2004-05-13REGULAR MAY TERM HELD MAY 13, 2004
THE STATE OF TEXAS §
COUNTY OFCALHOUN §
BE IT REMEMBERED, that on this the 13" day of May, A.D., 2004 there was begun and holden
at the Courthouse In the City of Port Lavaca, said County and State, at 10:00 A.M., a Regular
Term of the Commissioners' Court, within said County and State, and there were present on this
• date the following members of the Court, to -wit:
Michael J. Pfeifer County Judge
Roger C. Galvan Commissioner, Precinct #1
Michael J. Balajka Commissioner, Precinct #2
H. Floyd Commissioner, Precinct #3
Kenneth W. Finster Commissioner, Precinct #4
Wendy Marvin Deputy County Clerk
Thereupon the following proceedings were had:
Commissioner Galvan gave the Invocation and Commissioner Finster led the Pledge of Allegiance.
Is
A Motion was made by Commissioner Galvan and seconded by Commissioner Balajka to offer a
letter of support requesting Formosa to be considered for the Texas Enterprise Zone Project for
Job Retention and authorize Judge Pfeffer to sign the letter of support. Commissioners' Galvan,
Balajka, Finster and Judge Pfeifer all voted In favor and Commissioner Floyd opposed the Motion.
Michael J. Pfeifer Calhoun Coun;
211 South Ann Street — Port lavaca, Texas 77979
(361) 553-4600 — Fax (361) 553-4444 — Email: Calhoun@tisd.net
May 5. 2004
Ms. Theresia Stolte-Goetz
Team Leader
Development Incentives
Governor's Office of Economic Development and Tourism
1700 N. Congress Avenue
Austin TX 78701
Re: Nomination of Formosa Plastics Corporation, Texas in Point Comfort TX as a
Texas Enterprise Zone Project for Job Retention.
Dear Ms. Stolte-Goetz
City of Point Comfort Mayor Pam Lambden and I have reviewed the Texas Enterprise
Zone opportunities for Formosa Plastics Corporation, Texas. I understand that the City
of Point Comfort is recommending Formosa's Point Comfort facility receive tax refunds
under the Texas Enterprise Zone Program.
Calhoun County supports the nomination and further recognizes that the County is not
• the nominating authority in this case. This is because part of the Formosa property is
inside the City of Point Comfort, and in the City of Point Comfort's extraterritorial
jurisdiction.
Sincerely.
/Michael J. ei r
County Judge
Calhoun County. Texas
cc: Mayor Pam Lambden, City of point Comfort 5f?
L v
Allen Junk spoke to the Court in regards In the new subdivision he is developing In Port
O'Connor, Texas. He spoke with the MUD District in regards to the road closures and they gave
their anonymous approval to dose the roads. Mr. Junek would also like to see the County give
their approval to close the requested roads in exchange Mr. Junek will help with the drainage
problems. Commissioners' see no problem with Mr. Junek moving forward.
APPROVE FINAL PLAT FOR VILLAS OF MARINA DEL REY SUBDMSION IN PORT
O'CONNOR- TEXAS:
Pass until the next meeting.
L . ,VILE , I , _ , r1tL[$QUuCA
A Motion was made by Commissioner Balajka and seconded by Commissioner Floyd to pass a
Resolution declaring May Mental Health Month in Calhoun County. Commissioners' Galvan,
Balajka, Floyd, Finster and Judge Pfeifer all voted In favor.
RESOL°UTION
MENTAL HEALTH MONTH
WHEREAS, Mental health is critical for our well-being and vitality as well as that of
our families, communities and businesses; and
WHEREAS, the President's New Freedom Commission declared that mental disorders
and mental health problems affect people of all backgrounds and all stages of life, and no one is
immune; and
WHEREAS, the World Health Organization found that mental illnesses rank first in
terms of causing disability in the United States and, collectively, are the most prevalent health
problem in America today — more common than cancer and lung and heart combined; and
WHEREAS, depression and anxiety disorders — the two most common mental illnesses
— each affect 19 million Americans annually; and
WHEREAS, one in five children have a diagnosable mental, emotional, or behavioral
disorder, and up to one in 10 may suffer from a serious emotional disorder; and
WHEREAS, mental health disorders such as schizophrenia, bipolar disorder, major
depression, and other severely disabling mental disorders are real, common and treatable
illnesses; and
WHEREAS, according to the National Advisory Mental Health Council, treatment
improves patient outcomes for the majority of Americans, even those with a severer mental
illness; and
WHEREAS, Gulf Bend M1. MR Center has a thirty-four year commitment to
community -based systems of mental health care for children and adults with severe and
persistent mental illnesses living in Calhoun and surrounding counties; and
WHEREAS, the National Mental Health Association, the National Council for
Community Behavioral Healthcare and their national partners observe Mental Health Month
each May to raise awareness and understanding of mental health and illness.
NOW, THEREFORE, BE IT RESOLVED that the Commissioners' Court of Calhoun
County, Texas does hereby declare May, 2004 as Mental Health Month in Calhoun County, and
BE IT FURTHER RESOLVED that the Commissioners' Court calls upon all citizens to
commit to learn more about mental illness and the need for appropriate and accessible services
for all people with mental illness.
Signed and Sealed this the 131h day of May, 2004
Michael J. Pfelf6r, Co' u ge
/j Calhoun County, Texas
oger Ga van, Cot issioner Michael Balajka, Commissio0er
Precinct'. o. I Precinct No. 2
H. Floyd, Commissioner Y Kenneth W. Finster, Commissioner
Precinct No. 3 Precinct No. 4
•
5J9
A Motion was made by Commissioner Balajka and seconded by Commissioner Galvan to re-
appoint Mrs. Annette Pfeil to another two-year term, July 2004 through June 2006, to the Gulf
Bend Center Board of Trustees. Commissioners' Galvan, Balajka, Floyd, Finster and Judge Pfeifer
all voted in favor.
HEAR REPORT FROM MEMORIAL MEDICAL CENTER.
The Memorial Medical Center monthly financial report was presented by Saad Makhail.
Buzz Currier spoke to the Court in regards to the hospital still pursuing the critical care facility,
and should be awarded in the next 60 days. They are recruiting new physicians at this time, one
for Dr. McFarland's Office and one pediatrician. The five-year budget plan has been done and
each Commissioner and Judge has received one.
MEMORIAL MEDICAL CENTER
YEAR-TO-DATE SUMMARY
MARCH 31, 2004
OPERATING REVENUE
4,134,314
LESS:
OPERATING EXPENSES
(4,307,712)
(173,398)
CHANGE IN INVESTMENT:
Accounts Receivable-
267,409
(Incr) Decr
Accounts Payable-
(15,041)
Incr (Decr)
Prepaid Expense-
(105,904)
. (Incr) Decr
Inventory
3,092
(Incr) Decr
149,556
TOTAL INVESTMENT CHANGE
(INCR) DECR
(23,842)
PLUS:
Depreciation
371,747
Contribution to the County
0
347,905
PLUS:
County Subsidies Hospital
0
Total Cash-
347,905
Incr (Decr)
LESS:
. Equipment Purchases
(18,521)
NET CASH- ]NCR (DECR)
329,384
1
560
CALROUN COUNTY, TEXAS
COUNTY TREASURER'S REPORT
MONTH Or: MARCH tow
BEGVVN➢VG
ENDING
FUND
FUND BALANCE
RECEIPTS
DLSBURSEMEMS
FUND BALANCE
MEMORIAL MEDICAL CENTEFU
OPERATING
MEMORIAL
RESTRICTED DONATION
$591,899.26
17251.29
13,68238
$1,700,010.59
21.92
17.38
$1,519,783.08
0.00
0.00
$772,126.77
17273.21
13,699.76
INDIGENT HEALTHCARE
183,12621
120y40.71
179,391.45
123,975.47
TOTALS
$805,959.14
$1,820,290.60
$1,699,17453
5927,075.21
BANK RECONCHAATION
LESS. CART.
POND
OFDEPOSIT
PLUS: CIfECKB
BANK
FUND
BALANCE
OTHER ITEMS
OUTSTANDING
BALANCE
MEMORIAL MEDICAL CENTER
OPERATING
772.126.77
0.00
111,390.34
883,517.11
IAPMORIAL
17,27321
0.00
Om
1727321
RESTRICTED DONATION
13,699.76
0.00
0.00
13 fi99.76
INDIGENT HEALTHCARE
123,975.47
0.01
238.94
124214.40
TOTALS
$927,075.21
$0.011
$111,629.n
S3,038,704A8
2 5 UJL
0
i
•
MEMORIAL MEDICAL CENTER
PORT LAVACA, TEXAS
PHYSICIAN'S
ANALYSIS REPORT
MARCH 31, 2004
•
YTD
YTD
YTD.
REVENUE
CONTRACTUAL -
WR1T&OFF
NET REVENUE
NAME
MONTH
YTD
AMOUNT
AMOUNT
GENmtATED
PERCENT
APOSTOL, C.F.
64,118.86
148,062.03
24,562.03
9,475.97
114,024.03
77%
WILLIAM, GA
110,309.41
338,303.10
67,849.76
21,651.40
248,801.95
74%
LJN, M.S.
134,890.52
440,435.32
159,832.65
28,187.86
252,414.81
57%
SMITH, J.K.
73,671.38
300,504.78
91,407.31
19,232.31
189,865.16
- 63%
CHEN, D.
1 0.00
126,069.60
52,070.36
8,068.45
65,930.79
52%
MCFARLAND, T.R.
168,880.57
620,991.78
165,292.91
39,743.47
415,955.39
67%
GRIFFIN, JEANNINE
19,639.24
55,833.45
(7,264.24)
3,573.34
59,524.35
71%
BUNNELL, D.P.
243,040.58
735,612.79
257,325.47
47,079.22
431,208.10
59%
NIRATSUWAN
21,192.80
111,269.81
11,346.73
7,12117
92,801.81
83%
ARROYO-DIAZ, R.
226,600.88
626,534.17
233,878.68
40,098.19
352,557.31
56%
GILL, J.
114,139.59
259,827.38
52,023.95
16,628.95
191,174.48
740/6
WILLIAMS, WES
80,937.05
176,663.10
23,552.54
11,306.44
141,804.12
80%
`�-...
CUMMINS, M.
55,843.50
110,330.52
35,710.06
7,061.15
67,559.31
61%
RUPLEY, M.
3,630.37
37,567.85
3,662.92
2,404.34
31,500.58
84%
LEE, J
41,387.22
164,849.23
63,451.42
10,550.35
90,847.46
55%
0.00
0.00
0.00
0.00
STEINBERG, R
4,755.26
27,211.27
3,394.31
1,741.52
22,075.44
81%
RAMOS LABORATORY
5,622.25
11,422.99
0.00
731.07
10,691.92
94%
VISITING PHYSICIANS
322,532.87
910,922.15
226,104.51
58,299.02
626,518.62
69%
•
ER PHYSICIANS
564,188.28
1,595,823.22
246,742.88 -
102,132.69
1,246,947.66
78%
NO LOCAL PHYSICIAN
307.66
2,443.96
712.59
156.41
1,574.96
64%
OTHER
516,450.11
1,474,765.06
195,055.74
94,646.57
1,185,062.75
800%
TOTAL.
2,772,138.41
8,275,443.57
1,906,712.58
529,889.99
5,839,841.00
71%
3
•
M MIAL MEDICAL CENTER
BRIANCE SHEET 04/14/64 10:10 AM
AS OF: 03/31/04
THIS YEAR LAST YEAR LAST MONTH
03/31/04 03/31/03 V/29/04
ir•�T .a, ,
OPERATING FLN
772,126.77
1,806,%8.20
591,899.26
IMPREST CASH ACCOUNT
5,008.00
5,M.00
5,M.00
PETTY CASH
625.00
625.08
625.08
W BON) PROCEEDS
00
. m
.00
MW 18I9PITAL PORTION
.0B
.90
.00
RESTRICTED DONATION
13. T39.36
13,455.53
13,714.21
W BON) SINNING FLRD)/INTEREST
36.21
36.21
36.21
TOTAL CASH .....................
791,527.34
1, 826, 084.94
611,274.68
iCCMWS RECEIVABLE
PATIENT ACCDL TS RECEIVABLE
4, 564, 551. 76
4, 755, 436.11
4, 92,157.72
ALLOWANCE FOR BAD DEBT
(2,191,026.a)
(a,224,666.00)
(2,376,123.90)
PLAZA SPECIALTY CLINICS RECEIVARL
.86
.00
.00
MISC ACCMWTS RECEIVABLE
290,706.19
247,417.97
349,948.50
THIRD PARTY RECEIVABLE
.00
63,718.00
.00
TIF GRANT
.Am
.08
.00
TOTAL ACCOIR(fS RECEIVABLE......
2,664,232..Z
2, 841, 906. 08
2,931,90.22
NVENTORIES
RADIOOBY--FILM
5,04153
6,905.79
7,072.79
LABORATORY
75,558.80
59,923.79
88,287.79
CENTRAL GUPPLY
A 572.35
189,350.92
97,284.89
SURGERY
162,995.86
149,503.30
162,995.86
DIETARY
9,US. 88
9,785.62
9,MG. 88
PBAINfE11ANCE
3,424.32
4,6T7.96
3,424.32
PIAWm
121,499.:M
146,531.74
121,499.22
TOTAL INVENTORY ................
466,988.96
486,679.12
490,451.75
)REPAID EXPENSES
PREPAID INSURANCE
96 292.06
79,352.46
42,424.46
PREPAID EXPENSES
58,282.97
49,980.28
87,630.60
TDTAI. PREPAID EXPENSES.........
154,575.03
129,332.74
130,855.06
TOTAL CURRENT ASSETS...........
4,077,315.88
5,284,002.88
4,163,764.71
MPERTY, PLANT, I EQUIPMENT
LAND
32,142.60
32,142.60
32 142.60
BIJILDIN69
8,07,744.87
8,827,365.87
8,837,744.87
FIXED EDUIPMW
2,413,482.93
2,408,710.36
2,413,482.03
MA30R MOVABLE EQUIPMENT
9,938,388.73
9,308,828.41
9,921,635.79
MEMORIAL MEDICAL PLAZA
7,249,846.35
7,245,046.35
7,249,846.35
REPORTABLE BOB) IS9IARNCE COST
70,557.08
76,557.00
70,557.00
C26TWION IN PROGRESS
.00
.@
.86
LESS: ACCUMULATED DEPRECIATION
(16,798,767.68)
(15,A348.69)
(16,674,861.88)
TOTAL PROPERTY, PLANT, d EQUIP
11,743,393.90
12,592,301.90
11, 858, 546.84
TOTAL UNRESTRICTED ASSETS .....
15, 820, 709.78
17,876,304.78
16,014,311.55
4
C
563
•
•
E
MMIAL 4l;DIC(U_ CENTER
r
BALANCE SHEET
04/14/84 10:16 AN
AS OF: 63/31/04
THIS YEAR
LAST YEAR
LAST MM
ON31134
03/31/03
02/29/54
IRRk LIABILITIES
ACCOUNTS PAYABLE
527,844.71
533,646.4E
548,899.62
ACCRUED PAYABLE
59,542.02
166,673.79
53,654.56
ACCRUED PAYROLL
258,199.34
286,210.02
265,984.07
ACCRUED RETIREMENT
(17.36)
(331.33)
(17.30)
ACCRUED STATE SALES TAX
3.38
.00
(.03)
THIRD PARTY PAYABLES
.00
275,602.00
.00
qFFRETENTION-CONSTRUCTION IN PR(ERES
.00
.00
.00
ACCRUED VACATION/H(LIDAY/SICK
284,643.39
284,643.39
284,W.39
CAPITAL LEASES OBLIGATION
396,83200
3%,832.N
3%,83208
MP BONDS
.00
.00
. m
REPORTABLE BNB) DISCOUNT
(18,290.001
(18,290.60)
(18,298.80)
IOSP OBLIGATION FOR BONDS
24,222.Be
(2,939.a)
41,731.38
TOTAL CURRENT LIABILITIES......
1,532,979.54
1,922,947.35
1,573,437.63
IN TERN LIABILITIES
MCP BOW
2,316,M.Be
2,490,000.00
2,310,000.00
LONG TERN LEASE
1,107,360.00
1,197,368.00
1,107,362.00
TOTAL LONG TERN LIABILITIES....
3,417,360.00
3,597,360.M
3,417,360.00
TOTAL LIABILITIES .............
4,950,339.54
5,520,307.35
4,990,797.63
RET)-. 8 EARNINGS
GENERAL FUND BALANCES
11,415,515.22
12,146,196.45
11,415,515.20
YERR-TO-DATE GAIN/LOSS
(545,144.96)
209,800.98
(392,001.28)
TOTAL GENERAL FUND BALANCE.....
10,870,370.24
12,355,997.43
11,023,513.92
• TOTAL UNRESTRICTED LIABILITIES.
15,820,709.76
17,876,304.76
16,014,311.55
RESTRICTED FUND ASSETS
ItWRIAL FUND
17,273.21
16,965.27
17,251.29
FORM TRUST
533,637.41
533,637.41
533,637.41
TOTAL RESTRICTED FUND ASSETS...
5%,910.62
550,602.68
55% US.70
RESTRICTED FUND LIABILITIES
RESTRICTED FUND BALANCE
17,273.21
16,965.27
17,251.29
FORMOSA TRUST BALANCE
533,637.41
533,637.41
533,637.41
-VITAL RESTRICTED FUND LIAR.....
550,910.62
550,W.58
550,SM. 70
r
L_J
5
564
Operating Revenue
Inpatient Revenue:
Medicare
Medicaid
Other
Total IP Revenue
YTD IP Revenue Variance
Outpatient Revenue
Medicare
Medicaid
Other
Total OP Revenue
YTD OP Revenue Variance
MEMORIAL MEDICAL CENTER
OPERATING STATEMENT
Forth@ 03 Months Ending
March 31, 2004
SINGLE MONTH —
Current Budget Prior Year
346,077.7S 565,418.04 724,451.87
150,535.93 164,26414 134,714.58
217,921.84 320,676.66 _ 317,851.87
714,535.52 1,050,358.94 1,177,018.32
903,390.49 1,088,294.93 750,909.72
242,519.17 164,977.83 139,337.18
911,69323 739,131.50 1,084,168.13
2,057,602.89 1,992,40426 1,974,415.03
Total Operating Revenue 2,772,138.41 3,042,763.20 3,151,433.35
YTD Total Revenue Variance
Revenue Deductions
Medicare Cont. Adj.
(741,829.22)
(780,909.41)
(955,531.17)
Medicare Pass-thru
69,447.87
0.00
36,972.00
Medicaid Cont. Adj.
(213,933.01)
(166,694.37)
(246.172.47)
IndigentlCharity Cont. Adj.
(98,675.57)
(89,836.67)
(52,272AS)
Bad Debt Expense
(150,800.17)
(177.797.54)
(174.905.78)
Other Deductions
(234,511.10)
(243,832.52)_
(228,374.70)
Total Rev Deductions
(1,370,301.20)
(1,469,070.51)
(1,620,284.60)
Deducts as % of Oper Revenue
Payments as % of Oper Revenue
Other Revenue
Cafeteria Sales
Interest Income
Interest from Bonds
Interest from Hosp Portion
Mail Rental
Miscellaneous Income
Total Other Revenue
Net Revenue
YEAR TO DATE —
Current YTD Budget YTD Pdor YTD
1,276,529.59
1,659,77528
2,016,262.81
478,41SA3
482,194.65
373,277.11
782,555.73
941,34120
856,955.69
2,537,500.75
3,083,311.33
3,246,495.61
(545,81D.58 (708,994.88
2,614,711.77 3,194,674.16 2,143,534.38
669,242.08 484,269.70 391,875.11
2,453,988.97 2,169,708.61 3,317,169.13
5,737,942.82 5,848,672A7 5,852,578.62
110,729.85) (114,635.80)
8,275,443.57 8,931,983.80 9,099,074.23
E
658,540.23) F (823,630.66)
(2,431,487.96)
(2,292,346.79)
(2,553,785.67)
170,240.59
0.00
168,435.37
(546,841.54)
(489,328.55)
(579,130.B4)
(290,826.40)
(269,610.01)
(151,810.74)
(529,889.99)
(521,921.78)
(580,044.87)
(584,280,79)
(715,766.56)
(597,363.07)
(4,213,086.09) (4,288,873.69) (4,293,699.82)
52.97% 48.02% 49.04%
47.03% 51.98% 50.98°h
8,652.21
7,622.95
8,321.08
25,281.23
22,377.05
24,568.18
1,314.39
2,640.98
5,756.78
4,204.80
7,459.02
14,194.73
25.15
0.00
37.04
73.99
0.00
107.25
0.00
0.00
0.00
0.00
0.00
0.00
7,432.90
0.00
11,604.52
21,770.75
0.00
31,101.18
12,210.35
2,964.48_
5,528.92
20,625.39
8,702.20
87,926.01
29,635.00
13,128.41
31,248.34
71,956.16
38,538.27
157.897.35
1,431,47221
1,596,821.10
1,562,397.09
4,134,313.64
4,681,648.38
4,9e3,271.76
Page -1-
6
•
MEMORIAL MEDICAL CENTER
OPERATING STATEMENT
�-� For the 03 Months Ending
March 31, 2004
SINGLEMONTH —
Current Budget Prior Year
Operating Expense
Salaries
584,739.92
616,169.23
585,205.36
Employee Benefits
200,327.37
153,095.97
127,674.96
Professional Fees
203,464.56
239,139.51
251,419.82
Plant Operation
38,639.87
34,780.27
34,564.07
Hospital General
51,416.86
50,583.34
50,235.49
Other Operating Expenses
383,548.47
464,642.92
409,176.08
Total Operating Expense
1,462,137.05
1,558,411.24
1,458,265.78
Net Operating Gainl(Loss)
(30,664.84)
38,409.86
104,131.31
Non -Operating Expense
Depreciation
123.905.88
126,932.50
126,444.79
Contribution to County
0.00
0.00
0.00
.10al Non -Operating Expense
123,905.88
126,932.50
126,444.79
�..�..al Operating Gaird(Loss)
(154,570,72)
(88,522,64)
(22,313,48)
County Subsidy
0.00
0.00
(28,341.13)
Net Gaini(Loss) after Subsidy
(154,570,72)
(88,522,64)
6,027.65
0
Pepe •l.
•
YEAR TO DATE —
Current YTD Budget YTD Prior YTD
1,714,473.84
1,808,754.69
1,752,945.73
560,437.56
449,410.79
383,680.99
608,633.84
717,668.53
706,890.39
112,882.40
104,103.09
91,958.51
154,636.20
_ 151,750.02
155,265.91
1,158,075.12
1,375,023.40
1,309,506.13
4,309,138.96
- 4,606,710.52
4,400,247.66
297,571.57)
F (91,108.70)
(174,825,32)
74,937.86
563,024.10
371,746.68
380,797.50
381,56425
0.00
0.00
0.00
371,746.68
380,797.50
381,664.25
(546,572.00)
- (305,859.64)
181,459.85
0.00
0.00
(28,341.13)
(546,572.0(1) (305,859,64) 209,800.98
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IdBmNG STATION
ACitlAL
VENUE
DUTINE REVENUE
14,M.00
TOTAL REVENUE.
14,200.00
PENSES
(ALARIES
18,616.59
EXPENSES
,3B7.78
TOTAL EXPENSES
22,804.29
NET GAIN/(LOSS
(7,884.29)
:D/SURG NURSING STATION
:VENUE
ROUTINE REVENUE
84,870.08
TOTAL REVENUE.
84,870.00
XPENSES
SALARIES
62,437.31
OTHER EXPENSES
9,596.65
TOTAL EXPENSES
70,M.96
NET GAIN/(LOSS
14,834.04
:CU NURSING STATION
1EVENUE
IN'?TT REVENU
43,660.80
OLI ... IENT REVEN
.80
TOTAL REVENUE.
43,660.80
EXPENSES
SALARIES
32,689.47
OTHER EXPENSES
5,958.50
TOTAL EXPENSES
38.647.97
NET GAIN](LOSS
*RSERY
5,012.03
NURSING STATION
REVENUE
ROUTING_ REVENUE
11,530.00
TOTAL REVENUE.
11,532.00
EXPENSES
SALARIES
14,166.15
OTHER EXPENSES
1,673.89
TOTAL EXPENSES 15,840.14
NET GAIN/(LOSS 14,310.64)
MEMORIAL MEDICAL CENTER
DEPARTMENTAL INCOME
STATEMENT
94/14/04 10:10 AM
FOR THE 3 MONTHS ENDING 031184
SINGLE
MONTH
YEAR TO
DATE
BUDGET
$ VARIANCE
X VAR
ACTUAL
BUDGET
$ VARIANCE
% VAR
15,272.14
(1,872.14)
(7.02)
40,085.00
44,831.38
(4,746.08)
(13.58)
15,272.14
(1,072.14)
(7.82)
40,085.00
44,831.08
(4,746.08)
(10.58)
17,909.79
(706.80)
(3.94)
67,692.74
52,573.85
(15,118.89)
(28.75)
2,722.91
(664.79)
124.41)
11,819.81
7,906.49
(3,113.32)
(39.37)
20,632.70
(1,371.59)
(6.64)
78,712.55
62,480.34
(18,232.21)
(30.14)
15,MO. 56)
(2,443.73)
(45.5B)
(38,627.55)
(15,649.26)
(22,978.29)
(146.83)
135,132.56
(50,26L56)
137.19)
328,335.30
396,679.41
(68,294.41)
(17.21)
135,132.56
(50,262.56)
(37.19)
328,385.00
396,679.41
(G8,294.41)
(17.21)
79,410.99
18,973.68
23.89
212,814.12
24 109.69
20,295.57
8.70
29,468.84
19,870.19
67.42
43,762.68
87,696.41
43,933.73
50.09
108,879.83
38,843.87
35.67
256,576.80
3a,a&10
64,229.30
20.22
26,25273
(11,418.69)
(43.49)
71,us. 20
75,873.31
(4,00.11)
(5.35)
71,520.59
(27,860.59)
(38.95)
156,970.00
209,947.47
(52,977.47)
(25.23)
.00
.08
.00
.00
.00
.02
.00
71,520.59
(27,860.59)
(38.95)
156,970.00
209,947.47
(2,977.47)
(25.23)
45,W.75
13,144.28
28.67
110,491.31
134,544.25
24,052.94
17.87
17,185.58
11,227.08
65.32
18,%3.70
51,098.09
32,134.39
62.88
63,219.33
24,371.3E
38.67
129,455.01
185,642.34
56,187.33
30.2E
8,521.26
(3,489.23)
(41.04)
27,514.99
24,305.13
3,M.86
13.20
10,628.50
901.50
8.48
31,77L W
31,199.80
57L20
1.82
10,628.50
901.50
8.48
31,770.00
31,199.80
570.20
1.82
11,057.94
(3,108.2ll
(28.10)
34,898.18
32,460.38
(1,637.72)
(5.04)
2,281.74
607.85
26.63
9,494.24
6,728.78
12,675.46)
139.76)
13,339.68
(2,582.36)
(18,74)
43,502.34
39,189.16
(4,313.18)
(11.00)
(2,711.18)
(1,598.86)
(58.97)
(11,732.341
(7,989.36)
(3,742. 98)
146.84)
9
568
INPATIENT REM
51,431.80
OUTPATIENT REVEN
139,332.00
TOTAL REVERIE.
-EXPENSES
190,763.80
SALARIES
44,179.53
LEASE AND RENTAL
552.48
OTHER EXPENSES
23,M.43
TOTAL EXPENSES
68,307.44
NET GAIN/(LOSS 122,456.36
SWING BED
ROUTINE REVENUE
.00
TOTAL REYBIRE.
.09
EXPENSES
SALARIES
.00
OTHER EXPENSES
101L25
TOTAL EXPENSES
10&25
NET OIIN/REVEN
(10&25;
OBSERYRTION MEVENRE
REVENUE
INPATIENT REVENO
.00
OUTPATIENT REVEN
6,89L00
TOTAL REVENUE.
6,898.00
LABOR AND DELIVERY
REVERE
INPATIENT RBENU
6,705.88
(RUTPATIENT EVEN
809.75
TOTAL REVERE.
EXPENSES
7,514.75
CARIES
8,GE& 45
OTHER EXPENSES
1,666.57
TOTAL EXPENSES It, M.22
NET GAIN/(LOSS (2,780.27)
MEMORIAL MEDICAL CENTER
DEPAROO'NTUD. INCOME STATEMENT
04/14/04
10-10 AN
FOR
THE 3 MONTHS ENDING 03131104
S I N 6 L E
MONTH
YEAR TO
DATE
BUOGET
S VARIANCE
f( VAR
ACRIAL
AU06Ei
S VARIANCE
% VAR
64,648.74
(13,216.94)
(2& 44)
148,847.10
189,775.37
(40,928.27)
(21.56)
173,680.01
(34,348.01)
(19,77)
364,836.75
509,835.01
(144,998.26)
(28.44)
238,328.75
(47,564,95)
(19.95)
513,6B3.85
693,612.38
(185,926.53)
(26.57)
52,125.49
7,945.96
15.24
118,782.67
153,013.51
34,230.84
22.37
4,884.33
4,331.85
G8.68
2,709.11
14,652.99
11,943.88
81.51
44,611.17
21,035.74
47.15
81,23& 34
131,149.49
49,919.15
38.06
101,620.99
33,313.55
M 78
202,722.12
298,815.99
96,093.87
32.15
136,707.76
(14,251.40)
(10.42)
310,961.73
400,794.39
(89,832.66)
(22.41)
2,395.97
(2,395.97)
(100.00)
4,250.99
7,@a 35
(2,783.351
(39.57)
2,395.97
(2,395.97)
(100.00)
4,25&00
7,033.35
(2,783.35)
(33.57)
.00
.00
.00
.00
.80
.00
.00
.00
(112.25)
.00
11&25
ea
(112.25)
.28
.00
(10& 25)
.00
118.25
.00
(110.25)
.00
2,395.97
(2,496.22)
(104.18)
4,139.75
7,033.35
(2,893.66)
(41.14)
.00
.00
.00
.00
.00
.00
.00
19,124.06
(12,234.06)
(61 97)
23,125.00
56,138.39
(4013.39)
(58.80)
19,124.06
(12,234.06)
(63.97)
23,125.90
56,138.39
(33,013.391
(58.861
11,250.79
(4,545.70)
(40.40)
26,141.00
33,MG. 24
(6,885.24)
(20.84)
1,412.16
(692.41)
(42.65)
3,269.00
4,145.37
(876.37)
(21.14)
•
12,662.86
(5,1413.11)
(40.65)
29,410.00
37,171.61
(7,761.61)
(20.a8)
17, 853. 47
8, 4Z5. 02
49.46
26,178.41
50, NO.17
23, 889. 76
47.72
2,973.95
1,W.38
43.%
7,518.51
6,734.90
1,216.39
13.92
20,82.7.42
9,72P,40
48.59
33,M.92
58,795.07
25,106.15
42.79
(7,364.56)
4,W.29
62.24
(4,278.92)
(21,623.46)
17,344.54
80.21
10
569
A
I
ACTUAL
NTRA�SUPPLY
VENIE
NPATIENT REVENU
34,825.17
UTPATIENT REVEN
7,5B4.40
TOTAL REVENUE.
41,609.57
:PENSES
1,478.65
EXPENSES
:EXPENSES
11,066.83
TOTAL EXPENSES
12,545.48
NET GAIN/(LOSS
29,864.09
HARMACY AND IV THERAPY
EVENUE
INPATIENT REVENU
143,396.60
OUTPATIENT REVEN
97,886.91
TOTAL REVENUE.
241,283.51
XPEPSES
SALARIES
9,745.82
PROFESSIONAL FEE
7,867.00
EXPENSES
37,678.45
TOTAL EXPENSES
55,290.47
tNT�,GRIN/(LOSS
185,993.04
YF`. tSION THERAPY
TEVENUE
INPATIENT REVENU
.08
OUTPATIENT REVEN
.00
TOTAL REVENUE.
.00
EXPENSES
SALARIES
.09
OTHER EXPENSES
.00
TOTAL EXPENSES
.09
NET GAIN/(LESS
.00
•
MEMORIAL MEDICAL (ENTER
DEPARTMENTAL INIXBE STATEMENT
FOR THE 3 MONTHS ENDING 03/31/04
SINGLE N 0 N T H
BUDGET $ VARIANCE % VAR
04/14/64 10:10 AN
Y E A A TO DATE
ACTUAL BUDGET $ VARIANCE % VAR
64,939.73
(3% 913.56)
(47.60)
107,242.57
190,626.54
(83,383.97)
(43.74)
15,596.06
18,011.66I
(51.36)
26,656.90
45,781.95
(19,125.05)
(41.77)
82,534.79
(36,925.22)
(48.33)
133,899.47
236,488.49
t102,509.02)
(43.36)
2,910.44
1,431.79
49.19
4,657.91
8,543.SO
3,885.69
45.48
33,774.77
22,707.94
67.23
34,919.63
99,149.57
64,229.94
64.78
36,685.21
24,139.73
65.80
39,577.54
107,693.17
68,115.63
63.24
43,849.58
(14,78149)
(33.71)
94,M.93
128,715.32
(34,393.39)
(26.72)
252,129.50
(108,732.90)
(43.12)
547,065.87
746,121 01
(193,056.14)
(26.08)
122,B25.80
(24,938.89)
(20.30)
256,838.05
368,52.24
(183,715.19)
(28.76)
374,955.30
(133,671.79)
(35.65)
BE,903.92
1,108,675.25
(296,771.33)
(26.96)
7,533.26
(2,211.76)
t29.35)
27,777.20
22,113.70
(5,663.56)
(25.61)
7,916.67
49.67
.62
23,601.90
23,758.01
149.01
.62
49,789.72
12,031.27
24.20
134,845.22
145,600.99
10,755.77
7.38
65,159.65
9,869.18
15.14
186,223.42
191,464.70
5,241.28
2.73
309,795.65
(123,802.61)
(39.96)
617,680.50
909,210.55
(291,530.05)
(32.86)
.00
.20
.80
.00
.00
.00
.80
.00
.03
.00
.00
.02
.00
.00
.00
.08
.90
.00
.00
.00
.00
.00
.20
.08
.00
.00
.20
.00
.09
.90
.00
.00
.92
.00
.00
.00
.00
.02
.00
.00
.09
.60
.09
.06
.00
.00
.00
.00
.00
11
5'i0
MEMORIAL MEDICAL CENTER
DEPARTMENTAL IPA STATEMENT
64/14/84
10:10 AM
FOR
THE 3 MONTHS ENDING 63/31/04
SINGLE
MONTH
YEAR TO
DATE
ACRIAL
BUDGET
4 VARIAMM
% VAR
ACTUAL
BUDGET
S VARIANCE
% VAR
EMERGENCY ROOM
REVENUE
,..�
INPATIENT REVENU
32,396.25
26,140.02
6,256.23
23.93
103,319.25
76,733.70
26,585.55
34.64
OUTPATIENT EVEN
177,314.25
151,092.40
26,221.85
17.35
483,395.88
443,529.44
39,866.44
8.98
TOTAL REVENUE.
209,710.50
177,232.42
32,478.88
18.32
586,715.13
52% 263.14
66,451.39
12.77
EXPENSES
SALARIES
PROFESSIONAL FEE
57,030.08
53,423.33
I3,606.751
(6.75)
153,847.53
156,823.35
2,975.E
1.89
A750.17
76,666.67
(4,083.58)
(5.32)
243,480.81
230,800.01
(13,480.80)
(5.86)
LEASE d RENTAL
1,971.75
2,M.00
2125
1.41
6,474.58
6,on. 00
(474.58)
(7.90)
OTHER EXPENSES
15,252.95
9,429.28
(5,823.67)
(61.76)
33,796.78
27,831.31
(5,965.47)
(21.43)
TOTAL EXPENSES
155,094.95
141,519.28
(13,485.67)
(9.52)
437,599.70
420,654.67
(16,345.03)
(4.02)
NET GAIN/(LOSS
54,70.9.55
35,713.14
18,992.41
53.18
149,115.43
99,608.47
49,506.%
49.70
ER PHYSICIANS
REVENUE
INPATIENT REVENU
19,86125
12,093.63
7,769.62
64.24
39,727.00
35,500.57
24,2P6.43
68.24
OUTPATIENT REVEN
128,790.25
120,638.25
8,15.00
6.75
369,W.87
354,131.62
15,771.25
4.45
TOTAL REVENUE.
148,653.50
132,731.88
15,92:1.62
11.99
429,6IS.87
389,632.19
39,S97.68
10.26
EMERY MEDICAL SERVICE
REVENUE
INPATIENT REVENU
00
.00
.08
.06
.06
.00
.00
.08
OUTPATIENT REUEN
.00
.00
.80
.00
.00
.00
.08
.00
TOTAL REVENUE.
.00
.89
.00
.00
.00
.00
80
.90
EXPENSES
SALARIES
.00
.00
.00
.00
.00
.00
.00
.00
LEASE 6 RENTAL
423.11
.a
(42111)
.80
1,062.55
.99
(1,062.55)
.00
OTHER EXPENSES
.90
.00
.00
.00
.00
.00
.00
.06
CITY SUBSIDY
.09
.00
.08
.00
.00
.00
.00
.00
COUNTY SUBSIDY
.60
.00
.00
.80
.08
.@$
.00
.90
TOTAL EXPENSES
423.11
.w
(42:4.11)
00
1,862.55
.90
(1,062.55)
.00
NET GAIN/(LOSS
(423.11)
.00
(423.11)
.00
(1,062.55)
.08
(1,062.55)
.00
LABORATORY d PATHOLOGY
REVENUE
INPATIENT REVENU
84,362.70
104,237.94
(19,875.24)
(19.06)
275,792.61
305,986.67
(30,196.06)
(9.86)
OUTPATIENT REVEN
251,826.26
228,819.20
23,087.06
10.0.5
718,984.31
671,697.13
47,287.18
7.03
TOTAL REVENUE.
336,18L 96
333,057.14
3,131.82
.94
994,776.92
977,685.80
17,091.12
1.74
EXPENSES
SALARIES
40,%4.06
45,099.83
4,135.77
9.17
112,343.25
132,389.85
20,M.60
15.14
LEAK 6 RENTAL
5,23L 33
4,758.00
1480,33)
(IL 11)
13,590.30
14,250.00
659.70
4.62
OTHER EXPENSES
56,473.19
55,201.88
(1,271.31)
(2.30)
167,967.56
163,183.33
(4,864.23)
(2.98)
TOTAL EXPENSES
102,667.58
105,051.71
2,3B4.13
2.26
293,901.11
389,743.18
15,842.07
5.11
NET GAIN/(LOSS
233,521.3E
228,M.43
5,515.95
2.41
703,875.81
667,942.62
32,933.19
4.93
12
5`�
•
_OOO�lK
ACTUAL
:VENUE
INPATIENT REVENU
23,291.50
RRATIENT REVEN
5,928.25
TOTAL REVENUE.
29,219.75
XPENSES
5
6, W.96
TOTAL EXPENSES
6,147.96
NET GREW (LOSS
23,071.79
CCUPATIONAL MEDICINE
EYED
INPATIENT REVENU
.00
OUTPATIENT REVEN
00
TOTAL REVENUE.
00
Xeas
PROFESSIONAL FEE
00
OTHER EXPENSES
.80
TOTAL EXPENSES
00
NET GAIN/ILOSS
.a
SAFETY TESTING
;Ey^
OiY ....rIENT REVEN
.00
TOTAL REVEWIE.
00
PENSES
SALARIES
00
OTHER EXPENSES
.00
TOTAL EXPENSES
.00
NET GAIN/(LOSS
.00
ROCRRDIOLOGAAPHY
(EKG)
REVENUE
INPATIENT REVENU
7,768.00
D UTPATIENT REVEN
37,539.75
TOTAL REVEWIE.
45,299.75
EXPENSES
EXPENSES
2,716.83
TOTAL EXPENSES
2,7ML 83
NET GAIW/ LOSS
42,590.92
0
MEMORIAL MEDICAL CENTER
DEPAR1HMAL INCOME STATE1011T
FOR THE 3 NUNN ENDING 03/31/04
5IN6LE M0NTN
BUDGET I VARIANCE % VAR
04/14/04 10:10 AM
YEAR TO DATE
ACTUAL BUDGET $ VARIANCE % VAR
14,693.30
a,598.20
58.51
73,682.36
43,131.91
30,MO. 45
70.83
5,655.88
272.37
4.81
18,289.00
16,602.81
1,686.19
10.15
A 349.18
8,870.57
43.59
91,971.36
59,734.72
32,236.64
53.96
5,801.91
(346.05)
(5.96)
19,328.82
17,031.45
(2,297.37)
(13.48)
5,801.91
(346.05)
(5.96)
19,328.82
17,831.45
(2,297.37)
(13.48)
14,547.27
8,524.52
58.59
72,W.54
42,783.27
29,939.27
70.11
.00
.00
.08
.00
.00
.00
.00
.82
00
.80
.00
.00
.00
.00
.80
.62
.08
.00
.00
.08
.80
.00
.00
.68
.00
.00
.86
.00
.00
.02
.00
.00
.00
Am
.18
.02
.00
.00
.08
.SO
.00
.00
00
.00
.00
.00
.SO
.00
.00
.02
.00
.00
.00
.00
.00
.00
.09
.80
.90
.00
.00
.00
.00
.a
.00
.80
.20
.00
.90
.00
.60
.00
.00
.00
.00
.00
.00
.00
.00
.00
.90
.00
.08
.02
0m
w
.og
.00
.00
.06
.00
17,SU.19
(9,906.191
(56.07)
42,199.50
51,&M.77
111,659.27)
122.48)
50,853.94
(13,314.19)
(26.18)
114,984.25
149,2B0.89
(34,296.64)
(22.97)
68,520.13
(23,220.38)
(33.88)
155,183.75
281,139.66
(45,955.91)
122.84)
2,971.41
26L 58
8.83
7,897.77
8,766.59
868.82
9.91
2,971.41
252.58
8.83
7,897.77
8,766.59
868.82
9.91
65,548.72
(22,957.80)
(35.02)
147,285.98
192,373.07
(45,087.09)
(23.43)
13
572
MEMORIAL MEDICAL CENTER
DEPRRTPffNTAL INCOME
STATEMENT
04/14104
10:10 AM
FOR
THE 3 MONTHS ENDING 03/31/04
SINGLE
M 0 N T H
YEAR TO
DATE
AL'm
BUDGET
i VARIANCE
% VAR
ACTUAL
BUDGET
$ VARIANCE
% VAR
U)I(106'N
Vm
WATIENT REVENU
9,136.50
16,182.32
(7,945.82)
(43.54)
32,137.25
47,502.93
(15,365.68)
(32.34)
RNTPATIENT REVEN
112,379.14
100,179.86
12,199.28
12.17
308,898.53
294,076.31
14,822.22
5.04
TOTAL REVENUE.
121, 515.64
116, 362.18
5,12, 46
4.42
341, 035. 78
341, 579. 24
(543. 46)
(.15)
(PENSES
3P ARIES
E2,224.22
51,474.15
(10,750,07)
(28.88)
143,344.91
151,101.49
7,756.58
5.13
)ROFESSIONAL FEE
2,382.12
2,500.00
117.88
4.71
7,113.92
7,SM. 00
386.68
5.14
rm EXPENSES
11, 0.29
13, W. 04
1,811.75
13.90
33, 811. 47
38, 328.16
4,516.69
11.78
TOTAL EXPENSES
75,827.63
67,W.19
(8,820,44)
(13.16)
184,270.30
196,929.65
12,09.35
6.42
NET GAIN/(LOSS
45,688.61
49,354.99
(3,666.98)
(7,42)
156,765.48
144,649.59
12,115.89
8.37
JCLEAR ME➢ICINE
'vm
INPATIENT REVENU
.90
4,471.85
(4,471,85)
(102.00)
12,806.23
13,127.08
(320.85)
(E.44)
AUTPATIENT iSEN
23,090.02
39,896.27
(16,806,27)
(42.12)
101,449.50
117,114.87
(15,665.37)
(13.37)
TOTAL REVENUE.
23,M.08
44,368.12
(21,278.12)
(47.95)
114,255.73
130,241.95
(15,986.22)
(12.271
XPENSES
OTHER EXPENSES
3,877.23
7,W.47
3,SM,24
49.53
8,754.69
22,702.85
13,948.16
61.43
TOTAL EXPENSES
3,877.23
7,683.47
3,80(i.24
49.53
8,754.69
22,702.85
13,948.16
61.43
NET GAIN/(LOSS
19,212.77
36,684.65
(17,471.88)
(47.62)
105,501.04
107,539.18
(2,038.06)
(1.89)
LTRPSOIRND
EVE L E
INPATIENT REVENU
4,493.25
4,939.21
(455.96)
(9.23)
15,408.78
14,498.99
901.79
6.21
OUTPATIENT EVEN
53,001.56
48,319.17
4,W.,39
9.69
138,M.27
141,840.05
(3,540.79)
(2.49)
TOTAL REVENUE.
