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2012-05-24 Regular May Term Held May 24, 2012 COUNTY OF CALHOUN ~ ~ ~ TH E STATE OF TEXAS BE IT REMEMBERED, that on this 24th day of May, 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 Kenneth W. Finster Anita Fricke County Judge Commissioner, Precinct #1 Commissioner, Precinct #2 Commissioner, Precinct #3 Commissioner, Precinct #4 County Clerk Thereupon the following proceedings were had: Commissioner Galvan gave the Invocation and Commissioner Finster led the Pledge to the US Flag and Judge Pfeifer led the Pledge to the Texas Flag. 'I} , PROCLAMATIONS AND PRESENT TO SIMON DESOTO OF THE GALVESTON DISTRICT, US ARMY CORPS OF ENGINEERS: (1) NATIONAL MILITARY APPRECIATION MONTHS (MAY AND JUNE, 2012) Judge Pfeifer announced to Commissioners Court that they will sign a proclamation which is more of a Resolution because the Commissioners and County Judge will sign it. The first Proclamation is declaring May and June 2012 as "National Military Appreciation Months" Whereas the freedom and security that citizens of the United States enjoy today are direct results of the blood shed and continued vigilance given by the United States Armed Forces over the history of our great nation; whereas the sacrifices that such members of the United States Armed Forces and of the family members that support the, have preserved the liberties that have enriched this nation making it unique in the world community' and whereas the United States Congress, in two thousand and four, passed a resolution proclaiming Mayas National Military Appreciation Month, calling all Americans to remember those who gave their lives in defense of freedom and to honor the men and women of all of our Armed Services who have served and are now serving our Country, together with their families; and whereas the months of May and June were selected for this display of patriotism because during these months, we celebrate Victory in Europe eVE) Day, Military Spouse Day, Loyalty Day, Armed Forces Day/Week, National Day of Prayer, Memorial Day, Navy Day, Army Day and Flag Day. It is to be proclaimed that the Calhoun County Commissioners Court does hereby proclaim May and June 2012 as "National Military Appreciation Months" in Calhoun County, and urge all citizens to join the County Judge along with the Galveston District, US Army Corps of Engineers in showing their gratitude by the appropriate display of flags and ribbons during the designated period, not only in Calhoun County, but the entire State of Texas. A Motion was made by Commissioner Galvan and seconded by Commissioner Fritsch to proclaim May and June 2012 as "National Military Appreciation Months". Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Proclamation Declaring May and June, 2012 as "National Military Appreciation Months" WHEREAS, The freedom and security that citizens of the United States enjoy today are direct results of the blood shed and continued vigilance given by the United States Armed Forces over the history of our great nation; and WHEREAS, the sacrifices that such members of the United States Armed Forces and of the family members that support them, have preserved the liberties that have enriched this nation making it unique in the world community; and WHEREAS, the United States Congress, in two thousand and four, passed a resolution proclaiming Mayas National Military Appreciation Month, calling all Americans to remember those who gave their lives in defense of freedom and to honor the men and women of all of our Armed Services who have served and are now serving our Country, together with their families; and WHEREAS, the months of May and June were selected for this display of patriotism because during these months, we celebrate Victory in Europe (VE) Day, Military Spouse Day, Loyalty Day, Armed Forces DaylWeek, National Day of Prayer, Memorial Day, Navy Day, Army Day and Flag Day; NOW, THEREFORE, BE IT PROCLAIMED, that the Calhoun County Commissioners Court does hereby proclaim May and June 2012 as "National Military Appreciation Months" in Calhoun County. and urge all citizens to join me along with the Galveston District. US Army Corps of Engineers in showing their gratitude by the appropriate display of flags and ribbons during the designated period. not only in Calhoun County. but the entire State of Texas. " llt;;y ~ Calhoun County Commissioner, Pet. 2 /~w.~~ Kenneth W. Finster Calhoun County Commissioner, Pet. 4 Attest: Anita Fricke, County Clerk j(~O~~AA()~ By: Deputy Clerk (2) LEARN TO SWIM WELL CAMPAIGN KICKOFF (24TH DAY OF MAY, 2012) Judge Pfeifer announced to Commissioners Court that they will sign a Proclamation declaring the 24th day of May, 2012 as the United States Army Corps of Engineer's Learn to Swim Well Campaign Kickoff whereas the arrival of the summer months brings an increased level of outdoor activities in Calhoun County and throughout the State of Texas, especially with outdoor recreation involving water activities on public beaches, swimming pools, boating in the waters of Calhoun County and other aquatic related activities; and whereas the USACE Galveston District and Southwestern Division provides recreational opportunities to the public including having the most visited recreation areas in the entire Corps; and whereas the USACE Galveston District has a long history of leading the way in safety initiatives for the protection of life and property and whereas the USACE Galveston District understands the important role that education plays in saving lives and requests the assistance of community leaders, volunteers and the public to partner with us to help reduce public fatalities and improve public safety at our lakes, recreational areas and public facilities and whereas the USACE Galveston District encourages residents to raise their awareness of water recreation safety issues and participate in water- safety information to families and people of all ages, whether owners of private pools, users of public swimming facilities or visitors to Texas beaches and water parks; and whereas the USACE Galveston District requests Calhoun County to join us in supporting our goals to achieve a 50 percent reduction in public fatalities from its fiscal year 2011 levels by putting "safety first" and becoming "water aware" when participating in water-related recreational activities. It is to be proclaimed that the Calhoun County Commissioners Court does hereby proclaim the 24th day of May, 2012 as The United States Army Corps of Engineer Galveston District's "Learning to Swim Well Campaign Kickoff" in Calhoun County, and urge all citizens to increase their awareness of water safety while sharing that awareness with others, and assist the USACE in reducing public facilities while working to improve public safety in all recreational areas, not only in Calhoun County, but the entire State of Texas. A Motion was made by Commissioner Lyssy and seconded by Commissioner Fritsch to declare the 24th day of May, 2012 as the United States Army Corps of Engineer's Learn to Swim Well Campaign Kickoff. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Simon DeSoto with the Galveston District, US Army Corps of Engineer's approached Commissioners Court and expressed his appreciation to the Commissioners Court. PROCLAMATION Declaring May 24, 2012 as the United States Army Corps of Engineer's Learn to Swim Well Campaign Kickoff WHEREAS, the arrival of the summer months brings an increased level of outdoor activities in Calhoun County and throughout the State of Texas, especially with outdoor recreation involving water activities on public beaches, swimming pools, boating in the waters of Calhoun County and other aquatic- related activities.. and WHEREAS, the USACE Galveston District and Southwestern Division provides recreational opportunities to the public including having the most visited recreation areas in the entire Corps; and WHEREAS, the USACE Galveston District has a long history of leading the way in safety initiatives for the protection of life and property; and WHEREAS, . the USACE Galveston District understands the important role that education plays in saving lives and requests the assistance of community leaders, volunteers and the public to partner with us to help reduce public fatalities and improve public safety at our lakes, recreational areas and public facilities; and WHEREAS, the USACE Galveston District encourages residents to raise their awareness of water recreation safety issues and participate in water-safety programs conducted by trained and certified professionals to build stronger Corps' and national Water Safety programs; and WHEREAS, the USACE Galveston District requests Calhoun County and the residents of Texas ' support in communicating water safety information to families and people of all ages, whether owners of private pools, users of public swimmingfacilities or visitors to Texas beaches and water parks; and WHEREAS, the USACE Galveston District requests Calhoun County to join us in supporting our goals to achieve a 50 percent reduction in public fatalities from its fiscal year 201 ] levels by putting "safety first" and becoming "water aware" when participating in water-related recreational activities. NOW, THEREFORE, BE IT PROCLAIMED, that the Calhoun County Commissioners Court does hereby proclaim May 24,2012 as THE UNITED STATES ARMY CORPS OF ENGINEER GALVESTON DISTRICT'S "Learning to Swim Well Campaign Kickoff" in Calhoun County, and urge all citizens to increase their awareness of water safety while sharing that awareness with others, and assist the USACE in reducing public fatalities while working to improve public safety in all recreational areas, not only in Calhoun County, but the entire State of Texas. " ADOPTED THIS THE 24th of MA Y, 2012. ~l/LI ~ {Mi; ichaelJ. fe e,C ntyJudge I E. Fritsch lhoun County Commissioner, Pet. 3 1L~ Vern Lyssy Calhoun County Commissioner, Pet. 2 ~W~ Kenneth W. Finster Calhoun County Commissioner, Pet. 4 Attest: Anita Fricke, County Clerk ko Q ~~ ,AAoJJ1t; } By: Deputy Clerk - MEMORIAL MEDICAL CENTER REPORT: Memorial Medical Center presented their monthly report for March, 2012. March's financial operating resulted in a net monthly income of $55,492, contrasted with the budget expectations of a $13,413 loss for the month. Almost all operating volumes in March exceeded February's volumes. A Motion was made by Commissioner and seconded by Commissioner to approve Memorial Medical Center's report. Commissioner Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. ~. Memorial Medical Center CFO Report Month of: March 2012 Overview: March's financial operating resulted in a net monthly income of $55,492, contrasted with the budget expectations of a ($13,413) loss for the month. Almost all operating volumes in March exceeded February's volumes.. Statistics: For the month, total hospital inpatient days were up 15 days from February's totals. Acute days were up 30 days while swing bed days were down 15 days. Average Daily Census was down to 14.29 ADC, reflecting a slight decrease from February's level of 14.76. Average length of stay dropped slightly to 3.33, for a year-to-date total of 3.86. Observation hours were down 216 hours, down 57% for the month. Total clinic visits (including outpatient, ER and specialty clinic visits), were up 225 total visits, while total surgeries were down 30 for the month. Births were down 1 from February. All other ancillary services, including Laboratory, Respiratory Therapy, Physical Therapy and Pharmacy, recorded more patient volume in March over the February results. Balance Sheet: Cash showed an increase from the prior month, up by $493,000. MMC has $2,397,100 in cash, consisting or $1,897,100 in Operating Funds and $500,000 in CD investments, providing 42 days of cash on hand. MMC continues to monitor what the impact would be on its cash balance if the estimated amount due Medicare were to be taken from its current cash balance. The impact is shown, below: November December January February March $1,959,429 $1,920,778 $1,746,789 $1,904,095 $2,397,100 $ 443,500 $ 740,068 $ 997,606 * $1,112,772* $1,154,782 Cash Medicare Payable Net Cash After Deducting Medicare Payable Estimated Cash Increase / (Decrease) From the Prior Month $1,515,929 $1,180,710 $ 749,183 $791,323 $1,242,318 $ 15,644 ($335,219) ($431,527) $ 42,140 $450,995 * Estimated Liability artificially high due to seasonality. As previously stated in prior month reports, it is not unusual for the 3rd party liability to remain high during this time of year, due to higher year-to-date census and revenue. However, this will begin to level out later in the year when lower patient volume and gross patient charges decrease. The adjustment in the interim rates, effective March 1st, already significantly reduced the increase in the estimated 3rd party liability for the month. This reduction in the interim rates, along with the seasonal changes in volume and revenue, is expected to begin reducing the estimated 3rd party liability during future months. Income Statement: Grosspatient revenue showed a increase of over $485,500 from February, due to high patient volumes, a reported. Contrasted to March 2011, this month's gross revenue exceeded last year's total for the same month. Reductions of revenue were up from February's totals by almost $442,000. Total expenses were up from the prior month by $121,000, with salaries, benefits and purchased services expenses showing the largest increases from February. Three paydays in March attributed to the increases in salary and benefit costs reported during the month. Year-to-Date, MMC's net income through March is $127,500, contrasted to the budgeted ytd net income of $11,688 and February 2011 ytd's net income of $107,100. N " ~ N '" g ~ ~ N .. ~ , ~ N ~ m .. i N .. ~ N ~ ., .. 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"' ... o :2 z o ~ U w a: 0. w C lfJ '" W ...l lfJ W lfJ Z W 0. t1i a: W 0. o Iii ~ o ... o .. > 5 ~ lfJ W lfJ Z W a. t1i ::; <( c o ~ c Z <0: :!: Z o :!: ~ U ~ C -5- MEMORIAL MEDICAL CENTER CAPITAL ACQUISITIONS FOR PERIOD ENDED 03/31/12 MONTH DESCRIPTION DEPT BUILDING EQUIPMENT TOTAL 01/12 N/A - - - SUB TOTAL JANUARY - - - 02/12 MEMORIAL WOMEN'S CENTER 027 33,665 - 33,665 SUB TOTAL FEBRUARY 33,665 - 33,665 03/12 ADDED TO MEMORIAL WOMEN'S CENTER 027 420 - 420 SUB TOTAL MARCH 420 - 420 TOTAL $ 33,664.96 $ - $ 33,664.96 -6- MEMORIAL MEDICAL CENTER PATIENT ACCOUNTS RECEIVABLE MARCH, 2012 AGED TRIAL BALANCE: ORIGINAL - Based on time of admission I FINANCIAL CLASS < 30 31 > 60 61 > 90 91> 120 > 121 TOTAL MEDICARE $ 2,093,488 710,521 196,264 178,285 372,093 3,550,651 % 59.0% 20.0% 5.5% 5.0% 10.5% 39.4% MEDICAID $ 453,799 147,147 24,755 30,531 81,740 737,973 % 61.5% 19.9% 3.4% 4.1% 11.1% 8.2% BCBS $ 503,895 121,224 109,349 72,829 206,111 1,013,409 % 49.7% 12.0% 10.8% 7.2% 20.3% 11.2% COMMERCIAL $ 565,468 431,389 233,842 149,730 500,404 1,880,833 % 30.1% 22.9% 12.4% 8.0% 26.6% 20.9% PRIVATE $ 615,989 322,297 397,928 243,803 294,994 1,830,810 % 31.2% 17.6% 21.7% 13.3% 16.1% 20.3% TOTAL $ 4,188,438 1,732,578 962,140 675,178 1,455,342 9,013,676 . % 46.5% 19.2% 10.7% 7.5% 16.2% 100.0% NOTE -- Amounts and percentages may sum to '+' or '-' 1 and 1 % of the total or 100%, respectively, of their particular category due to rounding. AVERAGE DAYS IN PATIENT ACCOUNTS RECEIVABLE: DECEMBER 2011 JANUARY FEBRUARY MARCH APRIL MAY JUNE GROSS 61.64 62.68 63.57 60.16 #REF! #REF! #REF! JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER #REF! #REF! #REF! #REF! #REF! #REF! AGED TRIAL BALANCE: CURRENT FINANCIAL CLASS SOURCE: ACCOUNTANT'S REPORT I FINANCIAL CLASS I < 30 31 > 60 61 :> 90 91 > 120 > 121 TOTAL MEDICARE $ 1,642,313 319,766 107,332 72,636 131,508 2,273,555 % 72.2% 14.1% 4.7% 3.2% 5.8% 25.2% MEDICAID $ 457,506 181,222 40,898 31,153 71,927 782,706 % 58.5% 23.2% 5.2% 4.0% 9.2% 8.7% BCBS $ 391,953 61,022 48,010 13,865 19,727 534,576 % 73.3% 11.4% 9.0% 2.6% 3.7% 5.9% COMMERCIAL $ 545,856 424,022 155,069 81,396 224,747 1,431,090 % 38.1% 29.6% 10.8% 5.7% 15.7% 15.9% PRIVATE PAY $ 880,677 743,248 611,052 499,406 1,023,480 3,757,863 % 23.4% 19.8% 16.3% 13.3% 27.2% 41.7% IN HOUSE $ 317,747 6,917 2,960 924 15,403 343,950 % 92.4% 2,0% 0.9% 0.3% 4.5% 3.8% CREplTS $ (110,064) - - - - (110,064) % 100.0% 0.0% 0.0% 0.0% 0.0% -1.2% HOME HEALTH $ - - - - - - % TOTAL 4,125,988 1,736,197 965,320 699,379 1,486,792 9,013,676 % 45.8% . 19.3% 10.7% 7.8% 16.5% 100.0% NOTE - Amounts and percentages may sum to '+' or '-' 1 and 1 % of the total or 100%, respectively, of their particular category due to rounding. - 7- VI w C) a: <( :r: u III III ON a:.... ~2 w;i' ::::lu zo: w<( >:E w a: z <( U Vi > :r: Q. 1;: I>. w O~ :) VI .... <( Zw o :) in Z Vlw w> ... w o 0: a: I>. . w :) l>:Z 'LU-~ w l>: w :) I>.Z O~ w l>: w :) I>. 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NLt)("()(Y)MNNNN.q Mocic:icidciciou1 V> C V> '" I: '0 .~ .~ ~ '~E ~ ::l c: ~ ~"S"~~~~wt:: .5'~ g~ ~-c~ OJ ~o~ffi~~~~ i~~ijil~ 5 "d""d"or--..mNLf'I"d" OOOONOlDom DOOOmOOOt""t moooooo......o OOOOOOLf"lO oooenooooen "E '" ~ .J:: '" u E a: ~ .!!! ~~ >~ o o ,..: en N ci' LI1 en ~ o ci a ..... o a ui ..... '" en o a N <t o en ..... '" ~ o ci o ..... o <t ,..: N en .....' en LI1 .....' ~ a ci a ..... a LI1 cxi LI1 <0 en a <t .....' ~ a ci a ..... a o N ..... N .....' <0 <t rl ~ a ci a ..... a '" ui en ..... .....' 00 N ",' ~ a ci a ..... MEMORIAL MEDICAL CENTER CHECK REGISTER 03/01/12 THRU 03/31/12 BANK--CHECK---------------------------------------------------- CODE NUMBER DATE AMOUNT PAYEE RUN DATE:04/18/12 . TIME:08:48 PAGE 1 GLCKREG ------------------------------------------------------------------------------------------------------------------------------------ AlP * 147439 03/15/12 A/P 147501 03/01/12 AlP 147502 03/08/12 AlP 147503 03/08/12 A/P 147504 03/08/12 AlP 147505 03/08/12 AlP 147506 03/08/12 A/P 147507 03/08/12 AlP 14750803/08/12 A/P 147509 03/08/12 AlP 147510 03/08/12 AlP 147511 03/08/12 AlP 147512 03/08/12 AlP 147513 03/08/12 A/P 147514 03/08/12 AlP 147515 03/08/12 AlP 147516 03/08/12 A/P 147517 03/08/12 ~/P 147518 03/08/12 . AlP 147519 03/08/12 AlP 147520 03/08/12 AlP 147521 03/08/12 A/P 147522 03/08/12 AlP 147523 03/08/12 AlP 147524 03/08/12 AlP 147525 03/08/12 AlP 147526 03/08/12 A/P 147527 03/08/12 AlP 147528 03/08/12 AlP 147529 03/08/12 AlP 147530 03/08/12 AlP 147531 03/08/12 AlP 147532 03/08/12 A/P 147533 03/08/12 A/P 147534 03/08/12 AlP 147535 03/08/12 AlP 147536 03/08/12 A/P 147537 03/08/12 AlP 147538 03/08/12 AlP 147539 03/08/12 AlP 147540 03/08/12 AlP 147541 03/08/12 A/P 147542 03/08/12 AlP' 147543 03/08/12 AlP 147544 03/08/12 AlP 147545 03/08/12 A/P 147546 03/08/12 AlP 147547 03/08/12 AlP 147548 03/08/12 AlP 147549 03/08/12 100.14CR AUTO PARTS & MACHINE CO 5,000.00 PORT LAVACA ANESTHESIA 43.65 FILTER TECHNOLOGY CO, I 3,185.00 PHILIPS HEALTHCARE 144.66 WHOLESALE ELECTRIC SUPP 22,688.57 SUNTRUST EQUIPMENT FINA 515.00 CENTURION MEDICAL PRODU .00 VOIDED .00 VOIDED 1,371.48 DEWITT POTH & SON 111.94 AMBU INC 9,455.39 MMC EMPLOYEE BENEFITS 481.05 RICK HART 11,240.97 MORRIS & DICKSON CO, LL 1,475.00 ROGERS HOME MEDICAL 1,098.40 ALLIED WASTE SERVICES # 175.00 AHRA 4,570.19 LUMINANT ENERGY COMPANY 44.40 GLENN CRISP 2,400.00 JACKSON NURSE PROFESSIO 375.00 REVISTA de VICTORIA 540.00 SIGN AD, LTD. 305.25 QUALITY CARE STAFFING, 4,238.02 AUSTIN MEDICAL PRACTICE 2,231.25 AUREUS HEALTHCARE LLC 1,564.50 ALCON LABORATORIES INC 67.53 AIRGAS-SOUTHWEST 401.41 ALCO SALES & SERVICE CO 1,226.95 CARDINAL HEALTH 705.01 AT&T MOBILITY 269.50 C R BARD INC 673.06 BAXTER HEALTHCARE CORP 1,753.50 BECKMAN COULTER INC 135.91 BRIGGS HEALTHCARE 488.00 CAD SOLUTIONS, INC 868.00 COASTAL OFFICE PRODUCTS 5,582.55 CITY OF PORT LAVACA 305.56 CDW GOVERNMENT, INC. 74.55 CPSI 1,022.80 SIEMENS HEALTHCARE DIAG 20.00 DOWNTOWN CLEANERS 3,823.08 GE HEALTHCARE 1,973.80 GREAT AMERICA LEASING C 225.00 . GULF COAST DELIVERY 140.47 H E BUTT GROCERY 66.58 INDEPENDENCE MEDICAL 805.53 INFOLAB INC 102.78 M.C. JOHNSON COMPANY IN 1,206.53 JOHNSON & JOHNSON 212.11 VICKY KALISEK -10- , RUN DATE:04/18/12 TlME:08:48 MEMORIAL MEDICAL CENTER CHECK REGISTER 03/01/12 THRU 03/31/12 BANK--CHECK---~------------------------------------------------ CODE NUMBER DATE AMOUNT PAYEE . PAGE 2 GLCKREG ------------------------------------------------------------------------------------------------------------------------------------ A/P 147550 03/08/12 99.69 LOWE'S HOME CENTERS INC A/P 147551 03/08/12 889.60 MEDRAD INC A/P 147552 03/08/12 2,275.92 MERRY X-RAY- SAN ANTONI A/P 147553 03/08/12 22.50 MINNTECH CORPORATION A/P 147554 03/08/12 461. 39 MUSTAIN & ASSOCIATES A/P 147555 03/08/12 23.73 OFFICE DEPOT CREDIT PLA A/P 147556 03/08/12 1,045.20 OUTBURST ADVERTISING A/P 147557 03/08/12 .00 VOIDED A/P 147558 03/08/12 5,854.24 OWENS & MINOR A/P 147559 03/08/12 790.00 PHYSIO CONTROL CORPORAT A/P 147560. 03/08/12 4,425.00 PREMIER SLEEP DISORDERS A/P 147561 03/08/12 125.26 POLYMEDCO INC. A/P 147562 03/08/12 900.00 PORT LAVACA CLINIC ASSO AlP 147563 03/08/12 64.88 POWER ELECTRIC A/P 147564 03/08/12 1,352.30 R G & ASSOCIATES INC A/P 147565 03/08/12 1,160.00 RADIOLOGY UNLIMITED, PA A/P 147566 03/08/12 185.06 SHERWIN WILLIAMS A/P 147567 03/08/12 941.58 SIEMENS MEDICAL SOLUTIO A/P 147568 03/08/12 1,839.00 SO TEX BLOOD & TISSUE C A/P 147569 03/08/12 44.37 THE ST JOHN COMPANIES, A/P 147570 03/08/12 325.00 STRYKER SALES CORP A/P 147571 03/08/12 987.87 SYSCO FOOD SERVICES OF A/P 147572 03/08/12 914.15 TLC STAFFING A/P 147573 03/08/12 350.05 TEXAS ELECTRICAL SUPPLY A/P 147574 03/08/12 6,236.00 TEXAS MUTUAL INSURANCE A/P 147575 03/08/12 1,110.36 UNIFIRST HOLDINGS INC A/P 147576 03/08/12 855.19 UNITED PARCEL SERVICE A/P 147577 03/08/12 1,000.00 US POSTAL SERVICE A/P 147578 03/08/12 97.01 VERIZON SOUTHWEST A/P 147579 03/08/12 62.00 THE VICTORIA ADVOCATE A/P 147580 03/08/12 181.15 WALMART COMMUNITY A/P 147581 03/08/12 146.00 DEBORAH WITTNEBERT A/P 147582 03/08/12 30.00 MIRNARVA R CHAVARRIA A/P 147583 03/08/12 2,475.00 IRENE P DUENEZ AlP 147584 03/08/12 506.25 AUDREY A LARBALESTRIER A/P 147585 03/08/12 20.00 DONN STRINGO A/P 147586 03/08/12 1,132.00 BETTYE L HAMMONS A/P 147587 03/08/12 1,108.00 RUBY PARRISH A/P 147588 03/08/12 179.20 WILLIE CARL GAINES A/P. 147589 03/08/12 60.38 KAY F KEY A/P 147590 03/08/12 20.40 MELISSA SHIPP A/P 147591 03/08/12 12.05 FRANCES FLOYD A/P 147592 03/08/12 70.00 MARIA OROZCO AlP 147593 03/16/12 10,320.70 OMNI-PORT LAVACA 07, L. A/P 147594 03/16/12 3,577.64 US FOOD SERVICE A/P 147595 03/16/12 148.52 PHARMEDIUM SERVICES LLC A/P 147596 03/16/12 750.00 JAMES A DANIEL A/P 147597 03/16/12 9,166.67 HITACHI MEDICAL SYSTEMS A/P 147598 03/16/12 220.00 JENISE SVETLIK A/P 147599 03/16/12 457.61 CENTURION MEDICAL PRODU AlP 147600 03/16/12 .00 VOIDED ':""'11- I RUN DATE:04/18/12 TlME:08:48 MEMORIAL MEDICAL CENTER CHECK REGISTER 03/01/12 THRU 03/31/12 BANK--CHECK---------------------------------------------------- CODE NUMBER DATE AMOUNT PAYEE PAGE 3 GLCKREG ---~---------------------------------------------------------------------------------------------------------------------~---------- AlP 147601 03/16/12 1,288.38 DEWITT POTH I< SON AlP 147602 03/16/12 400.00 WILLIAM E HElKAMP, TRUS AlP 147603 03/16/12 28,938.70 ENTRUST INSURANCE I< BEN AlP 147604 03/16/12 495.00 WILLIAM E HEITKAMP, TRU AlP 147605 03/16/12 40,994.00 MMC EMPLOYEE BENEFITS AlP 147606 03/16/12 786.14 RHINO MEDICAL SERVICES AlP 147607 03/16/12 23.50 VELMA ESCAMIA AlP 147608 03/16/12 .00 VOIDED AlP 147609 03/16/12 9,552.35 MORRIS I< DICKSON CO, LL AlP 147610 03/16/12 126.73 IPC, INC AlP 147611 03/16/12 200.00 ROGERS HOME MEDICAL AlP 147612 03/16/12 23,106.67 NOBLE AMERICAS ENERGY AlP 147613 03/16/12 34.50 RED HUMMINGBIRD PHOTOGR AlP 147614 03/16/12 29.50 QUEST DIAGNOSTICS AlP 147615 03/16/12 2,304.00 JACKSON NURSE PROFESSIO AlP 147616 03/16/12 7,192.00 ONESTAFF MEDICAL, LLC AlP 147617 03/16/12 300.00 CHRIS RAMIREZ, JR. AlP 147618 03/16/12 544.64 PRUDENT PUBLISHING COMP AlP 147619 03/16/12 624.75 AUREUS HEALTHCARE LLC AlP 147620 03/16/12 132.95 PORT LAVACA HARDWARE AlP 147621 03/16/12 87.90 ACTION LUMBER AlP 147622 03/16/12 345.89 AMERISOURCEBERGEN DRUG AlP 147623 03/16/12 20.00 ALCON LABORATORIES INC AlP 147624 03/16/12 420.77 CARDINAL HEALTH AlP 147625 03/16/12 52.20 AQUA BEVERAGE COMPANY AlP 147626 03/16/12 3,340.08 BAXTER HEALTHCARE CORP AlP 147627 03/16/12 270.48 BECKMAN COULTER INC AlP 147628 03/16/12 125.95 BEEKLEY MEDICAL AlP 147629 03/16/12 35.06 BRIGGS HEALTHCARE AlP 147630 03/16/12 25.00 CAL COM FEDERAL CREDIT AlP 147631 03/16/12 269.50 CERTIFIED LABORATORIES AlP 147632 03/16/12 650.00 COMPUTER COMMAND CORPOR AlP 147633 03/16/12 193.15 CDW GOVERNMENT, mc. AlP 147634 03/16/12 22.29 THE COUNCIL COMPANY AlP 147635 03/16/12 14,148.22 CPSI AlP 147636 03/16/12 121.52 MELISSA HOPPER AlP 147637 03/16/12 3,841.61 SIEMENS HEALTHCARE DIAG AlP 147638 03/16/12 16.65 AMY DAY AlP 147639 03/16/12 223.00 DATEX-OHMEDA AlP 147640 03/16/12 4,822.62 FISHER HEALTHCARE AlP 147641 03/16/12 250.00 GULF COAST PAPER COMPAN AlP 147642 03/16/12 143.47 H E BUTT GROCERY AlP 147643 03/16/12 79.44 HALL WIRELESS AlP 147644 03/16/12 13.50 HAYES ELECTRIC SERVICE AlP 147645 03/16/12 31.26 INDEPENDENCE MEDICAL AlP 147646 03/16/12 93.46 INGENIX, INC AlP 147647 03/16/12 32.98 JACK L. MARCUS, INC AlP 147648 03/16/12 110.00 VICKY KALISEK AlP 14764903/16/12 181. 40 LABCORP OF AMERICA HOLD AlP 147650 03/16/12 435.55 MMC AUXILIARY GIFT SHOP AlP 147651 03/16/12 165.00 NFPA PROFESSIONAL DEVEL -12..,.. , RUN DATE:0.4/18/12 TlME:08:48 MEMORIAL MEDICAL CENTER CHECK REGISTER 03/01/12 THRU 03/31/12 BANK--CHECK---------------------------------------------------- CODE NUMBER DATE AMOUNT PAYEE PAGE 4 GLCKREG ------------------------------_._-----~---------------------------~--------------~--------------------------------------------------- A/P 147652 03/16/12 .00 VOIDED A/P 147653 03/16/12 3,446.89 OWENS &: MINOR A/P 147654 03/16/12 229.00 PITNEY BOWES INC A/P 147655 03/16/12 26.86 POWER ELECTRIC A/P 147656 03/16/12 30.92 SHERWIN WILLIAMS A/P 147657 03/16/12 6.48 STRICTLY BUSINESS A/P 147658 03/16/12 .88.77 DANETTE BETHANY A/P 147659 03/16/12 863.18 SYSCO FOOD SERVICES OF A/P 147660 03/16/12 30,071. 24 TEAM REHAB A/P 147661 03/16/12 9,874.50 TOSHIBA AMERICA MEDICAL A/P 147662 03/16/12 133.90 TEXAS WIRED MUSIC INC A/P 147663 03/16/12 144 . 23 TG A/P 147664 03/16/12 995.71 TORCH A/P 147665 03/16/12 63.99 USI INC A/P 147666 03/16/12 32.54 UNIFIRST HOLDINGS A/P 147667 03/16/12 2,530.81 UNIFIRST HOLDINGS INC A/P 147668 03/16/12 76.20 UNITED AD LABEL CO INC A/P 147669 03/16/12 144.01 VERIZON SOUTHWEST A/P 147670 03/16/12 12.40 THE VICTORIA ADVOCATE A/P 147671 03/16/12 375.00 CARMEN C. ZAPATA-ARROYO A/P 147672 03/16/12 100.00 THOMAS PORTER A/P 147673 03/16/12 16.77 ROBERT COEN A/P 147674 03/16/12 28.14 ROBERT COEN A/P 147675 03/16/12 17.12 NANCY L MAYER A/P 147676 03/16/12 31.44 NANCY L MAYER A/P 147677 03/16/12 200.00 JOSEPH JUSTIS A/P 147678 03/16/12 50.00 CHARLENE ST CLAIRE A/P 147679 03/16/12 168.00 RUSSELL PILZNER A/P 147680 03/21/12 36.29 POJO'S LIQUOR &: GIFTS A/P 147681 03/22/12 56.83 CUSTOM MEDICAL SPECIALT A/P 147682 03/22/12 154.70 PHILIPS HEALTHCARE A/P 147683 03/22/12 281. 00 CHRIS KOVAREK A/P 147684 03/22/12 4,453.45 US FOOD SERVICE A/P 147685 03/22/12 6,012.05 ARUP LABORATORIES A/P 147686 03/22/12 907.97 CENTURION MEDICAL PRODU A/P 147687 03/22/12 18,745.48 MMC EMPLOYEE BENEFITS A/P 147688 03/22/12 236.80 INTERSTATE ALL BATTERY A/P 147689 03/22/12 278.50 CLINICAL &: LABORATORY A/P 147690 03/22/12 5,211.84 VISA A/P 147691 03/22/12 6,580.31 ALERE NORTH AMERICA INC A/P 147692 03/22/12 7,741.24 MORRIS &: DICKSON CO, LL A/P 147693 03/22/12 17,825.00 CPP WOUND CARE #28,LLC A/P 147694 03/22/12 1,648.50 TEAM HEALTH MEDICAL CAL A/P 147695 03/22/12 31.34 CAREFUSION 2200, INC A/P 147696 03/22/12 274.96 CENTURYLINK . A/P 147697 03/22/12 1,567.69 AMNISURE INTERNATIONAL, A/P 147698 03/22/12 495.00 FASTHEALTH CORPORATION A/P 147699 03/22/12 599.70 QUALITY CARE STAFFING, A/P 147700 03/22/12 2,168.98 AUSTIN MEDICAL PRACTICE A/P 147701 03/22/12 150.00 CLIA LABORATORY PROGRAM A/P 147702 03/22/12 200.00 THE METHODIST HOSPITAL -13- MEMORIAL MEDICAL CENTER CHECK REGISTER 03/01/12 THRU 03/31/12 BANK--CHECK-------------~-------------------------------------- CODE NUMBER DATE AMOUNT PAYEE RUN DATE:04/18/12 TIME:08:48 PAGE 5 GLCKREG -------------------------------------------------------------------------------------------------------.----------------------------- A/P 147703 03/22/12 2,905.77 ANDERSON CONSULTATION S A/P 147704 03/22/12 12.26 PORT LAVACA HARDWARE A/P 147705 03/22/12 2,904.60 AIRGAS-SOUTHWEST A/P 147706 03/22/12 3,562.06 AFLAC . A/P 14 7707 03/22/12 516.53 ARROW INTERNATIONAL INC A/P 147708 03/22/12 5.49 AUTO PARTS & MACHINE CO A/P 147709 03/22/12 578.98 BAXTER HEALTHCARE CORP A/P 147710 03/22/12 5,705.46 BECKMAN COULTER INC A/P 147711 03/22/12 435.00 BMI A/P 147712 03/22/12 324.96 CABLE ONE A/P 147713 03/22/12 199.50 CENTRAL DRUGS A/P 147714 03/22/12 27.56 CHUBB SECURITY SYSTEMS A/P 14 7715 03/22/12 205.00 COMPUTER COMMAND CORPOR A/P 147716 03/22/12 188.00 CONMED CORPORATION A/P 147717 03/22/12 1,440.00 SUDDENLINK MEDIA A/P 147718 03/22/12 186.60 CPSI A/P 147719 03/22/12 172.08 DIVERSIFIED BUSINESS SY A/P 147720 03/22/12 322.00 DOWNTOWN CLEANERS A/P 147721 03/22/12 172.18 DLE PAPER & PACKAGING A/P 147722 03/22/12 64.20 DYNATRONICS CORPORATION A/P 147723 03/22/12 19.43 FASTENAL COMPANY A/P 147724 03/22/12 49.92 FEDERAL EXPRESS CORP. A/P 147725 03/22/12 1,133.87 FISHER HEALTHCARE A/P 147726 03/22/12 495.00 FORT BEND SERVICES, INC A/P 147727 03/22/12 195.09 GULF COAST PAPER COMPAN A/P 147728 03/22/12 514.05 INFOLAB INC A/P 147729 03/22/12 312.90 INGENIX, INC A/P 147730 03/22/12 1,924~29 INSTRUMENTATION LABORAT A/P 147731 03/22/12 91. 92 JACK L. MARCUS, INC A/P 147732 03/22/12 297.44 JOHNSON & JOHNSON A/P 147733 03/22/12 159.17 VICKY KALISEK A/P 147734 03/22/12 69.63 MARKS PLUMBING PARTS A/P 147735 03/22/12 201. 78 MARKETLAB, INC A/P 147736 03/22/12 267.20 MEDRAD INC A/P 147737 03/22/12 29.96 MELSTAN, INC. A/P 147738 03/22/12 258.52 METLIFE A/P 147739 03/22/12 1,299.08 MERRY X-RAY- SAN ANTONI A/P 147740 03/22/12 291.52 OUTBURST ADVERTISING A/P 147741 03/22/12 .00 VOIDED A/P 147742 03/22/12 .00 VOIDED A/P 147743 03/22/12 10,246.62 OWENS & MINOR A/P 147744 03/22/12 201. 00 PC MALL A/P 147745 03/22/12 635.50 PORT LAVACA WAVE A/P 147746 03/22/12 51. 98 POWER ELECTRIC A/P 147747 03/22/12 92.67 PROGRESSIVE DYNAMICS ME A/P 147748 03/22/12 891. 67 RECEIVABLE MANAGEMENT, A/P 147749 03/22/12 12.64 SHERWIN WILLIAMS A/P 14 7750 03/22/12 697.58 SIEMENS MEDICAL SOLUTIO A/P 147751 03/22/12 3,888.00 SO TEX BLOOD & TISSUE C A/P 147752 03/22/12 205.00 THE ST JOHN COMPANIES, A/P 147753 03/22/12 126.60 STRYKER SALES CORP -14- RUN DATE:04/18/12 TIME:08:48 MEMORIAL MEDICAL CENTER CHECK REGISTER 03/01/12 THRU 03/31/12 BANK--CHECK---------------------------------------------------- CODE NUMBER DATE AMOUNT PAYEE PAGE 6 GLCKREG ----------------------------------------------------------------------------------------------------------------~------------------- AlP 147754 03/22/12 343.55 SUN COAST RESOURCES, IN AlP 147755 03/22/12 1,626.63 SYSCO FOOD SERVICES OF AlP 147756 03/22/12 589.56 STERICYCLE, INC AlP 147757 03/22/12 1,019.73 TLC STAFFING AlP 147758 03/22/12 4,291.00 T-SYSTEM, INC. AlP 147759 03/22/12 70.37 TRI-ANIM HEALTH SERVICE AlP 147760 03/22/12 4,182.73 UNUM LIFE INS CO OF AME AlP 147761 03/22/12 32.54 UNIFIRST HOLDINGS AlP 147762 03/22/12 641. 