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2020-01-29 CC MINUTESCommissioners' Court-'anuary 29, 2020 REGULAR 2020 TERM 0 JANUARY 29I 2020 BE IT REMEMBERED THAT ON 7ANUARY 29, 2020, THERE WAS BEGUN AND HOLDEN A REGULAR TERM OF COMMISSIONERS' COURT. 1. CALL TO ORDER This meeting was called to order at 10:00 A.M by Judge Richard Meyer. 2. ROLL CALL THE FOLLOWING MEMBERS WERE PRESENT: Richard Meyer David Hall Vern Lyssy Clyde Syma Gary Reese Anna Goodman Catherine Sullivan County Judge Commissioner, Precinct #1 Commissioner, Precinct #2 Commissioner, Precinct #3 Commissioner, Precinct #4 County Clerk Deputy County Clerk 3. INVOCATION &PLEDGE OF ALLEGIANCE (AGENDA ITEM NO. 2 & 3) Invocation -Commissioner David Hall Pledge to US Flag &Texas Flag -Commissioner Gary Reese/Vern Lyssy Page 1 of 9 CommissionersCourt—January 29, 2020 4. General Discussion of Public matters and Public Participation. N/A S. Approve the minutes of January 15, 2020 meeting. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Clyde Syma, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 6. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 6) On the following FY 2020 Interlocal Agreements, authorize payment of purchase orders, and authorize the County Judge to sign. (RM) Calhoun County Soil and Water Conservation Dist. No. 345 - $7,750 RESULT. APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER, David Hall, Commissioner Pct l AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Calhoun County Senior Citizen's Association, Inc. - $35,000 RESULT: ' APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER. David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese The Harbor Children's Alliance &Victim Center - $28,500 RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 2 of 9 Commissioners' COUr� —January 29, 2020 The Harbor Children's Alliance & Victim Center - $28,500 RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct I SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 7. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 7) To Join with the Calhoun County Sheriff in adopting a resolution making Calhoun County a 2nd Amendment Sanctuary County. (RM) ;riff Bobby Vickery read the resolui iULT: APPROVED VER: David Hall, Commiss i )NDER Richard Meyer, Cour cS: Judge Meyer, Comm r Pct 1 Judge mer Hall, Syma, R er esPct 2 8. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 8) To approve a lease agreement with Xerox Corporation for a Xerox copier for the Calhoun County Extension Service and authorize the County Judge to sign. (DH) APPROVED Gary Reese, ( ER: Vern Lyssy, C Judge Meyer, isl Pct 4 'ct 2 r all, Lyssy, Sym; geese Page 3 of 9 Commissioners' Court —Jan uary29, 2020 9. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. g) To approve a credit card for R.J. Shelly, Calhoun County Marine Education Extension Agent. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 10. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 10) To renew a contract with Cintas Uniforms for Precinct 3 employees and authorize Commissioner Syma to sign. (CS) RESULT: - 'APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Clyde Syma, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Nall, Lyssy, Syma, Reese 11. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 11) To approve the installation of STOP signs in Port O'Connor, Texas at Lite Following intersections: 1. Two-way stop on Madison Avenue at Madison & 4t" Street 2. Two-way stop on Madison Avenue at Madison & 5t" Street 3. Two-way stop on Madison Avenue at Madison & 6t" Street 4. Two-way stop on 31d Street at 31 & Taylor Avenue RESULT: APROVED [UNANIMOUS] MOVER: David Hall, Commissioner PctI SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 4 of 9 Commissioners' Court — January 29, 2020 12. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 12) To allow the Port O'Connor Chamber of Commerce to use King Fisher Beach/ Park April 25, 2020 for their annual Crawfish Festival. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 13. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 13) To authorize the Port O'Connor Chamber of Commerce to sell alcohol at their Annual Crawfish Festival Fundraiser to be held April 25, 2020 at King Fisher Beach/Park in Port O'Connor, TX and authorize the County Judge to sign a Letter of Approval to the TABC. (GR RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Clyde Syma, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 14. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 14) To designate Park Avenue as a One -Way street during the annual Crawfish Festival to be held April 25, 2020 between the hours of 7 a.m. and 8 p.m. in Order to deter traffic hazards. Also designate the grass north of the pier Between Jackson and Harrison Streets be utilized as a golf cart parking lot. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 5 of 9 Commissioners' Court — January 29, 2020 S. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 15) To authorize the POC Chamber of Commerce to hold the annual Fireworks Display at King Fisher Beach/Park on July 4, 2020 and utilize the Park as a Vendor area during the hours of 10:00 a.m. and 10 p.m. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 16. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 16) To designate Park Avenue as a One -Way Street during the annual fireworks Display between the hours of 5 p.m. — 10 p.m. in order to deter traffic Hazards. Also designate the grass area north of the pier between Jackson And Harrison streets be utilized as golf cart parking only. (GR) RESULT: 'APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 17. Accept the 2019 Certificate of Completion for Continuing Education Hours From the District Clerk and enter into official Court Records. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER:David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 6 of 9 Commissioners' Court —January 29, 2020 18. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 18) To place funds from GOVPLANET for the auction of 1. 2002 Ford F450 XL Asset # 21-0242 - $841.50 2. Vermeer 1250 BC Wood Chipper Asset # 665-0034 - $1,496.60 3. Miller Bobcat 225G Welder Asset # 21-0116 - $794.00 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDERN 9 Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese AMENDED TO READ: The total amount of $3I25 and place in the 2020 ' Pct 1 budget acc't # 540-53510 Road and Bridge Supplies. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDERS Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 19. Accept the attached list of donations to the Calhoun County Public Library System during November and December 2019. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 7 of 9 Commissioners' Court —January 29, 2020 20. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO, 20) To declare the attached list as Surplus/Salvage and authorize the Calhoun County Librarian to dispose of same. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 21. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 21) To declare the attached list of items as Waste and authorize the Calhoun County Librarian to dispose of same. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 22. Accept a report from the following County Offices: a. Tax Assessor -Collector —December 2019 23. Accept Auditor's Office Reports for the attached County Offices: RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Clyde Syma, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 8 of 9 Commissioners' Court —January 29, 2020 24, Consider and take necessary action on budget adjustments. 2019 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Clyde Syma, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 2020 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Clyde Syma, Commissioner Pct 3 AYES: Judge Meyer, Commissioner. Hall, Lyssy, Syma, Reese 25. Approval of bills and payroll. MMC RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese County - 2019 RESULT: APPROVED [UNANIMOUS] MOVER: David Nall, Commissioner Pcti1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese County - 2020 RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 9 of 9 Commissioners' Court — January 29, 2020 REGULAR 2020 TERM ]ANUARY 29, 2020 BE IT REMEMBERED THAT ON )ANUARY 29, 2020, THERE WAS BEGUN AND HOLDEN A REGULAR TERM OF COMMISSIONERS' COURT. 1. CALL TO ORDER This meeting was called to order at 10:00 A.M by Judge Richard Meyer. 2. ROLL CALL THE FOLLOWING MEMBERS WERE PRESENT: Richard Meyer David Hall Vern Lyssy Clyde Syma Gary Reese Anna Goodman Catherine Sullivan County Judge Commissioner, Precinct #1 Commissioner, Precinct #2 Commissioner, Precinct #3 Commissioner, Precinct #4 County Clerk Deputy County Clerk 3. INVOCATION & PLEDGE OF ALLEGIANCE (AGENDA ITEM NO. 2 & 3) Invocation —Commissioner David Hall Pledge to US Flag &Texas Flag —Commissioner Gary Reese/Vern Lyssy Page 1 of 23 Con Imission ers' Court —January 29, 2020 4. General Discussion of Public matters and Public Participation. N/A Page 2 of 23 Cornmissioners' Court —January 29, 2020 5. Approve the minutes of January 15, 2020 meeting. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Clyde Syma, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 3 of 23 mm David Hall, Commissioner, Precinct 1 Vern Lyssy, Commissioner, Precinct 2 Clyde Syrna, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 The Commissioners' Court of Calhoun County, Texas met on Wednesday, January 15, 2020, at 10:00 a.m. in the Commissioners' Courtroom in the County Courthouse at 211 S. Ann Street, Suite 104, Port Lavaca, Calhoun County, Texas. Attached are the true and correct minutes of the above referenced meeting. ichard Meyer, Coun udge Calhoun County, Texas Anna Goodman, County Clerk l R � ) . /_ _ Per, ` Deputy Cler Page 1 of 1 Commissioners' Court — January 15, 2020 REGULAR 2019 TERM 0 )ANUARY 15I 2020 BE IT REMEMBERED THAT ON ]ANUARY 15, 2020, 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. F#Zi7�f�[�7T�J THE FOLLOWING MEMBERS WERE PRESENT: Richard Meyer David Hall Vern Lyssy Clyde Syma Gary Reese Anna Goodman Catherine Sullivan County Judge Commissioner, Precinct #1 Commissioner, Precinct #2 Commissioner, Precinct #3 Commissioner, Precinct #4 County Clerk Deputy County Clerk 3. INVOCATION &PLEDGE OF ALLEGIANCE (AGENDA ITEM NO. 2 & 3) Invocation —Commissioner David Hall Pledge to US Fiag &Texas Flag —Commissioner Gary Reese/Vern Lyssy Page 1 of 7 . Commissioners' Court -January 15, 2020 4. General Discussion of Public matters and Public Participation. N/A 5. Hear a report from Memorial Medical Center for November 2019. 6. Approve the minutes of the December 18, 2019 and December 23, 2019. 7. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM N0.7) On a petition to abandon a portion of public road In Alamo Beach, Calhoun County, Texas. (RM) 8. CONSIDER AND TAKE NECESSARX ACTION (AGENDA ITEM NO.B) To approve an order to declare closure of a portion of a public road in Alamo Beach, Calhoun County, Texas. (RM) Page 2 of 7 CommissionersCourt --January 15, 2020 9. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO.9) To approve and accept the request of the Calhoun County Historical Commission to transfer the Bauer Half Moon Reef Lighthouse Trust #137 to Calhoun County in the amount of $10,617,50. The funds will be deposited into the County depository in an interest bearing fund. (RM) 10. CONSIDERAND TAKE NECESSARY ACTION (AGENDA ITEM NO. 10) To acknowledge an increase in the Sheriff's Forfeited Property Fund for 2019 as follows: 2860-00145060 Forfeitures Revenue $11,460.00 and 2860-999- 63920 Miscellaneous $5,500.00. (RM) 11. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 11) To accept a check in the amount of $454.63 from American Agencies Old American County Mutual Insurance Company for damages to Sheriff's Office Unit 00 from an accident on August 11, 2019. The vehicle is not covered under the County Insurance because it Is over 6 years old. We reached out to other party involved in the accident for reimbursement for the damage from his insurance company. Monies will be added to the 2020 budget, line item 760-60360 Vehicle Repair. (RM) Page 3 of 7 . Commissioners' Court --January 15, 2020 12. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 12) To approve a resolution authorizing Commissioner Lyssy to file a Grant Application with the Golden Crescent Regional Planning Commission for a regional solid waste grant and authorize Commissioner Lyssy to act on behalf of Calhoun County in all matters related to this application. (see attached) (VL) 13. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 13) On insurance proceeds from TAC in the amount of $11,160.23 ($131660.23 $2500.00 deductible) for damages to a Sheriff's Office vehicle from an accident on December 312019. (RM) 14. CONSIDER AND TAKE NECESSARX ACTION (AGENDA ITEM NO. 14) On a resolution providing for the public sale of property acquired by Calhoun County from delinquent taxes. (RM) Page 4 of 7 Commissioners` Court —January 15, 2020 15. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 15) To transfer an Envy 540 All -In -One Printer and Ink cartridges from the Justice of the Peace, Precinct 5 to the Constable, Precinct S. (RM) RESULT...':... APPROVED [UNANIMOU5j F. F.. MOVER:.`.;..:`: Gary Reese, Commissioner Pct;4_ SECONDER: Vern :Lyssy, Corrimissioner Pck;`2 IF I I IF AYES JudgIF e Meyer, Coipmissloner Hap, Lyssy, Syma, Reese :::.IF IF 16. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 16} To declare items in Precinct 1 as Waste and authorize Commission Hall to dispose of same. (see attached) (DH) 17. Accept reports from the following County Offices: i. District Cterk —December 2019 2. Justice of the Peace, Precinct 1—December 2019 3. Justice of the Peace, Precinct 2 — December 2019 4. Justice of the Peace, Precinct S — December 2019 5. Justice of the Peace, Precinct 5 - December 2019 6. Sheriff`s Office — December 2019 Page 5 of 7 • Commissioners' Court --January 15, 2020 18. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 18) On any necessary budget adjustments. (RM) 20. Approval of bills and payroll. Page 6 of 7 . Commissioners' Court —January 15, 2020 Adjourned: 10:38 am Page 7 of 7 Commissioners' Court —January 29, 2020 6. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 6) On the following FY 2020 Interlocal Agreements, authorize payment of purchase orders, and authorize the County Judge to sign. (RM) Calhoun County Soil and Water Conservation Dist, No. 345 - $7,750 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Calhoun County, Senior Citizen's Association, Inc. - $35,000 RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese The Harbor Children's Alliance 8c Victim Center - $28,500 RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES. Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese The Harbor Children's Alliance &Victim Center - $28,500 RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 4 of 23 i i i The Harbor it rAlliance Victim January 7, 2020 Judge Mike Pfeifer 211 S. Ann Street Port Lavaca, TX 77979 l Judge Pfeifer, Thank you for allowing me to submit this request for support for The Harbor Children's Alliance & Victim Center. Our request is for $ 28,500 to support the operation of the center to enable us to provide services for victims of child abuse, sexual assault and domestic violence. I have enclosed the proof of insurance and will send the financial report and performance review as soon as the reports are completed. d Abuse touches all of us. It can occur among people of all ages, genders, races, educational background and socioeconomic. groups. She crimes of child abuse, sexual assault, and family violence do not just affect those to whom the violence is directed, but affect all of society as well. We strive to be a non-profit victim center that meets the needs of the community. We see our task as offering services to victims who have been abused, and also facilitating an environment of awareness, prevention and safety. Assessment of our community has led us to revise our program by expanding our services, education and outreach to the underserved members of our community. As a small rural center with a staff of six, we are cross trained to allow each member to provide services to anyone who seeks assistance whether it is for child abuse, domestic violence, sexual abuse and any other need. We sincerely appreciate the county leaders assisting us in providing services to citizens in Calhoun County.. Thank you again for your support. Sincerely, %ria T. Walton, Ex�cutive Director 215 W. Railroad Port Lavaca, Texas 77979 Bus. Office 361 /552-1982 Fax 361 /552-4309 ° Hotline 361 /552-4357 cacti ? wit childYen NATIONM EF 3 :aR CHILDRENS ALLIANCE- IIIEVANSTON INSURANCE COMPANY NIARKEV DECLARATIONS - SPECIFIED MEDICAL PROFESSIONS INSURANCE POLICY ClaimsMade: Undercertah, overage Parlsofthispolicy,thecovemgeaffordedislimfledtoliabiltyforonlythoseGlaims chat are first made against the Insured during the Policy Period or the Extended Reporting Period, if exercised, and reported to the Company pursuant to the terms herein. Refer to each Coverage Part's opening page to determine if that Coverage Part is Claims Made. Notice: All Coverage Part of this policy contain provisions that reduce the limits of liability stated in the policy by the costs of legal defense and permit legal defense costs to be applied against the deductible, unless otherwise endorsed. Please read the policy carefully. POLICY NUMBER: SM932901 RENEWAL OF POLICY: SM927346 1. NAMED INSURED: CHILD WELFARE ALLIANCE OFCALHOUN COUNTY DBA: THE HARBOR CHILDREN'S ALLIANCE& VICTIM CENTER 2, BUSINESS ADDRESS: 215 W RAILROAD PORT LAVACA, TX 77979 3. POLICY PERIOD: From 09/22/2019 to 09/22/2020 12:01 A.M. Standard Time at address of Insured stated above 4. PROFESSIONAL SERVICES AND SPECIFIED PRODUCTS, GOODS, OPERATIONS OR PREMISES; A. Professional Services: Crisis Intervention Information and Referral Services B. Specified Products, Goods, Operations or Premises: Not Purchased IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, THE COMPANY AGREES WITH THE NAMED INSURED TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. Producer Number, Name and Address 42230 U.S. Risk, LLC 900 South Capital of Texas Highway, Suite 450 Austin, TX 78746 MDSM 6013 0815 Page 1 of 3 5. COVERAGE SCHEDULE: This policy includes only those Coverage Parts designated below by W as purchased. If a Coverage Part is not expressly designated as purchased, this policy does not include such Coverage Part, Coverage Part Coverage Part Coverage Part Coverage Part Coverage Part Purchased Limits of Liability Deductible Retroactive Date A. Specified Medical Professions Yes X $500,000 Each $1,000 08122/2001 Professional Liability Insurance Claim Each Claim Coverage Part —Claims Made $500,000 Coverage Aggregate B. Specified Medical Professions Yes _ Not Purchased Not Purchased Not Purchased General Liability Insurance No X Coverage A. Coverage A. Coverage Part —Claims Made Each Occurrence Each Occurrence Coverage Not Purchased Damage to Premises - Any One Premises Not Purchased Not Purchased Coverage B. Coverage B. Each Person or Each Person or Organization Organization Not Purchased Coverage C. Each Injured Person Not Purchased Aggregate -All Coverages C. Specified Medical Professions Yes _ Not Purchased Not Purchased General Liability Insurance No X Coverage A. Coverage A. Coverage Part —Occurrence Each Occurrence Each Occurrence Coverage Not Purchased Damage to Premises - Any One Premises Not Purchased Not Purchased Coverage B. Coverage B. Each Person or Each Person or Organization Organization Not Purchased Coverage C. Each Injured Person Not Purchased Aggregate - Al I Coverages 6, PREMIUM FOR POLICY PERIOD: Minimum $ 3,000.00 Deposit $ 3,OOD.00 7, RATE: Flat PREMIUM BASE: Flat 8, PREMIUM FOR EXTENDED REPORTING PERIOD: 150% for 12 months; 175% for 24 months; or 2D0%for 36 months MDSM 5013 0815 Page 2 of 3 9. The Insured is not a proprietor, superintendent, executive officer, director, partner, trustee or employee of any hospital, sanitarium, clinicwith bed -and -board facilities, laboratory, orany business enterprise not named in Item 1. hereinabove, except as follows: None 10, ENDORSEMENTS ATTACHED AT POLICY INCEPTION: See MDIL 1001 08 10 attached. 11, NOTICES: Notices required to be provided to the Company under this policy shall be by email, fax or mail addressed to: CLAIM OR DISCOVERY CLAUSE NOTICES: ALL OTHER NOTICES: Claims Service Center Markel Mid South Region, a division of Markel MARKEL SERVICE, INCORPORATED Service, Incorporated Ten Parkway North 7500 Dallas Parkway, Sute 400 Deerfield, Illinois 60015 Plano, TX 75024-4018 Telephone: (�469) 241-3400 &mail: newclaims@markelcorp.com Fax: (866) 7 0-3615 Fax: (855) 662-7535 These declarations, together with the Common Policy Conditions, Coverage Part(s), any Endorsement(s) and any application(s) complete the above numbered policy. Countersigned: 9/27/2019 'JI' (Date) By: AUTHORIZED REPRESENTATIVE MDSM 5013 0815 Page 3 of 3 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1 of 1 Complete Nos. 1 - 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos. 11 21 31 5, and 6 if there are no interested parties. CERTIFICATION Certificate Number: OF FILING 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2020-574350 The Harbor Children's Alliance & Victim Center Pon Lavaca, TX United States Date Filed: 01/07/2020 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract- 2020 Contribution The Harbor provides services to victims of crime and their non -offending family members as well as a place for them to go for assistance. Nature of interest 4 Name of Interested Part y City, State, Count lace of business ty, Country (p ) check applicable) ( pp ) Controlling Intermediary The Harbor Children's Alliance & Victim Center, Port Lavaca, TX United States X 5 Check only if there is NO Interested Party. 6 UNSWORN DECLARATION I My name is t ' } 0� 'C t a- l �y,} r.�.� �O ^ and my date of birth is yn� ` My address is� (street) (city) (stale) (zip cone) (country) I declare under pe y of perjury that the foregoing is true and correct. Execute ✓ County, Stale of �`.Yp"'/ ,on the '�yay of (month) 0 . (y ar) ignature of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.3a6aaf7d CONTRACT between CALHOUN COUNTY and THE HARBOR CHILDREN'S ALLIANCE AND VICTIM CENTER STATE OF TEXAS COUNTY OF CALHOUN WHEREAS, Calhoun County, hereinafter COUNTY, a political subdivision of the State of Texas, has determined that the expenditure of county funds proposed herein is one which serves a public purpose and has further determined that the State of Texas, by its Constitution or by its state statutes, either implicitly or explicitly, has conferred upon COUNTY the authority, the power and the jurisdiction to accomplish the uses for said funds as proposed herein, infra. Having found the above elements fully satisfied, COUNTY may contract with a private nonprofit corporation so that they may use said public funds for the purposes contemplated herein, but only if the expenditure is to accomplish "county business" (which encompasses matters of general concern to county residents) and only if COUNTY assures itself that the funds to be transferred by this contract are subject to adequate contractual or other controls to ensure that expenditure of said county funds for the public purpose stated herein will be accomplished and so long as COUNTY received adequate consideration for the county funds to be provided by this contract. WHEREAS, COUNTY, a political subdivision of the State of Texas, has the authority and duty to conduct necessary investigations, enforce the laws and under legislative mandate, through its district attorney, assist all victims of crime, and further, pursuant to ' 264.402, Texas FaviiyCode, the authority to establish child-ten's advocacy centers, which centers shall provide certain services to and support of the children of COUNTYwho are victims of child abuse and neglect, and FURTHER, that COUNTY has determined such activities serve valuable public purposes and constitutes county business, and WHEREAS, COUNTY, pursuant to ' ' 264.403 and 264.406, Texas FanzjCode, has the authority to develop, maintain and support, through the cbidren's advocacy center, an environment that emphasizes the best interests of abused and neglected children and that provides investigatory and rehabilitative services, and further, to enter into contracts to provide certain services to and support of the children of COUNTYwho are the victims of child abuse and neglect, and FURTHER, that COUNTYhas determined such activities serve valuable public purposes, and constitute county business, and WHEREAS, The Harbor Children's Alliance and Victim Centex, a Texas nonprofit corporation, hereinafter referred to as THE HARBOR, is engaged in providing investigations of child abuse and assisting the child victims of abuse and neglect, along with their families, and desires to enter into such a contract for the provision of certain services to and support of the children and adults of COUNTY who are victims of physical/sexual abuse and neglect; said services being considered by both parties to this contract as fair consideration from THE HARBOR to COUNTY in exchange for the funds transferred hereby. IT IS THEREFORE AGREED THAT: 1. Payment by County: In consideration that the services described below to the residents of COUNTY, THE HARBOR shall be entitled to a sum not to exceed $28,500,00 per annum. Such amount shall be disbursed by COUNTY to THE HARBOR after January 1, 2020, upon written request for THE HARBOR. 