2012-09-27
Regular September Term
Held September 27, 2012
COUNTY OF CALHOUN
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THE STATE OF TEXAS
BE IT REMEMBERED, that on this 27th day of September, A.D., 2012 there was begun and holden in the
Commissioners' Courtroom in the County 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
Roger C. Galvan
Vern Lyssy
Neil Fritsch
County Judge
Commissioner, Precinct #1
Commissioner, Precinct #2
Commissioner, Precinct #3
Thereupon the following proceedings were had:
Commissioner Galvan gave the Invocation and Commissioner Lyssy led the Pledge to the US Flag and
Commissioner Fritsch led the Piedge to the Texas Flag.
Judge Pfiefer:
Welcomed students from Our Lady of Guadalupe Catholic Church School visiting Commissioners Court.
Susan Riley
From:
Sent:
To:
Subject:
Julie Sullivan [JulieS@county.org]
Thursday, August 09,2012 12:36 PM
'susan. riley@calhouncotx.org'
Sept 27 commissions court - Employer Rewards review I Calhoun County
Hi Susan-
I'm excited for the opportunity to give a shout out to Calhoun Countyl You've done a great job with the wellness program.
E.t.9a go. Can you provide the address where I should be at 10am?
Thanks so much and iooking forward to seeing you.
,Iulie Sullivan, CEBS
Wellness Supervisor, Risk Management Services
Texas Association of Counties
1210 San Antonio, Austin TX 78701
(512) 615-8943 (phone)
(512) 481-8481 (fax)
http://www.facebook.comlT ACHealthvCountv
www.county.orq
..
.
"Together. Better. Stronger."
The information contained in this communication is confidential, private, proprietary, or otherwise privileged and is
intended only for the use of the addressee. Unauthorized use, disciosure, distribution or copying is strictiy prohibited and
may be unlawful. If you have received this communication in error, please notify the sender immediately at 512.615.8943
or 1-800-456-5974.
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HEAR FROM TEXAS ASSOCIATION OF COUNTIES REGARDING EMPLOYER REWARDS FOR COUNTY
PARTICIPATION IN SONIC BOOM PILOT PROGRAM AND HEALTH RISK ASSESSMENTS:
Jennifer Rehme with TAC as an Employees Benefit Consultant for the Health and Employees Benefit Pool:
Here today to present the Employer Rewards Application to Calhoun County. Calhoun County was number 1
across the State of Texas Wants to recognized the Wellness Committee for their successful recruitment efforts
which made it the reward possible. Would like to recognize the Wellness Committee and Susan Riley and Judge
Pfiefer as Wellness Sponsors.
Sixty (60) employees completed the Health Risk Assessment and ninety-one (91) employees compieted the
Sonic Boom Eight-Week Challenge which made Calhoun County eligible to receive $3,775 in Employer Rewards.
Last year the county earned $3,175 in Employer Rewards.
Susan Riley:
Asked the Committee Members to stand and be recognized.
Susan Riley
From:
Sent:
To:
Cc:
Subject:
Pam Villafuerte [pvillafuerte@mmcportlavaca.comj
Tuesday, September 18, 2012 3:53 PM
susan. riley@calhouncotx.org
jangiin@mmcportlavaca.com; Iharvey@mmcportlavaca.com
Commissioner's Court Agenda Item; 27 September 2012 Meeting
Importance:
High
Hello Susan,
Would you please include the following to the Commissioner's Court Agenda for the September 27'h meeting date:
. MMC's proposed Waiver 1115 Plan.
Please let me know the latest you need copy for your packet.
Thank you.
Pam Viffa/lwde
Administrative Assistant
Memorial Medical Center
815 N Virginia Street
Pod Lavaca, TX 77979
361.552.0222
361.552.0220 Fax
rr:dJJiJJ!!t!:t,@mm~12.mjJ1!Y1jgJL~Qln
1
MEMORIAL MEDICAL CENTER'S PROPOSED WAIVER 1115 PLAN:
Jason Anglin:
Under Waiver 1115 Plan, Memorial Medical Center is allocated $2,971,000 in district funds over the next four
years. In order to receive those funds MMC will have to do an Intergovernmentai transfer of $1,250,000, which
will allow them to net $1,726,000 over the next four years.
At this time the written plan has not been completed. Some of the deadlines has been pushed back.
The target areas for the hospital side of the plan:
1. Access to Care: (primary goal to tap into those district funds to bring in more physicians)
Clinic
Recruitment of primary care
. Recruitment of specialty care
2. Behavioral Health Project: (outpatient geriatric program targeting Medicare-age population)
3. Quality Reporting: (as required to do)
The county would ability to tap into district funds ($507,000) which will would require Intergovernmental
transfer of $213,000 which would net $294,000.
The EMS substation would fit in the Plan and they are working with Henry Barber on submitting that on the
Plan.
Laurie Harvey:
The initial deadline was September 28, 2012. As of this morning CMS still had not approved the guidelines on
what to submit. Confirmed projects will be submitted on October 5, 2012.
A Motion to approve Memorial Medical Center's proposed Waiver 1115 Plan was made by Commissioner Fritsch
and seconded by Commissioner Galvan.
Commissioners Galvan, Lyssy, Fritsch and Judge Pfeifer all voted in favor.
Sep,21, 2012 7:59AM
No, 0944 p, 1
ROGER C. GALVAN
Calhoun County Commissioner Precinct #1
211 S. Ann
Port Lavaca, TX 77979
(361) 552.9242
Fal( (361) 553-8734
Pager (361) 579"7915
Mobile (361) 935.3552
September 21, 2012
To: l'Ionorable county Judge Michael Pfeifer
From: Commissioner Roger C. Galvan
Re: Agenda Item
Please place the following line item on the Commissioner's Court Agenda scheduled
for Thursday, September 27, 2012
Public hearing regarding vacating the plat of Block 2, Lots 1-8, 11-13 and a portion of Lots
9 and 10, Mallory's Second Addition to Magnolia Beach as recorded In Volume Z, Page 351, Plat Records
of Calhoun County, Texas.
cc: Vern Lyssy - Pc! 2
Nell Fritsch- Pet 3
Kenneth W, Finster - Pct 4
~StJtl,MDnunlftll
1,.J1.".,a,"-""
PUBLIC HEARING REGARDING VACATING THE PLAT OF BLOCK 2, LOTS 1-8, 11-13 AND A PORTION
OF LOTS 9 &. 10, MALLORY'S SECOND ADDITION TO MAGNOLIA BEACH AS RECORDED IN VOLUME
Z, PAGE 351, PLAT RECORDS OF CALHOUN COUNTY, TEXAS:
The Public Hearing began at 10: 11 A.M.
Anne Marie Odefey:
The first plat shows the originally platted area with Lots 1-5 across the top, Lots 6-9 down and Lots 10-13 up.
The second plat shows a consolidation of all the lots into Lots 1 & 2 of the same block. There are a couple of
mistakes on the second plat that will get corrected before filing with the Court.
. It will not be called Lemke Subdivision as it is just to be a replat of that area.
. The Chief Appraiser, Calhoun County Appraisal District: Change from Philiip Gonzales to Jerry Duam
Mr. Lemke owns all of the property to be replatted. He is asking that the 13 lots that he owns be replatted into
two large lots. He owns a home on Lots 10, 11, 12 and 13 which would become the repiatted Lot 1 and he
would like to sell the replatted Lot 2. None of the alleyways are built and are raw land.
Commissioner Lyssy:
Will the new plat square up the lots with the road?
Commissioner Galvan:
Originally the roads had to be redone and had to go through the property. The original plat does not show the
changes to the road. The new plat will clean up the road changes.
The Public Hearing ended at 10:14 A.M.
Sep.21. 2012 7:59AM
No. 0944 p, 4
Chacha BenavIdes
From:
Sent:
To:
Subject:
Attachments:
Anne Marie Odefey (amo@portlavacalaw.ccm]
Thursday, September 20.20124:37 PM
chacha1@cableone.net
f'W: l.emke replat
1210170_plal.pdf: Pellllon and Ilr to wave.pdf
Sorry I wrote it down wrong!
Anne Marle
From the Desk of Anna Marie OdehlY
amo@oortlavacalaw.com
NOT INn:NDED AS A SUBSTITUTE FOR A WRlTtNG~ NolWllhstandlng the Uniform Elllctrcnf<: TranS3GtlonsAtt or the: ;applicablllty of any other law (If similar subsUII\ce
3ntf effect, absent an expreS5st~temel1t to th~ contrary hereinabove, thIs ~"mall meM3ge, itf> t;Qfltents, and '111\1 attachments hereto are nat Intended to represeJ1' an
offer' Or' acceptance to enter into a (OflUact and are not olhel'Wisa Intended to bind the sender, Roberts) Robens, Odefev & Witte, LlP any of Its clients, or any other
pel'son or entity.
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From: Anne Marie Odefey
Sent: Thursday, September 20, 2012 4:43 PM
To: 'chacha_1@cableone.net'
SUbject: FW: Lemke replat
Chacha,
I believe the agenda ltelns would be:
I. Public hearing regardhig vacating the plat of Block 2, Lots 1-8, 11-13 and a portion ofLots 9 and 10,
Mallory's Second Addition to Magnolia Beach as recorded in Volume Z, Page 351, Plat Records of Calhoun
County, Texas.
2. Consider and take any action to vacate the plat of Block 2, Lots 1-8, 11-13 and a portion of Lots 9 alid 10,
Mallory's Second Addition to Magnolia Beach as recorded in Volume Z. Page 351, Pial Records of Calhoun
County, Texas.
3. Consider and lake any action to approve plat of Block 2, Lots land 2, Mallory's Second Addition to
Magnolia Beach as recorded in Volume Z, Page 351, Plat Records of Calhoun County, Texas,
The plat and petition are attached, They were p\lbllshed in the Port Lavaca Wave at least 30 days before the
public hearing date. Since MI'. Lemke owns all of the property to be replatted. I don't think there are any issues
of controversy. Be lsjust taking the 13 lots he owns and is replatting them to 2 large lots. My email to Rogel' is
shown below.
Thank yo\\ very much for your helpl
Anne Marie
From the Desk of Anna Marie Ode fey
amo@portlavacalaw.com
NOT INTE/WED AS A SUBSTITUTE FOil A WRITING: Norwithstandlng lhe Uniform EI.d'onl<Tronsacllons Act or the applicability of anv other law of ,Imllar .ubst.nce
and effel;t, absent an express st~tement to the contraryherein"bave, lhis Q-Mall message! its contents, and allY auachmellts heretQ life not intendtld to represerat olin
offer or acceptance tQ enter Inlo. a tonltact and "re not otherwise Inlended tQ bind the :!iende:r, Roberts, koberts, Odetev & Witte, UP any of Its dleJul), Of anvothet
person or eraUlv.
1
Sep,21. 2012 7:59AM
No, 0944 p, 5
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F'rom: Anne Marie odefey
Sent: Tuasday, August 28, 2012 9:44 AM
To: Roger Galvan (fQger.oalvan(Qlcalhouncotx.oro)
Subject: Lemke replat
Roger,
This is the gentleman who owns property In bayside beach that he owns all 12 lots in a block and wants
to replat just his block into two lots. We had talked about road closure, but that didn't end up being
what he needed. With the replat, it takes care of everything. What we would propose to do is abandon
the lots on the block in the original plat and come right behind at the same meeting and replat the 12
lots into two lots. The map is attached, You can see in faint lines the old lots and in bold lines the
proposed new two lots. If you would like, I could come over to your office to discuss further. I
believe Chris Wall talked to you about doing it this way several months ago. We would propose to do
this on September 2711'.
Thanks,
Anne Marie
Anne Marie Odefey
Roberts, Roberts, Odefey & Witte. LLP
Attorneys at Law
2206 N. Hwy 35/ P.O. Box 9
Port Lavaca, Texas 77979
phone: 361.552.2971 fax: 361.552.5368
email: amo(@.portlavacalaw.com
website; www.portlavacalaw.com
ROllllRiS, ROllERTS, ODEFEY & WITTE, LLP ._ CONFIDENT! "UTY NOTICE: This elecllonie messagc i> Inlended 10 be viewed only by thelndivld.et /)I
ooUIY \1) whOrtl iL (s addressed. n may contl'lh, h,fomlation that is privileged, conndenllal and exempl from disc)ngt1te under applicable law. Any diSStlmh,ation,
distribution or c:opyingofthis COnlMtlnlcalion Is 81riQUyprtJhibited without our priorpenni5$I()n.lflhe ltll1der ortbis message is Dol ,hQ Intflnded recipient, or the
employee or agent n;~pol\sible for delivering tho nt~$age to llle intended rc:eiplcnl. (lr If}'(lu have reooived this oomml1nlcatlofl in error. please noUfy us immcdialc:ly by
relUm c...aU""d deMo the origln.1 me"n~. "nd anl' copIes of it fro.. )'011' eompnler system. NOt lNTllNOEO AS A SUBSTITUTE FOR A WRITINO:
Nolwlthshmdlng the Ulllfonn EltQtronio: Transactions Act or Ihe npplic&bllllY or any olher law of simitar S\lb!itW\ce end effecl, absent an C"pK~ $taleMentlo tile
C;::l)nl(tuy hereinabovo, this e-moil nleSSl1ge, Us contents, fUld IlilY aUl1chments hereto aro nttt inlCQdtd to represent An offer or accepttlltCO to enler into 1l cOnlrocL and arc
not otherwise intended to bhtd the sender) Robcns, Rober1s, Odefey & WiU~. LLP MY af its clienl&, or any olher pcrsoll or entity.
2
lOTS NO. ONE (II. TWO (21, THREE en, FOUR t4J, FIVE (51, SIX {51, SEVEN m, EIGHT .(81,
NINE (91, TEN (lOI, ELEVEN (Ill, TWELVE 1121 AND THIRTEEN (131. IN BLOCK NO, TWO 121,
OF MALLORY'S SECOND ADDITION TO MAGNOLIA BEACH, IN CALHOUN COUNTY. TEXAS ACCORDING TO
THE PLAT OF SAID ADDITION OF RECORD IN VOLUME Z, PAGE 351. PLAT RECORDS OF CALHOUN
COUNTY, TEXAS.
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III i OCEAN DRIVE
THE UNDERSIGNED HEREBY CERTIFIES.
THAT THIS SURVEY WAS MADE ON THE GROUND ON 08/2612011. TI;lAT THE ONLY
IIJPROVEMEHTS ON THE GROUND ARE AS SHOWN, THAT THERE ARE HO VISIBLE
ENCROACHMENTS, OVERLAPS, PROTRUSIONS, CONFLICTS OR VISIBLE EASEMENTS
EXCEPT AS SHOWN,
ACCORDING TO THE FLOOD INSURANCE RATE MAP {FIRM} FOR CALHOUN COUNTY. TEXAS,
COlIMUNITY PANEL NUMBER 460091 0152 C, MAP REVISED JANUARY 3, .1985 T . IJBJECT
PROPERTY IS lOCATED IN ZONE VI8 (EL 141 WHICH IN THIS CASE ]S t[1;l'i00It
HAZARD AREA. '".:...?'&t~
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BENNIE L. GALVAN < '.:;'0,.,. -o"t...!<,
REGISTERED PROFESSIONAL LAND SURVEYOR ~~D"'~!!~~;~~
TEXAS No, 5229 OH. II ~':'..P
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LAND TITLE SURVEY
ADDRESSI II] I OCEAN DRIVE
LEGEND
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Sep,21. 2012 7:59AM
No, 0944 p, 2
ROGER C. GALVAN
211 S. Ann
Port Lavaoa. TX 77979
(361) 552-9242
Fax (361) 553-8734
Pager (361) 579-7915
Mobile (361) 935-3552
september 21, 2012
To: Honorab,le County Judge Michael Pfeifer
from: Commissioner Roger C. Galvan
Re: Agenda Item
Please place the following line Item on the CommissIoner's Court Agenda scheduled
for Thursday, september 27, 2012
Consider and take necessary action to vacate the plat of Block 2, lots 1-8i 11-13 and a portion of
lots 9 and 10, Mallory's Second Addition to Magnolia Beach as recorded In Volume Z. Page 3S1. plat
Records of Calhoun County, Texas,
Vern Lyssy - Pet 2
Nell Frltsch- Pet 3
Kenneth W. Finster - pct 4
lA Sarl' MonlDNnt
rnJl"".,~ ,....
REQUEST TO VACATE THE PLAT OF BLOCK 2, LOTS 1-8, 11-13 AND A PORTION OF LOTS 9 &. 10,
MALLORY'S SECOND ADDITION TO MAGNOLIA BEACH AS RECORDED IN VOLUME Z, PAGE 351,
PLAT RECORDS OF CALHOUN COUNTY, TEXAS:
Anne Marie Odefey:
Requesting to abandon the current plat as proposed in the Public Hearing.
A Motion to vacate the plat of Block 2, Lots 1-8, 11-13 and a portion of Lots 9 and 10, Mallory's Second Addition
to Magnolia Beach was made by Commissioner Lyssy and seconded by Commissioner Fritsch,
Discussion:
Commissioner Galvan:
The 10' alleyway was condemned when the roadwork was being done and is not in use at this time.
Commissioners Galvan, Lyssy, Fritsch and Judge Pfeifer all voted in favor.
LOTS NO. ONE Ul, TWO 12l, THREE (31, FOUR 141, FIVE 151, SIX 161, SEVEN (7), EIGHT .(81.
NINE {9l, TEN (101, ELEVEN {lll, TWELVE (12) AND THIRTEEN 031, IN BLOCK NO. HID (21.
OF MALLORY'S SECOND ADDITION TO MAGNOLIA BEACH, IN CALHOUN COUNTY, TEXAS ACCORDING TO
~~5N~~~\~kA~~lD ADDITION OF RECORD IN VOLUME Z, PAGE 351, PLAT RECORDS OF CALHOUN
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I I I I OCEAN DRIVE
LEGEND
THE UNDERSIGNED HEREBY CERTlFIES,
THATTHISSURVEYWASIAADEONTHEGROUNDON~TI}ATTHEONLY
IMPROVEMENTS ON THE GROUND ARE AS SHOWN, THAT THERE ARE NO VISIBLE
ENCROACHMENTS, OVERLAPS, PROTRUSIONS, CONFLICTS OR VISIBLE EASEMENTS
EXCEPT AS SHOWN.
ACCORDING TO THE FLOOD INSURANCE RATE MAP (FIRMl FOR CALHOUN COUNTY, TEXAS,
COMMUNITY PANEL NUMBER 480097 0152 C, MAP REVISED JANUARY 3, 1985, TH~.sCJBJECT
PROPERTY IS LOCATED IN ZONE VIB IEL 141 WHICH IN THIS CASE IS A ~E!1"Ar:/..:"l;:r:tcmD
HAZARD AREA. ~~~,*,9.f...?~t~
~ ~ ,~~~~~~P;~r.r4}\J'&
/ 1& "a~"NiE"':~'iiiiL;;AN"~
SIGNED ~4 ;~ / -";'::~""52'2~'''':fJ'j'',-{h
BENNIE L. GALVAN < '..;;'0,10 ~\~o,?:(l1
REGISTERED PROFESSIONAL LAND SURVEYOR .y1rD,..!j"~?~::!:::,':{ ,., '_.
TEXAS No. 5229 01.'.11 ~,~~ () .-
I) IrCl ~ .t~fRrnS t~~[ p LAND TITLE SURVEY
f"JH . FOUNE> 5/6 WCHDlAMETER
IRO~ ROE>
_ SET 5/6 I~CH E>IAIJETER
IRONRODWJTHYELLOiV
PLASTlCCAI'STAl.!PED
.CIVlLCORp.
_SET'PK'11A1Llt-lASPHALT
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'PIV
NOTE'
THEREFEREHCED IS SUBJECT TO'
!. RECOMTHLESEARCIlPl'.RFORUErlANDPROVlDtD
BY BEDGOOD ABSTRACT ~ TITLE CO"
GFNO,310BllDATEDJUNEI4,IS9S1.
SCALE IN FEET
I"M "'-io~.-~r'---'-~-'-'_._--"--,,,o 6'0'"''''''
M~~-L",~,,,_-.-I
90
DRAWN BY: JBO
DATE: 08/31/1f
SCALEI ,. " 30'
SHEET 1 OF f
JOB NO,' 1 f 10298
1501 E. l.lOCKlllGBIRO,SUlTE406,VICTORIA,lElUlS71904
TEL' U611510-1500 FA~' lJ611510-1501
ADDRESSI IIII OCEAN DRIVE.
FLD, 8K, NO,: NA
Sep,2{ 2012 7:59AM
No, 0944 p, 3
ROGER C. GALVAN
211 S. Ann
Port Lavaca, TX 77979
(361) 552-9242
Fax (361) 553.8734
Pager (361) 579-7915
Mobile (361) 935-3552
September 21, 2012
To: Honorable county Judge Michael Pfeifer
From: Commissioner Roger C. Galvan
Re; Agenda Item
Please place the following line Item on the Commissioner's Court Agenda scheduled
for Thursday, September 27, 2012
Consider and take necessary action to approve plat of Block 2,lots 1 and 2, Mallory's Second
Addition to Magnolia Beach as recorded In Volume Z, Page 351, plat Records of Calhoun County, Texas,
Vern Lyssy - ect 2
Neil Fritsch- pct 3
Kenneth W. Flnster- Pct4
La SGJ/, )(onUIMfff
In.ll...",n..u
PLAT OF BLOCK 2, LOTS 1 AND 2, MALLORY'S SECOND ADDITION TO MAGNOLIA BEACH AS
RECORDED IN VOLUME Z, PAGE 351, PLAT RECORDS OF CALHOUN COUNTY, TEXAS:
Anne Marie Odefey:
The copy of the plat presented today will need to have the corrections to the subdivision name and the Chief
Appraiser's name made before the final plat is filed for record,
A Motion to approve the plat of Block 2, Lots 1 and 2, Mallory's Second Addition to Magnolia Beach once the
corrections to the plat have been made was made by Commissioner Galvan and seconded by Commissioner
Fritsch,
Commissioners Galvan, Lyssy, Fritsch and Judge Pfeifer all voted in favor.
Sep,21, 2012 7:59AM
No, 0944 p, 7
DAVID RODBR'rS
WA'NDAROBERTS'
AN~E MAIIIB ODEPBY
SANDRA W11"l1l
ROBERTS, ROB,BRTS. ODEFEY & WITTE, u:.:r
A'r'l'OlINl!YS AT J-AW
:t206 HlOHWAY,)$ NOl\"l"H
FOSJ' OPF'lCM BOX 9
paR'): LAVAGA, T6XAS 77979
TS~' J6l.SlU971
MX, J61,m,lJ68
CAIUY W. WALL
August 21,2012
Port LElvaca Wave
107 E. Austin Street
POlt Lavaca, Texas 77979
Re: Petition to Vacate
Gentlemen:
Enclosed is a Petition to Vaoate, whioh I would appreoiate your publishing one
time In the Lflgal Notice section, Once you have published the same, I would further
appreciate YOul' forwarding the Publisher's Affidavit to me, together with your statement.
Thllnk you for your asslslllnce.
Yours truly,
,ROBERTS, ODEFBY & WrITE. LLP
,"
"
AMOftk
Enclosure:
co:
Mr. Ken Lemke (VvY'"".:e, )
Sep,21, 2012 7:59AM
No, 0944 p, 6
PETlTIONTO VACATE LOTS 1-8, ll-BAND A PORTION OF 9 AND 10.
BLOCK 2, MALLORY'S SECOND ADDITION TO MAGNOLIA BEACH
STATE OF TEXAS 9
9
COUNTY OF CALHOUN 9
KNOW ALL MEN BY TIIESE PRESENTS:
That the undetslgned, belog the attomey fol' the ownel' of the properl)' described liS
Lots 1,2,3,4,5,6,7, 8, 11, 12, 13 and a portion of Lots 9 and 10, Block 2, Mallory's
Second Addition to Magnolia Beach as recorded in Volume Z, Page 351, Plat Records of
Calhoun County, Texas, do hereby petition the Calhoun County Commissioners CO\lrt to
Vacate said Lots 1,2,3,4,5,6,7,8,11,12,13 and a POttiOR of Lots 9 and 10, Block 21n
accordance with Section 206 and 201 of the Subdivision Regulations and Property
Development adopted by the Calhoun County Commissioners Court on December 13.
Z007, flS amended.
The property is proposed to be replatted in accordance with a plat submitted to the
Calhoun County Commissioners Court.
The petition will be considered by the Calh n County Commissioners Court on
Septembel' 27, 2012 at 10:00 a,Jn,
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ROGER C. GALVAN
No, 0942 p, 1/3
Calhoun County Commissioner Precinct #1
"i!"{~'
f!!~~~
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211 S. Ann
Port Lavaca, TX 71979
(361) 552-9242
September 21, 2012
To: Honorable County Judge Michael Pfeifer
From: Commissioner I\oger C. Galvan
Re: Agenda Item
please place the following line Item on the Commissioner's Court Agenda scheduled
for Thursday. september 27.2012
Discuss and take necessary aetion to accept the Oow Community Grant on
behalf of Magnolia Beach Volunteer Department of Calhoun county; In the
amount of $9,232.91.
'.
Vern Lyssy -,pet 2
Neil Frltsch- pct :I
Kenneth W. Flnster- Pct 4
'.
~ stlr/, Monumlnl
lrtJ!{tuI(I/a, r~XdI
Fax (361) 553-8734
Pager (361) 579-7915
Mobile (361) 935-3552
DOW COMMUNITY GRANT ON BEHALF OF MAGNOLIA BEACH FIRE DEPARTMENT OF CALHOUN
COUNTY IN THE AMOUNT OF $9,232.91:
Item # 1:
Upgrade & enhance the Marine Rescue Boat & Trailer for a total price of $6,790.91.
Item # 2:
Motorola Mintor 5 VHF 143-174 Mega Hrtz Radios (6) for a total price of $2,442.00
Total amount of $9,232,91
A Motion to approve the DOW Community Grant on behalf of Magnolia Beach Fire Department in the amount of
$9,232.91 was made by Commissioner Galvan and seconded by Commissioner Fritsch.
Commissioners Galvan, Lyssy, Fritsch and Judge Pfeifer all voted in favor.
Sep,21. 2012' 8: 12AM
No, 0942 p, 2/3
Magnolia Beach VoltUlteet Fire Department
Of
Calhoun County
361/120-8046
,
now COMMUNTlY GRANT PROGRAM
Item if 1
Upgrade & enhance the Marine Rescue Boat &. Traill;ll'- see itemi:z;cd
eiti.tm\~ last page for from Wetfab, Inc. $3800.00
. G<<J:m1n UPS 740 SOl!lU'lPlottM/Rtltillt'
Olltmln P66 Transducer
Rule 2000 OPR Bilge Pump- Quanity i
Rule Flollt Switcb~s - Quanity 2
$2469.00
$199.95
$211.98
$79.98
TOTAL :PRICE
$6790.91
ltem'# 1,
Motorola Mintor 5 VHF 143-174 Mega Hrtz Radios
, Code # A03KM51239 Qutinity 6
Prioe $407.00 eaoh Suggested retail price: $513,00 each
Shipping weight 5 Ibs. E~oh.
From; Action Communication
520mn~0326 8001214-6001
2816 Ncnth Stone Ave.
Tuscan, A2 85705
5201192~0326 800/214-6001
Fax 520/792-2709
l>.I"~11ilIlcIl0l1CIlI"1lI11n\cntlon.con\
TOTAL PRICE ~ $2442.00
GRANT tOTAL FUNDS:
$923:2.91
,Sep,21. 2012' 8: 12AM
No,0942 p, 3/3
,'WflLFAB{tNt:.
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M/J.B#WlU!: V~/up.iSet Fire Dept. QfWte
Attention: President Tom Andrews
R.$~efor Work on IB' Alum. ROM & Galvan4ed Baal Trailer
8e<ipe: pill' 'Ibm Antb:ewi
1) Alulninum Boat
. 2ea ai1.ln\inum floor plates
. Boat bow closure
I; lea SS Nipple
Labor I Equipment I MaterialS. $1,:360.00
~) (JalvlUliz\:4 Boat Trailer
.. Axles, U-:Bolts, Spl'ill.gs
Labor I E..qlJ!p~1 M~wrMll~' $?,,440.0Q
TOTAL S 3.800.00
Note: Taxes not ihc/uded
By:
+;H~ ~.. '
Est1ttlatot, fennin Cllstillo
Pate: r:- (J,/-I:<..
Aocepted by:
Date:
Susan Riley
From:
Sent:
To:
Cc:
Subject:
Attachments:
Kathy Smartt [smarttgrants@sbcglobal.net]
Friday, September 21,20128:23 AM
Susan Riley
Commissioner Roger Galvan
Next court agenda
CiviclCorp Work Order,docx; ATT00119,htm; Final Proposal.pdf; ATT00122,htm
Susan,
I just spoke with Commissioner Galvan and he wants the item put on the 27th agenda. The court will have to
approve the proposal and the Judge will need to sign the work order. Both are attached.
Kathy
f~e~j~
'1-'d.)-)'"2.
1
WORK ORDER NO. 04-5107-483-WOl BETWEEN CALHOUN COUNTY AND CIVILCORP, LLC TO
RETROFIT THE EXISTING COUNTY RESTROOM FACILITIES AT MAGNOLIA AND INDIANOLA
BEACHES IN CALHOUN COUNTY FOR AN AMOUNT NOT TO EXCEED $40,000 AND AUTHORIZE
COUNTY JUDGE TO SIGN:
MaintenanceEdge
Estimated square footage 130,000
MaintenanceEdge Charges:
Quick Start
One Time
$1,307
Now - September 30, 2013
Waived = $0
Yearly
Yearly
$1,542
Now - September 30, 2013
Waived = $0
Ongoing Annual
years $1,128
Annual
$1,542
Starting October 1, 2013 Yr 2 & subsequent
Commissioner Galvan:
Paying the money to the engineer for everything that the State requires.
Judge Pfiefer:
Since the area is in an environmentally sensitive area, will probably need special permits,
Commissioner Galvan:
Going to take out the old septic tank and put in a new one as well as some shower and make it a nice area.
A Motion to approve Work Order No. 04-S107-483-W01 between Calhoun County and Civilcorp, LLC and
authorize County Judge to sign was made by Commissioner Galvan and seconded by Commissioner Lyssy.
Commissioners Galvan, Lyssy, Fritsch and Judge Pfeifer all voted in favor.
WORK ORDER NO. 04-5107-483-W01
UNDER PROFESSIONAL SERVICES PROVIDER CONTRACT
Pursuant to the Professional Services Provider Contract (Contract) between Calhoun
County (County) and CivilCorp, LLC (Provider), Provider is authorized to perform the
services described below, subject to the Scope of Services, Tasks, Budget, Deliverables,
and any other conditions of this Work Order (Work Order) for the federal grant entitled
"lndianola Wetland Preservation."
SCOPE OF SERVICES
Provider will support the County's efforts to retrofit the existing county restroom facilities at
Magnolia and lndianola beaches in Calhoun County by providing the associated engineering
tasks listed below,
TASKS
Task 1. Conduct site assessment and preliminary engineering (October - November 2012)
Provider will conduct a site assessment, including the topographic survey required for
construction plans, and will develop a conceptual site plan for retrofitting the two restroom
facilities and for replacing the existing wastewater systems with an aerobic system. A
preliminary engineering drawing and cost estimate will be prepared and discussed with the
County.
Deliverables due on or before November 30. 2012
1, Topographic survey consisting of AutoCad drawing that includes points and descriptors,
one (I) foot contours showing all features surveyed and ASCI! file containing all
surveyed points (Northing, Easting, Elevation, Descriptor),
a. One (I) hard copy and one (I) digital copy on CD
2, Preliminary engineering drawing and cost estimate.
a. One (1) hard copy and one (1) digital copy on CD
Task 2. Coordinate necessary permits (November 2012 - January 2013)
Provider will work with the U.S, Army Corps of Engineers (Corps) and the Texas Commission
on Environmental Quality (TCEQ) to ensure that the project complies with applicable
environmental laws and to obtain any necessary permits, Provider will coordinate with the Corps
Page lof9
and state and federal regulatory agencies, including TCEQ and the Victoria County Health
Department, to identify any potential environmental issues that may need to be addressed before
construction.
Deliverables due on or before January 3 L 2013
I. Corps Notification Letter/Permit, as applicable
2. Victoria County Health Department Authorization
Task 3. Conduct final design and prepare construction contract documents (December
2012 - February 2013)
Provider will develop technical specifications, construction level drawings and construction cost
estimates. A 70% level completion set of technical specifications and construction drawings will
be submitted to the County for review and comment. Following final review, a 100% completion
level set of constmction documents will be submitted in a Project Manual to be used for
solicitation of contractor proposals and bids. The 100% level submittal bid documents will
include contract documents, final engineering drawings/technical specifications, a constmction
cost estimate, and construction schedule.
Deliverables due on or before Febmarv 28, 2013:
1. 70% level completion set technical specifications and construction drawings,
a. One (1) hard copy and one (I) digital copy on CD
2. 100% completion level set construction documents consisting of contract documents,
final engineering drawings and technical specifications, a construction cost estimate, and
constmction schedule.
a. Three (3) hard copies and two (2) digital copies on CD
Task 4. Conduct a competitive solicitation for a construction contractor (February 2013)
The County will follow its procurement process and 43 CRF 12,76 in the solicitation. of
competitive sealed construction proposals. The County, in coordination with Provider, will
evaluate the submitted proposals to determine an award of construction contract. Following
execution of the contract, a Notice to Proceed will be issued to the contractor.
Task 5. Construction Administration (March - June 2013)
The construction contractor will rebuild the restrooms and septic systems to the specifications of
the final design, Provider will oversee the construction process and coordinating efforts, Provider
will process the monthly pay estimates, submit to the County for payment, and make at least one
site visit per week to inspect the construction project.
BUDGET
The total compensation due to Provider for services provided or performed pursuant to this Work
Order will not exceed Forty Thousand Dollars ($40,000.00). Compensation will be based on
actual costs incurred.
Page 2 of9
MONTHLY PROGRESS REPORTS
Provider must submit progress reports electronically on or before the first day of each calendar
month during the term of this Work Order, commencing December 1, 2012, All Progress Reports
should be prepared in Microsoft Word@ and follow the format of the Progress Report Form,
attached hereto as Attachment A. All reports should be emailed to the County Project Manager,
as identified herein below,
REOUESTS FOR REIMBURSEMENT
Provider shall submit monthly invoices electronically to the County Project Manager and follow
the format of the Request for Reimbursement Form, attached hereto as Attachment B, Requests for
payment must be supported by documentation as required under the Contract, such as invoices,
receipts, cancelled checks, statements, stubs, tickets, time sheets, and any other which, in the
judgment of the County, provides full substantiation of reimbursable costs incurred, The County
is not liable to Provider for any costs incUlTed by Provider before the effective date of this Work
Order or after termination of this Work Order,
Requests for Reimbursement under this Work Order must be received by the County
Project Manager not later than sixty (60) days from the date Provider incurs the expense.
Notwithstanding the preceding, requests for reimbursement for expenses incurred by any
subcontractor must be received by the County Project Manager not later than thirty (30)
days from the date Provider receives that invoice from a subcontractor. Failure by
Provider to comply in a timely manner with these two requirements may, at the County's
sole discretion, result in denial of the request for reimbursement.
ACKNOWLEDGEMENT OF FEDERAL FUNDS
All reports and other materials completed as a result of this Work Order must bear the following
statement and the Department of the Interior and County logos on the front cover or title page of
such document and other materials:
"This report was funded with qualified outer continental shelf oil and gas revenues by the
Coastal Impact Assistance Program, Fish and Wildlife Service, U.S. Department of the
Interior."
MISCELLANEOUS
County Project Manager Point of Contact:
Kathy Smartt
SmarttGrants
1-512-800-4740
smarttgrants@sbcglobal,net
Page 3 of9
Termination 01' Interruption of Work: The County reserves the right to halt or defer all or any
portion of the work included in the Scope of Services of this Work Order any time during the
performance period. If such an event occurs, the parties agree that the schedule and budget may
require renegotiation,
Amendments to Work Order: Material changes to this Work Order may be made only by
agreement ofthe parties, in writing,
In witness whereof, all parties executed this Work Order, to be effective as ofthe date signed by
the last pll1ty.
CALHOUN COUNTY
f'fv. tAM~ \;} A;J ,t.-
Michael J. Pfeifer
Calhoun County Judge
Date of execution: f -). 7, /"--
/~7/
Ben Galvan
President
Date of execution: '1 ~ 2, 8 - I z..
Page 4 of9
~_~.__~_3~~~---~.~~--~_.~~_.._~_._~--
-"'~
ATTACHMENT A
PROGRESS REPORT FORM
Page 5 of9
PROGRESS REPORT
IndianolalMagnolia Restrooms
CivilCorp, LLC
Date:
Work Order No. 04-5l07-483-WOl
Point of Contact: Ben Galvan
Phone: 361-920-7505
Email Address:BGalvan@civilcorp.us
Task 1, Conduct site assessment and preliminary engineering
Percentage of completion:
Activity completed during this reporting period:
Problems or obstacles encountered during this reporting period:
Plans for the next reporting period:
Deliverables submitted during this reporting period:
Task 2, Coordinate necessary pennits,
Percentage of completion:
Activity completed dm:ing this reporting period:
Problems or obstacles encountered during this reporting period:
Plans for the next reporting period:
Deliverables submitted during this reporting period:
Task 3. Conduct final design and prepare construction contract documents.
Percentage of completion:
Activity completed during this reporting period:
Problems or obstacles encountered during this reporting period:
Plans for the next reporting period:
Page 60f9
Deliverables submitted during this reporting period:
Task 4, Conduct a competitive solicitation for a construction contractor.
Percentage of completion:
Activity completed during this reporting period:
Problems or obstacles encountered during this reporting period:
Plans for the next reporting period:
Deliverables submitted during this reporting period:
Task 5, Construction Administration.
Percentage of completion:
Activity completed during this reporting period:
Problems or obstacles encountered during this reporting period:
Plans for the next reporting period:
Deliverables submitted during this reporting period:
Page 7 of9
ATTACHMENT B
REQUEST FOR REIMBURSEMENT FORM
Page 8 of9
REQUEST FOR REIMBURSEMENT
Date:
Civil Corp, LLC
Indianola/Magnolia Restrooms
Invoice No,
Invoice Point of Contact:
Phone:
Email Address:
Federal ID No.:
Work Order No. 04-5107-483-WOl
Billing Period:
Submitted by:
Signature:
Printed Name:
Amount Requested: $
Supporting documentation is attached.
Page 9 of9
CINDY MUELLER
COUNTY AUDITOR, CALHOUN COUNTY
COUNTY COURTHOUSE ANNEX - 202 S ANN ST, STE B
PORT LA V ACA, TEXAS 77979
(361) 553-4610
MEMORANDUM
TO: JUDGE PFEIFER & SUSAN RILEY
COUNTY JUDGE'S OFFICE
FROM: AUDITORS OFFICE - PEGGY HALL
DATE: September 19,2012
RE: AGENDA ITEM - SEPTEMBER 27,2012
AGENDA ITEM
THURSDAY, SEPTEMBER 2012
~ Consider and take necessary action to approve RFP Specifications and authorize
the County Auditor to advertise for bids for General Liability Insurance,
Auto Liability/Physical Damage Insurance, Public Officials E&O Liability
Insurance, Law Enforcement Liability Insurance, Property, Equipment Breakdown,
Inland Marine, Sudden & Accidental Pollution Liability Insurance, Workers'
. Compensation & Crime Insurance for Calh01m County for the period beginning
January 1,2013. Bids will be due by 10:00 AM, Monday, November 19,2012 and
considered for award on Thursday, December 13,2012. (CM)
RFP SPECIFICATIONS AND AUTHORIZE THE COUNTY AUDITOR TO ADVERTISE FOR BIDS FOR
GENERAL LIABILITY INSURANCE, AUTO LIABILITY/PHYSICAL DAMAGE INSURANCE, PUBLIC
OFFICIALS E&.O LIABILITY INSURANCE, LAW ENFORCEMENT LIABILITY INSURANCE, PROPERTY
EQUIPMENT BREAKDOWN, INLAND MARINE, SUDDEN &. ACCIDENTAL POLLUTION LIABILITY
INSURANCE, WORKER'S COMPENSATION &. CRIME INSURANCE FOR CALHOUN COUNTY FOR THE
PERIOD BEGINNING JANUARY 1, 2013. BIDS WILL BE DUE BY 10:00 AM, MONDAY, NOVEMBER
19,2012 AND CONSIDERED FOR AWARD ON THURSDAY, DECEMBER 13, 2012:
Cindy Mueller;
Don Gray asked for authorization for limited discretion to make immaterial technical changes to the document as
needed.
The RFP Specifications will be completed and reieased on the County's website on October 3, 2012. The
consultant will be advising bidders that the specifications will be on the website,
A Motion adopt the Specifications and authorize Gray & Company, LLC, limited discretion to make immaterial
technical changes as needed was made by Commissioner Fritsch and seconded by Commissioner Lyssy.
Commissioners Gaivan, Lyssy, Fritsch and Judge Pfeifer all voted in favor.
Susan Riley
From:
Sent:
To:
Subject:
Attachments:
Cindy Mueller [cindy,mueller@calhouncotx,orgJ
Wednesday, September 26,2012 10:00 AM
'Susan Riley'
Agenda item ii-additional verbiage to include in motion
Agenda Item ii-amend motion,pdf
Per request of Don Gray after agenda was posted, please include the attached verbiage in the motion,
Agenda Item iI-Insurance RFP specs
include the following in motion:
"...and authorize Gray & Company, LLC, limited discretion to make immaterial technical changes as
needed."
REQUEST FOR PROPOSALS #2012.09.27.01
GENERAL LIABILITY INSURANCE, AUTO LIABILITY/PHYSICAL
DAMAGE INSURANCE, PUBLIC OFFICIALS E&O LIABILITY
INSURANCE, LAW ENFORCEMENT LIABILITY INSURANCE,
PROPERTY, EQUIPMENT BREAKDOWN, INLAND MARINE, SUDDEN &
ACCIDENTAL POLLUTION LIABILITY INSURANCE, WORKERS'
COMPENSATION & CRIME INSURANCE
Calhoun County, Texas
Prepared by:
Gray & Company, LLC
605 The High Road
Austin, Texas 78746
Cell: (512) 496-3583
E-Mail: Don@lnsconsultant.com
Posting Date: October 3, 2012
Proposals Due: November 19, 2012 (10:00 AM, County Judge's Office)
(Refer to RFP for additional information regarding the Due Date)
NOTICE
This "Request for Proposals" is being provided to interested agents, brokers and insurance
pools and carriers solely for the purpose of obtaining insurance proposals for Calhoun
County, The information contained herein is confidential and may not be used for any
purpose other than preparing insurance proposals for Calhoun County.
RFP TABLE OF CONTENTS
PAGE #
Part I Introduction 1
Part II RFP Procedures 6
1, Proposal Due Date 6
2. Effective Date of Coveraqe & Term of Insurance Policies 7
3. Analysis of Proposals 7
4, Purchasing Decision 8
5. Insurer Eliaibilitv 8
6. Communication with Grav & Company 9
7. Underwriting Inspection 9
8, Underwritinq Information 10
9, Insurance Applications 10
10. Reauest For Proposals 10
11. Proposed Policv Lanauaae 11
12, Ancillarv Services 11
13, Premium Rate Guarantee 11
14, Drivina Record Standards 11
15, Supportinq Coveraaes 11
16. Proposal Negotiations 12
17. Premium Auditinq 12
18, Issuance of Binders and Policies 12
19, Loss Runs 12
20. Reservation of Riahts 12
21. Proposal Format 13
22, Qualifications of Aaents and/or Brokers 13
23, References 13
24, Vehicle Schedule 13
25. Automobile 10 cards 14
26. Access to Insurance Markets 14
27. Governmentallmmunitv & the Texas Tort Claims Act 14
28, Deliveries 14
29. Rejections 14
30. Protest Procedures 15
31, Public Information Act 15
Part III Insurance Coveraae & Proposal Questionnaire 16
Overview 16
Automobile Liabilitv & Phvsical Damaae 19
General Liability 23
Public Officials Errors & Omissions Liability 29
Law Enforcement Liabilitv 43
Crime 48
Workers' Compensation 50
Property/Eauipment Breakdown/lnland Marine 51
Aqent/Representative Services 58
I Insurer Services
59
I Exhibits
Note: Exhibits A, Band C can be obtained through the County's website at
http://www.????. All other exhibits are to be requested at the web links noted below
or by emailino the consultant at "don@insconsultant.com"
Exhibit A Auto Schedule
Exhibit B Buildinas & Contents Schedule
Exhibit C Inland Marine Schedule
Exhibit D Loss Runs Prepared by Insurance Carriers
Exhibit E Historical Premiums, Losses, and Loss Ratios by Year and by Line of
Coveraae
Exhibit F Audited Financial Statements Fiscal Years ending 2003-2011 (found at
hltp://www,calhouncotx,orq/trans,html)
Exhibit G Proposed Budget for Fiscal Year 2013 and final budgets for prior years 2009-
2012 (found at http://www,calhouncotx,orq/trans,html)
Exhibit H Calhoun County's Exposure Checklist
Exhibit I Photos of Several County.locations (i:)onisprl:lparingawebsite Which will
containext~riorph()tosofll)any ofthe County's buildings, a link to that
website will be provided here)
Exhibit J Schedule of Current Insurance Policies (coverage summary)
Exhibit K General Liabilitv Underwritinq Material
Exhibit L Auto Liabilitv & Phvsical Damaae Underwriting Material
Exhibit M Law Enforcement Underwritinq Material
Exhibit N Public Officials E&O Underwritina Material
Exhibit 0 Sudden & Accidental Pollution Liabilitv Underwritinq Material
Exhibit P Crime Insurance Underwriting Material
Exhibit Q Workers' Compensation Underwritinq Material
Exhibit R Property, Eauioment Breakdown, & Inland Marine Underwritina Material
Exhibit S Expiring Auto, General Liability, Property, Equipment Breakdown and Inland
Marine insurance policy
Exhibit T Expirinq Public Officials E&O insurance policy
Exhibit U Expirina Law Enforcement Iiabilitv insurance policy
Exhibit V Expirina Crime insurance policv
PART I
INTRODUCTION
Gray & Company, LLC has been retained by Calhoun County (herein after referred to
as "the County") to manage a request for insurance proposal process. At the CountyDs
request and the County's assistance, we have prepared this Request for Proposals
(RFP) for the purpose of obtaining competitive insurance proposals on the following
coverages for the period of 1/1/2013-2014 (and up to four additional annual terms if
renewal indications and proposals are deemed to be competitive with market conditions
at that time),
Proposals are to be submitted no later than Monday, November 19, 2012 (no later
than 10:00 AM) as detailed in Part II of this RFP,
Lines of Insurance Protection Addressed in this RFP
. Automobile Liability & Physical Damage
Public Officials Errors and Omissions Liability (with Employment Practices
Liability)
General Liability & Employee Benefits Liability
Law Enforcement Liability
Crime
Sudden & Accidental Pollution Liability
. Workers' Compensation
Property
Equipment Breakdown
Inland Marine
.
.
.
.
.
.
.
Not all of the County's property, liability and workers' compensation insurance policies
are included in this RFP (as addressed below).
Introduction to The County's Insurance Policies and Exposures
The County's exposures and insurance coverages are a bit complex without an
understanding of how things are arranged at present. The following is intended to help
vendors understand the basic scope of the policies included in this RFP and the
exposures they cover.
1) Automobile Liability & Physical Damage: limited to the County's non-emergency
vehicles and law enforcement vehicles, not to include EMSNolunteer Fire
Department units that are owned by the County and used by the County's EMS
department and by the VFD's who use vehicles owned by the County,
2) Public Officials Errors and Omissions Liability: to include Employment Practices
Liability, but not including the County's hospital which is governed by a board
appointed by the County, and operated as a separate accounting entity, but to
- 1 -
include coverage for eligible boards and commissions, and if possible, defense
coverage and damages coverage for the JP offices, County Clerk's office and the
District Clerk's office (to avoid the purchase of separate Clerk's E&O policies)
and to cover the collection of fines and fees by the JP offices, the County Clerk's
office and the District Clerk's office (currently appears to be excluded in separate
E&O policies covering the clerks). Also, certain aspects of coverage are to apply
to the District Attorney and District Judges as detailed in Part III (who are
employees and officials of the State of Texas, not employees or officials of
Calhoun County),
3) General Liability & Employee Benefits Liability: not include the hospital exposure,
airport exposure; volunteer fire departments (which are separate legal entities
apart from the County and insured elsewhere) or the County's EMS exposures
as the EMS exposures are covered by a separate specialty policy; but to include
the County's health clinic exposure, exhibition facilities and rodeo arena, libraries,
community centers, parks and piers, the landfill, waste recycling, and waste
collection sites, and if available, sudden and accidental pollution coverage)
4) Law Enforcement Liability: to apply to all of the County's law enforcement
departments and exposures, including the use of watercraft for law enforcement
purposes.
5) Crime
6) Sudden & Accidental Pollution Liability: presently not in force (other than
pesticide/herbicide spraying endorsement attached to the GL policy), to include
mosquito spraying and other sudden and accidental pollution exposures at all
County facilities (other than the County hospital) such as fuels, oils,
mechanics/garage operations, road tar, chemicals, run-off, above-ground fuel
tanks, etc, if not provided through the GL policy, Not to include underground fuel
tanks as they are insured separately and not to include the County's landfill
which was closed in 1993,
7) Workers' Compensation: to apply to all County employees and employed officials
other than the employees working for the County's hospital, as the hospital
purchases a separate WC policy outside of this RFP,
8) Property (not including flood, wind and hail, but including building locations
scheduled in RFP Exhibit B which includes parks and piers, the County's
hospital, community centers, libraries, museum, exhibition center buildings, etc)
9) Equipment Breakdown: to include all building locations scheduled in Exhibit B,
10) Inland Marine (various types of County owned property including road
maintenance equipment, waste management equipment, various types of
communication equipment, law enforcement equipment as scheduled in Exhibit
C,
Calhoun County provides its citizens the basic services provided by most county
governments in Texas (i,e., law enforcement, jail, courts, records management,
collection of fines and fees, etc. The County's property taxes are assessed and
collected by the Calhoun County Appraisal District, with the County's portion of the tax
revenues being turned over to the County (Le" the County does not collect taxes). In
addition, the County also provides services that are not routinely provided by county
governments which add a level of complexity to serving the County's insurance needs.
- 2 -
These services include mosquito spraying, an extensive system of libraries, juvenile
probation department, a small health clinic, a hospital (Memorial Medical Center), piers,
boat ramps, parks, use of watercraft for law enforcement purposes, airport, EMS
services, support for volunteer fire departments (which are not a part of the County) in
the form of providing fire vehicles, facilities and equipment, and a large exhibition center
and rodeo arena,
Property insurance is not being requested for the County's EMS facility as it is insured
elsewhere, but Exhibit C does include inland marine properties owned by the County
and used in its EMS operations that are to be covered.
Calhoun County is a "tier 1" county due to its location on the Texas coast. This RFP is
not reauestina protection for perils such as wind. hail and flood, These perils are insured
on policies that are not a part of this RFP,
This RFP is not requesting liability coverage for the hospital's operation, the airport
operation, or the EMS services and its EMS/Fire vehicles (all insured separately),
Further, this RFP is not requesting GL insurance for the VFD's as they are separate
legal entities apart from the County and insured elsewhere,
Liability coverage is being sought through this RFP for the County's basic county
services and it's non-routine county services to include non-routine services such as the
libraries, the health clinic (including nurses); the landfill, recycling operations, and waste
collection sites; community centers, piers, parks, juvenile probation, the use of
watercraft for law enforcement purposes, and the exhibition facilities and rodeo arena.
This RFP is not requesting liability coverage for the hospital operation (separately
insured), the airport operation (separately insured), EMS services (separately insured)
and the EMS/Fire vehicles (owned by the County but used the VFD's and separately
insured). Medical services provided to inmates at the County's jail are provided by a
separate private entity under contract to the County under which the contract requires
the private entity to provide WC, GL and medical malpractice coverage and to include
the County as an additional insurance under the GL and malpractice, Medical services
are also provided to the public through its health clinic operation, under which nurses
are employed by the County and the Medical Director's services are provided by a
physician under contract to the County and not employed by the County.
Law Enforcement liability insurance is to apply to services provided by the Sheriff's
Department (including the jail), bailiffs, constables, nuisance enforcement officer,
criminal investigators, juvenile probation department, and the juvenile board, and use of
LE canines (but coverage is currently limited to the Sheriff's Department, jail and a
bailiff),
The Auto insurance proposals are to be based on the schedule of vehicles that is
provided in RFP Exhibit A (includes all vehicles owned by the County except county-
owned EMS and Fire units),
- 3 -
Pollution liability coverage is presently limited to underground storage tanks (separately
insured) and to an endorsement to the GL policy which provides pesticide/herbicide
applicators pollution coverage. This RFP hopes to maintain the pesticide/herbicide
coverage and also obtain proposals for other sudden and accidental exposures noted in
the RFP,
Insurance Applications
In preparing this RFP an effort was made to review underwriting applications
generated by several sources that specialize in providing coverage to Texas
counties, While there is some redundancy among their applications, none of the
applications are identical. Rather than complete all of the applications generally
requested by each source to quote and bind coverage, the County has completed
the particular applications that appear to provide most of the data needed by all
sources, The intent is that sources will be able to provide insurance proposals based
on the applications contained within this RFP. Refer to RFP Part 11-8 and 11-9 for
additional information relating to underwriting applications.
A summary of the insurance protection provided by the policies to be proposed
through this RFP is provided in Exhibit J, Exhibit H provides a listing of the County's
exposures, Copies of the insurance policies currently in force that are to be quoted
through this RFP are provided in Exhibits S through V. Loss runs are provided in
Exhibit D. Exhibit E summarizes the County's historical premiums, annual losses,
and loss ratios by year and by line of coverage. Note th~t the 5-l(earcol1lbined
lo~s ratio is a healthy 12%?(pendinq co~rected PO loss run from aqent.
expected any day now and then the % be calculate) , Web links for the most
recent audited financial statement and budgets are provided in Exhibits F and G in
the Table of Contents to this RFP,
Part III of the RFP provides a description of the insurance coverage currently in force
and its pricing, options to be considered for quoting, and a questionnaire to be
completed and submitted as part of each proposal. Underwriting data is provided in the
Exhibits at the end of the RFP.
It is recognized that if compliance with rigid specifications were insisted upon, some
insurers would not be in a position to offer their best or most competitive programs, It is
our intent for this RFP to be viewed as general guidelines for coverage requirements
and options, Interested parties are encouraged to offer coverage alternatives to improve
the County's coverage. Quotes for coverage that would serve to restrict the County's
coverage are not desired,
Gray & Company, LLC is not an insurance brokerage firm or agency, nor is it affiliated
with any insurance carrier or claim administrator. We will show no bias to any proposer.