66 UNIFORM ADVANTAGE AlP 147763 03/22/12 2,422.87 UNIFIRST HOLDINGS INC AlP 147764 03/22/12 1,200.00 US POSTAL SERVICE AlP 147765 03/22/12 1,800.49 VERIZON SOUTHWEST AlP 147766 03/22/12 194.69 GRAINGER AlP 147767 03/22/12 95.74 VERONICA SERRILL AlP 147768 03/22/12 4,140.37 MICHAEL J. DICLEMENTE, AlP 147769 03/29/12 242.20 PHILIPS HEALTHCARE AlP 147770 03/29/12 1,737.09 PRINCIPAL LIFE AlP 147771 03/29/12 220.00 JENISE SVETLIK AlP 147772 03/29/12 814.58 CENTURION MEDICAL PRODU AlP 147773 03/29/12 14,277.98 ENTRUST INSURANCE & BEN AlP 147774 03/29/12 495.00 WILLIAM E HEITKAMP, TRU AlP 147775 03/29/12 20,800.30 MMC EMPLOYEE BENEFITS AlP 147776 03/29/12 239.85 INTERSTATE ALL BATTERY AlP 147777 03/29/12 3,000.00 BR HEALTHCARE SERVICES AlP 147778 03/29/12 5,742.85 MORRIS & DICKSON CO, LL AlP 147779 03/29/12 600.00 TELE-PHYSICIANS, P.A. AlP 147780 03/29/12 6,912.00 JACKSON NURSE PROFESSIO AlP 147781 03/29/12 375.00 REVISTA de VICTORIA AlP 147782 03/29/12 289.48 CAREFUSION 2200, INC AlP 147783 03/29/12 350.00 SIGN AD, LTD. AlP 147784 03/29/12 76.95 FAGAN ANSWERING SERVICE AlP 147785 03/29/12 146.90 INSIDE SKIES AlP 147786 03/29/12 2,088.00 ONE STAFF MEDICAL, LLC AlP 147787 03/29/12 675.00 CHRIS RAMIREZ, JR. AlP 147788 03/29/12 180.00 PALACIOS COMMUNITY MEDI AlP 147789 03/29/12 785.17 ANDERSON CONSULTATION S AlP 147790 03/29/12 97.41 PORT LAVACA HARDWARE AlP 147791 03/29/12 104.00 ACTION LUMBER AlP 147792 03/29/12 31.08 AMERISOURCEBERGEN DRUG AlP 147793 03/29/12 29.75 ADVANCE MEDICAL DESIGNS AlP 147794 03/29/12 477.00 ALCON LABORATORIES INC AlP 147795 03/29/12 1,022.73 AIRGAS-SOUTHWEST AlP 147796 03/29/12 140.00 AFLAC AlP 147797 03/29/12 99.90 NADINE GARNER AlP 147798 03/29/12 1.03 AT&T MOBILITY AlP 147799 03/29112 44.39 AUTO PARTS & MACHINE CO AlP 147800 03/29/12 381. 65 C R BARD INC AlP 147801 03/29/12 656.24 BAXTER HEALTHCARE CORP AlP 147802 03/29/12 .00 VOIDED AlP 147803 03/29/12 23,713.01 BECKMAN COULTER INC AlP 147804 03/29/12 215.00 BOSTON SCIENTIFIC CORPO -15- MEMORIAL MEDICAL CENTER CHECK REGISTER 03/01/12 THRU 03/31/12 BANK--CHECK---------------------------------------------------- CODE NUMBER DATE AMOUNT PAYEE RUN DATE:04/18/12 . TIME:08:48 PAGE 7 GLCKREG ------------------------------------------------------------------------------------------------------------------------------------ AlP 147805 03/29/12 25.00 CAL COM FEDERAL CREDIT AlP 147806 03/29/12 3,059.00 COASTAL OFFICE PRODUCTS AlP 147807 03129/12 1,085.49 COLLECTIONS INCORPORATE AlP 147808 03/29/12 11,712.16 CPSI AlP 147809 03/29/12 3,295.93 SIEMENS HEALTHCARE DIAG AlP 147810 03/29/12 84.00 EDWARDS LIFESCIENCES AlP 14781103129/12 34.99 FASTENAL COMPANY AlP 147812 03/29/12 3,352.69 FISHER HEALTHCARE AlP 147813 03/29/12 171.00 GE MEDICAL SYSTEMS, INF A/P 147814 03/29/12 122.59 GRAPHIC CONTROLS LLC AlP 147815 03/29/12 191. 35 GULF COAST PAPER COMPAN A/P 147816 03/29/12 95.18 H E BUTT GROCERY AlP 147817 03/29/12 461.91 INDEPENDENCE MEDICAL AlP 147818 03129112 4,870.00 IKON FINANCIAL SERVICES A/P 147819 03/29/12 2,840.49 INFOLAB INC AlP 147820 03/29/12 710.55 JOHNSON &: JOHNSON AlP 147821 03/29/12 117.04 VICKY KALISEK AlP 147822 03/29/12 129.00 MARKS PLUMBING PARTS AlP 147823 03/29/12 98.51 MERCURY MEDICAL AlP 147824 03/29/12 123.40 MMC AUXILIARY GIFT SHOP AlP 147825 03/29/12 133.83 MERRY X-RAY- SAN ANTONI AlP 147826 03/29/12 2,044 .10 MERIDIAN BIOSCIENCE AlP 147827 03/29/12 229.36 PATRICIA OWEN AlP 147828 03/29/12 .00 VOIDED AlP 147829 03/29/12 .00 VOIDED AlP 147830 03/29/12 3,823.43 OWENS &: MINOR AlP 147831 03/29/12 201.31 PENTAX MEDICAL COMPANY AlP 147832 03/29/12 32.74 POWER ELECTRIC AlP 147833 03/29/12 148.98 PROGRESSIVE DYNAMICS ME AlP 147834 03/29/12 207.67 R &: D BATTERIES INC AlP 147835 03129/12 172.20 R G &: ASSOCIATES INC AlP 147836 03129/12 465.00 RADIOLOGY UNLIMITED, PA AlP 147837 03/29/12 126.86 SERVICE SUPPLY OF VICTO AlP 147838 03/29/12 58.99 SHERWIN WILLIAMS AlP 147839 03/29/12 20.00 THE ST JOHN COMPANIES, AlP 147840 03/29/12 320.00 STANFORD VACUUM SERVICE AlP 147841 03/29/12 35.00 DANETTE BETHANY AlP 147842 03/29/12 194.50 ERIN CLEVENGER AlP 147843 03129112 15,000.00 TEAM REHAB AlP 147844 03/29/12 470.30 TLC STAFFING A/P 147845 03/29/12 367.37 TEXAS ELECTRICAL SUPPLY AlP 147846 03/29/12 143.80 TG AlP 147847 03/29/12 2,632.00 T-SYSTEM, INC. AlP 147848 03/29/12 223.41 TRI-ANIM HEALTH SERVICE AlP 147849 03/29/12 32.54 UNIFIRST HOLDINGS AlP 14785003/29/12 237.91 UNIFORM ADVANTAGE A/P 147851 03/29/12 2,538.38 UNIFIRST HOLDINGS INC AlP 147852 03/29/12 108..66 VERIZON WIRELESS A/P 147853 03/29/12 15.00 VITAL STATISTICS A/P 147854 03/29/12 78.64 CHARLENE HORNE AlP 147855 03/29/12 12.50 KENNETH WOOLDRIDGE -16- MEMORIAL MEDICAL CENTER CHECK REGISTER 03/01/12 THRU 03/31/12 BANK--CHECK----------------------~----------------------------- CODE NUMBER DATE AMOUNT PAYEE RUN DATE:04/18/12 TIME:08:48 PAGE 8 GLCKREG ------------------------------------------------------------------------------------------------------------------------------------ AlP 147856 03/29/12 AlP 147857 03/29/12 AlP 147858 03/29/12 AlP 147859 03/29/12 AlP 147860 03/29/12 AlP 147861 03/29/12 AlP 147862 03/29/12 AlP 147863 03/29/12 TOTALS: 51. 72 10.45 476.50 22.39 17.82 36.96 25.91 100.00 651,079.44 SANDRA HENKE SUSAN KARL NAW TU GARY G KOLAR EYVONE LORRA HERNANDEZ DONNA FALKSEN CASEY CARTER CINDY HARRIS -17- RUN DATE: 04/04/12 TIME: 14:30 PRTi tle PRDeptName PAGE 1 MEMORIAL MEDICAL CENTER DEFAULT FORMAT FROM DB019 (Y\AI2..Cr\ Z 011- PRTotGross -------------------------------------------------------------------- SUPERVISOR-PURCH/CS PURCHASING REGISTERED NURSE EMERGENCY ROOM REGISTERED NURSE EMERGENCY ROOM DEPARTMENTAL ASSIST MAINTENANCE CS TECH CENTRAL SUPPLY CENTRAL STERILE TECH SURGERY IMAGING TECH HEALTH INFORMATION MANAGEMENT DIRECTOR PFS PATIENT FINANCIAL SERVICES ES AIDE ENVIRONMENTAL SERVICES SHIFT SUPERVISOR DIETARY OFFICE MANAGER MEMORIAL WOMEN'S CENTER IC/EH/RM NURSE INFECTION CONTROL REGISTERED NURSE MED/SURG FOOD SERVICE STAFF DIETARY o R AIDE SURGERY ES AIDE ENVIRONMENTAL SERVICES REGISTERED NURSE EMERGENCY ROOM A.M, SHIFT SUPERVISO ENVIRONMENTAL SERVICES RN TRAUMA COORDINATO EMERGENCY ROOM RN/PACU SUPERVISOR SURGERY REGISTERED NURSE ICU LVN OBSTETRICS SHIFT SUPERVISOR-AM ENVIRONMENTAL SERVICES MANAGER-SURGERY-OPC SURGERY C. N ,0. ADMINISTRATION-CLINICAL SERVIC PAYROLL CLERK ACCOUNTING REGISTERED NURSE MED/SURG LVN OBSTETRICS REGISTERED NURSE ICU . REGISTERED NURSE ICU REGISTERED NURSE OBSTETRICS REGISTERED NURSE MED/SURG REGISTERED NURSE OBSTETRICS REGISTERED NURSE OBSTETRICS LVN MED/SURG ADMINIST ASSISTANT ADMINISTRATION REGISTERED NURSE ICU LVN/SCRUB NURSE/OFFI SURGERY REGISTERED NURSE ICU REGISTERED NURSE SPECIALTY CLINIC LVN OBSTETRICS LVN SURGERY MEDICAL SONOGRAPHER RADIOLOGY REGISTERED NURSE EMERGENCY ROOM RADIOLOGICAL TECH RADIOLOGY RADIOLOGY TECH RADIOLOGY MICRO MT LABORATORY MEDICAL LAB TECH LABORATORY LAB DIRECTOR LABORATORY LAB ASSISTANT LABORATORY MEDICAL LAB TECH LABORATORY . LAB SECRETARY LABORATORY REGISTERED NURSE EMERGENCY ROOM PT TECH II PHYSICAL THERAPY 4706.40 8281. 55 7698.59 3565,63 2765.68 4172,61 1120.88 5719.20 2446,54 2881.19 3460,00 8027,78 5146.03 2100,31 2371.13 1656,54 2491. 25 2238,70 7661. 44 9504.27 2623.82 1199.71 2787.20 9246.30 9797.60 5075,51 10350.76 5166.02 6185,00 436.29 5466.33 6373.66 7748.11 2182.19 3547,02 4725.60 7846.63 4544.35 7388.71 9493.52 754.37 5374.96 8280.61 6683.60 7578.49 900.53 551.55 1423.13 7000.73 3429.02 5582.88 2989.09 7696.44 2240.39 -18- RUN DATE: 04/04/12 MEMORIAL MEDICAL CENTER TIME: 14:30 DEFAULT FORMAT FROM DB019 Run Date: 03/26/12 MEMORIAL MEDICAL CENTER Page B3 PRTitle Time: 13:26 PRDeptName PayrqlRT~~~ ( Bi-week1y ) P2REG ____________nn__n ___ _n____ _____ _n_ ___ ____nJ.a}!miud..l13L09J1L-_ Si3/22/12 Run# 1 PT ASSISTANT PHYSICAL THERAPY 1505.85 PT TE~lhaFsumma PHYSICAL THERAPY 1739.18 PLANT OPS SUPE~ISOR MAINTENANCE 6506,62 ADMINIS.TW~ O\S.sI!'. AOMWiliSll'RAjl'lGN---G1IN-IGAL--SER.lJ.I(;--mm3-3gJ..,-2Q--+-- D e d u c t ion s Sum mar y m_mmm+ REGIStER~l)iNU)RW"iptionoBSTETRICS Hrs 10TISHlWEIHOICBI 64Qtp!l@5 I Code Amount I REGIStERED- NURSE - - - - - -OBSTETRICS- - - - - - - - -- - - -- - - - - - - - - - - - - - - - - - - -ItS 6"1]",75- - + - - - - - - - - - - -- - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - + ED MANAGER REGULAR PAYE~RGENCY ROOM7136. 75 N N N ~m?08j5 A/R 691. 01 AWARDS BOOTS ~ ,~PAY;~ 1115,75 N N N N 3~~8 ~1 CAFE-C CAFE-D 7B7.50 CAFE-F REGISTER~D 1~1lliGlJLAR PAy':'Sf/SURG 110.00 Y N N 3JJtf45~B7 CAFE-H 7917,50 CAFE- I CAFE-L REGISTE~D NTftm.AR PAyOSlPTETRICS 2426.25 N N N 5H~'4~i?8 CAFE-P CANCER CREDUN 25.00 REGISTER\jD ~ PAyOWTETRICS 72.00 Y N N 78~376.~~8 DENTAL 465.00 DEP-LF FEDTAX 32112 .52 REGISTERBD N1IllmLAR PAY8SBTETRICS 14B6. 50 N N N 591~S4 FICA-M 4156.67 FICA-O 12039.96 FLEX S DIRECTOR3UR/~MRR>YQmu.ITY ASSURAN~.25 Y N N 85~~f4~3 FORT D FUTA GIFT S 346.42 LVN C CALL PAY MED/SURG 54.00 N N N N 3111fl,B080 GRANT GRP-IN GTL REGISTERbD ,~PAY SURGERY 2143.50 N 1 N N 74~~B76~0 HOSP-I 4110.00 ID TFT LEAF ~ "~WAGES N N N N tJ4'd8 MISC 60.00 OTHER 1909.89 PR FIN CERTIFIE~ NU~~w~sMED/SURG N 1 N N N 302hs~60 REPAY ST-TX STUDEN 143.80 DIRECTOR1MS/lj!~~E MED/SURG 85.00 N 1 N N 90~~~3 TSA-1 TSA-2 TSA-C REGISTERED N1IRSHRVICE ICU 1.50 Y 1 N N 7797A51'J7 TSA-P TSA-R 20676.01 TUTION REGISTERBD ~LEAVE MED/SURG 2.00 N i. N N 279 Sll.9Si2 UW/HOS SUPERVIS~R L~~IfI~ 80.00 N N N N 49~l19~8~0 REGISTER& ,~emmED-I~~cMJjll: 276.00 N 1 N N 21ai172!6 MJJ "KREIMBlM~lW"" N N N N 1'8. 0 REGISTER~D ~&;.TIME_*RGENCY ROOM 136.00 N N N N 7~m~ 1 REGISTERlpD Nljl~$TIME-()I#:D/SURG 1142.00 N 1 N N 51gSlo54~6 CERTIFIEm NU:miLMYl~ MED/SURG 16.00 N N N N 205532700 LVN X CALL PAY 2 MED/SURG 140.00 N 1 N N 142~,0890 REGISTER~D ~~CURVESICU N N N N 4!jl.5s~0 REGISTER~D ,JrlAA,PAY 3 EMERGENCY ROOM 48.00 N N N N 567~~~0 Z "OILLPAY 3 48.00 N 1 N N 44 0 LVN d Decon TrainlJW~/SURG 3.00 N N N 359 1~ 8 REGISTERED NURSE MED/SURG 5707.74 REGIS'i'ERE1J...NURSEm---MEMallRtCtals: 16605,50 ------- ( Gross: 5!U~J.687 Deductions: 85m .28 Net: 209930.39) CERTlfJllbJackJUR:1l1IDl:AlIlEl'Mm/SeRG22 Other 31 Female 178 Male 3J.63I5r,~$t OverAmt 15 ZeroNet Term Total: 209 I LVN + - - -. -- - - - - - - - - - - - - "NEU/SURG - -- -- - - - - - - - - -. - - - - - - - -- - - -- - - - - - -1"2 22":03- - - - - - - - - - - - - - - - - - - - - - - - -. - - - - - -- - - - - - - - - - - - - - - - - - -. -" - + REGISTERED NURSE MED/SURG 23Q,50 REGISTERED NURSE OBSTETRICS 10476.36 REGISTERED NURSE EMERGENCY ROOM 7129.92 LVN 'I=F~DfSH~ 3 1 3141.51 CERTIFIED NURSE A!Dg-liIEDiSIM~ 2, 12.52 4515.26 LVN MED/SURG 2596.52 REGISTERED NURSE FIG:& 0 29,813.30 2338.26 REGISTERED NURSE ICU 6270.22 REGISTERED NURSE FIOAJ M 8,313.34 6479.16 REGISTERED NURSE ICU 8427.07 REGISTERED NURSE MED/SURG 4937.00 REGISTERED NURSE 1I01f~L 7365,16 RN/OR-PACU SUMERY 70,239.16 2543.32 REGISTERED NURSE SURGERY 7172.78 LVN SURGERY 1133,50 o R TECH SURGERY 4630.57 TRANSCRIPTIONIST HEALTH INFORMATION MANAGEMENT 3710.26 REGISTERED NURSE SURGERY 7998,80 OUT-PT PACU NURSE SURGERY 2859.89 PRESCRIPTION CLERK INDIGENT CARE PROGRAM 2199.77 ASSISTANT BUYER TRANSPORTATION 2520,00 OP COORDINATOR SPECIALTY CLINIC 2765,50 REGISTERED NURSE EMERGENCY ROOM 5687.18 REGISTERED NURSE EMERGENCY ROOM 5684.50 -19- PAGE 2 RUN DATE: 04/04/12 TIME: 14:30 PRTitle PRDeptName -------------------------------------------------------------------- PRTotGross CERTIFIED NURSE AIDE MED/SURG REGISTERED NURSE EMERGENCY ROOM REGISTERED NURSE EMERGENCY ROOM MEDICAL TECHNOLOGIST LABORATORY MT TECH SUPR LABORATORY MEDICAL TECHNOLOGIST LABORATORY LABORATORY ASSISTANT LABORATORY MEDICAL LAB TECH LABORATORY MEDICAL LAB TECH LABORATORY MEDICAL TECHNOLOGIST LABORATORY MEDICAL TECHNOLOGIST LABORATORY LAB ASSISTANT LABORATORY LAB ASSISTANT LABORATORY MEDICAL TECHNOLOGIST LABORATORY MEDICAL LAB TECH LABORATORY MEDICAL LAB TECH LABORATORY LAB ASSISTANT LABORATORY REGISTERED NURSE MED/SURG LICENSED VOCATIONAL MEMORIAL WOMEN'S CENTER REGISTERED NURSE MED/SURG RADIOLOGICAL TECH RADIOLOGY RADIOLOGICAL TECH RADIOLOGY RADIOLOGICAL TECH RADIOLOGY RADIOLOGICAL TECH RADIOLOGY RECEPT/SECRETARY RADIOLOGY RADIOLOGY TECH RADIOLOGY RADIOLOGY TECH RADIOLOGY DIRECTOR-RADIOLOGY RADIOLOGY RADIOLOGY SUPERVISOR RADIOLOGY RADIOLOGY TECH RADIOLOGY RADIOLOGY TECH RADIOLOGY RADIOLOGY TECH. RADIOLOGY RADIOLOGICAL TECH RADIOLOGY SECRETARY/RECEPTION MEMORIAL WOMEN'S CENTER LVN-CPhT PHARMACY REGIST PHARMACY TECH PHARMACY PHARMACIST PHARMACY REGISTERED NURSE EMERGENCY ROOM PT TECH II PHYSICAL THERAPY PT ASSISTANT PHYSICAL THERAPY PT SEC/RECEPTIONIST PHYSICAL THERAPY PT TECH 1 PHYSICAL THERAPY PT ASSISTANT PHYSICAL THERAPY PT TECH 1 PHYSICAL THERAPY CIHCP COORDINATOR INDIGENT CARE PROGRAM TRANSCRIPTION LEADER HEALTH INFORMATION MANAGEMENT HIM DIRECTOR HEALTH INFORMATION MANAGEMENT TRANSCRIPTIONIST/BR HEALTH INFORMATION MANAGEMENT CODING SPECIALIST HEALTH INFORMATION MANAGEMENT FOOD SERVICE STAFF DIETARY FOOD SERVICE STAFF DIETARY FOOD SERVICE STAFF DIETARY SHIFT SUPERVISOR DIETARY FOOD SERVICE STAFF DIETARY CERTIFIED NURSE AIDE MED/SURG MEMORIAL MEDICAL CENTER DEFAULT FORMAT FROM DB019 PAGE 3 2625.30 818.00 3429,51 5342.97 5672.25 5470.02 2364,30 5032.89 4783.69 1960.75 844.75 1846,80 2154.19 767.25 4878.18 1853.75 3135.77 6354,36 3151. 08 4784,89 6925.66 5488.36 6861.09 222.75 2994,90 3060.50 1056.10 8981.05 8311. 99 4770,04 5981.02 459,00 1900.50 2358.76 4245.54 4481.65 15600,00 3812.56 14,63 5848.77 2781. 62 132,50 412.50 1854,00 2763.36 6751. 26 4812.00 2296.25 3691. 01 2374.95 1669.63 947,20 2436.25 2182,50 2620.13 -20- RUN DATE; 04/04/12 TIME; 14:30 PRTitle PRDeptName -------------------------------------------------------------------- PRTotGross FOOD SERVICE STAFF DIETARY FOOD SERVICE STAFF DIETARY DIRECTOR OF DIETARY DIETARY BIO-MED TECHNICIAN BIO MEDICAL ENGINEERING BIO-MED TECHNICIAN BIO MEDICAL ENGINEERING GROUNDSKEEPR/PAINTER MAINTENANCE PLANT OPS SPECIALIST MAINTENANCE SECURITY SUPERVISOR SECURITY ES AIDE ENVIRONMENTAL SERVICES FLOOR TECHNICIAN ENVIRONMENTAL SERVICES ES MANAGER ENVIRONMENTAL SERVICES DIR OF PLANT SERVICE ENVIRONMENTAL SERVICES ES AIDE ENVIRONMENTAL SERVICES ES AIDE ENVIRONMENTAL SERVICES ES AIDE ENVIRONMENTAL SERVICES FLOOR TECHNICIAN ENVIRONMENTAL SERVICES ES AIDE ENVIRONMENTAL SERVICES ES AIDE ENVIRONMENTAL SERVICES ES AIDE ENVIRONMENTAL SERVICES ES AIDE ENVIRONMENTAL SERVICES ES AIDE ENVIRONMENTAL SERVICES SECURITY OFFICER SECURITY SECURITY OFFICER SECURITY SOCIAL WORKER SOCIAL WORK/DISCHARGE PLANNING INSURANCE FU CLERK PATIENT FINANCIAL SERVICES CASHIER/SWITCHBOARD PATIENT FINANCIAL SERVICES UNIT SECRETARY MED/SURG REGISTRTION CLERK PATIENT FINANCIAL SERVICES INSURANCE COORDINATO PATIENT FINANCIAL SERVICES PT ACCOUNT SUPERVISO PATIENT FINANCIAL SERVICES REGISTERED NURSE EMERGENCY ROOM REGISTRATION CLERK PFS - REGISTRATION REGISTRATION CLERK PFS - REGISTRATION LVN MED/SURG SECURITY OFFICER SECURITY REGISTRATION CLERK PFS - REGISTRATION OP CODER/ROI HEALTH INFORMATION MANAGEMENT REGISTRATION CLERK PFS - REGISTRATION MEDICAID COORDINATOR PATIENT FINANCIAL SERVICES REGISTRATION CLERK PFS - REGISTRATION REGISTERED NURSE EMERGENCY ROOM RADIOLOGY TECH RADIOLOGY REGISTRATION CLERK PFS - REGISTRATION REGISTRTION CLERK PFS - REGISTRATION REGISTRATION CLERK PFS - REGISTRATION REGISTRATION CLERK PFS - REGISTRATION R,O.I./R.I.T. HEALTH INFORMATION MANAGEMENT REGISTRATION CLERK PFS - REGISTRATION I.T. DIRECTOR INFORMATION TECHNOLOGY DIRECTOR OF I.T. INFORMATION TECHNOLOGY I,T, SYSTEM ANALYST INFORMATION TECHNOLOGY REGISTRATION CLERK PATIENT FINANCIAL SERVICES ACCOUNTANT ACCOUNTING C. F ,0, ADMINISTRATION C,E,O, ADMINISTRATION MEMORIAL MEDICAL CENTER DEFAULT FORMAT FROM DB019 PAGE 4 1597.48 1881.75 5191. 20 217,50 6483.53 3328.13 4740.07 3381.43 1409.10 2277.70 3291.12 6969.60 1582.30 2902.53 1200.65 2159.50 2125.25 1772.30 1884,00 1759,78 2034.20 2331.13 1617 . 32 7663.20 1912.00 2135.37 2124.42 1685.93 2198,29 2757,13 6024,69 1883.66 994,00 2362,30 2203.44 1861. 83 3448.80 1299.89 2452.95 659.14 6256.65 5284.00 1938,32 469.27 1826.45 1889.84 1682.17 1579.43 6807.58 12432.84 30.75 2224.63 8768.00 15150,00 17657.70 -21- RUN DATE: 04/04/12 TIME: 14:30 MEMORIAL MEDICAL CENTER DEFAULT FORMAT FROM DB019 PAGE 5 PRTitle PRDeptName PRTotGross -------------------------------------------------------------------- ADMINISTR. OFFICER ADMINISTRATION DIRECTOR MM,AP CLERK PURCHASING 5539.20 5654.40 Grand totals Total lines = 221 911504.23 -22- @IHS Source Totals Report Issued 04/18/2012 Calhoun Indigent Health Care 3-1-12 through 3-31-12 For Source Group Indigent Health Care For Vendor: All Vendors Source Description Amount Billed Amount Paid 01 Physician Services 02 Prescription Drugs 05 Lab/x-ray 08 Rural Health Clinics 13 Mmc - Inpatient Hospital 14 Mmc - Hospital Outpatient 15 Mmc - Er Bills 1,950.00 803,97 606.00 1,975.00 8,208.00 37,291.60 19,953.00 370.92 803.97 57.74 1,276.20 5,745.60 16,476.06 8,779.32 Expenditures Reimb/Adjustments 70,834.35 -46.78 33,556.59 -46.78 Grand Total 70,787.57 33,509.81 $126,858.70 i Fiscal Year Payroll/Expenses $6,111.80 VfVL(J1IU (!,tv ~ A f ~aAd:.fU Calhoun County Indigent Coordinotor -23- . " 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 5 2012 Calhoun Indigent Care Patient Case load Approved Denied Removed Active Pending Jan 4 10 2 37 9 Feb 1 17 2 36 11 Mar 4 16 3 38 20 Apr May Jun Jul Aug Sept Oct Nov Dec YTD 9 43 7 111 40 Monthly Avg 3 14 2 37 13 -24- ACCEPT OPERATION STONEGAROEN FY2011 GRANT: Calhoun County Chief Deputy, Mark Daigle requested Commissioners Court accept the Operation Stonegarden FY2011 Grant award of $298,229. The loan was previously approved by Commissioners Court. Mark Daigle wanted to make Commissioners Court and the public aware that with the award of this grant, this has given the Sheriff's office just over $500,000 in the last two years that has been used for equipment and overtime for boots on the ground, This grant requires 1/3 of operations plan to be waterborne. Calhoun County of the old boat, this grant is to enhance capability not to provide but enhance, Because they had an old boat that they've had for a long time, the grant approved they would get a new boat. The sheriff's office also got specialized equipment 4wheelers to patrol beach areas and islands. It's been a real good grant and lucky to get it, looks like they will be eligible to continue receiving this grant with the type of operations they've been bringing in. thank you for your cooperation in this process. Lyssy, there will be no other loan from the general fund for this? Money will not be the entire $298,000, just money that hasn't been reimbursed yet A Motion was made by Commissioner Lyssy and seconded by Commissioner Fritsch to accept Operation Stonegarden FY2011 grant award of $298,000, Commissioner Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor, .,,\ t,- _t'~,' FOR OFFICIAL USE ONLY (~~~~; FEMA \~~ ~~ U.s. Department of Homeland Secul'lty Washington, DC 20472 to WARNING: This document is FOR OFFICIAL USE ONLY (FOUO/LES) April 26, 2012 Department of Homeland Security (DHS), Federal Emergency Management Agency (FEMA), Grant Programs Directorate (GPO), Preparedness Grants Division (PGD), Program Office FY 2011 Operation Stonegarden (OPSG) Operations Order Approval for the State of Texas, Operations Order: Op Order Name: Op Order Number: Op Order Dates: Op Order Total: FY2011 OPSG TX Calhoun County 12-MCAMCA-02-003 Version 0 10/1/2011 to: 8/31/2014 $298,229.00 To Operation Stonegarden Program Coordinators, Please be advised that, based on the Department of Homeland Security, Federal Emergency Management's Operation Stonegarden Grant Program guidelines and special conditions associated with this grant program, the above described Operations Order has been approved. Purchases from the FY2011 OPSG program to include operational overtimelfringe benefits, mileage, per diem and fuel expenses, have been received, reviewed and approved by this program office. The Order has been cleared under the Environmental and Historic Preservation Program (EHP) guidelines as being categorically excluded from further EHP review and is approved by the GPD/PGD Program Office. For additional information on EHP please follow the resource links below. IB 345: https://www. fema.gov/pdf/government/grant/bulletins/inf0345.pdf Final PEA: https:/lwww. fema.gov/pdf/government/grant/bulletins/gpd_finaLpea_201 O. pdf Final FONSI: https://www.fema.gov/pdf/government/grant/bulletins/fonsi.pdf As expressed in grant guidance, construction, construction type activities, lethal or less than lethal forces, including but not limited to: weapons, guns, ammo, stun guns, and tasers are prohibited/non-allowable. Prohibited items/activities will not be reimbursed by DHS/FEMA. Failure to comply could jeopardize current and future grant reimbursement and funding consideration. Per the PRICE ACT, the State is reminded not to exceed 50% of the total fiscal year OPSG grant award for personnel costs (including overtime and fringe benefits). A request to exceed the 50% salary cap must be submitted on official letterhead to FEMA GPO and CBP/BP prior to incurring the additional costs. FOR OFFICIAL USE ONLY www.fema.gov j' Note: Per FEMAlCustoms Border Protection (CBP)/Border Patrol (BP) programmatic guidance and oversight for aircraft, watercraft, vehicles and purchases of single equipment items and/or equipment systems greater than $100,000; grantees are not authorized to purchase any of the above listed until: 1. A separate, signed request on letterhead for a waiver to purchase said equipment has been submitted and approved by FEMA GPO and CBP/BP. The waiver should detail the need, operational relevance and how the equipment will enhance law enforcement efforts to increase border security for the requesting agency. 2. And/or a signed "justification letter" on letterhead for vehicle(s) and/or equipmenUsystem(s) over $100,000 has been submitted and approved by FEMA GPO and CBP/BP. The justification should detail how this equipment will enhance law enforcement efforts to increase border security for the requesting agency. 3. All waivers and justifications will be subject to review and final approval by FEMA GPO and CBP/BP. The State Administrative Agency will be notified of such approval or denial via email by the FEMA Program Analyst. 4. Failure to provide comprehensive waivers and justifications in a timely manner could delay the approval process and/or jeopardize current and future grant reimbursements and funding consideration. It is mandatory that all participating agencies (especially County and Tribal stakeholders) closely monitor, review and track expenditures of OPSG funds under individual Operations Orders issued. Under no circumstances is it allowable to estimate, obligate, and/or encumber beyond the actual grant award. The spirit and intent of the Operation Stonegarden program is to build and strengthen coordination between State, local and Tribal law enforcement agencies, in conjunction with lead operational oversight provided by U.S. Customs Border Protection Border Patrol and Sector Headquarters. All Operations should be border centric and intelligence driven, with the goal of reducing or eliminating threat, risk and vulnerability along our Nation's borders. If you have any questions, please feel free to contact your Program Analyst at: Aimee Clancy U.S. Department of Homeland Security Federal Emergency Management Agency Grant Programs Directorate Preparedness Grants Division Email: Aimee.Clancy@dhs.Qov 0: 202-786-9989 WARNING: This document is FOR OFFICIAL USE ONLY (FOUO/LES) ~ .1" Texas Department of Public Safety 2011 Sub-Recipient Agreement for Calhoun County 2. Prepared by: Paynter, William GT 3. Award Number: 11-SR 48057-02 .~~~~~~i$~i~~;t*~:~-H~~~r~~~If;i':j~~~~~t~.~~~!::,,~,~~!:'~~~!~.T!~~_~:~:~~\~;~~~~~~~~~~~);]i:~~~ Judge Michael Pfeifer Calhoun County 211 South Ann Street #301 Port Lavaca, TX 77979 Federal Grant Title: Homeland Security Grant Program Federal Grant Award Number: EMW-2011-SS-0019 Date Federal Grant Awarded to TxDPS: September 1, 2011 Federal GrantIng Agency: Department of Homeland Security FEMA Grant Programs Directorate OPSG Award Amount (Federal) CFDA: 97.067 Grant Period: $298,229.00 FROM: Sep 1, 2011 NOTE: Match requirement details can be found in the federal guIdance for the grant named In Box 4 above. (The S TO: Aug 31, 2013 grant 6. Statutory Authority for Grant: This project is supported under the Department of Homeland Security Appropriations Act of 2010 (Public Law 111-83). 7. Method of Payment: Primary method is reimbursement. 8. Debarment/Suspension Certification: The Sub-Recipient certifies that the sub-recipient and its contractors/vendors are not debarred,suspended, proposed for debarment,en_US declared ineligible or voluntarily excluded by any federal department or agency and do not appear in the Excluded Parties List System at http://www.epls.gov.2.8.9029.0 I.~'~~ '\~r. ,,~. ~",,,/.,,t;! H",' .j;fAgenc:y Apl!l"Qya '~'f.;;c. ,> " '-I".t<(,. . < t "',(, ~ ,"~' Approving TxDPS Official: Signature of TxDPS Official: Machelle Pharr, Deputy Assistant Director State Administrative Agency Texas Department of Public Safety '-7,..J. {( -L ~ I have read and understand the attached Terms and Conditions. Type name and title of Authorized Sub-Recipient official: Michael J. Pfeifer Calhoun County Judge S;:;;J~;;PfF~I' 11. Enter Employer IdentificatIon Number (EIN) I Federal Tax Identification Number: 12. Date SIgned : 74-6001923 05-24-2012 13. DUE DATE: June 28, 2012 Signed award and Direct Deposit Form (If applicable) must be returned to TxDPS on or before the above due date. 'j .!,.- 2011 TERMS AND CONDITIONS InstroctJons: The Sub-recipient must; 1. Fill in the information and sign the Sub-Recipient Award, 2. Certify they have read and understand the Terms and Conditions by initialing the bottom of each page. 3. Fill in the information located on Page 4. 4. Certify to the statements provided in Exhibits A, 8, C and D located at the back of this document by filling in contact information and signing all exhibits. 5. Return all documents to the DPSlTHSSAA on or before the date provided in the transmittal letter and/or in the agreement. Parties to Sub-reciDient Aareement This Sub-recipient Agreement (includes the Sub-recipient Award and the Terms and Conditions) is made and entered into by and between the Department of Public Safety I Texas Homeland Security State Administrative Agency, an agency of the State of Texas, hereinafter referred to as "DPS/THSSM," and the funds recipient, hereinafter referred to as the "Sub-recipient." Furthermore, DPSlTHSSAA and the Sub-recipient are collectively hereinafter referred to as the .Parties." The SUb-recipient Agreement is only an offer until the Sub-recipient retums the signed copy of the 2011 Sub-recipient Agreement on or before the date provided in the transmittal letter andlor in the Sub-recipient Agreement Award. Sub-recipient may not assign or transfer any interest in this Sub-recipient Agreement without the express, prior written consent of the DPS/THSSAA. Overview and Performance Standards All allocations and use of funds under this grant must be in accordance with the FY 2011 Grant Program Guidance for the Federal Grant Title specified on the Sub-recipient Agreement Award. All award Sub-recipients are required to have read, understood and accepted the FY 2011 Grant Program Guidance as binding. Standard of Performance. The Sub-recipient shall perform all activities and projects entered into the DPS/THSSM web-based grants mana!;)ement system which were approved by the THSSM. The Sub-recipient shall perform all activities in accordance with all terms, proviSions and requirements set forth in this Sub-recipient agreement, Terms and Conditions and the following Exhibits located at the end of this document: 1. Assurance - Non-Construction Programs, hereinafter referred to as "Exhibit A" . 