perez; Diane C. Moore; Turner, Tom; Minton, Donna Subject: [WARNING -Remote attachments, verify sender) RE: Transactions in Golden Creek ACH Payment TSYS/TRANSFIRST DISCOUNT 543684555876917 910 Account Sarah, All of these with the exception of the last one are deposits for credit card payments paid to the facility. I will research to see why they are debiting out of the account and the last entry is a ACH payment from a hospice company that the facility uses. I will let you know what I find out. Thanks, Donna Minton Regional Financial Manager I Nexion Health Management, Inc. 6937 Warfield Avenue I Sykesville, MD 21784 832-677-8603 (mobile) 443-280-6326 (fax) DMinton@Nexion-Health.com I www.Nexion-Healtli.com I www.FaceBook.coin/NexionHealthlnc Your local leader in nursing, rehabilitation, and assisted -living services. From: Sarah Henderson[mailto:shenderson@mmcportlavaca.comj Sent: Monday, June 17, 2019 4:04 PM To: Hartner, Beth L <BHartner@Nexion-Health,com>; Minton, Donna <DMinton@Nexion-Health.com> Cc: Erica Perez <Erica.Perez@calhouncotx.org>; Diane C. Moore <dmoore@mmcportlavaca.com> Subject: Transactions in Golden Creek Account Good Afternoon, We have noticed some new transaction types coming through the MMC -Golden Creek Prosperity account. Can you please confirm that these are deposits and payments that Golden Creek has set up. We are particularly concerned the debit from TSYS/Transfirst Discount -typically the only money moving out of our partnering nursing facility accounts are the wire transfers we initiate and the checks MMC writes to pay out our portion of QIPP monies. The transactions in question are as follows. Date Description Amount 5/20/2019 ACH Deposit TSYS/TRANSFIRST BKCD STLMT 543684555876917 9 241.10 6/7/2019 ACH Deposit TSYS/TRANSFIRST BKCD STLMT 543684555876917 9 1,194.50 6/10/2019 ACH Payment TSYS/TRANSFIRST DISCOUNT 543684555876917 910 (23.02) 6/13/2019 ACH Deposit TSYS/TRANSFIRST BKCD STLMT 543684555876917 9 5,624.00 6/14/2019 ACH Deposit TSYS/TRANSFIRST BKCD STLMT 543684555876917 9 241.10 6/14/2019 ACH Deposit Amedisys Holding CCD+ 555380828 210000288123 476.93 Thank you, R� 9-Pvndn Staff Accountant Memorial Medical Center 815 N Virginia St. Port Lavaca TX 77979 shenderson@mmcoortlavaca.com 361-552-0342 Memorial Medical Center Nursing Home UPL Weekly HMG Transfer Prosperity Accounts 6/17/2019 PINI. Amount to ne Account Bginnln9 Pendine Tranalened to Nunin Home Hander Bal>nte Tnn19eo0a1 Tr.nlf.111 /Ckt Cleared an are, Tada 'tbo Innen Galan.. Nunln Ilome IMM 0.15 100.15 RaM rnlanrn ,D7.19✓�GTrah sTQt� ,•.'lame tenve In Mlanae N.. MMCPomoo QIPPI MMC Panic" Opp 1191Iapse March Interest ON Aprllnterett 0.0a/ M"rderet9 om Pending OPP Ck to MMC Adjust ealanle/Tnnster Net 0.19 ✓ previous Amountrace Account Oeelnnln{ Pendmy Tram9erred to NarOn xdme Number Balance T,,nale,-0a1 Tn..fe'1. Bks Cleared a".un Todaia Be9lmmnP balance Nunme Nome IM" sagas - Bank Balance 999.19 abe6G1+ 93945 NOZYw'tS V.r 1 V J r Inn, In Balance INM MMC Padlen QIpP 1 MMC Portion QIPP }.],lapse Marlblateren 0.w✓ O Mwi1nl..t Mavlte..len .01 ✓ 0N pendln9; glpP [k IpoMMC Adhtt Balan[</Namler And �(gOD(gmuwnlwQti$sainTepbap ' o �0f) 0 weil tothedame Note: habncuolar the can r abatever /tote l ,""canes hnt a 0mebolvnee of fnMMoI M.edloap<n otrount Each balance of Met too pC' BhneLMa.1.'ore.6o 6!O/]019 APPROVED ON JUN 17 2019 COUNTY AUDIWR CALAOUN COUNTY, TEXAS d\xlivleeHr TundeulNll upt Torr"(summagRal9\Tune\rvll UP, Tonto, Sommar, M 