The firm is to be considered as a disinterested party in the placement of the coverage,
We will be pleased to discuss this RFP or review any alternate ideas concerning
coverage requirements with interested parties participating in the proposal process.
- 4 -
It is Gray & Co.'s intention to treat each proposer equally. We trust it is recognized that
considerable effort has been made by County staff in providing this underwriting data,
The intent of this RFP is to:
1, Provide agents, brokers, and underwriters with the information that is needed to
develop a competitive proposal.
2. Receive proposals that contain the information necessary to perform a thorough
analysis and comparison,
3, Provide the County with unbiased factual information for the purpose of making
an informed purchasing decision.
We would welcome any suggestions or inquiries that might help us better achieve these
goals, Questions concerning this RFP or requests for additional information should be
directed in writinq (e-mail preferred) to:
Don Gray, ARM
Gray & Company, LLC
605 The High Road
Austin, Texas 78746
Cell: (512) 496-3583
E-Mail: Don@lnsconsultant.com
- 5 -
PARTn
RFP PROCEDURES
NOTE: Please review these procedures CAREFULLY and contact Gray & Co, with
any questions or requests for variances, Failure to adhere to these
procedures or to obtain approval for deviations may result in an incomplete
evaluation of your proposal.
1. Proposal Due Date
Proposals (an original and one photocopy) should be submitted in a sealed envelope
clearly labeled "Calhoun Countv Insurance RFP" no later than Monday, November 19,
2012 (10:00 AM) to:
The Honorable Michael J, Pfeifer
Calhoun County Judge
211 South Ann Street, Suite 301
Port Lavaca, Texas 77979
Phone: 361-553-4600
Proposals received by the County after this deadline will not be considered. The
clock in the County Judge's office is the official clock that will be used in determining
the time that a proposal is received and the time that proposal will be opened, A late
delivery with an early postmark will not suffice, Be sure you have allowed ample
time for postal delivery, The County will not be responsible for the delivery of your
proposal to the office of the County Judge. If you choose to send your proposal by
postal delivery, then it is recommended that you call the County Judge's office at
361-553-4600 to verify receipt of your proposal prior to the opening date. Calhoun
County accepts no financial responsibility for any cost incurred by any vendor in the
course of responding to these specifications.
Vendors are invited to be present at the opening of RFPs on Monday, November 19,
2012, 10:00 AM, in the County Judge's office, 3rd Floor, Suite 301, As proposals are
opened, the names of the proposers will be announced, but no other details about
the proposals will be made available at this time due to the potential for negotiations
to take place,
Also, a complete copy of the proposal (clearly labeled "Calhoun Countv Insurance
RFP") should be provided to the consultant (Gray & Co,) via physical delivery no earlier
than the deadline indicated and no later than 24 hours following the deadline above at
the following address:
Don Gray, ARM
Gray & Company, LLC
605 The High Road, Austin, Texas 78746
512-496-3583
Email: Don@insconsultant.com
- 6 -
Proposals must meet these requirements to be considered,
At this time, it is anticipated that the coverage will considered for awarding during
the Commissioners Court meeting set for Thursday, December 13, 2012 (10 AM
meeting).
A vendor may withdraw his/her proposal before County acceptance of his/her
proposal without prejudice to himself/herself, by submitting a written request for its
withdrawal to the County Judge.
The Proposal must be signed and dated by an officer (or employee) who is duly
authorized to execute this contract, that this company, corporation, firm, partnership
or individual has not prepared this proposal in collusion with any other Vendor, and
that the contents of this proposal as to prices, terms or conditions of said proposal
have not been communicated by the undersigned nor by any employee or agent to
any other person engaged in this type of business prior to the official opening of this
proposal.
2. Effective Date of Coverage & Term of Insurance Policies
Policies are to be written on an annual or multi-year term beginning 12:01 AM on
1/1/2013. If coverage is written on a multi-year policy, the County retains the
continuing right to terminate the policy at each annual anniversary without penalty
inasmuch as the County does not have the authority to commit beyond the current
budget period. However, the County may opt to not exercise its termination right.
After awarding the initial placement of policies for the first annual or multi-year term,
the County intends to continue renewing those policies to 1/1/18 provided:
a) The County is provided with a written "renewal indication" by each October 1
which is determined at that time to be competitive in relation to current market
conditions and in relation to the County's loss history,
b) The County is provided with a renewal proposal by each November 1 which is
determined at that time to be competitive in relation to current market conditions
and in relation to the County's loss history,
3. Analysis of Proposals
The County's interest in conducting a fair and thorough comparison of all proposals'
should be indicated by their engagement of Gray & Co, to assist in this matter.
Underwriters can be assured that their efforts in preparing a proposal that responds
to the coverage requested in this Request For Proposal (RFP) will be appreciated, It
is suggested that proposals be reviewed prior to submission to ensure they provide
the information requested in this RFP,
- 7 -
Part III of the RFP provides each proposer with a Questionnaire that details the
insurance coverage that the proposer is presenting for the County's consideration.
Proposers are welcome to attach additional material to fully detail the proposal. The
Questionnaire must be fully completed and submitted as part of each proposal.
Proposals will be evaluated in a three-step process. First, proposals will be reviewed
for basic information such as premiums, limits, deductibles, basic coverages, and
other qualifying factors. Some proposals may be identified as not warranting further
consideration at this point and set aside. Second, proposals determined by the
consultant and the County as deserving further consideration will receive a more
thorough evaluation (to include a review of the proposed policy language), The
County, through its consultant, reserves the right to negotiate in writing with
proposers during this stage of the evaluation without divulging specific information
about the competition's proposals. The third and final step of the process involves
the consultant meeting with the Commissioners Court to review the proposals,
4. Purchasing Decision
Gray & Co, will discuss the strengths and weaknesses of all proposals with the
members of the Calhoun County Commissioners Court. The decision for the
awarding of placement of insurance will be made by Calhoun County
Commissioners Court. Awards will be based on an evaluation of proposals using
the following factors:
Scope of coverage;
- Anticipated net cost;
Financial stability and reputation of the insurer or pool;
Insurer's ability to provide loss control and claims services requested;
Service capability; and
_ The opportunity for insurance policies to be placed with the same insurer when
such would benefit the County
The Commissioners' Court reserves the right to waive technicalities, reject any or all
proposals, to accept the proposal deemed most advantageous to Calhoun County
and to be the sole judge in determining which proposal will be most advantageous
to Calhoun County,
The County of Calhoun, Texas is an Equal Employment Opportunity Employer.
the County does not discriminate on the basis of race, color, national origin, sex,
religion, age or handicapped status in employment or the provision of services.
5. Insurer Eligibility
Insurance Companies and "Pool" Re-insurers: To qualify, each insurer and pool re-
insurer must have maintained a general policyholder's rating of "A-" or better and a
financial rating of Class 1 0 or better since 1 /1 /1 0 as published by Best's Key Rating
Guide, latest edition. Proposals from lower rated insurers will not be accepted.
- 8 -
Insurance companies should be authorized to do business in the State of Texas. In
the event a non-admitted insurance company is proposed, your proposal should
state your reasons for using the non-admitted insurance company and clearly spell
out any premium tax arrangements and/or filing procedures that should be required
in the event this insurance company was selected, Surplus lines tax and fees
should be included in the proposed premiums (or detailed as their amount).
Interqovernmental Risk-sharinq Pools: Due to the absence of an A.M. Best rating,
proposals submitted on behalf of "inter-governmental risk sharing pools" should
include audited financial statements (complete with auditor's notes). The most
recent two years audited financial statements should be provided as part of each
proposal. Statements should indicate whether loss reserves include IBNR and loss
development factors as determined by an actuarial analysis, Also, statements
should indicate whether loss reserves have been discounted for present
value/investment income and should detail the pool's reinsurance arrangements
(i.e., insurer, attachment point, limits, facultative, etc,).The financial statement
should reflect compliance with the ratios shown below:
Net Contributions Written to Surplus
Net Reserves to Surplus
Surplus to Retention
Net Combined Ratio (Losses &
Expenses)
2 maximum
4 maximum
6 minimum
100% maximum
6. Communication with Gray & Company
Proposers should contact Gray & Co, (in lieu of the County) if any information is
needed about the County or the RFP process, Questions relating to loss
exposures, the County's operations, underwriting information, and RFP
procedures should be presented in writing (Gray & Co. encourages use of e-mail
correspondence), While telephone inquiries are permitted, the proposer must agree
to provide Gray & Co. with a written summary of the questions, Gray & Co. will
respond to requests for additional underwriting information by issuing addendums to
the RFP to be distributed to all proposers,
7. Underwriting Inspection
Inspections necessary for presenting a proposal will be arranged on a group
appointment basis by contacting Gray & Co, Please provide detailed information as
- 9 -
to the locations needed to be visited, persons to be interviewed, the type of any data
needed, etc. You should allow five working days for an appointment to be arranged,
The County's intent is to schedule one date to accommodate all interested vendors
at the same time.
8. Underwriting Information
Due care and diligence have been used in the preparation of this RFP, and the
information contained herein is believed to be current and correct. The underwriting
information has been provided by the County, However, the responsibility for
determining the full extent of the exposure shall rest solely upon the proposer. It is
incumbent upon proposers to fully review this RFP and to request from Gray & Co,
any additional specific information required, The County, its representatives and
Gray & Co, shall not be responsible for any errors and/or omissions in this RFP, nor
for the failure on the part of the proposer to determine the full extent of the
exposures.
Requests for additional underwriting information should be made as soon as
possible (preferably no later than November 5, 2012).
9. Insurance Applications
All underwriting data provided in this RFP has been prepared by the County. For
the purpose of providing proposals, underwriters are asked to base their proposals
on the underwriting data contained in this RFP and, if applicable, its addendums.
Proposals that are based, to any degree, on any other sources of information should
indicate the source and type of information as part of the proposal. Our intent is for
all proposals to be based on identical underwriting data so that premiums can be
fairly compared,
Proposers may indicate that proposals are subject to receipt of a fully completed
application without material differences from data provided in the RFP. The County
recognizes that the successful carriers may elect to revise or withdraw their
proposals if the completed applications contain information that is not revealed in
this RFP,
Any underwriters that are not willing to accommodate the County on this matter (by
requiring completion of a signed application) should provide a letter to Gray & Co,
explaining why an exception should be made,
10. Request For Proposals
This RFP provides guidelines for the proposals desired, Any restrictions, deviations
or other modifications that would restrict or broaden the coverage that is presently in
force must be clearly noted in the proposals.
- 10 -
11. Proposed Policy Language
Proposals presented to the County and to Gray & Co. MUST include either a) a true
and exact copy of the complete policy language which is being proposed for the
County (including each endorsement and all terms and conditions other than
premium rating and schedules); or b) in the case of ISO forms, a complete listing of
all policy form numbers and titles. The policy language will be reviewed as part of
the proposal analysis, The sample policy language must be consistent with the
coverage that is being presented, The proposer must be certain that the actual
policies, when issued, agree with the provided sample policies. The proposer will be
responsible for all additional costs involved in correcting any discrepancies between
the sample policies and the actual policies, The incumbent insurer is not required to
provide sample policies if the proposed policies are to be a duplicate of the policies
presently in force.
12. Ancillary Services
All proposals should fully describe agent/broker/representative services, safety
engineering and inspection services, exposure review services, assistance in
drafting contractual insurance requirements, claims adjustment service, and other
services that will be offered and provided by the proposing carriers or their
agents/brokers, If independent firms are to be used, the name and address of the
firm is to be indicated,
The County intends to give due consideration to the ability of the insurance agent,
broker and/or carrier to service this account. Supporting information detailing these
abilities is recommended. The last two pages of RFP Part III have been reserved for
use in describing the proposed services.
13. Premium Rate Guarantee
All proposers should indicate the term for which rates and discounts are to be
guaranteed,
14, Driving Record Standards
Proposers should provide their minimum acceptable MVR standards when
submitting their proposals,
15. Supporting Coverages
Proposals should c1earlv detail any supporting coverage requirements that should be
considered when the proposals are compared. For example, proposals should
specify that Automobile Liability coverage is only available if General Liability
insurance is purchased from the same carrier.
- 11 -
16. Proposal Negotiations
The proposals will be opened by the County Judge's Office so as to avoid disclosure
of the contents to competing proposers and will not be disclosed by the County or
the consultant until the purchasing decision is finalized, Following the initial review of
the proposals, the County and/or Gray & Co. may elect to meet with or contact the
"top ranked" proposers (each separately, possibly by telephone or email) for the
purpose of:
1, Clarifying any aspects of the proposal,
2, Meeting the agents and underwriters, and/or
3. Discussing areas where the proposal might be able to be improved,
During the negotiation phase, neither the County nor Gray & Co, will share any
specific information with competing proposers in regard to the competitiveness of
premiums or coverage offered by proposers, Proposers who are determined by
Gray & Co. to be "top ranked" should assume that their premiums and coverage
terms are competitive, Insurers should do their best to initially offer their most
competitive pricing and coverage terms so they will qualify as being "top ranked",
17. Premium Auditing
Proposals should specify whether proposed premiums are subject to audit. If not
indicated, it will be assumed that premiums are not subject to audit.
18. Issuance of Binders and Policies
Proposals must include an agreement from the agent, broker and/or carrier that
binders detailing coverage to be provided will be delivered to the County prior to the
effective date of coverage, Further, the agreement should confirm that completed
policies will be delivered to the County within 15 calendar days following the
inception of coverage (unless delayed due to the fault of the County),
19. Loss Runs
Proposals should include an agreement that the agent, broker or carrier(s) will
furnish a monthly report of all claims indicating property or persons involved, date of
loss or accident, amount paid and amount reserved. This report must be furnished
within 30 days of the end of each report month to the County Auditor. The claims
report should continue to be provided until all claims are closed, even after the
expiration of the policy period.
20. The County's Reservation of Rights
The County reserves the right to select individual forms of insurance coverage or
coverages written on a group or package basis (unless the proposer's objection is
indicated in the proposal) from different insurers, The County also reserves the right
- 12 -
to reject any and all parts thereof, or to waive informalities, irregularities and errors
in the proposals as long as such are technical in nature and not material. Finally,
the County reserves the right to cancel, amend or discontinue at its discretion all or
any part of the insurance coverages or services utilized in accordance with the
provisions of each insurance policy, It is not incumbent on the County to accept the
lowest priced proposal(s) received,
21. Proposal Format
The questionnaire in Part III (Insurance Coverage & Proposal Questionnaire) must
be completed and submitted (with sample polices) as part of your proposal. The
table provides a standard format to present proposed limits, sub limits, coverage
conditions, exclusions, annual premiums and optional coverages. It can be
completed by hand and, for the most part, can be answered by responding "Yes",
"No", "Included" or "Not Included" or by writing a numerical limit or premium, The
table may require 2 to 3 hours to complete when completed by an individual who is
familiar with the coverage that is being proposed, Completion of the table gives the
proposers a standardized way to point out the strengths and weaknesses of the
coverage they are proposing as compared to the coverage presently in force,
22. Qualifications of Agents and/or Brokers
Proposers should state whether they meet the following qualifications and be
prepared to give satisfactory evidence upon request:
Agents, Brokers, and Pool administrators must maintain an Errors & Omissions
policy with limits of at least $1,000,000 per occurrence, available aggregate limits of
at least $1,000,000 and a maximum deductible not to exceed $10,000 while writing
the County's coverage, Exceptions will be considered on a case-by-case basis.
23. References
Proposing agents, brokers, pool administrators, and insurers must list three client
references that can be contacted by the County or by Gray & Company for the purpose
of discussing the proposer's service abilities. References should include firm name,
contact name, contact's title, mailing address, email address and telephone #),
24. Auto Schedule
Exhibit A provides proposers with the schedule of vehicles that is to be used as the
basis of premiums quoted for auto liability and physical damage insurance, Once
the coverage has been awarded, the successful proposer will need to contact the
County Auditor to obtain adjustments to the schedules to reflect additions/deletions
that have occurred after the schedules were prepared, The adjusted schedules will
then be the basis of the premium invoices for coverage to be effective 1/1/13. The
successful proposer will be required to detail the premium changes resulting from
the schedule updates, as compared to the premiums initially proposed,
- 13 -
25. Automobile 10 Cards
The successful Auto insurance proposer should be identified by December 13, 2012
with coverage to be bound that date for a 1/1/13 effective date, If possible, Auto ID
cards unique to each vehicle are requested to be delivered to the County by
December 27 for distribution (even though county governments are not required by
law to carry "proof of insurance"), If this is not possible, the County asks for the
successful proposer to provide generic auto 10 cards (cards that do not list the auto
make and model) by the 2yth for distribution and for cards unique to each vehicle to
be delivered as soon as possible after the 2yth, even if after 1/1/13.
26. Access to Insurance Markets
This RFP assumes that no insurance brokers have submitted underwriting
information to any insurance underwriters from sources outside this RFP in advance
of the RFP's release. Further, no insurance markets are being assigned by the
County. The only exception to this is that it is expected that the incumbent
insurance agent will submit proposals on behalf of the insurers currently writing the
policies included in the RFP.
27. Governmental Immunity & The Texas Tort Claims Act
The doctrine of governmental immunity enjoyed by Texas counties is strong under
Texas law. In essence, the doctrine waives liability under Texas law except where
the exceptions of the Texas Tort Claims Act (TTCA) apply. Insurers who provide
liability insurance to Texas counties need to be aware of the governmental immunity
and the exceptions provided by the TTCA.
The following two web links provide information on these subjects:
1. http://www.tml.org/legaLpdf/txtort-c1aims-act.pdf
2, http://www . texascityaUo rn eys, org/20 12spea ke rpapers/rileyfletche r/Lia b iI ity-
T ortClaimsAct-M M-Handout. pdIT exas
28. Deliveries
Upon any breach of contract/proposal, the County reserves the right to proceed
against the successful vendor and/or the surety on his bond for any and all
damages occasioned by the breach,
29. Rejections
All disputes concerning this proposal will be determined by Commissioners' Court
or their designated representative,
- 14 -
30. Protest Procedures
Any actual or prospective vendor who believes they are aggrieved in connection
with or pertaining to a proposal may file a protest. The protest must be delivered
in writing to the Auditor's Office, in person or by certified mail return receipt
requested prior to award, The written protest must include:
1. Name, mailing address and business phone number of the
protesting party;
2, Appropriate identification of the proposal being protested;
3, A precise statement of the reasons for the protest; and
4. Any documentation or other evidence supporting the protest and
any alleged claims.
The Auditor's Office will attempt to resolve the protest, including at the Auditor's
option, meeting with the protesting party. If the protest is successfully resolved
by mutual agreement, written verification of the resolution, with specifics on each
point addressed in the protest, will be forwarded to Commissioners' Court.
If the Auditor's Office is not successful in resolving the protest, the protesting
party may request in writing that the protest be considered by Commissioners'
Court. Applicable documentation and other information applying to the protest
will be forwarded to Commissioners' Court, who will promptly review such
documentation and information.
If additional information is desired, Commissioners' Court may notify the
necessary party or parties to the protest to provide such information. The
decision of Commissioner's Court will be final.
31. Public Information Act
All governmental information is presumed to be available to the public, Certain
exceptions may apply to the disclosure of the information, Governmental bodies
shall promptly release requested information that is not confidential by law, either
constitutional, statutory, or by judicial decision, or information for which an
exception to disclosure has not been sought.
- 15 -
PART III
INSURANCE COVERAGES & PROPOSAL QUESTIONNAIRE
Calhoun County desires proposais for insurance coverage that is equally as "broad" (or broader) as compared to
the coverage presently in force, Given certain coverage aspects to the current insurance policies that were
identified in the process of preparing this RFP, several coverage changes are requested, Enhancements not
found in the current policies that will likely be purchased if proposed are labeled below as "Desired
Enhancements", Other enhancements that mayor may not be purchased are identified below as being "Optional
Enhancements",
The coverage presently in force is summarized on the following pages in a "table" format. The actual policies
presently in force are provided as Exhibits to the RFP, Please review the information provided below before
reviewing or completing the following Proposal Questionnaire,
1, The Proposal Questionnaire serves four basic purposes,
. First, it provides proposes with details about the coverage currently in force and its pricing, Since the
RFP requests pricing for coverage similar to the coverage currently in force, this Questionnaire
provides proposers with details about the coverage presently in force,
. Second, the Questionnaire provides the proposer with a format to be used in detailing the proposed
coverage (including coverage options,)
. Third, the completed Questionnaire will be used in evaluating the proposals (Therefore, completion is
mandatory,)
. Fourth, the Questionnaire submitted by the successful proposers will be compared to the insurance
policies ultimateiy issued to make certain that the poiicies agree with the Proposal Questionnaire,
2, It is estimated that a person who is familiar with the coverage that is being proposed can complete the
Proposal Questionnaire in 2-4 hours,
3, You are welcome to the complete the Questionnaire by hand, It is not necessary to type the responses,
4, The proposal must include a true and exact copy of the policy language that would be found in policies issued
to Calhoun County (including all endorsements, terms and conditions, but not including limits, schedules of
insured property, retroactive dates, poiicy period term, deductible values), "Sample" or "Specimen" policy
language is not requested unless it is intended to be an exact match to the policies that would be issued to
Calhoun County,
5, Please attach compiete copies of the underwriter's "quote" sheet(s),
6, If quoting a separate Sudden & Accidental Pollution liability policy, you are welcome to present the proposal in
any form of your choosing, A Proposal Questionnaire form is not provided for this line of coverage,
7, Please attach any additional proposal material that you care to provide with the Proposal Questionnaire,
especially relating to coverage enhancements being offered that are not addressed in the questionnaires, ,
8, The layout of the Proposal Questionnaire only accommodates a quote for one premium and one deductible
option per line of coverage, If you plan to offer several deductible options, we suggest photocopying the
appropriate pages within the Proposal Questionnaire and providing the deductible option and resuiting
premium on the reproduced pages,
9, Proposers are asked to use the "Premium and Policy Period" portion of each insurance coverage section to
provide pricing for coverage similar to the coverage now in force, The "Options" portion of each coverage
section should be used to provide pricing for each proposed option, When providing the pricing for each
proposal "Option", provide only the additional cost or credit. For example, if you are quoting a $10,000
premium for a $2M occurrence/aggregate limit on Public Officials E&O coverage in the "Premium & Policy
Period" portion and an Option of $15,000 premium for a $4M aggregate limit, then Option 2b in the Option
section should reflect only the additional incremental pricing of $5,000 (i.e" $15,000-$10,000),
Page -16
10, Quoted premiums must include any applicable surplus lines and/or fees,
Please contact Don Gray of Gray & Co, if you have any questions regarding the completion of the Proposal
Questionnaire, (512-496-3583; don@insconsultant.com),
Questionnaire Kev
RFP = Request for Proposals
BI = Bodily Injury
PO = Property Damage
N/A = Not Applicable
Incl = Included
NI or Not Incl = Not Included
E = Excluded
NE = Not Excluded
Miscellaneous (Must be completed!)
1, Have you enclosed true and exact copies of proposed policy language in each copy of your
proposal (including all endorsements, terms and conditions, not required to complete
declaration pages and schedules)?
2, Reminder: Attach a listing of references in accordance with RFP 11-23.
3. Do proposing insurers satisfy the provisions of item 11-5 in the RFP (Insurer Eligibility)?
4, Rates are guaranteed for what period of time? (RFP 11-13)
5, Does the insurer agree to provide ioss runs in accordance with RFP 11-19?
6, Do the agent/brokers/representatives who wili service the proposal meet the requirements of
RFP 11-22?
7, In the space below, detail all "Supporting Coverage's Requirements" as required by RFP 11-15,
(VERY IMPORTANT)
8, Have you attached a copy of the insurer's criteria for excluding drivers?
9, Have you attached copies of the underwriter's quotations? (VERY iMPORTANT)
10, Please detail the date(s) by which you propose to provide auto 10 cards, as requested in RFP
Part 11-25,
Page-17
11, The Proposal must be signed and dated by an officer (or employee) below who is duly
authorized to execute this contract, and by signature below confirms that this company,
corporation, firm, partnership or individual has not prepared this proposal in collusion
with any other Vendor, and that the contents of this proposal as to prices, terms or
conditions of said proposal have not been communicated by the undersigned nor by
any employee or agent to any other person engaged in this type of business prior to the
official opening of this proposal.
Signature:
Page-18
Automobile Liability & Physical Damage Proposal
Proposing Insurer: Current A,M,Best Rating Level (ie" A-):
Current A.M,Best Financial Size (ie" XV):
Admitted/Non-Admitted in Texas:
DESCRIPTION Argonaut Ins. Co. Proposed Limit COMMENTS
(through the Tx. or Included (I) or
Associations of Not Included (NI)
Political Sub. Pool)
Expiring Limits 8,
Coverage ..
Liability Limit $ 100,000 BI
each person
$ 300,000 BI
each accident
$ 100,000 PD
each accident
Includes liability protection for "non- I
owned" vehicles (empioyee owned
vehicles while used for County
business) (symbol 9)
Inciudes liability coverage for I
"specifically described" vehicles (symbol
7)
includes liability protection for "Hired" I
vehicles (symbol 8, vehicles used on
County business which are not owned
by the County or by employees)
Includes liability protection for hired or I
borrowed vehicles
Inciudes physical damage protection for NI
hired or borrowed vehicles
I ncludes physical damage protection for I
"Specifically described" vehicles
(symbol 7)
"Hired" car physical damage (not $50,000
applicable to employee owned vehicles)
Airbag coverage $1,000
This insurance does not apply to EMS I
and fire vehicles which are scheduied
on a different policy purchased by the
County
Includes "glass breakage" coverage I
(deductible waived on private passenger
vehicles when glass is repaired instead
of replaced)
Page -19
Limited Mexico coverage NI
$10,000 Supplementary Death benefit NI
Garagekeepers Liability (Excess Basis) NI
Uninsured Motorists coverage NI
Personal Injury Protection coverage NI
Written on an occurrence form (not I
"claims-made")
Insurer has the right and duty to defend I
and to select defense counsel
I
Defense costs do not reduce limits
Insurer pays defense costs and I
damages on the insured's behalf,
Physical damage coverage includes I
flood, wind, hail and hurricane
Physical damage claims are adjusted on I
a "depreciated" value basis
No-fault Medical Payments coverage NI
Towing coverage NI
Reimbursement of physical damage Up to $500 per
deductibles under an employee's occurrence
personal auto policy if damaged in the
scope of services for the County
Employees as Insureds endorsement NI
(Form TE 9933 or its equivalent)
Pollution Liability - Broadened Coverage Ni
(TE 9948-A)
Care, Custody & Control Exclusions N/A NI
to property damage of the County
passengers
Automatic physical damage coverage NI
for unit that replaces a previously
scheduled physical damage unit
Bodily injury or property damage NI
expected or intended from the
standpoint of the insured
Contractual liability NI
Claims for which the State has the I
responsibility to defend, indemnify or
pay
Page -20-
Coverage for the unintentional failure to NI
disclose hazards
Physical damage coverage applies to I
permanently mounted electronic
equipment (radios, radar)
Transportation expenses at $50/day not I
to exceed $1,000 for stolen private
passenger vehicles
Personai effects coverage for stolen $250
vehicies
Excludes bodily injury to any volunteer I
firefighter or other volunteers if
sustained while engaged in volunteer
firefighting, rescue squad, ambulance
operations
Excludes liability for professional i
services such as failure to provide
medical services, injury resulting from
serving foods or drink, handling of
corpses
Fellow empioyee exclusion deleted I
TRIA Terrorism NI
Automobile Deductibles
DESCRIPTION Proposed COMMENTS
Expiring Limits & Limit .Q!
Coverage Included (I).Q!
Not Included
(NI)
Bodily Injury/Property Damage Liability None
Comprehensive, Collision physical $2,500 each auto
damage
Page -21-
Automobile Premium & Policy Period
Annual Premium for coverage outlined $54,669
above (including Auto Theft Fee, but
w/o TRIA)
Additional TRIA premium (if optional)
Policy Period 1/1/12-13
Subject To
Is Premium subject to audit? Yes
Will premium be subject to an No
experience modifier?
Underwriter's Conditions
Optional Enhancements
DESCRIPTION ADJUSTMENT to DEDUCTIBLE COMMENTS
premium quoted (if different (indicate "Not
Above (indicate "" from proposed" ifthe
option is not being
"for return premium deductibles proposed or
or "+" for additional provided "Included" if
premium) above) coverage is
provided at no
change in the
premium provided
above),
1, Broaden definition of "bodily injury" $ $
to include shock, mental anguish,
mental injury & damages for care or
loss of service,
2. Provide Flat Premium Basis, no $ $
additions, deletions or Final Audit
3, Provide broadened pollution $ $
coverage
4, Provide "Employees As Insureds" $ $
endorsement (TE9933 or its
equivalent)
5, Broadened pollution liability $ $
(TE9948-A or its equivalent)
6, $1,000 liability deductible $ $
Other (Expiain) $ $
Page "22-
General Liability
Proposing Insurer: Current A.M, Best Rating Level (ie" A-):
Current A.M, Best Financial Size (ie" XV):
Admitted/Non-Admitted in Texas:
DESCRIPTION Argonaut Ins. Co. Proposed Limit COMMENTS
(through the Tx, or Included (I) or
Associations of Not Included (NI)
Political Sub. Pool)
Expiring Limits &
Coverage
General Aggregate Limit (does not $2M
apply to Medical Payments,
Products/Completed Operations,
Fire/Lightning/Explosion Legal Liability)
Products and Completed Operations $2M
Aggregate Limit
Bodily Injury, and Property Damage- $1M
Each Occurrence Limit
Personal Injury and Advertising Injury $1M
Limits
Damage to premises rented to the $100,000
County
No-fault medical payments limit per NI
person
Employee Benefits Liability $1M
Includes park liability, swimming areas, I
pier liability, landfills, mobile equipment
liability, premise liability, all county
bridges and roads
Includes pollution liability for the use of I
herbicides and pesticides by licensed
person when done in accordance with
governmental regulations
Includes sudden and accidental NI
pollution coverage for exposures such
as runoff, mechanics, garage
operations, tar, oils, above ground fuel
storage tanks, chemicals, recycling,
waste collection, fumes, waste
collection, waste disposal, waste
storage etc,
Page -23-
Includes pollution liability for smoke NI
from hostile fires and fumes from
heating equipment, mobile equipment
fuel and lubricant
Includes coverage for claims arising out I Desired
of emergency medical services, fire Enhancement:
districts and departments, including Exclude the
claims for professional services operations of
the County's
EMS
department and
all volunteer fire
departments
inasmuch as
these
exposures are
covered under a
separate GL
policy
Building illness NI
Firework displays NI
Hospital exposures NI
Law Enforcement exposures, watercraft NI
and jail
Rodeo exposure Ni
Eminent domain or inverse NI
condemnation
Professional services provided by NI
engineers or architects
Personal injury to public officials Ni
Employment practices NI
Includes watercraft liability (owned, I
rented, borrowed, or commandeered by
the County) except when used for law
enforcement activities
Contractual liability assumed in an I
insured contract
Contractual liability that exists in the I
absence of a contract
Employers liability coverage NI
GL and Employee Benefits Liability is ,
written on an occurrence form (not
"claims-made")
Page -24-
Insurer has the right and duty to defend I
and to select defense counsel
Defense costs do not reduce limits I
Insurer pays defense costs and I
damages on the insured's behalf.
Covered parties includes employees, I
members of the Commissioners Court,
boards, elected or appointed officials,
voiunteers
"Covered party contract" includes I
operations on or within 50' of a railroad
Coverage applies to bodily injury and I
property damage resulting from the use
of reasonable force to protect persons
or property
Worldwide coverage territory I
Employers liability exclusion does not I
apply to injury to volunteer firefighters
Non-owned aircraft coverage (when I
chartered with a crew)
Host liquor liability coverage I
Claims for which the State has the Not addressed
responsibility to defend, payor
indemnify
Coverage for damage to personal NI
property in the care, custody or control
of a covered person
TRIA Terrorism NI
Protection for the County and for I
employees resulting from medical
services provided by employed nurses
and medical service employees through
the County's health clinic
Protection for the County and for NI
employees arising from medical care
rendered to jail inmates by medical
personnel not employed by the County
Separation of Insureds provision I
Coverage for the unintentional failure to NI
disclose hazards
Page -25-
Sexual Abuse or Molestation Not specifically
addressed as
respects defending
a person who is
determined to be
innocent or in
regard to a person
who is accused of
the failure to
supervise, properly
monitor employees,
etc,
Cost to purchase an ERP for the N/A
Employee Benefits liability coverage
"Additional insureds" when required in a I
written contract
Definition of Bodily "Injury" includes NI
mental anguish or mental distress
General Liability Deductibles
General Liability $1,000 per
occurrence/offense
Employee Benefits Liability $1,000 each claim
General Liability Premium & Policy Period
Annual Premium for coverage outlined $75,283
above but without TRIA
Additional TRIA premium (if optional)
Policy Period 1/1/12-13
Subject To...
Is Premium Subject to Audit? No
Proposing Underwriter's Conditions
Page -26-
Optional Enhancements
DESCRIPTION ADJUSTMENT to DEDUCTIBLE COMMENTS
premium quoted above (if different from (indicate "Not
(indicate "-" for return deductibles proposed" if the
premium ill "+" for provided above) option is not being
additional. premium) proposed Q.[
"Included" if
coverage is
provided at no
change in the
premium provided
above),
Decrease the GLlEBL Liability limits
to bodily injury at $100,000 per
person (up to $300,000 per
occurrence), $100,000 property
damage, $100,000 personal injury
(and leave EBL at $1 M if possible)
Provide defense and damages for
claims against insureds for
1) the actual or threatened
sexual abuse or molestation of
any person and
2) Coverage for the
negligent hiring, retention,
screening, investiga1ion,
supervision, reporting or failure
to report a person who has
threatened or performed sexual
abuse or molestation (including
a defense for persons accused
of sexual molestation until
proven guilty of such charges),
Provide pollution liability coverage
for hostile smoke; fumes, exhaust
and vapors resulting from
printing/photocopying operations;
HVAC systems, mobile equipment
fuel and lubricant
Provide sudden and accidental
pollution coverage for exposures
such as runoff, mechanics, garage
operations, tar, oils, above ground
fuel storage tanks, chemicals,
recycling, waste collection, fumes,
waste collection, waste disposal,
waste storage etc,
Page -27-
Provide protection for claims
against the County and its officials
and boards and employees arising
from the use of the County rodeo
arena by others
Provide coverage for professional
liability claims arising out of the
County's health clinic
Amend the definition of "bodily
injury" to include mental anguish or
mental distress
Provide pollution liability coverage
for products/completed operations
Provide $5,000 Medical Payments
coverage
$2,500 GL deductible
$5,000 GL deductible
Eliminate the GL deductible
Other (Explain)
Page -28-
Public Officials Errors & Omissions Legal Liability
Proposing Insurer: Current A.M,Best Rating Level (ie" A-):
Current A.M,Best Financial Size (ie" XV):
Admitted/Non-Admitted in Texas:
DESCRIPTION T AC Risk Management Proposed Limit COMMENTS
Pool Expiring Limits & or Included (I) Q!
Coverage Not Included (NI)
--
Each Occurrence/Aggregate Limit - $1,000,000 /
Monetary Damages (E&O/EPL $1,000,000
combined)
Defense costs Limited to $1 M
outside the liability
limits (as opposed
to unlimited outside
the limits)
Reputation loss $50,000
Defense of claims seeking non- $100,000
monetary relief or injunctive relief
Retroactive date for prior acts coverage 1/1/200S
Punitive Damages I
Includes Employment Practices liability I
coverage
Excludes the County hospital No, but this is likely
an oversight as the
hospital exposure
is not intended to
be covered for
E&)/EPL or
otherwise (a
separate policy
applies to the
hospital exposure)
Page -29-
County ClerklDeputy County Clerk limits Included within Desired
policy limits Enhancement:
Eliminate or
modify "insured
vs, insured"
exclusions so
that the Clerks
and staffs are
covered for
claims made the
County against
them (thus
eliminating the
need for the
County to
purchase
separate Clerk's
E&O policies)
District Clerk/Deputy District Clerks Included within
limits policy limits, but
claims by County
against clerks
would not be
covered due to the
"Named insured vs,
insured" exclusion)
Back wages NI
Limited defense coverage for "takings" NI
claims
Definition of "insureds" includes the 1, includes 1-5
County, 2, Employees, 3. Elected or
appointed county officials, 4,
Volunteers, 5, Members of commissions
or boards who operated by the county
and under the jurisdiction of the county
and who are within an apportionment of
the county's budget
Inciudes members of the following Not listed or named
boards as insureds: Juvenile Board, in the policy but it is
members of the Gulf Bend MHMR assumed that these
appointed by the County, Westside are covered by the
Navigation District policy
Includes limited coverage for District Not Inciuded
Judges
I ncludes limited coverage for District Not Included
Attorney
Page -30-
Malicious acts/omissions, criminal Defended by the
acts/omissions - insurer untii guilt is
proven or admitted
(no sublimit on
defense costs) , but
no coverage for
judgments
"Pay on Behalf' Basis I (except in regard
to the third row
below)
Claims for Injunctive Relief NI (other than
$100,000 to defend
such claims)
I nsurer is obligated to pay for defense NI (the insurer is
costs as they are incurred required to
reimburse the
County for defense
costs prior to the
conciusion ofthe
claim, which allows
the insurer to delay
reimbursement to a
date just prior to the
conclusion of the
claim)
Insurer has the right and duty to defend I (except the insurer
claims has no duty to
defend EPL claims
unless the defense
is tendered to the
insurer within 30
days of the claim
and w/o the insured
having taken
actions to prejudice
the insurer's
defense)
-- ,,- f--.. ~-
Selection of defense counsel must be I
approved or provided by the insurer
Insured has the right to associate with I
the insurer in the defense of claims and
negotiating settlements,
I nsurer has the right to approve claim I
settlements
Page -31-
Insured shall not admit or assume any I
liability, enter into settlement
agreement, stipulate to any judgment or
incur defense costs without the insurer's
written consent
Loss payment and defense when the The amount for
insured does not consent to a loss which the claim
settlement could have been
settled plus defense
costs as of the date
the claim could
have been settled
plus 50% of the
loss in excess of
the settlement
amount, leaving the
remaining 50%
uninsured
Insureds have the right to tender the
defense of claims to the insurer within
30 days of the claim
Insurer has the right, but not the duty, to I
participate in the defense of claims
involving administrative proceedings or
disciplinary hearing
Defense Costs do not serve to reduce I (defense costs are
the liability limit limited to the $1 M
defense limit)
Non-imputation provision I
Coverage applies on a "Claims-Made" I
basis, including claims made, and notice
of potential claims provided, within the
policy periodJor during the ERP if
purchased)
Insurer will not waive sovereign Silent
immunity as a defense
Page -32-
Definition of "Ciaim" includes 1) written Items 1, 2 and 3 are
demand for money, non-monetary or included
injunctive relief 2) a civil, administrative,
regulatory or arbitration proceeding for
monetary, non-monetary or injunctive
relief, and 3) formal civil, administrative
or regulatory investigation of an
individual insured commenced by the
service of a subpoena, 4)
EEOC/OFCCP pleading or
investigation, 5) an arbitration
proceeding pursuant to an employment
contract, policy or practice commenced
by a demand for arbitration
Definition of "wrongful act" includes 1) I
with respect to individuals, breach of
duty, neglect, misstatement, misleading
statement, omission or act, 2) with
respect to the named insured, , breach
of duty, negiect, misstatement,
misleading statement, omission or act,
by or on behaif of the named insured
Page -33-
Definition of Employment practices I
includes:
1, Wrongful termination
(actual or constructive)
2, Breach on an implied
contract
3, Harassment, sexual
harassment, or hostile work
environment
4, Discrimination, including
age, gender, race, color, origin,
religion, sexual orientation or
preference, pregnancy or
disability
5, Retaliation
6, Employment related
misrepresentation
7, Employment related
libel, slander, humiliation,
defamation or invasion of privacy
8, Wrongful failure to
employ or promote
9, Deprivation of a career
opportunity, wrongfui discipline,
wrongful demotion
(with respect to the above, negligent
hiring, retention, supervision, infliction of
emotional distress, mental anguish,
policies and procedures, violation of civil
rights)
Definition of an Insured includes:
1) the entity,
2) past, present or future elected or
appointed officials,
3) past, present, or future
employees,
4) a volunteer
5) members of boards and
commissions operated by and
under the jurisdiction of the
insured
Insurer can settle without County's
consent
Damages Ciaimed By All Persons Or
Organizations Resulting From A Series
Of Related E&Os Are Treated As One
Claim
All are included
Not addressed
either way in the
policy
I
Page -34-
Coverage Applies Separately To Each I
Insured (except liability limit)
Insurer retains the right to subrogate I
claims
Notice of a potential claim reported to I
the insurer will be considered as having
made a claim
Free 30-day ERP I
Insured has the option to purchase a I nsured has the Desired
one-year ERP option to purchase Enhancement:
ERP but the policy Proposers are
does not address asked to quote
the length of the a policy that
RFP or its cost outlines the
iength and cost
of ERP options
Extended Reporting Period Is Avaiiable I
Regardless of Whether The Policy Is
Canceled/Non-Renewed By Calhoun
County or The Insurer (except for the
failure to pay premium)
Reported "Potential" Claims are I
considered as claims
Term and cost of ERP Insurer is obligated
to provide ERP but
the policy does not
address the length
of the RFP or its
cost
Cost to purchase ERP under the $: Note: Only
expiring 1/1/12-13 policy if coverage is Time period: Hiscox is
not renewed by the County (for complete this
completion by row
Hiscox only)
Excess of Other Insurance I
TRIA Terrorism NI
Errors & Omissions/EPL Premium & Policy Period
Annual Premium for coverage outlined $15,214
above but w/o TRIA
Additional TRIA premium (if optional)
Policy Period 1/1/12-13
Page -35-
Subject To
Is Premium Subject to Audit? No
Underwriter's Conditions",
Errors & Omissions/EPL Deductible
Deductible - Each E&O Loss $ 15,000
(regardless of the number of insured, each wrongful act
claimants, or claims arising out of the
same incident)
Deductible - Each EPL Loss (regardless $35,000 each
of the number of insured, claimants, or wrongful act
claims arising out of the same incident)
Does deductible apply to defense and Yes
loss adjustment expenses?
Errors & Omissions Liability Exclusions (n/a to EPL)
Proposed COMMENTS
DESCRIPTION Expiring Exclusions (E)
Exclusions (E)
Libel, slander, defamation or publication E
or utterance in violation of an
individuai's right of privacy; wrongful
entry or eviction or invasion of the right
of occupancy; false arrest or wrongful
detention; plagiarism; or infringement of
copyright or trademark
Claims seeking redress in any form E
other than monetary damages
Defense costs for claims seeking E (except will
injunctive or other non-monetary relief defend up to
$100,000 in
defense costs)
Employment practices liability E
The insureds refusal to pay wages or E
overtime pay, improper payroll
deductions, the failure to provide or
enforce meal/rest periods or breaks
FLSA, Workers Adjustment and E
Retraining Notification Act, COBRA,
OSHA
Claims brought by the named insured E
against an individual insured (other than
derivative claims brought independent
of the named insured)
Page -36-
Claims brought by individual insureds NE
against named insured
Claims brought by individual insured NE
against another individual insured
Related to an event that occurred E
outside of duties for the named insured
~-
Related to an act that occurred prior to E
the retroactive date
Related to a claim reported to another E
insurer
Gaining of any profit or advantage E (except defended
until guilt has been
proven or agreed
to)
The failure to collect fines and fees NE unless the
exclusion
applicable to
"collection of taxes"
could be interpreted
to apply to the
collection of fines
and fees
Improper administration or collection of E
taxes, or a loss that reflects any tax
obligation
Claims invoiving the operation of a E Desired
hospital, clinic, jail. law enforcement Enhancement:
agencies Provide E&O
coverage for the
insured's health
clinic and all law
enforcement
departments
(the insured's
hospital
operation
should not be
covered)
Responsibilities as a fiduciary or trustee E
of an employee benefit plan
Professional services E
ERISA claims E
Inverse condemnation, adverse E
possession, eminent domain, takings,
adverse possession
Page -37-
Damages resulting from property E
seized, held, auctioned or sold by the
insureds
Unfair competition or violation of anti- NE
trust iaws
Bad faith, dishonesty, criminal acts, E (except defended
fraudulent act until guilt has been
proven or agreed
to)
Punitive Damages NE (covered up to
$1 M within policy
limits)
Breach of Contract E
Contractual obligations E
Preparation of bid specifications NE
Failure to provide governmental NE
services
Failure to properly insure NE
Strikes, riots, or civil commotion NE
Administrative, investigative, criminai or NE
disciplinary hearings
Failure to pay bonds or bond interest or NE
the failure to pay debts
Insolvency NE
Pollution E
Back wages, wages, overtime, back E
benefits
Violation of the Securities Exchange Act NE
A regulatory act or similar act by an NE
insured that restrict, limits, or prohibits a
person or entity's right to use property
owned by that person or to pursue a
certain business venture
.-.
E
-
Employment Practices Liability Exclusions (N/A to E&O)
Proposed COMMENTS
DESCRIPTION Expiring Exclusions (E)
Exclusions (E)
Page -38-
Claims based on Workers' E <other than
Compensation, disability benefits, retaliation claims)
unemployment benefits, retirement
benefits, SS benefits
The insureds refusal to pay wages or E
overtime pay, improper payroll
deductions, the failure to provide or
enforce meal/rest periods or breaks
ERISA, FLSA, Workers Adjustment and E (other than for
Retraining Notification Act, COBRA, claims alleging
OSHA retaliation)
Related to an act that occurred prior to E
the retroactive date <including claims
pending prior to the retroactive date)
~~-
Related to a claim reported to another E
insurer
Bad faith, dishonesty, criminal acts, E (except defended
fraudulent act until guilt has been
proven or agreed
to)
Claims involving the operation of a E Desired
hospital, ciinic, jail, law enforcement Enhancement:
agencies Provide EPL
coverage for the
insured's health
clinic and all law
enforcement
departments
(the insured's
hospital
operation
should not be
covered)
Labor or grievance proceedings which is E
subject to a collective bargaining
agreements
Professional services E
ERISA claims E
Claims alleging, arising out of, based E
upon or attributable to any bodily injury,
sickness, disease or death of any
person or property damage other than
emotionai distress or mental anguish
Emotional distress and mental anguish NE
Page -39-
Bad faith, dishonesty, criminal acts, E (except defended
fraudulent acts until guiit has been
proven or agreed
to)
Prior Claims or potential claims that E
should have been disclosed at inception
date of coverage
Punitive Damages NE (covered up to
$1M within policy
limits)
Preparation of bid specifications NE
Failure to provide governmental NE
services
Failure to properly insure NE
Strikes, riots, or civil commotion NE
Gaining profit, remuneration or E (except defended
advantage to which an Insured was not until guilt has been
entitled proven or agreed
to)
Named insured versus an individual E
insured
Insured vs, Named individual insured NE
Individual insured vs, individual insured NE
Page -40-
~.
Optional Enhancements
-
DESCRIPTION ADJUSTMENT to DEDUCTIBLE COMMENTS
premium quoted Above (if different from (indicate "Not
(indicate "-" for return deductibles proposed" if the
premium Q[ "+"for provided above) option is not being
additional premiUm) proposed or
"Included" if
coverage is
provided at no
change in the
premium .provided
above),
"Insurer Pay on Behalf and Duty to
Defend" Form with selection of
Attorney by Insured
Increase the Occurrence/Aggregate a)
limit to $2M/$2M, to include punitive
damages up to these limits
If not written on a true "insurer pays on
the insured's behalf' form of policy,
enhance the reimbursement of
defense costs and damages such
that the reimbursements are made
promptly upon receipt of an invoice
by the County (throughout the life of
a claim)
Defense Coverage Not Subject to a
RetentionlDeductible
Cover Back Wages and Future
Wages within full policy limits
Provide "back wages" coverage up to
$25,000 per wrongful act and
$25,000 annual aggregate
Change to deductibie structure to
be $25,000 per E&O/EPL act
Provide coverage for E&O claims by
the County and by third-parties
against County/District Clerks and
staff within the full policy limits
Provide a defense for claims alleging
criminal and malicious acts and
omissions ($50,000 per wrongful act
and $100,000 annual aggregate)
Page -41-
Expand the definition of "insureds" to
include the District Attorney and staff
when acting in prosecutorial or other
statutorily official capacity for Calhoun
County ($500,000/wrongful act and $1 M
annual aggregate) to include malicious
prosecution coverage and to not exclude
dishonest acts, bad faith, law
enforcement duties, malicious or
criminal acts
Expand the definition of "insureds" to
include District Judges when acting in a
judicial capacity concerning a case filed
in Calhoun County or when acting
concerning administrative matters of
either Caihoun County or a juvenile
board that serves Calhoun County
Provide unlimited defense costs outside
of policy limits
Add verbiage such that the policy
wording prohibits the insurer from
settling a claim without first offering the
County the opportunity to take over the
case
Provide a defense for "takings" claims
($50,000 per wrongful act, up to
$50,000 annual aggregate)
Add coverage to apply to claims alleging
the accidental faiiure to collect fines
and fees of office
Other (Explain)
Page -42-
Law Enforcement Liability
Proposing Insurer: Current A.M,Best Rating Level (ie" A-):
Current A.M,Best Financial Size (ie" XV):
Admitted/Non-Admitted in Texas:
DESCRIPTION Indian Harbor Ins. Co. Proposed Limit COMMENTS
(XL Ins. Group) m: Included (I) Q!
Expiring Limits & Not Included (NI)
Coverage
Limit Each Wrongful Act $ 1,000,000
Aggregate Limit $ 1,000,000
Line-of-Duty Death Benefit (as the result $50,000 (limited to
of a felony) $100,000/policy
period)
Occurrence form of coverage trigger I
"Claims-Made & Reported" form of NI
coverage trigger
"Pay on Behalf' Form I
Insurer has the Right & Duty To Defend I
Insurer has the right to select defense I
counsel
Insurer has the right but not the duty to I
appeal judgments
Insurer has the right to approve all claim I
settlements
The insurer will consult with the I
insureds when the insurer settles a
claim, If the insureds refuse to a
settlement recommended by the insurer,
the insurer's liability shall not exceed the
amount that the claim could have been
settled for plus supplementary
payments as of the date that the
settlement was refused
Defense applies to claims for non- I
monetary damages
Defense provided for non-monetary I
damages when compensatory damages
are also requested
Defense costs do not reduce policy I
limits
Prior Acts Coverage N/A
Page -43-
Covered law enforcement departments At present limited to Desired
include Sheriffs Department, the Sheriff's Enhancement:
Constables, criminal investigator, Department (which All listed LE
nuisance enforcement officer, criminal includes a court operations are
investigators, use of canine, juvenile bailiff and the jail) to be included
probation department, and the juvenile for coverage
board,
Includes District Attorney Not included
Costs incurred to replace and train LE NI
canines following their death in the line
of duty
Use of watercraft for LE purposes NI Desired
Enhancement:
In October 2012
the County will
begin using an
owned
watercraft for
law
enforcement
use, Proposals
are to provide
liability
coverage for
this exposure,
Coverage applies to moonlighting NI Desired
activities when approved in advance by Enhancement:
the appropriate authority Coverage for
authorized
moonlighting is
requested to be
proposed.
Coverage applies to dispatching I
exposures
Food service in the jail I
Punitive damages $1 M within the
policy limits
Insured shall not incur any expense, I
assume any liability without the insurer's
consent
Insurer retains the right to subrogate I
As respects the information contained I
within the underwriting application, the
policy is a separate agreement with
each insured
Coverages include personal injury, I
property damage, bodily injury, violation
of civil rights
Page -44-
"Bodily injury" definition includes mental I
anguish associated with or arising from
physical injury and from non-physical
injury
"Personal injury" includes false arrest, I
false imprisonment, mental distress,
improper service of process, libel or
slander, violation of civil rights, wrongful
detention, wrongful eviction, wrongful
entry, malicious prosecution, wrongful
invasion of the right of private
occupancy
Coverage for damage to property of NI
others in the County's care, custody or
control (other than property on persons
at the time of arrest)
"Property damage" includes physical I
injury to or destruction oftangible
property, including loss of use thereof,
loss of use of tangible property which
has not been physically injured or
destroyed
Coverage applies for damage to NI
property of others in the County's care,
custody or control (other than personal
property on persons at the time of an
arrest)
Coverage applies for damage to I
personal property of others when on
persons at the time of arrest and while
in the County's care, custody or control
Claims for which the State has the NI
responsibility to defend or pay
Automatic 60-day ERP N/A
ERP Cost N/A
Pollution exciusion does not apply to the I
use of mace, teargas and similar
substances
Providing notice of a potential claim is N/A
considered a claim
Defense of alleged criminal acts until NI
guilt is proven or admitted
Premise liability associated with law I
enforcement operations
TRIA Terrorism NI
Page -45-
Law Enforcement Liability Premium & Policy Period
Annual Premium for coverage outlined $26,172.95
above but w/o TRIA
Minimum earned premium 25% of the policy
premium
Additional TRIA premium (if optional)
Policy Period 1/1/12-13
Subject To
Is Premium Subject to Audit? No
Law Enforcement Liability Deductible
Deductible $25,000
per claim
Does deductible apply to defense, Yes
damages and loss adjustment
expenses?
