2019-10-07 CC MINUTES.pdfCommissioners' Court —October 07, 2019
i I II . I i � . I I" %�) I"
REGULAR 2019 TERM § OCTOBER 07, 2019
BE IT REMEMBERED THAT ON OCTOBER 07, 2019, THERE WAS BEGUN AND HOLDEN A
REGULAR TERM OF COMMISSIONERS' COURT.
1. CALL TO ORDER
This meeting was called to order at 10:00 A.M by Judge Richard Meyer.
2. ROLL CALL
THE FOLLOWING MEMBERS WERE PRESENT:
Richard Meyer
County Judge
David Hall
Commissioner,
Precinct
#1
Vern Lyssy
Commissioner,
Precinct
#2 - Absent
Clyde Syma
Commissioner,
Precinct
#3
Gary Reese
Commissioner,
Precinct
#4
Anna Goodman
County Clerk
Catherine Sullivan
Deputy County
Clerk
3. INVOCATION &PLEDGE OF ALLEGIANCE (AGENDA ITEM NO. 2 & 3)
Invocation —Commissioner
David
Hall
Pledge to US
Flag
&Texas
Flag —Commissioner
Gary Reese/Clyde Syma
Page 1 of 4
Commissioners' Court —October 07, 2019
4. General Discussion of Public matters and Public Participation.
N/A
5. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 5)
To approve an order Prohibiting Outdoor Burning. (RM)
RESULT: APPROVED [UNANIMOUS]
MOVER: Richard Meyer, County Judge
SECONDER: Gary Reese, Commissioner Pct 4
AYES: Judge Meyer, Commissioner Hall, Syma, Reese
6. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 6)
To approve a lease agreement with Great America Financial Services/Dewitt
Poth & sons for a Kyocera 6635cidn Copier/Printer for Precinct 3 and
authorize Commissioner Syma to sign. (CS)
RESULT: APPROVED [UNANIMOUS]
MOVER: Gary Reese, Commissioner Pct 4
SECONDER: Clyde Syma, Commissioner Pct 3
AYES: Judge Meyer, Commissioner Hall, Syma, Reese
7. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 7)
To approve a lease agreement with Great America Financial Services/Dewitt
Poth & Sons for a Kyocera 406ci Copier/Printer for the County Judge and
Emergency Management and authorize the County Judge to sign. (RM)
RESULT: APPROVED [UNANIMOUS]
MOVER: Richard Meyer, County Judge
SECONDERt Clyde Syma, Commissioner Pct 3
AYES: Judge Meyer, Commissioner Hall, Syma, Reese
Page 2 of 4
Commissioners` Court —October 07, 2019
8. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM 140.8)
To authorize the County Sheriff to sign a credit application in order to
purchase tires from Beasley Tire Service, Inc. (RM)
RESULT: ' APROVED [UNANIMOUS]
MOVER: Clyde Syma, Commissioner Pct 3
SECONDER: David Hall, Commissioner Pct 1
AYES: Judge Meyer, Commissioner Hall, Syma, Reese
9. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 9)
To approve a service contract with Silverback Septic Solutions for Precinct 2
and authorize Commissioner Lyssy to sign. (VL)
RESULT: APROVED [UNANIMOUS]
MOVER: Gary Reese, Commissioner Pct 4
SECONDER: David Hall, Commissioner Pct'1
AYES: Judge Meyer, Commissioner Hall, Syma, Reese
S0. Accept reports from the following County Offices:
1. County Auditor's Office —various department audits
2. Hoodplam Administration — Sept 2019
3. Sheriff's Office — Aug 2019 (revised)
RESULT: ` APROVED [UNANIMOUS]
MOVER: David Hall, Commissioner Pct I
SECONDER: Gary Reese, Commissioner Pct 4
AYES: Judge Meyer, Commissioner Hall, Syma, Reese
Page 3 of 4
Commissioners' Court —October 07, 2019
11. Consider and take necessary action on any necessary budget adjustments.
RESULT: APPROVED [UNANIMOUS]
MOVER: Gary Reese, Commissioner Pct 4
SECONDER: David Hall, Commissioner Pct 1
AYES: Judge Meyer, CommissionerHall, Syma, Reese
12. Approval of bills and payroll. (RM)
MMC
RESULT: APPROVED [UNANIMOUS]
MOVER: David Hall, Commissioner Pct 1
SECONDER: Gary Reese, Commissioner Pct 4
AYES: Judge Meyer, Commissioner Hall, Syma, Reese
County
RESULT: APPROVED [UNANIMOUS]
MOVER: David Hall, Commissioner Pct 1
SECONDER: Gary Reese, Commissioner Pct 4
AYES: Judge Meyer, Commissioner Hall, Syina, Reese
Payroll
N/A
ADJOURNED: 10:10 A.M.
Page 4 of 4
Commissioners' Court —October 07, 2019
BE IT REMEMBERED THAT ON OCTOBER 07, 2019, THERE WAS BEGUN AND HOLDEN A
REGULAR TERM OF COMMISSIONERS' COURT.
1. CALL TO ORDER
This meeting was called to order at 10:00 A.M by Judge Richard Meyer.
2. ROLL CALL
THE FOLLOWING MEMBERS WERE PRESENT:
Richard Meyer
County Judge
David Hall
Commissioner,
Precinct
#1
Vern Lyssy
Commissioner,
Precinct
#2 - Absent
Clyde Syma
Commissioner,
Precinct
#3
Gary Reese
Commissioner,
Precinct
#4
Anna Goodman
County Clerk
Catherine Sullivan
Deputy County
Clerk
3. INVOCATION &PLEDGE OF ALLEGIANCE (AGENDA ITEM NO. 2 & 3)
Invocation —Commissioner
David
Hall
Pledge to US
Flag &Texas
Flag —Commissioner
Gary Reese/Clyde Syma
Page 1 of 10
Commissioners' Court —October 07, 2019
4. General Discussion of Public matters and Public Participation.
N/A
Page 2 of 10
Commissioners' Court —October 07, 2019
5. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 5)
To approve an order Prohibiting Outdoor Burning. (RM)
RESULT: APPROVED [UNANIMOUS]
MOVER: Richard Meyer, County Judge
SECONDER: Gary Reese, Commissioner Pct 4
AYES: Judge Meyer, Commissioner Hall, Syma, Reese
Page 3 of 10
WHEREAS, on the 7th day of October; 20193 the Commissioners' Court finds that vEpM
circumstances present in all of the unincorporated areas of the County create a public
safety hazard that would be exacerbated by outdoor burning.
IT IS HEREBY ORDERED by the Commissioners' Court of Calhoun County that all
outdoor burning is prohibited in the unincorporated area of the County for 90 days from the date
of adoption of this Order. The County Judge may rescind this Order upon a determination that
the circumstances that required the Order no longer exist
Household Trash may be burned in a closed or screened container.
This Order is adopted pursuant to Local Government Code §352.081, and other applicable
statutes. This Order does not prohibit outdoor burning activities related to public health and
safety that are authorized by the Texas Commission on Environmental Quality for: (1)
firefighter training: (2) public utility, natural gas pipeline or mining operations; (3) planting or
harvesting of agricultural crops; or, (4) burns that are conducted by a prescribed burn manager
certified under Section 153.048, Natural Resources Code, and meet the standards of Section
153.047, Natural Resources Code.
In accordance with Local Government Code §352.081(h), a violation of this Order is a
Class C misdemeanor, punishable by a fine not to exceed $500.00.
ADOPTED this 7ch day of October, 2019 by a v4ard
ayes and � nays.
er
Caoun ounty Judge
ATTEST:
Anna oodman, County Clerk
By:
eputy
Page 1 of 1
Commissioners` Court — October 07, 2019
6. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 6)
To approve a lease agreement with Great America Financial Services/Dewitt
Poth & sons for a Kyocera 6635cidn Copier/Printer for Precinct 3 and
authorize Commissioner Syma to sign. (CS)
RESULT: APPROVED [UNANIMOUS]
MOVER: Gary Reese, Commissioner Pct 4
SECONDER: Clyde Syma, Commissioner Pct 3
AYES: Judge Meyer, Commissioner Hall, Syma, Reese
Page 4 of 10
Clyde ,Sym a
Calhoun County Commissioner, Precinct 3
24627 State FIwy. 172�01ivia, Pori Lavaca, Texas 7'1979 � Office (361) 89.3-5346 � Fax (361) 893-S309
Email: clydeyma@ca(honncotx ore
October 1, 2019
Honorable Richard Meyer
Calhoun County Judge
211 S. Ann
Port Lavaca, TX 77979
RE: Agenda Item
Dear Judge Meyer:
Please place the following item on the Commissioner's Court Agenda for October 7, 2019.
® Please Consider and Ta1ce Necessary Action on approval for lease agreement of a Kyocera 6635cidn
Copier•/Priuter with Great America financial Services/Dewitt poth & Sons, and allow Commissioner
Syma to sign all documents.
Sincerely,
Clyde Syma
Commissioner Pet. 3
r'GreatAmerica"
�1 FINANCIAL SERVICES
HARD WORK • INTEGRITY • EXCELLENCE
September 30, 2019
County of Calhoun
201 W Austin Street
Port Lavaca, Texas 77979-4210
Re: Agreement No. 1504655 (the "Agreement")
To Whom it May Concern:
625 First Street SE, Suite 800
Cedar Rapids, IA 52401
Toll Free 844-360-3897
We understand that you are contemplating entering into an agreement with GreatAmerica for
the lease/rental of certain office equipment ("Equipment") and that you desire to have
GreatAmerica sign the Agreement before delivery and the installation of the Equipment.
Ordinarily, we do not sign agreements until after the lesseelcustomer has signed the
document(s) and after we have confirmed with the customer/lessee that the Equipment has
been delivered and is installed satisfactorily. However, you have a strong desire that we sign
the Agreement prior to installation, and we are okay with that because you understand that,
per the terms of the Agreement, the Agreement will not become binding on us until we fund
your vendor for the Equipment.
Accordingly, enclosed please find two copies of the Agreement bearing our original
signature, one of which has a legend in the margin that states as follows: "This counterpart
original of this lease is not chattel paper. The counterpart original which constitutes chattel
paper is held by GreatAmerica Financial Services Corporation." You may keep the copy with
that legend on it. The other copy will be our original. You will need to sign our original and
return it to us before we can fund your transaction,
If you have any questions, feel free to contact us.
Thank you.
Sincerely,
Megan Goody
AGREEMENT GREATAMERICA FINANCIAL SERVICES CORPORATION ?
�� • ® - 625 FIRST STREET BE, CEDAR RAPIDS IA 52401 0
rR A G re a t A m e ri c a PO BOX 009, CEDAR RAPIDS IA 62406.0609 C
S i1111111111111111iPINANCIAL SERVICES i
AGREEMENT NO.: 1504655
z
FULL LEGAL NAME: Calhoun, County of
ADDRESS: Precinct 3 24627 Hi hwa 172 Port Lavaca, TX 77979 C
PrWrITOTOMM..is
G
Dewitt Poth & Son Yoakum, TX
1 EQUIPMENT AND PAYMENT TERMS
TYPE,MAKE, MODEL NUMBER, SERIAL NUMBER, AND INCLUDED ACCESSORIES SEE ATTACHED SCHEDULE T
1 Kyocera ECOSYS M6635cidn System _
EQUIPMENT LOCATION: As Stated Above ('PLUS TAX)
TERM IN MONTHS: 63 MONTHLY PAYMENT AMOUNT': $69.00 PURCHASE OPTION': Fair Market Value no
to
ADDITIONAL TERMS AND CONDITIONS z
AGREEMENT. You want As to now pay your Vendor W the equipment and/or software refererosdhemin INSURANCE. Yauagmeto maintain commercial genera111ah5ry lrKaanwaccoplable Cc us. YOU also agree -1
('Equipmeni') end the amounts your Vendor Included on the Invoke to us for the Equipment far related to: 1) keepthe Equipment futy Insured with us owned as,loss payee; and
installation, (mining. andlof Implementation costs, and you unconditionNiy agree In paayy us the amounts 2) provide proof of insurance satisfactory (o us m toter [him M days believing the eomnencemeet of this
Payable under the terms of ibis agreement CAgreememl each period by the due date. T fs Agreement will Agreement, and therawtor upon am written request If van fail to mabwan property foss Insurance sousfactoly
begin on The dale the Equipment Is delivered to you or any later date we designate. We may charge you a Is us and/or you fail is mnely provide PROOF Of such Insurance, we here the option, but not the obligation, to rib
one-time ortiinarion fee of$75.UD. ff any Amount payable to us is past duo, yen will pay a lots charge equal secure property Ines inummolAn The Equipmentit= a center ofourchooRmit In such forms and mounts as y
to, 1) the greater of ten (10) cents for each dollar overdue or twenty-six dollars ($26.00); oc2) the highest we deem reasonable to prolecl our interests. if we secure insurance an Me Equipment, we WO not name you m
legal charge. it less. As on Insured party, your Interests may not be fully infected, and you win reimburse us the premium which
NET AGREEMENT. THIS AGREEMENT IS NOMCANCELAGLE FOR THE ENTIRE AGREEMENT TERM, may be higher than ma pnelniumyou would pay if you obtained insurance, and whkh may result In a profit to
YOU UNDERSTAND WE ARE PAYING FOR THE EQUIPMENT BASED ON YOUR UNCONDITIONAL a through an investment in relnsuranca. Iryou are Recent in all of year oNyations under the Affmamenl al
ACCEPTANCE OF IT AND YOUR PROMISE TO PAY US UNDER THE TERMS OF THIS AGREEMENT, the time of bss, any insurance poceeds received wig be applied, at wo option, to repair or replace the
WITHOUT SETOFFS FOR ANY REASON, EVEN IF THE EQUIPMENT DOES NOT WORK OR IS Equlpmenl, a to pay us the remalning payments due a io boot due under Ihis Agreement plus our c
DAMAGED, EVEN IF IT IS NOT YOUR FAULT, Won residual, both discounted at 3%per annum
EQUIPMENT USE. You win keep the Equipment in good waking order, Use it for business purposes only, TAXES. We own the Equlpmenl. You will pay when due, either directly or by reimbursing us, all lazes and
and not modify or move A from Its initial location without our consent, You must resolve any dispute you may faes relating to the Equipment and this Agreement. Sales or use tax due Upfront will be payable over the
have snnceming the Equipment with the manufacturer or Vander. Payments under this Agreement may tann with a finance charge. j
Include amounts you owe your Venda under a separate arrangement (for maintenance, service, supplies, ENO OF TERM. At the end of the too of Ihis Agreement (or any renewal term) (the "End Date'), this 71
ok.),which amounts may be invoked by us on yourVendoea behalf for yourconvenienw. Agreement will renew month to month unless a) we receive written notice from you, at least 30 days prior O
SOFTWARER)ATA. Except as provided in this paragraph, ref xemeas to Tcuipnenr include any somvam to the End Date, of your intent to return the Equipment, and b) you gmay return the Equipment to the x
referenced above or Installed on (he Equipment. We der not own me software and cannot Walter any interest location designated by us, at your expense. If a Purchase Option Is indicated above and you we not in 6)
In itkyou, We are Rat responsible for lhesol(ware or the obliga0ons ofyou a The licenses undaany license detaull on the End Dale, you may purchase the Equipmenlfiom us'AS IS' for the Purchase Option price, y
agreement. You are solely responsible far protecting and removing any confidential datahmages shred on If the returned Equipment is not immediately available for use by another wgroul need of repair, you will
the Equipment prior to its Return for any reason, reimburse us for all repair cols. You cannot pay off this Agreement An retum the Equipment prior to the �
NO WARRANTY, WE MAKE NO WARRANTIES, EXPRESS OR IMPLIED, INCLUDING WARRANTIES OF End Date without ourconsent. If we coolant, we may charge you, in addition to other amounts owed, an =
MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. YOU HAVE ACCEPTED THE early termination fee equal to 5% cribs amountwe paid for the Equipment s
EOUIPMENT "A5•18". YOU CHOSE THE EQUIPMENT, THE VENDOR AND ANYlALL SERVICE OEFAULTIREMEDiES. It a payment becomes 10> days past due, or It yen otherwisebreach this
PROVIDER(S) BASED ON YOUR JUDGMENT, YOU MAY CONTACT YOUR VENDOR FOR A STATEMENT Agremron , you will be in default, and we may require that you return the Equipment to Us at your m
OF THE WARRANTIES, IF ANY, THAT THE MANUFACTURER OR VENDOR IS PROVIDING, WE ASSIGN expense and pay us: 1) all past due amounts and 2) erg remaning payments fur the unexpired ten, plus
TO YOU ANY WARRANTIES GIVEN TO US. Our booked residual, dlscoun ed at 3% put annum: and we may disable or repossess the Equipment and
ASSIGNMENT. You may cal sell, assign or sublease the Equipment in this Agreement without our written use ell other legal remedies available to us, You agree to pay all costs and expenses (Including c
colonel. We may sell or assign this Agreement or our rights in the Equipment in whole win pad, to a third reasonable attorney fees) we incur in any disputevdm you (dated to this Agreement, You agree Is pay us
party without notice to you. You agree that if we do so, the assignee will have cur rights but will net be subject 1.50/6Interest per month on at past due amounts,
to any Orion, defense, or selroR assedable against Us An anyone else. UCC. You agree that this Agreement is (and/or shall be treated as) a Thance Lease' as mat term is 0
LAWIFORUM. This Agreement and any clam related to this Agreement will be governed by [ova law. Any defined In Angola 2A of the Uniform Commercial Code (TC01. You agree to largo the rights and
dispute will be adjudicated in a stale or federal wed Iceated in Wn County, Iowa. YOU consent to personal remedies provided under sections 507,522afAckle 2A0f M UCC.