2. Insurance: The County will require documentation of General Liability insurance coverage, with adequate limits to be determined individually, depending on exposure. follows: 3. Services: IT-IE HARBOR shall provide services to the residents of COUNTYas a. To provide the children and adults residing in COUNTY and surrounding counties with a facility where children and adults who are the victims of sexual and/or physical abuse and their non -offending family members can go for evaluation, intervention and counseling. b. To provide the agencies and professionals of COUNTY and surrounding counties who work with abused children with a forum where they can gather and work together in assisting victims and their families. c. To provide a resource center for training and education in the area of child abuse, domestic violence and victimization. d. To provide a warm, non -threatening environment in which the victims of physical/sexual abuse and victimization and their families can work with law enforcement or protection services in preparation for their court appearances. e. To provide a location where local and area law enforcement agencies and those assisting them may obtain evidence to be used to investigate and prosecute those accused of child abuse, domestic violence, family violence and neglect. 4. IRS Classification: THE HARBOR'S Internal Revenue Service, non-profit classification is 501(c)(3) and its IRS EIN is 74-2578679 5. Most Recent Financial and Performance Reports: THE HARBOR shall submit to COUNTY Auditor and COUNTY Judge each a copy of THF. HARBOR'S most current independent financial audit or end -of -year financial report of all expenditures and income for the period of THE HARBOR's fiscal year ending in calendar year 2018, within 60 days of the approval of this contract. THE HARBOR shall provide to COUNTY Auditor and COUNTY Judge each a performance review by which THE HARBOR gives details of services provided and clients served for the previous CO UNTY fiscal year ending on December 31, 2018, on or before March 1, 2020, 6. Prospective Financial and Performance Reports: THE HARBOR shall submit to COUNTY Auditor and COUNTY Judge each a copy of THE HARBOR'r independent financial audit or end -of -year financial report of all expenditures and income for the period of THF, HARBOR's fiscal year ending in calendar year 2018, within thirty days following its receipt by THE HARBOR. THE HARBOR shall provide to COUNTY Auditor and COUNTY Judge each a performance review by which THE HARBOR gives details of services provided and clients served for THE HARBOR's fiscal year ending in calendar year 2019, by March 1, 2020, 7. Term: The Term of this contract is to begin on January 1, 2020 and end on December 31, 2020, unless earlier terminated by either party on thirty days written notice. 8. Use of Funds: No moneys paid to THE HARBOR shall be expended for any purpose other than for the provision of certain services to and support of the victims of COUNTYwho are victims of physical/sexual abuse and neglect; provides, however, that no exception of the person who shall conduct all of the child interviews and provide training to volunteers. 9. Books and Records: All books and records of TI-IE HARBOR shall be open fox inspection during normal business hours to any member of the public, the Calhoun County Auditor, and such persons as may be given that authority, in writing, by the Commissioners' Court, provided, however that this clause shall in no way be construed to override the provision of the Federal Privacy Act or other state or federal law or regulation concerning the disclosure of confidential or privacy matters. 10. Non -Exclusion: This contract is not exclusive and COUNTYreserves the right to contract with additional parties for the provision of certain services to and support of the victims of COUNTY who are victims of physical/sexual abuse and neglect in the area covered by this contract. 11. Effectiveness: This contract is effective upon approval by Oxdex of the Calhoun County Commissioners' Court. 12. Non -Discrimination: THE HARBOR agrees to operation under a policy of non-discrimination with regard to the provision of said services. Such policy shall prohibit discrimination on the basis of race, sex, age, religion, color, handicap, disability, national origin, language, political affiliation or belief or other non -merit factor. Any act of discrimination shall constitute a material breach of this contract. 13. Sexual Harassment Prohibited: a policy that prohibits sexual harassment. material breach of this contract. THE HARBORagrees to adopt and maintain Any act of sexual harassment constitutes a 14. Applicable Laws: THE HARBOA agrees to comply with any and all applicable laws, local, state and federal, regarding work hours, safety, wages, social security benefits, and/or workers compensation. This clause places a duty to meet the requirements of such laws only if the law itself places such a duty on 77-IE HARBOR. Any act in violation of any of those laws or ordinances shall constitute a material breach of this contract. 15. Default: a. In the event either party shall fail to keep, observe or perform any covenant, contract, term or provision of this contract to be kept, observed or performed by such party, respectively, and such default shall continue for a period of ten days after notice thereof by the non -defaulting party to the other, then in any such event the non -defaulting party shall be entitled to terminate this contract. b. No delay on the part of either party in exercising any right, power or privilege shall operate as a waiver thereof, not shall any single or partial exercise of any right, power or privilege constitute such a waiver not exhaust the same, which shall be continuing. No notice to or demand on either party in any case shall entitle such party to any other or further notice or demand in similar or other circumstances, or constitute a waiver of the rights of either party to any other or further action in any circumstances without notice or demand. 16. Successors and Assigns: This contract shall inure to the benefit of, and be binding upon, the parties hereto and their respective heirs, legal representatives, successors and assigns; provided that THE HARBOR may not assign this contract without COUNTY's prior written consent. 17. Governing Law: This contract shall be governed by and construed and interpreted in accordance with the laws of the State of Texas and shall be enforceable in, and venue shall be in, Calhoun County, Texas. 18. Notices: Any notice or communication hereunder must be in writing, and may be given by registered or certified mail; if given by registered or certified mail, same shall be deemed to have been given and received when a registered or certified letter containing such notice, properly addressed, with postage prepaid, is deposited in the United States mail; and if given otherwise than by registered mail, it shall be deemed by haven been given when delivered to and received by the party to whom it is addressed. Such notices or communications shall be given to the parties hereto at the addresses set forth below. Any party hereto may at any time by giving ten days written notice to the other party hereto designate any other address in substitution of the foregoing address to which such notice or communication shall be given. 19. Severability: If any term, covenant or condition of this contract or the application thereof to any person or circumstance shall, to any extent, be invalid or unenforceable, the remainder of this contract or the application of such term, covenant or condition to persons or circumstances other than those as to which it is invalid or unenforceable, shall not be affected thereby, and each term, covenant or condition of this contract shall be valid and shall be enforced to the fullest extent permitted by law. 20. Relationship: The parties hereby agree that this is a contract for the administration of the Program and hereby renounce the existence of any other relationship. In no event shall COUNTY have any obligation or liability whatsoever with respect to any debts, obligations or liability of THE HARBOR and THE HARBOR shall have no authority to bind COUNTY to any contract, matter or obligation. No duties of COUNTY are delegated to THE HARBOR by this contract and any provision which is or may be held to be such a delegation shall be of no force or effect. 21. Modification; Termination: This contract may be amended, modified, terminated or released only be written instrument executed by COUNTY and THE HARBOJI , except as herein otherwise provided. 22. Total Agreement: This contract is a total and complete integration of any and all undertakings existing between the parties hereto and supersedes any prior oral or written agreements, promises or representation between them. The headings of the various paragraphs of this contract are for convenience only, and shall not define, interpret, affect or prescribed the meaning and interpretation of the provisions of this contract. CALHOUN COUNTY t By: -- THE HARBOR CHILDREN'S ALLIANCE AND VICTIM CENTER �L � ' Date: � n L Date: /' a COUNTY: Calhoun County Judge 211 S. Ann Street, Suite 301 Port Lavaca, Texas 77979 NOTICES THE HARBOR: President of the Board P.O. Box 1300 Port Lavaca, Texas 77979 CLERK'S CERTIFICATION I, Anna Goodman, County Clerk of Calhoun County, T"exas, certify that the above t was accepted and agreed to by the Commissioners' Couxt of Calhoun County on By: Deputy Clerk AV Date: AGREEMENT between CALHOUN COUNTY and CALHOUN COUNTY CRIMESTOPPERS STATE OF TEXAS COUNTY OF CALHOUN WHEREAS, Calhoun County, hereinafter COUNTY, a political subdivision of the State of Texas, has determined that the expenditure of county funds proposed herein is one which serves a public purpose and has further determined that the State of Texas, by its Constitution or by its state statutes, either implicitly or explicitly, has conferred upon COUNTY the authority, the power and the jurisdiction to accomplish the uses for said funds as proposed herein, infra. Having found the above elements fully satisfied, COUNTY may contract with a private nonprofit corporation so that they may use said public funds for the purposes contemplated herein, but only if the expenditure is to accomplish "county business" (which encompasses matters of general concern to county residents) and only if COUNTY assures itself that the funds to be transferred by this contract are subject to adequate contractual or other controls to ensure that expenditure of said county funds for the public purpose stated herein will be accomplished and so long as COUNTY received adequate consideration for the county funds to be provided by this contract. WHEREAS, CALHOUN COUNTY CRIMESTOPPERS, hexeinaftex xefexxed to as CRIMESTOPPERS is engaged in providing services to Law Enforcement, offering rewards for information helpful to Law Enforcement personnel. CRIMESTOPPERS is thereby providing for the betterment of Calhoun County, and desires to enter into such a contract for the provision of certain services for the COUNTY; said services being considered by both parties to this contract as fair consideration from CRIMESTOPPERS to COUNTY in exchange for the funds transferred hereby. IT IS THEREFORE AGREED THAT: 1. Payment by County: In consideration that the services described below to the residents of COUNTY, CAI_HOUN COUNTY CRIMESTOPPERS shall be entitled to a sum not to exceed $$1,000.00 per annum. Such amount shall be disbursed by COUNTY to CRIMESTOPPERS after January 1, 2020, upon written request for CRIMESTOPPERS. 2. Bond: The County will require documentation of a Surety Bond, with adequate limits to be determined individually, depending on exposure. 3. Services: CALHOUN COUNTY CRIMESTOPPERS, hereinafter referred to as CRIMESTOPPERS is engaged in providing services to Law Enforcement, offering rewards for information helpful to Law Enforcement personnel. 4. Term: The Term of this contract is to begin on January 1, 2020 and end on December 31, 2020 unless earlier terminated by either party on thirty days written notice. 5. Effectiveness: This contract is effective upon approval by Order of the Calhoun County Commissioners' Court, 6. Relationship: The parties hereby agree that this is a contract fox the administration of the Program and hereby renounce the existence of any other relationship. In no event shall COUNTY have any obligation or liability whatsoever with respect to any debts, obligations or liability of CALHOUN COUNTY CRIMESTOPPERS, and CRIMESTOPPERS shall have no authority to bind COUNTY to any contract, matter or obligation. No duties of COUNTY are delegated to CALHOUN COUNTY CRIMESTOPPERS by this contract and any provision which is or may be held to be such a delegation shall be of no force or effect. 7. Modification; Termination: This contract may be amended, modified, terminated or released only be written instrument executed by COUNTY and CALHOUN COUNTY CRIMESTOPPERS, except as herein otherwise provided. CALHOUN COUNTY r By: Date: f '.-C CALHOUN COUNTY CRIMESTOPPERS By: Date: NOTICES COUNTY: CALHOUN COUNTY CRIMESTOPPERS Calhoun County Judge Attn: Susan Riley, President 211 S. Ann Street, Suite 301 U/Ylea eQGwl(C Or Port Lavaca, Texas 77979 Port Lavaca TX 77979 CLERK'S CERTIFICATION I, Anna Goodman, County Clerk of Calhoun County, Texas, certify that the above contract was accepted and agreed to by the Commissioners' Court of Calhoun County on ?{'c� -z 52020, t� By: 4 Deputyi Cler Date: 011 ` ,CERTIFICATE OF INTERESTED PARTIES FORM 1295 loft 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. 2020-578442 Calhoun County Crimestoppers Port Lavaca, TX United States Date Filed: 01/17/2020 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 2020-001 Crimestopper services Nature of interest 4 Name of Interested Party City, State, Country (place of business) (check applicable) Controlling Intermediary 5 Check only If there is NO Interested Party. X 6 UNSWORN DECLARATION My name is �i..�.S Ar n% / `y I and my date of birth is /� My address is (0 *-"V,4Ci4 ,W_, s r (city) /� �� " "� ?79% emu% (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in .X�(fa/h06u tv County, State of %GfC45 on the /1 day of3 20Zd . (month) (year) Signature of authorized rigent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission v✓ww.ethics.state.tx.us Version V1.1.376aat7d ,1 40n Cod Calhoun County Senior Citizens Association, Inc® 2104 W. Austin a P.O. Box 128 . Port Lavaca, Texas 77979 (361) 552-3350 . (361) 552-4991 . (361) 552-6477 Funding Souroer for Americans County Senior Citizens d e Cresent lac Federal and State funds from the Point older Americana Act Governed , the Golden Creand riv to c ntebutio Commission Supported locally by the County, Cities of Pori Lavaca, Point Comfort and Seadrift. United Way, client donations and private contributions Taxes Public Transportation funds. January 13, 2020 Honorable Richard H. Meyer Calhoun County Judge and Calhoun County Commissioners 211 South Ann Street Port Lavaca, TX 77979 Dear Judge Meyer and Commissioners Court Members. The Board of Directors and I would like to thank you for the support you have given to the Calhoun County Senior Citizens Association, Inc. in the past fiscal year. The Center was again a busy place. In 2019 we have provided approximately 34,150 congregate and home delivered meals - this number reflects those served at our satellite location of Port O'Connor as well as our primary location in Port Lavaca. Our Transportation Department has provided 8,566 trips. The usage of ow• facility and services by Calhoun County seniors and other community residents, has been gratifying to all of us who continue to strive to provide a venue for residents of our county, particularly senior citizens, to maintain their independence for as long as possible. As we continue to serve Calhoun County seniors and the community, we are grateful for the financial support of the Commissioners Court. The support we receive from you allows us to continue to provide for the seniors and citizens of our county. I respectfully ask the Commissioner's Court to consider the Calhoun County Senior Citizens at their next meeting and grant us the funds set aside for the Center for 2020. Thank you for your time! Sincerely, Monica Pelech Executive Director /mp R TRANSIT Local trips should call 24 hours in advance. UnlbedWag �3 Please contact the Senior Citizen Center for more information. COMMON POLICY DECLARATIONS Renewal of Policy Number CPS2961359 Underwritten by: Scottsdale Insurance Company CPS3927406 Home Office: One Nationwide Plaza . Columbus, Ohio 43215 Administrative Office: 8877 North Gainey Center Drive • Scottsdale, Arizona 85258 1-800-423-7675 • A STOCK COMPANY ITEM 1. Named Insured and Mailing Address CALHOUN COUNTY SENIOR CITIZENS (SEE UTS-SP-1 NAMED INSURED) 2104 W AUSTIN ST, PORT LAVACA, TX 77979 Agent Name and Address CRC - SAN ANTONIO 11550 111-10 West Suite 230 Agent NO,: 42018 Program No,: cR San Antanio, Is 78230 ITEM2 Policy Period From: 01/03/2020 TO: 01/03/2021 Term: 366 DAYS 12:01 A.M., Standard Time at the mailing address shown in ITEM 1. Business Description: SENIOR CITIZEN RECREATION CENTER In return for the payment of the premium, and subject to all the terms of this policy, we agree with you to provide the nsurance as stated in this policy. This policy consists of the following coverage parts for which a premium is indicated. Where no premium is shown, there is no coverage. This premium may be subject to adjustment. Coverage Parts) Commercial General LiabiVity Coverage Part Commercial Property Coverage Part Commercial Crime And Fidelity Coverage Part Commercial Inland Marine Coverage Part Commercial Auto Coverage Part Professional Liability Coverage Part Risk Location Zip Code is: ����� Premium Summary $ 5,280 $ NOT COV FIRED $ NOT COVERED $ NOT COVERED $ NOT COVERED i3 Total Policy Premium: $ 13 1 z 1. o 0 POLICY FEE SURPLUS LINTS TAX $ 646. 07 STAMPING OFFICE FEE Total: $ 13,9s";.os Forms) and Endorsement{s) made a part of this policy at time of issue: SEE SCHEDULE OF FORMS AND ENDORSEMENTS (yo FLAT GANGELLATIC?NS PERMITTED SAN ANTONIO, "IX R6/MA EPIPHANY INSURANCE AGENCY 601 E JACKSON THIS COMMON POLICY DECLARATION AND THE SUPPLEMENTAL DECLARATION(S); TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE PART(S), COVERAGE FORMS) AND FORMS) AND ENDORSEMENT(S), IF ANY, COMPLETE THE ABOVE NUMBERED POLICY. OPS-D-1 (1-17) INSURED Nationwide CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 Complete Nos. 1- 4 and 6 if there are interested parties. Complete Nos.1, 2, 31 51 and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2020-576563 Date Filed: 01/13/2020 Date Acknowledged: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Calhoun County Senior Citizens Association, Inc. Port Lavaca, TX United States 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County g Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 2020 Yearly Allocation Congregate and Home Delivered Meals, Transportation 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. X 6 UNSWORN ,DEECLARATION CL My name is { v l O 1(1 I 0 ou I G� f �--�e! i and my date of birth is r My address !III Phil kQN a, — ] j 9 7q v5A (city) (slate) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. On- , 7 Executed in � County, State of on the 1. 0day of Jake . , 20CAO ^�� Q (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 CONTRACT Between CALHOUN COUNTY and THE CALHOUN COUNTY SENIOR CITIZENS ASSOCIATION, INC. STATE OF TEXAS COUNTY OF CALHOUN WHEREAS, Calhoun County, hereinafter COUNTY, a political subdivision of the State of Texas, has determined that the expenditure of county funds proposed herein is one which serves a public purpose and has further determined that the State of Texas, by its Constitution or by its state statutes, either implicitly or explicitly, has conferred upon COUNTY the authority, the power and the jurisdiction to accomplish the uses for said funds as proposed herein, infra. Having found the above elements fully satisfied, COUNTY may contract with a private nonprofit corporation so that they may use said public funds for the purposes contemplated herein, but only if the expenditure is to accomplish "county business" (which encompasses matters of general concern to county residents) and only if COUNTY assures itself that the funds to be transferred by this contract are subject to adequate contractual or other controls to ensure that expenditure of said county funds for the public purpose stated herein will be accomplished and so long as COUNTY received adequate consideration for the county funds to be provided by this contract. WHEREAS, The Calhoun County Senior Citizens Association, Inc., a Texas nonprofit corporation, hereinafter referred to as SENIOR CITIZENS, is engaged in restoring and providing an economic development area for the betterment of Calhoun County, and desires to enter into such a contract for the provision of certain services for the COUNTY; said services being considered by both parties to this contract as fair consideration from SENIOR CITIZENS to COUNTY in exchange for the funds transferred hereby. IT IS THEREFORE AGREED THAT: 1. Payment by County: In consideration that the services described below to the residents of COUNTY, SENIOR CITIZENS shall be entitled to a sum not to exceed $35,000.00 per annum. Such amount shall be disbursed by COUNTY to SENIOR CITIZENS on or after January 1, 2020, upon written request by SENIOR CITIZENS. 2. Insurance: The County will require documentation of General Liability insurance coverage with adequate limits to be determined individually, depending on exposure. 3. Services: SENIOR CI77ZENS shall provide services at the Heritage Center and two satellite centers in the County a network for individualized assistance including meals, meal delivery for shut-ins, transportation, minor home repairs, life -line telephones when funding allows, preparing application forms, counseling, advocacy, check writing and various other needs. 4. IRS Classification: SENIOR CITIZENSInternal Revenue Service, non-profit classification is 501(c)(3) and its IRS EIN is 74-192-1482. 5. Most Recent Financial and Performance Reports: SENIOR CITIZENS shall submit to COUNTY Auditor and COUNTY Judge each a copy of SENIOR CITIZENS' most current independent financial audit or end -of -year financial report of all expenditures and income for the period of SENIOR CITIZENS fiscal year ending in calendar year 2019, within 60 days of the approval of this contract. SENIOR CITIZENS shall provide to COUNTY Auditor and COUNTY Judge each a performance review by which SENIOR C177ZENS gives details of services provided and clients served for the previous COUNTY fiscal year ending on December 31, 2019, on or before March 1, 2020. 6. Prospective Financial and Performance Reports: SENIOR CITIZENS shall submit to COUNTY Auditor and COUNTY Judge each a copy of SENIOR CITIZENS' independent financial audit or end -of -year financial report of all expenditures and income for the period of SENIOR CITIZENS' fiscal year ending in calendar year 2019, within thirty days following its receipt by SENIOR CITIZENS. SENIOR CITIZENS shall provide to COUNTY Auditor and COUNTY Judge each a performance review by which SENIOR CITIZENS gives details of set -vices provided and clients served for SENIOR CITIZENS' fiscal year ending in calendar year 2019, by March 1, 2020. 7. Term: The Term of this contract is to begin on January 1, 2020 and end on December 31, 2020, unless earlier terminated by either party on thirty days written notice. 8. Books and Records: All books and records of SENIOR CITIZENS shall be open for inspection during normal business hours to any member of the public, the Calhoun County Auditor, and such persons as may be given that authority, in writing, by the Commissioners' Court, provided, however that this clause shall in no way be construed to override the provision of the Federal Privacy Act or other state or federal law or regulation concerning the disclosure of confidential or privacy matters. 