2. Assurance' - Construction Programs, hereinafter referred to as "Exhibit B" 3. Certification, hereinafter referred to as "Exhibit C" 4. Assurance - From UGMS ~_.14 hereinafter referred to as "Exhibit 0" Failure to Perform. In the event the Sub-recipient fails to implement the project(s) entered into the DPS/THSSM web-based grants management system, or comply with any of this Sub-recipient agreement's provisions, in addition to the remedies specified in this Sub-recipient agreement, the Sub-recipient is liable to DPS/THSSAA for an amount not to exceed the award amount of this Sub-recipient agreement and may be barred from applying for or receiving additional DHS/FEMA grant program funds or any other federal program funds administered by DPS/THSSM until repayment to DPS/THSSM is made and any other compliance or audit finding is satisfactorily resolved. Failure to timely implement projects may reduce future funding in additional DHS/FEMA grant programs administered by the DPS/THSSM. DPSnHSSAA Obligations Measure of Liabilitv. DPS/THSSAA shall not be liable to the Sub-recipient for any costs incurred by the SUb-recipient that are not allowable costs. Sub-recioient Aareement Funds Defined and Limit of Liabilitv. The term "Sub-recipient agreement funds" as used in this Sub-recipient agreement means funds provided by DPS/THSSAA under the DHS/FEMA grant programs. The term .Sub-recipient's funds. or match funds as used in this Sub-recipient agreement means funds provided by the Sub-recipient. Notwithstanding any other provision of this Sub-recipient agreement, the total of all payments and other obligations incurred by DPS/THSSM under this Sub-recipient agreement shall not exceed the Total Award Amount listed on the Sub-recipient Award. Sub-recipient shall contribute the match funds listed on the Sub-recipient Award. Excess Pavments. The Sub-recipient shall refund to DPS/THSSAA any sum of Sub-recipient agreement funds that has been paid to the Sub-recipient by DPSlTHSSAA or that DPS/THSSM determines has resulted in overpayment to the Sub-recipient or that DPS/THSSAA determines has not been spent by the Sub-recipient in accordance with this Sub-recipient agreement. No refund payment(s) may be made from local, state or federal grant funds unless repayment with grant funds is specifically permitted by statute or regulation. The Sub-recipient shall make such refund to DPS/THSSAA within thirty (30) days after DPS/THSSM requests such refund. Initial-llf Date 5 -) t,,/ V Page 2 OF 18 Suspension In the event the Sub-recipient fails to comply with any of this Sub-recipient Agreement's terms, DPSITHSSAA may, upon written notification to the Sub-recipient, suspend this Sub-recipient agreement in whole or in part, withhold payments to the Sub-recipient and prohibit the Sub-recipient from incurring additional obligations of Sub-recipient agreement funds. Termination DPSITHSSAA's R~ht to Terminate. DPSITHSSAA shall have the right to terminate this Sub-recipient agreement, in whole or in part, at any time before the en of the Performance Period, whenever DPSITHSSAA determines that the Sub-recipient has failed to comply with any of this Sub-recipient Agreement's terms. DPSn;HSSAA shall notify the Sub-recipient in writing prior to the thirtieth (30th) day preceding the termination of such determination and include: 1. the reasons for such termination; 2. the effective date of such termination; and 3. in the case of partial termination, the portion of the Sub-recipient agreement to be terminated. Appeal may be made to the Deputy Director of Homeland Security, Department of Public Safety. Enforcement In taking an enforcement action, the awarding agency will provide the sub-recipient an opportunity for such hearing, appeal, or other administrative proceeding to which the sub-recipient IS entitled under any statute or regulation applicable to the action involved. Conflict of Interest No employee, officer or agent of the sub-recipient shall participate in selection, or in the award or administration of a contract supported by Federal funds if a conflict of interest, real or apparent, would be involved. Monitoring Sub-recipients will be monitored periodically by federal, state or local entities, both programmatically and financially, to ensure that project goals, objectives, performance requirement, timelines, milestone completion, budget. and other related program criteria are being met. DPSITHSSAA or its authorized representative reserves the right to perform periodic desk/office-based andlor on-site monitoring of the Sub-recipient's compliance with this Sub-recipient agreement's terms and conditions and of the adequacy and timeliness of the Sub-recipient's performance pursuant to this Sub-recipient agreement. After each monitoring visit, DPSITHSSAA shall provide the Sub-recipient with a written report of the monitor's findings. If the monitoring report notes deficiencies in the Sub-recipient's performance under this Sub-recipient agreement's terms, the monitoring report shall include requirements for the timely correction of such deficiencies by the Sub-recipient. Failure by the Sub-recipient to take action specified in the monitoring report may be cause for this Sub-recipient agreement's suspension or termination pursuant to the Suspension and/or Termination Section. Audit Audit of Federal and State Funds. The Sub-recipient shall arrange for the performance of an annual financial and compliance audit of Sub-recipient agreement funds received and performances rendered under this Sub-recipient agreement as required by the Single Audit Act (OMB Circular A -133; 44 C.F.R. 13.?6). The Sub-recipient will also comply, as applicable, with Texas Government Code, Chapter 783,1 TAC 5.141.et. seq. and the Uniform Grant Management Standards (UGMS), State Uniform Administrative Requirements for Grants and Cooperative Agreements. Richt to Audit. The Sub-recipient shall give the United States Department of Homeland Security (DHS), the Comptroller General of the United States, the Texas State Auditor, DPSITHSSAA, or any of their duly authorized representatives, access to and the right to conduct a financial or compliance audit of Sub-recipient agreement funds received and performances rendered under this Sub-recipient agreement. The Sub-recipient agrees to permit DPSITHSSAA or its authorized representative to audit the Sub-recipient's records. The sub-recipient shall provide any documents, materials or information necessary to facilitate such audit. Sub-recioient's Liability for Disallowed Costs. The Sub-recipient understands and agrees that it shall be liable to DPSITHSSAA for any costs disallowed pursuant to financial and compliance audit(s) of Sub-recipient agreement funds. The Sub-recipient further understands and agrees that reimbursement to DPSITHSSAA of such disallowed costs shall be paid by the Sub-recipient from funds that were not provided or otherwise made available to the Sub-recipient pursuant to this Sub-recipient agreement or any other federal contract. Sub-recioient's Facilitation of Audit. The Sub-recipient shall take such action to facilitate the performance of such audit(s) conducted pursuant to this Section as DPSITHSSAA may require of the Sub-recipient. The Sub-recipient shall ensure that this clause concerning the authority to audit funds received indirectly by subcontractors through the Sub-recipient and the requirement to cooperate is included in any subcontract it awards. Other Requirements A. During the performance period of this grant, Sub-recipient government jurisdictions must maintain an Emergency Management Plan at the Intermediate Level of planning preparedness or higher, as prescribed by the Texas Division of Emergency Management (TDEM). This may be accomplished by a jurisdiction maintaining its own emergency management plan or participating in an inter-jurisdictional emergency management program that meets the required standards. If TDEM identifies deficiencies in the Sub-recipient government jurisdiction's plan, Sub-recipient will correct deficiencies within 60 days of receiving notice of such deficiencies from TDEM. Initial ~ Date ~Z:; ~ ~I/- Fl- , Page 3 OF 18 B. Projects identified in the DPSITHSSAA web-based grant management system must identify and relate to the goals and objectives indicated by the applicable approved project investments for the period of performance of the grant. Sub-recipient will submit its project plans, narrative and budget to DPSITHSSAA and FEMA (if required) for approval prior to expending or requesting advances of any funds for' this award. During the performance period of this grant, Sub-recipient agrees that it will participate in a legally-adopted county andlor regional mutual aid agreement. C. During the performance period, the Sub-recipient must be a registered user of the Texas Regional Response Network (TRRN) (orother response asset inventory management system specified by DPSITHSSAA) and must identify all major resources such as vehicles and trailers, equipment costing $5,000 or more, and specialized teams/response units equipped and/or trained using grant funds (Le. hazardous material, decontamination, search and rescue, etc.). This registration is to ensure jurisdictions or organizations are prepared to make grant funded resources available to other jurisdictions through mutual aid. D. Sub-recipients must submit Fiscal Year 2010 Indirect Cost Allocation Plan signed by Cognizant Agency. "Cognizant agency. means the Federal agency responsible for reviewing, negotiating, and approving cost allocation plans or indirect cost proposals developed under 2 CFR Part 225 on behalf of all Federal agencies. OMB publishes a listing of cognizant agencies. Plan should be forwarded to the DPSITHSSAA. E. Regional Planning Commissions/Council of Governments (COGs) will follow guidelines listed in the DPSITHSSAA FY2011 COG Statement of Work. F. Sub-recipient acknowledges that FEMA National Preparedness Directorate reserves a royalty-free, non-exclusive, and irrevocable license to reproduce, publish, or otherwise use, and authorize others to use, for government purposes: (1) the copyright in any work developed under an award or sub-award; and (2) any rights of copyright to which a recipient or Sub-recipient purchases ownership with Federal support. The sub-recipient agrees to consult with DPSITHSSAA regarding the allocation of any patent rights that arise from, or are purchased with, this funding. Closing the Grant A. The Sub-recipient must have expended all grant funds and submitted expenditure reimbursement requests and any invoices by the end of the performance period listed on the sub-recipient agreement. B. DPSITHSSAA will close a sub-award after receiving Sub-recipient's final performance report indicating that all approved work has been completed and all funds have been disbursed, completing a review to confirm the accuraCy of the reported information, and reconciling actual costs to award modifications and payments. If the close out review and reconciliation indicates that the Sub-recipient is owed additional funds, DPSITHSSAA will send the final payment automatically to the Sub-recipient. If the Sub-recipient did not use all the funds received, DPSITHSSAA will issue a Grant Adjustment Notice (GAN) to recover the unused funds. Sub-recipient will retum the funds to the DPSITHSSM within 30 days of receiving the GAN. C. At the completion of the sub-recipient's performance period, DPSITHSSAA will de-obligate all uncommitted / unexpended funds. Restrictions. Disclaimers and Notices A. In cases where local funding is established by a COG or UASI governing board, the release of funds by DPSITHSSAA Is contingent upon funding allocation approval by the governing board. , B. Notwithstanding any other agreement provisions, the parties hereto understand and agree that DPSITHSSAA's obligations under this agreement are contingent upon the receipt of adequate funds to meet DPSITHSSAA's liabilities hereunder, except as required by HSGP grant. DPSITHSSAA shall not be liable to the Sub-recipient for costs under this Agreement which exceed the amount specified in the Sub-recipient Award. C. All notices or communication required or permitted to be given by either party hereunder shall be deemed sufficiently given if mailed by registered mail or certified mail, return receipt requested, or sent by overnight courier, such as Federal Express or Loan Star, to the other party at its respective address set forth below or to a Point of Contact listed for the sub-recipient in the DPSITHSSAA Grants Management System. .. - .. - -- -. ,--- ".-. I DPSrrHSSAA Contact Information I Sub-Recipient Contact Information I (Please Fill-In Contact In~ormatlon below) Deputy Assistant Director, ~ ; Name: Michael J. Pfeifer Texas Homeland Security State Admin. Agency . Title: Calhoun County Judge Calhoun County Texas Department of Public Safety Agency: . P.O. Box 4087 Address: 211 S. Ann Street, Suite 301 i Port Lavaca TX 77979 . A,:!sti.n!. TX ?~773-0220 . ~ ~ ---, . , Uniform Administrative Requirements. Cost Principals and Audit Requirements Except as specifically modified by law or this Sub-recipient agreement's provisions, the Sub-recipient shall administer the award through compliance with the most recent version of all applicable Laws and Regulations. A non-exclusive list is provided below. A. Administrative Requirements 1. 44 C.F.R. Part 13, Uniform Administrative Requirements for Grants and Cooperative Agreements to State an~ Local Governments; 2. 2 C.F.R. Part 215, Uniform Administrative Requirements for Grants and Agreements with Institutions of Higher Education, Hospitals and Other Non-Profit Organizations (OMB Circular A-110). 3. 44 CFR Part 10, Environmental Considerations Initial ttf Date Lj ~ ;It/ ,1 2- Page 4 OF 18 B. Cost Principles 1. 2 C.F.R. Part 225, Cost Principles for State, Local and Indian Tribal Govemments (OMB Circular A-8?) 2. 2 C.F.R. Part 220, Cost Principles for Education Institutions (OMB Circular A-21) 3. 2 C.F.R. Part 230, Cost Principles for Non-Profit Organizations (OMB Circular A-122) 4. 48 CFR 31.2, Federal Acquisition Regulations (FAR), Contracts with Commercial Organizations C. Audit Requirements -oMB Circular A-133, Audits of States, Local Governments and Non.Profit Organizations. D. Grant Guidance The sub-recipient agrees that all allocations and use of funds under this grant will be in accordance with the applicable FY2011 Grant Program Guidance and application kit and supplemental resources, e.g., for Homeland Security Grant Program currently available at http://wwwJema.govltxtlgovemmenUgranU20111fy11_hsgp_kit.txt; for Regional Catastrophic Preparedness Grant Program, http://wwwJema.govltxtlgovemmenUgranU2011/fy11_rcpgp_kit.txt; for Emergency Operations Center Grant Program http://wwwJema.govltxtlgovemmenUgranU2011/fy11_eoc_kit.txt; and Nonprofit Security Grant Program, http://wwwJema.govltxtlgovernmenUgranU2011/fy11_nsgp_kit.txt. Lobbvinq Prohibited Sub-Recipient understands and agrees that it cannot use any federal funds, either directly or indirectly in support of the enactment, repeal, modification or adoption of any law, regulation, or policy, at any level of government, without the express prior written approval of FEMA. Environmental Review The Sub-recipient, as soon as possible upon receiving their grant award, must provide information to DPSrrHSSAA to assist with the legally-required environmental planning and historic preservation (EHP) review and to ensure compliance with applicable EHP laws and Executive Orders (EO) currently using the FEMA EHP Screening Form OMB Number 1660-0115/FEMA Form 024-0-01 and submitting it, with all supporting documentation, to DPSrrHSSAA for review. These EHP requirements include but are not limited to National Environmental Policy Act, National Historic Preservation Act, Endangered Species Act, EO 11988 - Floodplain Management, EO 11990- Protection of Wetlands, and EO 12898 - Environmental Justice. The recipient must comply with all Federal, State, and local EHP requirements and obtain applicable permits and clearances. See FEMA Information Bulletin 329. Recipient shall not undertake any written activity from the project that would result in ground disturbance, facility modification, or purchase and use of sonar equipment without the prior approval of FEMA. These include but are not limited to communications towers, physical security enhancements involving ground disturbance, new construction, and modifications to buildings that are 50 years old or older. Recipient must comply with all mitigation or treatment measures required for the project as the result of FEMA's EHP review. Any changes to an approved project description will require re-evaluation for compliance with EHP requirements before the project can proceed. If ground disturbing activities occur durin~ project implementation, the recipient must ensure monitoring of ground disturbance and if any potential archeological resources are discovered, the recipient will immediately cease construction in that area and notify FEMA and the appropriate State Historical Preservation Office. Initiation of these activities prior to completion of FEMA's EHP review will result in a non-compliance finding and may not be eligible for grant funding. Retention and Accessibility of Records Retention of Records. The Sub-recipient shall maintain fiscal records and supporting documentation for all expenditures of Sub-recipient agreement funds pursuant to the applicable OMB Circular, 44 CFR Section 13.42, UGMS ~_.42, and this Sub-recipient agreement. The Sub-recipient shall retain these records and any supporting documentation for a minimum of three (3) years from the later of the completion of this project's public objective, submission of the final expenditure report, any litigation, dispute, or audit. Records shall be retained for 3 years after any real estate or equipment final disposition. The DHS or DPSrrHSSAA may direct the sub-recipient to retain documents or to transfer certain records to DHS custody when DHS determines that the records possess long term retention value. Access to Records. The Sub-recipient shall give the United States Department of Homeland Security (DHS), the Comptroller General of the United States, the Texas State Auditor, DPSrrHSSAA, or any of their duly authorized representatives, access to and the right to examine all books, accounts, records, reports, files, other papers, things or property belonging to or in use by the Sub-recipient pertaining to this Sub-recipient agreement including records concerning the past use of DHS/FEMA funds. Such rights to access shall continue as long as the records are retained by the Sub-recipient. The Sub-recipient agrees to maintain such records in an accessible location and to provide citizens reasonable access to such records consistent with the Texas Public Information Act, Texas Government Code Chapter 552. Inclusion in Subcontracts. The Sub-recipient shall include the substance of the Retention of Records and Access to Records sections in all su bcontracts. After Action Reoortina. The Sub-recipient shall complete, deliver to the appropriate source, and retain copies of all after-action and certificates of completion for all training and exercises paid for by this grant. Legal Authority Sianatorv Authoritv The Sub-recipient assures and guarantees that the Sub-recipient possesses the legal authority to enter into this Sub-recipient agreement, receive Sub-recipient agreement funds and to perform the services the Sub-recipient has obligated itself to perform pursuant to this Sub-recipient agreement. Authorized Reoresentative. The person or persons signing and executing this Sub-recipient agreement on the Sub-recipient's behalf do warrant and guarantee that he, she or they have been duly authorized by the Sub-recipient to execute this Sub-recipient agreement on the Sub-recipient's behalf and to validly and legally bind the Sub-recipient to all contractual terms, performances and provisions. Initial J1fJ Date 5,-//...'1-/'2- Page 5 OF 18 Conflicts in Reauirements. If conflict exists between federal, state, or local requirements, the sub-recipient shall comply with the strictest requirement. Notice of Litigation and Claims The Sub-recipient shall give DPSrrHSSAA immediate notice in writing of any action, including any proceeding before an administrative agency. filed against the Sub-recipient arising out of the performance under this Sub-recipient agreement. Except as othelWise directed by DPSrrHSSAA, the Sub-recipient shall furnish immediately to DPSrrHSSAA copies of all documentation or pleadings received by the Sub-recipient with respect to such action or claim. Non-Waiver of Defaults ANY FAILURE OF DPSrrHSSAA, AT ANY TIME, TO ENFORCE OR REQUIRE THE STRICT KEEPING AND PERFORMANCE OF ANY PROVISION OF THIS AGREEMENT WILL NOT CONSTITUTE A WAIVER OF SUCH PROVISION, AND WILL NOT AFFECT OR IMPAIR SAME OR THE RIGHT OF DPsrrHSSAA AT ANY TIME TO AVAIL ITSELF OF SAME. A WAIVER DOES NOT BECOME EFFECTIVE UNLESS DPSrrHSSAA EXPRESSLY AGREES TO SUCH WAIVER IN WRITING. ANY PAYMENT BY DPSrrHSSAA SHALL NOT CONSTITUTE A WAIVER OR OTHERWISE IMPAIR OR PREJUDICE ANY RIGHT, POWER, PRIVILEGE, OR REMEDY AVAILABLE TO DPSrrHSSAA TO ENFORCE ITS RIGHTS, AS SUCH RIGHTS, POWERS, PRIVILEGES, AND REMEDIES ARE SPECIFICALLY PRESERVED. Indemnity AS PERMITTED BY LAW, SUB-RECIPIENT SHALL INDEMNIFY, DEFEND AND HOLD DPSrrHSSAA AND THE STATE OF TEXAS (INCLUDING ITS DIRECTORS, COMMISSIONERS, EMPLOYEES, AGENTS AND THEIR SUCCESSORS) ("INDEMNITEES") HARMLESS FROM AND AGAINST ANY OF THE FOLLOWING THAT ARISE OUT OF OR RESULT FROM SUB-RECIPIE:NT'S NEGLIGENCE (ANY AND ALL), FAULT, ACT, FAILURE TO ACT, OMISSION, BREACH OF THIS AGREEMENT OR VIOLATION OF ANY STATE OR FEDERAL LAW AND/OR REGULATION, AS WELL AS ANY VIOLATION OF ANY MATTER MADE THE BASIS OF A TREATY ANDIOR CONVENTION ANDIOR AGREEMENT BElWEEN THE UNITED STATES AND ANOTHER NATION: CLAIMS; LAWSUITS; DAMAGES; LIABILITIES; PENALTIES; TAXES; FINES; INTEREST; EXPENSES (INCLUDING, WITHOUT LIMITATION, ATTORNEYS' FEES, COURT COSTS, INVESTIGATION COSTS AND ALL DIRECT OR INDIRECT COSTS OR EXPENSES INCURRED IN DEFENDING AGAINST ANY CLAIM, LAWSUIT, OR OTHER PROCEEDING, INCLUDING THOSE EXPENSES INCURRED IN ANY NEGOTIATION, SETTLEMENT, OR ALTERNATIVE DISPUTE RESOLUTION); ANY AND ALL DAMAGES, HOWEVER CHARACTERIZED, SUCH AS DiRECT, GENERAL, INCIDENTAL, INDIRECT, CONSEQUENTIAL, PUNITIVE, OR SPECIAL DAMAGES OF ANY KIND (INCLUDING LOST REVENUES OR PROFITS, LOSS OF BUSINESS, LOSS OF USE, OR LOSS OF DATA) ARISING OUT OF OR IN CONNECTION WITH OR RELATED TO THIS AGREEMENT OR THE RIGHTS PROVIDED THEREIN. IN ANY AND ALL CLAIMS AGAINST ANY OF THE INDEMNITEES BY ANY EMPLOYEE OF THE SUB-RECIPIENT OR ANY EMPLOYEE OF ITS SUBCONTRACTOR(S), THE INDEMNIFICATION OBLIGATION UNDER THIS AGREEMENT WILL NOT BE LIMITED IN ANY WAY BY THE AMOUNT OR TYPE OF DAMAGES, COMPENSATION, OR BENEFITS PAYABLE BY OR FOR THE SUB-RECIPIENT OR ANY OF ITS SUBCONTRACTOR(S) UNDER WORKER'S DISABILITY COMPENSATION ACTS, DISABILITY BENEFITS ACTS, OR OTHER EMPLOYEE BENEFITS ACTS. SUB-RECIPIENT SHALL COORDINATE ITS DEFENSE AND ANY SETTLEMENT WITH THE ATTORNEY GENERAL FOR THE STATE OF TEXAS AS REQUESTED BY THE DPSrrHSSAA. IN ANY SETTLEMENT, SUB-RECIPIENT MUST NOT MAKE ANY ADMISSION OF LIABILITY ON THE PART OF ANY OF THE INDEMNITEES. THIS SECTION SHALL NOT BE CONSTRUED TO ELIMINATE OR REDUCE ANY OTHER INDEMNIFICATION, CONTRIBUTION OR RIGHT WHICH ANY OF THE INDEMNITEES HAVE BY LAW OR EQUITY. THIS SECTION SHALL SURVIVE THE TERMINATION OR EXPIRATION OF THIS AGREEMENT. Changes and Amendments Modification. FEMA or the DPSrrHSSAA may change the award document after an award has been made. Once notification has been made in writing, any subsequent request for funds indicates sub-recipient's acceptance of the changes to the award. Written Amendment. Alterations, additions or deletions to this Sub-recipient agreement's terms, such as changes to period of performance and award amounts, will be made through Grant Adjustment Notices generated by the DPSrrHSSAA web-based grants management system and executed by the Parties. Authority to Amend. During the period of this Sub-recipient agreement's performance DPSrrHSSAA and/or FEMA may issue policy directives that serve to establish, interpret or clarify this Sub-recipient agreement's performance requirements. Such policy directives shall be promulgated by DPSrrHSSAA or FEMA in the form of Information Bulletins and Sub-recipient Manuals and shall have the effect of qualifying this Sub-recipient agreement's terms and shall be binding upon the Sub-recipient as if written in the Sub-recipient agreement. Effect of Chanaes in Federal and State Laws. Any alterations, additions, or deletions to the Sub-recipient agreement's terms that are required by the changes in federal and state laws or regulations are automatically incorporated into this Sub-recipient agreement without written amendment to this Sub-recipient agreement and shall become effective on the date designated by such law or regulation. In the event FEMA or DPSrrHSSAA determines that changes are necessary to the award document after an award has been made, including changes to period of performance or terms and conditions, recipients will be notified of the changes in writing. Once notification has been made, any subsequent request for funds will indicate sub-recipient acceptance of the changes to the award. Initial---1J;f Date S' ),4-/2.- Page 6 OF 18 t~ Headings Headings and captions of this Sub-recipient agreement's sections a~d paragraphs are only for convenien~e ~nd reference. .These ~eadings and captions shall not affect or modify this Sub-recipient agreement s terms or be used to interpret or assist in the construction of thiS Sub-recipient agreement. Venue For purposes of litigation pursuant to this Sub-recipient agreement, venue shall lie in Travis County, Texas, and be governed by Texas law. Other General Conditions DUNS Number. Sub-recipient confirms its Data Universal Numbering Systems Number (DUNS) is the number listed on the Sub-recipient agreement award. Data Universal Numbering System (DUNS) number means the nine digit number established and assigned by Dun and Bradstreet, Inc., at 8661705-5711 or http://fedgov.dnb.comfwebform. Central Contractor Reaistration and Universal Identifier Reauirements. Sub-recipient maintains that it has registered on www.ccr.gov, and entered DPSrrHSSAA-required information. See SAA Information Bulletin. Sub-recipient will keep current, and then review and update the CCR information at least annually, at the beginning of September of each year. Sub-recipient will keep information current in Central Contractor Registration database until the later of when it submits this grant's final financial report or receives final grant award payment. Sub-recipient agrees that it will not make any subaward agreement or contract related to this award without first obtaining the vendor/subawardee's mandatory DUNS number. See section .210 of OMB Circular A-133, Audits of States, local Governments, and Non-profit Organizations. Reoortina Total Comoensation of Sub-recioient Executives. 2 CFR 170.320; see FEMA Information Bulletin 350; SAA Information Bulletin. 1. Applicability and what to report: Sub-recipient must report whether Sub-recipient received $25 million or more in Federal procurement contracts or financial assistance subject to the Transparency Act per 2 CFR 170.320. Sub-recipient must report whether 80% or more of Sub-recipient's annual gross revenues were from Federal procurement contracts or Federal financial assistance. If Sub-recipient answers "yes" to both questions, Sub-recipient must report, along with Sub-recipient's DUNS number, the names and total compensation (see 17 CFR 229.402(c)(2)) for each of the Sub-recipient's five most highly compensated executives for the preceding completed fiscal year. 2. Where and when to report. Sub-recipient must report executive total compensation at www.ccr.aov. By signing this agreement Sub-recipient is certifying that, if required, Sub-recipient's jurisdiction has already registered, entered the required information, and agrees to keep information in the Central Contractor Registration database current, and update the information at least annually at the beginning of September for each year until the later of when the juriSdiction submits its final financial report or receives final payment. Sub-recipient agrees that it will not make any subaward agreement or contract without first obtaining the subawardee's mandatory DUNS number. Contract Provisions. All contracts executed under this award will contain the contract provisions listed under 44 CFR 13.37(b), Uniform Administrative Requirements for Grants and Cooperative Agreements to State and local Governments. No Contracts with Debarred or Susoended Parties. Prior to contracting with any vendor or subawardee, the Sub-recipient will determine whether the vendorlsubawardee is debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded by any federal department and agency and will confirm the vendor/subawardee does not appear in the Excluded Parties list System, currently at www.epls.gov.lsearch.do. Direct Deoosit. Since September 1, 2011, Sub-recipient has either forwarded or is currently forwarding to DPS an updated direct deposit form currently available at htto:/Iwww.window.state.tx.us/taxinfo/taxforms/74-176.odf. Sub-recipient may simultaneously sign up for the Advance Payment Notification email feature which provides state of Texas payees with a one-business-day advance notice that a direct deposit payment has been sent to their financial institution. After receiving an APN, payees may securely access their payment details online. Points of Contacts. Within 30 days of any change, Sub-recipient will enter, confirm, and/or correct the chief elected official, program, and/or financial points of contact in the DPSrrHSSAA grant management system. Publications. All publications produced as a result of this funding, which are submitted for publication in any magazine, journal, or trade paper shall carry the following: "This material is based upon work supported by the U.S. Department of Homeland Security. The views and conclusions contained in this document are those of the authors and should not be interpreted as necessarily representing the official policies, either expressed or implied, of the U.S. Department of Homeland Security." Quarterlv Performance Reoorts. The sub-recipient will submit performance reports and progress reviews per DPSrrHSSAA and/or FEMA's direction. Currently most reports are entered into the grants management system. For Homeland Security Grant Program, Emergency Operations Center Grant Program, Regional Catastrophic Preparedness Grant Program and Non-profit awards performance reports are currently due on each January 20, April 20, July 20 and October 20. The final report is to be filed the quarter after the end of Sub-recipients performance period. Failure to timely complete performance reports will result in the Sub-recipient being unable to request additional reimbursements/advances. Controlled Unclassified Information. Some information and materials provided pursuant to or resulting from this Award may be export controlled, sensitive, for official use only or otherwise protected by law, executive order or regulation. The sub-recipient is responsible for compliance with all applicable laws and regulations. Initial Iff Date S - J..4-/1..-- Page 7 OF 18 Securitv Reauirements. Sub-recipients of this award shall use their own security procedures and protections to protect Sensitive Information received or distributed under this Award. The sub-recipient shall also establish procedures to provide reasonable assurance that no Sensitive Information will be developed or generated under this award. Such security procedures should include procedures (e.g., security check forms, type of background checklinvestigations performed (if necessary) and requirements for successful adjudication of the type of background check/investigations performed) to determine the suitability of sub-recipients' personnel requiring recurring access to government facilities or access to Sensitive Information provided under this award. A copy of the security procedures and any proposed Non-Disclosure Agreement for the sub-recipients' personnel shall be submitted to the DPSrrHSSAA within two (2) weeks after signing this agreement. The sub-recipient will be notified of any concerns that may be identified once the security procedures are forwarded and reviewed by DHS. Sensitive Information. Work under this award may involve access to Sensitive Information from the Federal Government. Therefore, the sub-recipient shall not disclose, orally or in writing, any Sensitive Information to any person unless authorized in writing by the DHS Grants Officer. Further, the sub-recipient shall ensure that Sensitive Information is protected in such a manner that it is safeguarded from public disclosure in compliance with local, state or Federal laws and with sub-recipient's security procedures. For those sub-recipient personnel authorized access to Sensitive Information, the sub-recipient must ensure that these persons receive training concerning the protection and disclosure of Sensitive Information both during and after the period of performance. Public Dissemination of Sensitive Information. The sub-recipient will notify the DPSrrHSSAA of any workshops, conferences, seminars or other public venues at least 100 days before presenting any potentially sensitive information regarding this project. No Sensitive Information may be presented by the sub-recipients' personnel without DPSrrHSSAA and DHS Grants Officers review and prior written approval. . Securitv ConcernsNiolations. The sub-recipient shall inform the THSSAA's Deputy Assistant Director in writing within two (2) days of the sub-recipient being made aware of any security concerns with individuals having access to government facilities or Sensitive Information. In the event that Sensitive Information is divulged in violation of sub-recipient's security procedures, the sub-recipient will immediately notify the DPSrrHSSAA Deputy Assistant Director and take appropriate law enforcement and legal action. Site Visits. The DHS andlor DPSrrHSSAA, through authorized representatives, has the right, at all reasonable times to make site visits to review project accomplishments and management control systems and to provide such technical assistance as may be required. If any site visit is made by the DHS on the premises of the sub-recipient, or a contractor under this Award, the sub-recipient shall provide and shall require its contractors to provide all reasonable facilities and assistance for the safety and convenience of the Government representatives in the performance of their duties. All site visits and evaluations shall be performed in such a manner that will not unduly delay the work. Use of DHS. DPS. and DPSfTHSSAA Seals and Non-Endorsement. The sub-recipient shall obtain the respective agency's prior written approval before using either agencies' seal. Funding of this Award does not equate to endorsement of use of funding agencies' seals. Initial I't(J Date S -rJ-I/-1 '2..