Jurisdiction and venuain such toads and waive 6anskrorvenue. Each padywaiven anyd06ttoalury Idol. MISCELLANEOUS, This Agroonowl Is the Argon agreemenl between you and us totaling to the
LOSS OR DAMAGE. You am responsible for any damage to or loss of the Equipment No such less or Equipment and supermarket any prior representations or agreements, including any purchase elders,
damage will relieve you from your payment obigotions hereunder, We are not responsible fa, and you will Amounts payable under this Agresmanl may include a intent to as, The patties agree that (he original v
Indemnify us against, any claims, tosses or damages, Including attorney fees, in any way totaling to the harear or enlorcemaM and perfection purposes, and The sole Second' constituting %haNAl paper under
Equlpmenl or data stared one In no event Will WS be liable(a any consequential or indirect damages. me UCO, is the paper copy hereof bearing 0) the original or a copy Of enter your manual sgnalure or an 0
elac(ranieally applied Indlaaibn of your !Aloof to enter into Ibis Agreement, end (It) our original manual m
signature An chan emult he lnwdtln si nadb each ininAt. o
APPLICABLE TO GOVERNMENTAL ENTITIES ONLY
You hereby represent and warant to its that as of the date of the Agreements (a) me Indlvitlual woo executed the Agreement h Io Ipowar and aumordy to exeoule the Agmemend on your bah C (b al rognirotl
procedures necessary to make the Agreement a legal and binding obligation against you have been folkwed; to) the Equipment Will be operated end contra'ked by you and win be used for essengai government A
purposes for the engm term oftheAgreemenh (it) that all payments due and payable for the current But year we Wthin The currembudget and are Wmin an availabla, unexhausled, and unencumbered appropriation:
(a) you intend to pay all mounts payable under the terms of the Agresmalwhen due, if funds we legally avapable to der so; Oyour obligations to remit Amounts under the A9greamentwnsmme a current expense and y
not a debt under applicable state law; (g) Ro povislon of the Agreement consglules a pledge of your tax a general revenues; and (h) you will comply with any applicable location reporting requtmments of the lax >
code, which may Include BD38-G or 803"G Information Returns. If foods am Rat appropriated 10 pay mounts due under the Agreement re any hiture fiscal permit you shot[ have the right to return the Equipment and m
terminate the Agreement on the last day of the fiscal period for which hinds were mailable, Aliout penally w additional expense to you (other than the expense of returning the Equipment to the location designated by m
ue), provided that in bast Ihldy (30) days poor to the start of the fiscal period for which funds were Trot appropriated, your Chef Executive Officer (or Legal Counsel) delvers to us a cweficate (ofopmkn) codifying cal 9
(a) you are a state or a luny consmuled political Anoint a agency of the stale in which you are located; (b) funds have nod been apptepdated fa the applicaNe fiscal period to pay amounts due under me .m
AgreamenT: (c) such non-appoprlalion did not result from any act or failure 10 act by you: and (d) you have exhausled ag hinds legally available for the payment of amounts due under the Agreement, You agree that z
ibis err rannhalfillonhianda it end to theexientiha6 stale law mrscitides ilou from mileflop Into the Amemant It [he reamentmfnsGlutes a muid•ear unconditional n Mobilialka, z
• • •' • O
THISAGREEMENTIS C CELABLEFORT FULLAGREEMENT TERI IS AGREEMENT IS BINDINGWHEN WEEXECUTETHISAGREEMENT AND PAYFORTHEEQUIPMENT.
OWNER: GreatA ric inanci rvices Corporation �^ CUSTOMER: (Asglatend A A
SIGNATURE; DATE: ..J(! SIGNA'TURE: ' E— DATED �',T" 5
n
PRIM NAME &TITjdZ PRINT NAME&TI fmn
CERTIFICATE OF DELIVERY AND ACCEPTANCEO
The Cuslomerhereby ceNges matail the Equipment l) has been received, fnslalled, and Inspected, and 2) (s Nlly operational and uucondigonaliy asaptad.
SIGNATURE:X NAMEANDTITLE; DATE:
H
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VG01M(TL)_0510 09130/19 230
Amendment
GreatAmenca°
�IFINANCIAL SERVICES
This Amendment amends that certain agreement by and between GreaMmenca Financial Services Corporation ("Owner")
and Calhoun, County of ("Customer") which agreement Is identified in the Owner's Internal
books and records as Agreement No. 1504665 the "Agreement"), Ail capitalized terms used in this Amendment,
which are not otherwise defined herein, shall have the meanings given to such terms in the Agreement. Owner and
Customer have mutually agreed that the following modifications be made to the Agreement.
The Section entitled INSURANCE Is hereby deleted in its entirety and replaced with the following:
"You Agreo: (a) to keep the Equtpmentfuliy Ensured against loss at Its replacement cost; and (b) to maintain comprehensive public liability
Insurance'
Except as specifically modified by this Amendment, ail other terms and conditions of the Agreement remain in full force and
effect, If, and to the extent there is a conflict between the terms of this Amendment and the terms of the Agreement, the
terms of this Amendment shall control. A facsimile copy of this Amendment bearing authorized signatures may be treated as
an original. This Amendment is not binding until accepted by Owner.
ay:
Services
Lnq�trad Sjl ulrSf �..
Cate Accepted: �/�
af�4T5Za31ns F1109
Calhoun, Couniy of
@�Gu t}omer
X A C—
signature
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CERTIFICATE OF INTERESTED PARTIES FORM 1295
Intl
Complete Nos,1- 4 and 6 If there are Interested parties,
Complete Nos,1, 2, 31 5, and 6If there are no Interested parties,
OFFICE USE ONLY
CERTIFICATION OF FILING
Certificate Number:
2019.499330
i
Name of business entity filing form, and the city, state and country of the business entity's place
of business,
DEWITT POTH AND SON
YOAKUM, TX United States
Date Filed:
2
Name of governmental entity or state agency that is a party tot the contract for which the form Is
being filed,
06/03/2019
Calhoun County
Date Acknowledged:
3
Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a
description of the services, goods, or other property to be provided under the contract,
Copiers
Copier equipment and supplies
4
Name of Interested Parry
City, State, Country (place of business)
Nature of Interest
(check applicable)
Controlling
Intermediary
Jacque, Schumacher
Yoakum, TX United States
X
5
Check only If there is NO Interested Party, ❑
6
UNSWORN DECLARATION
My name is J C U , and my date of birth is
My address Is ,
(street) (city) (slate) (zip code) (country)
I declare under penalty ofperjurythat the foregoing is true and correct.
Executed in d Y U/W\. County, State of _�_e . _, on the 1st day of October , 20_ 19__
(month) (year)
ign ur authorized agent of contracting business entity
(Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx,us Version V1,1.39f8039c
�wift pohVson
TOMORHOW'911U41 NtS544P1111191 YOOMESTA-
®ffice Equipment I IT Services I Mice Supplies I romofional Produefs
102 West Street Yoakm,Texas 1361,550.74971 www.dewittpoth.com
® '37 pagesVer m ute blachlcolor output
® I00-single-pass Document Feeder
e Copy/Print/Scan/Fax
e Scan to Folder/email
e 1x250-sheet paper cassette Letter/Legal
® 1x500-sheet paper cassette Letter/Legal
o Storage Cabinet
FMV Lease
$b9/month
Maintenance �ontraet
Black images at .01 each; color at .07 each. Parts, labor, and toner included.
Pricing includes delivery, installation, networking and training on new copier. Also included is
the shipping of the existing Ricoh back to the leasing company at no additional charge.
Commissioners' Couri—October 07,2019
7. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 7)
To approve a lease agreement with Great America Financial Services/Dewitt
Poth & Sons for a Kyocera 406ci Copier/Printer for the County Judge and
Emergency Management and authorize the County Judge to sign. (RM)
RESULT: APPROVED [UNANIMOUS]
MOVER: Richard Meyer, County Judge
SECONDER; Clyde Syma, Commissioner Pct 3
AYES: Judge Meyer, Commissioner Hall, Syma, Reese
Page 5 of 10
7 GreatAmerica t� FINANCIAL SERVICES
HARD WORK . INTEGRITY .
EXCELLENCE
October 1, 2019
Calhoun 01 W A stinStreet,t,Suite 105 Judge Office
Port Lavaca, Texas 779794210
Re: Agreement No. 1505944 (the "Agreement")
To Whom It May Concern:
625 First Street SE, Suite 800
Cedar Rapids, IA 52401
Toll Free 844-360-3877
We understand that you are contemplating entering into an agreement with GreatAmerica for
the lease/rental of certain office equipment E
GreatAmerica sign the Agreement before delivery and the installation of the Equipment.
Ordinarily, we do not sign agreements until (aferithe lessee/customer that ouhasslsignedhave
documents) and after we have confirmed with the customer/lessee that the Equipment has
been delivered and is installed satisfactorily,ver, the
the Agreement prior to installation, and we are okay with that because you understand that,
Per the terms of the Agreement, the Agreement well not become a because
binding eon Us undunterstand
You have a strong desire that we sign
Your vendor for the Equipment,
we fund
Accordingly, enclosed please find signature, one of which has a legend in the margin that states as follows: "This counterpart
original of this lease is not chattel PaperTheThelcount part ores of the giginal whichreement econh .our original
Paper is held by GreatAmerica Financial Services Corporation." You may keep the co
PY with
that legend on it. The other co constitutes chattel
return it to us before we can fund your tan actionour �nal. You will need to sign our original and
If you have any questions, feel free to contact us.
Thank you.
Sincerely,
Amanda McDermott
GreatAmenca
r
F•IMANCIAL SSRVICRS
•
IZ,till ,r:�.,wn..r. Calhoun`.Dautitvof.DBAA
TEFthI.IN MONTHS: 63
The
AGREEMENT GREA'rAMERICA FINANCIKL SERVICES C9RPORATION
e26,FIR6TSsTREET se, CEDARRAPIDMA52401
RO BOJGOO9; CEDAR RAEIOS IA 52gOGnepO n
MONTHLY PAYMENT AMOUNT':,
trdnlep, aptller tmpiemenlaaad code, eddybu uilponQflldnell¢ eArae,m pay us the amounb
ler Iha terms at mksh"ant rAgioament') eechpedod by Ih9 due dale. This'Agmemeat•w111
a Malibu Equipments deligeiedio you oc any later dbte We desfggal0i W6 may dhar0e.you a
gioatibe fee o{Yj5.00. If arty aptaunTpayabia k us is pauhdo, Y.au uail phr: a lae.char0e:pgant
'eater often (10) camsla each doAefoveatup'Or (wenlysbr ollam %26,00)1 nr2) the Mohest
as If took
EMkHT..T.lits AGNEEMENT IS NOWCANCFIABLE FOR 'f{fE ENTIRE AGREEMENT'YERM.
'RSTAND,Wk ARE PAYINO:FOR:M5 EQUIPMENT BASED ON YOUR UNCONDNIONAL
IC$ OF IT AND YQUR•PROMISE TO.pAY'US UNDER THE TERMS OFTMS AbREEMENT,
SETOFFS FOR ANY REASON, EVEN IF THG:, EOU)PMENif DOES NOT WORK 0Rj 18
EVEN IF IT I0.N0PY0QR FAULT.
T USEw y1mvili keap,atp Equipment, to abo t wokng Order; use It for business purposes only,
illy cut mgva It hallo Its Inllial Iowodwlihuul'o v odgsefit You smit'resdve any dlspu(gyou may
rriing thb• Equipment Wb me mebo*(urer of Va§Upf, Payments under`t4h; Agraemenbmay
wnls You OW6 y0r•Vendor undgra'sgparata,.aaedgarV�nnt;(fo(.Ipainlenapcespy6me; suppnes,
emodnfem'sypafntidC "a say
wrVendoesbehaglmynurcdnvenlenoe,,
JDATA.•Exceppt as.proyldetl in 1Ms peregrpPfi, rdjerenges'p'EtjulprOgoC inONde:ggy software
shove alnatdledaplha EgutpmOg4 We da 0of nwn-mesoN+'aro a7idiannd traAslerenyllesisl
Me Ara not mspomlblo fa the odd dm:attieablf0eaohs afyau'a the licens"ruler'any,adepse
YOU
are sddy msposthie 1'orprdecVnp and ramovlp0'aeyCag(Idaeaal dadI9magbs:sfpted on
at
pdor id.lis mlum for any, reason,
ARTY: wE AfAirE NO WARRAffTiEs, E%PRE93 OR IMPLIED, INCLUJ)INII'WABRANTIS OF
'ABILITY'OR•FUNES5 FOR PARTICUfM PURP09E. YOU HAVE, ACCEPTER THE
r JAM"_ YOU CHOSE THE EQUIPMENT, 7HE VENDOR AND. ANYMM SERW09
S).B75ED ON YOURAMMENT. YOU;MAY.CONTAOrYOUR VENDbR FOR A STATEMENT
asAAHTffs,IF ANY, THAT THE MANUFACTURER OR VENDOR 19 PROVIDING. WEASSIGN
Y WARRANTIES OmanTOUS,
NT:.Ybu may rwl.sell, assign` Otwbt&NR the RuiPARIM a this AtIMMOnt without cut Asideq
: may sea or asslgnihis Agreemeetor Our itghis ih'tlie:Equipmebl, in whola.ar to Part, Ipa UYrd
Wee to you: YwagruaAlm ilwedb sc(Ihd'asslgnes wi0ha'vhauf(�ghis bulwillnotbesubfael
dofense asapdfassedable against us pranyane;else,
1A, This Agreement and any clNm Alated to flits j+greement`wal be gaverAed by.100M lax• Any
aq 9dJudlcalgd In a slate a federal coud loafed Ih-Unn Cminly� Ivwe. Yalu consedl fa personal
and venuoiubuchcharts and waue transfer ofvoue, EA85 pally w"sany dghtto AJOWYJA :
iAMAGE, Yap are mspapstbta for spy damage to a loss of the Eghupmen6 NO -such loseur
('PLUS TAX) r—
Fair Market Va{ue w
secure pmpa,rywx nwmaiwnainm cyan,R.,•,,w„arm,=,„.,w..•.....,.•ry•;-.-•._..__.; _,.._'--.- �
v+4deemTeeyonababprotedwrM(ereWs, Ilwe semre krsvance bn the Eggipnsanf, vs wAl noingna you �
as,an insured paiNI;your Wrosls may. not66 peaty p ow4 WA you VA r** PbLp'u's 0e PAR mmm whldh m
mbaT�Aha an lhaPrem{emy0u would paydyoudtimnea lnsur5:pe; gga,wMch may msullfnapbgfb,F
vA Ihiriugh an MYOshnenTln'mtnsaa ce, I(.you antunonl fn aG of youro6ligagons wdarllie.AA(aemePtat -'I
Ne.Unxsal'bsr, imylnsurenea Prodeeds reolred wit be applied) et ow uPieal to Ad pSr ayepdace the m:
Equfprrieni a m'paf us'Iha remektlnA'PaYmanla ¢uaCf lq haoon:@ dua.under.iMs Afvcemenl, plus ouF o..
bdakedrestdual:bolnU9counledat3M,perIDanupl. e -
TAf(E,S. We own@a Equlpmepl.Yiiti Wla pay whyndue;;utUJe¢direCgyorAyrelmhurstngus, all bxee.and za.
feerre)aling totNe Equipment andlllb p®re meAb Sales a pse IawduegPfronlwAl68paypbse avar•)he m
)arm vdlhailnancetEerge. v
ENO 01''tERM: At Ihe;eba ofdha'fedn oFMts^Agreem�nt tnr eeyradewd Wm) (Ufa 1EAd Z Oasyp this ,
Agraemenl wllirenaw month'lO mOnthunless'aJ vie.recetvawdtlen.noltne kOr
li yqu, -Vaasa' dAt to Its y
lo'iha Eqd Date, or your intenb{o retwn lhO.Egdpmen4 add'b) Ya0 timely reNtrt Ihb'Equtpm§nl;te idP O
tacaVbd do;Ignared by Us, aiyma expe®e:.lta PwoNa.Se;OpVafts.4•calt"d apovii n are•d01fo 22
default on Nc6nd Oats; you may pumhme.ihe Egdlpigeit from US "As 16' forlhe PargIi Op11 pdce, z
IlthergliUned Equipmen(is;Iwlfmn:edlately.avaPaGe to use by.ano)harwla�oul.nded:olfepdr, yell wAl p
rend6'uma us lot at repaircc3lg. Yuu cannN pay oD mis Agreamepl otralom 1AeEqutpmeAt pool to I* rR
Erid•tlalewitlwut bur dppsamlNwe.onsenV wO may,chaga.yW,.imadd111on.s7 etimr anioubfsaWed,ah
ewly(eriNnPffoorflee aquattc,6%af4he amobnl we:palddor meEgNPmen4 - O
OEFAULTIREMEDIES'If a palm¢nJ btdpnea 10+ deya'pasl'dua, a the Eq onf I breach this ?
Agreement;Yqu vh11 be m'tletad4 and wq 'm0Y'requ4!e (pea you migm the Equipment Ia.as et your
expe,iseTnd pbyyd; fj alt Pasidaa:emounls.aM 2), allremefning peYmPnmpasha ; se-E Vi farm, ptas
out booked reslduN, dLscoun(edaC3%pa emum;, end we maydiseMa ar reposspssxpenses. enl.gnd
use MI aDmt legal terjwdbB.' ayeaab)q.1O ua Yau agree !¢ pay all fX>ge .and expenses, tto pay us
mssoaate allomgy/eea)we ledur pnaPy_Ufspulew]lh yqd tpteled tdihls/gr6dman4 YOy.egreabpay.us.
1.616 tdtemst permonlh.OA.dI pasl'due ambunla,
UCC, You agree that Ihlg Aprgement is (andPoc'sheihbe ireatdd'as) a'Rnawa Lebse'as Inal.ieryn is
de6aPd m Adjd¢ ?Aal'Na U61fam c6nimea;W Cade rUCCryt'You'egrie.lo forgo Ibe ilghlu and
remedies pro;Aded under sea5ona6oT-622 ofArticte.TAOtihe UCG,
MISCELLANEOUS: This Agfaemen_, Is are entire'agtanndnt bed4een you, ad¢ us. relating fa Ihh
Equlpmenl. and e0pomedds my pdor repesentWons. or.agreemm�5, inciudnp any pumUase emcee, y,
AfdWhlp pay6,bte'ugder,thld Agtedment may Ih MOO a AM51 to us. thepeales agree:ihat.lhe. odAfnai >
haroplm;enfo7Cemept emlpodVion pmposo, sgd'tha sale Tecod' consiluling chao6paper Odder A
Uie UCC,isthp fWn.r copy haeol bgadag.(lPer odOhtd a a cop/. OfedhoryanrmanotOguatureorAn o
elec w1wly appaep. foll:006 or;ydarinteal to enter. Into this Agmemant; and (it our odgtnel manual ;F
sgnaNum h4v PhiinrAv muds f)ein welln AliteAd bi each ad: �n
lha Agfeambnl had roll erand.aut miry tooXacute the Agreement your beheN; lb 91H.Mibfrdd 5�
{c}'Ihq E4.Opmgdt- A operated "cbnWAedtry you aid wfll.be used for esseg At 00FAm9AL M
e,Mlhin the current Wdge aAd ate wNtM an avelaGl9, Unaxtlauskq,,entlanendu0bered approontil c w
doCo.dp:0((f}yodfubiigallons;b remitpmounls underlha An(eemanstmnshAttiol urrenLex bf[E and �u
xal mybnbes;anrt(A}y0awill cgmptywllh m,Y.apyfcabiafnfa. ma4olr,repaiOeA'mlNlremenlsof(nt fnx' n
tie underthe Agieemenlia any Nhireif50d palod,you'Ntall havathe ¢gryt tofai{pnrn iAe Equlppmmanlaby An
Ildon'al dxppeease{o yhu {amafhaelhe.axpansa o{resuming ifi9'Egyfpmedlmtlie]Oca9oh des:9ne0tat mx
edryaurCaief Fxeeutrve Offtca (a bpAgl Goghsel) deifgets to.ds a CaAA0818 tofapldoe)cm§Mnor, w v
n
yyb tends have nol been epprdprlaled surf M.e app(Ipetlle'fiscel.ppa�dtod b pay amaupisdaa•tmda the p
ds�ed•ell funds legally.avellaMefo9'tNe:peymenf.ol,eyngddis durlungdr lhgAgraame:¢. You agree( �
itlhe emadtbonaiiluleaamugl erundonditlo d nknl6611 lion.
