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2019-07-03 CC MINUTES.pdfCommissioners' Court —JuIy03, 2019 REGULAR 2019 TERM I. .pI lg� IwI" I DULY 03, 2019 BE IT REMEMBERED THAT ON 7ULY 03, 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 If 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 4 Commmissioners' Court -July 03, 2019 4. General Discussion of Public matters and Public Participation. N/A 5. Hear the May 2019 Memorial Medical Center Report. 1, 1 Jason Anglin, CEO of MMC, and Diane Moore, CFO of MMC, presented report. 6. Approve the Wednesday June 05, 2019 and Monday, June 10, 2019 Commissioners' Court 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 7. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 7) To approve a Drainage Easement Agreement location in Precinct 4 between Calhoun County and POC Park 1, LP and authorize the County Judge to sign same and file it of record in the Official Records. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Clyde Syma, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 8. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 8) To approve the County Municipal Road Mileage Certification and authorize the County Judge to sign. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Clyde Syma, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 2 of 4 Commissioners' Court —July 03, 2019 9. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 9) To approve the contract with G&W Engineers, Inc. for Engineering Services In support of Calhoun County State and Federal Grants and authorize the County Judge to sign all necessary documents. (RM) PASS 10. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 10) To approve the specifications for rebidding the RFP for Administration/Professional Services in support of Calhoun County State and Federal Grants and advertise for these services. The RFP will be due by 2:00 p.m. Wednesday, July 24, 2019 and considered for award on Wednesday, July 31, 2019. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese il. Consider and take necessary action on any necessary budget adjustments. 2019 RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 3 of 4 Commissioners' Cow rt— July 03, 2019 12. Approval of bills and payroll. (RM) 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: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Court Adjourned: 10:14 A.M Page 4 of 4 Commissioners' Court —July 03, 2019 REGULAR 2019 TERM § ]ULY 03, 2019 BE IT REMEMBERED THAT ON DULY 03, 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 4F1 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 10 Commissioners' Court -July 03, 2019 4. General Discussion of Public matters and Public Participation. N/A Page 2 of 10 Commissioners' Court — July 03, 2019 5. Hear the May 2019 Memorial Medical Center Report. (RM) Jason Anglin, CEO of MMC, and Diane Moore, CFO of MMC, presented report. Page 3 of 10 5 Memorial Medical Center - Port Lavaca, Texas CEO Report June 20th, 2019 Financial Results: In May, we had a Net Loss of $203,867 decreasing YTD to a loss of $136,001. Department Highlights: Plant Services Received facility assessment report. We have on Board agenda for review. A State Surveyor came on site for the Life Safety Survey. Survey went well. We expect to receive a report from the State with some minor items for us to address. Sleep Study Program We are in process of moving the department from the second floor of the hospital to our Rehab Services building. Lab New Biofire equipment Installed and new testing is available with the new equipment. Imaging CT Tube was replaced under service contract. Rehab Services We have added a contract Speech Therapist who specializes in kids to be able to provide that service locally. Other: Supplemental Program Presentation — On June 14, 1 gave a presentation to Commissioners Court on the Supplemental Payment Programs. Information on Board Items: Financial Items: 1. Review and Discuss Plant Assessment Report — Please review assessment report from Intalere. The report identifies major capital needs for the building. 2. Operating and Capital Budget for 2020 — Will Present our 2020 Proposed Budget. 3. Purchase of Sterrad Sterilization System — We need to replace one of the sterilizers for our surgery department. The cost of the equipment is $50,000, We can pay for the equipment over 5 months. � 011,60 4. Purchase of Patient Beds —Good news, we applied for and received a $75,000 grant for the purchase of beds. We have a 25% matching requirement. 5. Approval of Setting up Second Rural Health Clinic on Second Floor of Hospital —As we have discussed we need more clinic space to continue to grow our practices and to have space for physicians we are recruiting. At this time, we would like approval to move forward with establishing an additional clinic. Potential Items for Next Month: We had planned to include these items in this month's meeting, but decided delay to a future meeting for time considerations. 1, Presentation 2019-2020 Management Action Plan — I will do a presentation reporting on our 2019 -2020 Management Action Plan, 2. Presentation of Marketing Plan — Roshanda / Adrianna will present highlights of Marketing Plan. I Presentation of Supplemental Programs —On June 14th, we gave a presentation on the Supplemental Payment Programs to Commissioners Court. I am thinking a review of the information will be good review for the board also. 4. Presentation of the RevCycle report— Diane will present highlights from a recent review of our Revenue Cycle by our Computer Software Company CPSI. Education: Please find attached Publication from TORCH May 28'h issue of The Capital Voice. Closed Session• We have closed sessions posted for (1) Legal. Respectfully, lasonAnglin,JJJCE0 Memorial Medical Center N N a¢ N E m w o C E w o .0 >. o.L: a 3 = v o n 3= V E t E G o E 3 n w o? E cZ E o o x o amwo p qa< a C E o o ? ¢ _ m' m _ a N O aw c$ t H m S YE 3 _ ova„`¢ 8 m 93 uT c t `m 00. N'o t E � t E _ v E n o Ea c 'o c o _ a E a a w a. 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'oaG - -a E E EoE_5E mhoa.sm- w IN_'^ �.wa -E`oE�E �ia o3Eo0 0jid4ms h� $c 0 tx-moomE t af�w� C. a3.Oc� oro Ca 3as �.O o ,o_mt�,nam OLD M m n IN w rvnrvmiry m�� Y 2 x S x i S x x S S S S vmi �n v� v� vmi x E m m w 9 EY � w E 0a 5 nay n� S 3 0 0 C o Deb v t 0o E w 0 OR L° q E o E > 2za E = v - 05o Eo _ a 45 12 g E es m Ov Ow m 0 OwOw U OR Ov c$ v °.ax s 2° Q g o E r 3 a « = o w o E�S° IM `° bra w c,Orl E°wa E 7 0 to o = ¢ 3 w c> T o mOn 0 o t n a u� 3 3 2" Mm M w� 5 0 ON aIN L m m n i° m G 3 a4 ¢ Ri 3 w z x x¢ Q N j 0 E a 10 p Q Z C a Memorial Medical Center Financial Report For the Month of: May 2019 Overview: In May, we had a Net Loss of ($203,867) and a total YTD (year to date) 2019 loss of ($136,001), Memorial Medical Clinic had a profit of $45,845 and a total profit YTD of $411,533. We had an overall gross revenue of $6,196,359 for May 2019 as compared to $6,031,664 May 2018, an increase of $164,695. The increase in revenue was in Outpatient and ER. We had a decrease In Inpatient revenue. The loss in May 2019 was due to a couple of factors. The first in the increase in Self Pay, the increase from May 2018 to May 2019 is $63,443, This Increase in self -pay increased our contractual allowance by $60,271. The second, is the increase in Charity/Bad Debt deductions as compared to May 2018, the increase Is in the amount of $663,619, The total of these two items is $727,062. Statistics: May Highlights on Volumes; Key volumes in May as compared to April include: Overall Average daily census 1Z.17 a decrease from April's 12.67 ER Visits up 3.5%from 790 to 818 visits. Clinic Visits down 8.4% from 2,774 to 2,542 visits. Surgery down 5.9%from 101 to 95 cases. Imaging down 8.2%. Lab down 4.8%. Rehab down 17.5%. Program Hope up 2.6% Private Pay utilization increased to 16.9% of Revenue. Hospital —April's Self Pay was $1,066,150 compared to Mays $979,084 a decrease of $87,066. May of 2018 Self Pay revenue was $915,641— an increase of $63,443. Balance Sheet Hi�hliahts: ASSETS Bank Accounts Cash and Investment balances ended the month at $3,692,834, of which $660,803, is Nursing Home monies. This leaves the hospital with $3,032,030 which is an increase of $358,652 from April. At the end of May, we had 37.90 days of cash expenses on hand in hospital funds, which is an increase of 6.00 days from April. We also had a loan from Calhoun County to help assist us with the IGT payments due in early June 2019. The deposit was in the amount of $1,000,000. Accounts Receivable Patient Accounts Receivable balances were $10,854,590 for the hospital and $565,017 for the clinic. Net AR combined is $2,461,178. The AR decreased $339,466 in May. The decrease in both the hospital was due the increase in collections and reduction in revenue. The hospital AR days is currently at 58.04 days and the clinic is at 46.73 days. Accounts Receivable —Other The balance in Other A/R increased by $643,492. The increase was due to the monthly accrual. The balance at the end of May is $4,651,819. The balance of Accounts Receivable other is primarily made up of four accounts, DSH $165,581, UC $988,577, DSRIP (Waiver) $1,316,316 and NH QIPP $1,6981058. Accounts Receivable Nursing Home The nursing homes ended May with $10,518,746 in receivables. Accounts Receivable Est. 3rd Party Paver Settlements Our books reflect a net due from third party payers of $36,831, This consist of $21,282 which is an estimated amount due from Medicare for 2017, $555,718 due from Medicare for 2018 and an estimated due to Medicare $497,505 for 2019. Once the final audit report is received in June, we will correct these balances per the audit report discussed in the May 2019 board meeting. lIABIL1T1E5 Accounts Payable The balance in payments due to vendors and accruals at the end of the month was $1,006,984 down by $404,186 from $1,411,170 in Aprii. Accounts payable invoices received are at $1,908,061 vs $2,158,992 at the end of April. The decrease in the May month end AP balance is due to timing with payments. Due to Nursing Homes The balance due to Nursing Homes increased to $11,803,027. Accrued Expenses We carried accrued payroll and benefits payable to hospital employees totaling $1,484,996 which is down from $1,682,018 in April. Accrued Intergovernmental Transfers IGT (lability is $1,235,570 at the end of May. Leases Payable The hospital has $948,660 in capital leases total both long term and short term. Long-term portion also included below. Lone Term Debt, Net of Current: The total is $3,495,901. This consists of $2,730,075 in Pension liability and $765,826 the longterm portion of leases. Current Ratio The ratio between our current assets and current liabilities is 1.35 at the end of May. This is lower than our benchmark of 2.3 Income Statement Income Statement: Gross patient revenue for hospital and clinic in May was $6,196,359 which is a decrease of $536,626 from April. Revenue Deductions in May were at 69.6% compared to 69.6% in April. We also posted the first of the two grant payments received for the Rebuild Texas award. It was In the amount of $149,187. The other payment is due later this year. Also, comparing YTD May 2018 to May 2019, at the end of May 2018 we had a total loss in the amount of ($1,257,799) as compared to the total loss as of May 2019 ($136,001). Total Operating Revenue May 2019 as compared to YTD from May 2018, we are up by $1,690,179. This is due to the following: • Overall Patient Revenue is up $4,687,509 o Self -pay revenue YTD is up $870,304 • Overall Deductions are up $3,757,295 o Contractual expense up $2,006,146 o Charity is up $3,775,486 o Bad Debt is down $1,898,535 ■ Net Charity and Bad Debt is up $1,876,951 o Indigent is down $13,927 o DSH/UC/DSRIP is up $111,875 • Other Operating Revenue is up $898,645 o 340b is up $762,531 Total May expenses (excluding nursing home) were down from April by $34,125. This was driven by: • Salary expense up $2,123 • Benefits and PR Taxes cost down by $116,775 (BCBS incentive $100,000) • Professional Fees were down up $33,351 ($22,111 for Anesthesia and $24,895 for Pain Mngt and a decrease in Hospitalist $11,597) • Purchased Services were up by $23,750 ($12,720 Plant Ops— Chiller repairs, $17,275 for Wound Care) • Supplies were up by $16,061 ($3,400 for telephone server, $3,102 hot water heater clinic, $3,383 floor cleaning supplies and Flu and Lab tests) • Insurance was a $0 change • Utilities were down $2,492 (Reduction in fuel costs) • Other Expenses were up $10,115 • Depreciation was down by $258 Expense Comparison —10 years ago, 2008 as compared to 2018 2018 Expense excluding Depreciation and Nursing Home $26,583,601 Less Programs/Departments not included in 2008 Less: Clinic $ 4,432,870 Less: Clinic Physician Cost allocated hospital $ 391,618 Less: Program Hope $ 408,490 Less: Cardiac Pulmonary Rehab $ 221,542 Less Hospitalist 344,419 Subtotal of expenses for above 5,801p939 Comparative 2018 Expenses $20,780,662 2008 Expense excluding Depreciation $21,780,654 Difference $ (999,992) Difference 'S% Memorial Medical Center Income Statement by Operating Unit For the Month Ended May 31,2019 Revenue Current Period Nursing Hospital Clinics Homes combined 1,034,769 - 1,034,769 Inpatient Revenues 21723,197 S40o373 3,263,570 Outpatient Revenues 1,898,021 - - 1089%021 ER Revenues - - 4,407098 41407,098 Resident Revenues 5,655,987 540,373 4,407,098 10,G03,457 Total Patient Revenue 2,779,335 74,750 - 2,854,085 21527,878 91719 • 4537,597 47,494 2,321 49,815 (202,523) - - 1202,523) (927,274) 608 (9264666) 4,224,911 87,398 4,312,3D9 1,431,075 452,975 4,407,098 6,291,148 Revenue Deductions Contractuals Charity Indigent Care DSH/UCC Bad Debt Total Revenue Deductions Net Patient Revenue 221,209 178,717 - 399,926 Other OpemOng Revenue 11652,285 631 692 4,407,098 6,691,075 Total Operating Revenue LLrtent Period Hospital cllnirs Nursing Homes combined 831,461 144,284 - 975,745 1721366 42,254 - 214,619 212,778 262,621 4750399 394,915 50,173 - 355,088 279,135 34,077 313,211 5,241 - - 5,241 50,050 - - 50,pso 81,99D 81992 - 900982 4,482,129 41482,129 1,937,935 542p01 4,482,129 61962,465 65,362 56,000 - 81,162 2,0030097 558,401 4,482,129 7,0431627 (350,812) 73,291 (75,031) (352,553) Operating Expenses Salaries & Wages Employee Benefits & PR Taxes Professional fees Purchased Services Supplies Insurance Utilities Other Expenses Nursing Home Fee Total Operating Expenses Depreciation Total Expenses Net operating Income / (Lass) Nan Operating Income/ (Exp) 1,281 investment Income intefes[Fxpeme - Contributions and Grants - - _ - - IGT Expense _ - - Service Contribution bySOSEF - 1500063 150,063 Nursing Home Program (11378) 150,OB3 148,685 Total Non -Operating Revenue (352,19D) 73,291 75,032 (203,867) Total Net Income /(LasS) Year to Date Hasphalt Nursing Clinics Homes - Combined 5,6151743 - - 51675,743 14,557,567 2,977,119 - 17,534,686 91349,248 - - 9,349,248 - - 21,841,805 21,841,BD5 29,582,559 2,977,139 21,841,805 54,401,463 15,878,985 515,289 - 16,394,273 51309,530 114,062 - 5,423,592 99,B55 7,425 - 107,279 (1,0331591) - - (110334591) 998,071 53,856 11051,928 21,2521850 69D,631 21,943,481 8,329,708 2,286,488 21,8M11,805 32,458,001 481,218 765,665 1,246,882 9,810,926 3,052,153 21,841,805 33,704,964 vearm pate Nursing Hospital Clinics Homes com6lned 3,942,530 686,426 - 4,628,956 112071288 210,013 - 11417,301 1,0251250 1,199,562 - 2,224,812 1,411,863 199,724 - 11611,587 1,34%065 149,035 1,497,099 23,397 - - 23,397 254,021 - - 254,021 40So537 21,899 - 427,436 22,216,962 224216,962 %617,951 2,466,659 2202160962 34,301,572 349,664 801000 424,664 9,962,615 2,546,659 22,216,962 34,726,236 (1,351,689) 505,499 (375,15]) {1,021,353) - 893,961 893,961 (8,630) 893,961 885,351 (1 160 299} 505 494 518,804 (146,OD1) -1- Current Period Actual This Budget This Month Month Last Year 1,034,769 11184,332 11112,367 31263,570 3,7791700 21885,508 1,898,021 11653,920 11761,270 41407,098 41471,175 3,948,914 10,603,457 110089,128 9,708,D59 2,854,085 3,219,998 3,264,214 21537,597 337,329 296,516 49,815 21,500 26,828 (2024523) (144,993) (188,002) (926,666) 642,943 650j796 4,312,309 4s076,728.._ 4,050,352. `.,. ,.... n 6,291,148 7,012,399 5,657,707 399,926 97,304 84,020 m 6691075� 7,109,704 5,741,727 Current Period Ac[ual This Budget This Month Month Last Year 975,745 _ _ 966,9124 837,070 214,619 306,411 369,737 475,399 528,364 337,593 355,088 331,336 24%373 313,211 327,362 275,527 5,241 41000 21839 50,050 46,603 43,214 90,982 105,366 93,549 4,482,129 41012,782 61962,465 _4,546,207 61221,684 �71162,561„ 81,162 801693 8%260 �. 7,0431627 7,243,254 6,309,944 (352,553) (133,550) (5681217) 1,281 583 1,432 (2,658) (2,312) (2,828) 1,883 - r , 150,063 - 350,063 127,736 u .,-148,685 150,217 � 126,340 (203,867) 16,667 (441,877) Memorial Medical Center Income Statement - Combined For the Month Ended May 31,2019 Inpatient Revenues Outpatient Revenues ER Revenues Resident Revenues Total Patient Revenue x Revenue Deductions n Contractuals Charity Indigent Care DSH/UCC/DSRIP Bad Debt Total Revenue Deductions Net Patient Revenue Other Operating Revenue Vear to Date Actual YTD Budget YTD Vear YTD 5,675,743 4 51921,661 _Last 4,990,109 17,534,686 18,898,502 14,465,310 9,34%248 81269,601 8,416,750 21,841,805 22,355,875 20,9620309 54,401,483 55,445,690 48,834,478 16,394,273 16,099,742 14,388,127 5142%592 1, 686,647 1,648,106 107,279 107,500 121,205 (1,033,591) (724,964) (921,716) 1/0514928 31214,717 21950,463 21,94%481 20,383 642 18,1860186 N 32,458,001 35,061,997 30,648,292 1,246,882 486,522 348,237 4 Total Operating Revenue � 33,704,884 35,548,519 30,996,529 L, Operating Expenses Year to Date Actual YTD _ Budget YTD Last YearYiD Salaries &Wages 4,628,956 6�4,834,558 �� 4,151,816 Employee Benefits & PS Taxes 1,417,301 11532,054 1,52%250 Professional Fees 2,224,812 2,641,821 1,8811886 Purchased Services 11611,587 1,656,681 11616,784 Supplies 1,497,099 1,6360811 1,334,471 Insurance 23,397 20,000 17,061 Utilities 2544021 233,017 240,192 Other Expenses 427,436 526,832 3490194 Nursing Home Fee _ 224216,962 22,731,033 _211281,754 Total Operating Expenses 34,301,572 .. 35,812,805 32,402,407 Depreciation 424,664 403,466 474,507 Total Expenses 34,726,236 36,2161271 32,876,914 Net Operating Income / (Loss) (1,021,353) (667,752) (1,88%385) Non Operating Income? (Exp) Investment income 5,714 2,913 31644 Interest Expense (14,324) (11,558) (20,1441 Contributions and Grants - 91417 200 IGT Expense - - - Service Contribution bySOSET - - _ Nursing Home Program 893,961 750,315 638,887 Total Non -Operating Revenue 88SJ351 751,086� 622,587 Total Net Income/(Loss) (136001) 83,333 (102570799). -2- o A o N x �e x a N x o a a: d g m N x m x ^ x N t E u � mv.m'o'� El f mN 1999ZR E {3 0 u 2 °°ate a am at at mom °�� mm�m�� rvm � t e al m N �:-m"-�mm `rr' m o m s e a '� s., .at m+n v.a-i m IR at 0 at `^° m.:o tel m `mom m.'-�.^: a � ^a vmmi at 3 �mN ^�am�nat v� B gmm�m omlm�� - to .y a s . at al N �mm a rvm at o at m�mm �mgo�r. o�m mIn 6a N m�^o Gm to �m Noa 7e° 1 lvoa L4 Ixta a v n 9 nv a Ma 0N 'ei> i 87 c �"a w v�U=a x" "� o v - Saa12 r= za mm c Gu z z F s` N� n mm m >o �m y n o nma rv' a ommn n `�'im S mm � � ti � � mm�AIM 3 a a^, �- ` o ^mo o Nm �9�mmmmat �� m� m �m lzoo �o� mF m,atm�N� gofo m°3 �y^�vry°m�°�m -�namm �� N m � �a �rq a r, at ry a —3— F E 0 E z G a E - o E 5 v'r�n m .ati�"a ;`" m �`ati rvry ry ry Z c o 0 o z z o` r � -4- § / )o ' "H CILR §§ ®\} _B©raamw2§§k!¥RR fw§;mw"§ ;G&©&:$,®Na®:;, !ew&�kei&ii§ewi !ƒ r«#ca!! 40 tlP 2 \/)\}\\}/}\ -- c N N N Q U o U M "O O W O N m U m y o a E 2 H E LL In in o.�nN G O U E c � w o m U C 0 0 0 0 0 u ti ti ct N ti n V w 0 z m N CN l0 W O N C N Inll H cN-I H' W 0o m a n D V M O m N W m C n UI p� r c N W a01 n o Ol O1 to M G m d n N n a N M n m m m N K Z 06 N d d N 3 N m M .n-i r C C) in lO M c-I O 3 O m N m v W O N Q m M W w w d a m m M O o m jj -0 N ci N W U � � �m o vi im m o � w io m m m d V W 'cF N Ifml N V O V N n c-i Oml O C ' Om dm' W tmr) N 7 m (�11 m m o n n m m m N N n r/l In W W . N cf tri vl r N N n r C ' Om dm' W tmr) N 7 m (�11 m m o n n m m m N N n r/l In W W . N cf tri vl r N N n r dm' W tmr) N 7 m (�11 m m o n n m m m N N n r/l In W W . N cf tri vl r N N n r m ExIsOm Patlent Cihie Visits 2,265 2,471 2,487 2,387 2,111 71,691 2,32tl All OtherVlshe ' Total RHC& Surgery Clinic Vicils 21768 2,895 21895 2,774 2,542 13,874 21775 Specially Clinic Malts 234 215 210 314 276 1,249 260 Hospital OR Procedures 76 74 63 69 78 360 72 Total visits & Pmcedums 3,076 3104 3168 3157 2096 15,483 307 No Shows 170 105 212 170 209 920 185 No Shaw% 6% 5% 7% 6% 8% 6% Pmlesslonel Fees 1oi,971 743,200 159,392 140,025 Specialty Clinic Revenue 104456 92000 140364 195072 Pallent Revenue 5603768 6052789 636,808 6334391 Estimated Medicare Settlement 100633 (22,798) 15608 60B Revenue Rentnue fi12 567 517 3,131 340BR 417 128452 80632 2850fi8 90696 201 782531 MASS 153,133 Total Miscellaneous Revenue 129,368 81,248 2t15,634 90,696 1]8,71] V%717 785,665 153,733 Total Not Revenue 565529 457298 624213 573421 631692 3062,153 610,431 Salaries -Regular 108,133 IM799 121,341 123,194 126,928 593,398 11079 Salaries -Overtime 2,665 4,W4 3,874 3,934 2,471 17,587 3,617 Salaries -PTO 16,444 10,341 17,159 16,819 14,880 75,443 151089 Total Salaries 127246 128,774 142,375 10,747 144,284 fie6,926 137285 Denelts-FICA 91287 8,626 91460 10,104 94800 47,264 9,467 Benefits- State,Unemploymenl - - - - - - - Benefits- Federal Unemployment 708 324 288 134 50 11585 317 Denefils-Retirement 11,605 10,636 113944 12,698 12,334 59,615 11,923 Insurance -Hospitalization 1g297 12,337 21,713 28,789 17,584 9D,700 10,140 Insurance, Other 260 491 2,103 2,098 1,276 6,228 1,246 Talal Salaries, Wages, and 8enefils 160335 1fii 639 189101 18B B28 108538 896439 179,280 Supplies -General 354897 35,990 21,232 18,033 33,006 144,758 26,952 Suppilae-Once 654 819 - 449 889 921 3,672 722 Supplies - Forms - - - " Freight 188 91 145 90 160 664 133 Toles Supplles 38,639 36,900 21,8P6 19,693 34,077 149,035 2907 Software Maint 4,174 4,174 3,872 3,872 34872 19,9B4 3,893 Pm Fees - Physicians 217,734 2124655 250,615 255,938 26201 131D9,562 239,912 Minorequlpmenf - 478 2,608 - 5,201 8,18T 602 COIIeGIon as 201 873 733 997 - 2,fiO4 217 InlerestEzpense - - - - - 544 tDe Laundry 644 358 72 Travel Subsc4ip0ons 002 725 - 1,8DD 3,387 677 Education - - 676 _ 676 135 ^ Leases &Rental 995 995 995 995 995 43974 995 E uI ment toast-aNer#1 " Total Renl end Leases 995 985 895 995 895 4,9T4 995 Total F"enses Contribution A42723 457348 511 772 672474 _ 542401 2,486,859 493,332 N tOp 11 91n m 122805 (50) 972441 61007 09291 505494 117099 Depreciation (16,000) (16,000) 062000) (164000) (161000) (800000) (16,OD0) IGTExpense Commud Denefte Contribution - NetNarw era8n Income - M gin 108805 (16050) 296497 450W 79291 505494 101,099 New PaeantCUBIC 482a7 ESNnB Pat(entintc V fik 2,2609 244411 2,4 2,387 2,111 li,t6 2.329 All Omerwsn: Total Cale VlSBs 2,]68 24695 2,863 2,]as 2,678 13,W4 76 2,]72 Hospital OR Procedures 76 ]4 6a 89 78 %0 ]2 TWaIYsm4spmcadWas 2841 2989 285H 2843 2R20 14.234 2.847 NO Shows/Missed AppolRimends 170 165 212 170 %9 No IN NOSIIVN% 6% 5% 7% 6% e% 6% 6% 34 fl 12 A52 632 205086 90100 176,201 761531 MAW Total Rllsceilaneaua RBVenue 12e,462 80,832 2%,088 80,180 178,201 702,531 152,6OB Total Not R 6328)1 425 4] ]82078 639A]1 5625i6 2017645 M350 seledes-ReBuler Seladet-OvaNme Total Ce-P7O Total C9nke1 Selarlea saladee- Regular salertes-OveNme Total Talel CNnk PFS 6eledos aenefds clinked -FICA BenaMe clinical- Federal Nnamploymenl Benefits clinical indaITSR H ment Benefits Note ITS 0ene01s NOW PFS -Fedamlefat oymenl 6ana6ta Cflnk PFS -Retirement Group Health Clinical Other Insurance Clinical workars'Comp Citnkal Group HaIth Cpnk PFS Other Insurance clink PFS Workere Comp Clink PFS Tolal Emords Tram swedes. waeaa, and Become 490 ]1,327 82,00 86,505 80,AN 4%,62 a4,]93 SWI gOW6041 1,32] 2,091 2105 IA08 1.A03 896 7,028 1,666 40010041 10 ]PS 767] 12 so4 10005 11,843 62,754 10,651 91,%/ 91,119 100= Nadir IO2,062 484,250 88,850 40000042 25.457 2],]63 30,925 32.01 31,581 1484207 29,%1 40005942 1,395 2,641 1,591 IA20 IN 7r450 IAN 90030042 3,%3 2,26fi 4,0U 6,O69 2,514 10,266 BlA54 30, 06 32669 36,W3 a0,BB5 34,581 173,934 34.]W 4001SO41 6,741 6,142 0,796 7,028 71089 33,]09 61759 40025041 SIR 201 ITS 08 46 1,On 215 40040041 80616 Irises m,6Ui 8,776 818M 42,312 BA62 40015042 2,180 2t160 2,313 2,652 2202 11,603 20301 40025042 IN Ills 112 38 4 4% 93 40040042 24811 2,78/ 2,878 3,269 Z842 1417U Z952 Allocated 61091 S,T00 14A61 20,832 1467U 62,565 12,61a 130 182 1,499 Items 1,190 4,890 978 469 177 BSd set e)] 640 Ptlocated 2,312 81310 8,458 7,u59 1•els 2a,%2 4,702 43 299 621 IN 6 8% 10 1% 63 311 350 205 IJ14 06 31,0a6 31,600 4d,0B0 52,s56 40,I94 200,]26 40,145 1526]5 155989 lei 848 191182 1]7 ]3B BSe909 1T17022 Supplies-Genemi 40320091 35,661 36,614 21,083 18,352 32,778 143,890 28,13e lies -Office 40E35041 651 T70 415 830 818 3A91 69B SupFllas-Forms 40230041 40215041 - 170 - 91 145 90 IN 646 129 Frouldi Total suppmes - 36,a67 36,603 I Q i i 19,272 33,H43 /47,9M 29,666 sot WAR 4017MI 4,174 4,1]4 3,872 3,872 3,672 19,%4 3,993 e.•. c.... p6,t0au,.. 4051MI 21747N 212ASS 2BOA16 2%,938 262,621 16199,562 MOM Rapeln-Irwimmanls 90ll0041 - Malnt. Conbacls 40120041 - - ' A0135041 402B504I - 478 Mail 5,201 8,167 /,83] labore uarmapm6nlel M Pmenl Posis9e stage Collectioncosts; 402NOCI44WI 40440041 201 - 873 733 " - 99] 2,804 bTi Interest E(oense 4050INI - - 644 109 Laundry 40520041 644 - - - %B 72 Travel 40 =41 4NOW41 - 662 358 - - 726 - - - 1,800 3,360] 677 Subsedpllons Education 40IM41 - - 076 - 76 135 AdverOsk4 40330041 1,168 - 10166 04 Rar4u0k0-Employees 40MO041 - • - Miscellaneous exp 40900041 - 1,e0B - 1,510 4,842 1,188 ' ],9B] 16,025 3,385 Total GlhorPracticeExpenses LeasesBRandal 40500041 033 E33 833 633 833 6" 833 3164 3,1B4 633 833 Total Real and Leases 8% 699 833 T IiFx 42J 26 4 6818 4TA?]2 480068 fi00 ]30 2.326112 466222 Net Op 46403 610A6 491639 88,30]_ Oapmelallon (16,000) (10,000) (18,W0) (164000) (ISM (B),6c0) (164000) IGTExpens Commun 0enef115Lonidbu0on _ Ne1No0O amlin [name C IfbM Mean 93852 (28 n11 2]1704 29403 48016 411633 a2807 Net Reve0ueMsll 19244 147.10 26324 192.67 MAI 203.09 Greakeven VISAS WIG 4C.Ommbnny Benefit Z200 2,982 It= 2,00 2,263 2,2Ga 115454 11,454 13reaksvenVlsks w/COmmanity aenan 2,200 2,982 11802 2538 Specialty Clinic Revenue 182 563 54 487 - - 1,286 257 Infuslon Revenue 49,919 15,967 32,136 82,844 390052 219,918 43,984 Wound Care Revenue 54,355 75,470 108,174 111,741 76,838 426,678 853316 Rent 917 617 667 517 517 3,133 627 Total Miscellaneous Revenue 917 617 557 617 517 3,133 627 Total Net Revenue 32,852 31,450 62,138 38,951 69,117 234,507 46,901 Salaries - Regular 3,364 4,587 4,633 3,596 5,142 21,522 4,304 Salaries-Overtime (54) - 177 11100 1,076 24299 460 Salaries - PTO 2,356 498 498 546 523 41421 884 Total Salades 6,666 52085 5,509 51240 6,741 28,242 51648 Benefits - FICA 366 320 357 523 419 1,985 397 Benefits- State Unemployment a I- - Benefits- Federal Unemployment 38 4 - - - 42 8 Benefits - Retirement 479 403 466 656 537 21541 508 Group Health 995 318 794 11098 968 4,172 834 Other Insurance 87 10 82 101 78 358 72 Workers'Comp 29 10 47 46 57 189 38 Total Benefits 11994 1,066 1,746 21423 21060 91288 13858 Total Salades, Wages, and Benefits 7,660 6,160 71255 71663 81800 37,529 71506 Supplies -General 230 176 150 281 231 11068 214 Supplies - Office 4 41 34 40 3 121 24 Supplies - Forms - - - - - Freight 18 - - _ 18 4 Total Supplies 262 217 184 321 233 11207 241 Pro Fees - Physicians PurchasedServices- Non -physician 11,125 12,000 - 29,600 - 15000 321275 100,000 20,000 Total Purchased Services 11,125 12,000 29,600 153000 32,275 100,000 20,000 Education Total other Practice Expenses - - - - - _ Leases 8 Rental 1 362 362 382 362 362 11810 382 E ul ment least -other#1 362 362 362 362 362 - 1,810 362 Total Rent and Leases Total Expenses 19,399 18,730 37,401 23,346 41,671 140,546 283109 Net Operating Income 13,453 12,721 24,737 15,604 27,446 93,961 18,792 IGT Expense Communit Benefits Conidbution Net Non -operating Income - - - - _ Conldbutlon Margin 13,463 12,721 24,737 15,604 27,446 93,961 18,792 _g_ Memorial Medical Center Physician Revenue Trend -Hospital Only YiD for2019,2018,&2017 As Of May, 2019 Amount Amount Comparision %Comparision Compariston Comparlsion 2019 YTD 2018 WD 2017 WO 2019 to 2018 2019 to 2018 2019 to 2017 2019 to 2017 Memorial Medical Center Clinic 000966 TruongThao 573,205 530,435 573,034 42,770 8% 172 0% 001367 Pfell Michael 227,661 15B,320 - 69,341 44% 227,661 NDIV/01 002099 Shefcik Tracl 250,333 169,033 205,271 8113DO 48% 45,062 2270 OD2927 Gaines Michael 145,938 99,735 - 56,203 53% 145,93B #DIV/0! 005966 Carol Andrus - - 74,891 0 #DIV/0I (74,991) -300Y 009293 Serino Danielson - - 41%171 0 #DIV/01 (410,171) -100°/< 009294 John Burst - - 1980671 0 JIDIV/01 (198,671) -300% 011005 Crowley VJllliam 2,244,880 2,557,767 2,917,088 (312,886) -12% (672,208) -23% 019000 Arroyo Diaz Mc 1,590,301 11708,662 1*365,956 (118,361) -7% 224,345 16% 022000 Rojas Peter 516,333 625,107 610,747 (108,774) -17% (94,415) -15% 041574 Hinds Frank 73%100 664,413 200,475 73,687 11% 537,625 2689 041596 Schultz Mercede 664,316 494,446 - 16%870 34% 664*316 #DIV/01 041743 Angela Dobbins - - - O #DIV/0( 0 #DIV/01 058001 Thurikill Court 282,833 180,932 97,696 1010901 56% 185,136 189% 097445 Pete Papapetrmu 243,933 - - 24%933 #DIV/01 2431933 #DIV/01 100118 Joseph Jenkins 483,397 - - 483,397 #DIV/01 483,397 #DIV/ol 102218 Cook Marshall 70OA17 - - 700j417 #DN/01 700,417 #DIV/01 320001 Sharma Odonnell 293,050 29%050 #DIV/01 29%050 #DIV/01 81954,698 7,178,850 6,654,002 1,775,848 25% 2a300o696 35% 30% 28% 25% Hospitailst 015020 Hospltalist 5,456,536 %5281273 301500931 1,928,263 55% 21305,605 73% 5,456,536 3,528,273 31150,931 1,928,263 55% 2,3D5,605 73% 18% 14% 12% Part Lavaca Clinic 000983 Michael Caughron 196,138 - - 196,138 #DIV/01 196,138 #DIV/0I 0OU26 Timu N Kwi 889,290 701,916 837,833 187,373 27% 51,457 61Y 001500 Lincoln Jewel %154 20,695 909,623 (17,541) -85% (906,469) -30a% 012000 Griffin Jeannine 255,276 72,613 1380730 1824663 252% 116,546 94% 013001 Falcon Lelgh A 868,003 844,241 964550 23,762 3% (96,547) -10% 050001 wrightJohn 1,561,419 11316,134 1/6094224 245,285 19% (46,805) -3% 101202 Salinas Henry 26,813 - - 26,813 iIDIV/01 26,813 NDIWOI 320001 O'Donnell Sharma 191,468 182,845 (191,468) -100% (182,815) -100'% 3,80D,093 31147,06B 4,641,776 65%025 21% (841,682) -18% 13% 12% 17% Specially Clinic 000404 Ado Ayo 25,731 411,200 444,008 (385,469) -94% (418,277) -94% 000548 Haresh Kumar 38,525 - - 38,525 #1)IV/01 38,525 #DIV/01 D12100 Breech Donald 145,423 392,843 425,283 )247,421) .63% (279,860) -66% 013000 Bunnell Don Pau 399,807 367,129 287,007 320679 9% 112,800 39% 057004 Harlsh Chandra. 4,944 - 41944 #DIV/01 4,944 HDIV/01 ' 059000 Krueger Kuril$ 201613 - - 20,613 #DIV/01 20,613 #DIV/01 070002 Richard Steinberg - - 69,517 0 #DIV/01 (69,517) -100% 525225 Malik Azhar MD 52,548 22,896 24,322 29,662 130% 28,226 116% 900000 Dakshesh Parikh 11,055 837 11,055 #DIV/01 100218 1221% 698,646 11194,058 11750,973 (495,431) At% (552,327) -44% 2% 5% 5% physician Revenue Trend - Hospital Only Memorial Medical Center YTD for 2019,2018,& 2017 Amount Amount Comparision %Comparision Comparision Comparision 2019 YTD 2018 YTD 2017 YTD 2019 to 20182019 to 2018 2019 to 20172019 to 2017 Coastal Medici Clinic 000806 William McFarland 20,774 - 92,113 20,774 ODIV/01 (71,339) -77% 000809 Delgado Ana 6,555 11323 - 5,232 395% 6,555 8DN/OI 011000 McFarland, Tim R 49,604 24,122 361,226 25,481 106% (311,623) -860% 76,933 25,445 453,339 51,487 202% (376j407) -83% 0% 0% 2% Independent 006000 LIn Mau Shang 141,226 147,648 1000768 (6,422) -4% 40,457 40% 310001 Cummins Michelle 744324 161,325 144,588 (87,001) -54% (70,264) -49% 330000 Le Nhl MD 19,753 %573 16,237 16,180 453% 31516 22% 235 303 312,546 261,594 (77 243) .25% (26,291) -10% 1% 1% 1% Other Medical Staff 065002 George eoomlis $ 162,720 $ 67,626 $ 1244930 95,094 141% 37,790 30% 807077 Nllesh Patel $ 742 $ 301,636 $ 153,327 (300,894) -1t)05S (152,595) -100% 989112 Powaser Peter $ 72,301 $ 190380 $ 52,921 273% 72,301 ODN/Ul 235,763 311%642 278,257 (152,878) -39% (42,494) -15% d% 2% 1% retai P/R rhyslolan: KZrTa other ordering Physicians Totals 2016 Yrb Memorial Medical Center inpatient Volume Indicators Admissions by unit 4]6ly 2 1; 122 2017Y1D TO18 Yr0 2019 YR1 3 Medical/Surgtwl/IM aoW64Ics rSwlag Bed Average Daily Census 2016YtD 2017 VTD 20181TD T019 Yr0 a Medlcal%6usglcal/ICU a ObrteUics U6wing Bed Average Length of stay 14A0 i 12.T3 12.00 10A0 ].]6 SM 6.39 6.29 6.m 13:]BI 9 Ii 3a2i a51, 4A0 V s2zsi ;>IA 7 '��191 iso� TDD 2016YTD 2017 WD 2018 VID 2019YM o Medlcai/Surgicai/ICU saobsteW" USwing Bed -12- Memorial Medical Center Operating Statistics 14-Month Trends Outpatient Statistical Trends 2,500 2300 2020, 2053 -�... 2,033 2,10a 2,031 2,098 ^2006 ..-,,.., 606 -- 1 Soo - �,119¢` 000 Jan-18 Feb-18 Mar-13 Apr-18 May-18 Jun -IS Jul-18 Aug-18 5e11-18 Oct-18 N011-18 Dea18 Jan-19 reb19 -� outpatient vuits �EmergenryBoom Ylsits " speclalty clinic Visits Surgery & Endoscopy 88 110 IN 91 102 80 --85 - - 78 97..-. 92 -. 0 76 -. ---a2 .101 69_ Jan-18 Feb18 Mar-18 Apr-18 May-l8 Jun-18 lul-ya Aug -IS 5ep-18 Oct-18 Nov-18 Dec-18 Jan-19 Fetr19 Radiology Procedures zaoD .._ .._ — 1'M 1,909 1.349 1.358- 1536 1,456 129] 1j92 1452 1,281 14952 lA7i 1339 1;596--i,555 0 .__............ .. . ......----- ....__. Jan -IS Feb18 Mar-18 Apr -IS May-18 Jun -IS Jul -IS pug-18 Sep-38 Oct-18 Nov-18 Deo-18 Jan-19 Feb-19 Laboratory test fir, �-^_ 35 5M A4.861 30,000 -32252 ____ i7718 30,906 31,371 31,034 31,259 30,932 31,127 300663 30,632 31l491 ---- zs000 ------ — --------- — -- —30z----------------------------..