1119.Akc MMCPORTION NH ,y. �_, �w ,cm Tnns(erOut Tram QIPP/Cpmp3 QIPP/C..p2 QIPP/COmp3 QIPP/SeP3e QIPPTI PORTION 3/3111019 Ater Earning Pymt Added to Aeeoum 0.04 •1130/3019 Aur Earnln, Pymt Added m Aemunt 0.04 5117MI9 ACll Oepmit PaySpan PaySpan 03000104093383 0.13 0.13 5/31/3019 Aur Earning Pymt Added to Mmunt 0.00 0,35 Oda „9.15 8119.03 8/1712019 Home ALLACCOUNTS FAVORITES * Digital Banking Reorder Favorites Favorite Accounts Available Previous Day MEMORIAL MEDICAL CENTER - MEMORIAL MEDICAL CENTER / NH ASHFORdOM MEMORIAL MEDICAL CENTER / NH BROADMOORi MEMORIAL MEDICAL CENTER NH CRESCEN� MEMORIAL MEDICAL CENTER / SO�LERA AT WEST HOUSTON MEMORIAL MEDICAL CENTER / NH FORT BEN MEMORIAL MEDICAL/ NH GOLDEN CREEK HEALTHCARE am MMC -NH GULF POINTE PLAZA $100.25 $100.25 - PRIVATE PAY -5433 * MMC -NH GULF POINTE PLAZA $989.15 $989.15 - MEDICARE/MEDICAID-5441 * htIps;//pbsltx.secure.fundsxpress.com/fxweb/app/k/home 1/1 June 19, 2019 2019 APPROVAL LIST - 2019 BUDGET COMMISSIONERS COURT MEETING OR 06/19/19 BALANCE BROUGHT FORWARD FROM APPROVAL LIST REPORT PAGE 4 $28,535.94 FICA P/R $ 48,294.54 MEDICARE P/R $ 11,294.58 FWH P/R $ 33,181.35 AFLAC P/R $ 3,274.53 NATIONWIDE RETIREMENT SOLUTIONS P/R $ 3,453.48 OFFICE OF THE ATTORNEY GENERAL - CHILD SUPPORT P/R $ 1,604.62 TRUSTMARK P/R $ 3,118.60 AT&T MOBILITY A/P $ 278.85 ALICIA FLORES GONZALES JURY REIMBURSEMENT A/P $ 30.00 FRONTIER COMMUNICATIONS A/P $ 293.37 LETIZIA JOHNSON JURY REIMBURSEMENT A/P $ 133.00 RHONDA S KOKENA - JURY FUND REIMBURSEMENT JURY CASH A/P $ 4,620.00 SHANNON E SALYER JURY REIMBURSEMENT A/P $ 100.00 WHITE TRASH SERVICES AT $ 300.00 TOTAL VENDOR DISBURSEMENTS: $ 138,512.86 TOTAL AMOUNT FOR APPROVAL: $ 138,512.86 g n n n -in n n Hn n Hn n n n Hn n n n n n a a a a H a nOp 'no� P,0c� FO n0r� nq 000-00o N N N N N N N N N N N N N N N m a00 W W ro b b:b b 0 T H W H H � ?� � �°�ygOgOgtrAJ tr�J:N�C7 A 0 0 [0[ 0>oa�y��'a�a Po m n n n n p b o y°Oj N e -M rn rn oornrr�'tin0 °O �n rn rn rn rn ro� m� v ro O M 77 0 0 0 o v z Oz r 0 i a a 0 O o o Q O o O O O O o O O O O o o O o 0 0 o O N O p C O O O �j O O O O O O O O O O O O 0 0 0 0 0 0 0 0 0 O O O O O O O O O O O O O O O O 0 0 0 0 0 0 0 0 (dp y O O O O O O O O O O O O O O O O O O O O O O.O b O q C) rn rn a, a a. rn rn rn rn rn a a. rn rn o. rn a vrn o, a o. rn o. rn O N N N N N N N N N O O N N N N O N O Lui VUi N N N N 0 n Op R d N S 00 n N N N ii t� l3 t3 Z 2 0 0 0 0 0 0 0 0 0 0 0 E 0 0 2 0 2 0 0 0 0 r r rr r r rr rr r rr rr r rr rr rr rr r rr rr rr r 0 I n P P P P P P P P P P P P P P P P P P P P t+ m N ° R G F' I b A P O N W J P W J J O � N W O W N b U W V ✓ W N A W b "' P W P' N p O O O O O O O o O O O O O O O b a o b o b O b O b O O F' I o m� m� m� Nt o�+ tiro n H() n n Hf� to c� H(] < a a bra bra bra oo 0p0 o0 no ma a �a a a ma ma SIN �mn Mry� �mcryry�,pqq zzz z � � � Ny �D o n O O O f�t+�3 S ['� C7,. r r r r tto tt0 r t6 r r 0t tr^ z nz �z c�z c�z oz » �, rs ro roo ro ro ro �o b o g o o $ �� 61 io 00 0o Oo oa oo Co W oo ao V iW O 'Y iyC �-j ik ,iDi V (wji I� q Y W b CJ (^a� Vl N n 9 t1 U W W O QN A T O 1p 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 o m n t7 O A A o O N N N N N O V N A O O A p R O O a E Wl N O W N �O b W N V O� Oo rn A N N Orn e d O O a E Wl ^ NYy O d d b d d jY� (�7 hCj 7'S'bJ OO O �Ojo u M fn Oy Oy Oy Po- -01 Oy o. o 0 0 � � � n n � pp r 0, 0zz o C vmi rmn cMi� � tnn goo o b b b b b b SCE CF b W 61z O� N IJ zzo �z a v HG z A A Pd g A i+. 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