57,484.81
53,22.38
4,226.43
7.93
153,708.05
156,339.04
(2,63B.99)
(1.68)
xPENSES
LEASE I RENTAL
.80
.00
.80
.00
.00
.00
.00
.00
OTHER EXPENSES
3,151.66
2,570.46
(581.20)
(22.61)
7,380.22
7,678.54
290.32
3.78
TOTAL EXPENSES
NET GAIN/(LOSS
3,151.66
2,570.46
(581.20)
(22.61)
7.19
7,380.22
7,670.54
290.32
3.78
(1.57)
54,333.15
50,687.92
3,645.23
146,319.83
148,668.50
(2,348.67)
'T SCAN
EVENUE
INPATIENT REVENU
20,233.50
34,411.11
(14,177.61)
(41.20)
64,623.25
161,013.33
(36,390.08)
(36.82)
OUTPATIENT REVEN
166,691.50
140,586.47
26,105.03
18.56
470,167.65
412,689.38
57,478.27
13.92
TOTAL REVENUE.
186,925.00
174,997.58
11,927.42
6.81
534,790.90
513,702.71
21,088.19
4.10
:XPENSE5
LEASE 3 RENTAL
16,550.98
20,000.00
3,450.00
17.25
44,421.24
60,M.00
15,578.76
25.96
OTHER EXPENSES
18,578.30
8,192.62
(10,385„68)
(126.76)
34,108.97
24,115.70
(9,993.27)
(41.43)
TOTAL EXPENSES
35,128.30
28,192.62
(6,935„68)
(24.60)
78,530.21
84,115.70
5,585.49
6.64
NET GAIN/(LOSS
151,796.70
146,804.96
4,991.74
3.40
456,260.69
429,587.01
26,673.68
6.20
14
0
V8(O6 APHY
VENUE
INPATIENT REVEM)
HITPATIENT REVEN
TOTAL REVENUE.
XPENSES
WEXPENSES
TOTAL EXPENSES
NET GAIN/(LOSS
RI
EVENUE
INPATIENT REVEN)
OUTPATIENT REVEN
TOTAL REVENUE.
XPENSES
OTHER EXPENSES
TOTAL EXPENSES
NET GAIN/(LOSS
kIESTHESIA
REV
ir W- REVETB)
DU-.sxiTENT REVEN
TOTAL REVENUE.
EXPENSES
PROFESSIONAL FEE
LEASE I RENTAL
OTHER EXPENSES
TOTAL EXPENSES
NET SAIN/TLOSS
DIALYSIS UNIT
REVENUE
OUTPATIENT REVEN
TOTAL REVENUE.
EXPENSES
SALARIES
OTHER EXPENSES
TOTAL EXPENSES
NET SAIN/(LOSS
•
MEMORIAL MEDICAL CENTER
DEPARTMENTAL INCOM
STATEMENT
64/14/84 10:10 AN
FOR
THE 3 NON)HS ENDING 03/31/04
S I N 6 L E
MONTH
YEAR TO
DATE
ACTUAL
BUDGET
f VARIANCE
X VAR
ACTUAL
BUDGET
f VARIANCE
% VAR
75.80
.00
75.08
.00
155.00
.00
155.60
.80
4,917.52
6,M.89
(1,123.39)
118.59)
18,263.50
17,732.79
330.71
1.86
4,992.50
6,040.89
(1,M.39)
(17.3.5)
18,218.50
17,732.79
485.71
2.73
1,142.12
2,454.84
1,312.72
53.47
3,782.94
7,374.16
3,591.22
48.70
1,142.12
2,454.84
1,312.72
53.47
3,782.94
7,374.16
3,591.22
48.70
3,850.38
3,586.05
264.33
7.37
14,435.56
10,351L63
4,876.93
39.35
4,357.80
19,985.41
(6,628.41)
(68.33)
24,882.54
32 247.42
(7,364.88)
(22.83)
127,336.25
126,976.17
369.08
.28
354,019.27
372,736.44
(18,717.17)
(5.02)
131,693.25
137,961.58
%,268.33)
(4.54)
378,901.81
484,981 M
(26,082.05)
(6.44)
31,625.59
31,690.15
64.56
.20
95,495.26
94,Ea. 21
(866.05)
(.91)
31,625.59
31,699.15
64.56
.20
95,49126
94,629.21
(866.05)
(.91)
102,667.66
106,271.43
(6,203.77)
(5.83)
283,406.55
310,354.65
(26,948.10)
(8.68)
33,317.50
38,692.76
t5,375.20)
(13.89)
103,263.25
113,581.84
(10,318.59)
(9.88)
103,648.75
69,536.91
34,111.84
49.05
228,369.25
204,124.49
24,244.76
11.87
136,%6.25
108,229.61
28,736.64
26.55
331,6Z 50
317,706.33
13,926.17
4.38
37,054.29
44,630.25
7,575.96
16.97
99,654.68
14 890.75
34,236.15
25.57
104.12
58.00
(54.12)
(108.24)
208.59
159.80
(58.59)
(39.66)
3,211.87
3,321.86
189.99
3.31
7,358.14
9,878.14
2,5M 00
25.51
40,370.28
48,002.11
7,631.83
15.89
117,221.33
143,918.89
36,697.56
25.49
%,595.97
60,227.50
36,368.47
60.38
224,411.17
173,787.44
50,623.73
29.12
348,760.06
347,218.34
(6,458.28)
(1.86)
1,321,593.05
1,019,253.82
2,339.23
.22
348,760.06
347,218.34
(6,458.28)
(1.86)
1,021,593.05
1,019,253.82
2,339.23
.22
27,817.45
27,EN. 74
613.29
2.21
77,416.10
81,109.58
3,693.48
4.55
60,097.03
56,649.23
(3,447.80)
(6.08)
135,467.88
167,006.81
31,538.93
iB.BB
87,114.48
84,279.97
(2,834.51)
(3.36)
212,82.98
248,116.39
35 232.41
14.19
253,645.58
262,938.37
(9,292.79)
(3.53)
808,769.07
771,137.43
37,571.64
4.87
15
574
MEMORIAL MEDICAL CENTER
DEPAR@&NTAL INCK STATDENT
FOR THE 3 MONTHS ENDING 63/31/04
SINGLE MONTH
AmAL BUDGET $ VARIANCE S VAR
31RDIOPULMONARY
;REN(E
04/14/04 10:10 AM
YEAR TO DATE
ACTUAL BUDGET f VARIANCE % VAR
INPATIENT REVENU
73,784.00
109,838.51
(36,854.51)
('M82)
295,881.69
322,429.09
(26,547.40)
(8.23)
OUTPATIENT REVEN
27,551.81
22,615.43
4,936.3E
21.82
75,896.25
66,387.18
9,509.37
14.32
TOTAL REVENUE.
-EXPENSES
101,335.81
IA 453.94
(31,118.13)
(21 49)
371,777.94
380,816.27
(17,030.33)
(4.38)
SALARIES
.00
.30
.08
Be.
.a
.00
.00
.00
LEASE d RENTAL
559.09
5OO.00
(59.09)
(11.81)
1,379.38
1,sm. 00
120.62
8.04
OTHER EXPENSES
27,344.59
27,059.46
(225.13)
(1.05)
84,808.94
81,132.2E
(3,676.72)
(4.53)
TOTAL EXPENSES
27,963.68
27,559.46
(344.22)
(1.24)
86,188.32
82,632.22
(3,556.10)
(4.30)
NET GAIN/(LOSS
73,432.13
104,894.48
(31,462.35)
(29,99)
285,589.62
306,184.05
(20,594.431
(6.72)
CARDIAC REHAB
REVENUE
INPATIENT REVENU
.90
.00
.00
_.03
.00
.00
.00
.00
OIUTPATIENT REVEN
.00
.09
.00
.00
.00
.00
.00
.00
TOTAL REVENUE.
f
00
.00
.20
.00
.80
.00
.00
EXPENSES
SALARIES
.08
.00
.00
.80
.00
.09
.20
.00
OTHER EXPENSES
.90
.80
.m
.00
.00
.00
.00
.00
TOTAL EXPENSES
.80
.80
.00
.00
.80
.00
.00
.00
NET GAIN/(LOSS
.80
.00
.00
.30
.00
.00
.02
.00
OCCUPATIONAL THERAPY
REVENUE
INPATIENT REVENU
.89
1,135.69
(1,1e5.69)
um Be)
419.00
3,M.81
(2,914.81)
(87.43)
OUTPATIENT REVEN
.00
1,164.32
(1,1E4.32)
(160.00)
396.87
3,417.78
(3,02& 91)
(88.38)
TOTAL REVENUE.
.00
2,300.81
(2,310.81)
(180.08)
315.87
6,751.59
(5,935.72)
(87.91)
EXPENSES
SALARIES
.00
.00
.00
.00
.00
.02
.00
.00
OTHER EXPENSES
.06
50& 00
500.80
100. 00
.00
1,50& 00
1,502.80
100.00
TOTAL EXPENSES
m
50&00
56L 00
100.00
.00
1,500.00
1,500.08
100.00
NET GAIN/(LOSS
.09
1,M.01
(1,am 01)
(180.00)
815.87
5,251.59
(4,435.72)
(84.46)
PHYSICAL THERAPY
REVENUE
INPATIENT REVENU
11,656.50
26,953.63
(15,297.13)
(56.75)
44,454.50
79,121.95
(34,667.45)
(43.81)
OUTPATIENNT REVEN
133,654.75
115,937.40
17,71.7.35
15.28
341,795.87
340,332.27
1,463.60
.43
TOTAL REVENUE.
145,311.25
142,891.83
2,4!0.22
1.69
386,25O.37
419,454.22
(33,203.85)
(7.91)
EXPENSES
PROFESSIONAL FEE
49,991.83
37,50& 00
(3,491.83)
(9.31)
107,718.92
112,500.00
4,781.88
4.24
OTHER EXPENSES
2,256.94
2,874.46
61.7.52
21.48
5,BE. 42
8,308.86
2,420.44
29.13
TOTAL EXPENSE;
43,248.77
40,374.46
(2,974.31)
(7.11)
113,607.34
120,M.86
7,201.52
5.96
NET GAIN/(LSS
102,062.48
102,516.57
(454.89)
(.44)
272,643.03
298,645.36
(26,002.33)
(8.70)
16
•
0
0
DE'KgLTH CARE
ACTUAL
IEVENLE
INPATIENT REVENU
.90
OUTPATIENT REVEN
110,669.75
TOTAL REVENUE.
116,669.75
XPEN6ES
�ALARIES
29,282.71
d RENTAL
8& 19
OTHER EXPENSES
17,819.13
TOTAL EXPENSES
46,382.03
!ET GAIN/(LOSS
64,227.72
HOSPICE
REVENUE
OUTPATIENT REVEN
.00
TOTAL REVENUE.
.00
EXPENSES
SAARIES
00
PROFESSIONAL FEE
.00
OTHER EXPENSES
.00
TOTAL EXPENSES
.00
NET GAIN/(LOSS
.m
PR _ WAIN CARE
REVENUE
OUTPATIENT REVEN
.00
TOTAL REVENUE.
.30
EXPENSES
SALARIES
.00
OTHER EXPENSES
.00
TOTAL EXPENSES
.11
NET SAW (LOSS
.00
NEW VIEW
REVENUE
OUTPATIENT REVEN
.00
TOTAL REVENUE.
.00
EXPENSES
SALARIES
.00
PROFESSIONAL FEE
.00
OTTER EXPENSES
.00
TOTAL EXPENSES
.00
NET GAIN/(LOSS
.00
i
MEMORIAL MEDICAL CENTER
DEPARTMENTAL INCOME STATEMENT
FOR THE 3 MONTHS EtD)ING 03131,104
6IN6LE MONTH --
BUDGET f VARIANCE % VAR
04/14/04 10:10 AN
YEAR TO DATE
ACTUAL BUDGET S VARIA)a % VAR
.00
.00
.a
a
.00
.00
.00
84,235.27
26,434.48
31.38
298,711.80
247,271.24
51,440.56
20.80
84,235.27
26,434.48
31.38
298,711.80
247,271.24
51,440.56
20.80
26,208.89
(2,073.82)
(11.72)
88,275.75
76,935.79
(11,339.96)
(14.73)
83.33
3.14
3.76
281.72
249.99.
(31.73)
(12.69)
11,015.56
(6,003.57)
(54.50)
44,935.45
32,715.83
(12,219.62)
(37.35)
37,327.78
(9,074.25)
(24.32)
133,492.92
119,901.61
(23,591.31)
(21.46)
46,927.49
17,360.23
36.99
165,218.88
137,369.63
27,849.25
20.27
.a
.00
.00
.00
.00
.02
.00
.00
.00
.08
.00
.02
.w
.00
00
.00
.00
. w
.08
.00
.00
.00
.00
.00
- .00
.a
.00
.00
.00
.00
.00
w
.08
00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.m
.30
.09
00
.08
.00
.20
.00
.0
.00
00
.00
.00
.02
.00
.00
.00
.00
.00
.00
.00
.00
.02
.00
.00
.00
.02
.00
.00
.00
.00
.00
.06
.00
.00
.00
.00
.00
00
.02
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.03
.00
.00
.00
.00
00
.08
.00
.00
.00
.m
.00
.02
.00
.00
.00
.00
.00
.80
.00
.00
.02
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
,00
.00
.00
.00
.00
.00
.00
17
5'ib
MEMORIAL MEDICAL CENTER
DEPARTMENTAL INCXOE STATEMENT
04/14/04 10:10 AN
FOR
THE 3 MONTHS ENDING 03/31/04
SINGLE
MONTH
YEAR TO
DATE
ACTUAL
BUDGET
$ VARIANCE
% VAR
ACTUAL
BUDGET
$ VARIANM
% VAR
]EMICL DEPENDENCY
;EVEN IE
OUTPATIENT REVEN
.00
.00
.00
.00
.00
.00
.00
.00
TOTAL REVENUE.
DREMSES
.00
.00
.00
.00
.00
.00
.00
.00
SALARIES
.80
.80
.00
.00
.00
.00
.00
.00
PROFESSIONRL FEE
Be
.00
.00
.00
.00
.02
.00
.00
OTHER EXPENSES
.00
.80
.06
.00
.00
.00
Be.
.00
TOTAL EXPENSES
.02
.00
.00
.00
.00
.00
.00
.00
NET GAIN/(LO55
.09
.00
.00
.00
.00
.00
Be.
00
)IETARY
VENUE
INPATIENT REVENU
.20
.00
.00
.00
.00
.00
.09
w
OUTPATIENT REVEN
.00
.08
.00
.00
.00
.08
.00
.00
TOTAL REVENUE.
MENGES
.00
.00
.00
.00
.00
.00
.00
.00
SALARIES
10,947.12
12,901.84
1,954.72
15.15
36,991.87
37,873.16
881.29
2.32
PROFESSIONAL FEE
1, 30& 00
1,733.33
433.33
24.99
4,225.00
5,199.99
974.99
18.74
OTHER EXPENSES
11,156.35
17,M S3
5,900.58
34.53
44,23112
50,M.42
5,803.30
11.59
TOTAL EXPENSES
23,483.47
31,692.10
8,28B.63
26.15
85,449.99
93,109.57
7,659.56
8.22
NET GAINMOSS
(23,403.471
(31,M.lei
B,288.63
26.15
(85,449.99)
(93,109.57)
7,659.58
8.2
UICAL RETARDS
:XPENSE5
1
SALARIES
19,624.49
21,976.84
2,351.55
10.78
61,722.35
64,510.28
2,787.93
4.32
LEASE & RENTAL
1,727.27
2,666.67
939.40
35.22
5,381.81
8,ON. @1
2,618.20
32.72
OTHER EXPENSES
3,887.21
4,022.46
lra.25
3.36
12,091.78
11,970.16
(121.62)
t1.01)
TOTAL EXPENSES
25,238.97
28,665.17
3,42L1.20
11.95
79,195.94
84,480.45
5,284.51
6.25
-IRE PROGRAM
-JPENSES
OTHER
.
EXPENSES
(101.06)
.00
101.06
.00
(98.53)
.00
98.53
.00
TOTAL EXPENSES
(101.06)
.00
101.06
.00
(98.531
.00
98.53
.00
KIINTFIUANIE
7PEM
SALARIES
11, SQ. 64
12, 553.05
712.41
5.67
34, 756.14
36, 849.27
2,093.13
5.68
OTWR:R EXPENSED
1,947.47
2,089.39
1,041.92
49.86
4,101.43
6,179.03
2,077.60
33.62
TOTAL EXPENSES
12,on. 11
14,642.44
1,754.33
11.98
38,857.57
43,028..30
4,170.73
9.69
).ANT OPERATIONS
7(PENSES
LEASE E RENTAL
45.00
54.17
9.17
16.9^c
135.00
162.51
27.51
16.92
ELECTRICITY
16,321.55
27,916.67
11,595,12
41,53
53,643,49
83,750.01
30,106.52
35.94
WATER & SEWER
3,803.82
.00
(3,803.82)
.00
10,724.15
.00
(13,724.15)
.00
GAS
6,408.63
.20
(6,408„63)
Be
19,823.15
.00
(19,M.15)
.00
OTHER EXPENSES
12,135.87
6,M.43
(5,326.44)
(78,22)
28,651.61
20,190.57
(8,461.04)
(41.90)
TOTAL EXPENSED
38,714.87
34,78& 27
(3,934.66)
(11.31)
112,957.40
104,103.09
(8,854.31)
(8.50)
18
5'r'7
0
MEMORIAL MEDICAL CENTER
DEPARTMENTAL INCOME
STATEMENT
04/14/04
10:10 AN
FOR
THE 3 MONTHS ENDING 03/31/04
SINGLE
MONTH
YEAR
TO
➢ATE
ACTUAL
BUDGET
f VARIANCE
% VAR
ACTUAL
BUDGET
5 VARIANCE
% VAR
OUN6S
PENSES
ALARIES
.00
.00
.08
.00
.00
.00
.20
.00
THER EXPENSES
490.48
.00
(490.48)
.00
608.22
.80
1808.22)
.00
TOTAL EXPENSES
490.48
.00
WA.48)
.00
808.22
.00
(SM.22)
.00
giMNSPORTATION
S
RARIES
1,371.06
1,157.17
(213.89)
(18.46)
3,613.84
3,396.83
(217.01)
(6.38)
)THER EXPENSES
(318.98)
643.20
962.1E
149.59
693.07
1,899.41
1,206.34
63.51
TOTAL EXPENSES
1,052.88
1,M.37
74& 29
41.56
4,306.91
5,296.24
989.33
18.67
1115EHEEPING
(PENSES
SALARIES
2%,0B3.34
21,88E.54
1,805.20
8.24
61,123.72
64,253.46
3,129.74
4.87
STHER EXPENSES
5,085.76
71292.02
2,206.26
32.25
16,866.99
21,657.34
4,790.35
22.11
TOTAL EXPENSES
25,169.10
29,180.56
4,011.46
13.74
77,990.71
85,916.80
7,920.09
9.21
TUNDRY
MENGES
3UTSIDE SERVICES
6,378.43
9,M.00
2,621.57
29.12
30,171.56
27,000.00
(3,171.56)
(11.74)
OTHER EXPENSES
.00
.00
.00
.00
.SO
.00
.04
.00
TOTAL EXPENSES
6,378.43
9,M.00
2,621.57
29.12
30;171.56
27,00& 00
(3,171.56)
(11.74)
EC
SALARIES
5,463.90
5,559.92
%.02
1.72
16,690.46
16,221.08
(369.38)
(2.26)
OTHER EXPENSES
576.77
W.26
66.49
10.33
1,483.19-
2,044.75
561.56
27.46
TOTAL EXPENSES
6,040.67
6,203.18
162.51
2.61
18,173.65
18,365.83
192.18
1.04
ERFORMANCE IMPROVEMENT
XPENSES
SALARIES
1,920.81
6,106.83
4,186.02
68.54
6,204.2E
17,M.49
11,722.21
65.39
ER EXPENSES
191.24
1,078.06
8BG.82
82.26
838.75
3,299.51
2,460.76
74.57
TOTAL EXPENSES
2,112.05
7,184.89
5, 07184
70.60
7,043.03
21,22& 00
14,182.97
66.81
;OCIRL WORKER/DISCIARGE PLANNI
-
:XPENSES
SALARIES
4,96& 00
7,293.98
2,M.98
31.99
16,883.76
21,411.38
4,527.62
21.14
OTHER EXPENSES
383.38
742.55
359.17
48.36
1,805.63
2,319.00
513.37
22.13
TOTAL EXPENSES
5,343.3E
a,936.53
2,693.15
33.51
Is, 6E9.39
23,73& 38
5,M.93
21.24
:ALHOUN COUNTY IN➢IGENT
XPENSES
SALARIES
3,099.71
.00
(3,099.71)
.00
8,769.48
.00
(E,769.48)
.00
OTHER EXPENSES
36.64
.00
(36.64)
.00
54.10
.80
(54,10)
.00
COUNTY OFFSET
(2,899.65)
.00
2,899.65
.00
18,161.46)
00
8,161.46
.00
TOTAL EXPENSES
236.70
.00
(236.70)
00
66112
00
(662.12)
.00
19
5VN
MEMARIAL MEDICAL CENTER
DEPARTMENTAL INCOME
STATEMENT
FOR
THE 3 KKK ENDING 03/31/64
5IN6LE
MONTH
ACTUAL
UMSET
f UARIANCE
% UAR
JSIMESS OFFICE
(PEN5ES
3ALARIE5
19,133.05
19,954.26
821.21
4.11
EASE E RENTAL
377.56
1%m
(227.56)
(151.70)
X)LLECTION EXPEN
3,404.16
2,500.00
(904.161
136.161
ITHER EXPENSES
8,sm. 89
9,803.35
1,266.46
12.91
TOTAL EXPENSES
31,451.66
32,407.61
9%.95
2.94
OMPNICATIONS
XPENGES
3URIES
7,642.49
8,827.38
1,IPA. 89
13.42
3THER EXPENSES
832.20
1,838.80
1,006.60
54.74
TOTAL EXPENSES
8,474.59
10,666.18
2,151.49
28.54
PTA PROCESSING
XPENSES
SALARIES
4,681.16
2,721.90
(1,959.26)
(71,98)
OTHER EXPENSES
11,955.89
12,108.47
152.59
1.26
TOTAL EXPENSES
16,637.05
14,&Q.37
(1,886.68)
(12.18)
URGING ADMINISTRATION
XPENSES
SALARIES
8,756.05
8,649.00
(IV.05)
(1.23)
OTHER EXPENSES
953.32
2,870.69
1,117.37
53.96
TOTAL EXPENSES
9,799.37
10,719.69
1,610.32
9.42
BUSE SUPERVISOR
XPENSES
SALARIES
.98
.00
.00
.00
OTHER EXPENSES
.08
.00
N
.00
TOTAL EXPENSES
.00
.00
.00
.06
WECTION CONTROL
:XPENSES
SALARIES
4,733.67
.00
OTHER EXPENSES
364.56
.00
TOTAL EXPENSES
5,098.23
.00
0)IRATION
:XPENSES
SALARIES
3,776.47
4,250.05
OTHER EXPENSES
1,BE. 44
1,226.06
TOTAL EXPENSES
5,571L91
5,476.11
ZMW ING
-a(PENGES
SALARIES
5,397.29
5,818.39
OTHER EXP94EES
3,345.12
3,490.46
TOTAL EXPENSES
8,742.41
9,300.85
(4,733.67) .00
(364.56) .00
(5, 098. a .00
473.58 11.14
(576.38) (47,01)
(102.80) (1.87)
413.10 7.10
145.34 4.16
558.44 6.m
04/14/84 1000 A14
52,651.93
1,325.43
9,274,74
24,230.17
87,462.27
22,794.60
3,059.88
25,854.48
13,331.82
37,378.69
50,709.71
25,703.49
4,248.34
29,951.83
YEAR TD DATE
BUDI>'ET S VARIANCE % VAR
58,575.42
5,923.49
10.11
450.00
(875.43)
(194.54)
7,500.00
(1,774.741
(21 661
29, M.08
4,974.91
17.03
95,730.50
8,248.23
8.61
2j,912.62
3,Ila.&
12.93
5,377.58
2,317.70
43.09
31,290.20
5,425.72
17.37
•
7,990.10
(5,340 921
a.B41
36,316.75
(1,061.94)
(2.92)
44,306.85
(6,402.86)
(14.45)
25,389.a
(314.49)
(1.23)
6,213.93
1,965.59
31.63
31,602.93
1,651.10
5.22
�J
.02
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
.00
12,176.08
.00
(12,176.88)
.00
1,416.59
.00
(1,416.59)
.00
13,592.67
.00
(13,592.67)
.00
11,590.10
12,475.95
885.85
7.10
5,202.35
3,532.14
(1,670.21)
(47.2B)
16,792.45
16,M.09
(784.36)
(4.89)
15,791.08
17,056.25
1,265.17
7.41
10,731.10
10,420.89
(310.21)
(2.97)
25,522.18
27,477.14
954.96
3.47
20
F: 5'i9
0
MENDRIAL MEDICAL CENTER
DEPARTMENTAL INCOME STATEMENT
FOR THE 3 MONTHS ENDING 03/31/04
SINGLE MONTH
BUDGET $ VARIANCE % VAR
ACTUAL
iNINISTRATION
;PENSES
lALARIES
21,930.86
HE S RENTAL
121.74
ITHER EXPENSES
26,481.42
TOTAL EXPENSES
48,514.02
INE56 DEVELOPMENT
XPENSES
SALARIES
4,007.78
OTHER EXPENSES
316.21
TOTAL EXPENSES
4,323.99
I15PITAL GENERAL
XPENSES
ROARMWdS COMP IN
30,987.98
LN84PLOYMM INS
(17.37)
PROF LIABILITY I
8,412.73
LEASE 3 RENTAL
2,724.50
OTHER EXPENSES
9,139.46
TOTAL EXPENSES
51,247.30
rEP90N RESOURCES/PUBLIC
RELATIO
EXP�
S; 5
3,440.II
OTr�EXPENSES
(178.53)
TOTAL EXPENSES
3,261.5E
PURCHASING
EXPENSES
SALARIES
8,409.65
OTHER EXPENSES
1,374.69
eTOTAL EXPENSES
9,784.34
AUXILLARY
EXPENSES
SALARIES
.00
EXPENSES
3.32
TOTAL EXPENSES
3.22
PLAZA SPECIALTY CLINICS
SALARIES
34.70
EXPENSES
(34.70)
TOTAL EXPENSES
.00
•
04/14/04 10:10 P4
YEAR TO DATE
XIUAL BUDGET $ VARIANCE % VAR
21,628.43
(302.43)
(1,29)
72,794.90
63,489.93
(9,304.97)
(14.65)
I80.00
(1.74)
(1,74)
346.37
300.00
(46.37)
(15.45)
3B,797.25
12,315.83
31.74
59,721.42
116,M.32
%,6 a.90
48.68
60,525.68
12,811.66
19.84
132,862.69
180,165.25
47,302.56
26.25
4,W.Va
(4.72)
Ill
11,62I.22
11,7%94
0.72
-26.16
1.10
671.69
355.48
52.92
1,769.66
1,795.82
1.45
4,674.75
350.76
7.50
13,390.88
13,%.76
155.BB
1.15
26,666.67
t4,321.31)
(16.20)
92,994.96
80,000.01
112,994.95)
(16.24)
4,166.67
4,184.04
IN.41
(48.57)
12,500.01
12,548.58
IN.38
7,916.67
(496.06)
(6.26)
25,238.19
23,750.01
(1,488.18)
(6.26)
2,750.00
25.50
.92
7,936.83
8,250.00
313.17
3.79
9,083.33
(56.13)
(.61)
28,840.67
27,249.99
(798.68)
(2.90)
50,583.34
(663.96)
(1.31)
154,162.08
151,750.02
(2,412.86)
(1.58)
5,206.65
1,766.54
33.92
10,098.39
15,283.99
5,185.60
33.92
5,229.70
5,408.23
103.41
5,811.31
15,697.96
9,886.65
62.98
10,436.35
7,174.77
68.74
15,909.70
30,9B1.95
15,072.25
48.64
B,MG. 67
(400.98)
(5.00)
20,587.91
23,M.33
3,MI. 42
12.76
1,305.49
(69.20)
(5.30)
1,614.17
3,666.97
52.DO
1.43
9,314.16
147%.1B)
t5.84)
24,1&M
27,176.30
3,054.22
1I.23
.00
.00
.00
.08
.00
.00
.00
.00
(3.32)
.00
23.25
Be.
(23.25)
.00
.00
(3.32)
.90
23.25
.00
(23.25)
00
.00
(34.70)
00
88.20
.08
(88.a)
00
.06
34.78
.SO
(B8.20)
.00
M.20
.00
.08
.00
.00
.00
.00
.00
.00
21
5Si0
MEMORIAL MEDICAL (ENTER
DEPARTMENTAL INCOE STATEMENT
FOR THE 3 MONTHS ENDING 03/31/04
SINGLE MONTH
ACIUA. BUDGET M VARIANCE % VAR
EMORIAL MEDICAL PLAZA
EDENE
RENTALS
7,432.98
.00
TOTAL REVENE.
7,432.98
.00
EXPENSES
SALARIES........
3,562.73
.30
OTHER EIIPam.
(5,455.42)
.00
TOTAL EXPENSES
(1,892.69)
.00
NET GAIN/(LOSS
9,325.59
.02
Sl1OTOTAL GAIN/
1,475,878.76
1,590,318.97
MICR OWTING EXPENSES
1EVENE DEDUCTIONS
MEDICARE CONTR A
(741,829.22)
(788,909.41)
MEDICAI➢ CONTR A
(213,933.01)
(166,694.37)
INDIGENT CONTR A
(18,118.85)
.00
CHARITY CARE
(89,564.72)
(89,836.67)
BAD DEBT EXPENSE
(156,900.17)
(177,797.54)
OTHER DEDUCTIONS
(234,511.10)
(243,832.52)
TOTAL REVENGE
(1,439,749.37)
(1,459,070.51)
]PLOYEE BENEFITS
RETIREMENT
19,026.66
23,292.35
HM PITPLI7ATION
126,176.49
76,229.51
LIFE INSURANCE
999.29
1,058.74
DENTAL IN6URANCE
5,377.90
3,249.18
LONG TERM DIS
2,264.65
2,29.23
PAYROLL CLEARING
3,161.41
.00
TOTAL DKOYEE
156,916.40
125,959.81
TOTAL OTHER OP 1,5%,665.47 1,565,029.52
84/14/04 10:10 AM
YEAR TO ➢ATE
ACTUAL BUDGET f VARIANCE % VAR
7,432.90
.80
21,770.75
a
21,770.75
.00
7,432.90
.00
21,770.75
.00
21,770.75
.a
(3,562.73)
.80
18,023.01
.00
(10,023.01)
.00
5,455.42
.00
37,279.04
.08
(37,279.04)
.00
1,892.69
.00
47,302.05
.00
(47,302.05)
.00
9,Ms. 59
.80
(25,531.30)
.00
(25,531.30)
.00
(114,432.21)
(7.19)
4,422,361.63
4,636,314.31
(213,952.68)
(4.61)
39,on. 19 5.00 (2,431,487.96) (2,292,346.79)
(47,238.64) 128.33) (5%,841.54) (489,328.55)
(1E,110.85)
00
(65,495.25)
.30
9,271.95
10.32
(225,331,151
(269,510,01)
2G,997.37
15.18
(529,889.99)
(521,921.78)
9,321.42
3.82
(584,280.79)
(715,766.56)
19,321.44
1.32
(4,383,326.68)
(4,288,873.69)
4,265.69
18.31
56,739.62
68,374.33
(49,946.98)
(61 52)
354,391.72
223,770.49
149.45
14.11
2,690.59
3,IV. 94
(2,326.72)
(76.37)
9,077.32
6,9%.82
64.58
2.77
6,817.14
6,837.45
(3,161.41)
.00
3,844.31
.00
(58,957.39)
(48.09)
432,760.70
311,041.03
(31,1iM.95)
(2.02)
4,816,087.3E
4,599,914.72
(139,141.17) (6.86)
(57,512.99) (11.75)
(65,495.25) .00
44,178.86 16.39
(7,968.21) (1.52)
131,485.77 18.36
(94,452.99) (2.20)
11, 634.71 17.01
(130,621.23) (58.37)
417.35 13.42
(126.50) (1.41)
20.31 .29
(3,044.31) .00
(121,719.67) (39.13)
(216,172.66) (4.69)
PA58-11i
69,447.87
.00
69,447.87
.00
170,240.59
.00
178,240.59
.00
CAFETERIA SALES
8,652.21
7,622.95
1,029.26
13.50
25,281.23
22,377.05
2,904.18
12.97
INTEREST INCOME
1,314.39
2,540.98
(1,2& 59)
(48.27)
4,204.80
7,459.82
(3,254.2E)
(43.62)
INTEREST INCOE
2115
.m
25.15
.00
73.99
.00
73.99
.80
INTEREST INCOME
.08
.08
.09
.00
.00
.00
.02
.88
MISCeELLAE015 IN
12,218.35
2,964.48
9,24!487
311.88
20,625.39
8,702.20
11,923.19
137.01
TOTAL am RE
91,649.97
13,128.41
78,521.56
598.10
220,426.08
38,28.27
181,887.73
471.96
NET CRATING
(29,136.74)
38,409.86
(67,546.60)
(175.85)
(173,2%.75)
74,937.86
(248,237.61)
(331.25)
22
5�vI
0
MEMORIAL MEDICAL CENTER
DEPARTNENIAL INMME
STATEMENT
24/14/04 10:10 AM
FOR
THE 3 MONTHS ENDING 63/31/04
SIN6LE
MONTH
YEAR TD
DATE
ACTUAL
BUDGET
f VARIANCE
X VAR
ACTUAL
BUDGET
i VARIANCE
% VAR
gN-MWIN6 EXPENSE
DEPRECIATID RAN
00
.00
a0
.00
.00
.00
.90
.09
DEPRECIATION-BUI
30,114.78
.00
(30,114.78)
.82
98,344.34
.00
(90,344.34)
.02
DEPRECIRTION-FIX
18,179.44
.00
(10,179.44)
.88
30,538.32
.00
(36,538.32)
.00
DEPRECIATION W
46,142,81
126,932.50
80,789.69
63.64
138,457.47
380,797.50
242,340.03
Q.64
DEPRECIATION-POR
37,468.85
.00
(37,468.85)
.00
112,406.55
.08
(112,486.55)
.00
jIMPUTRIBUTION TO
.80
.00
.00
.00
.00
.02
.00
.00
TOTAL 04-OKR
123,905.88
126,932.30
3,02G.62
138
371,746.68
380,797.50
9,050.82
2.37
TOTAL OPERATIN
(153,042.62)
M,522.64)
164,519.98)
(72.88)
(545,W.43)
(305,859.64)
(239,186.79)
(78.20)
COUNTY SUBSIDY
00
.00
.98
.SO
.00
.00
.86
.00
NET GAIN/ILOSS
(153,142.62)
(88,522.64)
(64,519.98)
(72.88)
(545,046.43)
(315,859.64)
(239,186.79)
(78.22)
0
23
•
MEMORIAL MEDICAL CENTER
ACCOUNTS PAYABLE
BOARD OF TRUSTEES APPROVAL LIST FOR MARCH 2O04
DATE APPROVED
ACCOUNTS PATIENT
BY COUNTY AUDITOR
PAYABLE REFUNDS
3/2104
(weekly) $ 13,733.00
3/4/04
(weekly) $ 323,651.36 $
2,029.38
3/11104
(weekly) $ 107,112.89 $
45.06
3/18/04
(weekly) $ 110,678.08 $
1,461.80
3/24/04
(monthly) $ 144,315.71
3/25104
(weekly) $ 244,489.97 $
1,294.92
3/29/04
(weekly) $ 3,625.09
TOTAL
Referral
Charity
Indigent
$ 947,606.10
MONTHLY PAYABLES FOR APRIL 2004
$ 4,831.16
$ 90,754.53
2003 2003 YTD 2004 2004 YTD
$ 219,950.67 $ 222,733.01
$ 38,031.99 $ 129,241.17 $ 80,219.22 $ 225,100.65
$ 89,796.62 $ 324,471.80 $ 116,452.64 $ 400,259.13
24
5J3
•
;DATE.84rI2ra4
TIW�10:I2
DE NUMBER DATE
099405 03/02/04
v 099490 03/02/04
•
MEMORIAL MEDICAL CENTER P4IF
CHECK REGISTER GLCKREG
03/02/04 THRU 03/92/24
AMOLMT PAYEE
5a.00 MEMORIAL MEDICAL CENTER
13,683.00 TOGHIDA AMERICA MEDICAL
13,733.00
25
581
NUN DATE,.%/12/84 MEMORIAL MEDICAL CATER PAGE i
TINE:10:12 CHECK REGISTER GLCKREG
03/94194 THRU 03/04/04
WfK-CHECK -
ME NR89BER DATE RNOUN7 PAYEE
i/P
099492 03/04/04
iB0.80
RANI
UP
M93 03/04/04
79.21
ACE HARDWARE - PORTER'S
UP
099494 03/04/04
260.00
APPLIED MEDICAL
UP
M95 03/04/04
1,883.27
AS MICROSYSTEMS INC
UP
89949E 03/84/04
957.00
ANITA FRICKE - COUNTY C
UP
M97 03/04/04
345.93
AIRGAS3DUTHWEST
UP
M98 03/04/04
7,211.69
CARDINAL HEALTH
UP
099499 03/04/04
19.84
NADINE ARNOLD
UP
099500 03/04/04
436.00
AWESOME PAGING, INC
UP
099501 03/04/04
1,221.42
BANKCARD CENTER
UP
099502 83/04/04
313.9E
BAXTER HEALTHCARE MR'
UP
09M 03/24/04
1,201.84
BOOS
UP
099584 03/84/04
24,318.15
BERGEN BRUNSWIG DRUG CD
UP
099SE 03164/04
112.48
BARBARA BEARD
UP
099S06 03/04/04
52.50
CABLE LINE
UP
899507 03/94/04
275.82
CALHOUN COUNTY PEST CON
UP
09450E 03/04/04
117.49
RUBY CANTU
UP
89M 03/84/04
32- 44
CERTIFIED LABORATORIES
UP
09MIO 03/04/04
718.06
CHANNING L BETE CC INC
UP
099511 03/04/04
1,260.05
CINGIOAR WIRELESS
UP
M12 03/94/04
306.80
CLEAR CHANNEL-VICTDRIA
UP
099513 03/04/04
1,332.00
CALHOUN COUNTY NED FOUN
UP
M14 03/04/04
1,306.B3
DELL FINANCIAL SERVICES
UP
MIS 83/64/04
28.89
KATIERINE ➢IETZEL
UP
099516 03/04/04
286.00
➢LE PAPER & PONING
UP
OM17 03/04/04
11, 05G.50
EASTMAN KODAK COMPANY
UP
0%518 03/24/04
25.00
ECFMG
RIP
099519 23/04/04
401.50
EDWARDS PLUMBING INC
UP
09%a 03/04/04
IM85
EMBASSY SUITES HOTEL DA
UP
099521 03/04/04
273.70
EMBASSY SUITES HOTEL DA
RIP
099522 03/04/04
74,W.00
BORE NORTH TEXAS
RIP
099523 03/04/04
5,%6.02
ENTEX
RIP
099524 833/04/04
3,260.52
GE MEDICAL SYSTEMS
RIP
0995M 93/04/04
3,227.05
BE HEALTHCARE FIN SRVS
RIP
099526 83/04/04
3,500.02
LLOYD LANE GOBER, MD P.