Law Enforcement Exclusions
Use of autos or aircraft E
Use of watercraft E Desired
Enhancement:
watercraft
liability for
owned and non-
owned
watercraft
Auto/aircraft procedures & training NE
Dishonest, fraudulent, malicious or E
criminal acts
Damage to property owned, used, E
rented or controlled by the County
WC obligations, disability obligations E
Employment practices E
War, rebellions, seizure of power E
Pollution E
Use of mace, tear gas or similar NE
substances
Injury to an insured E
Punitive Damages Limited to $1 M
within policy
limits
Page -46-
Claims for injunctive, declaratory or E
equitable relief or non-monetary
damages
Foreign Terrorism NE
Domestic Terrorism NE
Fines, penalties, restitution E
Inverse condemnations, violation of NE
property rights or a reduction or loss
in the value of real or personal
property other than property
damage
Premise defects NE
Judicial acts or duties; prosecutorial NE
acts or duties
Contractual liability E (other than
mutual aid
agreements)
Claim for the return of money or other E
property seized, sold, held or
auctioned by the County
Insured versus insured NE
Medical malpractice claims, NE
LE duties for anyone other than the E
named insured (except when
involving mutual aid agreements or
to properly approved moonlighting)
Investigative or Administrative E
Proceedings
Law Enforcement Optional Enhancements
Increase the policy limits to $2M/$2M
$50,000 deductible
Provide a defense for claims alleging
criminal and malicious acts and
omissions ($50,000 per wrongful act
and $100,000 annual aggregate)
Defense of alleged criminal acts until
guiit has been proven or admitted
Page -47-
Crime Insurance
Proposing Insurer: Current A,M, Best Rating Level (ie" A-):
Current A,M. Best Financial Size (ie" XV):
Admitted/Non-Admitted in Texas:
DESCRIPTION Western Surety Proposed Limit COMMENTS
Expiring Limits & or Included (I) m:
Coverage Not Inciuded (NI)
Public Employee Dishonesty limit, each $10,000
occurrence
Employee Dishonesty "Discovery" form I
(Form "O"-per loss)
Faithful Performance of Duty coverage I
Forgery or alteration (Form "B") NI
Theft, Disappearance & Destruction NI
(Form "C"), Inside the premises and
outside the premises
Robbery and Safe Burglary (Form "0") NI
Computer fraud Not covered
Funds transfer fraud Not covered
Counterfeit currency (Form "R") NI
Persons required by iaw to be Not covered
individually bonded
Treasurers and tax collectors Not covered
Inventory shortages Not covered
Premium and Policy Period
Annual Premium for coverage outlined $4,307
above
Additional TRIA Terrorism (if optional)
Policy Period 1/1/11-14
Subject To
Is Premium Subject to Audit? No
Deductible
Deductible None
Page -48-
Optional Enhancements
Increase the Public Employee
Dishonesty limit to $100,000
Increase the Public Employee
Dishonesty limit to $500,000
Add excess coverage for theft by
treasurers and tax collectors
Add excess coverage for theft by
persons required by law to be
individually bonded
Add $500,000 computer fraud/funds
transfer
Add $1 M computer fraud/funds transfer
Page -49-
Workers' Compensation
Proposing Insurer: Current A.M, Best Rating Level (i.e" A-):
Current A.M, Best Financial Size (i.e" XV):
Admitted/Non-Admitted in Texas:
DESCRIPTION T AC WC Self- Proposed Limit COMMENTS
Insurance Pool or Included (I) or
Expiring Limits & Not Included (NI)
Coverage
Coverage "A" Statutory limits
Coverage "B" $1M
Volunteers $20,000
Includes elected and appointed officials Yes
Does not apply to employees who work Yes
for the County hospital
Premium and Policy Period
Annual Premium for coverage outlined $10S,104
above
Policy Period 1/1/12-13
Subject To
Is the proposed coverage and pricing
"subject to" any conditions?
Is Premium Subject to Audit? No
Deductible
Deductible None
Page -50-
Property/Equipment Breakdown/Inland Marine
Proposing Insurer: Current A.M, Best Rating Level (i.e" A-):
Current A.M, Best Financial Size (i.e" XV):
Admitted/Non-Admitted in Texas:
DESCRIPTION Argonaut Ins. Co. Proposed Limit COMMENTS
(through the T". or Included (I) or
Associations of Not Included (NI)
Political Sub. Pool)
Expiring Limits &
Coverage
Building & Contents Limit (Blanket $ 52,065,398 Base your quote on
Basis; Replacement Cost) (Blanket limit per the values provided in
Exhibit B
occurrence)
Inland Marine scheduled equipment $4,776,006 Quote on the
values provided
in Exhibit B
Inland Marine unscheduled equipment $232,719
(limited to $2,500 per item)
Inland Marine hired, leased borrowed $588,000
Extra Expense, Business Income (non- $250,000
equipment breakdown)
Ex1ra expense for computer loss $10,000
Earth Movement NI
Flood, mudflow, surface water NI
Newly Acquired Property Limit $ 500,000
(Contents)
Newly Acquired Property Limit $ 1,000,000
(Buildings)
Identity theft $5,000 per fulltime
employee
Loss of tax revenues $100,000
Arson Reward $7,500
Accounts Receivable $100,000
Page -51-
Historic contents (including museum $50,000 Desired
pieces) Enhancement:
eliminate this
sublimit so that
historic museum
contents are
covered up to
their full
replacement
cost as per the
values provided
in Exhibit B
"All Risk" Coverage (not including flood, I (except quake,
quake, wind damage, hail damage) wind and hail is
covered for inland
marine)
Claim Valuation (buildings and contents) Replacement cost
"new" (except
library books are
valued at "book
value" less trade
discounts and
depreciation plus
freight charges)
Ciaim Valuation (Inland Marine) RC if the value of
damaged
equipment is = to or
greater than the RC
Otherwise, ACV
Agreed values Not included
Coinsurance Waived for B&C,
90% for Inland
Marine
Preservation of Property (30 days) I
Includes the County's hospital buildings, I
contents, EDP and equipment as
scheduled in Exhibit B
Debris Removal Up to 25% of the
paid loss
Page -52-
Definition of "real property" includes: All "I" When within
1) permanently installed fixtures, 1000' of insured
machinery and equipment and buildings
outdoor fixtures (i.e" well
housings, signs, fences;
2) personal property owned to
maintain or service the building;
3) complete and incomplete
additions and their components;
4) buildings
Joint Loss Agreement I
Autos (confiscated or owned autos) NI
Bridges NI
Building sickness NI
CFC refrigerants I
Collapse caused by specified perils I
Commandeered property $100,000
Communication equipment $100,000
Computer Equipment (non-breakdown) $ 50,000
Computer breakdown bianket limit
Confiscated property other than autos $ 100,000
Crime Reward $1,000 per person,
up to $5,000 per
occurrence)
Detached signs $5,000
Electrical damage other than by arcing $50,000
or by lightning
Fuel storage tanks NI
Media & software $25,000
Off-Premise Utility Failure $50,000
Exhibition Property $50,000
Expediting Expenses for non-equipment Blanket limit
breakdown
Expediting Expenses for equipment Blanket limit
breakdown
Fine Arts $50,000
Page -53-
Fire Department service charge $5,000
Fire Equipment Recharge I
Flag poles $ 5,000
Foundations I
Glass I
Glass display and trophy cases $5,000 Desired
Enhancement:
eliminate this
sublimit so that
cases are
covered up to
their full
replacement
cost as per the
values provided
in Exhibit B
Grounds maintenance equipment $ 50,000
Inflation guard 5%
Inventory & appraisals NI
Jurisdictional inspections I
Lock replacement $500
Law enforcement canines NI
Loss payee SunTrust
Equipment Finance
and Leasing Corp.
as respects MRI
machine
Money and stamps $5,000
Money & Securities (inside) $5,000
Money & Securities (outside) $5,000
Damage caused by mold, virus or Not covered
bacteria
Ordinance or Law - Loss to undamaged Building Limit
portion of building
Ordinance or Law - Demolition, $100,000
I ncreased Cost of Construction
Outdoor Trees, Shrubs, Plants $1,000/plant
$50,000 each
Occurrence
Page -54-
Outdoor property such as fences, $50,000
antennas, detached signs, street signs,
street lights, lawn watering systems, etc
Off-premise property $50,000
Off-premises utility failure, direct $50,000
damage
Pairs or sets I
Park improvements (picnic tables, NI
playground equipment, wooden
walkways, etc,)
Personal effects of employees and $ 1,500 (up to
volunteers $50,000 per
occurrence)
Personal property of the insured within I
1,000 feet of an insured location
Personai property of others $50,000
Pollutant Cleanup $25,000 ($250,000
for equipment
breakdown)
Piers NI
Premises boundary increased distance 1,000'
Property in Transit $50,000 (n/a to
Inland Marine)
Rental reimbursement (Inland Marine) $2,500
Retaining wails that are not part of a NI
buiiding
Rewards (other than for arson) $1,000 per person,
up to $5,000
Refrigerant contamination for $250,000
mechanical breakdown
Sewer backup or overflow I nciuded in blanket
limit
Service interruption for mechanical Blanket limit
breakdown
Spoilage $10,000
Temperature/humidity change $50,000
TRIA Terrorism NI
Unintentional error in description NI
Page -55-
Valuable Papers $100,000 (blanket
over all scheduled
locations)
Weight load exceeding the carrying NI
capacity (Inland Marine)
Premium & Policy Period
Annual Premium for coverage outlined $64,366 for
above Property/Equipment
Breakdown and
$14,099 for Inland
Marine
Additional TRIA premium (if optional) N/A
Policy Period 1/1/12-13
Deductibles
Property Damage $2,500
Equipment breakdown $2,500
Money and stamps $250
Communication equipment $250
Glass breakage $250
Commandeered property $250
Transit $250
Inland Marine $500 (72 hours for
rental reimbursement)
Subject To/Misc.
Underwriter's Conditions
What type of verification of property
values wili be required by the insurer?
(I.e., appraisal provided by the insurer,
appraisal provided by the insured,
reasonable values by sq, footage, etc,)
What type of assistance is the
proposer/insurer willing to provide to
assist the County evaluating its
replacement cost values on buildings
and contents?
Optional Enhancements
Page -56-
DESCRIPTION ADJUSTMENT to DEDUCTIBLE COMMENTS
premium quoted Above (if different from (indicate "Not
(indicate "-" for return deductibles proposed" if the
, premium QI "+"for provided above) option is not being
additional premium) proposed Q[
"Included" if
coverage is
provided at no
change in the
premium provided
above),
$100,000 Key/Lock Replacement
$500,000 Extra Expense/Loss of
Revenues
$1 M Extra Expense/Loss of Revenues
Outdoor Trees, Shrubs, Plants @
$2,500 (up to $50,000 per loss)
Provide $200,000 ACV coverage for
covered damage to
confiscatedlimpounded vehicles held by
the County or by a contractor to the
County \ I I
I Demolition/ICC @ $500,000 I
I Valuable Papers @ $500,000
I Valuable Papers @ $1 M \ ! I I
$50,000 pollutant cleanup for non-B&M
$100,000 pollutant cleanup for non-B&M
Provide coverage for computer
equipment and software damage
resulting from non-equipment
breakdown at scheduled values without
a sublimit
Accounts receivables @ $250,000
Earth movement for buildings and
contents \$ i $
I Other (Explain) I I
Page -57-
AggntlRel2fesentative Services
Please use the space below to provide a detailed listing of services to be provided by the proposing
insurance agent/broker or insurer representative in serving Calhoun County, Indicate whether the
services are provided at no additional cost to the County or to be provided on a fee basis,
Suggested services to be proposed include the following:
1. Negotiating coverage and price with underwriters
2. Maintaining insurer relations
3, Promptly advise the County Auditor of any changes in AM Best ratings of the insurers who
provide coverage to the County purchased through this RFP (and of a pool's reinsurers)
4, Evaluating new exposures and adding coverage, as needed
5, Handling mid-year coverage disruptions
6, Issuing certificates of insurance
7. Verifying rates and premiums
8. Providing the County Auditor with suggested budget figures for insurance premiums
9, Delivering binders prior to December 30 each year
10, Checking policy wording and accuracy
11, Delivering policies within 60 days following the inception of coverage and mid-term
endorsements (hard copies and electronic copies)
12.Answering coverage questions
13,Attending meetings with the County or others
14, Premium billing
15, Checking premium billings for accuracy
16, Claim submission
17. Provide the County with receipt confirmation of all claims submitted by the County
18,Assisting with claims
19, Furnish a monthly report of all claims indicating property or persons involved, date of loss or
accident, amount paid and amount reserved, This report must be furnished within 30 days of
the end of each report month to County Auditor. The claims report should continue to be
provided until all claims are closed, even after the expiration of the policy period.
20. Review open claims via telephone or in person with the County Auditor (or Human
Relations Officer as respects WC) on a monthly basis,
21. Checking premium exposure audits for correctness
22,Answering questions regarding insurance and indemnity clauses in contracts
23, Loss control advice
24. Make certain that the County is aware of all loss control/engineering services that can be
provided by the insurers who write the County's policies purchased through this RFP
25, Developing special policy wording when needed
26,Auditing claims handling
27, Assistance with property valuations
28. Special studies when requested
29. Market the County's insurance program when requested by the County.
Page -58-
Insurer Services
Please use the space below to provide a detailed listing of services to be provided by the proposing
insurer in serving Calhoun County. Indicate whether the services are provided at no additional cost to
the County or to be provided on a fee basis.
Page -59-
CALHOUN COUNTY COMMISSIONER, PRECINCT 3
24627 state Hwy. 172 _ Olivia. Port Lavaea. Texas 77979 ~ Office (361) 893-5346 ~ Fax (361) 893-5309
Home (361) 552-3145 _ Neil E. fritsch, Commissioner, Pet.; ~ Mobile (361) 920-5346
Email: eepret3@laward.eom
September 12. 2012
To: Honorable Judge Michael Pfeifer
From: Neil Fritsch
Re: Agenda Item
Please place the following item on the Commissioner's Court Agenda for September 27,
2012:
"DlsCIISS alld take lIece.vsary actioll to allow Commissioller Fritscll to sigll a Cllstomer
Agreement / DIR Contract (DIR-SDDd779) with Verizoll Wireless."
Respectfully,/), }
. .'/)/' -Z- ;;
/ So /j , ./
;l-ii"j0../ l,.I//[/~<l~.
Neil E. Fritsch
cc: Roger Galvan
, Vern Lyssy
Kenneth Finster
Susan Riley
._.___"_..__,~~~_e____
CUSTOMER AGREEMENT fDIR CONTRACT (DIR-SDD-1779) WITH VERIZON WIRELESS AND
AUTHORIZE COMMISSIONER FRITSCH TO SIGN:
Commissioner Fritsch:
This is a government contract that Verizon has for cell phone service which has a cheaper rate and a few more
perks than going through the Verizon store.
A Motion to approve the Customer AgreementjDIR Contract with Verizon and authorize Commissioner Fritsch
was made by Commissioner Fritsch and seconded by Commissioner Galvan.
Commissioners Galvan, Lyssy, Fritsch and Judge Pfeifer all voted in favor.
\.....----~/
vel'iZOflwlreless
This agreement is dated September 12 2012 between Cellco Partnership dfbla Verll!on Wireless and its Related Entities
("Verizon Wireless") and Calhoun County Precinct 3("Customer"), a customer as defined in AppendiX A in the Contract for
Products and Related Services between the State of Texas Department of Information ResOurces (the "DIR) and Verlzon
Wireless, DIR Contract No. DIR-SDD-1179 (the "DIR Agreement") with an effective date of March 21, 2012 and as
amended.
DIR Contract No. DIR_SDD.1779
Verizon Wireless Customer Agreement
This Customer Agreement shall be governed by the terms and conditions of the DIR Agreement dated March 21, 2012. A
copy of the DIR Agreement Is Incorporated herein by reference and is available online at
tillQ:l1www.dir.tex..il...~gg..LlQlfLcontraclSIDIR.SDD.1779.Pdf or upon request from your Account Manager.
Autlloril!ed customer Is eligible and desIres to purchase wireless services and products from Verizon Wireless pursuant to
the terms and conditions of the DIR Agreemenl, any and all amendments, addenda and schedules as the DIR may
specify from time to time, as well as lhe terms and conditions of all calling plans activated under this customer
Agreement, which are Incorporated herein by reference.
DIR will only be responsible for services provided to DIR and will not be responsible for payments for services provided to
any individual customer.
The Authorized Customer hereby agrees that It Is separately and solely liable for all obligations and payments for
equipment and servIces provided hereunder.
The Authorll!ed customer agrees to the terms and conditions of the DIR Agreement Including the disclosure of limited
account information as parI of the contractual reporting requirements to DIR.
The undersigned represents and warrants that he/she has the power and authcrity to execute this Customer Agreement,
bind the respective Authorized customer, and that the execution and performance of this customer Agreement has been
duiy authorized by all necessary Authorized customer acllon.
The undersigned Is duly authorized by the Authorized customer to deslgna1e the following Indlvldual(s) (the "Authorized
Contacts') who are authorized to take action with respect to the account with Verizon Wireless to purchase equipment,
add lines of service, cancel lines of service and make changes to the account that financially bind the Authorized
customer to the terms and condiUons of this customer Agreement, and the DIR Agreement.
FEIN Number:
Means of Contact Acceptable TolFrom AuthorIzed User (e.g. fax, e-mail. etc.): neIlJrltsch@calhouncotx.org
son la.downs@calhouncotx.org
Verlzon Wireless Sales Representative Name: Mayra Mendel! and Wireless phone Number: (210) 627-0365
Exisllng Vendor customer Account Number(s): 520866826-00001
Authorized User has caused this User Agreement to be executed by its duty aull10rized representative to be effective as
of this 12'" day of september ,2012
Customer Name: Calhoun County Precinct 3
Authorlze~ Slg~at~"} -
, D1 /t;;;t
Prin ed Name: NEIL E. FRITSCH
Title: COMMISSIONER
Date: 9/12112
Verlzon Wireless
AU~~~
prlntedName:@7tl2 i~t/7JOe:z
Title: t; Cr' e (j I 't-e C. oW'...
Date: t?) z- 'f ?p ( Z-
verlZ<l1l Wireless
,032212
DIR-SOD.1779
.
ver'mnwireless
N
01
v
RVIEW
Prepared by
Russ Brown
National Account Manager - State of Texas
CooM.rn"'"'' ",o>><'rn" mrn"'" ,. """",.",,,,,.W''''''''''_'' 00" .... ."'".".,,..,,"~,"''"',~'"'''''' """mi'''''," .~.".v'~"" 0"'00'"' "',' """.."..,,""'''~ ~.~'"
veriZQllwireless
. What has changed?
. What has remained the same?
. Migration process to new contract
. What happens if agency doesn't migrate to new contract?
c~""",;.,,,,, ."""."~..,,"'. ~.'"~, w,,~ w~".""~"..,, "'.. """""..,""w,~"."~"'"'' ~,."""".. .,,"~_'~' ,.~..'"'" "",, .~"""""," ...~."'
\~ --,'Y/'""""
~;#" .
ver'l2!1wireless
. New contract - DIR-SDD-1779
- Go to
. communications Technology Services (CTS)
. About Wireless Services
. Contracts
. OIR-SOO-1779
. 23% discount on commercially-available rate plans
_ Increased from 19%
. 23% discount on eligible features ($24.99 and higher)
_ Increased from 19%
. 35% discount on accessories
_ Increased from 25%
. New custom National and State of Texas plans created
. Text/picture/video messaging now included free of charge on
several Nationwide voice/data bundle plans
OM"'''''''' "" ."""'......".. ,,, "',""''''''"'00'"'.......''.'''..00'' "" ".d..... ",,'w'''' ",...~""..,,"" ..~.,~".., ~..""',,".."-" .",,""".. ,,"'. ",,,,",",,,,,~.",
verizg!lwireless
. FUSF is only fee charged
. Unlimited data plans still available
_ Nationwide
_ State of Texas
_ Mobile Broadband
Smartphones
. Only representative sampling of rate plans will be seen on DIR
website
. Capability to add products/services that are within scope of the
contract (doesn't require addendum)
. Essentially everything else
"00"""""""" .".".."~""" ,. ".,,,",,.W<"'" """......"'".,"', '" ""~...,,"..;M"' '""~,.,,' """ .~".... "",,,,,,,",,,,,,,,. ..,."""' '"'" ."'....w."''''",,~'_m
'\,,_...,.~J'/"-';'-'/
verimpwireless
. Customer Agreement
_ It is acknowledgement of
terms and conditions of new
contract
_ Completed and signed by
agency and VZW
_ VZW submits to internal team
to migrate
_ Transparent to agency
. Purchase Order
_ Must have performance period
(example: 91112012-
813112013)
_ Must state the following:
All purchases in accordance to
DIR contract number DIR-SDD-
1779
Open market pricing
VZW submits to internal team
to migrate
_ Transparent to agency
OooM.o"" "" "00,""""""'" ,. _".,v""oow,,,..,,.".oo~' 00" ",", ,,'"..... ,..",00''''" '0""'"'''' """'..',,",...,,.., oo'"'~""" ."-,, ~"..";".~,, "..'"~ "...~",
verizgpwireless
if
. No purchases or changes to the accounts will be made after October 1,
2012.
. Agency can't take advantage of reduced pricing
0,,',000""000 ...",,"....,w ,,, ~..;,"v."'''w".,,,...W". ,,'" "", .""M'. """00"""'"'''''''''''' "".. .,,,,m,," .~"".v..,," ,,'00'. "'""..,,,,,,... ,,~"'~ "'00"'"
Susan Riley
From:
Sent:
To:
Cc:
Subject:
Attachments:
Neil E. Fritsch [neil.fritsch@calhouncotx.orgj
Saturday, September 22, 2012 10:03 AM
Susan Riley; Mike Pfeifer
Sonia Downs
Fwd: MaintenanceEdge Proposals
ATT00043.pdf; ATT00046.htm; ATT00049.pdf; ATT00052.htm
Judge Pfeifer,
Please place the following on the September 27th Commissioner's Court agenda.
"Consider and take necessary action to approve "Maintenance Edge Proposals" for maintenance tracking software
package with FacilityDude, and authorize appropriate signatures"
Any questions, please ask.
Neil E. Fritsch
Calhoun County Commissioner
Precinct #3, and
President, South Texas County Judges and commissioners Association
24627 State Highway 172
Port Lavaca, Texas 77979
361-893-5346-0ffice
neil. fritsch (alca I houncotx.org
Sent from my ipad
Begin forvvarded message:
From: Lauren Bullard <lbullard(1ilfacilitvdUde.com>
Date: September 21, 2012 12:18:13 PM CDT
To: "neil. fritsch (alca Ihouncotx.org" <neil. fritsch (al ca Ihou ncotX.o rg>
Cc: "everett. wood (alcalhouncotx.org" <everett.wood (alcalhouncotx.org>
Subject: MaintenanceEdge proposals
Neil and Everett,
Please see attached for both of the pricing options we discussed yesterday. When I was calculating
pricing while we were on the call-I noticed I miscalculated with my spreadsheet so the prices on the
proposal vary slightly from what we discussed yesterday. It actually works out in your favor should you
decide to take advantage of the funding opportunity with Johnson.
If you have any further questions on MaintenanceEdge, implementation, or the proposals - please
contact me at any time. All my contact information is below.
We're really excited to start working with you guys - and please rest assured we'll be with you every
step of the way. We believe in earning your business every day and want you to be as successful as
possible.
1
All we need on our end is the proposal back and we'll have client services contact you to setup a time for
your initial training.
All the best,
~--_.-------_. --
Lauren Bullard Account Representative 1 FacilitvDude.com p (919) 674-8725 1 c(352) 562-28781 1(919)
827-0647
.--.---.-.-.--......... -.-.-. -..-.,.-. .
A proud partner of NACo and ICMA - Learn more!
This communication is intended for the sole use of the person Is) to whom it is addressed and may contain information that is privileged,
confidential or subject to copyright. Any unauthorized use, disclosure or copying of this communication is strictly prohibited, If yoU have
received this comn)unication in error. please contact the sender immediately, Any communication received in error should be deleted and all
copies destroyed.
2
"MAINTENANCEEDGE PROPOSALS" FOR MAINTENANCE TRACKING SOFTWARE PACKAGE WITH
FACILITYDUDE AND AUTHORIZE COMMISSIONER FRITSCH TO SIGN:
Commissioner Fritsch:
Has been talking with FaclHtyDude. Everette Wood set up initial contact. The software package allows the
ability to track the history and movement of equipment. It is web-based. It initiates the work orders and
generates the numbers for better tracking. It is not on-site and is backed up. Everything is off-site. There is an
annual premium every year.
Two different proposals:
.
FacilityDude plan: First year $2,849 start up with a yearly premium of $1,542
Johnson controls (third party vendor) plan: will pick up the start up fees and first year's premium in
exchange for reviewing your equipment and work order history.
.
This item was passed for further review of other maintenance tracking programs.
FACILITY
DUDe"
9/21/2012
Calhoun County
221 S Ann St
Port Lavaca, TX 77979
Thank you for your interest in MaintenanceEdge. an affordable suite of powerful, easy-to-use online tools that
allow you to manage your facilities more efficiently with centralized requests, automated maintenance
workflow, and easy-to-use reporting. FacilityDude is dedicated to providing best in class solutions with
unlimited training and support. Ask us about our other simple, affordable online solutions that will help you
save money, increase efficiency and improve services.
Pricin for MaintenanceEd e is based on the total s
Estimated Square Footage'
our facilities:
130,000
'Totals added above those documented will be charged accordingly.
One Time
$1,307
MaintenanceEdge Quick Start
Yearly
$1,542
MaintenanceEdge Yearly
Year One
$2,849
Total First Year Investment
Annual
$1,542
Ongoing Annual
'Includes unlimited users, training and support'
. Proposal has been prepared for Calhoun County.
. Proposal is valid for 30 days.
. Agreement Is effective per the date listed on page one.
. Initial term: year to year.
. Automatic invoicing of annual fee will occur at the end of each term unless request for non-renewal is
received in writing 30 days prior to renewal date.
. Payment: Terms are net 30 days.
. Applicable sales taxes are in addition to the quoted price.
. Subscription begins upon written acceptance of termS and conditions of the proposal.
. All required data is to be provided by you prior to setup.
o Technical support is available from 8am to 6pm Eastern Standard Time at 877 _655-3833 or
supnmt@facilitvdude.com.
o A quote will be provided for any assistance outside the scope of this proposal.
o Although the terms of this document ccntrol, all other conditions of use can be found at
ht : fad\' dude. om ri c -t rms~of-u e .
The undersigned accepts the above detail and agrees to the terms herein.
SUBMITTED BV:
Lauren Bullard
Representative Name
9/21/2012
Date
ACCEPTED BV:
Date
Customer Signature
position
Print Name
please addresS the purchase order to:
FacilityDude.com
11000 Regency Parkway, Suite 200
Cary, NC 27518
'0' Please mail the original and fax or email a copy of the signed proposal and purchase order to 919-
674-8515 or salesla>facilitvdllde.com.
FACILITY
DUDe"
9/21/2012
Calhoun County
221 S Ann St
Port Lavaca, TX 77979
Thank you for your interest in MaintenanceEdge, an affordable suite of powerful, easy-to-use online tools that
allow you to manage your facilities more efficiently with centralized requests, automated maintenance
workflow, and simple reporting. FacilityDude is dedicated to providing best in class solutions with unlimited
training and support. Through our partnership with Johnson Controls we look forward to providing you with
new, innovative ways to achieve optimal building performance, and sustainable results.
Pricing for MaintenanceEdge is based on the total square footage of your facilities:
Estimated Square Footage':130,000
'Totals added abave those documented will be charged accordingly.
MaintenanceEdge Quick Start & First Year Investment
Now - September
30th 2013
Waived = $0
Annual Renewal (Starting October 1, 2013)
Year two and
subsequent years
$1,128
'Includes unlimited users,training and support'
In return for taking part in the Johnson Controls program you agree to:
1. Cooperate with FacilityDude to get your account implemented and functional within the first 120 days of
signing this agreement. If your account is not implemented in the first 120 days, you will be invoiced
directly for the year one investment.
2. Allow FacilityDude to provide Johnson Controls:
a. Branding and ad space on your MaintenanceEdge login and application pages.
b. Access to your data for presenting facility management and planned maintenance savings ideas
and opportunities to you that are specific to your operations.
c. Access to your data for anonymoUS use in their research.
. Proposal has been prepared fcr Calhcun County.
. Proposal is valid for 30 days.
. Agreement is effective per the date listed on page one.
. Initial term: year to year.
. Automatic invoicing of annual fee will occur at the end of each term unless request for non-renewal is
received in writing 30 days prior to renewal date.
. Payment: Terms are net 30 days.
. Applicable sales taxes are in addition to the quoted price.
. subscription begins upon written acceptance of the terms and conditions of tbe proposal.
. All required data is to be provided by you prior to setup.
. Technical support is available from 8am to 6pm Eastern Standard Time at 877 _655-3833 or
>J1Pport@facilitvdude.conl.
. A quote will be provided for any assistance outside the scope of this proposal including data imports.
. Although the terms of this document contrcl, all cther conditions of use can be found at
h : fadii d d. m ri aC ~t I'm -of~use .
The undersigned accepts the above detail and agrees to the terms herein.
SUBMITTED BY:
Lauren Bullard
Representative Name
9/21/2012
Date
ACCEPTED BY:
Date
Customer Signature
Position
Print Name
please address the purchase order to:
FacilityDude.com
11000 Regency Parkway, Suite 200
Cary, NC 27518
... Please mail the original and fax or email a copy ofthe signed proposal and purchase order to 919-
674-8515 or Silles@facilitvdnde,cOm.
In partnership with:
Johnson ~l<i
Controls
CINDY MUELLER
COUNTY AUDITOR, CALHOUN COUNTY
COUNTY COURTHOUSE ANNEX II - 202 S ANN ST, STE B
PORT LA V ACA, TEXAS 77979
(361) 553-4610
MEMORANDUM
I
TO: SUSAN RILEY
COUNTY JU1>GE'S OFFICE
FROM: AUDITORS OFFICE ~ PEGGY HALL
DATE: September 19,2012
RE: AGENDA ITEMS-
Commissioners' Court - September 23, 2010
Susan, AGENDA lTF~M
Tl:nusday, September 27, 2012
~ Discuss and take necessary action on Texas County and District Retirement
System 2013 Plan Information Document and authorize the'County Judge to
sign the Authorization to maintain TCDRS Plan provisions for the Plan
Year 2013. (MP)
TEXAS COUNTY AND DISTRICT RETIREMENT SYSTEM 2013 PLAN INFORMATION
DOCUMENTATION AND AUTHORIZE THE COUNTY JUDGE TO SIGN THE AUTHORIZATION TO
MAINTAIN TCDRS PLAN PROVISIONS FOR THE PLAN YEAR 2013:
A Motion to approve the Texas County and District Retirement System 2013 Plan Information and authorize the
County Judge to sign was made by commissioner Galvan and seconded by Commissioner Lyssy.
Commissioners Galvan, Lyssy, Fritsch and Judge Pfeifer all voted in favor.
RETIREMENT PLAN ASSESSMENT
FOR PLAN YEAR 20I3
Calhoun County - 128
Employee deposit rate - 7%
Mrttching rate - 200%
Prior service credit- 95%
Retirement Eligibility:
Age 60 with 8 years of service
Any age with 30 years afservice
Rule of75 (age plus yea" ofstroice equals 75)
Cost-of~Living Adjustments (COLAs) for retirees:
You have tltVer adopted a COLA.
Optional Benefit Provisions:
VOUR BENEFITS
Basic Benefit Provisions:
WHATVOU ARE PROVIDING
Under your plan, each employee makes deposits into his or her personal TCDRS account hy paying in a percentage of each paycheck.
Employee accounts earn 7% interest each year, which is compounded annually based on the account balance at the beginning of the year.
If one of your employees chooses to receive a retirement benefit, TCDRS adds the employee's personal account balance to marching and
otbet ctedits you ptovide as an employer. We then convert that sum into a monthly beneHt payment. payable for life.
The following cbart shows the estimated TCDRS benefit as a petcentage of final salary prior to rerirement for a neW hire'
120%
20%
Final salary
100%
80%
60%
STeoRS benefit as 11 % of
final salary before
retirement
40%
Hiredar55
Retired ar 65
Hlredar50
Rctlredar65
Hired ar 45
Redred.at65
I-llredat40
Retired at 65
Hkedat35
Retired at 65
0%
Assumpdons
Ernployees are new hires and wi\! work for yoU until retirement.
. YourclITrent plan provisions will rema.in in effect through employee's retirement.
Current laws governIng TCDRS will continue as they are.
. Gmd,d sol"" saU" ~iv< bi~ger ""'" ",Iy in arwS, with small" m"" hI" in am" (s<< Summ"" Valuation R'port a< www."d<s.o'lO'
Bas.ed on Ufe Only beneHt.
Mar. 3t, 2012
800-851-3841 . WWW.TCDRS.ORClIMPLOVeR
2
YOUR COSTS
Your employer contciburion rare represenrs tbe percenrage of payroll your organization needs to contribute to fund future benenrs for
your current employees, former employees and retirees.
To calculate your total required rate, add the rate for any COlA
you plan to adopt to the provided calculated contribution rate.
COLAs must be :lmhorb.ed each year. They are not "automatic." If you.
wish to aUthorize 1. COLA for me next plan year, yOll can estimate the
COSt based on the schedule of lates below:
Calculated contribution rate
1l.19%
I
,9
"1l
.
"I
Ii:
()
t., n .'ll
If " .~
\1-'1
, I 01.
, I "
I hll
I'. I '>1>
'I', ..'. I I
", '"
II', '(,-
i
,5
E
'"
-"
~
7.67%
Your normal cost rate
+
3.52%
Your UAAL rate
COLA rate (if ado pring)
+
T oral required rate
To determine the cost of your plan in dollars, move the decimalfor
your "Total required rate" two places to the left. then mtdtiply it by
yoftr estimated payroll for next year.
%
ofpayroJl
%
of aYIOJI
Below is a record of your required employer contribution rate hisrory over the last nve years.
12% .
to% I . -
..
8%
6%
4%
2%
0%
2009 2010 2011 2012 2013
REASONS FOR RATE CHANGE 2009-2010 2010-2011 2011-2012 2012~2013
BeginnmgRa.te 9.41% 10.27% 10.37% 10.72%
Plan Changes Adopted O.O{! 0,00 0.00 NfA
Investment Return l.47 -0.34 0.34 0.44
Elected RateJLump Sum 0.00 0.00 0.00 0.00
DemographidOrher ChanBt'5 .0.04 0.03 0.01 0.03
Assumptions/Methods ,0.57 0.41 0.00 0.00
EndIng Rate 10.27% 10.37% 10.72% 11.19%
V ALUATlON YEAR 200B 2009 2010 2011
FUNDED RATIO 85% 87% 87% 87%
A complete Summary Valuation Report forthc Dec. 31, 2011 valuation is available on [he web.
Mar. 31. 2012
BoooBBI-3848 . WWW.TCDRB.ORClBMPLOYlR
3
With respect to the participation of Calhoun County in the Texas County & District Rerirement System (TCDRS) for the 2013 plan
year. the following order was adopted:
Calhoun County, #12.8
Authorlzatic)l'l to Maintain TCDRS plan provisions
Plan Year 2013
1. Calhoun Cmioty makes no change in the plan provisions for non-retirees.
* 2. With respect to benefit payments being paid to retirees or their beneficiaries, Calhoun County (check one box):
~ does not adopt a cost-of-living adjustment (COLA).
D adopts a _% CPl_based COLA.
o adopts a _% flat-rate COlA.
* 3. The required employer conrriburion rale for Plan Year 2013 will be the following:
(a) Required ",te without COLA:
(b) COLA rate:
(c) Total required rate (a + b):
11.19%
+
D (enter 0 if not adopting a COLA)
1\. \ q 0/0
.
* 4. Employers may elect to pay a rate greater than the total required tate listed above. Calhoun County adopts for plan Year 2013
(check one box):
~ the total required rate listed above.
o add a new elected rate of 0/0.
5. In the event the 2013 total required rate as set out above exceeds 11%, and if a current waiver ofthatlimit is not on file with
TCDRS, the Commissioners Court of Calhoun County hereby waives the 11% limit on the tate of employer conrributions and
such waiver will remain effective with respect to future plan years nntil properly revoked by official action.
Certification
I certify that the foregoing authorization concerning the participation of Calhoun County in TCDRS for Plan Year 2013 rrulyand
accurately rellecrs the official action taken during a properly posted and noticed meeting on S.f~''''\'' r 21 ,2012. by the
Commissioners Court of Calhoun County as such action is recorded in the official minutes.
A~~~i~~!:O~J~L::counry
't(\ ;V"-!l{. J -S:, ~ tl d~1
Printed Name
Dated: q~ ~I- ~e\'d--
. pl<ase fill in the required information for items 2. 3 and 4 before signing and sending tbi, document '0 TCDRS.
Mar. 30, 2012
PLeASE FAXTO: (512)328,8881
Susan Riley
From:
Sent:
To:
Subject:
Attachments:
Cindy Mueller [cindy,mueller@calhouncotx.orgj
Thursday, September 20,20121:54 PM
'Susan Riley'
Agenda Item Request
Rutlege Crain Audit Engagement FYE 2012.12.31.pdf
Please place the following item on the agenda for September 27, 2012:
. Consider and take necessary action to approve the engagement of Rutledge Crain & Company, PC, Certified
Public Accountants, to perform the audit of the County's financial statements for the year ending December 31,
2012 at an estimated fee of $39,000 (plus $3,500 for single audit if applicable) and authorize the County Judge
to sign.
Susan}
Two originals will be delivered to you for judge's signature. Please return one to me for mailing to Rutledge Crain.
Cindy Mueller
Calhoun County Auditor
202 S. Ann, suite B
port Lavaca, TX 77979
phone 361.553.4610
Fax 361.553.4614
1
ENGAGEMENT OF RUTLEDGE CRAIN & COMPANY, PC, CERTIFIED PUBLIC ACCOUNTANTS, TO
PERFORM THE AUDIT OF THE COUNTY'S FINANCIAL STATEMENTS FOR THE YEAR ENDING
DECEMBER 31, 2012 AT AN ESTIMATED FEE OF $39,000 (PLUS $3,500 FOR SINGLE AUDIT IF
APPLICABLE) AND AUTHORIZE THE COUNTY JUDGE TO SIGN:
A Motion to approve the engagement of Rutledge Crain & Company, PC to perform the audit and authorize the
County Judge to sign was made by Judge Pfiefer and seconded by Commissioner Fritsch.
Commissioners Galvan, Lyssy, Fritsch and Judge Pfeifer all voted in favor.
RUTLEDGE CRAIN & COMPANY, PC
CERTiFIED PUBLIC ACCOUNTANTS
2401 Garden Park Court. Suite B
Arlington, Texas 76013
September 17,2012
Calhoun County, Texas
c/o Ms. Cindy Mueller, County Auditor
202 S. Aun Street, Suite B
Port Lavaca, TX 77979
We are pleased to confum our understanding of the services we are to provide Calhoun County, Texas
(the "County") for the year ended December 31, 2012. We will audit the financial statements of the
governmental activities, the discrete component unit, each major fund, and the aggregate remaining fund
information, which collectively comprise the basic fmancial statements, of the County as of and for the
year ended December 31, 2012. Accounting standards generally accepted in the United States of
America provide for certain required supplementary information (RSI), such as management's
discussion and analysis (MD&A), to supplement the County's basic financial statements. Such
information, although not a part of the basic financial statements, is required by the Goverrunental
Accounting Standards Board wno considers it to be an essential part of financial reporting for placing
the basic financial statements in an appropriate operational, economic, or historical context. As part of
our engagement, we will apply certain limited procedures to the County's RSI in accordance with
auditing standards generally accepted in the United States of America. These limited procedures will
consist of inquiries of management regarding the methods of preparing the information and comparing
the infonnation for consistency with management's responses to our inquiries, the basic financial
statements, and other knowledge we obtained during our audit of the basic financial statements. We will
not express an opinion or provide any assurance on the information because the limited procedures do
not provide us with sufficient evidence to express an opinion or provide any assurance. The following
RSI is required by generally accepted accounting principles and will be subjected to certain limited
procedures, but will not be audited:
1. Management's Discussion and Analysis.
2. Budgetary Schedules Presented as Required Supplementary Information.
3. GASB Required Supplementary Pension InfOlmation.
We have also been engaged to report on supplementary information other than RSI, that accompanies
the County's financial statements. We will subject the following supplementary information to the
auditing procedures applied in our audit of the financial statements and certain additional procedures,
including comparing and reconciling such information directly to the underlying accounting and other
records used to prepare the financial statements or to the financial statements themselves, and other
additional procedures in accordance with auditing standards generally accepted in the United States of
America and will provide an opinion on it in relation to the financial statements as a whole:
Metro (817) 265-9989
Members:
American Institute of Certified Public Accountants
Texas society of CertiHed Public Accountants
Fax (8171 861-9623
Calhoun County, Texas
September 17,2012
Page 2
1. Combining and Individual Fund Statements and Schedules Presented As Other Supplementary
Information.
The following information accompanying the financial statements will not be subjected to the auditing
procedures applied in our audit of the financial statements, and our auditor's report will not provide an
opinion or any assurance on that information:
1. Transmittal Letter
Audit Objectives
The objective of our audit is the expression of opinions as to whether your basic financial statements are
fairly presented, in all material respects, in conformity with U.S. generally accepted accounting
principles and to report on the faimess of the supplementary information referred to in the second
paragraph when considered in relation to the financial statements as a whole. The objective also includes
reporting on-
. Intemal control related to the financial statements and compliance with the provisions of laws,
regulations, contracts, and grant agreements, noncompliance with which could have a material effect
on the financial statements in accordance with Government Auditing Standards.
. Intemal control related to major programs and an opinion (or disclaimer of opinion) on compliance
with lawS, regulations, and the provisions of contracts or grant agreements that could have a direct
and material effect on each major program in accordance with the Single Audit Act Amendments of
1996 and OMB Circular A-l33, Audits of States, Local Governments, and Non-Profit Organizations.
The reports on internal control and compliance will each include a paragraph that states that the purpose
of the report is solely to describe (1) the scope of testing ofinternal control over financial reporting and
compliance and the result of that testing and not to provide an opinion on the effectiveness of internal
control over financial reporting or on compliance, (2) the scope of testing internal control over
compliance for major programs and major program compliance and the result of that testing and to
provide an opinion on compliance but not to provide an opinion on the effectiveness of internal control
over compliance, and (3) that the report is an integral pmt of an audit performed in accordance with
Government Auditing Standards in considering intemal control over financial reporting and compliance
and OMB Circular A-l33 in considering internal control over compliance and major program
compliance. The paragraph will also state that the repOlt is not suitable for any other purpose. We will
malce reference to Memorial Medical Center's ("MMC") auditors' audit ofMMC in our report on your
fmancial statements.
Our audit will be conducted in accordance with auditing standards generally accepted in the United
States of America; the standards for financial audits contained in Government Auditing Standards,
issued by the Comptroller General of the United States; the Single Audit Act Amendments of 1996; and
the provisions of OMB Circular A-l33, and will include tests of accounting records, a determination of
major program(s) in accordance with OMB Circular A-l33, and other procedures we consider necessary
to enable us to express such opinions and to render the required reports. If our opinions on the financial
Calhoun County, Texas
September 17,2012
Page 3
statements or the Single Audit compliance opinions are other than unqualified (unmodified), we will
discuss the reasons with you in advance. If circumstances occur related to the condition of your records,
the availability of sufficient, appropriate audit evidence, or the existence of a significant risk of material
misstatement of the financial statements caused by error, fraudulent financial reporting, or
misappropriation of assets, which in our professional judgment prevent us from completing the audit or
forming an opinion on the financial statements, we retain the right to take any course of action permitted
by professional standards, including declining to express an opinion or issue a report, or withdrawing
from the engagement.
Management Responsibilities
Management is responsible for the basic financial statements and all accompanying information as well
as all representations contained therein. Management is also responsible for identifying government
award programs and understanding and complying with the compliance requirements, and for
preparation of the schedule of expenditures of federal awards in accordance with the requirements of
OMB Circular A-133.
Nonattest Services _ As part of the audit, we will assist with preparation of:
. The County's financial statements,
. Adjusting journal entries,
. Reconciliations of taxes receivable, fines receivable, ambulance receivables, and taxes received
in advance,
. Major additions to capital assets, and
. Preparation of the schedule of expenditures of federal awards, and related notes.
You agree to assume all management responsibilities relating to the listed nonattest services and any
other nonattest services we provide. You will be required to acknowledge in the written representation
letter our assistance with preparation of the nonattest services and that you have reviewed and approved
them prior to their issuance and have accepted responsibility for them. Further, you are required to
designate an individual, preferably from senior management, with suitable skill, knowledge, or
experience to oversee any nonattest services we provide and for evaluating the adequacy and results of
those services and accepting responsibility for them.
Management is responsible for establishing and maintaining effective intemal controls, including
intemal controls over compliance, and for evaluating and monitoring ongoing activities, to help ensure
that appropriate goals and objectives are met and that there is reasonable assurance that government
programs are administered in compliance with compliance requirements. You are also responsible for
the selection and application of accounting principles; for the fair presentation in the financial statements
of the respective financial position of the governmental activities, the discretely presented component
units, each major fund, and the aggregate remaining fund information of the County and the respective
changes in fmancial position and, where applicable, cash flows in conformity with U.S. generally
accepted accounting principles; and for compliance with applicable laws and regulations and the
provisions of contracts and grant agreements.
Management is also responsible for making all financial records and related information available to us
and for ensuring that management is reliable and financial information is reliable and properly recorded.
Calhoun County, Texas
September 17,2012
Page 4
You are also responsible for providing us with (1) access to all information of which you are aware that
is relevant to the preparation and fair presentation of the financial statements, (2) additional information
that we may request for the purpose of the audit, and (3) unrestricted access to persons within the
government from whom we determine it necessary to obtain audit evidence.
Your responsibilities also include identifying significant vendor relationships in which the vendor has
responsibility for program compliance and for the accuracy and completeness of that information. Your
responsibilities include adjusting the financial statements to correct material misstatements and
confilming to us in the written representation letter that the effects of any uncolTected misstatements
aggregated by us during the cUlTent engagement and pertaining to the latest period presented are
immaterial, both individually and in the aggregate, to the financial statements taken as a whole.
You are responsible for the design and implementation of programs and controls to prevent and detect
fraud, and for informing us about all known or suspected fraud or illegal acts affecting the govel1unent
involving (1) management, (2) employees who have significant roles in internal control, and (3) others
where the fraud or illegal acts could have a material effect on the financial statements. Your
responsibilities include informing us of your knowledge of any allegations of fraud or suspected fraud
affecting the government received in communications from employees, former employees, grantors,
regulators, or others. In addition, you are responsible for identifying and ensuring that the entity
complies with applicable laws, regulations, contracts, agreements, and grants. Additionally, as required
by OMB Circular A-l33, it is management's responsibility to follow up and take COlTective action on
reported audit findings and to prepare a summary schedule of prior audit findings and a corrective action
plan. The summary schedule of prior audit findings should be available for our review on April 1 , 2013.
You are responsible for preparation of the schedule of expenditures of federal awards in conformity with
OMB Circular A-133. You agree to include our report on the schedule of expenditures of federal awards
in any document that contains and indicates that we have reported on the schedule of expenditures of
federal awards. You also agree to (include the audited financial statements with any presentation of the
schedule of expenditures of federal awards that includes our report thereon OR make the audited
financial statements readily available to intended users of the schedule of expenditures of federal awards
no later than the date the schedule of expenditures of federal awards is issued with our report thereon].
Your responsibilities include acknowledging to us in the written representation letter that (1) you are
responsible for presentation of the schedule of expenditures of federal awards in accordance with OMB
Circular A-133; (2) that you believe the schedule of expenditures of federal awards, including its form
and content, is fairly presented in accordance with OMB Circular A-l33; (3) that the methods of
measurement or presentation have not changed from those used in the prior period (or, if they have
changed, the reasons for such changes); and (4) you have disclosed to us any significant assumptions or
interpretations underlying the measurement or presentation of the schedule of expenditures of federal
awards.
You are also responsible for the preparation of the other supplementary information, which we have
been engaged to repOlt on, in confOlmity with U.S. generally accepted accounting principles. You agree
to include our report on the supplementary information in any document that contains, and indicates that
we have repOlted, on the supplementary information. You also agree to include the audited financial
statements with any presentation of the supplementary information that includes our repOlt thereon OR
make the audited financial statements readily available to users of the supplementary information no
Calhoun County, Texas
September 17,2012
Page 5
later than the date the supplementary information is issued with our report thereon. Your responsibilities
include acknowledging to us in the written representation letter that (1) you are responsible for
presentation of the supplementary information in accordance with GAAP; (2) that you believe the
supplementary information, including its form and content, is fairly presented in accordance with
GAAP; (3) that the methods of measurement or presentation have not changed from those used in the
prior period (or, if they have changed, the reasons for such changes); and (4) you have disclosed to us
any significant assumptions or interpretations underlying the measurement or presentation of the
supplementary information.
Management is responsible for establishing and maintaining a process for tracking the status of audit
fmdings and recommendations. Management is also responsible for identifying for us previous financial
audits, attestation engagements, performance audits, or other studies related to the objectives discussed
in the Audit Objectives section of this letter. This responsibility includes relaying to us corrective
actions taken to address significant findings and recommendations resulting from those audits,
attestation engagements, performance audits, or studies. You are also responsible for providing
management's views on our current findings, conclusions, and recommendations, as well as your
planned corrective actions, for the report, and for the timing and format for providing that information.
Audit Procedures-General
An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the
financial statements; therefore, our audit will involve judgment about the number of transactions to be
examined and the areas to be tested. An audit also includes evaluating the appropriateness of accounting
policies used and the reasonableness of significant accounting estimates made by management, as well
as evaluating the overall presentation of the financial statements. We will plan and perform the audit to
obtain reasonable rather than absolute assurance about whether the financial statements are free of
material misstatement, whether from (l) errors, (2) fraudulent financial reporting, (3) misappropriation
of assets, or (4) violations of laws or governmental regulations that are attributable to the entity or to
acts by management or employees acting on behalf of the entity. Because the determination of abuse is
subjective, Government Auditing Standards do not expect auditors to provide reasonable assurance of
detecting abuse.
Because of the inherent limitations of an audit, combined with the inherent limitations of internal
control, and because we will not perform a detailed examination of all transactions, there is a risk that
material misstatements or noncompliance may exist and not be detected by us, even though the audit is
properly plauned and performed in accordance with U.S. generally accepted auditing standards and
Government Auditing Standards. In addition, an audit is not designed to detect immaterial misstatements
or violations of laws or governmental regulations that do not have a direct and material effect on the
financial statements or major programs. However, we will inform the appropriate level of management
of any material errors or any fraudulent financial reporting or misappropriation of assets that come to
our attention. We will also inform the appropriate level of management of any violations of laws or
governmental regulations that come to our attention, unless clearly inconsequential, and of any material
abuse that comes to our attention. We will include such matters in the reports required for a Single
Audit. Our responsibility as auditors is limited to the period covered by our audit and does not extend to
any later periods for which we are not engaged as auditors.
Calhoun County, Texas
September 17,2012
Page 6
Our procedures will include tests of documentary evidence supporting the transactions recorded in the
accounts, and may include tests of the physical existence of inventories, and direct confirmation of
receivables and certain other assets and liabilities by correspondence with selected individuals, funding
sources, creditors, and financial institutions. We will request written representations from your attorneys
as part of the engagement, and they may bill you for responding to this inquiry. At the conclusion of our
audit, we will require certain written representations from you about the financial statements and related
matters.
Audit Procedures-Internal Control
Our audit will include obtaining an understanding of the entity and its environment, including internal
control, sufficient to assess the risks of material misstatement of the financial statements and to design
the nature, timing, and extent of further audit procedures. Tests of controls may be performed to test the
effectiveness of certain controls that we consider relevant to preventing and detecting errors and fraud
that are material to the financial statements and to preventing and detecting misstatements resulting from
illegal acts and other noncompliance matters that have a direct and material effect on the financial
statements. Our tests, if performed, will be less in scope than would be necessary to render an opinion
on internal control and, accordingly, no opinion will be expressed in our report on internal control issued
pursuant to Government Auditing Standards.
As required by OMB Circular A-B3, we will perform tests of controls over compliance to evaluate the
effectiveness of the design and operation of controls that we consider relevant to preventing or detecting
material noncompliance with compliance requirements applicable to each major federal award program.
However, our tests will be less in scope than would be necessary to render an opinion on those controls
and, accordingly, no opinion will be expressed in our report on internal control issued pursuant to OMB
Circular A-B3.
An audit is not designed to provide assurance on internal control or to identifY significant deficiencies or
material weaknesses. However, during the audit, we will communicate to management and those
charged with governance internal control related matters that are required to be communicated under
AICP A professional standards, Government Auditing Standards, and OMB Circular A-B3.
Audit Procedures-Compliance
As part of obtaining reasonable assurance about whether the financial statements are free of material
misstatement, we will perform tests of the County's compliance with provisions of applicable laws,
regulations, contracts, and agreements, including grant agreements. However, the objective of those
procedures will not be to provide an opinion on overall compliance and we will not express such an
opinion in our report on compliance issued pursuant to Government Auditing Standards.
OMB Circular A-B3 requires that we also plan and perform the audit to obtain reasonable assurance
about whether the auditee has complied with applicable laws and regulations and the provisions of
contracts and grant agreements applicable to major programs. Our procedures will consist of tests of
transactions and other applicable procedures described in the OMB Circular A-B3 Compliance
Supplement for the types of compliance requirements that could have a direct and material effect on
each of the County's major programs. The purpose of these procedures will be to express an opinion on
Calhoun County, Texas
September 17,2012
Page 7
the County's compliance with requirements applicable to each of its major programs in our report on
compliance issued pursuant to OMB Circular A-133.
Engagement Administration, Fees, and Other
We understand that your employees will prepare all cash, accounts receivable, or other confirmations we
request and will locate any documents selected by us for testing.
At the conclusion of the engagement, we will complete the appropriate sections of the Data Collection
Form that summarizes our audit findings. It is management's responsibility to submit the reporting
package (including financial statements, schedule of expenditures of federal awards, summary schedule
of prior audit findings, auditors' reports, and corrective action plan) along with the Data Collection
Form to the federal audit clearinghouse, We will coordinate with you the electronic submission and
certification. If applicable, we will provide copies of our report for you to include with the reporting
package you will submit to pass-through entities. The Data Collection Form and the reporting package
must be submitted within the earlier of 30 days after receipt of the auditors' reports or nine months after
the end of the audit period, unless a longer period is agreed to in advance by the cognizant or oversight
agency for audits.
The audit documentation for this engagement is the property of Rutledge Crain and Company, PC and
constitutes confidential information. However, pursuant to authority given by law or regulation, we may
be requested to make certain audit documentation available to the County or its designee, a federal
agency providing direct or indirect funding, or the U.S. Government Accountability Office for purposes
of a quality review of the audit, to resolve audit findings, or to cany out oversight responsibilities. We
will notify you of any such request. If requested, access to such audit documentation will be provided
under the supervision of Rutledge Crain & Company, PC personnel. Furthermore, upon request, we may
provide copies of selected audit documentation to the aforementioned patties. These parties may intend,
or decide, to distribute the copies or information contained therein to others, including other
govemmental agencies.
The audit documentation for this engagement will be retained for a minimum of five yeat.s after the
report release date. If we are aware that a federal awarding agency, pass-through entity, or auditee is
contesting an audit finding, we will contact the patty(ies) contesting the audit finding for guidance prior
to destroying the audit documentation.
We expect to begin our audit on approximately April I, 2013 and to issue our reports no later than June
30, 2013 (or earlier upon receipt of official audited statements of Memorial Medical Center). Chris
Rutledge is the engagement shareholder and is responsible for supervising the engagement and signing
the reports or authorizing another individual to sign them. Our fee for these services will be at our
standard hourly rates including out -of-pocket costs (such as report reproduction, word processing,
postage, travel, copies, telephone, etc.) except that we agree that our gross fee, including expenses, will
not exceed $39,000 plus an additional $3,500 for performance of a single audit. Our standard hourly
rates vary according to the degree of responsibility involved and the experience level of the personnel
assigned to your audit. Our invoices for these fees will be rendered each month as work progresses and
are payable on presentation. In accordance with our firm policies, work may be suspended if your
account becomes 30 days or more overdue and may not be resumed until your account is paid in full. If
Calhoun County, Texas
September 17,2012
Page 8
we elect to terminate our services for nonpayment, our engagement will be deemed to have been
completed upon written notification of termination, even if we have not completed our report(s). You
will be obligated to compensate us for all time expended and to reimburse us for all out-of-pocket costs
through the date of termination. The above fee is based on anticipated cooperation from your personnel
and the assumption that unexpected circumstances will not be encountered during the audit. If
significant additional time is necessary, we will discuss it with you and arrive at a new fee estimate
before we incur the additional costs.