--------- Jan-is Felrie Mar-18 Apr-ya May-18 Jun -is Jul -IS Aug-18 Sep-10 Ott-18 Ni Dec-18 Jan-19 Feb-19 Rehab Services Procedures 0 ._1,591 _.7'�3 ._IA97-._4,510 __1�839„ 1390- SA58 j40...1272---Ss449 -1,456--1,4]8 -1,506_ Jan-18 reb18 Mar -jut Apr-18 May-18 lun-18 jet is Aug -IS Sep-18 Oct.18 Nov-18 Dec-18 Jan-19 Feb-19 -13- r a° Qo�a�8v xo.Fa II Ee € .A a€ aaAn o CE o Q �° E rvE13 az �o€Es9 �aBzsGs�a ��r� �maa —14— Memorial Medical Center YTD YTD YTD YTD 5/31/2019 Statistical Comparison 05/31/16 05/31/17 05/31/18 05/31/19 OVER (UNDER) %OP (5 months) (5 months) (5 months) (5 months) 5/31/2018 CHANGE Total Admissions 517 407 395 452 57 12,6% ERAdmissions 316 265 260 232 (28) -12.1% Total Patient Days 1,985 1,644 1,514 2,011 497 243% AVERAGE DAILY CENSUS Med(caljSurgicaljlCU 10.65 8.38 8.07 9.55 1.48 15.5% Obstetrics 0,76 0,55 0,54 0,62 0,08 12,9% Swing Bed 1,74 1095 1,42 3,15 1,74 5510% Total AVG Daily Census 13,15 10,89 10,03 13,32 3429 243% Total AVG LOS -Acute Care 3,62 3.66 3,60 3,72 0412 3,1% Observation - Patients 247 199 178 246 68 27,6% Observation -Patients from ER 199 96 130 210 80 38A% Newborns -Births 46 36 38 47 9 1911% M MC Clinic Visits 91165 10,407 11,334 13,612 2,278 16,7% Outpatient Visits 10,386 10,205 100150 91437 (713) -7,6% Emergency Room Visits 31784 31749 31983 31998 15 0,4% Specialty Clinic Visits 2,548 2,445 2,250 11252 (998) -79,7% Surgery & Endoscopy 494 400 457 484 27 5,6% Laboratory test 155,749 157,077 156,622 177,121 20,499 11.6% Radiology Procedures 3,544 3,745 3,393 3,626 233 6.49/ Radiology OP - Clinic 568 666 630 896 266 29.77a Bone Density 54 66 100 119 19 1640% Nuclear Medicine 86 54 53 30 (23) -76.7% Ultrasound 970 752 835 847 12 1.40/a Ultrasound -Clinic 230 241 243 170 (73) -42.9% CT Scans 1,276 11153 1,080 1,250 170 1346% MRI 499 481 415 465 50 10,8% Mammograms 345 223 354 367 13 3,5% Total Radiology Procedures 7,572 7,381 71103 71770 667 846% Respiratory Tfierapy Procedures 41213 4,036 30321 3,726 405 10.9% Stress Test Halter Monitor 16 14 (2) -14.3% EKG Exams 11685 11290 11147 11252 105 8,4% Sleep Studies 64 67 - 45 46 1 2,2% Total Respiratory 5,997 5,416 4,548 51055 507 1000% Physical Therapy Services Procedures 81214 10,894 8,480 71792 (688) -8.8% Occupational Therapy Total 1,223 511 239 919 680 _ 74.0% Speech Therapy Total 153 403 299 106 (193)-18241% Behavioral Health Patient Encounters 1,880 863 526 560 34 6.1% Cardiac Rehab units 0 216 389 980 591 60,3% Pharmacy Total 61,099 53,128 48,094 58,387 10,293 17:6% Dietary Total 24,810 n,a, 17,424 23,673 6,249 26,4% -15- io h w m a0 W N W m rn 0 d' rl m OJ h N 'r-� O a-i ri Ol O' N d� W ei 00 vj rn N t0 0o d io m in to o m m m m 00 ,- i io io co 'n m �t m m h io m h N' ttl O 00 N d` C� � N rn W O a ri W m d• N h h M lO m w - d' O w tp m UI h 0 l0 rn ( O fri N O W' o V HI N h' d� h O d' cl rl h O O V o0 N W h a1 h m N T h � to W O h h d' O h r-1 N N 'ci rl O yd m .� io 0o OO c-I N 1n N ' m O o 00 00 d• h .-� m e0 a0 m m m m ti m h h h h h N a m m d ri ao W Oi txl 00 am m m m v� l0 lO W O( N ci ci N' t N' d' 0 � Owl COI' m a io O rn o m m O tD oo h W N m m o ry .+ d; o ao io o a rn h m h w m l0 tti M r � h N N rn N h rn N h h M h O rn t0 O O h W OD rn t0 rn rn N M N tp N N v-1 h M a0 O 61 rtcy l 4 W N t0 ttl rl r l0 l0 ttl N rn M h 00 1 d' m h tp N Ol m N d' 0 m h' d- m m m m tp N .-1 H �-1 O Ul m N o m cD h '•-� ci' r tD W r n L0 7 c-I O O •-i rn O O h m rn N h N N h h d' h tp N a4 rn N' d' 06 N .NI w W W m V am m h o n o m o' w m N N m o omo N t0 O t0 tt1 N N W O O w INK m % v r io m' L6 m N .-I o m o mo o w m m m m v o m m ao m N i0 m m' Nai N O 0 O m aNm V4 4 O n ti n w m l0 m l0 lYl N �-I m W O ".� 0 m m m r d m h O N n N (-I G U1 E m c > > O O U rn v oaq o c > U y u m E Yvi m a •°- _ t u � v c 0 ayi 0 L a • � � m v u v v E o u a v'vly t—N o p m 0 Q U a Z C Q Q¢ m m w ` 0 F- F- u a Q F- m m m N n n N n ry o m m o o m m o m o m m n m ry V o m N Ifl r trym0� a--1' W w W O M n .-i m m m m M M ci O a0 N n n n C N m m N ri N N r- ci ni N v o � cNi cNi m m N V m N YI Ol eF n r ul � r4 m N c-I cmi �rv-I crv-I m 7 N N W 1p n N O N l0 O V' a m m m m o0 �-I' L6 N' N' rtj cV n m m 'n o m o m M m N m ri m m n a N M N N n N ti N O H m r m r N r r r m r' O M' m m O N m W m O m c-1 N' N m M v1 d' N M m m m w m m M ti I cq N m n co m n o m o v N m m m '/1 N of w CO m n N m w N' N ci m r/I Ol }} n N m m ey d' M m N N m M W m vl a V� M N M (mp m O O rl H cN-i 'D N O W O N. M O O O lO l0 N O pp m \ W lD 'lY ei O tr M rr M m .y w O m m W d' M M O rl M 0 V jci' ri G C W u cn N U m v o w v y z m a m w m M u o v o m A o v N E iD w y o N W U m N N �� u F- wN ¢ Q v jp m =O O N 7 U a\ U1 G? u u O m J Z Q O Q Q Q 0 7 a Q Q Q Q aF- Memorial Medical Center Capital Acquisitions For the Month Ended May 31, 2019 Month Description Land Building Total Pacific Medical-Physlo Life Pak _Equipment 11,415 11,415 Smith & Nephew -Ortho 60055 6,055 Phillips - EKG Machines 13,733 134733 Arthrex-return Rasp - (345) (345) CDW Computers 7.229 7,229 Sub Total January - 380087 39,087 Evldent-RCM 10,000 COW Computers 50581 50581 McKesson-Blofire Lab 45,625 45,625 Sub Total February - 61,206 51,206 Elevator Repair and Panel 85,498 Evident- Lab Interface 5,400 Evident -Lab Biofire Interface 30600 Evident -PALS Workstation 14,554 Sub Total March 1090052 Water7ank and Install 12,567 Sub Total Aprll - 12,567 None for May Sub Total May - - Sub Total June Sub Total July - Sub Total August - SubTotal September ' Sub Total October - Sub Total November - - Sub Total December - Total $ $ 12,567 208,345 89,293 -19- \(R� (m } }(}(\}\ ` mm MN \\(mm / ,)§) )f22Jf4R/ � \ \ -2n- Memorial Medical Center Payer Mix Memorial Medical Center As of May 31, 2019 ..:,.,. . _ zzz�. 1 01ue Cross 13% 18 Month Trend so.o 450 .a--.--- r, 35.0 010 25.0 ......... _.......... 20.0 150 _p V—•�..�. 5.0 0.0 -. ."..__..... - LL €-5eriesl «�,«==Sedes2 ��-=Serfes3—.;=�5eries4 c=��5ertes5 �..^Series6 -21- Payer Mix Memorial Medical Clinic As of May 31,2019 11 Month Trend 35.0 30.0 15.0 .,. 10.0 5.0 0.0 O p o LL Z Ax v=-- Medicare .; .-.. is Title Medicaid ��r�— Blue Cross Commercial •=-•Private =- =HMO/PPO &Workers Comp -22- -23 Memorial Medical Center Accounts Receivable Agings T 181-365 Total Gsoss %Over /Over % U d r % Under AgJng 0-30 31-60 61 90 91-120 121-I50 151-180 120 Day 90 Days 60D ys 90 Dnys _ _.� __-.�.�..,.,_-....-� otal Jan-18 41037,071 1,50%038 11276,575 11302,392 622J606 469,173 1J322,009 10,338J864 23.3% 34.0% 53.6% 66.0% Feb-18 4,404,787 11771,312 966,966 949J627 805,456 354,935 1,385,778 10,63%860 23.9% 32.9% 58.1% 67.1% Mar-18 3,644,319 241420989 11295,861 817,250 739J113 637,321 1,431J215 10,708,068 26.2% 33.9% 54.0% 66.1% Apr-18 3,973,283 1,797,168 1J488,925 1,30%355 696,484 545,343 11487,965 11,092,525 24.6% 34.6% 52.0% 65.44Ya May-18 4,08%271 1,913,588 1,142A51 1,059,675 921,907 384,597 1,521,370 110029,259 25.6% 35.2% 54A% 64.8% Jun48 3J84%206 1,703,638 1,279,846 920,439 782J238 337,403 1,454J395 100327,165 24.9% 33.8% 53.8% 66.2% Jut-18 31900,269 11640J242 11264,165 973,541 859,006 743,071 1,807,759 114188,053 30.5% 39.7% 49.5% 60.8% Aug-18 3,763,400 117334095 11104,875 11052,621 898,089 774,197 11938,160 11,264,437 32.1% 41.4% 48.8% 58.6% Sep-18 %905,377 1,782,035 10042,315 787,688 872,556 776,132 2J182,860 11,3481962 33.8% 40.7% 50.1% 59.3% Oct-18 3,8740629 11471,773 10037,378 890JB85 688J179 648,286 11870,134 10,481,265 30.6% 39.1% 51.0% 60.9% Nov-18 4,089$98 14907,316 11093,596 896,339 863,349 650,706 21284,916. 11,7851820 32.2% 39.8% 50.9% 60.2% Dec-18 4J5531892 21169,847 11108,120 569,459 355,761 364,949 11442,022 10,5644050 20.5% 25.9% 63.6% 74.1% Jan-19 51012J841 21242,154 1,038,085 912,166 505,770 281,876 1J604,405 110597,296 20.6% 28.5% 62.6% 71.5% Feb-19 5,346,990 2,238,339 1116%585 723,702 5980287 336,206 1,738,383 121i51A91 22.0% 28.0% 62A% 72.076 Mar-19 4,87%798 2,493,565 11621J470 715,604 376,172 292J330 1,444,450 11182%400 17.9% 23.99/ 62,491 76.1% Apr-19 41915,031 200880266 1J836,828 11327,444 541,810 345j123 11659,569 12,714,072 20.0% 30.5% 55.1% 69.5% May-19 41457,167 1,974,316 963,685 847,964 709J931 381,013 11523,083 1%857,160 24.1% 31.9% 59.2% 68.1% Medicare Jan-18 1,844,700 4514558 77,713 52,902 161665 43,694 88,177 24575,409 5.8% 7.8% 89.2% 92.2% Feb-18 2J0881267 361,587 125J854 40,101 35,914 31745 71,835 2,727,305 4.1% 5.6% 89.8% 94.4% Mar-18 1,581,974 370,210 138J814 1054521 28,386 29J320 52,846 21307,071 4.8% 9.4% 84.691 90.6% Apr-18 1,734,620 410,877 227,646 91,038 71,717 23,247 78,523 2J6371667 6.6% 10.0% 81.3% 90.0% May-18 1/8250583 4080277 154,170 124,556 6%720 7%213 591169 2,7110689 7.3% 11.9% 82.4% 88.1% Jun-18 1,764,878 198,191 162,714 57,769 4%527 24,513 72,939 21329,531 63% 8.7% 84.3% 91.3% Jul-18 11759,349 244,537 82,156 34,860 49,928 30,310 470287 2J248,427 5.7% 7.2% 89.1% 92.8% Au9-18 1,5461920 284669 71,695 38,259 24,094 38,439 77,846 2/0810922 6.7% 8.6% 88.0% 91.4% Sep-18 11805,215 330,690 53,618 21,457 35,582 3,572 74J026 2,324,159 4.9% 5.8% 91.9% 94.2% Oct48 1J679,366 254111 77,659 34,946 26,921 31,218 1030583 21207,803 7.3% 8.9% 87.6% 91.1% Nov-18 21034,186 315,548 117,728 37,089 33,817 27,774 125,593 2,691,725 7.0% 8.3% 87.3% 91.7% Dec-18 2,083,669 426,067 196,721 66,915 23J144 28,061 540054 21878,632 3.7% 6.0% 87.2% 94.0% Jan-19 2,4691536 4951500 101,300 146,568 80J425 7,042 271935 3,32%306 3S% 7.9% 89.1% 92.1% Feb-19 21221,476 413,696 166,365 58,361 80,794 12,361 37,811 2,990,864 4.4% 6.3% 88.1% 93.7% Mar-19 2j304t532 363,228 186,739 135,129 4%459 64327 45,590 31152,304 5.2% 9.4% 84.6% 90.6% Apr-19 2,470,548 362,741 144,562 65,663 37,622 38,146 98,864 3,21%147 5.4% 7.5% 88.0% 92.5% May-19 2,088,198 457,737 120,730 55J356 85,991 41,564 112J288 21961,865 8.1% 10.0% 86.0% 90.0% Medicaid Jan-18 422,060 148J528 225,853 86,639 48,806 46,157 4%814 11027,857 14.17o 22.5% 55.5% 77.5% Feb-18 433,253 154,279 53,562 42,735 66,332 38,398 92,970 881,531 22AA 27.3% 66.6% 72.7% Mar-18 437,939 133,832 80,035 28,497 19,079 11863 31,576 733,121 7.2% 11.1% 78.0% 88.9% Apr-18 693,844 151J138 96,296 69,986 13J085 4,637 27A87 11046J473 43% 11.0% 79.8% 89.0% May-18 54%198 266,269 57,422 78,441 35,940 4,968 10,969 11003,207 5.2% 13.0% 81.3% 87.0% Jun-18 530J391 260,169 163fiV 43J823 54,626 1%590 160051 1,093,267 8.3% 12.3% 72.3% 87.7% Jul-18 423,204 191,192 158,059 712199 31,984 18,255 44,083 937,976 10.1% 17.6% 65.5% 82A% Aug-18 406,778 124,853 11%057 74,726 20,198 23,360 29,471 792,443 9.2% 18.6% 67.1% 81.4% Sep-18 335,414 161,756 87,984 47,466 33,959 23J860 33,938 724,378 12.7% 19,2% 68.6% 80.8% Oct-S8 448,030 122,525 87,883 29,213 24,348 71532 13,344 732,875 6.2% 10.2% 77.9% 89.8% Nov-18 3360075 156,777 53,327 28,582 21,941 11925 71186 605,811 5.1% 9.8% 81.4% 90.2% Dec-18 423,713 115,665 424878 48,822 24J280 14,850 141218 684,425 7.8% 14.9% 78.8% 85.1% Jan-19 40%337 199,287 52,899 2%055 160310 15,572 13J799 718,259 6.49/ 9.2% 83.5% 90.8% Feb-19 735,737 131,145 74,354 25,353 12,849 61870 17,031 1,0030340 3.7% 6.2% 86.4% 93.8% Mar-19 410,982 329,926 800275 55,287 13,403 31284 7,505 900,861 2.7% 8.8% 82.8% 91.2% Apr-19 395,798 2331790 284,917 78,653 35,649 10,817 81513 11048J337 5.2% 12.7% 60.1% 87.3% May-19 406,807 192,253 108,831 16s,137 47,059 16,219 12,907 952,206 8.0% 25.7% 62.9% 74.3% J:\2019\May 2019\AR ManthiyAnalysis Board Packet -May 2019.xisx Memorial Medical Center Accounts Receivable Agings Aging 0-3a � 31-60 - 61-90 9[-120 121-I50 151-180 A181.365 Tota1G oss %Over %Over %Under %Under �� -LL�20 Days 90 Days 60 Days 96Days BCBS Jan-18 314,301 41,036 15,097 99,861 31229 3,315 21,609 498,447 5.6% 25.7% 71.3% 74.3% F-eb-18 298,344 49,545 150003 61092 15,309 11956 91740 3954989 6.8% 8.4% 87.9% 91.6% Mar-18 295,992 108,847 36,620 71521 21126 180355 10912 471,374 4.8% 6.3% 85.9% 93.7% Apr-18 264,955 59,799 22,052 24,249 3,036 290 31381 377,761 1.8% 8.2% 86.0% 91.8% May-18 333,429 851657 28,772 13,701 11,066 853 11266 474,745 2.8% 5.7% 88.3% 94.3% Jun-18 243,731 39,136 15,863 19,935 5,982 - 339 324,987 1.9% 8.1% 87.0% 91.9% Jul-18 293,552 25,273 21,415 4,663 41641 11022 1,147 351,714 1.9% 3.3% 90.6% 963% Aug-18 246,685 76,065 10,129 15,588 21965 1,388 365 353,185 1.3% 5.7% 91.4% 94.39/ Sep-18 259,451 36,355 31,903 8,890 14,802 2,895 24167 356,462 5.6% 8.1% 83.0% 91.9% Oct-18 278,210 10,535 8,081 91175 7,660 31928 5,197 322,787 5.2% 8.0% 89.5% 92.0% Nov-18 473,891 65,622 13,374 5,239 21984 7,650 51218 573,977 2.8% 3.7% 94.0% 96.3% Dec18 510,844 475,304 584976 15,243 31227 51336 13,663 11082,593 2.1% 3.5% 91.1% 96.5% Jan-19 459,138 119,930 66,665 23,380 11444 3,724 5,413 679,593 1.6% 5.0% 85.2% 95.0% Feb-19 573,148 259,028 60,021 39,862 17,615 3,579 8,921 962,174 3.1% 73% 86.5% 92.7% Mar-19 662,668 231,969 125,808 11,513 B,343 160872 8,079 11065,252 3.1% 4.2% 84.0% 95.8% Apr-19 571,979 210,997 126,288 10%444 71771 7,155 43,037 1,067,670 5.4% 14.8% 73.3% 85.2% May-19 511,324 133,048 102,897 5%981 99,346 6,173 49,131 959,900 16.0% 22.2% 67.1% 77.8% Commercial Jan-18 824,258 285,290 217,186 165,843 12%015 129,879 187,441 19321911 22.8% 31.4% 57A% 68.6% Feb-18 918,183 364,431 202,273 130,000 93,883 63,325 228,521 2,0001617 19.3% 25.8% 64.1% 74.2% Mar-18 850,442 605,732 226,262 153,925 101,948 81,211 256,603 2,276,123 193% 26.1% 54.0% 73.9% Apw18 728,218 43IA23 357,405 141,985 128,892 92,298 262,489 21142,410 22.6% 29.2% 54.1% 70.8% May-18 800,862 278:160 230,641 173,663 65,732 85,795 274,780 11909,633 22.3% 31.49E 56.5% 68.6% Jun-18 8290499 388,496 1424866 150,542 83,399 24,000 284,230 1,903,032 20.6% 28.5% 64.07o 71.5% Jul-18 825,768 467,637 202,262 79,734 107,817 624825 248,128 1,994,172 21.0% 25.0% 64.9% 75.0% Aug -SS 744,010 433,200 186,860 115,254 57,004 97,936 223,446 10857,709 20.4% 26.6% 63.4% 73.4% Sep48 955,278 421,905 184,118 119,636 73,755 32,360 289,966 21077,017 19.1% 24.8% 66.3% 75.2% Oct-18 751,981 423,249 148,746 104,819 91,486 49,131 2564596 1,826,009 21.8% 27.5% 64.4% 72.5% Nov-18 754,369 434,004 280,506 122,980 92,969 87,543 3100882 2,083,255 23.6% 29.5% 57.0% 70.5% Dec-18 817,530 394,224 259,158 238,755 88,091 790660 348,069 2,225,488 23.2% 33.9% 54.4% 66.1% Jan-19 9270190 570,273 1751263 158,387 172,814 56,623 349,531 2,410,081 24.0% 30.6% 62A% 69.4% Feb-19 1,006,613 527,175 346,215 151,452 124,838 136,011 389o306 2,681,612 24.2% 29.9% 57.2% 70.1% Mar-19 7J.21768 556,825 397,004 254,630 112,539 87,656 486,118 2,6074539 263% 36.1% 48.7% 63.9% Apr-19 8254654 318,718 296,241 262,117 207,092 78,665 496,288 21484,775 31.5% 42.0% 46.1% 58.0% May-19 850,883 543,806 203,913 258,869 226,914 186,613 560,018 2,831,017 34.4% 43.5% 49.3% 56.5% Private Pay Jan-18 631,752 582,628 740,726 697,147 430,891 246,128 974,968 4,304,240 38.4% 54.6% 28.2% 45.4% Feb-18 666,740 841,468 570,272 730,699 594,017 247,510 982,712 40633,419 39.4% 55.1% 32.6% 44.9% Mar-18 477,973 924,367 814,130 521,786 587,573 506,572 1,087,977 41920,379 44.3% 55.0% 28.5% 45.034 Apr-18 561,647 744,232 785,526 776,098 479,755 424,871 11116,085 41888,213 41.3% 57.2% 263% 42.8% May-18 576,199 8750225 671,847 659,314 739,448 222,767 1,175,185 4,929,986 43.49f 56.9% 29.4% 43.1% Jun-18 480,707 817,645 789,785 648,370 589j705 269,300 1,080,836 41676,348 41.5% 55.3% 27.8% 44.7% Jul-18 598,396 711,603 800,272 783,06E 664,636 630,659 11467,114 5,655,765 48.8% 62.7% 23.2% 37.3% Aug-18 819,007 814,307 723,135 808,794 793,828 613,07E 11607,033 6,179A79 48.8% 61.9% 26A% 38.1% Sep-18 550,018 831,329 684,693 590,239 714ASS 713,445 1,782,763 %866,945 54.7% 64.8% 23.5% 35.2% Oct 18 717,042 661,353 715,009 712,732 537,764 556,476 1,491,414 5,391,791 48.0% 61.2% 25.6% 38.8% Nov-1B 491,088 935,365 628,661 702,449 711,638 525,804 1,836,047 5,831,052 52.7% 64.8% 24.5% 35.2% Dec-18 718,136 758,587 550,387 199,723 217,019 237,043 1,012,018 31692,912 39.7% 45.1% 40.0% 54.9% Jan-19 756,640 857,165 641,958 563,775 234,776 198,914 1,207,729 4,460,957 36.8% 49.4% 36.2% 50.6% Feb-19 8100016 907,295 522,629 448,673 362,191 177,385 1,285,312 4,513,502 40.4% 50.4% 38.0% 49.6% Mar-19 788,848 11011,617 831,644 259,046 192,429 117,192 896,868 41097,643 29.4% 35.8% 43.9% 64.2% Apr-19 651,051 962,021 9844820 820,567 253,676 210,340 1,012,867 4,895,342 30.2% 46.9% 33.0% 53.1% May-19 5990955 647,471 427,314 306,623 250,626 130,444 789,739 3,152,173 37.1% 46.9% 39.6% 53.1% 1;\2019\May 2019\AB Monthly Analysts Board Packet -May 2019.xisx -25` Aging 0-30 Memorial Medical Center Accounts Receivable Agings 31-60 61-90 91-120 I21-I50 151-]80 181-365 TotalG / Over re Over U d r % Uncle �i~'�� 120 Days� 90 Days 1 60Days 90Daya - All Insured Jan-18 31405,319 926,411 535,849 405,246 191,715 223,045 347,040 60034,625 12.6% 193% 71.8% 80.7% Feb-18 31738,047 929,843 396,693 218,923 211,439 107,424 403,066 60005,442 12.0% 15.7% 77.7% 84.3% Mar-18 3,1661346 1121%622 491,731 295,463 151,540 130,749 343,238 51787,689 10.8% 15.9% 75.8% 84.1% Apr-18 3,411,636 1,052,937 703,399 327,258 216,729 120,472 371,881 - 6,2044312 11.454 16.7% 72.0% 83.37a May-18 %50%072 1103%363 471,005 390j362 182,458 161,829 346,184 6,099,274 11.3% 17.7% 74.6% 82.3% Jun-18 3,368,499 885,993 490,060 272,069 192,533 69,104 373,559 51650,817 11.2% 16.0% 75.3% 84.0% Jul-18 3,301,873 92%639 463,893 190,456 194,371 112,412 340,645 51532,288 11.7% 15.1% 76.5% 84.9% Aug-18 21944,393 918,788 381,740 24%826 104,260 161,122 331,128 51085,258 113% 16.5% 76.0% 83.5% Sep-18 3,3551359 950,706 357,622 197,449 158,098 62,687 400,096 5,482,017 11.3% 14.9% 78.5% 85.1% Oct-18 31157,587 830,420 322,370 178AS3 150,415 91,809 378,720 %0891474 12.2% 15.7% 78.0% 84.3% Nov-18 3,598,510 971,952 464,935 193,890 151,711 124,902 448,869 5,954,768 12.2% 15.4% 76.8% 84.6% Deo-18 3,835,756 1,4111260 557,734 369,735 138,742 127,907 4300004 61871,138 10.1% 15.5% 76.4% 84.5% Jan-19 4,2561201 11394,989 396,126 348,391 2700993 82,961 3960677 7p136,339 10.5% 15.4% 79.0% 84.6% Feb49 41536,974 11331,044 646,956 275o029 236,096 15%821 453,070 71637,989 11.1% 14.7% 76.8% 85.394 Mar-19 4,09%950 IA811949 789,826 456,558 18%743 175,139 547,591 71725,757 11.7% 17.6% 72.1% 82.4% Apr-19 4,263,980 1,126,245 852,009 506,877 288,134 134,782 646,702 70818,729 13.7% 20.2% 68.9% 79.8% May-19 3,857,212 1,326,844 536,371 541,342 459,305 250,569 733,344 7,704,988 18.7% 25.8% 67.3% 74.2% J:\2019\May 2019WR Monthly Analysis Board Packet -May 2019.xisx -•Z�J- / ((()$}((}} , , §■„!m0" ,.:.._,..� -27- Memorial Medical Clinics Accounts Receivable Agings Aging Total 0.30 31-60 61-90 91-120 121-150 ---'777-r'••' 1_-t 15----1-180181-365 Tofal Gross %Over 120 Days %Over 90 Days %Under 60 Days %Under 90 Deys Jan-18 489,483 12,415 9,784 10,329 1,798 1,725 (7,453) 51Rj08O -0.89/ 1.2% 96.9% 98.8% Feb-18 662,437 81542 91431 10,058 1,294 10988 (41032) 689,718 -0.1% 1.3% 97.3% 983% Mar-18 339,013 88,982 6D,831 26,105 32,849 57,084 38,388 643,253 19.9% 24.0% 66.5% 76.05/ Apr-18 222,485 52,817 36,604 15,031 11,116 16,556 254,242 608,851 46.3% 48.8% 45,2% 51.2% May-18 335,753 113,813 52,167 36,240 43,889 6,351 61,873 650,086 17,2% 22.8% 69.2% 77.2% Jun-18 294,657 107,410 73,653 33,359 29,030 39,443 50,232 627,784 18.9% 24.2% 64.0% 75.83/ Jul-18 260,163 99,274 70,500 57,360 31,081 26,238 71,943 616,559 21.0% 30.3% 58.3% 69.79/ Aug-18 290,996 77,067 69,401 61,915 55,394 27,360 86,595 658,628 25.7% 35.1% 54.4% 64.9% Sep-18 248,325 86,054 66,173 69,908 571434 52,914 112,080 6924889 32,1% 42.2% 48.3% 57,8% WAS 291,839 80,198 43,070 54,574 56,767 54,791 151,394 732,633 35.9% 43.3% 50.8% 56.7% Nov-18 283,334 119,440 56,831 40,017 40,601 431012 177,569 76%805 343% 39.6% 52.9% 60.4% Dec-18 3091302 1260006 93,754 57,379 35,780 32,266 202,603 8570090 31.6% 38.3% 50.8% 613% Jan-19 286,577 90,591 47,156 41,525 38,396 30,694 198,243 733,183 36.5% 42.1% 51.4% 57.9% Feb-19 5311722 74,798 58,203 37,434 37,660 27,833 198,719 966,369 273% 31.2% 62.8% 68.8% Mar-19 369,686 199,482 44,579 42,242 30,517 31,697 210,733 928,936 29.4% 33.9% 61.3% 66.1% Apr-19 264,949 91,004 71,577 23,266 21,645 23,307 167,460 663,208 32.0% 35.5% 53.7% 64.5% May-19 217,505 58,477 49,405 49,246 27,906 14,235 175,771 592,545 36.8% 45;1% 46.6% 54.9% Medicare Jan-18 84,984 11657 291 - - 161 (463) 86,630 -0.3% -0.3% 100.0% 100.3% Feb-18 37,789. 246 90 15 161 (730) 37,573 -1.5% -15% 101.2% 101.5% Mar-18 46,304 11787 828 5 8,097 120 1,009 58,151 15.9% 15.9% - 823% 84.1% Apr-18 40,887 3,659 1,592 507 5 71751 23,694 78,096 40.3% 40.9% 57.0% 59.1% May-18 39,279 61412 656 1,119 362 (75) 8,674 56,426 15.9% 17.9% 81.0% 82.1% Jun-18 59,720 9,066 0,481 408 1,335 80 (783) 79,307 0.8% 1.3% 86.7% 98.7% Jul-18 68,106 61286 6,798 41141 70 819 (970) 85,251 -0,1% 4.894 87.3% 95.2% Aug-18 44,236 81677 31402 7,413 31187 190 (43) 67,062 5.0% 16.0% 78.9% 84.0% Sep-18 58,061 - 3,515 80218 3,402 71413 1,532 200 82,341 11.1% 15.2% 74.8% 84.8% Oct-18 461870 130775 989 4,803 31402 2,383 1,732 73,954 10.2% 163% 82.0% 83.3% Nov-18 42,211 9,728 10,660 365 1,833 3,402 3,747 71,947 125% 13.0% 72.29/ 87,0% Dec-18 49,651 51873 71211 61680 405 11833 7,032 78,686 11.8% 20.3% 70.6% 79.7% Jan-19 631956 14,851 31171 50926 61219 180 7,302 1011605 13.5% 19.3% 77,6% 80.7% Feb-19 951149 81400 71151 1,083 4,482 11526 61444 1241235 1040% 10.9% 83.3% 89,1% Mar-19 59,975 12,427 317 2,195 247 4,229 71343 860733 13,6% 16.2% 83,5% 83.8% Apr-19 58,655 10,971 81019 10032 1,275 1,577 12,946 94,475 16.7% 17.8% 73.7% 82.2% May-19 48,717 868 3,004 51779 11373 11436 31213 64,391 9.4% 18.3% 77.0% 81.7% Medicaid Jan-18 - 52,500 1,795 1,074 11817 674 443 (84) 58,218 118% 4.9% 93.3% 95.1% Feb -IS 180,174 2$76 2,454 2,616 108 268 (603) 1870593 -0.1% 1.3% 97.4% 98.7% Mar-18 414100 22,475 11,937 31830 3,377 41997 81406 95,123 17.5% 21.49t 66.1% 78.6% Apr-18 52,892 18,629 21,433 7,968 11786 3,337 1%907 125,852 19.8% 26.1% 56.8% 73.9% May-18 621491 360104 . 12,462 184326 51192 1,231 10,369 146,176 11.5% 24.0% 67.49po 76.0% Jun-18 49,771 38,609 16,595 81765 16,308 30990 21867 1360906 16.9% 23.3% 64.6% 76,7% Jul-18 37,712 27,135 280797 35,558 81267 14,650 5,291 137j4O8 20.5% 31.9% 47.2% 68.1% Aug-18 46,844 270268 25,800 24,544 15,418 81187 16,598 164,658 24.4% 39.3% 45.0% 60.7% Sep-18 50,254 1-71527 26,074 24,043 22,082 14,486 23,673 179,138 33.8% 473% 38.09/ 52.79/ Oct4.8 740987 17,600 19,624 28,277 24,543 21,921 37,302 224,253 37.4% 50.0% 41.3% 50.0% Nov-18 36,903 54,776 13,278 171977 19,628 15,621 51,516 2094698 41.49/ 49.9% 43.7% 50,1% Dec-18 70,610 18,453 30,732 13,344 11,175 14,826 590903 218,144 39.0% 45,1% 40.8% 54.9% Jan-19 48,748 19,702 12,025 15,416 81981 10,307 64,042 179,221 46.5% 55.1% 38.2% 44,9% Feb-19 110,975 6,784 150945 8,558 140553 7,992 59,193 2240000 36.5% 40.3% 52,64Ya 59.7% Mar-19 81,358 39,803 21938 10,107 5,450 14,273 45,913 199,843 32.8% 37.9% 60.6% 62.1% Apr-19 45,442 30,161 190781 1,238 3,373 169 41573 104,686 7.7% 8.9% 72.2% 91.1% May-19 42,677 15,199 14,156 15,363 31478 31247 4,299 9%420 11.2% 26.8% 58.8% 7342% 1:\2019\May 2019\AR MonthlyAnalysls Board Packe[-May 2019.x1sx r2s Memorial Medical Clinics Accounts Receivable Agings Aging 0-30 31-fi0 fit-90 91-120 121-150 151-180 (�®� 181-365 TofplG ss %Over /Over % Under % Under �� 120 Days 90 Dpys 60 Days 90 Days Y BCBS Jan-18 50,641 - 48 (24) - - (1,856) 48,808 -3.8% -3.9% 103.8% 103.9% Feb-38 85,189 - - (24) - 235 (1,856) 834544 -1.9% -2.0% 102.0% 102.0% Mar-18 43,110 1,026 1,940 1,161 15,789 %190 (11710) 64,507 26.8% 28.6% 68.4% 71.4% Apr-18 20,032 1,918 883 759 1,077 %434 33,269 61,372 61.6% 62.8% 35.8% 37.2% May-18 46,176 21168 11308 129 51 11280 11140 52,251 4.7% 5.0% 92.5% 95,0% Jun-18 3%387 5,243 145 802 129 (55) 1,140 42,791 2.8% 4.7% 95.0% 95.3% Jul-18 23,376 10,826 761 183 24 - 990 36,159 2.8% 3.3% 94.6% 96.7% Avg-38 33,724 3,099 61214 879 53 24 11494 45,487 3.5% 5.49/ 81,0% 94.65/ Sep-18 16,832 3,B34 %058 5,481 (40) 53 1,702 30,921 5.5% 23.3% 66.8% 76.7% Oct-18 40,167 7,467 2,059 329 675 (40) (2,235) 48,422 -3.3% -2.6% 98.4% 102.6% Nov-18 38,892 11,973 71427 2,099 329 675 (1,999) 59,397 -1.7% 1.9% 85.65/ 98.1% Dec-18 34,711 1%404 10,933 71252 2,089 329 (11222) 73,397 1.6% 11.5% 73.7% 88.5% Jan-19 31,537 11,155 (233) 3,B39 645 - (2,223) 44,720 -3.5% 5.1% 95.5% 94.9% Feb-19 83,571 31701 9,064 (233) %887 249 (24173) 98,066 2.0% 1.8% 89.0% 98.2% Mar19 25,847 91402 43 145 (1,332) 1,565 (21571) 33,100 -7.1% -6.6% 106.5% 106.691 Apr-19 34,108 5,004 8,027 - - (10332) 1,218 47,024 .0.2% .0.2% 83,2% 100.2% May-19 28,267 753 11132 912 212 - - (317) 30,960 -0,3% 2.6% 933% 97.4% Commercial Jan-18 2351748 21981 1,877 2,438 92 1,736 (3,990) 240,882 -0.9% 0,11ya 99.1% 99.9% Feb-18 206,928 (201) 397 11458 - 1,836 (30675) 206,743 -0.9% -0.2% 100.0% 100.29/ Mar-18 129,401 43,274 40835 23,519 81778 29,821 8,404 2480033 19.0% 28.4% 69.6% 71.64% Apr18 204869 (70062) 60843 (251374) 81806 51402 142,580 1521063 1031% 86,4% 9.1% 13.6% May-18 1204047 41,619 14,041 81497 31521 41324 5,315 197,364 6,7% 11.0% 81.9% 89.0% Jun-18 107,317 33,964 161185 11,405 63223 31117 61947 1854149 8.8% 15,0% 76.3% 85.0% Jul-18 96,918 361921 18,582 150670 10,230 61428 61741 191,490 12,2% 20.4% 69.9% 79.6% Aug-18 12%715 19,719 1%916 16,106 14,816 7,363 7,198 205,834 143% 22.1% 68.2% 77.9% Sep-18 79,477 35,827 14,332 18,938 154622 14,313 13,691 1920201 22.7% 32.6% 60.0% 67.495 Ott-18 92A27 22,537 71538 60564 161964 130668 23,937 183,334 29,81YS 33.3% 62.5% 66.7% Nov-18 115,695 26,818 110718 41087 5,716 80555 44,665 217,254 27,1% 29,0% 65.6% 71.0% Dec-18 1151904 400368 18,198 15,614 31350 40732 49,341 247j507 23.2% 29.5% 63.1% 7045% Jan-19 S%808 33,541 114937 34307 6,837 1,190 17,287 157,907 16,0% 18.1% 74.3% 81.9% Feb-19 194,610 170733 19,615 10,505 2,171 6,350 11,501 262,485 7.69/ 11.6% 80.9% 88.4% Mar19 B01953 44,443 5,087 23,649 50549 593 8,292 168,567 8.6% 22.6% 74.4% 77.4% Apr-19 761446 14,722 %538 2,637 13,079 419 6,187 122,027 16.1% 18.3% 74.7% 81.7% May-19 48,670 144873 3,154 6,354 1,074 3,870 21914 80,909 9.7% 17.6% 78,5% 82.4% Private Pay Jan-18 65,611 51982 60493 60098 11032 (615) (11060) 83,541 -0.8% 6.5% 85,7% 93.5% Feb-18 152,357 5,922 61490 5,992 11186 (513) 21832 174,264 2.0% 5,4% 90.8% 94.6% Mar-18 79,096 20,420 41,290 (21410) (31192) 18,956 22,278 176,437 21.6% 20.2% 56.4% 79,8% Apr48 87,804 35,673 5,853 31,171 (557) 134368) 34,890 191,467 16.2% 32.5% 64,5% 67,5% May-18 67,759 271510 23,701 80169 34,763 (409) 36,375 197,868 35.7% 39.9% 48.1% 60.1% Jun-18 42,461 20,528 31,246 11,979 5,045 32,310 401062 183,631 42.2% 48.7% 34.3% 51.3% Jul-18 34,052 18,106 15,562 21,808 12,490 4,341 59,892 166,251 46.1% 59.3% 31.4% 40.7% Aug-18 35,477 18,304 14,070 12,874 21,920 11,595 61,348 175,588 54.0% 614% 30.6% 38.6% Sep-18 43,701 251352 14,491 18,044 12,357 22,530 72,814 209,289 51.5% 60.1% 33,0% 39.9% Oct-18 37,688 180818 12,860 14,601 11,183 16,860 900659 202,670 58.6% 65.8% 27.9% 34.2% Nov-18 49,633 16,146 13,747 15,490 1%G94 A760 79,640 2021509 53,1% 60,7% 32.5% 39.3% Dec-18 38,426 41,907 2G;779 14,489 18,761 10,546 88,447 23%356 49.2% 55.29f 33.6% 44.06 Jan-19 58,528 11,343 20,256 13,037 15,714 19,017 111,836 249,730 58.7% 63.9% 28.0% - 36.1% Feb-19 47,417 381180 61428 17,S21 124568 110716 123,754 257,584 57.5% 64.3% 33.2% 35.7% Mar19 121,552 93,406 36,194 61146 201602 11,038 151,756 440,693 41.6% 43.0% 48.8% 57.0% Apr19 504299 30,146 27,212 18360 31968 221474 142,536 2940995 57,3% 635% 27.3% 36.5% May-19 49,173 26,785 27,958 201838 21,769 51682 165,661 317,866 60.8% 67.3% 239% 32,7% J:\2019\May 2019\AR Monthly Analysts Board Packet -May 2019.xIsk -29 Memorial Medical Clinics Accounts Receivable Agings gg�ng 0-30 31-60 67 91-120 121-150 151-190 181-36 Total G ss / Over / Over %Under %Under �-�� ay 90D ps 60 Days 90 Days 120 Days, n.,._..� j All Insured Jan-18 423,872 61433 34291 4,231 766 2,340 (6,394) 434,539 -0.8% 0.2% 99.0% 99.8% Feb-18 510,080 2,621 21941 4,066 108 2,501 (6,864) 51%453 -0.8% 0.0% 99.5% 100.0% Mar-18 259,916 6%S62 19,540 281515 36,042 38,128 16,110 466,813 19.3% 25.4% 70.4% 74.69/ Apr-18 134,680 17,144 30,751 (16,140) 11,673 19,924 21%351 417,382 60.1% 56.3% 36.4% 433% May-18 267,993 86,303 28,467 28,071 9,126 61760 . 25,498 452,217 9.2% 15.4% 78.3% 84.6% Jun-18 252,196 860883 42,406 21,381 23,985 71132 10,171 444,153 9.3% 14.1% 763% 85.9% Jul-18 226,111 31,168 K938 35,551 18,591 21,897 12,051 450,308 11.7% 19.6% 68.2% 80.4% Aug-18 245,519 58,764 55,331 48,941 33,474 15,765 25,247 483,041 15.4% 25.6% 63.0% 74.47a Sep-18 204,625 60,702 51,683 51,864 45,076 30,384 3%267 483,600 23.7% 34.4% 54.9% 65.6% Oct-18 254,150 61,380 30,210 39,973 45,583 37,932 60,735 529,963 27.2% 34.8% 59.5% 65.2% Nov-18 233,701 103,294 43,083 24,528 27,507 28,252 97,929 558,296 27.5% 31.9% 60.4% 68.1% Dec-18 270,876 84,098 66,975 42,889 17,019 21,720 114,156 617,734 24.8% 31.7% 57.5% 68.3% Jan-19 228,049 79,249 26,900 28,488 22,682 11,677 86,407 483,453 25.0% 30.9% 63.6% 69.1% Feb-19 484,306 36,618 51,774 19,913 25,092 16,117 74,965 708,785 16.4% 19.2% 73.5% 80.8% Mar-19 248,133 106,076 81385 36,096 9,915 20,659 58,978 488,243 18.3% 25.7% 72,5% 74.3% Apr-19 214,650 600858 44,364 41906 17,677 833 24,924 368,213 11.81Y 13.1% 74.8% 86.9% May-19 168,332 31,693 21,447 28,407 6,137 8,553 10,110 274,679 9.0% 19,4% 72.8% 80.6% J:\2019\May 2019\AB Mon[hlyAnatysis Board Parket-May 2019.x1sx _30, MEMORIAL MEDICAL CENTER CHECK REGISTER: 5-1-19 THRU 5-31-19 BANK CODE CK# DATE AMOUNT PAYEE A/P 1025 5/1/2019 1,326,08 AMERISOURCEBERGEN A/P 1026 5/8/2019 761.21 AMERISOURCEBERGEN A/P 1027 5/16/2019 1,760.41 AMERISOURCEBERGEN A/P 1028 5/22/2019 698.91 AMERISOURCEBERGEN A/P 1029 5/29/2019 887.82 AMERISOURCEBERGEN A/P 1032 5/8/2019 3,663.95 MCKESSON A/P 1033 5/16/2019 11,715.10 MCKESSON A/P 1034 5/22/2019 5,957.11 MCKESSON A/P 1035 5/29/2019 4,788.97 MCKESSON A/P 100000 5/28/2019 227,080.42 STATE COMP-TEXNET UHRIP A/P 179074 5/24/2019 -70 TEXAS DEPARTMENT OF LICENSING A/P 179710 5/24/2019-131.52 METLIFE A/P 180222 5/24/2019 -70.2 RECEIVABLE MANAGEMENT, INC A/P 180433 5/1/2019 558 ABILITY NETWORK (SHIFTHOUND) A/P 180434 5/1/2019 1638 ACE HARDWARE 15521 A/P 180435 5/1/2019 2,350,46 AIRESPRING INC A/P 180436 5/1/2019 90.11 AIRGAS USA, LLC - CENTRAL DIV A/P 180437 5/1/2019 1,431.00 ALCON LABORATORIES, INC. A/P 180438 5/1/2019 21.12 AUTO PARTS & MACHINE CO. A/P 180439 5/1/2019 689.24 BARD PERIPHERAL VASCULAR A/P 180440 5/1/2019 398.46 BAXTER HEALTHCARE A/P 180441 5/1/2019 33,923.17 BECKMAN COULTER INC A/P 180442 5/1/2019 1,140.14 BIRCH COMMUNICATIONS A/P 180443 5/1/2019 218 BOSTON SCIENTIFIC CORPORATION A/P 180444 5/1/2019 1,636.98 CABLE ONE A/P 180445 5/1/2019 140 CABLES AND SENSORS A/P 180446 5/1/2019 100 CALHOUN COUNTY A/P 180447 5/1/2019 294.73 CARDINAL HEALTH 4141LLC A/P 180448 5/1/2019 81.45 CAREFUSION A/P 180449 5/1/2019 214.46 CARROTTOP INDUSTRIES INC A/P 180450 5/1/2019 51105,67 CITY OF PORT LAVACA A/P 180451 5/1/2019 1,254.69 COASTAL OFFICE SOLUTONS A/P 180452 5/1/2019 794.27 CONMED CORPORATION A/P 180453 5/1/2019 496.05 COOPER SURGICAL INC A/P 180454 5/1/2019 913.84 DEWITT POTH & SON A/P 180455 5/1/2019 50,311,25 DIAMOND HEALTHCARE CORP A/P 180456 5/1/2019 59.63 EPIMED A/P 180457 5/1/2019 371291,58 EVIDENT A/P 180458 5/1/2019 18.23 FEDERAL EXPRESS CORP. A/P 180459 5/1/2019 388.08 FIRETROL PROTECTION SYSTEMS A/P 180460 5/1/2019 51195,96 FISHER HEALTHCARE A/P 180461 5/1/2019 175 GUERBET,LLC -31- A/P 180462 5/1/2019 706.82 GULF COAST PAPER COMPANY A/P 180463 5/1/2019 120.25 HEALTH CARE LOGISTICS INC A/P 180464 5/1/2019 425 HFMA A/P 180465 5/1/2019 236.25 HOLOGIC INC A/P 180466 5/1/2019 24;595.36 ITA RESOURCES INC A/P 180467 5/1/2019 509.35 J & J HEALTH CARE SYSTEMS, INC A/P 180468 5/1/2019 1,453,70 LEGAL SHIELD A/P 180469 5/1/2019 4,274,41 M CKESSON MEDICALSURGICAL INC A/P 180470 5/1/2019 8.9 MEDIMPACT HEALTHCARE SYS, INC. A/P 180471 5/1/2019 0 VOIDED A/P 180472 5/1/2019 0 VOIDED A/P 180473 5/1/2019 8132741G MEDLINE INDUSTRIES INC A/P 180474 5/1/2019 698.56 MERRY X-RAY/SOURCEONE HEALTHCA A/P 180475 5/1/2019 66.14 MID -COAST ELECTRIC SUPPLY, INC A/P 180476 5/1/2019 107.11 MINDRAY DS USA, INC. A/P 180477 5/1/2019 123.22 MMC AUXILIARY GIFT SHOP A/P 180478 5/1/2019 7,700.27 MMC EMPLOYEE BENEFIT PLAN A/P 180479 5/1/2019 0 VOIDED A/P 180480 5/1/2019 0 VOIDED A/P 180481 5/1/2019 24,813,53 MORRIS & DICKSON CO, LLC A/P 180482 5/1/2019 4/144962 NATIONAL FARM LIFE INSURANCE A/P 180483 5/1/2019 458.67 OCCUPRO LLC A/P 180484 5/1/2019 834 OCHOA'S LAWN SERVICE A/P 180485 5/1/2019 1,577.48 OLYMPUS AMERICA INC A/P 180486 5/1/2019 550.19 ORTHO CLINICAL DIAGNOSTICS A/P 180487 5/1/2019 28.73 PARTSSO URCE,LLC A/P 180488 5/1/2019 233 PENLON, INC A/P 180489 5/1/2019 1,365.38 PORT LAVACA WAVE A/P 180490 5/1/2019 1,625.00 RADSOURCE A/P 180491 5/1/2019 240 REVISTA de VICTORIA A/P 180492 5/1/2019 823.25 RX WASTE SYSTEMS LLC A/P 180493 5/1/2019 126.55 SARA RUBIO A/P 180494 5/1/2019 184.99 SERVICE SUPPLY OF VICTORIA INC A/P 180495 S/1/2019 11180,00 SIGN AD, LTD, A/P 180496 5/1/2019 58.92 SMILE MAKERS A/P 180497 5/1/2019 12,375.00SPBSCLINICAL EQUIPMENT SRVC A/P 180498 5/1/2019 385 STANFORD VACUUM SERVICE A/P 180499 5/1/2019 372.44 STRYKER SUSTAINABILITY A/P 180500 5/1/2019 2,362.13 SUN LIFE ASSURANCE COMPANY A/P 180501 5/1/2019 11,755,84 SUN LIFE FINANCIAL A/P 180502 5/1/2019 63.29 TALX CORPORATION A/P 180503 5/1/2019 3,690.52 TEXAS ADVANTAGE COMMUNITY BANK A/P 180504 5/1/2019 556.65 THE US CONSULTING GROUP A/P 180505 5/1/2019 1,269,72 THYSSENKRUPP ELEVATOR CORP A/P 180506 5/1/2019 3,343,81 UNIFIRST HOLDINGS INC VP 180507 5/1/2019 97.62UNITED AD -LABEL COINC A/P 180508 5/1/2019 3,551.61 UNITED STATES TREASURY -32- A/P 180509 5/1/2019 1,831,50 WALLER,LANSDEN, DORTCH & DAVIS A/P 180510 5/1/2019 177.02 WALMART COMMUNITY A/P 180511 5/1/2019 74 WATERMARK GRAPHICS INC A/P 180512 5/1/2019 2,234.10 WERFEN USA LLC A/P 180513 5/1/2019 55.74 ZIMMER BIOMET A/P 180515 5/8/2019 260.27 ACE HARDWARE 15521 A/P 180516 5/8/2019 2,448.00 ALLYSON SWOPE A/P 180517 5/8/2019 17.95 AUTO PARTS & MACHINE CO. A/P 1BOS18 5/8/2019 1,001.34 BAXTER HEALTHCARE A/P 180519 5/8/2019 7,515.02 BECKMAN COULTER INC A/P 180520 5/8/2019 %350.00 C-D ELECTRIC A/P 180521 5/8/2019 92 CABLES AND SENSORS A/P 180522 5/8/2019 29.63 CALHOUN COUNTY A/P 180523 5/8/2019 255.63 CARDINAL HEALTH 414, INC. A/P 180524 5/8/2019 51995,00 CFI MECHANICAL INC A/P 180525 5/8/2019 130 COASTAL OFFICE SOLUTONS A/P 180526 5/8/2019 11520,00 COMMAND ELECTRIC LLC A/P 180527 5/8/2019 4,886,00 COVIDIEN A/P 180528 5/8/2019 11780,00 DA&E A/P 180529 5/8/2019 1,083.38 DEWITT POTH & SON A/P 180530 5/8/2019 156,147.82 DISCOVERY MEDICAL NETWORK INC A/P 180531 5/8/2019 61.43 DOROTHY LONGORIA A/P 180532 5/8/2019 460.89 DR, MARSHALL COOK A/P 180533 5/8/2019 40,062.50 EMERGENCY STAFFING SOLUTIONS A/P 180534 5/8/2019 59.63 EPIMED A/P 180535 5/8/2019 144.58 FEDERAL EXPRESS CORP. A/P 180536 5/8/2019 0 FIRST CLEARING A/P 180537 5/8/2019 5,793.74 FISHER HEALTHCARE A/P 180538 5/8/2019 50 GCWDB A/P 180539 5/8/2019 525 GUERBET, LLC A/P 180540 5/8/2019 11540,19 GULF COAST PAPER COMPANY A/P 180541 5/8/2019 31000,00 HEALTH SOLUTIONS DIETETICS A/P 180542 5/8/2019 236.25 HOLOGIC INC A/P 180543 5/8/2019 227.8 INTERSTATE ALL BATTERY CENTER A/P 180544 5/8/2019 18,247.03 JACKSON & COKER LOCUM TENENS, A/P 180545 5/8/2019 2,190.00 M G TRUST A/P 180546 5/8/2019 11498,00 MASA A/P 180547 5/8/2019 2%418.00 MCKESSON MEDICAL SURGICAL INC A/P 180548 5/8/2019 675.47 MEDIVATORS A/P 180549 5/8/2019 0 VOIDED A/P 180550 5/8/2019 5,053.64 MEDLINE INDUSTRIES INC A/P 180551 5/8/2019 275 MEMORIAL MEDICAL CLINIC A/P 180552 5/8/2019 76.13 MERCEDES SCIENTIFIC A/P 180553 5/8/2019 0 VOIDED A/P 180554 5/8/2019 16,040,77 MORRIS & DICKSON CO, LLC A/P 180555 5/8/2019 3,849,00 MSDSONLINE, INC A/P 180556 5/8/2019 276.32 NADINE