AIR
099527 03/04/04
23.25
LINDA R GOEZ
RIP
099528 03/04/04
39.35
H E BUTT GROCERY
RIP
099529 03/04/04
2,846.86
HEALTH FORCE MEDICAL
RIP
0995A 03/04/04
934.35
HFALTeM/THA
RIP
099531 03/84/04
106.33
SALLY J HICKL
UP
OM32 03/04/04
43.28
HILL COUNTRY DAIRIES
RIP
099533 03/04/04
95.11
PAT HRANICKY
RIP
OMS34 83/04/04
26,357.00
ITA RESOURCES, INC
RIP
0995M 03/04/04
29.44
JECKER FLOOR & GLASS
RIP
099536 03/14/04
51.77
ORALIA MAVIOLETTE
RIP
099537 03/64/04
161.30
LIFELINE SYSTEMS INC
RIP
0993M 03/04/04
SOL 00
MEMORIAL HERMANN HOSPIT _
RIP
099539 03/04/24
16,79.65
MEMORIAL MEDICAL CENTER
RIP
09EQ 03/64/04
614.00
MATERA - 1%
RIP
099541 03/04/04
146.45
MAURITZ & COLEY
26
c5"S5
•
u
IN DATE:04/12104
MEMDRIAL MEDICAL CENTER PAGE 2
TIME:10:12
CHECK REGISTER GLCKREG
03/04/04 THRU 03/04/04
w(,
ODE --AMBER DATE
pmw PAYEE
/P
099542 03/04/04
61.07
7ANE MCCARN
/P
099543 03/04/04
6,161.92
MERIDIAN PROFESSIONAL S
iP
099544 03/04/04
52.70
LINDR MEYER
/P
099545 03/04/04
129.00
MMWR
099% 03/04/04
4.65
BETTY METOYER
099547 03/04/84
2,EN. 30
NUTRITION OPTIONS
/P
099548 03/04/04
412.50
POPULAR LEASING
/P
099549 03/04/04
29.82
POWER ELECTRIC
i/P
0%550 03/04/04
84.80
POWERCORD COMMl1NICATION
t/P
OMI 03/04/04
672.00
PRIORITY PHARMACEUTICAL
UP
O99552 03114M
241.25
R G & ASSOCIATES INC
11P
099553 03/04/04
572.20
RANDY'S FLOOR COMPANY
1/P
099554 03/04/04
2, Q.00
RADIOLOGY UNLIMITE➢
i/P
099555 03/04/04
77.19
ARCEE TAYLOR
i/P
099MG 03/04/84
60.02
SAM'S CLUB DIRECT
4/P
M557 03/04/64
7.67
SHERWIN WILLIAMS
A/P
099558 83/04/94
2,7.,0.00
SIEMENS MEDICAL SYSTEMS
VP
099559 03/04/04
6,260.00
SO TEX BLODD & TISSUE C
T/P
099560 03/04/04
7,564.16
STAFF CARE
T/P
099561 03/04/04
40.00
BARBARA STANFILL
i/P
099562 03/04/04
3,908.75
SYSCO - SAN ANTONIO, LP
I/P
099563 03JO4104
67 3. 29
STATE COMPTROLLER
l/?-^'k99564 03/04104
31,820.54
TEAM REHAB
A/A, 39565 03/04/04
2,577.64
TLC STAFFING
A/P
099556 03/04/04
135.00
T&T COMMUNICATIONS INC
RIP
099567 03/04/04
50,293.80
TEXAS CD & ➢ISTRICT RET
RIP
099568 03/04/04
347.38
TEXAS DEPT OF HUIMAN SER
RIP
099569 03/04/04
867.84
TEXAS ENVIRONMENTAL SER
AiP
099570 03/04/04
434.00
TTUH5C-HERLTHNET
A/P
099571 03/04/04
485.52
THYS5ENKRUPP ELEVATOR C
A/P
099572 03/04/04
110.00
TRIPLE D SECURITY CORPO
P
099573 03/04/04
32.57
UNIFIRST HOLDINGS
P
099574 03/04/04
2,5Q.00
UNITED SERVICES
RIP
099575 03/04/04
477.55
VERIZDN SOUTHWEST
RIP
099576 93/04/04
2,303.35
THE VICTORIA ADVOCATE
RIP
099577 03/04/04
13.95
VICTORIA OFFICE EDUIPME
RIP
099578 03/04/04
18.86
WALMART COMMUNITY
RIP
099579 03/04/04
1,487.08
WASTE MANAGEMENT
RIP
099580 03/04/04
29.76
ELIZABETH WESTBROOK
TOTALS:
32,651.36
27
UN DATE:04/12/04
TIME:16;13
RNK--CHECK
ODE NlMR DATE
MEMORIAL MEDICAL CENTER PAGE 1
CHECK REGISTER GLCKREG
03/05/04 THRU 03/05/04 _
-- 1
AMOUNT PAYEE �
/P 099`.,B1 03/05iO4
45.23
CORE5O➢RCE
/P 69%K 03/05/84
259.03
CORESOURCE, INC
IP 099W 03/05/04
247.30
FARIAS VALEMINE
UP 299594 03/95/04
621.03
HIGHMARK BLUE SHIELD
•
UP 099585 03/05/84
46.10
➢VEIL JAMES
UP M86 03/05/94
41.59
KLUMP OLEN DENNIS
UP 099587 03/05/04
123.26
BC/BS OF ILLINOIS
i/P 099588 03/85/04
20.20
RODRISUE2 ABIGAIL
VP 899589 03105/04
26197
VELASQUEZ GREGORY
I/P 099SO 03115/04
20.00
WOOD CAYLOPW
VP 099591 93/05/04
47.96
HSIEH LEIF
VP 099592 03/05/04
72.20
BOY➢ TAMMIE
UP 099593 03/05/04
58.41
WOODLE MARGARET
11P 099594 83/05/64
134.70
LAND ARTHUR B
VP 099595 03/05/84
14.40
MUIL NANCY
UP 699596 03/05/04
14.49
MILLER TRIIDA
'OTALS:
2,029.38
28
•
n
LJ
!N DATE:04il2/04 MEMORIAL MEDICAL CENTER PAGE 1
TIME:1.&13 CHECK REGISTER SLIMES
03/11/04 THRU 03/11/04
ODE NUMBER DATE AMOUNT PAYEE
,/P 099596 O3111iO4 13.99 ACE HARDWARE - PORTER'S
JP 099599 03/11/04 13.14 CONSTELLATION NEW ENER6
P
MEN 03/11/04
264.00
ANITA FRICKE - COUNTY C
P
099601 03/11/04
3,496.99
CARDINAL HEALTH
UP
09960E 03/11/04
3,095.22
AFLAC
UP
099603 03/11/04
3323.34
BAXTER HEALTHCARE CORP
11P
099604 03/11/04
.N
VOIDED
1/P
0996M 033/11/04
0,594.60
BERGEN BRUNSWIG DRUG CD
1/P
09960E 03/11/04
918.70
BID-MED PLUS INC
liP
099607 03/11/04
4,680.00
CRL CON FEDERAL MIT
4/P
099G08 23/11/04
151.59
RUBY CANTU
I/P
0996H 03/11/04
91.85
CSED/CASH PROCESSING
R/P
ME10 03/11/04
450.00
CPSI SOUTH CENTRAL USER
A/P
ME11 03/11/04
206.42
DATASEARCH
RIP
099612 03/11/O4
164.36
PATRICIA G DELGADO
A/P
09%13 03111/04
106.73
KATHERINE DIETZEL
RIP
099614 03/11/04
6,408.63
ENTEX
RIP
099615 03/11/04
909.29
FORT DEARBORN LIFE INC
RIP
M16 03/11/04
72.00
G T PICKUP & DELIVERY
RIP
099617 03/11/04
66.00
ROBERTS, ROBERTS & ODEF
A/9-'-099616 03/11/04
8.99
LINDA R GONE
Rk
39619 03/11/04
10.78
H E BUTT GROCERY
A/P
099620 03/11/04
105.40
SALLY 1 HICKL
RIP
099621 03/ll/04
70.54
HILL COUNTRY DAIRIES
RIP
099622 03/11/04
87.02
PAT HRRNICKY
RIP
0991623 03/11/04
135.00
IDS CAPITAL
RIP
099624 03/11/04
1,.93.a
INSTITUTIONAL TRUST CON
RIP
099625 03/11/04
90.00
JACO INDUSTRIAL SUPPLY
RIP
099626 03/11/04
72.85
ORRLIA LAVIOLETTE
/P
099627 03/11/04
3,933.50
LUKER PHARMACY MANRGEKE
'P
099628 03/11/04
41,774.63
MEMORIAL MEDICAL CENTER,
/P
099629 03/11/04
201.28
MALLINCKRD➢T INC
RIP
099630 03/11/04
4.50
STEVE MARTIN
RIP
099631 03/11/04
6,546.15
TERRY W MCCLAIN CRNA
RIP
09963E 03/11/64
38.44
JAME MCCARN
RIP
099633 03/11/04
6,691.29
MERIDIAN PROFESSIONAL 5
RIP
099634 03111/04
45.2E
LINDA MEYER
RIP
099635 03/11/04
61.45
MID -MAST ELECTRIC SUPP
RIP
099E36 03/I1/04
2,072.65
NATIONAL BENEFITS PARTN
RIP
099637 03/11/04
136.20
MICHELLE DRTA
RIP
099638 03/11/04
730.80
POSTMASTER
RIP
099639 03/11/04
1.69
POWER ELECTRIC
RIP
099640 03/11/04
275.00
WACHDVIA SECURITIES
RIP
09%41 03/11/04
224.48
QUEST DIAGNOSTICS
RIP
049642 03/11/04
108.50
R G & AGSQCIATES INC
RIP
099643 03/11/04
73.35
RADIO SNACK
A: 099644 03/11/84
510.14
RECEIVABLE MANAGEMENT,
A�,---
099645 03/11/04
660.08
S➢ TEX BLOOD & TISSl1E C
RIP
099646 L13/11/04
3,392.15
SYSCD - SAN ANTONIO, LP
RIP
099647 03/11/04
676.80
TLC STAFFING
29
•
5 S 8
1UN DATE:04/12104 MEMORIAL MEDICAL CENTER
TIME:10:13 CHECK REGISTER
03/11/04 THRU 03/11/04
-
ME NUMBER DATE AMOUNT PAYEE
11P
099W 03/11/04
15L65
TEXAS CHILD SUPPORT SDU
I/P
099649 03/11/04
129.77
TEXAS DEPT OF HUMAN SER
I/P
OMO 03/11/04
685.20
TEXAS ENVIRONMENTAL SER
1/P
04901 03/11/04
168.15
TEXAS GUARANTEED STUDEN
11P
099652 03/11/04
22.01
TEXAS GUARANTEED STU14?1
VP
099653 03/11/04
100.00
TEXAS HOSPITAL ASSOCIAT
T/P
099654 03/11/04
392.00
TEXAS STATE HOARD OF PH
I/P
099655 03/11/04
129.96
TEXAS WIRED MUSIC INC
I/P
099656 03/11/04
6,353.65
GARY L. TILLEY, LRNA
I/P
099657 03/11/24
32.57
UNIFIRST HOLDINGS
I/P
099656 03/11/04
66.50
UNITED WAY OF CALHOUN C
I/P
099659 03/11/04
45.00
UROLITHIAGIS LABORATORY
VP
099660 03/11/04
31.62
ELVA VELA
I/P
E9661 03/11/04
196.20
THE VICTORIA ADVOCATE
I/P
099662 03/11/04
100.08
WALMART COMM
11P
099663 03111/04
451.92
WATERMARK GRAPHICS INC
A/P
099664 03/11/04
30.07
ELIZABETH WESTBROOK
TOTALS:
107,112.89
PAGE
GLCKREG
30
589
•
•
0
J DA E:04/12/04 MEMORIAL MEDICAL MWER PAGE I
T 0:13 DECK REGISTER SLMREG
03112M THRU 03/12/04
OE NUMBER DATE
P M665 03/12/04
TALS:
•
•
mw PAYEE
45.06 TRAILBLAZER
45.06
31
590
LAN DATE:0412/04 MEMORIAL MEDICAL CENTER PAGE 1
TiME:10:13 CHECK REGISTER 6LCKREG
03/18/04 THRN 03/18/04
ANK-i"F�Gi --
ODE NLmu DATE AMOIDIT PAYEE
/P
/P
IP
/P
/P
/P
/P
/P
JP
JP
JP
[/P
UP
i/P
✓P
JP
i/P
i/P
JP
dP
VP
i/P
VP
UP
i/P
UP
1/P
VP
UP
lip
lip
lip
lip
i/P
lip
UP
lip
UP
lip
UP
lip
UP
lip
lip
UP
lip
lip
lip
UP
1/P
M667 03/18/04
365.96
AERIFORM/IWECO-PGRT LAY
099668 83/18/04
22,87L 42
CONSTELLATION NEW ENER6
099669 03/18/04
495.00
Aft
099670 03/18/04
4,277.02
CARDINAL HEALTH
•
M71 03/18/04
67.50
AMASON APPLIANCE %RVIC
099672 03/18/04
38.50
AQUA BEVERAGE CDMP M
09%,3 03/18/04
3N.00
ARGYLE FIRE PROTECTIDN
M74 03/18/04
146.88
ESTER BARRIENTES
09%75 03/18/04
790.40
BAXTER HEALTHCARE CORP
0%676 03/LB/04
.00
VOIDED
09%77 03/18/04
15,28.99
BERGEN BRUN561IG DRUG CO
099678 03/18/04
976.50
BEST WESTERN PORT LAVAC
N3679 03/18/04
146.01
UY DAM
M680 03/18/04
67.95
CERTIFICATION BOARD OF
09%B1 03/18/04
280.40
CITIZENS MEDICAL CENTER
099682 03/18/04
150.08
CLIP LABORATORY PROGRAM
09%83 03/1B/04
410.00
COX MEDIA SOUTHZM DIV
099684 03/18/04
3,671.65
amINS WTERN PLAINS
099685 03/18/04
585.67
DELL FINANCIAL SERVICES
099686 03/18/04
28.52
KATHERINE ➢IETZEL
099687 03/18/04
64.00
DUWOWN CLEANERS
099688 93/18/04
125.00
EXCELSIGR COLLEGE
099689 031ISAK
716.00
ROBERTS, ROBERTS & DDEF
099690 03/18/04
21.39
_
LINDA R GOMEZ
OM91 03/18/04
124.93
SALLY J HICKL
099692 03/18/04
94.34
HILL COUNTRY DAIRIES
099693 03/18/04
71.27
PAT HRANICKY
099694 03/18/04
17.36
GLENDA G. JONES
099695 03/18/04
5.45
THE LAUNOROMAT
09%% 03118/04
26.66
DRALIA LAVIOLETTE
M9697 03/18/04
3,805.88
MEMORIAL MEDICAL CENTER
0%698 03/18/04
1,197.71
MATERA - 1%
099699 03/18/04
68.51
JANE MCCARN
093700 03/18/04
631.33
MERIDIAN PROFESSIONAL S
099701 03/18/04
22.32
LINDA MEYER
099702 03/18/84
78.12
SAM A MIKHAIL
e%703 03/18/84
59L 50
MINOLTA FINANCIAL SERUI
099704 03/18/04
5,00L 00
DR. NAPHPA9N NIRATSUWAN
099705 03/18/04
240.80
PORT LAVACA WAVE
099706 03/18/04
826.40
RMIDY'S FLOUR COMPANY
099707 03/18/04
6,MO. 00
REXCO INC
0%708 03/18/84
566.28
ROLANDO REYES
0%709 03/18/04
227.00
SPECTRA LABORATORIES
W10 03/16/04
3,664.83
SYSCO - SAN ANTONIO, LP
099711 03/18/04
6,314.43
TEXAS LINEN COMPANY LTD
M712 03/18/04
10,ON. 00
TEAM REHAB
099713 03/18/04
32.57
LNIFIRST HOLDINGS
099714 03/18/04
380.37
UNITED PARCEL SERVICE
09WIS 03/18/04
117.18
ELVA VELA �-
W16 03/18/04
909.91
VERIZON GOIRWEST
32
1N OATE:04/12/04
MEMORIAL MEDICAL CENTER PAGE 2
TIME:10:13
O1F.CK REGISTER GLCRRE6
03/IB/04 THRU 03/18/04
Ci{-
O SER DATE AMOUNT
PAYEE
/P 099717 03/18/04
1,528.33 VERIZON
/P 099718 03/18/04
97.35 WALMART COMMUNITY
iP 099719 83118/04.
40.92 ELIZABETH WESTBROOK
/P M20 03/IB/04
13,977.42 FISERV HEALTH - TEN E58
099721 03/18/04
150.95 WOLTERS KLUWER HEALTH,
099722 03/18/04
18.60 DEBORAH WITTNEBERT
P 099723 03/18/04
162.00 XEROX CORPORATION
OTRLS:
110,678.08
•
33
rJ,"-li>
UN DATE:04/12/04
NFAORIAL MEDICAL CENTER
PAGE 1
TIME:10:14
CHECK AE61STER
@CKREG
03/19/04 THRU 03/19/84
ANK-i.HEt7i
--
�
ME NUMBER DATE AMOUNT
PAYEE
i/P 099724 03/1W04
227.90 DRISCOLL CHILDREN HEALT
JP 099725 03/19/04
82.11 ERVIN STEPHMIE
VP 099726 03/19/04
M 37 BROWN PAMELA
VP M727 03/19/04
41.50 JOLLY WYNEMA T
•
i/P 099728 03/19/04
80.95 FORTIS
VP 099729 03/19/04
26.20 SPEARS JOY W
VP 099736 03/19/04
98.07 LAMBERT DOROTHY M
UP 099731 03/19/04
30.63 FOREMAN LEONISE V
I/P 099732 03/19/04
119.31 CLAY TALAREX
VP 099733 03/19/04
25.00 TUCKER SONIA
11P 099734 03;19104
40.00 ZEIS-ER MARY E
VP 099735 03/19/04
11.04 VERNIER JANE
VP 099736 03/19/04
11E 61 WAIN RHONDA C
VP M737 03/19/04
13.24 AGUIRRE HENRY
VP M738 03/19/04
40.05 TAYLOR SHERRY N
I/P M739 03/19/04
2- 69 SALAZAR LUPE
I/P 099740 03/19/04
49.18 RUSSELL SCOTT
VP 099741 03/19/04
21.42 GRAM THOMAS
I/P 0%742 03/19/04
27.53 THORMAMFN HEATHER
I/P M43 03/19/84
200.00 STANCIK CINDY M
I/P 099744 03/19/04
20.00 EASTON DIANE
TOTALS:
1,461.80
34
593
•
0
IN ➢ATE:04i12/04 14MRIAL MEDICAL CENTER PAGE 1
TT1k�18:14 CHECK RESISTER RZFEG
03/24/04 THRU 03/24/04
IDE NUMBER DATE AUNT PAYEE
/P 0%746 03/24/04 49.71 ADVANCE MEDICAL DESIGNS
/P 099747 03/24104 291.50 ACS
099748 03/24/04
181.00
AIRCAST INC
099749 03/24/04
165.00
AM LABORATORIES INC
iP
0997`.�0 03/24/04
201.95
ALIMED INC.
/P
099751 03/24/04
90.15
ALPHA TEC SYSTEMS INC
/P
0997`,,P 03/24/04
3,558.8E
CARDINAL HEALTH
/P
099753 93/24/04
859.24
ARROW INTERNATIONk INC
JP
0%754 03i24104
1,793.81
C.R. BARD LOCIMX
JP
099M 03/24/04
114.80
BAXA CORPORATION
UP
2%756 03/24/04
36,B64.40
BECIO N COULTER INC
VP
099757 03124/04
117.95
BELLS SELECT
UP
099758 03/24/04
105.00
BALLAR➢ MEDICAL PRODUCT
UP
099759 03/24/04
3,BED. 00
BOSTON SCIENTIFIC CORPO
1/P
E9760 03/24/04
79.73
BRIGGS CORPORATION
11P
099761 02/24/04
114.43
BRISTOL-MYERS SOUIBB CD
i/P
099762 03/24/04
457.12
BROONHOLLOW SPECIAL OCC
i/P
099763 03/24/04
1,2M.81
BUCKEYE INTERNATIONAL,
11P
0%764 03/24/04
80.50
CHANNING L BETE CO INC
11P
099765 03/24/04
351.05
CONMED CORPORATION
I/q'-'99766 03/24/04
285.00
COW GOVERNMENT, INC.
R/k�i9767
03/24/04
426.82
COOPERSURGICAL INC
RIP
M68 03/24/04
.N
VOIDED
RIP
099769 03/24/04
.20
VOIDED
RIP
999770 03/24/04
3,411.86
THE COUNCIL COMPANY
RIP
099771 03/24/04
14,925.78
CPSI
RIP
099772 03/24/04
7,221.42
➢ADE BEHRING
RIP
099773 03/24/04
807.64
DEPUY ORTHOPAEDICS INC
RIP 099T74 030/04 16,026.05 SOURCEONE HEALTHCARE TE
P
099775 03/24/04
217.67
DI-CHE14, INC.
P
099776 03/24/04
190.82
E➢WARDS LIFESCIENCE6
A/P
099777 03/24/04
77.20
ELECTRO MEDICAL EQUIP C
A/P
099778 03/24/04
1,118.00
EGUAL ➢IA6NOSTICS
A/P
049774 03/24/04
120.79
E-Z-EM, INC.
A/P
099780 03/24l04
521.49
EMERGENCY MEDICAL PRO➢ll
A/P
099781 03/24/04
13,518.65
FISHER HEALTHCARE
A/P
099782 03/24/04
28.28
FLOTEC INC
RIP
099783 03/24/04
8,564.76
FAE5ENIU5 USA MANUFACTU
A/P
099784 03/24/04
75.20
GE MEDICAL 5YSTEgS, IMF
A/P
099785 03/24/04
545.30
GARY EQUIPMENT CD.
A/P
099786 03/24J04
64.38
GYRU5 ENT LLC
A/P
099787 03/24/04
183.13
GLOBAL COMPUTER SllPPLIE
A/P
099788 03l24/04
15.49
GLOBAL OOSIMETRY SOLUTI
A/D
099785 03l24/04
818.65
HEALTH CARE LOGISTICS I
A/P
049790 03/24/04
331.52
NOLLISTER INC/�..-,
A049791 03/24/04
126.01
IMFOLtiB INC
A�
a99792 03/24/04
05.50
INSIGHT PIIDLIC SECTOR
A/P'
099793 03l24/04
87.52
INTERNATIONAL PLASTICS
A/P
099794 03124/04
422.00
INTOXIMETERS
A/P
099795 03124/04
303.50
J d J HEALTH CARE SYSTE
35
594
1A DATE:64/12104 MEMORIAL MEDICAL CENTER
TIME:10:14 CHECK RE61STER
03/24/04 THRU 03/24/04
ZE MR DATE AMOUNT PAYEE
11P
lip
lip
lip
lip
lip
lip
UP
lip
lip
lip
lip
lip
lip
lip
lip
lip
lip
l/P
lip
lip
lip
lip
lip
lip
lip
lip
lip
lip
lip
lip
lip
lip
lip
lip
09979E 024/04
099797 03/24/04
099798 03/24/04
899799 03/24/04
0998H 03/24/04
099881 03/24/04
099882 03/24/04
099B03 83/24/04
099804 03/24/04
099805 03/24/04
099886 03/24/04
099807 03/24/04
099808 03/24/04
09M 03/24/04
099810 63/24/04
099811 03/24/04
099612 03/24/64
099813 03/24/04
M814 03/24/84
0%815 03/24/04
099816 03/24/84
099817 03/24/04
099816 03/24/04
M9819 03/24/04
0998N 03/24/04
099821 03/24/04
09%22 03/24/04
099823 03/24/04
099824 OU24/04
899&^5 03/24/04
099826 03/24/04
099827 03/24/04
099B28 03/24/04
099829 03/24/04
09M 03/24/04
l/P 899831 03/24/04
VP 099B32 03/24/04
lip M833 93/24/04
VP 099834 03/24/04
VP 09M 03/24/04
lip 099836 03/24/04
TOTALS:
1, 276.11 KENDALL HEALTHCARE PROD
3,468.77 LABCORP OF AMERICA HOLD
78.12 LAND AND WHEELS INSTANT
79.80 LMA NORTH AMERICA
222.06 MEDI-GARB CO INC
51.65 MEDIBADGE
672.95 MEDLEARN
721.44 MEDRAD INC
79.75 MEDTRONIC USA, INC.
69.70 MEGADYNE MEDICAL
71.62 MYRON L COMPANY
930.20 OWENS 8 MINOR
127.57 ON -SITE TESTING SPECIAL
58.80 PHILIPS MEDICAL SYSTEMS
77.24 PITNEY BONES INC
19.21 POSEY COMPANY
79.00 PRO-TEX INTERNATIONAL,
181.80 DUEST DIAGOSTICS
64.72 R & D BATTERIES INC
100.99 REMEL INC
390.85 RPC REPROCESSING PRODUC
230.00 SCALE-TRONIX ACCESSORIE
18194 SYNTHES
649.66 ST JOHN RECORD PROGRAMS
1,560.80 STACY SYSTEMS INC
263.44 STRYKER SALES CORP
64.67 SD1 MEDICAL INC
34.10 SPRINGER-VERLAG NEW YOR
231.74 STERIS CORPORATION
271.36 TAYLOR-MED,LLC
74.67 TEXAS ELECTRICAL SUPPLY
1,395.35 THERMO BIOSTAR
275.00 TIMEMED LABELING SYSTEM
195.84 TRI-ANIM HEALTH SERVICE
4,334.93 TRI-STATE HOSPITAL SUPP
57.50 UAL
3& 75 US TOY COMPANY
196.10 UTAH MEDICAL PRODUCTS I
281.11 W W GRAINGER INC
3,194.00 WATER 8 POWER TECWOIDU
871.40 ZIMMER US, INC.
144,315.71
36
•
•
•
�vv�
iN DATE:04112/O4
MEMORIAL MEDICAL CENTER PAGE 1
T 10:14
CHEC{ REGISTER GLCKREG
03125104 THRU 03/25/04
PNK�exsECK-
- -
iDE NUMBER DATE
AMOUNT PAYEE
+P 099838 03/25iO4 14.07 ACE HARDWARE - PORTER'S
iP
099839 03/25/64
260.00
APPLIE➢ MEDICAL
099840 O3/25/04
83.30
AMERICAN HOMEPATIENT, I
099841 03/25104
5M 13
AIRBAS-SOUTHWEST
/P
09984E 03/25/04
128.50
MARY ALEXANDER,
IP
099843 03125/04
" 913.40
CARDINAL HEALTH
iP
099844 03/25/04
27.33
AUTO PARTS 8 MACHINE M
/P
099845 03/2E/04
733.93
BAXTER HEALTHCARE CORP
/P
099846 03/25/04
1,453.83
BECKMAN COULTER CAPITAL
/P
099847 03/M/04
14,818.43
BERGEN BRUNSWIG DRUG CO
/P
M848 03/25/04
194.45
BORES BEARING 6 POWER T
/P
H9849 03/25/04
19.50
SHIRLEY BOEDEKER
/P
099850 O3/25/04
4,833.00
CAL CUM FEDERAL CREDIT
�/P
099851 03/25/84
?50.00
CALHOUN COUNTY PEST CON
UP
099852 03125iO4
142.68
RUBY CANTU
UP
099853 03/25/04
91.85
'SED/CASH PROCESSING
VP
099854 03/25/64
123.50
DONNA DAVIS
UP
099855 033125/94
617.31
DELL FINANCIAL SERVICES
UP
099856 03/25/04
28.24
KATHERINE ➢IETZEL
I/P
099651 03/25/04
41.30
➢IVERSIFIE➢ BUSINESS SY
:/PI' 9%58 03/25/04
499.80
EAGLE FIRE 6 SAFETY INC
I A�d9859 93/25/04
9.38
MARIA FARIAS
11P
099860 03/25/04
48.53
FEDERAL EXPRESS CORP.
liP
099BEI 03/25/04
3,109.45
FISHER HEALTHCARE
7/P
099862 03/25/04
635.76
FORT DEARBORN LIFE INSU
a/P
099863 0,:/25/04
24,956.71
GE HEALTHCARE FIN SRVS
RIP
099864 03/25/04
10.54
LINDA R GOMEZ
RIP
099865 03i25/04
11.58
H E BUTT GROCERY
R/P
099866 03/25/04
108.50
SALLY U HICKL
0
099867 O3/25/04
70.31
HILL COUNTRY DAIRIES
P
099868 03i25/04
17.10
1ESUSITA S. HERNIUNDEZ
RIP
099869 03/25/94
82.37
PAT HRANICKY
RIP
099870 03/25iO4
95.00
IAHCSMM
A/P
099871 93125/04
466.85
105 CAPITAL
RIP
B99B72 03/25/04
1,26L24
INSTIMIONAL TRUST CON
RIP
399873 03/P5/04
197.12
KARL JANIK
A/P
M874 03/25/04
25.73
ORALIA LAVIDLETTE
RIP
099875 03/25/04
3,933.50
LUKER PHARMACY NANAGEME
RIP
099876 03/25iO4
50.00
MEMORIAL MEDICAL CENTER
RIP
099877 03/25J04
45,350.38
MEMORIAL MEDICAL CENTER
RIP
099878 O3/25/04
749.35
MALLINCKRODT INC
RIP
099879 03/25/04
71.50
CARRIE LYNN MARSHALL
RIP
099880 03/25/04
6,546.15
TERRY W MCCLAIN CPNA
RIP
099881 03125iO4
98.89
7ANE MCCARN
A/P
099882 63/25/04
68.71
MEDIFAX EDI
RIP �099883 03i25iO4
816.79
METLIFE
A'
399884 03/25/04
3,223.28
MERIDIAN PROFESSIONAL S
Ai---099885 03/25/04
29.14
LINDA MEYER
Al?
Z99886 03125iO4
1533.1E
SARO A MIKHAIL
RIP
099887 03/25104
251.39
CHERYL MITCHe1L
0
37
596
IN DATEn04/12/04
TIME:10:14
+Nil —'..HECK
IDE NUMBER DATE
MEMORIAL MEDICAL CENTER PAGE 2
CHECK REGISTER GLCKREG
03/25/04 THRU 03/25/04
AMOUNT PAYEE
IP
099888 03/25/04
871.72
MUSTAIN 3 ASSOCIATES
iP
099BB9 03/25/04
102.25
JOSIE NAVARRO
/P
099890 03/25/04
3.98
O'REILLY AUTO PARTE
1?
099891 03/2514
210.00
OUTBURST ADVERTISING
/P
099892 03/25/04
108.09
MID ELLE ORTA
/P
M93 03/25/04
758.00
POSTMASTER
•
/P
OMS94 03/25/04
1,713.67
PROCTER 6 GAMBLE PHARMA
/P
099895 03125104
275.00
WACHOVIA SECURITIES
/P
099896 03/25M
187.25
R 6 6 ASSOCIATES INC
/P
IVA897 03/25/04
61.99
RADIO SHACK
/P
0%898 03/25/04
7.67
9HERWIN WILLIAMS
/P
M99 03/25/04
409.88
STAFF CARE
/P
099900 03/25/04
3, 476.39
SYSCO - SAN ANTONIO, LP
/P
099%1 93/25/04
135.00
T&T COF0IUNICATIONS INC
/P
MOE 03/25/04
EM.86
MATTHEW TORRES
/P
09M 03/25/04
136.23
TEXAS CHILD SUPPORT SDU
/P
099904 03/25/04
301.68
TEXAS ENVIRO effAL SER
/P
09999 03/25/04
123.41
TEXAS GUARANTEED STUDEN
/P
09M 03/25/04
5,000.08
TEXAS HOSPITAL INS EXCH
1P
099907 03/25/04
8.80
T6
JP
099908 02/25/04
6,353.85
GARY L. TILLEY, CANA
JP
099909 03/25/04
32. 57
UNIFIRST HOLDINGS
VP
099910 03/25/04
98.69
UNIFORM CITY CATALOG
VP
099911 03/255/04
66.50
UNITED WAY OF CALHOUN C
r
i/P
099912 03/25/04
300.00
US POSTAL SERVICE
4 /
11P
099913 03/M/04
M.52
ELVA 14U
VP
099914 030/04
4,473.14
VERIZON SOUTHWEST
i/P
M15 03/25/04
90.97
WALMART COMM
VP
099916 03/25/04
331.6E
ELIZABETH WESTBROOK
11P
099917 03i25/04
73.52
DEBORAH WITTNEBERT
I/P
f 099918 03/25/04
165.60
SHELLY ZAVALA
I/P
09M 03/25/04
93,420.52
TEXAS ASSOCIATION OF CD
.
70TPLS:
244,485.97
38
0
5 DATE:84/124A
MEMORIAL Vain ;rDm PPS 1
i,T 4d:15
OHECN REGISTER 6LCKREG
9126104 THRU 23/26/04
-
DE NUMBER DATE
AMOUNT PAYEE
P
69919 03/26704
E2.72
MILLER LISA
03/26/04
18.11
ROEBEN WALTER
P09M
099921 03/26/04
80.15
FLORES OLDA
0999P2 N12LY04
B40.00
BRADLEY SAM A
'P
099923 03/26/04
79.79
MITOHELL JDHNNY
'P
099924 03/26104
E5.95
MI➢DAUGH TERRY
'P
099925 03/26104
65.59
LEE ROBERT E
lP
099926 03/26/04
82.57
BUTLER LINDA
3TALS:
234.92
•
39
598
LN DRiE:04/12/04 MEMORIAL MEDICAL CENTER PAGE 1
TIME:10:15 GM REGISTER G=REG
$3129/04 iHR(1 03/29/04
ADE "BER DATE AMDONT PAYEE
VP 09%30 03/29/04 3,b25.09 GOLDEN CRESCENT COMAONI
"O T ALS: 3,625.09
40
0
•
•
1N DATE: Aj12/64
ME40RIAL MEDICAL
CENTER
PAGE:
TIME: 10:54
AP CPO! INVOICE LIST THRu' ME DATE OF 04/28/04
APGPEN
$...........................
CLS.lNVOICEk.........
TRN DT.7NV DT. DIE DT.CR DT..PC.......
GROSS .....
DISC......
NO-PAY........NET
1315 AC14I
E4999633
031004 d22564 042804
22 00
.60
52L u
TOTALS .......................................:
52L60
.00
.00
522.00
ADVANCE MEDICAL DESIGNS X
�432
M 51628931
832404 031004 042804
49.71
.00
49.71
TOTALS .............................
..'......
49.71
.00
.00
49.71
i1692 ALLRVI5, INTERNATIONAL
M 15066
032404 022304 042804
110.51
.00
110.51
TOTALS .......................................:
110.51
.00
.00
110.51
41760 AMERICAN ACADEI4Y OF PEDIATRICS
W 1-000 A394
E31A 031004 042804
261.15
.00
261.15
TOTALS .......................................:
261.15
.N
.00
261.15
RIK5 CARDINAL iEAUH
M 08188701
LA31004 0229M 042804
3370.39
.00
3370.99
OBIN724
033104 U104 042804
2033.48
.N
2033.48
TOTALS .......................................:
5404.47
.00
.0
5404.47
42269 ARROW INTERNATIONAL INC
M 1738B54
031W 030104 e42804
209.15
.03
209.15
TOTALS .......................................:
209.15
.02
.00
209.15
Rat@ ART'HROTE( INC
14 42UW
033004 032304 042804
1026.00
.00
1026.00
TOTALS .........................................
1026.00
.M
.00
1026.00
R346 ASPECT MEDICAL SYSTEMS
M 102303
033004 61604 042804
442.17
.00
442.17
•
TOTALS .......................................:
442.17
.00
.00
442.17
B0437 C.R. BARD L OQMX
M 2989BEI
033104 C2404 042804
648.3E
.90
648.38
TOTALS .......................................:
648.38
.00
.00
W.38
B0441 BARNSTEAD INTERNATIONAL
407814
033104 030504 042804
172.55
80
172.55
TOTALS .......................................:
172.55
.00
.00
172.55
U959 BAXA CORPORATION
W SL1/10244133
033104 032384 B42W
114.80
.00
114.80
TOTALS .......................................:
114.80
.00
.00
114.80
B1220 BECRMd1N COLTER INC
M 502078AN24
032494 030104 042804
585.00
.00
565.00
502078AN25
032404 OM704 042664
574.50
.00
574.58
166435FLOI
033104 031504 042804
137.03
.00
137.03
`-
308514AN45
033104 030804 042804
11311.23
.00
11311.03
.
51-7251AN21--
033104432504-+i428W
250.80-
.00
250.80- ...
41
•
690
0 DAit: 04/12/94
MEMORIAL MEDICAL CENTER
PASS: 2
TIME: 10:54
AP OPEN INVOICE LIST THRIJ DUE DATE Of 14/28104
APOPEN
JENN.W, *.......... ................
CLS.IMV0ICE9......... TRN DT.IN4 DT.DUE ➢T.a➢T..PC
....... BROSS.....
DISC ......
No -NY ........ NE7 �J
TOTALS .......................................:
12858.3E
.00
.00 12858.36
BIEN BECKWITH ELECTRONIC 2 6INEER
M E12151-IN 033104 U3104 042804
337.35
.00
337.35
E12185-IN U3104 033004 W804
270.45
.00
270.45
TOTALS .......................................:
697.80
.00
.00 607.80 .
B1499 BALIARD MEDICAL PROIRET9
M 1494383 031004 OK404 042864
193.60
.00
192.60
TOTALS .......................................:
192.60
.00
.00 193.60
BIND BRI66S CORPORATION
M 1817169RI 032404 031104 042804
87.22
.00
87.2E
TOTALS.......................................:
87.22
.a
.00 87.2E
B1810 BRISTOL-MYERS SIIUIBB COMPfLJY
M 813604 933104 021M 942804
57.70
.00
57.70
TOTALS.......................................:
57.70
.00
.00 57.70
B1834 BSN MEDICAL INC
M
243195
032464 030304 042B04
85.75
.00
85.75
TOTALS .......................................:
65.75
.00
.00
85.75
C1275 CARROT TOP INDUSTRIES INC
-
M
000332936
033104 032404 042804
252.04
00
252 04 -
TOTALS .......................................:
252.04
.00
.00
252.04
C1410 CERTIFIED LABORATORIES
M
862242
031004 022504 042804
154.00
.00
154.60
TOTALS .......................................:
154.00
.00
.00
154.00
C1478 DIANNIN6 L BETE CO INC
M
5101737BRI
033004 031204 042804
503.92
.20
503.92
TOTALS .......................................:
503.9E
.00
.00
503.92
C1850 CODONICS-X
M
045993
031004 030404 042804
221.40
.00
221.40
TOTALS .......................................:
221.40
.00
.00
221.40
C1970 Cam CORPDRATION
M
140706
031304 030504 042804
33.72
.00
33.72
14MI
U2404 031004 042804
IN.15
. a
IN.15
142856
032404 031004 042804
33.72
.00
33.72
143192
032404 031004 042804
34L 66
.00
3342.6E
1472M
033004 031704 B42804
490.80
.00
490.80
151031
033004 032304 04EB04
141.33
.00
141.33
150779
033104 QM W894
491.80
.00
491.80
150914
U3104 M04 042804
91.62
.00
91.62
151253
M04 032404 042804
36.33
.00
36.'3
TOTALS .......................................:
1762.13
.00
.00
17E2 13
M308 CORNISri MEDICAL_ ELECTRONICS
0029522-IN
033004 032204 042804
203.00
.00
203,00
42
6O1
•
JN DATE: 04/12/04 MWRIAL MEDICAL CENTER PAGE: 3
i s 10:54 AP OPEN INVOICE LIST THRU DUE DATE OF 04/28/04 APOPEN
ENOME.......................... CLS.INVDICEa......... TRN DT.INV DT.DUE DT.CN DT..PC....... GROSS ..... DISC ...... NO -PAY ........ NET
TOTALS .......................................: 203.00 .00 .00 203.00
2450 TFE C"CIL COMPANY
M 20249
031004 030104 042804
65.59
.00
05.99
20292
031004 030204 042B04
437.35
.00
437.35
29331
031004 038304 042804
128.10
.00
128.10
20332
KIM 030304 042004
57.61
.00
57.61
20375
031004 030404 042804
159.00
.00
12.02
20475
032404 030904 042804
8.54
.00
8.54
20476
032484 830904 042804
213.26
.00
213.26
20479
032404 03M 942804
591.19
.00
591.19
20555
0324B4 031104 042804
7.86
.00
7.86
20640
0E2404 031664 042804
393.50
.00
393.58
20782
L132404 93EM W804
142.00
.00
142.00
20330
033004 038304.042804
4.11
.00
4.11
20478
033004 030904 042804
.54
.00
.54
20849
033004 032404 W884
91.06
.00
91.26
20850
033004 032404 042804
2.84
.00
2.84
20854
033004 B32404 042804
432.66
.20
432.66
20962
233194 032904 042W
17.52
.00
17.52
20997
63104 033004 042804
86.93
.0
86.93
20998
033104 "04 042904
159.a
.09
159.00
TOTALS .......................................:
2999.06
.00
.00 2999.36
:2:510 CPSI
M 146641
031004 022584 042804
362.52
.00
36L 50
147562
031004 030304 042604
382.00
.00
382.00
A0403041378
031004 030404 042B04
10539.00
.00
1029.00
148090
032484 031004 W004
322.00
.02
322.00
148135
032404 031004 M2804
440.00
.B0
449.00
148968
033104 031704 042804
414.52
.00
414.50
149645
033104 032404 M2804
317.00
.00
317.00
TOTALS .......................................:
12777.00
.00
.00 12777.00
CH93 CURT15 1000
M 45984705
033104 030304 042804
378.50
.00
378.50
TOTALS .......................................:
378.50
.00
.00 378.52
D0350 BADE B&RIN6
N 92955,214
032404 d30904 A2804
3881.69
.08
3081.69
929654N
033104 031604 042804
224.43
.08
224.43
929670M
033104 031704 042804
197.97
.00
197.97
92968433
033104 031804 Wd04
13.17
.00
13. 77
92978829
033104 032204 042B04
400.82
.00
400.82
TOTALS .......................................:
3918.68
.80
.00 3918.68
01220 Dc`%TERIii SURGICAL INC
_., M SI137826
033104 033084 042804
M.76
.00
108.76
TOTALS .......................................:
108.76
.00
.00 108.76
H243 SOURLDW HEALTWDW T-LLhNOL06
M 7598433
031084 030204 042W
223.51
.00
223.51
43
&! DATE: 04/1E/04 MEMORIAV_ MEDICAL CENTER Tom: 4
TIME: 10:54 AP OPEN INVOICE LIST THRU DUE DATE OF 04/28/04 APOPEW
Mi. iNAEE........................... LLS.INVOICE@.........TRN DT.INV DT.DUE ➢T.CS DT..PC ....... GROSS ..... DISC ...... NO -PAY ........ NET ` J
1600 E-Z-EM, INC.
34M EMERGENCY MEDICAL PRODUCTS
1400 FISHER HEALTHCARE
-1780 FRESENIUS USA MANUFACTURING
30100 GE MEDICAL SYSTEMS
61752 GLOBAL GOV'T/E➢UC SOLUTIONS
T565Tr1
032404 031804 W804
3442.42
.00
3442.42
756a-m
032404 631804 042804
1574.92
.80
1574.92
7511956
033104 63M 042804
445.66
.00
445.66
7<✓rrm
ID33104 131M 042804
12:8.46
.00
1238.46
756129
Kh04 OM04 042804
167.50
.00
161.50
7576122
033104 03M 042804
48.96
.00
48.96
7576126
M104 M04 042804
1530.25
.00
1530.35
75963336
M104 M104 042B04
2676.11
.00
2676.11
TOTALS .......................................:
11347.89
.20
.00
11347.89
M 556640
233104 032404 042804
111.38
.00
111.38
TOTALS .......................................:
111.38
.a
.00
111.38
M INY556492
U2404 031704 W804
45.46
.00
45.46
INU559293
033104 632404 042804
193.65
.09
193.a
TOTALS .......................................:
239.11
.60
.00
239.11
M 20B68m
031004 0P2664 042W
16.08
.00
16.08
20868M
231094 022604 042804
5.%
.00
5.96
2086834
031004 022684 042804
15.66
.00
15.66
2086M
031004 OM04 042804
236.98
.00
236.98
2365475
931004 M184 942804
666.09
.00
666.00 '-
2515619
032404 030204 042804
245.94
.00
245.94
2515685
032404 830204 042804
336.24
.00
336.24
2EM419
032404 030304 042804
-867.00
.00
-867.00
2738395
032404 03OW W804
926.03
.00
926.03
3154983
033104 831184 A2804
1175.38
.06
1175.28
3372912
033104 031684 842804
70.75
.00
72.75
3615240
033104 031804 842804
1165.32
.00
1165.32
4619603
033104 9323M 042804
77.52
.00
77.52
4619608
OM04 032304 042804
67.34
.00
6-1.54
4619609
M104 03M 042804
882.98
.00
882.98
4858346
M104 032604 M04
579.54
.00
Sr9.54
TOTALS .......................................:
5608.92
.00
.00
5800.92
M 92022965
031504 M04 042804
14.01
.00
14.01
92024844
031504 030804 042804
6-3.00
.00
65.00
92824845
031504 030884 M2804
3019.60
.00
3019.60
92024843
032404 030804 042804
20.00
.00
20.00
92032758
032404 831W 042804
184.00
.90
184.00
92637705
033004 031904 042804
3379.20
.00
3379.20
TOTALS .......................................:
6681.81
.00
.00
6681.81
W 200245531
032404 031104 042804
258.05
.00
258.05
TOTALS .......................................:
258.05
.00_
,60
258.25
M 74608158
M1594 021984 042B84
409.90
.8ID
409.9ID
44
6Q3
0
•
1Di DATE: 04r12/04 MEMORIAL MEDICAL CENTER : 5
7K: 10:54 AP OPEN INVOICE LIST TH@j DUE DAit OF 94/28/04 APOPEN
END ................ .......Z.S.INVOICE#.........TRN DT.INV DT.DUE DT.CK DT..PC....... GROSS ..... DISC ...... ND -PAY ........ Nei
TOTALS .......................................: 409.92 .00 .00 405.90
10945 HARBOR LINEN!
W 4108809
032404 031504 042804
65.4E
.00
65.46
TOTALS.......................................:
65.46
.08
.00
65.4E
'1011 THE H+H SYSTEM, INC
0304-4345
833104 032504 042804
31.87
.00
31.87
T07AL5.......................................:
31.87
.00
.N
31.97
i1135 HEALTH CARE LOGISTICS INC
M 1189566
N3104 832904 042804
80.28
.00
80.28
TOTALS .......................................:
80.28
.00
.00
80.28
I0525 IKON OFFICE SOLUTIONS
M 100220003
033004 031404 042804
130.95
.00
130.95
1002173194
033104 030304 W804
104.00
.00
104.00
TOTALS.......................................:
234.95
.00
.00
234.95
10950 INFOLAB INC
M
1895885
831N4 030204 042804
126.91
.20
126.81
TOTALS .......................................:
126.81
.00
.00
126.B1
if_, 4NSTRUKENTATION LABORATORY
M
9300008968
822904 020904 042804
-570.01
.w
-570.01
9100146754
M04 032904 042804
1266.68
.00
1266.68
TOTALS ........................................
696.£7
.00
.00
636.£7
I10 INTEGRATED MEDICiI. SYSTEMS,
IN
112147
032404 03169 042B04
71.00
.00
71.00
TOTALS .......................................:
71.W
.00
.00
71.N
101250 INTERNATIONAL PLASTICS INC
M
0032?394
E1594 030204 042804
87.2E
.80
87.2E
TOTALS .......................................:
87.22
.00
.Q
87.2E
11392 SIMSON, INC.
M
YC902980
031004 OM04 042804
114.39
.00
114.39
YC901133
033104 033M 042W
75.14
.00
79.14
TOTALS .......................................:
193.53
.90
.00
193.5'3
K1047 KEYDALL HEALTHCARE PRODUCTS CO
M 09132219
031004 022504 A28M
107.12
.00
09184464
032404 0310M 042W
374.31
.00
09234M
M04 032404 0428M
197.52
.N
TOTALS ........................................
678.95
.N
VJ-145 KIMBALL MIDWEST
M 59376
031004 030204 042804
63.39
.00
_ TOTALS .......................................:
63.39
.00
K1225 KRO L LABORATORY SPECIALISTS
W 472334
E1004 022904 042804
150.00
.00
1071.12
374.31
197. 52
.00 678.95
63.39
.00 62.39
150.00
45
6 `Y
IN DATE: 04/12114
MEMORIAL MEDICAL CENTER
PAGE: 6
TINE: 10:54
AP OPEN INVOICE LIST THR11 D1E DATE OF 04i28iO4
APOFEN
E7D4.,WM..........................
LIS.INVOICEi......... TFN DT.INV DT.➢UE DT.CK DT..PC.......
GROSS .....
DISC......
NO -PAY...