--- Page 8 OF 18 .' Prohibited Activities 1) Traffickino In Person and Commercial Sex Act Prohibition a) Provisions applicable to a sub-recipient that is a private entity. I) A sub-recipient andlor the sub-reclpient's employees, may not: ~1) Engage in severe forms of trafficking in persons during the period of time that the award is in effect; 2) Procure a commercial sex act during the period of time that the award is in effect; or 3) Use forced labor in the performance of the award or sub-award under this award. ii) DPSITHSSM or FEMA may unilaterally terminate this award, without penalty, if the sub-recipient that is a private entity: (1) Is determined to have violated a prohibition in paragraph 1a of this award term; or (2) Has an employee who is determined by an agency official authorized to terminate the award to have violated a prohibition of this award term through conduct that is either: (a) Associated with performance under this award; or (b) Imputed to the sub-recipient usin~ the standards and due process for imputing the conduct of an individual to an organization that are provided in 2 CFR Part 180, "OMB GUidelines to Agencies on Government Debarment and Suspension (Non-procurement)," as implemented at 2 CFR Part 3000. b) Provisions applicable to a sub-recipient that is not a private entity. I) THSSM may unilaterally terminate this award, without penalty, if the sub-recipient: iI) Is determined to have violated a prohibition in paragraph 1a of this award term; or iil) Has an employee who is determined by the agency official authorized to terminate the award to have violated an applicable prohibition in paragraph a1 of this award term through conduct that is either: (1) Associated with performance under this award; or (2) Imputed to the sub-recipient using the standards and due process for imputing the conduct of an individual to an organization that are provided in 2 CFR Part 180, "OMB Guidelines to Agencies on Government Debarment and Suspension (Non-procurement)," as implemented at 2 CFR Part 3000. c) Provisions applicable to any recipient: i) A Sub-recipient must inform the DPSrrHSSM immediately of any information it received from any source alleging a violation of a prohibition in paragraph a1 of this award term. ii) DPSITHSSAA's right to terminate unilaterally is described in 1 b or 2 of this section: (1) Implements section 106(g) of the Trafficking Victims Protection Act of 2000 (TVPA), as amended (22 U.S.C. 7104 (g)), and (2) Is in addition to all other remedies for noncompliance that are available to DPSITHSAA under this award. iii) Sub-recipient must include the requirements of 1a of this award term in any sub-award the sub-recipient makes to a private entity. d) Definitions. For purposes of this award term: i) "Employee" means either: (1) An individual employed by a sub-recipient who is engaged in the performance of the project or program under this award: or (2) Another person engaged in the performance of the project or program under this award and not compensated by Sub-recipient including, but not limited to, a volunteer or individual whose services are contributed by a third party as an in-kind contribution toward cost sharing or matching requirements. . ii) "Forced labor" means labor obtained by any of the follOWing methods: the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt, bondage, or slavery. . iii) "Private entity" means: (1) Any entity other than a State, local government, Indian Tribe, or foreign public entities, as those terms are defined in 2 CFR 175.25. (2) Includes: (a) A non-profit organization, including any nonprofit institution of higher education, hospital, or tribal organization other than one included in the definition of Indian Tribe at 2 CFR 175.25(b). . (b) A for-profit organization iv) "Severe forms of trafficking in persons," "commercial sex act," and "coercion" have the meaning given at section 103 of the TVPA, as amended (22 U.S.C. 7102). 2) Classified Security Condition a) "Classified national security information" as defined in Executive Order (EO) 12958, as amended, means information that has been determined pursuant to EO 12958 or any predecessor order to require protection against unauthorized disclosure and is marked to indicate its classified status when in documentary form. b) No funding under this award shall be used to support a contract, sub-award, or other agreement for goods or services that will include access to classified national security information if the award recipient has not been approved for that access to such information c) Where an award recipient has been approved for and has access to classified national security information, no funding under this award shall be used to support a contract, sub-award, or other agreement for goods or services that will include access to classified national security information by the contractor, sub-awardee, or other entity without prior written approval from the DHS Office of Security, Industrial Security Branch Program (ISBP), or an appropriate official within the Federal department or agency with whom the classified effort will be performed. d) Such contracts, sub-awards, or other agreements shall be processed and administered in accordance with the DHS . Standard Operation Procedures, Classified Contracting by States and Local Entities," dated July 7,2008: EO's 12829, 12959, 12968, as amended; the National Industrial Security Program Operating Manual (NISPOM); and lor other applicable implementing directives or instruction. All security requirement documents are currently located at: http;/lwww.dhs/gov/xopnbizigrantslindex.shtm. e) Immediately upon determination by the award recipient that funding under this award will be used to support such a contract, sub-award, or other agreement, and prior to execution of any action to facilitate the acquisition of such a contract sub-award, or other agreement, the award recipient shall contact ISPB, or the appropriate Federal department or agency, for approval and processing instructions. DHS Office of Security ISPB contact information: Telephone: 202-447-5346, Email: D254AdministrativeSecullidhs.gov, Mail: Department of Homeland Security, Office of the Chief Security Officer, ATTN: ASDllndustrial Security Program Branch, Washington, DC. 20528 Initial yf Date S - d).l{ -J Z- Page 9 OF 18 Operation Stonegarden (OPSG) Specific Condition The OPSG Sub-recipient is prohibited from obligating or expending Operation Stonegarden (OPSG) funds provided through this award until each unique, specific, or modified county level or equivalent Operational Order/Frag Operation Order with embedded estimated operational budget has been reviewed and approved through an official email notice issued by FEMA removing this special programmatic condition. The Operations Order approval process/structure is as follows: Operations Orders are submitted to (1) THE APPROPRIATE Customs and Border Productions (CBP) Border Patrol (BP) Sector Headquarters (HQ) upon approval by the Sector HQ, forwarded through the Border Patrol Enforcement transfer System (BPets) system to (2) the OPSG Coordinator, CBP/BP Washington, DC and upon approval forwarded to (3) Federal Emergency Management Agency (FEMA), Grant Program Directorate (GPD), Grant Development and Administrative Division (GD&A). Notification of release of programmatic hold will be sent by FEMA via email to the Texas Homeland Security State Administrative Agency (THSSAA) with a copy to OPSG Coordinator at CBP/BP HQ, Washington DC. Emergency Operations Center Grant Program (EOCGP) Specific Condition The Sub-recipient is prohibited from obligating, expending or drawing down EOCGP funds provided through this award until the required budget and budget narrative are reviewed and approved by FEMA and an official notice has been issued from FEMA removing this special condition. . Regional Catastrophic Preparedness Grant Program (RCPGP) Specific Condition The Sub-recipient is prohibited from obligating or expending RCPGP funds provided throuQh this award until the required budget and budget narrative are approved by FEMA and this condition is rescinded. In addition, the Sub-recipient is prohibited from obligating or expending RCPGP funds provided through this award until DHS/FEMA has provided signed approval of the project narrative and project plans to the Sub-recipient. State Requirements for Grants Sub-recipient shall also comply with all other federal, state, and local laws and regulations applicable to this Sub-recipient agreement's activities and performances rendered by the Sub-recipient including but not limited to the laws and the regulations promulgated in Texas Government Code Chapter 783, Uniform Grant and Contract Management Code: State Administrative Agency Information Bulletins, currently available at htto:/Iwww.txdosstate.tx.us/directorstaff/saa/informationbulletins.htm. Texas Uniform Grants Management Standards (UGMS) currently at governor.state.tx.uslfiles/state-grantsI?UGMS062004.doc; and the State Administrative Agency Sub-recipient Manual, currently available at htto:/Iwww.txdos.state.tx.us/director staff/saa/documents/subrecioientManual.odf. Sub-recipient(s) must, in addition to the assurances and certifications, comply and require each of its subcontractors employed in the completion of the project to comply with all applicable statutes, regulations, executive orders, OMB circulars, terms and conditions of the award, and the approved application. The Sub-recipient will follow Texas General Appropriations Act, Art. IX, section 4.05 which requires conforming with: a) Texas General Appropriations Act, Art. IX, Parts 2 and 3 of the General Appropriations Act, except there is no requirement for increased salaries for local government e'mployees; b) Texas Government Code section 556.004, 556.005, and 556.006 including not using any money or vehicle to support the candidacy of any person for office; not influencing positively or negatively the payment, loan, or gift to a person or political organization for a political purpose; and not using grant funds to influence the passage or defeat of a legislative including not assisting with the funding of a Lobbyist, or using grant funds to pay dues to an organization with a registered Lobbyist; c) Texas Govemment Code section 2113.012 and 2113.101 including not using grant funds to compensate any employee who uses alcoholic beverages on active duty plus Sub-recipient may not use grant funds to purchase an alcoholic beverage and may not payor reilT!burse any travel expense for an alcoholic beverage; , d) Texas General Appropriations Act, Art. IX, section 6.13 requiring Sub-recipients to make every effort to attain key performance target levels associated with this grant award, including performance milestones, milestone time frames, and related performance reporting requirements; and e) General Appropriations Act, Art. IX, section 7.01, 7.02, and 7.03 and Texas Government Code ~ 2102.0091, including grants funds may only be expended if the Sub-recipient timely completes and files its reports. Please fill in the appropriate information and sign. Print Name of Authorized Official Michael J. Pfeifer Title Calhoun County Judge Calhoun County Sub-recipient Organization 05-24-2012 Date Initial J( Date j ~;:).J/ -I V Page 10 OF 18 EXHIBIT A ASSURANCES - NON-CONSTRUCTION PROGRAMS See Standard Form 4248 As the duly authorized representative of the sub-recipient, I certify that the sub-recipient: 1. Has the legal authority to apply for Federal assistance and the institutional, managerial and financial capability (including funds sufficient to pay the non-Federal share of project cost) to ensure proper planning, management and completion of the project described in this agreement. 2. Will give the Department of Homeland Security, the Department of Public Safety, the Comptroller General of the United States and, if appropriate, the State, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives. 3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain. 4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. 5, Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. ~~4728-4763) relating to prescribed standards for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F). 6. Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race. color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. ~~1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. ~794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. ~~6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) ~~523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. ~~290dd-3 and 290ee- 3), as amended, relating to confidentiality of alCOhol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. ~~3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s) under which agreement for Federal assistance is being made; and, (j) the requirements of any other nondiscrimination statute(s) which may apply to the application. 7. Will comply, or has already complied, with the requirements of Titles II and III of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or federally-assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases. 8. Will comply, as applicable, with provisions of the Hatch Act (5 U.S.C. ~~1501-1508 and 7324-7328) which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds. . 9. Will comply, as applicable, with the provisions of the Davis-Bacon Act (40 U.S.C. ~~276a to 276a-7), the Copeland Act (40 U.S.C. ~276c and 18 U.S.C. ~874), and the Contract Work Hours and Safety Standards Act (40 U.S.C. ~~327-333), regarding labor standards for federally-assisted construction sub-agreements. 10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000 or more. 11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. ~~1451 et seq.); (f) conformity of Federal actions to State (Clean Air) Implementation Plans under Section 176(c) of the Clean Air Act of 1955, as amended (42 U.S.C. ~~7 401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended (P.L. 93-523); and, (h) protection of endangered species under the Endangered Species Act of 1973, as amended (P.L. 93- 205). 12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. ~~1271 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. ~ 70), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. ~~469a-1 et seq.). 14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance. 15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. ~~2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance. 16. Will comply with the Lead-Based Paint Poisoning Prevention Act (42 U.S.C. ~~4801 et seq.) which prohibits the use of lead-based paint in construction or rehabilitation of residence structures. 17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of 1996 and OMB Circular No. A-133, "Audits of States, Local Governments, and Non-Profit Organizations." Initial---li(l ~ Date 5-()L/-/2- Page 11 OF 18 18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations, grant guidance, and policies goveming this program. Please fill in the appropriate information and sign. Print Name of Authorized Official Michael J. Pfeifer Title Calhoun County Judge Sub-recipient Organization Calhoun County 05-24-2012 Date Initial-4-- Date :5..r ~" -}!l- _ Page 12 OF 18 EXHIBIT B ASSURANCES. CONSTRUCTION PROGRAMS As the duly authorized representative of the sub-recipient, t certify that the sub-recipient: 1. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (including funds sufficient to pay the non-F=ederal share of project costs) to ensure proper planning, management and completion of project described in this agreement. 2. Will give the Department of Homeland Security, the Department of Public Safety, the Comptroller General of the United States and, if appropriate, the State, the right to examine all records, books, papers, or documents related to the assistance; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives. 3. Will not dispose of, modify the use of, or change the terms of the real property title or other interest in the site and facilities without permission and instructions from the awarding agency. Will record the Federal awarding agency directives and will include a covenant in the title of real property acquired in whole or in part with Federal assistance funds to assure nondiscrimination during the useful life of the project. 4. Will comply with the requirements of the assistance awarding agency with regard to the drafting, review and approval of construction plans and specifications. 5. Will provide and maintain competent and adequate engineering supervision at the construction site to ensure that the complete work conforms with the approved plans and speCifications and will furnish progressive reports and such other information as may be required by the assistance awarding agency or State. 6. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. 7. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain. 8. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. ~~728-4763) relating to prescribed standards of merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F). 9. Will comply with the Lead-Based Paint Poisoning Prevention Act (42 U.S.C. ~~801 et seq.) which prohibits the use of lead-based pain in construction or rehabilitation of residence structures. 10. Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. ~~1681 1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1~73, as amended (29) U.S.C. ~794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. ~~61()1-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) ~~523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. ~~290dd-3 and 290ee 3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. ~~3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statue(s) under which agreement for Federal assistance is being made; and Q) the requirements of any other nondiscrimination statue(s) which may apply to the agreement. 11. Will comply, or has already complied, with the requirements ofTitles II and III of the Uniform Relocation Assistance and Real Property AcquiSition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal and federally-assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases. 12. Will comply with the provisions of the Hatch Act (5 U.S.C. ~~ 1501-1508 and 7324-7328) which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds. 13. Will comply, as applicable, with the provisions of the Davis-Bacon Act (40 U.S.C. ~~276a to 276a-7), the Copeland Act (40 U.S.C. ~276c and 18 U.S.C. ~874), and the ContractWork Hours and Safety Standards Act (40 U.S.C. ~~327- 333) regarding labor standards for federally-assisted construction sub-agreements. 14. Will comply with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000 or more. 15. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91- 190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. ~~1451 et seq.); (f) conformity of Federal actions to State (Clean Air) Implementation PI~n~ under Section 176(c) of th~ C.lean Air Act of 1955, as amended (42 U.S.C. ~~7401 et seq.); (g) protection of underground sources of dnnklng water under the Safe Dnnklng Water Act of 1974, as amended (P.L. 93-523); and, (h) protection of endangered species under the Endangered Species Act of 1973, as amended (P.L. 93-205). 16. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. ~~1271 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 17. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. ~470), EO 11593 (identification and protection of histonc properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. ~~469a-1 et seq). Initial 4- Date 5 --J'I-j z.- Page 13 OF 18 18. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of 1996 and OMS Circular No. A-133, "Audits of States, Local Governments, and Non-Profit Organizations." 19. Will comply with all applicable requirements of all other Federal laws. executive orders, regulations, grant guidance and policies governing this program. Please fill in the appropriate information and sign. Print Name of Authorized Official Michael J. Pfeifer Title Calhoun County Judge SUb-recipient Organization ~.I~Q~ gnature of Author" 0 iar Calhoun County Judge 05-24-2012 Date Initial-Af Date 5 -c).. V-I 2..- Page 14 OF 18 "1 Exhibit C Certifications The undersigned, Michael J. PfeifetJ:>rint), as the authorized official of Calhoun County to the best of his/her knowledge and belief. certifies the following A. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee or a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, of modification of any Federal contract, grant, loan, or cooperative agreement. B. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee or a Member of Congress in connection With this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL Disclosure of Lobbying Activities, in accordance with its instructions. C. The undersigned shall require that the language of this certification prohibiting lobbying be included in the award documents for all sub-awards at all tiers (including subcontract, sub-grants, and contracts under grants, loans, and cooperative agreements) and that all sub-recipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. D. As required by Executive Order 12549, Debarment and Suspension, and implemented at 28 C.F.R. Part 67, for prospective participants in primary covered transactions, as defined at 28 C.F.R. Part 67, Section 67.510. (Federal Certification). The Sub-recipient certifies that it and its principals and vendors: . 1. Are not debarred, suspended, proposed for debarment, declared ineligible, sentenced to a denial of Federal benefits by a State or Federal court, or voluntarily excluded from covered transactions by any Federal department or agency; Sub-recipients can access debarment information by going to www.eols.aov and the State Debarred Vendor List www window state.tx.us/orocuremenUoroalvendor oerformance/debarred. 2. Have not within a three-year period preceding this agreement been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performin!;'l a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 3. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (D)(2) of this certification; and 4. Have not within a three-year period preceding this agreement had one or more public transactions (Federal, State, or local) terminated for cause or default; or 5. Where the sub-recipient is unable to certify to any of the statements in this certification, he or she shall attach an explanation to this agreement. (Federal Certification) E. The Sub-recipient certifies federal funds will be used to supplement existing funds, and will not replace (supplant) funds that have been appropriated for the same purpose. Sub-recipient may be required to supply documentation certifying that a reduction in non-federal resources occurred for reasons other than the receipt or expected receipt of federal funds. F. Sub-recipient must comply with 2 CFR Part 180 Subpart C as a condition of receiving grant funds, and sub-recipient must require such compliance in any sub-grants or contract at the next tier. G. Drug-free Workplace Act, as amended, 41 U.S.C. ~701 et seq. - Requires the recipient to publish a statement about its drug-free workplace program and give a coPY of the statement to each employee (including consultants and temporary personnel) who will be involved in award-supported activities at any site where these activities will be carried out. Also, place(s) where work is being performed under the award (Le., street address, city, state, and zip code) must be maintained on file. The recipient must notify the Grants Officer of any employee convicted of a violation of a criminal drug statute that occurs in the workplace. For additional information, see 44 CFR Part 17. H. Sub-recipient agrees that it is not delinquent on any Federal debt. I. Sub-recipient will comply with all applicable requirements of all other federal laws, executive orders, regulations, program and administrative requirements, policies and any other requirements governing this program. Initial~ Date :5 - J- LJ.... /1--- Page 15 OF 18 J. Sub-recipient understands that failure to comply with any of the above assurances may result in suspension, termination or. reduction of grant funds. Please fill in the appropriate information and sign. Print Name of Authorized Official Michael J. Pfeifer Title Calhoun County Judge Sub-recipient Organization Calhoun County 05-24-2012 Date Initial-1if2- Date :5 -;J...tj -}'2.- Page 16 OF 18 EXHIBIT D State of Texas Assurances As the duly authorized representative of the sub-recipient, I certify that the sub-recipient 1. Will comply with Texas Govemment Code, Chapter 573, by ensuring that no officer, employee, or member of the applicant's goveming body or of the applicant's contractor shall vote or confirm the employment of any person related within the second degree of affinity or the third degree of consan!;luinity to any member of the governing body or to any other officer or employee authorized to employ or supervise such person. This prohibition shall not prohibit the employment of a person who shall have been continuously employed for a period of two years, or such other period stipulated by local law, prior to the election or appointment of the officer, employee, or governing body member related to such person in the prohibited degree. 2. Must insure that all information collected, assembled, or maintained by the applicant relative to a project will be available to the public during normal business hours in compliance with Texas Government Code, Chapter 552, unless otherwise expressly prohibited by law. 3. Must comply with Texas Govemment Code, Chapter 551, which requires all regular, special, or called meetings of governmental bodies to be open to the public, except as otherwise provided by law or specifically permitted in the Texas Constitution. 4. Must comply with Section 231.006, Texas Family Code, which prohibits payments to a person who is in arrears on child support payments. 5. Will not contract with or issue a license, certificate, or permit to the owner, operator, or administrator of a facility if the subgrantee is a health, human services, public safety, or law enforcement agency and the license, permit, or certificate has been revoked by another health and human services agency or public safety or law enforcement agency. 6. Must comply with all rules adopted by the Texas Commission on Law Enforcement Officer Standards and Education pursuant to Chapter 1701, Texas Occupations Code or must provide the grantor agency with a certification from the Texas Commission on Law Enforcement Officer Standards and Education that the agency is in the process of achieving compliance with such rules if the subgrantee is a law enforcement agency regulated by Texas Occupations Code, Chapter 1701. 7. Will follow all assurances. When incorporated into a grant award or contract, standard assurances contained in the application package become terms or conditions for receipt of grant funds. Administering state agencies and local subrecipients shall maintain an appropriate contract administration system to insure that all terms, conditions, and specifications are met. (See UGMS Section _.36 for additional guidance on contract provisions). 8. Must comply with the Texas Family Code, Section 261.101, which requires reporting of all suspected cases of child abuse to local law enforcement authorities and to the Texas Department of Child Protective and Regulatory Services. Subgrantees shall also ensure that all program personnel are properly trained and aware of this requirement. 9. Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352), which prohibits discrimination on the basis of race, color, or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. ~~1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. ~794), which prohibits discrimination on the basis of handicaps and the Americans with Disabilities Act of 1990; (d) the Age Discrimination Act of 1974, as amended (42 U.S.C. ~~6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to the nondiscrimination on the basis of alcohol abuse or alcoholism; (g) ~~523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. ~~290dd-3 and 290ee-3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. ~~3601 et seq.), as amended, relating to nondiscrimination in the sale, rental, or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is being made; and (j) the requirements of any other nondiscrimination statute(s) which may apply to the application. 10. Will comply, as applicable, with the provisions of the Davis-Bacon Act (40 U.S.C. ~~276a to 276a-7), the Copeland Act (40 U.S.C. ~276c and 18 U.S.C. ~874), and the Contract Work Hours and Safety Standards Act (40 U.S.C. 9~327-333), regarding labor standards for federally assisted construction subagreements. 11. Will comply with requirements of the provisions of the Uniform Relocation Assistance and Real Property Acquisitions Act of 1970 (P.L. 91-646), which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or federally assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases. 12. Will comply with the provisions of the Hatch Political Activity Act (5 U.S.C. 997321-29), which limit the political activity of employees whose principal employment activities are funded in whole or in part with Federal funds. 13. Will comply with the minimum wage and maximum hours provisions of the Federal Fair Labor Standards Act and the Intergovernmental Personnel Act of 1970, as applicable. 14. Will insure that the facilities under its ownership. lease, or supervision which shall be utilized in the accomplishment of the project are not listed on the Environmental Protections Agency's (EPA) list of Violating Facilities and that it will notify the Federal grantor agency of the receipt of any communication from the Director of the EPA Office of Federal Activities indicating that a facility to be used in the project is under consideration for listing by the EPA (EO 11738). Initial~ Date..)"" ~t./"'/2- Pege 17 OF 18 ( - I I l' . ~ I ... 15. Will comply with the flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973, Public Law 93-234. Section 102(a) requires the purchase of flood insurance in communities where such insurance is available as a condition for the receipt of any Federal financial assistance for construction or acquisition proposed for use in any area that has been identified by the Secretary of the Department of Housing and Urban Development as an area having special flood hazards. 16. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO i 1990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved state management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. ~~1451 et seq.); (f) conformity of federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. ~~7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended (P.L. 93-523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended (P.L. 93-205). 17. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. ~~1271 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 18. Will assist the awarding a~ency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. ~4 70), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. ~~469a-1 et seq.). 19. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. ~~2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance. 20. Will comply with the Lead-Based Paint Poisoning Prevention Act (42 U.S.C. ~~801 et seq.) which prohibits the use of lead-based paint in construction or rehabilitation of residential structures. 21. Will comply with Public Law 103-277, also known as the Pro-Children Act of 1994 (Act), which prohibits smoking within any portion of any indoor facility used for the provision of services for children as defined by the Act. 22. Will comply with all federal tax laws and are solely responsible for filing all required state and federal tax forms. 23. Will comply with all applicable requirements of all other federal and state laws, executive orders, regulations, and policies governing this program. 