✓T16BINDINGWHEN CUTDTHISAOHEEEIl1�NTANDPAYFORYREEQUIRI ENTy g
wsTO'MER;. As tad Ab a
IIONATURE: w DATE•
'RINF.NAME &TITLE: `y
O
!)fsWlry'aperdlbad and OriZvndlaanaly ecpepled. '-O�-pp
LE: DATE 'O
1
0
z
230
VGO.tM(TL) 06T0 1016T!79
Amendment
This Amendment amends that certain agreement by and between GreatAmerica Financial Services Corporation ("Owner")
and County of Calhoun DBA County Judge Office ("Customer") which agreement is Identified in the Owner's internal
books and records as Agreement No. 1505944 (the "Agreement"). All capitalized terms used in this Amendment, which
are not otherwise defined herein, shall have the meanings given to such terms in the Agreement. Owner and Customer
have mutually agreed that the following modifications be made to the Agreement.
1. The section entitled "INSURANCE" is hereby deleted and replaced with the following:
"INSURANCE. You Agree: (a) to keep the Equipment fully insured against loss at its replacement cost;
(b) to maintain comprehensive public liability insurance."
Except as specifically modified by this Amendment, all other terms and conditions of the Agreement remain in full force
and effect. If, and to the extent there is a conflict between the terms of this Amendment and the terms of the Agreement,
the terms of this Amendment shall control. A copy of this document containing your original or facsimile signature or other
indication of your intent to agree to the terms set forth herein shall be enforceable for all purposes. This Amendment is not
binding until accepted by Owner.
GreatAmeric financial Servic s Cor oration
caner
By:
Signature
f.vM nfto% .SPttiuliSa' �1�
Print Name & Tftle
Date Accepted: 10
Count of alh� DBA County Judge Office
Customer
By: X
Signature
fie nt Name Mgr / tit TI ye —
r nt &
Date: 77 7
C"un(yofCalhoun,1505844.03.ss PAGE i OF i
CERTIFICATE OF INTERESTED PARTIES FORM 1295
loll
Complete Nos. 1.4 and 6 It there are Interested parties.
OFFICE USE ONLY
Complete Nos. 11 21 31 5, and 61f there are no interested parties.
CERTIFICATION OF FILING
Certificate Number:
1
Name of business entity filing form, and the city, state and country of the business entity's place
of business.
2019-499330
DEWITT POTH AND SON
YOAKUM, TX United States
Date Filed:
06103/2019
2
Name of governmental entity or state agency that Is a party tot the contract for which the form Is
being filed.
Calhoun County
Date Acknowledged:
3
Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a
description of the services, goods, or other property to be provided under the contract.
Copiers
Copier equipment and supplies
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling
Intermediary
Jacque, Schumacher
Yoakum, TX United States
X
5
Check only if there Is NO Interested Party. ❑
6
UNSWORN DECLARATION
My name is J C �l and my date of birth is
My address Is
(street) (city) (state) (ZIP code) (country)
I declare under penalty oftperjury the foregoing is true and correct.
ythat
Executed in Pr County, State of e�s�, on the lstday of October , 20-19__
(month) (year)
D
.pIgniffdro authorized agent of contracting business entity
(Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.391`8039c
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
1of1
Complete Nos, 1- 4 and 6 if there are interested parties.
OFFICE USE ONLY
Complete Nos. 1, 21 31 5, and 6 if there are no interested parties.
CERTIFICATION OF FILING
Certificate Number:
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
2019-499330
DEWITT POTH AND SON
YOAKUM, TX United States
Date Filed:
2
Name of governmental entity or state agency that is a party to the contract for which the form is
06/03/2019
being filed.
Calhoun County
Date Acknowledged:
06/25/2019
3
Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a
description of the services, goods, or other property to be provided under the contract.
Copiers
Copier equipment and supplies
Nature of interest
4
Name of Interested Party
City, State, Country (place of business)
(check applicable)
Controlling
Intermediary
Jacque, Schumacher
Yoakum, TX United States
X
5
Check only if there is NO Interested Party. ❑
6
UNSWORN DECLARATION
My name is and my date of birth is
My address is
P
(street) (city)
(state) (zip code) (country)
I declare under penalty of perjury that the foregoing is true and correct.
Executed in County, State of , on
the _day of , 20_
(month) (year)
Signature of authorized agent of
contracting business entity
(Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.39118039c
Commissioners' Court — October 07, 2019
8. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 8)
To authorize the County Sheriff to sign a credit application in order to
purchase tires from Beasley Tire Service, Inc. (RM)
RESULT: APROVED [UNANIMOUS]
MOVER: Clyde Syma, Commissioner Pct 3
SECONDER: David Hall, Commissioner Pct 1
AYES: Judge Meyer, Commissioner Hall, Syma, Reese
Page 6 of 10
CALHOUN COUNTY, TEXAS
COUNTY SHERIFF'S OFFICE
211 SOUTH ANN STREET
PORT LAVACA, TEXAS 77979
PHONE NUMBER (361) 553-4646
FAX NUMBER (361) 5534668
MEMO TO: RICHARD MEYER, COUNTY JUDGE
SUBJECT: Copier Contract
DATE: October 7, 2019
Please place the following items) on the Commissioner's Court agenda for the dates)
indicated:
AGENDA FOR October 7, 2019
• Consider and take necessary
action
to allow
the Sheriff to sign a credit
application to apply to purchase
tires at
Beasley
Tire Service Inc.
Sincerely,
Bobbie Vickery
BEASLEY TIRE SERVICE e CORPORATE OFFICE
0 P.4. Box 11556 e Houston, Texas 77293
11802 Eastex Freeway
�f � f � EiY(Ct3 Ph. 281-449-2386 o Fax 281-449-79.39
To: Our Valued Customer
From: Beasley Tire Service
subject: AR Ma(ling Address
To whom it may concern,
To ensure tLnely and accurate payment processing, Beasley Tire Service requests that payments toward
balances owed be mailed to the following address.
Beasley The Service, Inc.
Attn: Accounts Receivable
P.O. Box 11556
Houston, Tx 77293
If you have any questions, please feel free to contact our department.
Thank you for your cooperation in this matter. Have a wonderful drill
Stacey Mitchell
Account Receivable
(281)449-2365 ext.112/ fax (281) 449-7239
5tviitchelleeasle MrexpoLq
Beasley Tire Credit
Name 4AIh Y\
Mailing Address gk$ i1n 0 r Of' Q Ti
Physical Address Z(
Phona',Jlpl
Fax
D&B#
Tax ID # %] _� a 3 No. of Vehicles to be Serviced
A/P Contact ,) C 4' A CU,12� Phone
Are Purchase Orders # Used? yes No
Email Invoices & Statements? Yes t` No
Email Address (if yes selected above)
If Corporation, live names of Principals.
President: Vice President:
If Partnership, list Partners.
Former Tire Company: M -Q f\l_4l �\\Q \J5y1 \')umu�
1 Name of Bank
Contact
Phone
2 Trade Reference
Contact
Phone
3 Trade Reference
Contact
Phone
4 Trade Reference
Contact
Phone
S Trade Reference
Contact
Phone
References
lie //L_1_ V ,,ttIi
J 3iDf'— 5-oZ'-`!7 Fax
Aced No
Fax
Acct No
Fax
Acct No
Fax
Acct No
Fax
I hereby authorize you to contact the references above and/or suppliers for a credit reference. I understand that if an account is
opened for me/my company all purchases through the last day of the month are due and payable in full by the tenth (10th) of the
following month. Late charges of 1.5%per month maybe charged on any balances unpaid that are 30 days past due. My signature
below signifies agreement of these terms and acceptence thereof.
Signed: Print:
Request for Taxpayer
Give Form to the
Forth.
F9
Identification Number and Certification
requester..
Octo6er2c19)
Department of the Treasury
IRS*
send to the IRS.
Internal
Revenue Service
►Go to tvtvw.irsgov1FormW9 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 line blank.
THE COUNTY OF CALHOUN TEXAS
2 Business name/dlsregarded entity name, g different from above
3 Check appropriate box for federal tax classification of the person whose name Is entered on line 1. Check only one of the
4 Exemptions (codes apply only to
mfollowing.
seven boxes,
certain entities, not individuals; see
a
instructions on page 3):
S
❑ Individuaysole proprietor or ❑ CCorporation ❑8Corporation ❑ Partnership ❑Tnowestate
vd
single -member LLO
Exempt payee code Of any)
ai
❑ United liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) ►
`p
Note: Check the appropriate box In the line above for the tax classification of the single -member owner. Donotcheck
Exemption from FATCA reporting.
e
LLC If the LLC Is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC Is
°Ode d ( an y)
e 5
another LLG that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a singla-member LLC that
o- 0
is disregarded from the owner should check the appropriate box for the tax classification of Its owner.
y
❑✓ Other (see Instructions)► GOVERNMENT
(Mt+b+roxrow,emmhmureewau•a.us7
N
5 Address (number, street, and apt. or suite no) See instructions.
Requester's name and address (optional)
202 S ANN ST
rm
e City, state, and ZIP code
PORT LAVACA TX 77979
7 Ust account number(s) hero (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 (SSM, However, for a
resident alien, sole proprietor, or disregarded entity, see the instructions for Part 1, later. For other
entities, it is your employer Identification number (EIN). If you do not have a number, see How to got
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.
Social security number
11 _m _ UTTI
or
Under penalties of perjury, I certiTythet:
1. The number shown on this form Is-mycomecttaxpayer Identification number (orl ern waitingfor a number to be Issuedto me); and
2,1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal. Revenue
Service (IRS) that I am subject to backup withholding: as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. 1 am a U.S. citizen or other U.S, person (defined below);and
4. The FATCA code(s) entered on this form (f any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out Item 2 above If you have been notified bythe IRS that you are currently subject to backup withholding because
you. have failed to report all interest and dividends on your tax return, For real estate transactions; Item 2 does not apply. For mortgage Interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an Individual retirement arrangement (IRA), and generally, payments
other than interest and dividends, you are not required to sign the: certification, but you must provide your correct TIN. See the instructions for Part II, later.
yrr Signatureoj/
Here us.parsa((t► - GLI
General Instr ctions
Section references are to the Internal Revenue Code unless otherwise
noted.
Future developments. For the latest information about developments
related to Form W-9 and its instructions, such as legislation enacted
after they were published, go to www.frs.goV1F0rmW9.
Purpose of Form
An Individual or entity (Ferri W-9 requester) who isrequired to file an
Information return with the IRS must obtain your correct taxpayer
Identification number (TIM which may be your social security number
(S.SM, individual taxpayer identification number(ITIN), adoption
taxpayer Identification number (ATIN), or employer identification number
(EIN), to report on an Informatlon return the mount paid to you, or other
amount reportable on an Information return. Examples of Information
returns Include, but are not limited to, the following.
• Form 1099-INT (Interest earned or paid)
Date► �%�
o2D/
• Fohn 1099-DN (dividends, Including those from
rizesstocks-or mutual
funds)
• Form 1099-MISO (various types of Income, p, awards, or gross
proceeds)
• Form 1099-01 (stack or mutual fund sales and certain other
transactions by brokers)
• Form1099-S (proceeds from real estate transactions)
• Form 109&K(merchant card .and third party network transactions).
•.Form 1098 (home mortgage: Interest), 1098-E-(student loan interest),
1098-T.(tuition)
• Form 1099-C(canceleddebt)
•-Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only Ifyou are aU,S, person pncluding a resident
alien), to provide your correct TIN.
If you do not return Fonn Wes. to the requester with a TIN, you might
be subject to backup withholding, See What is backup withholding,
r. late
Gat. No: 10231X Forth W-9 (Rev.10-2015).
Commissioners' Court—October07, 2019
9. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO.9)
To approve a service contract with Silverback Septic Solutions for Precinct 2
and authorize Commissioner Lyssy to sign. (VL)
RESULT: APROVED [UNANIMOUS]
MOVER: Gary, Reese, Commissioner Pct 4
SECONDER: David Hall, Commissioner Pct 1
AYES: Judge Meyer, Commissioner Hall, Syma, Reese
Page 7 of 10
Vern Lyss
Calhoun County Commissioner, Precinct #2
5812 FM 1090
Port Lavaca, TX 77979
October 1, 2019
Honorable Richard Meyer
Calhoun County Judge
211 S. Ann
Port Lavaca, TX 77979
RE: AGENDA ITEM
Dear Judge Meyer:
(361) 552-9656
Fax (361) 553-6664
Please place the following item on the next Commissioners' Court Agenda
Discuss and take necessary action to allow Vern Lyssy to sign for an aerobic
septic system service contract for Precinct 2 with Silverback Septic Solutions.
Sinc r ly,
VerkLy4ssxy,:
-TTIM
PO BOX 751
F1 Campo, TX 77437
Date: 9/26/2019
To: Calhoun County PCT 2
6812 FM 1090
Pt. Lavaca, TX 77979
Phone: (361) 552-9656 Subdivision:
Site: 5812 FM 1090, Pt. Lavaca, TX 77979
County: Calhoun
Installer:
Agency: Victoria County Public Health Department
Mfg/Brand: / Nayadic
www.silverbackseptic.com
Phone: (979) 330-6129
info@silverbackseptic. com
Contract Period
Start Date: 10/21/20,19
End Date: 10/21/2020
Silverback Septic Solutions
3 visits per year • one every 4 months
Map
This is to Certify that the above sewage system has a RENEWED inspections agreement per Texas Commission
on Environmental Quality (TCEQ) standards for onsite sewerage facilities as required.
Inspection reports by the above service company will be filed with the authorized agency as required by the TCEQ
regulations. A weather proof tag or label will be attached to the controller showing the month that each inspection was
made. Three (3) Inspections per year (at least one every 4 months).
Items included on the Inspection Report generally include aerators, filters, irrigation pump, air compressor, disinfection
device, chlorine supply, OK System light, spray field vegetation, probe, sprinkler or drip backwash. The air filter will be
cleaned at each visit. This agreement does not include the cost of repairs.
Siiverback Septic Solutions will visit your site within 72 hours of you notifying us of a problem. (Weekends & Holidays
excluded)
Owner signature
Silverback Septic Solutions
Date
Date
Please update
Primary PhonelCell; Email
yes/no._Email Copy of Inspection(s)
Gate Code
Pets/Animals yes/no If yes, special instructions?_
CERTIFICATE OF INTERESTED PARTIESFORM
1295
loll
Complete Nos, l - 4 and 6 if there ate Interested parties,
Complete Nos, l; 24 3, 5, and 6 if there are no Interested parties.
OFFICE USE ONLY
CERTIFICA71ON OF FILING
Certificate Number:
2019*544719 ,
1 Name of business'entiry filing form, and the city, state and country of the business entity's place
of business.
Calhoun County, Precinct 2
Port Lavaca, TX United States
Date:Fitech
OW412019
2 ama o govammen anti!; or state agency t ak s a party to the contract or w o the form is'
naing fired.
Calhoun County texas
bate Aoknowiedgeh
3
Provide the Identification number used bythe. governmental entity or state agencyto track or identity the contract, and provide a
description of the services,. goods, or otherproperty to beprovided under the contract.
2007-60
Septic; Maintenance Contract
4
Name of Interested Party
City,;State,
country (place of business)..
Nature of Interest
. (cbobk applicable)....
, ._
., ....
,
, .
.Controlling
Intermedl
anr
8
Check only It there IS,NO Interested Party,y,
isi
6
UNSWOERN D6 AiRA=N
d
My name is o t1 ) OGIc�"
:t
. end my date of birthh Is ✓ �,,
folyaddressis //?, (y�V4t�ts ` iS '
(Strbe,)
, r r— L WVS
Wty) (state) (zrp code). (country)
I declare under penalty of�perjury that the foregoing is true and correct;
Executed -ln• t` '+� V` County, State o
1Aa/
; on tha.�„day of (R-'!�'�l ,.20 1 qj
(month) - (year)
Ll Signature o
ap tiorized agent of contracting business entity
.eversion V7,7:;3abaatld
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
1of1
Complete Nos. 1- 4 and 6 if there are interested parties.
Complete Nos. 11 2, 31 5, and 6 if there are no interested parties.
OFFICE USE ONLY
CERTIFICATION OF FILING
Certificate Number:
2019-544719
Date Filed:
09/26/2019
Date Acknowledged:
10/24/2019
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
Calhoun County, Precinct 2
Port Lavaca, TX United States
2 Name of governmental entity or state agency that is a party to the contract
being filed.
Calhoun County Texas
for which the form is
3
Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a
description of the services, goods, or other property to be provided under the contract.
2007-80
Septic Maintenance Contract
4
Name of Interested Part Y
City, State, Country lace of business
Y� Y (p )
Nature of interest
check applicable)
( PP )
Controlling
Intermediary
5
Check only if there is NO Interested Party.
X
6
UNSWORN DECLARATION
My name is
My address is
and my date of birth is
,
(street) (city) (state) (zip code) (country)
I declare under penalty of perjury that the foregoing is true and correct.
Executed in County, State of , on the _day of , 20
(month) (year)
Signature of authorized agent of contracting business entity
(Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.3a6aaf7d
Commissioners' Court —October 07, 2019
10. Accept reports from the following County Offices:
1. County Auditor's Office — various department audits
2. Floodplain Administration — Sept 2019
3. Sheriff's Office — Aug 2019 (revised)
RESULT: APROVED [UNANIMOUS]
MOVER: David Hall, Commissioner Pct 1
SECONDER: Gary Reese, Commissioner Pct 4
AYES: Judge Meyer, Commissioner Hall, Syma, Reese
Page 8 of 10
2023 II�UIiE B BEMI CABRERA
Candice Villarreal PORT LAVACA.TEXAS 71979 ERICA PEREZ
VASSISTANT AUDITOR TELEPHONE E8011553=4610FANE86115534614 ASSISTANT AUDITORS
September 20, 2019
Honorable Vern Lyssy
County Commissioner, Precinct 2
Calhoun County Waste Management
Port Lavaca, Texas 77979
Dear Commissioner Lyssy:
In accordance with Local Government Code Chapter 115, a cash count was performed on your office funds on September 20,
2019. Your office has been authorized funds totaling $250.00.
The cash count totaled $360.00. When reconciled with receipts 7333 through 7339 totaling $110.00, the collections were found to
be in balance with no exceptions noted.
Thank you for the assistance and cooperation you and your staff extended during the cash count. If you have any questions,
please do not hesitate to contact me at 361-553-4463.
R�esppectfully Submitted,
VN�
Erica Perez
Assistant Auditor
Approved by:
Cindy
County Auditor
cc:
Judge Stephen Williams
County Judge Richard Meyer
County Commissioners
Dan Heard, District Atty.
Shannon Sayler, Asst. District Atty.
Auditor's File
UEMICARRERA
PE69TNALL
2025 A ITER CRISTINATUAZON
Candice Villarreal PORT LAVA014TEKAS71079 ERICAPEREZ
T"ASSISTANTAOOITOR TELEPRONE(3611553.4610TANT36115534614 ASSISTANTAUDITONS
September 25, 2019
Karen Lyssy
County Extension Agent
Calhoun County Extension Service
County Road 101
Port Lavaca, Texas 77979
Dear Mrs. Lyssy:
In accordance with Local Government Code Chapter 115, a cash count of funds collected by your office for Fairground Facility
Rentals was conducted on September 25, 2019,
At the time of our arrival, no funds had been taken in and all receipts were accounted for.
Thank you for the assistance and cooperation you and your staff extended during the cash count. If you have any questions,
please do not hesitate to contact me at 361-5534463.