Government Auditing Standards require that we provide you with a copy of our most recent external
peer review report, and any subsequent peer review reports received during the period of the contract
when requested by you. Accordingly, our 2010 peer review repOlt accompanies this letter.
We appreciate the opportunity to be of service to Calhoun County, Texas and believe this letter
accurately summarizes the significant terms of our engagement. If you have any questions, please let us
know. If circumstances occur related to the condition of your records, the availability of sufficient,
appropriate audit evidence, 01' the existence of a significant risk of material misstatement of the financial
statements caused by error, fraudulent financial reporting, or misappropriation of assets, which in our
professional judgment prevent us from completing the audit or forming an opinion on the financial
statements, we retain the right to take any course of action pennitted by professional standards,
including declining to express an opinion or issue a report, or withdrawing from the engagement. If you
agree with the terms of our engagement as described in this letter, please sign the enclosed copy and
return it to us.
t2~~ C-~ I
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Rutledge Crain & Company, PC
RESPONSE:
This letter correctly sets forth the understanding of Calhoun County, Texas.
By: -fY'A I A~( ~ 0/ l
Title: C.-n 1I n f'1 C(1, J '-f
Date: q - ~1 - J 2.-
Calhoun County, Texas
September 17,2012
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Page 9
Susan Riley
From:
Sent:
To:
Subject:
Attachments:
Naoma Bryant [Naoma.Bryant@GLO.TEXAS.GOV]
Monday, September 17, 2012 12:51 PM
susan. riley@calhouncotx.org
Fwd: Scanned document from Texas General Land Office ceo
20120917143626352.pdf
Ms. Riley,
Attached is the renewal application packet for the above-referenced Coastal
Lease. The current permit expires March 31, 2013. The attached cover letter
explains the renewal process. The application should be signed and notarized and
returned to our Corpus Christi Field Office as soon as possible. The application
may be scanned/e-mailed or mailed to the address below.
Please respond to this e-mail to verify receipt of the application.
If you have any questions, please let me know.
Thank you very much,
Naoma
Naoma Bryant
Texas General Land Office
TAMU-CC
6300 Ocean Drive Unit 5848
Corpus Christi, TX 78412-5848
Phone: (361) 825-3033
Fax: (361) 825-3040
naoma.brvant~glo.texas.gov
1
RENEWAL APPLICATION CL870002 WITH THE TEXAS GENERAL LAND OFFICE; ESPIRITU SANTO
BAY, CALHOUN COUNTY, TEXAS, AND AUTHORIZE ALL APPROPRIATE SIGNATURES:
A Motion approve the renew Application CL870002 with the Texas General Land Office; Espiritu Santo Bay and
authorize all appropriate signatures was made by Commissioner Fritsch and seconded by Commissioner Lyssy.
Commissioners Galvan, Lyssy, Fritsch and Judge Pfeifer all voted in favor.
"'[' '[' \' \ '
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(.. [,~ >< E F~. \L L.\.>--: '() () F ;[.' '[ (,' 1f;~
JERRY PATTEHSON, COMiVIISSrONER
September 17, 2012
Calhoun County
Attn: The Honorable Michael J. Pfeifer, County Judge
211 South Ann
Port Lavaca, TX 77979-4249
RE: CL870002 Renewal Application
Espiritu Sallto Bay, Matagorda Bay, Calhoun, Matagorda County, Texas
Dear Judge Pfeifer:
According to our records, the above-referenced Coastal Lease for from the School Land Board for the use of
Coastal Public Land owned by the Pelmanellt School Fund has an expiration date of March 31, 2013,
Please complete the enclosed application and affidavit and retUl'n them to the Texas General Land
Office, to the address below, within twenty (20) days of the receipt of this letter. Also enclosed is the
exhibit from your most recent contract. If you would like to make modifications andJor additions to the
permitted structure, please indicate those changes on the drawing and return it with the application and
affidavit. You do not need to seud any money at this time.
Your Coastal Lease will be reviewed and an on-site inspection may be conducted to detemline compliance with
the cunent contract.
Please note that placement of unauthorized structures and/or failure to obtain the required authorization from this
office for the use of Coastal Public Land may subject the responsible party to civil penalties and/or removal of
unauthorized stl'llctures by the State with recove,y of removal costs f!'Om the responsible party or placement of a
lien against the adjacent littoral property (V.C.T.A. Natural Resources Code, Section 33.112, 33.3021, and
51.302). Mitigation costs may also be assessed when necessary to compensate for damage to natural resources.
[fyou have any questions, please call me at (361) 825-3033.
Sincerely,
, /L,~ <6~4--
C ~:anl /
Administrative Assistant
Enclosures
Texas General Land Office
Texas A&M University-Corpus Christi
6300 Ocean Drive, Unit 5848. Corpus Christi, Texas 78412-5848
Phone: 361-825-3030. Fax: 361-825-3040
www.~lo.state.tx.lIs
AppLtrRenew_ CL
STATE OF TEXAS
GENERAL LAND OFFICE
APPLICA nON FOR RENEWAL OF COASTAL LEASE
GLO lD: CL870002
Expiration Date: March 31. 2013
Please type or print in the blanks below all applicable information. If information requested is not applicable,
indicate by placing N/A in the blank. ISSUANCE OF THE COASTAL LEASE FOR WHICH YOU HAVE
APPLIED IS CONTINGENT UPON VERIFICATION OF THE INFORMATION SUBMITTED, PAYMENT
OF APPROPRIATE FEES, AND COMPLIANCE WITH ALL APPLICABLE REGULATORY
REQUIREMENTS (SEE ATTACHED NOTES).
I. Applicant Information (Responsible Party Under Contract):
A. Name: Calhoun County (attn: Michael J. Pfeifer, County Judge)
Mailing Address: 21 I South Ann, Ste 301
City/State/Zip: Port Lavaca, TX 77979-4249
Telephone: Home: Work: (361) 553-4600
Cell Phone: Pax: (361) 553-4444
Email Address: susan.riley@calhouncotx.org
B. Please list any changes/corrections to demographic information above in the spaces provided
below if applicable:
Name:
Mailing Address:
City/State/Zip:
Telephone: Home: Work:
Cell Phone: Pax:
Email Address:
II. Signature of Applicant(s): Calhoun County
By:
Si'llaUl,!!J; tfI
J. ?f/,'k- .
(' -Ou J1 -1-'1 'Jh) U'
Title
111, c.A.# /
Printed Name
1- CJ.7- / 2-
Date
111[ormation collected by eleclronic mail and by web fOl'm is subject 10 Ihe Public 111[ol'lllation Acl, Chapter 552, Government Code,
obryant
Page 1
STATE OF TEXAS
~
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~
COUNTY OF CALHOUN,
MATAGORDA
COASTAL LEASE RENEWAL AFFIDAVIT
The undersigned being first duly sworn on oath, states as follows:
1. The undersigned is the grantee under Coastal Lease No. CL870002 (the "CL");
2. The undersigned has applied to the General Land Office (the "GLO") to renew the CL for an additional term;
3. The undersigned has complied with all of the terms of the CL during its term and has complied with all of the
guidelines and rules of the GLO and the School Land Board (the "SLB") applicable to the CL;
4. The undersigned has not made any improvements, additions, or modifications to the Premises, as shown on
Exhibit C, attached hereto and incorporated herein by reference, during the term of the CL, without the advance
written consent of the GLO; and
S. The nndersigned acknowledges that the SLB and the GLO will rely on the truth of the statements contained
herein in issuing the renewal of thc CL. In the event that any of the statemcnts herein prove to be untrue, the
renewal CL shall be subject to immediate termination, which will require that the undersigned remove all
structures from the Premises.
GRANTEE: Calhoun County
By: SignatlJ!t0 J ~ ~ J--
~"dHI ,y. f,r~;H'"
Printed Name
fAJ"-"7, nJv
Title
'1-,)7-1'-
Date
ACKNOWLEDGMENT
STATEOF Texas
COUNTY OF Calhoun
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This instrument was acknowledged before me on the
by, Michael J. Pfeifer
27 day of September
for Calhoun County.
/
20~,
SUSAN RilEY
Notary Public, State of Texas
My Commission
NOlcll'fl'lflt8l1pOl
Notary Public, State of
Texas
My commission expires:
04-18-2016
Infol'lI/alion eollecled by eleelI.oniemail and by webfol'm isslIbjeetlo the Public Infol'malion Acl, Chaplel' 552, Govel'11menl Code.
obryant Page 2
TEXAS GENERAL LAND OFFICE
AI'PLlCATlON FOR RENEWAL OF COASTAL LEASE
NOTES:
I. The application will be reviewed by the GLO Field Office to vedfy site conditions. Lessee will be advised
regarding tel'm length, special conditions, and payment amounts. It will then be submitted to the Texas School
Land Board (SLB) for consideration. If approved by SLB, a contract will be prepared and sent to Lessee for
signatures.
2, Lessee is advised that in accordance with the easement agreement, unless renewed on a timely basis, hold-over
occupancy beyond the expiration date ofthe easement is subject to increased Icase payment amounts.
3, Lessee is advised that in accordance with provisions of the easement agreement,. if the agreement is not
renewed, all private property and 'man-made improvements must be removed and the premises returned to pre-
easement conditions within 120 days ofthe expiration date.
nbrymll Page 3
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,
Town of Pori O'Conner
TITLE Call10un County (CL870002)
I
I COMPANY Texas Gelmral Lancl Office
DFZAWING SCALE Not to Scale
DATE OF INSPECTION 2,13.08
CFZEATOR Sbnscllang re,clrawn Iron Veselka '1999
Modllled l1y lWarels EXHIBIT C
RESOLUTION PROCLAIMING OCTOBER 13, 2012 AS VIETNAM VETERAN'S DAY IN CALHOUN
COUNTY, TEXAS:
The Resolution was read aloud by Judge Pfiefer. A parade for the Vietnam Veterans will be held in downtown
Victoria, Texas on Saturday, October 13, 2012 at 10:00 A.M.
A Motion to proclaim Saturday, October 13, 2012, as Vietnam Veteran's Day in Calhoun County was made by
Commissioner Lyssy and seconded by Commissioner Fritsch.
Commissioners Galvan, Lyssy, Fritsch and Judge Pfeifer all voted in favor.
Commissioner Fritsch:
Thanked the veterans for coming to the meeting and recognized Ron Kocian from Warrior Weekend and thanked
him for his many services.
Judge Pfiefer:
Conveyed Commissioner Finster's congratulations as he could not be in court today.
The Resolution was presented by Commissioner Fritsch and accepted by Dale Cooper representing the Veterans
of Foreign Wars.
Ron Kocian:
Thanked the Court for their continued support in Warriors Weekend down at Port O'Connor and the community
center. They had about 4S0 wounded and 2S0 - 300 family members who attended this year. The goal is to
have 500 next year and this could not be done without the support of the County.
in Calhoun County, Texas and do hereby reaffirm our commitment to honor, respect and support
Vietnam Veterans and express our deepest gratitude to the families of Veterans who have made the
ultimate sacrifice for the defense of this nation and ask all citizens to do the same.
-J_
Resolution
VIETNAM VETERANS DA Y
October 13,2012
WHEREAS, thousands of men and women from Cathoun and surrounding counlies have
answered the call to se/ve in the Vietnam War in Armed Forces of the United States; and,
WHEREAS, the men and women who have served in the Armed Forces of the United States
have contributed significantly toward the preservation of the freedoms of this nation and of many
nations across the world; and,
WHEREAS, all men and women who have answered that call have sacrificed some; some
have sacrificed all, and deserve the deepest respect and gratitude of this nation; and,
WHEREAS, the families of Vietnam Veterans from all across this nation deserve the adoration
of all citizens of this nation who enjoy the rights and privileges that have been guaranteed by their
$acrifia~s; and,
WHEREAS, the Calhoun County Commissioners' Courl recognizes that it is way past time to
honor those who answered their country's call to serve during the Vietnam War; and,
WHEREAS, these Vietnam Veterans were treated without the honor they deserved upon their
return, and these veterans will be honored by "The Parade That Never Was" on Saturday, October
13th, 2012 beginning at 10 a,m, in Downtown Victoria.
"A TIME TO HONOR ALL VIETNAM VETERANS
AND TO PA Y TRIBUTE TO THEM AND THEIR FAMILIES"
1
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1
NOW THEREFORE, tet it be resolved, that the Commissioners' Court of Calhoun County,
Texas, does hereby proclaim Saturday, October 13,2012 as Vietnam Veterans Day
Signed and adopted this 27'h day of September, 2012.
<..<<...1)
Ne I E. Fritsch. Commissioner
Ca houn County Precinct #3
Kenneth W. Finster, Commissioner
Calhoun County Precinct #4
Attest: Anita Fricke, County Clerk
b .,!t" E~~_
By: De ty Clerk
COUNTY REPORTS:
The following monthly reports were presented:
1) Calhoun Tax Assessor/Collector: August 2012
2) County Treasurer: July 2012
3) Justices of Peace:
i. Justice of the Peace #2: August 2012
ii. Justice of the Peace #4: August 2012
Iii. Justice of the Peace #5: August 2012
A Motion to approve the county reports was made by Judge Pfiefer and seconded by Commissioner Fritsch.
Commissioners Galvan, Lyssy, Fritsch and Judge Pfeifer all voted in favor.
SUMMARY
TAX ASSESSOR.COLLECTOR'S MONTHLY REPORT
FOR: AUGUST 2012
COLLECTIONS DISBURSEMENTS
Title Certificate Fees $ 10,959.00
Title Fees Paid TXDOl $ 6,744.00
Title Fees Paid County Treasurer Salary Fund $ 4,215.00
Motor Vehicle Registration Collections $ 155,928.28
Disabled Person Fees $ 70.00
Postage $ 211.00
FD Additonal Collections $ 7.00
FD Fees In Excess of Collections
Paid TXDOT $ 148,249.98
Paid TXDOT SP $ 970.50
Paid County Treasurer $
Paid County Treasurer Salary Fund $ 6,493.55
DMV CCARDTRNSFEE $ 495.25 $
FD Additonal Collections $ 7.00 $
First Data (IBC) Credit/Debit Card Fee's $ 403.38
FD Fees In Excess of Collections $ 98.87
Motor Vehicle Sales & Use Tax Collections $ 729,266.68
Paid State Treasurer $ 729,266.68
Special Road/Bridge Fees Collected $ 26,850.00
Paid TXDOT M RIB Fees $ 26,044.50
Paid County Treasurer M RIB Fees $ 805.50
Texas Parks & Wildlife Collections $ 4,959.00
fD Additional Collections
FD CREDIT CARD TRANSACTION FEES $ 222.82
Paid Texas Parks & Wildlife $ 4,463.10
Paid County Treasurer Salary Fund $ 495.90
First Data (lBC) Credit/Debit Card Fee's $ 223.25
FD Fees In Excess/Shortage of Collections $ (0.43)
State Beer & Wine Collections Month of AUGUST $ 1,080.00
$
State Beer & Wine Collections $
Paid Tx Alcoholic Beverage Commission- $ 3,772.00
Paid County Treasurer, Salary Fund $ 53.00
County Beer & Wine Collections $
Paid County Treasurer, County Beer & Wine $ 503.50
Paid County Treasurer, Salary Fund $ 26.50
Renewal Fees for County Beer & Wine $
Paid County Treasurer. Renewal Fees $ 10.00
Additional Postage M Vehicle Registration $ 25.35
Paid County Treasurer - Additional Postage $ 25.35
Interest earned on P&W $ 5.86 and $ 5.86
Refund $ Accounts
Paid CountyTreasurer-lnt. on P&W & Ref $ 5.86
Interest earned on Office Account $ 42.74
Paid co~nty Treasurer - Nav. East $ 0.05
Paid County Treasurer - all other districts $ 42.69
Busirjess Personal Property - Misc. Fees $ 87.83
Paid County Treasurer $ 87.83
Excess Funds $
Paid County Treasurer $
Overpayments $ 1.36
Current Tax Collections $ 29,010.17
Penalty and Interest - Current Roll $ 5,455.14
Discount for early payment of taxes $
Delinquent Tax Collections $ 13,877.05
Penalty & lliterest M Delinquent Roll $ 7,153.28
Collections for Delinquent Tax Attorney $ 8,243.08
Advance M FM & L Taxes $ 9.37
Advance ~ County AdValorem Taxes $ 49,815.90
Paid County Treasurer~ Nav. East $ 235.09
Paid County Treasurer ~ all other Districts $ 5,436.64
Paid County Treasurer - Delinq Tax Atty. Fee $ 8,243.08
Payment in Lieu of Taxes $
Paid County Treasurer - Navig. East $
Paid County Treasurer - All other Districts $
Boat/Motor Sales & Use Tax Collections $ 38,731.42
Paid State Treasurer $ 36,794.85
Paid County Treasurer, Salary Fund $ 1,936.57
Special Farmers Fees Collected $ 70.00
Paid State Treasurer, Farmers Fees $ 70.00
Hot Check Collection Charges $
Paid County Treasurers, Hot Check Charge $
Overage on Collection/Assessing fees $
Paid County Treasurer, overage refunded $
Escheats $
Paid County Treasurer~escheals $
TOTAL COLLECTIONS $
1,032,257.06
BAt FORWARD JULY 2012 STATE/COUNTY BEER AND WINE CaLL'S
$
4,365.00
BAt FORWARD AUGUST 2012 STATE/COUNTY BEER AND WINE COLL'S
$
(1,080.00)
TOTAL COLLECTIONS/INCLUDING CHANGE IN BEER AND WINE BALANCE FORWARD $
TOTAL DISBURSEMENTS 1,035,542.06
TOTAL OF ABOVE RECEIPTS PAID TO STATE AND COUNTY
$
1,035,542.06
~}a.~
/ GLORIA A. OCHOA
Tax Assessor-Collector
~h'O~
. Ie A L J. PFEIFER
County JUdge
CALHOUN COUNTY, TEXAS
CALHOUN COUNTY TREASURER'S REPORT MONTH OF: JULY 2012
BEGINNING ENDING
FUND FUND BAI.ANCE RECEIPTS DISBURSEMENTS FUND BALANCE
GENERAL $ 22,223,141.20 $ 1,101,166.76 $ 3,847,667.11 $ 19,476,640.85
AIRPORT MAINTENANCE 52,168.93 262.83 692.46 51,739.30
APPELLATE JUDICIAL SYSTEM 981.79 117.35 (0,04) 1,099,18
COASTAL PROTECTION FUND 33,438.32 8,23 (4,08) 33,450.63
COUNTY AND DIST COURT TECH FUND 711.59 67.07 (0,05) 778.71
COUNTY CHILD WELFARE BOARD FUND 446.52 64.11 (0,02) 510.65
COURTHOUSE SECURITY 200,812.05 1,624.72 (23,75) 202,460.52
DIST eLK RECORD PRESERVATION FUND 2,579.75 139.33 (0.23) 2,719.31
CO eLK RECORDS ARCHIVE FUND 6,165.00 23,795.52 (2,71) 29,963.23
DONATIONS 120,432.29 352,13 445.43 120,338.99
DRUG/DWI COURT PROGRAM FUND-LOCAL 3,357.38 284,99 (0.26) 3,642.63
JUVENILE CASE MANAGER FUND 17,859.19 1,434.45 1,290.19 18,003.45
F AMLL Y PROTECTION FUND 4,921.61 16.21 (0.57) 4,938.39
JUVENILE DELINQUENCY PREVENTION FUND 8,526,40 2.10 (1.04) 8,529.54
GRANTS 250.059,13 5,063.54 7,385.92 247,736.75
JUSTICE COURT TECHNOLOGY 55,147.22 1,204,38 (6,34) 56,357.94
COUNTY CHILD ABUSE PREVENTION FUND 100,00 0,00 0.00 100.00
JUSTICE COURT BUILDING SECURITY FUND 13,725.91 195.96 (1.62) 13,923.49
LATERAL ROAD PRECINCT #-1 4,236.05 1.04 (0,51) 4,237.60
LATERAL ROAD PRECINCT #-2 4,236,05 1.04 (0,51) 4,237.60
LATERAL ROAD PRECINCT #-3 4,236,05 1.04 (0,51) 4,237.60
LATERAL ROAD PRECINCT #4 4,236,06 1.04 (0.51) 4,237.61
PRETRIAL SERVICES FUND 58,207.60 14,32 (7.08) 58,229.00
LAW LIBRARY 181,490.73 881.01 601.77 181,769.97
LAW ENF OFFICERS STD. EDUe. (LEOSE) 17,144.35 4,22 (2,09) 17,150.66
POC COMMUNITY CENTER 45,638.27 1.461.23 3,674.13 43,425.37
RECORDS MANAGEMENT-DISTRICT CLERK 2,711.47 106,60 (0.26) 2,818.33
RECORDS MANAGEMENT -COUNTY CLERK 174,719,88 105.64 51,862.29 122,963.23
RECORDS MGMT & PRESERVATION 72,615.32 31,751.16 (8.45) 104,374.93
ROAD & BRIDGE GENERAL 1,354,799.40 36,558.58 (134.79) 1,391,492.77
ROAD & BRIDGE PRECINCT #3 8.61 0.00 0.00 8,61
ROAD MAINTENANCE PRECINCT #4 644.51 0.00 0,00 644.51
SHERIFF FORFEITED PROPERTY 1,272.70 0.31 (0,16) 1,273,17
6MILE PIER/BOAT RAMP INSUR/MAINT 63,754.93 15.69 362,78 63,407,84
CAPITAL PROJ - COASTAL MANAGEMENT PGM 72,246.62 0,00 6,767.78 65,478.84
CAPITAL PROJ - ClAP COASTAL IMPROVEMENTS 127,260.41 18,307.48 23,659.97 121,907.92
CAPITAL PROJ-PARKING LOT 80,543.81 0,00 0,00 80,543.81
CAP PROJ-PCT 2 - STORM REPAIRS 17,796,13 0,00 0,00 17,796.13
CAPITAL PROJ-RB INFRASTRUCTURE 72,599.35 0,00 0,00 72,599.35
CAPITAL PROJ-SW AN POINT PARK 5,096.40 0,00 0.00 5,096.40
CAPITAL PROJ~AIRPORT RUNWAY IMPROV 153,687.13 0,00 0.00 153,687.13
CAPITAL PROJ~EMER COMM SYS 30.848,06 0.00 0.00 30,848.06
CAP PROJ~PORT ALTO PUBL BEACH-STORM REP 30,384.78 0.00 0.00 30,384.78
CAPITAL IMPROVEMENT PROJECTS 444,758.74 0.00 0.00 444,758.74
CAP PROJ- SEADRIFT LIBRARY 769.00 0.00 769.00 0.00
CAP PROJ- ANNEX II 25,755.89 0.00 0.00 25,755.89
CAP PROJ-ANNEX RENOVATION 16,141.40 0.00 0.00 16,141.40
CAP PROJ-HEALTH DEPT RENOVATIONS 92,879.08 0.00 0.00 92,879.08
CAP PROJ - ENERGY EFFECIENCY/SECO STIMULUS 86,365.00 0.00 0.00 86,365.00
CPROJ - MMC CLINIC ACQUISITION LOAN 0.00 2,000,000.00 0.00 2,000,000.00
CPROJ - MMC BUSINESS IMPROVEMENT LOAN 1,500,000.00 0.00 0.00 1,500,000.00
CAP PROJ - MAGNOLIA BEACH JETTY CONSTRUCT 144,171.21 0.00 144,171.21 0.00
CAP PROJ - OLIVIA/PORT ALTO AMBULANCE 600.00 0.00 0.00 600.00
ARREST FEES 1,160.47 590.27 1,750.74 0.00
BAIL BOND FEES (HB 1940) 1,155.00 675,00 1.875,00 (45,00)
CONSOLIDATED COURT COSTS (NEW) 25,510,02 13,890,01 39.400,02 0,01
DNA TESTING FUND 250,00 4,16 4,16 250,00
DRUG COURT PROGRAM FUND - STATE 563.24 284,38 847.63 10,01
SUBTOTALS $ 27915068.00 $ 3 240 453.90 $ 4133032.01 $ 27022489.89
Page 1 of3
COUNTY TREASURER'S REPORT MONTH OF: JULY 2012
BEGINNING ENDING
FUND FUND BALANCE RECEiPTS DISBURSEMENTS FUND BALANCE
OPERATING FUND - BALANCE FORWARD $ 27,915,068,00 $ 3,240,453.90 $ 4,133,032.01 $ 27,022,489.89
ELECTIONS CONTRACT SERVICE 37,165.36 9.13 (4,54) 37,]79.03
EMS TRAUMA FUND 917.43 480.81 1,271.67 126.57
FINES AND COURT COSTS HOLDING FUND 7,847.31 0.00 0,00 7,847.31
INDIGENT CIVIL LEGAL SERVICE 575.00 206.00 781.00 0,00
JUDICIAL FUND (ST COURT COSTS) 551.16 217.23 768.39 0,00
JUDICIAL SALARIES FUND 5,281.08 2,895.84 8,176.92 0,00
JUROR DONATION-TX CRIME VICTIMS FUND 218,00 0,00 28.00 190.00
JUVENILE PROBATION RESTITUTION 295.00 1,662.68 285.00 1,672.68
LIBRARY GIFT AND MEMORIAL 48,241.21 176.87 (1.62) 48,419.70
MISCELLANEOUS CLEARING 25,449.74 13,996.44 19,204.34 20,241.84
REFUNDABLE DEPOSITS 2,000,00 0,00 0,00 2,000.00
STATE CIVIL FEE FUND 4,322.31 2,216,13 6,538.44 0.00
CIVIL JUSTICE DATA REPOSITORY FUND 24,69 17.83 42.52 0.00
JURY REIMBURSEMENT FEE 1,995.84 1,219,79 3,215.63 0.00
SUBTITLE C FUND 7,908.96 5,375.33 13,284.29 0.00
SUPP OF CRIM INDIGENT DEFENSE 1,008.51 619.28 1,627.79 0,00
TIME PAYMENTS 4,365.90 1,727.09 6,092.99 0.00
TRAFFIC LAW FAILURE TO APPEAR 3.041.90 902.72 3,944.62 0.00
UNCLAIMED PROPERTY 4,591.39 1.13 0.00 4,592.52
BOOT CAMP!JJAEP 16.97 0.00 0.00 16.97
JUVENILE PROBATION 153075,01 19377.66 33,966,64 138,486.03
SUBTOTALS $ 28,223,960.77 $ 3,291,555.86 $ 4,232,254.09 $ 27,283,262.54
TAXES IN ESCROW 0,00 0.00 0.00
TOTAL OPERATING FUNDS $ 28 223 960.77 $ 3291 555.86 $ 4232254.09 $ 27 283 262.54
D A FORFEITED PROPERTY FUND 15,974,93 2.77 0,00 15.977.70
SHERIFF NARCOTIC FORFEITURES 13,736.15 2,11 4.000,00 9,738.26
CONSTRUCTION (JAIL) SERIES 2003 - 1& S 510,379.82 4,878.18 0.00 515,258.00
CERT. OF OB-CRTHSE REN. I&S FUND SERIES 2004 366,455.64 2,571.58 0.00 369,027.22
CAL. CO. FEES & FINES 107,251.54 124,929.11 105,510.27 126,670.38
OCEAN DRIVE IlvfPROVEMENTS 1.00 0.00 0.00 1.00
CERT OF OB-CRTHSE REF SERIES 2010 91,265.82 1,020.39 92,286.21
CERT OF OB-CRTHODSE I&S SERIES 2012 113,037.99 7.74 0.00 113,045.73
TAT' . rA ""NnO 05 64 90 133411 88 109510.27 12 o 45
MEMORIAL MEDICAL CENTER:
OPERATING 2,659,207.86 $ 1,682,730.09 $ 1,410,916,06 $ 2,931,021.89
REFUND IMPREST ACCOUNT 5,069.26 1,051.91 1,051.00 5,070,17
INDIGENT HEALTHCARE 84.44 49255,69 49255.28 84,85
TOTALS $ 2664361.56 $ 1 733 037.69 $ 1 46 I 222.34 $ 2936176,91
DRAINAGE DISTRICTS
NO,6 15,838.66 $ 2.75 $ - $ 15,841.41
NO. 8 106,329.35 177.58 0.00 106,506.93
NO. 10-MAINTENANCE 108,019.46 181.36 0.00 108,200.82
NO. II-MAINTENANCE/OPERATING 141,427.74 5,410.26 1,283.88 145,554.12
NO. II-RESERVE 129.629.34 22,47 0,00 129,651.81
TOTALS $ 501244,55 $ 5 794.42 $ 1283,88 $ 505755.09
CALHOUN COUNTY WCID #1
OPERATING ACCOUNT $ 420,925.87 4518.70 10.111.46 $ 415333.11
CALHOUN COUNTY NAVIGATION OIST.
MAINTENANCE AND OPERATING $ 230,461.84 $ 3,479.29 $ 11 115.39 $ 222,825,74
CALHOUN COUNTY
FROST BANK $ 3,708.51 $ - $ 10.27 $ 3698.24
TOTAL MMe, DR. DIST., NA V. DIST, welD & FROST $ 3816993.82 $ 1746830.10 $ 1 483 733.07 $ 4083789.09
rUIAL ALL tiUNV~
Page 2 on
COUNTY TREASURER'S REPORT I MONTH OF: JULY 2012
BANK RECONCILIA TION
LESS: CERT.OF DEPI
FUND OUTSTNDG DEP/ PLUS: CHECKS BANK
FUND BALANCE OTHER ITEMS OUTSTANDING BALANCE
OPERATING * $ 27,283,262.54 $ 29,081,235.93 $ 2,270,712.98 $ 472,739.59
D A FORFEITED PROPERTY FUND 15,977.70 0.00 0,00 15,977.70
SHERIFF NARCOTIC FORFEITURES 9,738.26 0,00 0,00 9,738.26
CONSTRUCTION (JAIL) SERIES 2003 ~ I & S 515,258.00 23.46 0,00 515,234.54
CERT. OF OB-CRTHSE REN. I&S FUND SERIES 2004 369,027.22 39.51 0,00 368,987.71
CERT OF OB-CRTHSE REF SERIES 2010 92.286,21 21.50 0.00 92,264.71
CERT OF OB-CRTHQUSE I&S SERIES 2012 113.045,73 0.00 0,00 113,045.73
CAL. CO FEES & FINES 126,670.38 36,422.67 14.322.43 104,570.14
OCEAN DRIVE IMPROVEMENTS- CAP PROJ 1.00 0.00 0.00 1.00
MEMORIAL MEDICAL CENTER:
OPERATING * 2,931,021.89 499,999.70 112,297.40 2,543,319,59
REFUND IMPREST ACCOUNT 5,070.17 0,00 0.00 5,070.17
INDIGENT HEALTHCARE 84.85 48,345,09 50,185.45 1,925.21
DRAINAGE DISTRICT:
NO.6 15,841.41 0,00 0.00 15,841.41
NO.8 106,506.93 0,14 0.00 106,506.79
NO. 10 MAINTENANCE 108,200.82 0,03 0.00 108,200.79
NO. I I MAINTENANCE/OPERATING 145,554.12 1.35 0.00 145,552.77
NO. 11 RESERVE 129,651.81 0,00 0.00 129,651.81
CALHOUN Co. WCID #1
OPERATING ACCOUNT 415,333.11 0,00 0.00 415,333,11
CALHOUN CO. NAVIGATION DIST:
MAINTENANCE/OPERATING **** 222,825.74 0.00 0,00 222,825.74
CALHOUN COUNTY
FROST BANK 3,698.24 0.00 0,00 3,698.24
TOTALS $ 32 609 056.13 $ 29666089.38 $ 2447518.26 $ 5390485.01
"'* THE DEPOSITORY FOR CALHOUN CO. NA VIGA nON DISTRICT IS FIRST NATIONAL BANK - PORT LA V ACA
THE DEPOSITORY FOR ALL OTHER COUNTY FUNDS IS INTERNATIONAL BANK OF COMMERCE - PORT LA V ACA
'''* THE DEPSOSITORY FOR CALHOUN COUNTY FROST IS FROST BANK - AUSTIN, TEXAS
Court costs and fees collected and reported may not be current a~ - o-date due to non-compliance by other county offices. I
hereby certify that the current balances are correct to all monie~'that hay I ~een r~cei~ed ~e 0 ty Treasurer as 0, f the date
of this report. . . ~ ~ . OjL,.f.(.{",lJ
RH NDA S. KOKENA
COUNTY TREASURER
Page 3 of3
CCDE
CASH BONDS
ADMINISTRATION FEE - ADMF
BREATH ALCOHOL TESTING - BAT
CONSOLIDATED COURT COSTS - CCC
COURTHOUSE SECURITY - CHS
_ _ OJ!=?
CIVIL JUSTICE DATA REPOSITORY FEE - CJDR
CORRECTIONAL MANAGEMENT INSTITUTE - CMI
CR
CHILD SAFETY - CS
CHILD SEA TBELT FEE - cseF
CRIME VICTIMS COMPENSATION - CVC
, DPSC/FAILURE TO APPEAR - OMNI- DP
FUGITIVE APPREHEN
'GENERAL REveN
o LEGAL SVCS SUPPORT - 10F
CRIME & DELINQUENCY - JCD
JUVENILE CASE MANAGER FUND - JCMF
JUSTICE COURT PERSONNEL TRAINING - JCPT
JUSTICE COURT SECURITY FUND - JCSF
JUROR SERVICE FEE - JSF
LOCAL ARREST-FEES ~ LAF
LEMI
LEOA
LEOC
OCL
PARKS & WILDLIFE ARREST FEES - PWAF
$TATE ARREST FEES,. -SAF
SCHOOL CROSSING/CHILD SAFETY FEE - SCF
Sl)BTITLE C, ~_:SUBc:
TAec ARREST FEES - TAF
TECHNOlOGY FUND - IF
, TRAFFIC ~ TFC
TIME PAYMENT - TIME
LOCAL & STATE WAR'RANT FEES - WRNT
COLLECTION SERVICE FEE-MVBA - CSRV
DEFENSIVE DRIVING COURSE - DOC
DEFERRED FEE', OfF
DRIVING EXAM FEE- PROV DL
FILING FEE - FFEE
FILING FEE SMALL CLAIMS - FFSC
JURY FlOE - JF
COPIES/CERTIF"D COPIES - CC
IND1G,ENT-FEE ~'-GIFF oijNDE
JUDGE PAY RAISE FEE - JPAY
SERVIC" FlOE --SFEE
OUT-OF-COUNTY SERVICE FEE
EXPUNGEMENT FEE - EXPG
RENEWAL - EXPR
EMENT - AOJ
-WOP/WOE
TA FINE - DPSF
L FINES - FINE
T FEES - LWF
,FINES - PWF
SEATSElT/UNRESTRAINED CHILD FINE- SEAT
. OVERPAYMENT ($10 & OVER) - OVER
. OVERPAYMENT (lESS A ,OVER
R - REST
PARKS &WILDLlFE-WATE S-WSF
WCR
ECEIVED
Revised-07/13/11
ENTER COURT- NAME:
ENTER MONTH OF REPORT
"NTER YEAR OF R"PORT
TYPE:
TOTAL WARRANT FEES
ENTER LOCAL WARRANT FEESI
, ,STATE WA~RANT FEES
AMOUNT
797,11
1,7"8;32.IRECORD ON TOTAl PAGE OF HILL COUNTRY SOFTWARE MO. REPORT
$6'18.79 - RECORD ON TOTAl PAGE OF HILL COUNTRY SOFTWARE MO. REPORT
DUE TO OTHERS:
DUETO-~CISD ;; 50% of FIne on: JV cases
DU" TO DA R"STITUTION FUND
REFUND OF OVERPAYMENTS
OUT-OF-COUNTY SERVICE FEE
CASH BONDS
PLEASE INCLUDE D.RREQUESTINGOIS8URSEMENT
PLEASE INCLl,JDE DR REQUESTING DISBURSEMENT
PlEASE INCLUDE DR REQUESTING DISBURSEMENT
PLEASE INCLUDE DR REQUESTING DISBURSEMENT
PLEASE INCLUDE DR REQUESTING DISBURSEMENT (IF REQUIRED)
TREASURERS RECEIPTS FOR MONTH:
CASH, CHECKS, M.O.s & CREDIT CARDS
TOTAL TREAS, RECEIPTS
AMOUNT
$16;300:85 Calculate from ACTUAL Treasurer's Receipts
$16,300.85
MONTHL Y REPORT OF COLLECTIONS AND DISTRIBUTIONS
9/1012012 COURT NAME: JUSTICE OF PEACE NO.2
MONTH OF REPORT: AUGUST
YEAR OF REPORT: 2012
ACCOUNT NUMBER ACCOUNT NAME AMOUNT
CR 1000-001-45012 FINES 5,318.00
CR 1000-001-44190 SHERIFF'S FEES 975.16
ADMINISTRATIVE FEES:
DEFENSIVE DRIVING 133.60
CHILD SAFETY 0.00
TRAFFIC 130.19
ADMINISTRATIVE FEES 350.39
EXPUNGEMENT FEES 0.00
MISCELLANEOUS 0.00
CR 1000-001-44362 TOTAL ADMINISTRATIVE FEES 614.18
CR 1000-001-44010 CONSTABLE FEES-SERVICE 75.00
CR 1000-001-44062 JP FILING FEES 80.00
CR 1000-001-44090 COPIES I CERTIFIED COPIES 0.00
CR 1000-001-49110 OVERPAYMENTS (LESS THAN $10) 20.00
CR 1000-001-44145 SCHOOL CROSSING/CHILD SAFETY FEE 0,00
CR 1000-999-20741 DUE TO STATE-DRIVING EXAM FEE 0.00
CR 1000-999-20744 DUE TO STATE-SEATBEL T FINES 20.05
CR 1000-999-20745 DUE TO STATE-CHILD SEATBELT FEE 0.00
CR 1000-999-20746 DUE TO STATE-OVERWEIGHT FINES 0.00
CR 1000-999-20770 DUE TO JP COLLECTIONS ATTORNEY 972.86
TOTAL FINES, ADMIN. FEES & DUE TO STATE $8,075.25
CR 2670-001-44062 COURTHOUSE SECURITY FUND $217,55
CR 2720-001-44062 JUSTICE COURT SECURITY FUND $72.52
CR 2719-001-44062 JUSTICE COURT TECHNOLOGY FUND $294.94
CR 2699-001-44062 JUVENILE CASE MANAGER FUND $210.31
STA TE ARREST FEES
DPS FEES 160.74
P&W FEES 9.88
TABC FEES 0.00
CR 7020-999-20740 TOTAL STATE ARREST FEES 170.62
CR 7070-999-20610 CCC-GENERAL FUND 294.90
CR 7070-999-20740 CCC-STATE 2,654.26
DR 7070-999-10010 2,949.16
CR 7860-999-20610 STF/SUBC-GENERAL FUND 65.09
CR 7860-999-20740 STF/SUBC-STATE 1,236.68
DR 7860-999-10010 1,301.77
CR 7950-999-20610 TP-GENERAL FUND 159.08
CR 7950-999-20740 TP-STATE 159.07
DR 7950-999-10010 318,15
CR 7480-999-20610 CIVIL INDIGENT LEGAL-GEN. FUND 0.90
CR 7480-999-20740 CIVIL INDIGENT LEGAL-STATE 17.10
DR 7480-999-10010 18.00
Page 1 of2
MONTHL Y REPORT OF COLLECTIONS AND DISTRIBUTIONS
9/1012012
CR 7865-999-20610
CR 7865-999-20740
CR 7970-999-20610
CR 7970-999-20740
CR 7505-999-20610
CR 7505-999-20740
CR 7857-999-20610
CR 7857-999-20740
CR 7856-999-20610
CR 7856-999-20740
Revised 07/13/11
COURT NAME: JUSTICE OF PEACE NO.2
MONTH OF REPORT: AUGUST
YEAR OF REPORT: 2012
DR 7865-999-10010
CRIM-SUPP OF IND LEG SVCS-GEN FUND
CRIM-SUPP OF IND LEG SVCS-STATE
136.78
TUFTA-GENERAL FUND 114.40
TUFT A-STATE 228.80
13.68
123.10
DR 7970-999-10010 343.20
JPAY - GENERAL FUND 41.58
JPAY - STATE 374.18
DR 7505-999-10010 415.76
JURY REIMB. FUND- GEN. FUND 27.55
JURY REIMB, FUND- STATE 247.95
DR 7857-999-10010 275.50
CIVIL JUSTICE DATA REPOS.- GEN FUND
CIVIL JUSTICE DATA REPOS.- STATE
0.41
3.68
DR 7856-999-10010
4.09
TOTAL (Distrib Req to Oper Acct)
$14,803.60
DUE TO OTHERS (Distrib Req Attchd)
CALHOUN COUNTY ISD
DA - RESTITUTION
REFUND OF OVERPAYMENTS
OUT-OF-COUNTY SERVICE FEE
CASH BONDS
PARKS & WILDLIFE FINES
WATER SAFETY FINES
0.00
0.00
439.00
0.00
0.00
956.25
102.00
TOTAL DUE TO OTHERS
$1,497.25
TOTAL COLLECTED-ALL FUNDS
LESS: TOTAL TREASUER'S RECEIPTS
OVER/(SHORT)
$16,300.85
$16,300.85
$0.00
Page 2 of 2
ENTER COU,RT NAME:
ENTER MONTH OF REPORT
ENTER YEAR OF REPORT
CODE
CASH BONDS
ADMINISTRATION FEE - ADMF
eREA TH ALCOHOL TESTING - BAT
CONSOLIDATED COURT COSTS M CCC
COURTHOUSE SECURITY - CHS
CJP
CIVIL JUSTICE DATA REP - MVF/CJDR
CORRECTIONAL MANAGEMENT INSTITUTE - CMI
CR
CHILD SAFETY - CS
CHILD SEA TBEL{ FEE ~ CSBF
CRIME VICTIMS COMPENSATION - CVC
DPSC/FAILURE TO APPEAR. OMNI.-DPSC
FUGITIVE APPREHENSION M FA
GENERAL REVENUE ~ GR
CRIM - IND LEGAL SVCS SUPPORT -IDF
JUVENILE CRIME & DELINQUENCY M,JCD
JUVENILE CASE MANAGER FUND - JCMF
JUSTICE COURT PERSONNEL TRAINING - JCPT
JUSTICE COURT SECURITY FUND ~ JCSF
JUROR SERVICE FEE,. JSF
LOCALARRESTFEES-LAF
LEMI
LEOA
LEOC
OCL
PARKS & WILDLIFE 'ARREST FEES. PWAF
STATE ARRESTFEES - SAF
SCHOOL CROSSING/CHILD SAFETY FEE - SCF
SUBTITLE C - .sUBC
T ABC ARREST FEES. T AF
TECHNOLOGY FUND M TF
TRAFFIC .'TFC
TIME PAYMENT - TIME
LOCAL & STATE WARRANT FEES - WRNT
COLLECTION SERVICE FEE-MveA - CSRV
DEFENSIVE DRIVING COURSE - DOC
DEFERRED FEE - OFF
DRIVING EXAM FEEM PROV DL
FILING F'EE ~ FFEE
, FILING FEE SMALL CLAIMS M FFSC
COPIES/CERTIFED COPIES,~ CC
INDIGENT FEE - CIFF or.!NDF
JUDGE PAY RAISE FEE M JPAY
SERVICE FEE - SFEE
OUTMOFM,COUNTY SERVICE FEE
EXPUNGEMENT FEE. EXPG
EXPIRED RENEWAC---'EXPR
ABSTRACT OF JUDGEMENT - AOJ
ALL WRITS - WOP / WOE
OPS FTA FINE - DPSF
LOCAL FINES - FINE
LICENSE & WEIGHT FI;ES.. LWF
PARKS & WILDLIFE FINES - PWF
SEATBEL T/UNRESTRAINED CHILD'FINE ~ SEAT
. OVERPAYMENT ($10 & OVER) - OVER
. OVERPAYMENT (LESS THAN $10) - OVER
RESTITUTION - REST
PARKS',& WILDLIFE-WATER SAFETY FINESMWSF
WCR
TOTAL ACTUAL MONEY RECEIVED
TYPE:
TOTAL WARRANT FEES
ENTER LOCAL WARRANT FEESI
STATE WARJ3:ANT FEES
DUE TO OTHERS:
DUE TO CCISD. 50% of Fine 011 JV cases
DUE TO DA RESTITUTION FUND
REFUND OF OVERPAYMENTS
OUT-OF-COUNTY SERVICE FEE
CASH BONDS
TOTAL DUE TO OTHERS
TREASURERS RECEIPTS FOR,MONTH:
CASH, CHECKS, M.O.s & CREDIT CARDS
TOTAL TREAS. RECEIPTS
JUSTICE OF PEACE NO.4
AUGUST
2012
AMCUN
Revised 07/13/11
882.11
83.10
1.06
74.72
44.11
55.00
7.59
85.71
52.81
57.45
346.86
88.20
34.71
139.85
149.07
212.10
19.90
50.00
12.00
140.75
75.00
20.00
2,429.00
$S,061.10
AMOUNT
,149.0,7
0.00 IRECORD ON TOTAL PAGE OF HILL COUNTRY SOFTWARE MO. REPORT
$149.07_ RECORD ON TOTAL PAGE OF HILL COUNTRY SOFTWARE MO. REPORT
AMOUNT
0.00 PLEASE INCLUDE D.R. REQUESllNG DISBURSEMENT
0.00 PLEASE INCLUDE D.R. REQUESTING DISBURSEMENT
0.00 PLEASE INCLUDE D.R. REQUESTING DISBURSEMENT
0.00 PLEASE INCLUDE a.R. REQUESTING DISBURSEMENT
0.00 PLEASE INCLUDE a.R REQUESTING DISBURSEMENT (IF REQUIRED)
$0.00
AMOUNT
$5,061.10 Calculate from ACTUAL Treasurer's Receipts
$5,061.10
MONTHL Y REPORT OF COLLECTIONS AND DISTRIBUTIONS
9/512012 COURT NAME: JUSTICE OF PEACE NO.4
MONTH OF REPORT: AUGUST
YEAR OF REPORT: 2012
ACCOUNT NUMBER ACCOUNT NAME AMOUNT
CR 1000-001-45014 FINES 2,429.00
CR 1000-001-44190 SHERIFF'S FEES 218.03
ADMIN/STRA T1VE FEES:
DEFENSIVE DRIVING 19,90
CHILD SAFETY 0,00
TRAFFIC 34.71
ADMINISTRATIVE FEES 20.00
EXPUNGEMENT FEES 0.00
MISCELLANEOUS 0,00
CR 1000-001-44364 TOTAL ADMINISTRATIVE FEES 74,61
CR 1000-001-44010 CONSTABLE FEES-SERVICE 75,00
CR 1000-001-44064 JP FILING FEES 50.00
CR 1000-001-44090 COPIES I CERTIFIED COPIES 0.00
CR 1000-001-49110 OVERPAYMENTS (LESS THAN $10) 0.00
CR 1000-001-44145 SCHOOL CROSSING/CHILD SAFETY FEE 0.00
CR 1000-999-20741 DUE TO STATE-DRIVING EXAM FEE 0.00
CR 1000-999-20744 DUE TO STATE-SEATBEL T FINES 0.00
CR 1000-999-20745 DUE TO STATE-CHILD SEATBEL T FEE 0.00
CR 1000-999-20746 DUE TO STATE-OVERWEIGHT FINES 0.00
CR 1000-999-20770 DUE TO JP COLLECTIONS ATTORNEY 212.10
TOTAL FINES, ADMIN. FEES & DUE TO STATE $3,058.74
CR 2670-001-44064 COURTHOUSE SECURITY FUND $83.10
CR 2720-001-44064 JUSTICE COURT SECURITY FUND $7.59
CR 2719-001-44064 JUSTICE COURT TECHNOLOGY FUND $88.20
CR 2699-001-44064 JUVENILE CASE MANAGER FUND $55.00
STA TE ARREST FEES
DPS FEES 41.30
P&W FEES 0.00
TABC FEES 0.00
CR 7020-999-20740 TOTAL STATE ARREST FEES 41.30
CR 7070-999-20610 CCC-GENERAL FUND 88.21
CR 7070-999-20740 CCC-ST A TE 793.90
DR 7070-999-10010 882.11
CR 7860-999-20610 STF/SUBC-GENERAL FUND 17.34
CR 7860-999-20740 STF/SUBC-STATE 329.52
DR 7860-999-10010 346.86
CR 7950-999-20610 TP-GENERAL FUND 69.93
CR 7950-999-20740 TP-STATE 69.92
DR 7950-999-10010 139.85
CR 7480-999-20610 CIVIL INDIGENT LEGAL-GEN. FUND 0.60
CR 7480-999-20740 CIVIL INDIGENT LEGAL-STATE 11.40
DR 7480-999-10010 12.00
Page 1 of2
MONTHL Y REPORT OF COLLECTIONS AND DISTRIBUTIONS
9/5/2012
CR 7865-999-20610
CR 7865-999-20740
CR 7970-999-20610
CR 7970-999-20740
CR 7505-999-20610
CR 7505-999-20740
CR 7857-999-20610
CR 7857-999-20740
CR 7856-999-20610
CR 7856-999-20740
Revised 07/13/11
COURT NAME: JUSTICE OF PEACE NO.4
MONTH OF REPORT: AUGUST
YEAR OF REPORT: 2012
DR 7865-999-10010
CRIM-SUPP OF IND LEG SVCS-GEN FUND
CRIM-SUPP OF IND LEG SVCS-STATE
44,11
TUFTA-GENERAL FUND 24.91
TUFTA-STATE 49,81
4.41
39,70
DR 7970-999-10010 74.72
JPAY - GENERAL FUND 14.08
JPAY - STATE 126.67
DR 7505-999-10010 140.75
JURY REIMB. FUND- GEN. FUND 8.57
JURY REIMB. FUND- STATE 77.14
DR 7857-999-10010
DR 7856-999-10010
85.71
CIVIL JUSTICE DATA REPOS.- GEN FUND
CIVIL JUSTICE DATA REPOS.- STATE
1.06
0.11
0,95
TOTAL (Distrib Req to Oper Acct)
$5,061.10
DUE TO OTHERS (Distrib Req Attchd)
CALHOUN COUNTY ISO 0.00
DA - RESTITUTION 0.00
REFUND OF OVERPAYMENTS 0.00
OUT-OF-COUNTY SERVICE FEE 0.00
CASH BONDS 0.00
PARKS & WILDLIFE FINES 0,00
WATER SAFETY FINES 0,00
TOTAL DUE TO OTHERS $0.00
TOTAL COLLECTED-ALL FUNDS
LESS: TOTAL TREASUER'S RECEIPTS
OVER/(SHORT)
$5,061.10
$5,061.1 0
$0,00
Page 2 012
09/05/2012 Money Distribution Report Page
_______________________________N______________________________________________ ----------------------------------------- -----------
Receipt Cause/Defendant Code Amount Code Amount Code Amount Code Amount Code Amount Code Amount Total
3929837 2012-266 08-01-2012 CCC 40.00 CHS 4.00 TF 4.00 JSF 4.00 !OF 2.00 JPAY 6.00 120.00
ASHLEY, JCHN CHARLES FINE 50.00 JCMF 5.00 SAF 5.00
Cash
3929838 2012-258 08-02-2012 TFC 3.00 CCC 40.00 CHS 4.00 LAF 5.00 TF 4.00 SUBC 30.00 113.00
NGUYEN, TRINH THI JSF 4.00 !OF 2.00 CJDR D.l0 JPAY 6.00 FINE 4.90 DDC 10.00
Personal Check
3929839 2012-273 08-02-2012 TFC 3.00 CCC 40.00 CHS 4.00 LAF 5.00 TF 4.00 SUBC 30.00 16S.00
MORGAN, JCAN ELIZAeETH JSF 4.00 !OF 2.00 CJDR 0.10 JPAY 6.00 FINE 66.90
Cash
3929840 2012-268 08-06-2012 CCC 40.00 CHS 4.00 SAF 5.00 TF 4.00 JSF 4.00 !OF 2.00 I 120.00
WILSCN, WINSTON DEAN JPAY 6.00 FINE SO.OO JCMF 5.00
Cash
3929841 2012-234 08-06-2012 TFC 3.00 CCC 40.00 CHS 3.00 LAF 5.00 TF 4.00 SUBC 30.00 100.00
KILPATRICK, EDIE MAE JCSF 1.00 JSF 4.00 !OF 2.00 CJDR 0.10 FINE 7.90
Cash
3929842 2012-2S6 08-08-2012 FINE 75.00 75.00
CARTER, PATRICK STEVEN
Money Order
3929843 2012 - 271 08-08-2012 CCC 40.00 CHS 4.00 LAF 5.00 TF 4.00 JSF 4.00 IDF 2.00 120.00
GCMEZ, GUADALUPE D JPAY 6.00 FINE 50.00 JCMF 5.00
Cash
3929844 2012-249 08-08-2012 CCC 40.00 CHS 4.00 LAF 5.00 TF 4.00 JSF 4.00 !OF 2.00 120.00
DEBUSK, JAMES THOMAS JPAY 6.00 FINE 50.00 JCMF 5.00
Cash
392984S 2012-073 08-08-2012 JPAY 6.00 FINE 38.00 44.00
HARTMAN, JAMIE RENEE
Cash