9. Effectiveness: This contract is effective upon approval by Order of the Calhoun County Commissioners' Court. 10. Non -Discrimination: SENIOR CITIZENS agrees to operation under a policy of non-discrimination with regard to the provision of said services. Such policy shall prohibit discrimination on the basis of race, sex, age, religion, color, handicap, disability, national origin, language, political affiliation or belief or other non -merit factor. Any act of discrimination shall constitute a material breach of this contract. 11. Sexual Harassment Prohibited: SENIOR CITIZENS agrees to adopt and maintain a policy that prohibits sexual harassment. Any act of sexual harassment constitutes a material breach of this contract. 12. Applicable Laws: SENIOR CITIZENS agrees to comply with any and all applicable laws, local, state and federal, regarding work hours, safety, wages, social security benefits, and/or workers compensation. This clause places a duty to meet the requirements of such laws only if the law itself places such a duty on SENIOR CITIZENS. Any act in violation of any of those laws or ordinances shall constitute a material breach of this contract. 13. Default: a. In the event either party shall fail to keep, observe or perform any covenant, contract, term or provision of this contract to be kept, observed or performed by such party, respectively, and such default shall continue for a period of ten days after notice thereof by the non -defaulting party to the other, then in any such event the non -defaulting party shall be entitled to terminate this contract. b. No delay on the part of either party in exercising any right, power or privilege shall operate as a waiver thereof, nor shall any single or partial exercise of any right, power or privilege constitute such a waiver not exhaust the same, which shall be continuing. No notice to or demand on either party in any case shall entitle such party to any other or further notice or demand in similar or other circumstances, or constitute a waiver of the tights of either party to any other or further action in any circumstances without notice or demand. 14. Successors and Assigns: This contract shall inure to the benefit of, and be binding upon, the parties hereto and their respective heirs, legal representatives, successors and assigns; provided that SENIOR CITIZENS may not assign this contract without Couny's prior written consent. 15. Governing Law: This contract shall be governed by and construed and interpreted in accordance with the laws of the State of Texas and shall be enforceable in, and venue shall be in, Calhoun County, Texas. 16, Notices: Any notice or communication hereunder must be in writing, and may be given by registered or certified mail; if given by registered or certified mail, same shall be deemed to have been given and received when a registered or certified letter containing such notice, properly addressed, with postage prepaid, is deposited in the United States mail; and if given otherwise than by registered mail, it shall be deemed by haven been given when delivered to and received by the party to whom it is addressed. Such notices or communications shall be given to the parties hereto at the addresses set forth below. Any party hereto may at any time by giving ten days written notice to the other party hereto designate any other address in substitution of the foregoing address to which such notice or communication shall be given. 17. Severability: If any term, covenant or condition of this contract or the application thereof to any person or circumstance shall, to any extent, be invalid or unenforceable, the remainder of this contract or the application of such term, covenant or condition to persons or circumstances other than those as to which it is invalid or unenforceable, shall not be affected thereby, and each term, covenant or condition of this contract shall be valid and shall be enforced to the fullest extent permitted by law. 18. Relationship: The parties hereby agree that this is a contract for the adininistration of the Program and hereby renounce the existence of any other relationship. In no event shall COUNTY have any obligation or liability whatsoever with respect to any debts, obligations or liability of SENIOR CITIZENS, and SENIOR CITIZENS shall have no authority to bind COUNTY to any contract, matter or obligation. No duties of COUNTY are delegated to SENIOR CITIZENS by this contract and any provision which is or may be held to be such a delegation shall be of no force or effect. 19. Modification; Termination: This contract may be amended, modified, terminated or released only be written instrument executed by COUNTY and SENIOR CITIZENS, except as herein otherwise provided. 20. Total Agreement: This contract is a total and complete integration of any and all undertakings existing between the parties hereto and supersedes any prior oral or written agreements, promises or representation between them. The headings of the various paragraphs of this contract are for convenience only, and shall not define, interpret, affect or prescribed the meaning and interpretation of the provisions of this contract. CALHOUN COUNTY CALHOUN COUNTY SENIOR CITIZENS ASSOCIATION, INC. By: t By:�Y nu;u Pa POOP, Date: [ i6 Cal ` r Date: NOTICES COUNTY: SENIOR CITIZENS: Calhoun County Judge Chairman of the Board Michael J. Pfeifer P.O. Box 128 211 S. Ann Street, Suite 301 2104 W. Austin Street Port Lavaca, Texas 77979 Port Lavaca, Texas 77979 CLERK'S CERTIFICATION I, Anna Goodman, County Clerk of Calhoun County, Texas, certify that the above contract was acce ted and agreed to by the Commissioners' Court of Calhoun County on C1 By: / putty Clerk t ` Date: F� ') ' 0t7l 41 CALHOUN SOIL and WATER CONSERVATION DISTRICT N0, 345 Post Office Box 553 Port Lavaca, Texas 77979 January 21, 2020 Richard Meyer, Judge Calhoun County Commissioners Court 211 South Ann Street, Suite 301 Port Lavaca, Texas 77979 Dear Judge Meyer and Commissioners: Calhoun Soil and Water Conservation District is making request to receive the allocation from Calhoun County Commissioners Court that was allocated in its 2020 budget. Thank you for your assistance. Sincerely, V7m Dennis Klump Chairman INTERLOCAL AGREEMENT between CALHOUN COUNTY and CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 STATE OF TEXAS COUNTY OF CALHOUN WHEREAS, Calhoun County, hereinafter COUNTY, a political subdivision of the State of Texas, has determined that the expenditure of county funds proposed herein is one which serves a public purpose and has further determined that the State of Texas, by its Constitution or by its state statutes, either implicitly or explicitly, has conferred upon COUNTY the authority, the power and the jurisdiction to accomplish the uses for said funds as proposed herein, infra. Having found the above elements fully satisfied, COUNTY may contract with the CALHOUN SOIL & WATER CONSERVATION DISTRICT so that they may use said public funds for the purposes contemplated herein, but only if the expenditure is to accomplish "county business" (which encompasses matters of general concern to county residents) and only if COUNTY assures itself that the funds to be transferred by this contract are subject to adequate contractual or other controls to ensure that expenditure of said county funds for the public purpose stated herein will be accomplished and so long as COUNTY received adequate consideration for the county funds to be provided by this contract. WHEREAS, CALHOUN SOIL &WATER CONSERVATION DISTRICT #345, hereinafter referred to as CALHOUN SOIL dam' WATER CONMRVAI70N DISTRICT #345, is engaged in various functions involving agricultural production - including livestock, crops, aquaculture, horticulture and forestry and providing services for the betterment of Calhoun County, and desires to enter into such a contract for the provision of certain services for the COUNTY; said services being considered by both parties to this contract as fair consideration from CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 to COUNTYin exchange for the funds transferred hereby. IT IS THEREFORE AGREED THAT: 1. Payment by County: Inconsideration that the services described below to the residents of COUNTY, CAI_FIOUN SOIL dam' WATER CONSERVATION DISTRICT #345 shall be entitled to a sum not to exceed $7,750.00 per annum. Such amount shall be disbursed by COUNTY to CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 after January 1, 2020, upon written request from CALHOUN SOIL dam' WATER CONSERVATION DISTRICT #345. 2. Insurance: CALHOUN SOIL dam' WATER CONSERVATION DISTRICT #345 shall at all times maintain a policy of liability insurance fox premises liability fox personal injury. The County will require documentation of General Liability insurance coverage, with adequate limits to be determined individually, depending on exposure. 3. Services: CALHOUN SOIL c7 WATER CONSERVATION DISTRICT 41345 shall provide services to the residents of COUNTY by providing diverse services including the following: providing secretarial help to the Natural Resource Conservation Service, which in turn provides technical time for assistance to our local government, drainage districts, industry, local businesses, farmers and ranchers, in addition to developing and carrying out programs for the conservation, protection and development of soil, water, and related plant and animal resources and shoreline erosion projects with the County. 4. Most Recent Financial and Performance Reports: CALHOUN SOIL d� WATER CONSERVATION DISTRICT #345 shall submit to COUNTY Auditor and COUNTY Judge each a copy of CALHOUN SOIL dam' WATER CONSERVATION DISTINCT #345's most current independent financial audit or end -of -year financial report of all expenditures and income for the period of CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 fiscal year ending in calendar year 2018, within 30 days of the approval of this contract. CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 shall provide to COUNTY Auditor and COUNTY Judge each a performance review by which CALHOUN SOIL dam' WATER CONSERVA77ON DISTRICT #345 gives details of services provided and clients served for the previous COUNTYfiscal year, within 30 days after the approval of this contract. G. Prospective Financial and Performance Reports: CALHOUN SOIL dam' WATER CONSERVATION DISTRICT #345 shall submit to COUNTY Auditor and COUNTY Judge each a copy of CALHOUN SOIL & WATER CONSERVATION DISTRICT #345's independent financial audit or end -of -year financial report of all expenditures and income for the period of CALHOUN SOIL & WATER CONSERVATION DISTRICT #345s fiscal year ending in calendar year 2018, by the earliest of thirty days following its receipt by CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 or by September 30, 2020. CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 shall provide to COUNTY Auditor and COUNTY Judge each a performance review by which CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 gives details of services provided and clients served for CALHOUN SOIL dam' WATER CONSERVATION DISTRICT #34Ys fiscal year ending in calendar year 2018, by September 30, 2020. 7. Term: The Term of this contract is to begin on January 1, 2020 and end on December 31, 2020, unless earlier terminated by either party on thirty days written notice. 8. Books and Records: All books and records of CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 shall be open for inspection during normal business hours to any member of the public, the Calhoun County Auditor, and such persons as may be given that authority, in writing, by the Commissioners' Court, provided, however that this clause shall in no way be construed to override the provision of the Federal Privacy Act or other state or federal law or regulation concerting the disclosure of confidential or privacy matters. 9. Effectiveness: This contract is effective upon approval by Order of the Calhoun County Commissioners' Court. 10. Non -Discrimination: CALHOUN SOIL dr WATER CONSERVATION DISTRICT #345 agrees to operation under a policy of non-discrimination with regard to the provision of said services. Such policy shall prohibit discrimination on the basis of race, sex, age, religion, color, handicap, disability, national origin, language, political affiliation or belief or other non -merit factor. Any act of discrimination shall constitute a material breach of this contract. 11. Sexual Harassment Prohibited: CALHOUN SOIL dr WATER CONSERVATION DISTRICT #345 agrees to adopt and maintain a policy that prohibits sexual harassment. Any act of sexual harassment constitutes a material breach of this contract. 12. Applicable Laws: CALHOUN SOIL �' WATER CONSERVATION DISTRICT #345 agrees to comply with any and all applicable laws, local, state and federal, regarding work hours, safety, wages, social security benefits, and/or workers compensation. This clause places a duty to meet the requirements of such laws only if the law itself places such a duty on CALHOUN SOIL & WATER CONSERVATION DISTRICT #345. Any act in violation of any of those laws or ordinances shall constitute a material breach of this contract. 13. Default: a. In the event either party shall fail to keep, observe or perform any covenant, contract, term or provision of this contract to be kept, observed or performed by such party, respectively, and such default shall continue for a period of ten days after notice thereof by the non -defaulting party to the other, then in any such event the non -defaulting party shall be entitled to terminate this contract. b. No delay on the part of either party in exercising any right, power or privilege shall operate as a waiver thereof, nor shall any single or partial exercise of any right, power or privilege constitute such a waiver not exhaust the same, which shall be continuing. No notice to or demand on either party in any case shall entitle such party to any other or further notice or demand in similar or other circumstances, or constitute a waiver of the tights of either party to any other or further action in any circumstances without notice or demand. 14. Successors and Assigns: This contract shall inure to the benefit of, and be binding upon, the parties hereto and their respective heirs, legal representatives, successors and assigns; provided that CALHOUN SOIL dam' WATER CONSERVATION DISTRICT #345 may not assign this contract without COUNTY's prior written consent. 15. Governing Law: This contract shall be governed by and construed and interpreted in accordance with the laws of the State of Texas and shall be enforceable in, and venue shall be in, Calhoun County, Texas. 16. Notices: Any notice or communication hereunder must be in writing, and may be given by registered ox certified mail; if given by registered or certified mail, same shall be deemed to have been given and received when a registered or certified letter containing such notice, properly addressed, with postage prepaid, is deposited in the United States mail; and if given otherwise than by registered mail, it shall be deemed by haven been given when delivered to and received by the party to whom it is addressed. Such notices or communications shall be given to the parties hereto at the addresses set forth below. Any party hereto may at any time by giving ten days written notice to the other party hereto designate any other address in substitution of the foregoing address to which such notice or communication shall be given. 17. Severability: If any term, covenant or condition of this contract or the application thereof to any person or circumstance shall, to any extent, be invalid or unenforceable, the remainder of this contract or the application of such term, covenant or condition to persons or circumstances other than those as to which it is invalid or unenforceable, shall not be affected thereby, and each term, covenant or condition of this contract shall be valid and shall be enforced to the fullest extent permitted by law. 18. Relationship: The parties hereby agree that this is a contract fox the administration of the Program and hereby renounce the existence of any other relationship. In no event shall COUNTY have any obligation or liability whatsoever with respect to any debts, obligations or liability of CALHOUN SOIL dam' WATER CONSERVATION DISTRICT #345, and CALHOUN SOIL dam' WATER CONSERVATION DISTRICT #345 shall have no authority to bind COUNTY to any contract, matter or obligation. No duties of COUNTY are delegated to CALHOUN SOIL & WATER CONSERVATION DISTRICT #345 by this contract and any provision which is or may be held to be such a delegation shall be of no force or effect. 19. Modification; Termination: This contract may be amended, modified, terminated or released only be written instrument executed by COUNTY and CALHOUN SOIL dam' WATER CONSERVATION DISTRICT #345, except as herein otherwise provided. 20. Total Agreement: This contract is a total and complete integration of any and all undertakings existing between the parties hereto and supersedes any prior oral or written agreements, promises or representation between them. The headings of the various paragraphs of this contract are for convenience only, and shall not define, interpret, affect or prescribed the meaning and interpretation of the provisions of this contract. CALHOUN COUNTY r By: Date: CALHOUN SOIL &WATER CONSERVATION DISTRICT #345 Date: COUNTY: CALHOUN SOIL &WATER CONSERVATION DISTRICT #345 Calhoun County Judge 211 S. Ann Street, Suite 301 P.O. Box 553 Port Lavaca, Texas 77979 Port Lavaca, Texas 77979 CLERK'S CERTIFICATION I, Anna Goodman, County Clerk of Calhoun County, Texas, certify that the above contract was accepted and agreed to by the Commissioners' Court of Calhoun County on - r)fl , 2020. By: PY Deputy Clerk Date: 0 € !e a c1U (Policy Provisions: WCOOOOOOC) INFORMATION PAGE WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY INSURER: The Hartford Underwriters Insurance Company ONE HARTFORD PLAZA HARTFORD CT 06155 NCCI Company Number: 10456 Company Code: 6 CA Suffix LARS RENEWAL POLICY NUMBER: 65 WEC EX0998 F 77 19 Previous Policy Number: 65 WEC EX0998 1. Named Insured and Mailing Address: CALHOUN SOIL &WATER CONSERVATION DISTR #345 (No., Street, Town, State, Zip Code) P.O. BOX 553 PORT LAVACA TX 77979 FEIN Number: 74-6223695 State Identification Number(s): The Named Insured is: Non Profit Business of Named Insured: Portfolio Management Other workplaces not shown above: 38 COUNTY RD 101 PORT LAVACA TX 77979 2. Policy Period: Producer's Name: From 05/24/19 To 05/24/20 ANNUAL 12:01 a.m., Standard time at the insured's mailing address. PURIFOY INSURANCE AGENCY LTD PO BOX 1088 TEMPLE TX 76503 THE HARTFORD BUSINESS SERVICE CENTER 3600 WISEMAN BLVD SAN ANTONIO TX 78251 ual Premium: $207 Total Estimated Ann Deposit Premium: Policy Minimum Premium: $188 TX Audit Period: ANNUAL Installment Term: Full Pay (100%Down) The policy is not binding unless countersigned by our authorized representative. 04/14/19 Authorized Representative Date Countersigned by �`��� Form WC 00 00 01 A (1) Printed in U.S.A. Page 1 (Continued on next page) Process Date: 04/14/19 Policy Expiration Date: 05I24/20 INFORMATION PAGE (Continued) Policy Number: 65 WEC EX0998 3. A. Workers Compensation Insurance: Part one of the policy applies to the Workers Compensation Law of the states listed here: TX B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3.A. The limits of our liability under Part Two are: Bodily injury by Accident $100,000 each accident Bodily injury by Disease $500,000 policy limit Bodily injury by Disease $100,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any ,listed here: ALL STATES EXCEPT NORTH DAKOTAI OHIO, WASHINGTONI WYOMING, U.S.TERRITORIES AND STATES DESIGNATED IN ITEM 3.A. OF THE INFORMATION PAGE. D. This policy includes these endorsements and schedule: SEE ENDORSEMENT -WC 99 03 68 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans All information required below is subject to verification and change by audit. Premium Basis Classifications Total Estimated Rates Per Estimated Code Number and Annual $100 of Annual Description Remuneration Remuneration Premium Total Standard Premium Expense Constant Terrorism. Risk Insurance Program Reauthorization Act Disclosure Endorsement Estimated Annual Premium (before Surcharges) *See the attached Schedules) of Operations for Location and State Level Premium Information Total Estimated Annual Premium: $207 Deposit Premium: Policy Minimum Premium: $188 TX Interstate/Intrastate Identification Number: Refer to Schedule of Operations NAICS: 523920 Labor Contractors Policy Number: SIC: 6163 Form WC 00 00 01 A (1) Printed in U.S.A. Page 2 Process Date: 04l14/19 Policy Expiration Date: 05/24/20 EXTENSION OF THE INFORMATION PAGE - ITEM 3.D - ENDORSEMENTS Policy Number: 65 WEC EX0998 Endorsement Number: Effective Date: 05/24/19 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: CALHOUN SOIL & WATER CONSERVATION DISTR #345 P.O. BOX 553 PORT LAVACA TX 77979 Item 3.D. of the Information Page is completed to include the following endorsements: WC000000C WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC000001A.1 INFORMATION PAGE WC000001A.2 INFORMATION PAGE WC000403 EXPERIENCE RATING MODIFICATION FACTOR ENDORSEMENT WC000414A 90-DAY REPORTING REQUIREMENT- NOTIFICATION OF CHANGE IN OWNERSHIP ENDORSEMENT WC000422B TERRORISM RISK INSURANCE PROGRAM REAUTHORIZATION ACT DISCLOSURE ENDORSEMENT WC4203011 TEXAS AMENDATORY ENDORSEMENT WC420407 TEXAS -AUDIT PREMIUM AND RETROSPECTIVE PREMIUM ENDORSEMENT WC550022A NOTICE TO WORKERS' COMPENSATION POLICYHOLDERS IN TEXAS LETTER WC9900011 Signature/ Copyright WC990002 WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY BUSINESS INSURANCE POLICY WC990005 SCHEDULE OF OPERATIONS WC990368 EXTENSION OF THE INFORMATION PAGE - ITEM 3.D. - ENDORSEMENTS Form WC 99 03 68 Printed in U.S.A. Process Date: 04/14/19 Policy Expiration Date: 05l24/20 SCHEDULE OF OPERATIONS This Schedule of Operations forms a part of the policy effective on the inception date of the policy unless another date is ndicated below: INSURER: THE HARTFORD UNDERWRITERS INSURANCE COMPANY Company Code: 6 Policy Number: 65 WEC EX0998 Schedule Number: 01-42-01 Effective Date: 05/24/19 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Location Address of operations covered by this schedule: CALHOUN SOIL & WATER CONSERVATION DISTR #345 38 COUNTY RD 101 PORT LAVACA TX 77979 FEIN:74-6223695 NAICS: 523920 SIC: 6163 NO. OF EMPL: 1 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. - Premium Basis Classifications Total Estimated Rates Per Estimated Code Number and Annual $100 of Annual Description Remuneration Remuneration Premium 8601 IF ANY 0.220000 0 SURVEYOR 8810 253000.00 0.100000 25 CLERICAL OFFICE EMPLOYEES NOC Total State Summary Total Class Premium 25 Premium Incentive For Small Employers 0.850000 -4 Total Estimated Annual Standard Premium 21 Expense constant 180 Terrorism Risk Insurance Program Reauthorization Act 25,000.00 0.024000 6 Disclosure Endorsement Total Estimated Annual Premium 207 Countersigned by a _ Authorized Re7resentative Form WC 99 00 05 (1) Printed in U.S.A. _- Process Date: 04/14/19 Policy Expiration Date: 05/24/20 ACORN CERTIFICATE OF LIABILITY INSURANCE DATE11/05/019(MM/02019 Y) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT pat Ebarb NAME: Punfoy & Company Insurance plc No Exit : (254) 773-6844 plc, No : (254) 773-6551 P.O. Box 1088 E-MAIL ADDRESS: Pat urifo insurance.com @P y Temple TX 76503-1088 INSURERISIAPFOROING COVERAGE NAICq INSURERA: Hartford Accident and Indemnity Company INSURED Stale Soil & Water Conservation Districts 1497 Country View Ln Temple TX 76504 INSURER B : Hartford Fire Insurance Company INSURER C : Sentinel Insurance Company Limped INSURER D : INSURER E: INSURER F: rrnn=RnrFA CFRTIFICCTF NLIMRER C1.1911503757 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADULSUBR INSD WVO POLICY NUMBER POLICY EFF FOLIC YYYY POLICY EXP FOLIC YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE ❑X OCCUR DAMAGE [OREN D PREMISES Ea occurrence)S 300,000 MEDEXP(Anyoneperson) 5 10,000 PERSONAL&ADV INJURY 5 11000,000 A 65UENIX8801 01/01/2020 01/01/2021 GENLAGGREGATE LIMB -APPLES PER: GENERALAGGREGATE S 21000,000 PRODUCTS-COMP/OPAGG S 2,000,000 POLICY ❑ JEC LOC X $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT LEA accident) $ 500,000 BODILY INJURY (Per personl S ANY AUTO C OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X AUTOS ONLY AUTOS ONLY 65UENIX8801 - 01/01/2020 01/01/2021 BODILY INJURY (Per accident) $ PerraccidenI AMAGE $ 5 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE 5 EXCESS LIAR CLAIMS -MADE DED RETENTION S $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN I PER STATUTE Eft ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFIC EXCLUDED? NIA E.L. EACH ACCIDENT S (Mandatory ry in NHt E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE -POLICY LIMIT 5 If yes, describe under DESCRIPTION OF OPERATIONS below Per Loss 10,000 B Bond - Employee Theft 656DDHT7558 01/01/2018 01/0112021 Deductible 500 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be allached if more space Is required) Certificate Holder is a Named Insured. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Calhoun SWCD #345 ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 553 AUTHORIZED REPRESENTATIVE ' p PortLavaca TX 77979 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Commissioners' Court —January 29, 2020 7. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 7) To Join with the Calhoun County Sheriff in adopting a resolution making Calhoun County a 2nd Amendment Sanctuary County. (RM) eriff Bobby Vickery read the resolutic n. Page 5 of 23 CALHOUN COUNTY, TEXAS COUNTY SHERIFF'S OFFICE 211 SOUTH ANN STREET PORT LAVACA, TEXAS 77979 PHONE NUMBER (361) 553-4646 FAX NUMBER (361) 553=4668 MEMO TO: RICHARD MEYER, COUNTY JUDGE SUBJECT: 2ND AMENDMENT SANCTUARY COUNTY DATE: JANUARY 29, 2020 Please place the following items) on the Commissioner's Court agenda for the dates) indicated: AGENDA FOR JANUARY 29, 2020 • Consider and take necessary action to join with the Calhoun County Sheriff in adopting a resolution making Calhoun County a 2°d Amendment Sanctuary County. Sincerely, Bobbie Vickery Calhoun County Sheriff CALHOUN COUNTY COMMISIONERS' COURT Resolution in Support of Protecting and Defending Individual Second Amendment Rights WHEREAS, the Constitution of the United States is the supreme law of our nation, and The Second Amendment to the Constitution states "A well -regulated militia being necessary to the security of a free State, the right of the people to keep and bear arms shall not be infringed", and WHEREAS, The Texas Constitution, Article 1, Section 23 states "Every citizen shall have the tight to keep and bear arms in the lawful defense of himself or the State", and, WHEREAS, it is the desire of the Sheriff of Calhoun County and the Calhoun County Commissioners to declare its support for the Second Amendment to the United States Constitution and the Texas Constitution, Article 1, Section 23, protecting citizens' inalienable and individual tight to keep and bear arms, and, WHEREAS, the Sheriff of Calhoun County and the members of the Calhoun County Commissioners' Court took an oath to support and defend the United States Constitution, the Constitution of the State of Texas, and the laws of the State of Texas (insofar as they are constitutional), NOW THEREFORE, BE IT RESOLVED by the Commissioners' Court of the County of Calhoun, by the authority granted to the Commissioners' Court by the laws of the State of Texas and the people of Calhoun County, Texas, to stand and defend their rights and liberties, which are guaranteed by the United States and Texas constitutions, we hereby declare this Resolution as follows: Second Amendment Preservation Resolution Designating Calhoun County a Second Amendment Safe Haven County BE IT RESOLVED, that this Commissioners' Court affirms its support for the duly elected Sheriff of Calhoun County, Texas, in the exercise of his sound discretion, and affirms its resolve to support decisions made by our Sheriff to not enforce any unconstitutional firearms restrictions against any citizen. FURTHERMORE, the Calhoun County Commissioners' Court will not authorize or appropriate government funds, resources, employees, agencies, contractors, buildings, detention centers, or offices for the purpose of enforcing law that unconstitutionally infringes on the right of the people to keep and bear arms. Through this resolution hereby declares our rights, our freedom and our liberty so guaranteed by the Constitution of the United States of America. ADOPTED, RESOLVED, AND SIGNED this 29th day of January, 2020 Calhoun County Sheriff BJ Vickery County Judge Richard Meyer David Hall, Commissioner, Pct #1 Vern Lyssy, Commissioner, Pct #2 Clyde Syma, Commissioner, Pet #3 Guy Reese, Commissioner, Pet #4 Attest: Arma Goodman, County Clerk o41 0 0 d m o C '6 o N _ � (-Oi p ,fl .mot+" y, ram b ° p O 'N O Y O U 'O O O V1 o Gd Cd w p `8 �' a� v ° ��� p w �� F7 O 'O o cC ti c6 N n 0... N O. ti p FG. ° - w°u o i' 'Ooaoi (U o k o w j a°i O S"i cJ Vl :0 N N o yy++ ++ bA. Gi "' O ° O .� Cj yy..,� GJ CC: ti p N O 'y o w 4y 'a-+ •' o o td v1 > o p ;,a.. cd 3;o,q W`'�" aUi b) 0 o N U k `� bmmA..� .� x, :. p.. .o U fo 0 40•° q't�' " "a �,.o. not 0 M o ��++ a�i cr '+ p a� o w ;,d U, • ,o �C�" U w. 0 m O C'. U• a N° N N q ti 'U ' V 3 V , q y w U d 0 Nn.N y d o. N a°i �6 b U p �aP v4� '- N aO OL_G7N cd xV > =m p @ v o00 o v00 icq M , Os �'. o o U� o� p p o s #. w�° m°'oy vaoi �Uom Q. ramp0 U � 0 0 cd .t/1o'er Uc0-0 ,w.+ o o � 3o � 5^� po U F4 [� V w W qqq� N O O W Q U Commissioners' l.ourt—January 29, 2020 8. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 8) To approve a lease agreement with Xerox Corporation for a Xerox copier for the Calhoun County Extension Service and authorize the County Judge to sign. (DH) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 6 of 23 [.ease' Agreement INTRODUCTION: t. NEGOTIATED CONTRACT. The Products are subject solely to the terms in the Negotiated Contract identified on the face of this Agreement, and, for any option you have selected that is not addressed in the Negotiated Contract, the then -current standard Xerox terms for such option. GOVERNMENT TERMS: 2. REPRESENTATIONS & WARRANTIES. This provision is applicable to governmental entities only. You represent and warrant, as of the date of this Agreement, that: (1) you are a Slate or a Iuliy constituted political subdivision or agency of (lie State in which you are located and are authorized to enter into, and carry out, your obligations under this Agreement and any other documents required to be delivered fit connection with this Agreement (collectively, tite "Documents"); (2) the Documents have been duly authorized, executed and delivered by you in accordance Willi all applicable laws, rules, ordinances and regulations (including all applicable laws governing open meetings, public bidding and appropriations required in connection with this Agreement and the acquishlon of the Products) and are valid, legal, binding agreements, enforceable in accordance Willi their terms; (3) the person(s) signing the Documents have the authority to do so, are acting with the full amhorizailon of your governing body and hold the offices indicated below their signatures, each of which are genuine; (A) the Products are essential to the immediate performance of a governmental or proprietary function by you within the scope of your authority and will be used during the Term only by you and only to perform such function; and (5) your payment obligations under this Agreement constitute a current expense and not a debt under applicable state law and no provision of this Agreement constitutes a pledge of your tax or general revenues, and any provision that is so construed by a court of compelentjurisdiclion is void from die inception of this Agreement. 3. FUNDING. This provision is applicable to governmental entities only, You represent and warrant that all payments due and to become due during your current fiscal year are within the fiscal budget of such year and are included within an unrestricted and unencumbered appropriation currently available for the Products, and it is your intent to use the Products for the entire term of this Agreement and make all payments required under this Agreement. If you legislative body does not appropriate funds for the continuation of this Agreement for any fiscal year after the lost fiscal year and has no funds to do so from other sources, this Agreement may be terminated. To effect this lerminallon, you mush at least 30 days prior to the beginning of the fiscal year for which your legislative body does not appropriate funds, notify Xerox in wfiI of Ihat your legislative body failed to appropriate funds. Your notice must be accompanied by paymerd of all sums then awed through the current fiscal year under this Agreement. You Will return the Equipment, at your expense, to a location designated by Xerox and, when returned, the. Equipment will be to in good condition and free of all lions and encumbrances. You will then be released from any further payment obligations beyond those payments due for the current fiscal year (with Xerox retaining all sums paid to date). PRICING PLANIOFFERING SELECTED; 4. FIXED PRICING. If "Pricing Fixed for Term" is identified in Maintenance Plan Fealures, Ilse maintenance component of the Minimum Payment and Print Charges Will not Increase during the intlial Term of this Agreement. GENERAL TERMS & CONDITIONS: 5. REMOTE SERVICES. Certain models of Equipment are supported and serviced using data that is automatically collected by Xerox or transmitted to or from Xerox by the Equipment connected to your network ("Remote Data'g via electronic transmission to a secure off -site location ("Remote Data Access'). Remote Data Access also enables Xerox to transmit Releases of Software to you and to remotely diagnose and modify Equipment to repair and correct malfunctions. Examples of Remote Data include product registration, meter read, supply level, Equipment configuration and settings, software version, and problemifault code data. Remote Data may he used by Xerox for billing, report generation, supplies replenishment, support services, recommending addilional products and services, and product improvement/development purposes. Renote Data will be transmitted to and from you in a secure manner specified by Xerox. Remote Data Access will not allow Xerox to read, view or download the, content of arty of your documents or other information residing on or passing through the Equipment or your information management systems. You grant tile right to Xerox, tvilhout charge, to conduct Remote Data Access for the purposes described above, Upon Xerox's request, you will provide contact information for Equipment such as name and address of your contact and IP and physical addresses/locations of Equipment. You will enable Remote Data Access via a method prescribed by Xerox, and you will provide reasonable assistance to allow Xerox to provide Remote Data Access, Unless Xerox deems Equipment incapable of Remote Data Access, you will ensure that Remote Data Access is maintained at all times Maintenance Services are being performed. Katherine Sutherland From: Mercy Uresti <mercy.uresti@dSIVICLorIa.com> Sent: Thursday, January 9, 2020 9:37 AM To: Katherine Sutherland Subject: Xerox C8045 with Booklet maker Proposal - Calhoun Extension Office Attachments: Lease Proposal C8045.pdf,, C8045.pdf Hi Kathryn, It was such a pleasure to meet you! I am so glad we were able to discuss your needs in detail and work up a unit that will be an asset to your office productivity! Attached is a Full brochure as well as a lease proposal that Includes 75,000 black and white impressions. Included with this unit is the Booklet Maker Finisher, details are listed below. -v Optional BR Booklet Maker Finisher (Requires Horizontal Transport Kit) Capacity` Offsetting Top Tray: 500 sheets of 8.5 x 11 in. i A4 unstapled Stacking Stapling Tray: 1,500 sheets of 8.5 x 11 in. / 11 x 17 in. t A4 / A3 unstopled or 200 stapled sets of 8.5 x 11 in. / A4 (single -position stapling or dual or 4-position stapling) 100 stapled sets of 11 x 17 in. / A3 Sizes 4 x 6 in. to 11 x 17 in. / A6 to A3 for stacking t 7.25 x 10.5 in. to 11 x 17 in, / 65 toA3 for stapling Weights 16 lb. bond to 110lb, cover! 60to 300 gsm (coated and uncoated) Stapling Single and multlposition stapling Auto stapling (50 sheets maximum) - 24 lb. 190 gsm Letter. Legal, Tabloid.A3, A4. B4 and B5 sizes supported Hole Punch North America ( 2-3-hole punch DOCUMENT SOLUTIONS INC www. documentso lutionsine.com March 28, 2019 R1✓: State of Texas form 1295 The requirement for form 1295 was modified by the State of Texas Acts 2017, 85th R.S., Ch. 526 (SB 255), The modification creates an exemption of the Form 1295 requirement for a contract entered into or amended on or after January 1, 2018 with a publicly traded business entity, including a wholly owned subsidiary of the business entity. Xerox Corporation is a publicly traded company. If you have any questions please do not hesitate to call me at (361) 575-5931. Thank you, Rob Bigham Sales Agent 4d01 N. Muin, Suite A � 615 N. Upper Qmadway, Ste 108 P.O. Box 3503 ��f � .;J� Corpus Christi, Tx 78�177 Victoria, Tx 77903-3503 361-991-2679 361-575-5931 Authorized Sales Agent Comrnissioners' Court —January 29, 2020 9. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO.9) To approve a credit card for R.J. Shelly, Calhoun County Marine Education Extension Agent. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct I AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 7 of 23 Commissioners' Court —January 29, 2020 10. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 10) To renew a contract with Cintas Uniforms for Precinct 3 employees and authorize Commissioner Syma to sign. (CS) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Clyde Syma, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 8 of 23 Clyde Syma Calhoun County Commissioner, Precinct 3 24627 State Hwy, 172^'01ivia, Port Lavaca, Texas 77979 ~ Office (361) 893-5346 ~ Fax (361) 893-5309 Email: clvde.svmaQcalhouncotx.orsc 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 January 29, 2020. • Please Consider and Take Necessary Action on renewal contract with Cintas Uniforms for PCT.3 and authorize Commissioner Syma to sign the rental service agreement. Sin�ce�rjely, Clyde Syma Commissioner Pct. 3 o Contract No. Customer No. 4� 0 38 Location No.�R3 STANDARD RENTAL SERVICE AGREEMENT Date 2011110 Customer t c\ \"OLA� Cotklr iy gf'ec:iAc " Phone 70 1 39C Address 19 Sh&k "rn)niW&-J f72 City 80r Lit" StateT_Zip'7'?%'79 I mIIGpRM RENTAL PRICING: item # Description Unit Price � O NS �1 o This agreement Is effective as of the date of execution for a term of 60 months from date of installation. o The additional charges listed below are subject to adjustment by Company effective upon notice to Customer, which notice may be in the form of an invoice. • Name Emblem $ f as °Company Emblem $ Z+00 as o Custom Emblem $ ea a Embroidery $ ea o COD Terms $ per week charge for prior service (if Amount Due is Carried to Following Week) o Credit Terms —Charge Payments due 10 Days After End of Month o Automatic Lost Replacement Charge: Item % of Inventory. $ Ea. • Automatic Lost Replacement Charge: Item % of Inventory $ Ea. o Minimum Charge $ 60 -00 per delivery. o Make -Up charge $ 1 •%S per garment. o Non-Standard/Special Cut Garment (i.e., non-standard, non -stocked unusually small or large sizes, unusually short or long sleeve or length, etc.) premium $ per garment. o Seasonal Sleeve Change $ per garment. o Under no circumstances will the Company accept textiles bearing free liquid. Shop towels may not be used to clean up oil or solvent spills. Shop towel container $ per week. o Artwork Charge for LogoMat $ o Uniform Storage Lockers: $ ea/week, Laundry Lock -up: $ ealweek Shipping: $ • Service Charge $ " ` per delivery. This Service Charge is used to help Company pay various fluctuating current and future costs including, but not limited to, costs directly or indirectly related to the environment, energy issues, service and delivery of goods and services, in addition to other miscellaneous costs incurred or that may be incurred in the future by Company. o Size Change: Customer agrees to have employees measured by a Cintas representative using garment "size samples". A charge of $ per garment will be assessed for employees size changed within 4 weeks of installation. o Uniform Advantage $ per garment. Premium Advantage $ per garment. Uniform and Premium Advantage covers damaged garments needing to be replaced outside of normal wear. Uniform Advantage does not cover lost or unreturned garments. The Customer or Company may cancel Uniform Advantage at any time. o Other FACILITY SERVICES PRODUCTS PRICING: Bundle` Item # Description Rental Freq. Unit Price Discount 'Indicates bundled items/services _Initial and check box If Unilease. All garments will be cleaned by Customer. Date / Initial and check box if receiving Linen Service. Company may make periodic physical inventories of items in possession or under control of Date Customer. ! Initial and check box if receiving direct embroidery. If service Is discontinued for any employee, or Customer deletes any of the garments Date with direct embroidery for any reason, or terminates this agreement for any reason or fails to renew this agreement, Customer will purchase all direct embroidered garments at the time they are removed from service at the then current replacement values. / Initial and check box If declining the Uniform Advantage program. CUSTOMER: Cintas Loc. No. Please Sign Name By M0.'t"4iA$ Rvai., Please Print Name Sa Title �+ Please Print Title_ R-2700A (rev, Ot/2013) Folm nislribullon: (1)Whlto-01fice (2)Canary-Customer (3)Plnk-Corperole Oftlre STANDARD UNIFORM RENTAL SERVICE AGREEMENT 1. The Customer, its successors and assigns ("Customer ) orders from CINTAS CORPORATION or any of its subsidiaries, successors and assigns ("Company") all of the Customer's requirements of garment rental services and other items covered by this agreement during the term of this agreement all in accordance with the pricing, terms and conditions contained herein. Pricing is based on 62 weeks billing per rental item per year. 2. All garments and other rented items will be cleaned and maintained by Company and remain the property of the Company. Any garments that require replacement due to normal wear will be replaced by Company at no charge to Customer. 3. Unless specified otherwise, the garments supplied under this agreement are not flame retardant or acid resistant and contain no special flame retardant or acid resistant features. Flame retardant and acid resistant garments are available from Company upon request. Customer agrees to notify its employees that their garments are not designed for use in, areas of flammability risk or where contact with hazardous materials is possible. Customer warrants that none of the employees for whom garments are supplied under this agreement require flame retardant or acid resistant clothing. 4. Customer agrees to notify Company, in writing of any hazardous materials, including lead, arsenic, hexavalent chromium and cadmium, that may be picked up by Company in the soiled garments or other textiles serviced under this agreement. In no case will hazardous materials be present to the extent that they may be harmful to Company's employees. 5. The weekly rental charge for any Individual leaving the employ of Customer can be'terminated, but only after all garments Issued to that individual, or the current replacement value of same, have been returned or paid to Company. Any non standard, or special products (i.e., logo mats) must be purchased by the Customer if service is stopped for any reason. If items are lost or damaged by any means Customer will pay the then current replacement values for said items. Should Customer require garment sizes that are outside the standard size range, Customer agrees to pay the specific premium price for those items and sizes designated under Uniform Pricing. 6, This agreement is effective as of the date of execution. The initial term of this agreement shall be as set forth on the front of this agreement and shall automatically renew for the same period of time unless Company is notified, to the contrary, in writing, 60 days in advance of the expiration of the then current term. Company has the right to Increase prices. The Customer has the right to reject the price increase within ten (10) days of the notice. If Customer rejects the price increase, Company may terminate this agreement. If the Customer receives discount pricing due to bundling of products/services, Customer acknowledges that discount is subject to Customer continuing the bundling of the product/services. Should Customer discontinue bundling, pricing may be increased to the non -discounted pricing. Ail' invoices must be paid within ten days after the end of the month. Interest will accrue on any amounts which are not paid when due from the date due to the date of payment In full at an annual percentage rate equal to the lesser of (a) eighteen percent 18% or (b) the maximum rate permitted by applicable law. 7. Company is a licensee and not the owner of the Carhartt trademarked products. If Company should no longer have such license, 'then Company will substitute the Carhartt trademarked garments with garments of similar material and quality. o Customer hereby agrees to defend, indemnify and hold harmless Company from any claims and damages arising out of or associated with this agreement. 9. Company guarantees to deliver the highest quality textile rental service at all times. Any complaints about the quality of the service which have not been resolved in the normal course of business must be sent by registered letter to Company's General Manager. If Company then fails to resolve any material complaint in a reasonable period of time, Customor may terminate this agreement provided all rental items are paid for at the then current replacement values or returned to Company in good and usable condition. 10. Additional Customer employees, products and services may be added to this agreement and shall automatically become a part of and subject to the terms hereof this agreement, and subject 'to all of its provisions. if this agreement is terminated early, the parries agree that the damages sustained by Company will be substantial and difficult to ascertain. Therefore, if this agreement is terminated by Customer prior to the applicable expiration date for any reason other than documented quality of service reasons which are not cured as set forth above, or terminated by Company for cause at any time, Customer will pay to Company, as liquidated damages and not as a penalty, the greater of 60% of the average weekly invoice total multiplied by the number of weeks remaining in the unexpired term, or buy back all garments and other products allocated to Customer at the then current replacement values. Customer shall also be responsible for any unpaid charges on Customer's account prior to termination. 11. Any dispute or matter arising in connection with or relating to this agreement shall be resolved by binding and final arbitration. The arbitration shall be conducted pursuant to applicable state or federal arbitration law. Any such dispute shall be determined on an individual basis, shall be considered unique as to its facts, and shall not be consolidated in any arbitration or other proceeding with any claim or controversy of any other party. The exclusive jurisdiction and forum for resolution of any such dispute shall lie in the state where Customer is located. 12. Customer certifies that Company is in no way infringing upon any existing contract between Customer and any other service provider. 13, This agreement contains the entire agreement of the parties with respect to the subject matter of this agreement and supersedes all prior negotiations, agreements and understandings with respect thereto. This agreement may only be amended by a written document executed by all parties 14. This Agreement may not be modified, amended or supplemented except in writing signed by an authorized representative of Cintas, provided, however, if a Federal, state or local governmental body or its representative is a party to this Agreement, the proposed modification, amendment or supplement must be in a writing signed by a President or Senior Vice President of Cintas. R-2100A (rev. O1I2013) CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 Complete Nos, I - 4 and 6 if there are interested parties. OFFICE USE ONLY Complete NOS. 1, 2, 31 5, and 6 d 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. 