Respectfully Submitted,
q/ V. FMA
Erica Perez
Assistant Auditor
Approved by: n n
( , , wk VAS X' V
Cindy Mueller
County Auditor
cc:
Judge Stephen Williams
County Judge Richard Meyer
County Commissioners
Dan Heard, District Atty,
Shannon Salyer, Asst. District Atty,
Auditor's File
C
6ro PEBOT HNK
CRISTINATUAiON
202 S.1 UITE B BENI CABRERA
CanOIcaUlllarreal PONT LAVACA, TEXAS 71070 ERICA PERU
1"ASSISTABTAUSITOR TELEPHONE (3611558-4610FAX(36115584614 ASSISTANTAUBNTORS
September 18, 2019
Mrs. Noemi Cruz
Calhoun County Library
Port Lavaca, Texas 77979
Dear Mrs. Cruz:
In accordance with Local Government Code Chapter 115, a cash count of your office funds was conducted on
September 18, 2019. Your office has been authorized funds totaling $150.00: petty cash in the amount of $50.00, an office
change fund of $80.00, and a cash drawer change fund of $20.00.
The cash count of your petty cash funds totaled $50.00. The funds were found to be in balance and no exceptions were noted.
The cash count of your change fund totaled $80.00. The funds were found to be in balance and no exceptions were noted.
The cash count of the cash drawer change fund totaled $35.40. When reconciled with collections for the day totaling $14.40,
the funds were found to be over $1.00. It is recommended the $1.00 be included in your next deposit as a donation.
The cash count of the funds collected week to date totaled $36,55. When reconciled with the collection logs totaling $36.55,
the funds were found to be in balance and no exceptions were noted.
Thank you for you and your staff's assistance and cooperation extended during the cash count.
Respectfully Submitted,
as,%
� P�
Erica Perez
Assistant Auditor
Approved by:
Cindy Mueller'
County Auditor
cc:
Judge Stephen Williams
County Judge Mike Pfeifer
County Commissioners
Dan Heard, District Atty.
Shannon Salyer, Asst. District Atty.
Auditor's File
r:1sE �> Ans PE99rNw.
CRISi1NATUAZON
202 S ITE B DEMI CABBERA
Candice Ylllarfaid PORT IAVACA,TEXAS 77979 ERICA PEREZ
1ffASSISTANTAUDITOR TEUPNONE186115534610FAX (36115534614 ASSISTANTAUDITORS
September 24, 2019
Honorable Bobbie Vickery
Calhoun County Sheriff
Calhoun County Courthouse
211 South Ann Street
Port Lavaca, Texas 77979
Dear Sheriff Vickery:
In accordance with Local Government Code Chapter 1151 a cash count of the funds collected in your office was conducted on
September 24, 2019, Your petty cash fund consists of an authorized sum of $100.00,
The cash count of your petty cash fund totaled $95.65, When reconciled with your petty cash receipt of $4.35, the funds
were found to be in balance and no exceptions were noted.
There were no office funds at the time this audit was conducted.
Thank you for the assistance and cooperation you and your staff extended during the cash count. If you have any questions,
please do not hesitate to contact me at 361-5534463.
Respectfully
Submitted,
r V
Erica Perez
Assistant Auditor
Approved by:
Cind�ller
County Auditor
cc:
Judge Stephen Williams
County Judge Richard Meyer
County Commissioners
Dan Heard, District Atty,
Shannon Sayler, Asst, District Atty,
Auditor's File
C
C S PE601 HALL
CRISTINATUAION
202 S URE B OEMI CABRERA
Candice Villarreal PORT LAVACA, TEXAS 71979 ERICA PEREZ
1"ASSISTANTAUOITOR TELEPHONE 13611553-4610FAX(36115534614 ASSISTANT AUDITORS
September 30, 2019
Honorable Tanya Dimak
Justice of the Peace Pct. 3
Point Comfort, TX 77978
Dear Judge Dimak:
I recently conducted an
audit of your office
records. The audit
included an examination
of reports,
receipts and supporting
documentation for
the period of July 1,
2018 through March 31,
2019.
In sampling the fees charged on citations issued, the following exceptions were noted:
A citation issued in August 2018 was listed as pending although the deferral fee was paid.
Your clerk stated that all the required documents have not been turned in. You stated you
would have to have a show cause hearing before taking it off of deferral.
The following citations are in pending status with one courtesy letter sent, some payments
made, or no activity:
o Citation issued in October 2018 — courtesy letter sent in March 2019
o Citation issued in December 2018 — stopped making payments in March 2019; no other
activity.
o Two citation issued to the same person in January 2019 — one citation has a courtesy
letter sent in May 2019; the other has no activity.
o Three citations issued to the same person in February 2019 — originally a jury trial was
requested. A court date was set after July 2019; the defendant did not appear. Once he
received my independent verification letter, he contacted your office and made
arrangements to have citations deferred.
o Three citations issued to the same person in February 2019 — two citations have no
activity; one has a courtesy letter sent in June 2019.
o A citation issued in March 2019 has a courtesy letter sent in June 2019.
The following Gov Pay payments were posted late:
o December 18th for $115 — posted on December 28th
o Two on January 4th - one for $170 & the other for $25 — posted on January 31s�
o January 7th for $170 — posted on January 315t
o January 10th for $230 — posted on January 31at
o January 22"d for $170 — posted on January 31st
o February 26th for $170 — posted on March 31st
Your clerk stated that your office never received notification of payments made. It is my
recommendation to check Gov Pay at least once a week to check for payments waiting
approval.
County Auditor's Office Page 2 9/30/2019
Some written receipts were delayed in getting posted to Hill Country:
o Two written on December 18th — one was posted December 26th the other December
28th
o One written on January 11th was posted on January 16th
o One written on February 11th was posted on February 26tn
It is recommended posting receipts in Hill Country within one or two days after the receipt is
written.
As a reminder the $4 Juror Reimbursement fee (CCP 102.0045) does not apply to citations in
deferred disposition.
After noting for the above, I found nothing that would lead me to conclude that your office is not
operated in compliance with the "Standard Financial Management System for Texas Counties -Justice
of the Peace Manual" as issued by the Comptroller of Public Accounts of the State of Texas. It
appears that the balances and collections of your office for this period were, in all material respects,
appropriately charged, collected, reported and remitted.
I appreciate the excellent
cooperation extended to me
by
your staff during my review. If you have any
questions concerning the
audit, please do not hesitate
to
contact me at 361-5534613.
Respectfully Submitted,
Demi Cabrera
Assistant Auditor
Approved by:
Cindy Mueller
County Auditor
cc:
Judge Stephen Williams
County Judge Richard Meyer
County Commissioners
Dan Heard, District Atty.
Shannon Salyer, Asst, District Atty,
Auditor's File
GA�1® ,'IRRn1i PEOOYNALL
CRISTINATVAZON
202 S. URE B REEII CABBERA
Candice Villarreal PORT IAVACA,TEN1111171919 ERICA PEREZ
1"ASSISTARTAUOITOR TELEPHONE 13611553-4610FAA136115534614 ASSISTANTAUOITORS
September 24, 2019
Honorable Bobbie Vickery
Calhoun County Sheriff
Calhoun County Courthouse
211 South Ann Street
Port Lavaca, Texas 77979
Dear Sheriff Vickery
In accordance with Local Government Code Chapter 115, a cash count of funds collected by the Adult Detention Center was
performed on September 24, 2019, The cash drawer consists of an authorized sum of $100,00,
The cash drawer count for outgoing Commissary funds totaled $23.32. When reconciled with the drawer receipt 2780 through
2819 for $76.68, the funds were found to be in balance with no exceptions noted.
The cash count of funds collected for Commissary accounts and Cash Bond accounts totaled $453,11, When reconciled with
receipt 11607 through 11610 and 16399 through 16400 totaling $453.11 the funds were found to be in balance.
If you have any questions, please do not hesitate to contact me at 361-5534463,
Respectfully Submitted,
Erica Perez
Assistant Auditor
Approved by:
Cindy Mueller
County Auditor
cc:
Judge Stephen Williams
County Judge Richard Meyer
County Commissioners
Dan Heard, District Atty.
Shannon Sayler, Asst District Atty,
Michelle Velasquez, Jail Administrator
Auditor's File
0EMICAURERA
PERRY RUL
2028 A I7E0 CRISTINATUAION
Candlee1011arreal PORT LAVACA, TEXAS 71979 ERICAPEREZ
T"ASSISTANTAURTTOR TELEPNONE(36135534010PAN136115584014 ASSISTANT AUDITORS
September 255 2019
Mrs. Noemi Cruz
Calhoun County Library
Port Lavaca, Texas 77979
RE: Port O'Connor Library
Dear Mrs. Cruz:
In accordance to Local Government Code Chapter I t 5, a cash count of the funds collected in the Port O'Connor Library was
conducted on September 25, 2019. The library has been authorized change funds totaling $20.00.
The cash count totaled $42.60. When reconciled with the collection logs of $22.60, the funds were found to be in balance and
no exceptions were noted.
The cash count of deposit bag funds collected during the previous week totaled $4.70. When reconciled with the collection
logs totaling $4.70, the funds were found to be in balance with no exceptions noted.
Thank you for the assistance and cooperation you and your staff extended during the cash count. If you have any questions, please
do not hesitate to contact me at 361-5534463.
Respectfully Submitted,
Lt� PV � e)
Erica Perez
Assistant Auditor
Approved by:
Cindy Mueller
County Auditor
cc:
Judge Stephen Williams
County Judge Richard Meyer
County Commissioners
Dan Heard, District Atty.
Shannon Salyer, Asst. District Atty,
Auditor's File
C
PEssvxAll
2015 INUREB DEMICADBERA
COWIN VIIlarreal PONT IAVACA,TEMAS71079 [RICA PEREZ
1°ASSISTANTAUDITOR TELEPHONE 186115534610FAX136115534614 ASSISTANT AUDITORS
September 30, 2019
Honorable Rhonda Kokena
County Treasurer
201 West Austin Street
Port Lavaca, Texas 77979
Dear Ms. Kokena:
In accordance with Local Government Code Chapter 115, a cash count of funds received by your office was conducted on
September 30, 2019,
The cash count of office funds totaled $330,129.38. When reconciled to the corresponding documentation and treasurer
receipts for Fees and Fines and the General Fund, the funds were found to be in balance and no exceptions were noted.
Your deputy treasurer was at the
courthouse paying
jurors
at the time this audit was conducted, therefore we were unable to
perform a cash count on the Jury
Pay imprest funds
at this
time.
Thank you and your staff for the assistance and cooperation extended during our cash count.
Respectfully Submitted,
M �MrA
Erica Perez
Assistant Auditor
Approved b'y,_r/� p p_
VJL
Cindy Weller v
County Auditor
cc:
Judge Stephen Williams
County Judge Richard Meyer
County Commissioners
Dan Heard, District Atty.
Shannon Sayler, Asst, District Atty,
Auditor's File
In PE0 TI HALL
CRISTINATUAION
202 S ANN SURE B ERICA PEREI
CANUICEVILIARREAt PORTIAVACA,TERAS77979 UEMICABREBA
t"ASSISTANTAUOtTOR TELEPNONE136115534610FAX(3611553.4614 ASSISTANTAUOITORS
September 243 2019
LaDonna Thigpen
Calhoun County Floodplain Administrator
Calhoun County Courthouse
Port Lavaca, TX 77979
Dear Ms. Thigpen:
An audit was conducted of the Flood Plain receipts for the period of January 1, 2019 through June 30, 2019. 1 examined the
receipts, permit logs, and took a sample testing of cash receipts.
A receipt with two (2) names was found but the permit has only one name. As per my conversation with your office clerk, the
check has two names though only one person was applying for the permit. I recommend matching the receipt and the permit for
the actual transaction.
Two receipts had same permit numbers. I recommend emphasizing to your employee the importance of verifying receipts for
accuracy.
One day in the month of June, all original was retained and the yellow copies were given to the customers. 1 recommend to give
the original to customers and retain the copies for your office. I also suggest stressing the importance of uniformity in doing
transactions.
I found nothing that would lead me to conclude that the balances and collections of your office for this period were not, in all
material respects, appropriately charged, collected, remitted and reported.
I appreciate the cooperation you gave me during this audit. If you have any questions please do not hesitate to contact me at
3614534615.
Res e�ctf�itted,
Crlstina Tuazon
Compliance Auditor
Approved
by,
d
Cindy Mu ler
County Auditor
cc:
Judge Stephen Williams
County Judge Richard Meyer
County Commissioners
Dan Heard, DistrictAtty.
Shannon Salyer, Asst, District Atty,
Auditor's Office
C
Pf66Y HALL
2025 IBI�UITEB BfMICIIBRERA
CandiceUillaneal PONT LAVACA,TEXAS 71979 ERICAPERU
WASSISTANTAUBITOR TELEPHONE (38115534610FAX 18611553.4614 ASSISTANT AUDITORS
September 20, 2019
Honorable Tanya Dimak
Justice of the Peace Precinct 3
PO Box 543
Point Comfort, TX 77978
Dear Judge Dimak:
In accordance with Local Government Code Chapter 115, a cash count of your office funds was conducted on
September 20, 2019. Your office has been authorized a petty cash fund of $50.00.
The cash count of your office funds totaled $175.00 with credit card transactions totaling $775.00. When reconciled
with receipts 229385 through 229391 totaling $950.00, the funds were found to be in balance. However, it must be
noted that your Deposit Listing showed money orders at $475,00 and credit card transaction at $475.00 causing
money orders to be short $300.00 and credit cards over $300.00. It was discovered that a payment was mistakenly
entered in under the wrong payment type. The error was corrected while we were still in your office.
The cash count of your petty cash funds totaled $28.73. When reconciled with your petty cash receipt of $21.27,
the funds were found to be in balance with no exceptions noted.
Thank you for the assistance and cooperation your staff extended during the cash count.
Respectfully Submitted,
Erica Perez
Assistant Auditor
Approved by:
Cindeller
County Auditor
Auditor's File
County Auditor's Office Page 2 9/20/2019
cc:
Judge Stephen Williams
County Judge Richard Meyer
County Commissioners
Dan Heard, District Atty.
Shannon Salyer, Asst. District Atty.
Auditor's File
CsaAlre Ylllarraal
September 20, 2019
Mrs. Noemi Cruz
Calhoun County Library
Port Lavaca, Texas 77979
RE: Point Comfort Library
Dear Mrs. Cruz:
PORTIAVACA,TEMAS71979
ONE (36115534610 FAN 136115534014
PEOOY NALL
CRIBTINATUAEON
OfMICABRERA
ERICAPERU
ASSISTANTAUOITORS
In accordance with Local Government Code Chapter 115, a cash count of the funds collected in the Point Comfort
Library was conducted on September 20, 2019. The library has been authorized change funds totaling $20.00.
The cash count of funds totaled $21.90. When reconciled with the collection logs showing $1.90, the funds were found to be
in balance and no exceptions were noted.
Thank you for the assistance and cooperation you and your staff extended during the cash count. If you have any questions,
please do not hesitate to contact me at 361-553-4463.
Respectfully Submitted,
u ��
Erica Perez
Assistant Auditor
Approved by:
Cind�ller
County Auditor
cc:
Judge Stephen Williams
County Judge Richard Meyer
County Commissioners
Dan Heard, District Atty.
Shannon Sayler, Asst. District Atty.
Auditor's File
CARS PE90TNA
CRISTINAT0AE0N
2025 UIiEB OEMICARRERA
CandiceWilarraal PORT LAUACA,TENAST1919 ERICAPEREZ
10ASSISTANTAUDITOR TELEPHONE (3611553.4610FAX 13611553,4614 ASSISTANTAUOITORS
September 20, 2019
Honorable Bobbie Vickery
Calhoun County Sheriff
Calhoun County Courthouse
Port Lavaca, Texas 77979
Dear Sheriff Vickery:
I recently conducted an audit of the Jail Commissary, Inmate Property Funds and the Commissary
Proceeds account. I examined the reports, books, and supporting documentation for the period of
January 1, 2019 through June 30, 2019.
During the examination I noted the following exceptions:
Commissary Account:
• While doing some research on an old outstanding balance it was discovered that a check
(#9388) previously listed as outstanding and submitted to the Treasurer's office in 2016
as unclaimed cleared in 2012. Supporting documents have been submitted to the
Treasurer's office and a check totaling $16.55 will be issued back to the Calhoun County
Adult Detention Center; the check will then be deposited back into the Commissary
Account.
• Check #13670 dated 4/17l18 for $15.25 cleared in August 2018; it was still listed as
outstanding in Keefe. The check was corrected during my audit and will reflect on the next
bank reconciliation.
• In February 2019 duplicate check numbers cleared the bank. Yourjailer stated it was due
to temporary checks being used. It was my recommendation that in the future if temporary
checks are needed; use numbers that are not in the regular sequence.
• In April 2019 there were discrepancies between the Commissary check register and the
checks that cleared the bank. Check numbers 14310, 14311 and 14312 had different
payees. The error is being looked into and will be corrected as soon as possible.
Proceeds Account
• In January &May 2019 issued checks were left off the register currently being used
causing the end of month balance to be inaccurate. A different register has been provided
to the jail to help account for all checks; both written and voided. The register can be
County Auditor's Office Page 2 9/20/2019
changed as it seems necessary; however a copy will need to be attached with each
monthly statement.
• The deposit made into the Proceeds account from Keefe invoice dated 2/19/1 V was
incorrect. The shortage of $15.48 will be added to the next deposit.
Southern Healthcare Partners
In addition to the monthly payment made to SHP; the jail is responsible for any inmate
medical claims that go over the yearly allowed cost pool amount of $29,999.99, For 2018
the overages totaled $14,048,80. When looking at the 2018 statements it was noticed that
in April 2018 claims were being paid with a date of service of September and December
of 2017; in May 2018 claims were paid with a date of service of December 2017. In
February 2019 a claim was paid with a date of service of July 2017. 1 contacted the SHP
accounting representative for our area and asked why there is such a delay in the
processing of claims. She stated that SHP processes and pays claims that are submitted
within one calendar year of the date of service.
Receipts
• When an inmate is released from jail they are issued a receipt that states the number of
days spent in jail along with an amount for court cost. The number of days should be
enough to cover their sentence as well as court cost (inmates earn $100 jail credit for
each day served). Inmates can also earn good time credit; however it cannot exceed
more than 1/3 of their sentence. Another office was questing if the time stated on the
receipts covered any fine amounts. Your jail administrator stated that an inmate is allowed
to earn jail credit towards their fine only if the order says they can. The District Attorney's
office was asked why some orders allow for jail credit while others do not. They stated
they were under the assumption that all inmates could earn jail credit towards their fines
and agreed that it needed to be stated in the orders. The orders have since been revised
to state that inmates are allowed to earn jail credit towards their fines in addition to their
court cost. The receipts will now state that the inmate has satisfied their sentence, court
cost and fines.
Cash Bonds
• Another office has requested that ALL cash bonds include a copy of the surety's driver's
license or ID. Although the jail is willing to comply with the request; not all persons
dropping off money for a cash bond are willing to provide their driver's license or ID due to
various reasons. Not having a copy of the driver's license/ID with the cash bond has
caused a delay with depositing funds with the appropriate court. Without the proper
documentation stating it is a requirement; the jail is not allowed to deny any cash bond
payments. At this time your Jail Administrator has been advised to forward all cash bond
money to the Sheriffs office where it will then be taken to the appropriate court.