GARNER -33- A/P 180557 5/8/2019 21.98 NAZARIO HERNANDEZ A/P 180558 5/8/2019 118.37OLYMPUSAMERICAINC A/P 180559 5/8/2019 2,145.00 PABLO GARZA A/P 180560 5/8/2019 229.95 POSITIVE PROMOTIONS A/P 180561 5/8/2019 200,000.00 PRIVATE WAIVER CLEARING ACCT A/P 180562 5/8/2019 208.49 QIAGEN INC A/P 180563 5/8/2019 3,292.00 RADSOURCE A/P 180564 5/8/2019 419.75 RITA DAVIS A/P 180565 5/8/2019 256.31 SAM'S CLUB DIRECT A/P 180566 5/8/2019 5,166.70 SERVICE SUPPLY OF VICTORIA INC A/P 180567 5/8/2019 475.97 SHIRLEY KARNEI A/P 180568 5/8/2019 37.95 SMILE MAKERS A/P 18OS69 5/8/2019 5,060,00 SOUTH TEXAS BLOOD & TISSUE CEN A/P 180570 5/8/2019 420 ST DAVIDS HEALTHCARE A/P 180571 5/8/2019 510 STORAWAY & STASH -AWAY A/P 180572 5/8/2019 4,895,51 UNIFIRST HOLDINGS INC A/P 180573 5/8/2019 226.07 UTAH MEDICAL PRODUCTS INC A/P 180574 5/8/2019 7,500,57 WAGEWORKS A/P 180575 5/8/2019 129.6 WAGEWORKS, INC A/P 180576 5/8/2019 1,571.67 WERFEN USA LLC A/P 180577 5/15/2019 314.29 AIRGAS USA, LLC, CENTRAL DIV A/P 180578 5/15/2019 4,782.45 ALCON LABORATORIES, INC. A/P 180579 5/15/2019 109.06 ALIMED INC. A/P 180580 5/15/2019 236.78 ALPHA TEC SYSTEMS INC A/P 180581 5/15/2019 62.94 AUTO PARTS & MACHINE CO. A/P 180582 5/15/2019 150 BARD ACCESS A/P 180583 5/15/2019 5,380.92 BAXTER HEALTHCARE A/P 180584 5/15/2019 212.95 BEEKLEY MEDICAL A/P 180585 5/15/2019 6,240.00 BKD,LLP A/P 180586 5/1S/2019 246 CABLES AND SENSORS A/P 180587 5/15/2019 200 CALHOUN COUNTY INDIGENTACCOUN A/P 180588 5/15/2019 180.57 CARDINAL HEALTH 414, INC. A/P 180589 5/15/2019 1,339,99 CARLZEISS MEDITEC,INC. A/P 180590 5/15/2019 46.62 CENTERPOINT ENERGY A/P 180591 5/15/2019 320 CHRIS KOVAREK A/P 180592 5/15/2019 419.88 COASTAL OFFICE SOLUTONS A/P 180593 5/15/2019 11778,85 COASTAL REFRIGERATION A/P 180594 5/15/2019 446 CYGNUS MEDICAL LLC A/P 180595 5/15/2019 11105,24 DEWITT POTH & SON A/P 180596 5/15/2019 59.66 EPIMED A/P 180597 5/15/2019 0 VOIDED A/P 180598 5/15/2019 27,799,42 FISHER HEALTHCARE A/P 180599 5/15/2019 1,122.50 FLDR DESIGNS LLC A/P 180600 5/15/2019 688.08 FRONTIER A/P 180601 5/15/2019 115.3 GETINGE USA SALES LLC A/P 180602 5/15/2019 11245,90 GULF COAST PAPER COMPANY VP 180603 5/15/2019 299.03 GULF COASTSCIENTIFIC -34- A/P 180604 S/15/2019 49.73 H + H SYSTEM, INC. A/P 180605 5/15/2019 359.9 HILL -ROM COMPANY, INC A/P 180606 5/15/2019 227.8INTERSTATE ALL BATTERY CENTER A/P 180607 5/15/2019 2149334 J & J HEALTH CARE SYSTEMS, INC A/P 180608 5/15/2019 41.66 JESSICA GLOVER A/P 180609 5/15/2019 2,025.08 MCKESSON MEDICAL SURGICAL INC A/P 180610 5/15/2019 0 VOIDED A/P 180611 5/15/2019 0 VOIDED A/P 180612 5/15/2019 0 VOIDED A/P 180613 5/15/2019 0 VOIDED A/P 180614 5/15/2019 10,307,72 MEDLINE INDUSTRIES INC A/P 180615 5/15/2019 400.87 MERRYX-RAY/SOURCEONE HEALTHCA A/P 180616 5/15/2019 293.06 MICROTEK MEDICAL INC A/P 180617 5/15/2019 283.5 MID -COAST ELECTRIC SUPPLY, INC A/P 180618 5/15/2019 99.6 MMC AUXILIARY GIFTSHOP A/P 180619 5/15/2019 1,509.64 MMC EMPLOYEE BENEFIT PLAN A/P 180620 5/15/2019 111.52 MMC VOLUNTEERS A/P 180621 5/15/2019 0 VOIDED A/P 180622 5/15/2019 14,759,37 MORRIS & DICKSON CO, LLC A/P 180623 5/15/2019 10,980,17 PAETEC(WINDSTREAM) A/P 180624 5/15/2019 210.84 PARTSSOURCE, LLC A/P 180625 5/15/2019 135.75 PHILIPS MEDICAL SYSTEMS HSG A/P 180626 5/15/2019 2,817.50 REALITY MEDICAL IMAGING OFTX A/P 180627 5/15/2019 240 REVISTA de VICTORIA A/P 180628 5/1S/2019 81802,19 RICOH USA, INC. A/P 180629 5/15/2019 45.61 SCAN SOUND, INC A/P. 180630 5/15/2019 224.08 SERVICE SUPPLY OF VICTORIA INC A/P 180631 5/15/2019 390 SIGN AD, LTD. A/P 180632 5/15/2019 62.64 STRYKER SALES CORP A/P 180633 5/15/2019 74.54 STRYKER SUSTAINABILITY A/P 180634 5/15/2019 4,547.50 TEXAS HOSPITAL INS EXCHANGE A/P 180635 5/15/2019 204 THE UNIFORM CONNECTION A/P 180636 5/15/2019 41215,04 TLC STAFFING A/P 180637 5/15/2019 26,687.98 TXU ENERGY A/P 180638 5/15/2019 3,234.11 UNIFIRST HOLDINGS INC A/P 180639 5/15/2019 260.89 UNIFORM ADVANTAGE A/P 180640 5/15/2019 199 UPDOX LLC A/P 180641 5/15/2019 397.41 UPS A/P 180642 5/15/2019 2,000.00 US POSTAL SERVICE A/P 180643 5/15/2019 500 VICTORIA MEDICAL FOUNDATION A/P 180644 5/15/2019 163.92 WERFEN USA LLC A/P 180645 5/15/2019 2,853.00 WEST COAST MEDICAL RESOURCES A/P 180646 5/15/2019 770.32 ZIMMER BIOMET A/P 180651 5/15/2019 70 A/P 180652 5/15/2019 50 A/P 180653 5/15/2019 25 A/P 180654 5/15/2019 105 -35- A/P 1806S5 5/15/2019 A/P 190656 5/15/2019 A/P 180657 5/15/2019 A/P 180658 5/15/2019 A/P 180659 5/15/2019 A/P 180660 5/15/2019 A/P 180661 5/15/2019 A/P 180662 5/15/2019 A/P 180663 5/15/2019 A/P 180664 5/15/2019 A/P 180665 5/15/2019 A/P 180666 5/15/2019 A/P 180667 5/15/2019 A/P 180668 5/15/2019 A/P 180669 5/15/2019 A/P 180670 5/22/2019 A/P 180671 5/22/2019 A/P 180672 5/22/2019 A/P 180673 5/22/2019 A/P 180674 5/22/2019 A/P 180675 5/22/2019 A/P 180676 5/22/2019 A/P 180677 5/22/2019 A/P 180678 5/22/2019 A/P 180679 5/22/2019 A/P 180680 5/22/2019 A/P 180681 5/22/2019 A/P 180682 5/22/2019 A/P 180683 5/22/2019 A/P 180684 5/22/2019 A/P 180685 5/22/2019 A/P 180686 5/22/2019 A/P 180687 5/22/2019 A/P 180688 5/22/2019 A/P 180689 S/22/2019 A/P 180690 5/22/2019 A/P 180691 5/22/2019 A/P 180692 5/22/2019 A/P 180693 5/22/2019 A/P 180694 5/22/2019 A/P 180695 5/22/2019 A/P 180696 5/22/2019 A/P 180697 5/22/2019 A/P 180698 5/22/2019 A/P 180699 5/22/2019 A/P 180700 5/22/2019 A/P 180701 5/22/2019 1 558 ABILITY NETWORK (SHIFTHOUND) 15,751.04 ACl/BOLAND, INC. 3,313,84 AIRGAS USA, LLC - CENTRAL DIV 61311,00 ALCON LABORATORIES, INC. 3,361,50 ALLYSON SWOPE 47.94 AQUA BEVERAGE COMPANY 6,126.77 BECKMAN COULTER INC 2031695,13 BLUE CROSS BLUE SHIELD 23.8 BOSART LOCK & KEY INC 548.35 CARDINAL HEALTH 414, INC. 73,29 CAROLINA LIQUID CHEMISTRIES 11869,70 CDW GOVERNMENT, INC. 12,321.77 CLINICAL PATHOLOGY LABS 1,148.54 COMBINED INSURANCE 266.43 DEWITT POTH & SON 50,311.25 DIAMOND HEALTHCARE CORP 313.57 DIANE MOORE 11430,00 DOWELL PEST CONTROL 223 DRIESSEN WATER INC. 621.95 DUTCH OPHTHALMIC USA 39.91 ELCAMPO REFRIGERATION 40,062,50 EMERGENCY STAFFING SOLUTIONS 27.37 EMILIE KESTNER 1,923.98 EVOQUA WATER TECHNOLOGIES LLC 33.99 FARAH JANAK 495 FASTHEALTH CORPORATION 21593,15 FISHER HEALTHCARE 5,439.71 GARDNER & WHITE, INC. 225.39 GENESIS DIAGNOSTICS 125 GULF COAST DELIVERY 0 VOIDED 756.9 HEB CREDIT RECEIVABLES DEPT308 -36- A/P 180702 5/22/2019 555.35 HUNTER PHARMACY SERVICES A/P 180703 5/22/2019 3,400.00 ITERSOURCE CORPORATION A/P 180704 5/22/2019 23,540,87 JACKSON & COKER LOCUM TENENS, A/P 180705 5/22/2019 11301,29 LABCORP OF AMERICA HOLDINGS A/P 180706 5/22/2019 1,925.00 LOFTIN EQUIPMENT COMPANY A/P 180707 5/22/2019 635.86 LOWE'S HOME CENTERS INC A/P 180708 5/22/2019 936.38 MARLIN BUSINESS BANK A/P 180709 5/22/2019 369.08 MCKESSON MEDICAL SURGICAL INC A/P 180710 5/22/2019 96.55 MEDI-DOSE, INC A/P 180711 5/22/2019 4,139.50 MEDICAL DATA SYSTEMS, INC. A/P 180712 5/22/2019 203.82 MEDIMPACT HEALTHCARE SYS, INC. A/P 180713 5/22/2019 0 VOIDED A/P 180714 5/22/2019 0 VOIDED A/P 180715 5/22/2019 10,029,28 MEDLINE INDUSTRIES INC A/P 180716 5/22/2019 1,997,85 MERCK SHARP & DOHME CORP A/P 180717 5/22/2019 526.57 MERRY X-RAY/SOURCEONE HEALTHCA A/P 180718 5/22/2019 158.85 MMCAUXILIARYGIFTSHOP A/P 180719 5/22/2019 21491,51 MMC EMPLOYEE BENEFIT PLAN A/P 180720 5/22/2019 0 VOIDED A/P 180721 5/22/2019 20,114488 MORRIS & DICKSON CO, LLC A/P 180722 5/22/2019 2,070.00 NEOGENOMICS LABORATORIES A/P 180723 5/22/2019 750.46 ORTHO CLINICAL DIAGNOSTICS A/P 180724 5/22/2019 21175,00 PABLO GARZA A/P 180725 5/22/2019 187.5 PALACIOS BEACON A/P 180726 5/22/2019 5.99 POWER HARDWARE A/P 180727 5/22/2019 6,825.00 PREMIER SLEEP DISORDERS CENTER A/P 180728 5/22/2019 99 PSYCHEMEDICS CORPORATION A/P 180729 5/22/2019 45.47 RED HAWK FIRE AND SECURITY A/P 180730 5/22/2019 1,230,64 REED, CLAYMON, MEEKER & HARGET A/P 180731 5/22/2019 21478,00 REVCYCLE+,INC. A/P 180732 5/22/2019 17.9 ROBERT RODRIQUEZ A/P 180733 5/22/2019 51794,25 ROBERTS, ODEFEY, WITTE & WALL A/P 180734 5/22/2019 235 RX WASTE SYSTEMS LLC A/P 180735 5/22/2019 367.18 SHIRLEY KARNEI A/P 180736 5/22/2019 7,571,60 SINGLETON ASSOCIATES PA A/P 180737 5/22/2019 3,680,00 SOUTH TEXAS BLOOD & TISSUE CEN A/P 180738 5/22/2019 2/300600 STERICYCLE, INC A/P 180739 5/22/2019 1,562.88 STRYKER ENDOSCOPY A/P 180740 5/22/2019 10,716.23 SUN LIFE FINANCIAL A/P 180741 5/22/2019 51699,00 T-SYSTEM, INC A/P 180742 5/22/2019 3,690.52 TEXAS ADVANTAGE COMMUNITY BANK A/P 180743 5/22/2019 242.69 THE US CONSULTING GROUP A/P 180744 5/22/2019 41558,24 TLC STAFFING A/P 180745 5/22/2019 1,010,00 TRIZETTO PROVIDER SOLUTIONS A/P 180746 5/22/2019 1,889.73 UNIFIRST HOLDINGS INC A/P 180747 5/22/2019 60.03 UNITED RENTALS (NORTH AMERICA) A/P 180748 5/22/2019 560 VICTORIA RADIOWORKS, LTD -37- A/P 180749 5/22/2019 129.6 WAGEWORKS, INC A/P 180750 5/22/2019 6,009.03 WERFEN USA LLC A/P 180751 5/21/2019 688.94 ALISON KING A/P 180752 5/29/2019 1,400,00 ACUTE CARE INC A/P 180753 5/29/2019 1,500.00 ADVANCED PLUMBING A/P 180754 5/29/2019 1,594,15 ALCON LABORATORIES, INC. A/P 180755 5/29/2019 21.99 AQUA BEVERAGE COMPANY A/P 180756 5/29/2019 30.97 AUTO PARTS & MACHINE CO. A/P 180757 5/29/2019 507.68 BAXTER HEALTHCARE CORP A/P 180758 5/29/2019 562.32 BAYER HEALTHCARE A/P 180759 5/29/2019 20,318.40 BECKMAN COULTER INC A/P 180760 5/29/2019 81.45 CAREFUSION A/P 180761 5/29/2019 42 CENTRAL DRUG A/P 180762 5/29/2019 51 CITIZENS MEDICAL CENTER A/P 180763 5/29/2019 1,260,00 CROSSROADS MECHANICAL, INC A/P 180764 5/29/2019 306.99 CYRACOM LLC A/P 180765 5/29/2019 728.6 DEPUYSYNTHESSALES, INC, A/P 180766 5/29/2019 631.37 DEWITT POTH & SON A/P 180767 5/29/2019 481.15 DIANE MOORE A/P 180768 5/29/2019 128,098,64 DISCOVERY MEDICAL NETWORK INC A/P 180769 5/29/2019 361.3 DOWNTOWN CLEANERS A/P 180770 5/29/2019 223 DRIESSEN WATER INC. (CULLIGAN) A/P 180771 5/29/2019 155.98 ERBE USA INC SURGICAL SYSTEMS A/P 180772 5/29/2019 17,388,00 EVIDENT A/P 180773 5/29/2019 152.52 FISHER HEALTHCARE A/P 180774 5/29/2019 530 FORT BEND SERVICES, INC A/P 180775 5/29/2019 11591,26 FRONTIER A/P 180776 5/29/2019 62.81 GALLS,LLC A/P 180777 5/29/2019 5,399.92 GARDNER & WHITE, INC. A/P 180778 5/29/2019 11,477.94 GE PRECISION HEALTHCARE, LLC A/P 180779 5/29/2019 1,266.35 GRAINGER A/P 180780 5/29/2019 255.87 GULF COAST PAPER COMPANY A/P 180781 5/29/2019 3,750.00 HEALTH SOLUTIONS DIETETICS A/P 180782 5/29/2019 970 HEALTHCARE CODING & CONSULTING A/P 180783 5/29/2019 17,205.19 HEALTHCARE EQUIPMENT FINANCE A/P 180784 5/29/2019 11.25 ICU MEDICAL, INC A/P 180785 5/29/2019 488.75 INTOXIMETERS INC A/P 180786 5/29/2019 420.99 IRON MOUNTAIN A/P 180787 5/29/2019 25,071.62 ITA RESOURCES INC A/P 180788 5/29/2019 250 ITERSOURCE CORPORATION A/P 180789 5/29/2019 1/104440 J &J HEALTH CARE SYSTEMS, INC A/P 180790 5/29/2019 10,699.46 JACKSON & COKER LOCUM TENENS, A/P 180791 5/29/2019 505.18 JASON ANGLIN VP 180792 5/29/2019 1,482,10 LEGAL SHIELD q/P 180793 5/29/2019 29,344,02 LUBY'S FUDDRUCKERS RESTAURANTS VP 180794 5/29/2019 1,095.00 M G TRUST A/P 180795 5/29/2019 106.33 M.C. JOHNSON COMPANY INC A/P 180796 5/29/2019 2,313,37 MCKESSON MEDICAL SURGICAL INC A/P 180797 5/29/2019 411.41 MEDIVATORS A/P 180798 5/29/2019 0 VOIDED A/P 180799 5/29/2019 0 VOIDED A/P 180800 5/29/2019 7,904,61 MEDLINE INDUSTRIES INC A/P 180801 5/29/2019 220 MEMORIAL MEDICAL CLINIC A/P 180802 5/29/2019 322.83 MERRY X-RAY/SOURCEONE HEALTHCA A/P 180803 5/29/2019 0 VOIDED A/P 180804 5/29/2019 8,306.70 MORRIS & DICKSON CO, LLC A/P 180805 5/29/2019 3,353.49 NELSON WESTERBERG OF TX, INC A/P 180806 5/29/2019 900 NEOGENOMICS LABORATORIES A/P 180807 5/29/2019 1,137,51 OLYMPUS AMERICA INC A/P 180808 5/29/2019 2,000.00 PARA A/P 180809 5/29/2019 9.93 POWER HARDWARE A/P 180810 5/29/2019 3,061.54 PRO ENERGY PARTNERS LP A/P 180811 5/29/2019 224.08 SERVICE SUPPLY OF VICTORIA INC A/P 180812 5/29/2019 114 SHIP SHUTTLE TAXI SERVICE A/P 180813 5/29/2019 115.8 SINGLETON ASSOCIATES PA A/P 180814 5/29/2019 12,375,00 SPBS CLINICAL EQUIPMENT SRVC A/P 180815 5/29/2019 4,060,00 TEXAS MUTUAL INSURANCE CO A/P 180816 5/29/2019 675 THE DOCTORS'CENTER A/P 180817 5/29/2019 309.53 THE US CONSULTING GROUP A/P 180818 5/29/2019 3,743,11 UNIFIRST HOLDINGS INC A/P 180819 5/29/2019 57.5 UNITED RENTALS (NORTH AMERICA) VP 180820 5/29/2019 199 UPDOX LLC A/P 180821 5/29/2019 3,744,71 WAGEWORKS A/p 180822 5/29/2019 543.5 WAGEWORKS A/P 180823 5/29/2019 1,830.10 WATERMARK GRAPHICS INC A/P 180824 5/29/2019 28,850.00 WOUND CARE SPECIALISTS A/P TOTAL: 2,125,497.40 A/P 180427 2019 49,759.32 ASHFORD GARDENS A/P 180428 5/1/2019 9,309.37 BROADMOOR AT CREEKSIDE PARK A/P 180429 5/1/2019 20,456,15 FORTBEND HEALTHCARE CENTER A/P 180430 5/1/2019 101,181,60 GOLDENCREEK HEALTHCARE A/P 180431 5/1/2019 17,655.47 SOLERA WEST HOUSTON A/P 180432 5/1/2019 10,137,62 THE CRESCENT VP 180647 5/15/2019 852.5 BROADMOOR AT CREEKSIDE PARK A/P 180648 5/15/2019 243.08 FORTBEND HEALTHCARE CENTER q/P 180649 5/15/2019 58,892.48 GOLDENCREEK HEALTHCARE A/P 180650 5/15/2019 21160,00 THE CRESCENT A/P TOTAL (nursing home): 270,647.59 ICP 12233 5/6/2019 4,166.67 MEMORIAL MEDICAL CENTER ICP 12234 5/6/2019 22,472.29 MEMORIAL MEDICAL CENTER ICP 12235 5/6/2019 88.47 CLINICAL PATHOLOGY LABS ICP 12236 5/6/2019 29.67 COMMUNITY PATHOLOGY ASSOCIATES -39- ICP ICP ICP ICP ICP ICP ICP ICP ICP ICP ICP ICP ICP ICP ICP ICP NHA NHA NHA NHA NHB NHB NHB NHC NHC NHC NHF NHF NHF NHG NHS NHS NHS 12237 5/6/2019 12238 5/6/2019 12239 5/6/2019 12240 5/6/2019 12241 5/6/2019 12242 5/6/2019 12243 5/30/2019 12244 5/30/2019 12245 5/30/2019 12246 5/30/2019 12247 5/30/2019 12248 5/30/2019 12249 5/30/2019 12250 5/30/2019 12251 5/30/2019 12252 5/30/2019 ICP TOTAL: 55 5/1/2019 56 5/8/2019 57 5/22/2019 58 5/29/2019 22 5/1/2019 23 5/8/2019 24 5/29/2019 51 5/1/2019 52 5/8/2019 53 5/29/2019 49 5/1/2019 50 5/8/2019 51 5/29/2019 35 5/8/2019 49 5/1/2019 50 5/8/2019 51 5/29/2019 NURSING HOME TOTAL: 98.98 ESS OF PORT LAVACA LLC 188.23 MEMORIAL MEDICAL CENTER 1,716.64 MEMORIAL MEDICAL CLINIC 225.87 MMC PROFESSIONAL FEES 133.66 SINGLETON ASSOCIATES PA 134.45 VICTORIA EYE CENTER 29.67 COMMUNITY PATHOLOGY ASSOCIATES 625.26 ESS OF PORT LAVACA LLC 17,148.99 MEMORIAL MEDICAL CENTER 278.59 MEMORIAL MEDICAL CENTER 1,457.00 MEMORIAL MEDICAL CLINIC 248.14 MICHELLE M. CUMMINS, M.D. 598.77 MMC PROFESSIONAL FEES 310.89 PORT LAVACA CLINIC ASSOC, PA 309.53 SINGLETON ASSOCIATES PA 314.6 VICTORIA ANESTHESIOLOGY, LLP 50,576.37 21,487.36 MMC OPERATING 311359,41 MMC OPERATING 1,430,55 MMC OPERATING 121133.02 MMC OPERATING 4,196.84 MMC OPERATING 61098,18 MMC OPERATING 21364,50 MMC OPERATING 4,148.78 MMC OPERATING 51948.96 MMC OPERATING 21349,96 MMC OPERATING 8,795.08 MMC OPERATING 121755,50 MMC OPERATING 41969.16 MMC OPERATING 43,462.22 MMC OPERATING 61121.41 MMC OPERATING 8/884983 MMCOPERATING 31454.58 MMC OPERATING 179,960.34 PR- 62491 5/3/2019 619.99 PAY-P.04/12/19 04/25/19 PR- 62492 5/3/2019 1,143.97 PAY-P.04/12/19 04/25/19 PR- 62493 5/3/2019 766.54 PAY-P.04/12/19 04/25/19 PR- 62494 5/3/2019 836.92 PAY-P.04/12/19 04/25/19 PR- 62495 5/3/2019 423.93 PAY-P.04/12/19 04/25/19 PR- 62496 5/3/2019 140.39 PAY-P.04/12/19 04/25/19 PR- 62497 5/17/2019 767.2 PAY-P.04/26/19 05/09/19 PR- 62498 5/17/2019 11075,23 PAY-P.04/26/19 05/09/19 PR- 62499 5/17/2019 149.64 PAY-P.04/26/19 05/09/19 PR- 62500 5/17/2019 630.97 PAY-P.04/26/19 05/09/19 -40- PR- 62501 5/17/2019 PR- 62502 5/17/2019 PR- 62503 5/17/2019 PR- 62504 5/17/2019 PR- 62505 5/17/2019 PR- 62506 5/31/2019 PR- 62507 5/31/2019 PR- 62508 5/31/2019 PR- 62509 5/31/2019 PR- 62510 5/31/2019 PR- 62511 5/31/2019 PR- 999999 5/3/2019 PAYROLL TOTAL: 1,002.15 PAY-P.04/26/19 05/09/19 397.89 PAY-P.04/26/19 05/09/19 434.7 PAY-P.04/26/19 05/09/19 655.18 PAY-P.04/26/19 05/09/19 768.52 PAY-P.04/26/19 05/09/19 1,273.94 PAY-P.05/10/19 05/23/19 11622,08 PAY-P.05/10/19 05/23/19 193.86 PAY-P.05/10/19 05/23/19 597.06 PAY-P.05/10/19 05/23/19 635.92 PAY-P.05/10/19 05/23/19 768.57 PAY-P.05/10/19 05/23/19 8811119,38 896,024.03 GRAND TOTAL: 3,252,058.14 -41- MEMORIAL MEDICAL CENTER GROSS PAYROLL REPORT MAY 2019 PR I itle PRDeptName PRTotGross DEPARTMENTAL ASSIST PLANT OPERATIONS 31974,20 ASST PURCHASE BUYER CENTRAL SUPPLY 33389,75 LICENSED VOCATIONAL MEMORIAL MEDICAL CLINIC 4,204.04 PURCHASING SUPERVISR CENTRAL SUPPLY 6,204.00 IP/EH/RM NURSE INFECTION PREVENTION 93160,18 REGISTERED NURSE MED/SURG 5,738.51 ES AIDE ENVIRONMENTAL SERVICES 3,091.71 SURGERY MANAGER SURGERY 13,260.60 REGISTERED NURSE MED/SURG 11,382,19 LICENSED VOCATIONAL OBSTETRICS 61074,47 REGISTERED NURSE MED/SURG 9,868.04 REGISTERED NURSE OBSTETRICS 4,764,41 REGISTERED NURSE EMERGENCY ROOM 10,091,53 DIRECTOR OF INPT SVC MED/SURG 9,400.20 REGISTERED NURSE OBSTETRICS 72642,98 LICENSED VOCATIONAL MED/SURG 41099,84 ADMINIST ASSISTANT ADMINISTRATION 51605,80 CNA MED/SURG 3,503.87 REGISTERED NURSE ICU 9,209.11 PRE -ADMISSION NURSE SURGERY 5,966.61 REGISTERED NURSE MEMORIAL MEDICAL CLINIC 83873,05 LICENSED VOCATIONAL SURGERY 6,325.25 RADIOLOGICAL TECH DIAGNOSTIC IMAGING 81216,26 MLT LABORATORY 2,646,75 MEDICAL LAB TECH LABORATORY 8,539.32 LAB ASSISTANT LABORATORY 5,053.15 MEDICAL LAB TECH LABORATORY 6,726.04 MEDICAL TECHNOLOGIST LABORATORY 7,844.16 REGISTERED NURSE EMERGENCY ROOM 2,564.75 REGISTERED NURSE MED/SURG 1,642.25 BIRTH REG/TRANSCRIP HEALTH INFORMATION MANAGEMENT 2,723.17 REGISTERED NURSE OBSTETRICS 91561,85 REGISTERED NURSE OBSTETRICS 71473,37 CLINICAL IT SPCLST ADMINISTRATION -CLINICAL SERVIC 71594,50 MEDICAL LAB TECH LABORATORY 114.75 REGISTERED NURSE OBSTETRICS 419.25 REGISTERED NURSE OBSTETRICS 4,148.68 REGISTERED NURSE OBSTETRICS 6,528.01 CNO QUALITY ASSURANCE 12,197.80 REGISTERED NURSE MED/SURG 8,438.45 OCCUPATIONAL THERAPY OCCUPATIONAL THERAPY 101384,61 LICENSED VOCATIONAL MED/SURG 11943,35 PRACT ADMINISTRATOR CLINIC FS 113864.20 REGISTERED NURSE ICU 4$47.84 TECHNICAL SUPERVISOR LABORATORY 2,843.00 NURSE PRACTIONER MEMORIAL MEDICAL CLINIC 11,873,52 REGISTERED NURSE MED/SURG 1,048,38 -42- REGISTERED NURSE MEDISURG 1,745,50 CASE MANAGER/UR/DP UTILIZATION REVIEW 7,230.34 REGISTERED NURSE ICU 7,070.06 REGISTERED NURSE MED/SURG 71886,03 REGISTERED NURSE OBSTETRICS 71301,66 CERTIFIED NURSE AIDE MED/SURG 21515,38 REGISTERED NURSE MED/SURG 3,533.50 REGISTERED NURSE MED/SURG 51144,63 CERTIFIED NURSE AIDE MED/SURG 23522,94 REGISTERED NURSE MED/SURG 21029,25 REGISTERED NURSE MED/SURG 7,481.95 REGISTERED NURSE ICU 61796,56 REGISTERED NURSE EMERGENCY ROOM 91104,29 CERTIFIED NURSE AIDE MED/SURG 2,892.91 OP/QA NURSE SPECIALTY CLINIC 92980,29 REGISTERED NURSE ICU 7,820,98 REGISTERED NURSE EMERGENCY ROOM 2,124.82 LICENSED VOCATIONAL MED/SURG 277.25 REGISTERED NURSE MED/SURG 51325,01 RN -OR SCRUB NURSE MED/SURG 71816,87 REGISTERED NURSE MED/SURG 73069,38 LICENSED VOCATIONAL MED/SURG 41364,62 NURSE PRACTITIONER MEMORIAL MEDICAL CLINIC 11,914.76 LICENSED VOCATIONAL MEMORIAL MEDICAL CLINIC 437.00 CERTIFIED NURSE AIDE MED/SURG 31791,68 LVN MEMORIAL MEDICAL CLINIC 793.25 REG PHARM TECH SUPER PHARMACY 41834,12 NURSE PRACTIONER MEMORIAL MEDICAL CLINIC 11,873.52 REGISTERED NURSE OBSTETRICS 81156,85 REGISTERED NURSE ICU 6,463.87 REGISTERED NURSE ICU 31186,43 REGISTERED NURSE ICU 51830,09 REGISTERED NURSE ICU 81997,04 REGISTERED NURSE ICU 1,262.64 REGISTERED NURSE EMERGENCY ROOM 21560,57 O R TECH SURGERY 4,988,22 REGISTERED NURSE SURGERY 81965,73 RN-PERI OPERATIVE SURGERY 81677,66 REGISTERED NURSE OBSTETRICS 4,169.79 REGISTERED NURSE LABOR/DELIVERY 21831,06 REGISTERED NURSE OBSTETRICS 858.57 CERTIFIED STERIL TEC SURGERY 31905,88 COURIER -SUPPLY TECH. CENTRAL SUPPLY 31069,68 REGISTERED NURSE EMERGENCY ROOM 91744,04 DIRECTOR EMERGENCY ROOM 113040,50 REGISTERED NURSE EMERGENCY ROOM 6,970.71 REGISTERED NURSE EMERGENCY ROOM 8,196.94 REGISTERED NURSE EMERGENCY ROOM 410.44 REGISTERED NURSE EMERGENCY ROOM 51756,13 REGISTERED NURSE EMERGENCY ROOM 6,389.71 REGISTERED NURSE EMERGENCY ROOM 703.88 REGISTERED NURSE EMERGENCY ROOM 3,172,13 _qg_ LAB DIRECTOR LABORATORY 7,990.25 REGISTERED NURSE MED/SURG 11256,32 REGISTERED NURSE MED/SURG 11329,75 LAB ASSISTANT LABORATORY 1,102.60 REGISTERED NURSE EMERGENCY ROOM 61839,89 LAB ASSISTANT LABORATORY 1,218.50 MEDICAL TECHNICIAN LABORATORY 1,149,75 MEDICAL LAB TECH LABORATORY 5,371,60 GENERAL SUPERVISOR LABORATORY 61361,88 LAB ASSISTANT LABORATORY 31428,96 LAB ASSISTANT MMC CLINIC - LABORATORY 31733,65 LABORATORY ASSISTANT LABORATORY 350,00 REGISTERED NURSE MED/SURG 452,50 REGISTERED NURSE MED/SURG 2,259.25 MLT LABORATORY 21650,00 LAB ASSISTANT LABORATORY 3,749.76 LAB ASSISTANT LABORATORY 518,00 MEDICAL TECHNOLOGIST LABORATORY 945,50 REGISTRATION CLERK PATIENT FINANCIAL SERVICES 2,782,71 MEDICAL LAB TECH MMC CLINIC - LABORATORY 51112,20 MEDICAL LAB TECH LABORATORY 63296.18 REGISTERED NURSE MED/SURG 6,664.88 REGISTERED NURSE MED/SURG 5,728,36 CERTIFIED NURSES AID MED/SURG 1,106.60 REGISTERED NURSE MED/SURG 51260,18 REGISTERED NURSE MED/SURG 21623,75 REGISTERED NURSE MED/SURG 21536,50 CERTIFIED NURSES AID MED/SURG 1,661.97 REGISTERED NURSE MED/SURG 1,853.76 REGISTERED NURSE EMERGENCY ROOM 61264,13 RADIOLOGICAL TECH DIAGNOSTIC IMAGING 512,00 RADIOLOGICAL TECH DIAGNOSTIC IMAGING 71667,61 RECEPT/SECRETARY DIAGNOSTIC IMAGING 39205,00 RADIOLOGY SUPERVISOR DIAGNOSTIC IMAGING 4$20.75 RADIOLOGY TECH MMC CLINIC - DIAGNOSTIC IMAGIN 9,171.45 RADIOLOGYTECH DIAGNOSTIC IMAGING 21150,58 RADIOLOGICAL TECH DIAGNOSTIC IMAGING 8,434.13 RADIOLOGICAL TECH DIAGNOSTIC IMAGING 61592,49 NUCLEAR MED TECH DIAGNOSTIC IMAGING 9,985.50 RADIOLOGICAL TECH DIAGNOSTIC IMAGING 61427,01 RADIOLOGYTECH DIAGNOSTIC IMAGING 11512,00 RADIOLOGIC TECH DIAGNOSTIC IMAGING 2,396,53 RAID TECHNOLOGIST DIAGNOSTIC IMAGING 1,318.26 RADIOLOGICAL TECH DIAGNOSTIC IMAGING 253,38 RADIOLOGICAL TECH DIAGNOSTIC IMAGING 31770,00 RADIOLOGICAL TECH DIAGNOSTIC IMAGING 61766,90 LVN-CHG-CHARTAUDITR PHARMACY 4,362.72 REGIST PHARMACY TECH PHARMACY 4,454.01 REG PHARMACY TECH PHARMACY 41626,64 OPERATOR CLINIC FS 2,946.15 RECEPTIONIST CLINIC F$ 23978,43 MEDICAL ASSISTANT MEMORIAL MEDICAL CLINIC 3,084.89 -44- MEDICAL ASSISTANT MEDICAL ASSISTANT LICENSED VOCATIONAL MEDICAL ASSISTANT RECEPTIONIST RECEPTIONIST INSURANCE CLERK REGISTERED NURSE OPERATOR LICENSED VOCATIONAL OPERATOR RECEPTIONIST MEDICAL ASSISTANT REFERRAL SPECIALIST LICENSED VOCATIONAL MEDICAL ASSISTANT MEDICAL ASSISTANT REFERRAL SPCLST/MA MEDICAL ASSISTANT INSURANCE CLERK MEDICAL ASSISTANT LVN RN -NURSE SUPERVISOR NURSE PRACTITIONER MEDICAL ASSISTANT NURSE PRACTITIONER PT ASSISTANT PT ASSISTANT DIRECTOR REHAB SERVC PHYSICAL THERAPIST PHYSICIAL THERAPIST TEAM LEAD PTA REGISTERED NURSE OFFICE COORDINATOR BEHAV. HEALTH THERA DISCHARGE ANALYST HIM SPECIALIST CODING SPECIALIST MEDICAL ASSISTANT DIRECTOR OF DIETARY FOOD SERVICE STAFF FOOD SERVICE STAFF FOOD SERVICE STAFF FOOD SERVICE STAFF OPERATOR FOOD SERVICE STAFF FOOD SERVICE STAFF EVS AIDE/ FLOOR TECH PLANT OPS SPECIALIST PLANT OPS SPECIALIST SECURITY SUPERVISOR PLANT OPS SPECIALIST MEMORIAL MEDICAL CLINIC MEMORIAL MEDICAL CLINIC MEMORIAL MEDICAL CLINIC MEMORIAL MEDICAL CLINIC CLINIC FS CLINIC FS CLINIC FS EMERGENCY ROOM MEMORIAL MEDICAL CLINIC MEMORIAL MEDICAL CLINIC CLINIC FS CLINIC FS MEMORIAL MEDICAL CLINIC MEMORIAL MEDICAL CLINIC MEMORIAL MEDICAL CLINIC MEMORIAL MEDICAL CLINIC MEMORIAL MEDICAL CLINIC MEMORIAL MEDICAL CLINIC MEMORIAL MEDICAL CLINIC CLINIC FS MEMORIAL MEDICAL CLINIC MEMORIAL MEDICAL CLINIC MEMORIAL MEDICAL CLINIC MEMORIAL MEDICAL CLINIC MEMORIAL MEDICAL CLINIC MEMORIAL MEDICAL CLINIC PHYSICAL THERAPY PHYSICAL THERAPY PHYSICAL THERAPY PHYSICAL THERAPY PHYSICAL THERAPY PHYSICAL THERAPY OBSTETRICS PHYSICAL THERAPY BEHAVIORAL HEALTH HEALTH INFORMATION MANAGEMENT HEALTH INFORMATION MANAGEMENT HEALTH INFORMATION MANAGEMENT MEMORIAL MEDICAL CLINIC DIETARY DIETARY DIETARY DIETARY DIETARY CLINIC FS DIETARY DIETARY ENVIRONMENTAL SERVICES PLANT OPERATIONS PLANT OPERATIONS SECURITY PLANT OPERATIONS 3,383.16 1,574.94 4,779,57 3,005,05 3,914,97 3,717,88 3,611.89 410,44 2,711.66 819,00 3,688,30 3,182,30 3,291,37 3,278,22 3,490.74 1,197.37 4,000,38 4,206,14 2,687,39 3,609419 3,473.41 5,759,91 5,418,88 11, 73,52 2,719,72 13,324480 6,381.51 6,449,45 13,606,50 10,346,40 10,616,27 8, 020.69 8,247.95 3, 263.41 6,662,40 2,907,11 2,630,16 4, 57,63 3,434.79 7,240,00 3,020.89 2,926,01 4,318.63 334,75 2,894,65 2,837,91 3,787,90 3, 099,10 3,019,50 3,727.50 3,810,21 4,858,00 -45- EVS AIDE ENVIRONMENTAL SERVICES 2,423.47 EVS AIDE ENVIRONMENTAL SERVICES 21460,05 EVS AIDE ENVIRONMENTAL SERVICES 11734,14 EVSAIDE ENVIRONMENTAL SERVICES 13327,45 ES AIDE ENVIRONMENTAL SERVICES 21361.76 LICENSED VOCAT NURSE MED/SURG 41435,27 E.S. TEAM LEADER ENVIRONMENTAL SERVICES 3,468.02 EVS AIDE ENVIRONMENTAL SERVICES 21823,16 EVS AIDE ENVIRONMENTAL SERVICES 11727,73 ES AIDE ENVIRONMENTAL SERVICES 21864,63 EVS AIDE ENVIRONMENTAL SERVICES 13411.78 FOOD SERVICE STAFF DIETARY 31074,11 ES AIDE ENVIRONMENTAL SERVICES 31659,27 FLOOR TECHNICIAN ENVIRONMENTAL SERVICES 21932,71 FOOD SERVICE STAFF DIETARY 3,214.69 EVS AIDE ENVIRONMENTAL SERVICES 21192,43 OR AIDE SURGERY 31145,28 SECURITY OFFICER SECURITY 33712,00 DIRECTOR OF PLANT OP PLANT OPERATIONS 81360,28 SECURITY OFFICER SECURITY 11607,27 REGISTERED NURSE SURGERY 11,144.59 PERIOPERATIVE RN SURGERY 91933.18 SELF PAY CLERK PATIENT FINANCIAL SERVICES 2,989,95 OFFICE MANAGER CLINIC FS 11091,98 REGISTRATION CLERK PFS - REGISTRATION 2,381.35 BILLING CLERK PATIENT FINANCIAL SERVICES 21813,30 REGISTRATION CLERK PATIENT FINANCIAL SERVICES 875,00 REGISTRATION CLERK PATIENT FINANCIAL SERVICES 31068.00 REGISTRATION CLERK PFS - REGISTRATION 3,089.04 PT FIN COUN/CIHC COO INDIGENT CARE PROGRAM 92,40 REGISTRATION CLERK PFS - REGISTRATION 13233,31 CASHIER -SWITCHBOARD PATIENT FINANCIAL SERVICES 21707,72 INSUR COORDINATOR PATIENT FINANCIAL SERVICES 2,869.40 MEDICARE COORDINATOR PATIENT FINANCIAL SERVICES 41140,37 REGISTRATION CLERK PFS - REGISTRATION 2,066.09 REGISTRATION CLERK PATIENT FINANCIAL SERVICES 2,650.31 HR MANAGER HUMAN RESOURCES 41799,53 RECEPTIONIST CLINIC FS 31650,28 TEAM LEADER PATIENT FINANCIAL SERVICES 4,236,23 PFS DIRECTOR PATIENT FINANCIAL SERVICES 51722,60 REGISTERED NURSE EMERGENCY ROOM 11429,26 REGISTRATION CLERK PFS - REGISTRATION 41372,42 REGISTRATION CLERK PFS - REGISTRATION 31842,04 REGISTRATION CLERK PFS - REGISTRATION 331,72 SECURITY OFFICER SECURITY 31004,84 FINANCIAL COUNSELOR INDIGENT CARE PROGRAM 31652,54 DIRECTOR OF HIM HEALTH INFORMATION MANAGEMENT 6,621.80 REGISTERED NURSE EMERGENCY ROOM 71007084 MEDICAID CLERK INDIGENT CARE PROGRAM 33945.37 PERIOPERATIVE RN SURGERY 61741,60 TRAUMA COORDINATOR ADMINISTRATION -CLINICAL SERVIC 7,623,50 DIRECTOR DIAGNOSTIC IMAGING 91676,78 -46- REGISTRATION CLERK PATIENT FINANCIAL SERVICES I.T. DIRECTOR INFORMATION TECHNOLOGY IT SYSTEM ANALYST INFORMATION TECHNOLOGY IT SYSTEM ANALYST INFORMATION TECHNOLOGY ACCOUNTANT ACCOUNTING REGISTERED NURSE EMERGENCY ROOM LAB ASSISTANT LABORATORY SENIOR ACCOUNTANT ACCOUNTING CONTROLLER ACCOUNTING C. F.O. ADMINISTRATION ASSIST ADMINISTRATOR ADMINISTRATION C.E.O. ADMINISTRATION ADMIN ASST TO AA-CNO ADMINISTRATION -CLINICAL SERVIC SPECIAL PROJECTS MGR BUSINESS DEVELOPMENT 687.88 9,762.79 61313,25 735,00 4,459.31 8,552,91 11772,76 52152,48 63000,00 20,179.60 15,640,00 27,360,38 3,998,79 5,697.97 1,311,361.42 -47- ©iHS Source Totals Report Issued 06/13/19 Calhoun Indigent Health Care Batch Dates 05/02/2019 through 06/01/2019 For Source Group Indigent Health Care For Vendor: All Vendors Source Description Amount Billed Amount Paid 01 Physician Services 3,782.00 313,01 01-2 Physician Services -Anesthesia 13560,00 424.24 02 Prescription Drugs 328,44 328,44 13 Mmc - Inpatient Hospital 81618,00 4,998.44 14 Mmc - Hospital Outpatient 17,852,00 53712,64 15 Mmc - Er Bills 8,782.00 21810,24 Expenditures 40,996,45 14,661402 Reimb/Adjustments -74,01 -74.01 Grand Total 40,922,44 14,587.01 EXPENSES 41166,67 18,747.68 COPAYS <190.00> TOTAL t 8,557.88 -48- olHS Issued 06/13/19 Source Description Source Totals Report Calhoun Indigent Health Care Batch Dates 02/01/2019 through 06/01/2019 For Source Group Indigent Health Care For Vendor: All Vendors Amount Billed Amount Paid 01 Physician Services 47,153645 51008,22 01-2 Physician Services- Anesthesia 31744,00 1,051,85 02 Prescription Drugs 11242*16 1,242,16 08 Rural Health Clinics 81680A3 7,635,02 13 Mmc - Inpatient Hospital 8,618.00 4,998,44 14 Mmc - Hospital Outpatient 146,863,22 47,205,62 15 We - Er Bills 48,115,00 15,396,80 Expenditures 264,648,31 82,852,08 Relmb/Adjustments-232,45 -313,97 Grand Total 264141536 82,538.11 EXPENSES 20,833,35 103,371,46 COPAYS <1120.00> TOTAL 102,251.46 -49- January February March April May June July August September October November December Calhoun County Indigent Care Patient Caseload 2019 Approved Dented Removed Active Pending 0 1 6 15 4 2 0 0 17 2 2 1 1 18 6 2 0 0 20 4 1 2 0 21 L 2 YTD Monthly Avg 1 1 1 18 4 December2018Active 21 Number of Charity patients 245 Number of Charity patients below 1000/6 FPL 138 January February March April May June July August September October November December d Reflils Removed Activ Value YTD PATIENT SAVINGS Monthly Avg 5 12 0 98 $32,791,08 0 December 2018 Active 87 -51- Commissioners' Court —July 03, 2019 6. Approve the Wednesday June 05, 2019 and Monday, June 10, 2019 Commissioners' Court 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 4 of 10 The Commissioners' Cour¢ off Calhoun County, Texas met on Wednesday, June 5, �019 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. 4 r ichard Meyer, my Judge Calhoun County, Texas Anna Goodman, County Clerk Deputy Clerk Calhoun County Commissioners' Court—JUNE 05, 2019 REGULAR 2019 TERM JUNE 05, 2019 BE IT REMEMBERED THAT ON ]UNE 05, 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 6y judge Richard Meyer. 2. ROLL CAL! THE FOLLOWING MEMBERS WERE PRESENT: Richard Meyer David Hall Vern Lyssy Clyde Syma Gary Reese Anna Goodman Catherine Sullivan County judge Commissioner, Precinct it, 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 7 I• Calhoun County Commissioners' Court—.IUNC 05, 2019 4. General Discussion of public matters and Public Participation. NI 5. Approve minutes of May 15, 2019 meeting. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 6. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 6) To authorize the Calhoun County Sheriff to transfer full and complete ownership of Calhoun County Sheriff's Officer K9 Tessa to her handler, Cpl. James Tolar, effectively immediately. (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 N0.7) Ta reappoint lack Campbell, Jr: Yo the West Side Navigation District. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner PcC 4 SECONDER: Richard Meyer, Calhoun County Judge AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 2 of 7 • Calhoun County Commissioners' Court—JUNE OS, 2019 8. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 8) On FEMA4332-DR-TX Project #394493 Public Assistance Management Cost Selection (Appendix C) and Certification of Management Cost Eligibility (Appendix D) and authorize the County Judge to sign. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 9. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 9} On FEMA-4332-DR-TX Project Completion and Certification Report for Project Worksheet #03889 County -Wide Debris Disposal and the Duplication of Benefits form and authorize the County Judge to sign. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hail, Lyssy, Syma, Reese 10. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 10) On FEMA4332-DR-TX Project Completion and Certification Report for Project Worksheet #04216 Agriculture Building and the Duplication of Benefits form and authorize the County Judge to sign. (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 3 of 7 • Calhoun County Commissioners' Court—JUNE 05, 2019 11. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 11) On FEMA-4332-DR-TX Project Completion and Certification Report for Project Worksheet #03997 Airport Hangar Office and the Duplication of Benefits form and authorize the County Judge to sign. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 12. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 12) On FEMA-4332-DR-TX Project Completion and Certification Report for Project Worksheet #00959 Precinct #3 Building and the Duplication of Benefits form and authorize the County Judge to sign. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissloner 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. 13) On FEMA4332-1DR-TX Project Completion and Certification Report for Project Worksheet #02576 Precinct #4 main Shop Building and the Duplication of Benefits form and authorize the County Judge to sign. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissloner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 4 of 7 • Calhoun County Commissioners' Court -DUNE 05, 2019 14. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM 140.14) On FEMA-4332-13114X Project Completion and Certification Report for Project Worksheet #00872 IT Building and the Duplication of Benefits form and authorize the County Judge to sign. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 15. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 15) On FEMA4332-DR4X Project Completion and Certification Report for Project Worksheet #03960 Twin Bridges and the Duplication of Benefits form and authorize the County Judge to sign. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 16. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 16) On FEMA4332-DR-TX Project Completion and Certification Report for Project Worksheet #03281 Main Library Contents and the Duplication of Benefits form and authorize the County Judge to sign. (RM) RESULT: APPROVED [UNANIMOUS] ', MOVER% David Hall, Commissioner Pct 1 SECONDER, Vern Lyssy, Commissioner Pct 2 RYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 5 of 7 Calhoun County Commissioners' Court-1UNE 05, 2019 17. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 17) On contract with Kathy Smartt for Grant Preparation Services for Boggy Bayou Nature Park, Phase I and authorize the County Judge to sign. Allan Berger (Parks Board) spoke on this matter. RESULT: APPROVED[UNANIMOUS) MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 18. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 18) To authorize payment of $1,500 to Kathy Smartt for grant preparation services for Boggy Bayou Nature Park, Phase I to be paid from GOMESA funds. (GR) RESULT: APPROVED [UNANIMOUS] . MOVER: Clyde Syma, Commissioner Pct 3 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 19. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 19) On insurance proceeds from TAC in the amount of $3,518.45 ($6,018.45 minus $2,500 deductible) for damages to a Sheriff Office vehicle from an accident on May 11, 2019. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Clyde Syma, Commissioner Pct 3 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 6 of 7 I� Calhoun County Commissioners' Court-JUNE 05, 2019 20. Consider and take necessary action on any necessary budget adjustments. (RM) 2019 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 21. APPROVAL OF BILLS AND PAYROLL. (AGENDA ITEM NO. 21) 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 pD70URNED: 10:22 A.M. Paga 7 of 7 Commissioners' CoutL—July 03, 2019 7. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 7) To approve a Drainage Easement Agreement location in Precinct 4 between Calhoun County and POC Park 1, LP and authorize the County Judge to sign same and file it of record in the Official Records. (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 5 of 10 Gary D. Reeser County Commissioner County of Calhoun Precinct 4 June 27, 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 Commissioners' Court Agenda for July 3, 2019. • Consider and take any action to approve Drainage Easement Agreement located in Precinct 4 between Calhoun County and POC Park 1, LP, authorize Judge to sign same and file it of record in the official records. Sincerely, Gary D. Reese P.O. Box 177 � Seadrift, Texas 77983 _email: eary reese�iJcalhouncotx.or¢ _ (361) 785-3141 � Fax (361) 785-5602 Commissioners' Court—July03, 2019 8. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 8) To approve the County Municipal Road Mileage Certification and authorize the County Judge to sign. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Clyde Syma, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 6 of 10 COUNTY MAINTAINED ROAD MILEAGE CERTIFICATION Calhoun County concurs with TxDOT's certified mileage of 221 for the County Maintained Road Mileage. NOTE: The certified mileage total may not be changed on this form. Changes (i.e. additions or deletions) to certified mileage must be made and submitted via the Data Updates and Sharing Application (DUSA), described in the attached letter. 7— 3 / ? LV County J.Td.ge Date Please return to: Texas Department of Transportation Transportation Planning and Programming Division Attention: Data Management Section - Mapping P.O. Box 149217 Austin, Texas 78714-9217 125 EAST 11TH STREET, AUSTIN, TEXAS 78701-2483 1512.463.8588 I W W W.TXDOT.GOV June 3, 2019 The Honorable Richard Meyer Calhoun County Judge 211 S Ann St, 3rd FI Port Lavaca, Texas 77979-4203 Dear Judge Meyer: This letter is a follow up to the previous letter to notify you that the Texas Department of Transportation (TxDOT) is soliciting updates to the county road inventory (CRI) from your county. This is the second year that TxDOT is accepting updates from every county, every year, using a new process. The deadline for the 2019 submission is August 31, 2019, CERTIFICATION In September 2019, the certified county -maintained road mileage from 2018 will be submitted to the Texas Department Of Motor Vehicles for disbursement of the title and registration fees and to the State.Comptroller's Office for disbursement of the Lateral Road and Bridge funds. Updates made by August 31st will be reported in September of 2020. Your 2018 certified mileage is: 221. If the mileage is correct, sign the Mileage Certification form (enclosed) and return it. If not, please follow the instructions on pages TRAINING TxDOT understands this is a new process. For those who need assistance, TxDOT will be hosting live WebEx video training. Date: Wednesday, June 26, 2019 Time: 2:00 - 3:00 pm Date: Wednesday, July 31, 2019 Time: 2:00 - 3:00 pm To join training, type in the following website address: https://txdot.webex.com/joinJjferrell OUR VALUES: People • Accountability •Trust •Honesty OUR MISSION: Through collaboration and leadership, we delivera safe, reflable, and integrated transportation system that enables the movement ofpeople and goods. N, Equal Opportunity Employer The Honorable Richard Meyer 2 June 3, 2019 INSTRUCTIONS County road inventory updates can be submitted to TxDOT through the Data Updates & Sharing Application (DUSA). To access DUSA, you must have a username and password. Follow the steps below to obtain your username and password. You will only have to do this one time. If your county previously registered to access DUSA, you may proceed with updates for 2019 at any time. However, if your county has not yet registered to access DUSA, please forward the instructions outlined below to your staff or whomever you wish to delegate responsibility for updating the CRI for your county. 1) The person responsible for making updates (a county official or designated 3rd party) should use the following link to register: https://www.dot.state.tx. us/a pps-cg/co ntact_us/form/d usa-form. htm 2) Within 24 hours you will receive an email from ArcGIS Notifications providing your unique username and inviting you to join the ArcGiS Online Organization, Texas Department of Transportation. Follow the link within this email to finish setting up your account and establish your own password. 3) Once you receive a unique username and password, you will then sign -into DUSA at the following website address: https://www.txd ot.gov/a pps/statewide_ma ppi ng/d usa/ i nd ex. htm I 4) Select the 'ArcGIS login' option to sign into the Data Updates &Sharing Application with your new ArcGIS Online username and password. DO NOT attempt to sign -in usingthe'Enterprise login' option, as it will be unsuccessful. OUR VALUES: People • Accountablllty •Trust •Honesty OUR MISSION: Through collaboratlon antl leadership, we dellvera safe, reliable, and integrated Vansportation system that enables the movement ofpeople antl gootls. M Equal Opportunity Employer The Honorable Richard Meyer June 3, 2019 Data Updates & Sharing Application wants to access your ArcGIS Online account information Sign in to Texas Department of Oesri Transportation with Enterprise login A II n 5) Once you have successfullysigned in, select your county from the dropdown list and click Go': DUSA will open and automatically zoom to your county. Follow the instructions provided within the'Resources' section of the application and begin making updates to your county road inventory. Alternatively, watch the 'Editing'video in the'Training Videos' link to view how to make edits. For GIS professionals, there is an option to download GIS files, make updates with GIS software, and upload the bulk changes back to DUSA. OUR VALUES: People • Accountablllty •Trust •Honesty OUR MISSION: Through collaboration antl leadership, we delivera safe, reliable, and integra[etl transportation system that enables the movement ofpeople and gootls. An Equal epportuntty Employer The Honorable Richard Meyer 4 June 3, 2019 Thank you for your assistance in keeping the county road inventory up to date. If you have any questions or need clarification regarding the new process for CRI, please contact us by email or phone. Sincerely, ``5" �r�d12i 2c.v Michael Chamberlain Transportation Planning and Programming Division Director of Data Management TPP-GIS@txdot.gov (512) 486-5054 OUR VALUES: People • Accountability • Trust • Honesty OUR MISSION: Through collaboration antl leadership, we tlelivera safe, reliable, and integrated transportation system that enables the movement ofpeople antl goods. An Equal Opportunity Employer April Townsend From: notifications@arcgis.com (ArcGIS Notifications) <notifications@arcgis.com> Sent: Wednesday, June 19, 2019 12:55 PM To: april.townsend@calhouncotx.org Subject: An invitation tojoin an ArcGIS Online organization, Texas Department of Transportation. TXDOT has invited you to join an ArcGIS Online Organization, Texas Department of Transportation. Access to the County Road Inventory can be found here: http://txdot, m a ps,a rcgis,co m/home/group. htm I?id=eee 7595l lfl3425491393180e b6a7918#ove rview Please click this link to finish setting up your account and establish your password to join the organization, Texas Department of Transportation: https://www.arcgis.com/home/`newuser.html?invitation=A396bbec3405e4639aaf9755100786f7O Note that your account has already been created for you with the username, April.Townsend_CALHOUN. If you have difficulty signing in, please contact GIS Support (jason.henderson@nttdata.com). Be sure to include a description of the problem, the error message, and a screenshot. For your reference, you can access the home page of the organization here: https:HTXDOT. ma ps, a rcgis.com This link will expire in 14 day(s). This is an automated email. Please do not reply. 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Support €lplore Premier Login and Registration FAO Phone and Device Support AT&T Business Forum Contactus Comrnissioners' Court—July03, 2019 9. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 9) To approve the contract with G&W Engineers, Inc. for Engineering Services In support of Calhoun County State and Federal Grants and authorize the County Judge to sign all necessary documents. (RM) PASS Page 7 of 10 C 0 11" ASSISTANT AUDITOR TELEPHONE (36115534610 FAX (36115534614 ASSISTANT AUDITORS June 27, 2019 TO: Honorable Richard H. Meyer Calhoun County Judge RE: Agenda Item for Commissioners' Court Wednesday, July 3, 2019 Please place the following item on the Commissioners' Court Agenda for July 3, 2019. • Consider and take action on the contract with G & W Engineers, Inc. for Engineering Services in support of Calhoun County State and Federal Grants and authorize the County Judge to sign all necessary documents. Thank you, Peggy 3-faCC Assistant Auditor Commissioners' Court — July 03, 2019 10. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 10) To approve the specifications for rebidding the RFP for Administration/Professional Services in support of Calhoun County State and Federal Grants and advertise for these services. The RFP will be due by 2:00 p.m. Wednesday, July 24, 2019 and considered for award on Wednesday, July 31, 2019. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct i SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 8 of 10 CIN LLER FLUUX HALL CRISTINAPTINIZON 11"ASSISTANT AUDITOR TELEPHONE 136115534610 FAX (36115534614 ASSISTANT AUDITORS June 27, 2019 TO: Honorable Richard H. Meyer Calhoun County Judge RE: Agenda Item for Commissioners' Court Wednesday, July 3, 2019 Please place the following item on the Commissioners' Court Agenda for July 3, 2019. . Consider and take necessary action to approve the specifications for rebidding the RFP for Administration/Professional Services in support of Calhoun County State and Federal Grants and advertise for these services. The RFP will be due by 2:00 PM, Wednesday, July 24, 2019 and considered for award on Wednesday, July 31, 2019. Thank you, Peggy 3-CaCC Assistant Auditor RequestP RFP 0 Cover Letter July 3, 2019 Re: Proposed Contract Funding for the CDBG — Disaster Recovery Fund through GLO Community Development & Revitalization Dear Administrative Service Providers: Attached is a copy of the County of Calhoun's Request for Proposals (RFP) for application and administrative services. These services are being solicited to assist the County of Calhoun in its application and administration of a contract, if awarded, from the CDBG — Disaster Recovery Fund of the General Land Office (GLO) Community Development Block Grant Program, The County of Calhoun is considering applying for such funding to support Infrastructure activities in the County of Calhoun. Firms may submit proposals for any or all activities. Multiple contracts may be awarded as a result of this solicitation. The County will, in its sole discretion, determine the number of contracts awarded, and may decide not to award any contracts. The submission requirements for this proposal are also included on the attached RFP. Firms andlor individuals should have past experience with federally funded programs. Please submit a sealed proposal of services and statement of qualifications to: Honorable Richard H. Meyer Calhoun County Judge Calhoun County Courthouse 211 S. Ann St., Ste, 301 Port Lavaca, TX 77979 Along with your proposal, you must also include the following: • Cost of Services: Infrastructure NOTE: Updated to say "Amount" of Profit instead of "Percentage" • Certification Regarding Lobbying • Disclosure of Lobbying Activities • Verification that your company as well as the company's principal(s) is not listed (is not debarred) through the System for Award Management (www.SAM.gov). Please include a print out of the search results. • Affidavit • Form 1295 (Certificate of Interested Parties) • Form CIQ (Conflict of Interest Questionnaire) • W-9 The County of Calhoun is seeking to enter into a services contract with a competent administration/management firm/professional service provider to assist the County in preparing an application for and in the overall management of its proposed CDBG-Disaster Recovery project, if funded by the Texas General Land Office Community Development & Revitalization (GLO). The following outlines the request for proposals. Scope of Work The professional administration/management firm/consultant to be hired is to provide application and contract -related management services to the County of Calhoun, including but not limited to the following areas: Pre -Funding Services* Grant Administrator will develop project scope and complete CDBG-DR application. The provider will work with the local government and Engineering, if applicable, to provide the concise information needed for submission of complete disaster recovery funding application and related documents. The required information shall be submitted in a format to be described by the GLO. Post -Funding Services Grant Administrator will administer and complete infrastructure, utilities, housing and eligible projects approved for disaster recovery funding. The selected administrative firm must follow all requirements of the Texas CDBG Disaster Recovery program. General Administration Services —General • Administrative Duties • Construction Management Grant Administration Services — Infrastructure • Administrative Duties • Acquisition Duties • Environmental Services Please specify actual tasks to be performed under each of these categories. *Pre -funding services are not eligible for CDBG-DR reimbursement and must be paid with local or other non-CDBG- DR funds. II. Statement of Qualifications The County of Calhoun is seeking to contract with a competent professional administrationlmanagement firm/consultant(s) experienced in grants/contracts application and administration. Specifically, it is seeking those consultant(s) or firm(s) with the following qualifications: Related experience in applying for and managing federally -funded local public works construction projects —Infrastructure, with an emphasis on directly -related and recent experience; Related Experience / Background with specific project type (CDBG-DR Consultant/Firm is not debarred or suspended from the Excluded Parties List System (EPLS) in the System for Award Management (SAM). As such, please provide within your proposal a list of referrals from past local government clients, as well as the resumes of all employees who will or may be assigned to provide technical assistance to the county on this project if your firm is awarded this management services contract. III. Proposed Cost of Services Please provide your cost proposal to accomplish the scope of work by activity (Infrastructure) outlined above and for any additional services required. The final grant amount is yet to be determined and this award is contingent upon funding of the CDBG-DR grant with the Texas General land Office. The proposal IV V must include all costs that are necessary to successfully complete these activities. Firms may submit proposals for any or all activities. Please note that the lowest/best bid will not be used as the sole basis for entering into this contract. Profit (either % /actual cost) must be identified and negotiated as a separate element of the price of the contract. To comply, the bidder must disclose and certify in its proposal the amount of profit being used. "Cost plus percentage of cost" type proposals are prohibited. Evaluation Criteria The proposal received will be evaluated and ranked according to the following criteria: Criteria Experience Work Performance Capacity to Perform Proposed Cost Maximum Points 30 40 20 10 Total 100 Contracting with small and minority businesses, women's business enterprises, and labor surplus area firms. Small and minority businesses, women's business enterprises, and labor surplus area firms are encouraged to participate in this RFP. If the awarded vendor is a prime contractor and may use subcontractors, the following affirmative steps are required of the prime contractor. 1) Placing qualified small and minority businesses, and women's business enterprises on solicitation lists; 2) Assuring that small and minority businesses, and women's business enterprises are solicited whenever they are potential sources; 3) Dividing total requirements, when economically feasible, into smaller tasks or quantities to permit maximum participation by small and minority businesses, and women's business enterprises; 4) Establishing delivery schedules, where the requirement permits, which encourage participation by small and minority businesses, and women's business enterprises; 5) Using the services and assistance, as appropriate, of such organizations as the Small Business Administration and the Minority Business Development Agency of the Department of Commerce VI. Submission Requirements • Proposal • Cost of Services: Infrastructure -NOTE: Updated to say "Amount" of Profit instead of "Percentage" • Certification Regarding Lobbying • Disclosure of Lobbying Activities • System for Award Management — Consultant/Firm, and its Principals, may not be debarred or suspended nor otherwise on the Excluded Parties List System (EPLS) in the System for Award Management (SAM). Include verification that the company as well as the company's principals are not listed (are not debarred) through the System for Award Management (www.SAM.gov). Enclose a print out of the search results that includes the record date. • Affidavit • Form 1295 (Certificate of Interested Parties) — Must include when submitting your proposal. When completing and submitting online, there will be a Certificate Number and Date Filed in the box marked "Office Use Only —Certification of Filing". • Form CIQ (Conflict of Interest Questionnaire) — Every vendor doing business with the County or seeking to do business with the County must complete Box 1 and sign and date in Box 7. Whether or not a conflict exists determines the other information to include on the form. • W-9 VII. Deadline for Submission Proposals must be received in the County Judge's office no later than Wednesday, July 24, 2019 at 2:00 PM. It is the responsibility of the submitting entity to ensure that the proposal is received in a timely manner. Proposals received after the deadline will not be considered for award, regardless of whether or not the delay was outside the control of the submitting consultant/firm. Please submit one (1) original and four (4) hard copies to the following address: (If original is in color, please submit the copies in color and mark "Copy") Honorable Richard H. Meyer Calhoun County Judge Calhoun County Courthouse 211 S. Ann St., Ste. 301 Port Lavaca, TX 77979 The submittal must be delivered in a sealed 9 x 12 or larger envelope clearly marked on the outside - "RFP 2019.07.03.APS, CDBG-DR Grant Administration Services". The RFP will be considered for award on Wednesday, July 31, 2019. The Grant Administrator shall provide the following scope of services: SCOPE OF SERVICES REQUESTED Providers will help the GLO fulfill State and Federal Community Development Block Grant Disaster Recovery ("CDBG-DR") statutory responsibilities related to recovery in connection with any federally declared disaster. Providers will assist the GLO and/or grant recipients in completion of CDBG-DR qualified housing or non -housing projects. Respondents may be qualified to provide Grant Administration services for housing projects, non -housing projects, or both. Grant administrative services must be performed in compliance with the U.S. Department of Housing and Urban Development ("HUD") and guidelines issued by the GLO. DESCRIPTION OF SERVICES AND SPECIAL CONDITIONS Respondent must be able to perform the tasks listed herein to be considered eligible for an award under this Solicitation. Respondents should provide a detailed narrative of their experience as it relates to each of the items below. Respondents should clearly indicate if they intend to provide services in-house with existing staff or through subcontracting or partnership arrangements. Grant Administration Services will be provided in conformance with the guidance documents and use forms provided by the subrecipient utilizing GLO guidance. The providers shall furnish pre -funding and post -funding grant administrative services to complete the disaster recovery projects, including, but not limited to the following: Pre -Funding Services Grant Administrator will develop project scope and complete CDBG-DR application, if applicable. The provider will work with the subrecipient and Engineering, if applicable, to provide the concise information needed for submission of complete disaster recovery funding application and related documents. The required information shall be submitted in a format to be described by the GLO. Post -Funding Services Grant Administrator will administer and complete infrastructure, utilities, housing and eligible projects approved for disaster recovery funding. The selected administrative firm must follow all requirements of the Texas CDBG Disaster Recovery program. Grant Administration Services —General a) Administrative Duties: i. Coordinate, as necessary, between subrecipient and any other appropriate service providers (i.e. Engineer, Environmental, etc.), contractor, subcontractor and GLO to effectuate the services requested. ii. May assist in public hearings. iii. Will work with GLO's system of record. iv. Provide monthly project status updates. v. Funding release will be based on deliverables identified in the contract. vi. Labor and procurement duties: a. Provide all Labor Standards Officer (LSO) Services. b. Ensure compliance with all relevant labor standards regulations. c. Ensure compliance with procurement regulations and policies. d. Maintain document files to support compliance. vii. Financial duties: a. Prepare and submit all required reports (Section 3, Financial Interest, etc.). b. Assist subrecipient with the procurement of audit services. Cost of Services: Infrastructure Please indicate No Cost Proposal if your firm is not proposing for the services specified on this Cost of Services page. Maximum amount of grant funds firm is able and/or willing to manage: $ INFRASTRUCTURE Potential Grant Award Amount Cost of Services - (maximum) Amount of Profit $1 million $5 million $10 million $50 million $100 million $250 million Hourly Rates Work Classification Hourly Rate CALHOUN COUNTY, TEXAS REQUEST FOR PROPOSAL ADMINISTRATION/PROFESSIONAL SERVICES RFP 2019.07.03-APS Request for Proposal (RFP) for Administration/Professional Services RFP 2019.07.03-APS Cover Letter July 3, 2019 Re: Proposed Contract Funding for the CDBG — Disaster Recovery Fund through GLO Community Development & Revitalization Dear Administrative Service Providers: Attached is a copy of the County of Calhoun's Request for Proposals (RFP) for application and administrative services. These services are being solicited to assist the County of Calhoun in its application and administration of a contract, if awarded, from the CDBG — Disaster Recovery Fund of the General Land Office (GLO) Community Development Block Grant Program. The County of Calhoun is considering applying for such funding to support Infrastructure activities in the County of Calhoun. Firms may submit proposals for any or all activities. Multiple contracts may be awarded as a result of this solicitation. The County will, in its sole discretion, determine the number of contracts awarded, and may decide not to award any contracts. The submission requirements for this proposal are also included on the attached RFP. Firms andlor individuals should have past experience with federally funded programs. Please submit a sealed proposal of services and statement of qualifications to: Honorable Richard H. Meyer Calhoun County Judge Calhoun County Courthouse 211 S. Ann St., Ste. 301 Port Lavaca, TX 77979 Along with your proposal, you must also include the following: • Cost of Services: Infrastructure NOTE: Updated to say "Amount" of Profit instead of °Percentage" • Certification Regarding Lobbying • Disclosure of Lobbying Activities • Verification that your company as well as the company's principal(s) is not listed (is not debarred) through the System for Award Management (www.SAM.gov). Please include a print out of the search results. • Affidavit • Form 1295 (Certificate of Interested Parties) • Form CIQ (Conflict of Interest Questionnaire) . W_9 The deadline for submission of sealed proposals is Wednesday, July 24, 2019 at 2:00 PM. It is the responsibility of the submitting entity to ensure that the proposal is received in a timely manner. Proposals received after the deadline will not be considered for award, regardless of whether or not the delay was outside of the control of the submitting firm. The RFP will be considered for award on Wednesday, July 31, 2019, The County of Calhoun reserves the right to negotiate with any and all persons or firms submitting proposals, per the Texas Professional Services Procurement Act and the Uniform Grant and Contract Management Standards. These services are being funded by the saster Recovery Fund of the General an Office (GLO) Community Development Block Grant Program. The County of Calhoun, Texas is an Affirmative Action/Equal Opportunity Employer. The County does not discriminate on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age or handicapped status in employment or the provision of services. Section 3 Residents, Minority Business Enterprises, Small Business Enterprises, Women Business Enterprises, and labor surplus area firms are encouraged to submit proposals. Sincerely, 0 �C�-C�X Peggy Hall Assistant County Auditor peggy,hall@calhouncotx.org 361-553-4610 RFP for Administration/Professional Services The County of Calhoun is seeking to enter into a services contract with a competent administration/management firm/professional service provider to assist the County in preparing an application for and in the overall management of its proposed CDBG-Disaster Recovery project, if funded by the Texas General Land Office Community Development & Revitalization (GLO). The following outlines the request for proposals. Scope of Work The professional administration/management firm/consultant to be hired is to provide application and contract -related management services to the County of Calhoun, including but not limited to the following areas: Pre -Funding Services* Grant Administrator will develop project scope and complete CDBG-DR application. The provider will work with the local government and Engineering, if applicable, to provide the concise information needed for submission of complete disaster recovery funding application and related documents. The required information shall be submitted in a format to be described by the GLO. Post -Funding Services Grant Administrator will administer and complete infrastructure, utilities, housing and eligible projects approved for disaster recovery funding. The selected administrative firm must follow all requirements of the Texas CDBG Disaster Recovery program. General Administration Services —General • Administrative Duties • Construction Management Grant Administration Services — Infrastructure • Administrative Duties • Acquisition Duties • Environmental Services Please specify actual tasks to be performed under each of these categories. *Pre -funding services are not eligible for CDBG-DR reimbursement and must be paid with local or other non-CDBG- DR funds. II. Statement of Qualifications The County of Calhoun is seeking to contract with a competent professional administrationlmanagement firm/consultant(s) experienced in grants/contracts application and administration. Specifically, it is seeking those consultant(s) or firm(s) with the following qualifications: • Related experience in applying for and managing federally -funded local public works construction projects —Infrastructure, with an emphasis on directly -related and recent experience; • Related Experience / Background with specific project type (CDBG-DR • Consultant/Firm is not debarred or suspended from the Excluded Parties List System (EPLS) in the System for Award Management (SAM). As such, please provide within your proposal a list of referrals from past local government clients, as well as the resumes of all employees who will or may be assigned to provide technical assistance to the county on this project if your firm is awarded this management services contract. III. Proposed Cost of Services Please provide your cost proposal to accomplish the scope of work by activity (Infrastructure) outlined above and for any additional services required. The final grant amount is yet to be determined and this award is contingent upon funding of the CDBG-DR grant with the Texas General Land Office. The proposal IV. V. must include all costs that are necessary to successfully complete these activities. Firms may submit proposals for any or all activities. Please note that the lowest/best bid will not be used as the sole basis for entering into this contract. Profit (either % / actual cost) must be identified and negotiated as a separate element of the price of the contract. To comply, the bidder must disclose and certify in its proposal the amount of profit being used. "Cost plus percentage of cost" type proposals are prohibited. Evaluation Criteria The proposal received will be evaluated and ranked according to the following criteria: Criteria Experience Work Performance Capacity to Perform Proposed Cost Maximum Points 30 40 20 10 Totai 100 Contractino with small and minority businesses, women's business enterprises and labor surolus area firms. Small and minority businesses, women's business enterprises, and labor surplus area firms are encouraged to participate in this RFP. If the awarded vendor is a prime contractor and may use subcontractors, the following affirmative steps are required of the prime contractor. 