2019-571340 Cintas Corporation No. 2 Corpus Christi, TX United States Date Filed: 12/18/2019 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. CALHOUN COUNTY Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 14702658 Garment and facility services rental products 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling intermediary 5 Check only If there Is NO Interested Party. ❑x 6 UNSWORN DECLARATION My name is Kimberly Kinney . and my date of birth is My address is (street (city) (state) (zip code) (country) i declare under penalty of perjury that the foregoing is true and correct. Executed In Nueces County, State of Texas , on the 18 day of December 2D 19 . (month) (year) /�G1�1 /16�LI221� Signature of authorized 46ent of contracting business entity (Declarant) Forms orovided by Texas Ethics Commission www.ethics.state.ix.us Version V1.1.3a6aaf7d CERTIFICATE OF INTERESTED PARTIES FORnn 1295 1 of1 Complete Nos. 1- 4 and 6 if there are interested parties. complete Nos. 1, 2, 3, 5, and 5 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2019-571340 Date Filed: 12/18/2019 Date Acknowledged: 01/28/2020 1 Name of business entity filing form, and the city, state and country of the Business entity's place of Business. Cintas Corporation No. 2 Carpus Christi, TX United States 2 Name of governmental entity or state agency that is a party to the contract for which the farm is Being filed. CALHOUN COUNTY g Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 14702658 Garment and facility services rental products 4 Name of Interested Part Y Cit State, Count lace of business Y� rY (p ) Nature of interest check a licable I PP ) Controlling Intermediary 5 Check only if there is NO Interested Party. ❑ X 6 UNSWORN DECLARATION My name is ,and my date My address is 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.Satiaatia Commissioners' Court — January 29, 2020 11. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 11) To approve the installation of STOP signs in Port O'Connor, Texas at the Following intersections: 1. Two-way stop on Madison Avenue at Madison at w Street 2. Two-way stop on Madison Avenue at Madison & 5t" Street 3. Two-way stop on Madison Avenue at Madison & 6t" Street 4. Two-way stop on 3rd Street at 3rd & Taylor Avenue RESULT: APROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct i SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 9 of 23 Gary D. Reese County Commissioner County of Calhoun Precinct 4 January 22, 2020 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: Please place the following item on the Commissioners' Court Agenda for January 29,2020, • Consider and take necessary action to approve installation of Stop signs in Port O'Connor, Texas at the following intersections: o Two Way Stop on Madison Ave. at Madison & 4'h St. o Two Way Stop on Madison Ave. at Madison & 5th St. o Two Way Stop on Madison Ave. at Madison & 6fh St. o Two Way Stop on 3rd St at 3rd & Taylor Ave. Sincerely, )t. GDR/at P.O. l3os 177 -Seadrift, Texas 779S:i _ enmil: kury.reoseC�calhouncolx.ura - (361) 785-3141 -Pax (361) 785-Sh02 Comrnissioners' Court --January 29, 2020 12. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 12) To allow the Port O'Connor Chamber of Commerce to use King Fisher Beach/ Park April 25, 2020 for their annual Crawfish Festival. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 10 of 23 Gary D. Reese County Commissioner County of Calhoun Precinct 4 January 20, 2020 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 Dear Judge Meyer: Please place the following item on the Commissioners' Court Agenda for January 29, 2020. • Discuss and take necessary action to allow the Port O'Connor Chamber of Commerce to use King Fisher Beach/Park April 25, 2020 for their Crawfish Festival. Sincerely, Gary Reese\ GDR/at P.O. Box 177 —Seadrift, Texas 77983 —email: karv.rcescC�+calhooncotx.ora — (36l) 785-3141 —Fax (36t) 785-5602 Commissioners' Court —January 29, 2020 13. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 13) To authorize the Port O'Connor Chamber of Commerce to sell alcohol at their Annual Crawfish Festival Fundraiser to be held April 25, 2020 at King Fisher Beach/Park in Port O'Connor, TX and authorize the County Judge to sign a Letter of Approval to the TABC. (GR RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Clyde Syma, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 11 of 23 Gary D. Reese County Commissioner County of Calhoun Precinct 4 January 20, 2020 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGE[�TDA ITEM Dear Judge Meyer: Please place the following item on the Commissioners' Court Agenda for January 29, 2020. • Discuss and take necessary action to allow the Port O'Connor Chamber of Commerce/Crawfish Fest to sell alcohol at their annual fundraiser to be held April 25, 2020 at Kingfisher Beach in Port O'Connor, TX and authorize County Judge to sign letter of approval to the TABC. Sincerely, Gary. Reese GDR/at P.O. Box 177 —Seadrift, Texas 77983 —email: eary.reese(�calhouncotx.ora — (361) 785-3141 —Fax (361) 785-5602 'tii.�pTE Op TQ lRk��' +q� RICHARD H. MEYER Calhoun County judge ���� \o=w% 211 S. Ann Street, Suite 301 � Port Lavaca, Texas 77979 (361) 553-4600 � Fax (361) 553-4444 � Email: richard.meyer@calhouncotx.org January 30, 2020 Texas Alcoholic Beverage Commission Victoria, TX 77901 PORT O'CONNOR CHAMBER OF COMMERCE CRAWFISH FESTIVAL On January 29, 2020, the Calhoun County Commissioners' Court heard and approved a request by the Port O'Connor Chamber of Commerce to sell alcohol at their Crawfish Festival. Darla Parker of the Port O'Connor Chamber of Commerce is authorized to hold a Temporary License —Special Three -Day Wine and Beer Permit for allon-Profit Charitable Organization for the Crawfish Festival to be held on Apri125, 2020 from 7 am to 8 pm at King Fisher Beach and Park located at Highway 185 and Park Street in Port O'Connor, Texas. Please do not hesitate to contact my office if you require any further information. t ICHARD H. MEY R County Judge RHM/mbc www.calhouncotx.org Port O'Connor Chamber of Commerce a_ P.O. Box 701 -, Port O'Connor, Texas 77982 OF CO� www,portoconnorchamber.com January 163 2020 Calhoun County Commissioners Court Commissioner Gary Reese, Precinct 4 211 S. Ann St, Port Lavaca, Texas 77979 Dear Commissioner Reese: The Port O'Connor Chamber of Commerce would like to request permission to use King Fisher Park on the following dates during the calendar year of 2020. 1. Saturday, Apri125th, 2020 for the 8th Annual Crawfish Festival and Cook off. This event would be held from 7:00 am to 8:00 pm, which includes the time for set up, deliveries, and clean up afterwards. The Chamber would be selling alcohol and will have insurance and permits in place per requirements of Texas State Laws and TABC. We would respectfully request a letter from the County for use of the property, to obtain a temporary license from TABC. The Crawfish Festival and Cook off will also include food and craft vendors, children and adult activities, as well as live music. 2. Saturday, July 4, 2020 for the Annual Fireworks Display. King Fisher Park would be utilized as a vendor area during the hours of 10:00 am to 10:00 pm and use of the pier for the Fireworks Display to begin at dark (approximately 8:00-9:00 pm). The Chamber will NOT be selling alcohol at this event, and will have insurance in place per requirements of state laws. For the above events, The Chamber of Commerce will be coordinating volunteers, set up, clean up and required security, as well as working with Mr. Reese to meet all the County requirements as needed. We would also, at this time, request that Park Ave be maintained as a one way street, during these events, as to deter traffic hazards. As well, we would request that the grass area, north of the pier, between Jackson and Harrison be utilized as golf cart parking only, during the Crawfish Festival. This, as last year, would eliminate a lot of parking issues for this event. Sincerely, /s/ Darla Parker Darla Parker, President Port O'Connor Chamber of Commerce Comrnissioners' Court —.January 29, 2020 14. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 14) To designate Park Avenue as a One -Way street during the annual Crawfish Festival to be held April 25, 2020 between the hours of 7 a.m. and 8 p.m. in Order to deter traffic hazards. Also designate the grass north of the pier Between Jackson and Harrison Streets be utilized as a golf cart parking lot. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct`I SECONDER; Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 12 of 23 nary D. Reese County Commissioner County of Calhoun Precinct 4 January 20, 2020 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear judge Meyer: Please place the following item on the Commissioners' Court Agenda for January 29, 2020 • Discuss and take necessary action to designate Park Avenue as a One -Way street during the Crawfish Fest being held April 25, 2020 between the hours of 7 am and 8 pm in order to deter traffic hazards. Also designate the grass area north of the pier, between Jackson and Harrison, be utilized as golf cart parking only. Sincerely, Gary D. Reese GDR/at P.O. Box 177 — Seadrift, Texas 77983 — emnii: _ i e r : C_% c.ilh n o�g,pr�� — (361) 785-3I41 —Fax (361) 785-560'L Commissioners' Court —January 29, 2020 15. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 15) To authorize the POC Chamber of Commerce to hold the annual Fireworks Display at King Fisher Beach/Park on July 4, 2020 and utilize the Park as a Vendor area during the hours of 10:00 a.m. and 10 p.m. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, CommissionerHall, Lyssy, Syma, Reese Page 13 of 23 Gary D. Reese County Commissioner County of Calhoun Precinct 4 January 20, 2020 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: Please place the following item on the Commissioners' Court Agenda for January 29, 2020. • Discuss and take necessary action to authozize Port O'Connor Chamber to hold the annual Fireworks display at King Fisher Beach/Park on July 4, 2020 and utilize the park as a vendor area during the hours of 10:00 am to 10:00 pm. S' cexely, OOX ,QN� Gary D. Reese GDR/at P.O. Box 177 —Seadrift, Texas 77983 —email: earv.rcesc@callunmcotx.org — (361) 785-3141 —Pax (361) 785-5602 Commissioners' Court —January 29, 2020 16, CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 16) To designate Park Avenue as a One -Way Street during the annual fireworks Display between the hours of 5 p.m. — 10 p.m. in order to deter traffic Hazards. Also designate the grass area north of the pier between Jackson And Harrison streets be utilized as golf cart parking only. (GR) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 14 of 23 Gary A Reese County Commissioner County of Calhoun Precinct 4 January 20, 2020 Honorable ltichazd Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: Please place the following item on the Commissioners' Court Agenda fox January 28, 2020. • Discuss and take necessary action to designate Park Avenue as a One -Way street during the annual Fireworks Display between the hours of 5 pm and 10 pm in order to deter traffic hazards. Also designate the grass area north of the pier, between Jackson and Harrison, be utilized as golf cart parking only. Sincerely, ese GDR/at P.O. Box 177 —Seadrift, Texas 77983 —email: xarv.reeseC`calhouncrnx.org — (361) 785-3141 —Fax (361) 785-5602 Comrnissioners` Court —January 29, 2020 17. Accept the 2019 Certificate of Completion for Continuing Education Hours From the District Clerk and enter into official Court Records. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner PctI AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 15 of 23 ��tipLl A P/�j� Lj Commissioners' Court—!anuary 29, 2020 18, CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 18) To place funds from GOVPLANET for the auction of 1. 2002 POrd F-150 XL Asset # 21-0242 - $841.50 2. Vermeer 1250 BC Wood Chipper Asset # 665-0034 - $1,496.60 3. Miller Bobcat 225G Welder Asset # 21-0116 - $794.00 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese AMENDED TO READ: The total amount of $3,132.25 and place in the 2020 Pct 1 budget acc't # 540-S3510 Road and Bridge Supplies. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pd 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 16 of 23 9 January 17, 2020, 202 S. Ann, Port Lavaca -- Texas 77979 — Office (361) .552-9242 — Fax (361) 553-8734 David E. Hall, Commissioner, Pct. 1 _ Mobile (361) 220-1751 Email: david.hall@calbouncoix.org 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 January 29, 2020 . • Consider and take the necessary action to place funds from GOVPLANET, for the auction of: • 2002 Ford F-150 XL Pickup( Vin4 1FTRF17252N696090) Asset# 21- 0242, for the amount of $841.50. • Vermeer 1250BC Wood Chipper Assetit 665-0034, for amount of $1,496.00. • Miller Bobcat 225G Welder Asset# 21-0116, for the amount of $794,75, For the total amount of $3,132.25 to be placed into 2020 Precinct 1 budget account ff540-53510 Road and Bridge Supplies. Sincere) County DaVld C-. r-ran , DEH/apt Seller Statement for Contract# 299706 Seller Calhoun County Precinct 1 202 S. Ann, Suite A Port Lavaca, TX 77979 Attn: David Hall Item I Description � Sale Date 2799750 2002 Ford F-150 Xl. Pickup (S/N: 12/4/19 IFTRF17252NB96090) 2799752. Verrneer 1250BC Chipper(S/N:lVRC14136P1003650) 12/1119 2799753 Puller Bobcat 225G Engine Driven Welder 12/4/19 (5/N:KC293407) ... d �ail:h checkrl 80M1612 on 12/2fi/2019. Statement Statement Contract UserRef 11 DeptCode Date tl L"2/26/19 299796 3580030 307 Gross Guarantee j0.U0 SU.UO $0.00 Net Proceeds Due Total Proceeds Noto: All�rlces are in USD Net Proceeds 51,496,00 $794.75 $3,132925 $3,132.25P $3,132.25 Note: All prices are in USD htlps://vnvw.govplanet.comisplaccUview-sta(emmri.jsp7docld=3M17M1SB 1/I GOVPLANET, LLC CHECK NO.: 804612 3880 Hulen Street, Suite 200, Fort Worth, TX. 76107 DATE: 26-DEC4019 Telephone'1.80D-211.3903 Fax 1-888.433-3467 Supplier: Calhoun County Precinct 1 INVOICE INVOICE INVOICE INVOICE INVOICE NUMBER DATE DESCRIPTION DEDUCTIONS NETAMOUNT 6-2799750-OC14I 04-13EC-19 IP Auction Invoice - Se11erID 3580830 .00 841a50 6-2799752-0c1dI 04-DEC-19 IP Auction Invoice - Se13er2D 3580830 .00 1,496*00 6-2799753-0c1dI 04-DEC-19 IP Auction Invoice - Se11erID 3580830 too 794.75 TOTALe (U8D) 3,132.25 I I44/1210 GOVPLANET,LLC 604612 3880 Hale Slreeb Suite 200, Fort Wonh, TX, 76107 201912 26 Telephone: 1.800.211.3963 Fez: 1.888-033.3467 DATE Y Y r Y M M DO Wells Fargo Bank, N.A., 420 Montgomery SlwA San Francisco, CA, 94104 PAY Three Thousand One Hundred Thirty -Two Dollars And Twenty -Five $ 3,132.25 Cents***** PAY Calhoun County TO Attu Precinct 1 .THE 202 S Ann SteA ORDER Port Lavaca TX 77979(� OF United States AUTHORMOO G ONATony BEFORE ACOP77NO CHECK, PLa4EE HOLO UP AND EXAMINE FOR THEOENuiNe EECUnNy WA7ERtmRK PRONrANO BACK n'8046 L 21I1 10 L 2 L000 248R 4 2468 2 i0 29u' Commissioners' Court —January 29, 2020 19. Accept the attached list of donations to the Calhoun County Public Library System during November and December 2019. (RM) RESULT: APPROVED[UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 17 of 23 Calhoun County Public Library w .cchbmry.org 200 W. Mahan I Port Lavaca, TX 77979 Ph: 361.552.7323 Fax: 361.552.5218 The following materials have been donated to the Calhoun County Public Library System during the month of NOWDEC 2019 Books Donor 64 Books Unknown 23 Books Jim Dunlap 4 Books Alice Long 14 Books Ann Sikes Paperbacks 143 Paperbacks Unknown 13 Paperbacks Joyce May 28 Paperbacks Jim Dunlap 31 Paperbacks Alice Long 35 Paperbacks Ann Sikes �azines 17 Magazines Unknown 12 Magazines Fred Rhodes 19 Magazines Ann Sikes DVD'S 14 DVD`s Unknown 5 DVD's Bo Warren Others 3 Audio Books Unknown $ 6.25 Donation Bucket Seadrift Library $ 15.00 Donation Bucket Point Comfort Library $ 5.53 Donation Bucket Port O'Connor Library $1000,00 To Seadrift Library from Seadrift Seafood Processing Inc $30.00 Memorial for Atla Lippold from Ursula Price & Judy Whitworth $ 10.45 Donation Bucket Seadrift Library $ 1.10 Donation Bucket Point Comfort Library $27.50 Donation Bucket Port O'Connor Library 1 Set of Book Ends Jim Dunlap 1 CD -Rom Jim Dunlap 1 Scroll Saw Pattern Kit Jim Dunlap 13 VHS Ann Sikes 1 Small Fiber Optic Christmas Tree Barbara Wilson 65 Small Pumpkin Carving Kits Wal-Mart 25 Pumpkin Carving Kits w/book Wal-Mart 56 Pumpkin Carving Books Wal-Mart 9 Pumpkin Carving Kits w/accessories Wal-Mart 20 Party Carving Kits Wal-Mart 30 Metal Signs Wal-Mart 6 Gel Cling Packs Wal-Mart 63 Paint Your Tote Bag Kits Wal-Mart 4 70 Count Mini Lights Wal-Mart 5 Ceramic Cats Wal-Mart 8 Tapered Bleeding Candles Wal-Mart 78 Light Bulbs/Flicker/Black Light Wal-Mart 26 Light Up Necklaces Wal-Mart 5 Packages of Eyelashes Wal-Mart 2 Fingernail Kits Wal-Mart 1 Package of Spider Confetti Wal-Mart 15 Small Scarecrows Wal-Mart 2 Decorating Kits —Graves Wal-Mart 1 Package Pumpkin Decorations Wal-Mart 3 Halloween Trays Wal-Mart 5 Minion Buckets Wal-Mart 9 Lion King Buckets Wal-Mart 3 Black Panther Buckets Wa-Mart 120 Headbands Wal-Mart 1' Plastic Bone Wal-Mart 31 Halloween Dress Up Kits Wal-Mart 15 Halloween Costumes Wal-Mart 22 Wigs Wal-Mart 3 Pairs of Earrings Wal-Mart 7 Hair Bows Wal-Mart 15 Pony Tail Bows WaI-Mart 8 Coin Purses Wal-Mart 3 Pairs of Tights Wal-Mart 9 Talking Skulks Wal-Mart 2 Kid Size Brooms Wal-Mart 4 Deco Spiders Wal-Mart 11 Tea Light Sets (baftery powered) Wal-Mart 29 Real Tea Lights Wal-Mart 15 LED Pumpkins Lights (2 Pk) Wal-Mart 35 Make -Up Kits Wal-Mart Commissioners' Court — January 29, 2020 20. CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 20) To declare the attached list as Surplus/Salvage and authorize the Calhoun County Librarian to dispose of same. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 18 of 23 Calhoun County Public Library www.cdibmry.org 200 W. Mahan I Port Lavaca, TX 77979 Ph: 361.552.7323 Fax: 361.552.5218 I would like the following items to be declared Surplus/Salvage 480 Books 222 Paperbacks 42 Magazines 138 DVD's Others 12 VHS 1 CD-ROM 1 Scroll Saw Pattern Kit Commissioners' Court —January 29, 2020 21, CONSIDER AND TAKE NECESSARY ACTION (AGENDA ITEM NO. 21) To declare the attached list of items as Waste and authorize the Calhoun County Librarian to dispose of same. (RM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER. Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 19 oF23 Z Calhoun County Public Library wvrvacdibrory.org 200 W. Mahan I Port Lavaca, TX 77979 Ph: 361.552.7323 Fax: 361.552.5218 NOV-DEC 2019 I would like the following items to be declared Waste 109 Books 34 Paperbacks 19 DVD's 13 Magazines Others 1 Backpack 1 VHS 1 Set of Bookends Commissioners' Court—.lanuary 29, 2020 22. Accept a report from the following County Offices: a. Tax Assessor -Collector —December 2019 Page 20 of 23 F 00 00 1O O W O O O (D O O O tO N t} N Lc)N Z O O N N O H O (D r 00 O M tO h N N N W h O M M n 0 O 01 f0 N N w 0 n CO C 00 00 O 2 W (0 d' (0 co(0 qt O 00 r N y O n M co n W W) t` co tO 00 N 0) V' N t0 G> t0 (O M N C 00 R T N 06 K m N p fA M to tR to H H t9 ti! ER M EA EA fR t9 H tH 69 t9 m t9 VA t9 to to t% tH y O (00 (D 0) O O 001 0) t0O O N N N O z to M OCd W O n 000 M 00i n t0 00 ((0 � 00 0 LO J O 04 N e J J 2 O F U O O) fA fA t9 EA 69 fA to t9 f9 H t9 H t9 to EA20 fR EA E9 N M W V g 0 jWU .o wm m , mJ0 o wcd 0 d w to c u O LL m o O d C ¢ O Q N j (A (9 -O O a O -0 LL O w c 'c d C Ic W a0 N Nc = z C V N W tO j (A E9 -O U C O LL LL m O 0 J 0. 1- W 3 O LL N 0 W d a LL W z LL 05 O LL Q Q LL T LL Z v O 0 z 0 V) N Z` U Gr N O ad+ N LL O Z U d 0 N sJs O N N N 16 O W '0) a U O m c z F ..d.. N m W t6 �. (0 O O W L S b U d N !Y O Q N t0 Z z f6 N O t0 ¢ ~ O U N p U c d O C0U ZFwF W U U W z ¢0 d x 0 d 4) 0 =w Q o° U O O >> W U V N N N 0 p y mi Q md (Nd DW 0O UUmO UmO d :4Nw Gw70 N Pd>N :4>N0 �wKWUtLLLW N a"N:J ¢NW¢YK aaNJ LLI ¢NW.Z7LL aaH�cNNU U LL d d W N N p d W U U I� fO O LLU tiz Z z LL LL U Iad 0) Z~ z p p p- O Z �T�O O c c Q O W WO xLLOod N UU�°FUmm ¢ ZO O Z O Z O C.) U mo QXFUIl lL aOUv(L 00 OwOR 0 o �(D0 a0¢vv a0 Q O@ �9 O 0O Q. C 0 am 0CD N FF(7 a0 m 11- U .d. ' z z z O) 00 CO) M p 00 p 00 CO) p n p M N OV t0 M'L6' ' ' cm N r V toN Re �00 00 O> r' 00 Mcc C4 cm N in N v VZ u� u9 ur ur u� v► 6a cry 649. to cn to cn m m �n van c (O m M NO) O)tiM ' w N qq {O < t0 0) O 00 f0 LO r�M N N a fA fR 69 6% 69 fH 69 fA d9 fA EA EA EA z Z O v w J O � U O N J yLL w rn ° F c� c r v O N o x o U N N N T X N Nd x 0)Fj I U` N LL 6 C {j= LL N .NNa o c E> j a)p O cQ 0 Z N N O 0 0)Cin LL c 0) a) a) a F Q>>> >> d m h> a c y J w m m m 4) m m ° N 0 6 O N N c V V y F'i G d d N N N U p7 C N ° N d 0 c 'o F F F 0) c F O F- F m y o o d U Z w A 0)F C LL ° o 0 0 o V>> > �+ CDo 0 0' dU aU �3U5 0 �„d o c c000 �UU wU oU UU U Wy aN > c _ > N ccco N U OIL E o a(6= Q Q a a a a s LL a a v a a a.` '� m R s rn m W 10 c m N N 4J T d V d = U m w OOUa Via, a m = O w 0) F Z w z w n O U 0] z V) Z � Q J w a a O � F y O FM F a W U ww w O Q O O 1- Commissioners' Court --January 29, 2020 23. Accept Auditor's Office Reports for the attached County Offices: RESULT; APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDERq Clyde Syma, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 21 of 23 F90011 NALL in CRTSISTINATUAION M S ANN SUITE B ERINAPEREI CANDICEVILLARREAL PORT LAVACA,TEAAS71979 OEMICABRERA 1°ASSISTABTAUDITOR TELEPHONE 13B1)553=4610FAX (36115534614 ASSISTANTAURITORS January 22, 2020 Honorable Dan Heard Criminal District Attorney Calhoun County Courthouse 211 South Ann Street Port Lavaca, Texas 77979 Dear Mr. Heard: An audit was recently conducted of the District Attorneys Hot Check Fee Fund for the period of January 1, 2019 through December 39, 2019. I examined the reports, receipts and disbursements, and supporting documentation for this period. I found nothing that would lead me to conclude that the balance and collections of your Hot Check Fee Fund for this period were not, in ali material respects, appropriately charged, collected and remitted. I appreciate the cooperation your staff extended to me during this audit. If you have any questions concerning the audit, please do not hesitate to contact me at 361-553 4615. Respectfully Submitted, 514 Cristina Tuazon V Assistant Auditor Approved By: Wam6 V Cindy Moeller County Auditor cc: Judge Stephen Williams Judge Richard Meyer County Commissioners Sara Rodriguez, Asst. District Atty, Auditor's File i PfOOY RALL 2D2 S AIRI<DRE B DEMI CARRERA Caedice11111arreal PORT LAYACA,TEXAS 71970 ERICAPEREZ 1" ASSISTANTAODITOI TELEPHONE (36115534610FAX136115534614 ASSISTANT AUDITORS December 305 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 December 26, 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 $380.00. When reconciled with receipts for the day totaling $150.00 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, Demi Cabrera Assistant Auditor Approved by: U.QXXti1J �• Cindy M ller _ County Auditor cc: Judge Stephen Williams County Judge Richard Meyer County Commissioners Dan Heard, Dist, Atty. Shannon Sayler, Asst. District Atty. Auditor's File 60aalo �eAuuc PE98YRAtE CRISTIMATDAZOM 202 S ITE B DEMI CABRERA Caadlcs1111ormll PORT IAVACA,TMS71979 ERICAPEREZ 1°ASSISTANTADDIT00 MEPMOME13611553 4610FAX138115534614 ASSISTANT AUDITORS December 135 2019 Mary Orta Elections Administrator Calhoun County Courthouse 211 South Ann Street Port Lavaca, Texas 77979 Dear Mrs. Orta: In accordance with Local Government Code Chapter 115 a cash count of your office funds was conducted on December 11, 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 your staff extended during the cash count. If you have any questions, please do not hesitate to contact me at 361-553-4613. Respectfully Submitted,", 'F�9 Demi Cabrera Assistant Auditor Approved by: Cindy ueller 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 6 PEOOY HALL CRISTINATUIIION 20251 UREB DWI CABRERA CandiceUlllarreal PORT LAVACA. TERMS 71979 ERICA PEREZ 1"ASSISTANTAUITOR TELEPHONE (36115534610 FAX (36115534614 ASSISTANT AUDITORS December 305 2019 LaDonna Thigpen Calhoun County Floodplain Administrator Calhoun County Courthouse 211 South Ann Street Port Lavaca, Texas 77979 Dear Ms. Thigpen: In accordance with Local Government Code Chapter 115 a cash count of your office funds was conducted on December 17, 2019. The cash count of your funds totaled $0; no receipts were taken in at the time the audit was conducted. Thank you for your assistance and cooperation you extended during the cash count. If you have any questions, please do not hesitate to contact me at 361-55346136 Respectfully Submitted, Demi Cabrera Assistant Auditor Approved by: Cindy Mu 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 PEBBT HAu N CRISTINATUAZON 202E ANNSUITE I ERINAPEREZ CANDICENILLARREAL PORTLAVACA4TEAAS71979 DENIICABRERA VASSISTANTAUDITOR TELEPHONE (36115584610FAX13011553=4614 ASSISTANTAUDITORS January 22, 2020 Honorable Dan Heard Criminal District Attorney Calhoun County Courthouse Port Lavaca, Texas 77979 Dear Mr. Heard: An audit was recently conducted of the District Attorney's Hot Check Restitution Fund for the period of January 1, 2019 thru December 31, 2019, 1 examined the reports, books, receipts and disbursements, and supporting documentation for this period. In this audit the following exceptions were found • The Manual Receipts, Computer Receipts and Checks issued were out of sequence. After talking to your office clerks, it was found that they were trying to backdate some transactions to when the money were received, I recommend that all transactions should be dated and posted on the actual date of transaction. • It was also discussed that the check register be included in the submission of the audit documents. I found nothing that would lead me to conclude that the balance and collections of your Hot Check Restitution Fund for this period were not, in all material respects, appropriately charged, collected, remitted and reported. I appreciate the cooperation you and your staff gave during this audit. if you have any questions concerning the audit, please do not hesitate to contact meat 553 4615I Respectfully Subm(tted, Cristina� �1�.ryr+�---r Compliance Auditor (V� Approved by: Cindy eiler County Auditor cc: Judge Stephen Williams Judge Richard Meyer County Commissioners Sara Rodriguez, Asst, District Attorney Auditor's File i C PEfifiYNAIE CRISTINATUAZON 202 S 1 UITE U BENI CABRERA Candice Villarreal PORT IAVACA,TEAAS77979 ERICAPEREZ 1°ASSISTANTAUUITOR TEUEPNONE 13611553 4610 FAX 18611553 4614 ASSISTANT AUDITORS December 30, 2019 Honorable Dan Heard Criminal District Attorney Calhoun County Courthouse 211 South Ann Street Port Lavaca, Texas 77979 Dear Mr. Heard: In accordance with Local Government Code Chapter 115, a cash count of your office fund was conducted on December 17, 2019. The office fund consists of an authorized petty cash fund of $100.00. The cash count of your office funds totaled $70.00. When reconciled with expenditure receipts totaling $30.00, 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 361-5534613. Respectfully Submitted, C c0jXLM0J Demi Cabrera Assistant Auditor Approved by: Cindy WL y Mu 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 PE96Y HALL CRISTINAT911ION 21 S. ITER OERIICARREIIA Candice 9Nlarreal PORT LAVACA TEMS71979 ERICA PERU 1RRSSISTANTAUOITOR TELEPHONE(36115534610EAX136115534014 ASSISTANT AUDITORS December 13, 2019 Dustin Jenkins EMS Director Calhoun County EMS 705 Henry Barber Way Port Lavaca, Texas 77979 Dear Mr. Jenkins, In accordance with Local Government Code Chapter 115 a cash count of your office funds was conducted on December 11, 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 your staff extended during the cash count. If you have any questions, please do not hesitate to contact me at 361-5534613. Respectfully Submitted, C&VfIJ Demi Cabrera Assistant Auditor Approved by: in�el��QX-�4/I� County Auditor cc: Judge Stephen Williams County Judge Richard Meyer County Commissioners Dan Heard, District Atty. Shannon Sayler, Asst. District Atty, Auditor's File CaRAlca Yillarrasl 1°ASSISTABiAaRQOR December 30, 2019 Honorable Bobbie Vickery Calhoun County Sheriff Calhoun County Courthouse 211 South Ann Street Port Lavaca, Texas 77979 Dear Sheriff Vickery: C 202 S. IR�RITE 8 PORTIAYACA,T=71919 TEEEPHONE (36115534610 FAN 136115534614 PE00Y NAEE CRIRi1NATOAEON REMICARRERA ERICA PERU in accordance with Local Government Code Chapter 115, a cash count of funds collected by the Adult Detention Center was performed on December 11, 2019. The cash drawer consists of an authorized sum of $100.00. The cash drawer count for outgoing Commissary funds totaled $62.19. When reconciled with the drawer receipts 2824 through 2835 for %M.