3929846 2012-279 08-08-2012 TFC 3.00 CCC 40.00 CHS 4.00 SAF 5.00 TF 4.00 SUBC 30.00 135.00
BROWN, ANDREW HERMAN JSF 4.00 !OF 2.00 CJDR 0.10 JPAY 6.00 FINE 36.90
Cash
3929847 2009-414 08-13-2012 TFC 3.00 CCC 40.00 CHS 4.00 SAF 5.00 WRNT 50.00 TIME 25.00 370.50
ARREDCNDO, VALDEMAR ANTONIO TF 4.00 SUBC 30.00 DPSC 30.00 JCSF 1.00 JSF 3.00 !OF 2.00
Credi t Card FINE 82.00 CSRV 85.S0 JPAY 6.00
3929848 2009-414A 08-13-2012 CCC 40.00 CHS 4.00 SAF 5.00 WRNT 50.00 TF 4.00 DPSC 30.00 548.60
ARREDONDO, VALDEMAR ANTONIO JCSF 1.00 JSF 3.00 !OF 2.00 FINE 277.00 CSRV 126.60 JPAY 6.00
Credi t Card
3929849 2012-270 08-13-2012 TFC 3.00 CCC 40.00 CHS 4.00 LAF 5.00 TF 4.00 SUBC 30.00 300.00
RUIZ, IRMA SOLOYA JSF 4.00 !OF 2.00 CJDR 0.10 JPAY 6.00 FINE 201.90
Credit Card
3929850 2010-511 08-13-2012 CCC 19.63 CHS 1.96 SAF 2.45 WRNT 49.07 TIME 12.27 TF 1.96 105.00
ARRIAGA, ANDREA ANN DPSC 14.72 JCSF 0.49 JSF 1.47 !OF 0.98
Credit Card
3929851 2012-2S9 08-13-2012 TFC 3.00 CCC 40.00 CHS 4.00 LAF 5.00 TF 4.00 SUBC 30.00 16S.00
BARBOSAf PATRICIO III JSF 4.00 !OF 2.00 CJOR 0.10 JPAY 6.00 FINE 66.90
Cash
3929852 2012-260 08-13-2012 TFC 1.39 CCC 18.35 CHS 1.83 LAF 2.29 TF 1.83 SUBC 13.76 4S.00
BARBOSA, PATRICIO III JSF 1.83 !OF 0.92 CJDR 0.05 JPAY 2.75
Cash
3929853 JC-2012-014 08-14-2012 SF 75.00 FFEE 25.00 CIFF 6.00 106.00
AMASCN, JERRY SR
JERRY AMASON Personal Check
39298S4 2012-239 08-14-2012 TIME 25.00 FINE 69.00 JPAY 6.00 JCMF 5.00 105.00
VILLALPANDO, JESUS JR
Cash
09/05/2012 Money Distribution Report Page 2
~------------------------------------------------- ---------------------------------------------------------------------------------
Receipt Cause/Defendant Code Amount Code Amount I Code Amount I Code Amount Code Amount Code Amount TotaL
I I
3929855 2012-082 08-14-2012 CCC 40.00 CHS 4.00 I LAF S.OO I WRNT 50.00 TIME 25.00 TF 4.00 240.00
MAREK, EOOIE OON JCSF 1.00 JSF 3.00 I IOF 2.00 I FINE 95.00 JPAY 6.00 JCMF S.OO
Jai L Credit I I
3929856 2012-243 08-16-2012 CCC 40.00 CHS 3.00 I SAF 5.00 I TIME 25.00 TF 4.00 JCSF 1.00 110.00
FLORES, CANOICE ELAINE JSF 4.00 IOF 2.00 I FINE 26.00 I
Money Order I I
3929857 2012-328 08-20-2012 TFC 3.00 CCC 40.00 I CHS 4.00 I SAF 5.00 TF 4.00 SUBC 30.00 220.00
BURKE, JONATHAN ANOREW JSF 4.00 IOF 2.00 I CJDR 0.10 I JPAY 6.00 FINE 121.90
Cash I I
3929858 2012-280 08-20-2012 CCC 40.00 CHS 4.00 I SAF 5.00 I TF 4.00 JSF 4.00 IOF 2.00 325.00
PEREZ, GUSTAVC JPAY 6.00 FINE 260.00 I I
Cash I I
3929859 2011-600 08-21-2012 FINE 89.00 JPAY 6.00 I JCMF 5.00 I 100.00
FULBERG, KATHLEEN MAC I I
Money Order I I
3929860 2011-600A 08-21-2012 FINE SO.OO I I 50.00
FULBERG, KATHLEEN MAC I I
Money Order I I
3929861 2012-2S7 08-21-2012 CCC 40.00 CHS 4.00 I LAF S.OO I TF 4.00 JSF 4.00 IOF 2.00 165.00
CARTER, PATRICK STEVEN JPAY 6.00 FINE 95.00 I JCMF 5.00 I
Cash I I
3929862 2012-283 08-21-2012 EXRF 20.00 I I 20.00
CARTER, PATRICK STEVEN I I
Cash I I
3929863 JC-2012-015 OB-23-2012 FFEE 25.00 CIFF 6.00 I I 31.00
MIOLAND FUNOING LLC, I I
PROFESSICNAL CIVI Persona l Check I I
3929864 2012-282 08-27-2012 CCC 40.00 CHS 4.00 I LAF 5.00 I TF 4.00 JSF 4.00 IOF 2.00 165.00
CARTER, PATRICK STEVEN JPAY 6.00 FINE 100.00 I I
Money Order I I
392986S 2012-267 08-27-2012 TFC 3.00 CCC 40.00 I CHS 4.00 I LAF 5.00 TF 4.00 SUBC 30.00 225.00
MAZAL, SARAH NICCLE JSF 4.00 IOF 2.00 I CJOR 0.10 I JPAY 6.00 FINE 121.90 JCMF 5.00
Cash; er I sCheck I I
3929866 2012-176 08-27-2012 TFC 0.32 CCC 4.13 I CHS 0.31 I LAF 0.52 TIME 2.58 TF 0.41 165.00
SHEOO, PAUL OAVIO SUBC 3.10 JCSF 0.10 I JSF 0.41 I IOF 0.21 CJOR 0.01 FINE 141.90
Money Order JPAY 6.00 JCMF 5.00 I I
3929867 2012-191 08-28-2012 CCC 40.00 CHS 3.00 I SAF 5.00 I TIME 25.00 TF 4.00 JCSF 1.00 330.00
POSTERT, CURTIS NICOLAS JSF 4.00 IOF 2.00 I FINE 235.00 I JPAY 6.00 JCMF 5.00
Credit Card I I
392986B 2012-190 08-28-2012 TFC 3.00 CCC 40.00 I CHS 3.00 I SAF 5.00 TIME 25.00 TF 4.00 190.00
POSTERT, CURTIS NICOLAS SUBC 30.00 JCSF 1.00 I JSF 4.00 I IOF 2.00 CJOR 0.10 FINE 61.90
Credit Card JPAY 6.00 JCMF 5.00 I I
3929869 2012 - 330 08-29-2012 TFC 3.00 CCC 40.00 I CHS 3.00 I SAF 5.00 TF 4.00 SUBC 30.00 108.00
GONZALES, JESSICA ANNETTE JSF 4.00 IOF 2.00 I JCF 1.00 I CJOR 0.10 JPAY 6.00 OOC 9.90
Money Order I I
09/05/2012 Money Distribution Report Page 3
------------------------------------------------------------------------------------------------------------------------------------
The following totaLs represent - Cash and Checks Collected
Type Code Description Count Retained Disbursed Money-Totals
COST CCC CONSOLIDATED COURT COSTS 18 66.25 596.23 662.48
COST CHS COURT HCUSE SECURITY 18 63.14 0.00 63.14
COST CJDR CIVIL JUSTICE DATA RES\POSITORY FEE 10 0.09 0.77 0.86
COST DPSC DPS CMNIBASE FEE 0 0.00 0.00 0.00
COST IDF INDIGENT DEFENSE FUND 18 3.31 29.82 33.13
COST JCF JUSTICE COURT FEES 1 1.00 0.00 1.00
COST JCSF JUSTICE COURT SECURITY FUND 3 2.10 0.00 2.10
COST JPAY JUDICAL SUPPCRT FEE 16 9.27 83.48 92.75
COST JSF JUROR REIMBURSEMENT FEE 18 6.62 59.62 66.24
COST LAF SHERIFF'S FEE 11 47.81 0.00 47.81
COST SAF DPS 7 28.00 7.00 35.00
COST SUBC SUBTITLE C 10 12.84 244.02 256.86
COST TF TECHNOLCGY FUND 18 66.24 0.00 66.24
COST TFC TFC 10 25.71 0.00 25.71
COST TIME TIME PAYMENT FEE 3 26.29 26.29 52.58
COST WRNT WARRANT FEE 0 0.00 0.00 0.00
FEES CIFF CIVIL INDIGENT FILING FEE 2 0.60 11.40 12.00
FEES CSRV CCLLECTION SERVICE FEE 0 0.00 0.00 0.00
FEES DDC DEFENSIVE DRIVING 2 19.90 O.DO 19.9D
FEES EXRF EXPIRATION RENEWAL FEE 1 2D.00 0.00 20.00
FEES FFEE FIll NG FEE 2 5D.DO 0.00 SO.OO
FEES JCMF JUVENILE CASE MANAGER FEE 9 45.00 0.00 45.00
FEES JPAY DISTRICT JUDGE PAY RAISE FEE 3 18.00 0.00 18.00
FEES SF SERVICE FEE 1 75.DO D.OO 7S.00
FINE FINE FINE 21 1,571.20 0.00 1,S71.20
Money TotaLs 26 2,158.37 1,OS8.63 3,217.00
The folLowing totals represent - Transfers Collected
COST CCC CONSOLIDATED COURT COSTS 0 0.00 D.DD O.DD
COST CHS CCURT HOUSE SECURITY 0 0.00 D.OO O.DD
COST CJDR CIVIL JUSTICE DATA RES\POSITCRY FEE 0 D.DD 0.00 0.00
COST DPSC DPS CMNIBASE FEE 0 0.00 0.00 0.00
COST IDF INDIGENT DEFENSE FUND 0 0.00 0.00 0.00
COST JCF JUSTICE CCURT FEES 0 0.00 0.00 0.00
COST JCSF JUSTICE COURT SECURITY FUND 0 0.00 0.00 0.00
COST JPAY JUDICAL SUPPORT FEE 0 0.00 0.00 0.00
COST JSF JUROR REIM8URSEMENT FEE 0 0.00 0.00 0.00
COST LAF SHERIFF'S FEE 0 0.00 0.00 0.00
COST SAF DPS 0 0.00 0.00 0.00
COST SUBC SUBT ITLE C 0 0.00 0.00 0.00
COST TF TECHNOLOGY FUND 0 0.00 0.00 0.00
COST TFC TFC 0 0.00 0.00 0.00
COST TIME TIME PAYMENT FEE 0 0.00 0.00 0.00
COST WRNT WARRANT FEE 0 0.00 0.00 0.00
FEES CIFF CIVIL INDIGENT FILING FEE D 0.00 0.00 0.00
FEES CSRV CCLLECTION SERVICE FEE 0 0.00 0.00 0.00
FEES DDC DEFENSIVE DRIVING 0 0.00 0.00 0.00
FEES EXRF EXPIRATION RENEWAL FEE 0 0.00 0.00 0.00
09/05/2012 Money Distribution Report Page 4
MM__________________________________________________________.___.___________________________________________._______________________
The following totals represent - Transfers CoLlected
Type Code Description Count Retained Disbursed Money-Totals
FEES FFEE F I LI NG FEE 0 0.00 0.00 0.00
FEES JCMF JUVENILE CASE MANAGER FEE 0 0.00 0.00 0.00
FEES JPAY OISTRICT JUOGE PAY RAISE FEE 0 0.00 0.00 0.00
FEES SF SERVI CE FEE 0 0.00 0.00 0.00
FINE FINE FINE 0 0.00 0.00 0.00
Transfer Totals 0 0.00 0.00 0.00
The following totals represent - Jai L Credit and Community Service
COST CCC CCNSOLIOATEO COURT COSTS 1 4.00 36.00 40.00
CCST CHS COURT HOUSE SECURITY 1 4.00 0.00 4.00
CCST CJOR CIVIL JUSTICE DATA RES\POSITORY FEE 0 0.00 0.00 0.00
COST DPSC DPS OMNIBASE FEE 0 0.00 0.00 0.00
COST !DF INDIGENT DEFENSE FUND 1 0.20 1.80 2.00
CCST JCF JUSTICE CCURT FEES 0 0.00 0.00 0.00
COST JCSF JUSTICE COURT SECURITY FUND 1 1.00 0.00 1.00
COST JPAY JUDICAL SUPPORT FEE 0 0.00 0.00 0.00
COST JSF JUROR REIMBURSEMENT FEE 1 0.30 2.70 3.00
COST LAF SHERIFF'S FEE 1 5.00 0.00 5.00
COST SAF DPS 0 0.00 0.00 0.00
COST SUBC SUBT ITLE C 0 0.00 0.00 0.00
COST 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 1 12.50 12.50 25.00
COST WRNT WARRANT FEE 1 50.00 0.00 50.00
FEES CIFF CIVIL INDIGENT FILING FEE 0 0.00 0.00 0.00
FEES CSRV COLLECTION SERVICE FEE 0 0.00 0.00 0.00
FEES DCC DEFENSIVE DRIVING 0 0.00 0.00 0.00
FEES EXRF EXPIRATION RENEWAL FEE 0 0.00 0.00 0.00
FEES FFEE F I LI NG FEE 0 0.00 0.00 0.00
FEES JCMF JUVENILE CASE MANAGER FEE 1 5.00 0.00 5.00
FEES JPAY DISTRICT JUDGE PAY RAISE FEE 1 6.00 0.00 6.00
FEES SF SERVICE FEE 0 0.00 0.00 0.00
FINE FINE FINE 1 95.00 0.00 95.00
Credit Totals 187.00 53.00 240.00
The following totals represent - Credit Card Payments
COST CCC CCNSOLIDATED COURT COSTS 6 21.96 197.67 219.63
CCST CHS COURT HOUSE SECURITY 6 19.96 0.00 19.96
COST CJDR CIVIL JUSTICE OATA RES\PCSITORY FEE 2 0.02 0.18 0.20
COST DPSC DPS OMNIBASE FEE 3 24.66 50.06 74.72
COST !DF INDIGENT DEFENSE FUND 6 1.10 9.88 10.98
COST JCF JUSTICE COURT FEES 0 0.00 0.00 0.00
CCST JCSF JUSTICE COURT SECURITY FUND 5 4.49 0.00 4.49
COST JPAY JUDICAL SUPPORT FEE 1 0.60 5.40 6.00
COST JSF JUROR REIMBURSEMENT FEE 6 1.95 17.52 19.47
CCST LAF SHERIFF'S FEE 1 5.00 0.00 5.00
09/05/2012 Money Distribution Report Page 5
----------------- -------------------------------------------------------------------------------.-----------------------------------
The folLowing totaLs represent - Credit Card Payments
Type Code Description Count Retained Disbursed Money-TotaLs
COST SAF DPS 5 17.96 4.49 22.45
COST SUBC SUBTI TLE C 3 4.50 85.50 90.00
COST H TECHNOLOGY FUND 6 21.96 0.00 21.96
COST HC HC 3 9.00 0.00 9.00
COST TIME TIME PAYMENT FEE 4 43.63 43.64 87.27
COST WRNT WARRANT FEE 3 149.07 0.00 149.07
FEES CIFF CIVIL INDIGENT FILING FEE 0 0.00 0.00 0.00
FEES CSRV COLLECTION SERVICE FEE 2 212.10 0.00 212.10
FEES DOC DEFENSIVE DRIVING 0 0.00 0.00 0.00
FEES EXRF EXPIRATION RENEWAL FEE 0 0.00 0.00 0.00
FEES FFEE Fill NG FEE 0 0.00 0.00 0.00
FEES JCMF JUVENILE CASE MANAGER FEE 2 10.00 0.00 10.00
FEES JPAY DISTRICT JUDGE PAY RAISE FEE 4 24.00 0.00 24.00
FEES SF SERVICE FEE 0 0.00 0.00 0.00
FINE FINE FINE 5 857.80 0.00 857.80
Credit Totals 6 1,429.76 414.34 1,844.10
The following totals represent Combined Money and Credits
COST CCC CONSOLIDATED CCURT COSTS 25 92.21 829.90 922.11
COST CHS CCURT HOUSE SECURITY 25 87.10 0.00 87.10
COST CJDR CIVIL JUSTICE DATA RES\POSITORY FEE 12 0.11 0.9S 1.06
COST DPSC DPS OMNIBASE FEE 3 24.66 50.06 74.72
COST IDF I ND I GENT DE FENSE FUND 25 4.61 41.50 46.11
COST JCF JUSTICE COURT FEES 1 1.00 0.00 1.00
COST JCSF JUSTICE COURT SECURITY FUND 9 7.S9 0.00 7.59
COST JPAY JUDICAL SUPPORT FEE 17 9.87 88.88 98.7S
COST JSF JUROR REIMBURSEMENT FEE 25 8.87 79.84 88.71
COST LAF SHERI FF' S FEE 13 S7.81 0.00 57.81
COST SAF DPS 12 45.96 11.49 57.4S
COST SUBC SUBT ITLE C 13 17.34 329.52 346.86
COST H TECHNOLOGY FUNO 25 92.20 0.00 92.20
COST HC HC 13 34.71 0.00 34.71
COST TIME TIME PAYMENT FEE 8 82.42 82.43 164.85
COST WRNT WARRANT FEE 4 199.07 0.00 199.07
FEES CIFF CIVIL INDIGENT FILING FEE 2 0.60 11.40 12.00
FEES CSRV CCLLECTICN SERVICE FEE 2 212.10 0.00 212.10
FEES DDC DEFENSIVE DRIVING 2 19.90 0.00 19.90
FEES EXRF EXPIRATICN RENEWAL FEE 1 20.00 0.00 20.00
FEES FFEE FILING FEE 2 50.00 0.00 SO.OO
FEES JCMF JUVENILE CASE MANAGER FEE 12 60.00 0.00 60.00
FEES JPAY DISTRICT JUDGE PAY RAISE FEE 8 48.00 0.00 48.00
FEES SF SERVICE FEE 1 75.00 0.00 75.00
FINE FINE FINE 27 2,524.00 0.00 2,S24.00
Report Totals 33 3,775.13 1,525.97 5,301.10
09/05/2012 Money Distribution Report Page 6
__________N_________________________________________________________________________________________________________N____N__________
DATE PAYMENT-TYPE fINES CCURT-COSTS fEES BONDS REST nUT ION OTHER TOTAL
00-00-0000 Cash & Checks Collected 0.00 0.00 0.00 0.00 0.00 0.00 0.00
JaiL Credits & Comm Service 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Credit Cards & Transfers 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Total of all Collections 0.00 0.00 0.00 0.00 0.00 0.00 0.00
09-01-1991 Cash & Checks Collected 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Jail Credits & Comm Service 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Credit Cards & Transfers 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Total of all ColLections 0.00 0.00 0.00 0.00 0.00 0.00 0.00
09-01-1993 Cash & Checks Collected 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Jail Credits & Comm Service 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Credit Cards & Transfers 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Total of all Collections 0.00 0.00 0.00 0.00 0.00 0.00 0.00
09-01-1995 Cash & Checks CoL leeted 0.00 0.00 0.00 0.00 0.00 0.00 0.00
JaiL Credits & Comm Service 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Credit Cards & Transfers 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Total of alL Collections 0.00 0.00 0.00 0.00 0.00 0.00 0.00
09-01-1997 Cash & Checks ColLected 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Jail Credits & Comm Service 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Credit Cards & Transfers 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Total of all Collections 0.00 0.00 0.00 0.00 0.00 0.00 0.00
09-01-1999 Cash & Checks Collected 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Jail Credits & Comm Service 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Credit Cards & Transfers 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Total of all Collections 0.00 0.00 0.00 0.00 0.00 0.00 0.00
09-01-2001 Cash & Checks Collected 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Jail Credits & Comm Service 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Credit Cards & Transfers 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Total of all Collections 0.00 0.00 0.00 0.00 0.00 0.00 0.00
09-01-2003 Cash & Checks Collected 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Jail Credits & Comm Service 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Credit Cards & Transfers 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Total of all Collections 0.00 0.00 0.00 0.00 0.00 0.00 0.00
01-01-2004 Cash & Checks Collected 1,571.20 1,405.90 239.90 0.00 0.00 0.00 3,217.0C
Jail Credits & Comm Service 95.00 134.00 11.00 0.00 0.00 0.00 240.00
Credit Cards & Transfers 857.80 740.20 246.10 0.00 0.00 0.00 1,844.10
Total of all Collections 2,524.00 2,280.10 497.00 0.00 0.00 0.00 5,301.10
TOTALS Cash & Checks Collected 1,571.20 1,405.90 239.90 0.00 0.00 0.00 3,217.00
Jail Credits & Comm Service 95.00 134.00 11.00 0.00 0.00 0.00 240.00
Credit Cards & Transfers 857.80 740.20 246.10 0.00 0.00 0.00 1,844.10
Total of all Collections 2,524.00 2,280.10 497.00 0.00 0.00 0.00 S,301.10
09/05/2012
Money Distribution Report
Page
7
OATE
PAYMENT. TYPE
-------------~----------------------------------------------------------------------------------------------------------------------
OTHER
TOTAL
State of Texas Quarterly Reporting Totals
Oeser i pt i on
State Comptroller Cost and Fees Report
Section I: Report for Offenses Committed
01.01-04 forward
09-01-01 12-31-03
08-31-99 08.31-01
09-01.97 08-30-99
09-01-91 08-31-97
Bai L Bond Fee
DNA Testing Fee - Convictions
DNA Testing Fee - Corom Supvn
DNA Testing Fee - Juvenile
EMS Trauma Fund (EMS)
Juvenile Probation Diversion Fees
Jury Reimbursement Fee
Indigent Defense Fund
Moving Violation Fees
State Traffic Fine
Section II: As Applicable
Peace Officer Fees
Failure to Appear/Pay Fees
Judicial Fund - Const County Court
JudiciaL Fund M Statutory County Court
Motor Carrier Weight Violations
Time Payment Fees
Driving Record Fee
Judicial Support Fee
Report Sub Total
State Comptroller CiviL Fees Report
CF: Birth Certificate Fees
CF: Marriage License Fees
CF: Declaration of Informal Marriage
CF: Nondisclosure Fees
CF: Juror Donations
CF: Justice Court Indig Filing Fees
CF: Stat prob Court Indig Filing Fees
CF: Stat prob Court Judie Filing Fees
CF: Stat Cnty Court [ndig FiLing Fees
CF: Stat Cnty Court Judie FiLing Fees
CF: Cnst Cnty Court Indig Filing Fees
CF: Cnst Cnty Court Judie Filing Fees
CF: Dist Court Divorce & Family Law
CF: Dist Court Other Divorce/FamiLy Law
CF: Dist Court Indig Legal Services
CF: JudiciaL Support Fee
Report Sub Total
TotaL Due For This Period
fINES CCURT-CQSTS
fEES
BONDS RESTITUTICN
Count
Collected
Retained
Disbursed
24 882.11 88.21 793.90
0 0.00 0.00 0.00
0 0.00 0.00 0.00
0 0.00 0.00 0.00
0 0.00 0.00 0.00
0 0.00 0.00 0.00
0 0.00 0.00 0.00
0 0.00 0.00 0.00
0 0.00 0.00 0.00
0 0.00 0.00 0.00
0 0.00 0.00 0.00
24 85.71 8.57 77.14
24 44.11 4.41 39.70
12 1.06 0.11 0.95
13 346.86 17.34 329.52
12 57.45 45.96 11.49
3 74.72 24.66 SO.06
0 0.00 0.00 0.00
0 0.00 0.00 0.00
0 0.00 0.00 0.00
7 139.85 69.92 69.93
0 0.00 0.00 0.00
24 140.75 14.07 126.68
143 1,772.62 273.25 1,499.37
0 0.00 0.00 0.00
0 0.00 0.00 0.00
0 0.00 0.00 0.00
0 0.00 0.00 0.00
0 0.00 0.00 0.00
2 12.00 0.60 11.40
0 0.00 0.00 0.00
0 0.00 0.00 0.00
0 0.00 0.00 0.00
0 0.00 0.00 0.00
0 0.00 0.00 0.00
0 0.00 0.00 0.00
0 0.00 0.00 0.00
0 0.00 0.00 0.00
0 0.00 0.00 0.00
0 0.00 0.00 0.00
2 12.00 0.60 11.40
145 1,784.62 273.85 1,510.77
09/10/2012 15:25 351-983-2451
CALHOUN CO PCT 5
PAGE 01
Judge Nancy Pomykal
Justice of the Peace Pet. 5
Collections for the Month of ~ugustt 2012
Date: September 10,2012
Calhoun County COMMISSIONERS'S COURT
211 S. Ann Street
Port Lavaca, TX 77979
Fax no: 553-4444
COMMISSIONER'S COURT:
Attached is the August 2012, Money Distribution Report for the Justice
of the Peace, Precinct 5 court.
Faxing 9 r Pages includin~ tijis cover.
09/10/2012 16:26
361-983-2461
CALHOUN CO PCT 5
PAGE 02
09/06/2012
Mcney D;stribyt;on Report
JUDGE NANCY POMYKAL- AUGUST 2012 RE~ORT
Page 1
_____"__W_________~______~~_______~~.__________~~_________~"_~~________~____________~___~_______~___________--__~6________~9__~____
Reoeipt C.U.e/Defond.nt Codo Amount I cod. Amount I Code AmoUnt I Code Amount I Code Amount I Code Amount I Totat
I I I I I I
037449712-07-0241 08-01-2012 JSF 4.00 I CCC 40.oq I CHS 3,00 I PWAF '.00' TF 4.00 I JCSF 1.00 I 115.00
MoNDOLFI, PAUL E JPAY 6.00 I [DF 2.00 I WSF 50.00 I I I I
Porsonal ehoek I I I I I I
037449S 12-07-0236 08-01-2012 JSF 4.00 I eec 40,00 I eNS 3.00 I PWAf 5.00 I TF 4.00 I JCsP 1.00 I 115.00
KELLY, RYAN ALLEN JPAY 6,00 I IDF 2.00 I WSF 50,00 I I I I
per.onol Chock I I I I I I
0374499 12-06-0201 08-01-2012 JSF 4.00 I ccc 40.00 I eHS 3,00 I SA, 5,00 I TF 4.00 I JCsF 1.0C I 120,00
PARNELL, JOSHUA DAVID JPAY 6.00 I!DF 2.00 I fINE 55.00 I I I I
Pe..o""l Che.k I I I , I I
037450012-07-0233 OS-OH012 JSF 4.00 I CCC 40,00 I CHS 3.00 I TF 4.00 I JCSF 1.00 I JPAY 6.00 I 165.00
MCCORD, SEAN DAVID IDF 2.00 I PWF 100.00 I PWAF 5.00 I I I I
Money order I I I I I I
0374501 12-07-0235 08-01-2012 JSF 4.00 I cce 40.00 I CHS 3.00 I PWAF 5.00 I TF 4,00 I JCSF 1.00 I 115.00
BENsoN, FRANKLIN c J~AY 6.00 I IDF 2.00 I WSF 50,00 I I I ,
Money or4er , I I I I I
037450212-05-0183 08-02-2012 I JS, 4.00 I Cce 40.00 I CHS 3.00 I LAF 5.00 I TF 4,00 I JCSF 1.00 I 165.00
PERRY, SOPHIE MAE I JPAY 6.00 I IDF 2.00 I FINE 100.00 I I I I
Comm Servi.o I I I , I I I
037450~ 12-05-01S2 08-02-2012 I J$F 4,00 I cee 40.00 I eHS 3.00 I LAF 5,00 I TF 4.00 I Je$F 1.00 I 135.00
PERRY, $OPHIE MAE I JPAY 6.00 I IOF 2,00 I FINE 70.00 I I I I
eomm Sorvi.o I I I I I I I
0374504 1Z-0S-0181 08-02-2012 I JSF 4.00 I ttC 4e,oo I CHS 3.00) LAF 5,00 I TF 4.00 I JPAY 6.00 I 325,00
PERRY, SOPHIe MAE IIDF 2.00 I FINE 260,00 I JCGF 1.00 I ) I I
eomm sorvice I I I I I I I
0374505 12-01-0107 06-02-2012 I JSf 4.00 I cee 40.00 I eHS 3.00 I LAF 5.eO I WRNT 50.00 I TF 4.00 I 279.50
WHITT^K'~, GADRIEL LEE I JPAY 6,00 I IOF 2.00 I FINe 100.00 I CSRV, 64.50 I JeSF 1.00 I I
Cashior'. Chock I I I I I I I
037450611-01-0114 08-02-2012 I JSF 4.001 TFt 3.00 I ccc 40.00 I CHS 3,00 I LAF 5.00 I TF 4.00 I 407.50
WHITTAKER, GABRIEL LEE I DPSC 30,00 I JCSF 1.00 I JPAY 6.00 I IDF 2,00 I MVF 0,10 I FINE 146.90 I
Coshier'. Chock I SUSC 30.00 I CS~V 82.50 I WRNT 50.00 I I I I
0374507 11-01-0115 08-02-2012 I JSF 4.CO I cee 40.00 I eHS 3.00 I LAf 5.00 I WRNT SO.OO I TF 4.00 I 296.50
WHITTAKER, GABRI~L LeE I OPSt 30.00 I JCSF 1.00 I JPAY 6,00 I IDF 2,00 I FINE 83.08 I CSRV 68.4Z I
Cashier'. tho.k I I I I I I I
0374508 11-01-011S 08-02-2012 I FINE 200.10 I I I I I I 200.10
WHITTAKER, GABRIEL LeE I I I I I I ,
Js; l credit I I I I I I I
037450912-08-0245 08-006-2012 I JSF 1.78 I TfC 1.3Z I ece 17.6Z I CHS 1.32 I LAF 2,20 I TF 1.76 I 30.00
WILLIAMS, MATTHEW I JtSF 0,44 I JPAY 2.64 I IDF 0,88 I MVF 0.04 I I I
po..onat Check I I I I I I
0374510 12-08-0246 08-06-2012 I JSF 4.00 I TFC 3.00 Ieee 40.00 I CMS 3.00' LAF 5.00 I TF 4.00 I 108.00
SATTERFIELD, MELISSA KAY. I JtSF 1.00 I JPAY 6.001IDF 2.00 I HVF 0.10 lose 9.90 I suec 30.00 I
Monoy Or4er I I I I I I I
0374511 1Z-08-0247 08-07-2012 'JSF 4.00 I ttC 40.00 I eHS 3.00 I SAF 5.00 I TF 4.00 I JeSF 1.00 I 125.00
GARCIA, EDUARDO JULIAN I JPAY 6.00 I IOF 2.00 I FINE 60.00' I I I
HonoyOrdor I I I I I I I
0374512 12-08-024B OS-07-2012 I JSF 4,00) ccc 40.00 I tHS 3.00 I SAF S.OO' TF 4.00 JeSf 1.00 I 125.00
PA~K, ~ANDAL MICHAEL I JPAY 6.00 I IDF 2.00 I FINE 60.00 I I I I
MonoyOrdor I I I I I I I
0374513 12-0S-0249 08-07-2012 I JSF 4.00 I CCC 40.00 I CHS 3,00 I SAF 5.00 I TF 4.00 I JCSF 1.00 I 125.00
COFFMAN, AMANDA LYNN I JPAY 6.00 IIDF 2.00 I FINE 60.00 I I I I
Money Oroor I I I I I ,
0374514 12-07-0243 OS-07-2012 I JSF 4.CO Ieee 40,00 I eHS 3.00 I PWAF 5.00 I Tf 4.00 I JeSF 1.00 I 16'.OC
DICK, b~A~K ALLEN I JPAY 6.00 I IOf 2.00 I WSF 100,00 I I I I
Mon.yOr.or I I I I I I I
09/10/2012 16:26
361-983-2461
09/06/2012
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PAGE 03
Money Distribution Report
JUDGE NANCY POMYKAL- AUGUST 2012 REPORT
PA5Ie Z
Rec~ipt caUse/Defendant
-----~-----~~-----~-----~------~~--------~~--------------~~----*~._-----------------------------~~--~------------------------------
To~.l
I Coda Amoun~ I Cod. Amount
I I
I TIME 25.00 I OPSC 30.00
I I
I I
I FINE 95.00 I SUBC 3C.00
I I
Monoy Ordor I I
0374517 12-06-0210 08-07-2012 I JSF 4.00 I ccc 40.00
GOSSETT, MICHAEL GCROON I JPAY 6.00 I IDF 2.00
parsonal ChoOK I I
0374518 12-07-0224 08-07-2012 I JSF 4.001 TFC
VASQUEZ, ALICIA ANN I JCSF 1.00 I JPAY
C..hi.r'. Chock 1 SUaC 30.00 I
0374519 12-07-0222 09-08-2012 I EXRF 10,00 I
WALTERS, BOBBY EARL. I I
Porsona l Chook , I
0374521 12-08-0253 08-09-2012 I JSF 4,00 I TFC
WEMLMANN, DAVID WAYNE I JCSF 1.00 I JPAY
1988 Parsonsl Chook I I
0374522 12-07-0242 08-09-2012 I JSF 4,00 I TFC
MIL.L.ER, RAYMCND M III I JCSF 1.00 I JPAY
543 pa"o".l Ch.ok I I
0374523 12-08-0260 08-09-2012 I JSF 4.00 I TFC
WMELESS, WILLIAM MEADE III I JCSF 1.00 I JPAY
16284 porsonal Chaek I I
0374524 12-08-0259 08-13-2012 I JSF 4.00 I TFC
THOMAS, DENNIS WAYNE I JCSF 1.00 I JPAY
Porsonsl eh.ok I I
0374525 12-08-0252 OB-13-2012 I JSF 4.00 I cec
cAMPBELL, CHARLES LEE I JPAY 6.00 I IOF
erodi~ Card I I
0374526 12-08-0264 OB-14-2012 I JSF 4.00 I cee
VEVEGAS, lAURA ANN I JPAY 6.0C' IDF
Jail cr.dit I I
0374527 12-05-0196 08-14-2012 I JSF 1.e5 TfC
BALAD~l, CARMELA VALLEJC I TF 1.85 I JPAY
Monoy Order I I
0374528 12-Qe-0256 08-14-2012 'JSF 4.00 I eec
COOPER, TIMOTHY ALLEN I JPAY 6,00 I IDF
7380 Persona t Chock I I
0374,29 12-05-0189 08-14-2012 I JSF 4.00 I cce
SOLIS, JOHN ARNOLD I JPAY 6,00 I IDF
333 Porsonal chaek I I
0374530 12-08-0269 08-20-2012 I JSf 4.00 I TFC
OEL.SCHLEGEL, CANDicE PAIGE I TF 4.00 I JCSF
e..h I OFF 81.90 I
0374,31 12-08-0253 08-21-2012 , FINE 116,90 I SUBC
UEHLMANN, DAVID WAYNe I I
1991 Par.onat ehook I I
0374532 12-08-0245 08-21-2012 I JSF 2.22 I TFe
WILLIAMs, MATTHEW I JCSF 0.56 I JPAY
144 Parsonal chook I ,
0374533 12-08-0263 06-27-2012 I JSF 4.00 I TFC
AARCIA. TIMOTHY FLOR.' I JCSF 1.00 I JPAY
Money Ordor I I
0374515 06 -11-0268 08-07-2012
MAY, KeNNETH EARL. JR.
company CheQK
0374516 12-07-0227 08-07-2012
MANCERA, MAYRA cARMELA
Cod. Amouot I Codo Amount I Coda Amoun~ , Codo AmoUht I
I I I I
FINE 136,00 I CSRV 57.30 I I I
I I I I
I I I I
I I I I
I I I I
I I I I
CMS 3,00' LAF 5.00 I n 4.00 I JeSF 1,00 I
fiNE 100.00 I I I I
, I , I
cec 40,00 I CHs 3.00 '"AF 5.00 I TF 4.00 I
IDF 2.00 I MVF 0.10 I OFF 5.00 I DSC 9.90 I
I I I I
I I I I
I I I ,
I I I I
40.00 ,eHS 3.00 I LAF 5.00 I TF 4.00 I
2.00 'MVF 0.10 I FINE 176.90 I I
I I I I
40.00 CMS 3.00 I LAP 5,00' TF 4.00 ,
2.00 MVF 0.10 DSC 9.90 I SUBC 30.00 J
I I I
40.00 CHS 3.00 I L.AF 5,00 I TF 4.00 I
2.00 MVF 0.10 I SUBC 30.00 I DFF 66,90 I
I I I
40.00 CHS 3,00 I LAF 5.00' TF 4.00 I
2.00 MVF 0.10 I DFF 66.90 I SUBC 30.00 I
I I
SAF 5.00 I TF 4.00 I JCSf 1.00 I
I I I
I I I
5,00 I TF 4.00 I JCSF 1,00'
I I I
I I I
1.B5 I LAF 2.31 I TIME 11.57 I
0,05 I FINE 6,90 I I
I I I
5.00 I TF 4.00 I JCSf 1.00 I
I I I
I , I
5,00 I TF 4.00 I JCSF 2,00 I
I I I
I I I
CMS 3.00 I SAF 5.00' LAF 5.00'
10F 2.00 I MVf 0.10 I SUBC 30.00 I
I I I
I I I
I I I
I I I
1.68 I LAF 2.80 I TF 2.24 I
0,06 'OSC 9.90 I SUBC 30.00 I
I I I
3.00 'SAF 5.CO I TF 4.00 I
0.10 I 'lNE 133.90 J ,UBC 3C.00 I
I I I
232 .00
248,30
125,00
165.0C
3.00
6.00
I
I
I
I
3.00 I CCC
6.00 J 1PF
I
3.00 Ieee
6.00 I lnF
I
3,00 Ieee
6.00 I IDF
,
3.00 I cce
6.00 I IDF
I
40.00 I eHS 3.00
2,00 I FINE 55.00
I I
40.00 I CHS 3.00 I LAF
2.00 I FINE 237.00 I
J I
1,39 I ccc 18.52 I eNs
2.7e I IOF 0.93 I MVF
I I
40.00 I CHS 3.00 I SAF
2.00 I FINE 5,.00 I
I I
40.00 I CMS 2.00 I LAF
2.00 I WSf 100.00 I
I I
3,00 Ieee 40.00 I
1.00 I JPAY 6,00 I
I I
30.00 I I
I I
I I
1.6B I cec 22.38' eMS
3.36 IIOF 1.12 I MVF
I I
3.0C I ccr 40.00 I eHS
6.00 I 10F ..00 I MVF
I I
113.00
10.00
245.00
we. 00
1es.00
165.00
120.00
302,00
50,00
1M.CO
165.00
185.00
146.90
78.00
09/10/2012 16:26
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CALHOUN CO PCT 5
PAGE 04
09/06/2012 Money Diotribution Report Poge 3
JUDGe NANCY POMYKA"- AUGUST 2012 REPORT
_______W-_*M_____________~____________~__._~__________~~__~___________~______~_______~_______~________~_____~__________~~____~_____
Receipt Cou../Oefendent I Code Amount I cod. Amount I Cod. Amount I code Amount I Code Amount I Code A.ount I Totet
I I I I I I I
0374534 12~08u0251 08-27-2012 I JS~ 4.00 I CCC 40,00 I CHS 3.00 I TF 4.00 I JCSF 1,00 I JPAY 6.00 I 125.00
eLLIOTT, JACK KYLE I 10F 2.00 I FINE 60.00 I SAF 5.00 I I I I
15674 Per!ilclnQl Chfl:tk I I I I I I I
0374~3~ 12-oa-0254 08-27-2012 1m 4.00 I TFC 3.00 I CCC 40,00 I CHS 3.00 I LAF 5,00 f TF 4.00 I 225.00
TY~ON, BENJAMIN ~V~RTT III I JC~F 1.00 I JPAY 6.00 I IOF 2.00 I HVF 0.10 I FINE 126,90 I SUBC 30.00 I
1126 Pel"aonBl Cneok I I f I I I I
0374536 12-08-0255 08-29-2012 I JSF 4,00 I TFC 3.00 I CCC 40.00 I CHS 3.00 I SAF 5,00 I TF 4.00 I 215.00
GUTIERREZ, ALEXAHDER III I JCSF 1.00 I JPAY 6.00 I ID~ 2,00 I HVF 0.10 I FINE 116,l'O I suec 30.00 I
Perionllll Check I I I I I I I
09/10/2012 16:26
361-983-2461
CALHOUN CO PCT 5
PAGE 05
09/06/~01Z MOfiey Distribution Report page 4
JUDGE NANCY POMYKAl- AUGUST ~012 REPORT
~~_w_________~___~_______~____~_____________~_______~_____~._-----~~------~------~~_____~_________ww______________~_________________
The following lotllo '.pre.ent . CI.h and Checko COlle.ted
Type Code Description (Ql,lnt Retained Di8bura~d Honey-Totals
Th& 10llQwing totals repre$ent - Cash and Checks Colleoted
COST CCC CCNSOLIQATEb COURT COSTS Z9 109.85 988.67 1,098.52
COST CHS COURTHOUSE SECURITY ~9 81,85 0.00 81. 8>
COST bPSC DP$ FAilURE TO APPEAR /OHNI ~EES 3 29.70 60,30 90.00
COST ID~ INDIGENT DEFENSE FUND 29 5.'9 ~9," 54,93
COST ICSf JUSTICE cOU~T SECURITY fUNQ ~8 28,00 0.00 28.00
COST JPAY JUbGE PAY RAISE fEE 29 16.48 148.30 164.78
COST JSF JUROR SERVICE FUND 29 10.98 98.87 109,85
COST LAF SHERif f' S fEE 16 72.31 0.00 n.31
COST MVf MOVING VIOLATION FEE 14 0.12 1.13 1,25
COST PWAF T~XAS PARKS & WILDLIFE S 20.00 >.00 25.00
COST SAF DPS 9 36.00 9.00 ~5,OO
COST Tf TEcHNOLOGY FUND 29 109.85 0.00 109.85
COST TFC TFC 1~ 37.39 0.00 37.39
COST TIME TIME PAYMENT ~EE 2 18.28 18.Z9 36.57
COST WRNT WARRANT FEE 3 1;0,00 0.00 150.00
FEES cSRV COllECTION SERVICES FEE , 2n.n O.eo 272,72
FEES DFF DEFERRED FEE 4 240.70 0.00 ~40.70
FEES DSC DRIVER SAFETY CCURSE 01/2008 ~ 39.60 0.00 39.60
FeES eXRf EXPIRATION RENEWAL ~EE 1 10,00 0,00 10.00
FEes SUBc SU8 TITLE C 13 19.>0 370,50 390.00
FINE FINE FINE 18 1,689.38 0.00 1,689.38
FINE PWF PARKs & WllDlI~E ~INE 1 15.00 85.00 100.00
FINE WSF WATER SAFETV ~INE 5 52.50 297.50 350.00
Horll~Y Tota lit 33 3,065.70 2,132,00 5,197.70
The follow1ng total. repre.ont . T'.n.f.ro collected
COST CCC cONSOLIDATED COURT COSTS 0 0.00 0.00 0.00
COST CHS COURTHOUSE SECURITY 0 0.00 0.00 0,00
COST DPSC OPS fAILURE TO APPEAR /OMNI FEES 0 0.00 0.00 0.00
COST IDf INDIGENT DEfENSE fUND 0 0.00 0.00 0.00
COST JCSF JUSTICE COURT SECURITY fUNQ 0 0,00 0.00 0.00
coST JPAY JUDGE PAY RAISE FEE 0 0.00 0.00 0.00
CoST JSF JUROR SERVICE FUND 0 0.00 0.00 0.00
COST LAF SHERIFF'S FEB 0 0.00 0.00 0.00
COST MVf MOYING VIOLATION FEE 0 0.00 0.00 0,00
COST PWAF TEXAS PARKS & ~IlDLlfB 0 0.00 0.00 0.00
COST $Af DPS 0 0.00 0.00 0.00
COST TF TECHNOLOGY FUND 0 0.00 0.00 0.00
COST TfC TFC 0 0.00 0,00 0.00
COST TIME TIME PAYMENT FEE 0 0.00 0.00 0,00
COST WRNT WARRANT fEE 0 0,00 0,00 0.00
FEES CSRV COllECTION SERVICES fEE 0 0.00 0,00 0.00
FEES OFF DEfeRRED FEE 0 0,00 0.00 0.00
fEES DSC DRIVER SAFETY COURSE 01/2008 0 0.00 0.00 0,00
FEES EXRF EXPIRAtION RENeWAL FEE 0 0.00 0.00 0.00
09/10/2012 16:26
361-983-2461
CALHOUN CO PCT 5
PAGE 06
09/06/2012 Honey Di.tribution Report Pa9~ 5
JUDGE NANCY ~OHYKAL- AUGUST 2012 RE~ORT
----~------~~----------------~------~~---------------_~~______~~_______________~_~_w_____________________________~_____~______._____
The 1oLlowing total~ t~preBent ~ Transfer$ colleoted
Typ. cod. D..Qription Count Retained Disburs.d Honey-Tot.L.
FEES suec SUB TITLE C 0 0.00 0,00 0.01)
FINE FINE FINE 0 0.00 0.00 0.00
FINE PWF PARKS & WILDLIFE FINE 0 0.00 0.00 0.00
FINE WSF WATER SAFETY FINE 0 0.00 0.00 0.00
Transfer Totals 0 0.00 0,00 0.00
The 1oLlowing totals repre&ent - J~il Credi~ .n~ Community serv;ce
COST W; CONSOLIDATED COURT COSTS 4 16.00 144.00 160,eO
COST CHS COURTHOUSE SECURITY 4 12,00 C.OO 1~.00
COST DPSC DPS FAILURE TO APPEAR /OMNI FEU 0 0.00 0.00 O.CO
CCST IDF INDIGENT DeFENSE FUND 4 0.80 7.~0 8.00
COST JCSf JUSTICE COURT SECURITY PUND 4 4.00 0.00 4.00
CCST J~AY JUDGE ~AY RAISE FEE 4 2,40 21,60 24.00
COST JS' JUROR SERVICE FUND 4 1.60 14.40 16.00
COST I.AF SHERIFF's fEE 4 2e,OO 0.00 20,00
COST MVF HOVING VIOLATION FEE C 0.00 0.00 0.00
COST PWAF TEXAS PARKS & WILDLIFE 0 0.00 0.00 0.00
COST SAF DPS 0 0.00 0,00 0.00
COST TF TECHNOI.OGY fUND 4 16.00 0.00 16.00
COST TFC HC 0 0.00 0.00 0.00
COST UME TIME PAYMENT FEE 0 0,00 0.00 0.00
COST WRNT WARRANT FEE 0 0.00 0.00 0.00
PEES CSRV COLLECTION SERVICES FEE 0 0.00 0.00 0.00
FEES OFF DEFERRED PEE 0 e,oo 0.00 0.00
FEES DSC DRIVER SAFETY COURSE 01/2006 0 0.00 0.00 0.00
FEES EXRF EXPIRATION RENEWAL FEE 0 0,00 0.00 0.00
FEES suec sue TlTI.E C 0 0.00 0.00 0.00
FINE FINE FINE 5 867.10 0.00 867.10
FINE PWf PARKS & WILDLIFE FINE 0 0.00 0.00 0.00
nNE WSF WATER SAF~TY FINE 0 0.00 0.00 0.00
CI"8cHt Totl!lLs 5 939.90 187.20 1,127,10
Th~ following totals represent - credit ca~d Payments
COST CCC CONSOLIDATED COURT COSTS 1 4,00 36.00 40.00
COST CHS COVRTHOVSE SeCURITY 1 3.00 0,00 3.00
COST DPSC DPS FAlLURE TO APPEAR /OMNI FEES 0 0,00 0,00 0.00
COST IDF INDIGENT DEFENSE FUND 1 0.20 1.80 2.00
COST JCsr JUSTICE COVRT S~CURITY FUND 1 1.00 0.00 1.00
COsT JPAY JUDGE PAY RAISE FEE 1 0.60 5.40 6.00
COST JSF JUROR SERVICE FUND 1 0.40 3.60 4.00
COST lAF SHERIFF'S FEE 0 0.00 0.00 0.00
COST MVf MOVING VIOLATlCN F.~ 0 0.00 0.00 0.00
COST PWAF TEXAS PARKS & WILDI.If. 0 0.00 0.00 0.00
COST SAF eps 1 4.00 1.00 S.OO
COST TF TECHNOLOGY fUND 1 4,00 0,00 4.00
09/10/2012 15:25
351-983-2451
CALHOUN CD PCT 5
PAGE 07
09/06/2012 Money Distribution Report Page 6
JUDGE NANCY PCMYKA~- AUGUST 2012 REPORT
-~--------_~w______________~~______w_w~_________~.______~_~____________~________._________________~_______~___________________~____~
The fotlcwin9 total$ reprOs4~t - Credit Cftrd peymontti
Typo code Oesori pHon Count Retainod Disburs&d Money-Total$
COST TFC TFC 0 0,00 0,00 0,00
cOST TIME TIME PAYMENT FEe 0 0.00 0.00 0.00
COST W~NT WARRANT FEE 0 0,00 0.00 0.00
FEES CSRV CO~LECTION SERVICES FEE 0 0.00 0.00 0.00
FEES OFF DEFERRED FEE 0 0,00 0.00 0.00
FEES DSC O~IVER SAFETY COURSE 01/2008 0 0.00 O,OC 0.00
FEES EX~P EXPIRATICN RENEWA" FEE 0 0.00 0.00 0.00
FEES SUBC SUB T lT~E C 0 0.00 0.00 0.00
FINE PINE fINE 1 55,00 0.00 55.00
FINE PWP PA~KS & WI"DLIFE FINE 0 0,00 0,00 0.00
FINE WSF WATER SAFETY PINE 0 0.00 0.00 0.00
credit Tot.ls 72.20 47.80 120,00
The following t~t.le represent - Combined Honey end credits
COST CCC CONSO~IDATED COURT COSTS 34 129.85 1,168,67 1,298.52
COST CMS COURTHOUSE SECU~ITY 34 96.85 0.00 %.85
COST DPSe DPS FAI"URE TO APPEAR /OHNI FEES 3 29.70 60.30 90.00
COST 10F INDIGENT DEFENSE FUNO 34 6.49 58.44 64.93
COST JCSF JUSTICE COURT SECURITY FUND 3~ ~~.OO 0,00 33.00
COST JPAY JUDGE PAY RAISE FEE 34 19.411 175.~0 194.78
COST JSf JUROR SE~VICE FUND 34 12.98 116.87 129.85
COST ~AF SHERIFF'S FEE 20 92.31 0.00 92.31
COST HVF HOVING VIO~ATION pee 14 0.12 1.13 1,25
COST PWAF TEXAS PARKS & WI~D"IFE 5 20,00 5,00 25.00
COST SAF DPS 10 40.00 10.00 50.00
COST TF TECHNO~OGY FUND 34 129.85 0.00 129.85
COST TFc TFC 14 37.39 0.00 37.39
COST HME TINE PAYHENT FEE 2 18.28 18.29 36.57
COST WRNT WARRANT FEE 3 150.00 0.00 150.00
FEES CSRV CO""ECTION SERVICES FEE 4 272.72 0,00 272.72
FEES OFF DE F E~~eD FEE 4 240.70 0.00 240.70
FEES DSC D~IVE~ SAFETV COU~SE 01/200B 4 39.60 0.00 39.60
FEES EXRF EXPIRATION RENEWAL FEE 1 1e,OO 0.00 10.00
FEES SUBC SUB TlT~E C 13 19.50 370.50 390.00
FINE FINE FINE 24 2,611.48 0.00 2,611,48
FINe PWF PARKS & WILD"IFE fINE 1 15.00 85.00 100.00
fINE WSF WATER SAFETY FINE 5 52.50 297.50 350.00
Report TOIBls 39 4,077.80 2,367.00 6,444,80
09/10/2012 16:26
361-983-2461
CALHOUN CO PCT 5
PAGE 08
09/06/2012 Money Distribution Report Page 7
JUDGE NANCY POMYKAl- AUGUST 2012 REPORT
_~~~_______________________________.~_M________~_W~__~____________________~~_____________.___________________-~----~----------------
DATE PAYHENT-TYPE FINES CCURT-COsTS fEES BONDS RESTITuTION CTHER TOTAL
00-00-0000 C..h & Checks COllected 0.00 0.00 0.00 e.oo 0.00 0.00 0,00
J~il Credits & Comm Service 0,00 0.00 0.00 0.00 0.00 0.00 0.00
Credit Ctrds & Transfers C,OO 0.00 0.00 0.00 0.00 0.00 0.00
Total of atl collections 0.00 0,00 0.00 0.00 0.00 0.00 0.00
09-01-1991 Ca$h & 'heoke Colleoted 0.00 0,00 0.00 0.00 0,00 0,00 0.00
Jail Credits & COMm Servi~e 0.00 0,00 0.00 0.00 0.00 0.00 0.00
credit Cord$ & Tr~n$f~r; 0.00 0.00 0,00 0.00 0,00 0.00 0.00
Tot.l of all Collections 0.00 0.00 0.00 0.00 0.00 0,00 e.oo
09-01-1993 Cash & Checks coLlected 0.00 0.00 0.00 0.00 0.00 0.00 0,00
J~il tredits & COMM servioe 0.00 0,00 0.00 e,oo 0.00 0,00 0,00
Crtdit Cards & Tran,fer$ O.CO 0.00 0,00 0.00 0.00 0.00 0.00
Tot~l of ~ll CoLlections 0.00 0.00 0.00 0.00 0,00 0.00 0.00
09-oH 995 cuh & Checks Collected 0.00 0.00 0,00 0.00 O,OC 0.00 0.00
Jail Credits & Comm $erviQe 0.00 0.00 0.00 0,00 0.00 0.00 0.00
Credit Ca~d$ & Tran$fers 0.00 0,00 0,00 0.00 0.00 0,00 0.00
Tot.l of all COllections 0,00 0.00 0.00 o.eo 0.00 0,00 0.00
09-01-1997 Cash & Checks Collected 0,00 0.00 0.00 0.00 0.00 0.00 0,00
Jail Credits & COMm strvice 0.00 0.00 e.oo 0.00 0.00 0.00 0.00
Ctedit Cards & 1ran~fer$ 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Tot8l of all collect1one 0.00 0,00 0,00 0.00 0.00 0.00 0.00
09-01-1999 C..h & Chocks Collected 0,00 0.00 0.00 0.00 0.00 0.00 0.00
Jail credits & Comm $ervioe 0.00 0.00 0.00 0.00 0,00 0.00 O.CO
Credit Cards & Tl"tlns.1er& 0.00 0.00 0.00 0,00 0.00 0.00 0.00
Total of aU Collections 0,00 0.00 0.00 0,00 0.00 0.00 0.00
09-01-2001 cosh & Checks Co~leoted 0,00 0.00 0.00 0.00 0.00 0,00 0.00
Jli~ Credits & Comm servioe 0.00 0.00 0.00 0,00 0.00 0.00 0,00
Credit C.rds & Tranafers 0.00 0,00 0.00 0,00 0.00 0.00 0.00
TotaL 01 alL collections 0.00 0.00 0,00 0.00 0.00 0,00 C,OC
09-01-2003 C.sh & Cheok, Collected 0.00 0.00 0,00 0.00 0.00 0.00 0.00
Joil credits & Comm servioo 0.00 0.00 0.00 0.00 0.00 0.00 0,00
CreQit ~&td& & Transfere 0.00 0.00 0.00 0,00 0.00 0.00 0,00
Total of ~lL Collection$ 0.00 0,00 0,00 0.00 0.00 0,00 0.00
01-01-2004 Ca.h & Checks Collectad 2,139.38 2,105.30 953.02 0,00 0,00 0.00 5,197.70
Jail CreQi~s & Comm servioe 867.10 260.00 0,00 0.00 0.00 0,00 1,127,10
Credit card$ & Trenafers 55.00 65,00 0.00 0.00 0.00 0.00 120.00
fotal of alL Collection$ 3,061,48 2,430.30 953.02 0,00 0.00 0.00 6,444.80
TOTALS C~eh & ,haoks Collected 2,139.38 2,105.30 953.02 0.00 0,00 0.00 5,197.7C
J~;l Credits & ComM servioe 867.10 260.00 0.00 0.00 0.00 0.00 1,1.27.10
Cr!dit cards & Tr.n~+er~ ;S.OO 65.00 0,00 0,00 0.00 0.00 120.00
Totat of oll Co(leotions 3,061.48 2,430.3C 953,02 0.00 0.00 0.00 6,444.80
09/10/2012 16:26
361-983-2461
09/06/2012
CALHOUN CO PCT 5
Honoy Distribution Report
JUDGE NANCY POHYKAL- AUGUsT 2012 REPOR1
PAGE 09
Pag.
a
DATE
PAYMENT-TYPE
~_~~__~_______~~_______________________~~~~_____._________________________~M_______~~_________________.______._.~_________________~~
OTHER
TOTAL
State 01 Texas Quarterly Reporting Totals
De,oription
State ComptrolLer COJt ~n~ F~ea Repo~t
Seotion J: Repo~t for offenses ~Qmmitted
01-01-04 Forword
09-01-01 - 12-31-03
08-31-99 - OB-31-01
09-01-97 - 08-30-99
09-01-91 - OB-31-97
Bali l Bond fee
DNA Tee1;;ng Fee - Colivittions,
DNA T~$tins Fee ~ Comm SupV~
DNA Tt~ting Fee - Juvenile
EMS Trauma Fund (EHS)
J~venile probation biver$ion Fea&
Jury ReiMbur&ement Fee
Indigont oofense Fund
Moving Violation Feee
Stete TreffiQ Fine
So.tion II' Ao Appli..ble
Peaoe Officer Fa6$
FaiLure to App'~r/Pay Fea&
JudioiaL Fund ~ Const County Court
Judicial Fund - statutory county Court
Motor Carrier Weight Violations
Time Payment Fees
Driving Record Fee
Judicial support fee
Roport Sub Total
State Comptroller Civil Fees Re~ort
Cf: Birth Certi11eato Fee$
cr: M~rriB9a Licente Fe~a
CF: D$claration of Informal Marri6ge
CF: Nondi~cLoi~re F,es
CF: Jurot Donation$
CF~ Justice Cou~t Indig Filing Fee$
CF, Stat Prob Court Indlg Filing F...
eF; St.t Prob Court Judie Filing Fe..
eF: Stet Cnty Court Indig Filing F...