24. Certifies that is and its principals are eligible to participate and have not been subjected to suspension, debarment, or similar ineligibility determined by any federal, state, or local governmental entity and it is not listed on a state or federal government's terrorism watch list as described in Executive.Order 13224. Entities ineligible for federal procurement are listed at htto:/Iwww.eols.aov. 25. Must adopt and implement applicable provisions of the model HIV/AIDS work place guidelines of the Texas Department of Health as required by the Texas Health and Safety Code, Ann., Sec. 85.001, et seq. Please fill in the appropriate information and sign. Print Name of Authorized Official Michael J. Pfeifer Title Calhoun County Judge Sub-recipient Organization Calhoun County 05-24-2012 Date Initial bf Date :5-~t/-/2-- Page 18 OF 18 REQUEST BY MAINTENANCE SUPERVISOR FOR COUNTY CREDIT CARD: Everett Wood, Head Maintenance for Calhoun County requested Commissioners Court accept a credit card for the Maintenance Department for the limit of $5000. A Motion was made by Commissioner Finster and seconded by Commissioner Lyssy to accept a credit card for the Maintenance Department. Commissioner Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Susan Riley From: Sent: To: Subject: J everett wood [everett.wood@calhouncotx.org] Tuesday, May 15, 2012 1:02 PM susan riley credit card I need a credit card for our department. Can you please put this on our next court agenda. A 5,000 dollar limit will be sufficient for purchasing supplies on the net or places we don't have accounts. Thank You Everett Wood AMENDMENT TO COASTAL IMPACT ASSISTANCE PROGRAM (ClAP/GREEN LAKE) GRANT MANAGEMENT SERVICES CONTRACT WITH SMARTTGRANTS: Cindy Mueller, Calhoun County Auditor requested Commissioners Court accept CANTA on $5,421 amendment to Coastal Impact Assistance Program (ClAP/Green Lake) grant management services contract with SmarttGrants (Kathy Smartt.) A Motion was made by Commissioner Galvan and seconded by Commissioner Fritsch on the amendment to Coastal Impact Assistance Program grant management services contract with SmarttGrants. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. ~ Susan Riley From: Sent: To: Cc: Subject: Attachments: )? Cindy Mueller [cindy.mueller@calhouncotx.org] Friday, May 04,2012 11 :21 AM 'Susan Riley' 'Kathy Smartt' Agenda Item Request Re: Working on ClAP projects (9.82 KB); Kathy Smartt Contract.pdf Please place the following item on the agenda for May 24,2012: · CANTA on $5,421 amendment to Coastal Impact Assistance Program (ClAP/Green Lake) grant management services contract with SmarttGrants (Kathy Smartt). See attached email from Kathy Smartt. Cindy Mueller Calhoun County Auditor 202 S. Ann, Suite B Port Lavaca, TX 77979 Phone 361.553.4610 Fax 361.553.4614 1 LOAN FROM GENERAL FUND TO CAPITAL PROJECT-ClAP COASTAL IMPROVEMENTS FUND TO PAY ADDITIONAL ADMINISTRATIONAL SERVICES FOR GREEN LAKE: Cindy Mueller, Calhoun County Auditor requested Commissioners Court authorize the $5,421 loan from general fund to Capital Project-ClAP Coastal Improvements fund to pay additional administration services for Green Lake. A Motion was made by Commissioner Galvan and seconded by Commissioner Lyssy to authorize the $5,421 loan from general fund to Capital Project-ClAP Coastal Improvements fund, Commissioners Galvan, Lyssy, Fritsch, Finster, Fritsch and Judge Pfeifer all voted in favor, Susan Riley From: Sent: To: Subject: q Cindy Mueller [cindy.mueller@calhouncotx.org] Friday, May 04, 2012 11 :32 AM 'Susan Riley' Agenda Item Request Please place the following item on the agenda for May 24, 2012: · CATNA to authorize $5,421 loan from general fund to Capital Project-ClAP Coastal Improvements fund to pay additional administration services for Green Lake. Cindy Mueller Calhoun County Auditor 202 S. Ann, Suite B Port Lavaca, TX 77979 Phone 361.553.4610 Fax 361.553.4614 Susan Riley From: Sent: To: Subject: Kathy Smartt [smarttgrants@sbcglobal.net] Thursday, May 03, 20124:51 PM Cindy Mueller Re: Working on ClAP projects Yes, thanks. What about my CMP contract? Does anything else need to be done since the court approved the $1000 increase last week? On May 3, 2012, at 4:46 PM, Cindy Mueller wrote: Kathy, I think your billing plan should work fine. An agenda item will be needed to amend your contract. Do you want me to send the request to Susan to put on 5/24 agenda? From: Kathy Smartt [mailto:smarttQrants(6)sbcglobal.net] Sent: Thursday, May 03, 2012 10:29 AM To: Cindy Mueller Subject: Working on ClAP projects Cindy, In addition to the Port Alto project, I will start spending some time on the Green Lake project. Even thought the projects have not yet been awarded, I really should start charging my administrative time to the individual projects and not to the overall ClAP administration project. I had moved admin funds into all the projects when I submitted the grant applications, so administration funds could be charged against each project. My contract is not tied to any particular project, although all my expenses to date should be drawn down from the overall ClAP administration project. But the time is approaching to separate my expenses into various projects. Please give it some thought on what you want me to do when invoicing. ie. I can invoice against my contract, but separate out expenses by project. I had broken down my contract to cover the admin amounts for each project. $34,000 for overall admin $4,000 for Port Alto $3,000 for Indianola $3,000 for Seadrift $1,000 for Green Lake Total: $45,000 However, now that I have to write the conservation and management plan for Green Lake, my contract needs to be increased by $5,421. The admin costs for Green Lake per the grant application is $6,421. I will probably be in Port Lavaca on the 24th for the Commissioners Court meeting and can meet with you afterwards to discuss all of this if needed. Please let me know what is the best course of action to ensure that my expenses are charged to the appropriate project. 1 EASEMENT AGREEMENT WITH JOHN BEHRENS TO IMPROVE DRAINAGE IN PRECINCT #3: Commissioner Fritsch with Precinct 3 requested Commissioners Court allow himself to enter into an easement agreement with Mr. John Behrens to improve drainage, The Dominant Estate Property is generally described as Block 7, Tract Part 8, 26.22 acres more or less in Tract 4 Swenson Estate. The Easement Property is a drainage ditch along the fence line of the property in a Westerly direction to State Highway 172 to improve the drainage from the Olivia Volunteer Fire Department property. Commissioner Fritsch announced to Commissioners Court that Shannon Salyer, County Attorney, looked over the agreement and everything looked correct. A Motion was made by Commissioner Fritsch and seconded by Commissioner Lyssy to improve drainage and enter into an easement agreement with Mr, John Behrens. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. If) C'AL'O"'N'C." ' 'C'.OMlSS' ',"'" - "".--PRt"" ",' '" "";}-' ft' ' 'U ' '0 UNTYMIONER' - 'CIN' , 'CT' , . . .' :..,', .', ,'C,'. '" '", "'','/ .<,,'_ j' '. .' . ',_ :,;': . '::' ' _' :,. ,l,' :::. ' ';';'> ,,'~" "'.,'. , ',' .,_'. '/J: ,,: """""_"':";~ " .," _, ' " ,,', ".. ..' . .' .' . _,_ " . ','~' -"'. " ," ,,_" ',' . -'. .:f. ,.,..', :,' :'. ' ." _ , , . .',.- ,-.'. .. . , '". , '-"" - ... .'-, ',', -, ,,_ .- . .. . . ._..:.... . ',,_ .....-.'.:..__..., .C.:', ........', ',..,"'_ .... ',:._,,"".,'J- . . .. '. . . ','-, .,'. "-" .' -. _ ...., ", -, .' ,,'-., -',', -....-"..., ,,- _ ....... -. "'" -.',-..,.,', ..,....".;, 240717 stot~ Hwv. 172....01Ivlo, Port Lovaco, te)(0$17979 ~ Offi~E) ($61>$9'3,;5346 ...Fclx:($6iJ'e<}a~ HornE) (.361 }$$2~$~tl.5'...NcWE. Frltseh,QJf(lmi$$1onei':.Pci.., "'Mt>bUE) (36r) 92Q~46 Emolt: ccptCf$@!GfWotd,Com May 17,2012 H(jjl1orabte JUdge Miohii:lel Pfeifer From: Neil Fritsch Re: Agenqa Item Please placethefoIJowitl9 item on the Commissioner~s Court Agenda.forlVlay24,2D12; ttCim'$itleta~dt4ke necessary tlcti()h 10 allow Cf)Wllni$sioner Fri~ch If) ehlt!t .tlt; 1(j.i1n Jiasement Agreement willi Mr. Julin Behrens to improve drai1lage. " "":.,. 1J;~ NeUE. Fritsch cc: Roger Galvan Vern Lyssy Kenneth Finster Susan Riley M^V_~~_~n4~ ~n.~~ ..-~ _ _...,,.... t:""t:""..,AA....... MAY-23-2012 10:17 From: 3615534421 Page: 2/6 EasetDent Agreement for Access Date: JU/le tfJ t;::, .2012 Grantor: Calhoun County, a division of Texas government GJ'8otor's Mailibg Address: Neil Fritsch Calhoun County Precinct 3 24627 SWe Highway 172 Port Lavaca, Texas 77979 Calhoun County G.raotee: John Behren.s Grantee's Mailing Address: John Behrens 382 County Road 304 E Port Lavaca, Texas 77979 Calhoun County Domi09ntEstate I'roperty: .Generally described as Block?, Tract Pan 8, 26.22 Acres morc::or less in Tract 4 Swenson Estate, Calhoun County, Texas, andponions thereof. Easeme'Ot Propeny: a drainage ditch along the fence line of the property ina Westerly direction to State Highway 172 to improve the drainage from the Olivia VolUntccr Fire Department propeny. Easement Purpose: Drainage easement CoosldeW'8don: The sum of TEN AND NO/IOO DOLLARS ($10.00) tuld other good and valuable consideration, the receipt and sufficiency of which are hotChy acknowledged. by Grantor. Reservatioos from COOyeyaD": Calhoun County will pay forQllydamages done and dispose oithe dirt in a manner acec:ptllblc: to John Behrens. Exceptions to Warraoty; None. GnulI Of Easement: Grantor, for the ConsidCI'lition Oll.d subject to the Reservations from Conveyance and Exceptions to Wanonty, grWltB, sel15, and conveys to Grantee and GJ:antee's MAY-23-2012 10:18 From: 3615534421 PClge:3/6 heirs, successors, and assigns an easement over, on" and across the Easement Property for the Easem.ent Purpose . and for the. benefit of the Donlinant Estate Property, together With all and singular the rights and appurtenances thereto in any way belonging (collectively, the "Easement"), to have and to hold the Easement to Grantee and Grantee's heirs, successors, and asSlgnS. Grantor binds Grantor and Grantor's heirs, successors, and assigns to warrant and forever defend the title to the Easement in Grantee and Orantee's heirs, successors, and assigns against every person whomsoever lawfully claiming or to claim the Easement or any part thereof, except as to the Reservations from Conveyance and Exceptions to warranty, to the extent that such claim arises by, through, or under Grantor but not otherwise. Tennsand ConditioDs: The following terms and conditions apply to tbeEasement granted by this agreement: 1. Character of Easement. Drainage Easement 2. Durarton of Easement. The duration of the Easement is for 90 days. 3. ReServation of Righls. Grantor reserves for Omntor and Gnmtor's heu:!, successors, and assigns the right to continue to u.scand enjoy the ,urface of the Easement Property fo.. all pw:poses that do not intcrfcrc with or interrupt the we or enjoyment of the Easement by Holder for the Easement Purposes. Grantor l"C3Cxve$ for GrtUltor and <kantor's heirs, SUQA,;$SOr.i, and assigns the right to we all or port of the Basement in conjunction with Holder and the right to convey to others the right to use all or part of the Easement in conjunction with Holder. as long as such further conveyance is subject to the terms of this agreement and the other use.-s agree to bear a proportionate part of the costs of improving and maintaining the Easement. M^V_~7_~~1~ 1~.10 L___.~':=1C=C=~AA~1 0...._-..,1/1::.. MAY-23-2012 10:18 From: 3615534421 Page:4/6 4. Binding Effect. lbis agreement binds and inures to the benefit of the parnes and their respective heirs, successors, and permitted assigns. 5. Choice of Law. This agreement will be construed under the laws of the state of Texas. without regard to choice-of-lawrules of any jurisdiction. Venue is in the eounty or counties in which the Easement Property is located. 6. Counterparts., This agreement may be executed in any number of OOl.Ultexparts with the same effect as if all signatory parties had signed the same document. All COl.Ulterpart:5 will be construed together and will constitute one and the same instrUment. 7. Waiver of Default. It is not a waiver of or consent to default if the nondefaulting party fails to declare immediately a default or delays in taking any action. Pursuit of any remedies set fonh in this agreement does not preclude pursuit of other remedies in this agreement or provided by law. 8. Further Assurances, Each signatory partyagrccs to execute and deliver any additional documents and insttumcnts and to perform MY additional acts necessary or appropriate to perform the terms, provisions. and conditions of this agreeroentahd all transactiom; oontcmplated by thi3 ~en,t. 9. EnJire Agreement. This agreement and MY exhibits constitute the entire. o.greement of the parties concerning the grant of the Easement by Grantor to Grantee. There are no representations, agteements, warranties, OJ: pl'omises that are not in this agreement and any exhibits. 10, Legal Construction. If any prOVISlon in this agreement is: for any reason unenforceable, to the extent the unenforceahility does not destroy the basis of the bargain among the parties, theunenfol'ceability will not affect any other provision hereof. and this agreement MHY-c~-c~lc 1~:1~ I- rom: ~bl~~:d44cl t-'"ge: ~/b will be construed as if the unenforceable provision bad never been a pan of the agreemenL Whenever context requires, the singular will include the plural and neuter include the masculine or feminine gender, and vice versa Article and section headings in this agreement are for reference only and are not intended to restrict or define the text of any section. This agreement will not be construed more. or less favorably between the parties by reason of authorship or origin of language. 11. Notices. Any notice required orpennitted \Uuler this agreement must be in writing. Any notice required by this agreement will be deemed to be delivered (whether actuaHy received or not) when deposited with the United States Postal S~rvice, postage prepaid, certified mail, return receipt requested, and addressed to ilie intendedrecjpient at the address shown in this agreement. NOtice may also be given by regular mail, personal delivery, courier delivery, facsimile transmission, or other commercially reasonable means and will be effective when actually rccc:ived. Any address for notice maybe ch611ged by written notice delivered as provided herein. 12. Re.citals. Any ~itals in this agreement arc represented by the parties to be acCU11ltc, 6lld COh5titutc aport of the substantive agreement. 13. Time. Time is of the essence. Unless otherwise specified, all references to "days" mean calendar days. Business days exclude Saturdays, Sundays, and legal public holidays. If the date for performance of any obligation falls on a Saturday, Sunday, or legal pu.blic holiday, the date for perfonnance will be the next following J"eguIar business day. Signed in duplicate this the ~ (;, day of Tune .2012. MAY-23-2012 10:18 From: 3515534421 Page:5/6 Calhoun Cowny, a Texas corporation, BV:~~ Neil ri sch, COmmissioner . u~ Johf'Behrens STATE OFTEXAS ) COUNTY OF CALHOUN ) This ~ent was acknowledged before me on <: j l{)'1 ~ r. . 2012,. by Neil Fritsch,as the Commissioner of Calhoun COuilty, a unit of Te'l<." 80vpnme!!. t, on behalf of SaJ.. . d county. /.....~~ SONlADOWNS ~ j I~ 5 MY~",,'f'RES . Notaty ~blic. s...~ ofTex.. "-5-.) A I~ / ~ MYCOIDmlSSlOn expues: =t7=>.~ 0 . ""C-V, STATE OF TEXAS ) COUNTY OF CALHOUN ) This was acknowledged before me ,2012, by John Behrens. on SONIA DOWNS MY COMMISSION EXPIRES August 5, 2014 Notary P~bl~c, S~ of Texas R e::- ~ 1.'1 MycoxmmsslonexpJres: - J-- () l' CONTRACT AMENDMENT FROM DEPARTMENT OF STATE HEALTH SERVICES TO CALHOUN COUNTY HEALTH DEPARTMENT: Bain C. Cate, with Calhoun County Health Department requested Commissioners Court sign a contract agreement from Department of State Health Services to Calhoun County Health Department. The purpose of the amendment is to increase the contract Categorical Budget amount by $7,046.72. Supplies increased by $1,050. Other items have increased by $744 and property equipment is increased by $5,253. Personnel is being decreased by $0.28. the total revised amount of the contract is $37,088. A Motion was made by Commissioner and seconded by Commissioner to approve and sign the contract amendment from the Department of State Health Services to Calhoun County Health Department. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. ..;," r Ii 117 WASH ST PORT LA V ACA, TX 77979-2912 Bain C. Cate, M. D., Medical Director Phone (361) 552-9721 Fax (361) 552-9722 May 10, 2012 Calhoun County Commissioners' Court Attn: Honorable Judge Michael J, Pfeifer 211 S ANN ST STE 301 PORT LAVACA TX 77979-4249 Judge Pfeifer, The Texas Department of State Health Services (DSHS) has forwarded to Calhoun County Health Department (CCHD) Amendment No. 001A : RLSS/LPHS to Contract No. 2012-039455. Calhoun County Commissioners' Court (CCCC) previously approved the base contract during the meeting which occurred on September 08, 2011, and the fully executed contract was returned to CCCC for filing shortly thereafter. The award amount of the original contract was $30,041.28, which was a 19% decrease when compared to the FY 2011 funding of $37,088. This contract amendment will serve to restore these lost funds, totaling $7046.72, for just this one time. There is no plan to provide this increase during the next contract term (FY 2013). Strangely enough, DSHS, for the first time in many years of awarding these funds, will not allow CCHD to use these funds on personnel, but rather the funds may be spent on supplies, equipment and other expenses. As you will note in the budget document of this amendment, $5253 has been granted for equipment, which will amount to replacing the current four desktop computer systems which were placed into service on September 10, 2007. As well, $1050 will be used for various medical and office supplies expenses, and $744 will be used for other expenses including laboratory tests ordered for Tuberculosis patients and postage for immunization reminders. Lastly, $0.28 will be subtracted from the personnel line item of the budget. I really don't understand why DSHS fools with those pennies, but they do. More importantly, the non-equipment dollar amounts can be used to recover allowable expenses of CCHD incurred since the Calhoun County fiscal year starting January 01, 2012, so this amendment, if approved, will result in return of Calhoun County budget funds to those line items for said expenses. I have already communicated with Cindy Mueller concerning this process, and she will assist Kathy Dietzel in identifying allowable expenses, and recovering some of those funds. In summary, this appears to be a little "Christmas in May" for CCHD, and it is my intent to capitalize on this one-time offering of funds for the benefit of Calhoun County. I have looked over these documents, and recommend that Calhoun County Commissioners' Court review, potentially approve, and subsequently authorize the County Judge to sign these documents. Two original sets of documents have been submitted, and I will need both sets back as soon as possible so that they can be sent back to OSHS for their signature via secure delivery. Ultimately the fully executed agreement will be returned to the Court for filing, hopefully in the near future. Please notify me if there are any questions or concerns about this, or any CCHO issue. Sincerely, ~e.~/~. Bain C, Cate, M.D, ..;t '" DEPARTMENT OF STATE HEALTH SERVICES 1100 WEST 49TH STREET AUSTIN, TEXAS 78756-3199 CATEGORICAL BUDGET CHANGE REQUEST DSHS PROGRAM: RLSS-LOCAL PUBLIC HEALTH SYSTEM CONTRATOR: CALHOUN COUNTY HEALTH DEPARTMENT CONTRACT NO: 2012-039445 CONTRACT TERM: 09/01/2011 THRU: 08/31/2012 BUDGET PERIOD: 09/01/2011 THRU: 08/31/2012 CHG: 001A Personnel $30,041.28 $30,041.00 $(0.28) Fringe Benefits $0.00 $0.00 $0.00 Travel $0.00 $0.00 $0.00 Equipment $0.00 $5,253.00 $5,253.00 Supplies $0.00 $1,050.00 $1,050.00 Contractual $0.00 $0.00 $0.00 Other $0.00 $744.00 $744.00 Total Direct Charges $30,041.28 $37,088.00 $7,046.72 Cost Total $30,041.28 Performing Agency Share $0.00 Receiving Agency Share $30,041.28 Total Reimbursements Limit $30,041.28 $37,088.00 $0.00 $37,088.00 $37,088.00 $7,046.72 $0.00 $7,046.72 $7,046.72 Financial status reports are due: 12/30/2011, 03/30/2012, 07/02/2012, 10/31/2012 e~ .( DEPARTMENT OF STATE HEALTH SERVICES Amendment To The Department of State Health Services (DSHS) and CALHOUN COUNTY HEALTH DEPARTMENT (Contractor) agree to amend the Program Attachment # 001 (Program Attachment) to Contract # 2012-039455 (Contract) in accordance with this Amendment No. OOIA : RLSSILPHS. effective 04/12/2012. The purpose of this Amendment is to increase the contract Categorical Budget amount by $7.046.72. Suoplies is increased by $1.050.00. Other is increased by $744.00 and Prooerty Eouipment is increased by $5~253.00. Personnel is being decreased by $0.28. The Total revised amount of the contract is $37.088,00. Therefore, DSHS and Contractor agree as follows: The Program Attachment number is revised as follows: PROGRAM A IT ACHMENT NO. 00l 00lA All other terms and conditions not hereby amended are to remain in full force and effect. In the event of a conflict between the terms of this contract and the terms of this Amendment, this Amendment shall control. Department of State Health Services Calhoun County Health Department Signature of Authorized Official s~:i.g~ii~ Date: Date: May 24. 2012 Bob Bumette, C.P.M., CTPM Name: Michael J. Pfeifer Director, Client Services Contracting Unit Title: Calhoun County Judge 1100 WEST 49TH STREET AUSTIN, TEXAS 78756 Address: 211 S. Ann Street, Suite 301 (512) 458-7470 Port Lavaca TX 77979 Bob.Bumette@dshs.state.tx.us Phone: 1/11-'1'11-4/100 Email: mike. pfeifer@calhouncotx.org Page - 10fl PUBLIC HEARING ON THE MATTER OF AMENDING THE 2011 AND 2012 CALHOUN COUNTY BUDGETS: Judge Pfeifer opened a public hearing on the matter of amending the 2011 and 2012 Calhoun County Budgets at 11:47 A.M, Cindy Mueller with the Auditor's Office read the following 2011 and 2012 Calhoun County Budget Amendments. There were no objections from the Public. The public hearing ended at 11:51 AM. /2-.. NOTICE OF PUBLIC HEARING NOTICE IS HEREBY GIVEN that Calhoun County Commissioners' Court will hold a public hearing in the Commissioners' Courtroom, 211 S. Ann Street, in Port Lavaca, Texas, at 10:00 a.m. on May 24,2012 on the matter of amending the 2011 and 2012 Calhoun County Budgets. The public shall have the right to be present and participatejn such hearing. Michael J. Pfeifer Calhoun County Judge AMEND THE 2011 AND 2012 CALHOUN COUNTY BUDGETS: A Motion was made by Commissioner Fritsch and seconded by Commissioner Lyssy to .amend the 2~11 and 2012 Calhoun County Budgets. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted In favor. ~ (I) Co ::> (I) Ul Co III ':< 5:: III '< I\) 5" I\) ~ I\) "'tI III CO (I) 8- ee -- CI= m= "a = :1>= ::0= -1= 3:~ m= z= -I~ z~ :1>= 3:= m~ .. - c..~ :1>= -= r-~ CI~ m= "a = :I>~ ::0= -1= 3:= m= z~ -1= z~ 0= .. = ~= CD= Q~ Iii iftifllllll CO~ 11 ..'. 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I: l: w m ... .. ... z oIiIo Z m 0 m a " m m a " -I - 0 =a ;a -I m I: n 0 m ;a Z a -I en % m S Z G) '1J C ;a n % ~ en m a all -< "" 0 " en r- m - " z - N = 0 ... N I: m z -I z 0 .. U>> U>> U>> I r I r ; I , ! ! I l ~l'" = c:: = <: = 0 ~ I~ = Ii: = I'll - - ':.1. l. :.:t ~ J! ~ r- I~ I~ o -;t. CI) ~ o ~ .""'t r- 6i ~ ::0 "< ." ~ '0 C!: o .. U'I ~ 0) U'I EXECUTIVE SESSION: The Commissioners' Court shall go into Executive Session as authorized by V.T.C.A. Government Code Chapter 551, Subchapter D. Following is the subject matter of the Executive Session and the Specific Section of the Open Meetings Act permitting discussion/deliberation in Executive Session. Section 551.072 A government body may conduct a closed meeting to deliberate the purchase, exchange, lease or value of real property if deliberation in an open meeting would have a detrimental effect on the position of the governmental body in negotiations with a third party. MATTERS DISCUSSED IN EXECUTIVE SESSION: Commissioner Finster announced that he authorize through Commissioners Court a loan from the General Fund to Capital Project ClAP Improvement Project Fund for $480,000 for the Port O'Connor Acquisition. A Motion was made by Commissioner Finster and seconded by Commissioner Fritsch. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. COUNTY REPORTS: The County Clerks Office presented their monthly report for the month of April, 2012, Justice of the Peace #1 presented their monthly report for the month of April, 2012, Justice of the Peace presented their monthly report for the month of April, 2012. Justice of the Peace presented their monthly report for the month of April, 2012. The County Treasurer's Office presented their monthly report for the month of April, 2012. A Motion was made by Commissioner and seconded by Commissioner to approve all county reports, Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. ANITA FRICKE - COUNTY CLERK MONTHLY REPORT RECAPITULATION OFFICE FUND - APRIL 2012 CIVIL FUNDS County Fees County Clerk's Fees Recording Probate Civil Total County Clerk's Fees Judge's Fees Probate Civil Total Judge's Fees Probate Fees (Education Fees) Sheriffs Fees Jury Fees Law Library Fees Beer Licenses Appellate Fund (TGC) Court Reporter Fees Civil Indigent Fees Record Management Fees (County Clerk) Record Management Fees (County) Security Fees (County) Bond Forfeitures Subtotal County Fees $10,191.00 40.00 520.00 $10,751.00 10.00 10.00 5.00 350.00 22.00 490.00 70.00 210.00 160.00 1,610.00 80.00 408.00 0.00 $14,166.00 State Fees Judicial Funds (CV$ + PR$) Marriage License Fees Birth Certificate Fees Total State Fees SUBTOTAL Overpmt of Filing Fees to be Refunded by Co. Clk. TOTAL CIVIL FUNDS COLLECTED 1,148.00 535.00 108.00 1,791.00 $15,957.00 0.00 $15,957.00 CRIMINAL FUNDS Total Criminal Court Costs & Fines & Pre-Trial Diversion TOTAL FUNDS RECEIVED (As per ACS Report) Bank Interest Earned $8,328.10 $24,285.10 TOTAL FUNDS RECEIVED $24,285.10 0.00 $24,285.10 Less Refunds for Overpayment of Filing Fees ADJUSTED FUNDS RECEIVED Plus Re-Deposit of NSF Checks (Not recorded in ACS) Less NSF Checks (Not recorded in ACS) Co. Clerk Check AMOUNT DUE COUNTY TREASURER $24,285.10 I --".., .!, ANITA FRICKE - COUNTY CLERK MONTHLY REPORT RECAPITULATION (con't) OFFICE FUND - APRIL 2012 DISBURSEMENTS CK# Pavable To Description Amount $0.00 $0.00 $0.00 TOTAL DISBURSEMENTS $0.00 $0.00 BANK RECONCILIATION. OFFICE FUND Ending Bank Balance Outstanding Deposits" Outstanding Checks" Plus Other Items" Less Other Items" Reconciled Bank Balance $0.00 CASH ON HAND. OFFICE FUND Beginning Book Balance Funds Received Disbursements Plus Redeposit of NSF Checks Less NSF Checks Ending Book Balance CASH ON HAND. TRUST FUND Beginning Book Balance Funds Received Disbursements Ending Book Balance $22,499.63 BANK RECONCILIATION. TRUST FUND Ending Bank Balance Outstanding Deposits" Outstanding Checks" Reconciled Bank Balance $22,494.63 0.00 0.00 $22,494.63 (5.00) $22,494.63 "See Attached ~~~ SUBMITTED BY: Anita Fricke, County Clerk '. ~ /~ ENTERCOURTNAME: .... .. ENTERMQNTH()f'RI;~dRT..' ENTERYEAROF..REPORT DUPO()'f DUETO CCISD -50%of..Fineon.JVcases.: .. [)UET06AREStltlJTION.FlJ~D. ,., REFUNDOFpVERPAYMENTS .. OUT-OF-COUNTXSERVICEFEE. CASH BOf\lOS, .' .,. , , ,. .. . ",",'.: .-:.. ,,:..-,.. ",,:"';'.:,':.::.:':':'''', -' " ,"',-,' ,", .....,'..-' ",-.-' .... , . ... .", -,-, ",..-''', ".."" '-,.," ", ,"",,' .., ,'''"'",','.....,,..- --'", ' , TREASURERS RECEIPTS.FOR MONTH: .', ." ~ MONTHL Y REPORT OF COLLECTIONS AND DISTRIBUTIONS 5/4/2012 COURT NAME: JUSTiCE OF PEACE NO.1 MONTH OF REPORT: APRIL YEAR OF REPORT: 2012 ACCOUNT NUMBER ACCOUNT NAME CR 1000-001-45011 FINES CR 1000-001-44190 SHERIFF'S FEES ADMINISTRA T1VE FEES: DEFENSIVE DRIVING 69.30 CHILD SAFETY 0.00 TRAFFIC 109.84 ADMINISTRATIVE FEES 735.06 EXPUNGEMENT FEES 0.00 MISCELLANEOUS 0.00 CR 1000-001-44361 TOTAL ADMINISTRATIVE FEES CR 1000-001-44010 CONSTABLE FEES-SERVICE CR 1000-001-44061 JP FILING FEES CR 1000-001-44090 COPIES I CERTIFIED COPIES CR 1000-001-49110 OVERPAYMENTS (LESS THAN $10) CR 1000-001-44145 SCHOOL CROSSING/CHILD SAFETY FEE CR 1000-999-20741 DUE TO STATE-DRIVING EXAM FEE CR 1000-999-20744 DUE TO STATE-SEATBELT FINES CR 1000-999-20745 DUE TO STATE-CHILD SEATBEL T FEE CR 1000"999-20746 DUE TO STATE-OVERWEIGHT FINES CR 1000-999-20770 DUE TO JP COLLECTIONS ATTORNEY TOTAL FINES, ADMIN. FEES & DUE TO STATE CR 2670-001-44061 COURTHOUSE SECURITY FUND CR 2720-001-44061 JUSTICE COURT SECURITY FUND CR 2719-001-44061 JUSTICE COURT TECHNOLOGY FUND CR 2699-001-44061 JUVENILE CASE MANAGER FUND STA TE ARREST FEES DPS FEES 140.15 P&W FEES 0.00 T ABC FEES 0.00 CR 7020-999-20740 TOTAL STATE ARREST FEES CR 7070-999-20610 CCC-GENERAL FUND CR 7070-999-20740 CCC-ST A TE DR 7070-999-10010 3,051.93 CR 7860-999-20610 STF/SUBC-GENERAL FUND CR 7860-999-20740 STF/SUBC-ST A TE DR 7860-999-10010 1,099.45 CR 7950-999-20610 TP-GENERAL FUND ;iI CR 7950-999-20740 TP-ST A TE i DR 7950"999-10010 678.64 CR 7480-999-20610 CIVIL INDIGENT LEGAL-GEN. FUND I CR 7480-999-20740 CIVIL INDIGENT LEGAL-STATE l DR 7480-999-10010 30.00 , I: I Page 1 of 2 AMOUNT 8,012.55 1,018.58 914.20 150.00 125.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1,839.33 $12,059.66 $303.85 $14.80 $304.85 $362.03 140.15 305.20 2,746.73 54.97 1,044.48 339.32 339.32 1.50 28.50 .. . ~. ~ "'1 MONTHL Y REPORT OF COLLECTIONS AND DISTRIBUTIONS 5/4/2012 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 7/13/2011 COURT NAME: JUSTICE OF PEACE NO.1 MONTH OF REPORT: AP~L YEAR OF REPORT: 2012 DR 7865.999-10010 CRIM-SUPP OF IND LEG SVCS-GEN FUND CRIM-SUPP OF IND LEG SVCS-STATE 150.47 TUFTA-GENERAL FUND 110.00 TUFTA-STATE 220.00 15.05 135.42 DR 7970-999-10010 330.00 JPAY - GENERAL FUND 42.89 JPAY - STATE 386.02 DR 7505-999-10010 428.91 JURY REIMB. FUND- GEN. FUND 29.11 JURY REIMB. FUND- STATE 261.95 DR 7857-999-10010 291.06 CIVIL JUSTICE DATA REPOS.- GEN FUND CIVIL JUSTICE DATA REPOS.- STATE 0.00 0.00 DR 7856-999-10010 0.00 TOTAL (Distrib Req to Oper Acct) $19,245.80 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 55.18 0.00 0.00 0.00 306.00 0.00 TOTAL DUE TO OTHERS $361.18 TOTAL COLLECTED-ALL FUNDS LESS: TOTAL TREASUER'S RECEIPTS OVER/(SHORT) $19,606.98 $19,606.98 $0.00 Page 2 of2 ~) !:f ..,': ~ !:I' . <.! MONTHL Y REPORT OF COLLECTIONS AND DISTRIBUTIONS 5/7/2012 COURT NAME: JUSTICE OF PEACE NO.2 MONTH OF REPORT: APRIL YEAR OF REPORT: 2012 ACCOUNT NUMBER ACCOUNT NAME AMOUNT CR 1000-001-45012 FINES 11,439.61 CR 1000-001-44190 SHERIFF'S FEES 2,473.94 ADMINISTRA TIVE FEES: DEFENSIVE DRIVING 39.60 CHILD SAFETY 0.00 TRAFFIC 126.58 ADMINISTRATIVE FEES 559.61 EXPUNGEMENT FEES 0.00 MISCELLANEOUS 0.00 CR 1000-001-44362 TOTAL ADMINISTRATIVE FEES 725.79 CR 1000-001-44010 CONSTABLE FEES-SERVICE 150.00 CR 1000-001-44062 JP FILING FEES 150.00 CR 1000-001-44090 COPIES I CERTIFIED COPIES 0.00 CR 1000-001-49110 OVERPAYMENTS (LESS THAN $10) 10.00 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-SEATBELT FINES 51.00 CR 1000-999-20745 DUE TO STATE-CHILD SEATBEL T FEE 0.06 CR 1000-999-20746 DUE TO STATE-OVERWEIGHT FINES 0.00 CR 1000-999-20770 DUE TO JP COLLECTIONS ATTORNEY 3,652.50 TOTAL FINES, ADMIN. FEES & DUE TO STATE $18,652.90 CR 2670-001-44062 COURTHOUSE SECURITY FUND $374.41 CR 2720-001-44062 JUSTICE COURT SECURITY FUND $0.00 CR 2719-001-44062 JUSTICE COURT TECHNOLOGY FUND $382.41 CR 2699-001-44062 JUVENILE CASE MANAGER FUND $324.89 STA TE ARREST FEES DPS FEES 267.30 P&W FEES 5.00 T ABC FEES 0.00 CR 7020-999-20740 TOTAL STATE ARREST FEES 272.30 CR 7070-999-20610 CCC-GENERAL FUND 382.40 CR 7070-999-20740 CCC-ST ATE 3,441.56 DR 7070-999-10010 3,823.96 CR 7860-999-20610 STF/SUBC-GENERAL FUND 63.29 CR 7860-999-20740 STF/SUBC-STATE 1,202.45 DR 7860-999-10010 1,265.74 CR 7950-999-20610 TP-GENERAL FUND 380.64 CR 7950-999-20740 TP-ST ATE 380.63 DR 7950-999-10010 761.27 CR 7480-999-20610 CIVIL INDIGENT LEGAL-GEN. FUND 1.80 CR 7480-999-20740 CIVIL INDIGENT LEGAL-STATE 34.20 DR 7480-999-10010 36.00 Page 1 of 2 ~ ~ !! MONTHL Y REPORT OF COLLECTIONS AND DISTRIBUTIONS 5/7/2012 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 07113/11 COURT NAME: JUSTICE OF PEACE NO.2 MONTH OF REPORT: APRIL YEAR OF REPORT: 2012 DR 7865-999-10010 CRIM-SUPP OF IND LEG SVCS-GEN FUND CRIM-SUPP OF IND LEG SVCS-STATE 155. 