1) Placing qualified small and minority businesses, and women's business enterprises on solicitation lists; 2) Assuring that small and minority businesses, and women's business enterprises are solicited whenever they are potential sources; 3) Dividing total requirements, when economically feasible, into smaller tasks or quantities to permit maximum participation by small and minority businesses, and women's business enterprises; 4) Establishing delivery schedules, where the requirement permits, which encourage participation by small and minority businesses, and women's business enterprises; 5) Using the services and assistance, as appropriate, of such organizations as the Small Business Administration and the Minority Business Development Agency of the Department of Commerce VI. Submission Requirements • Proposal • Cost of Services: Infrastructure -NOTE: Updated to say "Amount" of Profit instead of "Perceniage" • Certification Regarding Lobbying • Disclosure of Lobbying Activities • System for Award Management — Consultant/Firm, and its Principals, may not be debarred or suspended nor otherwise on the Excluded Parties List System (EPLS) in the System for Award Management (SAM), Include verification that the company as well as the company's principals are not listed (are not debarred) through the System for Award Management (w.A ,SAM.gov). Enclose a print out of the search results that includes the record date. • Affidavit • Form 1295 (Certificate of Interested Parties) — Must include when submitting your proposal. When completing and submitting online, there will be a Certificate Number and Date Filed in the box marked "Office Use Only — Certification of Filing". • Form CIQ (Conflict of Interest Questionnaire) — Every vendor doing business with the County or seeking to do business with the County must complete Box 1 and sign and date in Box 7. Whether or not a conflict exists determines the other information to include on the form. . W-9 VII. Deadline for Submission Proposals must be received in the County Judge's office no later than Wednesday, July 24, 2019 at 2:00 PM. It is the responsibility of the submitting entity to ensure that the proposal is received in a timely manner. Proposals received after the deadline will not be considered for award, regardless of whether or not the delay was outside the control of the submitting consultant/firm. Please submit one (1) original and four (4) hard copies to the following address: (If original is in color, please submit the copies in color and mark "Copy") Honorable Richard H. Meyer Calhoun County Judge Calhoun County Courthouse 211 S. Ann St., Ste, 301 Port Lavaca, TX 77979 The submittal must be delivered in a sealed 9 x 12 or larger envelope clearly marked on the outside - "RFP 2019.07.03.APS, CDBG-DR Grant Administration Services". The RFP will be considered for award on Wednesday, July 31, 2019. SCOPE OF WORK The Grant Administrator shall provide the following scope of services: SCOPE OF SERVICES REQUESTED Providers will help the GLO fulfill State and Federal Community Development Block Grant Disaster Recovery ("CDBG-DR") statutory responsibilities related to recovery in connection with any federally declared disaster. Providers will assist the GLO and/or grant recipients in completion of CDBG-DR qualified housing or non -housing projects. Respondents may be qualified to provide Grant Administration services for housing projects, non -housing projects, or both. Grant administrative services must be performed in compliance with the U.S. Department of Housing and Urban Development ("HUD") and guidelines issued by the GLO. DESCRIPTION OF SERVICES AND SPECIAL CONDITIONS Respondent must be able to perform the tasks listed herein to be considered eligible for an award under this Solicitation. Respondents should provide a detailed narrative of their experience as it relates to each of the items below. Respondents should clearly indicate if they intend to provide services in-house with existing staff or through subcontracting or partnership arrangements. Grant Administration Services will be provided in conformance with the guidance documents and use forms provided by the subrecipient utilizing GLO guidance. The providers shall furnish pre -funding and post -funding grant administrative services to complete the disaster recovery projects, including, but not limited to the following: Pre -Funding Services Grant Administrator will develop project scope and complete CDBG-DR application, if applicable. The provider will work with the subrecipient and Engineering, if applicable, to provide the concise information needed for submission of complete disaster recovery funding application and related documents. The required information shall be submitted in a format to be described by the GLO. Post -Funding Services Grant Administrator will administer and complete infrastructure, utilities, housing and eligible projects approved for disaster recovery funding. The selected administrative firm must follow all requirements of the Texas CDBG Disaster Recovery program. Grant Administration Services —General a) Administrative Duties: i. Coordinate, as necessary, between subrecipient and any other appropriate service providers (i.e. Engineer, Environmental, etc.), contractor, subcontractor and GLO to effectuate the services requested. ii. May assist in public hearings. iii. Will work with GLO's system of record. iv. Provide monthly project status updates. v. Funding release will be based on deliverables identified in the contract. vi. Labor and procurement duties: a. Provide all Labor Standards Officer (LSO) Services. b. Ensure compliance with all relevant labor standards regulations. c. Ensure compliance with procurement regulations and policies. d. Maintain document files to support compliance. vii. Financial duties: a. Prepare and submit all required reports (Section 3, Financial Interest, etc.). b. Assist subrecipient with the procurement of audit services. c. Assist subrecipient in establishing and maintaining a bank account for disaster recovery funds. d. Implementation and coordination of Affirmatively Furthering Fair Housing ("AFFH") requirements as directed by HUD and the GLO. e. Implementation and coordination of Section 504 requirements. f. Program compliance. g. Ensure that fraud prevention and abuse practices are in place and being implemented. h. Prepare and submit all closeout documents. i. Submit all invoices no later than 60 days after the expiration of the contract. All outstanding funds may be swept after 60 days. The provider may request an extension of this requirement in writing. j. Assist in preparation of contract revisions and supporting documents including but not limited to: • Amendments/modifications, • Change orders. b) Construction Management i. The provider will assist the subrecipient in submitting/setting up project applications in the GLO's system of record. ii. The provider may compile and collate complete contract/bid packages that meet GLO program requirements. The packages will contain supporting documentation that meets or exceeds the requirements of the GLO's program. If applications do not have the necessary forms, the provider may assist the subrecipient by coordinating to acquire the necessary documentation. iii. The provider may monitor, report, and evaluate contractor's performance; notify the subrecipient if the contractor(s) fails to meet established scheduled milestones. Receive, review, recommend, and process any change orders as appropriate to the individual projects. iv. The provider may assist the subrecipient with project Activity Draws/Close Out. v. The provider may assist the subrecipient by submitting all the necessary documentation for draws and to close a project activity in the GLO's system of record. The provider will compile, review for completeness, and collate complete contract/closeout packages that meet GLO program requirements for draw requests. If applications do not have the necessary forms, the provider may assist the subrecipient by coordinating to acquire the necessary documentation. vi. The provider may assist the subrecipient in developing Architectural and Engineering plans with guidance from the GLO. vii. Reassignment scope alignment (ifnecessary). Grant Administration Services —Infrastructure a) Administrative Duties: i. Ensure program compliance including all CDBG-DR requirements and all part's therein, current Federal Register, etc. ii. Assist subrecipient in establishing and maintaining financial processes. iii. Obtain and maintain copies of the subrecipient's most current contract including all related change requests, revisions and attachments. iv. Establish and maintain record keeping systems. v. Assist subrecipient with resolving monitoring and audit findings. vi. Serve as monitoring liaison. vii. Assist subrecipient with resolving third party claims. viii. Report suspected fraud to the GLO. ix. Submit timely responses to the GLO requests for additional information. x. Complete draw request forms and supporting documents. xi. Facilitate outreach efforts, application intake, and eligibility review. xii. Perform any other administrative duty required to deliver the project. xiii. Utilize and assist with GLO's system of record to complete milestones, submit documentation, reports, draws, change requests, etc. xiv. Submit change requests and all required documentation related to any change requests. b) Acquisition Duties: i. Submit acquisition reports and related documents. ii. Establish acquisition files (if necessary). iii. Complete acquisition activities (if necessary). c) Environmental Services i. Assist detailed scope of services a. Review each Review each project description to ascertain and/or verify the level of environmental review required: Exempt, Categorical Exclusion not Subject to 58.5, Categorical Exclusion Subject to 58.5, Environmental Assessment, and Environmental Impact Statements; b. Prepare, complete and submit HUD required forms for environmental review and provide all documentation to support environmental findings; c. Consult and coordinate with oversighttregulatory agencies to facilitate environmental clearance; d. Be able to perform or contract special studies, additional assessments, or permitting to secure environmental clearance. These may include, but are not limited to biological assessments, wetland delineations, asbestos surveys, lead - based paint assessments, archeology studies, architectural reviews, Phase I & II ESAs, USACE permits, etc.; e. Prepare all responses to comments received during comment phase of the environmental review, including State/Federal Agency requiring further studies and/or comments from public or private entities during public comment period; f. Maintain close coordination with local officials, project engineer and other members of the project team to assure appropriate level of environmental review is performed and no work is conducted without authorization; g. Complete and submit the environmental review into GLO's system of record; h. At least one site visit to project location and completion of a field observation report i. Prepare and submit for publication all public notices including, but not limited to the Notice of Finding of No Significant Impact (FONSI), Request for Release of Funds floodplain/wetland early and final notices in required order and sequence; j. Provide documentation of clearance for Parties Known to be Interested as required by 24 CFR 58.43; k. Process environmental review and clearance in accordance with NEPA; 1. Advise and complete environmental re-evaluations per 24 CFR 58.47 when evidence of further clearance or assessment is required; m. Prepare and submit Monthly Status Report; and n. Participate in regularly scheduled progress meetings. ADMINISTRATION/PROFESSIONAL SERVICES RATING SHEET How proposals will be rated Administration/Professional Services Rating Sheet Grant Recipient CDBG-DR Name of Respondent Date of Rating Evaluator's Name Experience +- Rate the Respondent of the Request For Proposal (RFP) by: awarding;points.up to. the maximum listed for each factor.:,Information necessary to assess the Respondent on these criteria may be gathered either from.past'experience with; the Respondent and/or by contacting past/current clients of the Respondent. -. Experience Factors 1. Related Experience / Background with federally funded projects 2. Related Experience / Background with specific project type (housing rehabilitation, acquisition of property, coordination with regulatory agency, etc.) 3. References from current/past clients 4. Familiarity of County and Demographics Subtotal, Experience Work Performance Factors 1. Submits requests to client/GLO in a timely manner 2. Responds to client/GLO requests in a timely manner 3. Past client/GLO projects completed on schedule 4. Work product is consistently of high quality with low level of errors 5. Past client/GLO projects have low level of monitoring findings/concerns 6. Manages projects within budgetary constraints Subtotal, Performance Capacity to Perform Factors 1. Qualifications of Professional Administrators / Experience of Staff 2. Present and Projected Workloads 3. Quality of ProposaIANork Plan 4. Demonstrated understanding of scope of the CDBG-DR Project Subtotal, Capacity to Perform Max.Pts. Score 10 10 5 5 30 Max.Pts. Score 5 5 10 5 10 5 40 Max.Pts. 5 5 5 5 20 Proposed Cost Factors Max.Pts. Proposed cost within GLO-CDR project delivery and administration 10 fee caps. 10 TOTAL SCORE Factors Max,Pts, ❑ Experience 30 ❑ Work Performance 40 ❑ Capacity to Perform 20 ❑ Proposed Cost 10 Total Score 100 Score Score Score Required RFP Forms • Proposal • Cost of Services: Infrastructure Note: Updated to say "Amount' of Profit instead of "Percentage" • Certification Regarding lobbying • Disclosure of Lobbying Activities • Verification that your company as well as the company's principal is not listed (is not debarred) through the System for Award Management (www.SAM.gov) • Affidavit • Form 1295 (Certificate of Interested Parties) • Form CIQ (Conflict of Interest Questionnaire) Insert Proposal Cost of Services: Infrastructure Please indicate No Cost Proposal if your firm is not proposing for the services specified on this Cost of Services page. Maximum amount of grant funds firm is able and/or willing to manage: INFRASTRUCTURE Potential Grant -Award Cost of Services - Amount of Profit Amount; , (maximum)' $1 million $5 million $10 million $50 million $100 million $250 million Hourly Rates �: Work Glassiflcabon � � Hourly'Rate Certification Regarding Lobbying (To be submitted with each bid or offer exceeding $100,000) The undersigned certifies, to the best of his or her knowledge and belief, that: (a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (b) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer.or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (c) The undersigned shall require that the language paragraph 1 and 2 of this anti -lobbying certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31, U.S.C. § 1352 (as amended by the Lobbying Disclosure Act of 1995). The Contractor, , certifies or affirms the truthfulness and accuracy of each statement of its certification and disclosure, if any. In addition, the Contractor understands and agrees that the provisions of 31 U.S.C. § 3801 et seq., apply to this certification and disclosure, if any. Signature of Contractor's Authorized Official Printed Name and Title of Contractor's Authorized Official INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352, The filing of a form is required for each payment or agreement to make payment to any lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with a covered Federal action. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in item 4 checks "Subawardee," then enter the full name, address, city, State and zip code of the prime Federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action (item 1), If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for Proposal (RFP) number; Invitations for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number assigned by the Federal agency). Included prefixes, e.g., "RFP-DE-90-001 " 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the awardAoan commitment for the prime entity identified in item 4 or 5. 10, (a) Enter the full name, address, city, State and zip code of the lobbying registrant under the Lobbying Disclosure Act of 1995 engaged by the reporting entity identified in item 4 to influence the covered Federal action. (b) Enter the full names of the individual(s) performing services, and Include full address if different from 10(a). Enter Last Name, First Name, and Middle Initial (MI). 11, The certifying official shall sign and date the form, print his/her name, title, and telephone number. According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid OMB control Number. The valid OMB control number for this information collection is OMB No. 0348-0046. Public reporting burden for this collection of information is estimated to average 10 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, DC 20503 Approved by OMB 0348-0046 Disclosure of Lobbying Activities Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 (See reverse for public burden disclosure) Type of Federal Action: Status of Federal Action: Report Type: a. contract a, bid/offer/application a, initial filing _ b, grant b, initial award b. material change c, cooperative agreement c. post -award d, loan e. loan guarantee f, loan insurance Name and Address of Reporting Entity: If Reporting Entity in No. A is Subawardee, Enter _ Prime _ Subawardee Name and Address of Prime: Tier , if Known: Congressional District if known: Congressional District if known: Federal DepartmentfAgency: 7. Federal Program Name/Description: CFDA Number, if applicable: Federal Action Number, ffknown: 9. Award Amount, if known: 10. a. Name and Address of Lobbying Registrant b. Individuals Performing Services (including (if Individual, last name, first name, MQ: address if different from No. 10a) (last name, first name, MI): It. information requested through this form is authorized by title 31 U.S.C. section 1362. This Signature: disclosure of lobbying activities is a material representation of fact upon which reliance was placed Print Name: by the tier above when this transaction was made or _ entered into. This disclosure Is required pursuant to 31 T1Uas U.S.C.1352. This information will be reported to the — Congress semi-annually and will be available for public Telephone No.: Date: inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Federal 'Use Only.. Authorized for Local Reproduction Standard Form - LLL (Rev. 747) Insert System forAward Management (SAM) Record Search for company and company principal(s) STATE OF TEXAS {} AFFIDAVIT COUNTY OF CALHOUN {} 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 Proposer in the matter of the proposal to which this affidavit is attached, and I have full knowledge of the relations of the Proposer with the other firms in this same line of business, and the Proposer is not a member of any trust, pool or combination to control the price of the services in this proposal, or to influence any person to submit a proposal or not to submit a proposal thereon. I further affirm that the Proposer 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 proposal. 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 day of 20_ Notary Public in and for County, Texas Proposer Signed By Title Address Phone Number Fax Number Email Address NOTE: PROPOSALS NOT ACCOMPANIED BY THIS AFFIDAVIT WILL NOT BE CONSIDERED The County of Calhoun, Texas is an Affirmative Action/Equal Opportunity Employer, The County does not discriminate on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age or handicapped status in employment or the provision of services. Section 3 Residents, Minority Business Enterprises, Small Business Enterprises, Women Business Enterprises, and labor surplus area firms are encouraged to submit proposals CERTIFICATE OF INTERESTED PARTIES FORM 1295 OFFICE USE ONLY Complete Nos. 1 - 4 and 6 if there are interested parties. Complete Nos. 1, 2, 31 5, and 6 if there are no interested parties. nn•• ♦`�(,J �I 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. J. 3 Provide the identification number used by the governmental entity or state agency to tKkQ identify the contract, and provide a description of the services, goods, or other property to be provided upcib(t a contract. V 4 City, State, Country ature of Interest (check applicable) Name of Interested Party (place of business) A Controlling Intermediary 5 ❑Check only if thereel terested Party. 6 UNSWORN DE[Ci-tlJ► N My name is �c`` , and my date of birth is My addre� , � (street) (City) (state) (zip code) (country) �LddCil rider penalty of perjury that the foregoing is We and coned. Executed in County, State of , on the day of , 20 (month) (year) Signature of authorized agent of contracting business entity (Declarant) ADD ADDITIONAL PAGES AS NECESSARY Form provided by Texas Ethics Commission www.athics.state.tx.us Revised 12122/2017 CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ For vendor doing business with local governmental entity This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session, OFFICELISEONLY This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who Date Received has a business relationship as defined by Section 176.001(1-a) with a local governmental entity and the vendor meets requirements under Section 176.006(a). By law this questionnaire must be filed with the records administrator of the local governmental entity not later than the 7th business day after the date the vendor becomes aware of facts that require the statement to be filed. See Section 176.006(a-1), Local Government Code. A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code. An offense under this section is a misdemeanor. 1 Name of vendor who has a business relationship with local governmental entity. 2 ❑Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business day after the date on which you became aware that the originally filed questionnaire was incomplete or inaccurate.) 3 Name of local government officer about whom the information is being disclosed. Name of Officer 4 Describe each employment or other business relationship with the local government officer, or a family member of the officer, as described by Section 176.003(a)(2)(A). Also describe any family relationship with the local government officer. Complete subparts Aand B for each employment or business relationship described. Attach additional pages to this Form CIO as necessary. - A. Is the local government officer or a family member of the officer receiving or likely to receive taxable income, other than investment income, from the vendor? ElYes 0No B. Is the vendor receiving or likely to receive taxable income, other than investment income, from or at the direction of the local government officer or a family member of the officer AND the taxable income is not received from the local governmental entity? El Yes 0 No 6 Describe each employment or business relationship that the vendor named in Section 1 maintains with a corporation or other business entity with respect to which the local government officer serves as an officer or director, or holds an ownership interest of one percent or more. 6 this box if the vendor has given the local government officer or a family member of the officer one or more gifts ❑Check as described in Section 176.003(a)(2)(B), excluding gifts described in Section 176.003(a-1). 7 Signature of vendor doing business with the governmental entity Date Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 11/30/2016 CONFLICT OF INTEREST QUESTIONNAIRE For vendor doing business with local governmental entity A complete copy of Chapter 176 of the Local Government Code maybe found at httpl/www.statutes,legis.state.tx,us/ Docs/LG/htm/LG.176.htm. For easy reference, below are some of the sections cited on this form. Local Government Code 5176.001(1Mel: "Business relationship" means a connection between two or more parties based on commercial activity of one of the parties. The term does not include a connection based on: (A) a transaction that is subject to rate or fee regulation by a federal, state, or local governmental entity or an agency of a federal, state, or local governmental entity; (B) a transaction conducted at a price and subject to terms available to the public; or (C) a purchase or lease of goods or services from a person that is chartered by a state or federal agency and that is subject to regular examination by, and reporting to, that agency. Local Government Code 4176.003(a)(2)(A)and (B): (a) A local government officer shall file a conflicts disclosure statement with respect to a vendor if: (2) the vendor: (A) has an employment or other business relationship with the local government officer or a family member of the officer that results in the officer or family member receiving taxable income, other than Investment income, that exceeds $2,500 during the 12-month period preceding the date that the officer becomes aware that (I) a contract between the local governmental entity and vendor has been executed; or (it) the local governmental entity is considering entering into a contract with the vendor; (B) has given to the local government officer or a family member of the officer one or more gifts that have an aggregate value of more than $100 in the 12-month period preceding the date the officer becomes aware that: (1) a contract between the local governmental entity and vendor has been executed; or (ii) the local governmental entity is considering entering into a contract with the vendor. Locat Government Code 5176.006(a) and (a-1) (a) Avendor shall file a completed conflict of interest questionnaire If the vendor has a business relationship with a local governmental entity and: (1) has an employment or other business relationship with a local government officer of that local governmental entity, or a family member of the officer, described by Section 176.003(a)(2)(A); (2) has given a local government officer of that local governmental entity, or a family member of the officer, one or more gifts with the aggregate value specified by Section 176.003(a)(2)(B), excluding any gift described by Section 176.003(aA); or (3) has a family relationship with a local government officer of that local governmental entity. (a-1) The completed conflict of interest questionnaire must be filed with the appropriate records administrator not later than the seventh business day after the later of: (1) the date that the vendor: (A) begins discussions or negotiations to enter into a contract with the local governmental entity; or (B) submits to the local governmental entity an application, response to a request for proposals or bids, correspondence, or another writing related to a potential contract with the local governmental entity; or (2) the date the vendor becomes aware: (A) of an employment or other business relationship with a local government officer, or a family member of the officer, described by Subsection (a); (B) that the vendor has given one or more gifts described by Subsection (a); or (C) of a family relationship with a local government officer. Form provided by Texas Ethics Commission www.ethtcs,state.tx.us Revised 11/30/2015 W-9 Request for Taxpayer Give Form to the Fonn Identification Number and Certification requester. Do not (Rev. October 2018) Department of the Treasury send to the IRS. Internal nevenue service ► Go to www.irs gov1FonnW9 for instructions and the latest information. t Name (as shown on your Income tax return). Name is required on this line; do not leave this One blank. 2 Business nameMsmilarded entity name, it different from above w m 3 Check appropriate box for federal lax classification of the person whose name is entered on line 1. Check only one of the 4 Exemptions (wand apply only to following seven boxes. certain entities, rat individuals; see Q. instructions on page 3): o [IIndivlduaysole proprietor or El C Corporation ❑SCorporation ❑ Partnership ❑Trusgesiate c sinfll •member LLC Exempt payee code (if any) ai ❑Limited liability company. Enter the tax classification (C--C corporation, S=S corporation, P=Partnership) ► o 2 Note: Check the appropriate box In the line above forthe taxdassificagon of the single -member owner. Do not check Exemption from FATCA reporting c m LLC if the LLC Is classified as a single -member LLC that Is disregarded from the owner unless the owner of the LLC Is code rf t = another LLC that Is not disregarded from the ownerfor U.S. federal tax purposes. Otherwise, a single -member LLC that a o Is disregarded from the owner should check the appropriate box for the fax classification of its owner. d❑ Other(see lnstruc0ons)► fPpPrPim°C°1i°nieNhevdvr ieivV'� as S Address (number, street, and apt orsuite no.) See Instructions. Rem:} Address Requester's name and address (optional) m m 8 City, state, and ZIP code ' 7 List account numbet(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 backup withholding. For individuals, this is generally your social security number va Np 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 Now to get a 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. �-�rtanr..:-�nrr. rnrra:ra 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a numberto be issued tome); and 2. I am not subject to backup withholtling because: (a) I am exempt from backup withholding, or N) 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 hotified me that 1 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 (d any) Indicating that I sm_exempt from FATCA reporting is correct. Certification i astructlons. You must cross out Rem 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 reel 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 ammilement 0". 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 II, later. Signature of U.S person► General Instructions Sec0on references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Forth W-9 and its Instructions, such as legislation enacted after they were published, go to www.irs.gov1Fom)1N9. 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 (M) which may be your social security number (SSN), Individual taxpayer identification number (MM, 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 pald) • Form 1099-DN (dMdends, Including those from stocks or mutual tunas).. ......... . • F )rm 1099-MISC (various types of Income, prizes, awards, or grew progeads) • Form 1099-B (stock or mutual fund sales and certain other Transactions by brokers) • Farm 109" (proceeds from real estate transactions) • Fonn 1099-K (merchant card and third party network transactions) • Fonn 1098 (home mortgage interest),1098-E (student loan Interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Fomn 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. ll you do not retum Form W-9to the requester With a TIN, you might be subject to backup withholding. See What Is backup withholding, later. Cat. Nit. 10231X Form W-9 (Rev. 10.2018) Required Contract Provisions REQUIRED CONTRACT PROVISIONS 2 CFR 200,326 Contract provisions. The non -Federal entity's contracts must contain the applicable provisions described in Appendix II to Part 200—Contract Provisions for non -Federal Entity Contracts Under Federal Awards. The non -Federal entity's contracts must contain the applicable provisions described in Appendix II to Part 200—Contract Provisions for non -Federal Entity Contracts Under Federal Awards. Ail Contracts THRESHOLD PROVISION CITATION Contracts for more than the simplified acquisition threshold currently set at >$150,000 $150,000, which is the inflation adjusted amount determined by the Civilian 2 CFR 200 (Simplified Agency Acquisition Council and the Defense Acquisition Regulations Council APPENDIX II Acquisition (Councils) as authorized by 41 U.S.C. 1908, must address administrative, (A) Threshold) contractual, or legal remedies in instances where contractors violate or breach contract terms, and provide for such sanctions and penalties as appropriate, All contracts in excess of $10,000 must address termination for cause and for 2 CFR 200 410,000 convenience by the non -Federal entity including the manner by which it will be APPENDIX II effected and the basis for settlement. (B) Rights to Inventions Made Under a Contract or Agreement. If the Federal award meets the definition of 'funding agreement" under 37 CFR §401.2 (a) and the recipient or subrecipient wishes to enter into a contract with a small business firm or nonprofit organization regarding the substitution of parties, assignment or 2 CFR 200 None performance of experimental, developmental, or research work under that "funding APPENDIX II (F) agreement," the recipient or subrecipient must comply with the requirements of 37 CFR Part 401, "Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements," and any implementing regulations issued by the awarding agency. Debarment and Suspension (Executive Orders 12549 and 12689�—A contract award (see 2 CFR 180,220) must not be made to parties listed on the government- wide exclusions in the System for Award Management (SAM), in accordance with 2 CFR 200 the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR APPENDIX II None part 1986 Comp., p. 189) and 12689 (3 CFR part 1989 Comp., p. 2235), "Debarment (H) and Suspension." SAM Exclusions contains the names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549, Records of non -Federal entities. The U.S. Department of Housing and Urban Development (HUD), Inspectors General, the Comptroller General of the United States, the Texas General Land Office (GLO), and the pass -through entity, or any of their authorized representatives, must have the right of access to any None documents, papers, or other records of the non -Federal entity which are 2 CFR 200.336 pertinent to the Federal award, in order to make audits, examinations, excerpts, and transcripts. The right also includes timely and reasonable access to the non -Federal entity's personnel for the purpose of interview and discussion related to such documents. Financial records, supporting documents, statistical records, and all other non - Federal entity records pertinent to a Federal award must be retained for a period of three years from the date of submission of the final expenditure report or, for Federal awards that are renewed quarterly or annually, from the date of the None submission of the quarterly or annual financial report, respectively, as reported to 2 CFR 200.333 the Federal awarding agency or pass -through entity in the case of a subrecipient. Federal awarding agencies and pass -through entities must not impose any other record retention requirements upon non -Federal entities. The only exceptions are the following: (a) If any litigation, claim, or audit is started before the expiration of the 3-year period, the records must be retained until all litigation, claims, or audit findings involving the records have been resolved and final action taken. (b) When the non -Federal entity is notified in writing by the Federal awarding agency, cognizant agency for audit, oversight agency for audit, cognizant agency for indirect costs, or pass -through entity to extend the retention period. (c) Records for real property and equipment acquired with Federal funds must be retained for 3 years after final disposition. (d) When records are transferred to or maintained by the Federal awarding agency or pass -through entity, the 3-year retention requirement is not applicable to the non -Federal entity. (a) Records for program income transactions after the period of performance. In some cases recipients must report program income after the period of performance. Where there is such a requirement, the retention period for the records pertaining to the earning of the program income starts from the end of the non -Federal entity's fiscal year in which the program income is earned. (f) Indirect cost rate proposals and cost allocations plans. This paragraph applies to the following types of documents and their supporting records: indirect cost rate computations or proposals, cost allocation plans, and any similar accounting computations of the rate at which a particular group of costs is chargeable (such as computer usage chargeback rates or composite fringe benefit rates). (1) If submitted for negotiation. If the proposal, plan, or other computation is required to be submitted to the Federal Government (or to the pass -through entity) to form the basis for negotiation of the rate, then the 3-year retention period for its supporting records starts from the date of such submission. (2) If not submitted for negotiation. If the proposal, plan, or other computation is not required to be submitted to the Federal Government (or to the pass -through entity) for negotiation purposes, then the 3-year retention period for the proposal, plan, or computation and its supporting records starts from the end of the fiscal year (or other accounting period) covered by the proposal, plan, or other computation. Contracting with small and minority businesses, women's business enterprises, and labor surplus area firms. (a) The non -Federal entity must take all necessary affirmative steps to assure that minority businesses, women's business enterprises, and labor surplus area firms are used when possible. (b) Affirmative steps must include: None (1) Placing qualified small and minority businesses and women's business ( 2 CFR 200.321 enterprises on solicitation lists; (2) Assuring that small and minority businesses, and women's business enterprises are solicited whenever they are potential sources; (3) Dividing total requirements, when economically feasible, into smaller tasks or quantities to permit maximum participation by small and minority businesses, and women'a business enterprises; (4) Establishing delivery schedules, where the requirement permits, which encourage participation by small and minority businesses, and women's business enterprises; (5) Using the services and assistance, as appropriate, of such organizations as the Small Business Administration and the Minority Business Development Agency of the Department of Commerce; and (6) Requiring the prime contractor, if subcontracts are to be let, to take the affirmative steps listed in paragraphs (1) through (5) of this section. Verification No Boycott Israel. As required by Chapter 2270, Government Code, CONTRACTOR hereby verifies that it does not boycott Israel and will not boycott Israel through the tens of this Agreement. For purposes of this verification, "boycott Israel" Texas None means refusing to deal with, terminating business activities with, or otherwise taking Government any action that is intended to penalize, inflict economic harm on, or limit commercial Code 2270,002 relations specifically with Israel, or with a person or entity doing business in Israel or in an Israeli -controlled territory, but does not include an action made for ordinary business purposes. Foreign Terrorist Organizations. Pursuant to Chapter 2252, Texas Government Code, [Company] represents and certifies that, at the time of execution of this Agreement neither [Company], nor any wholly owned subsidiary, majority -owned subsidiary, parent company or affiliate of the same (i) engages in business with Iran, Sudan, or Texas any foreign terrorist organization as described in Chapters 806 or 807 of the Texas Government None Government Code, or Subchapter F of Chapter 2252 of the Texas Government Code, Code 2252.152 or (ii) is a company listed by the Texas Comptroller of Public Accounts under Sections 806.0511 807.051, or 2252.153 of the Texas Government Code. The term "foreign terrorist organization" in this paragraph has the meaning assigned to such term in Section 2252.151 of the Texas Government Code, Option Contract Language for The contract award is contingent upon the receipt of CDBG-DR funds. If no such Optional contracts funds are awarded, the contract shall terminate. awarded prior to Grant Award EO Clause for Construction Contracts > $10K including administration & engineering contracts associated with construction contracts THRESHOLD PROVISION CITATION Equal Employment Opportunity. Except as otherwise provided under 41 CFR Part 60, all contracts that meet the definition of "federally assisted construction contract" in 41 CFR Part 60-1.3 must include the equal opportunity clause provided under 41 CFR 60-1.4(b), in accordance with Executive Order 11246, 41 CFR §60- >$101000 "Equal Employment Opportunity" (30 FR 123192 12935, 3 CFR Part, 1964A965 1.4(b) and Comp., p. 339), as amended by Executive Order 11375, "Amending Executive 2 CFR 200 Order 11246 Relating to Equal Employment Opportunity," and implementing APPENDIX II (C) regulations at 41 CFR part 60, "Office of Federal Contract Compliance Programs, Equal Employment Opportunity, Department of Labor." 