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 $3,945.14. When reconciled with racelpt 11762 through 11773 totaling $3,900.13 and 1667 through 1669 totaling $45.00, the funds were found to have a net overage of $0.01; receipt #11764 was over $0.02 and receipt #11764 was short $0.01, All corrections have been made to make the Commissary account back in balance. If you have any questions, please do not hesitate to contact me at 361-553-0613. Respectfully Submitted, IOv Qom- ca.QvuLo Demi Cabrera Assistant Auditor Approved by: Cindy Mueller County Auditor cc: Judge Stephen Wllilams County Judge Richard Meyer County Commissioners Dan Heard, District Atty. Shannon Sayler, Asst District Atty, Michelle Velasquez, Jail Administrator Auditor's File PE09Y HALL CRISTINATUAZON 202 S ANN SOITE R ERICA PERU CANDICEYILIARREAL PORT LAVACA, TEARS 71079 DEMICA6RERA 1" ASSISTANT AUDITOR 7ELEPRONE136115584610FAX 13611553.4614 ASSISTANTAUDITORS January 22, 2020 Dustin Jenkins, EMS Director Calhoun County EMS Port Lavaca, Texas 77979 Dear Mr. Jenkins: An audit was recently conducted of the EMS Department for the period of January 1, 2019 thru December 31, 2019. I examined the reports, receipts, and supporting documentation for this period. I found nothing that would lead me to conclude that the balance and collections of your office for this period were not, in all material respects, appropriately charged, collected and remitted. I appreciate the cooperation extended by your staff during this audit. If you have any questions concerning the audit, please no not hesitate to contact me at (361) 553-4615. Respectfully Submitted, Cris o % C� Assistant Auditor Approved by: Cin�eller County Auditor cc: Judge Stephen Williams Judge Richard Meyer County Commissioners Sara Rodriguez, Asst. District Attorney Auditor's File C 202 5.11�91TE B BEMI CABREMA Candice1011arreal FORTIAVACA, TENAS71970 ERICA PEREZ 1°ASSISTANTRURITOR TELEPHONE 13611553,4610 FAX (36115534014 ASSISTANT AUDITORS December30,2019 Honorable Anna Kabela Calhoun County District Clerk Calhoun County Courthouse 211 South Ann Street Port Lavaca, Texas 77979 Dear Mrs. Kabela: In accordance with Local Government Code Chapter 115, a cash count of your office funds was conducted on December 17, 2019. Your petty cash fund consists of an authorized sum of $125.00: (5) cash drawer change funds with $20 each and (1) cash drawer change fund with $25. The cash count of your funds totaled $348.00 with credit card transactions totaling $671.00. After reconciling with receipts 30088 through 30091 totaling $894.00, 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 361-5534613. Respectfully Submitted, gnu w( Demi Cabrera Assistant Auditor Approved by: a" Cindy M Iler County Auditor cc: Judge Stephen Williams County Judge Richard Meyer County Commissioners Dan Heard, District Atty. Shannon Sayler, Asst. District Atty. Auditor's File Im OEMICABREAA PE®OYRALL 202SA UITEB CRISTINA TOUCH Candice Villarreal PORT LAVACA,TENAS71979 ERICAPERE2 1"ASSISTANTA6RffOR TELEPHONE (36115534610FU13611553-4614 ASSISTANT UPffORS December 13, 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 December 13, 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 361-5534613, Respectfully Submitted, � � h � � � t/��W `� �kil� Demi Cabrera Assistant Auditor Approved by: Cind� y M�Iler mil• 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 PE00TNRLL CRISTINATUAEON 202 S.1 UITE R nEMI CIIRRERA CandlCeVillanoal PORT LAVA04YEKAS71979 ERICAPEREI 1"ASSISTANTAUOITOR TELEPHONE 136115534610FAX 1311115534614 ASSISTANT AUDITORS December 13, 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 December 13, 2019. Your office has been authorized a petty cash fund of $50.00. The cash count of your office funds totaled $410.00 with credit card transactions totaling $1,570.00. When reconciled with receipts 229584 through 229602 totaling $1,980, the funds were found to be in balance with no exceptions noted. 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. Ressppecntf�u�ll1y_ Submitted, n� � "^ Ct�JJ�/�/ Demi Cabrera Assistant Auditor Approved by: �L Cindy M eller County Auditor Auditor's File cc: Judge Stephen Williams County Judge Richard Meyer County Commissioners Dan Heard, District Atty. Shannon Salyer, Asst. District Atty. Auditor's File Commissioners' COUrt—January 29, 2020 24. Consider and take necessary action on budget adjustments. 2019 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Clyde Syma, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese 2020 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: " Clyde Syma, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssv, Svma, Reese Page 22 of 23 a =- a v= WNW Z m M �_ Z W t m= m g m C Z= r z G) Zcn o Z= z w aE c�� � r 3E me a m 0= p G O= a a r= W p m= c C _ r n o o= =I e z m e N p = O Z O O C = D 3 O O m Z z N n N Z p m rn 0 y T = a n O = r r z W O'- o 000 ,rn m= m= o oOo z =_ � W� �= N N O (OT N1= W N N N O z fA 69 a� W a =- a v= m m= NOH T. 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Approval of bills and payroll. MMC RESULT: APPROVED [UNANIMOUS] MOVER: David Hall,' Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese County - 2019 RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct i SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese County - 2020 RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct I SECONDER: Vern Lyssy, Commissioner Pct 2 AYES Judge Meyer, Commissioner Hall, Lyssy, Syma, Reese Page 23 of 23 January 29, 2020 2020 APPROVAL LIST - 2019 BUDGET COMMISSIONERS COURT MELTING OF 01/29/20 BALANCE BROUGHT FORWARD FROM APPROVAL LIST REPORT PAGE 4 $4099.92 SOUTHERN HEALTH PARTNERS JAIL- COST POOL IDECEMBER A/P $ M92.57 TOTAL VENDOR DISBURSEMENTS: $ 515492.49 ✓ TOTAL AMOUNT FOR APPROVAL: $ 51,49149 January 29, 2020 i 4YdlElti'3:T$IVJIwWLjoKiFI1 BjBjH'OYII COMMISSIONERS COUR"C MEETING OF 01/29/20 BALANCE BROUGHT FORWARD FROM APPROVAL LIST REPORT PAGE 16 $3403570,31 FICA P/R $ 4%549.52 MEDICARE P/R $ 11,588.08 FWH P/R $ 355602,99 AFLAC P/R $ 3,169.86 NATIONWIDE RETIREMENT SOLUTIONS P/R $ 3,918.98 OFFICE OF THE ATTORNEY GENERAL - CHILD SUPPORT P/R $ 19309,00 PRINCIPAL FINANCIAL GROUP P/R $ 2,095.83 TMPA P/R $ 336.00 UNITED WAY OF CALHOUN COUNTY P/R $ 10,00 AT&T MOBILITY A/P $ 472,29 CAHOUN COUNTY GENERAL FUND 4TH QTR FEES AND FINES A/P $ 7,977,18 CALHOUN COUNTY CRIMESTOPPERS ANNUAL CONTRIBUTION TO EXPENSE A/P $ 1,000.00 CALHOUN COUNTY JUVENILE CASE 4TH QTR FEES AND FINES A/P $ 692.67 CALHOUN COUNTY SENIOR CITIZENS ANNUAL CONTRIBUTION TO EXPENSE A/P $ 355000,00 CALHOUN COUNTY SOIL & WATER CONSERVATION ANNUAL CONTRIBUTION A/P $ 7,750.00 FRONTIER COMMUNICATIONS A/P $ 269.15 MCI COMM SERVICE A/P $ 29.34 SPARKLIGHT A/P $ 14.45 STATE COMPTROLLER 4TH QTR FEES AND FINES A/P $ 845297,23 THE HARBOR CHILDREN'S ALLIANCE ANNUAL CONTRIBUTION TO EXPENSE A/P $ 28,500,00 WHITE TRASH SERVICES A/P $ 1,782.20 TOTAL VENDOR DISBURSEMENTS: $ 615,935.08 I TOTAL AMOUNT FOR APPROVAL: $ 615,935.08 �' g o o o0 00 ro �°0 O zg 'yz 0 n a a z� z� s o Hy o 0pp 0 0 4 A N N A N A o O O O I ^r pG H O S S S S N N N ii H TT.. 777...��� �aff ffGG n rim cgnq^m e^m to m O O O o 0 r O Chi 0 rysO.r k O 0 6 < g o p� z a a a o D m o a a a<n 0 >� >°> r r r 2 m m t lcyi ,G � H p H p N N N O O O O c d b J A A W Om m m m rp O0 rO O m Dm m H C o3 3 3 mN ma pe D z v3 i o cngC D W mW yn yn n< C W O y� Q izy n m tri z O Z w Y z p n M x x Q A N w p Ap p O O pJ N N a 0 �y d7o °10 �� �� � mDz � C7 l7 � n H H o A p M O a � � � � u u A � O O O O O O 8 � � � � � 'd y y N N (yC/� EGA Q � � � � S r r r r r r cri � � cri � � N � � � r � � u 3, a Q T O. rn tT (� b W � � p �pO C H P a P Q O� �P ;v 7As A A 7Ar m ;Av o t*r1� � W h1 b7 � W z W � W .Z.'Co ��� �w r� �� -'FIS �� �w o� � � � � � � "' `" o o � o e� A F � F A A O a VAi � N N � � � N O� w b O O •-• N N •+ � A cam^ m g o � r O O O NN N N'p NN"9 °z °z °z A P �� O `O O ��Fy �' G �' Z Ti � A � c`dB b V a w Nr Nr Nr H [� Cm �� �" A � n � n � o z a �'� �� �j °z� °zw °z� � a as �� g• [� � � � in' N T b N ei 0 S. r Fa°. 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MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR -- Janaury 29, 2020 TOTAL PAYABLES, PAYROLL AND ELECTRONIC BANK PAYMENTS $ 306,258.76 TOTAL TRANSFERS BETWEEN FUNDS $ 261,995.16 TOTAL NURSING HOME UPL EXPENSES '$ 1,013,492.55'; TOTAL INTER -GOVERNMENT TRANSFERS $ 309,009.34 GRANQ TOTAL DISBURSEMENTS APPROVED January 29, 2020 $ 1,890,755.81 i MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---January 29, 2020 1/23/2020 Weekly Payables 293,037.71 1/27/2020 Building Kid Steps -Speech Therapy 13450,00 1/27/2020 McKesson-340B Prescription Expense 6,366.48 1/27/2020 Amerisource Bergen-340B Prescription Expense 3,002.05 Prosperity Electronic Bank Payments 1/21-1/2312020 Credit Card & Lease Fees 769.32 1/21/2020 Sales Tax for December 2019 11550,97 1/22-1/24/2020 Pay Plus -Patient Claims Processing Fee 82,23 TOTAL PAYABLES, PAYROLL AND ELECTRONIC BANK PAYMENTS ' $ 306,258.76: TRANSFER BETWEEN FUNDS -NURSING HOMES 1/23/2020 MMC Operating to Ashford -Medicare Recoup 30,457.31 1/23/2020 MMC Operating to Solera-Medicare Recoup 89,365,37 1/23/2020 MMC Operating to Fortbend-Medicare Recoup 13,605,35 1/23/2020 MMC Operating to Broadmoor-Medicare Recoup 63,857,90 1/23/2020 MMC Operating to The Crescent -Medicare Recoup 31,132,57 1/23/2020 MMC Operating to Golden Creek Healthcare -Medicare Recoup 330576.66 TOTAL TRANSFERS BETWEEN FUNDS $ 261,995416 NURSING HOME UPL EXPENSES 1/27/2020 Nursing Home UPI-Cantex Transfer 696,456.67 1/27/2020 Nursing Home UPI-Nexion Transfer 92,916.83 1/27/2020 Nursing Home UPI -HMG Transfer 194,132.43 Nursing Home Electronic Bank Payments 1/23/2020 Ashford -Harland Clarke Ached from wrong account 15,54 1/23/2020 Solera-Harland Clarke order ACHed from wrong account 15,54 QIPP/INTEREST/RECOUP CHECKS TO MMC 1/27/2020 Ashford 12,233.96 1/27/2020 Broadmoor 4,395.98 1/27/2020 Crescent 31785,98 1/27/2020 Fort Bend 4,998.96 1/27/2020 Solera 4,540,66 TOTAL NURSING HOME UPL EXPENSES :' $ 110132492465' INTER -GOVERNMENT TRANSFERS 1/27/2020 IGT DY9 UC to be paid on 02/05l2020 309,009.34 TOTAL INTER -GOVERNMENT TRANSFERS $ 309,009.34 GRAND TOTALDISBURSEMENTS APPROVED January 29, 2020 $ 1,890,755.81' E JAPE 2 3 2020 1v'rcll2elttikl F23yp(9pp� 1@sd`��.-}may, MEMORIAL MEDICAL CENTER 10:25 AP Open Invoice List Due Dates Through: 02/05/2020 Vendor# Vendor Name / Class Pay Code A0401 ABBOTT NUTRITION cd Invoice# /Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 611539787%/ 01/16/20 12/18/20 01/16/20 11.58 SUPPLIES Vendor Total: Number Name Gross A0401 ABBOTT NUTRITION 11,58 Vendor# Vendor Name Class Pay Code 11283 ACE HARDWARE 15521 c// Invoice# / Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 140946 ✓ 12/30/20 01/06/20 01/31/20 2.79 0 ap_open_invoice.lemplate Discount No -Pay SUPPLIES 140995 01/14/20 01/07/20 02/01/20 30,96 0.00 SUPPLIES 141016 01/14/20 01/08/20 02/02/20 14,99 0.00 0.00 / SUPPLIES 141050 ✓ 01/15/20 01/09/20 02/03/20 26-99 0,00 0.00 SUPPLIES Vendor Total: Number Name Gross Discount No -Pay 11283 ACE HARDWARE 15521 75,73 0.00 0.00 Vendor# Vendor Name Class Pay Code A1680 AIRGAS USA, LLC - CENTRAL DIV M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 9096641673� 01/21/20. 12/31/2001/30/20 2,183.26 0.00 0,00 OXYGEN 9967662281 ✓ 01/21/20 12/31/20 01/30/20 653.05 0.00 0.00 OXYGEN 9967562279� 01/21/20 12/31120 01130120 498,23 0.00 0,00 OXYGEN 9967662282 `/ 01121/2012131/20 01/30/20 77,31 0.00 0.00 OXYGEN Vendor Total: Number Name Gross Discount No -Pay A1680 AIRGAS USA, LLC -CENTRAL DIV 3,411.85 0.00 0.00 Vendor# Vendor Name / Class Pay Code 10958 ALLYSON SWOPE d Invoice# Comment Tran Dt Inv Dt Due Dt Check D* Pay Gross Discount No -Pay 012120 01/21/20 01/21/20 01/21/20 21252,25 0.00 0,00 CONTRACT EMPLOYEE li �ttlr2vpo-iJIUJIa2oi Vendor Totals Number Name Gross Discount No -Pay 10958 ALLYSON SWOPE 20252,25 0.00 0.00 Vendor# Vendor Name Class Pay Code A1746 ALPHA TEC SYSTEMS INC ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay INV00081654 01/20120 12/17/20 12/27/20 160.51 0,00 0.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay A1746 ALPHA TEC SYSTEMS INC 160.51 0.00 0.00 Vendor# Vendor Name Class Pay Code Page 1 of 14 Net 11.58 2.79 / ✓ Net 11.58 Net � 14.99 Y 26.99 Net 75.73 Net 2,183.26 /� 653.05 ✓ 498.23 77.31 Net 3,411.85 Net 2,252.25 Net 2,252.25 Net 160.51 ✓ Net 160.51 Page 2 of 14 10730 AMERICAN COLLEGE OF RADIOLOGY y/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 200689202024809 01/21/20 01/06/20 01106/20 11299.00 0.00 0,00 1,299.00 REPORTING FEE (41MhuJL� Vendor Totals. Number Name Gross Discount No -Pay Net 10730 AMERICAN COLLEGE OF RADIOLOGY 11299.00 0.00 0.00 1,299.00 Vendor# Vendor Name Class Pay Code 81150 BAXTER HEALTHCARE ✓ W Invoice# pomment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 65304655 01/21/20 12/21120 01/15/20 629.50 0.00 0.00 629.50 EASE 65304758 01/21/2012/24/2001/18/20 2,367.50 0,00 0,00 21367.50 LEASE Vendor Total: Number Name Gross Discount No -Pay Net B1150 BAXTER HEALTHCARE 2,997.00 0,00 0.00 21997.00 Vendor# Vendor Name Class Pay Code B1220 BECKMAN COULTER INC M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 108185811 01/13/20 01/06/20 01/31/20 11995.61 0.00 0.00 11995.61 ✓ SUPPLIES / 108184489 � 01/13/20 01/06/20 01/31/20 11306.89 0.00 0.00 11306,89 r! SUPPLIES / 7263463 ✓ O1/13/20 01/06/20 01/31/20 51004.94 0.00 0.00 51004.94 I/ SS PPLIES . / 108186485 ✓ 01/13/20 01/06/20 01/31/20 11002.30 0.00 0,00 1 t002,30 vo SUPPLIES / 108185653✓ 01M3/2001/0612001/31/20 51143,62 0,00 0,00 51143,62 / 108186441 S)1PPLIES 01/13/2001/06/2001/31/20. 130.08 0.00 0.00 130.08 t� SUPPLIES / 108186617✓ 01113/20 01106/20 01/31/20 140.00 0,00 0,00 140.00r SUPPLIES 108185412v1 01/13/20 01/06/20 01/31/20 225,44 0.00 0.00 225,44 ✓ SUPPLIES 108184922 01/13/20 01/06/20 01/31/20 397,50 0.00 0,00 397,50 SUPPLIES 108187448 01/13/20. 01/07/20 02/01/20 11462.38 0.00 0,00 11462.38 SUPPLIES 108185438 ,/ 01/22/2001/03/2001/28/20 747.74 0.00 0.00 747.74 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net B1220 BECKMAN COULTER INC 17,556.50 0.00 0.00 171556.60 Vendor# Vendor Name Class Pay Code B1800 BRIGGS HEALTHCARE M Invoice# /Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net B263682 V 01/20/20. 01/06/20 02/05/20. 162,20 0,00 0,00 162.20 SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net B1800 BRIGGS HEALTHCARE 162.20 0.00 0.00 162.20 Vendor# Vendor Name Class Pay Code 11224 CABLES AND SENSORS v/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net Page 3 of 14 82567 01/21/20 12/19/20 01/19/20 154.00 0.00 0,00 154.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net 11224 CABLES AND SENSORS 154.00 0.00 0.00 154.00 Vendor# Vendor Name Class Pay Code C1325 CARDINAL HEALTH 414, INC. W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 8001799856 / 01/20/20. 11/17/2001/20/20 134.43 0.00 0,00 134.43 SUPPLIES 8002035085 01/20120 09/07/20 10/02/20 180.57 0,00 0.00 180.57 ✓ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net C1325 CARDINAL HEALTH 414, INC. 315.00 0,00 0.00 315.00 Vendor# Vendor Name Class Pay Code / 13028 CAVALLO ENERGY TEXAS LLC ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net B1909300706 V11 01/16/20. 09130/2001/16/20 17,35 0,00 0.00 17.36 ELECTRIC BILL ACCT. 521900' 131909300705✓ 01/16/20. 09130/2001/16/20 5.35 0.00 0.00 5.35 ✓ ELECTRIC BILL ACCT. 521900' / 81909300704 v01/16/20 09/30/20 01/16120 42,72 0,00 0.00 42.72 y ELECTRIC BILL ACCT. 521900' / B1909300703 ✓ 01/21/20. 09/30/2001/21/20 321.77 0.00 0.00 321,77 ✓ ELECTRIC Vendor Totals Number Name Gross Discount No -Pay Net 13028 CAVALLO ENERGY TEXAS LLC 387.19 0.00 0.00 387,19 Vendor# Vendor Name / Class Pay Code 11030 COMBINED INSURANCE >,/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 010120 01/20/20 01/01/20 01/01/20 877.94 0,00 0,00 877.94 INSURANCE Vendor Totals Number Name Gross Discount No -Pay Net 11030 COMBINED INSURANCE 877,94 0.00 0.00 877.94 Vendor# Vendor Name / Class Pay Code R1050 CULLIGAN OF VICTORIA M Invoice# CommentTran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 1430270312312019 V 01/22120 12/31120 01/25/20 190.00 0.00 0.00 190.00 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net R1050 CULLIGAN OF VICTORIA 190,00 0,00 0.00 190.00 Vendor# Vendor Name Class Pay Code 10368 DEWITT POTH & SON Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 5945340 �/ 01/15/20 01/06/20 01/31/20 30.98 0.00 0.00 30.98 ✓ SUPPLIES 5944640 v1 01/15/20 01/06/20 01/31/20 80,90 0,00 0,00 80.90 w/ SUPPLIES 6944620 v/ 01/15/20 01/06/20 01/31120 3.59 0.00 0,00 3,59 SUPPLIES 5945510 e/ 01/15/20 01/06/20 01/31/20 523.58 0.00 0.00 523.58 SUPPLIES Page 4 of 14 5944630� 01/15/2001/0612001/31/20 27,21 0.00 0.00 27.21 / SUPPLIES / 5945150 ✓ 01/15/20 01/06/20 01/31/20 152.24 0,00 0.00 152.24 / SUPPLIES / 5947680 01/15/20 01/07/20 02/01/20 100.70 0.00 0.00 100.70 ✓ SUPPLIES / 6947810 v1 01 /15/20 01/07/20 02/01/20 20.07 0.00 0,00 20.07 y/ /SUPPLIES 5951370 ✓ 01/20/20 01/10/20 02/04/20 155,15 0.00 0.00 165.15 SUPPLIES 5939400 ✓/01/23/20 11/29/20 12/24/20 523.93 0,00 0.00 523.93 ADDITIONAL IMAGES . Vendor Totals Number Name Gross Discount No -Pay Net 10368 DEWITT POTH & SON 1,618.35 0.00 0,00 11618.35 Vendor# Vendor NameClass Pay Code C2510 EVIDENT ✓/ M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / A2001071378 J 01/20/20 01/07/20 02/01/20 17,255.00 0.00 0.00 17,255.00 ✓ SUPPORT/MONTHLY SUBSCR Vendor Total: Number Name Gross Discount No -Pay Net C2510 EVIDENT 17,255.00 0.00 0.00 17,255.00 Vendor# Vendor Name Class Pay Code 10689 FASTHEALTH CORPORATION Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 01A20MMC✓ 01/21/2001101/2001/16/20. 495.00 0,00 0,00 495,00 WEBSITE Vendor Total: Number Name Gross Discount No -Pay Net 10689 FASTHEALTH CORPORATION 495,00 0.00 0.00 495.00 Vendor# Vendor Name / Class Pay Code F1400 FISHER HEALTHCARE M Invoice# /. Comment Tran Dt Inv Dt Due Dt Check D, Pay Gross Discount No -Pay Net 6330536 ./ 01/17/20. 01/02/2001/27/20 116.00 0.00 0.00 116.00 ✓ SUPPLIES 6330527 01/17/2001/02/2001/27/20 31240,29 0.00 0.00 31240,29 /SUPPLIES / 6404516 ✓ 01/17/20 01/03/20 01/28/20 560,68 0,00 0,00 560,68 r/ / SUPPLIES 6507226 01/17/20 01/06/20 01/31/20 1,299.34 0,00 0.00 1,299.34� /SUPPLIES / 6633580 ✓ 01/17/20 01/07/20 02/01/20 426.81 0.00 0.00 426.81 SUPPLIES 6633579 01/17/20 01107/20 02/01120 177,95 0.00 0,00 177.95 SUPPLIES 3633794 ✓ 01/20/20 11/18/20 12/13/20 59.00 0,00 0,00 69,00 SUPPLIES 4756463 v1 01/20/20 12/03/20 12128/20 17,374,67 0.00 0,00 17*374.67 SUPPLIES 5118551 01/20/20 12/05/20 12/30/20 448.92 0.00 0.00 448.92 /SUPPLIES 6611947 ✓ 01/20/20. 12111/2001/05/20 1$19.89 0,00 0.00 1,319.89✓ / SUPPLIES 6698700 01/20/20 12/12/20 01/06/20 1,883.25 0,00 0,00 11883.25 r/ Page 5 of 14 SUPPLIES 5747668 01120/20 12/13/20 01/07/20 270,19 0.00 0.00 270.19,/ /SUPPLIES 5972475 r/ 01/20/20. 12/19/20 01/13/20 10,218.98 0,00 0.00 10,218.98 /SUPPLIES 6133513 V 01/20/20 12126/20 01/20/20 51854.24 0.00 0.00 51854.24 SUPPLIES Vendor Total: Number Name Gross Discount No -Pay Net F1400 FISHER HEALTHCARE 43,250.21 0.00 0.00 43,250.21 Vendor# Vendor Name / Class Pay Code 12948 GREAT AMERICAN FINANCIAL SVCS ✓ Invoice# omment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 26232672 v 01/14/20 01/06/20 01/31/20 91575.84 0.00 0.00 9,575.84 ✓ Vendor Total: Number Name Gross Discount No -Pay Net 12948 GREAT AMERICAN FINANCIAL SVCS 91675.84 0.00 0.00 9,575.84 Vendor# Vendor Name Class Pay Code / G1210 GULF COAST PAPER COMPANY �/ M Invoice# Comment Tran Dt Inv Dt Due Dt Check Dr Pay Gross 1776693 01/20/20. 12/03/2001/02/20 500.94 /SUPPLIES 1788366 ✓ 01/20/20 12/31/20 01/30/20 23.79 SUPPLIES / 1734529 ✓ 01/21/20. 09/16/20 10/16/20 96,25 Discount No -Pay Net 0.00 0,00 500.94 0.00 0,00 23.79 e/ 0.00 SUPPLIES 1737559 � 01/21/20 09/20/20 10/20/20 192.50 0.00 /SUPPLIES 1738116 to O1/21/20 09/23/20 10/23/20 96.25 0,00 /SUPPLIES 1739234 �/ 01/21/20 09/24/20 10124l20 42.00 0.00 SUPPLIES 1739967V1 01/21/20 09/25/20 10/25/20 -25.28 0,00 0.00 96.25 es 0.00 192.50 0.00 96.25 0.00 42.00 ✓ 0.00 -25.28 ✓ / CREDIT 1751442 � 01/21/20. 10/15I2011114/20 32.00 0.00 0.00 SUPPLIES Vendor Total: Number Name Gross Discount No -Pay G1210 GULF COAST PAPER COMPANY 958,45 0,00 0.00 Vendor# Vendor Name Class Pay Code / 10334 HEALTH CARE LOGISTICS INC ./ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 307415603�/ 0112012001/06/2001/31/20. 136.55 0.00 0,00 SUPPLIES Vendor Total; Number Name Gross Discount No -Pay 10334 HEALTH CARE LOGISTICS INC 136,55 0,00 0.00 (endor# Vendor Name Class Pay Code 12380 HEALTH SOLUTIONS DIETETICS Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 012020 01/20/20 01/20/20 01/20/20 3,000.00 0.00 0.00 DIETICIAN <'103- ijSSjU1Q) Vendor Total: Number Name Gross Discount No -Pay 12380 HEALTH SOLUTIONS DIETETICS 31000.00 0.00 0.00 32.00 Net 958.45 Net 136.55 Net 136.55 Net / 3,000.00 t� Net 3,000.00 Page 6 of 14 Vendor# Vendor Name Class Pay Code 11552 HEALTHCARE FINANCIAL SERVICES Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 100252127 ,/ 01/15/20 12128/20 02/01/20 3,227.85 0.00 0.00 31227.85 r/ P/HONESYSTEM It1It(lbI g51.0q 100258369 ✓ 01/21/20 01/08/20 02/01/20 4,919.41 0.00 0.00 41919,41 LEASE iAl((LV LI7%a6 100258370 ✓ 01/21120 01/08/20 02/01/20 7,154.17 0,00 0,00 71154.17>S LEASE 100258372 01/21/20 01/08/20 02/01/20 11797.44 0.00 0.00 11797,44 LEASE IkVtjt&.{ �05,l3 ✓ 100258371 011211/2001/08,/`2002/01/20 71447.86 0.00 0.00 71447.86 t/ LEASE J&JUt6l %b�j.(-1' . Vendor Totals Number Name Gross Discount No -Pay Net 11552 HEALTHCARE FINANCIAL SERVICES 24,546,73 0,00 0,00 24,546.73 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 2350317 V/! 01/14/20 01/03/20 02103/20 160.00 0.00 0,00 160.00 ✓ EPIDRUAL PUMP BATTERY Vendor Totals Number Name Gross Discount No -Pay Net 12196 ICU MEDICAL, INC 160.00 0.00 0,00 160,00 Vendor# Vendor Name Class Pay Code 11285 ITA RESOURCES INC ✓/ Invoice# comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net MMC12020 01/14/2001/1312001/13/20. 