After noting for the above, I found nothing that would lead me to conclude that the balances and
collections of your office for this period were not, in all material respects, appropriately charged,
collected, remitted and reported.
I appreciate the excellent cooperation extended to me by your staff during my review. If you have
any questions concerning the audit, please do not hesitate to contact me at 361-553-4613.
County Auditor's Office Page 3 9/20/2019
Respectfully Submitted,
NO IrTavow
Demi Cabrera
Assistant Auditor
Approved by:
Cindy Mueller
County Auditor
cc:
Judge Stephen Williams
County Judge Richard Meyer
County Commissioners
Dan Heard, District Afly.
Shannon Salyer, Asst, District Atty.
Auditor's File
C
C 1f11S FangP NA CRI
CRISTINATUAION
202 S. I UIiE R DEMI CHRERA
CandiceMilarreall PORTIAVACA4TEMAS77910 ERICAPEREi
1"ASSISTANTAUDITOR TREPNONE13011553.4610FAN136115534614 ASSISTANTAUDITORS
September 25, 2019
Honorable Wesley Hunt
Justice of the Peace, Precinct #4
PO Box 520
Seadrift, TX 77983
Dear Judge Hunt:
In accordance with Local Government Code Chapter 115, a cash count of your office fund was conducted on September 25,
2019,
The cash count of your office totaled $196.00 with credit card transactions totaling $1,605,00, When reconciled with receipts
3944369 through 3944377 totaling $1,801,00, the funds were found to be in balance and no exceptions were noted.
Thank you for the assistance and cooperation you and your staff extended during the cash count. If you have any questions,
please do not hesitate to contact me at 361-5534463.
Respectfully Submitted,
Erica Perez
Assistant Auditor
Approved by: �g
Cindy Mueller
County Auditor
cc:
Judge Stephen Williams
County Judge Richard Meyer
County Commissioners
Dan Heard, District Atty,
Shannon Sayler, Asst, District Atty.
Auditor's File
S OEMICABRERA
PEOBTNAR
2025 A ITEB CRISTINATOAZON
Candice 111 larreal PORT IAVACA,TENAS71979 ERICAPERE2
1" ASSISTANTAUOROR TELEPHONE (36115534610FANI86115534614 ASSISTaNTAUOITORS
September 25, 2019
Mrs. Noemi Cruz
Calhoun County Library
Port Lavaca, Texas 77979
RE: Seadrift Library
Dear Mrs. Cruz:
In accordance to Local Government Code Chapter 115, a cash count of the funds collected in the Seadrift Library was co�rducted
on September 25, 2019. The library has been authorized change funds totaling $20.00.
The cash count totaled $3237. When reconciled with the log of collections for the week totaling $12.37, the funds were found to
be in balance with no exceptions noted.
The cash count of deposit bag funds collected during the previous weeks totaled $3.30. When reconciled with the collection logs
totaling $3.30, the funds were found to be in balance with no exceptions noted.
Thank you for the assistance and cooperation you and your staff extended during the cash count. If you have any questions, please
do not hesitate to contact me at 361-553-4463.
Respectfully Submitted,
p� W 0
Erica Perez
Assistant Auditor
Approved by:
Cind�ler
County Auditor
cc:
Judge Stephen Williams
County Judge Richard Meyer
County Commissioners
Dan Heard, District Atty.
Shannon Salyer, Asst. District Atty,
Auditor's File
C
f; S PEU6Y NALL
CRISTINATUATON
20Y S.1 UITE R OENI CABRERA
CandiceYillarreal PORTIAUACA4TENAS77979 ERICA PEREZ
1"ASSISTAUTAUOITOR TELEPHONE 136115534610FANE3611553-4614 ASSISTANT AUDITORS
September24,2019
Honorable Anna Goodman, County Clerk
Calhoun County Courthouse
211 South Ann Street
Port Lavaca, Texas 77979
Dear Mrs. Goodman:
In accordance with Local Government Code Chapter 115, a cash count of your office funds was conducted on September 24,
2019. Your office has been authorized funds totaling $230.00: (2) cash drawer change funds in the amounts of $115.00 each.
The cash count of the front Odyssey and Eagle cash drawer change funds totaled $845.00. When reconciled with receipts for the
day totaling $615.00 the funds were found to be in balance and no exceptions were noted.
Thank you for the assistance and cooperation extended by you and your staff during the cash count.
Respectfully Submitted,
0CkPn
Erica Perez
Assistant Auditor
Approved by:
Cindy Mueller
County Auditor
cc:
Judge Stephen Williams
County Judge Richard Meyer
County Commissioners
Dan Heard, Dist. Atty.
Shannon Sayler, Asst. District Atty.
Auditor's File
PE9BYNAlI
2023 AILITEB CRISTINATOAZON
CandiceOillarreal FORT IAOACA,IDIAS71979 DEMICABBERA
1°ASSISTANTAOOITOR TELEPHONE 136115534616M13611553.4614 ASSISTANTAODITORS
September 252 2019
Honorable Nancy Pomykal
Justice of the Peace, Precinct #5
P. O. Box 446
Port O'Connor, Texas 77982
Dear Judge Pomykal:
In accordance with Local Government Code Chapter I IS, a cash count of your office funds was conducted on
September 25, 2019. Your office has been authorized a change fund of $25.00,
The cash count of funds collected was $340.00 with credit cards totaling $20.00. When reconciled with receipt numbers 376874
through 376875 totaling $335.00 the funds were found to be in balance with no exceptions noted.
Thank you for the assistance and cooperation you and your staff extended during the cash count. If you have any questions,
please do not hesitate to contact me at 361-553-4463.
Respectfully Submitted,
V I- pIVWA6
Erica Perez
Assistant Auditor
Approved by:
Cind�ller
County Auditor
cc:
Judge Stephen Williams
County Judge Richard Meyer
County Commissioners
Dan Heard, District Atty.
Shannon Sayler, Asst. Dist Arty.
Auditor's File
CanAlce Ylllarreai
rASSISTAKAURITOR
September 24, 2019
Honorable Bobbie Vickery
Calhoun County Sheriff
Calhoun County Courthouse
211 South Ann Street
Port Lavaca, Texas 77979
Dear Sheriff Vickery:
C
202 & AIBRUITE B
PORT IAVACA,TEXAS 71970
TEEEPNONE 13611553.4610 FAX (3011513.4614
PE99Y NALL
CRISTINATUAZON
OENICABRERA
ERICA PEREZ
ASSISTANTAUO(TORS
In accordance with Local Government Code Chapter 115, a cash count of the Narcotics Buy Money fund was conducted on
September 24, 2019.
The cash count of your funds totaled $1,729,00, When reconciling with the balance at the end of receipt #498076 of
$1,729.00 the funds were found to be in balance.
Thank you for the assistance and cooperation you and your staff extended during the cash count. If you have any questions,
please do not hesitate to contact me at 361-5534463.
Respectfully Submitted,
p�
Erica Perez
Assistant Auditor
Approved by:
Clnd�lier
County Auditor
cc:
Judge Stephen Williams
County Judge Richard Meyer
County Commissioners
Dan Heard, District Atty,
Shannon Sayler, Asst. District Atty,
Auditor's File
Calhoun County Floodplain Administration
211 South Ann Street, Suite 301
Port Lavaca, TX 77979-4249
Phone: 361-553-4455/Fax: 361-553-4444
e-mail: amanda.marek@calhouncotx.org
September 2019 Development Permits
New Homes — 4
Renovations/Additions — 0
Mobile Homes -0
Boat Barns/Storage Buildings/Garages - 2
Commercial Buildings/RV Site -0
Move —1 (moved from one lot to another, same property)
Total Fees Collected: $420.00
t
SHERIFF'S OFFICE MONTHLY REPORT
Aug-19
Revised O^A-
BAIL BOND FEE
$ 960.00
CIVIL FEE
$ 11724,00
JP#1
$ 2,851,60
JP#2
$ 778.00
JP#3
$ 320.00
JP#4
$ 380.00
JP#5
$ 1,097.20
PL MUN.
$
COUNTY COURT
$
SEADRIFT MUN.
$ 11160000
PC MUN.
$ 31209,70
OTHER
$
PROPERTY SALES
$
-
DISTRICT
$
CASH BOND
$
750.00
TOTAL:
$
13923150
Commissioners` Court —October 07, 2019
11, Consider and take necessary action on any necessary budget adjustments.
RESULT: APPROVED [UNANIMOUS]
MOVER: Gary Reese, Commissioner Pct 4
SECONDER: David Hall, Commissioner Pct 1
AYES: Judge Meyer, Commissioner Hall, Syma, Reese
Page 9 of 10
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Commissioners' Court — October 07, 2019
12. Approval of bills and payroll. (RM)
MMC
RESULT: APPROVED [UNANIMOUS]
MOVER: David Hall, Commissioner Pct 1
SECONDER: Gary Reese, Commissioner Pct 4
AYES: Judge Meyer, Commissioner Hall, Syma, Reese
County
RESULT: APPROVED [UNANIMOUS]
MOVER: David Hall, Commissioner Pct 1
SECONDER: Gary Reese, Commissioner Pct 4
AYES: Judge Meyer, Commissioner Hall, Syma, Reese
Payroll
N/A
ADJOURNED: 10:10 A.M.
Page 10 of 10
MEMORIAL MEDICAL CENTER
COMMISSIONERS COURT APPROVAL LIST FUR"- October 07 2019
TOTALS TO BE APPROVED -TRANSFERRED FROM ATTACHED PAGES
TOTAL PAYABLES, PAYROLL AND ELECTRONIC BANK PAYMENTS $ 7843623676
TOTAL TRANSFERS BETWEEN FUNDS $ -
TOTAL NURSING HOME UPL EXPENSES $ 458,3422
TOTAL INTER -GOVERNMENT TRANSFERS $
MEMORIAL MEDICAL CENTER
COMMISSIONERS COURT APPROVAL LIST FOR ---October 07 2019
10l4l2019
Weekly Payables
396,550.53
10/4/2019
Ashford -Nursing home insurance payment/QIPP sent to MMC in error
11,728.00
10/4/2019
Broadmoor-Nursing home insurance payment sent to MMC in error
15,423,00
10/4/2019
Crescent -Nursing home QIPP Payment deposited in MMC Operating in error
10,358.97
10/4/2019
Gulf Pointe Plaza -Nursing home insurance payment sent to MMC in error
148,918,08
10/412019
Goldencreek-Nursing home insurance payment/QIPP sent to MMC in error
59,907,31
Prosperity Electronic Bank Payments
10/4/2019 TCDRS - Estimated Retirement 141,489,76 _
9/30-10/3/19 Pay Plus -Patient Claims Processing Fee 138,11
10/2/2019 Authnet Gateway Billing-3rd Party Payor Fee 10.00
TOTAL PAYABLES, PAYROLL AND ELECTRONIC BANK PAYMENTS $ 784,623976
TOTAL TRANSfERS BETWEEN FUNDS $
NURSING HOME UPL EXPENSES
10/4/2019 Nursing Home UPI-Cantex Transfer
10/4/2019 Nursing Home UPI-Nexion Transfer
10/4l2019 Nursing Home UPI -HMG Transfer
351,578.52
8,849,16
95,060,22
QIPP/INTEREST CHECKS TO MMC
10/4/2019 Ashford -Interest Earned
141.33
10/4/2019 Solera-Interest Earned
266.66
10/4/2019 Crescent -Interest Earned
161.78
10/4/2019 Broadmoor-Interest Earned
142,24
10/4/2019 Fort Bend -Interest Earned
55.54
10/4/2019 Golden Creek -Interest Earned
74,65
10/4/2019 Gulf Pointe VIM -Interest Earned
12.54
10/4/2019 Gulf Pointe PP -Interest Earned
0,11
TOTAL
NURSING
HOME
UPL
EXPENSES
$ 466,342.80
TOTAL INTER -GOVERNMENT 3RANSFERS $
GRAND TOTAL DISBURSEMENTS APPROVED October 07, 20'19 $ 1,240,866 s6
RECEIVED Page 1 of 11
Cai$Ssnm Co" Aissfitor MEMORIAL MEDICAL CENTER
10/03/2019 0
11:04 AP Open Invoice List ap_open_invoice.template
Due Dates Through: 10/16/2019
Vendor# Vendor Name Class Pay Code
A1680 AIRGAS USA, LLC - CENTRAL DIV ✓ M
lnvolw# Cc menl Tran Dt Inv Dt Due Dt Check D•Pey Gross Discount No -Pay Net /
9964697007 09/30120 08131/20 09126/20 704,50 0.00 0.00 704,50 ./
OXYGEN
Vendor Totals Number Name Gross Discount No -Pay Net
A1680 AIRGAS USA, LLC -CENTRAL DIV 704,60 0.00 0,00 704,60
Vendor# Vendor Name Class Pay Code
10958 ALLYSON SWOPE
Invoice# Comment Tran DI Inv DI Due DI Check D' Pay Gross Discount No -Pay Net
092519 09/30/20 09/25/20 1,923.76 0,00 0.00 11923,75 tell
CONTRACT EMPLOYEE (.0 �la-qI It
I Lti�
Vendor Totals Number Name Gross Discount No -Pay Net
10958 ALLYSON SWOPE 11923,75 0.00 0,00 11923,75
Vendor# Vendor Name /Class Pay Code
12828 AMERICAN PRECISION MEDICAL GAS ✓
Invoice# ,G�omment Tran DI Inv Dt Due Dt Check 0' Pay Gross Discount No -Pay Net
208748 ✓ 09/30120 08120120 08120/20 11388900 Oboe 0,00 1,388.00
INVESTIGATE GAS ALARM DEiWCK h
Vendor Totals Number Name Gross Discount No -Pay Net
12628 AMERICAN PRECISION MEDICAL GAS 1,388,00 0.00 0,00 1,388.00
- VendoAl Vendor Name Class Pay Code
B1220 BECKMAN COULTER INC V// M
Invoice# Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net
✓
107978946 09/24/20 09117120 10/12120 1,288.45 0.00 0.00 10288,45
SUPPLIES
107978921 s// 09/24/20 09/17/20 10/12120 - 61249,42 0.00 0100 61249,42
SUPPLIES
Vendor Totals Number Name Gross Discount No -Pay Net
B1220 BECKMAN COULTER INC 71537,87 0.00 0.00 71537,87
Vendor# Vendor Name Class Pay Code
12600 BIOFIRE DIAGNOSTICS LLC
Invoice# Co ment Tran Dt Inv Dt Due DI Check D Pay Gross Discount No -Pay Net /
1289001515 09/30/20 09/16/20 09/16/20-870,09 0= 0.00-876,09 ✓
/
1280014310 CR DIT 09130120 09/18/20 10116/20 91456,29 0.00 0.00 91456,29
SUPPLIES
Vendor Totals Number Name Gross Discount No -Pay Net
12600 BIOFIRE DIAGNOSTICS LLC 81680420 0,00 0,00 8,680.20
Vendor# Vendor Name Class Pay Code
C1048 CALHOUN COUNTY V W
Invoice# Comment Tran Dt Inv Ot Due Dt Check D' Pay Gross Discount No -Pay Net /
092419 09/30/20 09/24/20 10116120 28,08 0.00 0.00 28,08 ✓
FUEL
Vendor Totals Number Name Gross Discount No -Pay Net
C1048 CALHOUN COUNTY 28,08 0.00 0.00 28,08
Vendor# Vendor Name Class Pay Code
10368 DEWITT POTH & SON
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Page 2 of 11
Invoice# Comment Tran Dt Inv Dt Due Dt Check D• Pay Gross Discount No•Pay Net /
5838980 �// 09/23/20 09I18/20 10/13/20 188,34 0.00 0.00 188.34 ✓
/SUPPLIES
6839240 ✓ 09123/20 09118120 10113120 22,94 0,00 0,00 22.94
/SUPPLIES /
6841330 ,/ 09/23/20 09119120 10114/20 79,80 0.00 0.00 79,80 ✓
/SUPPLIES
6843330 �/ 09/24/20 09/20/20 10/16/20 280,96 0.00 0,00 280.96
SUPPLIES /
5843260✓ 09124/20 09120120 10/16120 201,12 0.00 0.00 201.12 r/
/SUPPLIES
5836150 ✓ 09/25/20 09116/20 10/11/20 384,60 0.00 0.00 384.60
/ SUPPLIES
5839060✓ 09/26/20 09H8/20 10/13/20 69.04 0.00 0.00 59,04
SUPPLIES
Vendor Totals Number Name Gross Discount No -Pay Net
10368 DEWITT POTH&SON 112%80 0,00 0000 1,216,80
Vendor# Vendor Name Class Pay Code
10892 DIANE MOORE
Invoice# Comment Tran Dt Inv Dt Due DI Chock D Pay Gross Discount No -Pay Net
093019 09/30/20 09/30/20 09130/20 176,32 0.00 0,00 176,32
QTRLY NURSING HOME VISIT �2'1 �19 rill 90UM (,Y&,Y.