41 CFR 601.4 Equal opportunity clause. (b) Federally assisted construction contracts. (1) Except as otherwise provided, each administering agency shall require the inclusion of the following language as a condition of any grant, contract, loan, insurance, or guarantee involving federally assisted construction which is not exempt from the requirements of the equal opportunity clause: The applicant hereby agrees that it will incorporate or cause to be incorporated into any contract for construction work, or modification thereof, as defined in the regulations of the Secretary of Labor at 41 CFR Chapter 60, which is paid for in whole or in part with funds obtained from the Federal Government or borrowed on the credit of the Federal Government pursuant to a grant, contract, loan, insurance, or guarantee, or undertaken pursuant to any Federal program involving such grant, contract, loan, insurance, or guarantee, the following equal opportunity clause: During the performance of this contract, the contractor agrees as follows: (1) The contractor will not discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, or national origin. The contractor will take affirmative action to ensure that applicants are employed, and that employees are treated during employment without regard to their race, color, religion, sex, sexual orientation, gender identity, or national origin. Such action shall include, but not be limited to the following: Employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided setting forth the provisions of this nondiscrimination clause. (2) The contractor will, in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin. (3) The contractor will not discharge or in any other manner discriminate against any employee or applicant for employment because such employee or applicant has Inquired about, discussed, or disclosed the compensation of the employee or applicant or another employee or applicant. This provision shall not apply to instances in which an employee who has access to the compensation information of other employees or applicants as a part of such employee's essential job functions discloses the compensation of such other employees or individuals who do not otherwise have access to such information, unless such disclosure is in response to a formal complaint or charge, in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or is consistent with the contractor's legal duty to furnish information. (4) The contractor will send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or understanding, a notice to be provided advising the said labor union or workers' representatives of the contractor's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. (5) The contractor will comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor. (3) The contractor will furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules, regulations, and orders. (7) In the event of the contractor's noncompliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, this contract may be canceled, terminated, or suspended in whole or in part and the contractor may be declared ineligible for further Government contracts or federally assisted construction contracts in accordance with procedures authorized in Executive Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulation, or order of the Secretary of Labor, or as otherwise provided by law. (8) The contractor will include the portion of the sentence immediately preceding paragraph (1) and the provisions of paragraphs (1) through (8) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontractor or vendor. The contractor will take such action with respect to any subcontract or purchase order as the administering agency may direct as a means of enforcing such provisions, including sanctions for noncompliance: Provided, however, that in the event a contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency, the contractor may request the United States to enter into such litigation to protect the interests of the United States. The applicant further agrees that it will be bound by the above equal opportunity clause with respect to its own employment practices when it participates in federally assisted construction work: Provided, that if the applicant so participating is a State or local government, the above equal opportunity clause is not applicable to any agency, instrumentality or subdivision of such government which does not participate in work on or under the contract. The applicant agrees that it will assist and cooperate actively with the administering agency and the Secretary of Labor in obtaining the compliance of regulations, and relevant orders of the Secretary of Labor, that it will furnish the administering agency and the Secretary of Labor such information as they may require for the supervision of such compliance, and that it will otherwise assist the administering agency in the discharge of the agency's primary responsibility for securing compliance. The applicant further agrees that it will refrain from entering into any contract or contract modification subject to Executive Order 11246 of September 24, 1965, with a contractor debarred from, or who has not demonstrated eligibility for, Government contracts and federally assisted construction contracts pursuant to the Executive Order and will carry out such sanctions and penalties for violation of the equal opportunity clause as may be imposed upon contractors and subcontractors by the administering agency or the Secretary of Labor pursuant to Part II, Subpart D of the Executive Order. In addition, the applicant agrees that if it fails or refuses to comply with these undertakings, the administering agency may take any or all of the following actions: Cancel, terminate, or suspend in whole or in part this grant (contract, loan, insurance, guarantee); refrain from extending any further assistance to the applicant under the program with respect to which the failure or refund occurred until satisfactory assurance of future compliance has been received from such applicant; and refer the case to the Department of Justice for appropriate legal proceedings. (c) Subcontracts. Each nonexempt prime contractor or subcontractor shall include the equal opportunity clause in each of its nonexempt subcontracts. (d) Inclusion of the equal opportunity clause by reference. The equal opportunity clause may be included by reference in all Government contracts and subcontracts, including Government bills of lading, transportation requests, contracts for deposit of Government funds, and contracts for issuing and paying U.S. savings bonds and notes, and such other contracts and subcontracts as the Director of OFCCP may designate. (a) Incorporation by operation of the order. By operation of the order, the equal opportunity clause shall be considered to be a part of every contract and subcontract required by the order and the regulations in this part to include such a clause whether or not it is physically incorporated in such contracts and whether or not the contract between the agency and the contractor is written. (f)Adaptation of language. Such necessary changes in language may be made in the equal opportunity clause as shall be appropriate to identify properly the parties and their undertakings. THRESHOLD PROVISION CITATION Compliance with the Davis -Bacon Act (40 U.S.C. 3141 at seq.) as supplemented by Department of Labor regulations (29 CFR part 5) and with the Copeland 'Anti-Kickback"Act (18 U.S.C. 874; 40 U.S.C. 3145) as supplemented in Department of Labor regulations (29 CFR part 3): Davis -Bacon Act, as amended (40 U.S.C. 3141-3148). When required by Federal program legislation, all prime construction contracts in excess of $2,000 awarded by non -Federal entities must include a provision for compliance with the Davis -Bacon Act (40 U.S.C. 3141-3144, and 3146-3148) as supplemented by Department of Labor regulations (29 CFR Part 5, "Labor Standards Provisions Applicable to Contracts Covering Federally Financed and Assisted Construction"). In accordance with the statute, contractors must be required to pay wages to laborers and mechanics at a rate not less than the prevailing >$29000 wages specified in a wage determination made by the Secretary of Labor. In 2 CFR 200 addition, contractors must be required to pay wages not less than once a week. APPENDIX II (D) The non -Federal entity must place a copy of the current prevailing wage determination issued by the Department of Labor in each solicitation. The decision to award a contract or subcontract must be conditioned upon the acceptance of the wage determination. The non -Federal entity must report all suspected or reported violations to the Federal awarding agency. The contracts must also include a provision for compliance with the Copeland "Anti -Kickback" Act (40 U.S.C. 3145)3 as supplemented by Department of Labor regulations (29 CFR Part 3, "Contractors and Subcontractors on Public Building or Public Work Financed in Whole or in Part by Loans or Grants from the United States"). The Act provides that each contractor or subrecipient must be prohibited from inducing, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he or she is otherwise entitled. The non -Federal entity must report all suspected or reported violations to the Federal awarding agency. Contract Work Hours and Safety Standards Act (40 U.S.C. 3701-3708). Where applicable, all contracts awarded by the non -Federal entity in excess of $100,000 that involve the employment of mechanics or laborers must include a provision for compliance with 40 U.S.C. 3702 and 3704, as supplemented by Department of Labor regulations (29 CFR Part 5). Under 40 U.S.C. 3702 of the Act, each contractor must be required to compute the wages of every mechanic and laborer on the basis of a standard work week of 40 hours. Work in excess of the standard >$1001000 work week is permissible provided that the worker is compensated at a rate of not 2 CFR 200 less than one and a half times the basic rate of pay for all hours worked in excess APPENDIX 11 (E) of 40 hours in the work week. The requirements of 40 U.S.C. 3704 are applicable to construction work and provide that no laborer or mechanic must be required to work in surroundings or under working conditions which are unsanitary, hazardous or dangerous. These requirements do not apply to the purchases of supplies or materials or articles ordinarily available on the open market, or contracts for transportation or transmission of intelli ence. Clean Air Act (42 U.S.C. 7401-7671 q.) and the Federal Water Pollution Control Act (33 U.S.C. 1251-1387), as amended —Contracts and subgrants of amounts in excess of $150,000 must contain a provision that requires the non -Federal award to agree to comply with all applicable standards, orders or regulations 2 CFR 200 >$1501000 Issued pursuant to the Clean Air Act (42 U.S.C. 74014671q) and the Federal APPENDIX 11 (G) Water Pollution Control Act as amended (33 U.S.C. 1251-1387), Violations must be reported to the Federal awarding agency and the Regional Office of the Environmental Protection Agency (EPA), Byrd Anti -Lobbying Amendment (31 U.S.C. 1352)—Contractors that apply or bid 2 CFR 200 for an award exceeding $100,000 must file the required certification. Each tier APPENDIX 11 (1) >$100,000 certifies to the tier above that it will not and has not used Federal appropriated and funds to pay any person or organization for Influencing or attempting to influence 24 CFR an officer or employee of any agency, a member of Congress, officer or §570,303 employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal contract, grant or any other award covered by 31 U.S.C. 1352, Each tier must also disclose any lobbying with non -Federal funds that takes place in connection with obtaining any Federal award. Such disclosures are forwarded from tier to tier up to the non -Federal award, All Section 3 covered contracts shall include the following clause (referred to as the Section 3 clause): A. The work to be performed under this contract is subject to the requirements of Section 3 of the Housing and Urban Development Act of 1968, as amended, 12 U.S.C. 1701u (Section 3), The purpose of Section 3 is to ensure that employment and other economic opportunities generated by HUD assistance or HUD -assisted projects covered by Section 3, shall, to the greatest extent feasible, be directed to low- and very low-income persons, particularly persons who are recipients of HUD assistance for housing. B. The parties to this contract agree to comply with HUD's regulations in 24 CFR part 135, which implement Section 31 As evidenced by their execution of this contract, the parties to this contract certify that they are under no contractual or other impediment that would prevent them from complying with the part 135 regulations. C. The contractor agrees to send to each labor organization or representative of workers with which the contractor has a collective bargaining agreement or other understanding, if any, a notice advising the labor organization or workers' representative of the contractor's commitments under this Section 3 clause, and will post copies of the notice in conspicuous places at the work site where both employees and applicants for training and employment positions can see the notice. The notice shall describe the Section 3 preference, shall set forth minimum number and job titles subject to hire, availability of apprenticeship and >$1007000 training positions, the qualifications for each; and the name and location of the 24 CFR §135,38 person(s) taking applications for each of the positions; and the anticipated date the work shall begin. D, The contractor agrees to include this Section 3 clause in every subcontract subject to compliance with regulations in 24 CFR part 135, and agrees to take appropriate action, as provided in an applicable provision of the subcontract or in this Section 3 clause, upon a finding that the subcontractor is in violation of the regulations in 24 CFR part 135, The contractor will not subcontract with any subcontractor where the contractor has notice or knowledge that the subcontractor has been found in violation of the regulations in 24 CFR part 135. E. The contractor will certify that any vacant employment positions, including training positions, that are filled (1) after the contractor is selected but before the contract is executed, and (2) with persons other than those to whom the regulations of 24 CFR part 135 require employment opportunities to be directed, were not filled to circumvent the contractor's obligations under 24 CFR part 135, F. Noncompliance with HUD's regulations in 24 CFR part 135 may result in sanctions, termination of this contract for default, and debarment or suspension from future HUD assisted contracts. G. With respect to work performed in connection with Section 3 covered Indian housing assistance, section 7(b) of the Indian Self -Determination and Education Assistance Act (25 U.S.C. 450e) also applies to the work to be performed under this contract. Section 7(b) requires that to the greatest extent feasible (i) preference and opportunities for training and employment shall be given to Indians, and (ii) preference in the award of contracts and subcontracts shall be given to Indian organizations and Indian -owned Economic Enterprises. Parties to this contract that are subject to the provisions of Section 3 and section 7(b) agree to comply with Section 3 to the maximum extent feasible, but not in derogation of compliance with section 7(b). A non -Federal entity that is a state agency or agency of a political subdivision of a state and its contractors must comply with section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act. The requirements of Section 6002 include procuring only items designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR part 247 that contain the highest percentage of recovered materials practicable, consistent with maintaining a satisfactory level of competition, where the purchase price of the 2 CFR 200 item exceeds $10,000 or the value of the quantity acquired during the preceding APPENDIX 11 (J) fiscal year exceeded $10,000; procuring solid waste management services in a manner that maximizes energy and resource recovery; and establishing an affirmative procurement program for procurement of recovered materials identified in the EPA guidelines. 78 FIR 78608, Dec. 26, 2013, as amended at 79 FIR 75885, Dec. 19, 2014 Mandatory standards and policies relating to energy efficiency which are contained in the state energy conservation plan issued in compliance with the 42 U.S.C. 6201 Energy Policy and Conservation Act. Calhoun County, Texas General Conditions If Applicable CALHOUN COUNTY, TEXAS GENERAL CONDITIONS Read all documents carefully. Follow all instructions. You are responsible for fulfilling all requirements and specifications. General Conditions apply to all advertised bids, proposals or contracts; however these may be superseded in whole or in part by the scope, special requirements, specifications or special sections of Texas Government Code and/or Texas Local Government Code. Governine Law: Bidder is advised that the Invitation to Bid, Request for Proposal or Contract shall be fully governed by the laws of the State of Texas and that Calhoun County may request and rely on advice, decisions and opinions of the Attorney General of Texas and the County Attorney concerning any portion of the Invitation to Bid, Request for Proposal or Contract. All parties agree that the venue for any litigation arising from this Invitation to Bid, Request for Proposal and/or Contract shall be held in Port Lavaca, Calhoun County, Texas. Bid. Proposal and/or Contract Form Completion: Once a bid, proposal and/or contract is released for bidding, Calhoun County will not answer any questions except through an addendum that has been approved by Commissioners' Court or at a mandatory pre -bid meeting. Fill out, sign, and return to the Calhoun County Judge's Office the required number of bid forms, proposal forms, and/or contracts, and any other required information by the day and time the bid, proposal and/or contract is due. The bid, proposal and/or contract must be signed and dated by an officer (or employee) who is duly authorized to execute this bid, proposal and/or contract, and that this company, corporation, firm, partnership or individual has not prepared this bid in collusion with any other vendor, and that the contents of this bid, proposal and/or contract as to prices, terms or conditions of said bid have not been communicated by the individual signing nor by any employee or agent to any other person engaged in this type of business prior to the official opening of this bid, proposal and/or contract. The use of liquid paper or white out is not acceptable and may result in the disqualification of the bid, proposal and/or contract. If an error is made, the vendor must draw a line through the error and initial each change. All responses typed or handwritten must be clear and legible. Bid, Proposal and/or Contract Return: On or before the due date and time, the vendor must return all completed bids, proposals and/or contracts and required information and copies to the Calhoun County Judge's Office, 211 S. Ann St., 3'd Floor, Suite 301, Port Lavaca, Texas. Page 1 of 9 The clock in the County Judge's office is the official clock that will be used in determining the time the bid, proposal and/or contract is received and the time the bid, proposal and/or contract will be opened. A late delivery with an early postmark will not suffice. Calhoun County will not be responsible for the delivery of your bid, proposal and/or contract to the office of the County Judge. Calhoun County is not responsible for late deliveries due to mail, carrier, etc. Calhoun County does not accept faxed or emailed bids, proposals and/or contracts. If you would like to confirm the delivery of your bid, proposal and/or contract, you may call the County Judge's office at 361-553-4600. Late bids, proposals and/or contracts will not be accepted. All late bids, proposals and/or contracts will be returned unopened to the bidder. Bid, proposal and/or contract must be submitted in a sealed 9 x 12 or larger envelope, addressed as follows: Honorable Richard H. Meyer, Calhoun County Judge, Calhoun County Courthouse, 211 S. Ann St., Yd Floor, Suite 301, Port Lavaca, TX 77979. The outside of the envelope must be clearly marked: SEALED BID (PROPOSAL) and the name of the bid or proposal must also be clearly stated. Withdrawal of BID, Proposal and/or Contract: A vendor may withdraw their bid, proposal and/or contract before County acceptance of the bid, proposal and/or contract without prejudice to the vendor, by submitting a written request for its withdrawal to the County Judge and mail or hand deliver to the address the bid, proposal and/or contract was submitted to. A bid, proposal and/or contract that were opened are not subject to amendment, alteration, or change for the purpose of correcting an error in the bid, proposal and/or contract price. Bids, proposals and/or contracts containing an error may be offered "as is" or withdrawn by the vendor in accordance with applicable State Laws. Bid. Proposal and/or Contract Openins and Award: Vendors are invited to be present at the opening and awarding of the bid, proposal and/or contract. Governing Forms: In the event of any conflict between the terms and provisions of these conditions and the specifications, the specifications shall govern. In the event of any conflict of interpretation of any part of this overall document, Calhoun County's interpretation shall govern. Addendums: When specifications are revised, the Calhoun County Auditor's Office will send each vendor that received a bid, proposal and/or contract package the addendum once it has been approved by Commissioners' Court. No addendum can be sent out until the Commissioners' Court has approved the addendum. Hold Harmless Agreement: Successful vendor shall defend, indemnify and hold Calhoun County and its officers, agents, and employees harmless from all suits, actions, or for personal injury, death and/or property Page 2 of 9 damage arising from any cause whatsoever, resulting directly or indirectly from vendor's performance. Vendor shall procure and maintain, with respect to the subject matter of this bid, proposal and/or contract, appropriate insurance coverage including, as a minimum, general liability and property damage, workers' compensation, employers liability and auto insurance with adequate limits to cover vendors liability as may arise directly or indirectly from work performed under terms of this bid, proposal and/or contract. Certification of such coverage must name Calhoun County as an additional insured and be provided to the County upon request. Waiver of Subroeation: Vendor and vendor's insurance carrier waive any and all rights whatsoever with regard to subrogation against Calhoun County as an indirect party to any suit arising out of personal or property damages resulting from vendors performance under this agreement. Bonds: If this bid or proposal requires submission of bid or proposal guarantee and performance bond, there will be a separate page explaining those requirements. Bids or proposals submitted without the required bid bond or cashiers checks are not acceptable. Taxes• Calhoun County is exempt from all federal excise taxes and sales tax (state, city and county sales tax). Tax exempt forms will be furnished upon request to the Calhoun County Auditor's Office. Pricine: Prices for all goods and/or services shall be firm for the duration of this bid, proposal and/or contract and shall be stated on the bid sheet, proposal and/or contract. Prices shall be all inclusive. All prices must be written in ink or typewritten. Pricing on all transportation, freight, and other charges are to be prepaid by the vendor and included in the bid, proposal and/or contract prices, If there are any additional charges of any kind, other than those mentioned above, specified or unspecified, vendor must indicate the items required and their costs or forfeit the right to payment for such items. Inspections• Calhoun County reserves the right to inspect any items) or service location for compliance with specifications and requirements and needs of the using department before accepting them. Testin¢: Calhoun County reserves the right to test equipment, supplies, materials and goods bid for quality, compliance with specifications and ability to meet the needs of the user. Should the goods or services fail to meet requirements and/or be unavailable for evaluation, the bid is subject to rejection. Awards: Calhoun County reserves the right to award this bid, proposal and/or contract on the basis of lowest and best bid, proposal and/or contract that met specifications in accordance with the Page 3 of 9 laws of the State of Texas, to waive any formality or irregularity, to make awards to more than one vendor, to reject any or all bids, proposals and/or contracts and to be the sole judge in determining which bid, proposal and/or contract will be most advantageous to Calhoun County. An award is final only upon formal execution by the Calhoun County Commissioners' Court, in the event of tie bids, proposal and/or contracts, the winning bid, proposal and/or contract is determined per the Texas Local Governmental Code 262.027(b). Calhoun County, Texas is an Equal Employment Opportunity Employer. The County does not discriminate on the basis of race, color, nation origin, sex, religion, age or handicapped status in employment or the provision of services. Assienment: The successful vendor may not assign, sell or otherwise transfer this bid, proposal and/or contract without written permission of Calhoun County Commissioners' Court. Term of Bids. Proposals and/or Contracts: If the bid, proposal and/or contract are intended to cover a specific time period, said time will be given in the specifications and/or instructions. Bid, Proposal and/or Contract Oblieation: Calhoun County Commissioners' Court must award the bid, proposal and/or contract. If a contract is required, the County Judge or other person authorized by Commissioners' Court must sign the contract before it becomes binding on Calhoun County, Delivery: All items shall be shipped F.O.B. inside (or site location) delivery unless otherwise stated in the specifications. Default in promised delivery (without accepted reasons) or failure to meet specifications, authorizes the County to purchase supplies from the next lowest bidder that met specifications. Rejections• Articles not in accordance with samples and specifications must be removed by the vendor at the vendor's expense. All disputes concerning quality of supplies, products, and/or services delivered under this bid, proposal and/or contract will be determined by Commissioners' Court or their designated representative. Termination: Calhoun County reserves the right to terminate the bid, proposal and/or contract for default if the vendor breaches any of the terms therein, including warranties of vendor or if the vendor becomes insolvent or commits acts of bankruptcy. Such right of termination is in addition to and not in lieu of any other remedies, which Calhoun County may have in law or equity. Default may be construed as, but not limited to, failure to deliver the proper goods and/or services within the proper amount of time, and/or to properly perform any and all services required to Calhoun County's satisfaction and/or to meet all other obligations and requirements. Bids, Page 4 of 9 proposals and/or contracts may be terminated without cause upon thirty (30) days written notice to either party unless otherwise specified. The vendor or Calhoun County must state therein the reasons for such cancellation. Calhoun County reserves the right to award cancelled bid, proposal and/or contract to the next lowest and best vendor that met specifications and is deemed to be in the interest of the County. Delinauent Property Taxes: Calhoun County reserves the right to reject any bid, proposal and/or contract submitted by a vendor owing delinquent property taxes to Calhoun County, Texas. Certificate of Interested Parties —Form 1295 Section 2252.908 was added to the Government Code by the 84th Texas Legislature through adoption of House Bill 1295, Senate Bill 255 adopted by the 85th Legislature Regular Session amended the law effective for contracts entered into or amended on or after January 1, 2018. Additional exemptions from Form 1295 requirement were added for 1) a contract with a publicly traded business entity, including a wholly owned subsidiary of the business entity, 2) a contract with an electric utility as defined by Section 31.002 of the Utilities Code, or 3) a contract with a gas utility as defined by Section 121.001 of the Utilities Code. Notarization of Form 1295 has been replaced by an unsworn statement under penalty of perjury by an authorized representative of the business entity. The Texas Ethics Commission promulgated rules to implement the law and established an online portal: https://www.ethics,state,tx,us/whatsnew/elf_info forml295,htm. The law states that a County may not enter into a contract with a business entity unless a Certificate of Interested Parties (Form 1295) has been completed and provided to the County at the time the contract is considered for action by Commissioners' Court. The term "business entity" includes a sole proprietorship, partnership or corporation (whether for -profit or non-profit). The term "contract" includes amendment, extension or renewal of an existing contract (bids and/or, proposals also require Form 1295). The law does not apply to a contract, bid and/or proposal between the County and another governmental entity or state agency. The county is required to file Form 1295 with the state within thirty (30) days of approving a contract with a business entity. Governmental transparency is the objective of the law. A business entity will generate Form 1295 online. A business entity must use the application at the Texas Ethics Commission website to enter the required information on Form 1295 and print a copy of the completed form, which will include a certification of filing that will contain a unique certification number and date filed in the box marked "Office Use Only" located at the top right hand corner of the form. An authorized agent of the business entity must sign the printed copy of the form affirming under the penalty of perjury that the completed form is true and correct. Page 5 of 9 Calhoun County Commissioners' Court will not consider for action any bid, proposal and/or contract with a business entity unless it is accompanied by a completed, signed Form 1295 or a signed statement declaring the provision of the law under which the business entity is exempt. No later than thirty (30) days after Calhoun County CommissionersCourt approves a contract or awards a bid or proposal with a business entity, the County Clerk will file acknowledgement of receipt of the Form 1295 with the Texas Ethics Commission. The Texas Ethics Commission will post the completed Form 1295 to its website within seven (7) business days after Calhoun County acknowledges receipt of the form. Debarment• Vendor certifies that at the time of submission of its bid, proposal and/or contract, vendor was not on the federal government's list of suspended, ineligible or debarred vendors and that vendor has not been placed on this list between the time of its bid, proposal and/or contract submission and the time of execution of the bid, proposal and/or contract. If vendor is placed on this list during the term of the bid, proposal and/or contract, the vendor shall notify the Calhoun County Auditor. False certification or failure to notify may result in termination of the bid, proposal and/or contract for default. Invoices and Payments: All invoices are subject to approval by the County