CF: St.t Cnty Court JYdic Filing Fet~
CF: Cnst Cnty court Indig Filing F..s
CF: Cost cnty c~urt J~dic fi~ing Fees
tF: Dist Court Divorce & Family Law
of: Oi ot Court Oth.r Oivorco/FamiLy LOW
CF: Di't Court lndig Leg~L $ervio'$
CF: Judic;.l support Fee
R.port sub Total
Total DuO For This period
FINES CCURT-COSTS
Count
30
o
o
o
o
o
o
o
o
o
o
30
30
14
13
15
3
o
o
o
z
o
30
167
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
167
FEES
Collected
1,138.5.
0,00
0.00
0.00
0.00
0.00
0,00
0.00
0.00
0,00
0.00
113.a5
56.93
1..5
390,OC
7,,00
90.00
0.00
0.00
0.00
36..7
0,00
170.7B
2,072.90
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
0.00
0,00
0.00
2,072.90
BONOS RESTITUTION
RetaineQ
113.85
0.00
0.00
0,00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
11.3B
..69
0.12
19.50
60.00
29.70
0.00
0.00
0.00
18.28
0,00
17.08
275.60
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
0.00
0.00
0.00
275.60
Di.buroed
1,024.67
0.00
0.00
0.00
0.00
0.00
0.00
0,00
0.00
0,00
0.00
102,47
51.24
1.13
370.50
15.00
60.30
0.00
0,00
0.00
1B.29
0.00
153.70
1,797.30
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
0.00
0,00
0.00
1,797.30
PRE-APPROVE EXPENDITURES BY INCUMBENT COUNTY OR PRECINCT OFFICER(S) UNDER
COUNTY'S POLICY OF COMPLIANCE WITH LGC 130.908:
Claims totaling $35,642.33 were presented by Calhoun County Sheriff's Office and after reading and verifying
same a Motion was made by Commissioner Fritsch and seconded by Commissioner Lyssy to approve the
expenditures and that all said claims are approved for payment.
Commissioners Galvan, Lyssy, Fritsch and Judge Pfeifer all voted in favor.
Claims totaling $41,841.84 were presented by Calhoun County Adult Detention Center and after reading and
verifying same a Motion was made by Commissioner Fritsch and seconded by Commissioner Lyssy to approve
the expenditures and that ail said claims are approved for payment.
Commissioners Galvan, Lyssy, Fritsch and Judge Pfeifer ail voted in favor.
Calhoun County Sheriff's Office
Bills to be approved on
September 27, 2012
Vendor Description Amount
Sprint Telephone Services 1803.32
Pitney Bowes Postage 87.00
Dewitt Poth and Son Office Supplies 37.99
Dewitt Poth and Son Capital Outlay 99.38
Cintas Mise Supplies 79.88
Downtown Cleaners Uniforms 108.00
Ken's Enterprises Misc Service 110.00
Quill Office Supplies 500.00
Aqua Beverage Company Misc Supplies 136.67
Port Lavaca Bail Bond Co Bail Bond Fees County 1.50
Port Lavaca Bail Bond Co Bail Bond Fees State 13.50
Affordable Automotive Repair Misc Supplies 51.71
WatchGuard Law Enforcement Supplies 826.00
Wilke Tire Vehicie Repairs 110.00
Port Lavaca Ford Vehicle Repairs 858.98
Firestone of Port Lavaca Vehicle Repairs 1191.29
Rose Stringo Uniforms 440.00
Timeco Office Supplies 125.00
Exxon Fuel 10000.00
Shell Fuel 10000.00
Credit Card Center Fuel 5000.00
Credit Card Center Training out of County Travel 1500.00
Credit Card Center Meai Allowance 500.00
Credit Card Center Law Enforcement Supplies 100.00
Credit Card Center Office Supplies 200.00
Calhoun County Sheriff's Office
Sills to be approved on
September 27, 2012
Credit Card Center Misc. Service 200.00
Credit Card Center Vehicle Repairs 100.00
G. T. Distributors Uniforms 717.65
Ricoh USA, Inc Copier Rental 502.00
The Port Lavaca Wave M isc Service 171.46
Cintas Misc Suppiies 71.00
Total 35642.33
Vendor
Calhoun County Adult Detention Center
Bills to be approved on
September 27 ,2012
Description Amount
Radiology Unlimited Inmate Medical 395.00
Memorial Medical Center Inmate Medical 25000.00
Port Lavaca Family Dentistry inmate Medicai 783.00
Bob Barker Company Inc. Physicals 502.20
Ben Keith Co Groceries 6731.84
Ben Keith Co Misc. Supplies 179.66
HEB Groceries 400.00
HEB Misc Supplies 100.00
Glove Planet Misc Supplies 300.00
FedEx Postage 86.04
Gulf Coast Paper Misc Supplies 517.89
Gulf Coast Paper Inmate Supplies 368.82
Gulf Coast Paper Capital Outlay 482.16
David Hensley Physicals 900.00
Downtown Cleaners Uniforms 124.00
Pitney Bowes Postage 87.00
Ricoh USA, Inc Copier Rental 858.00
Dewitt Poth and Son Office Supplies 244.78
Downtown Cleaners Uniforms 58.00
Gulf Coast Hardware Misc Supplies 53.44
Pitney Bowes Postage 174.00
The Productivity Center Misc Service 60.00
Stericycle Misc Service 359.81
The Port Lavaca Wave Misc Service 76.20
Credit Card Center Training Travel Out of County 2000.00
Calhoun County Adult Detention Center
Bills to be approved on
September 27,2012
Credit Card Center
Meal Allowance
1000.00
Total
41841.84
BILLS:
Claims in the amount of $1,311,424.88 for operating fund and $59,706.80 for indigent healthcare fund expenses
totaling $1,371,131.68 were presented by Memorial Medical Center and after reading and verifying same a
motion was made by Commissioner Fritsch and seconded by Commissioner Lyssy to approve the bills and that
all said claims are approved for payment.
Commissioners Galvan, Lyssy, Fritsch and Judge Pfeifer all voted in favor.
Claims totaling $436,415.56 were presented by the County Treasurer's office and after reading and verifying
same a motion was made by Commissioner Fritsch and seconded by Commissioner Lyssy to approve the bills
and that all said claims are approved for payment.
Commissioners Galvan, Lyssy, Fritsch and Judge Pfeifer all voted in favor.
Claims totaling $20,697.11 were presented by the Calhoun County Sheriff's Office and after reading and
verifying same a motion was made by Commissioner Fritsch and seconded by Commissioner Lyssy to approve
the bills and that all said claims are approved for payment.
Commissioners Galvan, Lyssy, Fritsch and Judge Pfeifer all voted in favor.
MEMORIAL MEDICAL CENTER
COMMISSIONERS COURT APPROVAL LIST FOR ----- September 27. 2012
MEMORIAL MEDICAL CENTER OPERATING FUND
MEMORIAL MEDICAL CENTER WEEKLY CHECKS
Date Approved bv Countv Auditor (See attached lists)
8/1412012 Weekly Payables
811612012 Weekly Payables
8120/2012 Weekly Payables
8/22/2012 Weekly Payables
8/22/2012 Patient Refunds
8/30/2012 Weekly Payables
813012012 Patient Refunds
813012012 Weekly Payables
9/6/2012 Weekly Payables
91612012 Weekly Payables
Total Payables and Patient Refunds
MEMORIAL MEDICAL CENTER PAYROLL
Date of Pavroll Run & Date L1abilitv Called In (See attached lists)
8/14/2012 Net Payroll
8/14/2012 Net Payroll
812112012 Payroll Liabilities
812812012 Net Payroll
812912012 Net Payroll
8130/2012 Net Payroll
91412012 Payroll Liabilities
Total Net Payroll and Payroll Liabilities
GRAND TOTAL OPERATING FUND
APPROVED INDIGENT HEAL THCARE FUND EXPENSES
$ 5,478.52
142,096,01
2,500,00
220,523.60
1,333.43
143,661.73
1,269.31
15,000.00
198,502.37
390,56
213,709.44
4,164.91
72,175.18
216,552.35
882.99
1,652.75
71,531.73
$ 730,755.53
$ 580,669.35
$ 1,311,424.88
$ 59,706.80
IGRAND TOTAL BILLS APPROVED 9/27/2012
$ 1,371,131.681
MEMORIAL MEDICAL CENTER
COMMISSIONERS COURT APPROVAL LIST FOR ---- September 27, 2012
INDIGENT HEAL THCARE FUND:
INDIGENT EXPENSES
Calhoun County Home Health
Coastal Medical Clinic
HEB Pharmacy
.Refund from HEB Pharmacy - Credit on Bill
Laboratory Corporation of America
Mau-Shong Un MD
Memorial Medical Center (In-patient $36.251,60 Out,patient $8.386,95 ER $4.752.00)
Port Lavaca Anestesia Group
Port Lavaca Clinic
Ahmad I. Qadri MDPA
Radiology Unlimited PA
Victoria Surgical Associates
George A. William MD FACOG
SUBTOTAL
Memorial Medical Center <Indigent Healthcare Payroll and Expenses)
ITOTAL INDIGENT HEAL THCARE FUND EXPENSES (net of Refunds)
Refunds from Above
ITOTAL APPROVED INDIGENT HEAL THCARE FUND EXPENSES
197.84
1,321.49
1,167.72
(152.38)
83.52
33.27
49,390.55
218.58
1,288.68
179.43
129,64
358.28
71.93
54,288.55
5,265.87
59,554.42 I
152.38
59,706.80 I
**$410.00 in Co-Pays were collected by Memorial Medical Center in August
@IHS
Source Totals Report
Issued 09/13/2012
Calhoun Indigent Health Care
8- 1-12 through 8-31-12
For Vendor: All Vendors
Source Description
Amount Billed
Amount Paid
01 Physician Services
01-1 Injections
02 Prescription Drugs
05 Lab/x-ray
08 Rural Health Clinics
10 Optional Services - Home Healt.
13 Mmc - Inpatient Hospital
14 Mmc - Hospital Outpatient
15 Mmc - Er Bills
4,843.00
1,800.00
1,015.34
246.00
3,440.73
360.00
51,788.00
18,822.00
10,800.00
1,120.07
218.58
1,015.34
83.52
2,262.65
197.84
36,251 .60
8,386.95
4,752.00
Expenditures
Reimb/Adjustments
93,323.66
-208.59
54,497.14
-208.59
Grand Total
93,115.07
54,288.55
APPROVED
BY
SEP 20 2012
Fiscal Year
33,8801.54
CALHOUN COUNTY
AUDITOR
Payroll/Expenses
5,265.87
\..1\IWvu-~'c.u ~(..CJ.c~
Calhoun County Indigent Coordinator
800 09212012 01 CALHOUN COUNTY, TEXAS
DATE:
9/21/2012
VENDOR # BS2
CC Indigent Health Care
QUANTITY
pay bills for Indigent Health Care
Commissioners Court on 9/27/2012
UNIT TOTAL
PRICE PRICE
$59,554.42
1000-001-46010
$0.00
August Interest
COUNTY AUDITOR
APPROVAL ONLY
THE ITEMS OR SERVICES SHOWN ABOVE ARE NEEDED IN THE DISCHARGE
OF MY OFFICIAL DUTIES AND I CERTIFY THAT FUNDS ARE AVAILABLE TO PAY
THIS OBLIGATION.
APPROVED
BY
DEPARTMENT HEAD
I CERTIFY THAT THE AHOVE ITEMS OR
IN GOOD CONDITION AND REQUEST THE
THE ABOVE OBLIGATION.
DATE
SERVICES WERE RECEIVED BY ME
COUNTY TREASURER TO PAY
SEP 2 1 2012
CALHOUN COUNTY BY :
AUDITOR
DEPA
9/21/12
DATE
$0.00
$59,554.42
2011 Calhoun Indigent Care Patient Caseload
Approved Denied Removed Active Pending
Jan 7 22 10 152
Feb 9 13 17 156
Mar 32 33 26 153
Apr 8 19 28 164
May 6 19 16 149
Jun 25 21 23 146
Jul 1 19 5 140
Aug 1 13 39 108 2
Sept 2 43 32 79 11
Oct 8 15 27 62 16
Nov 7 8 21 47 15
Dec 1 24 27 30 14
YTD 107 249 271 1386 58
12 Mo Avg 9 21 23 116 S
2012 Calhoun Indigent Care Patient Caseload
Approved Denied Removed Active Pending
Jan 4 10 2 37 9
Feb 1 17 2 36 11
Mar 4 16 3 38 20
Apr 1 15 3 39 21
May 3 11 3 40 17
Jun 10 12 5 46 15
Jul 6 15 5 48 22
Aug 10 21 1 S9 20
Sept
Oct
Nov
Dec
YTD 39 117 24 343 13S
Monthly Avg 5 15 3 43 17
Rill! DATE: 09/0!/12
TIME: H:02
MEMORIAL MEDICAL CENTER
RECEIPTS FROM 08/01/12 TO 08/31/12
PAGE 121
RCMREP
G/L
NUMBER
RECEIPT PAY
DATE NUMBER TYPE PAYER
CASH
AHOM
RECEIPT
AlIOM NUMBER NAME
DISC COLL GL CASH
DATE linT CODE ACCOUNT
----------------~----------------------------~-----------------------------------~--------------------------------------------------
J1G 2
AHD 2
CA.~ 2
CAlI 2
CAlI 2
CAlI 2
CAlI 2
CAlI 2
CAlI 2
JLG 2
CA.~ 2
CAM 2
CAlI 2
502!0.00008/01/12 10.00 AYK 2
50240,00008/01/12 10.00 AYK 2
50240.00008/02/12 10.00 AYK 2
50210.00008/02/12 10.00 AYK 2
50240.000 08/03/12 10.00 AYK 2
50240.000 08/06/12 10.00 HEW 2
50240.00008/06/12 10.00 AYK 2
50240.00008/08/12 10.00 AYI 2
50240.000 08/09/12 10.00 HE\/ 2
50240.00008/10/12 10.00 KRR 2
502!0.0000a/10/12 10.00 AYK 2
502!0.000 Oa/13/12 10.00 AYK 2
50240.00008/13/12 10.00 AYK 2
50240.0000a/13/12 10.00 AYK 2
50240.0000a/H/12 10.00 AYK 2
502!0.0000a/H/12 10.00 AYI 2
502!0.000 Oa/H/12 10.00 AYK 2
50240.00008/15/12 10.00 AYK 2
50240.00008/15/12 10.00 KRR 2
50240.0000a/15/12 10.00 KRR 2
50240.0000a/16/12 10,00 AYI 2
50240.000 Oa/20/12 10.00 AYK 2
50240.000 Oa/22/12 10.00 EGH 2
50240.0000aI22/12 ! 10.00 MRP 2
50240.0000a/22/12 ,10.00 CAlI 2
50240.0000a/23/12 ' 10.00 JJ!B 2
50240.0000a/23/12 ! 10.00 JJ!B 2
50240.00008/23/12 10.00 JHB 2
50240.00008/23/12 10.00 AYK 2
50240.0000a/21/12 ' 10,00 AYI 2
502!0.000 Oa/21/12 10.00 AYK 2
50240.0000aI2a/12 10.00 AYI 2
50240.0000a/2aI12 10.00 AYK 2
502!0.00008/2a/12 10.00 YJlR 2
50240.000 Oa/29/12 10.00 AYK 2
50240.000 Oa/29/12 10,00 AYK 2
50240.0000a/30/12 10.00 AYK 2
50240.000 08j30/12 10.00 AYI 2
Rilll DATE, 09/01/12
TIME,IU2
MEVIlRIAL MEDICAL CEIITER
RECEIP'IS FRO!! OB/Ol/12 '10 OB/31/12
OiL
NUMBER
RECEIPT PAY
DATE NUMBER TYPE PAYER
CASII
AMOUNT
~~ ~~~~__________ ~~___~~___~_________M_____..___~_____________ _ - _ ______ _ _______~___~~ ~--- -.__ -- ~ ----- ~--- ----~-------- .---.-------
50210.0000B/30/12
50240.0000B/31/12
50240.0000B/31/12
UTQTA1** S024C.OOO comITY UIDIGENT COPAYS
50420.000 08123/12
50120.000 08123/12
50120,00008/23/12
50120.000 08/21/12
50120.00008/27/12
50420,00008/27/12
HTOTALU 50420.1
50510.00008101/12
50510.0000B/Ol/12
50510.00008/01/12
50510.00008/01/12
50510.00008/01/12
50510.00008/01/12
50510.00008/02/12
50510.000 08/02/12
50510.0000B/02/12
50510.00008/02112
50510.00008102/12
50510.000 00/02/12
50510.00008/03/12
50510.00000/03/12
50510.00008/03/12
50510.00008/03/12
50510.00008/03/12
50510.00000/03/12
50510.00008/06/12
50510.00008/06/12
50510.0000B/06/12
50510.0000B/06/12
50510.00008/06/12
50510.00008/06{12
50510.00008106/12
50510.00008/06/12
50510.00008/06{12
50510.00008/06{12
50510.0000B/06/12
50510.00008/06/12
50510.00008/06{12
50510.00008/06{12
50510.00008/06/12
50510.00008/06{12
50510.0000BI06/12
50510,00008/06/12
50510.00008/06{12
50510.00008/06{12
50510.00008/06/12
PAGE 122
RCMREP
RECEIPT
AMOUNT IlUMBER liME
DISC COLL OL CASH
DATE !HIT CODE ACCOOlIT
10.00
10.00
10.00
410.00
JJO
flIT
AYK
AYK
AlK
AlK
AlK
AlK
AlK
AYK
AlK
AlK
AlK
AlK
AlK
AlK
AlK
AlK
AlK
AlK
AlK
AlK
AlK
AlK
AlK
AlK
AlK
AlK
AlK
AlK
AlK
AlK
AlK
AlK
AlK
AlK
AlK
AlK
AlK
AYK
AlK
AlK
AlK
AlK
AlK
AYK
AlK
AlK
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
..
~@cQ]lp _ ct
~8IiVerii1g' Flexible' Choke
10680 Treena Street, 5th Floor
San Diego, CA 92131
(858) 566-2727 Credit Memo
To: HPLlO
Monica Escalante
BEE - CALHOUN COUNTY
815 N, VIRGINIA ST
PORT LA VACA, IX 77977
Invoice Date:
&/25/2012
Invoice #:
O&l2R216
Batch #:
Phone: (361) 552-0340
Fax:
Due Date: &/25/2012
Quantity
REBATE
]
Description
Amonnt
Page 1 ofl
Price Each
-152.3800
-15238
-152,38
Item Code
111&
Monthly Rebates Distribution August2012
Invoice Total---- >
152.3&
MedImpac.t Data Servi.ces
Report Date: 08/01/12
Client P;i.stribution S\lIIIlD.al:'Y
HPL10 CALHOUN COUNTY
l-1edImpact Conunercial
Rebate
08/01/2012
Qtr: 1Q2012
ManuEacturer
Distributed
Thi.s Me.
Gross Rea'd
This Mo.
Invo:i-c.e.d
AmoUllt
Cum $ % Collected
Gross Reo.' d to lnvoiced
NOVO NORDISK
1.3.U
1.3.1.2
1.3_1.2
1.3.1.2
100.00
Plan Mlocation This Quarter:
Cumulative If, Colleated:
Colle-ated Rebate / Claim:
13.1.2
87 _35
0.11
13.12
Qtr: 2Q2011
Manufacturer
Distributed
This Mo.
Gross Rec' d
This Me.
I.nvoiced
Amount
Cum $ It Co1.1ected
Gross Rea'd to Invoiced
PFIZER
139.26
B9.26
1.39.26
139.26
100.00
Plan Allocation This Quartar:
Cumul.ative ~ Coll.ected:
Collected Rebate / C1.aim:
1.39.26
99.9B
2.09
139.26
Pl.an Allocation This Month:
152.38
Contains prop."::"ietary, privi.leged, or individually identifiable health infoz:mation protected by the llealth
InsurancE' Portabi1.ity and Acc.ountability Act. (HJ:::PAA) and other statutes, or confidential commercial or
financial data not subject to di.sclasure under the Fraedom of Information Act.
MedDividend{bn} I\ebate System
Page :1 of 1
MEMORIAL MEDICAL CENTER
Port Lavaca, Texas
MANUAL JOURNAL ENTRIES
MONTH OF
AUGUST, 2012
Page_of_
Debit Credit
Acct# JE# Description Check # Amount Amount
10255000 Indigent Healthcare 5,265,87
40450074 Reimbursement - Calhoun Cty 3,985.27
40015074 Benefits - FICA 220.63
40025074 Benefits - FUT A -
40040074 Benefits - Retirement 244.03
60320000 Benefits - Insurance 717.35
40220074 Supplies - General 90.19
40225074 Supplies - Office 8.40
40230074 Forms -
40610074 Continuing Education -
40510074 Outside Services -
40215074 Freight -
40600074 Miscellaneous -
'"~~
BY
;)t.F I ~ LUlL
CALliOiJN COUNTY
A<.IUII I.IN ,
TOTALS 5,265.87 5,265.87
./
/
v'
./
./
EXPLANATION FOR ENTRY
-;;t2.(! .A-tt.....h.ll d
REVERSING:
YES
NO
v'
JE#
O'dld-I S'
Indigent Healthcare Program
Incurred by MMC
AUGUST,2012
Indigent Weare Coordinator Salary # 40450074 9-Aug 1,786.11
# 40450074 23-Aug 1,867.60
# 40450074
(# 40000074 )
(# 40000074)
(# 40010074) 331.56
I 3,985.271
Benefits: #40040074 I 244.031
FICA #40015074 9-Aug 108.21
# 40015074 23-Aug 112.42
# 40015074 I 220.631
FUTA
9-Aug
23-Aug I
Other Benefits (18 %) # 63200000 I 717.351
General Supplies # 40220074 I 90.191
Office Supplies # 40225074 I 8.401
Forms #40230074 I
Continuing Education #40610074 I
Outside Services #40510074 I
Freight #40215074 I
Travel #40600074 I
RlIlI DATE, "'/16/12
'flUE: 11:46
MHIORlAL MEDICAL C3~n-ER
GL DBTAIL REPORT - COST CENTER SEQUENCE
FOR, 88/81/12' OS/31/12
ACcr llUJ.1BE!l. &. DESC DATE }jE!tlD
40000074 Sl>.1ARIES REG PROD -CALHOUN C
REFEREnCE
JOURlIAL CS~/8j'''T/SRQ
40000074 SA1A..iUES REG PROD -CALHO BEGINNING BA1ANCIl AS OF: OS/Ol{12
03/01/12 REVERSE ACCRUAL PR
03/09/12 PAn,07f27/12 08/OS/12 PR
Oa/23/12 PAH.OS/I0/1' 08/23/12 PR
Oa/31{12 Accrual--Days<: 8 PR
OS/31 ACTIVITY/BlID BlJ.ANCE
40(105014 SAI.ARIRS OVERTnl
BEG~NNING MD BHDHlG BAL.?;llCE:
'0810074 SA111RIES PTO/SIS -CA1110 ERGINIIIRG RA1f1NCE AS OF, 88101112
08/01/12 REVERSE ACCRUAl, PR
08/09/12 Auto PR Bene Accrual Re PR
03/09/12 Auto PR Bene Accrual PR
OB/OS/12 PAH.07/27/t2 08jG9jJ2 PR
08/23/12 Auto PR Bene Accrual Re PR
08/23/'1.2 At:.to PR Bene Accrual PR
OS/23112 P'Y-P,88110/12 08/13/12 PR
08/31/12 Accrual--Days= 8 PR
08/31 AClIVITY/EIID BALANCE
48015014 FICA
-CALHO BEGINIIIRG BA1~~Ca AS DP, Oa/81/12
88/01/12 REVERSE A(I;RUA1 PR
08/01/12 REVERSS A(I;RUA1 PR
08/05/12 PAY.P.07/27/12 08/0S/t2 PR
08/09/12 PAY-P.07/17jJ2 08/0S/12 PH
08/23/12 P'Y,P.08/10/12 0'/23/12 PR
0./23/12 PAY-P.08/10/12 s8123jJ2 PH
08/31/12 Accrual--Days= 8 PR
08/31/12 Accrual --Days" 8 PR
OSI31 ACTIVITY/END SALANCE
40025074 FDT
llEGWNIllG AND R.~DIfiG BALANCE:
40040074 RETIREl,ffiN'l'
,CALHO BEGIlllm~ BALANCE NJ OF, 08101/12
08/01/12 REVERSE ACCRUAL PR
08/09/12 PAH,0712'/112 08/09/12 PR
08/23!I2 PAH.OS/10/12 08/23/12 PR
08[31/12 Accrual ~~Days:: 8 PR
08/31 ACTIVITY/END BALANCS
192579370
192591 42
192999 36
192595359
192579466
1925'J8 87
192590 81
192591 89
192590 83
192594 81
192595 84
192595455
192519654
192579716
152591 337
19259136B
192595495
192595526
192595639
192595701
192579 1142
192591 no
192595588
192595823
40220074 SlJPPLIES GENERAL -CALHO BEGINNING 5ALlINCB liS OF: 08/01{12
08/13{12 DIVERSIFIED BUSINESS 8Y 22653 PJ 556 959 28
08/31/12 AUro,TRAN/EXP.REPORT 0'0000 YJ'1 89 610 23
ACrIVITY
-746.10
1/186.11/
1,867.60/
1,(i67.211
3,974.B1
-11.25
-971.70
947.03
202.~8/
-941.03
9lU7
128.B8/
73,68
40':/.46
-32.45
-7.60
20.51/
87.70/
21.31/
91.11 .....
52.0B
12 .1~
244.82
,44.50
120.79./
123.24 ./
70.40
26S.93
90.00
.19
PAGE 1
GLGWC
BAIJII:1CE
31,472.34
35,147.15
80.19
2,159,49
2,56B.95
24.13
268.95
4.73
26.90
2%.83
,00
RUN DATB, 09/16/12
TIME: 14:46
ACcr NUI'lBER (; DSSC DATE
40220C14 SUPPLIES G~ERA1
MENORIl'-11.JEDlCAL CENTER
G1 DETAIL REPORT - COST CENTER SEQlJ~IlCE
FOR, 08/01/11 . 08/31/12
llE}!O REFERENCE
-CAlJIOilll C
08/ll AmVITY/&~D a_CE
,_A1 CSI/BAT/SEQ
4022507~ OFFICE SUPPLIES .CALHO BHGINN:::NG BALANCE AS OF: 08/01/12
08/31/12 AUl~'THAN/EXP.RBroRT 000000 1'"
08/ll ACTlVI!T/8ND BALANCE
40450014 RWlBURSRHRNT
89610 11
BEGINMING AIm ENDING B1bA.l-iCE;
Al'flVITY
90.::>'9
8.40'/
8.40
COST CRlITER TOTlb: 4,997.61
ENDING BAfl1\NC2 GRAND TOTAL:
GRAND TOTAL ACTIVITY:
PAGE 2
GLGLDC
BALllNeR
/
90.19
-5.09
J.ll
~33,368.01
5/392.29
4./997.61
RUN DATE: 08115/12
TIl~E: 16:37
MEMORIAL MEDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 08/28/12
PAGE: 1
APOPEN
VEND#,NM~E..........".....,.,......,CLS.INVOICE#....,....TEN DT.INV DT.DUE DT.CK DT..PC.......GROSS.....DISC...,..NO-PAY........NET
A1430 ADVANCE MEDICAL DE8IGNS IN ./
SUPPLIES SURGERY M SI991101 072712 072312 082212 29.75 .00 29.75
TOTALS...."..,......................,....... : 29.75 .06 29.75
A1360 ANERISOURCEBERGEN DRUG COR 12.99/
PHARJoIACEUTICALS W 037-686604 081512 080912 082512 12.99 .00
PHARJoIACEUTICAL8 037 -688521 081512 081012 082512 374.40 .00 374 ,40/
TOTALS......"............,....,.,.,......,.. : 387.39 .00 387.39
A2218 AQUA BEVERAGE COMPANY 26.01~
SUPPLIES LAB JoI 414067 081112 071212 081112 26.01 .00
SUPPLIES WONEN CLINIC 414043 081512 071212 081112 17.26 .00 17.26
TOTALS.,.,................,."....."..",... : 43.27 .00 43.27
A2260 ARRCl; INTEENATICNAL INC
SUPPLIES CS INV l~ 4184097 073112 072412 082312 352,59 .00 352,59/
TOTALS...................,..........,......., : 352.59 .00 352,S9
A1965 ARRT /
CERTIFICATION W 24058 081512 081512 081512 175.00 .00 175.00
TOTALS.,..............,...,..",.,..."...... : 175,00 .00 175,00
10751 ARTISAN MEDICAL 371.50/
SUPPLIES WOMEN CLINIC BD-47714 073112 072812 082712 371. 50 ,00
TOTALS...........,........,......,.,......... : 371.50 .00 371.50
Bl075 BAXTER HEALTHCARE CORP
SUPPLIES CS INV I~ 37897800 073112 072312 082212 152.78 .00 152,78/
SUPPLIES CS INV 37903630 073112 072412 082312 449.84 .00 449.84/
PHARlIACEUTICALS 37903954 080712 072412 082312 305.54 .00 305.54/
TOTALS.,..,..,..,..,.........,...,........... : 908.16 .00 908.16
B1220 BECKblAN COULTER INC 110.46 /
SUPPLIES LAB II 102923765 081112 060212 070112 110.46 .00
SUPPLIES LAB 103033468 081112 080312 082712 975.00 .00 975.00
SRV LAB 4175872 081112 072512 082412 5947.00 .00 5947.00,/"
TOTALS.,.,.....,.....,...................... ,: 7032.46 .00 7032.46
B1650 BOSART LOCK << KEY INC 27.8~
SUPPLIES ADIUN II 96090 073112 072312 082212 27.80 .00
TOTALS.........,....,........................ : 27.80 .00 27.80
Cl0l0 CABLE ONE 286.501
CABLE SERVICE W 081612-091512 081512 081612 082512 286,50 .00
TOTALS.......,..,..,..,..........,........... : 286.50 .00 286.50
Cl030 CAL COM FEDERAL CREDIT UNI 25.00/
EMPLOYEE DEDUCTION W 18226 081512 081312 081312 25.00 .00
TOTALS................. ..........,.....,...,.: 25.00 .00 25.00
C1390 CENTRAL DRUGS 360.00 /
PHARJolACEUTICALS 11 JULY2012 081512 081512 081512 360.00 .00
RUN DATE, 08/15/12
TII1E, 16,37
MEMCRIAL MEDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 08/28/12
PAGE, 2
APOPEN
VEND#.NAl1E.......,..............,... .CLS.INVOICE#........ .TRN DT.INV DT.DUE DT,CK DT, .PC...... .GROSS.... .DISC.... ..NO-PAy....... . NET
TOTALS..,..,................................. , 360.00 .00 360.00
10350 CENTURION I!EDlCAL PRODUCTS
SUPPLIES CS INV 91074298 081112 072712 082612 290,68 .00 290,68/
TOTALS."............,..,.",..,.,........... , 290,68 .00 290.68
C2510 CPSI
EBOS M 741445 081512 073112 073112 235.99 .00 235.89 ,/
STATElffiNT PROCESSING 742210 081512 080212 080212 63.60 ,00 63.60/
STATENEI~ PROCESSING 743063 081512 080912 080912 72,60 .00 72.60../
PRIVATE PAY 743314 081512 080912 080912 9521.93 .00 9521. 93 v
TECH SUPPORT A1208061379 081512 090612 080612 14981.00 .00 14991. 00 ......-
TOTALS...."..,..............,.........,..... , 23875,01 .00 23875,01
1'13290 DEBORAH WITTNEBERT
FLEX SPEND REIMBURSEMENT 1'1 24048 081312 081312 081312 683.36 .00 683.36 /
TO'l'ALS....,.....,....,....................... , 683,36 .00 683.36
10368 DEIITTT POTH & SON 290.79 ,/
CFFICE SUPPLIES HIN 339578-0 081112 080612 081512 290.79 .00
OFFICE SUPPLIES WONEN CLI 339660-0 081312 080712 081512 183.46 .00 183,46/
OFFICE SUPPLIES PFS 339666-0 081312 080712 081512 26.63 .00 26,63v"
OFFICE SUPPLIES PFS 339851-0 081312 080812 081512 174.88 .00 174.88/
OFFICE SUPPLIES VARIOUS 339880-0 081312 080801 081512 420,86 .00 420.86/
OFFICE SUPPLIES PFS 339932-0 081512 080912 081512 9.38 .00 9.38 ,/'
OFFICE SUPPLIES SURGERY 339934-0 081512 080912 081512 40.49 .00 40.49/
OFFICE SUPPLIES LAB 340224-0 081512 081012 081512 27.94 .00 27,94/
TOTALS..,.................................,.. , 1174.43 .00 1174,43
D1752 DLE PAPER & PACKAGING
FORl1S PFS 1'1 6710 072512 072312 082212 79,95 .00 79.95 ,/'
TOTALS.,..,.,....,.........,...,...,......... , 79,95 .00 79.95
01710 DO\1NTOWN CLEANERS 330,00/
OUTSIDE SRV ITO!IEN CLINIC Ii 1804 081512 071612 081512 330.00 .00
TOTALS...........,...........,......,..,."., , 330.00 .00 330.00
10042 ERBE USA INC SURGICAL SYST 178,51/
SUPPLIES SURGERY 221551 072712 072312 082212 178.51 .00
TOTALS.....,..,...,."..............,........ , 178.51 .00 178.51
F1400 FISHER HEALTHCARE
SUPPLIES LAB N 2056200 073112 072412 082312 201.59 .00 201.59/
SUPPLIES LAB 2056201 073112 071412 082312 2000.14 .00 2000.14 ,,/
SUPPLIES LAB 2780133 073112 072512 082412 75.33 .00 75,33/
SUPPLIES LAB 3068584 073112 072612 082512 401.33 .00 401.33/
SUPPLIES LAB 5806257 091112 073112 092712 131.73 .00 131. 73'/
SUPPLIES LAB 6507444 081112 080112 3374.14 .00 3374,14'/
SUPPLIES LAB 6507445 081112 080112 082712 763.69 .00 763,69'/
SUPPLIES LAB 6955678 081112 080212 082712 604,18 .00 604.18
TCTALS....................................... , 7552.43 .00 7S52.43
Gl001 GETIWGE USA
INSTRUMENT REPAIR/TRAVEL 3134417 072712 072312 082212 3858,45 ,00 3858.15/
RUN DATE, 08/15112
TUIE, 16,37
MEMORIAL MEDICAL CENTER
AP OPEM IMVCICE LIST THRU DUE DATE OF 08/28/12
PAGE: 3
APOPEM
VEMDH.MAME...,........,..............CLS.IMVOICE#.........TAN DT.IMV DT,DUE DT,CK DT..PC.......GROSS..,..DISC......MO-PAY,....,..NET
TOTALS......................................, , 3858,45 .00 3858,45
A1292 GULF COAST HARDWARE I ACE 13.99/
SUPPLIES GROUNDS W 070276 073112 072412 082312 13.99 .00
TOTALS",...........,..,................,..., , 13,99 .00 13.99
G1210 GULF COAST PAPER COMPANY
SUPPLIES HOUSEKEEPING II 427179 072712 072412 082312 114,33 .00 114.33/
SUPPLIES HOUSEKEEPING 427180 072712 072412 082312 232.00 .00 232.00 V-
TOTALS..".".,.",.,.. ,..,."."............, 346.33 ,00 346.33
H0030 H E BUTT GROCERY
SUPPLIES DIETARY 11 292169 073112 072612 082512 223.39 .00 223.39 v
TOTALS,.".."............................... , 223.39 .00 223.39
H0947 HALL WIRELESS
DEPT REPAIR SURGERY 10066606 080712 072412 082312 28.97 .00 28, 97 .--
TOTALS.......,........,........,.,.,.......,. , 28.97 .00 28.97
10298 HITACHI ~mDICAL SYSTENS
SRV CCNTRACT 8/25 - 9/24 PJIN0041076 080712 071612 082512 9166.67 .00 9166.67 ,/
TOTALS.,..............,...............,..... ., 9166.67 .00 9166.67
H3400 HUBERT COllPANY
SUPPLIES DIETARY II 888043 072712 072312 082212 179.34 .00 179.34/
TOTALS..".""...".,....,........,......... , 179.34 .00 179.34
10415 IMDEPEMDENCE llEDICAL
SUPPLIES CS IMV 26934391 073112 072512 082412 72. 09 .00 72,09"'-
TOTALS............."."............."..,.. ,: 72,09 .00 72.09
10950 INFOLAB INC
SUPPLIES LAB II 3144394 073112 072512 082412 976.90 .00 976,90/
SUPPLIES LAB 3144843 073112 072512 082412 174.60 .00 174,60/
TCTALS..........,.....................,...,.. , 1151.50 .00 1151.S0
Il100 INSTRiJNENTATION LABORATORY
SUPPLIES LAB II 9101070178 073112 072312 082212 2067,08 .00 2067.08/
TOTALS"".,..,.,..".".,...",.....".,..., , 2067.08 .00 2067.08
10285 JAMES A DANIEL
RENT SEPTEIIBER 24054 081512 081512 081512 750.00 .00 750.00/
TOTALS..,..."...........,................,.. , 750.00 .00 750.00
K1231 KONICA IlINOLTA llEDICAL IMA
. SRV CONTRACT 7/1 - 7/31 15475 080712 072312 082212 510.00 .00 510.00/
TOTALS........"...,.."...",...""..,.,.., , 510,00 .00 510.00
L0700 LABCCRP OF AMERICA HOLDING 27.60/
SUPPLIES LAB II 38493749 081112 072812 082712 27.60 .00
TOTALS...,................,.................. , 27.60 .00 27.60
10141 LAWSON PRODUCTS J
SUPPLIES DIETARY 9300984575 073112 072312 082212 95.76 .00 95.76
RUN DATE: 08/15112
TIfIE: 16:37
MEIIORIAL MEDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 08/28/12
PAGE' 4
APOPEN
VENDn.NAlW......,.....,....,.,.....,.CLS.INVOICEn.,.....,.TRN DT.INV DT.DUE DT.CK DT,.PC.......GROSS.....DISC......NO-PAY...,....NET
TOTALS..,......,. ,.. ,.., ,."....,........,.. ,: 95.76 .00 95.76
L1640 LOWE'S HOME CENTERS INC
EUPPLIES PLANT OPS W 80256614 081112 072512 082412 131.10 .00 131.10/
TOTALS."."",..".,..........,....,.,...... , 131.10 ,00 131.10
lUlU llAINE STANDARDS CO., LLC
SUPPLIES LAB 12-16S24 073112 072312 082212 557.29 .00 557.29 v'
TOTALS..................,.................,.. , 557.29 .00 557.29
M1511 MARKETLAB, INC ,/
SUPPLIES LAB W 1~655490 073112 072412 082312 108.30 ,00 108.30
TOTALS...........,.,...,......"............. , 108,30 ,00 108.30
M2310 NEDELA INC
SUPPLIES CS INV 10I 11217456 081112 072012 081912 317.90 .00 317.90 v'
TOTALS...................,...,..,............ , 317.90 .00 317.90
M2485 MEDRAD INC
SUPPLIES CT SCAN 10I 139263866 081512 071812 081712 805.97 .00 805.97'/
SUPPLIES CT SCAN 139263867 081512 071812 081712 290.04 .00 290.04v
TOTALS.,......,..,..................,........ , 1096.01 .00 1096.01
112550 !IELSTAN, INC. 29.96/
SUPPLIES GROUNDS W 1258560 073112 072512 082412 29.96 .00
TOTALS.,........................,.......,..., , 29.96 .00 29.96
10182 MERCEDES MEDICAL
SUPPLIES LAB 1498422 081112 071012 080912 294.90 .00 294.90 v'
SUPPLIES LAB 1498912 081512 071212 081112 291.90 .00 294.90,/
TOTALS........".........................,.., , S89.80 .00 589,80
112590 MERCURY MEDICAL
SUPPLIES CS INV 10I 549830 071812 072312 082212 96,40 .00 96.40 ,/
TOTALS..................",...............,., , 96.40 .00 96.40
112659 I~ERRY X-RAY- SAN ANTONIO 514,39 /
SUPPLIES RADIOLOGY 10I 476167 073112 072312 082212 511. 39 .00
SUPPLIES RADIOLOGY 76049 073112 072412 082312 981. 81 .00 984.81V'
TOTALS.............. to... It..................: 1199.20 ,00 1499.20
M2827 MINNTECHCCRPORATION
SUPPLIES SURGERY l~ 1407941 071812 071112 081012 186.00 .00 186.00
SUPPLIES SURGERY CREDIT C133416 071812 062212 081012 -186.00 .00 -186.00
TOTALS...........................,........,.. , .00 .00 .00
M2621 W~C AUXILIARY GIFT SHOP
EloIPLOYEE DEDUCTIONS W 24052 081312 081312 081312 373.86 .00 373.86/
TOTALS................,...,..............,... , 373.86 .00 373.86
10441 MlIC EloIPLOYEE BENEFITS 5682.49 /
WEEKLY CLAIfIS 18225 081112 080912 080912 5682.49 .00
RUN DATE: 08/15/12
TII1E: 16:37
NENORIAL llEDICAL CENTER
AP OPEN IEVOICE LIST THRU DUE DATE OF 08/28/12
PAGE: 5
APOPEN
VEND~.NM~E...."...,..,.,...".....,.CLS.IEVOICE~..,..,.,. THE DT.IEV DT.DUE DT.CK DT..PC......,GROSS..,..DISC.,....NO-PAY,.......NET
WEEKLY CLAINS 18230 081512 081412 081412 3215.17 .00 3215,17 ./
TOTALS..,.....,.....,........................ : 8897.66 .00 8897,66
10536 NORRIS << DICKSON CO, LLC 799.64 ./
PHAmlACEUTICALS 3657440 080712 080112 082512 799,64 .00
PHAmlACEUTICALS 3657441 080712 080112 082512 1636,59 .00 1636.59/
PHAmlACEUTICALS 3660281 080712 080212 082512 4.85 .00 4.85 ./
PHARI.lACEUTICALS 3660282 080712 080212 082512 54.11 .00 54.11'/
PHAmlACEUTICALS 3661268 080712 080212 082512 929,90 .00 929.90'/
PHARMACEUTICALS 3661706 080712 080212 082512 98.84 .00 98.84v./
Pll1>IDlACEUTICALS 3664521 080712 080312 082512 75.01 ,00 75.01/
PHAmlACEUTICALS 3664795 080712 080312 082512 416.95 .00 416,95./
PHAmlACEUTICALS 3671186 080712 080612 082512 1535.31 .00 1535,31.....-
PHAmlACEUTICAL CREDIT C~123697 080712 080112 082512 -361.27 ,00 -361.27 ~
PHAmICEUTICALS 3681341 081512 080812 082512 87.01 .00 87.01-
PllARNCEUTICALS 3681342 081512 080812 082512 4130.35 ,00 4130.35......
Pll1>IDlACEUTICALS 3684484 081512 080912 082512 778.19 ,00 778.19.-'
PHARMACEUTICALS 3694844 081512 081312 082512 217.57 ,00 217 .57----
Pll1>IDlACEUTICALS 3694845 081512 081312 082512 1988,37 ,00 1988.37-
PHAmlACEUTICALS 3699832 081512 081412 082512 65.30 .00 65.30......-
PHARl1CEUTICALS 3699834 081512 081412 082512 2973.99 .00 2973,99 ......
Pll1>IDICEUTICAL CREDIT 6554 081512 081312 082512 -31.97 .00 -31.97 -
PHARMACEUTICAL CREDIT 6675 081512 081312 082512 -181.67 .00 -181.67-
PHAmlCEUTICAL CREDIT CN29061 081512 081312 082512 -17.73 .00 -17.73...-----
PHAmlACEUTICAL CREDIT CN29062 081512 081312 082512 -17,73 .00 -17,73..-
TOTALS.,..,....".,............,......,..",. : 15181,61 .00 15181. 61
A2252 NADINE GARNER
TRAVEL EXPENSES IEF CONTR 1'l 24053 081512 081312 081312 215.65 .00 215.65 ---
TOTALS."........"...................,...... : 215.65 .00 215.65
10008 OI~I-PORT LAVACA 07, L.P.
RENT SEPTEllBER 24055 081512 081512 081512 10320.70 .00 10320.70 ......-
TOTALS.".....,.,..".."..."............... : 10320.70 .00 10320.70
10709 ONESTAFF NEDICAL, LLC
CONTRACT NURSE 5919 073012 072512 082412 2494.00 .00 2494.00 ,./
TOTALS,.........,..,.....................,... : 2494.00 .00 2494.00
OM425 OIIENS & MINOR
SUPPLIES CS lEV 1964596 072712 072412 082312 81.32 .00 81. 32/
SUPPLIES CS lEV CREDIT 1964652 072712 072412 082312 -21.60 ,00 -21.60........
SUPPLIES CS lEV 1964653 072712 072412 082312 9.89 .00 9.89'/
SUPPLIES CS lEV 1964699 072712 072412 082312 175.20 ,00 175.20'/
SUPPLIES VARIOUS 1964756 072712 072412 082312 1077.94 ,00 1077 ,94/
SUPPLIES ER 1964757 072712 072412 082312 201.69 .00 201. 69 ./
SUPPLIES CS lEV 1965067 073012 072512 082412 7.63 .00 7,63/
SUPPLIES HOUSEKEEPING CRE 1965123 073012 072512 082412 -21.60 .00 -21.60/
SUPPLIES CS lEV 1965226 073012 072512 082412 24.42 .00 24.42/
SUPPLIES CS lEV 1964894 073112 072412 082312 2320.53 .00 2320.53./
SUPPLIES CS lEV 1964955 073112 072412 082312 91.74 .00 91. 74./
RUN DATE, 08/15/12
THIE, 16,37
IIElICRIAL IIEDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 08128/12
PAGE' 6
APOPEN
VEND#,NMIE....,...........,..........CLS.INVOICE#,........TRN DT.INV DT.DUE DT.CK DT..PC..,.,..GROSS,....DISC.....,NO-PAY........NET
SUPPLIES VAROUS 1966512 073112 072712 082612 1639.25 .00 1639.25 ./
TOTALS....,.."".........,...." ,......,...., 5586.41 .00 5586.41
D1S31 PATRICIA DIEBEL 772.21 ,/
FLEX SPEND REINBURSEllENT W 24049 081312 081312 081312 772.21 .00
TOTALS.".................................... : 772.21 .00 772. 21
P1876 POLTI.IEDCO INC.
SUPPLIES LAB II 1007453 073112 072412 082312 125.26 .00 125.26 ,,/
TOTALS....,.........,....."...",........... , 125.26 .00 125.26
P2370 PROGRESSIVE DYNAMICS MEDIC 149.04"/
SUPPLIES SURGERY M 129481 073112 072412 082312 149.04 .00
TOTALS.."................,....,., ,.".......: 149,04 .00 149.04
10629 QUEST DIAGNOSTICS 35.40 ../
CUTSIDE SRV LAB 9144435546 OSl112 072612 082512 35.40 .00
TOTALS......,.".,...,.........,. ,..,........: 35,40 .00 35.40
R1050 R G & ASSOCIATES INC
SALT DELIVERY M 20310S 081112 072612 082512 65,60 .00 65.60 .---
TOTALS...,.....,..........,......,........... f 65.60 .00 65.60
R1268 RADIOLOGY UNLIMITED, PA 120.00)
READING FEES W 24050 081312 081012 081012 120.00 .00
READING FEES FORNOS 24056 081512 062812 072712 420.00 .00 420.00 ________
TOTALS...... ,..".,...,...,................,.: 540.00 .00 540.00
R1321 RECEIVABLE ImNAGEMENT, IMC 933.00/
COLLECTIONS tl 060112-063012 081512 063012 073012 933.00 .00
TOTALS.................,...."....."........ , 933.00 .00 933.00
R1471 RESPIRONICS, INC. 179.88/
RENTAL 4/28 - 7/27 II 915942542 081112 072712 082612 179.88 .00
TOTALS."..,................................. , 179.88 .00 179.88
G0425 ROBERTS, ROBERTS & CDEFEY, 11503.25"/
LEGAL FEES W 125 072712 072412 082312 11503.25 ,00
TOTALS.............,......,.,..,.,..,.,..,.., , 11503.25 ,00 11503.25
10543 ROGERS HOME llEDICAL
SUPPLIES PT 37390 073112 072612 082512 50.00 .00 50.00/
TCTALS........,..........,.................. .1 50,00 .00 50.00
S1243 SOURCEONE HEALTHCARE TECH.
OUTSIDE SRV RADIOLOGY tv 32590238165 080712 072412 082312 94.50 .00 94,50'/
TOTALS......,.......,.""..""............. , 94.50 ,00 94,50
S2951 SYSCC FOOD SERVICES OF
SUPPLIES DIETARY M 208020774 080312 080212 082212 1547.99 .00 1547.99/
TOTALS..,.....,....,......,....,.",.,..,.... , 1547.99 .00 1547.99
T1900 TEXAS ELECTRICAL SUPPLY
SUPPLIES PLANT CPS 11 26765 081112 071012 080912 37.80 .00 37,80'/
RUN DATE: 08/15/12
TINE: 16:37
MEMORIAL MEDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 08/28/12
PAGE: 7
APOPEN
VEND#.NM1E...,.."........"..,....,.CLS.INVOICE#."......TRN DT.INV DT.DUE DT.CK DT..PC.......GROSS,.".DISC......NO-PAY........NET
SUPPLIES PLANT OPS 26816 081112 073112 082812 262,50 .00 262.50 --'
TOTALS..,....",.,..,..............."."..., : 300.30 .00 300.30
10758 TEXAS SELECT STAFFING, LLC
CCNTRACT NURSE 0002334-51-079-1 081512 062112 072012 1980.00 .00 1980.00'--
TOTALS..............,................,. ,.....: 1900.00 ,00 1900.00
T2303 TG 129,11 ,,/
EMPLOYEE DEDUCTION \'1 18227 081512 081412 081412 129.11 .00
TCTALS.....""".,..,..,..............,...., : 129.11 .00 129.11
10192 THIE 4110.00/
MONTHLY PAYMENT 091012 081512 081512 081512 4118.00 ,00
TOTALS...............................,.".... : 4118.00 .00 4118.00
P2190 U S POSTAL SERVICE
POSTAGE INP 24057 081512 081512 081512 1000.00 .00 1000.00/
TOTALS....,............................,..... : 1000.00 .00 1000.00
UI054 UNIFIRST HOLDINGS
LAUNDRY MAINTENAlICE \'1 8150578163 073112 072412 082312 32.54 ,00 32.54/
TOTALS....................,............ I.....: 32,54 .00 32.54
UI064 UNIFIRST HOLDINGS INC
LAUNDRY HOSPITAL LINEN 8400130000 073012 072712 082612 740.67 .00 740.67/
LAUNDRY SURGERY 8400130001 073012 072712 082612 348,59 .00 348.59.--
LAUNDRY HOSPITAL LINEN 8400129763 073112 072412 082312 964,16 ,00 964.16./
LAUNDRY HOUSEKEEPING 8400129764 073112 072412 082312 182.19 ,00 182.19/
LAUNDRY DIETARY 8400129766 073112 072412 082312 174,86 .00 174,86/
LAUNDRY OB 8400129767 073112 072412 082312 86.70 .00 86,70'--
LAUNDRY HOUSEKEEPING 8400129768 073112 072412 082312 63.42 ,00 63.42 ...-
TOTALS...,..",..".,.,....,........,....,.,. : 2560.59 .00 2560.59
UI056 UNIFORl! ADVANTAGE
E~IPLOYEE DEDUCTION 11 4514447 001512 071812 081712 154. 08 .00 154.80-
E~IPLCYEE DEDUCTION 4514731 001512 071812 081712 27.99 .00 27.99/
TOTALS................,...................... : 102.07 .00 182.87
10172 US FOOD SERVICE 4241,16/
SUPPLIES DIETARY 4873618 080312 080212 082212 4241.16 ,00
SUPPLIES DIETARY 4873619 080312 000212 082212 357.06 ,00 357.06/
TOTALS..................,........,...,....,.. : 4S98.22 .00 4590.22
V0555 VERIZON SOUTffi'mST 100.00/
TELEPHONE !! 5520220072812 080712 072812 082212 108.80 .00
TELEPHONES 5523521080112 081312 080112 082612 43.64 .00 43.64/
TCTALS.........,."..,.,.,...,........."..., : 152.44 .00 152,44
10394 NILLIMI E HEIKMIP, TRUSTEE
ENPLOYEE DEDUCTION 18229 081512 081412 081412 400.00 .00 400,OO/'
TOTALS........,........................,..... : 400.00 .00 400,00
10429 \'1ILLIM1 E HEITKAlip, TRUSTE 495,00/
EMPLOYEE DEDUCTION 18228 081512 081412 081412 495.00 .00
TOTALS........".,..,..".,.."..,..,....,... : 495.00 ,00 495.00
GRAND TCTALS
.................................:
142096.01
tKs~14OJS7;)
+0
dL1YCI&f1
V 0 IDS
----- ~
jjjlN :; t.)