.... INET
TOTALS.......................................:
150.00
.00
.00
150.00
.M LAB SAFtiY UPLY INC
M 1004423620 032404 M04 042804
126.15
.00
126.15
TOTALS .......................................:
126.15
.00
.00
126.15
.
.0780 LABCAP.P OF AMERICA HOLOIN65
M 14842144 031004 022604 042804
4190.04
.00
419t.O4
1489586E 031004 022804 042804
28.00
.00
28.00
TOTALS ........ . .............................. :
4218.04
.00
.00
4218.04
.100E LAND AND WHEELS INSTANT SLPPLY
M979 0 IB04 022704 042804
12.52
.00
12.52
TOTALS ............. I.........................:
12.52
.08
.00
i2.52
.1430 LINVATEC CORPORATION
M 3659187 031504 021704 042804
109.50
.20
109.50
TOTALS........... I ...........................:
109.50
.00
.00
109.50
.1438 LMA NORTH AMERICA
M 221128 OL1504 030204 042804
155.60
.06
159.60
224913 033104 OM04 042804
159.60
.00
159.60
TOTALS........... I ...........................:
319.20
.00
.00
319.20
11511 MARKETLAB
--
W N3873A-IN 032404 122203 042804
285.00
.00
285.00
TOTALS .......................................:
285.00
.00
.00
285.00
0485 MEDRAD INC
M 90760586 K2104 832604 042804
360.72
.00
360.72
12499 MmTAONIC USA, INC.
TOTALS .......................................:
360.72 -
.20
.00
360.72
.
W 4MG183 022104 031604 042804
185.25
.00
165.25
TOTALS .......................................:
185.25
.00
.00
185.25
4255E MEGRDYNE ME01CAL
W I0332600 OC2404 030904 042804
200.50
.00
200.50
I2334946 033104 032304 042804
69.70
.00
69.70
TOTALS.......................................:
270.20
.00
.00
270.20
12685 MICROTEK ME➢ICAL INC
M 1314177 E2404 031604 W804
76.86
.00
76.66
TOTALS .......................................:
76.86
.00
.00
76.86
i33s1 @LOREE Main
W 93259249RI 032404 030904 042804
79.76
.00
79.76
TOTALS.......................................:
79.76
.00
.00
79.76
10425 OWENS 8 MINOR
M 048237E 032404 831204 842804
164.83
.00
164.83
46
6UJ
u4 DATE.. Ail2104
CCRIAL Mala MiTEER
PRUE: 7
10:54
W OPEN INVOICE LIST TIM DUE DATE OF W28104
APOPEW
d0a 7*-K....................:.....CLS.iNVQICEj.........TAN
D7.;N4 DT.DUE LT.u4 DT.. C.......
GROSS .....
DISC ......
NO --PAY........ NE
0484825 023104 031604 942804
-E3.24
as
-EZ.24
MEE58 033104 a31904 a428a4
169.01
as
169.01
048912E 033104 032404 a42BO4
225.6E
.00
225.6E
0489445 a331a4 0324a4 042804
81.17
.00
81.17
TOTALS ....................................... :
617.39
.00
as 617.39
•
0900 OFFICE MICNICAITONS SYSTEMS
N32462A a31004 03a404 042804 280.40 .00 280.4E
TOTALS .......................................: 289.40 .0a .0a 28a.40
i410 G"ITE TESTING EPELINLiST6
254.97
W
1128
E2494 030304 042604
254.97
.00
TOTALS .......................................:
254.97
.00
.00
254.9!
'i47= PidLiPS NELILAL SYSTEMS ABU
W
9000210138
033104 a32404 042804
116.B0
.00
116.80
TOTALS .......................................:
116.8a
.00
.00
116.80
)EIH POSITIVE PROMOTION6
N
01125794
033104 a32304 042804
51.55
.00
51.95
TOTALS .......................................:
51.95
.06
.00
51.95
i{16RE5SIVE DYNAMICS
M
111142
_
032404 031004 a42804
86.25
.00
BE.25
1112EB
033104 032404 042804
14E.63
.a0
142.63
TOTALS .......................................:
2a.8B
.00
.00
228.38
00560 QUARTERMASTER
in
P58EaWN&2
032404 031204 a42804
2i. 87
.00
2r. tl7
P567614aa019
032404 031504 042U4
97.55
.00
97.55
&57a QuE3T DiAMSTiCS
TOTALS .......................................:
125.42
.00
.00
0.42
W
91029i5960
032404 022504 042aM
IU9.85
.00
1065.85
91031544il
033104 9K9a4 042804
474.30
.00
474.30
9363154423
0331A M04 a42804
127.50
.00
127.50
TOTALS .......................................:
16i1.65
.00
.Q
iEIi.E5
R1464 RPC REROCESSING PPLDUCTS LQY.P
N
R669
033104 MIN OA2804
65.84
.00
05. d4
TOTALS .......................................:
65.84
.00
.00
65.84
R1468 RESPONSIVE PROVIDERS 11K
M
004202E-iN
a33104 032364 042804
406.75
.00
4a6.75
TOTALS .......................................:
406.75
.00
.30
406.75
;ILJIa misoRoics CORP
N 705591 aKia4 031a04 042804 M.85 .a0 in.65
TOTALS .......................................: 173.85 .00 .00 173.85
S2204 TEXAS STAR POLL SERV S SUPPLY
446 031004 021804 A28M 165.00 .00 1S& 00
47
•
W6
81f1 DATE: 04/084 MEMORIAL MEDICAL CENTER PAGE: 5
TIME: 18:54 AP OPEN INVOICE LIST THRU 011E DATE OF 04/28/04 APOPt.�I
iENDO.NAME.......................... CLS.INVOICE@......... TRN DT.INV DT. DUE DT.CA DT..PC ....... GROSS ..... DISC ...... NO -PAY ........ NET
447 031004 OU404 &H04 55.00 .00 55.00
TOTALS .......................................: 220.00 .00 .80 220.B0
M79 ST 30HN RECORD PROGRAMS
M 016220162
031064 022584 042804
32.63
.00
32.83
•
- 016LE633
831504 830184 042804
29.95
.00
29.95
01623483
031504 830204 042804
64.60
.00
64.60
01625165
831504 030404 W804
80.80
.00
60.80
01634593
033004 031804 W804
2128
.00
23.28
216384/6
033104 032404 A2804
70.35
.00
70.35
01638417
033194 032404 042804
23.28
.00
23.28
TOTALS .......................................:
324.89
.00
.00 324.89
iEU STRYKER SALE CORP
M 3351M
031004 822504 042804
W5.92
00
105.3E
353699A
032404 031004 042804
372.6E
.00
372.62
345353A
M104 03M 042804
927.85
.00
927.85
TOTALS ........................................
1406.39
.00
.00 1486.39
34W STERIS CORPORATION
M 716355
832404 U1764 042804
33.86
.00
33.86
716565
OK404 031704 042504
143.00
.00
143.00
TOTALS .......................................:
176.86
.00
.00
176.86
_.
TM TAYLOR-MED,LLC
1
W 3159
033004 032304 M2804
271.06
.00
271.86
TOTALS .......................................:
271.06
.00
.80
271.06
TI900 TEAS ELECTRICAL SUPPLY
M 10867
0,31504 030184 W804
165.60
.02
165.60
-
TOTALS .......................................:
165.60
.00
.00
165.60
090 THERMO BIOSTAR
M 360126
033104 030804 042804
439.35
.88
439.35
TOTALS .......................................:
439.35
B8
.a
439.35
T2670 TIMEMED LABELING SYSTEMS INC
M 2523.5
032404 031004 W804
222.09
.00
c22.09
TOTALS .......................................:
222.09
.00
.00
222.09
T3136 TRI-ANIM iEALTH SERVICES INC
M HTH40765106
033004 031604 042804
32.10
.00
32.10
HTH40844844
033104 032404 W804
32.45
.00
32.45
TOTALS ................
I......................:
64.55
.00
.00
64.55
T3190 TRI-STATE HOSPITAL SUPPLY CORP
M 1578634
031884 030204 042804
30.05
.00
30.05
1579319
031004 03M 042804
1557.4E
80
1557.42
1582356
032404 030504 042804
241.00
.00
241.00
124462
LA322484 ON904 042804
254.34
.00
254.34
1584W
032404 OM04 042804
Bel. be
.00
801.60
48
6197
1
N Ni,r: 04li2/04
MEMORIAL MEDIO L
CaHR
Pam'
T)' � 10:54
AP OPEN INVOICE LIST TMRU DUE DATE Of 04/28/04
APGp&
ND�.NAME ..................
.m
CLS.INVOICEi.........TRN
DT.INV DT. DUE Di. CA DT..PC.......GROSS.....DISC......NO
PAY........17
1566113
63064 031504 042804
-451.36
.00
-451.36
1589869
O33004 M1604 042804
497.20
.00
497.20
1594856
023604 Ea04 042804
519.86
.00
519.86
1597005
233104 032504 0428M
241.00
.00
241.00
•
1599971
OM04 033004 042804
27.50
6-718.61
.06
.60
.00
E7.50
3718.61
TOTALS .......................................:
1390 UNITED STATES SURGICAL
M 928609"s3
032404 630904 042804
169.95
.60
169.95
TOTALS .......................................:
169.95
.00
.00
169.95
I005 ZINMER U5, 1K.
ti 758262
631604 030104 042804
111.67
.06
111.67
764932
031504 030304 042W
69.03
.00
69.033
799812
032404 031604 042804
158.38
.00
158.38
TOTALS .......................................:
339.08
.00
.00
339.08
GRAN➢ TOTALS .................................:
90754.2
.a
.00
90754.53
•
49
•
608
REFERRAL ACCOUNTS FOR MARCH 2O04
FINANCIAL CLASS B - REFFERAL ACCOUNTS -
FINANCIAL CLASS E - REFFERAL ACCOUNTS -
FINANCIAL CLASS I - HOSPITAL ACCOUNTS -
FINANCIAL CLASS J - MEDICARE ACCOUNTS
TOTAL
CHARITY FOR THE MONTH OF MARCH
CHARITY FOR THE YEAR OF 2004
$ 91,872.84 •
$ 99,889.46
$ 19,538.01
$ 11,432.70
$ 222,733.01
$ 80,219.22
$ 225,100.65
50
609'
0
RFFFFRRAT,
MffiAORIN, N®ICAL CENTER
MARCH 2004
'tL. CODE PAT. TYPE PAT. k PAT. NAME GDARANTOR NAME WRITE OFF AMT.
B
1
B11617
BARBFIHLD BOBBY
BARHFIBLD BOBBY
536.46
B
1
B43909
BARKER DOWNIE
BARREN DONHIB
-19122.42
B
1
B44614
BECK AMANDA LEE
BECK JESSE R
1677.28
1
B47826
CBABHETERI MARGARET! L
CHARMM MARGARET L
990.85
•B
B
1
B49765
LLORANCE TYLISHA
LLOBANCE TYLISHA
147.44
B
1
B50484
CARDENAS WARY T
CARDENAS JOSE M
519.00
B
1
B51297
CANTO GLORIA
CANTD GLORIA
434.12
B
1
B52601
KING CHARITY
KING CHARITY
10517.23
B
1
B53164
CERVANTES LORI
CERVANTES LORI
574.39
B
1
B53599
GARCIA MAMIEL JR
GARCIA MANOEL JR
30.00
B
2
B26815
HALLAM JOHN
HALLAM JOHN
49.57
B
2
B44065
DAVILA ARMOLDO
DAVILA ARNOLDO
1201.75
B
2
B4543B
GONZALES GEORGE III
GONZALBS GEORGE III
- 142.25
B
2
B48100
BARRIRNTES CONM
RARRRRNTES ROSH =
14.90
B
2
B48105
BARRIENT88 COHNIE
BARRIENTES ROSENDO
100.41
B
2
B48137
DRYTON TIM
DEYTON TIM
94.06
B
2
B48401
HKRNAMIDEZ CHRISTIHA
28161ANDEZ CBRISTINA
423.00
B
2
B48533
CAMACHO MARTIN
CAM+CHO MARTIN
226.36
B-
2
B48601
CHAVRZ BRITTNEY E
CHAVBZ KIMIERLY
48.69
B.
2
B48762
CARR JARB
CARE KIWBBRELY
111.56
B
2
B48868
GALVIN BLANCA
GALVIN BLANCA
86.05
B
2
B48989
BOWDEN MARGARET
HONDO MARGARET
62.10
2
B49414
BLEVINS LINDY
BLBVINS METER
245.87
2
B49865
BOY= DARROW
BOYKIN DARROW
21.04
B
2
B50059
BEHAVIORS HORTBNCIA
BEHAVIDAS HORTENCIA
590.95
B
2
B50507
FLARES BRITTINI
FLARES DOLORES
13.05
B
2
B50802
GARCIA RACHEL J
GUM RACHEL J
225.95
B
2
R51175
ASLIN SHERRY
ASLIN JAMBS
10.00
B
2
B51181
BORE JERRY L III
EDEB JANE Am
177.44
B
2
B51223
GALVIN FRANK
GALVIN FRANK
42.97
B
2
B51227
GALVIN FRANK
GALVIN FRANK
68.83
2
B51401
FLARES SOPHIE
FLARES SOPHIE
126.47
•B
B
2
B51465
CHANDLER ROBIN R
f ICKE MOHR
779.21
B
2
B51469
GARZA GOILLERMO R
GARZA GGIIANRMO R
203.72
B
2
B51575
HILL CAROLYN C
HILL CAROLYN C
59.81
B
2
B51592
FLORRS MARTHA J
FLORES MARTHA J
232.35
S
2
B51929
GOZMAN MARIA SALAS
G024W KUM SAW
139.27
B
2
B52114
GOMM DOES
GOMKE DENNIS
25.49
B
2
B52134
LOPEZ ISABEL
LOPEZ ISAHSL
47.95
B
2
B52389
LOPEZ AM V
LOPEZ AMA V
416.85
B
2
B52474
LAGASSE MIKE
LAGASSE MIKE
404.53
B
2
B52487
HAGAMAN BETTY
HAGAM JAM
42.50
B
2
B52726
HONG YIN CUM
HONG YIN CUM
232.95
B
2
B52732
JOHL KUM
JOE MARSHA
200.00
B
2
B52771
CONSTANCIO JOSIR
CHRISTIANSEN PADL H
272.13
B
2
R52776
DAVILA ANGELITA D
DAVILA ANGELITA D
413.70
B
2
B52941
GARCIA ETHAAN
GARCIA RHONDA
73.14
B
2
B52956
HOELSCHER KELSEY
HOELSCHER DOMALD R
93.50
B
2
B52962
CANTO GLORIA
CANTD GLORIA
13.53
-" B
2
B53381
LENTO RICHARD
LENTO RICHARD
96.90
3
2
R53774
DODD TTAHE K
DODD DAVID
30.83
'p B
2
B53824
IVY JEFFERY K
IVY KIM
117.60
B
2
B53839
BARRIOS TERESITA
BARRIOS MANOEL
211.37
B
2
B54016
EDWARDS JMJE ANN
EDWARDS HARRY J
17.63
•
PAGE 1
63 V
MEMORIAL MEDICAL CENTER
MARCH 2O04
.COL. CODE
PAT.
TYPE PAT. A
PAT. BAMB
GUARANTOR NAM
MITE OFF AMT.
B
2
B54063
GIBSON BARBARA
GIBSON BARBARA
56.65
B
3
B42188
ALHAMZAR DASH
AUD11 R DMA
1447.64
B
3
1345930
CARAWAY LESLIE CHRISTI CARAWAY JOHN 0
139.47
B
3
B46217
BLRVINS GLORIA
BLEVINS WALTER
79.85
B
3
B47820
CASTILLO HORACIO
CA.STILNQ HORACIO
64.25
B
3
B47841
AMMON LUIS MANUEL
BEPNON LUIS MANUEL
344.05
B
3
B48624
HOLLA➢AY CONNOR
HOLLADAY JANICE M
110.76
B
3
B48028
ESCOBAR LOR]LBB
ESCOBAR IORILKE
43.21
B
3
B48944
LANGPORD SRMWN ROMAN LANGFORD SHARMiN BOMAR
1920.74
B
3
B49067
GARCIA SUSIE
GARCIA SUSIE
70.47
B
3
B49296
HUNTER SHELLY
SOFTER SHELLY
154.17
B
3
B49716
COMM JINOVEL D
C04TN10 JINOVEL D
929.09
B
3
349795
EMERY JUDITH A
EMERY JUDITH A
40.00
B
3
B49981
BALDERA ESPHRANZA
BAIDERA &SPERAANZA
172.25
B
3
B50993
CORTEZ JOHN ERIC
CORTEZ JOHN ERIC
109.48
B
3
RSOB94
CORTEZ MBLANIE
CORTEZ MELANIE
44.44
B
.3
B51007
ADAME MARY
ADAME MARY
42.57
B
3
B51010
DANISH GARY
BANKER GARY
416.44
B
3
B51018
GONZALES ANTHONY
GONZALES CHRIS A
98.80
B
3
B51070
GOMM DARREN
GOMM DARREN
2538.37
B
3
E51070
FLORAS JESSICA
FLORAS ALICE
804.62
B
3
B512D2
PULP MISTY
BURKE TERRY
114.74
R
3
251240
FIELDER LESLIE+
FIELDER I.R51
172.25
B
3
B51309
CAMICHO MANY LDO
CAMACHO MANY URN
116.03
B
3
B51313
COEU R ANDREA
CUELLAR MUM
843.97
B
3
B51410
AGUILAR JOSS
AGUILAR JOBS
684.92
B
3
B51426
GOODMAN BILLY
GOODMAN BILLY
2432.68
B
3
B51177
CALZADA JOHN
CALUDA JOHN
832.99
B
3
B51492
BRADLEY JENNIFER
BRADLEY JENNIFER
152.25
B
3
251501
BLANKINSHIP ROBERT
BLANKENSH P ROBERT
172.25
B
3
B51555
FIERROS MIGUEL ARM
FIERROS MIGNEL ANGEL
548.89
B
3
B51617
BARER JACK M
BASER JACK M
401.04
B
3
B51629
nT MARCUS
FEW MANGOS
100.00
B
3
B51663
BEGO NATHAN ANTHONY
HBO JOEL
1665.02
B
3
B51664
CARRILES TOIIYA T
CARRILES TONTA T
223.85
B
3
R51678
GARCIA MICUTIR
GARCIA MICCm-T
256.41
B
3
B51701
COFER MARILYN
COF.ER SAMUEL
71.22
B
3
B51727
GRIGGS ELENTHA
GRDGGS ELMTHA
123.46
B
3
B51832
GARCIA DARLENE V
GARCIA DARLENE V
715.06
B
3
B51877
GARCIA ALEXANDER
DELGADO ROBERT
622.62
B
3
B52022
COTSBAVER VIRGINIA D
CNTSHAVER VIRGINIA D
513.58
B
3
B52151
LAMERS HENRY D
LAMERS HENRY ➢
74.81
B
3
252271
FONSECA MANIA EM
FONSECA MANIA KIM
200.15
B
3
252284
ESCOBAR CATARINO JR
ESCGKAR CATARINO JR
637.92
B
3
B52335
COLUNGA JACINTO
COLONGA JACINTO
1783.03
B
3
E52250
HOL66II1 DAHM
HOLGUIN DANIEL
140.55
B
3
B52386
ESCOBAR KIER= REIGN KSCOBAR KRIM
201.70
B
3
B52388
ANZALDDA ERIC W
ANZALDM4 ERIC W
264.85
B
3
B52392
JOHNSON CRNIS
JOHNSON CHRIS
467.34
B
3
B52403
GREM OSCAR JR
GEM OSCAR JR
-544.09
B
3
R51106
BALDERA DANYELLB L
BALDERA GOMM
660.62
B
3
B52158
KIM KIMBERLY
KING KIMBERLY
218.80
B
3
B52528
GARCIA ROBERT L JR
GARCIA ROBERT L JR
1034.18
B
3
152642
JACKSON GARRETT
JACKSON SONDRA
236.97
B
3
B52702
SDMAHDS VERONICA
MEWS VERONICA
559.08
PAGE 2
52
611
•
•
0
MARCH 2O04
,01. CODE PAT. TYPE PAT. I PAT. NAME
GDARBMTOR NAME WRITS OFF ANT.
B
3
B52762
JONES ALLEN
JONES Au
1234.75
B
3
B52770
ALCALA JULISSA
ALCALA LNCILA
464.66
B
3
B52816
BLANKENSHIP ROBERT
BLANKENBHIP ROBERT
172.25
B
3
B52886
DARILEX MIA
DARILER LUCINDA
285.12
3
B52907
GUTIERREZ JUAN M
GPFffitMEZ JOAN M
852.12
•B
B
3
B52955
DESOTO JIMIIE LEE
DESOTO JIIIIIE LEE
451.92
B
3
B52973
GALVAN ALFREDO C
GALVAN ALFREDO C
446.23
B
3
B52974
GARCIA ERLINDA
GARCIA BELINDAA
562.53
B
3
B53042
ANGOIANO JOAN P III
OCBNAS MARY MEN
172.25
B
3
B53064
.CIA= MIMI,
CIA= CHRIS L
136.11
B
3
B53073
LEDSZMA SAM
LBDEZMA Mm
311.08
B
3
B53090
LOPEZ ISABELL
LOPEZ ISABELL
146.38
B
3
B53092
LLAW85 DANNY (DANIEL)
TIM DANNY (DANIEL)
302.41
B
3
B53111
GAMABRA LUIS
GAMARRA LUIS
1184.53
B
3
B53113
FONSECA AMELIA
FONSECA AMELIA
279.35
B
3
B53124
LOZANO FELIPE III
LOZANO FRLIPE III
628.19
B
3
B53130
BOOM RAYN@ID
BOON RAYMOND
530.97
B
3
B53136
DESOTO JIMMIE LEE
DESOTO J114IIS LEE
285.12
B
3
B53147
GARCIA DANIEL DAVID
GARCIA LIM
201.12
B
3
B53163
AMEJOBADO ALEXIS
AMEJORADO ALEXIS
331.45
B
3
B53174
CHRISCO JACOB NEED
CHRISM JAMB REBD
298.62
B
3
B53219
DAWSON DARLA M
DAWSON DARW M
720.14
B
3
B53255
GARCIA ELIZABETH
GARCIA ELIZABETH
1745.95
•-B
3
B53338
HOFFMAN MOMTE WAYNE
HOFFMAN MONTE WAYNE
1287.57
3 -
B53382
JUAREZ MARY .
JDAREZ MARY
638.49
3
B53391
CHRISTIANSON HEAT6ffi!
CHRISTIANSON HEATHER
487.67
B
3
B53426
DESOTO JD9I9 LEE
DESOTO JIMIIS LEE
569.04
B
3
B53614
DARILBE SARRAH
DARILEX LUCIDA
619.32
B
3
B53725
ESPINOZA CERISTINA
AIN= ALIAA
228.95
B
3
B53736
FRAZIER MELISSA L
FRAZIER MELISSA L
617.53
B
3
B53743
ESCOBAR RIERSTIN REIGN ESCOBAR SELMA
390.27
B
3
B53744
ESCOBAR GAVIN REED
ESCOBAR ERIC
327.12
•B
B
3
3
B53764
B53840
POSTER IRA JOHN
DELAGARM MARY E
POSTER IRA JOHN
DELAGARZA MAU E
591.SB
327.12
B
3
B53849
SABLE JESSIE
XIXBLE JESSIE
281.75
B
3
B53921
DODD IOTA
DOM DAVID
49.63
B
3
B54113
LIMA XAVIER J
OVALLE STARLETT
255.75
B
3
B54264
LUNA XAVIER J
OVALLE STARLETT
285.12
B
3
B54411
LAZANO PEDRO
LOZANO PEDRO
552.79
B
3
B55493
FLARES PATSY
FLARES PATSY
422.72
B
3
B56199
CAIN MICHAEL DEWAYlDS
CAIN MICHAEL DEWAYNE
167.50
B
3
B56335
BERMON LUIS MANUEL
BERNON LUIS MANURE
565.19
B
3
B56635
ALANIZ MAYRA
ALANIZ MAYRA
615,29
B
3
B60625
COPELAND EIM
COPELAND RIM
339.00
B
3
B64174
ADAMS ALEX
ADAMB ALEX
337.25
Subtotals
•
91872.84
PAGE 3
53
612
RFFFFRRAI.
MEMORIAL MEDICAL CENTER
MARCH 2O04
COL. CODE
PAT.
TYPE PAT. #
PAT. NAME
FTGARANTOR NAME
E
1
B31019
RENSHAW THOMAS E
RENSHAW THOMAS E
8
1
B37SBO
SACEIN GM
SACRIN GENA
E
1
841860
SPARES JASON
SPAM JASON
B
1
B46612
TIDRICZ ALICE
TIDRICR ALICE
E
1
B47212
PEREZ JOAN J JR
OBREZ JOAN J JR
8
1
B48361
MOORS RBVIN SCOTT
MOORE RSSEN SC0TT
E
I
B48427
WILLIAMS JACKIE SR
WI11W JAME SR
E
1
B54316
STRINGO MARC
STB.INGO MARC
B
2
B40606
SANCHEZ JOSEPH
SAE'CHEZ JOSEPH
B
2
B43039
SUMMERS JANICE
SIMMERS JANICE
E
2
B46809
SPENCER LINDA
SPENCER LIM
E
2
B47005
STRATMANN JAM
STRATMANN JAMES
E
2
B47351
ROGERS ANGELA M
ROGERS ANGELA M
E2
B49327
PHILLIPS PATRICIA
PHILLIPS PATRICIA
E
2
B49337
MCCOWN HILMM J
MCCOWN EILEEN J
E
2
1349541
RECKER RICURD
RECEER RICHARD
B
2
B49581
VIC86RY BRANDER
VICKE4Y BAANDEE
E
2
B49915
MENDEZ SOLEMA
MENDEZ SOLEMA
E
2
B50093
!ffiIDOZA LISA A
MEND02A LISA A
E
2
B50828
PEREZ MM D
PEREZ HEM D
H
2
B51268
ORTIZ SECTOR
ORTIZ HECTOR
E
2
B51444
MDNOZ MATTHEW A
VASQUEZ ANITA
E
2
B51565
WILSON DENNIS
WILSON DENNIS
E
2
B51573
SQOYRES ANGIE
WERE ANGIE
E
2
B52032
TORRES JOHN
BARRIENTES ANGELA
E
2
B52232
PALM SYLVIA
PALMER SYLVIA
E
2
BS2365
PADL JEFFREY
PAM JEFFREY
8
2
E52502
MOSELEY MICHAEL LEE
MOSELEY MCBM LS8
E
2
B52518
WILKINSON JOHN
WILREN60N JOHN
E
2
B52743
SIMONS DARRELL
SIMONS DARRELL
E
2
B52777
MEYER ALISSA
DYER ALISSA
8
2
B52799
MORALES ALICIA P
MORALES ALICIA P
H
2
B53050
PEREZ MARIA R
PEREZ JOSS
B
2
B53066
MORALES CINDY
MORALES CINDY
B
2
R53348
MOSIER DEBORAH
MOSIER DEBORAH
E
2
B53380
THEDFORD TAACY
THEIFORD TRACY
B
2
B53455
SMITH DANIEL
SMITH DANIEL
E
2
B53521
MORENO AMBROSIO
MORENO AMBROSIO
E
2
B53779
PENA ANDREW
PENA EOQARDO
E
2
B53789
MASEDA NINFA
MASEDA NINFA
E
2
B54246
MENDOZA SONIA
MENDOZA DAM
E
2
B54263
MCELVEEN TOMI4Y
MCELVERN TOMMY
B
2
254676
SOTO JASMINE
SGIO VELMA A
E
2
B54830
RANGE. MELISSA
SAM JUAN
E
2
B55010
MCELVEEN TOMMY
MCELVERN TOMMY
H
3
B27891
STECAMAN SAMOEL
STECRMAN SAMOE,
B
3
B36968
ROGERS MISTY
R02U WENDY
E
3
B43324
MON= ALM
MONTANA RAY
E
3
B46427
RISEN RONALD
RISEN RONALD
8
3
B46457
WALTHER ANGELICA
WAI.THER ANGELICA
E
3
B48171
MDNIZ GEORGE D
MNIZ GEORGE D
E
3
B48729
ROSBNBROCR LANDON
ROSBNBROCE CDRTIS R
E
3
349848
PNILLIPS PATRICIA
PHILLIPS PATRICIA
E
3
B49098
MARTIN EACI G +
RODD GAYLE
E
3
B49549
WOOD CONNIB
WOOD COME
WRITE OFF AMT.
60.00
250.00
575.00
30.00
90.00
710.91
6400.14
332.48
281.64
53.72
74.71
65.72
53.75
864.69
38.33
107.44
258.70
4208.22
30.00
2771.60
91.52
127.25
112.50
22.51
135.09
20.00
28.32
163.00
171.50
245.73
34.60
71.31
264.63
429.88
218.14
23.59
170.00
514.90
11.88
250.58
49.30
487.93
37.12
132.66
236.90
1029.49
489.56
260.63
352.16
39.46
502.09
128.23
393.01
216.95
1526.96
PAGE 4
54
613
•
•
•
A 4
MARCH 2O04 RFFFTRRAT
COL. CODE
PAT. TYPE
PAT. B
E
3
B49793
B
3
B50128
E
3
B50335
E
3
R50346
3
B50457
•B
g
3
B510131013
E
3
B51038
E
3
B51230
B
3
M259
E
3
B51293
E
3
B51358
E
3
B51511 .
E
3
B51538
S
3
B51587
E
3
B51632
E
3
B51672
B
3
B51619
B
3
B51703
E
3
B51722
E
3
B51123
8
3
B51737
B
3
B51743
E
3
B51818
3
B51937
3
B52012
E
3
B52023
B
3
B52156
E
3
B52160
B
3
B52172
E
3
R52422
B
3
B52429
E
3
R52438
E
3
B5244
S
3
B52449
E
3
B52456
E
3
B52464
B
3
B52524
H
3
B52567
E
3
B52568
S
3
B52570
B
3
B52697
E
3
B52707
E
3
B52813
R
3
B52821
E
3
B52823
E
3
B52971
B
3
B53020
B
3
B53074
E
3
B53086
E
3
B5310E
�4
3
B531V
E
3
B53117
B
3
B5311!
E
3
35313:
R
3
B53141
•
PAT. NAME
MEMORIAL MEDICAL CENTER
eR: t ; ,. 4 . r:.,Ii4
PECm WILLIAM
PZCM WILLIAM
REYES GOADALUPE III
ME LIZZIS
THUMUSOE MATTHEW
HALL HICIAB3, I
WWZ GEORGE D
MNIZ GEORGE D
MUNOZ MATTHEW A
STUDENT INSURANCE
SUTTON LINDSEY
WOODIN JEFFREY A
TORRES JOSBPHM
TORRES ROBERT
MARTINEZ SONI.
MARTIN&Z LOPE
MUNOZ JESUS
MUNCH JB5U9
PARKA ALMA
PARKA ALMA
SAM GRACE LYNN
BASMZ GRACE LYNN
SANCHEZ IRM
SANCHEZ THESE
MONIZ JOL7A
MUNIZ JULIA
ROGERS DOM
ROGERS DONNA
ROSENBROCR DANNY
ROSENBROCI DANNY
RAMOS RICHARD
RAMOS RICHARD
SHAW WBSLEY
SHAW WESLEY
VILIARML LISA A
VI LARREAL LISA A
STOCAON LARRY
STOCKTON LAW
PROPST RICHARD
PROPST RICBARD
SCOTT BRANDON
SCOTT BRADIDON
TIBLOW JESSICA
MCNERSE LESLIE
SANCHEZ EMIR
SANCHEZ BENN3:8
REM ROBERT JR
REM ROBERT JR
TORRES DANIEL JR
TORRES JERRY
ORTIZ MIGUEL
ORTIZ MIGUEL
SANDERS CLAY
SANDERS CLAY
HASCHBCI HALEY BRODIE
BOYBIN DARROW
HILLS SCOTT AIM
MILLS SCOTT ALAN
WARD BOMM L.
WARD BONMIB L.
RODRIGUEZ NOEL JR
RODRIGUEZ ROEL JR.
NOR= RUTH
MORRIS RUTH
WILLIAMS SIARON W
WILLIAMS IEVIN
VILLA MARIA
VILLA MARIA
REM CHRISTY
REAGAN CHRISTY
ORTIZ ®DIE
ORTIZ EMIR
RECTOR AMBER
RECTOR CATHY
PECHBA CHASITY L
PECENA WILLIAM
PEMBA IAILA
PECENA DAWN
VALADRZ MANTRA A
VALADEZ HARM A
NIVBRA MECCA
RIVSBA RICHARD
POWERS IEVIN
POWERS Emm
MORALES ALMMERA
MORALES ALE%AIM
WILSON GARY ALLAH
WILSON GARY ALLAN
PERBZ ALPONZO
PBRSZ ALFONZO
NOEL MARY IOU
NOEL MARY LOU
VICKERS BEATRICE
VICKER BEATRICE
MARTINEZ CARLOS
MARTIIOBZ LUPB JR
PM MADSLINH
PENA CHRIS
RIOS RODOLFO V
RIOS RODOLFO V
MARTINSZ DANIEL
MARTINBZ MARIE ANDREA
MARTI= DSLIA
MARTINEZ DSLIA
ZAMORA EHBILA
ZAMORA MILK
SANCHEZ CUM
SANCHEZ CUM
I POINTS@ BRANDY C
POINTER BRANDY C
WRITS OFF ANT.
907.46
596.03
233.58
579.77
817.74
698.69
369.28
256.36
2081.09
469.74
680.77
1474.78
958.75
422.89
388.05
1138.90
605.49
50.00
629.67
888.07
497.64
1605.89
994.44
562.42
571.89
725.94
1540.49
539.02
BB8.97
460.14
587.39
786.52
114.62
214.25
514.64
968.91
359.81
393.51
285.12
686.79
280.12
503.49
441.43
2526.72
369.28
1927.66
747.77
304.92
172.25
545.99
218.05
1473.53
329.52
83.85
214.25
PAGE 5
55
614
MARCH 2O04
COL. CODE PAT. TYPE PAT. I PAT. NAME
E 3
B53141
E 3
253159
E 3
B53278
-E 3 -
B53307
E 3
B53308
E 3
B53379
E 3
B53389
E 3
B53466
E 3
B53477
E 3
B53516
E 3
B53537
E 3
B53560
E 3
B53561
E 3
B53593
E 3
B53620
H 3
B53622
E 3
B53627
E 3
B53630
9 3
B53637
9 3
B53666
R 3
B53682
R 3
353730
H 3
B53732
B 3
B53895
E 3
B53901
E 3
B53905
E 3
B53922
E 3
B53923
E 3
B53952
E 3
B53953
E 3
B53961
R 3
B53965
E 3
B53986
E 3
B53990
E 3
B54039
E 3
B54050
E 3
B54327
E 3
B5432B
E 3
B54415
B 3
B54421
E 3
B54545
E 3
B54637
E 3
B54714
3 3
B54731
E 3
B54734
3 3
B54754
A 3
B54826
E 3
B54866
B 3
B54922
E 3
B54998
E 3
B55223
E 3
B55278
E 3
B55410
B 3
H55661
E 3
B55747
MEMORIAL MEDICAL CENTER
MODTEMAYOR JESSE
VE)ECIA ROCHELLE
ORTONO JOAN A
ORESTI ANGEL RORAM
VALDEZ THOMAS J
TOMPRINS LISA M
ODELL DONALD
MILLER FIORENCE
PIMA ROGER
SANDIDGE JAM
RAGGSIN ALLYSON
RAMIREZ CHRISTIAN
RAMIREZ GUSTAVO
SERENA JOSE
MORALES ER140
MORALES VIOLA
VARGAS SHARON
MEJIA REFOGIO J
SANCHEZ MICHEJ3
MORENO R08A1R7A
!OSIER DBBORAR
VAZQOBZ CINDY
VAZQORZ DARIELA
RAMOS SONYA KUM
CDRLL DONALD
STINSON LORAN JR
PARRS EESEY
PARRS RAYLA
SAWYER KEVIN
RODRIGUEZ DEVIN REVS
TMINW BAIRN
MRRNOBZ MARIO M III
ZAMODIO ROSIE
SOTO ADR=
50018 JOSIIDA
REM DORCAS
SHERRIII IAN A
TIBBETTS MICfAET
SONIGA NADIA LAMAS
RRSBNDEZ RANDY
SMITH SAVANAH
VASODEZ SABRINA
RODRIQUEZ JENNIFER
WISHERT DAN RAY
MEZA CARLOS JONATHAN
YARBOROUGH MELBA
MATSON JAMBS MICHAEL
TSCHATBCROLA MEAGAN
ROOM DOMnM
SEGORA DONALD LEROY
SALINiS CYNTHIA REM
OABLEY REBECSA
TIJE RIIA VERONICA
RDIZ HIM
SHRRATA ANGELITA A
MONOEAYOR JESSE
VEMECIA VICTOR
ORTE30 JOANNA
OBBSTI AM
VALDEZ KIMBERLY A
TOM?KINS LISA M
ODELL DONALD
MILLER FIORENCE
PM ROGER
SANDIDGE JAM
RAOOSIN JOE JR
RAMIREZ MARICBLJA
RAMIREZ GUSTAVO
SERER JOSE
MORALES RLMO
MORALES VIOLA
VARIAS JESSE
METIA RBFOGIO J
SANCHEZ FIICTIM
MOREO R)SANNA
NOSIER DE30RAR
VAZODEZ main
VAZQUEZ EEMYA
RAMOS SOMYA MARIE
GOETZ DONALD
STINSON LORAN JR
WEBSTER WILLIAM
WILLIAM WEBSTER
SAMBER KEVIN
VILLARIM STEPHANIE
TWINN BRIM
MENOEZ MARIO M II
ZAMUDIO ANDREW
SOT) ADRIAIA
SOUTH JOSH(%
SNRRRELL IAN A
TIBHETTS MICBAET
MORENO SABRI A C
RSSENDEZ RANDY
SMITH DANIE,
VASQUEZ JOm
RODRIQUEZ JENNIFER
WISHBRT DAN RAY
Km CARLOS JO ATHAM
MAT30H JAMBS MICHAEL
TSCBATSCou MARK
SW= DONALD LEROY
SAL;GAS CYNTTHIA REM
CHEM MOLLY
TIJ3RINA VERONICA
RDIZ EMMA
SERATA ANGELITA A
WRITE OFF AMT.
1119.81
107.13
172.25
332.52
795.28
261.92
339.32
985.45
2685.27
11.50
327.12
531.71
547.44
B79.67
710.27
501.12
393.08
466.83
442.97
143.19
138.73
356.57
356.57
285.12
214.25
693.33
126.00
209.60
824.80
329.42
604.37
477.52
254.91
629.67
538.99
285.12
327.12
564.93
862.94
325.94
83.24
340.47
417.52
80.33
578.74
214.25
581.99
55.61
553.78
711.96
327.12
327.12
279.19
1422.18
403.64
PAGE 6
56
615-
•
REFFRRRAT, MEMORIAL MEDICAL Cwm PAGE 7
MARCH 2O04
CODE PAT. TYPE PAT. Y PAT. MAKE GUARANTOR NAME WRITE OFF ART.
E
3
B55822
SANCHEZ MENE
SANCERZ TRENE
661.34
E
3
B55959
MXBROQUIN JASON
MARROQUIN JASON
889.59
E
3
R.55996
RICBARD SHAVARIUS DAQ
DORSEY SAMEM
690.70
E
3
B56183
TURNER BRANDON
TURNER BRANDON
214.25
3
156186
TORRES ALONZO
TORRES ALO ZO
347,17
.E
E
3
B56197
VELA SAMANTHA
VELA PETE
327.12
E
3
B56198
PEtA SAMMY
PENA SAMMY
1319.75
E
3
B56908
MUNGUTA JOSE JR
MUBGOIA JOSE JR
256.41
E
3
B57925
SALAZAR BLIJAH
SMITH RALEB
230.94
E
3
B57929
VALADEZ TROY
VALADEZ TROY
1964.57
E
3
B58480
SMITH CHRISTOPHER C
SMITH CHMSTOPHER C
1130.74
E
3
B58483
REM RAQUEL
REM RAQUEL
58.69
E
3
B59313
VILLARREAL MIGUEL
VILLARREAL MIGUEL
226.25
R
3
B59355
VILLARREAL MIGUEL
VILLARREAL MIGUEL
60.50
E
3
B61434
MONIZ RICHARD
MUNIZ RICHARD
353.00
Subtotals 99889.46
57
61
MARCH 2O04 IMUSE
COL. CODE PAT. TYPE PAT. 4 PAT. HAMS
ISialu;i44Ti:n)(wil M:l+r arar
e r.. 4• Tyr. f,. 04: 4;M' :.e4
I 1
B47056
DIEDERING BILLIE D
DIEDERING BILLIE D
945.00
I 1
B51096
VELA ROSE
VMLA ROSE
200.00
I 1
B53931
VELA ROSE
VHLA RASE
200.00
I 2
B27206
RUSE1Tg., CYNTHIA L
RUSHING CYNTHIA L
443.64
I 2
B37070
RUSHING CYNTHIA L
RUSHING CYNTHIAL
367.32
I 2
B40503
RALISEK BRANDI
YALISEY VICKY
132.70
I 2
B43917
HERNANDEZ JESUSITA
HERNANDEZ JBSUBITA
35.00
I 2
B44235
MCZEB IMM
MCKKR XATEY
446.52
I 2
B44367
GGAJARDO JO
GSJ MR00 JO
229.39
I 2
B44713
CORDOVA IMELLDA
CORDOVA HERIBRRTO
38.68
I 2
B44793
HERRERA GILBERT
HERRERA GILBERT
436.22
I 2
B45669
MCREE XATRY
MCREE YAM
248.28
I 2
346235
SUNIGA MARY M
+ SUNIGA MY M +
244.75
I 2
B46371
STRATTON PATRICIA
STR)ITTON PATRICIA
292.83
I 2
346741
JIMENEZ MISTY
JIM@4EZ MISTY
379.80
I 2
B46912
JIMS= MISTY
JIMENEZ MISTY
364.47
I 2
B48369
TAYLOB SHERRY
TAYL0R SHERRY
295.32
I 2
B48393
COX JOEY
COY JOEY
94.44
I 2
B48558
QUINTAKILU EMILIA
QUIDTABILLA EMILIA
24.32
I 2
B49019
YEARRA LINDA
YHARRA LINDA
60.10
I 2
B49186
FAUST SARNESTINE
FAUST BARNESTINS
566.90
I 2
B49214
MONDRIX MICHAEL
MONURIS MICHAEL
525.00
I 2
B49431
GARZA PEW V
GARZA PEW V
153.73
I 2
B49799
HOPPE= STEVEN
RUPPSLIUS STEVEN
504.45
I 2
B49817
VENGLAR ADRIENNE
V@9GLAR TIYI
551.00
I 2
B49975
DIETRICH BETTY
DIH:.'RICH BETTY
450.00
I 2
B50231
MCXEE KATHY
MCKEE XAM
332.22
I 2
B50481
SONNIER JAMBS
SORRIER JAMES M
339.15
I 2
B51207
MARTINEZ DISIDORO
MARTITNEZ DISIDGRO
171.85
I 2
B51816
ARRAMBIDE JOB G
ARRAMBIDE JOE G
185.59
I 2
B52182
B@IDICX CECIL
BURDICK CECIL
41.06
I 2
B52369
AUSTIN EDGER MAYBE
AUSTIN ROGER MAYNE
258.15
I 2
B52472
LIIJIGE COLLE@7
Lium COLLEEN
97.42
I 2
B53155
PEARCE NICKOLAS
PEARCE JOHN
297.06
I 2
B53177
MATUSEX DEBORAH
MATUSHX DEBORAH
27.80
I 2
B53259
RUSSELL BARBARA
ROSA'S I DALE
167.51
I 2
B53293
HARTL MUM FAITH
HIARTL MIRANDA
517.62
I 2
B53340
ADAMS JACKIE
ADA103 JACKIE
24.50
I 2
B53432
HODGES KATHY
HODGES HAM
133.45
Z 2
B53813
AMEJOFADO ARNOLD
AMEJORADO ARNOLD
187.89
I 2
B54029
FREDRICK REGGIE
FREDRICK RICKY
118.00
I 2
B54394
CLARK HIM T
GARNER ROBERTS S BOBER
130.04
Z 2
B55499
ALHRECST EVELYN R
ALBPECRT SHELTON B
41.19
I 2
B57704
ADAMS JACKIE
ADAME JACKIE
.59
I 3
B33803
THOMAS BMW SEEMSSSEY THOMAS RENNY HENNESSEY
561.73
I 3
B40637
JONES CHRISTOPHER
JOKES CHRISTOPHER
127.37
I 3
B40725
POSTER SRALYNNB
FOSTER SAMANTHA
37.10
I 3
B43677
MARSHAL. MICHAEL JR
MADEIALL MICHAEL
173.89
I 3
B44673
BELL GARY
BELL GARY
127.56
I 3
B46283
JIMENEZ MISTY
JIMENEZ MISTY
263.67
I 3
B47158
PHREZ STEPHEN JR
PRUE ROSA
81.56
I 3
B47938
TAYLOR LACEY N
TAYLOR S88RRY
160.49
I 3
B48405
EDWARDS SHAME JAMES
HOWIE SEW JAMES
78.88
I 3
B48438
VILLARM PH VALBNZOELA VrLLARIN PE VALENZ08LA
130.00
I 3
B49053
TUCKER BETTY
I= BE77T
27.22
PAGE 8
58
617
•
MUZRIAL MEDICAL CENTER
PAGE 9
I=USE
MARCH 2O04
�Cl. CODE
PAT.