17 TLlFTA-GENERAL FUND 327.80 TLlFTA-STATE 655.59 15.52 139.65 DR 7970-999-10010 983.39 JPAY - GENERAL FUND 50.56 JPAY - STATE 455.01 DR 7505-999-10010 505.57 JURY REIMB. FUND- GEN. FUND 35,04 JURY REIMB. FUND- STATE 315.36 DR 7857-999-10010 350.40 CIVIL JUSTICE DATA REPOS.- GEN FUND CIVIL JUSTICE DATA REPOS.- STATE 0.36 3.23 DR 7856-999-10010 3.59 TOTAL (Distrib Req to Oper Acct) $27,892.00 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 57.73 548.00 0.00 0.00 650.25 0.00 TOTAL DUE TO OTHERS $1,255.98 TOTAL COLLECTED-ALL FUNDS LESS: TOTAL TREASUER'S RECEIPTS OVER/(SHORT) $29,147.98 $29,147.98 $0.00 Page 2 of2 ENTERCOURTNAME: EN'TERMONTHOF. REPORT ENTER. YI:AR OF REpORT, ~~l1l~~i(,.:::"11;::i:~,: ,I. ' i!:lL::,i~;,~.'Y !I b MONTHL Y REPORT OF COLLECTIONS AND DISTRIBUTIONS 5/7/2012 COURT NAME: JUSTICE OF PEACE NO.4 MONTH OF REPORT: APRIL YEAR OF REPORT: 2012 ACCOUNT NUMBER ACCOUNT NAME AMOUNT CR 1000-001-45014 FINES 2,860.25 CR 1000-001-44190 SHERIFF'S FEES 508.26 ADMINISTRA TIVE FEES: DEFENSIVE DRIVING 0.00 CHILD SAFETY 0.00 TRAFFIC 40.28 ADMINISTRATIVE FEES 321.90 EXPUNGEMENT FEES 0.00 MISCELLANEOUS 0.00 CR 1000-001-44364 TOTAL ADMINISTRATIVE FEES 362.18 CR 1000-001-44010 CONSTABLE FEES-SERVICE 75.00 CR 1000-001-44064 JP FlUNG FEES 50.00 CR 1000-001-44090 COPIES / 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-SEATBELT FINES 0.00 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 427.20 TOTAL FINES, ADMIN. FEES & DUE TO STATE $4,282.89 CR 2670-001-44064 COURTHOUSE SECURITY FUND $127.74 CR 2720-001-44064 JUSTICE COURT SECURITY FUND $27.76 CR 2719-001-44064 JUSTICE COURT TECHNOLOGY FUND $128.74 CR 2699-001-44064 JUVENILE CASE MANAGER FUND $110.00 STATE ARREST FEES DPS FEES 109.07 P&W FEES 8.00 T ABC FEES 0.00 CR 7020-999-20740 TOTAL STATE ARREST FEES 117.07 CR 7070-999-20610 CCC-GENERAL FUND 128.74 CR 7070-999-20740 CCC-ST A TE 1,158.65 DR 7070-999-10010 1,287.39 CR 7860-999-20610 STF/SUBC-GENERAL FUND 20.14 CR 7860-999-20740 STF/SUBC-STATE 382.74 DR 7860-999-10010 402.88 CR 7950-999-20610 TP-GENERAL FUND 92.87 CR 7950-999-20740 TP-ST ATE 92.87 DR 7950-999-10010 185.74 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 of 2 MONTHL Y REPORT OF COLLECTIONS AND DISTRIBUTIONS 5/7/2012 COURT NAME: JUSTICE OF PEACE NO.4 MONTH OF REPORT: APRIL YEAR OF REPORT: 2012 CR 7865-999-20610 CRIM-SUPP OF IND LEG SVCS-GEN FUND 6.24 CR 7865-999-20740 CRIM-SUPP OF IND LEG SVCS-STATE 56.13 DR 7865-999-10010 62.37 CR 7970-999-206,10 TUFTA-GENERAL FUND 82.88 CR 7970-999-20740 TUFT A-STATE 165.76 DR 7970-999-10010 248.64 CR 7505-999-20610 JPAY-GENERALFUND 15.60 CR 7505-999-20740 JPAY - STATE 140.40 DR 7505-999-10010 156.00 CR 7857-999-20610 . JURY REIMB. FUND- GEN. FUND 9.70 CR 7857-999-20740 JURY REIMB. FUND- STATE 87.29 DR 7857-999-10010 96,99 CR 7856-999-20610 CIVIL JUSTICE DATA REPOS.- GEN FUND 0.12 CR 7856-999-20740 CIVIL JUSTICE DATA REPOS.- STATE 1.12 DR 7856-999-10010 1.24 TOTAL (Distrib Req to Oper Acct) $7,247.45 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 0.00 0.00 0.00 1,049.75 0.00 TOTAL DUE TO OTHERS $1,049.75 Revised 07/13/11 TOTAL COLLECTED-ALL FUNDS LESS: TOTAL TREASUER'S RECEIPTS OVER/(SHORT) $8,297.20 $8,297.20 $0.00 Page 2 of 2 =It -'" U <l> .c o .i?' c '" o o ~ >- N o 0:: C3 ~ o UJ C) o ::J ..., u.. o UJ o u: u.. o UJ I f- >- ell o UJ f- 0:: o c.. LU 0:: ... o Z LU o ~ c.. u.. o LU o i= cn ::J ..., ~ -'" U <l> .c o '0 C '" o E <l: cn W Z u: WN u..... ~:;: ....I ;: oil ~::! 0::0:: <l:11. 11.<l: c o O+:l Q) '(j) 1ii 0 o Vl is N o N N ~ N o N c;; ~ .... 0- Vl S ~ <Il ~ O<l: N o ~ M ~ <'l N o ~ ~ <'l 3: O~ ';ft..... 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N C; N 00 <'l a <'l <'l o N o N N C; N .,~' tc ,"~ ' :'-, , '~,:' "~.:: .~,,:...~~, : 05/07/2012 Money Distribution Report Page ------------------------------------ ------------- ------------- ------------- ----------------------------------------- ----------- Receipt Cause/Defendant Code Amount Code Amount Code Amount Code Amount Code Amount Code Amount Total 3929661 2012-135 04-02-2012 CCC 40.00 CHS 4.00 PWAF 5.00 TF 4.00 JCSF 1.00 JSF 3.00 205.00 ALVAREZ, SERGIO TERRAZAS IDF 2.00 PWF 135.00 JPAY 6.00 JCMF 5.00 Cash 3929662 2011-592A 04-02-2012 CCC 40.00 CHS 4.00 SAF 5.00 WRNT 50.00 TF 4.00 DPSC 30.00 220.00 MERRILL, NICHOLAS BRAOLY JCSF 1.00 JSF 3.00 IDF 2.00 FINE 81.00 Credit Card 3929663 2012-137 04-04-2012 CCC 40.00 CHS 4.00 PWAF 5.00 TF 4.00 JCSF 1.00 JSF 3.00 160.00 CHACON, RICHARD G IDF 2.00 PWF 90.00 JPAY 6.00 JCMF 5.00 Money Order 3929664 2012-139 04-04-2012 TFC 3.00 CCC 40.00 CHS 4.00 SAF 5.00 TF 4.00 SUBC 30.00 225.00 PLUNKETT, LAWRENCE RICHARD JCSF 1.00 JSF 3.00 IDF 2.00 CJDR 0.10 FINE 121. 90 JPAY 6.00 Credit Card JCMF 5.00 3929665 2012-038 04-04-2012 CCC 40.00 CHS 4.00 PWAF 5.00 TF 4.00 JSF 4.00 IDF 2.00 205.00 WILLIAMS, JOHN HENRY PWF 135.00 JPAY 6.00 JCMF 5.00 Cash 3929666 2012-033 04-04-2012 CCC 40.00 CHS 4.00 PWAF 5.00 TIME 25.00 TF 4.00 JSF 4.00 430.00 WILLIAMS, JOHN HENRY IOF 2.00 PWF 335.00 JPAY 6.00 JCMF 5.00 Cash 3929667 2012-134 04-04-2012 TFC 3.00 CCC 40.00 CHS 4.00 SAF 5.00 TF 4.00 SUBC 30.00 135.00 MATT, GREGORY ALAN JCSF 1.00 JSF 3.00 IDF 2.00 CJDR 0.10 FINE 31. 90 JPAY 6.00 Credit Card JCMF 5.00 3929668 2012-073 04-05-2012 TFC 2.68 CCC 35.87 CHS 3.59 SAF 4.48 TIME 22.42 TF 3.59 105.00 HARTMAN, JAMIE RENEE SUBC 26.90 JSF 3.59 IDF 1.79 CJOR 0.09 Cash 3929669 2009-661A 04-09-2012 CCC 40.00 CHS 4.00 SAF 5.00 WRNT 50.00 TF 4.00 DPSC 30.00 548.60 ELIZONDO, JOSE ROBERT JCSF 1.00 JSF 3.00 IDF 2.00 FINE 277.00 CSRV 126.60 JPAY 6.00 MVBA Personal Check 3929670 2010-537 04-09-2012 CCC 40.00 CHS 4.00 LAF 5.00 WRNT 50.00 TIME 25.00 TF 4.00 559.00 JENNINGS, AMANDA LYNN DPSC 30.00 JCSF, 1.00 JSF 3.00 IOF 2.00 FINE 255.00 CSRV 129.00 Money Order JPAY 6.00 JCMF 5.00 3929671 2010-537A 04-09-2012 CCC 40.00 CHS 4.00 LAF 5.00 WRNT 50.00 TF 4.00 DPSC 30.00 548.60 JENNINGS, AMANOA LYNN JCSF 1.00 JSF 3.00 IDF 2.00 FINE 277.00 CSRV 126.60 JPAY 6.00 Money Order 3929672 2012-130 04-09-2012 TFC 3.00 CCC 40.00 CHS 4.00 SAF 5.00 TF 4.00 SUBC 30.00 275.00 GRIFFITH, KATINA MARIE JCSF 1.00 JSF 3.00 IOF 2.00 CJDR 0.10 FINE 121. 90 DFF 50.00 Credit Card JPAY 6.00 JCMF 5.00 3929673 2012-136 04-09-2012 CCC 40.00 CHS 4.00 PWAF 5.00 TF 4.00 JCSF 1.00 JSF 3.00 205.00 BILCIC, ROMEO IDF 2.00 PWF 135.00 JPAY 6.00 JCMF 5.00 Money Order 3929675 2010-039 04-09-2012 CCC 40.00 CHS 4.00 LAF 5.00 WRNT 50.00 TIME 25.00 TF 4.00 265.00 LONGORIA, GARY ANTHONY DPSC 30.00 JCSF 1.00 JSF 3.00 IOF 2.00 FINE 95.00 JPAY 6.00 Jail Credit 3929676 2011-600 04-16-2012 TFC 1.60 CCC 21.31 CHS 2.13 SAF 2.66 WRNT 26.64 TIME 13.32 105.00 FULBERG, KATHLEEN MAC TF 2.13 SUBC 15.98 DPSC 15.98 JSF 2.13 IDF 1.07 CJDR 0.05 Cash 3929677 2012-143 04-16-2012 TFC 3.00 CCC 40.00 CHS 4.00 SAF 5.00 TF 4.00 SUBC 30.00 275.00 EBNER, THOMAS JACOB JCSF 1.00 JSF 3.00 IOF 2.00 CJDR 0.10 FINE 121. 90 DFF 50.00 Cashier's Check JPAY 6.00 JCMF 5.00 3929678 2012-144 04-16-2012 TFC 3.00 CCC 40.00 CHS 4.00 SAF 5.00 TF 4.00 SUBC 30.00 185.00 SONIER, BRIAN ALLEN JCSF 1.00 JSF 3.00 IOF 2.00 CJDR 0.10 FINE 81. 90 JPAY 6.00 Money Order JCMF 5.00 3929679 2012-153 04-16-2012 CCC 40.00 CHS 4.00 PWAF 5.00 TF 4.00 JCSF 1.00 JSF 3.00 205.00 STRICKLAND, RANDALL KILE IDF 2.00 PWF 135.00 JPAY 6.00 JCMF 5.00 Cash 05/07/2012 Money Distribution Report Page 2 ---------------------------------------------------------------- ------------- .........--------...- ------------- ------------------------- Receipt Cause/Defendant Code Amount Code Amount Code Amount Code Amount Code Amount Code Amount Total 3929680 2012-138 04-17-2012 TFC 3.00 CCC 40.00 CHS 4.00 LAF 5.00 TF 4.00 SUBC 30.00 165.00 WEHLING, MARLON JAMES JCSF 1.00 JSF 3.00 IDF 2.00 CJDR 0.10 FINE 61. 90 JPAY 6.00 Credit Card JCMF 5.00 3929681 JC-2012-009 04-17-2012 FFEE 25.00 CIFF 6.00 31.00 DELL FINANCIAL SERVI, FULTON FRIEDMAN & Personal Check 3929682 19624 04-18-2012 JCPT 2.00 CVC 15.00 TFC 3.00 CCC 17.00 FA 5.00 JCD 0.50 195.00 INGRAM, HELEN NICOLE CHS 3.00 C~lI 0.50 SAF 5.00 TIME 25.00 TF 4.00 SUBC 30.00 Cash FINE 40.00 CSRV 45.00 3929683 2012-094 04-23-2012 CCC 40.00 CHS 4.00 SAF 5.00 TIME 25.00 TF 4.00 JCSF 1.00 145.00 HISQUIERDO, ADRIAN RENE JSF 3.00 IDF 2.00 FINE 50.00 JPAY 6.00 JCMF 5.00 Cash 3929684 2012-117 04-23-2012 CCC 40.00 CHS 4.00 SAF 5.00 TF 4.00 JCSF 1.00 JSF 3.00 105.00 LAMPIER, RHONDA ROXANN IDF 2.00 FINE 46.00 Cash 3929685 2012-170 04-23-2012 CCC 40.00 CHS 4.00 SAF 5.00 TF 4.00 JCSF 1.00 JSF 3.00 120.00 RESENDIZ-GALICIA, CRESCENCIO IDF 2.00 FINE 61.00 Cash 3929686 2011-600A 04-23-2012 CCC 30.21 CHS 3.02 SAF 3.78 WRNT 37.77 TF 3.02 DPSC 22.66 105.00 FULBERG, KATHLEEN MAC JCSF 0.76 JSF 2.27 IDF 1.51 Cash 3929687 JC-2012-010 04-23-2012 SF 75.00 FFEE 25.00 CIFF 6.00 106.00 MARTIN, SOMER Cash 3929688 2012-163 04-24-2012 CCC 40.00 CHS 4.00 PWAF 5.00 TF 4.00 JCSF 1.00 JSF 3.00 205.00 HISQUIERDO, ROBERT R. IDF 2.00 PWF 135.00 JPAY 6.00 JCMF 5.00 Cash 3929689 2012-147 04-25-2012 TFC 3.00 CCC 40.00 CHS 4.00 SAF 5.00 TF 4.00 SUBC 30.00 135.00 PAGAN MONTALVO, WALDEMAR JCSF 1.00 JSF 3.00 IDF 2.00 CJDR 0.10 FINE 31.90 JPAY 6.00 ROBERTS,ROBERTS Personal Check JCMF 5.00 3929690 2012-146 04-25-2012 TFC 3.00 CCC 40.00 CHS 4.00 SAF 5.00 TF 4.00 SUBC 30.00 305.00 PAGAN MONTALVO, WALDEMAR JCSF 1.00 JSF 3.00 IDF 2.00 CJDR 0.10 DFF 201.90 JPAY 6.00 ROBERTS & ROBERTS Personal Check JCMF 5.00 3929691 2012-156 04-25-2012 TFC 3.00 CCC 40.00 CHS 4.00 SAF 5.00 TF 4.00 SUBC 30.00 185.00 KUSAK, JOSHUA BRIAN JCSF 1.00 JSF 3.00 IDF 2.00 CJDR 0.10 FINE 81.90 JPAY 6.00 Money Order JCMF 5.00 3929692 2012-141 04-25-2012 TFC 3.00 CCC 40.00 CHS 4.00 LAF 5.00 TF 4.00 SUBC 30.00 105.00 RIVERA, JOHN ANTHONY JCSF 1.00 JSF 3.00 IDF 2.00 CJDR 0.10 FINE 12.90 Cash 3929693 2012-002 04-25-2012 CCC 40.00 CHS 4.00 LAF 5.00 TF 4.00 JSF 4.00 IDF 2.00 315.00 MARTINEZ, DOLOREZ JR FINE 245.00 JPAY 6.00 JCMF 5.00 Jai l Credi t 3929694 11-0536 04-25-2012 CCC 40.00 CHS 4.00 LAF 5.00 TF 4.00 JSF 4.00 IDF 2.00 315.00 MILLER, CHARLES WAYNE FINE 245.00 JPAY 6.00 JCMF 5.00 Jail Credit 3929695 2012-162 04-25-2012 CCC 40.00 CHS 4.00 PWAF 5.00 TF 4.00 JCSF 1.00 JSF 3.00 205.00 LEYVA, JOSE LUIS IDF 2.00 PWF 135.00 JPAY 6.00 JCMF 5.00 Cash 3929696 2011-053A 04-26-2012 CCC 40.00 CHS 4.00 LAF 5.00 WRNT 50.00 TF 4.00 DPSC 30.00 422.00 NAVARRO, JESUS JCSF 1.00 JSF 3.00 IDF 2.00 FINE 277.00 JPAY 6.00 S/O Personal Check 3929697 2011-053 04-26-2012 TFC 3.00 CCC 40.00 CHS 4.00 LAF 5.00 WRNT 50.00 TIME 25.00 410.00 NAVARRO, JESUS TF 4.00 SUBC 30.00 DPSC 30.00 JCSF 1.00 JSF 3.00 IDF 2.00 S/O Personal Check CJDR 0.10 FINE 201.90 JPAY 6.00 JCMF 5.00 05/07/2012 Money Distribution Report Page 3 Receipt Cause/Defendant Code Amount Code Amount Code Amount Code Amount Code Amount Code Amount Total 3929698 2010-426 04-26-2012 CCC 40.00 CHS 4.00 LAF 5.00 WRNT 50.00 TIME 25.00 TF 4.00 240.00 NAVARRO, JESUS JCSF 1.00 JSF 3.00 IDF 2.00 FINE 95.00 JPAY 6.00 JCMF 5.00 S/O Personal Check 3929699 2010-039A 04-26-2012 CCC 40.00 CHS 4.00 LAF 5.00 WRNT 50.00 TF 4.00 DPSC 30.00 422.00 LONGORIA, GARY ANTHONY JCSF 1.00 JSF 3.00 IDF 2.00 FINE 277.00 JPAY 6.00 S/O Personal Check 3929700 2012-141 04-26-2012 FINE 129.00 JPAY 6.00 JCMF 5.00 140.00 RIVERA, JOHN ANTHONY Comm Service 3929701 2012-119 04-30-2012 FINE 69.00 JPAY 6.00 JCMF 5.00 80.00 DELAGARZA, J GUADALUPE Cash 3929702 2012-155 04-30-2012 EXRF 20.00 20.00 WALL, CHARLES BROCE Cash I 05/07/2012 Money Distribution Report Page 4 ------------------------------------------------------------------------------------------------------------------------------------ The following totals represent - Cash and Checks Collected Type Code Description Count Retained Disbursed Money-Totals , COST CCC CONSOLIDATED COURT COSTS 28 106.44 957.95 1,064.39 COST CHS COURT HOUSE SECURITY 28 107.74 0.00 107.74 COST CJDR CIVIL JUSTICE DATA RES\POSITORY FEE 9 0.08 0.76 0.84 COST CMI CMI 1 0.05 0.45 0.50 COST CVC CVC 1 1.50 13.50 15.00 COST DPSC DPS OMNIBASE FEE 8 72.15 146.49 218.64 COST FA FA 1 0.50 4.50 5.00 COST IDF INDIGENT DEFENSE FUND 27 5.24 47.13 52.37 COST JCD JCD 1 0.05 0.45 0.50 COST JCPT JCPT 1 0.20 1.80 2.00 COST JCSF JUSTICE COURT SECURITY FUND 23 22.76 0.00 22.76 COST JSF JUROR REIMBURSEMENT FEE 27 8.20 73.79 81.99 COST LAF SHERIFF'S FEE 7 35.00 0.00 35.00 COST PWAF TEXAS PARKS & WILDLIFE 8 32.00 8.00 40.00 COST SAF DPS 13 48.74 12.18 60.92 COST SUBC SUBTI TLE C 10 14.14 268.74 282.88 COST TF TECHNOLOGY FUND 28 108.74 0.00 108.74 COST TFC TFC 10 28.28 0.00 28.28 COST TIME TIME PAYMENT FEE 8 92.87 92.87 185.74 COST WRNT WARRANT FEE 9 414.41 0.00 414.41 FEES CIFF CIVIL I.NDIGENT FILING FEE 2 0.60 11.40 12.00 FEES CSRV COLLECTION SERVICE FEE 4 427.20 0.00 427.20 FEES DFF DEFERRED FEE 2 251. 90 0.00 251 .90 FEES EXRF EXPIRATION RENEWAL FEE 1 20.00 0.00 20.00 FEES FFEE FIll NG FEE 2 50.00 0.00 50.00 FEES JCMF JUVENILE CASE MANAGER FEE 18 90.00 0.00 90.00 FEES JPAY DISTRICT JUDGE PAY RAISE FEE 22 13.20 118.80 132.00 FEES SF SERVICE FEE 1 75.00 0.00 75.00 FINE FINE FINE 17 2,256.40 0.00 2,256.40 FINE PWF PARKS & WILDLIFE FINE 8 185.25 1,049.75 1,235.00 Money Totals 32 4,468.64 2,808.56 7,277.20 The following totals represent - Transfers Collected COST CCC CONSOLIDATED COURT COSTS 0 0.00 0.00 0.00 COST CHS COURT HOUSE SECURITY 0 0.00 0.00 0.00 COST CJDR CIVIL JUSTICE DATA RES\POSITORY FEE 0 0.00 0.00 0.00 COST CMI CMI 0 0.00 0.00 0.00 COST CVC CVC 0 0.00 0.00 0.00 COST DPSC DPS OMNIBASE FEE 0 0.00 0.00 0.00 COST FA FA 0 0.00 0.00 0.00 COST IDF INDIGENT DEFENSE FUND 0 0.00 0.00 0.00 COST JCD JCD 0 0.00 0.00 0.00 COST JCPT JCPT 0 0.00 0.00 0.00 COST JCSF JUSTICE COURT SECURITY FUND 0 0.00 0.00 0.00 COST JSF JUROR REIMBURSEMENT FEE 0 0.00 0.00 0.00 COST LAF SHER IF F 'S FEE 0 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 "\;,~'~ ~"'. '-.~. 05/07/2012 Money Distribution Report Page 5 ------------------------------------------------------------------------------------------------------------------------------------ The following totals represent - Transfers Collected Type Code Description Count Retained Disbursed Money-Totals COST SUBC SUBTITLE 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 0 0.00 0.00 0.00 FEES CSRV COLLECTION SERVICE FEE 0 0.00 0.00 0.00 FEES DFF DEFERRED FEE 0 0.00 0.00 0.00 FEES EXRF EXPIRATION RENEWAL FEE 0 0.00 0.00 0.00 FEES FFEE FILING FEE 0 0.00 0.00 0.00 FEES JCMF JUVENILE CASE MANAGER FEE 0 0.00 0.00 0.00 FEES JPAY DISTRICT JUDGE PAY RAISE FEE 0 0.00 0.00 0.00 FEES SF SERVICE FEE 0 0.00 0.00 0.00 FINE FINE FINE 0 0.00 0.00 0.00 FINE PWF PARKS & WI LDLI FE FINE 0 0.00 0.00 0.00 Transfer Totals 0 0.00 0.00 0.00 The following totals represent - Jail Credit and Community Service COST CCC CONSOLIDATED COURT COSTS 3 12.00 108.00 120.00 COST CHS COURT HOUSE SECURITY 3 12.00 0.00 12.00 COST CJDR CIVIL JUSTICE DATA RES\POSITORY FEE 0 0.00 0.00 0.00 COST CMI CMI 0 0.00 0.00 0.00 COST CVC CVC 0 0.00 0.00 0.00 COST DPSC DPS OMNIBASE FEE 1 9.90 20.10 30.00 COST FA FA 0 0.00 0.00 0.00 COST IDF INDIGENT DEFENSE FUND 3 0.60 5.40 6.00 COST JCD JCD 0 0.00 0.00 0.00 COST JCPT JCPT 0 0.00 0.00 0.00 COST JCSF JUSTICE COURT SECURITY FUND 1 1.00 0.00 1.00 COST JSF JUROR REIMBURSEMENT FEE 3 1.10 9.90 11.00 COST LAF SHERIFF'S FEE 3 15.00 0.00 15.00 COST PWAF TEXAS PARKS & WILDLIFE 0 0.00 0.00 0.00 COST SAF DPS 0 0.00 0.00 0.00 COST SUBC SUBTITLE C 0 0.00 0.00 0.00 COST TF TECHNOLOGY FUND 3 12.00 0.00 12.00 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 DFF DEFERRED FEE 0 0.00 0.00 0.00 FEES EXRF EXPIRATION RENEWAL FEE 0 0.00 0.00 0.00 FEES FFEE FILING FEE 0 0.00 0.00 0.00 FEES JCMF JUVENILE CASE MANAGER FEE 3 15.00 0.00 15.00 FEES JPAY DISTRICT JUDGE PAY RAISE FEE 4 2.40 21.60 24.00 FEES SF SERVICE FEE 0 0.00 ,O~OO 0.00 FINE FINE FINE 4 714.00 0.00 714.00 FINE PWF PARKS & WILDLIFE FINE 0 0.00 0.00 0.00 05/07/2012 Money Distribution Report The folLowing totaLs represent - Jail Credit and Community Service Type Code Description Credit Totals Count The following totals represent - Credit Card Payments 4 COST CCC COST CHS COST CJDR COST CMI COST CVC COST DPSC COST FA COST IDF COST JCD COST JCPT COST JCSF COST JSF COST LAF COST PWAF COST SAF COST SUBC COST TF COST TFC COST TIME COST WRNT FEES CIFF FEES CSRV FEES DFF FEES EXRF FEES FFEE FEES JCMF FEES JPAY FEES SF FINE FINE FINE PWF CONSOLIDATED COURT COSTS COURT HOUSE SECURITY CIVIL JUSTICE DATA RES\POSITORY FEE CMI CVC DPS OMNIBASE FEE FA INDIGENT DEFENSE FUND JCD JCPT JUSTICE COURT SECURITY FUND JUROR REIMBURSEMENT FEE SHERIFF'S FEE TEXAS PARKS & WILDLIFE DPS SUBTITLE C TECHNOLOGY FUND TFC TIME PAYMENT FEE WARRANT FEE CIVIL INDIGENT FILING FEE COLLECTION SERVICE FEE DEFERRED FEE EXPIRATION RENEWAL FEE FILING FEE JUVENILE CASE MANAGER FEE DISTRICT JUDGE PAY RAISE FEE SERVICE FEE FINE PARKS & WILDLIFE FINE Credit Totals 5 5 4 o o 1 o 5 o o 5 5 1 o 4 4 5 4 o 1 o o 1 o o 4 4 o 5 o The following totals represent - Combined Money and Credits 5 COST C.CC COST CHS COST CJDR COST CMI COST CVC COST DPSC COST FA COST IDF COST JCD COST JCPT CONSOLIDATED COURT COSTS COURT HOUSE SECURITY CIVIL JUSTICE DATA RES\POSITORY FEE CMI CVC DPS OMNIBASE FEE FA INDIGENT DEFENSE FUND JCD JCPT 36 36 13 1 1 10 1 35 1 1 Retained 857.50 20.00 20.00 0.04 0.00 0.00 9.90 0.00 1.00 0.00 0.00 5.00 1.50 5.00 0.00 16.00 6.00 20.00 12.00 0.00 50.00 0.00 0.00 50.00 0.00 0.00 20.00 2.40 0.00 418.60 0.00 657.44 138.44 139.74 0.12 0.05 1.50 91.95 .0.50 6.84 0.05 0.20 Page 6 Disbursed Money-Totals 177.50 1,035.00 180.00 0.00 0.36 0.00 0.00 20.10 0.00 9.00 0.00 0.00 0.00 13.50 0.00 0.00 4.00 114.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 21.60 0.00 0.00 0.00 362.56 1,245.95 0.00 1.12 0.45 13.50 186.69 4.50 61.53 0.45 1.80 200.00 20.00 0.40 0.00 0.00 30.00 0.00 10.00 0.00 . 0.00 5.00 15.00 5.00 0.00 20.00 120.00 20.00 12.00 0.00 50.00 0.00 0.00 50.00 0.00 0.00 20.00 24.00 0.00 418.60 0.00 1,020.00 1,384.39 139.74 1.24 0.50 15.00 278.64 5.00 68.37 0.50 2.00 05/07/2012 Money Distribution Report Page 7 ------------------------------------------------------------------------------------------------------------------------------------ The following totals represent - Combined Money and Credits Type Code Description Count Retained Disbursed Money-Totals COST JCSF JUSTICE COURT SECURITY FUND 29 28.76 0.00 28.76 COST JSF JUROR REIMBURSEMENT FEE 35 10.80 97.19 107.99 COST LAF SHERIFF'S FEE 11 55.00 0.00 55.00 COST PWAF TEXAS PARKS & WILDLIFE 8 32.00 8.00 40.00 COST SAF DPS 17 64.74 16.18 80.92 COST SUBC SUBTITLE C 14 20.14 382.74 402.88 COST TF TECHNOLOGY FUND 36 140.74 0.00 140.74 COST TFC TFC 14 40.28 0.00 40.28 COST TIME TIME PAYMENT FEE 9 105.37 105.37 210.74 COST WRNT WARRANT FEE 11 514.41 0.00 514.41 FEES CIFF CIVIL INDIGENT FILING FEE 2 0.60 11.40 12.00 FEES CSRV COLLECTION SERVICE FEE 4 427.20 0.00 427.20 FEES DFF DEFERRED FEE 3 301.90 0.00 301.90 FEES EXRF EXPIRATION RENEWAL FEE 1 20.00 0.00 20.00 FEES FFEE FILING FEE 2 50.00 0.00 50.00 FEES JCMF JUVENILE CASE MANAGER FEE 25 125.00 0.00 125.00 FEES JPAY DISTRICT JUDGE PAY RAISE FEE 30 18.00 162.00 180.00 FEES SF SERVICE FEE 1 75.00 0.00 75.00 FINE FINE FINE 26 3,389.00 0.00 3,389.00 FINE PWF PARKS & WI LDLI FE FINE 8 185.25 1,049.75 1,235.00 Report Totals 41 5,983.58 3,348.62 9,332.20 - 1 05/07/2012 Money Distribution Report Page 8 ------------------------------------------~~----~~~--------------------------~~~---------~~--------~---~~~~~~~~-----~------~~~----~~ DATE PAYMENT-TYPE FINES COURT-COSTS FEES BONDS REST ITUTI ON 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 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 09-01-1997 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 40.00 110.00 45.00 0.00 0.00 0.00 195.00 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 40.00 110.00 45.00 0.00 0.00 0.00 195.00 01-01-2004 Cash & Checks Collected 3,451.40 2,617.70 1,013.10 0.00 0.00 0.00 7,082.20 Jail Credits & Comm Service 714.00 282.00 39.00 0.00 0.00 0.00 1,035.00 Credit Cards & Transfers 418.60 507.40 94.00 0.00 0.00 0.00 1,020.00 Total of all Collections 4,584.00 3,407.10 1,146.10 0.00 0.00 0.00 9,137.20 TOTALS Cash & Checks CoLLected 3,491.40 2,727.70 1,058.10 0.00 D.OO 0.00 7,277.20 Jail Credits & Comm Service 714.00 282.00 39.00 0.00 0.00 0.00 1,035.00 Credit Cards & Transfers 418.60 507.40 94.00 0.00 0.00 0.00 1,020.00 Total of all Collections 4,624.00 3,517.10 1,191.10 0.00 0.00 0.00 9,332.20 05/07/2012 Money Distribution Report Page 9 DATE PAYMENT-TYPE ~----------------------------------------------------------------------------------------------------------------------------------- OTHER TOTAL State of Texas Quarterly Reporting Totals Description 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 - Comm 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 - 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 Fi ling Fees CF: Stat Prob Court Judic FiLing Fees CF: Stat Cnty Court Indig Filing Fees CF: Stat Cnty Court Judic FiLing Fees CF: Cnst Cnty Court Indig FiLing Fees CF: Cnst Cnty Court Judic 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 COURT-COSTS Count 32 6 o o o o o o o o o 32 32 13 14 25 9 o o o 8 o 26 197 o o o o o 2 o o o o o o o o o o 2 199 FEES Collected 1 , 247.39 40.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 96.99 62.37 1.24 402.88 120.92 248.64 0.00 0.00 0.00 185.74 0.00 156.00 2,562.17 0.00 0.00 0.00 0.00 0.00 12.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 12.00 2,574.17 BONDS RESTITUTION Retained 124.74 4.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 9.70 6.24 0.12 20.14 96.74 82.05 0.00 0.00 0.00 92.87 0.00 15.60 452.20 0.00 0.00 0.00 0.00 0.00 0.60 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.60 452.80 Disbursed 1,122.65 36.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 87.29 56.13 1.12 382.74 24.18 166.59 0.00 0.00 0.00 92.87 0.00 140.40 2,109.97 0.00 0.00 0.00 0.00 0.00 11.40 0.00 O.OD 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 11.40 2,121.37 CALHOUN COUNTY 201 West Austin Port Lavaca, Texas 77979 DISTRIBUTION REQUEST DR# 480 B 41036 PAYEE Name: Texas Parks 8: Wildlife Address: City: State: Zip: Phone: PAYOR Official: Title: James Dworaczyk Justice of the Peace, Pct. 4 : ACCOUNT NuMBER : ;; DESCRiPtiON T' i: AMOUNT ,'d " :", 7544-999-20759-999 JP4 - Parks ft Wildlife Fines S 1,049.75 APRIL 2012 V# 7603 TOTAL 1,049.75 CALHOUN COUNTY 201 West Austin Port Lavaca, Texas 77979 DISTRIBUTION REQUEST DR# 480 A 41036 PAYEE Name: Calhoun County Oper. Acct. Address: City: State: Zip: Phone: PAYOR Official: Title: James Dworaczyk Justice of the Peace, Pet. 4 )) ACCOUNT. NUMBER DESCRIPTION ), , AMOUNT " 7544-999-20759-999 JP4 Monthly Collections - Distribution $7,247.45 APRIL 2012 V# 967 TOT.AL 7,247.45 / CALHOUN COUNTY, TEXAS CALHOUN COUNTY TREASURER'S REPORT MONTH OF: APRIL 2012 BEGINNING ENDING FUND FUND BALANCE RECEIPTS DISBURSEMENTS FUND BALANCE GENERAL $ 25,581,290.46 $ 717,425.15 $ 1,386,787.56 $ 24,911,928.05 AIRPORT MAINTENANCE 52,944.63 353.14 320.34 52,977.43 APPELLATE JuDICIAL SYSTEM 566.97 175.49 0.00 742.46 COASTAL PROTECTION FUND 33,413.35 8.30 0.00 33,421.65 COUNTY AND DIST COURT TECH FUND 441.80 88.93 0.00 530.73 COUNTY CHILD WELFARE BOARD FUND 232.31 66.06 0.00 298.37 COURTHOUSE SECURITY 195,744.82 1,776.14 0.00 197,520.96 DIST CLK RECORD PRESERVATION FUND 2,169.95 188.18 0.00 2,358.13 CO CLK RECORDS ARCHIVE FUND 3,640.00 0.00 0.00 3.640.00 DONATIONS 119,059.19 960.35 5,949.60 114,069.94 DRUGIDWI COURT PROGRAM FUND-LOCAL 2;517.46 275.46 0.00 2;792.92 JUVENILE CASE MANAGER FUND 14,701.89 1,108.04 0.00 15,809.93 FAMILY PROTECTION FUND 4,839.37 46.20 0.00 4,885.57 mVENILE DELINQUENCY PREVENTION FUND 8,520.03 2.12 0.00 8,522.15 GRANTS 285,669.13 22,787.35 8,126.00 300,330.48 mSTICE COURT TECHNOLOGY 52,3 I om 1,069.69 109.00 53,270.72 JUSTICE COURT BUILDING SECURITY FUND 13,329.51 87.52 0.00 13,417.03 LATERAL ROAD PRECINCT # 1 4,232.88 1.05 0.00 4,233.93 LATERAL ROAD PRECINCT #2 4,232.88 1..05 0.00 4,233.93 LATERAL ROAD PRECINCT #3 4,232.88 1.05 0.00 4,233.93 LATERAL ROAD PRECINCT #4 4,232.89 1.05 0.00 4,233.94 PRETRIAL SERVICES FUND 57,964.25 114.39 0.00 58,078.64 LAW LIBRARY 180,207.51 1,321.31 623.70 180,905.12 LAW ENF OFFICERS STD. EDUe. (LEOSE) 17,131.56 4.25 0.00 17,135.81 POC COMMUNITY CENTER 46,050.60 1,161.43 2,227.51 44,984.52 RECORDS MANAGEMENT-DISTRICT CLERK 2,328.28 183.01 0.00 2,51 129 RECORDS MANAGEMENT-COUNTY CLERK 182,956.38 3,113.76 6.17 186,063.97 RECORDS MGMT & PRESERVATION 69,824.08 1,030.30 0.00 70,854.38 ROAD & BRIDGE GENERAL 1,194,191.05 99,521.48 0.00 1,293,712.53 ROAD & BRIDGE PRECINCT #3 8.61 0.00 0:00 8.61 ROAD MAINTENANCE PRECINCT #4 644.02 0.16 0.00 644.18 SHERIFF FORFEITED PROPERTY 1,271.74 0.32. 0,00 1,272.06 6MILE PIERlBOA T RAMP IN'SUR/MAINT 63,707.33 15.82 0.00 63,723.15 CAPITAL PROJ- COASTAL MANAGEMENT PGM 81,004.38 17,151.62 0.00 98,156.00 CAPITAL PROJ - ClAP COASTAL IMPROVEMENTS 189,408.27 0.00 0.00 189,408.27 CAPITAL PROJ-PARKING LOT 80,543.81 0.00 0.00 80,543,81 CAP PROJ-PCT2 - STORM REPAIRS 17,796.13 0.00 0.00 17,796.13 CAPITAL PROJ-RB INFRASTRUCTURE 117,819.35 0.00 320.00 117,499.35 CAPITAL PROJ-SW AN POINT PARK 5,096.40 0.00 0.00 5,096.40 CAPITALPROJ-AIRPORT RUNWA Y IMPROV 159,687.13 0.00 0.00 159,687.13 CAPITAL PROJ-EMERCOMM SYS 30,848.06 0.00 0.00 30,848.06 CAP J>ROJ-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 0.00 769.00 CAP PROJ- ANNEX II 25,755.89 0.00 0.00 25,755.89 CAP PROJ-ANNEXRENOV AnON 16,141.40 0.00 0.00 16,141.40 CAP PROJ-HEALTH DEPT RENOVATIONS 116,438:08 4,000.00 13,950.00 106,488.08 CAP PROJ - ENERGY EFFECIENCY/SECO STIMULUS 85,810.50 554.50 16,424.1 1 69,940.89 CPROJ - MMC BUSINESS IMPROVEMENT LOAN 1,500,000.00 0.00 0.00 1,500,000.00 CAP PROJ - MAGNOLIA BEACH JETTY CONSTRUCT 29,752.00 0.00 11,100.00 18,652.00 CAP PROJ - OLIViAlPORT ALTO AMBULANCE 600.00 0.00 0.00 600.00 ARREST FEES 1,320.98 779.17 2,100.15 0.00 BAIL BOND FEES (HB 1940) , 825.00 705.00 1,575.00 (45.00) CONSOLIDATED COURT COSTS (NEW) 23,945.05 13,401.55 37,346.59 0.01 DRUG COURT PROGRAM FUND - STATE 302.72 274.85 577.58 (0.01 SUBTOTALS $ 31 163615.51 $ 889755.24 $ 1487543.31 $ 30 565 827.44 Page 1 of3 COUNTY TREASURER'S REPORT MONTH OF: APRIL 2012 BEGINNING ENDING FUND FUND BALANCE RECEIPTS DISBURSEMENTS FUND BALANCE OPERATING FUND - BALANCE FORWARD $ 31)63,615.51 $ 889,755.24 $ 1,487,543.31 $ 30,565,827.44 ELECTIONS CONTRACT SERVICE 37,137.63 9.22 0.00 37,146.85 EMS TRAUMA FUND 575.22 502.95 943.96 134.21 FINES AND COURT COSTS HOLDING FUND 7,847.31 0.00 0.00 7,847.31 INDIGENT CIVIL LEGAL SERVICE 518.00 347.00 865.00 0.00 JUDICIAL FUND (ST. COURT COSTS) 335.45 320.03 655.48 0.00 JUDICIAL SALARIES FUND 6,568.99 3,290.02 9,859.01 0.00 JUROR DONA TION- TX CRIME VICTIMS FUND 102.00 18.00 0.00 120.00 JUVENILE PROBA nON RESTITUTION 923.37 10.50 913.37 20.50 LIBRARY GIFT AND MEMORIAL 47,495.77 36.79 0.00 47,532.56 MISCELLANEOUS CLEARING 14,293.59 13,779.53 13,216.73 14,856.39 REFUNDABLE DEPOSITS 2,000.00 0.00 0.00 2,000.00 STATE CIVIL FEE FUND 5,735.53 2,775.64 8,511.1 7 0.00 CIVIL JUSTICE DATA REPOSITORY FUND 26.39 12.29 38.68 0.00 JURY REIMBURSEMENT FEE 1,999.86 1,016.95 3,016.81 0.00 SUBTITLE C FUND 8,552.53 4,022.84 12,575.37 0.00 SUPP OF CRIM INDIGENT DEFENSE 1,039.21 523.20 1,562.4 I 0.00 TIME PAYMENTS 4,798.64 2,674.78 7,473.42 0.00 TRAFFIC LAW FAILURE TO APPEAR 3,421.58 2,200.96 5,622.54 0.00 UNCLAIMED PROPERTY 4,021.62 .0.00 0.00 4,021.62 BOOT CAMPIJJAEP 16.97 0.00 0.00 16.97 JUVENILE PROBATION 199943.80 17625.65 30622.74 186946,71 SUBTOTALS $ 31,510,968.97 $ 938,921.59 $ 1,583,420.00 $ 30,866,470.56 TAXES IN ESCROW 0.00 , . 0.00 0.00 TOTAL OPERATING FUNDS $ 31.510968.97 $ 938 921.59 $ I 583 420.00 $ 30 866 470.56 D A FORFEITED PROPERTY FUND 13;563.29 2,406.32 0.00 15,969.61 SHERIFF NARCOTIC FORFEITURES 8,935.88 4,795.69 0.00 13,731.57 CONSTRUCTION (JAIL) SERIES 2003 - I & S 603,259.05 8,654. I 7 0.00 61 1,913.22 CERT. OF OB-CRTHSE REN. I&S FUND SERIES 2004 356,225.03 ' 3,997.45 0.00 360,222.48 . CAL CO. FEES & FINES 203,726.45 . 113,008.01 199,876.33 116,858.13 OCEAN DRIVE IMPROVEMENTS 1.00 0.00 0.00 1.00 CERT OF OB-CRTHSE REF SERIES 2010 87320.00 I 382.43 0.00 88 702.43 Tn.... A T ~~n~~ rn FTTNn.;;: 'l: 1 773.030.70 ! $ 134.244,07 $ 1.876,33 'l: 1 2/)7 ~Cl8 dd MEMORIAL MEDICAL CENTER: OPERATING 2,403,560.06 $ 1,719,284.75 $ 1,548,269.20 $ 2,574,575.61 REFUND IMPREST ACCOUNT 5,066.76 0.81 0.00 5,067.57 INDIGENT HEALTHCARE 84.44 39 606.07 39621.61 68.90 TOTALS $ 2 408,71 1.26 $ I 758 891.63 $ 1587890.81 $ 2579712.08 DRAINAGE DISTRICTS NO.6 15,712.22 $ 160.31 $ - $ 15,872.53 NO.8 105,905.65 31.01 0.00 105,936.66 NO.IO-MAINTENANCE 107,077.02 875.35 0.00 107,952.37 NO. I I -MAINTENANCE/OPERATING 181,779.12 3,304.43 20,894.53 164,189.02 NO. II-RESERVE 129 565.30 20.82 0.00 129586.12 TOTALS $ 540 039.31 $ 4391.92 $ 20894.53 $ 523 536.70 CALHOUN COUNTY WCID #1 OPERATING ACCOUNT $ 490 859.3 I 356.09 40.1 I 8.66 $ 451096.74 CALHOUN COUNTY NAVIGATION DlST. MAINTENANCE AND OPERATING $ 242,443.86 $ .3400.72 $ 7591.88 $ 238 252.70 , , , CALHOUN COUNTY FROST BANK $ 4992.51 $ ~ $ - $ 4 992.51 TOTAL MMC, DR. DlST;. NA V. DlST, WCID & FROST $ 3682053.74 $ I 767,040;36 $ 1.656 495.88 $ 3797590.73 TUTAL ALL t'UNU~ :l> jL.,UI j,lSO!/.UU Page 2 of3 ,\ COUNTY TREASURER'S REPORT MONTH OF: APRIL 2012 BANK RECONCILIATION LESS: CERT.OF DEP/ FUND OUTSTNDG DEP/ PLUS: CHECKS BANK FUND BALANCE OTHER ITEMS OUTSTANDING BALANCE OPERATING · $ 30,866;470.56 $ 28,643;238.42 $ 259,151.05 $ 2,482,383.19 D A FORFEITED PRo.PERTY FUND 15,969.61 0.00 0.00 15,969.61 SHERIFF NARCOT-IC FORFEITURES 13,731.57 0.00 0.00 13,731.57 CONSTRUCTIo.N (JAIL) SERIES 2003 - I & S 611,913.22 4,425.09 0.00 607,488.] 3 CERT. OF o.B-CRTHSE REN. I&S FUND SERIES 2004 360,222.48 2,168.00 0.00 358,054.48 CERT OF o.B-CRTHSE REF SERIES 2010 88,702.43 822.25 0.00 87,880,18 CAL. Co. FEES & FINES 116,858.13 38,606.97 11,906.18 90,] 57.34 o.CEAN DRIVE IMPRo.VEMENTS- CAP PROJ 1.00 0.00 0.00 1.00 MEMo.RIAL MEDICAL CENTER: OPERATING :I: 2,574,575.61 533,622.81 203,410.25 2,244,363.05 REFUNDIMPRESTACCo.UNT 5,067.57 0.00 0.00 5,067.57 INDIGENT HEALTHCARE 68.90 37,560.69 40,551.78 3,059.99 DRAINAGE DISTRICT: NO.6 15,872.53 145.97 0.00 15,726.56 NO. 8 105;936.66 (41.24) 0.00 105,977.90 NO. 10 MAINTENANCE 107,952.37 182.27 0.00 107,770.10 NO. 11 MAINTENANCE/OPERATING 164;189.02 2,381. 70 0.00 161,807.32 NO. 11 RESERVE 129,586.12 0.00 0.00 129,586.12 CALHo.UNCO. WCID#I o.PERA TING ACCo.UNT 451,096.74 0.00 0.00 451,096.74 , CALHOUN Co.. NAVIGATION DIST: MAINTENANCE/OPERATING .... 238,252.70 0.00 0.00 238,252.70 CALHOUN COUNTY FRo.ST BANK 4,992.51 0.00 0.00 4,992.51 TOTALS $ 35871 459.73 $ 29263 112.93 $ 515019.26 $ 7 123 366.06 '~ t:.:_ .... THE DEPOSITORY FOR CALHOUN CO. NA VIGA TION IS FIRST NATIONAL BANK - PORT LA V ACA THE DEPOSITORY FOR ALL OTHER COUNTY FUNDS IS INTERNATIONAL BANK OFCOMMERCE- PORT LAV ACA **** THE DEPSOSITORY FOR CALHOUN COUNTY FROST IS FROST BANK - AUSTIN, TEXAS Court costs and fees collected and reported may not be current and up~to-date due to non-compliance by other county offices. I hereby certify that the current balances are correct to all monies e been received by the County Treasurer as of the date of this report. ~ ..!; eu.iJJ RH NDA s. KOKENA COUNTY TREASURER Page 3 of3 BILLS: Claims totaling $1,005,597.36 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. 