Vendor Totals Number Name Gross Discount No -Pay. Net
10892 DIANEMOORE 176,32 0.00 0.00 176,32
Vendor# Vendor Name Class Pay Code
10789 DISCOVERY MEDICAL NETWORK INC
Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net
MMC093019A e/ 09130/20 09130120 09/30/20 128,196,66 0.00 0,00 1283196.66
PRO FEES Vhyhtiu.VtSew+�S giIV I I30I I •
Vendor Totals Number Name Gross Discount No -Pay Net
10789 DISCOVERY MEDICAL NETWORK INC 128,196.66 0.00 0100 128,196,66
Vendor# Vendor Name Class Pay Code
12788 DUDE SOLUTIONS, INC
Invoice# menI Tran Dt Inv Dt Due Dt Check D• Pay Gross Discount No -Pay Net
INV-51870 Co 09/30/20 08/01/20 08131/20 21289,60 0.00 0.00 21289,60
MAINTANCE REQUEST SYSTE
Vendor Totals Number Name Gross Discount No -Pay Net
12788 DUDE SOLUTIONS, INC 2,289.50 0.00 0.00 21289.60
Vendor# Vendor Name Class Pay Code
11284 EMERGENCY STAFFING SOLUTIONS ✓
Invoice# Comment Tran Dt Inv Dt Due DI Check O Pay Gross Discount No•Pay Net
38387 09/30/20091301201Oft 0/20 40,062.60 0,00 0.00 40,062.60
ERSTAFFING (Iuty-myo l
Vendor Totals Number Name Gross Discount No -Pay Net
11284 EMERGENCY STAFFING SOLUTIONS 40,062.50 0.00 0.00 40,062,60
Vendor# Vendor Name Class Pay Code
T0383 ERIN CLEVENGER W
Invoice# Comment Tran Dt Inv Ot Due Dt Check D Pay Gross Discount No -Pay Net
093019 09/30120 09130120 09130/20 201,20 0.00 0.00 201�,20
QUARTERLY SITE VISIT QUIPI gJlu Olq-fittrkma1 TILL Crtscerlf, Galemi f sIr �GUllil
Vendor Totals Number Name M"VItW Gross Discount No -Pay Net _
T0383 ERIN CLEVENGER 201.20 0,00 0.00 201,20
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Vendor# Vendor Name Class Pay Code
C2510 EVIDENT !/ M
Invoice# ommenl Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net
961302 / 09130/20 09/18/20 10/13120 7,174.00 0.00 0.00 71174,00 /
APPLICATION WEB PORTAL S v
Vendor Totals Number Name Gross Discount No -Pay Net
C2510 EVIDENT 71174,00 0,00 0.00 7,174.00
Vendor# Vendor Name Class Pay Code
F1400 FISHER HEALTHCARE M
Involce# Comment Tran DI Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net
5294651 09/30/20 09/10120 10/05/20 4,036.80 0.00 0,00 4,036,80
SUPPLIES
Vendor Totals Number Name Gross Discount No -Pay Net
F1400 FISHER HEALTHCARE 41036,80 0,00 0.00 4,036.80
Vendor# Vendor Name Class Pay Cade -
11183 FRONTIER
Involce# Comment Tran Dt Inv or Due DI Check D Pay Gross Discount No -Pay Net
091919 09/30/20 09/19120 10114120 60,42 0400 0,00 50,42
PHONE BILL '
Vendor Totals Number Name Gross Discount No -Pay Net
11183 FRONTIER 50,42 0,00 0,00 50,42
Vendor# Vendor Name Class Pay Code
12636 FUSION CLOUD SERVICES, LLC
Involce# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net /
27416752 09/30/20 09116/20 10/08/20 11146,97 0,00 0.00 11145,97 t/
PHONES
Vendor Totals Number Name Gross Discount No -Pay Net
12636 FUSION CLOUD SERVICES, LLC 1,145.97 0,00 0.00 1,145.97
Vendor# Vendor Name Class Pay Code
G0401 GULF COAST DELIVERY
Involce# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net
807916 09/30/20 08/30/20 09/29/20 150.00 0.00 0,00 160,00
DELIVERY SERVICE C 9I ID 474sw -
Vendor Totals Number Name Gross Discount No -Pay Net
G0401 GULF COAST DELIVERY 160,00 0.00 0,00 150,00
Vendor# Vendor Name Class Pay Code
G4210 GULF COAST PAPER COMPANY M
Involce# Comment Tran Dt Inv Dt Due DI Check D' Pay Gross Discount No-Psy Net
1731263 v /09/23/20 09/10/20 10/10/20 288,76 0,00 0,00 288.75 s/
SUPPLIES
1712628 09/24/20 09/11120 10/11/20 80,30 0,00 0.00 80,30
Vendor Totals Number Name Gross Discount No -Pay Net
01210 GULF COAST PAPER COMPANY 369,05 0,00 0,00 369,05
Vendor# Vendor Name Class Pay Code
11102 GULF COAST REGIONAL s//
Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Grass Discount No -Pay Net
2228 ✓/ 09116120 09110120 10110/20 900.00 0.00 0,00 900,00 f
CONSULTING AGREEMENT '
Vendor Totals Number Name Gross Discount No -Pay Net
11102 GULF COAST REGIONAL 900.00 0,00 0.00 900.OD
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Page 4 of 11
Ventlor# Vendor Name Class Pay Code
H1399 HILL -ROM COMPANY, INC M -
Invoice# /Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net /
934871 ✓ 09/23/2009/1112010111/20 94,944,58 0.00 n 0.00 94,944,58 ✓
BEDS CAPITAL IMPROVMENTWVO9 rf glk 10k WS`IAIM 341,#l0•lu C(CcjJ .
Vendor Totals Number Name tLlt/trSAt1d0 Mt.d.."16(Al &G,2Ss@ �, �p�c4unt No -Pay Net
H1399 HILL -ROM COMPANY, INC 94,944468 0 5 0.00 94,944.58
Vendor# Vendor Name Class Pay Code
12196 ICU MEDICAL, INC �//
Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net
2230394 s// 09/30/20 09/'17/20 09/17/20 320,00 0,00 0,00 320,00
SAPPHIRE EPIDURAL PUMPS
Vendor Totals Number Name Gross Discount No -Pay Net
12196 ICU MEDICAL, INC 320.00 040 0.00 320,00
Vendor# Vendor Name Class Pay Code
11230 JACKSON & COKER LOCUM TENENS,
Involce# Comment Tran Dt Inv Dt Due DI Check D• Pay Gross Discount No -Pay Not
2034742 09/30120 09125/20 09125/20 630,14 0.00 0,00 530,14
PRO FEES/UONG ( 1'j-okl ) AwPA"L)
2034869 ✓ 09/30/20 09/25/20p 09126/20 234,99 0.00 0.00 234.99
PRO FEESIUONG
426639 09/301200912WO 09/26/20 231250J10 0,00 0.00 23,250.00 ✓
PROFEES/UONG (gjq-q oillt-g113 1 411`i g11411q) .
Vendor Totals Number Name Gross Discount No -Pay Net
11230 JACKSON & COKER LOCUM TENENS, 24,015,13 0,00 0.00 24,015.13
Vendor# Vendor Name / Class Pay Code
12832 KRISTI BOYD �/
Involce# Comment Tran Dt Inv DI Due Dt Check D' Pay Gross Discount No -Pay Net
092819 09130120 09125/20 09126/20 731,00 0.00 0.00 731.00 ✓
DEA REGISTRATION REIMBUF
Vendor Totals Number Name Gross Discount No -Pay Net
12832 KRISTI BOYD 731.00 0,00 0.00 731.00
Ventlor# Vendor Name / Class Pay Code
M1960 MARTIN PRINTING CO ✓ 1N
Invoice# / Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net
74544 ✓ 09124/20 09/12/20 10/12120 201.00 0.00 otoo 201,00 ✓
APPT CARDS lro 6o- QA t# 14150D 0107. 110 TvV0_%D)
Vendor Totals Number Name Gross Discount No -Pay Net
M1950 MARTIN PRINTING CO 201,00 0.00 0.00 201.00
Vendor# Vendor Name Class Pay Code
11141 MEDICAL DATA SYSTEMS, INC.
Invoice# Comment Tran Dt Inv Dt Due DI Check D' Pay Gross Discount No -Pay Net /
139786V/ 09/30/20 09130/20 10/14120 1,198.84 0,00 0,00 1,198.84
COLLECTION FEES
Vendor Totals Number Name Gross Discount No -Pay Net
11141 MEDICAL DATA SYSTEMS, INC. 1,196.84 0.00 0,00 I J98.84
Vendor# Vendor Name Class Pay Code
M2470 MEDLINE INDUSTRIES INC M
Involce# Co ment Tran DI Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net
18870117927 09130/20 09/11/20 10106120 263.68 0.00 0,00 263,68
SUPPLIES
1887406364 09/30120 09116/20 10/11/20 -64.59 0,00 0.00 -64,59
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CR DIT
1887516491 09130/2009117/2010/12/20 19.47 0,00 0.00 19,47
SUPPLIES
1887499836✓ 09/30/2009117I2010/72120 42.16 0.00 0.00 42.16
SUPPLIES
✓ /
1887646070 09/3012009/18/2010/13120 669,58 0.00 0.00 569.58 ✓
SUPPLIES
1887645071 7 09/30/20 09/18/20 10/13/20 54.60 0,00 0.00 64,60
SUPPLIES
1887645072 ✓ 09/30/20 09/18/20 10/13/20 389,97 0,00 0.00 389,97
SUPPLIES
1887637162 ✓ 09130/20 09/18/20 10/13/20 21.17 0.00 0.00 21.17
SUPPLIES /
1887545067 ✓ 09130120 09118/20 10/13/20 986,99 0,00 0,00 986,99 ✓
SU PLIES /
18876971437 09130120 09/19/20 10t14/20 2,109.61 0,00 0,00 2,109,51 ✓
BUpPLIES
1887697141 ti 09I30/2009/19/2010/14/20 768.16 0.00 0.00 758.18
PLIES SU /
18876971467 09130/20 09/19/20 10/14120 33,05 0.00 0.00 33,06 ✓
SUPPLIES ?(6jkf J1.joH M 16o9Q 00h
1887863693 ✓ 09/30120 09/20120 10/16/20 -35.96 0.00 0.00 -35,96
CREDIT
Vendor Totals Number Name Gross Discount No -Pay Net
M2470 MEDLINE INDUSTRIES INC 51147,79 0,00 0,00 5,147.79
Vendor# Vendor Name Class Pay Code
12836 MELISSA MCKISSACK
Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net
10/01/19 09/30120 10101/20 10/01/20 4.87 0.00 0.00 4,87
TRAVELTOCOUNTY (g111--t01611tet)
Vendor Total: Number Name Gross Discount No•Pay Net
12836 MELISSA MCKISSACK 4,87 0.00 0,00 4,87
Vendor# Vendor Name Cl ss Pay Code
M2659 MERRY X-RAY/SOURCEONE HEALTHCA M
Invoice# co ment Tran Dt Inv Dl Due Dt Check D Pay Gross Discount No -Pay Net
8800516074 09/25/20 09/13/20 10/13/20 794.18 0.00 o.0o 794.18
SUPPLIES
Vendor Totals Number Name Gross Discount No -Pay Net
M2659 MERRY X•RAYISOURCEONE HEALTHCA 794,18 0.00 0,00 794,18
Vendor# Vendor Name / Class Pay Code
M2662 MMC VOLUNTEERS ✓ w
Involrs# / Comment Tran Dt Inv Dt Due DI Check D Pay Gross Discount No -Pay Net
395165 ✓ 09/30/20 10/01/20 10/01/20 122,81 0.00 0.00 122.81 r/
CC MACHINE FEES
Vendor Total: Number Name Gross Discount No -Pay Net
M2662 MMC VOLUNTEERS 122.81 0,00 0.00 122,81
Vendor# Vendor Name Class Pay Code
10536 MORRIS & DICKSON CO, LLC
Invoice# comment Tran Dt Inv DI Due Dt Check D' Pay Gross Discount No -Pay Net
9767 09/30/20 09/23/20 10/03/20 -5.00 0.00 0.00 -5,00 rj
CREDIT '
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0868 ✓ 09/30/20 0W6/20 10/06/20 -4,99 0.00 0.00 -4.99
REDIT
4728886 09130/20 09/26/20 10/08/20 456.15 0,00 0.00 458,15 �✓
INVENTORY -
0867 0913012009/2612010106120 -4,99 0,00 0,00 -4,99
CREDIT
4728888 ✓ 09/30/20 09/26/20 10106/20 909.27 0.00 0.00 909,27 ✓
)NVENTORY
4728604 ✓ 09/30/20 09126/20 10/06/20 109,08 0.00 0.00 109.08 ✓
INVENTORY
4728890 09/30120 09/26/20 10106/20 360,02 0.00 0,00 360,02 ✓
INVENTORY •
4728380 � 09/30/20 09/26/20 10/06/20 7,023.27 0.00 0.00 7102327 ✓
/INVENTORY
4728379 ✓ 09/30/20 09/26/20 10/06/20 63,64 0.00 0.00 63,64
I VENTORY
4728603 09/30/20 09/26/20 10/06/20 85,31 0.00 0.00 85.31
/ INVENTORY /
4728381✓ 09130/20 09126/20 10/06/20 223.06 0.00 0.00 223,06 "
NVENTORY /
4728887 09130120 09/26120 10/06/20 53,96 0.00 0.00 53,96
INVENTORY
4728889 ✓ 09130/20 09126/20 10/06120 10100.89 0.00 0.00 1,100.89 ✓
INVENTORY
CM10269✓ 09130120 09/27120 10107/20 43,662432 0.00 0.00-3,652.32 �✓
CREDIT
4738923V /09/30120 09130/20 10/10120 124,82 0.00 0.00 124,52 ✓
INVENTORY
SC2791 ✓ 09130/20 09/30120 10/10/20 W11,52 0.00 0.00 108,52
SERVICE CHARGE
4739005%/ 09/30/20 09130/20 10/10/20 792.73 0,00 0.00 792.73✓
INVENTORY
4739007 ✓ 09/3012009/30/20 t0110/20 999.26 0.00 0.00 999,26 ✓
INVENTORY
4739009 ✓ 09/3012009/3012010/10/20 25,10 0,00 0.00 26,10 V
/INVENTORY
SC2792 ✓ 09/30120 09/30/20 10/10/20 95,62 0.00 0.00 95,62 ✓
SERVICE CHARGE -
4739006 V1 10/01120 09/30/20 10110120 24.13 0.00 0,00 24,13 ✓
INVENTORY
4739008 ✓ 10/01/2009/30/2010/10/20 1,166.12 0.00 0.00 1,166,12 ✓
INVENTORY
Vendor Total: Number Name Gross Discount No -Pay Net
10536 MORRIS & DICKSON CO, LLC 10,055,35 0.00 0.00 10,056.35
Vendor# Vendor Name Class Pay Code
12388 NATIONAL FARM LIFE INSURANCE >/
Involce# Comment Tran Ot Inv Dt Due DI Check D Pay Gross Discount No -Pay Net
3019879 V//09130/20 09/16/20 10/01/20 41637,31 0.00 0,00 41637,31
INSURANCE
Vendor TolalsNumber Name Gross Discount No -Pay Net
12388 NATIONAL FARM LIFE INSURANCE 41537,31 0,00 0,00 41537.31
Vendor# Vendor Name Class Pay Code
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01600 OLYMPUS AMERICA INC ✓ M
Invoice# /Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net
97941521V 09/30/20 08/07/20 09/01120 11137,61 0,00 0400 11137,61
SERVICE CONTRACT
Vendor Totals Number Name Gross Discount No -Pay Net
01600 OLYMPUS AMERICA INC 11137,51 0,00 0.00 1,137.51
Vendor# Vendor Name Class Pay Code
11069 PABLO GARZA ,
Involve# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net
10119 09/30/20 10/01/20 10/01/20 21160,00 0.00 0.00 21160,00
CONTRACT EMPLOYEE (01171 -wlUhq)
Vendor Totals Number Name Gross - Discount No -Pay Net
11069 PABLO GARZA 21160,00 0400 0.00 21160400
Vendor# Vendor Name Class Pay Code
12188 PENNYGOULDEN V/�p°'j Cl)
Involve# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net
092319 09/24/20 09123/20 10/10120 In'W 187.4/0 OAO 0.00 187/0 191'i'0
TRAVEL-OPM PAYMENT TRAIT '
Vendor Totals Number Name rrAr,, Gross Discount No -Pay Not E�
12188 PENNY GOULDEN ��'dV 18780 0.00 0,00 187.80
Vendor# Vendor Name / Class Pay Code
P2200 POWER HARDWARE r/ W
Invoice# /pomment TranDt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net
A55916 ✓ 08/26/20 0913012010/10120 34.71 0.00 0.00 34,71
SUPPLIES
Vendor Totals Number Name Gross Discount No -Pay Net
P2200 POWER HARDWARE 34131 0.00 0,00 34,71
Vendor# Vendor Name Class Pay Code
P1725 PREMIER SLEEP DISORDERS CENTER VClM
Invoice# Comment Tran Dt Inv Dt Due DI Check DPay Gross Discount No -Pay Net
87 ✓ 09/30/20 10/Ot/20 10/16/20 61250,00 0,00 0,00 6,260.00 ✓
SLEEP STUDIES
Vendor Totals Number Name Grass Discount No•Pay Net
P1726 PREMIER SLEEP DISORDERS CENTER 61250,00 0,00 0,00 %250.00
Vendor# Vendor Name / Class Pay Code
11080 RADSOURCE ✓
Involve# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net /
SC59579 ✓ 09/23/20 09/16/20 10/11/20 1,625.00 0.00 0.00 1,626.00
RAD SERVICES
Vendor Totals -Number Name Gross Discount No -Pay Net
11080 RADSOURCE 11626,00 " 0,00 0,00 11625,00
Vendor# Vendor Name Class Pay Code
11251 RAPID PRINTING LLC
Invoice## / Comment Tran Dt .Inv Dt Due Ot Check D' Pay Gross Discount No•Pay Net /
5675 r% 09/30/20 09/25/20 10/06/20 , 36,00 0.00 0.00 36,00 r/
SUPPLIES
Vendor Totals Number Name Gross Discount No -Pay Net
11261 RAPID PRINTING LLC 36,00 0,00 0.00 36,00
Vendor# Vendor Name Class Pay Code
11164 RS CLARK & ASSOCIATES, INC
Involve# Comment Tran Dt Inv DI Due Dt Check D Pay Gross Discount No -Pay Net
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20190831 09130/20 08131/20 08/31/20 80,66 0.00 0.00 80,66
COLLECTION
Vendor Tolalt Number Name Gross Discount No -Pay Net
11164 RS CLARK & ASSOCIATES, INC 80,66 0,00 0.00 80.66
Vendor# Vendor Name / Class Pay Code
50900 SAM'$ CLUB DIRECT ✓ W
Invoice# /Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net
000881 ✓ 09/30/20 08/19/20 10/08/20 167,47 0,00 0.00 167.47 r>�
SUPPLIES
005457 09/30/20 08/26/20 10/08/20 107,40 0.00 0,00 107,40
SUPPLIES
002299 09/30/20 08/26/20 10/08/20 28,48 0,00 0.00 28.48
SUPPLIES
005429 09/30120 09/11/20 10108120 100,19 0,00 0.00 100,19
SUPPLIE S
006706 09/3012009/16/2010108120 28,10 0,00 0.00 28,10
SUPPLIES
Vendor Total: Number Name Gross Discount No -Pay Net
50900 SAM'S CLUB DIRECT 431,64 0,00 0,00 431,64
Vendor# Vendor Name / Class Pay Code
10625 SARA RUBIO ✓
Invoice# Comment Tran Dt Inv DI Due Dt Check D•Pay Gross Discount No -Pay Net
092619 09/30/20 09126/20 09/26/20 276,32 0,00 0,00 276.32 f
CISD STOPTHE BLEED/TTCF/6e rNL Ktdli K'DS el IX3—rjIJS I �'
093019 09/30/20 09/30/20 09/30/20 97,20 0.00 0.00 97.20