TYPE PAT. i
PAT. NAME
G RANTOR NAME
WRITE OFF ANT.
____________________________________________________________________________________________
I
3
B49366
MATSON STANLEY
MATSON STANLEY
167.96
I
3
B49478
POLZIN BRIAN
POLZIN BRIAN
292.00
I
3
B49522
PFEIFFER RASEY
PFEIFFER WHY
175.00
I
3
B49595
ACCRA JOSE ANTONIO SR
SOCHA JOSE ANTONIO SR
813.33
3
B50133
NOLTE ROY
NOLTE ROY
853.72
.I
I
3
B50382
MITCHELL CHERYL
MITCHELL CUM
53.20
I
3
B50568
EDWARDS ASHLEY
EDWARDS ASHIM
10.71
I
3
B50896
HENRY GIBBER
BERRY GISELE
177.12
I
3
B51263
PONYEAL NANCY T
POMYEAL NANCY T
104.92
I
3
B51688
MCDONOOM JOANE
MCDONONGH JOANE
117.25
I
3
BSIB09
TODD JOHN
PORTE BOAT COMP
378.70
I
3
B52412
DAVILA ADAN H
DAVILA SHARON
307.53
I
3
B52446
BEEN TBEODORE SCOTT
BEEN THEODORE SCOTT
27.90
I
3
B52453
RIVERA AMANDA M
RIVERA J RICHARD
218.47
I
3
DS2496
CAMPBELL JAMES P
CAMPBELL JAMBS
371.50
I
3
B52703
SCOTT JOEL
SCOTT MERI
175.05
I
3
B53891
MONOZ RAMIRO
MONOZ RAMM
295.16
I
3
B53930
ADAMS HORTENCIA
ADAMS HORTENCIA
980.94
I
3
B53964
DEBORD JACOB
DEBORD WILLIAM
375.00
I
3
B54115
MCCLAIN THOMES III
MCCLAIN THOMAS III
109.74
I
3
B54289
MAYORGA HATIVIDA
MAYORGA JOSE
107.70
I
3
B57351
BARBERA LINDA
BARMRRA LDM
145.21
I
3
B57871
SODIE STORY
SDDIR RANDALL
129.28
ltotals
19538.01
•
•
59
618
MARCH 2O04 MEDICARE
COL. CODE PAT. TYPE PAT. I PAT. NAME
............................
J 1
B43923
J 1
B46431
T 1
B46563
J 1
B47981
J 1
B48071
J 1
B48492
S 1
B49062
T 1
B50539
J 1
B50589
J 1
B52698
J 2
B23191
J 2
B35604
J 2
B42292
J 2
B43511
J 2
B45497
J 2
845940
J 2
B46294
J 2
B46666
J 2
B46775
J 2
B47255
1 2
B48078
J 2
B48079
J 2
B48404
J 2
B48546
J 2
B48752
J 2
B48853
J 2
B48864
J 2
B48888
J 2
B49029
J 2
B49433
J 2
349834
J 2
B49964
J 2
850480
J 2
B50482
J 2
B51059
J 2
B51115
J 2
B51164
J 2
B51228
J 3
B21103
J 3
B28195
J 3
840851
J 3
341641
J 3
343132
J 3
B43733
J 3
B44109
J 3
B45276
J 3
B45302
J 3
B48450
J 3
B48454
J 3
B48463
J 3
B48483
J 3
B48517
J 3
348638
J 3
B48688
J 3
B48834
GONZALES [.ARIA E
FARIAS SOLALIA R
MRS BETTY
PEREZ TOMISITA
LEAL !ARIA
GONZALES SAMUEL
DODSON ROBERT
SOLIS PATRICIO JR
ALFORD EMT
LEWIS EDWIN
SMYTH ALVA B
GARCIA RAMON D
HOUSTON OLEN
GARCIA !ARIA
DRI,GADO MARGARET
FONSECA, AGOEOA M
WILLIAMS MICHAEL R
RILEY ROBERT
AMPS BETTY
SEGURA FELICITA
MALDONADO GOADALDPB
GALINDO NASARIO
VILIARREAL SALOME P
BUIS DANIEL
URESTE JOHN G
NETTLES JAMBS
VILLARREAL SALONS F
CORTEZ ADAM
RBVAREZ LEANDRO
DELGADO MARGARET
WARD NAMED,
ROOVIRRE LELA
BUIS DANIEL
RAMOS DOROTHY
NBVARBZ LEANDRO
GARZA ANTONI0
SIN® ROBERT L
ALMEANOBR VIOLET L
BLBVINS DAVID IM➢NIY
FLARES L80NOR
MORRIS-MARGIB
RAMOS JOB D SR
TURNER GWSSDA P
WARD MARISSA
RBRNAHIffiZ WILLIE SR
GATICA HBRMAN
DEASES ESTBVAN
Fnw BETTY J
NUBBARD LEVELL
VELA SANDRA
Z8Y ARTHOR L
PEREZ CONCEPCION G
BSNAVIIES EPITACIO
MEMORIAL MEDICAL CUM
[r,M43DFoili;
GOHZALHS !ARIA E
FABIAS EULALIA R
AMES BETTY
PEREZ TOMISITA
LEALMARIA
GORZALES SAMOBI,
DODSON ROBERT
SOLIS PATRICIO JR
ALFORD HONEST
LEWIS EDWIR
SMYTH ALVA B
GARCIA RAMON D
HOUSTON OLEN
GARCIA MARIA
DSIGADO MARGARET
FORSECA AGOBOA M
WILLIAMS MICHAEL R
RILEY ROBERT
ANDRE BETTY
SEGURA FELICITA
ELLIS DANIEL
MALLONADO GUADALUPE
GALINDO NASARIO
VILLARREAL SALOME F
ELLIS DANIEL
URESTS JOBS G
NETTLES JAMBS
VILIMJ= SALOME F
CORIRZ ADM
DSI ADO MARGARET
M M MARISSA
RODVIERE LELA OWENS
ELLI:S DANIEL
HANDS DORM
NHVARSZ LEANDRO
GAHZA ANTONIO
MUREN ROBERT L
ALK)=KR VIOLET L
BLSVINS DAVID LEROY
F141 ES LEM
MORRIS MARGIR
RAM JOE D ER
TURNER GWEBDA P
WAIN MARISSA
HHRNANDEZ WILLIB BE
PIN13Y CHARLES
GATICA HERMAN
DEAHBS RSTSVAW
FIRM BETTY J
HOBBARD LBVBLL
MA SARDRA
ASY.ARTHOR L
PEREZ CONCEPCION G
BSNAVIDES EPITACIO
WRITE OFF ANT
20.00
19.55
857.88
955.77
1732.62
30.00
908.41
840.00
31.09
857.8B
84.40
27.45
280.57
80.00
163.73
170.02
163.73
222.80
257.33
20.31
123.19
58.10
42.44
20.31
12.44
25.45
105.40
84.46
173.09
163.73
105.40
233.68
15.62
105.40
44.04
144.42
163.73
42.44
10.50
76.40
47.80
18.55
81.17
115.74
37.98
113.21
33.11
119.21
49.87
186.43
121.91
68.09
249.50
20.79
24.80
PAGE 10
60
619
•
•
•
MEDICARE
MEMORIAL MEDICAL CENTER
PAGE 11
!ARCH 2O04
COL. CODE PAT.
TYPE PAT. $
PAT. NAME
GDARAMDR NAME
WRITE OFF AMT.
J 3
B48939
GARCIA NAM
GARCIA IARIA
13.D0
J 3
B49371
RAMOS DOROTHY
RAMOS DOROTHY
157.66
0 3
349784
WARD MARISSA
WARD MARISEA
45.20
C 3
B49791
RECTOR OWL 0
RECTOR CARROL 0
51.13
0 3
0 3
1350280
B50426
OSBORN DAVID
OLSEN. BLLEH BDWARDS
OSBORN DAVID
OLSEN ELLSN EDWARDS
104.93
137.22
7 3
B50962
RAMOS DOROTHY
RAMOS DOROTHY
161.62
Subtotals
11432.70
Grand totals
222733.01
Total lines =
474
E
61
620
CHARITY ACCOUNTS
MARCH 2O04
Date Amount Due Charity
Patient Name of of from Adjustment
Service Bill Patient
Frank Galvan
09/17/03
$
2,431.49
$
1,458.89
$
972.60
Frank Galvan
10/07/03
$
859.50
$
42.97
$
816.53
Frank Galvan
10/10/03
$
1,376.63
$
68.83
$
1,307.80
Huyen Thi Tran
12/13/03
$
3,704.58
$
3,704.58
Russell White
09/24/03
$
2,036.38
$
814.55
$
1,221.83
Farris Williams Jr
10/29/03
$
1,784.75
$
1,784.75
Diana Williams
11/06/03
$
327.12
$
327.12
Diana Williams
11/08/03
$
927.98 1
$
927.98
Diana Williams
11/27/03
$
333.57
$
333.57
Diana Williams
12/13/03
$
345.50
$
345.50
Eillen Danysh
12/22/03
$
2,545.47
$
254.55
$
2,290.92
Darla Dawson
11/19/03
$
1,032.87
$
1,032.87
Mary DeLaGarza
12/14/03
$
502.32
$
502.32
Esther Garcia
12/11/03
$
2,385.25
$
477.05
$
1,908.20
Linda Cordell
12111/03
$
1,817.17
1 $
1,817.17
Natalia Cuellar
11/17/03
$
547.44
$
647.44
Maria Deases
11/26/03
$
9,337.03
$
9,337.03
Roxanne Canales
12/04/03
$
5,381.25
$
5,381.25
Gloria Amejorado
11/26/03
$
543.71
$
543.71
Melissa Morales
12/12/03
$
10,886.70
$
544.33
$
10,342.37
Linda Casey
12/05/03
$
4,520.92
$
452.09
$
4,068.83
Francisco Cruz
12/06/03
$
758.29
$
758.29
Carlos Gonzales
12/11/03
$
1,149.10
$
1,149.10
Chatham Camarra
09/16/03
$
1,715.71
$
1,715.71
Lucia Solis
11/23/03
$
588.42
$
588.42
Lucia Solis
11/24/03
$
543.71
$
543.71
Lorilee Escobar
10/15/03
$
2,785.68
$
139.28
$
2,646.40
Don Clifton
12/02/03
$
860.58
$
43.03
$
817.55
Don Clifton
12/04/03
$
2,365.00
$
118.25
$
2,246.75
Jackie Adame
12/11/03
$
315.00
$
94.50
$
220.50
Jackie Adame
12/12/03
$
1,085.00
$
325.50
$
759.50
Jackie Adame
12/15/03
$
6,730.85
$
2,019.25
$
4,711.60
Jackie Adame
12/22/03
$
490.15
$
147.04
$
343.11
Stephanie Beck
10/10/03
$
2,929.61
$
2,929.61
Christopher Beck
12/09/03
$
924.72
$
924.72
Christopher Beck
12/12/03
$
3,167.56
$
3,167.56
Pedro Bazaldua
11/24/03
$
470.00
$
470.00
Adele Rayne
11/28/03
$
331.85
$
331.85
Hope Thompson
12/15/03
$
75.00
$
45.00
$
30.00
Racquel Morales
12/16/03
$
441.95
$
22.10
$
419.85
Patricia Mosqueda
12/22/03
$
13.50
$
13.50
62
62'1
0
•
•
•
0
•
Cory Power
11/19/03
$
764.01
$
305.60
$
458.41
Daniel Covarrubiaz
12111/03
$
65.00
$
6.50
$
58.50
Eva Rodriguez
03/21/03
$
399.75
$
399.75
Arturo Fernandez
12/02/03
$
472.69
$
47.27
$
425.42
Roberto DeLaRosa
11/28/03
$
167.62
$
50.29
$
117.33
Guadalupe Torres
12/02I03
$
286.57
$
286.57
Brenda Torres
12/18/03
$
67.50
$
67.50
Mercelino Sanchez
12/03/03
$
512.16
$
25.61
$
486.55
Rosalinda Flores
12/16/03
$
202.03
$
202.03
Glenda Dunlap
12/05/03
$
306.61
$
91.98
$
214.63
Rogelio Guerrero
09/22/03
$
333.21
$
333.21
Maria M Flores
12/22/03
$
535.98
$
107.20
$
428.78
Bille Jo Curbow
11/10/03
$
369.28
$
36.93
$
332.35
Janie Solis
12/15/031
$
145.00
$
7.25
$
137.75
Alexandra Buckner
12/17/03
$
1,173.29
$
58.66
$
1,114.63
RobertCalzada
11/24103
$
1,199.21
$
1,199.21
"Diana Williams
12/13/03
$
(345.50)
$
(345.50)
TOTALS
88,023:72
7,804.50
$
80,219.22
Charity Bad Debt
Paid by Medicaid
Paid by Patient
"" Paid by Insurance
63
62?
ej• r.i ••
County Name CALHOUN
I. Application /Case Data
Report Month/Year MARCH 2O04
Cases
1. Applications Approved During Report Month
23
2. Applications Denied During Report Month
13
3. Active Cases Denied During Report Month
8
II. Creditable Expenditures During Report Month
1. Physician Services
$
14000.91
2. Prescription Drugs
$
26610.55
3. Hos itaL In atiern Services
$
22284. 50 '
4. Hospital Outpatient Services
$
52050.54
5. Laborato /X-Ra Services
$
1506.14
6. Skilled Nursing Facility Services
$
100
7. Family Planning
$
.00
Subtotal
$
116452.64
(=).REPORT MO-MM TOTAL
$
1164 5 2.64
FISCAL YEAR
TOTAL $ 400259.13
Signature of Person Submitting Report Date
Print Name and Title Monica Escaiante CIHCP Coordinator
64
623
r
•
•
0
L�
• s A �r� a�axa a sa..
CASE
PTAH4E
Ann'RFss
-DA-pE
DATE
003999
ADAME, JA.N1E
309
PORT LAVA TX
D9/04145
452-72-9997
42/02
004047 ,AMASON,
-HAWARD
PGBOX 211
p, TX
04/1�45
463 70 4583
07/2&03
BOX 126 GUADALUPE RIVER
-07/24/43
41/29/98
003461
Pdt?.IZAdCE
TIVOLI TX
464 66-2021
ARCHANGEL,SAN
ANfON10
J3mn5
11/25/03
004125
CLELNCLe
PORT LAVACA, TX
459-81-3097
004164
ARREDONDA,3EFF
716 N. ANN
PORT LAVACA, TX
1/2417$
467-03 4962
2/29/04
H.A, AURORA
PORSEASCAPEVTX
081@5/34
N/A
LBOA, JESSIE
PORT LAVACA, TX
06121/54
458-08-7066
i0l84/96
LDERAS, ROSIE
612 HALF LEAGUE #29
PORT LAVACA, TX
��
463-69-9651
114/04
RRIRNTES
F7BELL,=EC3P0LD0
617 S. ANN
1/11/49
34-04
UADALUPE
PORT LAVACA, TX
630-01-0680
"RR'Q�IGI'ON, CONNIE
�49 r9ARI
PORT-LAVACA ML
11730/64
467-47-0277
-09/11/01
ZAN, NOE
316'h W. AUSTIAT
PORT -LA
08131756
450-06-7979
� �
ELI.,ZECPDLD0
306W. MIX
PORT.J,AVACA, TX
I V15155
-265-S94934
- 0411=2
004137
BENIVAMONDE, RACHEL
603 S..BENASDES
_PORT LAVACA, TX
7/29l/6
453-01-7037
1!7l04
004137
BENIVAMONDE,ROBERT
-603 S.$ENAMDES
PORT—LAYACA, TX
4/6/71
-049-99-4438
1/7l04
003554
BERNARDINO,
PO -BOX 1337
6/28/S5
1017/98
GUMLERMINA
PORT-j-\VACA, TX
NIA
WQ96
BIANCHI, CARRAH
19" HOLLOMAN
PORT-LAVACA, TX
11/20(70
- 61-73-4943
10/24/03
004020
BLANKENSHIP, MICHAEL
18i8 BROADWAY3tOW 3 #10
3'ORT-IAVACA, TM
01/16/43
458-60-4048
04/14/03
004111
BLEVINS, KELLY
423 N.
PORT LAVACA, TX
9/28/84
-W-N-5736
10/26/03
004060
BOEDEKER, JACLYN
237 MULBERRY
?ORT LAMACA, TX
7/27/83
460.9 7 9224
8/3/03
004145
BOONE, ERIC
.1916 JACKSON-ST.
PORT LAVACA, TX
&S4/94
450-91-7297
1/2/04
004051
BOYKIN, GEORGETTA
ilo ?M Tx01/23/64
456-41.6428
08/06/03
004092
BRADFORA MARSHAIL
P080X-848
PORT-OCONNORTX
9/8/48
465-948706
8/24/03
003879
RRICEND MARTHA
POORT A
04/09/69
N/A
AW-14/02
002075
BROWN, GWYNNE
3TTWZ;EOAGE#140
PORTLAVA-CA.'IR.
03/18/51
-459-923198
07125/94
004000
BROWN, HARVIE
110. BENAVES
,Iy-
09/30/42
4b3�2-3215
--02/14102SID
004081
1 BRYANT. RUBY
118 TOMMY DR
PORT LAVACA, TX
1012"'
458-33-04M
9/1'
65
619,4
/'Y
004158
BUCK,167D�1AMRD.
MICHAEL
4111n2
12/16/03
PORT, LAV TX
463-71-1101
003611
CALDERA, JESSE
1309 W. TILLEY
01/15/63
05/03/99
FORT LAVACA, TX
457-37 9401
003701
CALZADA, ABIGAIL
PO BOX 1278
02/11/31
02/16/00
PORT LAVACA, TX
463�4 3022
003661
CARBAJAL, MARIA
14il NTDABOWVIEW
08/02/48
04/26/99
PORT' LAVACA,TX
456 233045
003661
CARBAJAL, GUADALUPE
1418 NlEADOWMEW
-PORT' LAVACA. TX
04/24/85
N/A
09/29/99
004002
CARDENAS, DIANA
6t8 S.-GUADAL;UPEPORT'1.AVA
06l29/63
0226/03
_IX
4fi0-33-7765
003555
CARRERA ANTONIA
627 W. GEORGE #172
08/24/37
IO/08/98
PORT' LAVACA, TX
449-74-6794
004132
CASTILLO AGAPITA
415 ANN Sr.
7/22/67
12/I0/03
PORTLA ACA, TX
N/A
004132
CASTnW, JEi3U
4,15 ANN ST.
X1987
PORT LAVACA, TX
N/A
-WI/03
004132
CASTTLLA, JONADAB
415 ANN. ST
9/27/35
12/10/03
FOAT' LAVACA �IX
N/A
003004
CASTILJ O, NIIELIA
611 OAKLAND AVE
10/26l62
02/13/96
�AD TX
N/A
003004
CASTILLO, JOSE
611 OOAAKL D AVE
01/13/59
02/13/96
N/A
003004
CASTIIdA, ZULMA
6111AOAKLAND AVE
08/19/84
-02/13/96
DRIFr, TX
N/A
003004
CASTI i O, MII,EIDY
61S11 AKLANDn AVE
09/17/82
02/13/96
TX
N/A
003004
,CAfrTIIZO;-CRiSTOBAL
611 OAKLANDAVE
04109/86
02/13/96
TX
N/A
_
003978
C-ASTILL--0; (MCILJA
811 S. ANN
ii/22/82
i1i/14/03
PORT' LAVACA,TX
N/A
003554
CERV*NTES, EDILIA
PO BOX 1337
-03/08/60
10107/98
PORT LAVACA, TX
N/A
003683
CHAFMAN, VICTORIA
133 CARRIGAN AVE
12/16/41
12/03/99
PORT LAVACA,'TX
376-42-7752
004103
CEARLES, MAMJE
161 MORALES RD.
6/29/50
10/31/03
SEADRIFI TX
458-90-8971
004084
CFIA.HAK SHELLZ,
PO BOX 391
'nV66
9125/03
PORT' O'CONNOR, TX
453-57-V45
004038
CLYNE CHERI
P&)X 423
07/26)54
Ob/23/03
jm,rI.I OMFORT, m
45644-2693
004073
CORTE7, CATALINA
-924-HAf3aMIRRY
12725/53
1113104
.PM
L36421945
004120
COX, MXMUCEL,
-POBOX 39
1T2T/51
11/I8/03
.456-90-6538
003864
CRONE, JULISSA
'PO BOX-S26
PDRT-PORT TX
Ol/2?J81
463-01-5048
1U07101
003825
CUELLAR, RAQUEL
205 INDIANOLA
12/06n2
07/03/01
MRT LAVACA, TX
467-53-9817
004044
DELAGARZA, ET A
-6121IALFLEAGUE-02
09/06/43
07/2ll03
TVRT' TX
-641-01-0702
004131
DELGADO, EN )ELIA
-709 S'-C-01 O
10/4/62
12/3/03
PORT-LAVAC-A, TX
N/A
-
004131
DELGADO, TIRSO
709 S.
1/28154
12/3/03
.-PORTLAOV
N/A
_
66
625
CJ
0
i
0
004131
CASTILLO, JENNIFER
709 S. COLORADO
12/29/92
12/3/03
'PORT LAVACA,TX
N/A
004135
DEAL, FOYII.
PO BOX 717
SEADRIPT TX
5/14/65
465 43-3932
12-25-03
004129
DELACRUZ, ADEi i A
-PO-BOX 1464
-PORT LAVA TX
7/3/51
455967275
3/5/04
003138
DIERCKS, CAROLINE
99EDGE WATER
PORT LAVACA,TX
02/28l49"
343-36-4614.
04/11/96
004085
DIERLAM, PHYLLIS
PO BOX 406
SEADRIFI', TX
6127/43
f
466-60-0223
9/26/03
004004
ESPARZA, IESSE
PO BOX 532
PORT LAVACA, TX
01/04/82
465-554268
02/13/03
003762
ESQUIVEL DAVID
415 N. GUADALUPE.
PORT LAVACA, TX
06/20/55
463-02-6721 '
07/I4100
004150
E77M L .JAMES
521 TOMMY DR,.
PORT LAVACA, TX
9119/63
467.31-8390
11/9/03
004130
FALCON, JOE
613BMORDEN
4126/54
12/3/03
PORT LAVACA. TX -
467-94-5614
004151FELLERS,JOFIII
618 PATQCVIEW
41-66
1-1904
PORT LAVACA,-TX
450-37-6i939
004013
FISHER, ISAAC
130 MAGNOLIA
03/1-VU
03/20/03
PORT LAVACA, TX
465-74-6600
004013
FISHER, TERRI
130 MAGNOLIA
03/10/56
03/20/03
PORT LAVACA, TX
467A6-%31
003981
FLORES, ANDREA
414 S, LAVACA
09/11/81
Ok/07/03
PORT LAVACA, TX
N/A
003980
FLORES. CLAUDIA
414 S. LAVACA
02102l72
01l14/03
PORT LAVACA, TX
N/A
003985
FLORES, IDA
145 S. JUANITA
03/12/51
01/14/03
PORT LAVACA, TX
467-94.6957
003736
FLORES, MENE
414 S. LAVACA
06/18165
05108M
PORT LAVACA. TX
N/A
003915
FOSSATI JOEL
479POWDERHORN
0324/61
06/24/O2
PORT LAVACA, TX
467-19-0679
004082
FOSTER, JACK
PO BOX 604
10/19/53
8/2UO3
PORT LAVACA,TX
452-98-2340
003923
FOWLER AMA
PO BOX 503PORT O CONNO TX
07t21/80
538-98-6335
06124/02
004090
FRANCO, SIMONA
233 ALCOA DR #907
lanz/47
9124103
PORT LAVACA,TX
454-76-437I
003706
FREDERICK, ANGELA
Po BOX 975
05/15R0
07/19/00
SEADRIFT, TX
455-69-M3
004079
FRMAAN, AMELIA
2208 LARRY DR
6W59
9/13p3
PORT LAVACA, TX
452-45-7361
004094
FUENTEZ, JUANTTA
PO BOX 213
724/49
10/1103
PORT LAVA TX
453-78-0720
004050
-GALVAN, THOMAS
1620 W, MAIN
0Sl17160
08/06/03
PORT LAVACA, TX.
454-04 1284
003890
GAN= JOE
PO BOX 763
10/12/59
03/05/02
PORT LAV TX
45527-2805
004049
GAM, S M A
PO BOX 104
08/15/64
O8/06/03
PORT O CONNOR, TX
458.69d851
003897
GARCIA` DEM MA
PO BOX 92
12I27135
03/19l02
GA
PORT O CONNOR, TX
N/A
004097
GARCIA, JAMCE
601 HALF LEAGUE
10/31l15
10/27/03
PORT LAVACA, TX
450-61-1929
67
626
004142
GARCIA KRYSTAL
233 ALCOA DR. #502
1/4183
12/10/03
PORT LAVACA, TX
449-65-7729
004053
GARCIA, LARRY
204 HOLIDAY
05/05/67
07/24/03
PORT' LAVACA, TX
454 Z1-3897
004063
GARCIA, LUPE
48 Nff!ADOViTROOK
3/10/94
9/3/03
-PORT' LAVACA, TX
456 67-3311
004089
GARCIA, MARY C. -
PO BOX 1106
1123149
8/20/03
-PORT' LAVACA, TX
460-80-3694
004052
GARCIA, TANGALEEN
PO BOX 438
1128/58
727/03
POINT COMFORT, TX
466-29-2909
004143
GARZA RUBEN
374 BACKBRRRY BEND
7/1&78
11-29-03
PORT LAVACA, TX
454-81-3760
003941
GERARDO, MAXIMINA
PORMARIVACA,
05/11/54
07/01/02
TX
464-59-2291
004119
GIL, OLIVIA
612 RALF LEAGUE #51
1228/69
1121/03
PORT' LAVACA, TX
N/A
003965
GODINAZ, LEONARD
502 BENAVIDES
05/02/42
I1/14102
PORT' LAVACA, TX.
628-05-1509
003956
GONZALEZ, SHARON
PO BOX 801
07/02/64
10/21/02
SEADRIFT, TX.
263.61-1677
003753
GUERRERO, DANIEL
1403 •IIJSTICE
09/13/62
08/16/00
PORT LAVACA, TX
465-29-2888
004114
GUICE, RODNEY
PO BOX 964
11/9/67
11/10/03
SEADRIFT TX
436-47.1505
004046
GUILT EN PETRA
1209 W. MAIN
09/10/30
0728/03
PORT LAVATX
633-32-3276
003867
HAMILTON,ARERA
1304TILLEY
03/04/63
12/05/01
PORT LAVACA,TX
465-35-7645
—
003868
HARVEY, VELMA
301 LA SALLE
04/06/47
12/14/01
POR.0 LAVACA, TX
455-02-5082
-
003249
HEIT, JOYCE
PO BOX 238
1 U16/50
09/12/96
SEADRIFT TX
454-92-3829
004153
HENDERSON, STEVEN
310 ALCOADR L Orr D
1/19/54
2/4/04
PORT LAVAC TX
30662-1655
003478
HERNANDEZ,LORENZO
215 VIRGINIA
081OS/41
-03/12/98
PORTLAVACA,TX
458-08-5610
004091
HERNANDEZ, MARINA
PO BOX 1390
12/83
10-15-03
PORC LAVACA, TX
455-59-6075
003964
HERRERA, MARIA
130 TANGERINE
0326145
1025102
X. PORT LAVACA, T
465-23-3678
004155
03YSQUIER0O; BRENDA
310.ALCAADR #12
11B7J0
2/9/04
PORTS.AVACA, TX
46549.2725
003583
HEYS iZIIIE[IDO;DIANA
fi10 REN&VMFc
10/13753
08/04/99
PORT-LAVACA =
450-0684M
004118
"HIINDS, D �IILYL
2526 ROYAL RD,
219/37
7/16/U3
PDRT. LAVACA TX
466 80-3866
003474
HOLT, JOANN
PO BOX 320
I ll11J56
02/18/98
PWU COMFORT, TX
458-23-M48
003950
IBARRA, ANDREA
414 S.
0226134
0924/02
PORT LAVACA-LAVACA.
N/A
004025
JACKSON, CARLA
306 MARTIN LAJTBER KING
1129/61
05/07/03
PORT LAVACA,TX
461-15-4949
004124
JACKSON, L.AVERNE
208 SEAGREEN
I V 17162
1125/03
PORT I AVACA TX
454-33-9177
003908
JARAMI11D, USA
440 WILBORNRD
3/10/80
1
5/0S/02
-PORT LAVACA, TX
466-59-1926
68
627
0
•
0
•
0
003430
JARAMELLO, NOBERTO
PO BOX 924
SEADRIFC TX
06/16/61
N/A
12/15/97
003430
JARAMILLO, NOBERTA
PO BOX 924
SEADRIFT TX
09/01/61
N/A
12/15/97
003430
7ARAMIILO, ORALIA
PO BOX 924
SEADRIFT, TX
01/12/98
N/A
09/12/97
003430
JARAMLLLO, RAUL
PO BOX 924
SEADRIFT, TX
N/A
12R5/97
004069
JJMENEZ, MARIA
PO BOX 322
PORT LAVACA, TX
3/21135
643-18-0114
9/12103
004043
KELLY, JOEL
PO BOX 1520
PORT LAVACA,TX
07/29/72
461-33-3852
06124/03
004161
KESTER ROBERT
106 AVE C
PORT LAVACA, TX
2/26/50
493-58=5848
y� 19/
004032
KNOWLES, JOSEPII
91 W. DOLPHIN
PORT LAVACA, TX
08/03/61
449-29-0194
06/04/03
004121
KURTZ, RAYMOND
1701 N. VIRGINIA #P7
TORT-LAVACA, TX
7/6152
467-96 8913
9/L5/03
004059
LACY, KIRK
PO BOX 714
PORT LAVACA'TX
1/25/61
365 29-3962
8/6/03
005057
LEDEZMA, Ha"O
721 PRIVATE RD
PORT LAVAC TX
02l27/45
605-38-0913
�20103
004107
LIGUES SR, MARIO
PO BOX 268
SEADRIFT, TX
1/19/77
N/A
I V5103
004107
LIGUES, ELVJRA
PO BOX 268
SEADRIFT TX
1MI72
N/A
1115/03
004107
PEREZ, LEYSSLY
PO BOX 268
SEADRIFT TX
5/2/90
NIA
I1/5/03
004107
LIGUES, LUCIA.
PO BOX 268
SEADRIFT, TX
2/13/03
N/A
11/5103
004107
LIGUES JR, MARIO
PO BOX 268
SEADRIFT TX
12/14/01
N/A
11/5103
004107
ANGUTANO, OSCAR
PO BOX 268
SEADRIFT TX
5/25/94
N/A
11/4/03
003994
LONGOMA, JOSEPH
106 CHARLOTTE
PORT LAVACA,TX
07/08J77
466 77 4382
02J06J03
004164
IANGORIA, MELONIE
716 N. ANNPORT LAVACA, TX
5/17l78
450.71-3174 -
1121/04
003799
LOPEZ, ABENAMAR
619 N. TRINITY #9
PORT LAVACA, TX
04/03/54
N/A
02/27/01
004028
LAVE HOLLLS
716S. ANN
PORT-LAVACA,-TX
09/04/49
450-94-5787
05/23/03
004140
LOZANO, ARMANDO
610 CR 101.PARKPLAZA
AT#] 32, PT LA.VACA
12/23/54
455-11-0022
1/7/04
004093
LOZANO, ESM13 AI .nA
177 MAMA ST.
PORT LAVACA, TX
10/26l65
467-19 7885
10/23/03
004088
LOZANO, JANIE
1815 W. GEORGE #1
PORT LAVACA,TX
7/30150
457-88 1928
11/6103
003995
LUERA MICHAEL
PO BOX 1035
PORT LAVA" TX
06/21/74
465 71�769
12/25/02
003989
MCCLOSKEY, MICHE[.LE
PO BOX 722PORT O'CONNOR, TX
07l7162
450-35-7128
06/18/03
003924
MCDANIEL, JOHN
205 BURNET
PORT LAVACA, TX
08/19/52
453 94 2108
07/03/02
004095
MALDONADO,
PO BOX 35
3/1/47
10/24/03
CONCEPCION
$?AHRIFT, TX
465-92-7592
69
61218
003742
MALDONADO, DOLORES
310 BONORDEN
10/11/61
07/08/00
PORT LAVACA, TX
459 37-5940
004160
MANGUM, CAVU
223 TOMMY DR
7/21176
2124/04
TORT LAVAC TX
461-59-3846
003946
MARE{ AUDREY
136
�A)$I
10/3U51
10/2UO2
,TY-
�-�2283
003946
MAREK, KENNEIR
PO -BOX 136
08/17/48
10/2ll02
SEADRIFI', TX
465-74-7067
00=8
MART2417, ANLTA
1508 AVALON
09/03/46
OS/OU94
PORT LAVACA, TX
451-74-M36
003897
MARTINEZ, AURORA
209 JUANITA
08/20/44
03/19/02
PORT' LAVACA, TX
449-724829
004070
MARTINEZ, GLORIA
93 AVENUE AE
g/y03
9/29/03
PORT LAVACA, TX
455-02-6745
004045
MARTTNEZ, JOSS
POBOX274
11/28/63
07/2y03
PORT O CONNOR, TX
N/A
003842
MAR2fNE7, OSCAR
PO BI X34
09/24/42
09/10/01
RE FT,.
465-00-9697
001152
MARTINEZ, PEIRA
-PO-BOX 432
Oy18/31
03/25/91
.
SEADRIF004159
N/A
MARTINEZ, VERONICA
E�RIFT 1TX
7/18/73
2/20/04
N/A
004159
CONTRERAS, MARIA
1�
�tOR
U5/90
1/30/04
T
N/A
004159
C4NTRF511AS, JOSS
PO 241
6/14/92
2/23/04
SEEADI�T TX
N/A
004159
MARTINFZ, PETRA
PO BOX 241
4/24/96
2/23/04
SEADRIFT, TX
N/A
_
004146
MATRON, JULIA
1021 BAUER.RD.
11/5/62
12/3103
PORT LAVACA, TX
451-37-2827
005056
MAUER, KATHY
PO BOX 1253
09/10/13
O8/09l03
PORT LAVACA, TX
463 77-2199
004065
MAYBERRY, GREGORY
448 W. KRUSE AVE
1y29/53
8/11/03
PORT LAVACA, TX
530-46-4440
004065
MAYBERRY, MARGARITA
448 W. KRUSE AVE
6IV53
9/1/03
PORT LAVACA, TX
458-02-1618
003966
MEDINA, ERLIIIDA
48 MEADOWBROOK
08/IS/54
11/14/02
PORT LAVACA, TX
450-06-8426
003967
M LENDEZ,MICHELLE
1201 SCHOOL
05/09/83
11/07/02
PORT LAVA
467-01-4521
004115
MELENDE7,CANDELO
619XTR=#3V
9123/60
9/15/03
�RTi.AVACA, T X
N!9
004115
MELIN E7 -ZENAIDA
619 N. TRINITY #5Y
6/5/�
11/14/03
PORT-LAVACA, TX
N/A
004115
MET R EZ ALEJANDRO
619 N. TRINITY #5 V
4/7/87
11/14/03
PORT LAVACA,TX
N/A
004115
MELENDEZ, ANGEL,
619 N. TRINITY #5V
4/20/89
11/14/03
PORT LAVACA TX
N/A
004011
MELINA, KARI
PO BOX 1418
07/25/54
03/18/03
PORT LAVACA, TX
459-31-3621
003909
MOERNIO , RICHARD
31 PARK LANE
07/19/63
06/13/02
PORT LAVACA„ TX
456-45-5270
004108
MONK, MICHAEL
309 INDIANOLA #2
11/23/63
1 U7/03
-PORT LAVACA, TX
585-49-1822
-
003760
MONROY,DELFINA
726-PRIVATERD
PORT LAVACA, TX
1U0y50
465-92�9635
09/28/00
70
629
0
•
11
0
0
•
E
MONTENEGRO, J�CHAALIE
1815 W. GEORGE #1
PORT LAVACA, TX
1122/62
NIA
9/26/03
MONTGOMERY,
PO BOX 841
SEADRIFT, TX
5/1/59
466-06-8490
10/28/03
g004148
MOONEY, JILL
PO BOX 465
SEADRIFT TX
6-2-85
627-20-9843
1-15-04
MORALES, BEI Y
440 WILBORN RD.
PORT LAVACA,TX
/�
452-23-3734
10127/03
004042
MORALES, JAMES
PO BOX 346
SEADRIFt, TX
10/18/69
459-41-8914
07/18/03
003976
MORALES, JOE A
PO BOX 573
CEADRIFT TX
9/25l/7
465-45-7424
9/26/02
004064
MORALES,SIDIA
PO BOX912
cRADRIFT,TX-
IL7/51
265-13 4534
9/5/03
003974
MORENO, MANLJELA
201
PO#A
PRTT LAVACA, TX
O
11/08/41
465-64-4247
12/12/02
003928
MUNIZ, ANGEI.A
10810 HWY 35 SO
PORT LAVACA, TX
07/08/25
N/A
07115/02
10810 ST HWY 35 SO
05/03/17
07/15/02
003928
MUNIZ, CARMEN
PORT LAVACA, TX
NIA
004112
MUN14 GREGORIO
608 W. WILSON
PORT LAVACA, TX
519166
466 93 4785
11/7/03
004112
MUNIZ, YOLANDA
609 W. WI SON
PORT LAVACA, TX
11/26/66
461-53-7712
11/7/03
004071
NAVARRO, JOHN
PO BOX S40
PORT LAVACA, TX
12/25 72
467-93-2232
9/18/03
004167
NEAL, FRANKLIN
PO BOX 536
SEARDRI17 TX
6/20/58
450-31-798I
2/26/04
004127
NGUYEN, LIEU Till
PO BOX 638
SEADRIFT TX
12/27/45
586 46 1262
12/1/03
003730
ORTIZ,ANTONIO
608-APARKVIEW
PORT LAVACA, TX
11/15/42
451 66-9311
10111-8/00
004109
PADGETT, NELLIE
PO BOX 811
SEADRIFT TX
511155
458-08-5129
10/14/03
004075
PATTILLO, ROSE
1100 ALCOA DR #8
7/26/55
8/27/03
PORT LAVACA, TX
459-17.8818
004029
PAYNE, JACQUELII IE
105 BOWIE
PORT LAVACA, TX
I I/25/68
452-77-9088
05/23/03
003643
PECENA, ELLA
PO BOX 441
POINT COMFORT, TX
07/27/46
449-74 2921
08/10/99
004134
PENA, SAMUEL
235 r.9AR1fttTF±
3ORTI,A SX
112284
46617,1212
12/15/03
004138
PENDERGRASS,CHERYL
POBOX782
SEADRIFT TX
2/15/76
459 61-9102
1/6/04
004154
PEREZ, ANNA
612 RAL.F LEAGUE #62
11/28/81
2/4/04
LAVACA, TX
N/A
004154
PEREZ, RODOLFO
612 HALF LEAGUE #62
PORT LAVACA, TX
215/83
N/A
2/4/04
004154
PEREZ, WENDY
612 HAIF LEAGUE462
10/24/01
12/30/03
PORT LAVACA, TX
N/A
004037
PEREZ SR, EL IAS
1111 BROADWAY4 8
06/07/03
PORT J AVAC-A, TX
N/A
004037
HERNANDEZ-PEREZ,
III 14MOADWAY #8
10/10/64
06/07/03
FRANCiSCA
-PORT LAVACA, TX
NIA
004037
1 PEREZ, MARIA
1-111-BROADWAY #8
06/02/96
06/07/03
ELI7.ABE llf
-PORT LAVACA, TX
N/A
71
6vFJ
004037
PEREZ, MARIA DE LA LUZ
1111 BR.OADWAY #8
02/10/88
06/07/03
PORT LAVACA,TX
N/A
004037
PEREZ, ZOYLA
1111 BROADWAY #8
10/21/99
06/07/03
-PORT LANACA, TX
N/A
004037
PEREZ, DULCE
-1141-BROADWAY #8
07/15/92
06/07/03
PORT LAVACA, TX
N/A
004037
PEREZ JR., HUM
1-11R1-BROADWAY*
07/23/94
06/07/03
NIA
004037
PEREZ,MARIADELOS
1111.BROADWAY*8
11/15/95
06/07/03
ANGELES
PORT LAVACA, TX
N/A
004061
PEREZ, REMMO
FO ROX 226
PORT LAVACA, TX
04/27/48
459-78-2194
09/11/03
003553
PEREZ URSULA
10/17/43
10/07/98
PPOOR LAVACA, T-X
N/A
004076
PESEK, PATRICIA
2112 T1 RY DR
4/26/56
9/18/03
PORT LAVACA,TX
467-94-5484
003875
PRESSLEY, TROY
627 W. GEORGE#139
06/73/70
Q1L17/02
PORT LAVACA,TIC
498-72-8676
003865
PRINCE, DIANA
�R��� IX
09/08/55
454-04-1133
11/04/01
004126
RAMIREZ, GUADALUPE
306 BONORDEN
11/2ll59
12/1/03
PORT LAVACA, TX
467-25-4211
004087
RAMIREZ, TOMMY
503 W. MAEAN
3/26/55
10/6/03
PORT LAVACA, TX
450-94-5535
004048
RHYNE, AUTUMN
PO BOX 65
10/13/84
OS103/03
PORT O CONNOR, TX
462-77.9887
004086
RIVERA, FRANCES
PO BOX 1538
PORT LAVACA, Tx
6/13/57
454 04-0695
10/1/03
004086
RIVERA, PRED
PO BOX 1538
3/21/58
10/1/03 -
PORT LAVACA,Tx
465-92-9812
003713
ROBLEDO;ESTE
612E. AUSTINCIA
D5/23/56
01/11/00
SEADRIPT.X
264-45-9056
004040
ROBLES, BRENDA
410S. LAVACA
08/09/62
07/01/03
PORT LAVA TX.