24,042.46 0,00 0,00 24,042.45 RESP SERVICES . Vendor Totals Number Name Gross Discount No -Pay Net 11285 ITA RESOURCES ING 24,042.45 0.00 0.00 24,042.45 Vendor# Vendor Name Class Pay Code J0150 J & J HEALTH CARE SYSTEMS, INC Invoice# Co ment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 921831570 ✓m 01/20/20 12/24/20 01/23/20. 419,34 0,00 0.00 419.34 �✓ SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net J0150 J & J HEALTH CARE SYSTEMS, INC 419.34 0.00 0.00 419.34 Vendor# Vendor Name Class Pay Code 11600 LEGAL SHIELD Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 011520 01/20/20 01/16/20 01/15/20. 11419.80 0.00 0,00 11419,80 ✓ PAYROLLDED Vendor Totals Number Name Gross Discount No -Pay Net 11600 LEGAL SHIELD 11419,80 0.00 0.00 11419.80 Vendor# Vendor Name Class Pay Code 10972 M G TRUST Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 122019 01/20/2012/20/2001116/20. 1,190.86 0.00 0,00 11190,86 PAYROLLDED 010620 01/20120 01/06120 01/06/20 1,190.86 0,00 0,00 1,190.86 PAYROLLDED Vendor Totals Number Name Gross Discount No -Pay Net 10972 M G TRUST 21381.72 0,00 0,00 2,381.72 Page 7 of 14 Vendor# Vendor Name Class Pay Code 11612 MASA GLOBAL BUILDING / Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 011620 01/20/20 01/16120 01/16/20 10678.00 0.00 0,00 11678.00 INSURANCE Vendor Totals Number Name Gross Discount No -Pay Net 11612 MASA GLOBAL BUILDING 11678,00 0.00 0.00 1,678.00 Vendor# Vendor Name Class Pay Code M2178 MCKESSON MEDICAL SURGICAL INC V// Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 70967925 f 01120/20 12/06/20 12/21/20 255,48 0,00 0.00 255,48 SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net M2178 MCKESSON MEDICAL SURGICAL INC 255,48 0.00 0.00 255,48 Vendor# Vendor Name Class Pay Code M2310 MEDELA INC v1 M Invoice# /Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net / 12504176 ✓ 01/20/2012/11120 12/27/20 284,80 0.00 0.00 284,80 f SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net M2310 MEDELA INC 284,80 0,00 0.00 284,80 Vendor# Vendor Name Class Pay Code 12588 MEDICAL TECHNOLOGY ASSOCIATES Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net INV165779 01/20/20 12/31/20 01/25/20 715.72 0,00 0.00 715.72 FIX VACCUM INLET FOR SUR0 6AI Vendor Totals Number Name Gross Discount No -Pay Net 12588 MEDICAL TECHNOLOGY ASSOCIATES 715.72 0.00 0.00 715.72 Vendor# Vendor Name / Class Pay Code 10613 MEDIMPACT HEALTHCARE SYS, INC. A/P Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 011520 01/21/20. 01/15/20 01/15/20 259.91 0.00 0.00 259,91 INDIGENT CARE Vendor Totals Number Name Gross Discount No -Pay Net 10613 MEDIMPACT HEALTHCARE SYS, INC. 259.91 0,00 0.00 259.91 Vendor# Vendor Name Class Pay Code M2827 MEDIVATORSv// M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 90373440 01/20120 12/18/20 01/08/20 446.82 0.00 0,00 446,82� SUPPLIES Vendor Totals Number Name Gross Discount No -Pay Net M2827 MEDIVATORS 446,82 0.00 0,00 446.82 Vendor# Vendor Name Class Pay Code M2470 MEDLINE INDUSTRIES INC M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 1897122135 01/17/20 12/31/20 01/25/20 338.86 0.00 0,00 338,86 SUPPLIES 1897122134 / 01 /17/20 12/31/20 01125/20 165.82 0.00 0.00 165.82 f SUPPLIES 1897122146 ✓ 01117/20 12/31/20 01/25/20 21871,15 0.00 0,00 2,871.15 SUPPLIES 61 E 1897122139 ✓ 01/17/20 12/31/20 01/25/20 751.06 0.00 0.00 751.06 SU/APLIES 1897122140 ✓ 01/17/20 12/31/20 01/25/20 11.46 0.00 0,00 11,46 WZ SUPPLIES / 1897371607 ✓ 01/17/20 01/03/20 01/28/20 59,26 0.00 0,00 59,26 SUPPLIES 1897371605 �/ 01/17/20 01/03/20 01/28/20 217.80 0.00 0,00 217.80 SUPPLIES 1897743272 01/17/20 01/07/20 02/01/20 46.54 0.00 0.00 46,54 SUPPLIES 1897743271 ✓ 01/17/20 01/07/20 02/01/20 4.59 0,00 0.00 4.59 SU PLIES 1897773189 01/17/20 01/07/20 02/01/20 62.00 0.00 0,00 62.00 SUPPLIES 1897743274 ✓ 01/17/20 01/07/20 02/01/20. 31,08 0.00 0,00 31.08 SUPPLIES 1897799245 ✓/ 01/17/20 01/O8/20 02/02/20 56.22 0.00 0.00 56.22 t/ SUPPLIES 1897799236 ✓ 01/17/2001/08/2002102/20. 309.89 0,00 0,00 309.89 SU PLIES / 1897799235 01/17/20 01/08/20 02/02/20 380.54 0,00 0.00 380.54 ✓ SUPPLIES 1897799243 / 01/17/20 01/08120 02/02/20 13141.18 0.00 0.00 1,141.18 � SUPPLIES 1897799240 01/17/20 01/08/20 02/02/20 61365.19 0,00 0.00 61365,19 SUPPLIES 1897799233 01/17/20 01/08/20 02102/20. 3,64 0.00 0.00 3,64 SUPPLIES 1897799244✓ 01/17/20. 01/0812002/02/20. 33,19 0.00 0.00 33.19� SUPPLIES 1897962984�/ 01117/20 01/09/20 02/03120 368,05 0.00 0,00 368,05 SUPPLIES 1897962985L// 01/17/20 01/09/20 02/03/20 27,23 0.00 0.00 27.23 SU PLIES / 188826164801/20120 09/26120 10121/20 19.55 0,00 0.00 19.65 SUPPLIES / 1893375090/ 01/20/2011/19/2012/14/20 38.29 0,00 0.00 38.29✓ SUPPLIES 1893610855 m/ 01/20/20 11/21/20 12/16/20 51,92 0.00 0.00 51,92 r/ SUPPLIES 1893824749 01/20120 11/22/20 12/17/20 78.73 0.00 0.00 78.73 SUPPLIES 1893824732 01/20/20 11/22/20 12/17120 75.66 0,00 0.00 75.66 SUPPLIES 1897743273 v1 01/20/20 01/07/20 02/01/20 173.51 0,00 0,00 173,51� SUPPLIES 1895980629,ol 01/21/2012/17/2001/11/20. 64.26 0.00 0,00 64.26 y% SUPPLIES Vendor Total<Number Name Gross Discount No -Pay Net M2470 MEDLINE INDUSTRIES INC 13,746,67 0.00 0,00 13,746.67 Vendor# Vendor Name / Class Pay Code ✓ 10963 MEMORIAL MEDICAL CLINIC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount 122019 01/20/20 12/20/20 12/20/20 355,64 0.00 PAYROLL DED 010620 01/20/2001/06/2001106/20 455.63 0,00 PAYROLLDED Vendor Totals Number Name Gross Discount 10963 MEMORIAL MEDICAL CLINIC 811.27 0.00 Vendor# Vendor Name Class Pay Code M2659 MERRY X-RAY/SOURCEONE HEALTHCA i/M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount 8800549755 11/30/20 11125/20 02101/20 -887.60 0.00 CREDIT 8800549754r/ 11/30/20 11/26/20 02/01/20 -9,422.20 0.00 CREDIT 8800537625 ✓ 01/20/20 10/30/20 11/29/20 9,970.47 0.00 SUPPLIES / 8800544216 Y 01/20/20 11/12120 12/12/20 338,23 SUPPLIES 8800547037 01/20/2011/19/2012/19/20 480.14 SUPPLIES 8800549756 v 01/20/20 11/25/20 12/25/20 927.10 SUPPLIES 8800549757 ✓ 01/20/20 11/26/20 12/25120 95,48 SUPPLIES Vendor Totals Number Name Gross M2659 MERRY X-RAY/SOURCEONE HEALTHCA 1,501.62 Vendor# Vendor Name Class Pay Code t 1976 MID -COAST ELECTRIC SUPPLY, INC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 185123800 ri 01/21/2009/06/2010/06/20 308,00 S�PPLIES 185154100✓ 01/21/20 09124/20 10/24/20 310,00 SUPPLIES 187366600 t/ 01121/20 12/16/20 01/16/20 45.00 SUPPLIES Vendor Totals Number Name Gross 11976 MID -COAST ELECTRIC SUPPLY, INC 663,00 Vendor# Vendor Name Class Pay Code / M2621 MMC AUXILIARY GIFT SHOP ✓ W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 011620 01/16/20 01/16/20 01/31/20 165.00 PAYROLLDEDUCT Vendor Totals Number Name Gross M2621 MMC AUXILIARY GIFT SHOP 165.00 Vendor# Vendor Name Class Pay Code M2662 MMC VOLUNTEERS ✓ W Invoice# Tran Dt Inv Dt Due Dt Check D Pay Gross /Comment 395167 t/ 01/21/20 12/02120 12102120 127.89 CC MACHINE Vendor Totals Number Name Gross M2662 MMC VOLUNTEERS 127.89 ay ay VIVO VIVO No -Pay VIVO No -Pay VIVO VIVO o.00 VIVO VIVO VIVO VIVO Discount No -Pay VIVO VIVO Discount No -Pay VIVO VIVO VIVO VIVO VIVO VIVO Discount No -Pay o.00 o.00 Page 9 of 14 Net 355.64 455.63 Net 811.27 Net 0✓ -887.6 -9,422.20 t/ 9,970.47 /� 338.23 ✓ 480.14 927.10 Net 1,501.62 Net 308.00 ✓ 310.00 45.00 ✓ Net 663.00 Discount No -Pay Net VIVO VIVO 165.00 Discount No -Pay Net VIVO 0,00 165.00 Discount No -Pay Net VIVO VIVO 12Z89 Discount No -Pay Net VIVO VIVO 127.89 Page 10 of 14 Vendor# Vendor Name Class Pay Code 10536 MORRIS & DICKSON CO, LLC / Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 5117889/ 01/20/20 01/13/20 01/23/20 11904,01 0.00 0,00 11904.01 r// INVENTORY 5117888 V// O1/20/20 01/13/20 01/23/20 602.75 0,00 0,00 602.75 /INVENTORY 5115550✓ 01/20/20 01/13/20 01/23/20 435.94 0.00 0.00 435.94 /INVENTORY 5117890 Y 01/20/20 01/13/20 01/23/20 1,285.36 0.00 0.00 11285.36 INVENTORY 6588 01/20/20 01114/20 01/24120 -44.94 0.00 0.00 -44.94 /CREDIT 5123934 v 01/20/20 01/14/20 01/24/20. 46.74 0.00 0.00 45.74 /INVENTORY 5122777✓ 01/2012001/14/2001/24/20. 686A2 0,00 0.00 686,12 ✓ / INVENTORY 6624d 01/20/20 01/14/20 01/24/20 -8,82 0.00 0.00-8.82)/ /CREDIT / 5123932 ✓ 01/20/20 01/14/20 01/24/20 131.28 0.00 0.00 131.28 r/ INVENTORY / 6567✓ 01/20/20 01/14/20 01/24/20 -12.89 0.00 0,00 -12,89 r/ CREDIT 5123933 01/20/20 01/14/20 01/24120 11066.61 0,00 0,00 1,066,61 /INVENTORY 5130028 ./ 01120/2001115/2001/25/20. 706.28 0.00 0,00 706,28 /INVENTORY 5130029 01120/2001/15/2001/25/20. 15.40 0.00 0.00 15,40 r /INVENTORY 5130027 ✓ 01/20/20 01/15/20 01/25/20. 380.02 0.00 0,00 380,02 /INVENTORY 5132692 ✓ 01/20/20. 01/16/20 01/26/20 406.36 0,00 0,00 406.36 .� INVENTORY 5132693 ✓ 01/20/20. 01/16/20 01/26/20 41773,09 0.00 0.00 41773.09 r,✓ INVENTORY 5132694 01/20/20 01/16/20 01/26/20. 297,08 0.00 0.00 297.08 ✓ INVENTORY Vendor Total; Number Name Gross Discount No -Pay Net 10536 MORRIS & DICKSON CO, LLC 12,669.39 0.00 0.00 120669,39 Vendor# Vendor Name / Class Pay Code 13012 McCALL AND LEE, LLC ✓ Invoice# /Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 065409A✓ 01/21/20 01/20/20 01/31/20 12,187.50 0,00 0,00 12,187.50 1/2 RECRUITING FEE APRIL Kttib«►A, Pkj'yt LitI ILL"isl Vendor Total: Number Name Gross Discount No -Pay Net 13012 McCALL AND LEE, LLC 12,187.50 0,00 0,00 12,187.50 Vendor# Vendor Name / Class Pay Code A2252 NADINE GARNER W Invoice# Comment Tran Dt Inv Dt Due Dt Check U Pay Gross Discount No -Pay Net 012020 01/21/20 01/20/20 01/20/20 31.51 0.00 0,00 31.51 TRAVEL AREA IF NURSES ME Vendor Total; Number Name Gross Discount No -Pay Net Page 11 of 14 A2252 NADINE GARNER 31.51 0,00 0.00 31.51 Vendor# Vendor Name / Class Pay Code 01500 OLYMPUS AMERICA INC M Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 98535910v/ 01/20/20 12/05/20 12/30/20 11026.79 0.00 0.00 11026.79 ✓/ /SUPPLIES / 98687950 ✓ 01/20/20 01/07/20 02101/20 11137.51 0,00 0.00 1,137.51 SERVICE CONTRACT Vendor Totals Number Name Gross Discount No -Pay Net 01500 OLYMPUS AMERICA INC 21164,30 0.00 0.00 21164.30 Vendor# Vendor Name Class Pay Code 11069 PABLO GARZA VI Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 012120 01/21/20 01/21/20 01/21/20 2,608.13 0.00 0.00 21608.13 >✓ CONTRACT EMPLOYEE I - j �(pW W) , Vendor Totals Number Name Gross Discount No -Pay Net 11069 PABLO GARZA 2,608.13 0.00 0,00 21608.13 Vendor# Vendor Name Class Pay Code 11142 PAETEC(WINDSTREAM) 1// Invoice# /Cymment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net ✓ 72112477 12/30120 12/22/20 01/31/20 11,108.82 0.00 0.00 11,108.82 PHONES Vendor Totals Number Name Gross Discount No -Pay Net 11142 PAETEC (WINDSTREAM) 11,108.82 0.00 0.00 11,108.82 Vendor# Vendor Name Class Pay Code 11155 PARA ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 6024 f 12130/20 01/01/20 01/31/20 2,000.00 0.00 0,00 21000,00✓ REVENUE INTEGRITY PROGR Vendor Totals Number Name Gross Discount No -Pay Net 11155 PARA 2,000.00 0,00 0.00 26000,00 Vendor# Vendor Name Class Pay Code P1971 PORT LAVACA FORD f Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 010820 01/16/20 01/08120 01/31/20 22,209.20 0.00 0.00 22,209.20 PURCHASE 2019 FORD EDGE Vendor Totals Number Name Gross Discount No -Pay Net P1971 PORT LAVACA FORD 22,209.20 0.00 0.00 22,209.20 Vendor# Vendor Name Class Pay Code S1001 SANOFI PASTEUR INC v1 W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 913755896 ✓ 11/25/20 11/06120 02/04/20 4,206.64 0.00 0,00 41206.64 r/ INVENTORY Vendor Totals Number Name Gross Discount No -Pay Net S1001 SANOR PASTEUR INC 41206.64 0.00 0.00 41206,64 Vendor# Vendor Name Class Pay Code / 10625 SARA RUBIO ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 011420 01/20/20 01/14/20 01/14/20 36.57 0,00 0.00 36.57 ✓ TRAVEL GCTASC/CPG MONT (l/gj?v7d) Vendor Total: Number Name Gross Discount No -Pay Net Page 12 of 14 10625 SARA RUBIO 36,57 Vendor# Vendor Name / Class Pay Code 31800 SHERWIN WILLIAMS J W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross 44669✓ 01/15/20 01/14120 01/31120 28.87 SUPPLIES 45237 ✓ 01/20/20 01/15/20 01/30/20 3.59 SUPPLIES Vendor Totals Number Name Gross S1800 SHERWIN WILLIAMS 32.46 Vendor# Vendor Name / Class Pay Code K0536 SHIRLEY KARNEI ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dr Pay Gross 012120 01/21/20 01/21/20 01/21/20 185,46 CONTRACT EMPLOYEE Vendor Totals Number Name Gross K0536 SHIRLEY KARNEI 185,46 Vendor# Vendor Name Class Pay Code 10699 SIGN AD, LTD, Invoice# Comment Tran Dt Inv Dt Due Dt Check D- Pay Gross 245900 ✓/ 01121/20 01/01/20 01111/20 790.00 0.00 0.00 36.57 ✓ Discount No -Pay Net 0.00 0.00 28.87/ 0.00 0,00 3,59 W/ Discount No -Pay Net 0.00 0.00 32.46 Discount No -Pay Net 0.00 0,00 185.46 Discount No -Pay 0.00 0.00 Discount No -Pay 0.00 0.00 AD LEASE Vendor Totals Number Name Gross Discount 10699 SIGN AD, LTD. 790,00 0,00 Vendor# Vendor Name Class Pay Code 12848 SKILLGIGS INC. Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount 21911 ,// 12/30/20 01/02/20 02/01/20. 33810,15 0,00 ICU NURSE ROWE Vendor Totals Number Name Gross Discount 12848 SKILLGIGS INC. 3,810.15 0.00 Vendor# Vendor Name Class Pay Code / 52345 SOUTHEAST TEXAS HEALTH SYS W Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount 26297 01/20120 01/01/20 01/31/20 51000.00 0.00 JAN-MAR DUES Vendor Totals Number Name Gross Discount S2345 SOUTHEAST TEXAS HEALTH SYS 5,000.00 0.00 Vendor# Vendor Name Class Pay Code 12288 SPBS CLINICAL EQUIPMENT SRVC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount INV007819 ✓ 01/08/20 01/02/20 02/02/20 12,375.00 0,00 BIO MED SERVICES Vendor Totals Number Name Gross Discount 12288 SPBS CLINICAL EQUIPMENT SRVC 12,375.00 0.00 Vendor# Vendor Name Class Pay Code 11672 STANLEY ACCESS TECH LLC Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount 905773308 01/21/20 01/06/20 02/05/20 3,531.00 0,00 LOADING DOCK - Avbw&4NL, door 906572783 01/21/2001/06/2002/05/20. 31422.00 0.00 EMERGENCY INTERIOR ENTFa.h_LC, �vvr No -Pay 0.00 No -Pay 0.00 No -Pay 0.00 No -Pay 0.00 0.00 Net 85.46 Net / 790.00 Net 790.00 Net / 3,810.15 ✓ Net 3,810.15 Ne[ 5,000'00 Net 5,000.00 Net 12,376.00 f Net 12,375,00 Net 3,539.00 3,422.00 ti� Page 13 of 14 Vendor Total:Number Name Gross Discount No -Pay Net 11672 STANLEY ACCESS TECH LLC 61953,00 0,00 0,00 61953,00 Vendor# Vendor Name / Class Pay Code 53960 STERICYCLE, INC �/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 4009046020/ 12/30/20 01/01/20 01/31/20 20300,00 0,00 0.00 2,300.00 DISPOSAL SERVICE Vendor Total: Number Name Gross Discount No -Pay Net S3960 STERICYCLE, INC 20300.00 0.00 0.00 21300.00 Vendor# Vendor Name / Class Pay Code ✓ 12440 SUN LIFE ASSURANCE COMPANY Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 011620 01/20/20 01/16/20 02/01/20 2,361.11 0,00 0,00 2,361.11 1� INSURANCE Vendor Total; Number Name Gross Discount No -Pay Net 12440 SUN LIFE ASSURANCE COMPANY 2,361.11 0.00 0.00 21361.11 Vendor# Vendor Name Class Pay Code U1064 UNIFIRST HOLDINGS INC v/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 8400320522 01/15/20 01/06/20 01/31/20 61.07 0,00 0.00 61,07 Q/ LAU DRY 8400320553 &01/15120. 01/06/2001/31/20 949,49 0.00 0.00 949.49 LAUNDRY / 8400320521 01/15/20. 01/06/20 01/31/20 47,15 0.00 0.00 47.15 ✓ LAUNDRY 8400320897✓ 01/16/20 01/09/20 02/03/20 11648,77 0,00 0.00 11648.77✓ LAUNDRY 8400320866 r/ 01/15/20 01/09/20 02/03/20 176,83 0,00 0.00 175.83 ✓ LAUNDRY 8400320860 ✓ 01/15/20. 01/09120 02/03/20 18,62 0,00 0.00 18.62 ✓ LAUNDRY 8400320864 v/ 01 /15/20 01/09/20 02/03/20 155,98 0,00 0.00 155.98✓ LAUNDRY Vendor Total: Number Name Gross Discount No -Pay Net U1064 UNIFIRST HOLDINGS INC 31056,91 0,00 0.00 3,056.91 Vendor# Vendor Name / Class Pay Code U2000 US POSTAL SERVICE Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 011720 01/21/20 01117/20 01117/20 235,00 0,00 0.00 235.00� BRM RENEWAL Vendor Total; Number Name Gross Discount No -Pay Net U2000 US POSTAL SERVICE 235.00 0.00 0.00 235,00 Vendor# Vendor Name Class Pay Code 10793 WAGEWORKS v/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay Net 122019 01/20/20 12/20/20 12120/20 31489,52 0,00 0,00 3,489.52 ✓ PAYROLL DED 010620 01/20120 01106/20 01/06/20 3,460,67 0.00 0.00 31460,67✓ PAYROLLDED Vendor Total: Number Name Gross Discount No -Pay Net 10793 WAGEWORKS 61950.19 0.00 0.00 6,950.19 Page 14 of 14 Grand Totals: Gross 293,037,71 APk'ROVED ON COUN7T AUDITOR CALIIOUN COUNTY, TEXAS Report Summary Discount No -Pay 0.00 0,00 Net 293,037.71 ��0i� � � ����� Page I Df 1 �'tsR4v.>tar4 C'dsttttiy �:udi���' 01/27/2020 MEMORIAL MEDICAL CENTER 0 AP Open Invoice List 08:37 ap_open_invoice.templale Dates Through: Vendor# Vendor Name � Class Pay Code 12740 BUILDING KID STEPS Invoice!! Comment Tran Dt Inv Dt Due DI Check l7 Pay Gross Discount No -Pay Nel OUTPATIENT1219A 01/27I20:01/27/2001I27/20 450.00 0.00 0.00 450.00 SPEECH THERAPY � , OUTPATIENT1219 01I27I20.01/27/2001/27/20. 1,000.00 O.DO 0.00 1,000.00 SPEECH THERAPY . Vendor Total; Numher Name Gross Discount No -Pay Nel 12740 BUILDING KID STEPS 1,450,00 0.00 D.00 1,450.00 Report Summary Grand Totals: Gross Discount No -Pay Net 1 ,450.00 0.00 0.00 1,450.00 ' 1 ull �. � � 1 �' file:///C:/Users/mmckissack/cpsi/memmed.cpsinet.com/u88150a/data 5/tmD cwSreDort7... I/27/2020 MWESSON STATEMENT Company: eeee MEMORIAL MEDICAL CENTER AMT DUE REMITTED VIA ACH DEBIT AP Statement for information only 815 N VIRGINIA STREET PORT LAVACA TX 77979 As of: 01/24/2020 DC: 8115 Te ritory: Customer: 632536 Dale: 01 /25/2020 Page: 002 accl 'r stuk ii As of: n Mall to Stal ' Cunt: i Date: Blltng Due Receivable allonal Account �.92 36 Cash Amount P Amour Date Date Number Refer Reference Description Discount (gross) F (net) PF column legend: P = Past Due Item, F = Future Due Item, blank = Current Due Item TOTAL National Aect 632536 MEMORIAL MEDICAL CENTER Subtotals: 6,496.38 USD Future Due: 0,00 It Paid By 01128/2020, Past Due: 0.00 Pay This Amount: 61366,48 USD Last Payment 20461,97 If Paid After 01/28/2020, 08/0712017 Pay this Amount: 6,496.38 USD APPROVE ON iL JAN 2 7 COUNTY AU CALIIOUN COITN E MWESSON STATEMENTAs of: 01/24/2020 Page: 001 To ace slut Company: 8000 DC: 8115 As of: Mall t( CVS PHCY 7475/MEM MC PHIS AMT DUE REMITTED VIA ACH DEBIT Territory: 400 AMI MEMORIAL MEDICAL CENTER Statement for information only Stab VICKY KALISEK Customer. 835438 815 N VIRGINIA ST Date: 01125/2020 PORT LAVACA TX 77979 Cusl: Date: Billing Due bl etional Account 6 Cash Amount P Amou N� � Date Date Number Reference Description Discount (gross) F (net) P Customer Number 835438 CVS PHCY 7475/MEM MC PHIS 01/2312020 01/28/2020 7179652294 052004 1151nvoice 32.17 1,608.51 1,5 P. PF column legend: P = Past Due Item, F = Future Due Item, blank = Current Due Item TOTAL, Customer Number 636438 CVS PHCY 7475/MEM MC PHIS !' Sublotals: 1,608,51 USD Future Due: 0.00 If Paid By 01/28/20209 I Past Due: 0,00 Pay This Amount: 1,576.34 USD Last Payment 8,864.04 If Paid After 01/28/2020, 01/2012020 Pay this Amount: 1,608,51 USD MSKESSON STATEMENT As of: 01/24/2020 Page: 001 To i ecru stut comN.,ov: e000 DC: 8115 As of: HEB PHY FC 490/MEN1 MC PHS Mail to AMT DUE REMITTED VIA ACH DEBIT Territory: 87 t MEMORIAL MEDICAL CENTER Statement for information only AMT VICKY KALISE( Slat( Customer: 464450 815 N VIRGINIA ST Date: 01/25/2020 PORT LAVACA TX 77979 k Curd: Date: IBillh ational Account 6 Date Due Numb ablcN ere Cash Amount P Amour Dete Date Number Reference Description Discount (gross) F —(net) Customer Number 464460 HE3 PHY FC 490/MEN MC PHS 01/21/2020 01/28/2020 7179005327 55x686265 I151nvoice 0198 48,78 4 01/21/2020 01/28/2020 7179006328 55x686519 1151nvoice 20,38 11019,00 9£ III 01/23/2020 01/28/2020 7179483810 55x691318 1151nvoice 3.31 165.69 1E PF column legend: P = Past Due Item, F = Future Due Item, blank = Current Due Item TOTAL Customer Number 464450 HE3 PHY FC 490/MEN MC PHS Subtotals: 1,233,47 USD Future Due: 0,00 E n� If Paid By 01/28/2020, L ,f Past Due: 0,00 Pay This Amount: 1,208.80 USD E `FF (i Lest Payment 81864,04 If Paid Aker 01/28/2020, E 01/20/2020 Pay this Amount: 1,233.47 USD L 1 MWESSON Canpy,y: 8000 WALMART 1098/META MED PHS MEMORIAL MEDICAL CENTER VICKY KALISEK 815 N VIRGINIA ST PORT LAVACA TX 77979 STATEMENT AMT DUE REMITTED VIAACH D®IT Statement for information only As of: 01/24/2020 DC: 8115 Territory: 400 Customer: 256342 Date: 01 /25/2020 Page: 001 As of: Mall tc AMT Slat Cust: Date: I Filling Due ational Account 36 r Cash Amoun P Amow Date Date Numberr Number Reference Description Discount (gross) F (net) Customer Number 256342 WALMAtTT 1098/MEM M® PHS 01/20/2020 01/28/2020 7178757946 1129173 1151nvolce 4,13 206.69 2( 01/20/2020 01/28/2020 7178757949 2917830026 1151nvoice 22.74 11137,16 1,11 01/20/2020 01/28/2020 7178898816 785679907 1951nvoice 1.90 95,14 , 01/20/2020 01/28/2020 7178943828 000001172020AS 115Invoice 0,01 0,32 01/21/2020 01/28/2020 7179019931 2917834569 115Invoice 7,51 375,33 3( 01/21/2020 01/28/2020 7179149478 786058024 1951nvoice 0,02 0.95 01/22/2020 01/28/2020 7179241327 2917839049 1151nvoice 1.14 57.02 , 01/22/2020 01/28/2020 7179393255 786311536 1951nvoice 0.18 01/23/2020 01/28/2020 7179494611 3567843555 115Invoice 0.16 01/23/2020 01/28/2020 7179494612 1129277 1151nvoice 0,20 01/23/2020 01/28/2020 7179682169 0000122201AS 1151nvoice 0.02 0.95 01/24/2020 01/28/2020 7179734797 3567848264 1151nvoice 9.25 462.73 4! 01/24/2020 01/28/2020 7179747149 0123200751,00 115invoice 7,81 390.63 31 PF column legend: P = Past Due Item, F = Future Due Item, blank = Current Due Item TOTAL Customer Number 256342 WALMART 1098/MEM MED PHS Subtotals: 2,727.46 USD Future Due: 0.00 L If Patd By Ol/28l2020, L Past Due: 0.00 Pay This Amount: 2,672.93 USD [ Last Payment 8,864.04 If Paid After 01/2812020, L 01/20/2020 Pay this Amount: 21727,46 USD l MWESSA /N STATEMENT As of: 01/24/2020 Page: 001 To 4 acc( Company: OUoa stub DC: 8115 As of: CVS PHCV 7006/MEMORIA PHS Mail to AMT DUE REMITTED VIA ACH DEBIT Territory: 400 MEMORIAL MEDICAL CENTER Slaloment for information only AMT Stale VICKY KALISEK Customer: 262252 815 N VIRGINIA Date: 01/25/2020 PORT LAVACA TX 77979 Cust: Date: 0 National Account g3p538 Billing Due Receivable Urr7fr Cash Amount P Amoun Date Date Number Reference Description Discount (gross) F (net) Customer Number 262252 CVS PHCY 7006/MEMORIA PHS 01/23/2020 01/28/2020 7179493427 651823 1151nvoico 16,39 819.68 80 01/23/2020 01/28/2020 7179493428 651823 1151nvolce 0.30 14,94 1 PF column legend: P = Past Due hem, F = Future Due Item, blank = Current Due Item A I TOTAL: Customer Number 262252 CVS PHCV 7006/MEMORIA PHS Subtotals: 834.62 LSD r V Future Due: 0.00 D4 II Paid By 01/28/2020, U Past Due: 0.00 Pay This Amount: 817,93 LSD D l Last Payment 8,864.04 If Paid After 01128/2020, D 01/20/2020 Pay this Amount: 834.62 LSD U MWESSONSTATEMENT As of: 01/24/2020 Page: 001 To ace( Company: e000 stut DC: 8115 As of: Hm PFiCY 0434lMt7v1 MED PHS Mail to AMT DUE REMITTED VIA ACH DEBIT Territory: 400 MEMORIAL MEDICAL CENTER Statement for information only AMT VICKY KAUSEK State 815 N VIRGINIA ST Customer: 190813 Date: 01 /26/2020 PORT LAVACA TX 77979 Cush Date: L nnitetional Account 8g33p5536 Billing Due Receivable" Refer Cash Amount P (Amoun net) Date Date Number Reference Description Discount (gross) F (net) Customer Number 190813 HES PHCY 0434/MBA Mm PHS 01/22/2020 01/28/2020 7179244362 2017011824 115invoico 0.92 46.22 4 01/24/2020 01/28/2020 7179740772 2017011927 1151nvoice 0.73 36.50 3 01/24/2020 01/28/2020 7179740773 2017011927 115invoice 0,19 9.60 PF column legend: P = Past Due Item, F = Future Due Item, blank = Current Due Item j TOTAL, Customer Number 190813 HFB PHCV 0434/MBA M® PHS Subtotals: 92.32 USD Future Due: 0.00 If Paid By 01/28/2020, Past Due: 0,00 Pay This Amount: 90.48 USD Last Payment 8.864.04 If Paid After 01/28/2020, 01/20/2020 Pay this Amount: 92.32 USD Ame�r�isourceBergen° STATEMENT AMERISOURCEBERGEN DRUG CORP • 12727 WEST AIRPORT BLVD SUGAR LAND TX 77478-8101 866-45t-9655 AMERISOURCEBERGEN DRUG CORP PO Box 905223 CHARLOTTE NC 28290-5223 Number: 58814741 Date: 01-24-2020 1 of 1 WAIGREENS gt24949409 MEMORIAL MEDICAL CENTER 1002 N VIRGINIA ST PORT LAVACA Tx 77979.2509 ACCOUNT: 100705284 / 007028186 Nol Yet Due: 0.00 Current: 3,002.05 Past Due: 0.00 Tolal Due: 3,002.05 Account Balance: 3,002.05 Activity Date Due Date Reference Number Purchase Order Number Activity Type Amount Ot-20-2020 01-20-2020 01.31.2020 01-31-2020 3032896t09 3032898330 154499 154507 Invoice Invoice 43026 ,.i 183.00 ✓ 01-20-2020 01-31.2020 3032955738 154580 Invoice 66.57 ✓ Ot-22-2020 Ot-31.2020 3033057123 154592 Invoice 390.80 ,/ 01-23-2020 01-31.2020 3033119001 154607 Invoice t,782.74 ✓ Ot-24-2020 01-31.2020 3033178451 154820 Invoice 148.68 ✓ Reminders Thank You for Your Payment Date Payment Number Amount Due Date Amount 07-24-2020 (2,002.10) 01-31.2020 Total Due: 3,002.05 due in 7 �I Y Lr �e I APPROVED ON JAN 2 7 2020 COUNTY AUDITOR CALHOUN COUNTY, TP:,XAS MEMORIAL MEDICAL CENTER PROSPERITY BANK ELECTRONIC TRANSFERS FOR OPERATING ACCOUNT --January 20, 2020- January 26, 2020 Oate Bank Descriotlon 1/24/2020 PAY PLUS ACHTRANS 452579291 101000699072257 1/24/2020 EXPERTPAY EXPERTPAY 746003411 91000017641516 1/24/2020 AMERISOURCE BERG PAYMENTS 01000077682100002 1/24/2020 MEMORIAL MEDICAL PAYROLL 746GO34111131226SO 1/23/2020 TSYS/TRANSFIRST CHARGEBACK41399801332393 61 CASE: 1/23/2020 PAY PLUS ACHTRANS 452579291 101000G98315431 1/22/2020 PAY PLUS ACHTRANS 452579291101000697588634 1/22/2020 PAY PLUS ACHTRANS 452579291101000696967285 1/21/2020 WEDFILE TAX PYMT DD 902/35863899 21000020168 1/21/2020 PAY PLUS ACHTRANS 452579291 101000696343669 I/21/2020 MCKESSON DRUG AUTO ACH ACH04050547 910000100 I/21/2020 FDGL LEASE PYMT 052.1312971-000410001227542 1/23/2020 WIRE OUT CBNA INCOMING SETTLEMENT ACCOUNT C�O Diane Moore, CFO Memorial Medical Center PROSPERITY BANK ELECFRONIC TRANSFERS FOR OPERATING ACCOUNT --ESTIMATED ACHS Oate Descriotlon 2/5/2020 ACH Payment STATE COMTRLR TEXNET \ 1 Ci'lJ Diane Moore, CFO Memorial Medical Center MMC Notes 3rd Party Payor Fee -Child Support Payment -Payroll Ending 1/16/20 - 3400 Drug Program Expense Payroll -Patient despuling collection charge - 3rd Party Payor Fee - 3rd Party Payer Fee 3rd Party Payer Fee Sales Tax 3rd Party Payer Fee 340B Drug Program Expense - Credit Card Machine Lease Expense -CitiOank Corporate Card Payment January 27, 2019 Tpavdtl 01.t 2jt" B u. MMC Notes -DY9 UC January 270 2019 1/21/2020 hltpsJ/lexnel.cpa.state,tx,usRXN HSC,aspx Texas Comptroller of Public Accounts Health and Human Services Commission Memorial Medical Center Operating County Identification Number: 60500 Location: 00136 Transaction Complete Tloace #: 36101888 Payment Totai $309,009.34 Settlement Date 02/05/2020 PAYMENT DETAIL -..