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Q Q Q 0 s: 0 0 0 0. <l) P:l ~ Q Z Z Z Q <l) S OJ Z .... o "I:l s= <l) :> u ~ C/.l- ~ Sl ~ ~ C/.l ~ 8 :>< ::E .... u ~ C/.l- ....:i o a C/.l rg C/.l ~ ~ ~ <l) "I:l o U ....:i C o M <n <n '" N '" <n <n '" ~ e:J ~ ~ ~ ~ C/.l C/.l~ 3 ~~ ~ ZU ~ ~BJ E:: 8 8:2-; C/.l C/.l0 <3 g;l g;le !I 0'> 0'> 0'> 'IS ~ May 24,2012 2012 APPROV AL LIST 33 COMMISSIONERS COURT MEETING OF OS/24/12 BALANCE BROUGHT FORWARD FROM PAGE 32 $ 749,744.88 FICA P/R $ 29,779.98 MEDICARE PIR $ 8,303.96 FWH PIR $ 28,097.25 NATIONWIDE RETIREMENT SOLUTIONS PIR $ 2,919.98 OFFICE OF THE ATTORNEY GENERAL - CHILD SUPPORT PIR $ 1,044.92 TEXAS COUNTY & DISTRICT RETIREMENT SYSTEM PIR $ 106,190.06 TMPA P/R $ 336.00 UNITED WAY PIR $ 12.00 ALLIED WASTE SERVICES AlP $ 618.60 AT&T AlP $ 51.35 CABLE ONE AlP $ 614.98 CALHOUN COUNTY INDIGENT HEALTH CARE AlP $ 33,987.44 CENTERPOINT ENERGY AlP $ 1,117.04 CP&L AlP $ 24.29 CREDIT CARD CENTER AlP $ 6,522.58 EXXON MOBILE AlP $ 66.54 RELIANT ENERGY SOLUTIONS AlP $ 29,911.35 RHONDA S. KOKENA AlP $ 225.00 SHERATON GUNTER HOTEL SAN ANTONIO AlP $ 423.17 STATE COMPTROLLER AlP $ 63.72 VERIZON SOUTHWEST AlP $ 4,889.88 VICTORIA ELECTRIC CO-OP AlP $ 652.39 TOTAL AMOUNT FOR APPROVAL $ 1,005,597.36 ~ ~,ii' ~..., MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ----- Mav 24.2012 MEMORIAL MEDICAL CENTER OPERATING FUND MEMORIAL MEDICAL CENTER WEEKLY CHECKS Date Approved bv CountvAuditor (See attached lists) 4/19/2012 Weekly Payables 4/19/2012 Patient Refunds 4/25/2012 Weekly Payables 4/25/2012 Patient Refunds 4/30/2012 Weekly Payables 5/3/2012 Weekly Payables 5/3/2012 Patient Refunds 5/4/2012 Weekly Payables 5/9/2012 Weekly Payables 5/9/2012 Patient Refunds Total Payables and Patient Refunds $ 189,503.67 5,317.16 203,868.07 630.42 210.93 187,226.31 2,319.85 1,280.00 145,983.32 4,740.70 $ 741,080.43 MEMORIAL MEDICAL CENTER PAYROLL Date of Pavroll Run & Date Liabilitv Called In (See attached lists) 4/18/2012 Net Payroll 4/18/2012 Net Payroll 4/18/2012 Net Payroll 4/24/2012 Net Payroll 4/30/2012 Net Payroll 5/1/2012 Payroll Liabilities 5/8/2012 Net Payroll 5/15/2012 Payroll Liabilities Total Net Payroll and Payroll Liabilities 82.22 (82.22) 251.45 206,994.11 211.60 68,983.35 207,689.61 69,242.08 $ 553,372.20 ~~T..Oif1:~~P.EAA1iINGlriON 52T631 ri~g~O~ED1INDIGEN;ri~l:tc*~E~lif.J!>JEXp'ENsE_r987t911 IG~ND"TJ.0.l'f~LIf.BII.!J!~I~P.P.~0~ED15/2~/20..12~'''''--."..._-! 11$ltr3-28T440T~~l " <;j' MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---- Mav 24.2012 INDIGENT HEAL THCARE FUND: INDIGENT EXPENSES Donald Breech MD PA Coastal Medical Clinic Community Pathology Associates HEB Pharmacy (April) Laboratory Corporation of America Mau-Shong Un MD Azhar Malik M.D. Memorial Medical Center (Out-patient $11,097.21 ER $9.213.16 In-patient $2,638.30) Port Lavaca Clinic Radiology Unlimited PA Victoria Surgical Associates SUBTOTAL Memorial Medical Center (Indigent Heallhcare Payroll and Expenses) 118.48 299.04 78.32 456.19 73.28 46.73 46.73 22,948.67 1,216.52 85.27 3,057.95 28,427.18 5,560.75 **$240 in Co-Pays were collected by Memorial Medical Center in April ~fi~Z,~t:. ~2:,:'::/ '/~,: ~:::;:<'~,;j-_. "";,;;"'i-:,':"i,;,~ . ~-, " @IHS Source Totals Report Issued OS/21/2012 calhoun Indigent Health care Batch Dates 05/15/2012 through 05/15/2012 For Vendor: All Vendors Source Description ArnoUn.f Silled Amount Paid 01 Physician Services 02 Prescription Drugs 05 Lab/x-ray 08 Rural Health Clinics 13 Mmc -Inpatient Hospital 14 Mmc- Hospital Outpatient 15 Mme. Er Bills 12,250.00 456.19 ;397,Ji1 2,421.42 3,769~OO 25,119.00 20,~39;00 Expenditures Reimb/ Adj ustments 65;356..22 -4.pO ~randTotlll 65,352;22 APPROVED BY MAY 2 Z 2012 CALHOiJN COUNTY AUDITOR Fiscal Year Payroll/Expenses 3,364.96 456.19 151.60 1,505.76 2,638.30 11,097.21 9,213,16 28,431.18 -4.00 28,427.18 155,285.88 51 56tJ.75 Ljvtnu'uv ~ ldtu~ Calhoun County Indigent Coordinator s .. 800 05222012, 01 CALHOUN COUNTY, DATE: 512212012 CC Indigent HealthCar~ VENDOR #$52 ACCOUNT WMBER 1000-800-98722~999 1000-00'1-46010 COUNTY AUDITOR APPROVAL ONLY APPROVED BY MAY 2 .2 2012 CALHOUN COUNTY AUDITOR DEi3CRIPTION OF Transfer to a bills Indi,ent Health Care a roved b Commissioners Court on 5/24/2012 a total of $33 ,987.93 for Aril Interest ( 0.49) 'I'tiE ITEMs OR SBRVICBS SHOW1il ABOVEARENEEt5EDINTHE DISCHARGE OF MY OFFI.CIAL DtrrlES .1WD I CERTIFY .THATF'\mDS ARE A'\lAILABLETO PAY . '"yi'<.".., THIS OBLIGATION. DEPARTMENT HEA!) DATE I CERTIFY THAT THE ABOVE I'I'EMS OR SERVICES WERE: RECEIVED BY ME IN1GOOD <:::ONDITIONAND REQUES.T THE CQ'\mTY.'!':REASlJRER TO PAY T:HE ABOVE 0BLIGA'I'ION. 5/22 12 DATE TOTAL PRICE $33,987.93' ($0.49 ) $33,987,.44 ~' 't. 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 5 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 Jun Jul Aug Sept Oct Nov Dee YTD 10 58 10 150 61 Monthly Avg 3 19 3 50 20 ..: RUN DATE :05/16/12 TIME: IJ: 52 G/L llUt1!3ER MEMORIAL MEDICAL CENTER REC~IPTS FROM04/01j12 TO 04/30/12 PAGE 123 RCMREP DISC COLL GL, cMH DATE INIT CODE ACCOUNT ~ ~..;._ _ .'. __ _.;. __...~'w __".. _ _.' _.. ___ _ _ ____'... w .":'__.. ___ __ .'...... ___ _ _.. _-"w _,_.;, _.............. _.. __ __.. __.... ___ __.... ___ ~ __...... ___.. __.... --.... - - -...... --.. _'w --- --.. -,- --..... ARM RECEIPT PAY .DATE NUMBER TYPE PAYER CASH AMOUNT RECEIPT AMOUNT NUMBER NAME 50200.000 04/30}12 3239!9 IN CHAMP VA 272.47- 272.47- **TOTAL" 50200.000 COMMERCIAL INS., 50240.00004/03112 50240.00004/03/12: 50240.000 04/04/12 50240.000,04/05/12 50240.000 04j06}12 50240.000 04/10/12 50240.000 04/11j12 50240.000 04/11112 50240.000 04/12j12 50240.000 04/13j12 50240.000 04/13/12 50240.000, 04/16/12 50240.000 04/16/12 50240.000 04/17j12 50240.000 04/18/12 50240.00,0 04/19j12 50240.000 04/20/12 50240.00.0 04/23/12 50240.000 04/24/12 50240.000 04/24/12 50240.000 04/24(12 50240.000 04/24/12 50240.000 04/27/12 50240.000 04/30/12 50240. boo 04/30/12 50240.000 04/30/12 -ADJ -270378.01 10.00 10.00 10.00 10.00 10.00 10.00 10.00 10.00 10.00 10. DO 10. DO 10.00 10.00 10.00 10.00 10.00 10.00 10.00 10.00 10.00- 10.00 10.00 10.00 10.00 10.00 10. DO 10.00 10.00 10..00 10.00 10.00 10.00 10.00 10.00 10.00 10.00 10.00 10.00 10.00 10.00 10.00 10.00 10.00 10.00 10.00 10.00- 10.00 10.00 10.00 10,00 10.00 10.00 50500.000 04/27/12 323738 DO TXCOMP DISPRO ocr 104084.00 104084.00 "TOTALU 50500.000 M/CAID DISPRO, SHARE .OTHER REV 104084.00 AKR AKR AKR AKR AKR AKR LA AKR AKR CAM KRR AKR AKR LA LA AKR LA AKR KRR KRR KRR AKR AKR AKR LA AKR 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 AKR AKR 2 AKR 2 AKR 2 AKR 2 AKR 2 AKR AKR 2 AKR 2 AKR 2 AKR 2 AKR AKR 2 AKR 2 AKR 2 AKR 2 AKR 2 AKR 2 MEMORIAL MEDICAL CENTER Port Lavaca, r~xas MANUAL JOURNAL ENTRIES MONTH OF APRIL, 2012 Pag~ ~of~ Debit Credit Acct # JE # Descrlbtion .... ...,.. Check # Amount Amou!,\t 10255000 Indigent Healthcare 5,560.75 40450074 Reimbursement -Calhoun Ctv 4,279.78 40015.074 Benefits - FICA 221.78 40025074 Benefits -FUTA 5.07 40040074 B..enefits - Retirement 246.83 60320000 Benefits. Insurance 770.36 40220074 SUDDlies - General - 40225074 Supplies - Office 36.93 40230074 Forms - 40610074 Conti.n.uina Education - 40610074 Outside Services - 40215074 Freiaht - 40600074 Miscellaneous - , BY lA A" ~ 0 ,.,...." 'Inl I.., 'OJ ,"VI(.. CALHOUN COUNTY - TOTALS 5,560.15 5,560.75 J .I I j / j EXPLANATION FOR ENTRY REVERSING: YES NO 'JE# RUN DATt! 04/19/12 .; TIME: 08:43 CLS INVOICE#.........TRN DT.INV DT.DUE DT.CK DT..PC.......GROSS.....DISC......NO-PAY........NET VENDi.NAME.. 0........................ . MEMORIAL MEDICAL CENTER AP OPEN INVOICE LIST THRU DUE DATE OF 05/01/12 PAGE: 1 APOPEN A1680 AIRGAS-SOUTHWEST /' MEDICAL GAS M 107782638 041612 033112 043012 2106.98 .00 2106.98 ./ 107782692 041612 033112 043012 221. 70 .00 221.70 MEDICAL GAS 2328.68 .00 2328.68 TOTALS. I . . . . . . . . .. , . . . . . . . , . I . . . . . . . . . . , . . . . . . : A1715 ALeO SALES & SERVICE CO .00 118.67 .,/ REPAIR - AUXILLARY M 2450784-IN 041712 041112 043012 118.67 TOTALS....................................... : 118.67 .00 118.67 A1360 AMERISOURCEBERGEN DRUG COR 27.08 .,/ PHARMACEUTICALS W 037-505193 040412 040312 042512 27.08 .00 PHAlOO.CEUTICALS 037-507247 040412 040412 042512 24.06 .00 24.06/ PHARMACEUTICALS 037-507248 040412 040412 042512 38.51 .00 38.51/ PHARMACEUTICALS 037-509219 041612 040512 042512 21.48 .00 21.481 PHARMACEUTICALS 037-518829 041612 041212 042512 15.29 .00 15.29/ PHARMACEUTICALS 037/518830 041612 041212 042512 75.24 .00 75.24/ TOTALS..."...... ................ .', I.... ,.,..,' t.: 201.66 .00 201. 66 A2218 AQUA BEVERAGE COMPANY 9.97/ SUPPLIES LAB M 389668 041612 031612 041612 9.97 .00 TOTALS. . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . : 9.97 .00 9.97 A4000 ARMSTRONG MEDICAL INDUSTRI ,./ SUPPLIES VARIOUS M 1504758 041612 032212 042212 132.35 .00 132.35 TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 132.35 .00 132.35 10297 ARUP LABORATORIES OUTSIDE SRV LAB 50405750 033112 040112 050112 8760.37 .00 8760.37 ,,/" TOTALS. . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . : 8760.37 .00 8760.37 Bl075 BAXTER HEALTHCARE CORP SUPPLIES CS INV M 35075131 033112 032812 042712 582.32 .00 582.32 ./ TOTALS. . . . . . . , . . . . I . . . , " . . . . . . t . . . . I . . . . . . . . . : 582.32 .00 582.32 B1220 BECKMAN COULTER INC / OUTSIDE SRV LAB M 102803126 041612 032612 042612 1301.25 .00 1301.25 ./ OUTSIDE SRV LAB 5264187 041612 033112 043012 5382.13 .00 5382.13 TOTALS.. I...... "..........,.. I....'...".....: 6683.38 .00 6683.38 B1650 BOSART LOCK & KEY INC 26.50 / SUPPLIES PLANT OPS M 94761 033112 032812 042712 26.50 .00 TOTALS............... ........................: 26.50 .00 26.50 A1825 CARDINAL HEALTH 240.68 j SUPPLIES NUC MED M 08107793 041612 033112 033112 240.68 .00 SUPPLIES NUC MED 08107807 041612 040612 040612 339.32 .00 339.32 TOTALS. . . , . . . . . . . . . . . . . I . . . . . . . . . , I . . . . . . . I . . .: 580.00 .00 580.00 10350 CENTURION MEDICAL PRODUCTS 816.27/ SUPPLIES VARIOUS 90985903 041612 032812 042812 816.27 .00 SUPPLIES CS INV 90983758 041712 032612 042512 522.50 .00 522.50 ,/ RUN DlTE: 04/19/12 TIME: 08:43 CLS INVOICE#.........TRN DT.INV DT.DUE DT.CK DT..PC.......GROSS.....DISC......NO-PAY........NET VEND#.!UME............................ . -135.00 .00 -135.00 1203.77 .00 1203.77 MEMORIAL MEDICAL CENTER AP OPEN INVOICE LIST THRU DUE DATE OF 05/01/12 PAGE: 2 APOPEN CREDIT CM90983758 041712 032612 042512 TOTALS.......,............................. .',: C1510 CauBB SECURITY SYSTEMS INC 27.56 ,/ SRV CONTRACT - APRIL M 7020375990 041612 040412 040412 27.56 .00 TOTALS. . . . . . . . . , , , . . . . . .. . . . . . I..' , . . . . . . . . . . . . : 27.56 .00 27.56 10467 CLINICAL & LABORATORY .00 35.00 / SUBSCRIPTION LAll 75588 041612 031612 041612 35.00 TOTALS...................................... ...: 35.00 .00 35.00 C2510 CPSI 37.17 ./ STATEMENT PROCESSING M 715588 041612 032912 032912 37.17 .00 EBOS 716357 041612 033012 033012 316.80 .00 316.801 ELECTRONIC PAYSTlJB - MARC 717785 041812 040912 040912 217.70 .00 217.70 TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 571. 67 .00 571. 67 10734 CPSI SPRING CONFERENCE ./ REGISTRATION 23821 041712 041312 041312 115.00 .00 115.00 TOTALS, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 115.00 .00 115.00 H0900 D HARRIS CONSULTINGLLC ./ MEDICAL PHYSICS IN NUC ME W 23814 041612 041312 041312 700.00 .00 700.00 TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 700.00 .00 700.00 D1500 DELL MARKETINGL.P. /' OFFICE SUPPLIES PFS M XFPK15474 040412 032912 042812 748.21 .00 748.21 TOTALS................. I.'......,............: 748.21 .00 748.21 10368 DEWITT POTH & SON OFFICE SUPPLIES PFS 326316-1 041612 033012 041512 4.48 .00 ./ 4.48 ./ OFFICE SUPPLIES WOMEN'S C 326602-0 041612 032912 041512 16.52 .00 16.52./ OFFICE SUPPLIES LAll 326608-0 041612 032912 041512 5.18 .00 5.18/ OFFICE SUPPLIES,ER 326624-0 041612 032912 041512 140.00 .00 140.00/ OFFICE SUPPLIES CS INV 326933-0 041612 040215 041512 242.91 .00 242.91 OFFICE SUPPLIES SURGERY 326935.0 041612 040212 041512 13.59 .00 13.59/ OFFICE SUPPLIES ADMIN 327305-0 041612 040412 041512 3.25 .00 3.25 ,/ OFFICE SUPPLIES PHARMACY 327306-0 041612 040412 041512 27.26 .00 27.26/ OFFICE SUPPLIES CS INVENT 327320-0 041612 040412 041512 162.47 .00 162.47/ OFFICE SUPPLIES ADMIN 327321-0 041612 040412 041512 304.98 .00 304.98./' OFFICE SUPPLIES DIETARY 327428-0 041612 040512 041512 58.90 .00 58.90/ OFFICE SUPPLIES ER 327460-0 041612 040512 041512 9.05 .00 9.05 ;"" OFFICE SUPPLIES ER 327468-0 041612 040912 041512 84.02 .00 ~ 84.02 "./ OFFICE SUPPLIES CS INV 327810-0 041612 041112 041512 303.90 .00 303.90./ OFFICE SUPPLIES 327866-0 041612 041112 041512 11. 80 .00 11.80 TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 1388.31 .00 1388.31 D1608 DIVERSIFIED BUSINESS SYSTE / SUPPLIES CS INV M 21690 033112 032812 042712 362.85 .00 362.85 TOTALS....................................... : 362.85 .00 362.85 D1785 DYNATRONICS CORPORATION 34.34./' SUPPLIES PT 579825 040412 032912 042812 34.34 .00 o'f.~' RUN DlTE: 04/19/12 TIME: 08:43 CLS I""OICE#......... TRN DT. INIl DT . DUE DT .CKDT. .PC. . . . . . . GROSS . . . . .DISC. . . . . .NO~PAY. .. . . . ..NET 'VEND#.NAtotE........................... . ",..v 34.34 .,.., 68.68 MEMORIAL MEDICAL CENTER AP OPEN INIlOICE LIST THRU DUE DATE OF 05/01/12 PAGE: 3 'APOPEN SUPPLIES PT 579893 040412 032912 042812 34.34 68.68 .00 .00 TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : E1238 ELECTRONIC DIAGNOSTIC & RE 301. 29 .00 301. 29 ......... REPAIR OB 6459 041712 040912 041912 TOTALS, . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . : 301. 29 .00 301. 29 10042 ERBE USA INC SURGICAL SYST 178.68 ,,/ SUPPLIES SURGERY 210912 033112 032612 042512 178.68 .00 TOTALS.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 178.68 .00 178.68 Fl050 FASTENAL COMPANY / SUPPLIES PLANT OPS M TXPOT105528 041612 022812 032912 19.43 .00 19.43 / SUPPLIES PLANT OPS TXPOT106149 041612 031612 041512 3.55 .00 3.55 TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . , . . , . . . . . . 01 . . . : 22.98 .00 22.98 10689 FASTHEALTH CORPORATION 495.00""""'- WEBSITE APRIL 04A12MMC 041812 040112 043012 495.00 .00 TOTALS....................................... : 495.00 .00 495.00 Fl100 FEDERAL EXPRESS CORP. / SHIPPING LAB W 7-845-47589 041612 040512 042012 26.71 .00 26.71 TOTALS. . . . .. . . . . . . . . . . . . . . . . . . . . . . . .. . . . .'. . . . : 26.71 .00 26.71 F1400 FISHER HEALTHCARE 832.54~ SUPPLIES LAB M 8935866 041612 032812 042812 832.54 .00 SUPPLIES LAB 9042158 041612 032912 042912 464.60 .00 464.60 TOTALS...... .................................: 1297.14 .00 1297.14 GOlOO GE HEALTHCARE SRV CONTRACT RADIOLOGY AP W 5344371 041612 040212 050112 3387.33 .00 3387.33/, SRV CONTRACT RADIOLOGY AP 5344372 041612 040212 050112 435.75 .00 435.75 TOTALS....................................... : 3823.08 .00 3823.08 G1210 GULF COAST PAPER COMPANY 185.64 / SUPPLIES HOUSEKEEPING M 368357 033112 032712 042612 185.64 .00 TOTALS....................................... : 185.64 .00 185.64 H0030 H E BUTT GROCERY SUPPLIES DIETARY M 101847 033112 032712 042612 230.93 .00 230.93:/' SUPPLIES DIETARY 106602 041612 033012 043012 73.13 .00 73.13 SUPPLIES DIETARY 106660 041612 033012 043012 11.68 .00 11.68 /" TOTALS................. .,.....................: 315.74 .00 315.74 H1399 HILL-ROM COMPANY, INC 285.00/ LEASE MEDSURG M 7512454 041612 033112 043012 285.00 .00 TOTALS.......................... .............: 285.00 .00 285.00 10298 HITACHI MEDICAL SYSTEMS 9166.67) SRV CONTRACT 4/25 - 5/24 PJIN0036635 040412 031512 042512 9166.67 .00 TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 9166.67 .00 9166.67 H0416 HOLOGIC 650.49 / SUPPLIES MAMMO 6493932 040412 032812 042712 650.49 .00 RUN DATE: 04/19/12 TIME:. 08:43 MEMORIAL MEDICAL CENTER AP OPEN INVOICE LIST THRU DUE DATE OF 05/01/12 PAGE: 4 APOPEN VEND#.NAME.......................... .CLS.INVOICE#........ .TRN DT.INV DT.DUE DT.CK DT. .PC...... .GROSS.... .DISC..... . NO-PAY. ...... .NET TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 650.49 .00 650.49 I0415 INDEPENDENCE MEDICAL 82.21 / SUPPLIES CS INV 26339149 041612 040212 050112 82.21 .00 TOTALS............. 'f.......... ...............: 82.21 .00 82.21 I0950 INFOLAB INC SUPPLIES BLOOD BANK M 3099407 041612 032312 042312 210.50 .00 210.50 .I SUPPLIES BLOOD BANK 3100585 041612 032712 042712 318.49 .00 318.49 ........- TOTALS.......................... .............: 528.99 .00 528.99 10632 JACKSON NURSE PROFESSIONAL / CONTRACT NURSE L&D 46054447 041612 032412 032412 2336.00 .00 2336.00 TOTALS..... ..........f....... .................: 2336.00 .00 2336.00 10285 JAMES A DANIEL 750.00/ RENT PAYMENT MAY2012 041612 041512 041512 750.00 .00 TOTALS. .................... ..................: 750.00 .00 750.00 J1400 ,JOHNSON & JOHNSON 28.21/ SUPPLIES SURGERY 907465761 033112 032612 042512 28.21 .00 SUPPLIES ER 907496525 041612 032912 042812 731.16 .00 731.16 ,/' TOTALS....... "....... I.............. .'........: 759.37 .00 759.37 L0700 LABCORP OF AMERICA HOLDING 41.40 'j OUTSIDE SRV LAB M 37212743 041612 033112 043012 41.40 .00 OUTSIDE SRV LAB 37212756 041612 033112 043012 85.00 .00 85.00 OUTSIDE SRV LAB 37385778 041612 033112 043012 26.50 .00 26.50'/ TOTALS....................................... : 152.90 .00 152.90 L1001 LANDAUER INC OUTSIDE SRV RADIOLOGY W 4081671 041612 032712 042712 671. 56 .00 671.56 ./ TOTALS. ......................................: 671.56 .00 671.56 L1288 LANGUAGE LINE SERVICES 29.76 I/"" OUTSIDE SRV ER W 2916777 041612 033112 043012 29.76 .00 TOTALS. t.......................... .'f.........: 29.76 .00 29.76 10028 LAUREL DRAEGER 210.00/ FLEX SPEND REIMBURSEMENT 23822 041812 041712 041712 210.00 .00 TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 210.00 .00 210.00 10729 LAURIE HARVEY 53.98/' TRAVEL EXPENSES 23826 041812 041712 041712 53.98 .00 PHYSICIAN RE.CRUITMEN'l' 23827 041812 041712 041712 59.88 .00 59.88./' TOTALS.............,............... I.........: 113.86 .00 113.86 L1640 LOwE'S HOME CENTERS INC SUPPLIES PLANT OPS W 42957006 033112 032812 042712 299.99 .00 299.99'/ TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 299.99 .00 299.99 L1707 LULAC COUNCIL #671 ./ ADVERTISING W 23816 041612 040112 050112 400.00 .00 400.00 RUN DATE: 04/19/12 TIME: 08:43 MEMORIAL MEDICAL CENTER AP OPEN INVOICE LIST THRU DUE DATE OF 05/01/12 PAGE: 5 APOPEN VEND#.NAME.......................... .CLS.INVOICE#........ .TRN DT.INV DT.DUE DT.CK DT. .PC...... .GROSS.... .DISC..... . NO-PAY. ...... .NET TOTALS....................................... : 400.00 .00 400.00 M1500 MARKS PLUMBING PARTS SUPPLIES PLANT OPS M 1107092 033112 032712 042612 111. 73 .00 111. 73 ./ SUPPLIES PLANT OPS 1107093 033112 032712 042612 327.24 .00 327.24/' SUPPLIES PLANT 01\S 1102252 041812 030912 040912 166.31 .00 166.31/ TOTALS....... .'...................,............: 605.28 .00 605.28 10616 MAYO COLLABORATIVE SVCS, I OUTSIDE SRV LAB 7031983-033112 041612 033112 043012 2203.90 .00 2203.90 ......... TOTALS. . . . . . . n . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 2203.90 .00 2203.90 M2465 MEDLEARN 534.25/ SUBSCRIPTION LAB W 151460 041812 021712 031712 534.25 .00 TOTALS. II.. It. II ,.. ... ..... I" II ... .... ......: 534.25 .00 534.25 M2659 MERRY X-RAY- SAN ANTONIO ./ SUPPLIES VARIOUS M 472567 033112 032912 042812 1477 .46 .00 1477.46 OUTSIDE SRV MAMMO 471786 041612 033012 043012 149.50 .00 149.50 ./ SUPPLIES CT SCAN 472883 041612 033012 043012 239.76 .00 239.76/ TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 1866. n .00 1866.72 M2698 MIDCOAST HURRICANE CONFERE ......... REGISTRATION W 23828 041912 041812 041812 45.00 .00 45.00 TOTALS.................. t...... "" I.'........: 45.00 .00 45.00 10441 MMC EMPLOYEE BENEFITS WEEKLY CLAIMS 18160 041812 041812 041812 10414.15 .00 10414.15/ WEEKLY CLAIMS 18161 041812 041812 041812 16297.72 .00 16297.72 /" TOTALS....................................... : 26711.87 .00 26711.87 10536 MORRIS &: DICKSON CO, LLC 14.43/ PHARMACEUTICALS 3251912 040412 040212 042512 14.43 .00 PHARMACEUTICALS 3252492 040412 040212 042512 3233.24 .00 3233.24 ./ PHARMACEUTICALS 3252493 040412 040212 042512 916.89 .00 916.89/ PHARMACEUTICALS 3255677 040412 040312 042512 216.90 .00 216.90 .; PHARMACEUTICALS 3257018 040412 040312 042512 772.76 .00 772.76/ PHARMACEUTICALS 3260070 041612 040512 042512 165.49 .00 165.49/ PHARMACEUTICALS 3260128 041612 040412 042512 619.65 " .00 619.65. PHARMACEUTICALS 3260494 041612 040412042512 36.57 .00 36.57 ./ PHARMACEUTICALS 3260495 041612 040412 042512 77 .14 .00 77 .14./ PHARMACEUTICALS 3261427 041612 040412 042512 73.63 .00 73. 63 ~ PHARMACEUTICALS 3261825 041612 040412 042512 2113.32 .00 2113.32 '" PHARMACEUTICALS 3261928 041612 040512 042512 54.93 .00 54.93~ PHARMACEUTICALS 3262800 041612 040412 042512 4896.04 .00 4896.04 ,,I, PHARMACEUTICALS 3265666 041612 040512 042512 85.15 .00 85.15 / PHARMACEUTICALS 3265667 041612 040512 042512 126.17 .00 126.17...... PHARMACEUTICALS 3267908 041612 040512 042512 10.20 .00 10.20 " PHARMACEUTICALS 3267909 041612 040512 042512 2147.70 .00 2147.70"'- PHARMACEUTICALS 3276559 041612 040912 042512 248.12 .00 248.12/ PHARMACEUTICALS 3276560 041612 040912 042512 9115.38 .00 9115.38./ RUN DATE: 04/19/12 TIME: 08:43 MEMORIAL MEDICAL CENTER AP OPEN INVOICE LIST THRU DUE DATE OF 05/01/12 PAGE: 6 APOPEN VEND#.NAME...........................CLS.INVOICE#.........TRN DT.INV DT.DUE DT.CK DT..PC.......GROSS.....DISC......NO-PAY........NET PHARMACEUTICALS 3285526 041612 041112 042512 52.54 .00 52.54 ./ PHARMACEUTICALS 3285527 041612 041112 042512 2462.23 .00 2462.23 ./ PHARMACEUTICALS 3285620 041612 041112 042512 14.90 .00 14.90..... PHARMACEUTCALS 3285764 041612041112 042512 141.05 .00 141.05 .... PHARMACEUTICALS 3286189 041612 041112 042512 40.47 .00 40.47.'" PHARMACEUTICALS 3286190 041612 041112 042512 117.21 .00 117.21 ./ PHARMACEUTICALS 3290829 041612 041212 042512 14.16 ..00 14.16 ....- PHARMACEUTICALS 3290830 041612 041212 042512 1264.82 .00 1264.82 ~ PHARMACEUTICALS 3291660 041612 041212 042512 216.26 .00 J 216.26 / LICENSE FEE MARCH 2012 7837 041612 040512 042512 1000.00 .00 1000.00 PHARMACEUTICAL CREDIT CM70933 041612 041112 042512 -156.76 .00 -156.76/ TOTALS................................. ......: 30090.59 .00 30090.59 M3866 MUSTAIN & ASSOCIATES 692.45/' COLLECTIONS FOR FEB W FEB2012 033112 032812 042712 692.45 .00 TOTALS................,. I" I.............. .,..: 692.45 .00 692.45 10008 OMNI-PORT LAVACA 07, L.P. ./" LEASE 23817 041612 041512 041512 10320.70 .00 10320.70 TOTALS........ "......................... i....: 10320.70 .00 10320.70 01410 ON-SITE TESTING SPECIALIST SUPPLIES LAB W 13656 041612 032712 042712 419.63 .00 419.63 / TOTALS........... t..,.,.."..................: 419.63 .00 419.63 10709 ONE STAFF MEDICAL, LLC 2088.00 ./ CONTRACT NURSE L&D 5398 033112 032812 042712 2088.00 .00 TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 2088.00 .00 2088.00 OM425 OWENS & MINOR SUPPLIES CS INV 1910437 033112 032712 042612 66.75 .00 66.75 ,/ SUPPLIES CS INV 1910463 033112 032712 042612 129.40 .00 129.40/ SUPPLIES CS INV 1910498 033112 032712 042612 33.88 .00 33.88 '" SUPPLIES SURGERY 1910764 033112 032712 042612 82.59 .00 82.59/ SUPPLIES ER 1911010 033112 032712 042612 29.98 .00 29.98/' SUPPLIES ER 1911018 033112 032812 042712 72.98 .00 72.98"" SUPPLIES VARIOUS 1911177 033112 032812 042712 2533.35 .00 2533.35/ SUPPLIES VARIOUS 1911581 033112 032812 042712 1671.70 .00 1671. 70 ,/ TOTALS....................................... : 4620.63 .00 4620.63 10727 PALACIOS COMMUNITY MEDICAL / RENT DICLEMENTE OFFICE 23818 041612 041512 041512 180.00 .00 180.00 . TOTALS. . .. . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . .. . . : 180.00 .00 180.00 P1876 POLYMEDCO INC. 608.70 / SUPPLIES LAB M 1001420 041612 031512 041512 608.70 .00 TOTALS....................................... : 608.70 .00 608.70 A1292 PORT LAVACA HARDWARE 3.49/ DEPT REPAIR MED SURG W 068179 033112 032712 042612 3.49 .00 DEPT REPAIR DIETARY 68100 041712 032312 042312 13.98 .00 13.98 / RUN ~TE: 04/19/12 TIME: 08:43 MEMORIAL MEDICAL CENTER AP OPEN INVOICE LIST THRU DUE DATE OF 05/01/12 PAGE: 7 APOPEN VEND#.NAME.......................... .CLS.!NVOICE#........ .TRN DT.INV DT.DUE DT.CK DT. .PC...... .GROSS.... .DISC..... .NO-PAY....... .NET TOTALS.... I................. I.................: 17.47 .00 17.47 P2200 POWER ELECTRIC ./ SUPPLIES PLANT OPS W 158336 033112 032712 042612 13.16 .00 13.16 ./ SUPPLIES PLANT OPS 158364 033112 032812 042712 7.18 .00 7.18 TOTAL-S.... i................................. ..: 20.34 .00 20.34 10629 QUEST DIAGNOSTICS / OUTSIDE SRV LAB 9142817000 041612 032712 042712 17.70 .00 17.70 TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . .. . . . . . . : 17.70 .00 17.70 Rl050 R G ~ ASSOCIATES INC ./ SALT DELIVERY M 197512 033112 032812 042712 155.80 .00 155.80/. SALT DELIVERY 197859 033112 032812 042712 147.60 .00 147.60/ DEPT REPAIR PLANT OPS 198672 033112 032812 042712 680.18 .00 680.18 MIXED BED SVC FEE 198412 040412 032812 042712 31. 50 .00 31.50./ TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 1015.08 .00 1015.08 R1268 RADIOLOGY UNLIMITED, PA READING FEES W 23819 041612 022912 032912 560.00 .00 560.00 /' TOTALS....................................... : 560.00 .00 560.00 R1321 RECEIVABLE MANAGEMENT, INC 411. 78"/ COLLECTIONS MARCH W 030112-033112 041612 033112 411.78 .00 TOTALS....................................... : 411.78 .00 411.78 G0425 ROBERTS, ROBERTS ~ ODEFEY, LEGAL FEES 1/1/12 - 3/7/1 W FIRSTQRT 033112 032912 042812 10226.80 .00 10226.80 .,/ TOTALS................................... t.,.: 10226.80 .00 10226.80 S1800 SHERWIN WILLI~S DEPT REPAIR ADMIN W 4154-1 041612 032112 042112 113.18 .00 113.18 / TOTALS.......................... t............: 113.18 .00 113.18 B1602 SHIRLEY BOEDEKER 275.00/ FLEX SPEND REIMBURSEMENT W 23823 041812 041712 041712 275.00 .00 TOTALS....................................... : 275.00 .00 275.00 D0350 SIEMENS HEALTHCARE DIAGNOS SUPPLIES LAB M 971050875 041612 032912 042912 580.93 .00 580.93 ./ TOTALS....................................... : 580.93 .00 580.93 S2001 SIEMENS MEDICAL SOLUTIONS 697.58/ SRV CONTRACT 3/30-4/28 M 95667886 041612 033012 043012 697.58 .00 TOTALS....................................... : 697.58 .00 697.58 S2345 SOUTHEAST TEXAS HEALTH BY 5000.00 ./ 2012 QRT MEMBERSHIP DUES W 23633 041812 040112 050112 5000.00 .00 TOTALS....................................... : 5000.00 .00 5000.00 S3960 STERICYCLE, INC 528.16 / OUTSIDE SRV HOUSEKEEPING 4003298434 041612 033112 043012 528.16 .00 RUN DATil': 04f19f12 TIME: 08:43 VEND#.NAME...........................CLS.INVOICE#.........TRN DT.INV DT.DUE DT.CK DT..PC.......GROSS.....DISC......NO-PAY........NET 528.16 .00 528.16 MEMORIAL MEDICAL CENTER AP OPEN INVOICE LIST THRU DUE DATE OF 05/01/12 PAGE: 8 APOPEN TOTALS.................................. .....: RUN DATi: 04119112 TIME: 08:43 MEMORIAL MEDICAL CENTER AP OPEN INVOICE LIST THRU DUE DATE OF 05/01/12 PAGE: 9 APOPEN ~, VEND#.NAME...........................CLS.INVOICE#.........TRN DT.INV DT.DUE DT.CK DT..PC.......GROSS.....DISC......NO-PAY........NET TOTALS....................................... : 525.00 .00 525.00 T3500 TRI-WHOLESALE CO 169.22 / SUPPLIES PLAN'!' OPS 7301-26330 033112 032712 042612 169.22 .00 TOTALS. . I . . I . . . . , . . I . . . . . . . . . . . . . . . , . . . .t_' , . . . : 169.22 .00 169.22 U1054 UNIFIRST HOLDINGS 32.54/ LAUNDRY MAINTENANCE W 8150565359 033112 032712 042612 32.54 .00 TOTALS.......... II..........., ............... t.: 32.54 .00 32.54 U1064 UNIFIRST HOLDINGS INC 749.08 ./' LAUNDRY HOSPITAL LINEN 8400123668 033112 032712 042612 749.08 .00 LAUNDRY HOUSEKEEPING 8400123669 033112 032712 042612 174.44 .00 174.441' LAUNDRY PLAZA 8400123670 033112 032712 042612 168.11 .00 168.11 / LAUNDRY HOSPITAL LINEN 8400123875 033112 033012 042912 680.91 .00 680.91/ LAUNDRY SURGERY 8400123876 033112 033012 042912 348.59 .00 348.59 LAUNDRY DIETARY 9400123671 033112 032712 042612 130.02 .00 130.02/ LAUNDRY OB 9400123672 033112 032712 042612 86.70 .00 86.70/ LAUNDRY HOUSEKEEPING 9400123673 033112 032712 042612 52.03 .00 52.03 ",...- TOTALS.. I......... I........,..............,..: 2389.88 .00 2389.88 U1500 UROLITHIASIS LABORATORY OUTSIDE SRV LAB W 12M457803 041612 033112 043012 26.50 .00 26.50/ TOTALS.. t, t'...,..... I....'.......,..,........,: 26.50 .00 26.50 10172 US FOOD SERVICE / SUPPLIES DIETARY 5548505 041612 032912 041812 3795.61 .00 3795.61 / SUPPLIES DIETARY 5548508 041612 032912 041812 31.40 .00 31.40 SUPPLIES DIETARY 5571326 041612 032912 041812 85.38 .00 85.38 ./" SUPPLIES DIETARY 5676491 041612 040512 042512 3504.55 .00 /' 3504.55 /' SUPPLIES DIETARY 5676492 041612 040512 042512 18.04 .00 18.04 SUPPLIES DIETARY 5757113 041712 041012 043012 45.79 .00 45.79~ SUPPLIES DIETARY 5802944 041712 041212 050112 3705.43 .00 3705.43 SUPPLIES DIETARY 5802946 041712 041212 050112 42.54 .00 42.54 /' TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 11228.74 .00 11228.74 V0555 VERIZON SOUTHWEST TELEPHONE M 5520220032812 041612 032812 042212 103.36 .00 103.36 / TELEPHONE 5523521040112 041612 040112 042612 40.72 .00 40.72/ TOTALS. . . '"f . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . : 144.08 .00 144.08 K1751 VICKY KALlSEK FLEX SPEND REIMBURSEMENT W 23824 041812 041712 041712 101.25 .00 101.25/ TOTALS....................................... : 101.25 .00 101.25 Vl080 VICTORIA COMMUNICATION SVC 29.99 / TELEPHONE - RANDY M 222054 040412 032912 042912 29.99 .00 TOTALS....................................... : 29.99 .00 29.99 V1471 VICTORIA RADIOWORKS, LTD ADVERTISING W 12030304 040412 033112 043012 144.00 .00 144.00 / ~ \. . t RUN DATE: 04/19/12 TIME: 08:43 MEMORIAL MEDICAL CENT~R AP OPEN INVOICE LIST THRiJ DUE DATE OJ' 05/01112 PAGE: 10 APOPEN VEND#.NAME........ n.,......... ...... .CLS.INVOICE#......., .TRN DT.INV DT.DUE DT.CK D'r..P,c..... ..GROSS... ..DISC..... .NO-PAY....... ,.NET TOTALS.. I . ." "," .. . . , " .., ~ " ',. 1-' . . , , , , . , ". , I , -. , , ,:_ 10472 VISA MISCELLANEOUS PURCHASES 2012MARCH 041812 032512 041912 TOTALS.,.. ..."......, .-....:.... I ,.. I ..1._..... ...........: 10325 WHOLESALE ELECTRIC SUPPLY SHIPPING CHARGES FOR P077 2709924 041812 020812 030,812 TOTALS...., '." ... _.. .-.......", '.'!" ,..", ,'",. .,.-,.: W1565 WRS GROUP, LTD SUPPLIES NURSERY 960151 032712 032112 042512 TO'rALS. , ',,' . '.' , , , , , , . ,.. '.' . . . , ., . _," . . . . -.. . .. . , : GR.AND -TOTALS,.."'...,, 'e'" """"i'" ..'.., i .,t...... i.: tKS::!t I <-riD 35 +0 Jll~~13\ 144.00 144.00 .00 239.95 .00 239.95 .,00 1.00 .00 7.00 .00 20.20 .00 20.20 .00 189503,.67 .00 239.95 ,,/ 239.95 7.00 7.00 ./ 20.20/' 20.20 189503.67 / APPROVED APR 1 9 2012 COUNTY AUDITOR ~ d:!- 14 5309 4 ~11.f2'oHq ~ M\chae\J. Pfeifer" .", e ca\hOUrl coun:'l~dg O~to:, .d '::,' ') JJ, ,"'1--.....__ . ..,....~~f.~'-. 'lUN DAT~: 04/18/12 t r"- . ,( -. TIME: 14:31 MEMORIAL MEDICAL CENTER EDIT LIST rOR PATIENT REFUNDS ARID=0001 PAGE t APCDEDIT -I- PA'rIENT PAY PAT NUMBER PAYEE .'NAMEDATEAMOUNTCODE TYPE DESCRIPTION --'-- - -~...- --- -----: -- -'-'~- -- -'-,- - -- - -:- - _..': - -- -- -',. - - - ~~~;~; - - - -- - --;;~ ~ ~ -7-- - . * .. 041812 041812 113.:281 129 . 92 .I 041812 137.00 / 041812 656.25 / 041812 580.80/ 041812 252.40 I 041812 1079.40 ,( 108.40 -I 25.00 I 041812 28.32 / *' 0.41812 14.16 J 0.41812 45.00 / GL NOM ;i..~_.......... ._'....... ..__.... -- -- -- -_......:..'........ -.... 'RUN DATE: 04/19/12 TIME,: 14:31 PATIENT NUMaER PAYEE,.NAME ...... ...,...... ...;........ _....-- -- -,,,,;;"... -........'-... ...'..... --'-'_.. ...-..,; --' PAY PAT DATE AMOUNT CODE T'IPE DESC!l.IPTION Gt. ~ - ~;~;~; - -- _n - -~;: ;,~ -7- -- - - -- -.,.- -. - - -- - .~... --- ~....,. ...,..'~ -~_... - .~~-- -- - -- - --.. -- --- MEMORIAL MEiDICALCElIlTER EDIT LIST FOR PATIENT REFUNDS ARID=OD01 041912 347.24/ PAGE '\I. AP,CDEDIT ARID=OOOlTOTAL _'.oio _._"'" _'.-_'_... ~......... __.~... ~... __... _'................. __................................ -.-............... ...... ............................ --........ --............... -:-......... -.-"''''''' ............ ...'... --......... ....... -:- ................ ....... .......-............ ........................ --.. ---- 041812 .I 303.45 .-'" _.- ........ ....-............... ---!",.,-" ....:~ ~-~... -... ...-.-'" ..".. --... --... ....-........ -.- _:...- --........ ........ --... --:---.............. --. -:-................ --. ....- --...............~................;. -- --... --"_... ....- ;....... ..:.... ......... -... .'-_._-'-... ~;.._._.. ........'- TOTAL 58.61/' 041 S12 5317.16 5317.1E ~ C, Kg:tJ I'~ <d, )3 2 +0 ~ )t.