455-15-8512
004066
RODRIGUEZ,
607 N. NUECES
g/g8
9/11/03
ARMANDINA
PORT LAVACA, TX
NIA
004066
RODRIGUEZ, CAMJLO
607 N. NUECES
7/18/56
9/6/03
PORT LAVACA, TX
N/A
004090
RODRIGUEZ, JOSE
1210 N. VIILGINIA *20
7/14/65
10/10/03
PORT LAVACA, TX
457 29-0027
003505
RODRIGUEZ JUAN
POBOX 817SEADEMMC
06/11/67
06/07/00
N/A
004163
RODRIGUEZ
1701 N. VIBGINIA #P8
9/29l13
2/16/04
'�"TO
EORT.LAVACA, TX
584-81-7428
004163
RODRIGUEZ LOLTTA
1701N. VIRODUA #P8
2124104
PORT LAVACA, TX68
455 45A608
003505
RODRIGUEZ MARINA
SEADR $f TX
12/25/71
06/07/00
N/A
004135
RODRIGUEZ, NELDA
711 S. COLORADO
11/19/71
12/29/03
PORT LAVACA,TX
453-39-9553
004135
RODRIGUEZ, ROBERT
711 S. COOLOORA17OPORT
5/12/81
12/29/03
LAVACA, TX
N/A
003939
RODRIGUEZ, ZOILA
414 S. LAVACA
11/11f74
08/27l02
-PORT LAVACA, TX
N/A
166
RUSSO, LINDA
PO BOX 732
1/15/47
12/19/03
IMADRIPT, TX
032-56-7209
72
i
0
6"Js
A , , J
•
•
•
MANUEL
PO BOX 713
SBAL�RIFT, TX
9/19/81
464-55-4918
2/24/04
711 S. COL,ORADO
11/15/54
1U7/03
A7.A7AR IREDIE
PORT-LAVACA- TX
457-13-2809
SALINAS, AURORA J
512 N.-COL-ORADO
PORT -LAVA TX
12/26/42
463(r88900
08/18J00
308E• JUANITA
04/30/51
11115100
SANCI4EZ JAN1E
PORT LAVACA TX
q67-94 5094
W6RAENZ,
SANDOVAL, ERUVINA
709 S' COI�i=
PORTLAVAC TXN/ASANDOVAL
06/26/70
10/12/99
LOSE
709 COI ORADO
PORTL.AVA TXSCHUBdIIv1ANN,
12/30/25
N/A0520/99
1317HOLLOMAN
06/20/52
SFIIRLEY
-PORT-LAVA TXSEE,
454-04-190404/04/97
JAMES
PO BO li rT7C
0624164
467-15-3520
08/18/03
SERV9NTBS,EVA
209I.A SALLE ST
PORT LAVACA, TX
U26/51
461-23-8828
.912/-03
004072
SERVANTES, SANITAGO
209ZASALLE ST
PORT L.AVACA.TX
11/24/51
4�_94 7090
9/18/03
004165
SHARP, STA14FORD
140 SILK STOCKING
PORT LAVACA, TX
3/3/44
329-36 6783
3/4104
004165
SHARP, SARA
140 SILK STOC[INU
PORT LAVACA, TX
10/9/46
329�0 2015
1/12/04
004077
SLATE, ELIOUSE
PO BOX 823
SEADRIFT, TX
3/19/42
208-36 6224
9/11/03
004077
SLATE, RICHARD
PO BOX 823
SEADRIF'r, TX
3116/60
436 27-3105
9111/03
004003
SMITH, ARTHUR
PO BOX 365
SEADRIFT TX
03/28l60
463-35-2844
03/04/03
004003
SMrrH, GL.ORIA
PO BOX 365
SEADRIFT, TX
01/23/42
561-56-6347
02/18/63
004116
SMITH, VANESSA
PO BOX 238
SEADRIFT, TX638-18
*20/94
7046
11/17/03
003527
SNIDER, THOMAS
524 S. VIRGU41A
PORT L.AVA TX
03/05/43
459�8-9084
08/O2198
003370
SOTO, MAN
619 N. TRINITY #11B
PORT LAVACA, TX
08/31/60
466 25-7116
07/03/97
003979
SPARKS, JERRY
1916 HOLLOMAN #F
PORT LAVACA, TX
10/19/53
455-02-6571
12/17/02
004133
SPENCER, LINDA
185 SII.,K STDCKlNG
LAVACA, AVACA, TX
4/11/43
464 33:2800
12/10/03
004032
SPRY, ZANE
1620 W. EORGEPORT LAVACA, TX
04/07J51
009-36-7797
04ro3
003942
STERLING, DAVID
401 S.-COMMERCE
PORT LAVACA, TX
06/14/50
467 88 2299
08/27/02
003874
STRINGO,ESMERALDA
1100ALCOA#25
PORT LAVACA, TX
08/10/46
451-49-6459
OV17/020
004152
TAMLIN, CODY
2010 FM 2717
PORT LAVACA, TX
5/31l74
-453-81-6425
1-20.04
003932
TAYLAR, JOSHUA
917 SCHL.EBACKRDPORT LAVACA, TX
07131/81
453-81-4636
08115102
003991
TAYLAR, ROBBI
PO BOX 22 .
PORT O CONNOR, TX
04/04/59
464 i9-7775
02/06/03
004062
THOMAS, JANA
SORT LAVACA,820- iACiCBEWLY AVACA, TX
9/I2164
448-62-7178
8/19/03
73
632
003400
THOMPSON, BECKIE
PO BOX 313
06/20/47
03/12/02
SEADRIF'I', TX
496-52-2212
j
004104
THOMI'SON, MANIAPORT
29 W. 23 S T.
LAVACA, TX
2123/66
452-57-3515
10/29/03
003871
THROWER WINONA
PO BOX 374SEADRIFT
06/01/49
11/28/01
436 64 9633
004016
URESTE, ANDREW
PO BOX 302
07/27/53
04/01/03
SEADRI T, TX
449-08-2624
004149
UR1AS, CONSUEL.O
1201 HENRYST.
8_21 49
12-5-03
PORC LAVACA, TX
467-94-3018
003700
VARGAS, DELIA
310 ALCOA #12
09/12/76
05/28/02
PORT LAVACA, TX
N/A
004001
VELASQUEZ, ADE i.A
417 W. RAILROAD
09/10/51
02/19/02
PORT LAVACA, TX
467-94-6177
.003773
VX.i.ARRFAi. ANGELICA
PO BOX843
07/3U81
1U0200
SEADRIFT
466 55 0497
001181
VX.T.ARREAi JOE
4616HWY35BOUTH
06/28143
04l25/91
PORTLAVACA, TX
462fib�073
004117
VX.i.ARRFAi MARTHA
503Zs.-WII,SON
Iy17/55
11/10/03
,
PWrLAVACA,'TX
455-35-5420
003527
VILL.ARREAL„ SALO4E
2302 LARRY
03/03154
08/24/98
POWC LAVACA, TX
461-42-9937
004105
VOSSLER EVELYN
PO BOX 673
10/1158
11/4/03
PORT O'CONNOR, TX
006-02-3666
004106
WALDEN, GRINDL
PO BOX 423
8/29/63
2/12/04
PT. O'CONNOR, TX
258-33-6926
004055
WALLACE, TERESA
532 N. COMMERCE
06/16/64
08/18/03
PORT LAVACA, TX
568 19 8273
003691
WARREN, PATRICK
PO BOX 229
03/17/59
01/07/00
POINT COMPORT, TX
462-11-7190
003894
WOOLDRIDGE, ROGER
50 WOOLDRIDGE
11130/65
03/27/02
SEADRIFT, TX
593-34-3144
003897
WOOLDRIDGE, SUSAN
50 WOOLDRIDGE
08/05/70
03/27/02
SEADRIFT, TX
457-57 4627
004035
ZAMBRANO, MICHAEL
104 P0'� RD.
01/22/63
05/18/03
PORT LAVACA, TX
461-23-2293
004101
ZAMORA, HECTOR
519 S. SAN ANTONIO
8/4l64
10/2103
PORT LAVACA, TX
384-68-2606
004157
ZAMORA, PATRICK
1620 W. MAW LOT 12B
8/1177
2/5/04
PORT LAVACA, TX
464 91 4899
004157
ZAMORA, SHEILA
1b20 W.11AINLOTI213
2J26//8
2110/04
PORTS.AVACA, TX
465-61-4963
74
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MEMORIAL MEDICAL CENTER
MEMORIAL MEDICAL PLAZA
OPERATING STATEMENT
. For the 03 Months Ending
March-04
CURRENT MONTH
YEAR TO DATE
Rental Revenue
Net Revenue
7,433
21,771
Operating Expense
Salaries
3,563
10,024
Employee Benefits
0
0
Professional Fees
0
0
Plant Operation
8,804
26,830
Hospital General
0
0
Other Operating Expenses
-14,258
10,451
Total Operating Expense
-1,891
47,305
Net Operating Gain/(Loss)
9,324
(25,534)
Non -Operating Expense
Depreciation
37,469
74,938
• Total Operating Gain/(Loss)
28,145
(100,472)
75
•
6
PATIENTS ADMITTED
ADMISSIONS FROM ER
AVERAGE LENGTH OF STAY
PATIENT DAYS OF SERVICE
PERCENT OF OCCUPANCY'
AVERAGE DAILY CENSUS
MAXIMUM ON ANY ONE DAY
MINIMUM ON ANY ONE DAY
ADJUSTED PATIENT DAYS
SWING BED DAYS
ICU PATIENTS ADMITTED
ICU PATIENT DAYS
OB'S ADMITTED
OB DAYS OF SERVICE
PEDIATRIC ADMISSIONS
PEDIATRIC DAYS OF SERVICE
NEWBORNS FOR MONTH
AVERAGE LENGTH OF STAY
DAYS OF SERVICE
MEDICARE PATIENTS ADMITTED
AVERAGE LENGTH OF STAY
DAYS OF SERVICE
MEDICAID PATIENTS ADMITTED
DAYS OF SERVICE
DEATHS
AUTOPSIES
SURGERY:
INPATIENT PROCEDURES
OUTPATIENT PROCEDURES
CESAREAN SECTIONS"
TOTALS
MEMORIAL MEDICAL CENTER
PATIENT STATISTICS
MARCH 2O04
THIS MONTH
THIS YEAR
LAST YEAR
THIS MONTH LAST YEAR
TO DATE
TO DATE
100 147
330
399
53 68
168
218
3.17 3.78
3.56
3.88
317 556
1,176
1,547
21.30% 37.37%
26.92%
35.81 %
10:23 17.94
12.92
17.19
20 24
27
27
2 7
2
10
1,230 1,489
3,833
4,336
0 10
36
53
22 39
70
99
45 101
154
248
21 20
57
50
44 40
120
106
5 3
12
12
10 10
26
28
16 14
47
38
2.13 2.14
2.04
1.97
34 30
96
75
46 76
149
205
3.50 4.47
4.26
4.71
161 340
635
966
26 25
73
67
58 57
180
158
1 4
7
10
0 0
0
3
9 13
39
50
127 128
341
453
_ 8 6
16
8
144 147
396
511
76
635
•
•
THIS MONTH
THIS YEAR
THIS MONTH
THIS MONTH
LAST YEAR
TO DATE
LAST YEAR
O�. .ATIENT VISITS
1,662
1,589
4,573
2,040
5,007
2,294
EMERGENCY ROOM VISITS
720
840
EMS RUNS
2,382
0
2,429
6,613
7,301
TOTALS
LABORATORY:
INPATIENT PROCEDURES
3,011
4,526
11,143
12,864
732
• OUTPATIENT PROCEDURES
15,011
14,814
44,147
55,190
58,596
58,596
TOTALS
18,246
19,340
RADIOLOGY:
121
202
375
525
INPATIENT PROCEDURES
537
1,591
1,545
OUTPATIENT PROCEDURES
590
137
BONE DENSITY
18
29
122
52
237
371
NUCLEAR MEDICINE
50
164
429
450
ULTRASOUNDS
161
162
188
463
528
CT SCANS
61
85
215
276
,'-AMMOGRAPHY
'-wfRl
98
119
281
362
TOTALS
1,261
1,446
3,643
4,194
PHARMACY:
IV SOLUTIONS DISPENSED
1,058
1,614
3,422
4,520
DRUGS DISPENSED
7,954
19,818
28,032
59,400
HIGH COST DRUGS DISPENSED
963
1,596
2,329
4,144
TOTALS
9,975
23,028
33,783
68,064
RESPIRATORY THERAPY:
INPATIENT PROCEDURES
1,421
3,309
5,888
9,033
OUTPATIENT PROCEDURES
499
1,162
2,108
3,172
STRESS TESTS
5
19
12
30
EKGS
185
248
501
705
EEGS
1
4
9
9
TOTALS
2,111
4,742
8,518
12,949
PHYSICAL THERAPY:
INPATIENT PROCEDURES
143
443
608
1,350
-OUTPATIENT PROCEDURES
2,260
2,551
5,764
8,450
HEALTH VISITS
159
78
404
300
,iOME
TOTALS
2,562
3,072
6,776
10,100
•
77
s2-6
HOME HEALTH CARE:
MEDICARE VISITS
OTHER VISITS
ST/SS
PHC HOURS
HOSPICE
TOTALS
DIETARY:
MEALS SERVED TO PATIENTS
MEALS SERVED IN CAFETERIA
TOTALS
DIETITIAN CONSULTS
THIS MONTH THIS YEAR
THIS MONTH LAST YEAR TO DATE
THIS MONTH
LAST YEAR
843
521
2,291
1,658
6
6
23
15
1
0
3
3
0
0
0
0
0
0
0
0
850
527
2,317
1,676
1,019 1,648 3,775 4,986
3,460 3,309 10,046 9,549
4,479 4,957 33,821 14,535
COST PER PATIENT DAY W/O DEPR
4,607.92
2,622.78
3,663.02
2,890.32
INCOME PER PATIENT DAY
4,515.69
2,810.07
3,515.57
3,209.89
BREAKEVEN W/O DEPRECIATION
10.43
16.65
13.44
15.29
AVERAGE DAILY CENSUS
10.23
17.94
12.92
17.19
PATIENTS ABOVE / BELOW BREAKEVEN
(0.20)
1.29
(0.52)
1.90
COST PER ADJ. PT. DAY W/O DEP.
1,187.72
979.57
1,123.85
1,570.54
INCOME PER ADJ. PT. DAY
1,163.95
1,049.52
1,078.61
1,744.19
78
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BIDS AND PROPOSALS - FUEL BIDS:
The following fuel bids, which were opened May 6, 2004 by Peggy Hall and Susan Riley, for the
period beginning May 16, 2004 and ending June 15, 2004, were read by the County Auditor.
After reviewing said bids, a Motion was made by Commissioner Balajka and seconded by
Commissioner Galvan to accept the bid of Mauritz & Couey for the automated card system fuel
and the delivery of gasoline and Diebel Oil Company for diesel to be delivered as the low bidders.
Commissioners' Galvan, Balajka, Floyd, Finster and Judge Pfeifer all voted In favor.
201 W. AUSTIN
• PORT L4VACA, TEXAS 77979
Phone: 361-553-4610
Fax: Wl-553.4614
Fa�c
CALHOUN
COUNTY
AUDITOR'S
OFFICE
TO0 COUNTYJUDGE&
From: PEGGY HALL
COMMISSIONERS ASSISTANT AUDITOR
Fax: NA Date: May6,2004
Phone: NA Pages: 3 Indudin this
9 page
Re: FUEL BIDS TO BE AWARDED 5/13/04 CC:
❑ Urgent ❑ For Review ❑ Please Comment O Please Reply ❑ Please Recycle
• *message:
The Fuel bids for the period BEGINNING MAY 16, 2004 AND ENDING JUNE is,
2004 were opened at 10:00 AM, Thursday, May 6th and will be considered for Award
in Commissioners' Court on Thursday, May 13, 2004,
Attached, please find the tabulations of the bids.
FUEL -AUTOMATED CARD SYSTEM -
• MAURITZ & COLEY WAS THE ONLY BID --
FUEL-BULK DELIVERED -
• DIEBEL OIL WAS THE LOW BID ON DIESEL
• MAURITZ & COUEY WAS THE LOW BID ON, REGULAR, MID -GRADE &
PREMIUM UNLEADED GASOLINE
Questions? Call Ben or Peggy.
•
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CALHOUN COUNTY, TX BID TABULATIONS: FUEL -BULK DELIVERED
ITEM FUEL -BULK DELIVERED
SPECDjCATIBN DIESEL FUEL
BID AMOUNT BOOM
LOW BID
COMMENTS
BEGINNING DATE ENDING DATE
$1.140 DIESEL OIL CO., INC.
LOW BID
5/16/2004 6/15/2004
$1.160 MAURITZ & COUEY
5/16/2004 6/15/2004
SPECIFICATION MID GRADE UNLEADED GASOLINE
BID AMOUNT BIDDER
LOW BID
COMMENTS
BEGINNING DATE ENDING DATE '
_.
$1.430 MAURITZ & COLEY
LOW BID
5/16/2004 6/15/2004
$1.460 DIESEL OIL CO., INC.
5/16/2004 6/15/2004
SPECOCATION PREMIUM UNLEADED GASOLINE
BID AMOUNT BIDDER
LOW BID
COMMENTS
BECINNUIG DATE ENDING -BATE
$1.480 MAURITZ & COLEY
LOW BID
5/16/2004 6/15/2004
$1.520 - DIESEL OIL CO., INC.
-
5/16/2004 6/15/2004
SPECIFICATION REGULAR UNLEADED GASOLINE
BM AMOUNT BBDIER
LOW BID
COMMENTS
BEGINNING OATS ENDING DATE
$1.380 MAURITZ & COUEY
LOW BID
5/16/2004 6/15/2004
-- $1.430 DIESEL OIL CO., INC.
5/16/2004 6/15/2004
I�i
Thursday, May 06, 2004
Page 1 of 1
EXECUTIVE SESSION: CAUSE #2004 4-14575 LEONARD KUNEFKE et.ux, VANESSA
KUNEFKE vs CALHOUN COUNTY, TEXAS:
The Court, being in open session, in compliance with the pertinent provisions of the Vernon's
Texas Code Annotated, Government Code, Section 551, Subchapter D, the County Judge, as
presiding officer, publicly announced at 10:40 a.m. that a closed session would be held under the
provision of Section 551.071; a government body may conduct a closed meeting to seek the
advice of its attorney about pending or contemplated litigation or on a matter in which the duty
of the attorney of the governmental body under the Texas Disciplinary Rules of Professional
Conduct of the State Bar of Texas clearly conflicts with the Texas Open Meetings Act, Cause No.
2004-4-14575 Leonard Kunefke, et.ux, Vanessa Kunefke vs. Calhoun County, Texas.
The County Judge further publicly announced that before any final action, decision or vote is
made regarding the subject matter of said closed session; this meeting would be reopened to the
public.
The Court then went into closed session. At the end of the closed session, the meeting was
reopened at 11:32 a.m.
A Motion was made by Commissioner Floyd and seconded by Commissioner Galvan that the
County enlist the services of Houston, Marek and Griffin to defend the County's rights in the
lawsuit of Kunefke vs. Calhoun County and that the defense be directed at the acceptance of the
dedication of the right-of-ways in the Sunilandings Subdivision to substantiate the County's
acceptance of public use and that they pursue to recover any and all expenses in the events of
this case. Commissioners' Galvan, Balajka, Floyd, Finster and Judge Pfeifer all vote in favor.
PUBLIC HEARING — MATTER OF POSTING 25 MPH SPEED SIGNS ON THE FOLLOWING
STREETS IN THE SAN LORENZO NEIGHBORHOOD• SANTA ROSA STREET WAREHOUSE
STREET AND AVENUE D, PORT LAVACA CALHOUN COUNTY, TEXAS:
Judge Pfeifer opened the Public Hearing regarding posting of 25 mph speed signs on the
following streets in the San Lorenzo Neighborhood; Santa Rosa Street, Warehouse Street and
Avenue D, Port Lavaca, Calhoun County, Texas at 11:35 a.m. There were no public comments.
Judge Pfeifer closed the public hearing at 11:36 a.m.
A Motion was made by Commissioner Galvan and seconded by Commissioner Balajka to accept
the posting of 25 mph speed signs on the following streets in the San Lorenzo Neighborhood;
Santa Rosa Street, Warehouse Street and Avenue D, Port Lavaca, Calhoun County, Texas.
Commissioners' Galvan, Balajka, Floyd, Finster and Judge Pfeifer all voted in favor.
APPROVAL OF MINUTES:
A Motion was made by Commissioner Balajka and seconded by Commissioner Finster that the
minutes of July 17, 2003 and July 2B, 2003 meeting be approved as presented. Commissioners'
Galvan, Balajka, Floyd, Finster and Judge Pfeifer all voted in favor.
Michael J. Pfeifer
CountyJudge
Roger C. Galvan
Commissioner Precinct #1
Michael J. Balajka
Commissioner Precinct #2
H. Floyd
Commissioner Precinct #3
Kenneth W. Finster
Commissioner Precinct #4
Wendy Marvin
Deputy County Clerk
AUTHORIZE THE USE OF THE PORT ALTO PUBLIC BEACH BY LGN ENTERPRISES ON
..�......v..,,u a Ai unnN rn11NTY REINC
A Motion was made by Commissioner Floyd and seconded by Commissioner Finster to authorize
the use of the Port Alto Public Beach by LGN Enterprises on July 3, 2004 for a Public Fireworks
Display with Calhoun County being named and also insured on all required Liability Insurance
Coverage. Commissioners' Galvan, Balajka, Floyd, Finster and Judge Pfeifer all voted in favor.
s4
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A Motion was made by Commissioner Finster and seconded by Commissioner Balajka to authorize
the dosing of streets on July le and July 17"' 2004 for Poco Bueno in Port O'Connor, Texas and
designate a parking area. Commissioners' Galvan, Balajka, Floyd, Finster and Judge Pfeifer all
voted in favor.
PIER IN THE AMOUNT OF $160,000 TO BE REIMBURSED BY FEMA:
A Motion was made by Commissioner Finster and seconded by Commissioner Balajka to make a
loan from the General Fund to the Capital Project Coastal Improvements/Reconstruction of Port
. O'Connor King Fisher Fishing Pier, In the amount of $160,000 to be reimbursed by FEMA.
Commissioners' Galvan, Balajka, Floyd, Finster and Judge Pfeifer all voted In favor.
AUTHORIZE COMMISSIONER H. FLOYD TO SIGN CHANGE ORDERS FOR THE JAIL
ARCHITECTURE CONDUCTION WITH IRFLUGER, WIGGINTON HOOKER, P r C:
A Motion was made by Commissioner Floyd and seconded by Commissioner Finster to approve a
change order in the amount of $8,200 and authorize Commissioner Floyd to sign the change
order for the Jail Architectural Construction with Pfluger, Wigginton, Hooker, PLLC.
Commissioners' Galvan, Balajka, Floyd, Finster and Judge Pfeifer all voted In favor.
PFLUGER WIG INTON HOOKER, P. L. L. C.
III ARCHITECTS / PLANNING CONSULTANTS
April 26, 2004
Mr. H. Floyd
County Commissioner, Precinct 3
Calhoun County, Texas
24627 State Hwy, 172
Port Lavaca, Tx 77979
Fax: No. 361-893-5309
• RE: Calhoun County
Law Enforcement Facility
PWH Project No. 0305
Dear Commissioner Floyd:
Based on the drawings and conversation over the past few weeks concerning the revision
to the link between the existing sallyport and the new jail, WHJ submits the following
addendum to our agreement with the County.
The link has been redesigned at the request of the County to coordinate with space
planning needs of the renovation concepts for the existing Courthouse. While we want to
help with planning goals, the scope of our contract does not include redesign and
documentation of approved areas of the project. For the consultant efforts associated with
design, documentation and processing of the newly approved link we request additional
service fees of Eight Thousand "Two Hundred Dollars (S8,200) consistent with contract
provisions.
If you are in agreement with this request please authorize below to initiate the work and
return one signed original to PWH for our files. This design revision will change the
location of structural piers. With pier work in progress at this time the redesign works
needs to be accomplished very quickly in order to avoid project delays.
If we can offer further explanation or information please let us know.
• Respectfully:
Pfluger Wiginton Hooker, PLLC
Walter T. Curry, AIA
Principal
9696 SKI W STREET / SUITE 2S6 / OALLAS, TEAS 75243
21X/319-65S• FAX: 21I/069.2322
Approved By:
Calhoun County, Texas
Date: p L/ — Z 8 — 0 y-
COLORADO CROSSING / 213 SOUTH IANAR / SUITE 300 / AUSTIN, TEXAS 7370A
5121474-IOAO FAX; 5121476-42.9
612
A Motion was made by Commissioner Fnster and seconded Commissioner Balajka to approve a
change order in the amount of $35,079.50 and authorize Judge Pfeifer to sign change order for
the Rexco Contract for Matagorda Lighthouse Project. Commissioners' Galvan, Balajka, Floyd,
Finster and Judge Pfeifer all voted in favor.
Commissioner Fnster announced that June 11, 2004 would be the Matagorda Lighthouse Project
Dedication and invitations will be sent out.
Y,� y
�`ESTENGEE�F 'p
ENGINEERING AAD TECHNICAL. SZRV10E8
3777 Hwy. 35 South ♦ P.O. Rox 557 -♦ PartLavaca, TX 77979 ♦ Phone. (361) 552-7621 -♦
May 4, 2004
Dear Conigtisstoner F>nster '
This letteri4 to request a chaige'order for the ItEXCO. ca
14
' additi
This additional work was completed by r.E Was �. a..n ��. <M a
application. The work was necessary to complete the project and could not7iaye been foreseen prior
to award of the contract
Funds are available as the Grant and mat ping fiords to pay for the change orders. i
I) Purchase and install TVSS Surge S 550.00 -
Suppressor .for Lightning Protection
2) Modify Lighthouse Fouudation dole S 17,682.00
to pre-existing condition
3) Add concrete foundation for park benches, $ 3,291.50
ramp and pedestal
4) Raised path to cemetery using S 3,550.00
existing materials
5) Backfill 400 CY of fill dirt $ 10 000 00 a;
:...Total $ 35 079 50 .
_i
This request represents 3.5% of the original contract and will result in a new contract price of
S 1,036,229.60.
If you have any questions you may contact me at (361) 552-7621.
Sincerely,
,
Byron L. Cumberland, P.E.
RLC: ad
643
TESTENGEER, INC. 661 552 6976 07/27/04 11:44am P. 002
TESTENGEE
1 .
ENGINEERING AND TECHNICAL SERVICES
3777 Hwy. 35 South ♦ P.O. Box 557 ♦ PortLavaca, T7t 7r979 ♦ Phone; (361) 552-7621 ♦ Fax: (512) 552-6976
May 4, 2004
Calhoun County Commissioner
• Precinct No. 4
P.O. Box 177
Seadrift; TX 77983
Attention: Kenneth Finster
Re: Matagorda Island Lighthouse Restoration
Project No. 0913-19-0171
Dear Cominissioaer Finster .G1 r r ;
-. ,. '; : ', ; 'ii'+xi'a� �. „t.'.� 5��,� Rat ��. f �r -- ♦ �x g i-�
This letter is to request a change order for the R$XCO contract for Matagorda L thotue Pro ect "_ ..
This additional work was completed by REXCO as additional.scope but wttilm We'uope oft6e grant
application. The work was necessary to complete the project and could not',"' a been forescw prior -
to award of the contract
Funds are available as the Grant and matching fimds to pay for the change orders.
1) Purchase and install TVSS Surge $ 550.00
Suppressor for Lightning Protection
2) Modify lighthouse Foundation dp8e— $ 17,682.00
to pre-existing condition
3) Add concrete foundation for park beaches, $ 3,297.50
ramp and Pedestal--------,----.---.—
• 4) Raised path to cemetery using S 3,550.00
-�cisting.mas-er�ls _ "'�
5) Backfill 400 CY of fill dirt to 000 00 /
-- - ^ — Total $ 35,614 50
This request represents 3.5% of the original contract and will result in a new contract price of .
$1,036,229.60. /
If you have any questions you may contact meat (361) 552-7621
BLC: ad
•
Sincerely,
1� 2 1// c_ _7
Byron L. Cumberland, P.B.
614
TESTENGEER, INC. 361 SS2 6976 07/27/04 11:44am P. 009
Rexco Inc. Change Order Request
I
Change Order NO: 4
Project Title:Matapg_rog Liohthouse Protect
Contract No. 09111MI7 Contract Date 1273W02 Contractor PQ#:
RC5005 —
li
Contractor. Rexca-Construction Services. Inc. ❑ Owner
N
Proposed By IdaIYH.ILBianell _ .,,,. _ Date: 8/1.103_ ❑ Arch. a Eng.
(Name)
Submitted By: Dennis Reddina Date: 811/03 Construction
(Name)
Actual job condlbano in ams of proposed change:
Reason for range ordpvchange in scope of work
1
F
Cnnlradn( 2i.thnri7ert to nmenett with this ehnnna my.. f I M. nn
Other contracts involved are as follows (IJst Contracts by No. J: _ Is Dwg. Req.?(]Yes ®I
Sheet No,
Descri ion of than es:
a
Purchase a install TVSS surge suppressor on lantern electrical system per instructions to
protect lantern, batteries, & solar panel so they will be covered by $10,000,00o insurance
required.
4
r i
1
Changes in scope of work:
Comments:
9
t,
Estimated change in wsY. $550.00
s
Change Osier is: U Lump 3um7Frice $550 oo ❑ T&M
❑ Unit Pnce 40. 4.e
Approved by authorized representative:
County Judge'
(Title.)
s�x5
•
•
E
REXCO INC.
1104 Mildred Drive
CONTRACT Port Lavaca, Texas 77979
CHANQE OROER ` (361) 552-5371 Fax: (361) 552-0956
Qer temen:
This CHANGE ORDER includes all Material. Labor and'Equipment necessary to complete the following work and to adjust tl
h--dcontract as indicated; -
0 ttw work below to be paid for at actual cost of Labor, Materials and Equipment plus
0 Me work below to be completed for the sum of percent
UNAN SES APPROVED The work covered by this order shall be performed under the same Terms and
Conditions as that included in the original contract unless stated otherwise above.
r�
U
Rem Inc. Change Order Request
Change Order NO: 4
Project Title Waaorde Lighthouse Pn�ect
Contract No. 00913-19417 Contract Date 12/30/02 Contractor POt
RCS005
Contractor. Rexco Construftn Services. Inc. ❑ Owner
Proposed By. Harvey Bignet Date: N1/03 ❑ Arch. 3 Eng.
Submitted By: Dennis Reddim
Mom) Date: SAM ® Construction
Cordrador authorized to proceed with this change ❑ Yes ❑ No on
Other coat wh involved areas blows (List Contracts by No.): la Owq. Req.7 i]Yes ®No
Sheet No. _.
Description of changes:
Lowered foundation one fool, inoreasai size of ring, extended forgers, and added piers to
top of fingers.
Lower Grades (416 Badduoe, Lot" - $1,900.00, Pour 15 Hunches - il,eeo.00
Remove extra Brick 18 ea. - $5.700, Now Finger Steel - $1,300
One trip with barge for steel - 32,000.00, Additional 0 days of Was time - $Z752.00
Additional lift to Ring - $2.450.00
Changes in scope of work:
Comments: - -- --
Estimated change In cost: $17,W2.00
Change Orderis: ❑ Lump Sun PrkeA97.68-ZQQ ❑ T&M
❑ Unit Price
Approved by authorized representative; Date: 7-28-04
County Judge
(idle)
a
647
•
CHANGE ORDER
Matagorda Island Lighthouse
1 Lower Grades 416
20 His
$ 800.00
Labor
40 Hrs
$ 1,000.00
•
Pour 16 — 24' x 24' Hunchs
16 Ea
Labor
48 His
S 1,200.00
Form Mang
LS
$ 480.00
Remove extra Brick 16 Ea
195 Hrs
$ 4,800.00
Backhoe
20 Hrs
$ 900.00
New Finger Steel
Ea
$ 1,300.00
One trip with barge
1 Trip
For steel
S 2,000.00
Added 8 days to shuttle
8 Trips
Boat
S 2,752.00
Additional 6 ft to Ring
Labor
72 Hrs
S 1,800.00
Material
LS
L. 650.00
Total
$17,682.00
•
648
i
. Rexco Inc. Change Order Request
Change Order NO: 8205-7
Project Title MetaOrde Lighthouse Project -
Contract No. 211kJ .017 Contract. Date 1,22/30/02 Contractor PO*
RCS005
Contractor. Rexco Construction Sandos- Inc. ❑ Owner
Proposed By: Harvey Bionell Date: 4r7/04 ❑ Arch. 3 Eng.
(N l _
Subrnitted By: Dennis ReMna Date: em64 LN uonstma on
Nm
ActW job canfta it a ofpmpeeed Hop:
R"Wafwd— wdrr.G>egen 9mpadYrak
Cordrador authorized to proceed with this change ❑ Yes ❑ No on
Other contracts Involved ere as follows (list Contracts by No.j Is Dwg. Req.? QYes ® No
Shed No.
scope
rnst:
Change Orderis: ❑ Lump Sum/Pricw$3.297.50 ❑ T&M
❑ Unit Price
Approved by authorized representative: Date: 7_7R-04
Count Ju e
(Tale)
649
•
•
06/06I¢000 13:37 13615536359
PAGE e2
REXCO INC.
1104 MKMftED DW4
PORT LAVACA, TEXAS 77979
(361)552- 371
FAX (381) 582.LW
CHANGE ORDER
• April 1, 2004
Matagorda Island Lighthouse
Later Lakes
`'" ---,,,-�,
Cox 1 'a Division 3.85 CY ® 5250.00 CY S %250-
Form Lumber $ 200.00
Equoncot
Labor 36 Hours MOD
Boat Trip
Plaque Pedestal
•
600.00
S1,762.50 S900.00
Total Chaage Orden
Pour 5 Additions! Poutxlation - 4 Picnic Tsbka
I Ramp
•
S3,297.6p
Y 1 /
$635.00
�c�
Rexco Inc. Change Order Request
Change Order NO: 8205-8
Project Title:Matacorda Lighthouse Proiect
Contract No. 0913-19-017 Contract Date 12/30/02 Contractor PO4:
RCS005
Contractor. Rexco Construction Services. Inc. ❑ Owner
Proposed By: Harvey Bignell Date: 4/12/04 ❑ Arch. & Eng.
(Name)
Submitted By: Mike Cockrill Date: 4/12/04 ® Construction
(Name)
Actual job conditions in area of proposed change:
Reason for change order.Change in Scope of Work ^ • - -
Contractor authorized to proceed with this change ❑ Yes ❑ No on
Other contracts involved are as follows (List Contracts by No.): Is Dwg. Req.? ❑Yes ® No
Sheet No.
scope
change in cost: $3,550.00
Change Order is: ❑ Lump Sum/Price:$3,550.00 ❑ T&M
❑ Unit Price
Approved by authorized representative: n�� date
County Judge
(Title)
651
0
0
•
•
11
CHANGE ORDER
#8205-8
April 12, 2004
Matagorda Island Lighthouse
Sidewalk to Cemetary @ 215 Ft. Long
Fill Material 130 CY @ $25.00
Boat Trips (2)
$3,250.00
Total Change Order $3,550.00
652
Kim Inc. Change Order Requtd
Change Order NO: ¢
Project TIVeMatagordA Lighthouse Proi
Contract No. 0913.19.017 Contract Date 12130/02 _ Cordracior POW.
RC§=
Contractor. Rem CorWruction SeMr es. Inc. ❑ owner
Proposed By' Harvey BkMR Date: VW _ ❑ Arch. 3 Eng.
. Mumal _ _
Contractor authorized to proceed with this Change []Yes ❑ No on
other contracts lma ved are as lmlows (Ust Contracts by NO.)' Is Dwg. Req.? QYea ® No
Shaer No.
scope
change in cost:
Change Orderis: ❑ Lump Sum/Prit;e:S10 000. 00 ❑ T&M
❑ Unit Price
Approved by authorized representative: Date: 7-28-04
(fle
rl-
03
•
0
•
•
•
TEXAS DEPARTMENT OF HEALTH DO i impmT iF2 F R TITLE V
A Motion was made by Commissioner Balajka and seconded by Commissioner Finster to approve
the Texas Department of Health Document #3 for Title V. Commissioners' Galvan, Balajka,
Floyd, Finster and Judge Pfeifer all voted In favor.
(a
TEXAS DEPARTMENT OF HEALTH
1100 WEST 49TH STREET
AUSTIN, TEXAS 78756-3199
STATE OF TEXAS
COUNTY OF TRAVIS
TDH Document No. 7460019239 2004
Contract Change Notice No. 03
The Texas Department of Health, hereinafter referred to as RECEIVING AGENCY, did heretofore enter into a contract in writing
with CALHOUN COUNTY HEALTH DEPARTMENT hereinafter referred to as PERFORMING AGENCY. The parties thereto
now desire to amend such contract attachmrnrrd v..n,...,�•
SUMMARY OF TRANSACTION:
Revised Contract Total: 10,000.00
and
NO. 02B AC FAMILY HEALTH -
force
EXECUTED IN DUPLICATE ORIGINALS ON THE DATES SHOWN,
CALHOU_ N�Ty
Authorized Contracting Entity (type above if different
from PERFORMING AGENCY) for and in behalf of:
PERFORMING AGENCY:
CALHOUN COUNTY HEALTH DEPARTMENT
By:
(Signature of persc au a sign)
Michael J. Pfeifer, County Judge
(Name and Title)
Date: May 13, 2004
RECOMMENDED:
By:
(PERFORMING AGENCY Director, if different
from person authorized to sign contract)
RECEIVING AGENCY:
TEXAS DEPARTMENT OF HEALTH
By: 1-� -
a
(Signature of person authorized tsozuthor ie�'gn)
Bob Burette, Director
Procurement and Contracting Services Division
(Name and Title)
Date:
Cover Page j
0
Rev. 2/03
654
DETAILS OF ATTACHMENTS
Art/
TDH Program ID/
Term
Financial Assistance
Direct
Total Amount
Amd
TDH Purchase Order
Assistance
(TDH Share)
No.
Number
Begin End
Source of Amount
Funds*
01
ACFH/FEE
09/01/03
08/31/04
State 93.994
5,098.00
0.00
5,098.00
0000001074
0213
ACFH/FEE-FP
09/01/03
08/31/04
State
10,000.00
0.00
10,000.00
TDH Document No.7460019239 2004 Totals
$ 15,098.00
$ 0.00
$15,098.00
Chan a No. 03
*Federal funds are indicated by a number from the Catalog of Federal Domestic Assistance (CFDA), if applicable. REFER TO
BUDGET SECTION OF ANY ZERO AMOUNT ATTACHMENT FOR DETAILS.
Cover Page 2
s155
•
•
•
The County Clerk, JP 1 and JP 5 presented their monthly reports for April 2004 and after reading
and verifying same, a Motion was matte by Commissioner Rnster and seconded by Commissioner
Balajka to accept said reports as presented, Commissioners' Galvan, Balajka, Floyd, Finster and
Judge Pfeifer all voted In favor.
CRARGEi
County Clerk's Foes
Recording
Probate
Civil
Judge's Fees
Probate
Civil
Probate Fee (Education Fee)
ANITA FRICKE. COUNTY CLERK
MONTHLYREPOR RECAPITULATION
MONTH ENDING .2OO4
8D•dd
BOD. d'd
/a.
A aD
Sheriff's Fee
Jury Fee
LL, d'fj
Law Library Fees
Beer Licenses
_ o _
Appellate Fund (TGC)
/5D"
—�—
Court Reporter Fees
<i5D• dd
Civil Indigent Fees
/G 67"
Record Management Fees (Co. Clerk)
_ 9 4 $O. OD
Record ManagementFees (County)
Security Fees (County)
•
Bond Forfeitures
a, �1d 7. 52)
TOTAL FOR COUNTY TREASURER
State Treasurer - Judicial Fund ((? *//ZD
1' YP,e aYS5 ?^1
J
State Treasurer - Marriage License Fees
State Treasurer - Birth Certificate Fees
C.A.R. FUND
REFUNDS:
E �ieC7051T -rro n Re-ittrmeo( rt„�
OTHER INCOME: TrustFund
CASH ON HAND, BEGINNING 4,�
W i.L / Total Income
County Clerk's Account
Trust Fund Account
TOTAL CHARGES
DISBURSEMENTS (SEE ATTACHED LIST)
County Clerk's Account
Trust Fund Account
CASH ON HAND, ENDING 400
•County Clerk's Account
Trust Fund Account
TOTAL CREDITS:
SUBMITTED BY:
ARM FRIG, coOBTr CLERK,
Sub -total
Interest for 44
srLa'
S
s a/, 999. z9
S
$= aa. za
$_ 7d
s o? 7.7y.O/f
X0. 7/
s_ 9G, oyez. 710
APPROVED BY:
65
ANITA FRICKE
Trust Fund Account Monthly Report
For the Month of: ,a�floc<
County Clerk's Trust
Previous Month's Balance ( / //A% t4,) ) # ZD /2D. 44
Deposits For this Month
Deposit from: a2� ' do �S f
i� # ��, G35. ae
LESS Disbursements:
CK #
to
CK#
to
CK it
to
CK #
to
CK #
to
CK #
to
#
TOTAL $
(Total of Balance 6 Deposits) ¢ .3�%, ��d • %/
#
#
#
TOTAL $ — b —
BALANCE
(Total of Bal. 6 Deps. LESS Disc
bursements)
# 3s a98.7/
•
•
•
65'7
ANITA FRICKE
County Clerk's Monthly Report
For the Month ofc ; e, ,'�p�k
County Clerk's Office Fund:
•
Previous Month's Balance `�IiGi t Ll✓
$_
Deposits for this Month
_
$
a iP0. 50
TOTAL
$
-51G , 7 73 .79
Disbursements, IBC:
C$
to
C& e 9ia to
2017(dA �qt ki A X
:
ozi. 70
Cx # to
$
CB I to
$
CB / to
$
CB I to
$ .
CS # to
$
CC / to
$
i
CK # to
CP #
$
to
$
Cx # to
$
CK # to
$
TOTAL DISBURSEMENTS
TOTAL AMOUNT (above)
$ 4, 773. 79
LESS DISBRUSEMENTS
SUB -TOTAL
g24,-
PLUS INTEREST
+ $
BALANCE..-
ld 17.7
0
658
0
•
TRUST POND
BANK BALANCE $ .39, X& 7/
LESS OUTSTANDING CHECKS
CK # $
CK # $
CK # $
CK # $
CK # $
CK # $
CK # $
CK # $
CK # $
PLUS DEPOSIT IN TRANSIT $ — D —
BALANCE D $ 3 /! ' d • 7/
BE-cAP , o�dJo�
I
OFFICE FOND
sANK BALANCE a �. 5�R 4. 39
LESS OUTSTANDING CHECKS $ 103.3
CK #
3/0
CK #
1..37
$
CK #
U39
$
a,OO
CK #
wl 70
$
CK #
7/Z)
$
oLIP. oz)
CK #
�z 9
$
ov
CK #
9/0
$
33. o-0
CK #
$
CK #
$
TOTAL BANK BAL. 6 Less
oLjtst Cks. $ a'% 4/.0j/
PLUS DEPOSSIT IN TRANSIT $ 314. a0
BALANCE 4QjjL30- $'2T.777.O4
05%04/2004 15:44 5537063 JPPCTI PAGE 01
05/04/2004
Money Distribution Report
JUSTICE OF THE PEACE PCT. #1 APRIL 2004
Page 1
---------------------------------
Receipt Cause/Daferdant
--------------------------------------------------------------------------------------------------
I Cede Amount I Code AM U11T I Code Amount I Code Amount I Code Amount I Code Amount I
Total
3679941 2004-0078
03/30/20" I TFC
3.00 I CCC
40.00 I CHS
3.00 I SAP
5.00
I TF
4.00 I SUBC
30.00 I
95.00
CHIANG, TED KUANG
I DOC
10.00 I
Money Order
I
I
I
I
3679942 2000-0077
03/31/2004 I TFC
3.00 I CCC
10.00 I CHS
3.00 I SAF
5.00
I TF
4.00 I SUBC
30.00 I
95.00
KNIGHT, TUCKER SPENCE I DOC
10.00
Money Order
I
I
I
I
I
I
I
3679943 2003-0153
03/31/2004 I JCPT
2.00 I CVC
15.00 I TFC
3.00 I CCC
17.00
I FA
5.00 I JCD
0.50 I
247.00
CHATHAM, BILLY RAT
I CHS
3.00 I-CNI
0.50 I SAP
5,00 I WANT
50.00
I TIME
25.00 I TF
4.00
Morey Order
I SUBC
30.00 I FINE
30.00 I CSRV
57.00 I
I
I
I
3679944 2003-0151.