___ __ ...___... _.__.. _. UC Hospital Amount $309,009,34 Return to Menu Logoff �R IMPORTANT: DO NOT USE TEIE BACI{ BUTTON ON YOUR BROWSER WHILE USING TEXNET. Revised:01/09/13 (483) DY9 UC/SDA Allocation Form TRACE Number:36101888 The Trace Number Is in the receipt you receive from the Comptroller once you have submitted your IGT into TexNet. The Trace Sheet and Allocation Form must be submitted together In the same email. All Trace Sheet submiss i11712020 Texas Health 8 Human Services secure e-mail portal . ... ll it I :It, I ill I 3Z 11 r.V.,.,, o T. Siyn Uut DY9 Advance UC IGT Notification - Gov Entities 4 of 10 I HHSC RAD UC Payments <RAD UC_Payments@hhsc,state,tx.usIf i� Reply all I Itot hmay, 10:37 AM Delaney,lohn cjohnd@Irmhmrcorga;'James Arnold@CCCIAHMR,org`•'lamesAmoM@ccs1967.org';'james.l.vitt@uth.tmc.edu'.102 more This message has been marked as Confidential. DY9 Advance SDA Alloc... �, 2020 DY 9 UC Advance ... 29 KB 194 Ka v 2 aita!hn'onts 12I9 Y,B) Providers, Government Entities, and Anchors: Please read this entire message carefully and make note of the Information provided below that failure by IGT entities and providers to submit the required forms Inay result in a delayeeg�p�yment for the providers. HHSC Is providing notice to IGT for the DY9 Advance UC Payment. Dates pertinent to this payment: 2/04/2020 Last day to submit your IGT Into TexNet 2(05/2020 IGT Settlement: date 2/10/2020 State Owned Submit Journal Entry 2/14/2020 State Owned paid 2128/2020 UC Providers paid Attached to this email are the following documents: DY9 UC Advance Payment Calculation spreadsheet DY9 UC UC/SDA Allocation Form Beginning with the DY9 UC Advance Payment, IGT received will be allocated at the Service Delivery Area (SDA) level. While providers are required to have an affiliation to be eligible to participate in the UC Program, IGT received is no longer allocated at the affiliation level. In the event of an IGT shortage in a SDA, a pro-rata reduction will be imposed for all participants In that SDA for the advance payment, with no additional funding opportunities. Should this occur in a final Q !or more assistance in rearlinn secure emails %rem HHS please copy and pauz this link inro your ,veh hrovrser: htyyr/!hhxiz�.as.gnv/about-hhslfind-.is/zmail- ..,�crypuo�l a� 1001 Will! *ill Numai S;�lizs CEIW JAN 2 3 2020 Caff"'b e' 0 6Y,�'{3dt(it�i7 MEMORIAL MEDICAL CENTER _. .... `OAT/ 3�/�6� 0 10:39 AP Open Invoice List ap_open_invoice.templote Dates Through: Vendor# Vendor Name Class Pay Code 11816 ASHFORD GARDENS Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount 012120 01/21/20 01/21/20 02/07/20 30s457.31 0.00 MEDICARE RECOUP Vendor Total: Number Name Gross Discount 11816 ASHFORD GARDENS 30,457.31 0.00 Report Summary Grand Totals: Gross Discount No -Pay 30,457.31 0.00 0.00 Page 1 of 1 No -Pay Net 0.00 30,457.31 No -Pay Net 0.00 300457,31 Net 30,467.31 RECHAp JAN 2 3 2020 MEMORIAL MEDICAL CENTER e�4huwu�3/2oedy IxasCttor° o AP Open Invoice List 10:41 ap_open_invoice.template Dates Through: Vendor# Vendor Name Class Pay Code 11828 SOLERA WEST HOUSTON ✓/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount 012120 01/21/20 01/21/20 02/07/20 899365.37 0.00 MEDICARE RECOUP Vendor Totals Number Name Gross Discount 11828 SOLERA WEST HOUSTON 89,365.37 0.00 Report Summary Grand Totals: Gross Discount No -Pay 89,365,37 0.00 0.00 AppROVEI9 ON JAN 2 3 2020 COTJNTY AUD):'POR CALHOUN COilNI'Y,'i'C1CA& Page 1 of 1 No -Pay Net 0.00 89,365.37 !// No -Pay Net 0.00 89,365.37 Net 89,365.37 Page I of I JAN 2 3 2020 01/23/2020 MEMORIAL MEDICAL CENTER 0 car,fulg ��0.c40atgag% tY utfitor AP Open Invoice List ap_open_invoice.template Dates Through: Vendor# Vendor Name Class Pay Code 11820 FORTBEND HEALTHCARE CENTER Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 012120 01121/20 01/21120 02/07/20 13,605.35 0.00 0.00 MEDICARE RECOUP Vendor Total: Number Name Gross Discount No -Pay 11820 FORTBEND HEALTHCARE CENTER 133605.35 0.00 0,00 Report Summary Grand Totals: Gross Discount No -Pay 13,605.35 0.00 0.00 ON OOUN'F1t AUDITOR CALHOUN COYJN'1'Y0'I'E3:A`: Net 13,605,35 Net 13,605.35 Net 13,605,35 Page i of 1 JAN 2 3 2020 Ol fisUfpJ3�bydtty.(i1ddoff}t MEMORIAL MEDICAL CENTER AP Open Invoice List 0 10:40 ap_open_invoice.template Dates Through: Vendor# Vendor Name /Class Pay Code 11832 BROADMOOR AT CREEKSIDE PARK V Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 012120 01/21/20 01/21/20 02/07/20 63,857.90 0.00 0.00 MEDICARE RECOUP Vendor Total Number Name Gross 11832 BROADMOOR AT CREEKSIDE PARK 63,857.90 Report Summary Grand Totals: Gross Discount 63,867.90 0.00 JAN 2 3 2020 courrrY nunrro� CALHOUN COUNTY,'t'EKAB Net 63,857,90 Discount No -Pay Net 0.00 0.00 63,857.90 No -Pay Net 0.00 63,857.90 Page 1 of 1 JAN 2 3 2020 MEMORIAL MEDICAL CENTER 01 /23l2020 p rzfanidab'"Xeac, (zticii i AP Open Invoice List ap_open_invo ice.template Dates Through: Vendor# Vendor Name Class Pay Code 11824 THECRESCENT✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 012120 01/21/20 01121/20 02/07/20 31,132.57 0.00 0,00 MEDICARE RECOUP Vendor Total: Number Name Gross Discount No -Pay 11824 THE CRESCENT 310132,57 0.00 0.00 Report Summary Grand Totals: Gross Discount No -Pay 31,t 32,57 0,00 0.00 APPRAVED ON JAN 2 3 2020 COUNW AUDMRNTY, CALHOUN COUTEXAS Net 3t,132.57 ✓/ Net 31.132,57 Net 31,132.57 Page I of 1 ]AM z 3 20B Cn(fibj)2'3S0210p1ry A114i$®1 MEMORIAL MEDICAL CENTER 0 10:42 2 AP Open Invoice List ap_open_invoice.template Dates Through: Vendor# Vendor Name / Class Pay Code 11836 GOLDENCREEK HEALTHCARE V/ Invoice# Comment Tran Dt Inv Dt Due Dt Check D Pay Gross Discount No -Pay 012120 01/21/20 01/21/20 02/07120 33,576.66 0.00 0.00 MEDICARE RECOUP Vendor Total: Number Name Gross 11836 GOLDENCREEK HEALTHCARE 33,676,66 Report Summary Grand Totals: Gross Discount 330576,66 0,00 APPROVED ON JAN 2 3 2020 C01INTY AUDITOR CALHOUN COUNTY, TEXAS Discount No -Pay 0.00 0,00 Net j 33,576.66 �// Net 33,576.66 No -Pay Net 0.00 33,576.66 Memorial Medical Center Nursing Home UPL Weekly Cantek Transfer Prosperity Accounts 1/27/2020 Raullno In/ormollon lorAshlord Gardens: A9h/ rdi cotth Care Center Ltd Go IP Morgan Chase Bank ABA' " Acco Innlna // ACH name Ion /Tmnshr-m ],5 128].28 /12),502At 874362.72 90,038.78 V 90,838.78 ✓187,062.73 130,027.07 +/ 129,927.87 61,003.92 {/ 48,783.60 ✓ 48,681.60 ✓ 49,801.]8 301,9]].09 ./ 301,892.63 i<1,212.14 outlnalnlormeNenlor r nl/Solnoot WeslNOWton/Fwlecgd/@ra4dmpor. lr+Rmllh Corr Centers Ill llC /PMwgon Oipae Bank ABA ccc Mole:OnlY boipn rea aJ over $s,OL wlli be IranaJened to the nuralnB h om e. Nate 1: Each orcaun(hoao basrbolanar o/$3W Naf MMCO<podledroopm awounl. J:\NHW<eklYTransfen\NtI UPITnnsler SummaM\2020\NN UPITrander Summary t�3].30.alse Bank Balance Variance Leave In Balance Pending CLIFF Ck to MMC MMC Portion QIPP 1&2 MM[ Portion QIPP 3,4,Lapse January Interest February Interest March Interest Atljust Balance/rransferAmt Bank Balance Variance Leave in Balance Pending QIPP Ck to MMC MMC Porklon CUPP 1&2 MMC PONon CUPP 3,40Lapse lanuary Interest February Interest March interest 0.dlwt Bahnce/Transter Ann: Bank Balance Variance Leave In Balance Pending CUPP or to MMC MMC Portion CUPP 1 &2 MMC Portion QIPP 3,4,Lapse January Interest Februarylnterest March interest Adjust 8alanu/Tran+rer At d.Yv Innlna Amount to ae Transferred to Nattiest Balanu I nt 18 75,113.22 18 00.00 13,i33.96 ]5,113122 a/ 18],162.73 / 182,666.75 38],362.73 300.00 4,395198 182,fi66.75 1/ 2fi1,t03.92 / 257,217,94 261,303.92 00.00 3,)85.98 29 49,901.)8 / 44,002,82 49,901.)e ✓ 100.00 4,998196 a/ 44A02.02 4/ 141,296.60 / 136,655.99 Bank Balanw 191,296.fi0 ✓ Variantt leave In Balanre 100.00 Pending QJPP Ck to MMC MMC Famous Opp 1&2 4,540.66I MMC Portion OIPP 3,4,tapse lanuary Interest February Interest March Interest Adjust Balance/TransfarAmt /36,655.94 TOTAIT iSFERS //aa 696456.67 A roved:�� Diane Moore, CFO ,/ y III.: APPROWD 1 rd 6 6 (, ; ON JAN 2 7 2020 tr U ;1 . COUNTY AUDITOR i1, ,, f: . _.__ . .. ..,, ,k Bank Galante Variance Leave In Balance Pending QFP Or to MMC MMCPortlon QIPP1&2 MMC Portion QIPP 3,4,tapse January Interest February Interest March Interest AtljusI Balance/Tnnsfer AAt P\NH W40MV Transfers\Bank Dowload WOfksheetAIG20\NH Bank Download 1.20-201Aru 1-26-20.4sa Pagel MMCPORPON }ltm Pf P-P91 T 1r1 QIPP(64mp1 QIPP/Go MP2 QIPPIUMP3 QIPP/COmp3 QIPPTI NN PORTION 1/21/2020 UHCCOMMUNNYPIHCCUIMPMT]460G3411910000TRN 102020011713600: $ $ 2,192.111 - 2,192.10 1/22/2020 WIRE OUT ASHFORD HEALTH CARE CENTER LTD S 12)A87.28 - - - 1/22/2020 MOLINA HEALTHCAR MOLINMCH 008SI32842000019[$A• • , 62: $ $ 124538.23 11,929.69 603.54 12233.96 304.27 1/22/2020 Assedgroup T%SC 11CCIAIMPAT3117025750111000 TRN'10311)025750•1)52 $ 52,622,90 2,62I.90 1/22/2020 NOVITAS SOLUTION HCCUIMPMT 615423420000137 TAN•1'EFT690964]•120! 5 $ 10,331.37 lot333.37 312212020 HEALTH HUMAN SVC PCCIAIMPMT 174600341130062 TRN' 1.0SE28749132641$ /�S, 13,734.19 - 13,734.19 1/2312020 HARIAND CLUDE CNN ORDERS 1M9U109603001A591 $ 1( 5.54 j/ - 1/23/2020 AmerlitouDTl5CHCCIAIMPMT3111148439111000TRN•1.3113148439'1>52 $ S 14S02.47 - 02.4] 1 1/33/3020 NOVITAS$O(UTION$iaUIMPMT6)542342000013]TRN•1#EFT6910381'120! 5 $ 687.42 - 687,41 1/23/2020 HEALTH HUMAN SVC NCCUIMPMT 174600341130052 TRN# 1.OSE2061513264F $ - $511.50 511.50 1/24/2020 O[POUL S - 5 31173.35 3,173.35 1/24/2020 UHCCOMMUNIWPLHCCUIMPMT]46003411930000TRN•1.2020012313100:$ - $ .84 - 2,141.04 1/24/2020 NOVffMSOlUT10NHCCUIMPMT6354234200001327RN#1'ER6910981.130! $ - $ 34,866.81 33957.34 1/24/2020 HEALTH HUMAN SVC NCCUIMPMT 174600341130052 TRUE 1.OSE3064613264:5 $/285i.34 $ .7 Wi.Jig ).363.]2 11,929.69 600.51 1Li33.96 >S.liB.76 MMCPORTION Trawrer-01 Transfer -in QIPP/Camel QIPP(C4mp2 QIPP/Comp3 QIPP/Comp4 QIPPTI NH PORTION 1/32/2020 WIRE OUT UNTE%HEALTH LIRE CENTERS III $ 90,838.]e $ - - 1/22/2020 MOLINA HULIHUR MOUNMCH 008S161042000019 HA'• ', •L$ - $ 44501.90 4,290.06 211.84 40395,98 105.92 1/22/2020 HUMANA INS CO HCCUIMPMT390861810000$76954 TRUE 1.00119004824001 5 - 5 250806.55 25,806.55 1/22/2020 HUMANA CM O158 HCCUIMPMT 39086I 42OGOOIS69 TR16100148101010263: $ - $ 2,395.66 - 31395.66 112212D20 HUMANA CHA DISB HCCUIMPMT 390861420000IS69 TRN•1401484010102311$ - $ 34664.51 - 30664.51 1/22/2020 NOVITM SOLUTION HCCUIMPMT 6)635) 420000136 TRN•1•EFT5440952. INC $ - $ 1164506.56 - 116,50656 1/23/2020 Unileditealtheare HCC1AIMPMT746003411124304 TRN• 1#9502153803' 14112 5 - S 74560.00 - 7,560.00 1/2312020 UPC COMMUNITY PL HCCUIMPMT 74603411 910000 TRN# 1a302D0119155001$ $ 280.00 - 280.00 1/23/2020 NOVITAS SOLUTION HCCI(MPMT 6]63$] 420000132 TRN•1#EH5443203#120! 5 - $ 7OSS4.19 7,554.19 1/23/2D20 HUMANA INS CO HCCUIMPMT 390861630000511594 TRN# 1•0012900483118a $ $ 31723.63 - 3,]]3.63 1/23/2020 HUMANA CHA DISB HCCUIMPMT 39086142000DIS24 TRN•1#000401010339E 5 - $ 70329.01 7,329.01 1/2312D20 PULP Supplementa HCCUIMPMT746003411124384 TRN# 1.9501778607'136; $ - $ 511.50 - 511.50 1/24/2020 Deyolit S - $ 1,136.72 - 1,136.72 V24/2020 MANAGEANDNU1719 MNS PMNT 00000000000429)410248743 5 $/6042.50 � 61042.50 $ 90,838.78 IB],062.]3 4,290.06 4,395.93 142,666,75 MM<PO0.110N LBOIISLJ 7S3yiferPP/Comp( , QI gIPP/C9mpE 41PP/CpmD3 QIPP/Comp1 PIPP TI HN PORTION 1/2112020 MANAGUNDHU17IB MNS PMNT OOO000000003268410248623 $ 5 14255.00 - 2,755.00 1/21/2020 UNHEDHEALTHUREHCCUIMPMT)46003411124384TRN•1•ITR$05]8940.3• $ - S 30310.00 3,33oA0 1/21/2020 UPC COMMUNITY PL HCCUIMPMT746003411910000 TRN•I.NQGO1171300N 5 - 5 1,405.44 - 1,405A4 1/22/2020 WIRE OUT LINTER HEALTH CARE CENTERS III $ 1294927.87 $ - 1/22/2020 MOLINA KAMM APPROACH 0085ISSA 420000191SA• • • # •22 $ $ 4,063.20 3,508.7S 554,45 3,785,98 2]].23 1/22/2020 HUMANA INS CO HCCUIMPMT 390864830000576954 TRN#I.O012900482400E $ - S 8016].]5 - 8,767.75 2/22/2020 NOVITAS SOLUTION HCCUIMPMT 676323420000136 TAN•I'EFT54409326120! $ - $ 145,606.63 - 1454606.63 1/22/2020 HEALTH HUMAN SVC HCCUIMPMT 114600341130082 TRN•1•OSE28]56166981 5 - 5 31500.54 1/23/2020 UnIledHeallhwe HCCWMPMT746003411124304 TRN•1•9502153802014112 5 - $ 90594.50 - 9,59450 1/21/2020 Unitedllealth4are HCCUIMPMT]46OD3411124304 TAN01.950203418i• 14112 $ - 5 64250.00 - 6,250.00 1/23/2020 UNC COMMUNITY PI HCCUIMPMT746003411910000 TRN' 1.2020012214400. $ - S 2,791.09 -2,791,09 1/23/2020 UPC COMMUNITY PL HCCUIMPMT)46003411910000 TRN#1.2020012215300 $ - $ 110860.37 - 114860.37 1/21/2020 UHC COMMUNITY PL HCCUIMPMT746003411910000 TRN' 1.2020011915500' $ - $ 23,022.70 23,022.70 1/23/2020 NOVITAS SOLUTION HCCUIMPMT 676323420000132 TRN• 10EH5443188. 1201 $ - 5 7,145.41 - 7,145.41 1/23/2020 HEALTH HUMAN SVC)HCCUIMPMT 174600341130082 END E1405E29622166981 S - $ 2,223.60 2,223.60 1/24/2020 OePG%U S - $ 2,770.76 2*710.76 1/24/NQO UHCCOMMUNITY PL HCCUIMPMT 746003411910000TRN#I.2o2O01231190D'$ - $ 24569.90 - 2,569.90 1/24/2020 UHCCommuniW PI HCCUIMPMT]46003411910000 TRN•l•2D2001231220050 5 - $ 4,440.0 1/24/2020 NOVITAS SOLUTION HCCUIMPMT 67632342ON0132 TIRIPPEFT54451564120! $ $ 21.03 907.03 $ 129,9E].8] 361,003.9E 3,508.)5 554.45 3,]85.90 25],EI).95 MMCPORHON LJHIar-Oue Translea.ln I QIPP/Comp3 QIPP/Comp3 QIPP/Comp3 QIPP/Comp4 QIPPTI NHPORTION 1/21/2020 UHC COMMUNITY PL HCCUIMPMT 746003411 91NOO Pill 1020200117102004 1 5 24 2,17. 1/22/2020 WIRE OUT LINTER HEALTH CARE CENTERS III $ 48,681.60 S - - 1/22/2020 MOLINA HULIHUR MOUNMCH 0065139642000019 V$A# , • • •L $ - $ 50125.45 4,8]3A] 252.98 40998.26 126,49 113I/2020 UHC COMMUNITY PL HCCURMPMT746003411910o00 TRN 0 1*2010011810200 S - $ 14385.92 1,385.92 1/23/2020 NOVITAS SOLUTION HCCUIMPMT 675663420000132 TAN' I DEFT54425320120! $ - $ 100144.74 10,144.74 1/24/2020 PePOSH $ $ 21454.99 - 2,454.99 1/24/2020 UNC Community PI HCCUIMPMT)4600341191MOO TAN #1.2020012316700305 5 34305.50 -3,305.50 1/24/2020 NOVITAS SOLUTION HCCUIMPMT 675663420000132 TRN• I bEfT54446374 120' $ - $ 224139.99 - 22,139.99 1/24/2020 HEALTH ROMAN SVC HCCUIMPMT 17460034113006 2 TRN# I.OSE3065SI 7305: JZ 3069.52 30069.S2 $ 10 601.60 49.801.]8 I,e72.1) 232,99 4.998,96 44,802.01 MMC PORTION RKWAINERVAIMTransfer-Oy0 Tranafenln QIPP/Comp3 QIPP/Comp3 QIPP/Comp3 41PP/Comp3 QIPPTI NH PORTION 1/2112020 MANAGEANDNETI718 MNS PANT MMO0000002482410248620 $ - $ 174825.00 - 120825.00 112112020 UNITEDHEALTLIME HCCUIMPMT)460034111243U TRH* 1•1TR50576598r U $ 6 $ ,560.00 - 6,560.00 1/22/2020 WIRE OUT UNTE% HEALTH CARE CENTERS III $ 301, ]].09 ' 1/22/2020 MOLINAHEALTHURMOLINMCH008515614200001915A• • r , •I: $ - 5 4,8)OA4 4,230.47 660.37 4,540.66 33D.18 11221202D HUMANA INS CO HCCUUMPMT39O96283ODD15]]31011161a001290010280H $ - $ 800.84 - 800.84 1/22/2020 UHCCommini(VPIHCCUIMPMT]46003411910000TRN610202001581420099 $ - $ 3,694.00 - 3,694.00 1/2I12020 NONTASSOWTIONHCCUIMPMT676310420000136TRN•1•ER5440922•I10! S $ 570936.93 - 57,936.93 1/23/2020 HARIANO CLARBE GO ORDERS 1A9U00210300PlS 91 $ 1.54 - ' 1/23/2020 Amer4roupUSC HCCUIMPMT311)14844011t000TRN•l.311]148440.12SE $ $ 2,425.54 - 20415.54 1/23/2020 UniledHeallheare NCCUIMPMT]46003411124384TRN•1a9S02153)53•14112 S - 5 9,19850 - 9,198.50 1/2312020UHCCOMMUHMPLHCCUIMPMT74M341191WWTRN•I$2010OI221S30O 5 - 5 50946.90 - 5,946.90 1/23/2020 NOVIEM SOLUTION NCCUIMPMT 6763104300001327RN•16EfT54431B3•l20! $ $ 6,203.47 - 60203A7 1/23/2020 MRP Supplementa HCCWMPMT746003411124384 TRN0109501800615•136: $ 5 2,387OO - 2,387.00 1/24/2020 Deposit $ S 3,339.12 - 34339,12 1/24/2020 MANAGEANDNET1718 MNS PMNT O00000000002482410248731 5 - $ 3,802.50 3,802.50 1/2412020 UHC COMMUNITY PL HCCUIMPMT 7460o341191U0DU TRN' 102010012311900'. $ - S 1,033.26 - 1,033.26 1/2412020 UHC COMMUNITY PI HCCUIMPMT )460034119100W TRN' t•20200123117M$ - S 201.00 201.00 1/24/2020 NOVITAS SOLUTION HCCUIMPMT 676310420ODU32 TRN•1•EFT5445251• 120! 5 S/ 4 90) M - 14987.24 $ 301 19263 $ 1/1,213 14 4210.47 660.37 4,540.66 136,673.49 TOTAIS S 590955.53 696,487.76 698.813.]0 $ 126.493.39 MAIL." 21288.19 1l27/2020 Treasury Center Quick View DDA Data reported as of Jan 27, 2020 8: . Account Number Current Balance Available Balance Collected Balance Prior Day Balance MEMORIAL MEDICAL IMF CENTER -OPERATING MEMORIAL MEDICAL CENTER - CLINIC SERIES 2014 MEMORIAL MEDICAL NMI CENTER - PRIVATE WAIVER CLEARING •4381 MEMORIAL MEDICAL $87,447.18 $171,366.80 $87,447.18 $44,206.64 CENTER/NH ASHFORD `4403 MEMORIAL MEDICAL $187,162473 $222,288,23 $187,162.73 $179,983.51 CENTER/NH BROADMOOR *4411 MEMORIAL MEDICAL $261,103,92 $290,202.67 $261,103,92 $231,416,23 CENTER/NH CRESCENT •4438 MEMORIAL MEDICAL $141,296,60 5171,564,99 $141,296,60 $117,933.48 CENTER I SOLERA AT WEST HOUSTON 44446 MEMORIAL MEDICAL $49,901.78 $74,390.94 $49,901.78 $184931,78 CENTER I NH FORT BEND MEMORIAL MEDICAL / NH GOLDEN CREEK HEALTHCARE CAL CO INDIGENT HEALTHCARE MMC -NH GULF POINTE PLAZA -PRIVATE PAY 00-NH GULF POINTE PLAZA- MEDICARE/MEDICAID ' indicates ret Page generated on 01/2.712020 at 8: Copyright 2020 Prosperity Bank. hilps://prosperi(y.oibanking.com/onlineMessenger 1/1 Memorial Medical Center Nursing Home UPL Weekly Nexion Transfer Prosperity Accounts 1/27/2020 Previous Amount Beginning 321,389.6] s/ 111,289.9J / 92,916.83 Foutina In/armarion Ior Golden CYeek Nexion Health at Golden Creek Wells Forgo Bank N.R. ABA Acer Note: GnN 6alonees o/over5$,000 will be Hans/erred fo Ms nursfnp Aame. Note 1: Each amavnthos a bole balance o/$100lhatMMC depaslled la open account. Pending Todey's Beginning Amount to Be Trani(erretl to Nursing )e osIts Balance Home 93,016.83 92,916.83 Bank Balance 93,016.83 Variance Leave in Balance 100.00 Pending QIPP Ck to MMC MMC Portion QIPP 1 &2 MMC Portion QIPP 3A,lapse January Interest February Interest March Interest Adjust 9alance/Transfer Ann 92,916.83 Approved: ✓✓✓� Diane Moore, cro 2/27/2020 APPROVEID ON JAN 2 7 2020 COUNTY AUDITOR CAi,HOUN COUNTY)'1'RXAh 1:\NH Weekty Transfers\NH UPL Transfer Summary\2a20\NN UPL transfer Summary 1�1]�io.alsx --- MMCPORTION I NH Transfer-0ul Transferdn QIPP/Compl QIPP/C4mp2 QIPP/Comp3 QIPP/C4mP4 QIPPTI PORTION 1/2212020 WIRE OUT NE%ION HEALTH AT GOLDEN CREEK $ 121,289.57 $ 1/2212020 TSYS/TMNSFIRST BKCO STIMT 54360455587691295436845S$826912 GO$ - $ 1.206.00 11206.00 1/22/2020 ACH SMUMENT SERVICE 41055234399601693996 $ $ 1,820.70 - 1,020.20 1/23/2020 TSY5/TRANSFIRST BKCO STLMT 5436845SS876917 9 $43684555876917 GO$ - $ 4,682.48 - 44687,48 1/23/2020 NOVITAS SOLUTION HCCLAIMPMT 62607420000132 TNN'1•EM44256$$ - $ 28,846.59 - 78,846.52 1/24/2020 Deposit $ $ A56.08 6,356.00 3211289.57 2,916.83 92,916,03 C /27/2020 Quick View Treasury Center ... Data reported as of Jan 27, 2020 MEDICALAccount Number Current Balance Available Balance Collected Balance Prior Day Balance CENTER - OPERATING MEMORIAL CENTER - CLINIC SERIES 2014 RIAL MEDICAL CENTER - PRIVATE WAIVER CLEARING RIAL MEDICAL CENTER / NH ASHFORD M RIAL MEDICAL CENTER/NH BROADMOOR ME ORIAL MEDICAL CENTER/NH CRESCENT on MEMORIAL MEDICAL CENTER /SOLERA AT WEST HOUSTON MEMORIAL MEDICAL CENTER/NH FORT BEND '4454 MEMORIAL MEDICAL / NH GOLDEN CREEK HEALTHCARE "RO INDIGENT HEALTHCARE W NH GULF POINTE PLAZA - PRIVATE PAY C -NH GULF POINTE PLAZA- MEDICARE/MEDICAID Copyright 2020 Prosperity Bank. $93,016.83 $93,247.93 $93,016.83 $86,660.75 • indicates rc. Page 9eneraled on 01/27/2020 al 8 htlps:!lprosperily.olbanking.com/onlineMessenger 1/i Memorial Medical Center Nursing Home UPL Weekly HMG Transfer Prosperity Accounts 1/27/2020 nvlou Account Begirming Pending Tomfemed to Nuno ln II Number ansftp(rd anefePln Cka Cleared capture Toda sBeginning Bnance NurshimHome 1A3a5 - Transfer Bank Balance 1.13o5e k/ Variance Leave in Balance low umm as mnnx Balance unHln Numbera851.1c 81.85 .7 onNaomnaK p/p.e. Ssaaevdnb<rrpn/wedmmenumnp home. Non I. Foch pttaun t hoe o 6oee bolvnw of 5300Ihm MMc depo3i ted ro open occoun(. 19d,131d3 Penalne Portion PP 3ex PontonCUgtPP 3,d,lavee FehYry Interest uuy inIamsI ueM1 Interest Aalxae Balance/TnnslarAm3 Armun rnnlenea to Bank Balance Le>ve lneBalance Ion glPP iax IonsIPP 3,d,tapse 3errarytnletnst Feb March Interest vt Adjust Balance/transfer Ant 194.11143 Approved: olanemoore,CFO 3/27/2020 �QR��f!i1p ON JAN 2 7 2020 CO'ONPY AUDITOR CALHOUN COUNTYITffiXA� 1:U'N\VeelN iranrlen\xlt u3t termfer summanUo30rxx 0et iraneler summery 43730.na. MMC PORTION aw-NUMMMMw NH Transfer -Out Transfer -In QIPP/Comps QIPP/Comp3 QIPP/Comp3 gIPP/Campo gIPP TI PORTION 1/22/2020 WIRE OUT HMG SERVICES, LLC $ 81,)51.1) $ 1/23/2020 NORMAN 13A HCCIAIMPMT 675892420N013))566 TRN`1`EFT685)932'1 $ - $ 146,654.00 - 146,654.00 1/24/2020 Deposit $ - $ 3,58I.00 3,581.00 1124/2020 NORIDIAN13q NCCLAIMPMT 67S8924200001412832 771'1'E96850863`l.$ $ 434897.43 4389743 81,)51.1) 194,132.43 194o132.43 83,)51.1? 194.1� 194,13243 ilYilYbYiS Quick View Treasury Center DDA Data reported as of Jan 27 2020 8- Account Number ORIAL MEDICAL CENTER •OPERATING ORIAL MEDICAL CENTER -CLINIC SERIES 2014 RIAL MEDICAL CENTER -PRIVATE WAIVER CLEARING ORIAL MEDICAL CENTER / NH ASHFORD MEMORIAL MEDICAL CENTER/NH BROADMOOR MEMORIAL MEDICAL CENTER! NH CRESCENT MEMORIAL MEDICAL CENTER/SOLERA AT WEST HOUSTON MORTAL MEDICAL CENTER/NH FORT BEND MEMORIAL MEDICAL / NH GOLDEN CREEK HEALTHCARE �CO INDIGENT HEALTHCARE '5433 MMC -NH GULF POINTE PLAZA -PRIVATE PAY 'S441 MMC •NH GULF POINTE PLAZA - MEDICARE/MEDICAID Copyright 2020 Prosperity Bank. Current Balance Available Balance Collected Balance Prlor Day Balance i $1,430.54 $194,232.43 $1,602.94 5195,207.32 $1,430.54 $194,232.43 $1,430.54 $146,754.00 ' indicalas rep Page generated on O1/27f2020 al 8 hops://prosperity.olbanking.com/onlineMessenger 1/1 MEMORIAL MEDICAL CENTER CHECK REQUEST P Memorial Medical Center Operating 1/27120 Date Requested: A Y APPROVED ON E JAN 2 7 2020 E COUNTY AUDITOR. FOR ACCTI USE ONLY imprest Cash �A/P Check Mail Check to Vendor Return Check to Dept CALHOUN COUNTY, TEXAS AMOUNT $12s23196 G/LNUMBER: 21000012 EXPLANATION: ASHFORD- To transfer funds for Comp 1 &2 - QIPP payment, REQUESTED BY: Sarah L. Henderson AUTHORIZED BY: ALI./ MEMORIAL MEDICAL CENTER CHECK REQUEST Memorial Medical Center Operating Date Requested: 1/27/20 Y APPROVED ON E JAN 2 7 2020 E COUNTY AUDITOR CALHOUN COUNTY, TEXAS AMOUNT $4,395,98 GA NUMBER: 21000009 EXPLANATION: BROADMOOR- To transfer funds for Comp 1 &2 - QIPP payment. REQUESTED BY: are L. Henderson AUTHORIZED BY: MEMORIAL MEDICAL CENTER CHECK REQUEST Memorial Medical Center Operating Date Requested: 1/27120 FOR ACCT. USE ONLY Y APPROVED 0Imprest Cash E ON []A/P Check JAN 2 7 2020 ❑ Mail Check toVendor E Return Check to Dept COUNTYAUDITOR $3,785,98 CALHOUN COUNTY, TEXAS AMOUNT G/L NUMBER: 21000010 EXPLANATION: CRESCENT- To transfer funds for Comp 1 &2 - QIPP payment. REQUESTED BY: Sarah L. Henderson AUTHORIZED BY: MEMORIAL MEDICAL CENTER CHECK REQUEST P Memorial Medical Center Operating 1127120 Date Requested: A APPRovcD FOR ACCT. USE ONLY Y ON FlImprest Cash E JAN 2 7 2020 ❑A/PCheck Mail Check to Vendor COUNTYAUDII'OR E CALHOUN COUN9`Y,'PE%AS Return Check to Dept AMOUNT $4,998,96 G/LNUMBER: 21000008 EXPLANATION: FORT BEND- To transfer funds for Comp 1 &2 - QIPP payment. REQUESTED BY: Sarah L. Henderson AUTHORIZED BY: MEMORIAL MEDICAL CENTER CHECK REQUEST Memorial Medical Center Operating Date Requested: 1127120 A APPROVED FOR ACCT, USE ONLY Y ON FlImprest Cash E JAN 2 7 2020 ❑A/P Check Mail Check to Vendor E COUNTYAUDITOR CALAOUN COUNTY, TReturn Check to Dept iXA. AMOUNT $4,540,66 G/L NUMBER: 21000011 EXPLANATION: SOLERA- To transfer funds for Comp 1 &2 - QIPP payment, REQUESTED BY: Sarah L. Henderson AUTHORIZED BY: �/�J