TRAVEL -MARKETING DAYCAP V — t11 L✓ tKN Al eel tel
Vendor Total: Number Name Gross Discount No -Pay Net
10825 SARA RUBIO 373,52 0,00 0,00 373,62
Vendor# Vendor Name Class Pay Code
12430 SHANNA O'DONNELL, FNP
Involve# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net
092019A 09/30/2009120120.09120/20 1,329.40 0.00 0.00 1,329.40
TX NP FALL CONFERENCE CA I4 - �I I Y' lel
Vendor Total: Number Name Gross 0 Discount No -Pay Net
12436 SHANNA O'DONNELL, FNP 1,329.40 0.00 0.00 11329,40
Vendor# Vendor Name Class Pay Cade
51850 SHIP SHUTTLE TAXI SERVICE ✓ W
Invoice# /Comment Tran DI Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net
848994A ✓ 09/30/20 09/30/20 09/30/20 8.00 0.00 0.00 8,00
TRANSPORT PT
Vendor Totals Number Name Gross Discount No -Pay Net
S1850 SHIP SHUTTLE TAXI SERVICE 8,00 0.00 0.00 8.00
Vendor# Vendor Name Class Pay Code
K0636 SHIRLEY KARNEI
Invoice# Comment Tran DI Inv Dt Due DI Check D Pay Gross Discount No -Pay Net
091819 09130120 09/18/20 10/01120 182,93 0.00 0,00 182,93
CONTRACT EMPLOYEE (61JU— I-L3I Ic)
Vendor Totah Number Name Gross. Discount No -Pay Net
K0536 SHIRLEYKARNEI 182.93 0.00 0,00 182,93
Vendor# Vendor Name /Closs Pay Code
11296 SOUTH TEXAS BLOOD & TISSUE CEN r/
Invoice# Comment Tran Dt Inv Dt Due Dt Check DPay Gross Discount No -Pay Net
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90048548 ✓ 09124/20 09/1 6120 10/11/20 -11150400 0100 0,00-11160,00 ✓
CREDIT
90048627 ,/ 09/24/20 09/16120 10/11/20 403.00 0.00 0.00 41663.00
BLOOD
Vendor Totals Number Name Grass Discount No -Pay Net
11296 SOUTH TEXAS BLOOD 8: TISSUE DEN 31513,00 0.00 0,00 31513,00
Vendor# Vendor Name / Class Pay Code
C1010 SPARKLIGHT y/ w
Invoice# Comment Tran Dt Inv Dt Due Dt Cheek D' Pay Gross Discount No -Pay Net
091619 09130120 09/16/20 09130120 418,83 0,00 0,00 418,83 V
CABLE
Vendor Totals Number Name Gross Discount No -Pay Net
C1010 SPARKLIGHT 418,83 0.00 0,00 418,83
Vendor# Vendor Name ✓ Class Pay Code
12288 SPBS CLINICAL EQUIPMENT SRVC
Invoice# Comment Tran Ot Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net
INVO07385 ✓ 09/30120 09/04/20 09/04120 12,375,00 0,00 0.00 12,375.00 ✓
BIO MED SERVICES
Vendor Total:Number Name Gross Discount No -Pay Net
12288 SPBS CLINICAL EQUIPMENT SRVC 121375.00 0.00 0,00 12,375,00
Vendor#, Vendor Name Class Pay Code
10094 ST DAVIDS HEALTHCARE ✓
Invoice# Comm nt TranOt Inv DI Due Dt Check D Pay Gross Discount No -Pay Net
MMCPL201908 7 09/30/20 09/27/20 09/27/20 420,00 0,00 0,00 420,00
TELENEUROLOGY '
Vendor Totals Number Name Gross Discount No -Pay Net
10094 ST DAVIDS HEALTHCARE 420,00 0.00 0,00 420,00
Vendorll Vendor Name / Class Pay Code
12440 SUN LIFE ASSURANCE COMPANY V
Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Gross Discount No -Pay Net
091719 09130120 09/17/20 10/01/20 2,345,31 0,00 0.00 21345,31
INSURANCE
Vendor Totals Number Name Gross Discount - No -Pay Net
12440 SUN LIFE ASSURANCE COMPANY 21345,31 0.00 0,00 21346,31
Vendor# Vendor Name Class Pay Code
U1064 UNIFIRST HOLDINGS INC
Invoice# Comment Tran Dt Inv Ot Due Dt Check D' Pay Gross Discount No -Pay Net
840031-1264_ V 0031t �ft4/2009/1612010/11120 47,15 0.00 0,00 47,16
LAUNDRY
8400311265 ✓/ 09124/20 09/16/20 10/11/20 132,89 0,00 0100 132,89
8400311296 09/24/20 09/16/20 10/11/20 11632,69 0,00 0,00 11632,69 ✓
LA NDRY
8400311628 y 09/24/20 09/19/20 10/14/20 80,83 0,00 0,00 80,83 ✓
8400311607 7ORY
09/24/20 09119/20 10114120 169,19 0100 0,00 169.19 W//
LAUNDRY
8400311668 ✓ 09/24120 09I19/20 10114i20 128.60 0.00 0.00 128,50
LAUNDRY
8400311605 ✓ 09/24/20091`19/2010114120 120,39 0,00 0,00 120,39
LAUNDRY
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8400311608 ✓ 09/24/20 09/19/20 10/14/20 175,83 0.00 0,00 176,83
LAUNDRY
8400311066 ✓/09/24/20 09/19/20 10114120 11633,87 0.00 0,00 11533,87
LAUNDRY
8400311642 ✓ 09/24/20 09/19120 10/14120 1,334.01 0.00 0.00 1,334.01
LAUNDRY
8400311602 09/24/20 09/19120 10114/20 18,62 0.00 0.00 18,62 j
LAUNDRY
8400308739 V1 09/30/20 08/15/20 09/09/20 120.39 0.00 0.00 120.39
LAUNDRY
8400311072 ✓ 09/30/20 0911200 10/07/20 11603,61 0,00 0.00 1,603.51
LAUNDRY
Vendor Total! Number Name Gross Discount No -Pay Net
U1064 UNIFIRST HOLDINGS INC 71097,87 0,00 0.00 7,097.87
Vendor# Vendor Name Class Pay Code
12400 UPDOX LLC
Invoice# Comment Tram Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net
INV00110799 V/ 09130/20 09/30/20 698.00 0,00 0.00 698,00
MONTHYLY PAYMENT
Vendor Total: Number Name Gross Discount No -Pay Net
12400 UPDOX LLC 698,00 0.00 0,00 698,00
Vendor# Vendor Name Class Pay Code
12208 WAGEWORKS
Invoice# Comment Tran Dt Inv DI Due Dt Check D Pay Gross Discount No -Pay Net
INV1642471 V/ 09/16/20 09/16/20 10/16120 543.50 0,00 0.00 543,60 ✓
ADIN/COMPLIANCE FEE
Vendor Total: Number Name Gross Discount No -Pay Net
12208 WAGEWORKS 543,50 0.00 0.00 643.50
Vendor# Vendor Name Class Pay Code
W1005 WALMART COMMUNITY ✓ W
Invoice# Comment Tran Dt Inv Dt Due Dt Check D4 Pay Gross Discount No•Pay Net
03956 09130/20 08/16/20 10/12/20 80,90 0.00 0.00 80,90
SUPPLIES
09765 - 09/30/20 08/16/20 10/12/20 38,96 0.00 0,00 38,95 ✓
SUPPLIES
03955 09/30/20 08115/20 10112/20 39.5B 0,00 0.00 39,58
SUPPLIES
04766 09/30/20 08/20/20 10/12/20 93,76 0,00 0,00 93.76
SUPPLIES
09700 09/30/20 08121/20 10/12120 43,74 0.00 0.00 43,74 L✓
SUPPLIES
05109 09/30/20 08/21120 10/12120 24,69 0,00 0.00 24,69✓
SUPPLIES
01015 09130120 08/27/20 10112120 28,06 0,00 0,00 28,06
SUPPLIES
04858 09/30/20 0910512010112120 %76 0,00 0,00 16.76
SUPPLIES
04869 09/30/20 09/06/20 10/12/20 18.00 0.00 0.00 18,00
SUPPLIES
Vendor Total: Number Name Gross Discount No -Pay Net
W1005 WALMART COMMUNITY 383,44 0.00 0,00 383.44
Vendor# Vendor Name Class Pay Code
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11110 WERFEN USA LLC V
Invoice# Comment Tran Of Inv Of Due Dl Check DPay Gross Discount No -Pay Net
9110722241 ✓ 09124/20 09116120 10/11/20 1,571.67 0,00 0.00 1,671,67 i/
LEASE
9110724034 t/ 09/25/20 09/17/20 10/12120 41293,36 0,00 0.00 4,293.36
SUPPLIES
9110723767 ✓ 09/25/2009/1712010/12120 721,50 0,00 0.00 721,50 /
SUPPLIES
Vendor Totals Number Name Gross Discount No -Pay Net
11110 WERFEN USA LLC 60686.63 0.00 0.00 60586.53
Vendor# Vendor Name Class Pay Code
12820 YOAKUM COMMUNITY HOSPITAL
Invoice# Comment Tran Dt Inv DI Due Of Check D Pay Gross Discount No -Pay Net
091319 09130/20 09/13/20 09/13/20 164,40 0.00 0.00 164.40
INVENTORY
Vendor Total: Number Name Gross Discount No -Pay Net
12820 YOAKUM COMMUNITY HOSPITAL 164,40 0.00 0.00 164,40
Report Summary
Grand Totals: Gross Discount No -Pay Net
396,587,63 0.00 0.00 396,687,63
Py � corrc�,•iiwl 4 G IB7.S�i
J'V I' ✓�
APPROVED
ON
OCT 0 a 2019
COUNTY AUDITOR
CALHOUN COUNPY,'1T4XA.8
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e a�
Vendor# Vendor Name
11816 ASHFORD GARDENS
MEMORIAL MEDICAL CENTER
AP Open Invoice List
Due Dates Through: 10/2012019
Class Pay Code
0
ap_open_invoice.template
Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay
092519 09/30/20 0�9//,25/20 10117/20 11,72.8.0,0 0.00 0.00
TRANSFER �JUYtilr C) Vha V .IY1�1-VU-t4-1-R._ pl�`kf �li"tU KML- Ilk cwvvY
Vendor Totals Number Name Gross Discount No -Pay
11816 ASHFORD GARDENS - 11,728.00 0.00 0,00
Report Summary
Grand Totals: Gross Discount No -Pay
11,728.00 0.00 0,00
APPROVDD
ON
OCi p y 2019
COUNTY AUDrTOR
CA1.IJOUN COUNTY, T»S
Net /
11,728.00 ✓
Net
11,728.00
Net
11,728100
file:///C:/Users/mmckissack/cpsihnemmed.cpsinet.com/u88150/data_5/tmp_cw5report30... (0/3/2019
Page 1 of 1 .
19 MEMORIAL MEDICAL CENTER
10103120190
AP Open Invoice List
' r10:04 1' ap_open_involce.template
�• • „., �k�tti{� � Due Dates Through: 10/20/2019
Vendor# Vendor Name Class Pay Code
11832 BROADMOOR AT CREEKSIDE PARK
Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net
092519 09/30/20 09/25/20 10/17/20 14,400.00 0.00 0.00 140400.00
TRANSFERWVVyIhtj j%VNN.VJ1 Not �w t MOL 11kLVWtr /
093019 09/30/20 09130/20 10117/20 1,023.00 0.00 0,00 11023,00 rs
TRANSFER Nut411V1y WOOL IYSI•kvPnO- 10�K111 9Cy�,1 ID MALL IV\ Crl(V&�
Vendor Total; Number Name Gross Discount No -Pay Net
11832 BROADMOOR AT CREEKSIDE PARK 15,423.00 0.00 0.00 15,423.00
Report Summary
Grand Totals: Gross Discount No -Pay Net
15A23.00 0.00 0.00 15A23.00
.l�PPROVEII
ON
OCT 0 4 2019
COTJIVtlTY AUDITOR
r,A7.xouN eDaNTY, TE1tA9
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10/03120 9 11
GRi t�
{ti'(Q�Sg12k. iC5414iE� P�.4'vtCtrtt'
Ventlor# Vendor Name
11824 THE CRESCENT ✓
MEMORIAL MEDICAL CENTER
AP Open Invoice List
Due Dates Through: 10/20/2019
Class Pay Code
0
ap_open_invoice.lemplate
Invoice# Comment Tran Dt Inv Dt Due Dt Check D' Pay Grass Discount No -Pay Net
092519 09/30/200�1"9^'�/�2512010117/20 N AA 612W,00 �♦1'�0,00 0,00 61210,00
TRANSFER NVIAV) NMJl' IVLSuVttWti V- w1 ew 'AO MVAL 1h LVW /
093019 .09/30/2009/30/2010117/20 11,718.97 0,00 th L� 11718.97
TRANSFER djkkII<'J NW lattY1j� W'�N''�1 P41''t AT VW`'-
093018A 09/30/20 09130/20 10/17/20 2,430.00 0,00 0.00 2,430.00 l%
TRANSFER NLkAIM WOML iMVWtjL" YVaTtj �- f 'N1 JVLM- It\ Cry
Vendor Totals Number Name U Gross Discount No -Pay Net
11824 THE CRESCENT 10,358,97 0.00 0.00 10,358.97
Report Summary
Grand Totals: Gross Discount No -Pay Net
10,358.97 0.00 0.00 10,358.97
lsPPROVEIP
ON
OCT 0 4 2019
COI1N'CY ATTDITOR
CALiIOUN COUNT'P, TIIiA9
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10/03121 � 20IJ
101
Crat@a-r)".n4`.owttyAu€lit r
Vendor# Vendor Name /
12696 GULF POINTE PLAZA
MEMORIAL MEDICAL CENTER
AP Open Invoice List
Due Dates Through: 1012012019
Class Pay Code
0
ap_open_invoice.template
Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross
093019 09/30/20 09,^/301'/2^0 10/17/20 30,0j08.r36
TRANSFER N0441y 1`ltry� Ii'>SIIYlUL2 P�At (j(.V'1 Iv
093019A 09/30/20 09/30/20 10/17/20 118,909,772
TRANSFERNUVhIM I6WL. 11ASUt4U%Jt j �f 'iv
Vendor Total: Number Name Gross
12696 GULF POINTE PLAZA 148,918,08
Report Summary
Grand Totals: Gross Discount
148,918.08 0.00
RPPRO'VM
ON
OCT 0 4 2010
COUNTY AUDITOh
CALHOUN COUNTY, 3'WIX
Discount
0.00
V.
0.00
Discwount
0.00
NoPay
0.00
No -Pay Net /
0,00 30,008.36 ✓
I Y� C.VVr.I�
0,00 118,909,72 ✓
�Vl cvvwr
No -Pay Net
0.00 148t918,08
Net
148,918.08
Yi lea//C:/Usershmnckissack/cpsi/memmed.cpsinet.Coln/u88150/data_5/tmp_cw5report53... 10!3/2019
Page I of 1
RECRINED
10/03M 0 3 2019 MEMORIAL MEDICAL CENTER 0
AP Open Invoice List
10:06 Due Dales Through: 10/20/2019 ap open_Invoice.template
CuFfi�slrt c€�eaoxty <iaactttcar`
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
092519 09130/20 09/25120 10/17/20 12,761,61 0,00 0.00 12,761.61
TRANSFER uIAY/4Ijq Wk" I%IAMUJ. It)OKJ W �h WlWV, 1K LWW
093019A 09/30/20 09/30/20 10/17/20 40,001.64 0.00 0.00 40,001.64 ✓
TRANSFER MRMIny WQLL jYUtLMAtJL rV"' 6ARk •h WWJ- Ili LVVVr
093019E 09/30120 019//30/20 10/17/20 2,056.10 0.00 0.00 2,056.10
TRANSFER UtkfVjjkq NWt �MtLWJ%LL p!Ykl w 'b wkL IYVLw
093019 09/30/20 09/30/20 10/17/20 51087496 LL 0.00 0.00 5,087.96 V/
TRANSFER tja&ilpy WOK€ 1NSUlU -lJL- VLYAir lzW 't Y&V&L I K CAMV
Vendor Totals Number Name vJGross Discount No -Pay Net
11836 GOLDENCREEK HEALTHCARE 59,907.31 0,00 0,00 59,907,31
Report Summary
Grand Totals: Gross Discount No -Pay Net
59,907,31 0.00 0,00 59,907.31
"PROVED
ON
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Memorial Medical Center
Nursing Home UPI.
Weekly Centex Transfer
Prosperity Accounts
10/4/2019
Prevlauf TvdaV's Amount lv Oe
Account Beginning ACH Beginning TraideFred to Nora Ing
NUNIn II _ Number Balance Transfer -Out /Transfer In Prandrigbanamitsi Balance Home
204,127,88 203,925.95 6 42.30210 - 43,009.23 / 42,767.85
Bank Balanaa 43,W9.23 V
Variance
Leave In Balance 100,00
Ck to MMC for QIPP 1
Routing Information for Ashford Caresses : MMC Portion QIPP 1
Ashford Nation Care Center / Id Cc MMC Portion QIPP 203kapse
he Morgan Chase Bank July Interest 45.55 ✓
AW Augustlnterest 56,37
-...-..-_. / September Interest 39A5.
/ Adjust Balance/rrarefer Aml 42,767,85 l/✓124o058,91/ 880728.62 st 8B,531.86 ✓123,862.25 Bank Balance 124,058 91 g� 1234816.67
Variance -
Leave ln Balance 100.00
MMC Partlan QIPP 1
MMC Portion QIPP 2,3,lapse - /
July Interest 49.59 ✓
August interest 47,17 ✓
September Interest 45,48
Ckto MMCfar QIPP1
/ Adjust Balance/TransferAmt 123,816.67 ✓/
396,232.37 k 396,026.92 g� 89,399.27 F/ Balance B9,604,72 72 g/ 894342,94
Bank
Variance
Leave In Balance 1W.W
Ck to MMCfor Capp 1
MMC Portion Capp 1
MMC Portion CaPP 203,lapsc
Julylnterest 68A41�
August Interest 37,01 g/
September interest 56,33
Adjust Balance/rransfol 89,342.94 ✓
127,351.68 a/ li],216.58 ✓ 17.598.80 17,733.90 / 1),5]8.36
V Bank Balance 1],]33.90 g/
Variance -
Leave In Balance 1010.00
Ck to MMCfor QIPP 1
MMC Portion QIPP 1 -
MMCPortlonQIPPMitigate -
Juayinterest 16.29
Augustlnterest 18.81 Ill
September interest 20.44 ✓/
Adjust 0alance/Cransffer Amt 17,578,36 a/
216844438 465,30E.12 v/465,021.59 g/ 78,156 83 ✓ Bank Oalance 784439,36 s/ 36 78,072,70
Reurin4 rnlvrmorion lu. uemenr/sukru ar tven Huurren /7urt Bentl/eruudme4r
eemeaxmlln care eemera rtrue
IP 4larpon CAvi<Bank
ABA
Arauv.
Nora: OnNbvbncea a/over 0.IX01410 be nano/erred ry the nursing
Note 2: Each account has abuse bahnee VS100 that 61AfC4epoaite
Variance
Leave In Balance
100,00
Ck to MM[ for QIPP 3
Adjust Balance/CransferAmt 78,072,70
TOTAL i8AN5FER5,351,5]8.52 ✓
Approved:
Diane C. Moore, CFO "pROVEDIO/4/2019
ON
FINAMIJ
1:\NH FVeeFly Transfers\NN UPt Tramler Summary\2a19\October\NII UPt iranfbr Summary 10-019.ana
COYJNTY AODTTOft
CALSIOUN COUNTY, TGXAS
tUdivitioldir TrAn0firsUrank oni
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MMCPORUON
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01Pp Tl
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9/30/2019
Ace.Uming Pact Added brAccounl
/ 394%
.
✓
9/10/2019
Cheek P69
11,860.75
✓
- .
0/ID/1019
A01DrpositUIICCONI6AUOITYPLIICCIAIAIP61TT4Cd03411910000
,34
✓/
/
799 3t
9/so/2o6
ACit nrPnslt lllH COMfAUNUY CI II[CMIM1IpfAi ]460OY111910000105
✓
ITS 105
11
1INU19
ACII Osposlt Arnerlgmup DSC UCCIAIMCMT 3UD4DUS711 MO
24
/
10/1/1019
ALI DepoHt UNC COMMUNITY CI NC(IAMIPMT 7460n341196000
215 96✓/
2115112
10/I/106
ACII Deposit UIIC COMMUNITY PI UCCMIMPMT 74MMI191000hi
2,952
]9✓�
71952.22
tO/1/2019
ACII De�OJt NOVITAS SOLUTION HC(MiMM016) T 6]542302000B90
990.25
10/3/1019I019
Chi BrO
17."