03/31/2004 I JCPT
2.00 I CVC
15.00 I CCC
17.00 I FA
5.00
I JCD
0.50 I CHS
3.00 I
494.00
CHATHAM, BILLY RAY
I CHI
0.50 I SAT
5.00 I WANT
50.00 I TIME
25.00
I TF
4,00 I FINE
253.00
Cash
I CSRV
114.00 I
(
I
I
I
I
3679945 Z003.0153A
03/31/2004 I JCPT
2.00 I CVC
15.00 I CCC
17.00 I FA
5.00
I JCD
0.50 I CHS
3.00 I
509.60
CHATHAM, BILLY RAT
I CHI
0.50 I SAP
5,00 I WANT
50.00 I TF
4.00
I DPSF
290.00 I CSRV
117.60
Cash
I
I
I
I
I
I
I
367991.6 2004.0090
03/31/2004 I TFC
3.00 I CCC
40.00 I CHS
3.00 I SAF
5.00 I TF
4.00 I SUBC
30.00 I
125.00
WILLIAMS, DIRK ALLEN
I SEAT
40.00 I
I
I
I
I
I
Cash
I
I
I
I
I
I
I
3679947 2004-0094
04/05/2004 I JCPT
2.00 I CVC
15.00 I TFL
3.00 I CCC
17.00 I FA
5.00 I JCD
0.50 I
95.00
LENTO, SONYA YSAGUIRRE I CMS
3.00 I CMI
0.50 I SAF
5.00 I TF
4.00 I SURC
30,00 I DDC
10.00
Cash
I
I
I
I
I
367994E 2004-0091
06/05/2004 I TFC
3.00 I [CC
40.00 I CHS
3.00 I SAF
5.00 I TF
4.00 I SUBC
I
30.00 I
95.00
VASQUEZ, DAVID ANTHONY I DOC
10.00 I
I
I
I
I
I
Money Order
3679949 2004-0001
04/05/2004 I TFC
3.00 I CCC
40.00 I CHS
3.00 I SAP
5.00 I TF
4.00 I SUBC
30.00 I
85.00
SERINO, GARAY RICHARD JR. I
I
I
I
(
I
I
Cash
I
I
I
I
I
3679950 2004-0029
04/06/2004 I TFC
3.00 I CCC
10.00 CHS
3.00 I SAF
5.00 I TIME
I
25.00 I TF
I
4.00 I
150.00
MAYBERRY, GREGORY ALLEN
I SUSC
30.00 I SEAT
40.00 I
I
I
Cash
I
367MI 1999-469
04/06/2004 I JCPT
1.00-I CVC
15.00 I TFC
3.00 I CCC
17.00 I FA
I
5.00 I JCD
I
0.25 I
225.00
CASTILLO, RODRIGO
I CHS
3.00 I SAF
5.GO I WRNT
50.00 I TIME
25.00 I DPSC
30.00 I FINE
25.75
Personal Check
I CSRV
G5.00 I
I
I
I
I
I
3679952 2002-080A
04/06/2004 I JCPT
2.00 I CVC
15.00 I CCC
17.00 I FA
5.00 I JCO
0.50 I CHS
3.00 I
392.00
MARTINEZ, CRUZ
I CHI
0.50 I WANT
50.00 I TF
4.00 I FINE 216.60 I CSRV
76.40
Personal Check
3679953 2002-080
04/06/2004 I JCPT
2.00 CVC
15.00 I TFC
3.00 I CCC
17.00 I FA
5.00 I JCD
0.50 I
200.00
MARTINEZ, CRUZ
I CHS
3.00 I CHI
0.50 I WANT
50.00 I TIME
25.00 I TF
4.00 I F114E
30.00
Personal Check
I CSRV
40.00 I LAP
5.00
3679954 2000-261
04/06/2004 I JCPT
2.00 I CVC
15.00 I TFC
3.00 I CCC
17.00 I FA
5.00 I JCD
0.25 I
155.00
GONZALES, DONATO VILLANUEVA
I CHS
3.00 I SAF
5.00 I WANT
50.00 I TIME
25.00 I CSRV
29.75
Personal Check
I
I
I
I
3679955 JV-04.0018
04/06/2000 I JCPT
1.16 I CVC
B.% I CS
11.94 I CCC
10.15 I FA
I
2.99 I JCD
OJO I
40.00
CASTRO, GINA DEMISE
I CHS
1.79 I CM1
0.30 I TF
2.39 I
I
I
I
Cash
3679956 2000-0092
04/07/2004 I TFC
3.00 I CCC
40.00 I CHS
3.00 I SAF
5.00 I TF
4.00 I SUBC
30.00 I
95.00
BARKER, HUNTER WAYNE
I DOC
10.00 I
I
I
I
I
I
Cash
36TW57 2004-OOB3
04/OT/2004 I TFC
3.00 I CCC
40.00 I CMS
3.00 I SAF
5.00 TF
4.00 SUBC
30.00
115.00
YEAGER, RUSSELL F.
I FINE
30.00 I
I
I
i
i
i
Cash
I
I
I
I
I
367MS 2004-0086
04/07/2004 I CCC
40,00 I CHS
3.00 I SAF
5.00 I TF
4.00 I FINE
I
63.00 I
I
I
115.00
BRUMFIELD, SARAN PFEIFER
I
I
I
I
I
I
I
Cash
I
I
I
I
I
I
I
•
669
05/04/2004 15:44 5537063
JPPCTI
OS/04/2004 Money Distribution Report
JUSTICE OF THE PEACE PCT. ei APRIL 2004
PAGE 02
Page 2
. - _-.___.. I_ ---- _.
____ --
__________________ rlt
Receipt Couce/Defendant I Code _ Amount I Cade Ancunt I Coda AMount I Cods Amount I Code Amount C
3679959 JV-04-0020
04/12/2004 I JCPT
2.00 I OJC
15.00 I CS
20.00 I CCC
17.00 I FA
5.00 I JCD 0.50
I
SURE, JERRY LEON
I CHS
3.00 I Oil
0.50 I TF
4,00 I
I
Money Order
3679960 2004-0085
04/12/2004 CCC
40.00 I CHS
3.00 I WAF
5.00 I IF
4.00 I PVF
I
105.00
KOENIG, JAMES PAUL
I
I
I
I
Cash
I
I
I
3679961 2003-0200
04/12/2004 I FINE
120.00 I
I
I
I
GAYLE,, JESSICA RENNE
cash
3679962 JV-04-0007
04/12/2004 I JCPT
0.82 I (VC
6.04 I. CS
8.06 I CCC
6.05 I FA
2.01 I JCD 0.20
PEW, TINA MARIE
I cNS
1.21 I CAI
0.20 I TF
1.61 I
I
I
Cash
3679963 JV-04.0022
I
04/12/2004 I JCPT
I
2.00 I CVC
I
15.00 I CS
I
20.00 I CCC
I
17.00 I FA
I
5,00 I JCD 0.50
RESSLER, SHALYNA DIANDRA I CNS
3.00 I CHI
0.50 I TF
4.00 I
I
I
Ceah
I
I
I
I
I
I
3679964 2004-00"
04/12/20" I JCPT
2.00 I CVC
15.00 I TFC
3.00 I CCC
17.00 I FA
5,00 I JCD 0.50
GARZA, ADAM
I CHS
3.00 I CHI
0.50 I TF
4.00 I SEAT
130.00 I LAF
5.00
Cash
I
I
I
I
I
I
3679965 2004-0081
04/15/200/. I FINE
110.00 I
I
I
I
I
SERINO, GARRT RICHARD JR. I
I
I
I
I
I
Comas Service
I
I
I
I
I
I
3679M 2004-0089
0L/15/2004 I TFC
3.00 I CCC
40.00 I CNS
MO I SAF
5.00 I TF
4.00 I SUBC 30.00
DEROWE, DAVID F.
I DOC
10.00 I
Cred-Carq/Trnsfr
I
I
I
I
I
3679967 Jv-04-0016
04/15/2004 I JCPT
2.00 I rvc
15.00 I cs
20.00 I ccc
17.00 I FA
5.00 I JCD 0.50
OVALLE, BRITTMEY NICOLE I CNS
3.00 11711
0.50 I TF
4,00
I
I
Corm Service
I
I
I
I
I
3679968 2003.0163
04/15/2004 I FINE
97.50 I CSRV
94.00 I
I
I
I
MODGE6, DENNIS WINE
I
I
I
I
Cash
3679%9 JV-04-0032
04/19/2004 i JCPT
2.00 j CVC
15.00 j CS
20.00 j CCC
17.00 j FA
5.00 j JCD 0.50
BONUZ, SARAN NICOLE
I CHS
3.00 I CHI
0.50 I TF
4.00 I
I
I
Cash
I
I
I
3679970 2002-047
04/19/2004 I JCPT
2.00 I IVC
15.00 CCC
I
17.00 I FA
I
5.00 I JCD
I
0.50 I CNS 3.00
FLORES. ABEL ESCOSEDO I CHI
0.50 I SAF
5.00 I WENT
50.00 I TIME
25.00 I TF
4.00 I DPSC 30.00
Cash
I CSRV
53.00 I
I
I
I
3679971 JC-o4-0006
04/19/2004 I ADMF
10,00 I wop
lo0.00
I
AMEJORADO, ALVA
Cash
3679M 2004-0104
04/19/2004 I TFC
3.00 I CCC
40.00 I CNS
3.00 I SAF
S.00 I TF
4.00 I Mac 30.00
LAWSON, CASSANDRA
I DOC
10.00
Cash
3679973 JV-04-0018
D4/19/2004 I JCPT
0.82 I CVC
6.04 I CS
8.06 I CCC
6.85 I FA
2.01 I JCD 0.2o
CASTRO, GINA DEMISE
i CNS
1.21 CHI
0.20 TF
1.61
Cash
i
i
3679974 2004-0097
04/20/2004 I TFC
3.00 I CCC
40.00 I CHS
3.00 I SAF
5.00 I TF
4.00 I SUBC WOO I,
STEWART, CHRISTOPHER
RYAN I DDC
10.00 I
Money order
3679975 200-0037
04/22,2004 I JCPT
2.00 I CVC
15.00 I TFC
3.00 I CCC
17.00 I FA
5.00 I JCD 0.50
ZAMORA, DOSE AYALA
I CHS
3.00 I CHI
0.50 I NRNT
50.00 I TIME
25.00 I TF
4.00 I FINE 3D.00
Peraorol Check
I CSRV
40.00 I LAF
5.00 I
I
I
I
3679976 JV-04-0028
04/22/2004 I JCPT
2.D0 I CVC
15.00 I CS
20.00 I ccc
17.00 I FA
5.00 I JCD O.sO j
GONZALEZ, JEREMY MATTHEW
I CMS
3.00 I CMI
0,50 I TF
4.00 I
I
I
Cash
I
6D
Total
67.00
157.00•
1200
27.00
67.00
185.00
110.00
95.00
67.00
181.50
67.00
210.•
110.00
95.00
27.00
95.00
200.00
67.00
05Y04/2004 15:44 5537063 JPPCTI PAGE 03
05/04/2004
Money Distribution Report
JUSTICE OF THE PEACE PCT. #I APRIL 2004
Page 3
--------- _---------- _______________----------------------------------------------------------------
Receipt Cauam/Defendent
__..............................
I Code Amount I Code Amount I Code AxeMnt I Code Aao t I Code Amur[ I Code Amount I
Total
3679977 JV-04.0021
O4/29/2004 I JCPT
2.00 I CVC
15.00 I CS
20.00 I CCC
i7.00
I FA 5.00 I JCD
0.50 I
67.00
BARTELS, BRANDYN MICHAEL I CHS
3.00 I CM1
0.50 I TF
4.00 I
I I
I
Cash
I
I
I
I
I I
I
367997E 2001-309
04/29/2004 I JCPT
2.00 I CVC
15.00 I CCC
17.00 I FA
5.00
I JCO 0.50 I CHS
3.00 I
190.00
MIRELES, JOSE A
I CHI
0.50 I LAP
5.00 I NRNT
50.00 I TIME
25.00
I TF 4.00 I FINE
53.00
Personal Check
I
I
I
I
I I
I
3679979 2004-0110
04/29/2004 I CCC
40.00 I CNS
3.00 I LAP
5.00 I TF
4.00
I FINE 143.00 I
I
195.00
YASGIURRE, MARIADEROSARIO I
I
I
I
I I
I
Personal Check
I
I
I
I
I I
I
3679"0 2004-0110
04/29/2004 I FINE
100.00 I
I
I
I I
I
100.00
YASGIURRE, MARIADEROSARIO
I
I
I
i I
I
Jail Credit
3679981 2004-0111
04/29/2004 I CCC
40.00 I CHS
3.00 I LAP
5.00 I TF
4.00
I FINE 243.00 I
I
295.00
WOOD, CONNIE TERESA
I
I
I
I I
I
Personal Check
36799a2 2004-0114
04/30/2004 I TFC
3.00 I CCC
40.00 I CHS
3.00 I SAP
5.00
TF 4.00 I SUBC
30.00 I
155.00
VEGO, FERNANDO PAUTAGUTA I FINE
70.00 I
I
I
I
I
Cash
I
I
I
I
I I
I
36799a3 2004-0095
04/30/2004 I TFC
3.00 I CCC
40.00 I CNS
3.00 I SAF
5.00
I TF 4.00 I SUSC
30.00 I
105.00
STROTHER, NOLAN LEE
I PINE
20.00 I
I
I
I I
I
Money Order
3679M 2004-00%
0/130/2004 I TFC
3.00 I CCC
40.00 I CHS
3.00 I SAP
5.00
I TF 4.00 I SUBC
30.00 I
95.00
DAVIS, KEVIN CARL
I DOC
10.00
Cash
I
I
I
I
I I
I
•
E
05/04/2004 15:44 5537063 JPPCTI PAGE 04
05/04/2004
Money Distribution Report Page 4
...............................................................................
The following totals represent - AttUal Money Received
Type
Code
Description
Count
Retained
Disbursed
Money-Totels
COST
ADMF
ADMINISTRATION FEE
1
10.00
0.00
10.00
COST
CCC
CONSOLIDATED COURT COSTS
38
103.29
929.56
1,032.85
COST
CHS
CMS
38
109.21
0.00
109.21
COST
CHI
CHI
18
0.82
7.38
8.20
COST
CS
CS
8
128.06
0.00
128.06
COST
CVC
CVC
20
27.61
248,43
276.04
COST
DPSC
OPS OMNIBASE FEE
2
19.80
40.20
60.00
COST
FA
FA
20
9.21
82.60
92.01
COST
JCD
JCD
20
0.87
7.83
8.70
COST
JCPT
JCPT
20
3.59
32.23
35.82
COST
LAF
SHERIFF'S FEE
- 6
30.00
0.00
30.00
COST
PWAF
TEXAS PARKS A WILDLIFE
1
4.00
1.00
5.00
COST
SAF
DPS
22
88.00
22.00
110.00
COST
SUBC
SUBTITLE C
16
24.00
456.00
480.00
COST
TF
TECHNOLOGY FUND
36
137.61
0.00
137.61
COST
TFC
TFC
21
63.00
0.00
63.00
COST
TIME
TIME PAYMENT FEE
9
112.50
112.50
225.00
COST
WRNT
WARRANT FEE
10
500.00
0.00
500.00
FEES
CSRV
COLLECTION SERVICE FEE
10
658.75
0.00
658.75
FEES
DDC
DEFENSIVE DRIVING
9
90.00
0.00
90.00
FEES
WOP
WRIT OF POSSESSION
1
100.00
0.00
100.00
FINE
OPSF
OPS FTA FINE
1
290.00
0.00
290.00
FINE
FINE
FINE
15
1,424.85
D.00
1,424.65
FINE
PWF
PARKS L WILDLIFE FINE
1
15.75
89.25
105.00
FINE
SEAT
SEATSELT FINE
3
105.00
105.00
210.00
Money Totals
41
4,G55.92
2,134.18
6,190.10
The following
totals represent - Jail
Credit 6 Comaunity Service
COST
ADMF
ADMINISTRATION FEE
0
0.00
0.00
0.00
COST
CCC
CONSOLIDATED COURT COSTS
1
1. TO
15.30
17.00
COST
CHS
CHS
1
3.00
0.00
3.00
COST
CHI
CMI
1
0.05
0.45
0.50
COST
CS
CS
1
20.00
0.00
20.00
COST
CVC
CVC
1
1.50
13.50
15.00
COST
DPSC
DPS ONNISASE FEE
0
0.00
0,00
0.00
COST
FA
FA
1
0.50
4.50
5.00
COST
JCO
JCD
1
0.05
0.45
0.50
COST
JCPT
JCPT
1
0.20
1.90
2.00
MST
LAF
SHERIFF'S FEE
0
0.0D
0.00
0.00
COST
PWAF
TEXAS PARKS A WILDLIFE
0
0.00
0.00
0.00
COST
SAF
DPS
0
0.00
0.00
0.00
COST
SUBC
SUBTITLE C
0
0.00
0.00
0.00
MST
TF
TECHNOLOGY FUND
1
4.00
0.00
4.00
COST
TFC
TFC
0
0.00
0.00
0.00
COST
TIME
TIME PAYMENT FEE
0
0.00
0.00
0.00
COST
VRNT
WARRANT FEE
0
0.00
0.00
0.00
FEES
CSRV
COLLECTION SERVICE FEE
0
0.00
0.00
0.00
FEES
DOC
DEFENSIVE DRIVING
0
0.00
0.00
0.00
653
•
•
05/04/2004 15:44 5537063 JPPCTI PAGE 05
05/04/2004 Money Distribution Report
The following totals represent - Jail Credit & Community Service
Type Code Description Count
FEES
WOP
WRIT Of POSSESSION
0
FINE
DPSF
DPS FTA FINE
0
FINE
FINE
FINE
2
FINE
P4f
PARKS It WILDLIFE FINE
0
FINE
SEAT
SEATSELT FINE
0
Credit Totals
3
The follwing
totals represent - Combined Money
and Credits
COST
ADMF
ADMINISTRATION FEE
1
COST
CCC
CONSOLIDATED COURT COSTS
39
COST
CNS
CMS
39
COST
CMI
CMI
19
COST
CS
CS
9
COST
CVC
CVC
21
COST
DPSC
DPS OMNISASE FEE
2
COST
FA
FA
21
COST
JCO
JCD
21
COST
JCPT
JCPT
21
COST
LAF
SHERIFF'S FEE
6
COST
PWAF
TEXAS PARKS & WILDLIFE
1
COST
SAF
DPS
22
COST
SUBC
SUBTITLE C
16
COST
TF
TECHNOLOGY FUND
37
COST
TFC
TFC
21
COST
TIME
TIME PAYMENT FEE
9
COST
WRNT
WARRANT FEE
10
FEES
CSRV
COLLECTION SERVICE FEE
10
FEES
DOC
DEFENSIVE DRIVING
9
FEES
WOP
WRIT OF POSSESSION
1
FINE
DPSF
DPS FTA FINE
1
FINE
FINE
PINE
17
FINE
DYF
PARKS & WILDLIFE PINE
1
FINE
SEAT
SEATBELT FINE
3
Report Totals
44
•
Retained Disbursed Money-TotaLs
0.00
0.00
0.00
0.00
0.00
0.00
210.00
0.00
210.00
0.00
0.00
0.00
0.00
0.00
0.00
241..00
36.00
277.00
10.00
0.00
10.00
104.99
9".56
1,049.55
112.21
0.00
112.21
0.87
7.83
8.70
148.06
MO
148.06
29.11
261.93
291.04
19.80
40.20
60.00
9.71
87.30
97,01
0.92
8.28
9.20
3.79
34.03
37.82
30.00
0.00
30.00
4.00
1.00
5.00
88.00
22.00
110.00
24.00
1.56.00
480.00
141.61
0.00
141.61
63.00
0.00
63.00
112.50
112.50
225.00
500.00
0.00
500.00
658.75
0.00
658.75
90.00
0.00
90.00
100.00
0.00
100.00
290.00
0.00
290.00
1,634.85
0.00
1,634.85
15.75
89.25
105.00
105.00
105.00
210.00
4,296.92 2,170.18 6,467.10
664
Page 5
05104/2004 15:44
5537063
JPPCTI
PAGE 06
05/04/20"
Mx"y Distriautiw
Report
Page
6
........................................................,._____......________...._______...,...______.._.,_______....,._____.....___
DATE
PAYMENT -TYPE
FINE$ COURT -COSTS
FEES
BONDS
RESTITUTION
OTHER
T07AL
00/00/0000
ACTUAL MONEY
0.00
0.00
0.00
0.00
0.00
0.00
0.00
CREDITS
0.00
0.00
0.00
0.00
0.00
0.00
0.00
COMBINED
0.00
0.00
0.00
0.00
0.00
0.00
0,00
09/01/1991
ACTUAL MONEY
0.00
0.00
0.00
0.00
0.00
0.00
0.00
CREDITS
COMBINED
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
09/01/1993
ACTUAL MONEY
0.00
0.00
0.00
0.00
0.00
0.00
0.00
CREDITS
0.00
0.00
0.00
0.00
0.00
0.00
0.00
COMBINED
0.00
0.00
0.00
0.00
0.00
D.OD
0.00
09/01/1995
ACTUAL MONEY
0.00
0.00
0.00
0.00
0.00
0.00
0.00
CREDITS
0.00
0.00
0.00
0.00
0.00
0.00
0,00
COMBINED
0.00
0.00
0.00
0.00
0.00
0.00
0.00
09/01/1997
ACTUAL MONEY
25.75
154.25
45.00
0.00
0.00
0.00
225.00
CREDITS
0.00
0.00
0.00
0.00
0.00
0.00
0.00
COMBINED
25.73
154.25
1.5.00
0100
0.00
0.00
225.00
09/01/19"
ACTUAL MONEY
0.00
125.25
29.75
0,00
0.00
0.00
155.00
CREDITS
0.00
0.00
0.00
0.00
0.00
0.00
0.00
COMBINED
0.00
125.25
29.75
0.00
0.00
0.00
155.OD
09/01/2001
ACTUAL MONEY
329.60
641.00
211.40
0.00
0.00
0.00
1,182.00
CREDITS
0.00
0.00
0.00
0.00
0.00
0.00
0.00
COMBINED
329.60
641.00
211.40
0.00
0.00
0.00
1,182.00
09/01/2003
ACTUAL MONEY
790.50
389.00
372.60
0.00
0.00
0.00
1,552.10
CREDITS
0.00
0.00
0.00
0.00
0.00
0.00
0.00
COMBINED
790.50
389.00
372.60
0.00
0.00
0.00
1,552.10
01/01/2004
ACTUAL MONEY
684.00
2,002.00
190.00
0.00
0.00
0.00
3,076.00
CREDITS
2io.00
67.00
0.00
0.00
0.00
0.00
277.00
COMBINED
1,D%.00
2,069.00
190.00
0.00
0.00
0.00
3,353.00
TOTALS
ACTUAL MONEY
2,029.85
3,311.50
848.75
0.00
0.00
0.00
6,190.10
•
CREDITS
210.00
67.00
0.00
0.00
0.00
0.00
277.00
COMBINED
2,239.85
3,378.50
"a. is
0.00
0.00
0.00
6,467.10
0
05/04/2004 15:44 5537063 JPPCTI PAGE 07
05/04/2004
Money
Oistribution Report
Pape 7
----------------------------------------------------------
DATE PAYMENT -TYPE PINES COURT -COSTS
---------------------------------
FEES BONDS
--------------------------------------
RESTITUTION
OTNER TOTAL
State of Texas Quarterly Reporting Totals
Description
Count
Collected
Retained
Disbursed
State Comptroller Cosa and Fees Report
Section I: Report for Offenses Conmitted
01.01.04 Forward
7B
1,056.12
105.62
950.50
09-01-01 - 12-31-03
48
320.00
32.00
288.00
09-01-99 08-31-01
3
39.25
3.93
35.32
09.01-97 - D8-31.99
5
38.25
3.83
34.42
09-01-95 - 08.31-97
0
0.00
0.00
0.00
09-01-91 - OB-31.95
0
0.00
0.00
0.00
Bail Bonds Fee
0
0.00
0.00
0.00
DNA Testing Fees
0
0.00
0.00
0.00
ENS Trauna Fund (EMS)
0
0.00
0.00
0.00
Juvenile Probation Diversion Feee
0
0.00
0.00
O.OD
State Traffic Pees
16
480.00
24.00
456.00
Section Ile As Applicable
State Police Officer Fees
22
110.00
80.00
22.00
Failure to Appear/Pry Fees
2
60.00
19,80
40.20
Judicial Fund - Connt County Court
0
0.00
0.00
0.00
Judicial Fund - Statutory County Court
0
0.00
0.00
0.00
Motor Carrier Weight violations
0
0.00
0.00
0.00
Tim Payment Fee
9
225.00
112.50
112.50
Report Sub Total
185
2,320.62
389.64
1,938.94
State Comptroller Civil Fees Report
Cf. Birth Certificate Fees
0
0.00
0.00
0.00
CF: Marriage License Fees
0
0.D0
0.00
0.00
CF: Declaration of Informal Marriage
0
0.00
0.00
0.00
CF: Nondisclosure Fees
0
0.00
0.00
0.00
CF. Juror Donati ore
0
0.00
0100
0.00
CF: Justice Court Indig Filing Fees
0
0.00
0.00
0.00
CF: Stat Prob Court Indig Filing Fees
0
0.00
0.00
0.00
CF: stat Prole Court Judic Filing Fees
0
0.00
0.00
0.00
CF: Stat Cnty Court Indig Filing Page
0
0.00
0.00
0.00
CF: Stet Cnty Court Judie Filing Fees
0
0.00
0.00
0.00
CF: Cnat Cnty Court Irdig Filing Fees
0
0.00
0.00
0.00
CF: Cnat Cnty Court Judic Filing Fees
0
0.00
0.00
0.00
CFe Dist Court District L Family Lew
a
0.00
0.00
0.00
CF: Dist Court Other Divorce/Family Lew
0
0.00
0.00
0.00
CF: Diet Court India Filing Fees
0
0.00
0.00
0.00
Report Sub Total
0
0.00
0100
0.00
Total Due For This Period
105
2,328.62
389.68
1,938.94
THE STATE OF TEXAS Before me, the undersigned authority, this day
County of Calhoun personally appeared Celestine V. Menchaca, Justice
of the Peace Precinct 1, Calhoun County, Taxes, who
being duly sworn, deposes and soya that the above
and foregoing report is true and correct.
uitn*aa Wry hood ,hie �JTday of A.D A !
.
Justice of the Peace, Precinct No 1
Calhoun County, Texan
•
666,
05/11/2004 .16:00 361-993-2461 CALHOUN CO PCT 5 PAGE 01
40 Judge Nancy Pomykal •
Justice of the Pence Pct. 5
Collections for the Month of Any
Date: May 11, 2004
Calhoun County Commissioners Court
211 S. Ann Street
Port Lavaca, Texas 77979
Fax No: 553-4444
Commissioners Court:
Attached is a report of all collections for my court for the month given.
Faxing Z Pages including this cover.
•
•
,,..
37
65/11/2004 .16'.00 361-983-2461 CALHOUN CO PCT 5
06/11/2004 Money Distribution Report
Judge Nancy Pomykal Calhoun Canty Pct, 5
---------------------------
Receipt Cause/Defendant
--------- --------'------'----------------------------'----------
I Code Amount I Code Amount I Code Amount I Code Amount
I
0371883 04.03-0070
I
04/01/2004 I TFC
I
3.00 I CCC
I
40.00 ( CHS
I
3.DO I SAF
5.00
CLARK, ROBERT HATTHEII
I sum
30.00 I
I
I
Cash
I
I
I
I
•
0171884 03-12-0887
HARPER, SHIPLEY
04/01/1014 I JCPT
1 CHS
2.00 I CVC
3,00 1 CHI
15.00 I TFC
0.60 1 SAF
3.00 1 CCC
5.00 I TF
17.00
4.00
Comm Service
I
I
I
0371885 04-03-0071
04/01/2004 1 TFC
3.00 1 CCC
40.00 1 CHS
3.00 1 SAF
5,00
O'CONNOR, JAMES STEPi0 JR 1 SUBC
30.00 I
I
Cashier's Check
1
I
I
I
0371886 04-03-0069
04/05/2004 1 CCC
40.00 I CHS
3.00 1 LAF
5.00 I IF
4.00
RIVERA, FRED
I
1
I
I
Honey Order
I
I
I
I
0371887 03-10-0823
04/05/2004 I AJFF
5,00 1
1
I
RHYNE. JOHN
I
I
I
I
Personal Check
I
I
I
I
0371808 04-03-0066
04/09YZ004 I CCC
40.00 I CHS
3.00 1 LAF
5.00 1 IF
4.00
MALLEY. KEVIN SCOTT
I
I
I
I
Cash
I
I
I
I
0371889 03.04-D601 A
04/10/2004 1 JCPT
2.00 1 CVC
15.00
1 CCC
17.00 1 FA
5.00
FIORES, BOBBY
I CHI
0.SO I PNAF
5.00
I NR14T
50.00 I IF
4,00
Cashier'S Check
I
I
1
1
0371890 03-04-0601
04/10/2004 I JCPT
2.00 1 CVC
15.00 1 CCC
17.00 1 FA
5.00
FLORES. BOBBY
1 CHI
0.50 1 PNAF
5.00 1 NRNT
SO.00 1 TF
4.00
Cashier's Check
I
I
I
I
0371891 2002-04-0170
04/10/2004 I JCPT
2-00 1 CVC
15.00 1 TFC
3.00 1 CCC
17,00
CALVO, RANDOM DAVID
CHS
3.00 1 CHI
0.SO I LAF
5.00 1 TF
4.00
Cashier's Check
i
I
1
1
0371892 02-04-0170 A
04/10/2004 I JCPT
2.00 I CVC
1S,00 1 CCC
17.00 I FA
5.00
CALVO. RRANDON DAVID
1 CHI
0.50 I LAF
5.00 1 IF
4,00 I DPSC
30.00
Cashier's Check
I
I
I
I
0371893 04-03-0062 SC
04/10/2004 1 SFEE
60.00 1 IFEE
2.00 1 FFEE
10.DO I
HOOKER. GEROLD LEE
Personal Check
I
I
I
I
0371894 04-02-0050
04/15/2004 1 CS
20.00 1 CCC
40.00
1 CHS
3.00 1 IF
4.00
FLORES. SAMANTHA, ANN
I
I
I
I
Money Order
0371896 04-04-0090
04/19/2004 I CCC
40.00 1 CHS
3.00 I TF
4.00 1 NSF
25.00
BABY. EM14A LEE
I
I
I
I
Personal Check
1
I
1
1
03718% 04.04-0091
04/22/2004 I CCC
40.00 I CHS
3.00 I IF
4.00 I NSF
25.00
CANTLEY, KENNON LEE
I
I
I
I
Money Order
PAGE 02
---'-----------------_.
Code Mount I Code Amount
IF
I
4.00 I FINE 130.00
I
FA
I
5.00 I JCD 0.50
FINE
40.00 1 SUBC 30.00
?F
I
4.00 I DSC 10,00
I
FINE 45.50
FINE 48.00
Page 1
-----Total
215.00
125.00
95.00
97.50
I
I
1 5.00
I
I
1 100.00
I
JCD 0.50 1 CHS 3.00 I
OPSC woo 1 FINE 208.00
I I I
JCD O.SO I CHS 3.00 I
OPSC 30.00 1 NSF 25.00 1
I I I
FA 5.00 1 JCD 0.50 1
OPSC 30.00 I FINE 110.00 1
I I I
JCD 0.50 1 CHS 3.00 1
1 FINE 208,00 1 I
PNAF 5.00 1
I
I
PW4F 5.00 I
0371897 04-03-OD68
04/27/2004 1 CCC
40.00 1 06
3.00 1 LAF
5.00 1 TF
4,00 1 FINE 243.00 1
CROUCH, JAMES ROBERT
I
I
I
I
I
I
Cashier's Check
I
I
I
I
I
I
0371898 03-12-0884
04/27/2004 1 JCPT
2,00 1 CVC
15.00 I TFC
3,00 1 CCC
17.00 I FA
5.00 1 JCD
0.50
DEAL, FOYIL EDNARD JR 1 CIS
3.00 I CHI
0.50 1 LAF
5.00 ( NRNT
50.00 I TF
4,00 1 OPSC
30.00
Cashier's Check
I FINE
50,00 1 SUBC
30,00 1
I
I
I
0371899 03-12-OW A
04/27/2004 1 JCPT
2.00 1 CVC
15.00 1 CCC
17,00 i FA
5,00 I JCD
0,50 1 CHS
3.00
DEAL. FOYIL EDNARD JR I CHI
0.50 1 NRNT
50.00 1 IF
4.00 1 DPSC
30.00 1 DPSF
213.00 1
Cashier's Check
I
I
I
I
I
I
0371900 03-12-CM
04/27/2004 JCPT
2.00 1 CVC
16.00 I CCC
17.DO I FA
S.00 I JCD
0.50 I CHS
3.00
DEAL, FOYIL EDYARD JR 1 CHI
0.50 1 LAF
5.00 1 NRNT
60.00 I TF
4,00 I DPSC
30.00 I FINE
153.00
Cashier's Check
I
I
I
I
I
I
•
66S
340.00
157.00
195.00
290.00
72.00
67.00
77.00
77.00
295.00
215.00
340.00
266-00
05/ 11,/ 2004 , 16: 00
361-963-2461
CALHOUN CO PCT 5
PAGE 03
05/11/2004
----- ___..........
Receipt Cause/Defendant
0371901 03-12-0883
04/27/2004 I
DEAL, FOYIL EDWARD JR I
Jail Credit
I
03719OZ 04.03-0072
04/27/2004
MARTINEZ, CRUZ
Money Order
I
0371903 04-04-0104
04/Z7/2004
MAIIETT. RONALD
Money Order
0371904 04-04-DO82
04/27/2004
M49ETT. RONALD
Money Order
0371905 04-04-0100
04/ZB/2004
JARAMILLO. CELSO HUERTA
Money Order
0371906 04-04-0088
04/30/2004
RICE. GARY J.
Cash
0371907 04-04-OD99
04/30/2004
GARZA. ALBERTO 120
GARR
Personal Check
0371908 04-04-0084
04/30/2004
KORCZYNSKI. PATRICK
PARTY
Money Order
0371909 04-04-0103
04/30/2004
RODRIGUEZ, JOSE
Money Order
0371910 04.04-010Z
04/30/2004
RODRIGUEZ, JUAN CARLOS
Money Order
0371911 04-03-0069
04/30/2004
RIVERA. FRED
Money Order
Nosey Distribution Report Page 2
Judge Nancy Punytal Calhoun County Pct. 5
Code Mount I Cale Amount I Code Amount I Code Awwt I Code M mIlt I Code Amount I Total
I I I I I I
FINE 100.00 I
I
I
I
I
(
I
I
I
I
I
100.00
CCC
40.00 I CPS
I
3.00 I LAF
i
5.00 1 TF
I
4.00 FINE
I
I
50.00 1
I
1
I
I
102,00 •
TFC
I
3.00 I CCC
!
40.00 I CHS
I
3.00 I SAF
I
5.DO I TF
I
4.00 I OFF
I
50.00 I
135,00
SUBC
30.00 I
I
I
I
I
I
I
CCC
I
40.00 I CHS
I
I
3.DO I LAF
I
I
5.00 I TF
I
I
4.00 I PNF
I
I
25.00 I
I
I
I
77,00
CCC
40.00 1 CHS
1
3.00 I PNAF
I
5.00 I IF
I
4.00 ( PNF
I
448.00 I
I
I
I
500.00
TFC
I
3.00 I CCC
I
40,00 I CHS
I
3.00 I SAF
I
5.00 I IF
I
4.00 I FINE
I
5.00 I
90.00
SUBC
30.00 I
I
I
I
I
I
TFC
3.00 I CCC
40,00 I CHS
3.00 SAF
5.00 I TF
4.00 I DSC
10.00 I
95.00
SUBC
30.00 I
I
I
I
I
I
TFC
3.00 1 C({
40.00 CHS
SAO � SAF
5.00 1 TF
4.00 � DSC
10.00 �
95,00
SUBC
30.0o I
I
I
I
I
I
I
CCC
I
I
40.00 I CHS
I
I
3.00 1 PNAF
I
I
5.00 I TF
I
I
4.00 ( PNF
I
I
448.00 I
I
I
500.00
I
CCC
I
I
40.00 I CHS
I
I
3.00 I PNAF
I
I
5,00 I TF
I
I
4.00 I PNF
I
I
448.00 I
1
I
I
I
500,DO
FINE
I
I
97.50 I
1
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
97,60
669
0
9
05/11/2004 .16:00 361-963-2461 CALHOUN CO PCT 5 PAGE 04
05/11/2004 Money Distribution Report Page 3
Judge Nancy Pomykal Calhoun County, Pct.5
------------------------ - ----- -------- -------- ------ ----------------------- ------- ----- ------------
The following totals represent - Actual Money Received
Type
Code
Description Count
Retained
Disbursed
MWY-Totals
COST
CCC
CONSOLIDATED COURT COSTS
24
79-90
719.10
799.00
COST
CHS
COURTHOUSE SECURITY
24
72.00
0.00
72.DO
CHI
CORRECTIONAL MANAGEMENT INSTITUTE
7
0.35
3.15
3.60
•COST
COST
CS
CHILD SAFETY
1
20.00
0.00
20.00
COST
CVC
COMPENSATION TO VICTIMS OF CRIME
7
10.50
94.50
105.00
COST
DPSC
OPS FAILURE TO APPEAR COURT COSTS
7
69.30
140.70
210.00
COST
FA
FUGIVITE APPREHENSION
7
3.50
31.50
36.00
COST
JCD
JUVENILE CRIME AND DELINQUENCY
7
0.35
3,15
3.50
COST
JCPT
JUDICIAL AND COURT PERSONNEL TRAINING
7
1.40
12.60
14.DO
COST
LAF
SHERIFF'S FEE
9
45.DO
0.00
45.00
COST
PWAF
TEXAS PARKS 6 WILDLIFE
7
20.00
7.00
35.00
COST
SAF
OPS
6
24.00
6.00
30.00
COST
IF
TECHNOLOGY FUND
24
%.00
0.00
96.OD
COST
TFC
TFC
B
2.40
21.60
24.00
COST
WRNT
WARRANT FEE
5
250.00
D.DO
250.00
FEES
AJFF
ABSTRACT OF JLOGP07 FILING FEE
1
5.00
0.00
5.00
FEES
OFF
DEFERRED FEE
1
50.00
0.00
60.00
FEES
DSF.
DRIVER SAFETY COURSE 09101
3
30,00
0.00
30.09
FEES
FFEE
FILING FEE
1
10.00
0.00
10.00
FEES
IF((
INDIGENT FEE
1
0.10
1.90
2.00
FEES
SFEE
SERVICE FEE
1
60.00
0.00
60.00
FEES
SU1C
SUMS TITLE C
7
10.60
199.50
210.00
FINE
OPSF
OPS FTA FINE
1
213.00
0.00
213.00
FINE
FINE
FINE
12
1.348.00
0.00
1,348.00
FINE
PWF
PARKS 6 WILDLIFE FIRE
4
2D5.35
1.163.65
1,369.00
FINE
WSF
WATER SAFETY FINE
3
11-25
63.75
76.00
MDney Totals 27 2.645.90 2,468.10 5.114.00
The following totals represent - Jail Credit 6 COmmity Service
COST
CCC
CONSOLIDATED COURT COSTS
1
1.70
15.30
17.00
COST
CHS
COURTHOUSE SECURITY
1
3.00
0.00
3.00
COST
CMI
CORRECTIONAL MANAGEMENT INSTITUTE
1
0.05
0.45
0.50
COST
CS
CHILO SAFETY
0
0.00
0.00
0.00
COST
CVC
COMPENSATION TO VICTIMS OF CRIME
1
1.50
13.50
15.00
COST
DPSC
DPS FAILURE TO APPEAR COURT COSTS
0
0.00
0,00
0.00
COST
FA
FUGIViTE APPREHENSION
1
0.50
4.50
5.00
COST
JCD
JUVENILE CRIME AND OELINQUENCY
1
0.05
0.46
0.50
COST
JCPT
JUDICIAL AND COURT PERSONNEL TRAINING
1
0.20
1.00
2.00
COST
LAF
SHERIFF'S FEE
0
0.00
0.00
0.00
COST
PWAF
TEXAS PARKS b WILDLIFE
0
0.00
0.00
0,00
COST
SAF
DPS
1
4.00
1,00
5.00
COST
TF
TECHNOLOGY FUND
1
4.00
O.OD
4.00
COST
TFC
TFC
1
0.30
2.70
3.00
COST
WRNT
WARRANT FEE
0
0.00
0.00
0.00
FEES
AJFF
ABSTRACT OF JUDGMENT FILING FEE
0
0.00
0.00
0.00
FEES
OFF
DEFERRED FEE
0
0.00
0.00
0.00
FEES
DSC
DRIVER SAFETY COURSE 09/01
0
0.00
0.00
0.00
FEES
FFEE
FILING FEE
0
0.00
0.00
0.00
•
7 60
05/11/2004 ,16'.00 361-983-2461 CALHOUN CO PCT 5 PAGE 05
OS/11/2004 Money Distribution Report Page 4
Judge Nancy Pomykal Calhoun County pct. 5
---------------- --------•------ -----------------.------------- ------•---------------------- -
The f0110wing COWS represent - Jail Credit & Coamnity Service
Type
Code
Description
Gent
Retained
Disbursed
Money -Totals
FEES
IFEE
INDIGENT FEE
0
0,00
0.00
0,00
FEES
$FEE
SERVICE FEE
0
0.00
0.00
0.00
FEES
SUBC
SUB TITLE C
1
1150
28.60
30.00
•
FINE
DPSF
DPS FTA FINE
0
0.00
0.00
0.00
FINE
FINE
FINE
2
140.00
0,00
140,00
FINE
PWF
PARKS & WILDLIFE. FINE
0
0,00
0.00
0.00
FINE
WSF
WATER SAFETY FINE
0
0.00
0.00
0.00
Credit Totals
2
156.80
68.20
225.00
The following
totals represent - Combined Money and
Credits
COST
CCC
CONSOLIDATED COURT COSTS
26
81.60
734.40
816.00
COST
CHS
COURTHOUSE SECURITY
25
76.00
0,00
75.00
COST
041
CORRECTIONAL MANAGEMENT INSTITUTE
8
0.40
3.60
4.00
COST
CS
CHILD SAFETY
1
20.00
0.00
20.00
COST
CVC
COMPENSATION TO VICTIMS OF CRIME
B
12.00
108.00
120,00
COST
DPSC
DPS FAILURE TO APPEAR COURT COSTS
7
69.30
140.70
210.00
COST
FA
FUGIVITE APPREHENSION
8
4.00
36.00
40,00
COST
JCD
JUVENILE CRIME AND DELIHOUENCY
8
0.40
3.60
4.00
COST
JCPT
JUDICIAL AND COURT PERSONNEL TRAINING
B
1.60
14.40
16,00
COST
LAF
SHERIFF'S FEE
9
45,00
O.DO
45.00
COST
PW1F
TEXAS PARKS & WILDLIFE
7
28,00
7.00
36.00
COST
SAF
DPS
7
28,00
7.00
35.00
COST
IF
TECHNOLOGY FUND
Z5
100.00
0.00
100.00
COST
TFC
TFC
9
2.70
24.30
Z7.00
COST
WRNT
WARRANT FEE
5
250.00
0.00
250-00
FEES
AJFF
ABSTRACT OF JUDGMENT FILING FEE
1
5.00
0.00
6.00
FEES
OFF
DEFERRED FEE
1
50.00
DAD
5D.00
FEES
DSC
DRIVER SAFETY COURSE 09101
3
30,00
0.00
30.00
FEES
FFEE
FILING FEE
1
10.00
0,00
10,00
FEES
IFEE
INDIGENT FEE
1
0,10
1.90
2.00
FEES
SFEF
SERVICE FEE
1
60.00
0.00
60.00
FEES
SUBC
SUB TITLE C
8
12,00
228.00
240.00
FINE
DPSF
DPS FTA FINE
1
213.00
0.00
213.00
FINE
FINE
FINE
14
1,488.00
0.00
1.488.00
FINE
PWF
PARKS & WILDLIFE FINE
4
205.35
1,163,65
1,369.00
FINE
WSF
WATER SAFETY FINE
3
11.25
63.75
75.00
Report Totals
29
2.802.70
2,636.30
5,339.00
•
05/11/2004 ,16:00
361-983-2461
CALHOUN CO PCT 5
PAGE 06
05/11/2004
Money Distribution
Report
Page 5
Judge
Nancy Pomykal Calhoun County, PCt.