JJ /Lf1fj30
APPROVlElr>>
AUG 16 2'u'l?
. ~ Ik.
lClJiJNl'V Aa.!Dil0!'l
~~~r
~~ ,IJ
C\:;if ~
.00
142096.01
,/
RUN DATE.08/20112
TlME.16.00
!lE!lORIAL MEDICAL CE!lTER
EDIT LIST FOR BATCH 556 0970
CRT#556
~RANSACTION SEQUENCE
PAGE 1
GLEDIT
ACCOUNT A.H.A.
SEQ. NUMBER NUlIBER
TRANS
DA~E JOURNAL
AloIOUNT SUB-LED REFERENCE 11E!l0
G.L. ACCOUNT DESCRIP~ION
~..._-----------------------------------------------------------------------------------------------------------------------------.-
1 20000000
2 40900001
08/20/12 PJ
08120112 PJ
2,500.00CR 10763
2,500.00 10763
24064
24064
VIRGINIA KALAFATIS
VIRGINIA KALAFA~IS
lEV D~=08120/12 DUE=082012
!lISCELLANEOUS -OB
- - - - - - - - - -R E C A P- - - - - - - - - -
JOURNAL YRNO COUNT DEBIT
PJ 1208 2 2,500.00
~OTAL 2 2,500.00
CREDIT
2,500.00
2,500.00
21526 48128
R~ \ DCi'......-\-; <r<\. I='-e.e... +)or
R. N +0 6e..~V (\ ~ IlIUJ VYl e/11--I-
AlP ~CTJ\L 2,500.00 "i'\ () f)De-p+'
60900001
ACCOUNT ~O~AL RECAP ON NEXT PAGE
c ~ 1:3 1 tcr (P If'i?
APPROVED
AlIb 2 0 2012
COUNTY AUDITOR
~~(J cr~
Mk'~'> -" , f)Felfer
9al' "r. ~ounJY ~ud~e
klatEl'_.o.p~L12
, -,
RUN DATE. 08/22/12
TIME. 10.33
I~EIIORIAL I1EDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 09/04/12
PAGE. 1
APOPEN
VEND#.NAlIE...........................CLS.INVOICE#.........TRN DT.INV DT.DUE DT.CK DT..PC.......GROSS.....DISC......NO-PAY........MET
A1350 ACTION Lm~BER
DEPT REPAIR DIETARY W 27468 081112 080112 083112 79.90 .00 79.90/
DEPT REPAIR DIETARY 27484 081112 080212 090112 45.95 .00 45.95/
DEPT REPAIR DIETARY 27486 081112 080212 090112 26.20 .00 26.20/
DEPT REPAIR PFS 27494 081112 080212 090112 32.00 .00 32.00 ,./
TOTALS............. ........................... 184.05 .00 184.05
A1490 ADVERTISING ON AIR 165.00'/
AD - MONTHS 8/7 - 10/7 3767-31 080312 080112 083012 165.00 .00
TOTALS....................................... , 165.00 .00 165.00
A1790 AFLAC 3265.14 ./
ONLIME BILLING W 24065 082112 082012 082012 3265.14 .00
TOTALS....................................... . 3265.14 .00 3265.14
A1680 AIRGAS-SOUTffiiEST 1660.88 ./
RENTAL PLANT OPS II 9007481136 081112 073112 083012 1660.88 .00
MEDICAL GAS 9903517093 081512 073112 083012 388.70 .00 388.70/
MEDICAL GAS 9903517094 081512 073112 083012 186.70 .00 186.70 .../
TOTALS....................................... . 2236.28 .00 2236.28
Al715 ALCO SALES & SERVICE CO
REPAIR AUXILLARY 14 2464805-IN 080712 073112 083012 35.41 .00 35.41 v'
~O'l'ALS....................................... ; 35.41 .00 35.41
A1645 ALCON LABORATORIES INC 363.00 ./
LENSES 14 13848142 080312 073012 082912 363.00 .00
LENS CREDIT 13839447 080712 072612 083012 -786.78 .00 -786.78/
LENSES 13850389 080712 073112 083012 477.00 .00 477.00/
LENSES 13850460 080712 073112 083012 318.00 .00 318.00/
TOTALS.................. ........... ........... 371. 22 .00 371.22
A0777 ANDERSON CONSULTATION SERV
COLLECTIONS W HHC080212 081512 080212 090112 5946.59 .00 5946.59 '"
'l'O'l'~S.................,.....................; 5946.59 .00 5946.59
B2001 ANGIE BURGIN 168.72 ./
TRAVEL EXPENSES ER 24059 081712 081512 081512 168.72 .00
TOTALS....................................... ; 168.72 .00 168.72
A2276 ARTHROCARE llEDICAL CORPORA
SUPPLIES SURGERY M 90979434 080312 073012 082912 1193.38 .00 1193.38 ,/
TOTALS......... ..... ....... ... ......... to....: 1193.38 .00 1193.38
10297 ARUP LABORATORIES 6698.42/
OUTSIDE SRV LAB 50435739 081112 080112 083112 6698.42 .00
TOTALS....................................... . 6698.42 .00 6698.42
10719 AUSTIN IIEDICAL PRACTICE 2062.00/
.eeN'PAAeT-NllllSES 4643 082112 080612 082112 2062.00 .00
I'\ec\:c...\ f,:\\\ .,~,$e<u:c-eS TO'l'ALS..... to 0..... ..... ... to.... ... .........: 2062.00 .00 2062.00
"-\'\0 ""0..+""",,,,,,"'$
Bl075 BAXTER HEALTHCARE CORP
LEASE - IV pm~ps 14 37967911 080712 080112 083012 2767.00 .00 2767.00 ,/
RUN DATE: 08/22/12
TIllE: 10:33
I~EHORIAL MEDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 09/04/12
PAGE: 2
APOPEN
VEND#.NANE...........................CLS.INVOICE#.........TRN DT.INV DT.DUE DT.CK DT..PC.......GROSS.....DISC......NO-PAY........NET
SOFTWARE LEASE 37968883 000712 080112 083012 190.50 .00 190.500/
SUPPLIES CS INV 37974016 081112 080212 090112 478.70 .00 478.70 ....-
TOTALS....................................... : 3436.20 .00 3436.20
B1220 BECKllAN COULTER INC
SUPPLIES LAB H 103032491 081112 080212 090112 1196.39 .00 1196.39 ,/
SUPPLIES LAB 103032492 081112 080212 090112 332.50 .00 332.50 ,/
SUPPLIES LAB 103033470 081112 080312 090212 975.00 .00 975.00'/
LEASEIRENTAL LAB 5274457 081112 073112 083012 5382.13 .00 5382.13 ~
SUPPLIES LAB 103030840 081512 080212 090112 14043.73 .00 14043.73 ./
SUPPLIES LAB 103030841 081512 080212 090112 3963.24 .00 3963.24/
SUPPLIES LAB 103032489 081512 080212 090112 5406.52 .00 5406.52/
TOTALS...................................... .: 31299.51 .00 31299.51
B1655 BOSTON SCIENTIFIC CORPORAT 306.00/
SUPPLIES SURGERY II 933426257 080712 073012 082912 306.00 .00
TOTALS........... to............... to,........: 306.00 .00 306.00
B0437 C R BARD INC
SUPPLIES SURGERY I~ 22499140 080312 073012 082912 131.06 .00 131. 06 -----
TOTALS....................................... , 131.06 .00 131. 06
C1203 CALHOUN COUNTY WASTE lIGl,IT
JULY DISPOSAL FEES 326890 081112 073112 083012 30.00 .00 30.00 <./"
TOTALS...................................... .: 30.00 .00 30.00
10350 CENTURION 11EDICAL PRODUCTS 187.50 v-'
SUPPLIES PT 91075770 073112 073012 082912 187.50 .00
SUPPLIES CS INVENTORY 91077963 080712 080112 083012 559.90 .00 559.90 ...--
TOTALS....................................... : 747.40 .00 747.40
10661 CENIURYLINK
TELEPHOME 1224249258 081312 080312 090212 252.29 .00 252.29 ,./
TOTALS....................................... , 252.29 .00 252.29
10720 CHRIS RAHIREZ, JR.
RECERTIFICATION COURSE 12039 081112 073112 083012 450.00 .00 450.00'/
TOTALS....................................... : 450.00 .00 450.00
10556 CPP WOUND CARE #28,LLC /
WOUND CARE 14123 081512 081012 083012 18725.00 .00 18725.00
TOTALS....................................... : 18725.00 .00 18725.00
C1443 CYGNUS IIEDICAL Ltc
SUPPLIES SURGERY II 81790 080712 073012 082912 355.00 .00 355.00 ./
TOTALS....................................... : 355.00 .00 355.00
T3075 DEBRA TlWlIlELL
FLEX SPEND REIMBURSEMENT 24063 081712 081712 081712 150.00 .00 150.00 ,/
TOTALS....................................... : 150.00 .00 150.00
D1608 DIVERSIFIED BUSINESS SYSTE 323.50)
SUPPLIES CS INV I~ 22638 080712 080312 090212 323.50 .00
RUN DATE: 08/22/12
TIllE: 10,33
MEHORIAL MEDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 09/04/12
PAGE: 3
APOPEN
VEND#.NAI.IE.......................... .CLS.INVOICE#....... ..TRN DT.INV DT.DUE DT.CK DT. .PC...... .GROSS... ..DISC..... .NO-PAY...... ..NET
'I'O'1'AL8....................................... : 323.50 .00 323.50
10689 FASTHEALTH CORPORATION
\1EBSITE Il0NTHLY 08A121~IC 082212 080112 083112 495.00 .00 495.00 .--
'r0'1'AL8. .t.. .,..... ......... ..... ... ..... .....: 495.00 .00 495.00
FI100 FEDERAL EXPRESS CORP.
SHIPPING CHARGES LAB W 7-986-70811 082112 081612 083112 19.66 .00 19.66 /
'I'O'1'AL8. ... ........ Ot.. ........... II ..........1 19.66 .00 19.66
F1400 FISHER HEALTHCARE
SUPPLIES LAB M 5806075 081112 073112 083012 49.83 .00 49.83 .....
SUPPLIES LAB 6955676 081112 080212 090112 721.34 .00 721. 34 v'
TOTALS...........,........................... : 771.17 .00 771.17
F1653 FORT BEND SERVICES, INC
SRV CONTRACT PO 0176173-IN 081112 080112 083012 495.00 .00 495.00"/
TOTALS...........,..................,........ : 495.00 .00 495.00
,/1300 GRAINGER
DEPT REPAIR PLANT OPS II 9890412217 080712 073112 083012 101.60 .00 101.60/
DEPT REPAIR PLANT OPS 9891159833 080712 080112 083112 21.08 .00 21. 08 .....
DEPT REPAIR PLANT OPS 9891159841 080712 080112 083112 21.49 .00 21.49/
TOTALS....................................... , 144.17 .00 144.17
A1292 GULF COAST HARDWARE I ACE 42.46 ,/
SUPPLIES PLANT OPS W 070375 081112 073012 082912 42.46 .00
DEPT REPAIR DIETARY 070442 081112 080112 083012 32.99 .00 32.99/
INSTROONT REPAIR HAD CRE 070249 082112 072312 082212 -19.98 .00 -19.98 /
TO'l'ALS.......................................: 55.47 .00 55.47
G1210 GULF COAST PAPER COMPANY
SUPPLIES HOUSEKEEPING II 430045 080312 073112 083012 67.90 .00 67.90 ,/
TOTALS....................................... : 67.90 .00 67.90
H0030 H E BUTT GROCERY
SUPPLIES DIETARY II 299248 073112 073112 083012 31. 20 .00 31.20--
SUPl'tIES DIETAll'l P....e\ +0 ( 300825 080312 080112 083012 10.00 .00 10.00 -'
\'f".~t..\je."'lt.\e. TOTALS....................................... : 41.20 .00 41.20
H1226 HEALTH MARK INDUSTRIES CO I
SUPPLIES SURGERY INV382741 080712 073012 082912 108.76 .00 108.76/
TOTALS....................................... t 108.76 .00 108.76
H0416 HOLOGIC INC
SUPPLIES MAI~IO 6601921 080712 080212 090112 895.30 .00 895.30 ,/
TOTALS................. 1,....0 .......... .....t 895.30 .00 895.30
H1850 HOSPIRA WORLDWIDE, INC
PIlARlIACEUTICALS II 917066781 081512 080112 083112 375.00 .00 375.00/
1'O'l'AL8.......................................: 375.00 .00 375.00
I0415 INDEPENDENCE HEDICAL
SUPPLIES CS INV 26971149 080712 080112 083012 110.29 .00 110.29 /
RUN DATE: 08/22/12
TIME: 10:33
I!EHORIAL HEDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 09/04/12
PAGE: 4
APOPEN
VEND#.NM1E...........................CLS.INVOICE#.........TRN DT.INV DT.DUE DT.CK DT..PC.......GROSS.....DISC......NO.PAY........NET
TOTALS........ .0............ It.. It...........1 110.29 .00 110.29
I0950 INFCLAB INC
SUPPLIES LAB H 3146329 081112 073012 082912 20.00 .00 20.00./
SUPPLIES BLOOD BANK 3146981 081112 073112 083012 872.92 .00 872.92 )
TOTALS....................................... , 892.92 .00 892.92
I1100 INSTRUlIENTATION LABORATORY
SUPPLIES LAB II 9101078276 081112 080112 083112 40.55 .00 40.55 ...-
TOTALS....................................... : 40.55 .00 40.55
J0150 J & J HEALTH CARE SYST~IS,
SUPPLIES SURGERY 908298948 080712 073012 082912 327.11 .00 327.11:;/
SUPPLIES SURGERY 908333470 081112 080312 090212 156.48 .00 156.48
TOTALS....................................... : 483.59 .00 483.59
L1288 LANGUAGE LINE SERVICES 214.52/
OUTSIDE SRV ER W 9020204912 081112 073112 083012 214.52 .00
TOTALS....................................... : 214.52 .00 214.52
R1452 lUUlISSA RUBIO
FLEX SPEND REUIBURSEI1ENT W 24061 081712 081712 081712 82.83 .00 82.83 l...-'
TOTALS....................................... , 82.83 .00 82.83
10749 11CKESSON AUTOllATION INC.
HEDICATION SYSTEM 3464065 081512 073012 082912 9832.40 .00 9832.40 ,/
TOTALS....................................... : 9832.40 .00 9832.40
H2827 MEDIVATORS
SUPPLIES SURGERY II 1407941 071812 071112 081012 186.00 .00 186.00
SUPPLIES SURGERY CREDIT C133416 071812 062212 081012 -186.00 .00 -186.00
TOTALS....................................... : .00 .00 .00
112485 HEDRAD INC
SUPPLIES CT SCAN 14 139278319 081112 073112 083012 1074.62 .00 1074.62/
TOTALS....................................... : 1074.62 .00 1074.62
H2499 HEDIRONIC USA, INC.
SUPPLIES SURGERY W 2508582564 080712 073012 082912 130.00 .00 130.00/
TOTALS....................................... : 130.00 .00 130.00
10182 MERCEDES MEDICAL
SUPPLIES LAB 1502688 081512 073112 083012 35.82 .00 35.82/
TOTALS..................................... ..: 35.82 .00 35.82
1I2659 lIERBY X-RAY- SAN ANTONIO 1056.61/
SUPPLIES VARIOUS II 476588 081712 080212 090112 1056.61 .00
TOTALS....................................... : 1056.61 .00 1056.61
112650 llETLIFE /
INSURANCE II 18232 082112 082012 082012 258.52 .00 258.52
RUN DATE: 08/22/12
TIME: 10:33
HEMORIAL HEDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 09/04/12
PAGE: 5
APOPEN
VEND#.NAlm...........................CLS.INVOICE#....,....TRN DT.INV DT.DUE DT.CK DT..PC.......GROSS.....DISC......NO-PAY........NET
TOTALS....................................... : 258.52 .00 258.52
10764 HICHAEL CHAVANA
TRAVEL EXPENSES ADmN 24069 082212 082212 082212 275.58 .00 275.58 /
TOTALS....................................... : 275.5B .00 275.58
10441 MlIC EMPLOYEE BENEFITS
WEEKLY CLAms 18231 081712 081612 081612 4475.81 .00 4475.81 -
TOTALS....................................... : 4475.81 .00 4475.81
A2252 NADINE GARNER
TRAVEL EXPENSE INF CONTRO W 24067 082112 081712 081712 30.97 .00 30.97 ~
TOTALS....................................... : 30.97 .00 30.97
10709 ONESTAFF HEDICAL, LLC 2088.00'/
CONTRACT NURSE 5963 081112 080112 083112 2088.00 .00
TOTALS....;...... ~.....................,.....: 2088.00 .00 2088.00
014425 OliENS & HINOR
SUPPLIES SURGERY 1967900 073112 073112 083012 39.38 .00 39.38./
SUPPLIES SURGERY 1967942 073112 073112 083012 52.70 .00 52.7V
SUPPLIES CS INV 1968017 073112 073112 083012 142.62 .00 142.6~
SUPPLIES SURGERY 1968266 073112 073112 083012 1345.93 .00 1345.93 ,/
SUPPLIES SURGERY 1968275 073112 073112 083012 75.10 .00 75.10"-
SUPPLIES VARIOUS 1968293 073112 073112 083012 3939.85 .00 3939.85/
SUPPLIES CS INV 1968589 080712 080112 083012 8.32 .00 8.32 ./
SUPPLIES CS INV 1968645 080712 080112 083012 9.18 .00 9.18/
SUPPLIES CS INV 1968778 080712 080112 083012 6.16 .00 6.16 ./
SUPPLIES VARIOUS 1969950 081512 080312 090212 1089.36 .00 1089.36 ,/
TOTALS...................................... .: 6708.60 .00 6708.60
10204 PHARlIEDIUlI SERVICES LLC
PHARlIACEUTICALS A658185 081512 073012 082912 148.52 .00 148.52 </
TOTALS....................................... : 148.52 .00 148.52
10032 PHILIPS HEALIHCARE
SUPPLIES CS INV 924270060 082212 051812 061712 128.04 .00 128.04 v'
TOTALS....................................... : 128.04 .00 128.04
P2200 POWER ELECTRIC
SUPPLIES BIOHED W 159969 081112 073112 083012 30.22 .00 30.22 ,./
TOTALS...................................... .: 30.22 .00 30.22
P1725 PREMIER SLEEP DISORDERS CE
SLEEP STUDIES JULY 14 114 081112 080112 083112 3375.00 .00 3375.00 .,/
TOTALS....................................... : 3375.00 .00 3375.00
10326 PRINCIPAL LIFE
INSURANCE 18234 082112 081712 090112 1902.15 .00 1902.15/
TOTALS....................................... : 1902.15 .00 1902.15
P2370 PROGRESSIVE DYNAlIICS HEDIC 290.03/
SUPPLIES SURGERY H 129518 081112 080112 083112 290.03 .00
RUN DATE: 08/22/12
TIllE: 10:33
llEHORIAL I~EDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 09/04/12
PAGE: 6
APOPEN
VEND#.NAIIE...........................CLS.INVOICE#.........TRN DT.INV DT.DUE DT.CK DT..PC.......GROSS.....DISC......NO-PAY........NET
TOTALS...........:........................... : 290.03 .00 290.03
R1321 RECEIVABLE IIANAGEIIENT, IHC
COLLECTIONS W 070112-073112 081512 073112 083012 804.17 .00 804.17 v'
TOTALS....................................... : 804.17 .00 804.17
R1200 RED HA~IK
MONTHLY PYlolT SRV CONTRACT 0387332 082112 071812 081812 27.56 .00 27.56/
TOTALS..................... to........... ,..t.: 27.56 .00 27.56
S1200 SEARS
SUPPLIES PLANT OPS lol T049036 081512 071312 083112 47.45 .00 47.45 t--
SUPPLIES PLANT OPS T675081 081512 072318 083112 114.81 .00 114. 81 v
SUPPLIES PLANT OPS T838471 081512 073112 083112 39.98 .00 39.98v
TOTALS....................................... : 202.24 .00 202.24 -
10602 SERVICE ORGANIZATION
JUNE 2012 ER/CRNA FEES 24068 082112 082012 082012 56337.20 .00 56337.20 ,./
TOTALS...........:........................... : 56337.20 .00 56337.20
S1800 SHERlQIN laLLIAl4S
DEPT REPAIR PFS W 9575-2 081112 073012 082912 116.98 .00 116.98 ..--
DEPT REPAIR PFS 9702-2 081112 080212 090112 147. 84 .00 147.84 --
TOTALS....................................... : 264.82 .00 264.82
D0350 SIEMENS HEALIHCARE DIAGNOS
SUPPLIES LAB lol 971288845 081512 080212 090112 196.56 .00 196.56 ./'
TOTALS....................................... : 196.56 .00 196.56
S2400 SO TEX BLOOD & TISSUE CENT ,/
SUPPLIES BLOOD BANK CREDI H 20123586 081512 080212 090112 -2514.00 .00 -2514.00
SUPPLIES BLOOD BANK 20123654 081512 080212 090112 9400.00 .00 9400.00/
TOTALS....., to......................,........: 6886.00 .00 6886.00
S3960 STERICYCLE, INC
OUTSIDE SRV JULY 4003560759 981112 073112 083012 748.88 .00 748.88/
TOTALS....................................... : 748.88 .00 748.88
10735 STRYKER SUSTAINABILITY
SUPPLIES SURGERY 1695765 081312 OB0312 090212 167.99 .00 167.99/
TOTALS....................................... : 167.99 .00 167.99
1'11131 SUE WILLIAlIS 462.15/
FLEX SPEND REIlIBURSEMENT 24062 081712 081712 081712 462.15 .00
TOTALS....................................... : 462.15 .00 462.15
T2539 T-SYSTElol, INC.
CREDIT W 17409 080712 050912 082912 -368.00 .00 -368.00/
SRV CONTRACT 21229 080712 073112 083012 4107.00 .00 4107.00
TOTALS..,.............., ....... ...,......... '0 3739.00 .00 3739.00
10618 TEAN HEALTH HEDICAL CALL C 1848.85 /
HOlolIHLY IlolIERPRETATION BA12277 082112 073112 083012 1848.85 .00
RUN DATE, 08/22/12
TIHE, 10:33
MEI40RIAL MEDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 09/04/12
PAGE, 7
APOPEN
VEND#.NAHE......................... ..CLS.INVOICE#....... ..THN DT.INV DT.DUE DT.CK DT. .PC...... .GROSS.... .DISC..... .NO-PAY....... .NET
TOTALS........................,.............. : 1848.85 .00 1848.85
T0500 TEAll REHAB 15000.00.J
INTERIH BILLING W 24066 082112 082012 082012 15000.00 .00
TOTALS....................................... , 15000.00 .00 15000.00
10611 TELE-PHYSICIANS, P.A. (TX)
TELE-NEUROLOGY 07-2067 081312 073112 083012 600.00 .00 600.00/
TOTALS...................................... .1 600.00 .00 600.00
N2336 TERESA NILLER ./
TRAVEL EXPENSES 24060 081712 081712 081712 202.00 .00 202.00
TOTALS...................................... .1 202.00 .00 202.00
10758 TEXAS SELECT STAFFING, LLC
CONTRRCT NURSE 0002489-51-079-I 082212 080912 080912 2016.85 .00 2016.85 ,../
TOTALS.............,........................ .1 2016.85 .00 2016.85
T2230 TEXAS WIRED HUSIC INC
OUTSIDE SRV PLANT OPS W A684290 081112 080112 083012 59.95 .00 59.95 /
OUTSIDE SRV PLANT OPS A684291 081112 080112 083012 73.95 .00 73.95 ,/
TOTALS...................................... .: 133.90 .00 133.90/
S2679 THE ST JOHN COHPAHIES, INC
SUPPLIES lillIl40 II 07929453 081112 080112 083112 52.27 .00 52.27 ,/
TOTALS....................................... : 52.27 .00 52.27
VI050 THE VICTORIA ADVOCATE
ADVERTISING JULY W IOOI82062-0723 080712 073112 083012 816.00 .00 816.00 ./
TO'l'ALS.......................................: 816.00 .00 816.00
T2250 THYSSENKRUPP ELEVATOR CORP
SRV CONTRACT 8/1-10/31 14 300214166 080712 080112 083012 1036.38 .00 I bl~.9~ ~
TOTALS...................................... .: 1036.38 .00 I 1036.
T0801 TLC STAFFING
CONTRACT NURSES W 10433 081112 073112 083012 3508.79 .00 3508.79/
TOTALS...........:........................... , 3508.79 .00 3508.79
UI054 UNIFIRST HOLDINGS
LAUNDRY llAINTENANCE W 8150578928 073112 073112 083012 32.54 .00 32.54/
TOTALS....................................... : 32.54 .00 32.54
UI064 OOFIRST HOLDINGS INC
LAUNDRY HOSPITAL LINEN 8400130121 073112 073112 083012 834.43 .00 834.43;:::
LAUNDRY HOUSEKEEPING 8400130122 073112 073112 083012 182.19 .00 182.19/
LAUNDRY PLAZA 8400130123 073112 073112 083012 140.67 .00 140.67
LAUNDRY DIETARY 8400130124 073112 073112 083012 174.86 .00 174.86:/
LAUNDRY OB 8400130125 073112 073112 083012 86.70 .00 86.70
LAUNDRY HOUSEKEEPING 8400130126 073112 073112 083012 63.12 .00 63.42 ./
LAUNDRY HOSPITAL LINEN 8400130356 081112 080312 090212 769.55 .00 769.55 ./
RUN DATE: 08/22/12
TIME: 10:33
MEI40RIAL HEDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 09/04/12
PAGE, 8
APOPEN
VEND#.NAlIE.......................... .CLS.INVOICE#........ .TRN DT.INV DT.DUE DT.CK DT. .PC..... ..GROSS.... .DISC..... .NO-PAY...... ..NET
LAUNDRY SURGERY 8400130357 081112 080312 090212
LAUNDRY PLAZA 8400129765 081712 072412 082312
TOTALS...........,........................... ,
U0414 UNm4 LIFE INS CO OF AlIERIC
INSURANCE 18233 082112 082012 082012
TOTALS....................................... :
V0555 VERIZON SOUTffi1EST
TELEPHONES
TELEPHONES
TELEPHONES
TELEPHONES
H 5512513080712 081712 080712 090112
5526713080712 081712 080712 090112
5528103080712 081712 080712 090112
5537803080712 081712 080712 090112
TOTALS...................................... .:
K1751 VICKY KALISEK
TRAVEL PA1Ill0LL
~1 18235
082112 OB2112 082112
TOTALS....................................... J
10472 VISA
HISC PURCHASES
06/28-07/25
082112 072512 081912
TOTALS....................,.................. :
GRAND TOTALS............................... i.:
CK.~.qt IlfCj~t.fq
+0
;:jt.jt.I<'1733
VO IbS
-
~/l/CJ70g
t\PPAOV\Eltli
P,iJG 2 2 2012
COI.lNTV l\I.lD!1fOh"8
348.59 .00 348.59 /
173.67 .00 173.67 ..-/
2774.08 .00 2774.08
4195.82 .00 4195;82/
4195.82 .00 4195.82
202.08 .00 202.08 V
1285.07 .00 1285.07 ,/
48.22 .00 48.22./'
303.97 .00 303.97./
1839.34 .00 1839.34
140.97 .00 140.97 ,/
140.97 .00 140.97
846.25 .00 846.25./
846.25 .00 846.25
220547.00 .00 220547.00
c.,(,.."("ec. 0\-\ 0 'f\ { <',b3!..3%/
I'<a '1 / +\,OI'Z.Qll
;?;?,OJ5~3.{"o
,/
ru4 fJ1~
Michael ,\. Pf~;r-:-
("alhoun C(.",.'~N .Iudge
Date:-4~).:r'1..--'"
r
RUN DATE, 08/22/12
TIME, 10:57
MEMORIAL MEDICAL CENTER
EDIT LIST FOR PATIENT REFUNDS ARID=OOOl
PAGE .
APCDEDIT
PATIENT
NmmER
PAYEE llANE
DATE
082212
082212
082212
082212
082212 '
082212
082212
082212
082212
ARID=OOOl TOTAL
PAY PAT
AHOUNT CODE TYPE DESCRIPTION
62.00 .I
79.60/
150.00/
51.12v
50.00/
100.00/
45.38/
134.00/
56.93/
1333.43
GL HUH
------------------------------------------------------------------------------------.-----------------------------------------------
TOTAL
1333.43 /
C.k!:t )4qT~Y
+0
.j! I q, Clltj-S
~9~-
Micn8()1 J, Pfeifer
Ca1h"}>\p COLlnty,JudgE
D'., "6 ~ ;'J~J~
J\IPPROVED
l\Ub 2 1 2012
K;OUNTiI AUDITOR
RUN DATE. 08/29/12
TIME: 14:19
MEHORIAL 11EDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 09/11/12
PAGE: 1
APOPEN
VEWD#.NAlIE.......................... .CLS.INVOICE#........ . TAN DT.INV DT.DUE DT.CK D'J'. .PC...... .GROSS... ..DISC..... .NO-PAY....... . NET
A1790 AFLAC 130.00/
SERVICE FEE II 453949ER 082412 081512 090112 130.00 .00
TOTALS....................................... , 130.00 .00 130.00
A1715 ALCO SALES & SERVICE CO
INSTRUl~ENT REPAIR OB II 2467353-IN 082712 082112 091012 33.42 .00 33.42 ,/
TOTALS...................................... .: 33.42 .00 33.42
10676 AHNISURE INTERNATIOHAL, LL
SUPPLIES LAB 00722771 081512 080812 090712 2697.83 .00 2697.83 V
TOTALS...................................... .: 2697.83 .00 2697.83
A0777 ANDERSON CONSULTATION SERV
COLLECTIONS PFS 1'1 ~ll!C050412 082412 050412 060312 2671.22 .00 2671.22 ,/
COLLECTIONS PFS Ill!C070512 082412 070512 080412 2107.65 .00 2107.65'/
TOTALS............. ,.,......,................1 4778.87 .00 4778.87
A2218 AQUA BEVERAGE COHPANY
SUPPLIES WOllEN CLINIC I~ 420226 081512 080912 090812 10.01 .00 10.01/
TOTALS...................................... ., 10.01 .00 10.01
A2276 ARTHROCARE ~IEDICAL CORPORA
SUPPLIES SURGERY M 90984313 081312 080612 090512 483.30 .00 483.30 ./
TOTALS...................................... ., 483.30 .00 483.30
10751 ARTISAN llEDICAL 100.00/
SUPPLIES WOHEN CLINIC BD-48932-1 082912 081112 090812 100.00 .00
TOTALS....................................... : 100.00 .00 100.00
A1551 ASPEN SURGICAL PRODUCTS IN
SUPPLIES SURGERY ~I CS1676093 081712 080812 090712 94.97 .00 94.97 ,/
TOTALS...................................... ., 94.97 .00 94.97
A2345 AT&T HOBILITY
TELEPHONE X08192012 082412 081112 090612 1.51 .00 1.51 /
TOTALS....................................... : 1.51 .00 1.51
A2600 AUTO PARTS & HACHINE CO.
DEPT REPAIR ICU W 650503 081712 081012 090912 14.22 .00 14.22 ./
TOTALS....................................... : 14.22 .00 14.22
B1075 BAXTER HEALTHCARE CORP /
SUPPLIES CS INV II 37995512 081312 080612 090512 495.47 .00 495.47/
SUPPLIES CS INV 37996493 081312 080612 090512 280.02 .00 280.02
SUPPLIES CS INV 38048503 081712 080912 090812 318.67 .00 318.67/
PIlARlIACEUTICALS 38000588 082412 080712 090612 569.46 .00 569.46/
TOTALS....................................... : 1663.62 .00 1663.62
B1220 BECKllAN COULTER INC 367.09,/,
SUPPLIES LAB M 103039035 081512 080712 090612 367.09 .00
SUPPLIES LAB 103045533 082912 081312 090112 535.51 .00 535.51
RUN DATE: 08/29/12
TIME: 14:19
llENORIAL llEDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 09/11/12
PAGE, 2
APOPEN
VEND#.NAlIE...........................CLS.INVOICE#......... TEN DT.INV DT.DUE DT.CK DT..PC.......GROSS.....DISC......NO-PAY........NET
SUPPLIES LAB 103051098 082912 081512 091112 19.35 .00 19.35...--'
LEASE I llAINTENANCE 5275308 082912 081212 091112 3440.19 .00 3440.19 .,/
LEASE I llAINTENANCE 5275309 082912 081212 091112 3933.48 .00 3933.48...-/
TO'.rALS............................,....... I": 8295.62 .00 8295.62
B1115 BRUCE'S AUTO REPAIR
DEPT REPAIR TRANSPORTATIO 11025 081112 080612 090512 57.50 .00 57.50./
TOTALS...... "....... II..... II......... II....: 57.50 .00 57.50
B0437 C R BARD INC
SUPPLIES SURGERY [-I 22505112 082112 080812 090712 240.00 .00 240.00 ,/
TOTALS....................................... : 240.00 .00 240.00
Cl033 CAD SOLUTIONS, INC
CAD CASES 201670 082412 073112 083012 592.00 .00 592.00 ,/
TOTALS...................................... .: 592.00 .00 592.00
Cl030 CAt CON FEDERAL CREDIT UBI
EHPLOYEE DEDUCTION W 18240 082912 082812 082812 25.00 .00 25.00 ,,p-
TOTALS...................................... ., 25.00 .00 25.00
A1825 CARDINAL HEALTH
SUPPLIES NUC NED 11 08108100 082412 081012 081012 450.82 .00 450.82 v
SUPPLIES NUC NED 08108118 082412 081712 081712 723.48 .00 723.48 ..---
TOTALS...........;........................... : 1174.30 .00 1174.30
10350 CENTURION IIEDICAL PRODUCTS
SUPPLIES VARIOUS 91080810 081312 080612 090512 758.12 .00 758.12 v-
SUPPLIES CS INV 91082768 081312 080812 090712 487.68 .00 487.68 -
TOTALS....................................... : 1245.80 .00 1245.80
C2157 COOPER SURGICAL INC 175.00 /
SUPPLIES WONEN CLINIC H 2942087 082112 081012 090912 175.00 .00
TOTALS......................... ..............: 175.00 .00 175.00
C2510 CPSI
SUPPLIES HR II 745155 082412 081712 081712 55.00 .00 55.00'/
ELECTRONIC PAYSTUBS 745944 082712 082312 082312 225.05 .00 225.05/
EBOS 744255 082912 081512 081512 523.40 .00 523.40 /
STATEMENT PROCESSING 744880 082912 081612 081612 37.80 .00 37.80/
TOTALS...................................... ., 841.25 .00 841.25
D1608 DIVERSIFIED BUSINESS SYSTE
SUPPLIES INDIGENT II 22653 081312 081112 091012 90.00 .00 90.00/
TOTALS....................................... : 90.00 .00 90.00
E3400 EMERGENCY 11EDICAL PRODUCTS
SUPPLIES CS INV II 1486205 081512 080812 090712 29.35 .00 29.3511
TOTALS....................................... , 29.35 .00 29.35
10701 FAGAN ANS1iERING SERVICE AN
OUTSIDE SRV 1I0MENS CLINIC 74132 081112 081012 090912 77.94 .00 77.94/
RUN DATE: 08/29/12
TIl1E: 14: 19
HEMORIAL HEDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 09/11/12
PAGE: 3
APOPEN
VEND#.NAlIE...........................CLS.INVOICE#.........TRN DT.INV DT.DUE DT.CK DT..PC.......GROSS.....DISC......NO-PAY........NET
TOTALS....................................... : 77.94 .00 77.94
F1400 FISHER HEALIHCARE 49.83 ./
SUPPLIES LAB 14 8224283 081512 080712 090612 49.83 .00
SUPPLIES LAB 8224284 081512 080712 090612 697.57 .00 697.57'/
SUPPLIES LAB CREDIT 8564884 081512 080812 090712 -60.00 .00 -60.001/
SUPPLIES LAB 8564901 081512 080812 090712 408.59 .00 408.59./
SUPPLIES LAB 8845937 081512 090812 090712 719.13 .00 719.131/
TOTALS...........:........................... : 1815.12 .00 1815.12
G0100 GE HEALIHCARE
SR CONTRACT 8/1-8/31 W 5440576 082412 080612 090512 447.91 .00 447.91./
SRV CONTRACT 8/1-8/31 5440571 082412 080612 090512 3504.39 .00 3504.39"--
DEPT REPAIR RADIOLOGY 5451257 082412 081012 090912 644.84 .00 644.84 v
TOTALS....................................... : 4597.14 .00 4597.14
G0120 DE I~EDICAL SYSTEI~S, INFO T
SRV CONTRACT 9/1-9/30 7377110 081312 080912 090812 171.00 .00 171.00 v
TOTALS....................................... : 171.00 .00 171.00
A1292 GULF COAST HARDMARE I ACE
SUPPLIES PLANT OPS 1'1 070625 081512 081012 090912 26.99 .00 26.99/
TOTALS...................................... .: 26.99 .00 26.99
G1210 GULF COAST PAPER COMPANY
SUPPLIES HOUSEKEEPING 11 433328 ~81312 080712 090612 248.08 .00 248.08......
SUPPLIES HOUSEKEEPING 440169 082412 082112 091112 442.70 .00 442.70"'/
TOTALS...................................... ., 690.78 .00 690.78
10374 HARDY DIAGNOSTICS
SUPPLIES LAB 1142996-0 082912 071012 080912 167.50 .00 167.50/
TOTALS....................................... : 167.50 .00 167.50
H1100 HAYES ELECTRIC SERVICE
SUPPLIES PLANT OPS W A2120807-05 081712 080712 090612 16.20 .00 16.20 /
TOTALS...................................... .: 16.20 .00 16.20
10334 HEALTH CARE LOGISTICS INC
SUPPLIES PHARHACY CREDIT 4477836 081312 061512 090612 -118.40 .00 -118.40/
SUPPLIES WOllEN CLINIC 4523715 081312 080712 090612 151.22 .00 151.22 /'
TOTALS....................................... : 32.82 .00 32.82
H3400 HUBERT C014PANY 346.71 /
DEPT REPAIR DIETARY II 884922 081712 081012 090912 346.71 .00
TOTALS...................................... ., 346.77 .00 346.71
I0950 INFOLAB INC 2150.63/
SUPPLIES LABIBLOOD BANK 11 3149719 081512 080712 090612 2150.63 .00
TOTALS....................................... , 2150.63 .00 2150.63
10671 INNOVATIVE X-RAY SERVICES 458.33 j
SRV CONTRACT SEPT2012 2012CL0515-5-5 082412 080112 083112 458.33 .00
RUN DATE, 08/29/12
TIHE, 14:19
MEHORIAL MEDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 09/11/12
PAGE, 4
APOPEN
VEND#.NANE.......................... .CLS.INVOICE#....... ..TRN DT.INV DT.DUE DT.CK DT. .PC..... ..GROSS.... .DISC..... .NO-PAY....... .NET
TOTALS....................................... : 458.33 .00 458.33
I1130 INTEGRA LIFESCIENCES CORP 46.06/
SUPPLIES SURGERY 2459975 082112 081012 090912 46.06 .00
I'O'1'AL8....................................... : 46.06 .00 46.06
I1263 IVANS
COLLECTIONS - olULY W 12DOII0474 081512 081012 090912 147.36 .00 147.36/
TOTALS..............................,........ : 147.36 .00 147.36
J0150 J & J HEALTH CARE SYSTEHS,
SUPPLIES VARIOUS 908343084 081312 080612 090512 535.80 .00 535.801/"
SUPPLIES SURGERY 908353327 081312 080812 090712 2925.60 .00 2925.60"""'-
SUPPLIES SURGERY 908363322 081312 080812 090712 82.38 .00 82.38 ....--
TOTALS...................................... ., 3543.78 .00 3543.78
J1201 JACK L. HARCOS, INC 80.91/
EMPLOYEE DEDUCTION 71688 081512 080812 090712 80.91 .00
TOTALS............~.......................... .1 80.91 .00 80.91
10507 JASON ANGLIN
TRAVEL EXPENSES ADMIN 24083 082912 082712 082712 265.94 .00 .::1 sa. 12- '*5T94-
TRAVEL EXPENSES 24084 082912 082712 082712 169.84 .00 169.84 V
TRAVEL EXPENSE ADIIIN 24085 082912 082712 082712 54.95 .00 54.95 ~
TOTALS....................................... : 490.73 .00 J9O...7.3.
J1300 JECKER FLOOR & GLASS Lj7(",Q I
DEPT REPAIR PLANT OPS W 67363 081712 080812 090712 255.90 .00 255.90 /
TOTALS.........,............................. ; 255.90 .00 255.90
KI070 KEY SURGICAL INC 23.50 ./
SUPPLIES SURGERY II 458804 081712 080912 090812 23.50 .00
'1'0'rAL8.......................................: 23.50 .00 23.50
L0700 LABCORP OF A11ERICA HOLDING
OUTSIDE SRV LAB M 38401645 082912 072812 082712 126.50 .00 126.50----
TOTALS. ...... oo..~.. ,....... ..0...... ........: 126.50 .00 126.50
10371 LOFTIN EQUIPI1ENT COHPANY 1490.0a/
OUTSIDE SRV PLANT OPS SRVCE031193 082412 073112 083012 1490.00 .00
TOTALS....................................... : 1490.00 .00 1490.00
L1640 LOWE'S HOllE CENTERS INC
SUPPLIES DIETARY W 88437-01 082912 081012 090912 214.34 .00 214.34 V
SUPPLIES DIETARY CREDIT 88437-1 082912 062512 072412 -16.34 .00 -16.34 ,/
TOTALS..........."......... ........:........: 198.00 .00 198.00
H1500 HARKS PLUlmING PARTS
SUPPLIES PLANT OPS H 1142092 081312 080612 090512 143.52 .00 143.52'"
SUPPLIES DIETARY 1143714 082412 081012 090912 57.36 .00 57,36/
TOTALS.....................................,. : 200.88 .00 200.88
10339 llATTHEW BOYLE j
TRAVEL EXPENSE 24086 082912 082712 082712 140.97 .00 140.97
RUN DATE: 08/29/12
TIllE: 14,19
IIEHORIAL MEDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 09/11/12
PAGE: 5
APOPEN
VEND~.NJ\ME.......................... .CLS.INVOICE#...... ...TRN DT.INV DT.DUE DT.CK DT. .PC...... .GROES... ..DISC..... .NO-PAY....... .NET
TOTALS....................................... : 140.97 .00 140.97
10749 IICKESSON AUTOHATION INC. 15422.00/
PHARl1ACY DRUG AUTO~lATION 3464064 082712 073012 083012 15422.00 .00
TOTALS....................................... : 15422.00 .00 15422.00
H2827 HEDIVATORS
SUPPLIES SURGERY [,I 1407941 071812 071112 081012 186.00 .00 186.00'/
TOTALS....................................... : 186.00 .00 186.00
H2659 l!ERRY X-RAY- SAN ANTONIO 106.56 /
SUPPLIES RADIOLOGY [1 476627 081112 080612 090512 106.56 .00
SUPPLIES RADIOLOGY 475694 082412 070612 080512 1142.91 .00 1142.91 ,../
TOTALS....................................... : 1249.47 .00 1249.47
M2685 HICROTEK I1EDICAL INC
SUPPLIES CS INV H 2915513 081512 080612 090512 211.00 .00 211. 00 ;/
TOTALS...................................... .: 211.00 .00 211.00
H2621 MMC AUXILIARY GIFT SHOP ./
EHPLOYEE PURCHASE ~I 24082 082712 082712 082712 145.24 .00 145.24
TOTALS...................................... .. 145.24 .00 145.24
10441 1~IC EHPLOYEE BENEFITS
WEEKLY CLAms 18236 082412 082412 082412 861. 95 .00 861. 95 /
~IEEKLY CLAms 18237 082412 082412 082412 6234.30 .00 6234.30)
WEEKLY CLAmS 18241 082912 082912 082912 6060.60 .00 6060.60
TOTALS....................................... : 13156.85 .00 13156.85
10536 HORRIS & DICKSON CO, LLC
PHARHACEUTICALS 3707981 081712 081612 091012 4244.68 .00 4244.68/
PHARHACEUTICALS 3707982 081712 081612 091012 1726.48 .00 1726.48/
PHARHACEUTICALS 3708837 081712 081612 091012 22.52 .00 22.52;;
PHARllACEUTICALS 3718302 082112 082012 091012 6.07 .00 6.07
PHARHACEUTICALS 3718303 082112 082012 091012 4799.05 .00 4799.05/
PHARHACEUTICAL CREDIT 7374 082112 081712 091012 -882.53 .00 -882.53,.1
PHARHACEUTICALS 3723386 082412 082112 091012 5348.68 .00 5348.68/
PHARHACEUTICALS 3723387 082412 082112 091012 1303.04 .00 1303.04/
PHARHACEUTICALS 3726624 082412 082212 091012 781.40 .00 781.40./
PHARl1ACEUTICALS 3727564 082412 082212 091012 577.27 .00 577 .27../
PHARllACEUTICAL CREDIT 7747 082412 082112 091012 -257.69 .00 -257.69./
PHARllACEUTICAL CREDIT 7774 082412 082112 091012 -18.37 .00 -18.37/
PHARl1ACEUTICAL CREDIT CH33443 082412 082212 091012 -717.57 .00 -717.57/
TOTALS....................................... , 16933.03 .00 16933.03
N2140 NOTARY PUBLIC UNDERWRITERS
LICENSE RENEWAL W 24087 082912 082712 082712 101.75 .00 101. 75V
TOTALS....................................... : 101. 75 .00 101. 75
01410 ON-SITE TESTING SPECIALIST
SUPPLIES LAB ~I 14346 082912 080712 090612 184.65 .00 184.65 /
RUN DATE: 08/29/12
TIllE: 14: 19
11EI~ORIAL 11EDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 09/11/12
PAGE, 6
APDPEN
VEND#.NANE.............. ............ .CLS.INVOICE#........ .TRN DT.INV DT.DUE DT.CK DT. .PC...... .GROSS.... .DISC..... .NO-PAY....... .NET
TOTALS....................................... : 184.65 .00 184.65
10709 ONESTAFF fIEDICAL, LLC
CONTRACT NURSE 5987 081512 080912 090812 2204.00 .00 2204.00./
TOTALS....................................... : 2204.00 .00 2204.00
OH425 OWENS & HINOR
SUPPLIES CS INV 1971134 081112 080712 090612 52.02 .00 52.02/
SUPPLIES VARIOUS 1971212 081112 080712 090612 156.08 .00 156.08/
SUPPLIES VARIOUS 1971447 081112 080712 090612 2769.49 .00 2769.49 "/
SUPPLIES CS INV 1971657 081312 080812 090712 10.64 .00 10.64
SUPPLIES ER 1971677 081312 080812 090712 159.23 .00 159.23/
SUPPLIES CS INV 1971684 081312 080812 090712 89.08 .00 89.08/
SUPPLIES CS INV 1971903 081312 080812 090712 79.24 .00 79.24/
SUPPLIES SURGERY 1972289 081312 080812 090712 236.27 .00 236.27 /
SUPPLIES VARIOUS 1972664 081312 080912 090812 2047.08 .00 2047.08/
SUPPLIES CS INV 1971240 081512 080712 090612 3.56 .00 3.56/
SUPPLIES VARIOUS 1971784 081712 080812 090712 200.68 .00 200.68 --
SUPPLIES SURGERY 1971488 082112 080712 090612 424.47 .00 424.47 ./
SUPPLIES SURGERY CREDIT 1974717 082112 080812 090712 -126.48 .00 .126.48/
TOTALS....................................... : 6101. 36 .00 6101.36
P1100 PC CONNECTION SALES CORP
SUPPLIES l~lC II 49337222 081312 080812 090712 181.87 .00 181.87 ./
SUPPLIE OB 49337224 081312 080812 090712 181.87 .00 181. 87 "..--
TOTALS....................................... , 363.74 .00 363.74
10541 PLATINmI CODE
SUPPLIES LAB 145685 081512 080712 090612 133.88 .00 133.88/
TOTALS...........,........................... : 133.88 .00 133.88
P2200 PO\1ER ELECTRIC
SUPPLIES BIOMED 1'1 160062 081712 080712 090612 5.29 .00 5.29/
SUPPLIES PLANT OPS 160107 081712 081012 090912 8.99 .00 8.99/
TOTALS.... ..0...... to... to.... .0..... I.......: 14.28 .00 14.28
RI050 R G & ASSOCIATES INC
SALT DELIVERY 1.1 203833 081512 080912 090712 246.00 .00 246.00/
TOTALS...................................... .: 246.00 .00 246.00
R1268 RADIOLOGY UNLIIoIIIED, PA
INS REIIoIBURSEflENT ;/ 24070 082412 082312 082312 110.00 .00 110.00'/
TOTALS....................................... : 110.00 .00 110.00
S1103 SCIENTIFIC DEVICE LABS
SUPPLIES LAB II 13635 081512 080812 090712 54.73 .00 54.73/
TOTALS...................................... .: 54.73 .00 54.73
S1800 SHERWIN If.rLLIM4S
DEPT REPAIR PFS W 9997-8 082112 080912 090712 61.71 .00 61.71/
TOTALS....................................... : 61.71 .00 61.71
D0350 SIEllENS HEALTHCARE DIAGNOS
SRV CONTRACT 8/7 /l2 - 816 II 950367572 081512 080712 090612 6700.00 .00 6700.00./
RUN DATE, 08/29/12
TIME: 14:19
!IEI!ORIAL llEDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 09/11/12
PAGE: 7
APOPEN
VEND#..NAl1E......................... ..CLS.INVOICE~....... "TRN DT.INV DT.DUE DT.CK DT. .PC...... .GROSS... ..DISC..... .NO-PAY....... .NET
TOTALS...................................... .: 6700.00 .00 6700.00
S2001 SIEMENS NEDICAL SOLUTIONS
SRV CONTRACT 7/30-8/29 II 95718269 082412 073012 082912 697.58 .00 697.58 .....-
TOTALS....................................... : 697.58 .00 697.58
S3940 STERIS CORPORATION
INSTRUl1ENT REPAIR OB I! 4361733 081712 081012 090912 199.60 .00 199.60 /
TOTALS...................................... .: 199.60 .00 199.60
10333 SUNTRUST EQUIPMENT FINANCE
IIRI FINANACE 1464569 082412 080712 090112 22688.57 .00 22688.57/
TOTALS....................................... , 22688.57 .00 22688.57
T1925 TEXAS DEPT OF STATE HEALTH
OUTSIDE SRV LAB 080212 082912 080212 090112 216.00 .00 216.00V
OUTSIDE SRV LAB 080212-1 082912 080212 090112 345.00 .00 345.00/'
TOTALS.........."................."....... .: 561.00 .00 561. 00
10765 TEXAS HOSPITAL ASSOCIATION
2012-2013 MEMBERSHIP DUES 00150174 082712 081312 090112 9152.00 .00 9152.00/
TOTALS....................................... : 9152.00 .00 9152.00
10758 TEXAS SELECT STAFFING, LLC 655.60 ./
CONTRACT NURSE 0002537-51-079-I 082412 082212 082212 655.60 .00
TOTALS...................................".. , 655.60 .00 655.60
T2303 TG
EMPLOYEE DEDUCTION II 18238 082912 082812 082812 130.49 .00 130.49/'
TOTALS.......".............".........".... , 130.49 .00 130.49
10732 THERACOM, LLC
PHARHACEUTICALS 65048610-301 082412 081012 090912 325.00 .00 325.00/
TOTALS. '0.. to ............ I.... ,.. ........... II 325.00 .00 325.00
T0801 TLC STAFFING
CONTRACT NURSE Ii 10470 081512 080712 090612 844.20 .00 844.20/
TOTALS....................................... : 844.20 .00 844.20
UI054 UNIFIRST HOLDINGS
LAUNDRY llAINTENANCE W 8150579713 080712 080712 090612 32.54 .00 32.54 /
TOTALS......................"............... : 32.54 .00 32.54
UI064 UNIFIRST HOLDINGS INC
LAUNDRY HOSPITAL LIMEN 8400130489 080712 080712 090612 978.26 .00 978.26/
LAUNDRY HOUSEKEEPING 8400130490 080712 080712 090612 182.19 .00 182.19 -'
LAUNDRY PLAZA 8400130491 080712 080712 090612 157.49 .00 157.49 )
LAUNDRY DIETARY 8400130492 080712 080712 090612 174.86 .00 174.86./
LAUNDRY OB 8400130493 080712 080712 090612 86.70 .00 86.70/
LAUNDRY HOUSEKEEPING 8400130494 080712 080712 090612 63.42 .00 63.42/
LAUNDRY HOSPITAL LINEN 8400130732 081312 081012 090912 914.57 .00 914.57/
RUN DATE, 08/29/12
TIME. 14,19
HEHORIAL HEDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 09/11/12
PAGE, 8
APOPEN
VEND#.NANE.......................... .CLS.INVOICE#....... ..TRN DT.INV DI.DUE DT.CK DT. .PC...... .GROSS... ..DISC..... .NO-PAY...... ..NET
LAUNDRY SURGERY
U1056 UNIFORl4 ADVANTAGE
EHPLOYEE PURCHASE
U1350 UNITED PARCEL SERVICE
SHIPPING CHARGES
V0555 VERIZON SOUTffiiEST
TELEPHONES
TELEPHONES
V0559 VERIZON WIRELESS
TELEPHONES
WI005 WALHART COHllUNIIY
SUPPLIES VARIOUS
8400130733 081312 081012 090912
TOTALS....................................... ,
W 4543835 081312 080912 090812
TOTALS...................................... .:
1'1 0000778941332 082912 081812 082912
TOTALS...................................... .:
M 5522646081612 082712 081612 091012
5525926081612 082712 081612 091012
TOTALS.......... .... ..........................:
6774162287 082712 081612 091112
TOTALS....................................... :
1'1 0717-0813
082412 081312 091112
TOTALS....................,.................. :
10429 WILLIAH E HEITKAMP, TRUSTE
EIIPLOYEE DEDUCTION 18239 082912 082812 082812
TOTALS...................................... ..
GRAND TOTALS.............. .......... .........,
C IZS il= jL{11Lfi/
+0
dt/t.f9F:z..(p
V DlbS
...-
1tNq?101
'APPROVED
AUIj 3 0 2012
~l\)lJNW AlJDllOAJ
348.59 .00 348.59 ./
2906.08 .00 2906.08
192.86 .00 192.86 ---
192.86 .00 192.86
339.95 .00 339.95 .,....-
339.95 .00 339.95
114.12 .00 111.;;( IS' _111.12 ~
108.53 .00 108.53...-/
222.65 .00 322.65
"?''l.lSl
161. 90 .00 161. 90 ---
161. 90 .00 161. 90
424.30 .00 424.30.....-
424.30 .00 424.30
495.00 .00 495.00/
495.00 .00 495.00
143678.39 .00 143678.39
s <- ~90.73 ';
(. -+ 4'7f,..Q'
{ <?:l.:l.r.6'!