Auditor's Office. Invoices shall be itemized and free of federal excise taxes and sales tax (state, city and county sales tax). Payment of all invoices will be made once the purchase order and invoices) are properly and timely submitted to the County Treasurer's Office by the appropriate County department. Each County department is responsible for submitting their purchase orders for payment to the County Treasurer's Office by the deadline time and date set forth by the Treasurer's office. No payment can be made or mailed out until approved by Commissioners' Court. Purchase order due dates/times and Commissioners' Court dates/times are subject to change. Calhoun County's obligation is payable only and solely from funds available for the purpose of this purchase. Lack of funds shall render the order null and void to the extent funds are not available and any delivered but unpaid goods will be returned to the seller by the county. Gratuities: Calhoun County may, by written notice to the vendor, cancel any order and/or service without liability, if it is determined by the County that gratuities, in the form of entertainment, gifts, or otherwise were offered or given by the vendor, or any agent or representative of the vendor to any officer or employee of Calhoun County with a view toward securing an order and/or service. In the event an order and/or service is canceled by the County pursuant to this provision, the County shall be entitled, in addition to any other rights and remedies, to recover or withhold the amount of the cost incurred by vendor in providing such gratuities. Page 6 of 9 Warranty Product: Vendor shall not limit or exclude any implied warranties and any attempt to do so shall render an order voidable at the option of the County. Vendor warrants that the goods and/or services furnished will conform to the specifications, drawings, and description listed in the bid invitation, proposal and/or contract and to the sample(s) furnished by vendor if any. In the event of a conflict between the specifications, drawings, and descriptions, the specifications shall govern. Cancellation: Calhoun County shall have the right to cancel for default all or any part of the undelivered portion of an order and/or services if vendor breaches any of the terms hereof including warranties of vendor, or if the vendor becomes insolvent or files for protection under the bankruptcy laws. Such rights of cancellation are in addition to and not in lieu of any other remedies, which Calhoun County may have in law or equity. Force Maieure: Force Majeure means a delay encountered by a party in the performance of its obligations under this Agreement, which is caused by an event beyond the reasonable control of that party. Without limiting the generality of the foregoing, "Force Majeure" shall include but not be restricted to the following types of events: acts of God or public enemy; acts of governmental or regulatory authorities; fires, floods, epidemics or serious accidents; unusually severe weather conditions; strikes, lockouts, or other labor disputes; and defaults by subcontractors. In the event of a Force Majeure, the affected party shall not be deemed to have violated its obligations under this Agreement, and the time for performance of any obligations of that party shall be extended by a period of time necessary to overcome the effects of the Force Majeure, provided that the foregoing shall not prevent this Agreement from terminating in accordance with the termination provisions. If any event constituting a Force Majeure occurs, the affected party shall notify the other parties in writing, within twenty-four (24) hours, and disclose the estimated length of delay, and cause of the delay. Waiver• No claim or right arising out of a breach of any bid, proposal and/or contract can be discharged in whole or in part by a waiver or renunciation of the claim or right unless the waiver or renunciation is supported by consideration and is in writing signed by the aggrieved party. Applicable Law: This agreement shall be governed by the Uniform Commercial Code. Whenever the term "Uniform Commercial Code" is used it shall be construed as meaning the Uniform Commercial Code as adopted in the State of Texas and in effective on the date of bid, proposal and/or contract. Prohibition against Personal Interest in Bids. Proposals and/or Contracts: No officer or employee of the County shall have financial interest, direct or indirect, in any bid, proposal and/or contract with the County, or shall be financially interested, directly or indirectly, in the sale to the County of any land, materials, supplies, or service, except on behalf of the County as an officer or employee. Any willful violation of this section shall constitute Page 7 of 9 malfeasance in office, and any officer or employee guilty thereof shall be subject to disciplinary action under applicable laws, statutes and codes of the State of Texas. Any violation of this section, with the knowledge, expressed or implied of the person or corporation contracting with the County shall render the bid, proposal and/or contract involved voidable by the Calhoun County Commissioners' Court, Insurance Before commencing work, the successful vendor shall be required, at his own expense, to furnish the Calhoun County Auditor within ten (10) days of notification of award with a certificate of insurance showing the following insurance coverage to be in force throughout the term of the bid, proposal and/or contract: General Liability ($100,000/$300,OD0 orgreater) Workers' Compensation (at Statutory Limits) Employers Liability ($1,000,000 or greater) Auto Insurance ($100,000 BIPP/$300,000 BIPO/$100,000 PD or greater) The certificate must reflect that Calhoun County is an additional insured on the General Liability coverage. Each insurance policy to be furnished by successful vendor shall include, by endorsement to the policy, a statement that a notice shall be given to the Calhoun County Auditor by certified mail thirty (30) days prior to cancellation or upon any material change in coverage. OSHA Requirements: The vendor or contractor hereby guarantees to Calhoun County, Texas that all materials, supplies, equipment or services listed on the bid, proposal and/or contract, purchase order or invoice meets the requirements, specifications and standards as provided for under the Federal Occupational Safety and Health Act of 1970, as amended and in force at the date hereof. Protest Procedures: All protests and disputes will beheld in Port Lavaca, Calhoun County, Texas. Any actual or prospective vendor who believes they are aggrieved in connection with or pertaining to a bid, proposal and/or contract may file a protest. The protest must be delivered in writing to the Calhoun County Auditor's Office, in person or by certified mail return receipt requested prior to award. The written protest must include: Name, mailing address and business phone number of the protesting party; Appropriate identification of the bid, proposal and/or contract being protested; A precise statement of the reasons for the protest; and Any documentation or other evidence supporting the protest and any alleged claims. The County Auditor's Office will rVIRMYGM attempt to resolve the protest, including at the County Auditor's option, meeting with the protesting party. If the protest is successfully resolved by mutual agreement, written verification of the resolution, with specifics on each point addressed in the protest, will be forwarded to Commissioners' Court. If the County Auditor's Office is not successful in resolving the protest, the protesting party may request in writing that the protest be considered by Commissioners' Court. Applicable documentation and other information applying to the protest will be forwarded to Commissioners' Court, who will promptly review such documentation and information. If additional information is required, Commissioners' Court will notify the protesting party to provide such information. The decision of Commissioners' Court will be final Public Information Act: All governmental information is presumed to be available to the public. Certain exceptions may apply to the disclosure of the information. Governmental bodies shall promptly release requested information that is not confidential by law, either constitutional, statutory, or by judicial decision, or information for which an exception to disclosure has not been sought. CALHOUN COUNTY AUDITOR To request information from Calhoun County, please contact: Cindy Mueller Calhoun County Auditor Calhoun County Courthouse Annex II 202 S Ann St, Suite B Port Lavaca, TX 77979 Phone: 361-553-4610 Fax: 361-5534614 Email: cindv.mueller@calhouncotx.ora To request abid/proposal package: Peggy Hall Assistant Auditor Calhoun County Courthouse Annex II 202 S Ann St, Suite B Port Lavaca, TX 77979 Phone: 361-5534610 Fax: 361-553-4614 Email: Peggv.hall@calhouncotx.ore Page 9 of 9 REQUEST FOR PROPOSAL THE COUNTY OF CALHOUN, TEXAS IS SEEKING PROPOSALS FOR CDBG-DR GRANT ADMINISTRATION / PROFESSIONAL SERVICES: RFP 2019.07.03-APS, CDBG-DR Grant Administration Services The County of Calhoun plans to apply for the upcoming Community Development Block Grant — Disaster Recovery funding related to Hurricane Harvey from the General Land Office —Community Development & Revitalization (GLO). These services are being solicited to assist the County of Calhoun in its application and administration of the CDBG-DR contract(s), if awarded, to support eligible activities in the County of Calhoun. Accordingly, the County of Calhoun seeks to contract with a qualified Grant Administration Service Provider (individual/firm) to prepare the application and/or administer the awarded contract(s). The complete submission requirements, evaluation criteria and other information concerning this RFP can be downloaded from the County's website, www.calhouncotx.org, or by contacting Peggy Hall, Calhoun County Assistant Auditor at 361-553-4610 or peggy.hall@calhouncotx.org. The complete submittal, consisting of 1 original and 4 copies, must be delivered in a sealed 9 x 12 envelope or larger clearly marked on the outside "RFP 2019.07.03-APS, CDBG-DR Grant Administration Services" and addressed to: Honorable Richard H. Meyer, Calhoun County Judge, Calhoun County Courthouse, 211 S. Ann St., Ste. 301, Port Lavaca, TX 77979. Deadline for submission of proposals is Wednesday, July 24, 2019 at 2:00 PM in the County Judge's office. Calhoun County's Commissioners' Court reserves the right to negotiate with any and all individuals or firms that submit proposals, to accept the proposal deemed most advantageous to Calhoun County and to be the sole judge in determining which proposal will be most advantageous to Calhoun County. The County of Calhoun is an Affirmative Action/Equal Opportunity Employer. The County does not discriminate on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age or handicapped status in employment or the provision of services. Section 3 Residents and Business Concerns, Minority Business Enterprises, Small Business Enterprises and Women Business Enterprises are encouraged to submit proposals and firms using subcontractors/subconsultants must solicit such firms in their procurement process. Cindy Mueller, County Auditor Calhoun County, Texas CommissionersCourt — July 03, 2019 11, Consider and take necessary action on any necessary budget adjustments. 2019 RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 9 of 10 a LZ N v: J W N N y O O N (AP C O v O O D D " n m m Zm m m rm OOP m m m 3 0 z z z z ;0000 z z z z �z J J R'1 T m O O o �g O O O sa O O O u O O O v: m: a 03 N N @S9 O O C m D D v �o o� ZA D { < eaa H A 000 ez-J r1r �o e� '0 4 �o m J O e � Dn t»T� � o a��e9 m W v c_ r v MEN Z z a p fib C o D c z y c m C z a z L 0 c m y 0 m �a MMI m z IMMI 0 ML MR O v 0 O O m: z: a' Z e z e z 0 SIC C9 z le � m w F O � O z�� n Z: a D O a A n D O O D m r W D n < w n MR _ m p i c {I n c n � M q m O D r z C ITef � EA T Vi ^fJi N N 9 W N N CO 0 o A A o o m m l� Z m: y 'li c Z? Z m `? o a } ) \ } k § r m§ mm § / ( � � � ))b §\ !2 � !/§ §§ \� e§ � A�R � mk� m§ _BB §©■ §§�■ v; k 0 Commissioners' Court —July 03, 2079 12. 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: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Court Adjourned: 10:14 A.M. Page 10 of 10 MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR --July 03. 2019 TOTALS TO BE APPROVED -TRANSFERRED FROM ATTACHED PAGES TOTAL PAYABLES, PAYROLL AND ELECTRONIC BANK PAYMENTS $ 220,678474 TOTAL TRANSFERS BETWEEN FUNDS $ TOTAL NURSING HOME UPL EXPENSES $ 1,573,134.42 TOTALINTER-GOVERNMENT TRANSFERS $ GRAND TOTAL DISBURSEMENTS APPROVED July 03, 2019 $ 1,793,713.16' MEMORIAL MEDICAL CENTER COMM15510NERS COURT APPROVAL LIST FOR---Ju1V 03, 2019 PAYABLES AND PAYROLL 6/28/2019 Weekly Payablas 202,475.62 7/1/2019 McKesson-340B Prescription Expense 6,237.55 7/1/2019 Amerisource Bergen-340B Prescription Expense 848.11 6/28/2019 Patient Refunds 1,178.12 6128/2019 Crescent -Nursing home insurance payment sent to MMC In error 7*968.27 6/28/2019 Goldencreek-Nursing home Insurance pymt sent to MMC in error 1,726.07 Prosperity Electronic Bank Payments 6/2412019 Credit Card & Lease Fees 120,80 6/24-6/28/19 Pay Plus -Patient Claims Processing Fee 24,20 TOTAL TRANSFERS BETWEEN FUNDS $ NURSING HOME UPL EXPENSES 7/1/2019 Nursing Home UPI 19421,134,72 7/1/2019 Nursing Home UPI 132,872.86 CIPP/INTEREST CHECKS TO MMC 7/1/2019 Golden Creek 18,319.28 7/1/2019 Ashford -Interest Earned 164.26 7/1/2019 Solera-Interest Earned 165,22 7/1/2019 Crescent -Interest Earned 159,24 7/1/2019 Broadmoor-Interest Earned 174,33 7/1/2019 Fort Bend -Interest Earned 65,65 7/1/2019 Golden Creek -Interest Earned 78,28 TOTALINTER-GOVERNMENT TRANSFERS $ GRAND TOTAL DISBURSEMENTS APFROUED July p3, Zp99 $ 1,793,T13.ASi Page 1 of 15 DE o6/270 2 t 2019 MEMORIAL MEDICAL CENTER AP Open Invoice List 1py CgibxgAuditor 140i' Due Dates Through: 07110/2019 Vendor# Vendor Name Class Pay Code 11283 ACE HARDWARE 15521 Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross 134873� 06111/20 06109/20 07/04120 35.17i / SUPPLIES (MaV) 134882 Y 06/11/20 06/10/20 07/05/20 - 54.50 SUPPLIES 134895 06111/20 06/10/20 07/05/20 3,99 w V1 SUPPLIES (%IUV �l AI) Q4982 06/24/20 06/12/20 07/07/20 13.99 SUPPLIES AAarIAb) Vendor Total: Number Name Gross 11283 ACE HARDWARE 15521 107.65 Vendor# Vendor Name / Class Pay Code 11062 AIRESPRING INC ✓ Invoice# / Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross 1343998A1 06/24/20 06/16/20 07/01/20 2,178.32 PHONES Vendor Total: Number Name Gross 11062 AIRESPRING INC 21178.32 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 9089799813 r/ 06/26/20 06/07/20 07/02/20 303,43 OXYGEN Vendor Total: Number Name Gross Al680 4 AIRGAS USA, LLC - CENTRAL DIV 303,43 Vendor# Vendor Name Class Pay Code A1690 ALCON LABORATORIES, INC: M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 9655878433 ✓ 06/10/20 06/04/20 07/04/20 159.00 SUPPLIES 9655923406 ✓ 06/19/20 06/10/20 07/10/20 1,769.11 SUPPLIES Vendor Total: Number Name Gross A1690 ALCON LABORATORIES, INC. 11928,11 Vendor# Vendor Name Class Pay Code 10958 ALLYSON SWOPE Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 062019 06/26/20 06/20/20 06/20/20 21805,75 CONTRACT EMPLOYEE tai-t►aq-yjW19q) Vendor Total, Number Name Gross 10958 ALLYSON SWOPE 2,805.75 Vendor# Vendor Name Class Pay Code 11632 AMERICAN CONSTRUCTION t/ . Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 1436 06/24/20 06/14/20 06/14/20 31550.00 ELECTRICAL WORK th YB.%Alo zblet.V t LiB 0 ap open_invoice.template Discount No -Pay Nel 0.00 0.00 35A7 t% 0.00 0.00 54.50 0.00 0.00 3.99 y� 0.00 0.00 13,99 ✓ Discount No -Pay Net 0.00 0.00 107,65 Discount No -Pay Net / 0.00 0.00 21178.32 ✓ Discount No -Pay Net 0.00 0.00 2,178.32 Discount No -Pay Net 0.00 0.00 303.43 Discount No -Pay Net 0.00 0.00 303.43 Discount No -Pay Net 0.00 0.00 159.00 0.00 0.00 1,769.11 Discount No -Pay Net o.00 o.00 ts2s.11 Discount No -Pay Net 0.00 0.00 2,805.75 ✓ Discount No -Pay Net 0.00 0.00 2,805.75 Discount No -Pay Net 0.00 0.00 3,550.00 1/ file:///C:(Userslmmckissack/cpsi/memmed.cpsinet.com/u88150/data_5/tmp_cw5report48... 6/27/2019 Page 2 of 15 Vendor Totals Number Name Gross Discount No -Pay .Net 11632 AMERICAN CONSTRUCTION 3,550.00 0.00 0.00 31550.00 Vendor# Vendor Name Class Pay Code 12660 AMERICORP FINANCIAL, LLC Invoice# Comment Tran Dt Inv Dt Due Dt Check Q Pay Gross Discount No -Pay Net 062019 06/26/20 06/20/20 06/20/20 10,000,00 0,00 0,00 10,000.00 EQUIPMENT FINANCE STERR • Vendor Totals Number Name Gross Discount No -Pay Net 12660 AMERICORP FINANCIAL, LLC 10,000,00 0.00 0,00 10,000.00 Vendor# Vendor Name Class Pay Code B1150 BAXTER HEALTHCARE v1 w Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 63348207 06/14/20 06/14/20 07/09/20 482.89 0.00 0.00 482.89 ✓ SUPPLIES / 63238653 ✓ 06/17/20 05/24/20 06/24/20 347,36 0.00 0.00 347.36 ✓ /SUPPLIES / 63291838 ✓ 06/17/20 05/31/20 07/10/20 843,99 0.00 0.00 843.99 e/ U3 ypu-ijV0SUPPLIES .6343M9. 06/26/20 06/12/20 07/07/20 128.40 0.00 0.00 128,40 SUPPLIES 63442790 06/26/20 06/13/20 07/08/20 483,03 0.00 0.00 483.03 V; SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net B1150 BAXTER HEALTHCARE 2,285.67 0.00 0.00 21285.67 Vendor# Vendor Name Class Pay Code B1220 BECKMAN COULTER INC ✓/ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 107798434 ✓ 06/20/20 06/11/20 07/06/20 4,233,46 0.00 0.00 41233.46 ✓ LAB SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net B1220 BECKMAN COULTER INC 43233,46 0.00 0.00 4,233.46 Vendor# Vendor Name Class Pay Code 12600 BIOFIRE DIAGNOSTICS LLC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 1280003722 V 06/18/20 06/10/20 07/10/20 13,624,77 0.00 0.00 13,624.77 ✓ GI & RP2 PANEL KIT fttiyk+ 2`W-j7 Vendor Totals Number Name Gross Discount No -Pay Net 12600 BIOFIRE DIAGNOSTICS LLC 13,624.77 0,00 0,00 13,624.77 Vendor# Vendor Name/ Class Pay Code 10599 BKD, LLP ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 053119 06/18/20 06/11/20 07/06/20 16,68 0.00 0,00 16.68 ✓ FINANCE CHARGES Vendor Totals Number Name Gross Discount No -Pay Net 10599 BKD, LLP 16.68 0.00 0.00 16,68 Vendor# Vendor Name Class Pay Code C1010 CABLEONEV w Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 063019E 06/24/20 06/30/20 06/30/20 418.83 0.00 0.00 418,83 ✓ CABLE 063019 06/24/20 06130/20 06/30120 68,15 0.00 0.00 68.15 CABLE file:///C:Nsers/mmckissack/cpsi/memmed.cpsinet.com/u88150/data_5/tmp_cw5report48... 6/27/2019 Page 3 of 15 063019A 06124120 06/30/20 06/30120 1,150,00 0,00 0.00 11150.00 V/ CABLE Vendor Totals Number Name Gross Discount No -Pay Net C1010 CABLE ONE 1,636,98 0.00 0.00 1,636.98 Vendor# Vendor Name Class Pay Code C1730 CITY OF PORT LAVACA ✓ W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 061719 !!1106/25/20 06/17/20 07/02120 50,20 0.00 0.00 50.20 WATER 9"" 061719A 06/25/20 06/17/20 07/02/20 51615.69 0,00 0,00 5,615.69 WATER 1AVA (r Vendor Totals -Number Name Gross Discount No -Pay Net C1730 CITY OF PORT LAVACA 51665.89 0.00 0100 5,665,89 Vendor# Vendor Name Class Pay Code ' 10006 CUSTOM MEDICAL SPECIALTIES ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 252495 ✓ 06/19/20 04/09/20 06/19/20 108.93 0.00 0.00 108.93 ✓ SUPPLIES 6hipQillA levog 1 ' Vendor Totals Number Name JJ Gross Discount No -Pay Net 10006 CUSTOM MEDICAL SPECIALTIES 108.93 0,00 0,00 108,93 Vendor# Vendor Name Class Pay Code C1443 CYGNUS MEDICAL LLC ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 280128 y/ 06/17/20 06104/20 07/04/20 447.00 0,00 0,00 447.00 v✓ SUPPLIES lr t t400 Vendor Totals Number Name Gross Discount No -Pay Net C1443 CYGNUS MEDICAL LLC 447,00 0.00 0,00 447,00 Vendor# Vendor Name Class Pay Code D1193 DEPUY SYNTHES SALES, INC. M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 21738546RI 06/26/20 06/l2I2/20 06/16/20 94.20 0,00 0.00 94,20 ✓ SUPPLIES �fegAY Vendor Totals Number Name - Gross Discount No -Pay Net D1193 DEPUY SYNTHES SALES, INC. 94,20 0100 0.00 94.20 Vendor# Vendor Name / Class Pay Code 10368 DEWITT POTH & SON ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net 5746360 ✓ 06/11/20 06/10/20 07/05/20 34.21 0.00 0.00 34.21 SUPPLIES 5746070✓ 06111/20 06110120 07105120 11.63 0,00 0,00 11.63 ✓ SUPPLIES 5746050✓ 06/11/20 06/10/20 07/05/20 60.29 0.00 0.00 60,29 ✓ SUPPLIES 5746150✓ 06111/20 06110120 07105/20 39,93 0,00 0.00 39,93 / SUPPLIES 5747050 v 06/12/20 06/11120 07/06/20 442.43 0.00 0.00 442,43 SUPPLIES 5747051 r//06/14/20 06/14/20 07/09/20 262.50 0.00 0,00 262.50 6/ SUPPLIES / 5747650 06/18/20 06/11/20 07/06/20 65,57 0,00 0.00 65,57 t. SUPPLIES file:///C:/Users/mmckissack/cpsi/memmed.cpsinet.com/u88150/data_5/tmp_cw5report48... 6/27/2019 Page 4 of 15 5742731 y 06/18/20 06/14/20 07/09/20 4.20 0.00 0,00 4,20 ✓ SUPPLIES / 5750630 06118/20 06/14/20 07/09/20 4.94 0.00 0.00 4,94 ✓ SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net 10368 DEWITT POTH & SON 925,70 0.00 0,00 925.70 Vendor# Vendor Name / Class Pay Code 10892 DIANE MOOR. ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay / MULTI SUBSCRIPTION FEES _ 27395 ✓ 06/26/20 03/18/20 03/18/20 8,690.00 0,00 SUBSCRIPTION FEE 289323 06126/20 05/13/20 05/13/20 50.00 0,00 / SUBSCRIPTION FEE 295755 ✓ 06/26/20 06/21120 06/21/20 9,290,00 0.00 / HOSTING SUBSCRIPTION 295923 ✓ 06/26/20 06/25/20 06/26/20 224.00 0,00 ID PROOFING/SETUP FEE 290281 ✓/06/2712005/21/2006/21/20 50.00 0.00 SUBPCRIPTION Vendor Total: Number Name Gros�s[[ Discount 11046 E-MDS, INC K,110t� u044,9w3.45 0.00 Vendor# Vendor Name Class Pay Code C2510 EVIDENT ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check Pay Gross Discount T1906101378 ✓ 06/24/20 06/10/20 07/05/20 17,018.59 0.00 BUSINESS AND HIM SERVICE: Vendor TotalsNumber Name Gross Discount C2510 EVIDENT 17,018,59 0.00 Vendor# Vendor Name Class Pay Code F1100 FEDERAL EXPRESS CORK W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount 668188062VI 06/25/20 06/13/20 07/08/20 10,13 0,00 Net 9,290.00 224.00 50.00 v „i 50.00 ti/ Net gg d 44,9b3.45 � b I��•�i� No -Pay Net 0.00 17,018.59 t� No -Pay Net 0.00 17,018.59 No -Pay Net 0.00 10.13 FREIGHT Vendor Total: Number Name - Gross Discount No -Pay Net F1100 FEDERAL EXPRESS CORP. 10.13 0,00 0.00 10,13 Vendor# Vendor Name Class Pay Code 10788 FIRETROL PROTECTION SYSTEMS Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net 100597128 J O6/24120 06/11/20 06/21/20 760,00 0.00 0.00 760.00 y% FIRE ALARM INSPECTION Vendor Totals Number Name Gross Discount No -Pay Net 10788 FIRETROL PROTECTION SYSTEMS 760,00 0.00 0.00 760.00 Vendor# Vendor Name Class Pay Code File:///C:/Usershnmckissack/cpsi/memmed.cpsinet.com/u88150/data_5/tmp_cw5repoi-t48... 6127/2O14 Page 5 of 15 F1400 FISHER HEALTHCARE ✓ M Invoice# JComment Train Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net / 7172211 Y 06/14/20 06/14120 07/09/20 21648.63 0.00 0,00 21648.63 ✓ SUPPLIES SW}rNl11� Ia1.'IV 7068230 ve� 06/14/20 06/14/20 07/09/20 61055.94 0.00 0.00 61055.94 ✓ SUPPLIES / 7641525 l/ 06(19l20 O6l12/20 07/07l20 232.00 O.DO 0.00 232.00 �! SUPPLIES 7641528 � O6(t9/20 06l12/20 07f07120 27.50 0.00 0.00 27.50 ✓ SUPPLIES 7739993 � 06(19/20 06/13(20 07/OSl20 9,868.09 0.00 0.00 9,868,09 SUPPLIES Sdtdppjrtq 1NL-l2/ 7414080 � 06120l20 06I70/20 07l05/20 2,321.78 0.00 0.00 2,321.78 y� SUPPLIES SluYpi YtV I"Yi�"IL} - 7532708 � 06/20/20 06/11 /20 07/06/20 120.52 0.00 0.00 120.52 ✓ SUPPLIES / 6001292 � O6(21l20 05/23/20 07f04/20 2,459.23 0.00 - 0.00 2,459.23 ✓ /SUPPLIES / 1061543 ✓ 06/26/20 01 /09(20 02l03/20 t 69.34 0.00 0.00 169.34 t/ SUPPLIES StuppiA� $tr-af ong3.Do . Vendor Totals Number Name Gross Discount No -Pay Net F1400 FISHER HEALTHCARE 23,903.03 0.00 0.00 23,903.03 Vendor# Vendor Name / Class Pay Code W1300 GRAINGER e/ M Invoice# C/omment Tran Dl Inv Dt Due Dt Check DPay Gross Discount No -Pay Net 9195344800 ✓ 06/24/20 06f05/20 06/30/20 159.44 0.00 0.00 159,44 S/UPPLIES / 9203800819 ✓ 06/26/20 06/12/20 07l07l20 235.66 0.00 0.00 235.68 r/ SUPPLIES Vendor Totals Number Name Gross Discouni No -Pay Net W7300 GRAINGER 395.12 0.00 0.00 395.12 Vendor#Vendor Name / Class Pay Code 11984 GUERBET, LLC ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net / 18356431 � 06/26120 O6/26(20 06/26/20 350.00 O.DO 0.00 350.00 �/ SUPPLIES - VendorTotal:Number Name Gross Discount No -Pay Net 11984 GUERBET, LLC 350.00 0.00 0.00 350.00 Vendor# Vendor Name / Class Pay Code G1210 GULF COAST PAPER COMPANY V M Invoice# /Comment Tran Dt Inv Dt Due Ot Check DPay Gross Discount No -Pay Net 1685313 ✓ 06117l20 O6/04l20 07/04l20 690.38 0.00 0.00 690.38 SUPPLIES 1685371 � 06/26/20 O6/04/20 07/04l20 t i t J 8 0.00 0.00 111.18 ✓ SUPPLIES Vendor Total=.Number Name Gross Discount No -Pay Net G1210 GULF COAST PAPER COMPANY 801.56 0.00 0.00 801.56 Vendor# Vendor Name Class. Pay Code t0334 HEALTH CARE LOGISTICS INC Invoice# /Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net 7170956 ✓ 06/19l20 06/13/20 07108/20 94.35. O.DO 0.00 94.35✓ file a//C:/Users/mmckissack/cpsi/memmed.cpsinet.com/u88150/data_5/tmp_cw5report48..: 6/27/2019 Page 6 of 15 SUPPLIES PHARMACY Vendor Totals Number Name Gross Discount No -Pay Net 10334 HEALTH CARE LOGISTICS INC 94,35 0,00 0.00 94.35 Vendor# Vendor Name J Class Pay Code H1610 HOBBY LOBBY W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 83978016A 06/27/20 06/19/20 06/19/20 77,17 0,00 0.00 77.17 SUPPLIES ( 1 kMV*tl'b / `it 1[Ws1 e'1z• 4%v- 64tp ChIttl y�Y7/yS) 83979965A 06/27/20 06/19/20 06/19/20 114.38 0,00 0.00 114.38 ✓ SUPPLIES t-{-Wb fa-W mav""w nlolhl V'oy1") Vendor Totals Number Name Gross Discount No -Pay Net H1610 HOBBY LOBBY 191.55 0.00 0,00 191.55 Vendor# Vendor Name Class Pay Code 12228 INNOVATIVE STERILIZATION Invoice#/ Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 15303 d 06/24/20 05/09/20 06/09/20 15414.44 0,00 0.00 1,414.44 ONE TRAY PROCESSING KIT C%� Vlpil(13 Vendor Totals Number Name Gross Discount No -Pay Net 12228 INNOVATIVE STERILIZATION 11414.44 0,00 0.00 11414.44 Vendor# Vendor Name / Class Pay Code 11260 INTOXIMETERS INC M Invoice# Comment Tran Dt Inv Dt Due Dt Check Or Pay Gross Discount No -Pay Net S00153141 V1 06/18/20 06/12/20 07/07120 11375,00 0.00 0.00 1,375.00 v/ LAB SERVICESC134-I] NY lG II xt'1l PSinr alb f1V Vendor Totals Number Name ( e} b-5) Gross Discount No -Pay Net 11260 INTOXIMETERS INC - 11375,00 0.00 0.00 11375.00 Vendor# Vendor Name Class Pay Code J0150 J & J HEALTH CARE SYSTEMS, INC ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net 920999502 ✓ 06/14120 06/03/20 07/03/20 763,36 0,00 0.00 763.36 /SUPPLIES 921007925 ✓ 06/14/20 06/04/20 07/04/20 1,533.67 0.00 0.00 1,533.67 SUPPLIES 921018897 ✓/06/17/20 06/06/20 07/06/20 812.85 0.00 0,00 812.85 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net J0150 J & J HEALTH CARE SYSTEMS, INC 31109.88 0.00 0.00 31109.88 Vendor# Vendor Name Class Pay Code 11230 JACKSON & COKER LOCUM TENENS, Invoice# /Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net / 2030635 t/ 06/24/20 06/19120 06/19/20 250,88 0.00 0,00 250.88 V/ /PRO FEESIDR. CHAU LONG 2030634 06/24/20 06/19/20 06/19/20 913.58 0.00 0.00 913,58 /PRO FEES/CRAWFORD 2030860 ✓ 06/24/20 06/20/20 06/20/20 52,87 0.00 0.00 52.87 // PRO FEES/DR. CHAU UONG 419811 ✓ 06/24/20 06/20/20 06/20/20 61920,00 0,00 0,00 51920,00 ✓ PRO FEES/CRAWFORD / 419812 y/ 06/24/20 06/20/20 06/20/20 4,125.00 0.00 0,00 4,125.00 1/ PRO FEES/DR. CHAU UONG Vendor Totals Number Name Gross Discount No -Pay Net 11230 JACKSON & COKER LOCUM TENENS, 111262,33 0.00 0.00 11,262,33 file://!C:/Users/mmckissack/cpsi/memmed. cpsinet.com/u88150/data_5/tmp_cw5report�}8... 6/27/2019 Page 7 of 15 Vendor# Vendor Name i Class Pay Code 12644 LYDIA ELSA CANTU ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 5202019 06/25/20 05/20/20 06/20/20 400.00 0.00 0.00 400.00 RECONCILE JAN-MAR WK Ytth C(+ 60100 V'l( Wk-r Vendor Totals Number Name Gross Discount No -Pay Net 12644 LYDIA ELSA CANTU 400.00 0.00 0.00 400.00 Vendor# Vendor Name f Class Pay Code 10972 M G TRUST ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 062419 06/25120 06/24/20 06/24/20 11286.72 0.00 0.00 11286,72 PAYROLLDED Vendor Totals. Number Name Gross Discount No -Pay Net 10972 M G TRUST I t286.72 0.00 0.00 11286.72 Vendor# Vendor Name Class Pay Code 11612 MASA GLOBAL BUILDING / Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 689768MKMMC O6/25/20 06/13/20 06/13/20 1,639.00 0.00 0.00 1,639.00 INSURANCE Vendor Total: Number Name Gross Discount No -Pay Net 11612 MASA GLOBAL BUILDING 11639.00 0.00 0.00 1,639.00 Vendor# Vendor Name Class Pay Code M2178. MCKESSON MEDICAL SURGICAL INC 1`/ Invoice# //Comment Tran Dt Inv Dt Due Dt Check D* Pay Gross Discount No -Pay Net 63751732 ✓ 05/08/20 06/05/20 07/05/20 195.18 0.00 0.00 195.18 54809381 y+ 06/2l/20 05/21/20 07/04/20 131.56 0.00 0.00 131.56 SUPPLIES 53201958 e// 06/26/20 04/30/20 05/15/20 21324.72 0.00 0.00 21324.72 SUPPLIES 60788069 r/ 06/27/20 03/29/20 04/28/20 173.40 0.00 0.00 173.40 SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net M2178 MCKESSON MEDICAL SURGICAL INC 2,824.86 0.00 0.00 2,824.86 Vendor# Vendor Name / Class Pay Cade M2280 MEAD JOHNSON NUTRITION ✓ Invoice# Comment Tran Dt Inv DI Due Dt Check D, Pay Gross Discount No -Pay Net 990406574 rJ 06/26/20 06/18/20 06/26/20 142.00 0.00 0.00 142.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net M2280 MEAD JOHNSON NUTRITION 142.00 0.00 0.00 142.00 Vendor# Vendor Name / Class Pay Code M2827 MEDIVATORS M Invoice# Comment Tran Dt Inv Dt Due Dt Check Ow Pay Gross Discount No -Pay Net 90168588 ✓/06/26/20 06/17/20 06/26/20 264.16 0.00 0.00 264.16 SUPPLIES 564tArpin�. { Ial e Vendor Total: Number Name U Gross Discount No -Pay Net M2827 MEDIVATORS 264.16 0.00 0.00 264.16 Vendor# Vendor Name / Class Pay Code M2470 MEDLINE INDUSTRIES INC ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check O Pay Gross Discount No -Pay Net file:///C:(Users/mmckissack/cpsi/memmed.cpsinet.com/u8815O/data_5/tmp_cw5report48... 6/27/2019 / - Page 8 of 15 1878878346 ✓ 06/14/20 06/14/20 07/09/20 11,66 0,00 0,00 11,66 V/ SUPPLIES / 1878878345 V1 06/14/20 06/14/20 07109/20 176.56 0.00 0.00 176,56 L/ SUPPLIES 1878790826 ✓ 06/14/20 06/14/20 07/09/20 473.48 0,00 0,00 473.48 SUPPLIES ` / 1878790838 �/ 06/14/20 06/14/20 07/09/20 11.66 0.00 0.00 11.66 SUPPLIES 1878878355 ✓ 06/14/20 06114/20 07109/20 21513.00 0.00 0.00 2,513.00 V S/UPPLIES 1878790835 ✓ 06/14/20 06/14/20 07/09/20 49.35 0.00 0.00 49.35 SUPPLIES 1878790834 ✓ 06/14/20 06/14/20 07/09120 766.81 0.00 0.00 766.81 SUPPLIES / 1878637278 06/14/20 06/14/20 07109/20 268.59 0.00 0.00 268,59 y SUPPLIES 1878790825 06/14/20 06/14/20 07/09/20 297.86 0,00 0.00 297.86 w' SUPPLIES 18788790824 06/14/20 06/14/20 07/09/20 208,73 0.00 0,00 208.73 S PPLIES 1878790836 f 06/14/20 06/14/20 07/09/20 10.50 0.00 0.00 10.50 V� SUPPLIES 1878972979 y/ 06/19/20 06107/20 07/02/20 78.73 0.00 0.00 78.73 SUPPLIES ,% 1878972977 06/19/20 0,/6/07/20 07/02/20 40.29 0.00 0,00 40,29 ✓ SUPPLIES hruIjiir IQ•Ya/ 1878972981 V1 06/19/20 06/07/20 07/02/20 175.97 .0.00 0.00 175.97 SUPPLIES ffIJIV,' �7 •�� 1879201357 ✓ - 06119/20 06/11/20 07/06/20 142.98 0,00 0,00 142.98 SUPPLIES 1879201350 v/ 06/19/20 06/11/20 07/06/20 33,25 0.00 0.00 33.25 SUPPLIES 1879201358 ✓1 06/19/20 06/11/20 07/06/20 239.39 0.00 0.00 239.39 SUPPLIES YIj jK t 1879201352 v'' 06/19/20 06/11/20 07/06/20 683,13 0.00 0.00 683.13 SUPPLIES / 1879201351 J/06/19120 06/11/20 07/06/20 1,980.27 0.00 0.00 11980.27V SUPPLIES 1879201356✓/06119/20 06/11/20 07106120 622,73 0,00 0.00 622,73 S/UpPLIES / 1879201354 ✓ 06/19/20 06/11/20 07/06/20 35071.51 0.00 0.00 31071,51 SUPPLIES 1879350456 V1 06/19/20 06/12/20 07/07/20 308,19 0.00 0,00 308.19 { SUPPLIES 1IUIj1vLVJ / 1879387281 V/ 06/19/20 06/1 /20 07/07/20 104.70 0.00 0.00 104,70 V S PPLIES 1879350458� 06/19/20 06/12/20 07/07/20 96.27 0.00 0.00 96,27 ✓ S/uPPLIES �'60Ak'�,(p, 1879464539 v 06/19/20 06/13/20 07/08/20 176.89 0.00 0,00 176.89 ✓ SUPPLIES / 1879526541 06/19/20 06/14/20 07/09120 21367,65 0,00 0.00 21367.65 y SUPPLIES file:///C:/Users/mmckissacldcpsi/memmed.cpsinet.com/u88150/data_5/tmp_cw5report48... 6/27/2019 Page 9 of 15 1878243021 / 06/21/20 05130/20 07/04120 11164,41 0,00 0.00 11164.41 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net M2470 MEDLINE INDUSTRIES INC 16,074.56 0.00 0,00 16,074.56 Vendor# 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 062419 06/25/20 06/24/20 06/24/20 150,00 0,00 0,00 150.00 e/ PAYROLL DED Vendor Totals Number Name Gross Discount No -Pay Net 10963 MEMORIAL MEDICAL CLINIC 150.00 0.00 0.00 150.00 Vendor# Vendor Name Class Pay Code M2659 MERRY X-RAY/SOURCEONE HEALTHCA /M Invoice# C mment Tran Dt Inv Dt DueDt Check D Pay Gross Discount No -Pay Net 8800468696 06/19/20 06/07/20 07/07/20 729.14 0,00 0.00 729A4 SUPPLIES �JJjii bjeciv Vendor Totals Number Name Gross Discount No -Pay Net M2659 MERRY X-RAY/SOURCEONE HEALTHCA 729.14 0.00 0.00 729.14 Vendor# Vendor Name Class Pay Code 10680 MMC EMPLOYEES ACTIVITIES TEAM f Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 062119 06/26/20 06/21/20 06/21/20 21370,00 0.00 0.00 21370.00 y� PAYROLL DED MOM DAY RAF Vendor Totals Number Name Gross Discount No -Pay Net 10680 MMC EMPLOYEES ACTIVITIES TEAM 20370,00 0.00 0.00 21370.00 Vendor# Vendor Name Class Pay Code 11972 MOMENTUM RENTAL & SALES Invoice# / Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 771321 ,1 06/11/20 06/06/20 07/06/20 218,96 0,00 0.00 218.96 v / SAW/ AIR HOSE/BLADE 773001 06/11/20 06/06/20 07/06/20 59,30 0,00 0.00 59.30 rj ELECTRIC BREAKER/ CHISEL 773611 V1 06/18/20 06/07/20 07/07/20 98,70 0,00 0.00 98.70 CONCRETE MIX Vendor Total: Number Name Gross Discount No -Pay Net 11972 MOMENTUM RENTAL & SALES 376,96 0.00 0.00 376.96 Vendor# Vendor Name Class Pay Code 10536 MORRIS & DICKSON CO, LLC Invoice#/ Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 4995 ✓ 06/24/20 06/17/20 06/27/20 -56.68 0.00 0.00 -56.68 / CREDIT / 5557 ✓ 06/24/20 06/18/20 06/28/20 -5.23 0.00 0.00 -5.23 ¢/ / INVENTORY ✓ ] 5551 06/24/20 06/18/20 06/28/20 -0.03 0.00 0.00 -0.03 r' CREDIT 5556 t/ 06/24/20 06/18/20 06/28/20 -5.00 0.00 0.00 -5.00 rJ /INVENTORY 4356324 ✓ 06/24/20 06/18/20 06/28/20 21,17 0,00 0,00 21,17 INVENTORY / 5553 r/ 06/24/20 06/18/20 06/28/20 -4,99 0.00 0,00 -4.99 ✓ CREDIT file://!C:/Userslmmckissacklcpsi/memmed.cpsinet.com/u88150/data_5/tmp_cw5report48... 