--------•-------- •-------------- ------------•--------
5
------
DATE
PAYMENT -TYPE
FINES
•-•
-------------
COURT -COSTS
FEES
BONDS
RESTIMION
OTHER
TOTAL
00/00/0000
ACTUAL MONEY
0.00
0-00
0.00
0,00
0.00
0.00
0.00
CREDITS
0.00
0,00
0.00
-0,00
0.00
0.00
0.00
COMBINED
0.00
0.00
0.00
0,00
0.00
0.00
0.00
09/01/1991
ACTUAL MONEY
0,00
0.00
0.00
0.00
0,00
0.00
0.00
CREDITS
0.00
0.00
0,00
0.00
0.00
0.00
0.00
•
COMBINED
0.00
0.00
0,00
0.00
0.00
0.00
0.00
09/01/1993
ACTUAL MONEY
0.00
0.00
0.00
0,00
0.00
0,00
0.00
CREDIIS
0.00
0.00
0,00
0.00
0.DO
O,DO
0.00
COMBINED
0.00
D.00
0.00
0.D0
0.00
0.00
0.00
09/01/1995
ACTUAL MONEY
0.00
0,00
0.00
0.00
0.00
0.00
0,00
CREDITS
0.00
0.00
0,00
0.00
0.00
0,00
0.00
COMBINED
0.00
0,00
0.00
0.00
0100
0.00
0.00
09/01/1997
ACTUAL MONEY
0,00
0.00
0.00
0.00
0.00
0.00
0,00
CREDITS
0.00
0.00
0.00
0.00
0.00
0.00
0.00
COINED
0.00
0.00
0.00
0.00
0.00
0.00
0.00
09/01/1999
ACTUAL MONEY
0.00
0.00
0.00
0.00
0.00
0,00
0,00
CREDITS
0.00
0.00
0.00
0.00
0,00
0.00
0.00
COMBINED
0.00
0,00
0,00
0.DO
0.00
0.00
0.00
09/01/2001
ACTUAL MONEY
551.00
431.00
0.00
0.00
- 0,00
0.00
962.00
CREDITS
0.00
0.00
0.00
0,00
0.00
0.00
0.00
COMBINED
651.00
431,00
0.00
0,00
0,00
0.00
982.00
09/01/2003
ACTUAL MONEY
203.00
267.00
35.00
0.00
0,00
0,00
505.00
CREDITS
140.00
55.00
30.00
0.00
0.00
0.00
225.00
COMBINED
343.00
322.00
65.00
0.00
0.00
0.00
730.00
01/01/2004
ACTUAL MONEY
2,261,00
1,044.00
332.00
0.00
0.00
0.00
3.627.00
CREDITS
0.00
0.00
0.00
0,00
0.00
0.00
0.00
COMBINED
2.251.00
1'0".00
332,00
0.00
0.00
0.00
3,627.00
TOTALS
ACTUAL MONEY
3,005,00
1,742.00
367.00
0,00
0.00
0.00
5.114.OD
•
CREDITS
140.00
55.00
30.00
D.00
0,00
0.00
225.00
COMBINED
3.145.00
1.797.00
397.00
0.00
0.00
0.00
5,339.00
05111/2004 16ieO 361-983-2461 CALHa N 00 PCT 5 PAGE 07
Money Distribution Report
5
page 6
05/11/2004
Judge Nancy
Pomykal
Calhoun
County Pct-
------------------------- •_.-----"-•---'--•--•-----^----------__.
DATE PAYMENT -TYPE FINES COURT -COSTS FEES
BONDS
RESTITUTION
OTHER TOTAL
State Of Texas Quarterly Reporting Totals
Count
Collected
Retained
Oi5Dursed
Description
State Comptroller Cost and Fees Report
•
Section I: Report for Offenses COMPitte0
770.00
122-00
648.00
01-01-04 - Forward
24
37
245.DO
29.00
216.00
09-01-01 - 12-31-03
0
0.00
0.00
0.00
09.01-99 - 08-31-01
0
0.00
O.DO
0.00
Og-01-97 - Oe-31-99
0
0.00
O.DO
0.00
09-01-95 - 08-31-97
0
0.00
0,00
0.00
09.01-91 - 09-31-95
0
D.00
0.00
0.00
Bail Bonds Fee
0
0.00
O.DO
0.00
DMA Testing Fees
0
0.00
0.00
0.00
Trauma Fund (EMS)
0
0.00
0,00
0.00
JEMSuvenile
Juvenile Probation Diversion Fees
210.00
10.50
199.50
State Traffic Fees
7
Section II: As Applicable
13
65.00
52.00
13.00
State Police Officer Fees
7
210.00
69.30
140.70
Failure to Appear/Pay Fees
0
0.00
0.00
0.00
Judicial Fund - const County Court
0,00
0.00
Judicial Fund - Statutory County Court
0
0.00
0.00
0.00
Motor Carrier weight Violations
0
0.00
0.00
Time Payment Fee
0
as
0,00
1,500.00
0.00
282.80
1.217.20
Report Sub Total
State Comptroller Civil Fees Report
CF: Birth Certificate Fees
0
0.00
0.00
0.00
CF: Marriage license Fees
0
0.00
0.00
0.00
CF: Declaration of Informal Marriage
0
0.00
0.00
0.00
CF: Nondisclosure Fees
0
0.00
0.00
0.00
CF. Juror Donations
0
O.Do
0.00
0.00
CF: Justice Court Indig Filing Fees
CF: Stat Prob Court Indig Filing Fees
1
0
2.00
0,00
0.10
0.D0
1.90
0.00
•
CF: Stat Prob Court Judie Filing Fees
0
0.00
0.00
0.00
CF: Stat Cnty Court Indig Filing Fees
0
0.00
0.00
0.00
CF: Stat Cnty Court Judic Filing Fees
0
0.00
O.DO
0.00
CF: Gut Cnty Court Indig Filing Fees
0
0.00
0.00
0,00
CF: Cnst City Court Judie Filing Fees
0
0.00
0,00
0.00
CF; Dist Court District 8 Family taw
0
0.00
0.00
0.00
CF: Dist Court Other Divorce/Family Law
0
0.00
0.00
0.00
CF: Dist Court Indig Filing Fees
0
0.00
O.DO
0,00
Report Sub Total
I
2.00
0.10
1.90
Total Due For This Period
89
11502.00
292.90
1,219.10
THE STATE OF TEIIAS Before me, the undersigned authority, this day
County of Calhoun County personally appeared Nancy Powkal. Justice of the
Peace, Precinct No 5. Calhoun County, Texas. who
being duly sworn, deposes and says that the above
an foregoing report is true and correct,
Witness my nand thi*C=ty
JAY A.D.
Pea e. P No
. Texa
DONATION OF $8,000 FROM FORMOSA PLASTICS ENVIRONMENTAL ENDOWMENT
FUND FOR THE ADOPT -A -BEACH GRANT PROGRAM:
A Motion was made by Commissioner Finster and seconded by Commissioner Balajka to accept •
the donation of $8,000 from Formosa Plastics Environmental Endowment Fund for the Adopt -A -
Beach Grant Program. Commissioners' Galvan, Balajka, Floyd, Finster and Judge Pfeifer all voted
In favor.
A Motion was made by Commissioner Finster and seconded by Commissioner Balajka to accept
various cash donations to the Calhoun County Museum in the amount of $19.38. Commissioners'
Galvan, Balajka, Floyd, Finster and Judge Pfeifer all voted in favor.
• • •
COMMISSIONERS' COURT BUDGET ADJUSTMENT APPROVAL LIST
!MENDMENT NO; 286
1MENDMENT REASON: LINE REM TRANSFER
GENERAL FU
AME: ELECTIONS
IWNO AWNAME
54020 DUES
64790 POSTAGE
DOWYEIR 4004
IBM
WX NO fAA l um A16Rm
999 NO GRANT $0.00
999 NO GRANT $0.00
REQUESTOR: DORA O. GARCIA
100D
DEPARTMENT
R&W BROOM BROOM
OEOREAAE FWASE OEOAEM$E
$0.00 $0.00 $400.00
$0,00 $400.00 $0.00
IMENDMENT NO: 287
A%NDMENTREASON: LINE ITEMTRANSFER REQUESTOR: MICHAEL J. PFEIFER
:UND NAME: GENERAL FUND WINE 1000
DEPARTMENT NAME: EMERGENCY MANAGEMENT DEPARTMENT NO: 630
LMINO AWNAME
5331D PROGRAMSUPPLIES
53470 RADIO EQUIPMENT SUPPLIES
REVW
WIND MMTNAME ONAEJISE
999 NO GRANT $0.00
999 NO GRANT $0.00
H1N0 NAL
OIOO m
OOEOAEAM9
$400.00
($400.00)
HIND DAL
NEVW SN'OOOHME OWOOUIOE OICA K
$0.00 $400.00 $0.00 ($400.00)
$0.00 $0.00 $400.00 $400.00
I MENDMENT NO; 288
MENDMENT REASON: LINE REM TRANSFER REQUESTOR: ELLEN WENSKE
'UND NAME: GENERAL FUND
HNM NO: 10oD
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imENDMENT NO: 288
AMENDMENT REASON: LINE ITEM TRANSFER REQUESTOR: ELLEN WENSKE
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:UND NAME: GENERAL FUND =me: 1000
DEPARTMENT NAM& ROAD AND BRIDGE -PRECINCT k2 DEPARTMENT NO: 650
— FUND M
REVENUE REM 9(PBINHAIE 90PETFOHUIE NGAM
IM NO AW NAME OM NO GRANT NAME WMEAEE OAR M NpEAgE MMIEAEE O8R=
53510 ROAD 8 BRIDGE SUPPLIES 999 NO GRANT $0.00 $0.00 $0,00 $3,000.00 $3,000.00
53992 SUPPLIES -MISCELLANEOUS 999 NO GRANT $0.00 $0.00 $3.000,00 $0.00 ($3,000.00)
IMENDMENT NO; 289
MENDMENT REASON: TRANSFER TO DEPLETED ACCOUNT REQUESTOR: A. ZAN MATTHIES, JR.
UND NAME: GENERAL FUND RMOK 1000
DEPARTMENT NAME: EXTENSION SERVICE DEPARTMENT NO: 110
ICCTNO AGGFRAW GRANTNO RRANTNAME
60340 AUTO ALLOWANCES -YOUTH CO 999 NO GRANT
66462 TRAVEL•YOUTHCOORDINATOR 999 NO GRANT
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IMENDMENT NO; 290
MENDMENTREASON: LINE ITEMTRANSFER REQUESTOR: ALEX R. HERNANDEZ
UND NAME: GENERAL FUND
ppp a 1000
'edgesday, May.12, 2004 Page 2 of 14
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4MENDMENT NO: 290
4MENDMENT REASON: LINE ITEM TRANSFER
NAME: GENERAL FUND
TMENT NAME: COUNTY COUR,
REQUESTOR: ALEX R. HERNANDEZ
fmNR 1000
RTMENT N0: 410
=OR -n
ACCiAO ACCENAME
64790 POSTAGE
tlUNiKO 6RANTNAME
WmKEm
NOSE
�AsE
EAPHr'Afm
OWE
EApumm
ffWSE
NgIEAEE °
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999 NO GRANT
$0.00
$0.00
$0.00
$180.00
$180.00 n
72350 EQUIPMENT -OFFICE
999 NO GRANT
$0.00
$0.00
$180.00
$0.00
($180.00)
COUNTY COURT -AT -LAW TOTA
$0.00
$0.00
$180.00
SISO.00
$0.00
GENERAL FUND TOTAL
$0.00
$0.00
$180.00
$180.00
$0.00
AMENDMENT NO 290 TOTAL
$000
$0.00
$180.00
$180.00
bi
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KENDMENTNO.- 291
tMENDIVIEN'rREASEM TRANSFER
LINE T
REQUESTOR: ELLEN WENSKE
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'UND NAME: GENERAL FUND
DEPARTMENT NAME: ROAD AND BRIDGE -PRECINCT 92
wNk 1000
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DEPARTMENT NO: 550
ACCENO valKB 6KANTNAME
REIIME BE M#1 WORM EAPE10111A1E
INK MORAL
�
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53210 MACHINERY PARTS/SUPPLIES 999 NO GRANT
NCKEA$E INCBEAEE DE�NEAEE
$0.00 $0.00 $3,000.00 $0.00
urcR ASEI
($3,000.00)
53510 ROAD & BRIDGE SUPPLIES 999 NO GRANT
$0.00 $0,00 $0.00 $3,000.00
$3,000.00
a
1ANE-NDMENT NO: 292
MENDMENT REASON; LINE ITEM TRANSFER
REQUESTOR; ELLEN WENSKE
UND NAME: GENERAL FUND RAIN: loon
Go°'ss `ednesday, May 12, 2a04 W
Page 3 o114
COMMISSIONERS' COURT BUDGET ADJUSTMENT APPROVAL LIST
IMENDMENT NO: 292
%MENDMENT REASON: LINE ITEM TRANSFER REQUESTOR: ELLEN WENSKE
:UND NAME: GENERAL FUND =NO: 1000
DEPARTMENT NAME. ROAD AND BRIDGE -PRECINCT 02 DEPARTMENT NOi 550
RIE BAL
REm REYEINE Boom = vm mtMf INCREASE
ACCTNO ACCiNAAE rmNO MmIANIE INCREASE RECR U RNpI6lSE ORREASE UUMS0
5351D ROAD & BRIDGE SUPPLIES 999 NO GRANT MOD $0.00 $0.00 $400.00 $400.00
63920 MISCELLANEOUS 999 NO GRANT $0.00 $0.00 $400.00 $0.00 ($400.00)
IMENDMENT NO: 293
MENOMENTREASON: LINE ITEM TRANSFER REQUESTOR: ELLEN WENSKE
:UND NAME: GENERAL FUND TTNmN& 1000
DEPARTMENT NAME: ROAD AND BRIDG&PAECINCT #2 DEPARTMENT NO. SSO
Rum REYEIRE 0(PETmIM EXP NKW
le fNO AWTNAME d1ABTNO SWRARE INCREASE DECREASE INCREASE OTIXIM
53510 ROAD & BRIDGE SUPPLIES 999 NO GRANT $0.00 $0.00 $0.00 $300.00
66476 TRAVEL IN COUNTY 999 NO GRANT $0.00 $0.00 $300.00 WOO
IMENDMENT NO: 294
MENDMENT REASON: TREASURER'S RECEIPT NO. 15666 (EMS SUPPLIES PURCHASED BY THIRD PARTY VFO) REQUESTOR: COUNTY AUDITOR
UND NAME: GENERAL FUND
RINONE 1000
FOND BAL
mCR m
BkERF m
$300.00
($300.00)
ednesday, May 12, 2004 Page 4 of 14
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COMMISSIONERS' COURT BUDGET ADJUSTMENT APPROVAL LIST
IMENDMENT NO; 294
MENOMENT REASON: TREASURERS RECEIPT NO. 15666 (EMS SUPPLIES PURCHASED BY THIRD PARTY VFO)
:UND NAME: GENERAL FUND
REQUESTOR: COUNTY AUDITOR
E6cr 0AW NAME MAKIN GMW NAME REVM REVENUE
N16ArASE NESREIIEE
53980 SUPPLIES/OPERATING EXPENSE 999 NO GRANT $0.00 $0.00
4ccr NO ACCT NAME GRANT Ne GRANT NAME
49210 MISCELLANEOUS REVENUE-GEN 999 NO GRANT
RKINk 1000
IT NO: 345
EIIPEIAIIIRE RPEfmIIINtE N$cBSE
NOSE DECREASE mECNF.ASE)
$15.00 $0.00 ($15.00)
NO: 1
RE1fM AEYEINE E1(PEARINiE EI(PBA ilk
IM MSE IrCREASE NI OSE MCRUSE
$15.00 $0.00 $O.DO $0.00
rMtIVDMENT NO: 295
MENDMENT REASON: TREASURERS RECEIPT NO. 15679 (TAC JUDICIAL FUND REIMB. FOR TRAINING) REQUESTOR: COUNTY AUDITOR
NAME:GENERAL
JUDGE
FnN0: 1000
IT NO: 260
RINIDAL
IMSE
mmm
$15.00
N
RUDu
ICCT NO ACCf NAME
9IANf rll Gr1ANi NAAg
REM
NICIO?ASE
RRW
RMSE
EKPFNINM
MUSE
DE&REASE
NNS IE
M f=
66316 TRAINING TRAVEL OUT OF COUN
999 NO GRANT
$0.00
$0.00
$348AD
$0.00
($348.00)
DEPARTMENT NAME. REVENUE
- COUNTY JUDGE TOTA
$0.00
$0.00
$348.00
$0.00
($348 00)
DEPARTMENT NO:
1
W DAL
lecr Ke AM NAME
GRANT NO GRANT NAME
REYEINE
INCREASE
REM
DEMIE
WHOM
NIWSE
0111D W
IrIS1fASE
UNIIFASE
MffjM
49210 MISCELLANEOUS REVENUE-GEN
999 NO GRANT
$348.00
$0.00
$0.00
$0.00
$348.00
REVENUE TOTA
$348.00
$0.00
$0.00
E0.00
$348 00
'ednesday, May f2. 2004
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COMMISSIONERS' COURT BUDGET ADJUSTMENT APPROVAL LIST
REARINWAM fila 004 REAfRA6 TYPE RE um BEN ET YEAR 2004
IMENDMENT NO: 295
IMENDMENT REASON: TREASURER'S RECEIPT NO. 15679 (TAC JUDICIAL FUND REIMB. FOR TRAINING) REQUESTOR: COUNTY AUDITOR
UND NAME: GENERAL FUND nmkk 1000
IMENDMENT NO; 296
"ENOMENT REASON: TREASURERS RECEIPT NO.15610(RESTITUTION FOR SEX OFFENDER AD) REQUESTOR: OOUNTYAUDITOR
:UND NAME: GENERAL FUND NpMW 1Doo
DEPARTMENT NAME: REVENUE DEPARTMEHTNG. i
FUND BAL
MCI NB AM NAME
CHART NB OUT NAME
Rmff
INCREASE
Raw
DECREASE
EXPENmI1BE
INCREASE
um mRm
MCREASE
NCREASE
MB EASD
49020 REBATES -RESTITUTION
999 NO GRANT
$164.00
$0.00
$0.00
$0.00
$164.00
REVENUE TOTA
$154.00
$0.00
$0.00
$0.00
$164.00
DEPARTMENT NAME; SHERIFF
DEPARTMENTNO:
760
FUND Ba
REM
REM
EXPE] IEW
EXPENDM
NUREAlE
ICCTNR ACCrNAME
CRANTTm CBANrNAME
INCREASE
INCREASE
NCRIIASE
DECREASE
mECTIEASD
60920 MISCELLANEOUS
999 NO GRANT
$0.00
$O.OD
$164.00
$0.00
($184.00)
IMENDMENT NO: 297
MENDMENT REASON: TREASURER'S RECEIPT NO, 155M (POSTAGE REIMB, BY HOT CK RESTITUTIION FUND) REQUESTOR: COUNTY AUDITOR
'UND NAME: GENERAL FUND RW NE 100D
DEPARTMENTNAME; DISTRICTATTORNEY DEPARTMENT NO; 510
ICCT NB AM NARE
~� 64790 POSTAGE
RNA RAL
RMREMSE
(KCREASEI
. ($45:00)
Fednesday, May 12, 2004 Page 6 of 14
W" NB GRANT NAME
999 NO GRANT
REM REM Elfflu E EAP9mNRE
INCREASE MMSE INCREASE MCIEASE
$0.00 $0.00 $45.00 $0.00
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I MENDMENT NO; 297
MENOMENT REASON: TREASURER'S RECEIPT NO.15553 (POSTAGE REIMB. BY HOT CK REST17UTIION FUND) REQUESTOR: COUNTY AUDITOR
NAME:GENERALFUND
TMENTNAME: DISTRICT ATTORNEY
ICCT NO AM NANF
RWN& 1000
DEPARTMENT NO: 510
RIND on
OW ENP611M EA'NRAtE BLWIEAW:
- -
DEPARTMENT NAME: REVENUE DEPARTMENT NO: 1 ^-•--
RN BAL
ICC►NO ACCTNAIIE Wm REYftBE El<Pf11�m E1<Pt]E= UMSE
tliAUNO CRANTNAME N86R M OEWIEAEE INWI M DEW SE WREA8D
49210 MISCELLANEOUS REVENUE-GEN 999 NO GRANT $45.00 $0.00 $0.00 $0.00 $45.00
IMENDMENT NO: 298
MENDMENT REASON: UNE ITEM TRANSFER REOUESTOR: KENNETH W. FINSTER
UND NAME: GENERAL FUND
RWR& 1000
DEPARTMENT NAME: ROAD AND BRIDGE -PRECINCT 94
DEPARTMENT NO: S70
Roam
=NO AtCTNAIVg GRANT ND CUR NA E
REVENUE
NN►3EAEE
REYENOE EA'E1811TUIE EAPEIAITUIE
OET USE U(MUEE OE1REAbf
NICK U
53510 ROAD & BRIDGE SUPPLIES 999 NO GRANT
$0.00
$0.00 $0.00 $2,000.00
$2,000.00
53920 MISCELLANEOUS 999 NO GRANT
$0.00
$0.00 $2.000.00 $0.00
($2,000.00)
IMeNDMENT NO; 299
MENOMENTREASON: BUDGET AMENDMENT APPROVED BYNOAA 50104. - REQUESTOR: COUNTYAUDITOR
fednesdag May 12, 2004 Page 7 of 14
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COMMISSIONERS' COURT BUDGET ADJUSTMENT APPROVAL LIST
AMENDMENT NO: 299
AMENDMENT REASON: BVDGET AMENDMENT APPROVED BY NOAA 507104
: CAPITAL PROJECT COASTAL I
NAME: NO DEPARTMENT
AM III ACCTNAME
53333 BROCHURES
53442 PADDLES AND PFDs
72870 TRAILER AND 16 KAYAKS
CRNNO CNANEN"
471 COASTAL MARSH EDUCATIO
471 COASTAL MARSH EDUCATIO
471 COASTAL MARSH EDUCATIO
REQUESTOR: COUNTYAUDITOR
RUN& 6105
DEPARTMENT NO: 999
EUIM DAL
REYEW
REYEIA.E WI]®fM EAPENDIM
DIMUSE
INCREASE
MMSE INCREASE INTI SE
EOECREASD
$0,00
$0.00 $9,234.13 $0.00
($9,234.13)
$0.00
$0.00 $0.00 $1,032.43
$1,032.43
$0.00
$0.00 $0.00 $8,201.70
$8,201.70
IMENDMENT NO: 301
WENDMENT REASON: OVERDRAWN ACCOUNTS REQUESTOR: COUNTYAUDITOR
'UND NAME: JUSTICE COURT TECHNOLOGY FUND
pqONO. 27`19
DEPARTMENT NAME: NO DEPARTMENT
OF PARTMENT NO:
999
FUND
DAL
SCC1N0 ACCENAME
tlUNTNO SRANTNAME
luau
INMM
BRIM
01311 SE
UPfND1M
INWASE
EAPENCEIIAIE
OECRFASE
INCREASE
OAECREASEI
53110 COMPUTER SUPPLIES
999 NO GRANT
$0.00
$0.00
$1,150.00
$0.00
($1,150.00)
_ NO DEPARTMENT TOTA
$0.00
$0.00
$1 150 00
$0.00
($1 150 00)
DEPARTMENT NAME, REVENUE
DEPARTMENT NO:
1 ,
ERPD Du
ICCT NO ACCE NAME
diANTNO ERANENAAOE
REM
INCREASE
REM
DECREASE
ESPEI1aIM
NIMSE
ENPFIW NiE
IEWSE
NN OSE
DOFim$EI
44002 FEES-JUSTfCE OF PEACE PRECI
999 NO GRANT
$801.00
$0.00
$0.00
$0.00
$801.00
44064 FEES -JUSTICE OF PEACE PRECI
999 NO GRANT
$349.00
$0.00
$0.00
$0.00
$349.00
------ Page 8of 14
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COMMISSIONERS' COURT BUDGET ADJUSTMENT APPROVAL LIST
NEARN(CDAIE a/tUTA04 IN'AIMGIyK AEEM BUDMT1fM YOD4
4MENDMENT NO; 302
4MENDMENT REASON: TO PAY BILLS FOR REPAIR OF HURRICANE DAMAGE AT AIRPORT
=UND NAME:
ACCTNO ACCTNAME SI(ANTNO CRANTNAME
60520 BUILDING REPAIRS 999 NO GRANT
91010 TRANSFERS FROM GENERAL FU 999 NO GRANT
REOUESTOR: COUNTYAUDITOR
fnNO: 2610
!PARTMENT NO: 999
REm EHPETQm EMPEIONIIAN:
DECREASE NOSE ff=SE
$0.00 S4,000.D0 $0.00
$0.00 $0.00 $0.00 $4.000.00
NND 09
INpfm
OOfx so
($4,000.00)
$4,000.00
NO DEPARTMENT TOTA
AIRPORTFUND TOTAL
=UND NAME: GENERAL FUND
DEPARTMENT NAME: COMMISSIONERS COURT
$0 00
$0.00
$0.00 $4,000.00 $4 000 00
$0.00 $4,000.00 $4,000.00
fLENa loon
DEPARTMENT NO: 230
$0.00
$0.00
RM DAL
6CCTNN ACCTMME CRINITNo NMI UK
63350 LEGAL SERVICES 999 NO GRANT
REm
IRMSE
$0.00
mYEN1N: EXPEIum
DE�AM SSE
$0.00 $0.00
FNPB®INNM
DECNA$E
$4,D00,00
MCAm
ODESSIEASET
$4,00400
(CCT m ACCT MAME ISM NO CRMNT NAME
98010 TRANSFERS TO AIRPORT FUND 999 NO GRANT
S00
EINNISAE
NEYFAUE BMW LXK MNNIE ElISETIOMMtE DICREASE
NICINN BMW W MCAEASE MICAEASE @ECK=
$0.00 $0.00 $4,000.00 $0.00 ($4,000.00)
IMENDMENT NO; 303
MENDMENT REASON: OVERDRAWN ACCOUNTS REOUESTOR: COUNTY AVDITOR
'UND NAME: CAPITAL PROJECT COASTAL IMPROVEMENTS REK& 5105
Go
2v
'ednesday, May 12, 2004
Page 9 o114
4
COMMISSIONERS' COURT BUDGET ADJUSTMENT APPROVAL LIST
BFARINGUATF 5/IS/20U IEARUGTYPE REGULAR BUDGETYEAR: 2004
IMENDMENT NO; 303
MENOMENT REASON: OVERDRAWN ACCOUNTS REOUESTOR: COUNTYAUDITOR
'UND NAME: CAPITAL PROJECT COASTAL IMPROVEMENTS
RRIDNO: 5105
DEPARTMENT NAME: NO DEPARTMENT
DEPARTMENT NO: 999
MORAL.
CCCT ND ACGT DAME
GRANT NO GRANT NAME
PROM
UCREASE
REVERUE E)(PEL MM EVEMMULE
DECREASE dlCRFASE BE CREASE
INPAfW
Q ECREASEI
62482 ENGINEERING/PERMITS (FEMA)
474 POO KING FISHER BEACH C
$0.00
$0.00 $8,543.00 $0,00
($8,543.00)
71082 CONSTRUCTION MATERIAL & SE
474 POO KING FISHER BEACH C
$0.00
$0.00 $82,413.00 $0.00
($82,413.00)
71142 ELECTRICAL MATERIALS AND SE
474 POC KING FISHER BEACH C
$0.00
$0.00 $0.00 $16,626.00
$16,626:00
DEPARTMENT NAMEt REVENUE
DEPARTMENT NO:
1
...
FIUNDRILL
4CCTNB AECTNAME
611ANTNO GRANTNANE
REHME
INCREASE
BEIRIRE
BECBEASE
EXPBm111RD:
NNW
EXPEimLLI�
OEMSE
INCREASE
uaff SEi
43015 FEMA 1479-DR HURRICANE CLAD
474 POC KING FISHER BEACH C
$74,330.00
$0.00
$0.00
$0.00
$74,330.DD
REVENUE
TOTA
$74 330.00
$0.00
$0.00
$0.00
S74 330.00
'AL PROJECTCOAS7ALIMPROVEMENTS
TOTAL
$74,330.00
$0.00
$90,956.00
$16,826.00
$0.00
'UND NAME: CAPITAL PROJECTMOLD REMEDIATION
Rn& 5210
DEPARTMENT NAME: NO DEPARTMENT
DEPARTMENT NO:
999
RIND UAL
ICCTNS ACCT NAME
MWNO CRARTNAME
REWO
NCREASE
REYEIRE
BECREASE
EAPENDRIRR:
UCREASE
E)0'4RRIULE
OEMM
INCREASE
UECEW
53992 SUPPLIES-NSCELLANEOUS
999 NO GRANT
$0.00
$0.00
$0.00
$37.00
$37.00
63990 MOLD REMEDIATION
999 NO GRANT
$0.00
$0.00
$0.00
$375.00
$375.00
66192 TELEPHONE SERVICES
999 NO GRANT
$0.00
$0.00
$412.00
$0.00
($412.00)
NO DEPARTMENT
TOTA
$0.00
$0.00
$412.00
$412.00
$0.00
CAPITAL PROJECTMOLD REMEDIATION
TOTAL
$0.00
$0.00.
$412.00
$412.00
$0,00
UND NAME: GENERAL FUND
RENR 1000
Cr
'ednesdaY. May 12. 2004
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IEABNnx- 6/C 2ou Nf/f a TYPE: MAR "GET YEAR m4
APPROVAL
LISTLn
N
4MENOMENT NO: 303
4MENDMENT REASON: OVERDRAWN ACCOUNTS
REOUESTOR: COUNTYAUDITOR
FUND NAME: GENERAL FUND
3
DEPARTMENT NAME; COUNTY CLERK
fnN0:
1000
DEPARTMENT NO:
250
FUND BAL
ACCTNB AUTNAW GRANTNO GRANTNAME
51010 OVERTIME
Rtm
AM
REYEIAE ESPoum
RfCREASE ROM
e(pullm
MWAEE
NCREAK
MRDM
999 NO GRANT
$0.00
$0.00 $0.00
$277.00
$277.00
n
51613 OVERTIME BASE PAY 999 NO GRANT
$0.00
$0.00 $151.00
$0.00
($151.00)
F
6
51616 OVERTIME PREMIUM PAY 999 NO GRANT
$0.00
$0.00 $76.00
$0.00
($76.00)
z
DEPARTMENT NAME: COUNTY COURT.AT•LAW COUNTY CLERK TOTA
40.90
$0.00 1227,00
S2T7.00
550.00
O
DEPARTMENT NO:
410
REVENUE
RtYfiNE
TTNB Bu
D
HUM ACCT NAME CRAM NO GRANT NAME
EMPENO m
EXP@MOR
NOREAEE
60050 ADULT ASSIGNEO-ATTORNEYFE 999 NO GRANT
WM
$0.00
SE NOSE
OIXASE
MMSD
63380 LEGAL SERVICES-COURTAPPOI 999 NO GRANT
$0.00 $396.00
$O.OD
($396.00)
$0.00
$0.00 $0.00
$396.00
$396.00
COUNTY COURT -AT -LAW TOTA
NA
DEPARTMENT ME: DISTRICT COURT
$0.00
$0.00 $396.00
$396.00
WOO
Ut
DEPARTMENT NO:
430
ulW
TccrNO ACCT NAME GRANT NO CAW NAME
REVENUE
NOSE
EAPEA�( OW M
FxFMM
NBC USE
60050 ADULT ASSIGNED -ATTORNEY FE 999 NO GRANT
$0.00
OE:R= NSRM
$0.00
DOSE
K�BEA' SE)
P
60053 ADULT ASSIGNED -OTHER LITIGA 999 NO GRANT
32,699.00
$0.00
($2,699.00)
63380 LEGAL SERVICES -COURT APPOI
$D.00
$0.00 $1,811.00
$0.00
($1,1
999 NO GRANT
$0.00
E0.00 $0.00
$4,510.00
$4,510.00)
.00
DEPARTMENT NAME: EMERGENCY MEDICAL SERVlCEB DISTRICT COURT TOTA
$0.00
S0,00 $4 510.00
S4 510A6
$0.00
DEPARTMENT NO:
345
T(Noeu
WHO ACCTNAME CBANTNO MANTUK
REV=
Iffm
REYQflA: UJMM
EAPf1®IW
NCREASE
51610 OVERTIME 999 NO GRANT
$0.00
SSE NOSE
$0.00 $0.00
Omm
$8.200.00
amsc
$8,20D.00
Gri
F
61613 OVERTIME BASE PAY 999 NO GRANT
$0.00
$0.00 $5,500.00
$0.00
($6,500.00)
Wednesday, May 12, 2004
Page 11
of 14
J
COMMISSIONERS' COURT BUDGET ADJUSTMENT APPROVAL LIST
NEABIN®ATE Mon IFANDE TYPE RESEAR MOM Y004
IIIIIIIII
4MEAIDMENT NO: 303
AMENDMENT REASON: OVERDRAWN ACCOUNTS
REQUESTOR: COUNTYAUDITOR
FUND NAME: GENERAL FUND
ANU)N0: 1000
DEPARTMENT NAME: EMERGENCY MEDICAL SERVICES
DEPARTMENT NO: 346
FUND BAT.
ACCTNO ACCTNAAE SRANTNO SRANTNAME
RRENDE
NR$EASE
REYENIE UP@m1M E%PEImW
SSE INCREASE 11OI{EASE
INCREASE
M[Cff EI
518T6 OVERTIME PREMIUM PAY 999 NO GRANT
$0.00
$0.00 $2.750.00 $0.00
($2,750.00)
EMERGENCY MEDICAL SERVICES TOTA
DEPARTMENTNAME. JAIL
$0.00
$0.00 $8250.00 $e 00.00
$50.00
DEPARTMENTNO: ISO
RINBAL
AMR ACCINAAE SRANT NO CRANT NAME
REVUR
muff
BEWMIE EXPEND M FXPFIRM
mECRE'ASE RICK m DEm m
I MERSE
mE)aIEASD
04880 PRISONER LODGING -OUT OF CO 999 NO GRANT
$0.00
$0.00 $0.00 $22.333.00
$22,333.00
64880 PRISONER LODGING -OUT OF CO 999 NO GRANT
$0.00
$0.00 $0.00 $1,970.00
$1,970.00
64910 PRISONER MEDICAL SERVICES 999 NO GRANT
$0.00
$0.00 $22,333.00 $0.D0
($22,333.00)
64910 PRISONER MEDICAL SERVICES 999 NO GRANT
$0.00
$0.00 $1,970.00 $0.00
($1,970.00)
DEPARTMENT NAME: JUVENILE COURT
DEPARTMENT NO:
600
on BAE
LCCT NO ACCi um
63070 JUVENILE ASSIGNED -ATTORNEY
SUANTNO SWIM
REY u
INIMUSE
REom
T>E1SIE1{SE
EAPENmQIAIE
IAIZASE
EIIP@Im low
DECREASE IUETUFASD
999 NO GRANT
$0.00
$0.00
$1,418.00
$0.00 ($1.418.00)
63380 LEGAL SERVICES-COURTAPPOI
999 NO GRANT
$0.00
$0.00
$0.00
$1,418.00 $1,418.00
DEPARTMENT NAME: OTHER FINANCING
JUVENILE COURT TOTA
$0.00
$0.00
$1 418.00
$1 418.00 $0.00
DEPARTMENT NO:
520
RUM
{CCTNO A�?NAME
SRANTNO SRAUTNAAE
REM
IRC
REYFlAIE
�� SE
ENPETA�INIE
� .0
0011ATNTIIIE MiUSE
wjB
DE�A� (O3,000.0
90005 GAINILOSS ON SALE OF ASSETS
999 NO GRANT
30.DEASE
$0.00
$0.00
$0.00
$3,OOD.00 $3,000.00
GJ�
OTHER FINANCING TOTA
$0.00
$0.00
$0.00
$3 000.00 $3 000.00
'ednesday, May 12. 2004
-
Page 12 0114
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N
COMMISSIONERS' COURT BUDSET ADJUSTMENT APPROVAL LIST
NEARINCDATE 5/11/2001 NEAOINO TYPE REOOIAR MMET YEAR: 20U
U,
N
AMENDMENT NO: 303
AMENDMENT REASON: OVERDRAWN ACCOUNTS
m
REQUESTOR: COUNTY AUDITOR
FUND NAME: GENERAL FUND
a
DEPARTMENTNAME: ROAD AND BRIDGE -PRECINCT al
rymNp;
1000
DEPARTMENT NO:
640
RMBAl
ACCTNO MMNINO ANTNANE
SR
REM
OA7IEASE
IBM E)(P9m11UiE
IN ►
A
MACHINERY
53210 MACHINERY PARTS/SUPPLIES 999 NO GRANT
$0.00
OE CN W maEiSfl
$0.00 $38.00
m
$0.00
�ASp
n
53510 ROAD & BRIDGE SUPPLIES 999 NO GRANT
50.00
00)
y
53992 SUPPLIES -MISCELLANEOUS 999 NO GRANT
$0.00 $0.00
E24,305,00
$24.305.305.00
65476 REPAIRS -RODEO ARENA 999 NO GRANT
$0.00
$0.00 $708.00
$0.00
($708.00)
z
66476 TRAVEL IN COUNTY 999 NO GRANT
$0.00
$0.00 $455.00
$0.00
($456.00)
p
73400 MACHINERY AND EQUIPMENT 999 NO GRANT
$0.00
$0.00 $60.00
$0.00
($60.00)
$0.00
$0.00 $26,044.00
$0.00 ($26,044,00)
ROAD AND BRIDGE -PRECINCT #1 TOTA
DEPARTMENT NAME: ROAD AND BRIOGE•pRECINCT #3
$0.00
E0.00 E27 305.00
E24 305.00
$3 000.00
0
0
_
DEPARTMENT NO:
560
�
AaINO ACC1NAll0 BIANINO SRANTNAME
5170D MEAL ALLOWANCE
REYEIAE
INCREASE
AMR EIIPEIOEIW
DECREASE UCREASE
EAPEN0INAIE
DECREASE
INCREASE
MUMM
}�
999 NO GRANT
53510 ROAD & BRIDGE SUPPLIES
$0.00
$0.00 $25.00
$0.00
($.00)
G�
999 NO GRANT
64640 PERMITS
$0.00
$0.00 $0.00
$50.00
$5050,00
m
999 NO GRANT
$0.00
$0.00 $25.00
$0.00
($25.00)
p
'=vl :meni NAME: SHERIFF
- - -
.�•��
svu.vv
aau.uu
30.00
-
DEPARTMENT NO:
760
NOUL
ACCICREASE
AMUK NAAE
516to OVERTIME
M W NO CRANT NAME
NE ou
MUSE
BMW
DECREASE
EXPEIONIUE
INCREASE
EfI4IB w
DEWSE
IN
00ECIffM
999 NO GRANT
$0.00
$0,00
$0.00
$1,198.00
$1,198.00
51613 OVERTIME BASE PAY
999 NO GRANT
$0.00
$0.00
$139.00
$0.00
($139.00)
51616 OVERTIME PREMIUM PAY
999 NO GRANT
$0.00
$0.00
E70.00
$0.00
($70.00)
51620 ADDITIONAL PAY -REGULAR RAT
999 NO GRANT
$0.00
$0.00
$989.00
$D.00
($989.00)
khesday, May 12, 2004
-
Page 13 of 14 W
COMMISSIONERS' COURT BUDGET ADJUSTMENT APPROVAL LIST
4MENDMENT NO: 303
4MENDMENTREASON: OVERDRAWN ACCOUNTS
REQUESTOR: COUNTYAUDITOR
=UND NAME; GENERAL FUND FmKk t000
DEPARTMENT NAMEI SHERIFF DEPARTMENT NO, 760
Win A66 mm
'rand Tolal
RN BAL
PIVEM RFMN FYOFIM11F FVPFIE MI: rmanx
CrD
lednesday, May 12, 2DD4 Page 14 of 14
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Claims totaling 907,921.46 were presented by the County Treasurer and after reading and
verifying same; a Motion was made by Commissioner Finster and seconded by Commissioner
Galvan that said claims be approved for payment. Commissioners' Galvan, Balajka, Floyd, Finster
and Judge Pfeifer all voted in favor.
GENERAL DISCUSSION:
Commissioner Finster brought to the Courts attention that the plats being approved in Port
O'Connor have a statement from the Board of Directors of the MUD District stating that they
approve the plat being consistent with the requirements, rules and regulations and it doesn't say
they will provide water and sewer to the subdivisions. Commissioner Finster is concerned with
this and feels this issue needs to be discussed in the near future.
Commissioner Floyd gave a little history behind the Courthouse Renovations and then introduced
Mark Crippen and Jamie Knight. Mark Crippen is with Spaw Maxwell Company and Jamie Knight
is with Bailey Architects they each gave a presentation on restitution and remodeling of the
Courthouse.
Commissioner Floyd feels like we should go with the Restitution and Remodeling of the
Courthouse and Judge Pfeifer also feels like if we do not move forward now, we will not have
another chance at this opportunity. A Motion was made by Commissioner Floyd and seconded by
Commissioner Balajka to move forward with the Restitution and Remodeling Option on the
Courthouse. Commissioners' Galvan, Balajka, Floyd, Finster and Judge Pfeifer all voted in favor.
HEAR REPORT FROM FIRST SOUTHWEST COMPANY ON OPTIONS FOR FINANCING
COURTHOUSE RENOVATIONS:
Joe Morrow with First Southwest Company presented the Court with a report on options for
financing of Courthouse Renovations. A Motion was made by Commissioner Floyd and seconded
by Commissioner Galvan to ask McCall, Parkhurst, & Horton, LLP to prepare an Order Authorizing
Publication of Notice of Intent to Issue Certificates of Obligation for the regular scheduled
Commissioners' Court Meeting on May 27, 2004. Commissioners' Galvan, Balajka, Floyd, Finster
and Judge Pfeifer all voted in favor.
See Attached Report
688
AUTHORIZE JUDGE PFEIFER TO SIGN CHANGE ORDERS FOR RECONSTRUCTION OF
PIER AT BAYFRONT PARK AT PORT O'CONNOR, TEXAS FOR CALHOUN COUNTY
PRECINCT #4:
A Motion was made by Commissioner Finster and seconded by Commissioner Galvan to approve
and authorize Judge Pfeifer to sign a change order for reconstruction of the Pier at Bayfront Park
at Port O'Connor, Texas for Calhoun County Precinct #4. Commissioners' Galvan, Balajka, Floyd,
Finster and Judge Pfeifer all voted in favor.
CHANGE ORDER •
No. 1
RECONSTRUCTION OF PIER AT BAYFRONT PARK
PROJECT PORT O'CONNOR, TEXAS FOR CALHOUN COUNTY PRECINCT NO. 4
......................................................................................................................................
DATE OF ISSUANCE 05/10/04
OWNER COUNTY OF CALHOUN
....................................................................
OW\ER's Contract No.
EFFECTIVE DATE 05/10/04
CONTRACTOR CARY CONSTRUCTION ENGINEER G & W ENGINEERS, INC.
...................... ................................................. I... ...........................................................................................
PROJECT - 9045 010
You are directed to make the following changes in the Contract Documents.
Description: 1. Install 2 x 4 Toe Board around entire timber portion of pier and walkway.
2. Extend Concrete Curb for full length of concrete portion of ramp.
Reason for Change Order: Required by Texas Department of Licensing and Regulation.
Attachments: (List documents supporting change) Letter from Contractor dated 05/05/04
CHANGE IN CONTRACT PRICE:
CHANGE IN CONTRACT TIMES:
Original Contract Price
Original Contract Times
S 147,313.00
Substantial Completion:
Ready for final payment: N/A
n o.
Net changes from previous Change Orders No. to No.
Net change from previous Change Orders No— to No_
s _Q_
0
nan
Contract Price prior to this Change Order
Contract Times prior to this Change Order
Substantial Completion
$� 147 313.00
Ready for final payment: June 20 2004
Net Increase (decrease) of this Change Order
Net Increase *crease) of this Change Order
S 3,040.00
2
d.y
Contract Price with all approved Change Orders
Contract Times with all approved Change Orders
Substantial Completion-
s 150,353.00
Ready for final payment: June 22 2004
RECO 11 :ND APPROVED EPT
�D: ACC
By. BvrFi446r's=(n o- si, w By, .,o, crAs�.. ,.,
G & W Engineers, Inc. County of Calhou Cary ConstrucBeii
David NI. Gann, P.E Michael J. Pfeifer Tony Holladay
Project Engineer County Judge Operations Manager
Date: S ° �O `I Date: I tJ.- H Date: .j ��
oe
689
r
fury Holladay
P.() 14w 554
Pohl ComfhN 1'um 7797a
t361) 997.582.1 naim
(361)987.5863 F=
Cary ConstruchOn
May 5, 2004
G & W Engineers
205 W. Live Oak Street
Puri 1.avara, Texas 77979
Ahentiun: Mr. David Cann
Dear Mr. Gunn:
As per your reyuesl, please accept the loilowing as our price to install 2 X 4 lumber along
the perimeter of the fort O'Connor Pier. I have also listed a price for installing a
concrete 2" X 6" curb on the A.D.A. approach ramp.
You have also added a'/4" spacing on the main deck boards. I have checked with Cary
on our original bid and he informs tnc that it 1" gap was planned for the main deck.
hoanis. 1 assume this would mean more boards will be nucded.
Change Order #1
Item No. I
110 2' X 4' X 16' #1 SYP @ 9.00/ca.
Labor to cut to size: & install
Item No. 1 Total
item No. 2
2" X 6" Concrete Curb
Total for Change Order #I
This will add 2 working days to the contract,
Thank you,
o dd, ..
Court was adjourned at 3:00 p.m.
990.00
1,250.00
5 2.240.00
800,UU
3,040.00
699