+~1"l.81
1~.3/b("l. '73 /
~,,4-..~
f'(j L\
Ct;J r( e.c;.+: QY\
PlJ '?
~
f!::~~tI#
Calh?un Cou~y Judge
D11ltfJ.~~ I~
RUN DATE, 08/29/12
TIME: 14,35
NEl40RIAL MEDICAL CENTER
EDIT LIST FOR PATIENT REFUNDS ARID=OOOI
PAGE .
APCDEDIT
PATIENT
NUHBER
PAYEE NAlIE
ARID=OOOl TOTAL
TOTAL
DATE
PAY PAT
AHOUNT CODE TYPE DESCRIPTION
165.95 /
125.32/
75.00 /
32.33/
60.00/
8.50 ,/
266.00 ,;
83.20 v'
16.89/
195.05 ,/
50.0iV'
100.00/
91.07,1
1269.31
1269.31 J
.APPROVED
AUli 3 0 2012
GL HUH
t\(S :!d.lLf'1\?2.7
+0
t!: 14'1'iS39
fYv1 (U-r-~ d--
Michael J. Pfeifer {-r'
Calhoun County ,Judge
Daro;_[]",,-t-:./.~~_
tOi..lNl'\f !:\lJDI10R
RUN DATE: 08/30/12
TIllE: 15:54
MEMORIAL tlEDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 08/30/12
PAGE: 1
APOPEN
VEND#.NAlIE.......................... .CLS.INVOICE#........ .TRN DT.INV DT.DUE DT.CK DT. .PC..... ..GROSS.... .DISC..... .NO-PAY....... .NET
T0500 TEro4 REHAB
INTERIII BILLING
15000.00
15000.00
.00
.00
1'1 24088
083012 083012 083012
TOTALS.......................,............... :
GRAND TOTALS.................................:
15000.00
.00
t/Ut I t.fC1 ?tfD
APPROVED
AUIj 3.0 2012
COUNTY t!},I.lDlTOR
mAd) lvPP
Michael J. Pfeifer
9~.dhoun cou~ty Judge
""'i": 0",/:: )?
f.9f;t~(i)-=-b-'6~- '.
15000.00
15000.00
15000.00 /
RUN DATE: 09/05/12
TI!1E: 17:22
HEHORIAL MEDICRL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 09/18/12
PAGE: 1
APOPEN
VEND#.NANE...........................CLS.IMVOICE#.........TRN DT.INV DT.DUE DT.CK DT..PC.......GROSS.....DISC......NO-PAY........NET
10250 4IMPRINT 402.66 /
SUPPLIES ADMIN 2535190 083112 081312 091212 402.66 .00
f.-Jh,r+s .c~r Net<> S-t-",-4l"(: 'I'OTALS.................................,...... : 402.66 .00 402.66
..co( ..::.....,~. or"en+a.I..n
A1350 ACTION LUHBER
SUPPLIES PLANT OPS W 27724 082112 081612 091512 48.00 .00 48.00 v
TOTALS....................................... : 48.00 .00 48.00
A1680 AIRGAS-SOUTHtIEST
SUPPLIES PLANT OPS !! 9007898440 082112 081512 091412 151.80 .00 151. 80 /
TOTALS....................................... : 151.80 .00 151. 80
10554 ALLIED WASTE SERVICES #847 1059.60 /
WASTE PICKUP 9/1 - 9/30 0847-000461604 090512 082612 091512 1059.60 .00
TOTALS....................................... , 1059.60 .00 1059.60
A1360 AHERISOURCEBERGEN DRUG COR 117.30 ,/
PHARlUlCEUTICRLS w 704591468 083112 083012 091012 117.30 .00
TOTALS....................................... , 117.30 .00 117.30
A2276 ARTHROCARE 11EDICAL CORPORA
SUPPLIES OR H 90989021 081712 081312 091212 1193.38 .00 1193.38 -::/
SUPPLIES SURGERY 90990814 082112 081512 091412 1193.38 .00 1193.38
TOTALS...................................... .1 2386.76 .00 2386.76
A2345 AT&T HOBILITY 639.10 ,/
TELEPHONES X08262012 083112 082612 091312 639.10 .00
TOTALS............,........................... : 639.10 .00 639.10
A2600 AUTO PARTS & lUlCHINE CO. 76.60/
SUPPLIES PLANT OPS W 651181 082112 081612 091512 76.60 .00
SUPPLIES BIOMED 648299 083112 072512 082412 43.00 .00 43.00"'/
TOTALS....................................... , 119.60 .00 119.60
BI075 BAXTER HEALTHCARE CORP 542.50 ,/'
SUPPLIES CS INV H 38095160 082412 081612 091512 542.50 .00
TOTALS....................................... : 542.50 .00 542.50
B1230 BECKWITH ELECTRONIC ENGINE
INSTRm1ENT REPAIR II 24670 083112 081012 090912 156.90 .00 156.90 v
TOTALS....................................... : 156.90 .00 156.90
10599 BKD, LLP
AUDITING FEES 220388 082412 081412 091312 6532.78 .00 6532.78 ;/
AUDITING FEES 225935 083112 082312 082312 3294.06 .00 3294.06 /
TOTALS....................................... : 9826.84 .00 9826.84
B1630 BOB BONAR 287.59/
TRAVEL EXPENSES ADIIIN W 24099 083112 082012 082012 287.59 .00
TOTALS....................................... : 287.59 .00 287.59
B0437 C R BARD INC 130.95 ./
SUPPLIES SURGERY 14 22507666 081712 081312 091212 130.95 .00
RUH DATE: 09/05/12
TmE: 17:22
MEHORIAL HEDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 09/18/12
PAGE: 2
APOPEN
VEND#.NAME...........................CLS.INVOICE#.........TRN DT.INV DT.DUE DT.CK DT..PC.......GROSS.....DISC......NO-PAY........NET
SUPPLIES SURGERY 22509174 082112 081512 091412 250.95 .00 250.95 v"
TOTALS....................................... : 381. 90 .00 381.90
10650 CAREFUSION 2200, INC
SUPPLIES WOHEN CLINIC 9103713854 082112 081312 091212 997.20 .00 997.20 v"
TOTALS....................................... , 997.20 .00 997.20
10350 CENTURION HEDICAL PRODUCTS 31.00 -----
SUPPLIES CS INV 91088304 082112 081512 091412 31.00 .00
SUPPLIES CS INV 91086154-1 083112 081312 091212 408.50 .00 408.50 ......-
TOTALS....................................... : 439.50 .00 439.50
10720 CHRIS RM1IREZ, JR.
CONTINUING ED VARIOUS 12040 082912 081512 091412 300.00 .00 300.00~
CONTINUING ED ~IED SURG 12041 082912 081712 091612 150.00 .00 150.00 ...--
TOTALS....................................... : 450.00 .00 450.00
C1600 CITIZENS MEDICAL CENTER 120.00 /
OUTSIDE SRV LAB 11 24100 083112 063012 073012 120.00 .00
TOTALS....................................... : 120.00 .00 120.00
C1730 CITY OF PORT LAVACA
WATERISEWER \'1 070912-080812 083112 080812 090512 5931. 35 .00 5931.35 :;
WATER 070912T0080812 083112 080812 090512 517.45 .00 517.45
TOTALS....................................... : 6448.80 .00 6448.80
S2896 DANETTE BETHANY
FLEX SPEND REIMBURSEMENT 1'1 24090 083112 083112 083112 128.65 .00 128.65 ,./
TOTALS....................................... : 128.65 .00 128.65
10766 DAVIS & IffiIGHT, PC 357.50 ./
LEGAL FEES 128904 083112 063012 073012 357.50 .00
TOTALS...................................... .: 357.50 .00 357.50
10368 DEWITT POTH & SON 18.38/
OFFICE SUPPLIES LAB 340620-0 082112 081512 091512 18.38 .00
OFFICE SUPPLIES VAHIOUS 340676-0 082112 081512 091512 41. 29 .00 41.29 ....-
OFFICE SUPPLIES ACCT 340813-0 082112 081612 091512 53.36 .00 53.36/
OFFICE SUPPLIES CS INV 340792-0 082412 081612 091512 219.00 .00 219.00/
OFFICE SUPPLIES PFS 341440-0 082412 082212 091512 20.47 .00 20.47 ...--
OFFICE SUPPLIES ER 341463-0 082412 082212 091512 115.74 .00 115.74---
OFFICE SUPPLIES CS INV 341464-0 082412 082212 091512 238.34 .00 238.34 ./
OFFICE SUPPLIES CS NV 341464-1 082912 082412 091512 1.64 .00 1.64/
OFFICE SUPPLIES ADHIN 341958-0 082912 082712 091512 73.50 .00 73.50/
OFFICE SUPPLIES OUTPATIEN 341960-0 082912 082712 091512 91.61 .00 91.61/
OFFICE SUPPLIES CS INV 342156-0 083112 082912 091512 182.50 .00 182.50 --
OFFICE SUPPLIES LAB 342293-0 990512 083012 091512 156.73 .00 156.73/
OFFICE SUPPLIES VARIOUS 342297-0 090512 083012 091512 173.60 .00 173.60/
TOTALS....................................... : 1386.16 .00 1386.16
W1372 DR. JOHN l1RIGHT
TRAVEL EXPENSES 24095 083112 083012 083012 287.59 .00 287.59/
RUN DATE: 09/05/12
TUIE, 17:22
JoIEllORIAL JoIEDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 09/18/12
PAGE: 3
APOPEN
VEND#.IWIE.......................... .CLS.INVOICE#........ .TRN DT.INV DT.DUE DT.CK DT. .PC...... . GROSS. ... .DISC..... .NO-PAY....... .NET
TOTALS....................................... , 287.59 .00 287.59
10448 ENTERPRISE RENT-A-CAR USA 168.31 -----
TRAVEL EXPENSE VARIOUS 79501538 082412 081412 091312 168.31 .00
TOTALS....................................... : 168.31 .00 168.31
10417 ENTRUST INSURANCE & BENEFI
INSURANCE PREMIUMS EN022989 090412 090112 090112 14556.40 .00 14556.40 ...-
TOTALS....................................... : 14556.40 .00 14556.40
F1400 FISHER HEALTHCARE
SUPPLIES LAB H 0171139 082912 081612 091512 146.88 .00 146.88 --
SUPPLIES LAB 9720098 082912 081412 091312 41.74. .00 41. 74 /
SUPPLIES LAB 9720100 082912 081412 091312 67.36. .00 67.36,/
SUPPLIES LAB 9899560 082912 081512 091412 489.B8 .00 489.BB
SUPPLIES LAB 9899575 082912 081512 091412 378.13. .00 378.13/
TOTALS....................................... , 1123.99 .00 1123.99
GIB70 GCLDEN CRESCENT COHllUNICAT
SUPPLIES PLANT OPS H 32662 090512 073012 082912 12.50 .00 12.50 ,.-/
TOTALS...................................... .: 12.50 .00 12.50
A1292 GULF COAST HARDWARE I ACE
SUPPLIES PLANT OPS II 070713 082112 081612 091512 6.99 .00 6.99/
SUPPLIES PLANT OPS 70703 082112 081512 091412 16.86 .00 16.86/
DEPT REPAIR ADHIN 70705 082112 081512 091412 19.94 .00 19.94/
DEPT REPAIR ADHIN 70729 082112 081612 091512 14.07 .00 14.07/
TOTALS....................................... : 57.86 .00 57.86
G1210 GULF COAST PAPER COllPANY
SUPPLIES HOUSEKEEPING II 436755 081712 081412 091312 71.99 .00 71.99./
SUPPLIES HOUSEKEEPING 436757 081712 081412 091312 89.76 .00 89.76 ,.-/
TOTALS...................................... .: 161.75 .00 161. 75
H1399 HILL-ROH CONPANY, INC
SUPPLIESIRENTAL II 23689262 083112 060412 070312 101.93 .00 101. 93 .......-
TOTALS....................................... : 101.93 .00 101. 93
H3400 HUBERT COMPANY 216.52/
SUPPLIES DIETARY II 918241 082112 081412 091312 216.52 .00
TOTALS....................................... : 216.52 .00 216.52
I0415 INDEPENDENCE HEDICAL
SUPPLIES C8 INV 27049492 082112 081512 091412 69.71 .00 69.71 /
TOTALS....................................... : 69.71 .00 69.71
10950 INFOLAB 1NC /
SUPPLIES LAB 1'1 3151944 082912 081312 091212 1144.96 .00 1144.96 /
SUPPLIES BLOOD BANK 3152476 082912 081412 091312 319.80 .00 319.80
TOTALS....................................... : 1464.76 .00 1464.76
J0150 J & J HEALTH CARE SYSTEMS, 255.92 /
SUPPLIES SURGERY 90E412644 082412 081512 091412 255.92 .00
RUN DATE: 09/05/12
TIllE: 17:22
11E!~ORIAL I~EDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 09/18/12
PAGE: 4
APOPEN
VEND#.NAl,lE......................... ..CLS.INVOICE#....... ..TRN DT.INV DT.DUE DT.CK DT..PC...... .GROSS.... .DISC..... .NO-PAY....... . NET
SUPPLIES SURGERY 908225997-1 083112 071812 081712 361. 73 .00 361.73 .,-
TOTALS....................................... : 617.65 .00 617.65
W1369 JACK WU /'"
TRAVEL EXPENSES 1'1 24094 083112 083012 083012 371. 77 .00 371.77
TOTALS....................................... : 371. 77 .00 371.77
H1502 JESUSITA S. HERNANDEZ
TRAVEL EXPENSE PHARlIACY 1'1 24089 083112 080512 080512 204.00 .00 204.00/
TOTALS....................................... : 204.00 .00 204.00
K0530 KCI USA 698.13 ./
SUPPLIES MED SURG H 13564016 p83112 081512 091412 698.13 .00
RENTAL PT 13578343 083112 082112 091812 104.71 .00 104.71 .,/
TOTALS....................................... : 802.84 .00 802.84
10578 LUHINAN'I ENERGY CO!~PANY LL
GAS 7/1/12 - 7/31/12 INV0514034 080712 080112 091612 2377. 01 .00 2377.01 ,./
TOTALS....................................... : 2377.01 .00 2377.01
H1500 HARKS PLUllBING PARTS
SUPPLIES PLANT OPS I~ 1144053 081712 081312 091212 83.90 .00 83.90/
SUPPLIES PLANT OPS 1144679 081712 081412 091312 249.96 .00 249.96'/
INSTRUllENT REPAIR RADIOLO 1145050 082112 081512 091412 22.18 .00 22.18/
SUPPLIES PLANT OPS 1139830 083112 072712 082612 14.00 .00 14.00/
TOTALS....................................... : 370.04 .00 370.04 _
10749 HCKESSON AUTOMATION INC.
CAPITAL 3465886 083112 081312 091212 3855.50 .00 3855.50 ./
CAPITAL 3465887 083112 081312 091212 2458.10 .00 2458.10 ./
!IAINTENANCE PHARHACY 3465888 083112 081312 091212 525.00 .00 525.00./
llAINTENANCE PHARHACY 3465889 083112 081312 091212 1385.42 .00 1385.42/
CAPITAL 3465942 083112 081512 091412 1562.56 .00 1562.56./
TOTALS....................................... : 9786.58 .00 9786.58
M2827 HEDIVATORS
SUPPLIES SURGERY N 1427750 082112 081512 091412 186.00 .00 186.00 ,./
TOTALS....................................... , 186.00 .00 186.00
M2659 HERRY X-RAY- SAN ANTONIO
SUPPLIES VARIOUS II 476884 082112 081612 091512 1741.54 .00 1741.54/
TOTALS....................................... : 1741. 54 .00 1741.54
10441 lR~C EMPLOYEE BENEFITS
WEEKLY CLAIIlS 18243 083112 083112 083112 10044.78 .00 10044.78 /
ADHIN FEES FOR SEPT 18244 083112 083112 083112 15922.00 .00 15922.00 /
TOTALS....................................... : 25966.78 .00 25966.78
10536 HORRIS & DICKSON CO, LLC /
PHARlIACEUIICALS 3730630 083112 082312 091012 548.69 .00 548.69 /
PHARHACEUIICALS 3730665 083112 082312 091012 2882.50 .00 2882.50
RUN DATE: 09/05/12
TIHE: 17:22
HEMORIAL HEDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 09/18/12
PAGE: 5
APOPEN
VEND#.NAlIE...........................CLS.INVOICE#.........TRN DT.INV DT.DUE DT.CK DT..PC.......GROSS.....DISC......NO-PAY........NET
PllAmlACEUTICALS 3731041 083112 082312 091012 1443.56 .00 1443.56 /
PHARHACEUTICALS 3733351 083112 082312 091012 270.70 .00 270.70/
PHARJoIACEUTICALS 3733352 083112 082312 091012 250.40 .00 250.40/'
PllAmlACEUTICALS 3742661 083112 082712 091012 444.78 .00 444.78/
PllAmlACEUTICALS 3742662 083112 082712 091012 2742.00 .00 2742.00/
PHARHACEUTICALS 3742844 083112 082712 091012 38.25 .00 38.25 /
PllAmlACEUTICALS 3747684 083112 082812 091012 55.92 .00 55.92 /
PHAlU'IACEUTICALS 3747685 083112 082812 091012 2165.14 .00 2165.14 /
PllAmlACEUTICALS 3753932 083112 083012 091012 901.62 .00 901.62 ,..-
PllAmlACEUTICALS 3753933 083112 083012 091012 10299.36 .00 10299.36./
PHAlU'IACEUTICALS 3754606 083112 083012 091012 64.94 .00 64.94/'
PllAmlACEUTICALS 3755364 083112 083012 091012 66.41 .00 66.41.r-
PHAlUIACEUTICALS 3758739 083112 083112 091012 92.17 .00 92.17/'
SPLITBILL LIC FEE 5551 083112 080612 090512 1000.00 .00 1000.00/
PHAlUIACEUTICAL CREDIT 8461 083112 082712 091012 -15.86 .00 -15.86....-
PHARHACEUTICAL CREDIT 8820 083112 082912 091012 -29.98 .00 -29.98 ....-
PHAlU,IACEUTICAL SRV CHARGE SC9257 083112 082712 091012 90.76 .00 90.76_
TOTALS....................................... : 23311.36 .00 23311. 36
10188 MATUS llEDICAL INC
INSTRUlIENT REPAIR HEDSURG 30292154 083112 072312 082212 493.86 .00 493.86 -----
TOTALS.............. .........................: 493.86 .00 493.86
10601 NOBLE AJ.lERICAS EMERGY 39332.39 /
ELECTRICITY 7/18-/16 122410002516246 083112 082812 090712 39332.39 .00
TOTALS....................................... : 39332.39 .00 39332.39
N1225 NUTRITION OPTIONS
DIETICIAN AUGUST 1'1 24093 083112 083112 083112 3750.00 .00 3750.00 /'
TOTALS....................................... : 3750.00 .00 3750.00
10709 ONESTAFF llEDICAL, LLC ./
CONTRACT NURSE 6031 082412 081612 091512 2291.00 .00 2291. 00
TOTALS...................................... .: 2291.00 .00 2291. 00
OH425 OWENS & HIMOR
SUPPLIES SURGERY 1974145 081712 081412 091312 17.96 .00 17.96/
SUPPLIES VARIOUS 1974148 081712 081412 091312 182.06 .00 182.06 ,/
SUPPLIES CS INV 1974164 081712 081412 091312 29.26 .00 29.26/'
SUPPLIES VARIOUS 1974202 081712 081412 091312 217.61 .00 217.61 ,
SUPPLIES PT 1974232 081712 081412 091312 53.22 .00 53.22 ./
SUPPLIES VARIOUS 1974406 081712 081412 091312 2202.57 .00 2202.57 ___
SUPPLIES SURGERY 1974409 081712 081412 091312 814.24 .00 814.24/
SUPPLIES CS INV 1975264 082112 081612 091512 100.01 .00 100.01 ../
SUPPLIES CS INV 1975339 082112 081612 091512 23.31 .00 23.31/
SUPPLIES VARIOUS 1975642 082112 081612 091512 1362.51 .00 1362.51 /
SUPPLIES SURGERY 1975602 082912 081612 091512 546.94 .00 546.94 ./
TOTALS....................................... : 5549.69 .00 5549.69
P1100 PC CONNECTION SALES CORP
SUPPLIES IT II 49337216 081512 080812 091712 162.44 .00 162.44 /
RUN DATE: 09/05/12
TIllE, 17:22
MEMORIAL MEDICAL CENTER
AP OPEN INVOIC? LIST THRU DUE DATE OF 09/18/12
PAGE' 6
APOPEN
VEND#.NAl!E.......................... .CLS.INVOICE#........ .TRN DT.INV DT.DUE DT.CK DT. .PC...... .GROSS.... .DISC.... ..NO-PAy....... .NET
LICENSE UPDATE 49365579 082912 081612 091512 2284.00 .00 2284.00/
SUPPLIES IT 49371140 083112 081712 091612 49.94 .00 49.94 /
TOTALS....................................... : 2496.38 .00 2496.38
10032 PHILIPS REALTHCARE
SRV CONTRACT 8/28-9/27 924641716 082412 081312 091212 3185.00 .00 3185.00/
TOTALS....................................... , 3185.00 .00 3185.00
P1600 PRYSIO CONTROL CORPORATION
SUPPLIES CS INV II 113036696 082912 081712 091612 118.00 .00 118.00 _____
TOTALS.............................,......... : 118.00 .00 118.00
P2180 POSITIVE PROHOIIONS
SUPPLIES DIETARY II 04490984 082112 081612 091512 211.75 .00 211.75 /
~M' I \.l...I+!tCo.re week TOTALS....................................... : 211.75 .00 211.75
P2200 PO~~R ELECTRIC
SUPPLIES PLANT OPS 1'1 160114 082112 081312 091212 11.17 .00 11.17 /
SUPPLIES PLANT OPS 160170 082112 081612 091512 10.34 .00 10.34/
TOTALS....................................... : 21.51 .00 21.51
10762 PO~~RVAR, INC.
INSTRm1ENT REPAIR LAB 217203 082112 081312 091212 112.62 .00 112.62 ----
TOTALS..................................... ..: 112.62 .00 112.62
P1725 PREHIER SLEEP DISORDERS CE
SLEEP STUDIES H 115 083112 090512 090512 6175.00 .00 6175.00 --
TOTALS....................................... : 6175.00 .00 6175.00
P2370 PROGRESSIVE DYNAHICS HEDIC
SUPPLIES SURGERY H 129580 082412 081612 091512 66.26 .00 66.26 --
SUPPLIES SURGERY 129617 083112 082412 090512 312.72 .00 312.72 /
TOTALS........... ~...........................: 378.98 .00 378.98
Rl050 R G & ASSOCIATES INC ,./
SUPPLIES PLANT OPS II 203639 083112 082812 082812 131.20 ,00 131.20./
SUPPLIES PLANT OPS 204076 083112 082812 082812 229.60 .00 229.60/
SUPPLIES PLANT OPS 204258 083112 082812 082812 246.00 .00 246.00
lIIX BED SVC FEE 204551 083112 082812 082812 31.50 .00 31.50 -----
TOTALS..o "" II 10.. ........ ...... ,... ," ,....0: 638.30 .00 638.30
R1268 RADIOLOGY UNLIIIITED, PA
READING FEES ~1 24092 083112 082212 082212 540.00 .00 540.00 /
TOTALS....................................... : 540.00 .00 540.00
H1410 REBECCA llALONE
CONTRACT 11 INVOICE#1 083112 090412 090412 542.50 .00 542.50 ./
TOTALS....................................... : 542.50 .00 542.50
R1200 RED HA~IK
HONTHLY CHG AUGUST 7020389342 083112 081712 091612 27.59 .00 27.59/
RUN DATE: 09/05/12
III~E: 17:22
HEHORIAL MEDICAL CENTER
AP OPEN INVOICE LIST THRU DUS DATE OF 09/18/12
PAGE: 7
APOPEN
VEND#.NAlm...........................CLS.INVOICE#....:....TRN DT.INV DT.DUE DT.CK DT..PC.......GROSS.....DISC......NO-PAY........NET
TOTALS....................................... : 27.59 .00 27.59
R1490 ROLANDO REYES ./
TRAVEL EXPENSES lq 24096 083112 083012 083012 287.59 .00 287.59
TOTALS....................................... : 287.59 .00 287.59
10360 RUSSELL CAIN
TRAVEL EXPENSES 24097 083112 083012 083012 287.59 .00 287.59/
TOTALS...................................... ., 287.59 .00 287.59
S1800 SHERWIN WILLIMIS
DEPT REPAIR PFS W 0383-0 082712 081712 091612 60.93 .00 60.93/
TOTALS....................................... : 60.93 .00 60.93
10699 SIGN AD, LTD. /
ADVERTISING JULY 156432 983112 070112 071012 350.00 .00 350.00
TOTALS....................................... : 350.00 .00 350.00
S2400 SO TEX BLOOD & TISSUE CENT
SUPPLIES BLOOD BANK CREDI M 20123773 082912 081712 091612 -2618.00 .00 ./
-2618.00 ./
SUPPLIES BLOOD BANK 20123836 082912 081712 091612 7735.00 .00 7735.00
TOTALS...................................... .: 5117.00 .00 5117.00
10769 SUSAN FOESTER
TRAVEL EXPENSES ADMIN 24098 083112 083012 083012 287.59 .00 287.59/
TOTALS....................................... , 287.59 .00 287.59
I2204 TEXAS ~lUIUAL INSURANCE CO
INSURANCE 8/1 - 8/31 1'1 18242 ~83112 083112 083112 9374.00 .00 9374.00/
TOTALS....................................... : 9374.00 .00 9374.00
10732 THERACOM, LLC
PHARlolACEUTICALS 65376416-301 083112 081712 091612 1300.00 .00 1300.00 /
TOTALS....................................... : 1300.00 .00 1300.00
T0801 TLC STAFFING
CONTRACT NURSE jq 10474 082412 081412 091312 1076.40 .00 1076.40/
TOTALS....................................... : 1076.40 .00 1076.40
T3130 TRI-ANIM HEALTH SERVICES I 274.64 ./
SUPPLIES CS INV II 60802427 082112 081512 091412 274.64 .00
. SUPPLIES CAHDIO 60805186 083112 081912 091812 58.78 .00 58.78 /
TOTALS....................................... : 333.42 .00 333.42
UI064 UNIFIRST HOLDINGS INC
LAUNDRY HOSPITAL LINEN 8400130849 081512 081412 091312 914.10 .00 914.10./
LAUNDRY HOUSEKEEPING 8400130850 081512 081412 091312 182.19 .00 182.19 ./
LAUNDRY PLAZA 8400130851 081512 081412 091312 148.94 .00 148.94/
LAUNDRY DIETARY 8400130852 081512 081412 091312 173.07 .00 173.07'/
LAUNDRY OB 8400130853 081512 081412 091312 86.70 .00 86.70
LAUNDRY HOUSEKEEPING 8400130854 081512 081412 091312 303.87 .00 303.87/
RUN DATE: 09/05/12
TIHE: 17:22
MEMORIAL 11EDICAL CENTER
AP OPEN INVOICE LIST THRU DUE DATE OF 09/18/12
PAGE' 8
APOPEN
VEND#.NAIIE...........................CLS.INVOICE#.........TRN DT.INV DT.DUE DT.CK DT..PC.......GROSS.....DISC......NO.PAY........NET
LAUNDRY HOSPITAL LINEN 8400131083 081712 081712 091612 747.83 .00 747.83 -
LAUNDRY SURGERY 8400131084 081712 081712 091612 348.59 .00 348.59 --
TOTALS....................................... : 2905.29 .00 2905.29
U1056 UNIFORH ADVANTAGE
EHPLOYEE PURCHASE jf 4549078 082912 081312 091212 105.93 .00 105.93/
TOTALS....................................... , 105.93 .00 105.93
V0555 VERIZON SOUTHilEST
TELEPHONES 14 1977697081912 082712 081912 091312 53.38 .00 53.38 /'
TELEPHONES 5521567081912 082712 081912 091312 43.43 .00 43.43
TOTALS....................................... , 96.81 .00 96.81/'
10768 VICTORIA MEDICAL FOUNDATIO
ANNUAL llEMBERSHIP 24091 083112 083012 083012 650.00 .00 650.00 --
TOTALS....................................... , 650.00 .00 650.00
GRAND TOTALS. ....:..... .......... ............, 198502.37 .00 198502.37
c~s~ Not r;{L{/
+0
:l:t I Lf OJ Of I '1
C.M'!!'."lhda~l~ J. ~~
&. 10Lln C
DqtiiJ;~~ JUdge
_ ifo IDS
.:J!; 1L{t1 ~L{&>
::fi:/<.{otCZ5t
=It Itf'i K0.5
6i.1rf?1Ft(!MEltJ
::it\"' 0 6 2012
COlliN'TV AUlJl'fO!"i,
RUN DATE: 09/06/12
TIME: 08:28
MEMORIAL MEDICAL CENTER
EDIT LIST FOR PATIENT REFUNDS ARID=OOOI
PATIENT
NUlIBER
PAY PAT
J\I!OUNT CODE TYPE DESCRIPTION
PAYEE NAl1E
'DATE
PAGE .
APCDEDIT
, 090612
252.99 /
------------------------------------------------------------------------------------------------------------------------------------
GL N1JII
090612
78.80./
090612
58.77/
------------------------------------------------------------------------------------------------------------------------------------
ARID=OOOl TOTAL
390.56
----------------------------------------------------------------------------------------------------------.-.-----------------------
TOTAL
390.56
CKs;tl/ IVqqlf
-to
j/ (119;Lo
APPROVED
:)1;,1-' 0 6 2012
COUNlV .IU.lDlTOR
~~'i3P/t--
Michael J. Pfeifer
g:~~7u1:~~~1~t:-~dge_
Run Date: G8/14/12 MIDlORIAL MEDICAL CENTER Page 84
Time: 08:47 Payroll Register I 8i-Week1y ) P2REG
Pay Period 01/27/12 . 08/G9/12 Run# 1
Final Summary
iu pay Cod e Sum mar y n~.__~_~_n~__n___~__n___________nn_L_ D e due t ion s Sum mar y nn__n_____t
I PayCd Description Hm IOTISHltlEIHOICEI Gross I Code Amount I
t_______n________________________________________________________u______:t____u_______________________________________n_n__t
1 REGIJLAR PAY-Sl 1851.GG N N N 139834.70 AIR 518,34 AWARDS BOOTS
1 REGIJLAR PAY-Sl mO.75 N N N N 35525_21 CAPE-C 679.96 CAFE-D 839.42 CAPE.p
1 REG01AR PAY-Sl 93.25 Y N N 2843.96 CAFE-H 185G.8G CAFE-I 288.G6 CAFE-L 410.14
2 REGIJLAR PAY-S2 2486.75 II N N 51025.69 CAPH 406.33 CANCER 12.68 CLmIC 50.00
2 REGIJLAR PAY-S2 34.75 Y II N 1394.99 CREDUN 25. GG DUN1AL 518.% DEP-LF 2GO.68
3 REGULAR PAY-S3 153J.'15 N N N 35298.61 FEDTAX 31244.85 FlCA-M 4216.06 FlCA-O 12212.G8
3 REGULAR PAY-S3 40.50 Y II N 1582.39 FLEX S 1547.14 FOR1D ruTA
B SICX BONUS 36.00 N N N N 481.44 GIF1 S 145.59 GRANT GRP-IN 129.26
C CALL PAY 2158.65 N .1 II N mUG OTL HOSP-I mUB 10 m
B BX1RA llAG8S II N II II 264.50 LEAF MIse OTHER 1998.71
R EXTRA WAGES N 1 II II N 630.GG PHI PR FIN 417 .54 REPAY
I lNSERVICIl 126.25 N 1 N 1/ 4412.85 S1-IX STUDRlI 129.11 1SA-l
I lNSBRVICIl 16.15 Y 1 N N 567.59 1SA-2 1SA-C 1SA-P
K EXTEUDED- ILLNESS -BANK 80.GG N 1 N II 1510.40 TSA-R 21Gl1.14 1UTlOlI utl/HOS
P PAID-TIME-OFF 82.GG II N N " 7G4.76
P PAID-1Jl{8-0FF 1105.46 II 1 II II 21650.16
X CALL PAY 2 64.00 N N N 11 128.GO
X CALL PAY 2 92.0G N 1 11 N 184.00
Y YMC1\/CURVBS 11 II N N 15.00
, CALL PAY 3 48.GG N II N N 144.00
, CALL PAY 3 48.00 N N N 144.00
L___n___n~________ Grand Totals: 17013,86 ____n_ ( Gross: 302786.27 Deductions: 89016.83 Net: 21l7G9.4~ )
I Checks Count: - Fl' 161 PT 21 Other 31 Female 180 Male 33 Credit OverAmt 10 ZeroNet Term Total: 2131
1_________________~_______._________~___________________________________________________________________________________________1
FED TAX
31.244.85
FICA 0
30,239.44
FICA M
8,432.12
TOTALS
69,916.41
Run Date, 08/14/12
Time: 16:a3
Department 015
MEMORIAL ~rEOICI\L CENTER
I:I<<Y1'o11 Register ( Bi -Weekly}
Pay Period 07/27/12 - 08/09/12 Ruul2
Dept, Sequence
Page 1
moo
*-- Em p 1 0 Y e e Uhhhtu T i III e un_n_..-..__________n_uuh____________.iu D e due t ion S UUhU_U_.Hhou_nn_*
INum/Type/Name{PaY/ExemptIPayCd Dept Hrs [oTlsHIHE[HO[CE[ Rate Gross I Code Aoount [
*________________________i____________________________________________u_________t___________________n_n_____________._______n_*
00073 ,. lid". 24.1200 P 015 265.30 N
N N N 24.1200
6399.04 CAFE-D 1.44 CAFE-H 14.32 FEDTAX 1409.78
FICA-N 92.56 FICA-O 268.10 TSA-R 447.93
Fed-Ex: ShOO St-Ex: -00
Lnn_n_uuh__n_uuu___* Total: 265,30 iW* High Net Pay { Gross: 6399.04
Deductions: 2234.13
Net, 4164.91 J
Department Surrrnary
in Pay Cod e S U III mar y u_______________n_n_n_n__uu_______L. 0 e due t ion s S U III mar Y _____h__n_n"
I PayCd Description Hra' [oTISHIHEIHOICB[ Gross I Code Amount I
i________________________ ______________ __________________________________i________,*_______________u___________u________n__i
P 265.30 II II N II 6399.04 A/R AHARDS BOOTS
CAFE-C CAFE-O 1.44 CAFE-F
CAFE-H 14.32 CAFE-I CAFE-L
CAFE-P CANCER CLINIC
CRRDUN OEIlTAL DEP-LF
FRDTAX 1409.78 FICA-I.j 92.56 FICA-O 268.10
FLEX S FORT D FUTA
GIFT S GRANT GRP-IN
GTL HOSP-I IO TIT
LiAF MISC UTHER
PHI PR FIN REPAY
ST-TX STUDEN" TSA-l
TSA-2 TSA-C TSA-P
TSA-R 447.93 TUTm1 UN/HOS
iu___u______n Department Totals: 265,30 _____n (Gross: 6399,04 Deductions: 2234.13 Net: 4164,91 )
I Checks Count:- FT 1 P'l' Other Female 1 Male Credit OverAmt 1 ZeroKet Term Total: 1 I
* * --" - -" ----- --- --*~- -----. _ _ ~-- -"- -- u _ ___ _ _ _ _____ _ __________ _ _ _ _ _ _ u __ __* _ _ _ _ ___ _ _ _ _ ____ ____ n ___ _ _ _ _ _ n ___ __ _ _ _. _ _ __*_ n_ _ _ _ i
C2J--:if. 0 / tf7 ~
.-V"
,,-
r----------:'
.
Tax Payment R~port Worksheet
EFTPS Voice Response S\ (Photocopy this worksheet for future use.)
IlJ1ill . You dial:
. EFTPS responds:
You enter:
1-800-555-3453
"Welcome to the Electronic Federal Tax Payment System"
"If you are calling from a Touch Tone phone, press 1."
1 (For Touch Tone phone)
nEnter your 9-digit Taxpaye r Identification Number"
~ EFTPSprompts:
You enter:
ITIlJlJfkJ[Q][QJrnmm[Z]
(9-digit Employer Identification Number)
~
:~"ill
EFTPS promts:
You enter:
"Enter your 4-digit PIN"
I 1 digit Personal Identification Numb
~ EFTPS prompts:
You enter:
lists the Main Menu Selections
Press 1 (to initiate a tax pryment)
~ EFTPS prompts:
You enter:
"Enter the Tax Type numberfoilowed by the pound (#) sign.n
mrn WDO D (3-to 6 digit tax type number from
the IRS Tax Form-Table in Appendix A)
EFTPS responds: "You entered Tax Type/Tax Description (Based on the selection in step #5)
'.
~ EFTPS prompts:
You enter:
"Enter Tax Payment Type"
1 digit number Tax Payment Type
(Tax Payment Type specific to Tax Form Code in Appendix D)
~ EFTPS prompts:
You enter:
"Enter th.e 4-digit Tax Filing Period starting with the year followed by month".
rt1 ClJ D n (Valid 4-digit Tax Period based on IRS Tax Fo'rm
'Tati;;' in Appendix A)
. EFTPS prompts:
You enter:
"Enter the payment Amount foilowed by the pound (#) sign."
(You must enter cents even if you are reporting a whole doilar amount.)
$DD,DGj[~JrnGJrm.rnlU ,/
(Your payment amount cannot exceed $99,999,999.99) .
IEl HTPS prompts: Enter the 2-digit Verification Code.n
D D Verification Code*
*(See Appendix E for Verification Code Calculation)
~ EFTPS responds: "Enter the 6-digit tax payment settlement date by month, day, year."
(Note, the next busines'j,date you ente!JPust be at ieast one business doy
in the future)..;' .,/
8\MlA You enter: mE[] I];][];]ITJ GEJ
. Si'l \..lJ;\ ~ ~ (6-digit tax payment settlement day in MMDDYV format)
~~
S46DlRg4b
(Continue)
~ JA)'
tl'VfI.'Y 'M
Run Oat" 06/26/12 MEMORIAL MEDICAL CENTER Page 63
Time: 09:46 Payroll Register I 'i-Reek1y I P2RE<l
Pay Period OB/10/12 . OB/23/12 Run! 1
FinalSUJl1l\1ary
L-payCode Sum 1ii a r Y _H__n___.uuHU_____n_._______u_nni__ D e due t ion s Sum In a r y _____nun__..
1 payCd Description 'rs IOTlsRIREIROI"1 Gross I Code A1llOunt
i_______u_______________n________n______________._______H_____n________fHHHH_n___________n______________n___H____n______i
1 REGULAR PAY-51 7452.00 N N N 131568.91 AIR 535.00 AWARDS BOOTS
1 RBGULllR PAY-51. 1010..s0 II N N N 29089.11 CAPE-C CAF1H 846.94 CAfR-F
1 RIlGtILAR PAY-S1 124,00 Y N N 3644.90 CAFE-R '1804,33 C1lFH-I CAPIl-L
2 REGULAR PAY-52 2451,'15 N N N 50940.70 CAFE-P C7INCER CLrnIC 50.00
2 REGIJIJIR PAY-52 4'J.O[} Y N N 1994.25 CRRDDN 25,00 Dlllll'A1 521.44 D8P-LF
3 RRGULlIR PAY-53 1506,50 H N 1I 34918.89 FIID'fAX .Ua31,15 FICA-M 4254.09 FICA-O 12322,12
3 REGUIJ\R PAY-53 74.00 y N 1I 3331.20 F1IlXS FORT D FlITA
C CALL PAY 2392.90 N 1 N 1I 521'1.8(1 GIFr S 21n.28 GRANT GRP-llr
" EXTRA WAGES N N 1I 1I 38B.1n GTL HOOP-I 4234,32 In TIiT
E EXTRA WAGES N 1 N N N 1050.00 LEAF MISC OTHHR 1627.46
F FlIlIllEAL LEAVE 24.00 N 1 11 N 269.52 PHI PR Fill REPAY
I U1SERVICR 75.25 N .1 N N 2262.59 ST-TX S'!U1JEN 130,49 TSA-1
I INSERVICE 1.25 y 1 N 1I 50.14 T811-2 'ISII-C TSA~P
K EXfENDED- ILLNESS-BANK 32.00 1I II 11 1I 641.60 TSA-R 21011.76 'fUTION m1/ROS
K EXtElIDED-ILLNESS-BANK 296.00 II N 1I 4377.34
M MEAL REIMBURSHMEIIT' 1I N 1I 1I 23.62
P PAlD-TlME-OFF 40,00 N N 1I 1I 746.52
P PAID-TIME-OPF 1120.00 N N H 24902.24
X CALL PAY 2 96.00 N 1I II N 192.00
X CALL PAY 2 64.00 II N " 128.00
Z C'llLL PAY 3 48.00 N N N 11 144.00
Z CALL PAY 3 48.00 N 1I N 144.00
*~_________~_____h__ Grand Totals: 16903.15 ------- (Gross: 302033.73 Deductions: B5481.38 Net: 216552.35)
[ Checks Count:" Fr 361 1'1 16 Other 34 Female 1B2 Male 31 Credit QtferAmt 15 ZeroNet Term Total: 2131
* __~ ~_~ ~ _ _ _ ____ n _ _ _n _ ______ _n _ _____ n__ ____ ____~____ ___ _ _ _~~__u _ ____ n___n_. _ ~~~ __________~____ _ _ n n n_ _ __~n ~_~ _ _ _ ~ ~_~ ~_ _ t
COMBINED TOTALS
. /
FED TAX 32,086.71
FICA 0 30,844.18'/
/
FICA M 8,600.84
"::\.1.'
"..';..
! ; j.! ~,
TOTALS
71,531.73
Run Date: 08/29/12
Time: 14:50
MEMORIAL MBOICAL CElITER
Payroll Register I Bi -Weekly I
Pay Period 08/10/12 - 08/23/12 Runl 2
Page
P2REG
Final Sul\\lltary
*-~ Pay Cod e Sum mar y ____~~_._.________~_u...un______._....*._ De due t ion s Sum mar y n_h_n_n..f
I PayCd Description Hr' IOTlsHlwEIHOlcBI Gross I Code Amount I
i_d____n______________________________________n_________________._______i________________n._________________________________1
P l1U8 N 1I N N 1080.32 AIR AWARDS BOOTS
CAPE-C CAFE-D CAPB-F
CAFE-H CAFS-I CAFH
CAFE-P CARCER CLINIC
CREDUN DENTAL DEnF
FEOTAX 60.68 FICA-M 15.66 FICA-O 45.37
FLEX S FORT 0 FUTA
GIFT S GR!lIT GRP-IN
GTL HooP-I ID TIT
LEAF MIse OTHER
PHI PR FIN REPAY
ST-TX STODEIl TSA-I
TSA-2 TSA-C TSA-I
TSA-R 75.62 TOTIOH UW/HOS
'"-un_nn____n__n Grand Totals; 116.48 nnn_ ( Gross: lOaO.32 Deductions: 191.33 Net: 882.99 }
I Checks Count:- IT 2 PT Other Female 1 I{ale 1 Credit OverAmt ZeroNet Term Total: 2!
i______________________________________________________________________._._______________________________.._....._._________.___*
~dt:,lf1
e).. tIYR"6
C1c- ~ /'11" 3 bls
~7<r~2
Run Date, 08/30/12
Time: Og:21
Department 080
NENORIALlffiDICAL CElITER
Payroll Register ( Bi.Weekly J
Pay Period 08/10/12 - 08/23/12 Runff 3
Dept. Sequence
Page
P2RW
L. E m p 1 0 Y e e _u_~L. Tim e ..nu___n+un____nnnu_nnn__un___i__ D e due t ion S _______nn______________r
INum/Type/Name/pay/ExernptIPayCd Dept Hrs ImlsHlwEIHOlc81 Rate Gross I Code Aoount I
t________________________'L______...______.______________.__________~____________*____.".__.______._.__________"__n_____ ________*
AOnOll F'I' lh'ly: 26.4400 1 DBl} 80.00 N
N N N 26.4400
2115.20 FEDTA>: 194,88 FICHI 30.67 PICA-O 88.84
TSA-R 148.06
Fed-Ex: IHl St-Ex: 0.00
L_______n_______..________.1: Total: 80,00 _n_____un__n (Gross: 2115,20
Deductions: 462,45
Net, 1652.75 J
Department Summary
L. Pay Cod e Sum mar y nnu____________u____n________n____.L_ D e due t ion s Sum mar y +u_______n_i
I PayCd Description Hrs 10TISHIWEIHOICB! Gross I Code Amount I
*-____________n___..._._n__....________________._________________________*_____________________________~_~""________________ut
80.00 N N N II 2115.20 A/R AWAROS BOOTS
CAFE-C CAFE.O CAFE-F
CAFE.H CAFB.I CAFE-L
CAFE-P CANCER CLINIC
CREDUII DENTAL DEP'LF
FEDTA>: 194.88 FICA.M 30.67 FICA-O 88.84
FLEX S FORT D FUTA
GIFT S GRANT GRp.m
O1L HOSP-I ID TFT
LEAF NISC OTHER
PHI PRFI>> REPAY
ST-TX STUDSN TSA-l
TSA.2 TSA-C TSH
TSA-R 148.06 TUTION OW/HOS
L_______"~_"___ Department Totals: 80.00 "-"---- (Gross: 2115.20 Deductions: 462.45 Net: 1652.75 J
! Cl1ecks Count:- F'r 1 PT Other Female ~Iale 1 Credit OverAmt ZeroNet Term Total: 1 I
*----------------------------"--~-"------" ------------------------------------------------------_________"~"_" __________~~______f
CA..
6/I/F<7/
~,
Tax Payment Report Worksheet
EFTPS Voice Response SI (Photocopy this worksheet for future use.)
11"".i1l1 You dial:
.EFTPS responds:
You enter:
1-800-555-3453
"Welcome to the Electronic Federal Tax Payment System"
J/lfyou are calling from a Touch Tone phone} press 1.1I
1 (For Touch Tone phone)
~ EFTPS prompts: "Enter your 9-digltTaxpayer Identification Number"
You enter: [LJ1JlJ W[Q]/1[] mmm m
(9-d)git Employer Identification Number)
You enter:
llEnter your 4-dlgit,PINII
~I""""
/;;;''::.1
EFTPS promts:.
;ligit Personal Identification Numb
~ EFTPS t .
~ promp $.
You enter,:
Lists the Main Menu Selections
Press 1 (to initiate a tax pryment)
IlliiJ] EFTPS prompts;
You enter:
EFTPS responds;
"Enter the Tax Type number followed by the pound'(#) sign."
rnrn moo D (3-t06digittaxtypenumberfrom
the IRS Tax Form-Table in Appendix A) .
"You entered Tax TypejTax Description (Based on the selection In step #5)
~ EFTPS prompts:
You enter:
lIEJ:1ter Tax Payment Type"
1 digit number Tax Payment Type
(Tax Payment Type specific to Tax Form Code In Appendix D)
IIi\r!J EFTPS prompts:
You enter:
"Enter the 4 digit Tax Filing Period starting with the year followe by month'"
rn []t;] J]:::J [gJ (Valid 4-diglt Tax Period based on IRS Tax Form
Table in Appendix A)
ilmI EFTPS pro~pts:
You enter:
"Enter the payment Amountfollowed by the pound (#) sign."
(You must enter cents even if you are reporting a whole dollar amount.)
$DD,D~rr]mrnl:CJ.ITll?2J
(Your payment amount cannot exceed $99,999,999.99)
_ EFTPS prompts;
Enter the 2-dlglt Verification Code."
D D Verjfjcation Code* .
*(See Appendix E for Verification Code Calculation)
![m!11 EFTPS responds:
v-I ~\ ~\ ,\'0"
~ 4,\~'\\
OY'~*
~6~4D \141
You enter:
"Enter the 6-digit tax payment settlement date by month, day, year."
(Note, the next business date you enter must be at least ane business day
ill the future).
[]][3] 01][K]u=! rn
(6-dlgit tax payment settlement day in MMDDYY format)
(Continue)
~JA/'
ql~l \'Oct
September 27, 2012 2012 APPRO V AL LIST 32
COMMISSIONERS COURT MEETING OF 09/27/12
BALANCE BROUGHT FORWARD FROM PAGE 31 $ 184,528.18
FICA P/R $ 28,827.36
MEDICARE P/R $ 8,038.42
FWH P/R $ 26,816.46
AFLAC P/R $ 4,579.52
NATIONWIDE RETIREMENT SOLUTIONS P/R $ 3,154.48
OFFICE OF THE ATTORNEY GENERAL - C~D SUPPORT P/R $ 1,019.54
PRINCIPAL FINANCIAL GROUP P/R $ 3,203.10
TEXAS ASSOCIATION OF COUNTIES HEBP P/R $ 166,115.1 0
TMPA P/R $ 364.00
UNITED WAY OF CALHOUN COUNTY P/R $ 12.00
ALLIED WASTE SERVICES AlP $ 29.06
AT&T AlP $ 50.04
AT&T MOBILITY AlP $ 89.40
CABLE ONE AlP $ 470.92
CPL RETAIL ENERGY AlP $ 87.1 0
EXXON AlP $ 3,056.75
GBRA AlP $ 36.94
MCI MEGA PREFERRED AlP $ 278.08
SANOFI PASTEUR INC. AlP $ 159.34
SHELL FLEET PLUS AlP $ 1,879.15
VERIZON SOUTHWEST AlP $ 393.20
WAL-MART AP $ 1,085.78
WASTE MANAGEMENT AlP $ 2,141.64
TOTAL AMOUNT FOR APPROVAL $ 436,415.56
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September 27, 2012
2012 APPROVAL LIST
COMMISSIONERS COURT MEETING OF 09/27/12
DEPT. OF CALHOUN COUNTY SHERIFF B B BROWNING
(SHERIFF/JAIL)
BALANCE BROUGHT FORWARD FROM PAGE 5
EXXON/MOBIL
SHELL FLEET PLUS
AlP
AlP
TOTAL AMOUNT FOR APPROVAL
6
$
12,778.11
$
$
4,434.67
3,484.33
$
20,697.11
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Kenneth W. Finster
County Commissioner
County of Calhoun
Precinct 4
September 21,2012
Honorable Michael Pfeifer
Calhoun County Judge
211 S.Ann
Port Lavaca, TX 77979
RE: AGENDA ITEM
Dear Judge Pfeifer:
Please place the following item on the Commissioner's Court Agenda for September 27, 2012.
. Discuss and take necessary action to declare certain items from Port O'Connor
Volunteer Fire Department - Department 680.
Sincerely,
~U/.J~
Kenneth W. Finster
KWF/at
P.O. Bo., 117. Seadrift, TX 77983 . cmail: kCllny.linslcl'@calhouncotx.org. (361) 785-3141 . Fax (361) 785-5602
DECLARE CERTAIN ITEMS IN THE PORT O'CONNOR VOLUNTEER FIRE DEPARTMENT AS
SURPLUS/SALVAGE:
. Bed from Chevy i-Ton: Discard
. Water Tank from 1967 Military Truck: Discard
A Motion to declare the Bed from Chevy i-Ton and water tank from 1967 military truck as surplus/salvage was
made by Commissioner Lyssy and seconded by Commissioner Fritsch.
Commissioners Galvan, Lyssy, Fritsch and Judge Pfeifer all voted in favor.
Calhoun County, Texas
SURPLUS/SALVAGE DECLARATION REQUEST FORM
Department Name: Port 0' Connor Volunteer Fire Department
Requested By: April Townsend for POC VFD
Inventory Reason for Surplus/Salvage
Number Description Serial No. Declaration
I Ror! frnm rho"" 1-Tn ~. .,
1..._< HlR7 .. trllr.k n;"'''"rrl
.
.
.
Kenneth W. Finster
County Commissioner
County of Calhoun
Precinct 4
September 18, 2012
Honorable Michael Pfeifer
Calhoun County Judge
211 S. Ann
Port Lavaca, TX 77979
RE: AGENDA ITEM
Dear Judge Pfeifer:
Please place the following item on the Commissioner's Court Agenda for September 27, 2012.
. Discuss and take necessary action to declare certain items on Precinct 4 Road &
Bridge inventory as surplus/salvage and send to auction.
Sincerely,
~w.#~
Kenneth W. Finster
KWF/at
P.O. Box 177' SClldriH, TX 77983' cHlnil: kCIlIl)'.llllstcl'@calhollllcotx.org' (361) 785-3141 . Fax (361) 785-5602
DECLARE CERTAIN ITEMS OF PROPERTY ON PRECINCT 4 ROAD & BRIDGE INVENTORY AS
SURPLUS/SALVAGE AND SEND TO AUCTION:
Inventory Number
Description
Serial No.
Reason for Surplus/Salvage
24-0156
Case IH 895 Tractor
JJE0016261
Sending to Auction
24-0333
Hyster C832A
A208C1545H
Sending to Auction
24-0172
Case 508SK
JJG0174102
Sending to Auction
24-0165
Rhino FL15 Shredder
A Motion to declare certain items on Precinct 4 Road and Bridge Inventory as surplus/salvage was made by
Commissioner Lyssy and seconded by Commissioner Fritsch.
Commissioners Galvan, Lyssy, Fritsch and Judge Pfeifer all voted in favor.
Calhoun County, Texas
SURPLUS/SALVAGE DECLARATION REQUEST FORM
Department Name: PRECINCT 4 ROAD & BRIDGE
Requested By: COMMISSIONER FINSTER
Inventory Reason for Surplus/Salvage
Number Description Serial No. Declaration
24-0156 CASE IH 895 TRACT~ JJEOO16261 SENDING TO AUCTION
24-0333 HYSTER C832A A208C1545H SENDING TO AUCTION
24-0172 CASE 508SK JJG0174102 SENDING TO AUCTION
24-0165 RHINO FL15 SHREDDE SENDING TO AUCTION
.
BUDGET ADJUSTMENTS:
A Motion to approve the budget adjustments was made by Commissioner Fritsch and seconded by
Commissioner Lyssy.
Commissioners Galvan, Lyssy, Fritsch and Judge Pfeifer all voted in favor.
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PUBLIC DISCUSSION:
Henry Barber/EMS:
What is the process for paying the copier readings like paying the credit card bills? During a short billing cycle,
by the time the bill gets here and processed it is past the due date and late charges are applied.
Judge Pfiefer: Work it out with Rhonda Kokena and see about getting it put on the agenda.
Henry Barber: Have less than 30 days by the time the bilis get here and keep getting late charges.
Rhonda Kokena: It's possible.
* * * *
Commissioner Galvan:
Arranged with the Chairman that ali the courts that have any equipment to be sold at auction wili be sold at
10% cost rather than 25% cost.
Court was adjourned at 10:40 A.M.