V/
/
10/l/Ire
CM SVDomigUe YOU OUt ASNFORO HFA1TH CARE CENTER LTD
1706t2 x3
✓
'
10/3/2019
Drown
31,IB480
- 11,186.69
10/3/2019
Deposit
4,031 SS
4.031.55
10/3/2019
ACII Deposit MANAGEANDN[T1718 MNS MINT MILMOCC000009341
10719."
�
- 1,719.90
10/3/2019
ACII DeporH UnlledtieAHncate llCCLUMPNIT 7460()1 11 123IW
260.
- 60.n0
10/3/2019
ACIIDepolit UHCCONIMUNITYPLIIC(WNIPAIT 74 00 411 910000
501.10
�/
507,30
46.12
10J3/3019
AGI Oeporit fl0NTA55UlVIlON IICCWMPIAi 6)64}3420000111
d}6.12
✓
201 92696
91d0)30
42]61d5
Anti
MMCPORTION
CUPPYRl
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714R31FCID
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Ail glpp/Camp] QIPPNpsr
OIPPA
NUPORTION
9/30/2019
Aca Eernlnd Pytnt AJJeJ Io Account
/ 4545
At
'
9/30/1010
eneck Nis
2,31115.
✓
/
9/30/1019
9/30/2019
AC110epoiltllNti[OU[ALTIIUREIICCUlkt?NiT74E0034111243M
ACII Deposit UIIC COMMUNITY PL IICMINEIAT 741AXIM11910000
5,29550
1HUS.SO✓//
I.Srlp.50
9/30/2019
ACH Deposit NOWTAS SOi HOCLAINIPAAT 676357420000149
12,57B.19✓/
- ?57819
]MCA"
101112019
ACH Deposit UPC COMPAUNIW PL 11cC1AIMPMT]4600MIl MOTOR
2,46959
✓/
ULAI019
ACU Deposit UnAcc Uealthum H(CMIAIPPAT]A60034111243M
4,29600
r/
4,29
10/3/2019
(1i9e1. R36
4,173.55
10/3/2019
Chi Wim 0omeeHEA C WIPE OUT MTEA HEALTH CARE CE14TEM LI
R?O1O.
I9 VVUR
Oep sit
AS
DRUM 6S
10/311019
ACH DoseHl Uniledifish care HCCIAlAPMT 74160034111243M
14206.E0
✓
- 14406w
6J3/2019
ACII Deposit NOVITAS WIUT1014 HCCINMPMT 676357420000110
61
Bd6}'IS
✓
t
e 8!1 B6
133
1
123,86.6I
MMCPORnON
Qipp Yal
SOMMERIMIMMIMEM
_MItMO T
Ln�s 4Ll0
g1PP/Commi
A01 g03110run i QVP/tap"
CU"T1
NHPORNOV
W3011015
Aces Earning News Added to Account
5633
✓
9/30/2019
clivi R6s
2,297M
-
9/30/2014
ACII Deposit UNHEDHEALNICARE NCCLAiMeAr7460034ll 12436I
2,1Cq pp
✓ •
1,1(D.cO
9/30/1019
ACII DepoHt UIIC Community Fit HCCU1MPMT 74(001411910000
4.285 0✓
- e,205M
3,761.36
9/30/2019
ACII Oeposit NOVUAS 501U110N HC(uVMPAIT 676323420000148
3,167.16
9/30/2019
ACII Deposit HUMANA1NSCO HCCLAIMPMT 49085183000053MIS
9,021.32✓
6,021.32
10/1/2019
ACH DepoHt HUMANACIIA OISO HCCLAVAPMT 3"AM 4200001889
546.S1
✓
54GAI
IO/l/2019
ACHDupolit UUCCommumvPIIeCUMMPMT24MPII1910000
2099150✓
• ),991 SD
10/2/I019
ACUllipai UniladllolUbrAte 11CMIMPMt 7AM411124864
30,WG.14
✓
- 10,WG.14
10/2/2019
ACHOdari NOVITAS SOIUHON IICCLAIMPAAT 676323420000190
95,07
AA/
RAW
1013/2019
Checkp66
4,14848
10/3/2019(M
WINt OumeHXWIREOUT UNTEX IIMORI CARE CENTERS NI
389,SB1.02
s✓
-
10/3/2019
Deposit
4,66645
✓
- 4,661,25
10/1/2019
Deposit
21480
R/
- 214,89
1013/2019
ACII Deposit Uniledtteallneate H(CIAIMPMT]461103111 224384
110995.10
11.995,10
10/3/2019
ACII Deposes HUNIANA INS CO HCCMIM1IPAAT 3908A 830M0555803
5,612.65
AC4265
1013/2019
ACII Di mIP UCCMiNIPAlt 3908619UNK012I01159 DI5OATA
0159A9
c✓
- 10,35949
39601692
69,39927
89d4i.94
MMCPORTIM
WyP TXl
JtL917£LOu(
4AR71er,1"
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OIIPPn
NUPORUON
91301
Am Esmin0PYml AddeJlo ACcount
2044.'
9/30/2019
Cheek A62
4,851.19
10/1/2019
ACH Depovt UIIC COMMUNITY PI HCCIAIMPMT]4M0341191M00
s✓
Sde690✓
-5.141M 90
10/2/2019
ACH DepoHt Unneelleadit<He HCCIARAPTAT746CXBUll 1243U
1 ]4.1 M
✓
Vu 6o
10/3/2019
Check 063
8,771aS
✓
'
10/3/2019
CM Wire pameHk WIRE OUT CANTER HEALTH "RE CENTERS III
113,586.94
si'
10/3/2019
Del"Al
7.102,19
✓
7.1039
10/3/2019
Deposll
88186
✓
- Bete
10/312029
ACII Deposit NOvEM901UTION IICCWMPMT 67S663420000110
/943AI
✓ a
1,96341
127,1126.51
sa 159680
1],538.36
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9/30/1019
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10316,9)
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9/30/2019ACIIOepmil
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9/10/1019AC11DOPusi1N0V1TAS50Ll11tONItCCNIMPMT676310420000148
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10/1/2019ACII
aNsit MANAG[M'DNLT1/1Bt,IN5PMNIW00WWOW248241
4G7.211/
461.11
10/1/2019
ACII Demnit HUMANA INS CO ETPAYMfNT 1901621300M5)89819
24,065A4
✓
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10/1/2019
ACH Deposit RUNUNA(HA DISO HCCIAIA1PAiT 1938624200001890
594,(Q
✓✓
591,C0
10/1/2019
ACII Deposit MAP Supplements HCCWIMPMT 74MMIl 1243M
1,10500
l
111050)
10/2/2019
ACU Deposit UIIC Community PI UCCLAIMPIAT 74100341191MM0
479M
✓
479M
10/3/2019
Check R63
6,097,85
.✓
10/3/2019
CM Wire Domestic WIRE OUT CANTER HUCTII(ARf CENTERS Pt
45541/1/
✓
10/3/2019
astern
12t992.21
M991.22
10/1/7019
Depoat
✓
745 RA
10/li
ACH Commit KIANAGtANOUR 171E AINS PMNTOMOCO '0:4e:❑
1,79w000�
"
10/3/2019
ACH Deposit MANAGMUMA MS ADS PlAUt MpMC61W[0248241
167AG✓
6I40
10/3/2019
ACII Deposit Unded11ollthcam UCCIAIMPMi N000}1111243M
1 8,195.00
�j
-
.
- 3 0.19500
10/!/2019
ACII nevosit NOVITAS SUIEHION UCCIAINIPIr 670104200011110
2J
V
- 242.76
10/3J2019
ACH nepcsit UU UUA Ilia HCCLAIMPAIt 39006283MMS5580e
A 9 51
✓/
- 9,059.51
465 21.59
V >e 66d3
74,012.70
TOME
353,B7B.52
V351d�
101412019
tal Banking
Home
ALL ACCOUNTS FAVORITES
Reorder Favorites
Favorite Accounts
Available
Previous Day
MEMORIAL MEDICAL CENTER -
OPERATING
MEMORIAL MEDICAL CENTER /
$51,076,73
$43,00923
NH ASHFORD k4381 *
MEMORIAL MEDICAL CENTER /
$136,230,66
$124,05891
NH BROADMOOR 44403*
MEMORIAL MEDICAL CENTER /
$94,636.62
$8904
72
NH CRESCENT •4411 *
MEMORIAL MEDICAL CENTER /
$78,780.36
$78,439
36
SOLERA AT WEST HOUSTON
•4438 *
MEMORIAL MEDICAL CENTER /
$17,733.90
$17,733
90
NH FORT BEND M446*
MEMORIAL MEDICAL / NH����
GOLDEN CREEK HEALTHCARE
MMC -NH GULF POINTE PLAZA
- PRIVATE PAYI
MMC -NH GULF POINTE PLAZA
- MEDICARE/MEDICAID_
htlpsa/pbsltzsecure.fundsxpress.com/fxweb/apprNlhome 7/7
Memorial Medical Center
Nursing Home UPL
Weekly Nexion Transfer
Prosperity Accounts
10/4/2019
Previous
Amount to Be
Account
Beginning
Pending
Transferred to
NoFrin� Number
Balance rooster -Out
Transfer -in Ce osits
Toda sse innln Balance
Nussin Name
169,155.08 169,005.45
9,874.18 -
9,023.81
8,899.36
Bank Balance
90023.81
Variance
(a.00)
teave In Balance
100.00
MMC Pardon QIPP 1
QIPP Yr l Adjustment
-
lulylnterest
19,83
✓
goutlnn information for Golden Creek;
August Interest
29,80
Nevfan Neafth at Golden Creek
September interest
25,02
Wells Fargo Bank, N.A.
Outstanding ck to MMC for QIPP
ABA
Account
Adjust Balance/Transfer Amt
8,849.16
✓
Note:Only balances oJover $S,OW fib Nansferaed to the nursing home.
Nate I: Coch ottount has a base hofonre o)$100 that MMC deposifM to open ocrounr.
npprovetl• ✓�..-t CEII
Diana C, Moose, CFO 10/4/2019
APPROVER
ON
dCT 0 4 20i9
COUNTY AUDTTOR
CALROUN COUNTY,'PEXA9
1:\N111Yeekly hantfers\NH UPl iramler Summary\2019\Octo'xr\NH UPL iransler Summary ]Od�19.Ylss
MMC PORTION
QIPP TIRE 1 NN
Irenefer-Qu3 ifansfer-I QIPP/Cumpi A El Perki QIPP/Camp3 QIPP/lapse QIPPII PORTION
9130/2019 Aar EvislnB Plrnt Added to Aci:oumt 2502//
9/30/2019 ACII Deposit TSYS/tPANSf1115i 8XCO STLAD 543684555BY69179 50000// - 1,SOJ.00
9/30/2019 ACII Deposit NOVNAS SOLUTION IICCIAIMPMT 67CLUD 420000148 / 1,222.06✓ - 1,222.06
10/3/2019 Check e.i4 18,391.)I ✓ `
10/3/2019 CM Woa DomerOc WIPE OUT NEMION HEALTH AT GOLDEN CREEP. 150,613.68 '
10/3/2019 Deposit 374.29 324"19
10/3/2019 ACII OeporI135T5/IPANSHPSf OYCO STIl ti 5436Wt5558269379 1411, 11 _1.
___. -
16%005.45 jr874.18 - - - e$39.16
t0/41201g
Home
ALL ACCOUNTS
FAVORITES *
tal Banking
Favorite Accounts Available Previous Day
MEMORIAL MEDICAL CENTER - �r
OPERATING®
MEMORIAL MEDICAL CENTER /
NH ASHFORD
MEMORIAL MEDICAL CENTER /
NHBROADMOOR IM
MEMORIAL MEDICAL CENTER /
NH CRESCENT
MEMORIAL MEDICAL CENTER /
SOLERA AT WEST HOUSTON
fto
MEMORIAL MEDICAL CENTER /
NH FORT BEND_
MEMORIAL MEDICAL / NH
GOLDEN CREEK HEALTHCARE
4454
MMC -NH GULF POINTE PLAZA
-PRIVATE PAY
MMC -NH GULF POINTE PLAZA
-MEDICARE/MEDICAID®
$9,023.81 $g,023.81
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Mnmorlal Medical CBe er
Nursing Home UPL
Weekly HMG Transfer
Prosperity Accounts
30/4/2019
Prevlvos
tv By
Aeevont
BeaiMnp
Patterns
Transferred to
Nonm
super Nome N D.,
B abn« Transtenbul
Tranalerin Cris cleared
De oNn
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NunlryN_
_. ... ... ...
100.20
0.at
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Oan4ariance
IOD.)a
✓/
name
care in n,nnw
1o0ro
AtMC Pnrllon once I
MMC Portion gIPP 2,T4upnpse
July Interest
0.04
✓
Amber Interest
elect
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GOLDEN CREEK HEALTHCARE
MMC -NH GULF POINTE PLAZA
-PRIVATE PAY •sass*
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$too.za
$95,172.76
$95,772.76
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1/1
MEMORIAL MEDICAL CENTER
CHECK REQUEST
p Memorial Medical Center Operating
Date Requested:
A APPROVED
ON
Y -- - - OCT 0 4 2019
COUNTYAUDITOR
CALHOUN COUNTY, TEXA'
AMOUNT 141.38 G/L PIUMBIR:
10l4/19
1-C)R ACCT, 11SF ONI Y
imprest Cash
�A/P Check
Mail Check to Vendor
Return Check to Dept
PXPLANATION: Ashford_Transferfnnds
for
quarter 3
Interest
payment
_— — —� __
RE01-lisr:D BY: Caitlin Clevenger AUTHOFW--ED
P
A
Y
E
I:
AMOUNI'
MEMORIAL MEDICAL CENTER
CHECK REQUEST
Memorial Medical Center Operating Date Requested:
AP%�RO'VRTI
ON
OCT n a 2019
COUNTY AUDTTO72
CALHOUN COUNd'Y, TLXA6
266.66 GA NUMBER:
ExPLANAI'ION: Soles -Transfer funds for
3 interest payment
1014/19
FOR ACf.;T. USE CtNf Y
Irnprest Crash
�A/P Check
Mail Check to Vendor
Return Check to Dept
r
REQUESTED BY: Caitlin Clevenger
NUMBER:
MEDICAL CENTER
CHECK REQUEST
P Memorial Medical Center Operating
Date Requested:
la
APPROV'EID
Y ON
E------------- OOCT0 4 2019
C,OUNTYAUDITOtt
_ --- CATY
LHOUN COUN, TEXA,g
AMOUP)T 161.78 6/L
EXPLANA110N: Crescent-Transferfundsfor quarter3inlerest
10/4/19
FOR
ACCT. 11SE ONLY
�Irnprest Cash
�AJP Check
Mail Check to Vendor
Return Check to Dept
REQUESTED BY; Caitlin Clevenger AUTHORIZED BY: ��
P
MEMORIAL. MEDICAL CENTER
CHECK REQUEST
Memorial Medical Center Operating Date Requested:
AMOUNT 142.24
APPR,OV);D
ON
OCT D 4 2019
COUNTY AUDITOR
CALUOU"PNYKeYBWjXAS
I°xPl ANA 11ON: Broadmoor- Transfer funds for quarter 3 interest
REQUESTED BY: Caitlin Clevenger AUTHORIZED BY:--
10l4/19
E-OR ACCT. USE ONI Y
�Imprest Cash
�A/P Check
Mail Check to Vendor
CReturn Check to Dept
MEMORIAL MEDICAL CENTER
CHECK rvF. tvEST
P Memorial Medical Center Operating
A
Y
E —
G
AMOUNT
EXPI ANA TION
55.54
Fort Bend -Transfer funds for
REQUFS rtD kiY• Caitlin Clevenger
Uate Requested:
APPROVEI9
ON
QCT 0 4 2019
COLIN4'Y ATIDYTOR
CAT,HOYfl icolIk$€i1 vEw
3 interest
AurFlonlzEU P;r:
10/4/19
F°OiZ ACCf. USF ONtY
�Imprest Cash
�A/P Check
�M0 Check to Vendor
Return Check to Dept
MEMORIAL MEDICAL CENTER
CHECK REQUEST
Memorial Medical Center Operating
Date Requested:
E
E
AP�OUNT 74.65
t�PROVEE}
ON
OCT o a 2019
COUNTY AUDITOR
CALIIOUN COUNTY, TEXAS
G/L R1U0.4BER:
PHPIANAI'Ic1NGolden Creek -Transfer funds for quarter3interest
10/4/19
FOR ACCT. USE ONLY
Irnprese Cash
�A/P Check,
Moil Check to Vendor
Return Check to Dept
REQUESStED BY: Caitlin Clevenger AUTHORIZED BY: l.lu
MEMORIAL MEDICAL CENTER
CHECK REQUEST
P Memorial Medical Center Operating
Data, Requested:
c
AMGUNi 12.54
APPftOVGY2
ON
OCT o a 2019
COUNTY AUDITOR
CA [MOUN COUNTY, TEXAS
G(L NUMBB;
rxPLANA rulu. Gulf Pointe MM -Transfer funds for quarter 3lnlerest
RPQUESTED t;Y: Caitlin Clevenger AUTHORIZED 8'C
10l4/19
r-OR ACCT. USE ONLY
�Imprest Cash
A(P Check
Mail Check to Vendor
Return Check to Dept
MEMORIAL MEDICAL CENTER
CHECK REQUEST
Memorial Medical Center Operating Date Requested: 10/4119
---_------ '---'-- ---'---
AMC7UPIT .11
APPRb'VEII
OBI
OCi 0 4 2019NTY
CbiIAUDITOR
CAI.II011N COUNTY, TMCAS
G/L NUMBER:
tXPIANA fIUi�L Gulf Pointe PP -Transfer funds for quarter 3 interest
FOR ACCT. t1SE UP1tY
�Imprest Cash
�A/P Check
Mail Check to Vendor
Return Check to Dept
REQUEST ED BY: Caitlin Clevenger AU H 10RIZEDR
October 7, 2019 2019 APPROVAL LIST - 2019 BUDGET
COMMISSIONERS COURT MEETING OF
BALANCE BROUGHT FORWARD FROM APPROVAL LIST REPORT PAGE
FICA
MEDICARE
FWH
NATIONWIDE RETIREMENT SOLUTIONS
OFFICE OF THE ATTORNEY GENERAL - CHILD SUPPORT
AT&T MOBILITY
CENTERPOINT ENERGY
CITY OF POINT COMFORT
CITY OF SEADRIFT
CPL RETAIL ENERGY
FRONTIER COMMUNICATIONS
GBRA
REPUBLIC SERVICES 4847
SPARKLIGHT
TEXAS WAVENET WIRELESS
10/07/19
1s $27,801.12
P/R
$
47,567.88
P/R
$
11,124.56
P/R
$
33,371.38
P/R
$
3,898.48
P/R
$
2,406.54
A/P
$
81.82
A/P
$
64.75
A/P
$
87.72
A/P
$
167.10
A/P
$
47.78
A/P
$
1,066.68
A/P
$
273.71
A/P
$
902.77
A/P
$
129.44
A/P
$
344.96
TOTAL VENDOR DISBURSEMENTS: $ 129,336.69 �
TOTAL AMOUNT FOR APPROVAL: $ 129,336.69 �
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