6/27/2019 Page 10 of 15 4354275 ✓ 06/24/20 06/18/20 06/28/20 INVENTORY 4365672 ✓ 06/24/20 06/18/20 06/28/20 4356322 e/ 06/24/20 06/18/20 06/28/20 / INVENTORY 4355671 ✓1 06/24/20 06/18/20 06/28/20 INVENTORY 5552 �% 06/24/20 06/18/20 06/28/20 CREDIT 5554 06/24/20 06/18/20 06/28/20 .INVENTORY 4356323✓ 06/24/20 06/18/20 06/28/20 INVENTORY 5555 V 06/24/20 06/18/20 06/28/20 /INVENTORY 4361878 v 06/24/20 06/19/20 06/29/20 INVENTORY 4361877 v1 06124/20 06/19/20 06/29/20 / INVENTORY 6627 ✓ 06/24/20 06/19/20 06/29/20 CREDIT 6626 ✓ 06/24/20 06/19/20 06/29/20 - / CREDIT 6628ty 06/24/20 06/19/20 06/29/20 / CREDIT 6630 ✓ 06/24/20 06/19/20 06/29/20 CREDIT 6629 �% 06/24/20 06/19/20 06/29/20 / CREDIT 6625 ✓ 06/24/20 06/19/20 06/29/20 CREDIT CM74157 V1 06/24/20 06/19/20 06/29/20 4366312 ✓/ 06/24/20 06120/20 06/30/20 INVENTORY 4367341 ✓ 06/24/20 06/20/20 06/30/20 INVENTORY 4366311 y 06124/20 06/20/20 06/30/20 INVENTORY 4364736 06/24/20 06/20/20 06/30/20 /INVENTORY 4366313 ✓ 06/24/20 06/20/20 06/30/20 / INVENTORY 7919A 06/25/20 06/20/20 06/30/20 / CREDIT 7763 ✓ 06/25/20 06/20/20 06/30/20 / CREDIT ✓ 7753 06/25/20 06/20/20 06/30/20 REDIT CM74912 >� 06/25/20 06/21120 07/01/20 CREDIT 3,730,45 0.00 0.00 3,730,45 2,167.18 0.00 0.00 21167,18 /✓ i59.35 0.00 0.00 159,35 ✓ 677.70 0.00 0,00 677.70 ✓/ 4 0,00 0.00 -3,24 ✓ 9 - 0,00 0,00 -4,99 1,385.66 0.00 0.00 11385.66 9 0,00 0.00 -4.99 12.38 0.00 0.00 12.38 ✓ 736.27 0,00 0,00 736.27 ✓ 9 0.00 0.00 -1.39 2 0.00 0.00 .1.32 0/ 9 0,00 0.00 -4.99 0 0,00 0.00 -5.00 0 0.00 0,00 -5.00 2 0.00 0.00 -0,02 -433.11 0.00 0.00-433.11 24.32 0.00 0.00 24,32 101.33 0.00 0.00 101.33 12t.51 0.00 0,00 121,51 264.66 0,00 0,00 264.66 495.94 0,00 0.00 495,94 ./ •879.22 0.00 0.00-879,22 ✓ 75 0.00 0,00 •11.75 ✓ 5 0.00 0.00 -2.65 32 0.00 0.00 -29.32 , f file:///C:/Users/mmckissack/cpsi/memmed.cpsinet.com/u88150/data_5/tmp_cw5report48... 6/27/2019 Page 11 of 15 4375771 ✓ 06/25/20 06/24/20 07/04/20 135.10 0.00 0.00 135.10 t1 INVENTORY 4377884 �/ 06/25/20 06/24/20 07/04/20 21301.79 0.00 0.00 2,301,79 V� /INVENTORY / 4375770 06/25/20 06/24/20 07/04/20 662,10 0.00 0,00 662.10 r� INVENTORY / 4377883 r/ 06/25/20 06/24/20 07/04/20 650.03 0.00 0.00 650,03 ✓ INVENTORY 4375772 06/25/20 06/2V20 07/04/20 14,49 0,00 0,00 14,49 .INVENTORY 4377710 06/25/20 06/24/20 07/04/20 18.98 0.00 0,00 18,98 /INVENTORY 4377711 ✓ 06/25/20 06/24/20 07/04/20 42.95 0.00 0.00 42.95 INVENTORY 4377882 06/25/20 06124/20 07/04/20 398,96 0,00 0,00 398.96 d/ INVENTORY Vendor Totals Number Name Gross Discount No -Pay Net 10536 MORRIS & DICKSON CO, LLC 12,663.40 0,00 0.00 12,663.40 Vendor# Vendor Name Class Pay Code / 12316 NCS PEARSON, INC. ,/ Invoice# / Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net 4813240 ✓ 06/26120 04/08/20 05108/20 220.00 0.00 0.00 220.00 SUPPLIES 4632345 06/26/20 04/12/20 05112/20 110.50 0,00 ub 110,50 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 12316. NCS PEARSON, INC. 330.50 0.00 0,00 330.60 Vendor# Vendor Name / Class Pay Code 11069 PABLO GARZA ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 062519 06/25/20 06/25/20 06/25/20 21227.50 0.00 0,00 2,227.50 ✓ CONTRACT EMPLOYEE tb j lI j l q _ (a J X+11h) Vendor Total: Number Name Gross Discount No -Pay Net 11069 PABLO GARZA 21227,50 0.00 0.00 2,227.50 Vendor# Vendor Name Class Pay Code P2100 PORT LAVACA WAVE W Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net 053119 06/24/20 06/31/20 06/25/20 21075,50 0,00 0.00 21075.50 GOLD PROGRAM PLUS Vendor Totals Number Name Gross Discount No -Pay Net P2100 PORT LAVACA WAVE 21075,50 0.00 0.00 2,075.50 Vendor# Vendor Name / Class Pay Code 10896 QIAGEN INC ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 98933505,// 06/19/20 06/08/20 07/08/20 208,49 0.00 0.00 208,49 n7 iv4 Vendor Total: Number Name Gross Discount No -Pay Net 10896 QIAGEN INC 208,49 0,00 0,00 208.49 Vendor# Vendor Name Class Pay Code 11080 RADSOURCE Z Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net file:///C:/Users/mmckissack/cpsi/memmed.cpsinet.com/u88150/data_5/tmp_cw5report48... 6/27/2019 Page 12 of 15 SC59108 / 06118/20 06/12120 07/07120 1,667,00 0,00 0.00 1,667.00 v/ RAID SERVICES Vendor Totals Number Name Gross Discount No -Pay Net 11080 RADSOURCE 11667,00 0.00 0.00 13667.00 Vendor# Vendor Name / Class Pay Code R1250 RANDY'S FLOOR COMPANY ,/ W Invoice# Cornment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net MMCPTL2019 ✓ 06126/20 06/05120 06105120 31516.44 0.00 0.00 34516.44 FLOORING INSTALLED / YU61YS) �ICS�Id4:}t5'e-y Vendor Totals Number Name ross Discount No -Pay Net R1250 RANDY'S FLOOR COMPANY 31516.44 0.00 0.00 31516.44 Vendor# Vendor Name / Class Pay Code 10645 REVISTA de VICTORIA ✓ Invoice# / Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 0522191h/ 06/26/20 06/20/20 05/22/20 240,00 0,00 0,00 240,00 AD (.PA(41) 062019?.'3 06/26/20 06/20/20 06/20/20 240.00 0.00 0.00 240.00 gi AD {3VO Vendor Totals Number Name Gross Discount No -Pay Net 10645 REVISTA de VICTORIA 480,00 0.00 0,00 480.00 Vendor# Vendor Name Class Pay Code 10960 RICOH USA, INC / Invoice# Comment Tran Dt Inv Dt Due Dt Check D• Pay Gross Discount No -Pay Net ;1fG81359515 06/18/20 06/06/20 07/06/20 21767.76 0.00 0.00 2,767.76 FAX AND SUPPORT Vendor Totals Number Name Gross Discount No -Pay Net 10960 RICOH USA, INC 21767.76 0,00 0,00 2,767.76 Vendor# Vendor Name / Class Pay Code S1405 SERVICE SUPPLY OF VICTORIA INC ✓ W Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net / 701017890 v1 06/18/20 06/13/20 07/10/20 207.21 0.00 0,00 207.21 r/ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net S1405 SERVICE SUPPLY OF VICTORIA INC 207,21 0,00 0.00 207.21 Vendor# Vendor Name Class Pay Code S1800 SHERWIN WILLIAMS W Invoice# /Comment Tran Dt Inv Dt Due Dt Check D- Pay Gross Discount No -Pay Net 53470 ✓ 06124120 06/19/20 07/04/20 23,42 0,00 0.00 23.42 v SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net S1800 SHERWIN WILLIAMS 23.42 0.00 0,00 23,42 Vendor# Vendor Name / Class Pay Code ✓ K0536 SHIRLEY KARNEI Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 061219 06/25/20 06/12/20 06/12/20 539.44 0.00 0,00 539,44 CONTRACT EMPLOYEE l a 113 i t9 � to IXIJ4) Vendor Totals Number Name Gross Discount No -Pay Net K0536 SHIRLEY KARNEI 539.44 0.00 0.00 539.44 Vendor# Vendor Name Class Pay Code 10681 SIMMLER, INC. Invoice# / Comment Tran Dt Inv Dt Due Dt Check D'Pay Gross Discount No -Pay Net 185869 ✓ 06/26/20 06/18/20 06/26/20 167,00 0,00 0.00 167,00 file:///C:/Users/mmckissack/cpsi/memmed.cpsiuet.com/u88150/data_5/tDip_cw5report48... 6/27/2019 Page 13 of 15 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10681 SIMMLER, INC. 167.00 0.00 0,00 167.00 Vendor# Vendor Name / Class Pay Code 52362 SMITH & NEPHEW t/ Invoice# C mment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 921620599 06107/20121117/2007/05/20 281.83 0,00 0.00 281.83 ✓ /SUPPLIES f�1tlg1t�1j,Q9 923209681 ✓ 06/26/20 06/17/20 06/26/20 489.37 0.00 0.00 489.37 SUPPLIES Rt14 i Hg,il - Vendor Totals Number Name Gross Discount No -Pay Net S2362 SMITH & NEPHEW 771,20 0.00 0,00 771,20 Vendor# Vendor Name / Class Pay Code 52694 STANFORD VACUUM SERVICE i/ M Invoice# / Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 243218 ✓ 06/24/20 06/20/20 06/20/20 385.00 0.00 0,00 385.00 r/ GREASE TRAP PUMPED Vendor Totals Number Name Gross Discount No -Pay Net 82694 STANFORD VACUUM SERVICE 385.00 0.00 0,00 385.00 Vendor# Vendor Name / Class Pay Code 53940 STERIS CORPORATION M Invoice# Comment Tran Dt Inv Dt Due DI Check D Pay Gross Discount No -Pay Net 502135122 v1 06/24/20 06/12/20 07/07/20 21827.00 0.00 0.00 2,827.00 REPAIRS ON STERILIZER Sl.ipYjhh� 3D•OO Vendor Totals Number Name CC Gross Discount No -Pay Net S3940 STERIS CORPORATION 2,827.00 0,00 0,00 2,827.00 Vendor# Vendor Name Class Pay Code 10735 STRYKER SUSTAINABILITY Invoice# /Comment Tran Dt Inv Dt Due Dt Check D* Pay Gross Discount No -Pay Net 3661131 ✓ 06/17/20 06/03/20 07/03/20 21124.37 0,00 0.00 2,124.37 SUPPLIES Slklpittra- ta•3-% 3651131 06/21/20 05/21/20 06/21/20 11585,87 0.00 0,00 1,585.87 ✓ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 10735 STRYKER SUSTAINABILITY 30710.24 0.00 0.00 31710.24 Vendor# Vendor Name / Class Pay Code 11944 TALX CORPORATION >/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D* Pay Gross Discount No -Pay Net 1000566560 a /06/11/20 06/08/20 07/08/20 63,29 0,00 0.00 63.29 EMP VERFICATION Vendor Totals Number Name Gross Discount.. No -Pay Net 11944 TALX CORPORATION 63,29 0,00 0.00 63.29 Vender# Vendor Name Class Pay Code 11038 THE INLINE GROUP Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 38402 t/ 06/25/20 06/19/20 07/04/20 2,500.00 0.00 0,00 2,500.00 r/ CANDIDATE SOURCING SERV Vendor Totals Number Name Gross Discount No -Pay Net 11038 THE INLINE GROUP 2,500.00 0.00 0.00 2,500.00 Vendor# Vendor Name Class Pay Code 11100 THE US CONSULTING GROUP file:///C:/Users/mmckissack/cpsi/memtned. cpsinet.com/u8815O/data_5/tmp_cw5report48... 6/27/2019 Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount 340374948 ✓/ 06111 /20 06/10/20 07/05/20 309.53 0.00 Vendor Total: Number Name Gross Discount 11100 THE US CONSULTING GROUP 309.53 0,00 Vendor# Vendor Name / Class Pay Code T2250 THYSSENKRUPP ELEVATOR CORP o/ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D* Pay Gross Discount / 60672 ✓ 06/24/20 06/12120 06/12t20 576,00 0.00 ELEVATOR Vendor Totals Number Name Gross Discount T2250 THYSSENKRUPP ELEVATOR CORP 576,00 0.00 Vendor# Vendor Name Class Pay Code U1064 UNIFIRST HOLDINGS INC ti/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount 8400303368 ✓ 06/10/20 06/10/20 07/05/20 57,35 0.00 LAUNDRY 8400303367 06/10/20 06/10/20 07105/20 47.15 0.00 LAUNDRY 8400303398 0611000 06/10/20 07/05/20 11208,46 0,00 LA NDRY 8400303721 V O6/18/20 06/13/20 07/08/20 269,36 0.00 UNDRY 8400303735 06/18/20 06/13/20 07/08/20 11208,62 0.00 LA}1NDRY 8400303702 7 06/18f20 06/13120 07/08l20 175.83 0.00 LAUNDRY 8400303696 06/18120 06113/20 07/08/20 27.42 0.00 LAUNDRY 8400303764 �,/ 06/18120 06/13/20 07l08/20 143.52 LAUNDRY 8400303700 06/18/20 06/13/20 07/08/20 142.62 LA{uNDRY 8400303701 06/18/20 06/13/20 07/08/20 156.89 LAUNDRY 8400303699 ✓ 06/18/20 06/13/20 07108/20 120,39 LAUNDRY Vendor Total: Number Name Gross U1064 UNIFIRST HOLDINGS INC 31547.61 Vendor# Vendor Name Class Pay Code / U1056 UNIFORM ADVANTAGE r/ W Invoice# Comment Tran Dt Inv Dt Due Dt Check D+ Pay Gross / 9688286 ✓ 06/25/20 04/29/20 05/14/20 62.96 UNIFORM Vendor Total: Number Name Gross U1056 UNIFORM ADVANTAGE 62,96 Vendor# Vendor Name Class Pay Code / U1200 UNITED AD LABEL CO INC ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 891956086 06/18/20 06/11/20 07/06/20 175.20 SUPPLIES Vendor Totals Number Name Gross 0.00 0.00 0.00 0.00 Discount 0.00 Page 14 of 15 No -Pay Net 0.00 309.53 No -Pay Net 0.00 309.63 No•Pay 0.00 ay ay o.00 No -Pay 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 No -Pay 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 Discount No -Pay Nel 576.00 Net 576.00 Nel / 57.35 ✓ 47.15 ✓ t,208.46 ✓ 259.36 1,208.62 175.83 27.42 v% 143-52 V 742.62 ✓ 156.89 1/ 120.39 �/ Net 3,547.61 Net 62.96 Net 62.96 file:///C:/Userslmmcicissack/cpsi/memmed.cpsinet,corn/tt8815O/data_5/tmp_cw5report48... 6(27/2014 Page 15 of 15 U1200 UNITED AD LABEL CO INC 175.20 0,00 0.00 175.20 Vendor# Vendor Name Class Pay Code U1350 UPS W Invoice# Comm nt Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net 0000778941249 06/27/20 06115/20 06/26/20 235.86 0.00 0,00 235.86 v% SHIPPING Vendor Totals Number Name Gross Discount No -Pay Net U1350 UPS 235.86 0.00 0.00 235.86 Vendor# Vendor Name / Class Pay Code 10793 WAGEWORKS ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net 062419 06/25/20 06/24/20 06/24/20 31757,52 0,00 0.00 31757,52 .PAYROLL DIED Vendor Totals Number Name Gross Discount No -Pay Net 10793 WAGEWORKS 31757,52 0.00 0,00 31757,52 Vendor# Vendor Name Class Pay Code 11110 WERFEN USA LLC Invoice# Co ment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 9110679280 06/14/20 06/14/20 07/09/20 255.95 0,00 0.00 255.95 SUPPLIES fy6 jki j' 14 U5 Vendor Totals Number Name Gross Discount No -Pay Net 11110 WERFEN USA LLC 255,95 0.00 0.00 255.95 Vendor# Vendor Name Class Pay Code 11166 WEST INTERACTIVE SERVICES CORP Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net INVO02114265 v/ 06/26/20 05/31/20 05/31/20 619.68 0.00 0.00 519,68 HOUSE CALLS Vendor Totals Number Name Gross Discount No -Pay Net 11166 WEST INTERACTIVE SERVICES CORP 519,68 0.00 0.00 519.68 Report Summary Grand Totals: Gross Discount No -Pay Net 228*525.07 0.00 0.00 228,525,07 16J q 00 .APPROVED J1 OW JUN 2 8 2019 courizrYgrmBxoR cnall�ourl cnm�rrYr'rE 18904_�uu 202,ILy,,=6t file:///C:/Users/mmckissack/cpsi/memmed.epsinet. com/u88150/data_5/tmp_cw5report48... 6/27/2019 6�2 O Qc ly � UO L� o m Eo O o ° c c U U Z 2 FM LU co szJ.° d O LL LL d n a ro o m N O .. .. 0T 0 C c C m In Q PL m 0 o N oa a0 ? o a 5 14 rvm AQ j� § ! !� /kE � !!k B) ■ § : K2 0 \ k k k] ; { � Z W 2 W Mo � co � � kk §y }\ \� \\ | \ o <— rnFa ❑ W Qo W 2 o Its E 8€ r e 0 Da NN 0003 _ ❑E o 0 a o« 1 m Qm � H d Ip Q "t U O N Z aLL m UO o m c E o 0 0. U Q ❑ F O C 'C ❑ Z LU W 'Q Vl x 8g O N W uC G M o n m m N N N N r tp vmi vmi vmi m O1 NM N vNn - N N v a v v v v a v a a a a n n n n r n n n n n r r r n N N M N N.- m QM'am N as r N O N I,� o N O 0 0 O n-cmv a n o v o E uit^iUl�bc�t�l�t�iit^; b U II �o a omm m N m ry In ro am m�mm —y � N N a m 0 N N 0 0 o N N xa o o ❑ �j aam n m m m M a m M a a a a v o v a v v o v o a y a � 3 li m m m rn_ m m m m m rn II O o o 0 0 0 o N N N N N 6 0 0 0 0 0 0 o ` o n O n 0 0 0 0 0 0 0 V E 0 0 0 0 0 � o d z m_ m m rn rn m m rn m m m m m m c N N N j N N In I_o mw co Comm L.. a m m N o D C o E v E g Q y � 0 0 0 o n ❑ O � H r: 11-0 � § /\ q ! a� /ice ){ !§ 7!E e `e ~ k=! : G F2 G . ! £ i-. m D.Z.)j a ƒ E00 / \ k ) J/ ; ! $ f - f ° � ƒ � ) z W _ d) \ � §) - W E« k E ! Mo 46 �E Cl) §/ !@ / \ m z $§at ! ul §§ #/ 1. x _ act (A)2|§; W ®/)!\ ! Z at u { (§§&® E � $ �;»E Ill %d \ [/ |2 kt k! j\ \E §/ §/ ) ! «d � (§ !IRE of 12 � 2 / ! D� 2 £!2 : `k wj:- a§; / k )/ EE , a �: \ : e \ 2 ` \\ m / 5 » cai ! §! ) k / J) ; ! ! 2 ® _ & e . \ \t }t ! E� t! £7 ! \ \ �\ // // y ! � W r/ 2 ] § �) Zo � 2 " raa <, . ~ as {taaa� f / ° laaa 2! R ! k ® S j� ( {2it A \ / § \2W\6 {\ / 0 . �} ; Roaaaj )z Lu k= { § E Ul { E|k22 w \\ \ / k \ �\ !§ f G ® me AmensourceBergen° STATEMENT AMERISOURCEBERGEN DRUG CORP 12727 WEST AIRPORT BLVD • SUGAR LAND TX 77478-6101 866-451-9655 AMERISOURCEBERGEN DRUG CORP PO Box 905223 CHARLOTTE NC 28290-5223 Number: 58090960 Date: 06-28-2019 1 of 1 WALGREENS #12494 340E MEMORIAL MEDICAL CENTER 1302 N VIRGINIA ST PORT LAVACA TX 77979-2509 ACCOUNT. 1001352841037028186 Not Yet Due: 0.00 Current: 048.11 Past Due: 0.00 Total Due: 848.11 Account Balance: 848.11 Account Activity Date Activity Due Date Reference Number Purchase Order Number Activity Type Amount 06-24-2019 07-05-2019 3024268951 147820 Invoice 80.27 06-24-2019 07.05-2019 3024268952 147821 Invoice 291.37 ✓ 06-24-2019 07-05-2019 3024268953 147822 Invoice 33.47✓ 06-24-2019 07-05-2019 3024314759 147870 Invoice 219.33 ✓ 06-26-2019 07.05-2019 3024399940 147911 Invoice 29.44 06-26-2019 07-05-2019. 3024399941 147912 Invoice 33.47 ✓ 06-27-2019 07-05-2019 3024445586 147939 Invoice 4.58 ✓ 06-27.2019 07.05.2019 3024445587 147940 Invoice 66.94 ✓ 06-28-2019 07-05-2019 3024490665 147947 Invoice 89.24 ,✓ Thank You for Your Payment Reminders Date Payment Number Amount Due Date 06-28-2019 (900.49) 07-05-2019 Terms: C� spa ocri C� Q03laaaa arrl?ovrn ON JUL O I GOIJ COUNTY AiIY)YTt7Yt CALHDYIN COUNTY, TT:'3C.AE1 Total Due: Amount RUN /j I .YM.. 9 ill TOTAL MEMORIAL 14EDICAL CENTER EDIT LIST FOR PATIENT REFUNDS ARID=0001 PAY PAT DATE MIER CODE TYPE DESCRIPTION 062719 14.07 ,/ 77979 062719 392.00 77465 062719 15.45 7T978 062719 50.63 77979 062719 67.27 V/ 77979 062719 30.78 77979 062119 / 265.29 77465 062719 99.46 77979 062719 210.87 , 77979 062719 32.30 78363 ARID=0001 TOTAL 1178.12 APPitOV.0TT3 ON JUN z s 2919 COUNTY AUDITOR CALHOUN COUNTY, Trxne 1178.12 PAGE 1 APCDEDIT GL PM•1 Vendor# Vendor Name 11824 THE CRESCENT MEMORIAL MEDICAL CENTER AP Open Invoice List Dates Through: Class Pay Code 0 ap_open_invoice.template Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross 062619 06/26/20 06/26/20 07/11/20 6,068.27 TRANSFER h) 51 V113 NOr., IVIED riN1L VnVW4 6e f 4t 062619A 06/26/20 06/26/20 07111/20 1,900.00 TRANSFER NUY61y1y1'0vjv. jrtW4W4(QL yqn,,,,, fi �-t- + Vendor Total: Number Name ••J Gross 11824 THE CRESCENT 7,968.27 Grand Totals: %at�zlectvt;ra OPT JUN 2 � �D19 CAT.} OOoi NyCOAUTY, Ti �+� ra; Discount No -Pay 0.00 0.00 MINLin cvvw r 0.00 0,00 Discount No -Pay 0.00 0.00 Page 1 of 1 Net 6,068.27 1,900.00 Nel 7,968.27 Report Summary Gross Discount No -Pay Net 7,968.27 0.00 0.00 7,968.27 file:///C:/Usershnmckissack/cpsi/memmed.cpsinet.comlu88150/data_5/tmp_cw5report47... 6l27(2019 Page I of I RECEIVED JUN 6 t 2�p 019 MEMORIAL MEDICAL CENTER 06/27/2019 0 „1/�� AP Open Invoice List - kj?tjg'a:.. flpttfful' .- Dates Through: ap_open_invoice.template Vendor# Vendor Name Class Pay Code 11836 GOLDENCREEK HEALTHCARE Invoice# Comment Tran Dt Inv Dt Due Dt Check D&Pay Gross Discount No -Pay Net / 062419 O6/25120 06/24/20 07/11/20 262,63 0.00 0.00 262.63 r/ TRANSFER NtAN Ylc�VIO W4- 1VIWVPLt.0 PY4 4th_ 1b M4'N�ih Q.vwd) 062619A 06126120 06/26/20 07/11/20 62.10 0.00 0.00 62.10 XX TRANSFER Nlbrsinq VIOW in9At7SQL ptaytfi edr4 41 mwkL Im 0~- 062619 06/26/20 06/26/20 07/11/20 1,401.34 0.00 0.00 1,401.34 TRANSFER NWoiVly {1p(yt(- jYl&c}yxyt(.Q V9VOAT e7Wt '�0 ItAt"AA- iA UYVV� Vendor Totals Number Name U• Gross Discount No -Pay Net 11836 GOLDENCREEK HEALTHCARE 11726,07 0.00 0.00 1,726.07 ReportSummary Grand Totals: Gross Discount No -Pay Net 13726.07 0.00 0.00 1,726.07 APPIiOl%LOI? OP7 .1�IV h U LU 13 COIIN"I'I'A�ITOii CAT,IIOiIN OOiTN'I"'Y,'C1:i{Akb file:///C:/Userslmmckissack/cpsilmemmed.cpsinet.com/u88150/data_5/tmp_cwSreport46... 6/27/2019 77, }/k \§R ƒ& Memorial Medical Center Nursing Home UPL Weekly Cantex Transfer Prosperity Accounts 7/1/2019 Previous Today's Amount to Be Account Beginning ACH Beginning Transferred to Nurfln Nome Number Balance Transfen0ut Tfansferin Pending Deposits Balance NursingHome 65,893AB 65,68d.12 334,1064 - 314,315,78 J 314,051.52 Bank Oalance 314,315.]8i. Variance Leave in Balance 100.00 Routine Information for Ashford6ardeas: MMC Portion QIPP I Ashford Health Core Center fill Ca MMC Portion QIPP 2,30tapse 1PMorgan Chase Bank April Interest 40.7E ABA May Interest 68.64 ✓ Arcs___ June Interest 54,90 / / Adjust Balance/TransferAmt 314,051.52 t// Suffasom 266,273.95 a/ 266,053.43 158,062.24 ✓ - 158,282.76 1 1584008,43 flank Balance ]58,282.76 Variance Leave in Balance 100.00 MMC Portion QIPP 1 MMC Portion QIPP 2,3,Lapse April Interest 59.21 Maylnterest 61,31 June Interest 53,81 Adjust Balancofrransfer Amt 159000BA3 ✓/ 280,331.66 g/ 2800124.80 e/216,668.55 Bank Balance 216*875,41 41 e/216,616.17 Variance - Leave inBalance 100.00 MMC Portion QIPP 1 MMC Portion QIPP 2,3,1apse Apriiinterest 51.89 t/ Maylnterest 54.97 ✓ June Interest 52,38 Adjust Balance/TransferAmt 2160616.17 26,637.09 / 26,486.31 V 100,507.14 - 100,657.9E 1002492,27 Bank Balance 100,657,92 Variance Leave lnBalance 100.00 MMC Portion QIPP 1 MMC Portion QIPP 2,3,lapse April Interest 25,47 May Interest 25.31 June Interest 14,87 Adjust Balance/TransferAmt 1004492.27 65,225.77 3/ 65,039,28 V 632,045.06 )J 632,231.55 /631,966.33 Bank Balance 632,231.55 ✓ Variance Leave In Balance 100.00 moral In/ammlbn for Oe+renr/Saiero of VJe+f lfousren/fort B<nd/Broadmoor MMC Portion QIPP 1 .,. Adjust Balance/Transfer Amt 6310966.33 TOTALTRANSfER3 (M1y4(2�1334.T2 T Approved:,„^„„�,,,,� .F Diane G. Moore, CEO JUL 0 i 2019 1:\NH Y'!elkly Tranflers\NM UPLTransfer Svmmary\20t9VulY\NM UPLTrani/er Summary 0]-01-19.ds+ COUPTTY AUDITOR OALIiOUN COi7NY'Y, T1sX215 6/24/2019 AM Deposit A3ANAGFANONETI]18 MNSPhSNT C0000000000M.9341 6/24/2019 ACH Deposit Nnerigroup T%SC HCCLAIMPMT 31027064501110M 6/24/2019 AM Deposit UHC COMMUNITY PL HCCIAIM.PMT 746003411910000 6/24/2019 ACH Deposit NOVITASSOLUTION HCCLAIh1Ph1T 6)5423 420 126 6/25/2019 AM Deposit UHCCOMI.tUNITY PLHCCtAIMPMT 74W03411910000 6/25/2019 ACH Deposit NOVITAS SOLUTION HOOLANAP.L4T 6]5423 420000125 6/26/2019 ACH Deposit UHC COMMVNITY PL HCCLAIMPMT 74GW3411910000 6/27/2019 CM suite Domestic WINE OUT ASHFORD HEALTH CARE CENTER LiD 6/27/2019 ACH Deposit UHC COMMUNITY PL HCCWMPMT 74BW341 t 9I0000 6/27/2019 ACH Deposit UHC COMMUNITY PL HCCWMPMT 746034 11910000 6/27/2019 ACH Deposit HEALTH HUMAN SVC HCCLAIMPMT 17460014113005 2 Q28/2019 Check 960 6/29/2019 Deposit 6128/2019 ACH Deposit UHC COMMUNITY PL HCCLAIMPMT 74SM3411910000 6/28/2019 ACH Deposit NOVITAS SOLUTION HCCIAIMPMT 6]5423 420003119 6/30/2019 Accr Earning Pymt Added to Account 6/24/2019 AM Deposit MANAGEANQNET1738 MNS PAINT 00000000000429341 6/24/2019 ACH Deposit UNITEDHEALTHCARE HCCLAIMPNIT 746003411124384 6/24/2019 ACH Deposit NOVITAS SOLUTION HCO.AIMPMT 676357420000325 6/24/2019 AM Deposit HEALTH HUMAN SVC HCCLAIMPMT 17460034I13004 2 6/25/2019 ACH Deposit UnitedHealthCare NCCLAIMPMT 746003411 124394 6/25/1019 AN Oeposit HUMANA INS CO HCCIAINUMT 390861830000576615 6/26/2019 ACH Deposit UHC COMMUNITY PL HCCLAIMPMT 74EM241t 9100M 6/2612019 AM Deposit NOVUAS SOLUTION HCCLAIMPMT 676357 420000117 6/27/2019 CM Wire Domestic WIRE OUT CANTE%HEALTH CARE CENTERS III 6/27/2019 AN Deposit UnitedHeatthcare HCCIAIMPMT 746003411124394 6/27/2019 ACH Deposit MANAGEANON ET1718 WAS PMNTOIN;000OOOL 4293 41 6/27/2019 ACII Deposit UIIC COMMUNITY PL HCCIAIMPMT 746003411910000 6/27/2019 ACH Deposit UHC Community Pl H(O.AIMPMT 7460054119 10000 6127/2019 ACH Deposit NOVITAS SOLUTION HCCIAIMPA4t 676357420010104 6/28/2019 Check PIS 6/28/2019 Deposit 6/28/2019 ACH Deposit UnlledHealthcare HCCIAIMPMT 746003411 124384 6/28/2019 ACH Deposit UNC COMMUNITY PL HCCLA MPMT 746003411910)00 6/28/2019 ACH Deposit NOVITAS SOLUTION HCCIAIMPIMT 6I057 4200001IS 6/30/2019 Asir Earning Pymt Added to Account 6/24/2019 ACH Deposit MANAGEANDNEiI]38 h3N5 PMNT000000W0003269 4t 6/24/1019 ACH Deposit VHC COMMUNITY PL HCO.AIMPMT 7460334119100011 6/24/2019 AM Deposit UHC Community PI HCCLAIMPMT 746003411910000 6/24/2019 AM Deposit NOVITAS SOLUTION HCCWMPMT 676323420thi 6/25/2019 AM Deposit UHC COMMUNITY PL HCCLAIMPMT 74600341191COW 6/25/2019 ACT{ Deposit UHC COMMUNITY PL NCCIAIMPMT 7460334119 10000 6/25/2019 ACH Deposit NOWTAS SOLUTION HCCLAIMPMT 676323430000125 6/25/2019 ACH Deposit HUMANA INS CO HCCLAIMPMT 390964830000576615 6/25/2019 AM Deposit HUMANA INS CO HCCLAIMPMT 390864830000S77427 6/25/2019 ACH Deposit HUMANA CHA 0158 HCCIAIMPMT 3508644200001293 6/25/2019 AM Deposit HUMANA CHA DISB HCCIAIMPMT 39OB644200001294 6/25/2019 AM Deposit HEALTH HUMAN SVC HCCWMPMT 174GR0341130011 2 6/26/2019 AM Deposit UHC COMMUNITY PL HCCLAIMPMT 746003411910000 9/26/2019 AN Deposit NOWTM SOLUTION HCCWMPMT 676323410000117 6/2612019 ACH OepONt HEALTH HUMAN SVC NCCLAIMPMT 17460034113008 2 6/27/2019 CM Wire Domestic WIRE OUT CANTE%HEALTH CARE CENTERS III 6/27/2019 AM Deposit UHC COMMUNITY PL HCCLAIMPMT 746O034119 Kola 6/2712019 AM Deposit NOVITAS SOLUTION HCCWMPMT 676313 410000104 6/27/2019 ACH Deposit STEALTH HUMAN SVC HCCLAIMPMT 17460034113008 2 6/28/2019 Checc ASS 6/28/2019 Deposit 6/28/2019 AM Deposit UnitedHealthcare HCCLAIMPMT 7460014111243PI 6/28/2019 AN Deposit NOVITAS SOLUTION HCCLAIMPMT 676323420000119 6/30/2019 Accr Earning Pymt Added to Account 6/24/2019 AM peposll kOYITA$SOLDTIDN HCCWMPMT 6]5663 420000125 6/25/2019 AN Deposit UHC COMMUNITY PLHCCLAIMPMW T ]463411910000 6/25/2019 AM Deposit HUMANA INS CO HCCLAIMPMT 39086383WW576615 6/26JI019 AOI Deposit UHC COMMUNITY PL HCCWMPMT 74600341191MM 6/26/2019 AM Deposit HUMANA INS CO HCCWMPMT 390863830000503349 6/27/2019 CM Wire Domestic WIRE OUT CANTE%HEALTH CARE CENTERS IN 6/29/2029 Check A53 6/28/2019 Deposit 6/28/2019 AM Deposit NOVITA9 SOLUTION HCCIAIMPNIT 65663420000118 6/30/2019 Asir Earning Pymt Added to Account oa0 Wolksheets120191ilune\NH Bak Droadritond 6 24 19 evil 6.30 19 al v Page 1 MMCPDRTION Tmnsler-0ul Transler•In Q)PP/Comp1 QIPP/Comp2 QIPP/Comp3 QIPP/Lapse QIPPII NH POR310N 5,265.00 - 5,265.00 29,942.96 ✓ - 29,942.96 16,1T0.09�/ - 16,17008 66,J85.2}a/ - 66.785.27 2],]34.J2� - 2),734]2 839.52 ,// - 819,52 1,972.00 / - 14972'ea 53,423.73 t/ ' 25,358.48 ✓ - 25.353,48 1,485,37 �/ - 1,485.37 15,525.82 k/ - 15,525.82 12,260.39 • / ' 85,316.8Q ,// - 85,316,80 126.69 ✓/ - IMES 32,528.81 r/ - 37.528AI 59.90 6s,689.ii 319,IO6A2 314,0S1.S2 MMCPORTION Transfer -Om TraTtsfery2r QIPP/Comps QIPP/Comp2 QIPP/Comp3 QIPP/Lapse QIPPTI M1PORTION 7,217.50 V/ - 7,217.50 1,890.w - 11990.0 9,205.55 / 9,205.55 4,369.12 ✓ 4,369.12 11,393.60 - 11*193.60 7,935.56 - 74935.56 961 IS - 951,89 3,643.40 - 3.64340 363,664,10 el - - 1.228.50 � - 1.228.50 725.00 - 725.00 4,944,50 - 4,944SO 6,989.w 6,989.00 /28,660.86 r/ - - 28,660.fl6 2,389.33 ✓ - 40,291.96 - 40.291.96 la,]0033 - 15,]00.33 ,503,50 - 4,503,50 8.348,16 8,348.16 53.81 266.053.43 158,063.20 158,01PBA3 MMCPORDON Transfer.out Transfer -In 91PP/Comp, QIPP/Comp2 QIPP/Comp3 QIPP/lapse QIPP TI Nil PORTION I350.00V - 1,350.00 16:397.26 ✓ - 16,397.26 ),65].50 ✓ - 3,65J.5o 11,]00,66 - 11,700.66 15,271.69� - 15,271.69 12,113.12� 12,713.12 6'436.49 - 8,436A9 3,98).19 y/ - 3,987.19 1,601.1O - 1,601,10 60004.14 ✓ - 6,004,14 3,60248 - 3,02.48 6,700A0 s/ - 6,700.00 50636.70 - 5,636.70 2415.61 - I,425.I 5,115.00 - Silts 0 3,536.52 1.536.53 634099.04 V// - 63,069.04 / 5,285.50 ✓ 5.}8550 2,3]4.60 ✓ 34.044.27 34,044.27 3,692.49 ✓ - 3,692.49 1,369.41 V� 1,399AI / 52 38 —ire ecuec -/ -w IIAMe.12 l 41PP/[Omp1 gIPP/Comp2 QIPP/Comp3gIPP(lapse 41PPTI NN PORTION Tr iZyferA3 Tran�fenl9.. 55,054.65 ✓ - 55,054.65 2,303.04 ✓ - 2,303.04 3116.76 ✓ 386.76 1],09J.48 � I1,09J.4B 3894 7 3 289.73 21,464.98✓ / - 5,023.33 �/ 1),992.01 ✓/ 17,992.01 13,268,60 + 13.20.60 b/24/2019 ACH Ocposit IAANAOEANONETI]18 MNSPM1LNT 000000100002402 i 6/24/2019 ACH Deposit Amedgmup TXSC HCCLAIMPMT 3102T06451111000 6/24/2019 AN Deposit UNITEDHEALTHCARE HCCLAIMPMT T46003411 IZ4384 6/24/1019 AN Deposit UHC COMMUNITY Pl. HCCIAIMPMT 74GW3411910000 6/24/2019 AN Deposit UHC COMMUNITY Pl. HCCIAIMPMT 74GW34119100g0 6/24/2019 AM Deposit NOWTAS SOLUTION HCMIMPMT 676310 420000125 6/25/1019 AM Deposit UHCC LIMUNITTPLHCCWNIPMT746003411910000 6/2512019 AM Deposit NOVNAS SOLUTION HCCLAIMPMT 676310420000125 612512019 ACH Deposit HUMANA INS CO HCCIAIMPMT 390862830000S72038 6/25/2019 ACH Deposit HUMANA INS CO HCCIAIMPMT 390862030000576615 6/25/2019 ACH Deposit HUMANA MA O156 HOMIMPMT 390362 4200001295 6/25/2019 ACH Deposit HUMANA CIA DISK HCCIAIMPMT 390862 4200001293 6/25/2019 ACH Deposit HEALTH HUMAN WC HCCIAIMPMT 1]46003411300] 2 6/26/2019 ACH Deposit Amerigroup TXSC HCCLAIMPMT 310291316511100D 6/26/2019 ACH Deposit NOVITAS SOLUTION HCCLAIMPMT 676310420000I 17 6/27/2019 CM Wife Domestic WIRE OUT CANTEX HEALTH CARE CENTERS III 6/27/2019 AN Deposit UnitedHeaitheare HCCLAIMPMT 746003411124394 6/27/2019 AN Deposit LINE COMMUNITY Pl. HCCUAIMPMT 746003411 910000 6/27/2019 AM Deposit UHC COMMUNITY PL HCCLAIMPMT 746003411910500 6/27/2019 AN Deposit UHC Community Pi HCCWIMPAIT 74$0011411910000 6/27/2019 AM Deposit NOVITAS SOLUTION HCCUIMPMT 676310420000104 6/28/2019 Check 953 6/20/2019 Deposit 6/29/2019 ACH Deposit UnnedHealihcare HCCLMNIPMT 746003411124384 6/28/2019 ACH Deposit LANE COMMUNITY Pl. HCCLAIMPMT 7460034119I00O3 6/3012019 A"N Earning Pymt Added to Account TOTALS atl Worksheets\2019\lunc\NH Bank Download 6-24-19 Boa 6.30-19.sise Page 2 TmnslerAut Transfer I OIPP/Comp1 OIPP/Comp2 OIPP/Camp3 DIPP/lapse glPPll ( NIIPORTION 7,355.00 - 7,355.00 18,602.85 - 18,602.89 9020.00 ✓/ - 9,020.00 1:691.55 a/ 14691.55 5,266.88 $1766.88 141,730.29✓ - 141,73D.29 16.776.36 ✓ - 16,776.36 2040555.95 204,555.95 21,20].29 - 27,207.29 12,412.09 17,412.09 9,612.47 - 9,612.47 24,487.58 e% 24,487.59 7,305.79 /� - 71305.79 5.503.63 J - 5,503.63 G3,808.88 - 6308.88 6154HA5 V/ - - 12,7100 - 124730A0 9,134.40 - 9,134.40 1,170.46 ✓ - 1*17046 2,634,50 2,634.50 / 7,7SO.78 ,/ - 7,750.78 3,490,83 J / 0 3,849.07 3,849.97 24,445.55 - 24,445.55 14,434.12 - 14,434.12 ]8.T3 65,039.28 632.045.06 631,966.33 703,3B7.94 ]A21,3B9.41 1,421,134.22 7/1/2019 Home ALL ACCOUNTS FAVORITES tal Banking Reorder Favorites Favorite Accounts Available Previous Day MEMORIAL MEDICAL CENTER - OPERATING MEMORIAL MEDICAL CENTER I $316,249,55 $314,315.78 NH ASHFORD'43s1* MEMORIAL MEDICAL CENTER / NH BROADMOOR •4403* MEMORIAL MEDICAL CENTER / NH CRESCENT+4411* MEMORIAL MEDICAL CENTER / SOLERA AT WEST HOUSTON 4438* MEMORIAL MEDICAL CENTER / NH FORT BEND •4446* MEMORIAL MEDICAL / NH GOLDEN CREEK HEALTHCARE G MMC -NH GULF POINTE PLAZA - PRIVATE PAJ� MMC-NH GULF POINTE PLAZA - MEDICARE/MEDICAI[M $156,282.76 $158,282.76 $222,636.91 $216,875.41 $672,779.65 $632,231.55 $105,949.92 $100,657.92 hltps://pbsitxsecure.Tundsxpress.com/fxweb/app/k/home i/1 Memorial Medical Center Nursing Home UPL Weekly Negion Transfer Prosperity Accounts 7/1/2019 Previous Amount to Bc Account Beginning Pending Transferred to Nursbutiloure Number Galante Transfer -Out ]runslenin [ks Cleared Deposits Toda's Begin Galante Nursin home 929.38 IB0,fa1.W - ]6I,3]042 /13I.B]2.86 Bank balance ]63,370.42 k/ Rputina health of rtpte:Onty bpiontea aJ o'rrr 59,000 av31 be is Jrzed to the nurain4 home. Nple 1: foth account Aaa a bwe balance of S1DJ Ihot RiMCdeposifrd to eDen account. Varlancc I.\HV\Ve<AIY ]ramleis\Nal UPL iransler Summary\]019Vuh\mr UPl nanale� Summary u>0119�ba MMC PORTION NH T nder-In I QIPP/Cempl QIPP/ComP2 OIPP/COmP3 QIPP/lapse QIPPTI PORTION 42,95L32 - 42,951-32 2>,600.66 - 39,600 66 4,035.14 ✓ 440335,14 58 50355 5245 .95 1 ,319.28 1% 19,319.28 18,319.29 - 7!il2019 Home ALL ACCOUNTS FAVORITES Favorite Accounts MEMORIAL MEDICAL CENTER - OPERATINGS MEMORIAL MEDICAL CENTER / NH ASHFORD$M MEMORIAL MEDICAL CENTER / NH BROADMOOFF40ft MEMORIAL MEDICAL CENTER / NH CRESCENT_ MEMORIAL MEDICAL CENTER / SOLERA AT WEST HOUSTON I" MEMORIAL MEDICAL CENTER / NH FORT BEND` MEMORIAL MEDICAL / NH GOLDEN CREEK HEALTHCARE 4464 * MMC-NH GULF POINTE PLAZA PRIVATE PAmomov MMC -NH GULF POINTE PLAZA -MEDICARE/MEDICAID tal Banking Available Previous Day $152,759,62 $151,370.42 Reorder Favorites hops:!lpbsitxsecure.fundsxpress.comlfxweblappl#!home 7/1 � Memorial Medical Center Nursing Home UPL Weekly HMG Transfer Prosperity Accounts 7/1/2019 heviaus Pmiaua FWrneln/dmatbn h16vYPourtt Pbae Note. OFNbeten ,o/overSvsauanlbe xansferrearu errant Were rare . Each taunt Am ab se bobnre a/5300 thatMMC arPanea to horn crevices. APPR0VEID ON JUL tl i 7.019 COUNTY AUI7TTUR Pename to Be rr�aymmto Oank Balance 3W.]9v Variance Leave In Balance Iroa Ponlon0.1PP MMCvortlauto on NPP;i,Upse Marrbinterest via✓ Paylitereat O Maylnteret ON jurpefiflevest ON` Aalvst Balaniefttarmernml.__ a13 llmaunt to Be ani BaUn<e i,653.63 Variance In BQFF1 3W4O MM0PartlonLeave MMC Prince QIPP Zj,tapse Martbintettit ON total interest as May Interest ON lunelnterest Falart eman<elrrans(erant 2,35. Approve Olane G140arg60 ill/2a9 unu,v..n,ir.n,b�naal a6t.rang.asammaruaa5uasyxnaPa3rannersaanm..,mmaBam mmt PORTION NH Trdnsfa-Ons Transfer -In I QIPP/Compl CJPP/ComP2 QIPP/COmp3 gIPP/Lapse gIPPq PORTION 6/30/1039 Attr Fanning rymtAdded to Arcouna 7112019 Home ALL ACCOUNTS FAVORITES * Favorite Accounts MEMORIAL MEDICAL CENTER - OPERATIN( MEMORIAL MEDICAL CENTER / NH ASHFORN MEMORIAL MEDICAL CENTER / NH BROADMOOR#Mo MEMORIAL MEDICAL CENTER / NH CRESCENDI MEMORIAL MEDICAL CENTER / SOLERA AT WEST HOUSTON D MEMORIAL MEDICAL CENTER / NH FORT BEND MEMORIAL MEDICAL / NH GOLDEN CREEK HEALTHCARE NNW MMC -NH GULF POINTE PLAZA PRIVATE PAY 5433* MC -NH GULF POINTE PLAZA -MEDICARE/MEDICAID saa1 tal Banking Available Previous Day $100.29 $100.29 $2,853.82 52,853.62 Reorder Favorites httpsalpbsitxsecure.(undsxpress.com/txweb/appt#!home 1/1 MEMORIAL MEDICAL CENTER CHECK REQUEST P Memorial Medical Center Operating Date Requested: i1 Y E E AMOUNT $18t319•28 nrrrtov>;1a ON JUL D toT� AlUDYT011 COUNTY FOR ACCT. USE ONU' Imprest Cash �A/P Check Mail Check to Vendor Return Check to Dept CAT.TIOXJN COiN CY TE G/L NUMBER: 000013 EXPLANATION: Golden Creek- To transfer funds for Comp 1- OIPP payment. R[QUISTED BY: Sarah L. Henderson AtI(HORIZEU U'Y: a I_1 MEMORIAL MEDICAL CENTER CHECK REQUEST Memorial Medical Center Operating Date Requested: 711/19 O t?N E JUL 01 2019 E FOR ACCT. USE ONLY Imprest Cash �A/P Check Mail Check to Vendor Return Check to Dept UNTY, TP.XAS AMOUNT S164.26 G/L NUMBER: 21400012 COYINI'Y AUDT'lOIt CALHOUN CO EXPLANATION: ASHFORD - To transfer funds for Interest earned. R[QUESfED BY: Sarah L. Henderson AUTHORIZED BY: 0 MEMORIAL MEDICAL CENTER CHECK REQUEST Memorial Medical Center Operating Date Requested: AMOUNT 5165.22 FOR ACCT. USE ONLY APPROVED F1Imprest Cash ON i F]A/P Check - JUL 01 2019 Mail Check to Vendor CO'ONTYAUDITOR ❑Return Check to Dept CAT.HOUT COUN'IT, TEXAE GA NUMBER: 21400011 EXPLAPIATIOtJ: Solera-To transfer funds for interest earned. REQUESTED 8Y: Sarah L. Hentlerson AU'I'I10RILED BY: MEMORIAL MEDICAL CENTER CHECK REQUEST p Memorial Medical Center Operating 7/1/19 Date Requested: A FOR ACCT. USE ONLY Y hPPAPPROVEDnImp rest Cash "kl ON E �A/PCheck JUL 01 2019 ❑NiailChecktoVendor E Return Check to Dept COUNTY AUDt2'OR CALUOUN COUNfIrY, Tti:;AS AMOUNT $159,24 G/L NUMBER: 21400010 EXPLANATION: Crescent - To transfer funds for interest esrnetl. REQUESTED BY: Sarah L. Henderson AUTHORIZED BY: eta MEMORIAL MEDICAL CENTER CHECK REQUEST Memorial Medical Center Operating Date Requested: 7Y1/19 AMOUNT 5174.33 APPnovED ON JUL 01 2019 COUNTTAUDYrOR CAWOUN COUNTY FOR ACCT. USE ON LY Imprest Cash �A/P Check Mail Check to Vendor Return Check to Dept ,rExAs G/L NUMBER: 21400009 EXPLANATION: Broadmoor • To transfer funds for interest earned. REQUESTED BY: Sarah L. Henderson AU'fI10RIZEll BY: 0 i MEMORIAL MEDICAL CENTER CHECK REQUEST Memorial Medical Center Operating Date Requested: 711/19 AMOUNT 565.65 FOR ACCT. USE ONLY APPROVID ON �Imprest Cash �A/P Check JUL 01 201 El Mail Check to Vendor COUNTY AUDITOR El Return Check to Dept E,'Ai.LiOT1N COUNTY, SPki.S G/L NUMBER: 21400008 EXPLANATION: Fort Bend - To transfer funds for interest earned. REQUESTED BY: Sarah L. Henderson AUTHORIZED BY: MEMORIAL MEDICAL CCIN I tM CHECK REQUEST P Memorial Medical Center Operating A Y — E E AMOUNT $7828 Dale Requested: 7/i�t9 FOR ACCT. USEONLY Imprest Cash �AJP Check Mail Check to Vendor Return Check to Dept CAL DLW CO.AT/DIToR GA Nt R;27400013 'r, 400013 �1. AP ON JUC U 1 2019 Co EXPLADIATION: Golden Creek -To transfer funds for interest earned. REQUESTED BY: Sarah L. Henderson AUTIiORIZED BY: MEMORIAL MEDICAL CENTER CNECi< REQUEST Memodal Medical Center Operating Date Requested: 7/111g Y E E .4MOUNT 5.58 .APPRQVLID QN JUL 0 9 2019 COt]N'a`YAUDITOIi CALHOUN COYINTX, TEXA9 FOR ACCT. USE ONLY �Imprest Cash �A/P Check �tJlail Check to Vendor Return Check to Oepi G/L NUMBER: 27400014 EXPLANATION: Gulf Pointe - To transfer funds for interest earned. REQUESTED 6Y: Sarah L. 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