-18 Jf; ) APPROVED APR 19 2012 co UN"" AUOITOR RUN DATE: 04/25/12 TIME: 11:15 MEMORIAL MEDICAL CENTER AP OPEN INVOICE LIST THRU DUE DATE OF 05/08/12 PAGE: 1 APOPEN VEND#.NAME...........................CLS.INVOICE#.........TRN DT.INV DT.DUE DT.CK DT..PC.......GROSS.....DISC......NO-PAY........NET A1790 AFLAC 130.00 I SERVICE FEE W 267558ER 042312 041612 041612 130.00 .00 TOTALS....................................... : 130.00 .00 130.00 A1690 ALCON LABORTORIES INC 159.00 ./ LENSES M 13177430 041612 040212 050212 159.00 .00 LENSES 13178120 041612 040212 050212 477.00 .00 477.00./ TOTALS. . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . : 636.00 .00 636.00 10282 ALLIED HEALTHCARE PRODUCTS 44.341'1 SUPPLIES PLANTOPS 1307663 041612 040412 050412 44.34 .00 TOTALS. . . . . . . . . . . . . . . . . t,' . . . . . . . . . . . . . . . . . . . . : 44.34 .00 44.34 D1125 AMY DAY 190. 61 V' TRAVEL EXPENSES W 23828 042312 041912 041912 190.61 .00 TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . ~ . . . . . . . .. . . . : 190.61 .00 190.61 A2345 AT&T MOBILITY TELEPHONE X04192012 042312 041112 050612 3.55 .00 3.55 v' TOTALS....................................... : 3.55 .00 3.55 B0436 BARD ACCESS 131.16 ,/ SUPPLIES SURGERY 22427493 041612 040412 050412 131.16 .00 "'- SUPPLIES SURGERY 43443117 041612 040212 050212 381.65 .00 381.65/ SUPPLIES SURGERY 43446289 041612 040412 050412 747.30 .00 747.30v' TOTALS. . . . . . . . . . . . . . . . . . . . . . . of . . . . . . . . . . . 't, . 'f . : 1260.11 .00 1260.11 B1220 BECKMAN COULTER INC 5940.04/ OUTSIDE SRV LAB M 102817172 041612 040312 050312 5940.04 .00 OUTSIDE SRV LAB 102818342 041612 040312 050312 81.24 .00 81. 24 ~ OUTSIDE SRV LAB 102821242 041612 040412 050412 1274.20 .00 1274.20/ OUTSIDE SRV 102821245 041612 040412 050412 333.00 .00 333.00 OUTSIDE SRV LAB 102821933 041612 040412 050412 17734.,39 .00 17734.39/ OUTSIDE SRV LAB 102822665 041612 040512 050512 46.50 .00 46.50 "I TOTALS....,.,..... ,f..........................: 25409.37 .00 25409.37 B1655 BOSTON SCIENTIFIC CORPORAT SUPPLIES SURGERY M 932064561 041612 040212 050212 206.00 .00 206.00/ SUPPLIES SURGERY 0931005338 042312 122911 012912 2016.00 .00 2016.00 ./ SUPPLIES SURGERY 923124347 042312 040412 050412 -1240.00 .00 -1240.00 TOTALS....................................... : 982.00 .00 982.00 C1033 CAD SOLUTIONS, INC 552.00/ CAD CASES 201648 042312 033112 552.00 .00 TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 552.00 .00 552.00 Cl030 CAL COM FEDERAL CREDIT UNI 2S. 00 / PAYROLL DEDUCTIONS W 18164 042412 042412 042412 25.00 .00 TOTALS. .......... t...........................: 25.00 .00 25.00 A1825 CARDINAL HEALTH SUPPLIES NUC MED M 08107823 042312 041312 041312 581.19 .00 581.19 ./ RUNI3ATE: 04/25/12 TIME: 11:15 MEMOItIAtMEDICAL CEN'l'ER AP OPEN INvOICE'LIST'THRU DUE ,DATE OF 05/08/12 PAGE: 2 APOPEN VEND#.NAME. Hi... ',' i... .,........... .,..CLS.INv'OICE#...., ... ,T~ DT.INV DT~DUED'j,\.CKD'l'. ,PC"'" n ..GROSS... ..DISC..... .,N6~PAY...,.;. .NET C1390CEN'l'RAL IlRUGS SUPPLIES PHARMACY 10350 CEmlJRION MEDICAL PRODUCTS SUPPLIES ell INV SlJPPLIESV1iRIOUS 10661 CENTURYLINK 'l'ELEPHONE 10720 CHR:tS IWtIREZ, JR. RECERTIFICATION C1730 cITY OF ,PORT LAVACA WATER/S:EWER 03/08-04/09 WATER 3/8 - 4/9 10556 CPPWOUND 'CARE#28,t.tC WOuND 'CARE C2510 CPSI SUPPLIESPH!RMACY HDW/SFTW/TECH:SUPPORT 10026 DONN STRINGO TRAVEL EXPENSES DI710 DOWNTOwN CLEANERS OUTSIDE ,SRV WOMEN'S CLINI W OUTSIDESRY HOUSEREEPING 10175 DSHS CENTRAL LAB' ~C2004 SUPPLIES LAB E0500 EAGLE FIRE &' SAFETY INC SUPPLIES PLANT OPS TOTAL-S...... II I,t ,..:.. ,.,.,;.. ..... 1.1" It.. fl...:. It.: .w 23832 042312 033112 TOTALS....... .'.............. ...... i,...... ....: 90989966 90991328 041612 040312 050212 041612 040412050412 TOTALS. ._.....".. .,'.......... I,' II ..,'...." ....+... It',,,.: 1208306382 041812 040312 050312 TOTALS. . . . . . .. . .. .." .. .... . . .. .. . .. .. . . H' . . . : 12021 042312041012 041012 TOTAI..S::. 'f.... "f_ to. ';': '.. ".... ..... to to 1:, " ......:.' to 0 ,'"..._..: W030812~040912 3/8-4/9 042412 041812 050712 042412 041812 ,050712 TOT~S-.,..,.. .,. :.... ":- ,',.. 1_..... ~ '_f'" II... "f,I""': 13769 042312041012050512 '.T6TAL'S~.".,. t... ~-. .".... ..'........... .,.,'"," ,.,..."..'.... ':",. ,.., ,-; M 719909 A1204051378 042312, 041812 041712 042412 04,0512 040512 TOTALS',.,....,. f.'" ..'...., ."... ~..... .'.... _.. .,....: 23838 042312 041612 041612 T9T~S..,.".... '.' '," ".- "'11' ........... .'..'....."...: 581.19 581.19 .00 225.00 .00 225.00 .00 671.66 .00 872.92 .00 1544.58 .00 268.84 .00 268..84 .00 300.00 .00 300,.00 .00 6475.85 .,00 383.80 .00 6859.65' .00 Q0400.00 .00 20400.00 .00 300.00 .00 14981.00 .00 15281. 00 .00 23.00 .00 23.00 .00 225.00/ 2,25 . 00 ../ 671.66 872.92 ./ 1544.58 268.84 ;/ 268.84 300.00 ,/ :300.00 ,/ 6,475.85 / 383.80 v 6859..65 20,400.00/ 20,400.00 300.00 ./ 14981.00 ../ 15281.00 23.0,0 ../ 23..00 1759 041612040912050812 1"001; o4~ SaJe,!;r~s<- 1760 041612040912 050812 10.00 TOTALS. '.... .:....,.......... ....... .,.,...... ....: 309.85 23821 041612 040312 050312 'l'OTALS'.... . . .. . . . . '.. . . .. . . . . . . . . . . .... . . . . . i .: M 44326 041612 0405t2 050412 TOTALS'. ,'-'......... ._....."..... .'.. .'.. .,............ ..: E3400EMERGENCY MEDICAL PRODUCTS SUPPL!ESCS INV ,M 1454168 041612 040512 05,0412 .00 ;)77.00--:199.85; .00 10.00 .00 ~ <<87.00 103.50 .00 103..,50 .00 127.75 .60 127.75 .00 85.90 .00 103.50 v- 103..50 ., ./ 127.75 127.,75 / 85.90 RUN DATE: 04/25/12 TIME: 11:15 -, , NET CLS INVOICE#.........TRN DT.INV DT.DUE DT.CK DT..PC.......GROSS.....DISC......NO-PAY........ VE!ID# ,'NAIwIE. . . . . . . . . . . . . . . . . . . . . .. . . . . . . 85.90 .00 85.90 MEMORIAL MEDICAL CENTER AP OPEN INVOICE LIST THRU DUE DATE OF 05/08/12 PAGE: 3 APOPEN TOTALS..............,............"........... : 10417 ENTRUST INSURANCE & BENEFI V EN022336 042412 050112 050112 13646.55 .00 13646.55 INSURANCE TOTALS.... .',........,...................,.....: 13646.55 .00 13646.55 T0383 ERIN CLEVENGER .00 213.61/ TRAVEL EXPENSES W 23829 042312 041912 041912 213.61 TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 213.61 .00 213.61 10701 FAGAN ANSWERING SERVICE AN 76.81 ./ OUTSIDE SRV WOMEN'S CLINI 72435 042312 042012 042012 76.81 .00 TOTALS....................................... : 76.81 .00 76.81 F1400 FISHER HEALTHCARE ./ SUPPLIES LAB M 9238304 041612 040312 050312 687.48 .00 687.48 ../ SUPPLIES LAB 9309169 041612 040412 050412 464.23 .00 464.23 TOTALS............ I........ i.................: 1151. 71 .00 1151.71 F1653 FORT BEND SERVICES, INC OUTSIDE SRV PI..ANT OPS APR 0173530-IN 041612 040212 050212 495.00 .00 495.00 / TOTALS...................................... .: 495.00 .00 495.00 G0120 GE MEDICAL SYSTEMS, INFO T SRV CONTRACT OB 7370487 041712 040812 050812 171.00 .00 171.00 / TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . t' . : 171.00 .00 171.00 G1210 GULF COAST PAPER COMPANY SUPPLIES HOUSEKEEPING M 371801 041612 040312 050212 175.21 .00 175.21 ,. SUPPLIES HOUSEKEEPING 372091 041612 040312 050212 134.88 .00 134.88 .-*' TOTALS.. I.......,................. ,f..........: 310.09 .00 310.09 H0030 H E BUTT GROCERY SUPPLIES DIETARY M 115108 041612 040412 050412 90.88 .00 90.88 ,. TOT.ALS~.........................,............ : 90.88 .00 90.88 10334 HEALTH CARE LOGISTICS INC / SUPPLIES PHARMACY 4413212 041612 040412 050412 225.12 .00 225.12 TOTALS........................... ............: 225.12 .00 225.12 H1399 HILL-ROM COMPANY, INC 75.36 .J DEPT REPAIR ICU M 23658377 041712 040712 050712 75.36 .00 TOTALS....................................... : 75.36 .00 75.36 I0520 IKON FINANCIAL SERVICES ~ COPIER LEASE M 86808702 041712 041012 050512 4870.00 .00 4870.00 TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 4870.00 .00 4870.00 I0950 INFOLAB INC / SUPPLIES BLOOD, BANK / LAB M 3102565 041612 040212 050212 1581. 62 .00 1581. 62 SUPPLIES LAB 3104083 041612 040412 050412 1969.55 .00 1969.55 .I RUN BATE: 04/25/12 TIME: 11: 15 MEMORIAL MEDICAL CENTER AP OPEN INVOICE ,LISTTHRU DUE DATE OF 05/08/12 PAGE: 4 APOPEN ~ ~ u.~ CL'S INVOICE#.........TRN DT.INV DT.DUE DT.CK DT..PC.......GROSS.....DISC......NO-PAY........NET VEND1tt,l.'loN,J.I:.l.,.................. I.t. t'" . TOTALS. . . . . . , . . . . . . . . . . . . . . . . . . . . .1 . . . . . . " . . . . : 3551.17 .00 3551.17 10736 INTEGRATED COMMERCIALIZATI 137.49/ PHARMACEUTICALS 15011596771 042312 030612 040612 137.49 .00 TOTALS. . . . . . . . . ., . . . . . . . . . , . . t . . . . . , . . . . . . . . . I : 137.49 .00 137.49 10632 JACKSON NURSE PROFESSIONAL 2304.00 ...,/ CONTRACT NURSE 46154447 042412 033112 033112 2304.00 .00 TOTALS.....,..,...,...,....................,. : 2304.00 .00 2304.00 J14 0 0 JOHNSON & JOHNSON ./ SUPPLIES SURGERY 907533939 041612 040412 050412 130.44 .00 130.44 TOTALS.............................,......... : 130.44 .00 130.44 Kl070 KEY SURGICAL INC 39.00/ SUPPLIES SURGERY M 434290 041612 040412 050412 39.00 .00 TOTALS...................... I..'.............: 39.00 .00 39.00 Dl033 LAURA DAVILA 446.05/ FLEX SPEND REIMBURSEMENT 23833 042312 042312 042312 446.05 .00 TOTALS.... ...................................: 446.05 .00 446.05 M2659 MERRY X-RAY- SAN ANTONIO 240.00 ./ OUTSIDE SRV MAMMO M 40982 042312 032812 042812 240.00 .00 TOTALS....................................... : 240.00 .00 240.00 M2650 METLIFE INSURANCE W 23840 042312 040112 040112 258.52 .00 258.52 V TOTALS................ I......................: 258.52 .00 258.52 M2621 MMC AUXILIARY GIFT SHOP PAYROLL DEDUCTIONS W 23839 042312 041712 041712 130.11 .00 130.11.,/' PAYROLL DEDUCTION 23934 042312 041212 041212 74.67 .00 74.67/" TOT'ALS........,.'..,.......'.. t,....,..,..,...; 204.78 .00 204.78 10441 MMC EMPLOYEE BENEFITS WEEKLY CLAIMS 18167 042512 042412 042412 23134.73 .00 23134.73 ........ TOTALS....................................... : 23134.73 .00 23134.73 A2252 NADINE GARNER TRAVEL EXPENSES W 23831 042312 041912 041912 46.00 .00 46.00 ./ TOTALS.,..........................,.. .........: 46.00 .00 46.00 10709 ONESTAFF MEDICAL, LLC /' CONTRAC'l'. NURSE 5429 041612 040412 050412 2088.00 .00 2088.00 TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . : 2088.00 .00 2088.00 OM425 OWENS & MINOR I SUPPLIES LAB 1913530 041612 040312 050312 64.61 .00 64.61./ SUPPLIES CS INV 1913607 041612 040312 050312 / 88.48 .00 88.48 / SUPPLIES VARIOUS 1913898 041612 040312 050312 2894.92 .00 2894.92 RUN nATE: 04/25/12 TIME: 11: 15 MEMORIAL MEDICAt. CEN'I'ER AP OPEN INVOICE LIST THRU DUE DATE OF 05/08/12 PAGE: 5 APOPEN VEND#.NAME. ......................... .CLS.INVOICE#........ .TRN D'l'.INV DT.DUE DT.CK DT. .PC...... .GROSS.... .DISC..... .NO-PAY....... .NET / 902.15/ 334.16 40.19 ,/ 19.67 ,/" 110.40'/ 15.99~ 3.00 . J 1486.68/ 5960.25 SUPPLIES SURGERY SUPPLIES PT SUPPLIES CARDIO SUPPLIES CS INV SUPPLIES CS INV SUPPLIES CS INV SUPPLIES PT SUPPLIES VARIOUS 1913902 1913972 1914070 1914874 1914911 1914970 1915116 1915319 041612 040312 050312 041612 040312 050312 041612 040312 050312 041612 040512 050512 041612 040512 050512 041612 040512 050512 041612 040512 050512 041612 040512 050512 902.15 334.16 40.19 19.67 110.40 15.99 3.00 1486.68 5960.25 .00 .00 .00 .00 .00 .00 .00 .00 .00 TOTALS... "...... I...... ,f......,....... t......: 00450 PATRICIA OWEN /. FLEX SPEND REIMBURSEMENT W 23835 042312 042312 042312 230.00 .00 230.00 TOTALS................,.......,............., : 230.00 .00 230.00 A1292 PORT LAVACA HARDWARE 49.46/ DEPT REPAIR LAB W 068312 041612 040412 050412 49.46 .00 TOTALS...... .'.........,......................: 49.46 .00 49.46 P2100 PORT LAVACA WAVE ADVERTISING MARCH W 188 042412 033112 043012 720.50 .00 720.50/ TOTALS....................................... : 720.50 .00 720.50 P2200 POWER ELECTRIC DEPT REPAIR DIETARY W 158501 041712 040912 050812 9.98 .00 9.98/ TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 9.98 .00 9.98 P1725 ,PREMIER SLEEP DISORDERS CE SLEEP STUDIES M 110 2012 041612 040412 050412 3950.00 .00 3950.00 ./ TOTALS.......,.................... I..........: 3950.00 .00 3950.00 10326 PRINCIPAL LIFE INSURANCE PREMIUM 5/1-5/3 18163 042412 041712 050112 1950.18 .00 1950.18 ./ TOTALS. . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 1950.18 .00 1950.18 R1045 R & D BATTERIES INC INSTRUMENT REPAIR NUC MED M 969001 041712 040912 050812 31.00 .00 31.00/ TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 31. 00 .00 31. 00 R1268 RADIOLOGY UNLIMITED, PA READING FEES W 23836 042312 041612 041612 225.00 .00 225.0~ TOTALS., "'" I ".................. "" ,.....,..: 225.00 .00 225.00 R1465 RENEE DUNAGAN 23.50/ CONTINUING EDUCATION 23844 042412 042312 042312 23.50 .00 TOTALS....................................... : 23.50 .00 23.50 10645 REVISTA de VICTORIA / ADVERTISING APRIL 04201237 042412 042012 043012 375.00 .00 375.00 TOTALS... I.............. I....................: 375.00 .00 375.00 S2400 SO TEX BLOOD i TISSUE CENT SUPPLIES BLOOD BANK M 20121621 041612 040312 050312 -3159.00 .00 -3159.00/ RUN DA1E: 04/25/12 TIME: 11:15 MEMORIAL MEDICAL CENTER AP OPEN INVOICE LIST THRU DUE DATE, OF 05/08/12 PAGE: 6 APOPEN VEND# ......... CLS INVOICE#.........TRN DT.INV DT.DUE DT.CK DT...PC.......GROSS......DISC........NO-PAY.........NET .I""".~........................... . .,/ SUPPLIES BLOOD BANK 20121685 041612 040312 050312 8334.00 .00 8334.00 TOTALS... ".....,..t.. ",..t.,.,...t.........".: 5175.00 .00 5175.00 S2694 STANFORD VACUUM SERVICE 320.00 ./ OUTSIDE SRV DIETARY M 927563 041612 040412 050412 320.00 .00 TOTALS....................................... : 320.00 .00 320.00 10333 SUNTRUST EQUIPMENT FINANCE /' MONTHLY PAYMENT 1450411 042312 040612 050112 22688.57 .00 22688.57 TO'1'ALS. . . . . . . . . . . , . . . , . . . . . . . . . . . . . . . , . . . . . . . : 22688.57 .00 22688.57 S2951 SYSCO FOOD SERVICES or / SUPPLIES DIETARY M 204190836 042412 041912 050712 1132.55 .00 1132.55 TOTALS....................................... : 1132.55 .00 1132.55 '1'0500 TEAM REHAB 15000.00/' INTERIM BILLING W 23841 042312 042312 042312 15000.00 .00 TOTALS. . . . . . . . , . . . . . , '. . . . . . . . . . . . . . . . . . , . . . '. . : 15000.00 .00 15000.00 M2336 TERESA MILLER TRAVEL EXPENSES 238330 042312 041912 041912 23.00 .00 23.00 ,,/ TOTALS. . . . . . .. . . . . . . . . . . . . . . . . . . . . . ... . . . . . .. . : 23.00 .00 23.00 V1050 THE VICTORIA ADVOCATE / SUBSCRIPTION W 877365 041812 040712 050712 12.40 .00 12.40 TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 12.40 .00 12.40 '1'0801 TLC S~AFFI~G 800.08/ CONTRACT NURSE W 10037 041612 040312 050312 800.08 .00 TOTALS....................................... : 800.08 .00 800.08 P2190 U S POSTAL SERVICE 1200.001 POSTAGE IMP 23842 042312 041612 041612 1200.00 .00 TOTALS. . . . . . . . . . , . . . . . . . . . , . . . 'f . . . . . . . , . . . . . . : 1200.00 .00 1200.00 U1054 UNIFIRST HOLDINGS 53.44/ LAUNDRY MAINTENANCE W 8150566093 041612 040312 050312 53.44 :00 TOTALS....................................... : 53.44 .00 53.44 U1064 UNIFIRST HOLDINGS INC LAUNDRY HOUSEKEEPING 8400124025 040412 040312 050212 182.19 .00 182.19 /' LAUNDRY PLAZA 8400124026 040412 040312 050212 172.10 .00 172.10 :; LAUNDRY DIETARY 8400124027 040412 040312 050212 130.02 .00 130.02 LAUNDRY OB 8400124028 040412 040312 050212 86.70 .00 86.70/ LAUNDRY HOUSEKEEPING 8400124029 040412 040312 050212 52.03 .00 52.03 :::. LAUNDRY HOSPITAL LINEN 9400124024 040412 040312 050212 743.91 .00 743.91 LAUNDRY HOSPITAL ,LINEN 8400124232 041612 040612 050612 798.58 .00 798.58 ./ LAUNDRY SURGERY 8400124233 041612 040612 050612 348.59 .00 348.59/ LAUNDRY PLAZA 8400123322 042312 032012 042012 149.40 .00 149.40 I TOTALS. . . . . . <II . . . . . . . I . . . . t, . . . . . , . . . . . . . , . . . . t': 2663.52 .00 2663.52 U0414 UNUM LIFE INS CO OF !MERIC I~SURANCE PREMIUM 18162 042312 042012 042012 4197.29 .00 4197.29 / RUN DATE: 04/25/12 TIME: 11:1S MEMORIAL MEDICAL CENTER A~ OPEN.INVOlCELIST THRU DVE DATE OF 05/08/it PA~E: 7 APOPEN VEND#.NAME....... .................. ..CLS.INVOICE#......... .TRN D'l'.INV DT.DutDT,.CKD'l'. .PC.'... ...~ROSS.... .DISC.... '. .N'O~PAY.... ... .NET 101 n US FOOD SERvICE SUPPLIES DIETARY SUPPLIES DIETARY SVPPLIES DIETARY SUPPLIES DIETARY V0555 VERIZONSOUTIlWEST, 1'EI.EPHOm: TELEPHONE TELEPHONE TELEPHONE Rl184 VERONICA RAGUSIN TRAVEL EXPENSES 10394 WILLIAM E HEIKAMP,TRUSTEE PAYROLL. DEDUCTION 10i29 WILLIAM,E HEITKAMP, TRUSTE PAYROLL. DEDUCTION' TOTALS',.. "I" ,'., ",," "II........ .-, II ...._.. I" ._....: 5863291 5700166 5728127 3028923 041812 041612 050412 042312 040512 042512 042312 040612 042612 042412 041912 050712 .TOTALS..............1i Ii ...,. ... i..... ," ",-,.',. .:.,. .': M 551251304'0712 55281,03040712 5537803040712 5526713040712 041712 040712 050212 041712 040712 050t12 041712 040712 05021t 041812 040712 050212 TOTALS._. .... II" 1-" ,1:,_._............... .'.,' ,", ,"...,: 23837 042312 041612041612 T.OTALS.... ..... I"t '"t.' ':"','" t.I" I.'" ........ "1 ....... I.....: 18165 042412042412 042412 T-OTALS. . . .. . .:. . . ... . . . . . . .. II II . . . . . '_"'.. . . . of. t". . : 18166 042412 042412 042412 "TOTALS. I"... ",, II' ..'... .'...... ,',,, ,',.10."... II .:_.: GRAND TOTALS...................................: APPROVED APR l:J 2~J'i2 COUNTY AUi.:.)iTOR C K S.Jt; /4f? 152.. +0 :11:. N g ~;;l.tP V'DIO ~ 14~;ZD& 4197.29 60.40 47.58 36.32 4846,.03 4990.33 195.08 47.91 294.91 1t60.12 1798.02 167.30 167.30 400.00 400.00 ,495.00 495.00 20,389,0,.,92 .00 4197.29 .0'0 60.40"""'- .00 .,,/ 47.58,/ .00 36.32 .00 4846.03/ ..00 4990.,33 .00 195..08/ .00 47.91........ .00 294.91 ..-'" .00 1260.12 /' .00 1798.02 .00 167.30 /" .00 167.30 .00 400.00 ....- .00 4'00.00 .00 495,.00 ./ .00 495.00 .00203890.92 PtJ~ f < .;?q<f. g$") C~c.+;61\ ( +- ;1.77.00 :(D.3'iUc>~. 07 I I ~,~9~ '!~hae\ J, Pfeifer lJhotln CGuntyJudge ,,)ate: J.J..... !))w )? RUN DATE: 04/25/12 TIME: 11:14 MEMORIAL MEDICAL CENTER EDIT LIST FOR PATIENT REFUNDS ARID=OOOl PAGE , APCDEDIT 'PATIENT PAY PAT NllMBEIt PAnE NAME DATE AMO~ CODE TYPE DESCRIPTION - - - -- - - - --- - ---- - -'- :\" -' - -'-.. - - -'- - '-- -.... -- ---- - - - - - -,.- -~~;;~; - - - -- - - ;;;:;; 'T -- GL NuM 042512 55.04 .. _ _ .'_.... _'... _ ....'...i'... _'.;,;,;.;,.'...__......... _~"._'...'_ _:..........__:.'. .......,.... .._. ....'...... ._"'~".."'~'" ..'~._ "_..;'" ..:... ...,........... _.",! _,''-,_ __....... .'....... ..'..._ ...."!' ..._.......... ...-.. ...':.... .:...........:..... ioo..........._.. __ ................... ..'_...... .....:... "'!' ...~... .-__ ....,...--. t ARID=OOOlTOTAL 630.42 ......... .'.......... __ ....__... .......... __....,........................... .................... _.... __ ____... __......... __.... __..... __ __........ __... _........_.. ...._......... ....__... ~... _._ __.. __... _...,_,_ _'... _._... ,",'.,;,_._ ....... _.__......... _,_.OM" .'. __... __ ............ __... TOTAL 630.42 v" CKftJL{~~;{ 1 +6 I 'i~~~g A,PPROVED APR 2 4 t:G12 COUN1YAYDITOR ~~-:-g if'- MichaelJ. Pfeifer Calhcl.,inCIJWlty Judge D''1te: ,q-'JJ~"" t RuN DATE:.04/30112 TIME:U:17 MEMORIAL MEDICAL CENTER !n!T.L!ST FOR ~'l'CH 5560778 CRT#556 'l'R.AIqSAC'rION SEQUENC! PAGE 1 GLEDI'l' ACCOUNTA.H.A. SEQ. NUMBER NUMBER 'l'llANS DA'l'EJOURNAL AMOUNT SU8~LED REFERENC! MEMO G.L. ACCQUNTDESCRIPTION ...... ........... ...... __... __ _.,...,.. ...._....,_.................. _,""'''; .....:....... _.';,.'... .__..:.;..'._,....._.._.. _.....'...:_...,... ..........::_~._._'_.~.;..:..._'... _:_ ~"~"_.. .,...._......... ... ___ _...._ .'_...__:__'_'__ _;_'."",... ..._:_ ...._,_......... __,_ _........'..... ;;,.'._...-';;,;"..;,. .'.....'... .(_"iiiI ;'Ii;-..' 1 10000000 20000000 04/30/12 CD 04/30/12 CD 210.93CR 10519 210.93i 10519 A/PC148229 ,LESL!E SIMMONS A/PC148229LESL!! SIMMONS OPERATING ACCOUNTS PAYABLE -CASH -Alp 30000000 21038 296458 - -- -'- - :- ~ - -REC A P- .. :- - '- - - - -- JOI1il.NALYRMOCOUNT DEBIT cn 12042 210.93 ToTAL 2 210.93 +r-a.. \Je\ Re.~ t'l\.b. CREDIT 210.93 210.93 ACCOUNT 'l'OTALRECAPON NE,XT,PAG.E t\~~ \4<6 Iit~~~ CQunWJudge Date:,....c L~-~e. ~ ll.UN DATE: 05/03/12 TIME: 10:40 ~; ME.MORIAL MEDICAL CENTER AP ,OPEN INVOICE LIST THRU DUE DATE OF 05/15/12 PAGE: 1 1l.POPEN VEND~.NAME. . ... . . ....,.. . . .... . . ... . , . ..CLS. INvOICE#.. .. .. . . .TRN D'l'. tNV P'l'.DUEP'r.CK DT.,.PC... . .. . ,GROSS. .. ..!:ltse. .... .NO-PAY. ..........NE'l.' 10569 AHRA SUPPLIES RADIOLOGY A1715ALCO SALES&:,SERVICE CO DEP1\.RTMElfrllEPAIR AllXILIlAM 10739 ALT-N TECHOLQGIES" L'J.'I). $UPP1i:rFosIT A136.0AMERISOURCEBERGENDR1{GCOR PHARMACEUTICALS W P!iMMACEUTICALS PHARJlIACEUTICALS P!iMMACEUTlCALS P~EU'l.'ICAtS PHAI!MACEU'!'ICALS PHARJlIACE.UTICAL8 P1Woo.CEUT:tCALS PHARJlIACEUTICALS PliARMACEU'l.'ICAts PHARMACEUTICALS PHA1OO.CEUTICALS PAHRNACE.UTIOALs PHARJlIACEU'!'IOALS D1125 AMY DAY TRAVEL EXPEijsES W TRAVEL EXPENSES NURSE ADM AQ777l1ijDERSONCONSULTATIONSERV COLLECTIONS W A2J50 ANNOUNCEMENTS PLUS '1'00 AGA SuPPLIES OB W EMPLOYEERECOOOTION A2260All.ROW INTERNAT:tONA):, INC SUPPLIESCS 1NV M A2345 AT&,T MOBILITY 'l'ELEP.IrONE 10719 ,AUSTIN MEDICAL PRACTICE OUTSI!)E SRV 23862 043012 043012 043012 TOO!J\LS. .. . .. . . .. ,u.. . . . ... . . .. '. '.... ..... . . '," .: 2452566-IN TOTAL'S...'. t_." _ti..... ,.,',1" '..:,',',. ..i.,. i_.'":"",, ._. .,:.: 043012 042512 051512 00468255 050212 050212 050212 TO'l.'ALS....... ...... n... 0" 0...0. ... ........ .,...: 037-526475 037-52.2920 037-522921: 037-522922 037-522923 037-528495 037-534905 :037-537019 03']- 537020 on-538936 037-541794 037-541795 C88202 037-518832-12 041812 0418120.5,1012 042312 041612051012 042312.041612 051012 042312 041612 051012 042312 041612 051012 042312 041912 051012 042712042412. 051012 042712 042512 051012 042712 042512051012 042712 042612 051012 042712 042712 051012 042712 042712 051012 042712, 042512051012 043012 041212 042512 :'!',O'rALS., ..' 1,1." :,.,t,' . I' ,'.. . . . i... 1,1'" . .1"'.. -. . ..:,. I : 23866 043012 043012043012 .238,67 043012 043012 043012 TOTALS.. 0 . . . .. 0 0 . 0 . .... . 0 . . . . . . .. .. . . .. . . . . ... : MMC04/05/2012 -T.OTALS. '. t,', I......... .'.'. t'...;, ......... .'.;;,:,' ....'..... .,.:.,,': 043012 040512 050512 2341 042312 041012 051012 2355 043012 043012 043012 TOTALS'.. . . . . . ... .,.. . .. . . . . . . .. . . . . .. . .. " . . 0 . . .. : 4114728 TOTALS..... ... ...... H'" .;,...... ..... ...... ....: 041712 040912050912 X0426203.2 TOTA'uS. ,', ,:"..... ,,','" I'. .:.,..... t"':_'" ........,'.',.:.. "'I',' '.,... .:..: 043012 0418120513.12 4477 043012 040612 042112 260.00 2liO.OO 96.05 96..05 2218.50 2218.50 7.77 36.8.5 24.06 62,.80 13.79 7.68 15.54 21.06 77.10 13.82 315.90 117.00 10.98 271.48 995.83 80.99 297.00 377 . 99 3212.16 3212.16 174.00 132.00 306.00 517.52 517.52 !/54.49 954.49 2001.40 .00 .00 .00 .00 .00 .00 .00 .,00 .00 .00 .00 .00 .00 .00 .,00 .00 .00 .,00 .00 .00 .00 .00 . oo::lr.L{.G,.'7S .00 v .00 .00 .00 .00 .00 .00 .00 .00 .00 .0,0 .00 ,/ 260.00 260 .00 96.05/ 96.05 2218.50.;/" 2218.50 ,7.77V 36.85 '" 24.06.~ 62.80.....-- 13.79. ,/ 7.68./ 15..54/ 21.06/ 77 .10 ~ 13.82....... 315.90"- 117 . 0.0 ........ 10.98/ 271..n/ 995.83 80.99....... ~J7 . oo~ ..:j11.!lr t;t"7. ""'1 323.2.16 ./ 3212.16 174.00/ 132.00 .,/' 306.00 .,/ 517.52 517.52 954 .4!/ ,/ 954.49 / 2ll01.40 RUN DATE: 0510311.2 TrME: 10: 40 ~, MEMORIAL MEDICAL CENTER ,APOPEN INVOICE LIST THRUDUE DATE OF 05115/12 PA:GE: 2 APO~EN VEND#.NAME...................... ... ...CLS.INVOICE#.. .,.. ....TRN PT.INV PT.DUEDT,CJ( DT..PC. ..... ..GROsS,. ...DISC..... .NO.PAoy........ .NET 2001..40 B0436 BARn ACCESS SUPPloIESV'uIOUS SUPPloIES CS INV Bl075 BAXTER HEALTHCAn COR!> SU:PPLIESCS ,rNV SUPPLIESCS rNV P!tARMACEUT.ICALS B1.220 :BECKlWl COULTER INC OUTSIDE SRV LAB OUTSIDESRV LAB OUTSIDE SRVLAB OUTSIDE SRVI.AIl, OUTSIDE SRV IlA.B LEASE LAB oUTSIDE SRVW C101 Q C!BtJ:ONE ,CABLE' C1.992 CDW GOVERNMENT, INC. OFFICE SUPPLIES ER 10350CEN'!'URION MEPICALPRODUCTS SUP!>LIES OS INV C1410 CERTIFIED LABORATORIES SUP:PLIES DIETARY c1600 CITIZENSNEPICAL CENTER OUTSIDE SRV W C2510 CMI PRIVATE: PAYSRV E:BOS STATEMENT PROCESSING STATEMENT PROCESSING '1'3075 DEBRATRAMMELt TRAVEL EXPENSES TOTAIiS. . i 1.'" II . III ",, ';' . . ._t,'_. . . II:' " .'~ ''',' .. ,f. ,,'t.t : 09228703 43454465 0417.12 041.01.2 050.91.2 04,1.712 041.:L12 051.01.2 TOTALS', '.1',"" .,"11 ....,... '.._. I" i. '" '..',..... I ,',II,f .: M 37018383 37106394 37115596 041.61204041.2 06121.2 04231.2041.212 0511.1.2 042712041.31.2 051.312 ToTALS', .'...:..'.... .:';'f.'.' '"", ....-.... ."-'" .".}.....: M 1.02707016 043012020212030212 102707694 043012 020212030312 1027091.39 04301.2 020312030312 1.02832589 043()12 041.112051112 102835642 043012 041.212051212 5265195 04301.204121.2051212 5265195 043012041.212 051112 TOTALS. . . . . ... .. . ..,.. . .. . .. .. . . . ... . . . . . .. .. .: W 4/16-5/15 042712 041.612042512 -TOTAL,S:.,.,. II ,f.,... ,'t..'.... II.. ,..-.". ..f...". ~.."....: M ,J226026 042312041012 051012 TO'l',A!,S........... ,...... ,.. .".. H, ...... ...,...1 90996213 04171.2 ,041112 051012 .'l'9TALS_....~ . I.... . '.,1' , . ,,"'.' ." .-.-..,. . .,. . I . "-,,,'. ...': M701s32 042712 ()41812 042812 TO'l'ALS....... ........... ....... ........... H.'...: W 23865~1 04,3012 103111 1130,11 TOTAIiS.:~... ...'.'.. ............ ................ ._.-,: M 7175,26 718765 719184 720188 042712 040612 040612 042712041112041112 042712 041212 041212 042712 041912 04191.2 'TOTALS'..,. i. -."i.... ....-. '.'... .', .....;.. .._.. ..;.....,. ..': 23863 04301.2043012043012 2001.40 378.25 74.00 452.25 578.98 318.67 178.40 1076.05 292.25 454.00 4481...27 58.86 127 .79 34140.19 3.933 .0 12787.84 324.96 324.,96 132.68 1.:32.68 376.86 376.86 269.'50 269.50 178.00 178.00 14164.04 507.04 67.85 101.48 14840.41 161.75 .()O .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 ..00 .00 .00 .00 .00 .00 .()O .,00 .00 .00 378.25"'/ 74.00/ 452.25 / 578.98./ 318.67 178.40 / 1.076.05 292.25/ ;/ ,454.00 4481.27/ 59.8,6/ 127,79:/ 3.440.19 ' / 3933.48......- 12787.84 324.96 ,/ 324.96 /' 13t.,68 132.68 376.96 ,/" 376.86 269.50Y' 269.50 1.78.00"""""" 178.00 ,,/ 14164.04 / 507.04 / 67.85 101.48,,7 14840.41 13g.15'~ RUN DA~E: 05/03/12 TIME: 10:40 MEMORIAL MEDICAL CENTER AP OPEN INVOICE LIST THRU DUE DATE OF 05/15/12 PAGE: 3 APOPEN .. VEND#.NAME.......................... .CLS.INVOICE#........ .TRN DT.INV DT.DUE DT.CK D'l'. .PC...... . GROSS. ... .DISC..... .NO-PAY.;. '.... .NET TOTALS.....,..,.. I....'.............,.".,....: 161. 7 5 .00 ~5 ('3,.1) 10368 DEWITT POTH , SON OFFICE SUPPLIES ER 328044-0 042312 041812 051512 140.00 .00 140.00......... OFFICE SUPPLIES PFS/ER 328304-0 042312 041612 051512 26.63 .00 26.63/ OFFICE SUPPLIES CS INV 328562-0 042312 041812 051512 306.74 .00 ./ 306.74.,/ OFFICE SUPPLIES RADIOLOGY 328590-0 042312 041812 051512 20.13 .00 20.13 SUPPLIES VARIOUS 329054-0 042712 042312 051512 249.07 .00 249.0Y OFFICE SUPPLIES OB 329415-0 042712 042412 051512 36.74 .00 36.74,1' OFFICE S~PLIES ACCT 329421-0 042712 042412 051512 91.86 .00 .,/ 91.86 / OFFICE SUPPLIES VARIOUS 329619 -0 042712 042512 051512 150.25 .00 150.25./' OFFICE SUPPLIES ADMIN 329655-0 042712 042512 051512 14.94 .00 14.94 OFFICE SUPPLIES LAB 329746-0 043012 042612 051512 39.06 .00 39.06/' OFFICE SUPPLIES LAB 329838-0 043012 042612 051512 3.43 .00 3.43/ TOTALS....................................... : 1078.85 .00 1078.85 D1608 DIvtRSIFIED BUSINESS SYSTE 58.62/ PRINTING WOMEN'S CLINIC M 21834 041712 041112 051012 58.62 .00 OFFICE SUPPLIES WOMEN'S C 21833 042312 041012 051012 21.50 .00 21.50'/ TOTALS. . . . . . . . I . . . . .:. . . . . . . . . . . . . . . . . . . . . . . . . : 80.12 .00 80.12 Dl710 OOWN'l.'OWN CLEANERS OUTSIDE SRV W 23850 042712 021712 031712 10.00 .00 10.00/ TOTALS....................................... : 10.00 .00 10.00 D1785 DYNATRONICS CORPORATION 171.20/ SUPPLIES PT 583317 042312 041312 051312 171.,20 .00 TOTALS............... I....................,..: 171.20 .00 171.20 E0500 EAGLE FIRE & SAFETY INC 280.00/ OUTSIDE SRV DIETARY M 44144 041712 041112 051012 280.00 .00 TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 280.00 .00 280.00 Fl050 FASTENAL COMPANY 25.67 / SUPPLIES PLANT OPS M TXPOT107149 042312 041212 051212 25.67 .00 TOTALS................. '.J'" .... 11.1" ,'........: 25.67 .00 25.67 10689 FASTHEALTH CORPORATION 583.33/ WEBSITE SETUP 03CS12MMC 042712 042712 042712 583.33 .00 TOTALS....................................... : 583.33 .00 583.33 Fl100 FEDERAL EXPRESS CORP. 86.03/ OUTSIDE SRV - SHIPPING W 7-860-62142 042712 041912 050412 86.03 .00 TOTALS" . . . . . . . . . . . . . . . . . . . , . . . . . , . . . . . . . . . . . . : 86.03 .00 86.03 F1400 FISHER HEALTHCARE / SUPPLIES LAB M 0204622-1 043012 041712 051512 48.34 .00 48.34./' SUPPLIES LAB 9569790-1 043012 041012 051012 69.98 .00 69.98 SUPPLIES LAB 9569792-1 043012 041012 051012 1148.97 .00 1148.97 ./ S~PLIES LAB 9659879-1 043012 040212 050212 740.97 .00 740.97/ SUPPLIES LAB 9659880-1 043012 041112 051112 69.82 .00 69.82/ RUN DATE: 05/03/12 TIME: 10:40 MEMORIAL MEDICAL CENTER AP OPEN INVOICE LIST THRU DUE DATE OF 05/15/12 PAGE: 4 APOPEN s- VEND#.NAME.......................... .CLS.INVOICE#........ .TRN DT.INV DT.DUE DT.CK DT. .PC...... .GROSS.... .DISC..... .NO-PAY....... .NET SUPPLIES LAB 9773440-1 043012 041212 051212 48.34 .00 48.34 ,/ SUPPLIES LAB 9773441-1 043012 041212 051212 25.84 .00 25.84/ TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 2152.26 .00 2152.26 G0100 GE HEALTHCARE 042312 041012 051012 1324.28 .00 1324.28 ,.... DEPT REPAIR RADIOLOGY W 5355894 TOTALS. . . . . . . . , . . . . . . . . . . . . . , . . . . . . . t . . . . . . . . : 1324.28 .00 1324.28 10598 GLENN CRISP 44.40 ,/' TRAVEL EXPENSE 23845 042712 042412 042412 44.40 .00 TOTALS....................................... : 44.40 .00 44.40 G0401 GULF COAST DELIVERY ,./ OUTSIDE SERVICE 23864 043012 043012 051512 225.00 .00 225.00 TOTALS.............,......................... : 225.00 .00 225.00 G1210 GULF COAST PAPER COMPANY 48.001 SUPPLIES HOUSEKEEPING M 375885 041612 041012 050912 48.00 .00 TOTALS....................................... : 48.00 .00 48.00 H0030 H E BUTT GROCERY 77.16 ./ SUPPLIES DIETARY M 125598 041712 041112 051012 77.16 .00 SUPPLIES DIETARY 127286 041712 041212 051112 140.24 .00 140.24/ SUPPLIES DIETARY 134479 041812 041612 051512 120.63 .00 120.63./' TOTALS....................................... : 338.03 .00 338.03 H1050 HAVEL'S INCORPORATED 277.95/ SUPPLIES CT SCAN M 969253 042312 041312 051312 277.95 .00 TOTALS.......I.......".I.. 1'1'" 1.1..........: 277.95 .00 277.95 10950 INFOLAB INC 873.34/ SUPPLIES BLOOD BANK M 3106049 043012 041012 050912 873.34 .00 TOTALS....................................... : 873.34 .00 873.34 I1263 IVANS 106.49/ COLLECTIONS w 12D0037975 042712 041112 050212 106.49 .00 TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 106.49 .00 106.49 J0150 J & J HEALTH CARE SYSTEMS, 208.62/ SUPPLIES SURGERY 907576798 041712 041112 051012 208.62 .00 TOTALS... I'............................ I.......: 208.62 .00 208.62 J0356 J.A. MAJORS 202.04/ SUPPLIES VARIOUS I2053541 043012 031412 041412 202.04 .00 TOTALS...................................... .: 202.04 .00 202.04 10632 JACKSON NURSE PROFESSIONAL CONTRACT NURSE 46254447 042712 040712 040712 2304.00 .00 / 2304.00 / CONTRACT NURSE 46354447 043012 041412 041412 2336.00 .00 2336.00 TOTALS........ ........ ... ....... .......... ...: 4640.00 .00 4640.00 10507 JASON ANGLIN 451.16 ) TRAVEL EXPENSE 23846 042712 042612 042612 451.16 .00 MEMORIAL MEDICAL CENTER AP OPEN INVOICE LIS'l' 'l'HRU DUE DA'l'E OF 05/15/12 TIME: 10:~0 ~ ,CLS INVOICE#.........'l'RN D'l'.INV D'!'.DUE D'l'.CK D'l'..PC.......GROSS.....DISC......NO-PAY........NE'!' VE!m#.N~,......... '.. II ........, II' . 142.08 .00 142.08 ,/ 9~. 91 .00 94.91-:::: 169.84 .00 169,.84 857.99 .00 857.99 RUN DA'!'E: 05/03/12 '!'RA VEL EXPENSE '!'RA VEL EXPENSE '!'RAVEL EXPENSE 042712 042612 042612 042712 042612 042612 042712 042612 042612 23847 23848 23849 '!'O'!'ALS....................................... : PAGE: 5 APOPEN PAGE: 6 APOPEN MEMORIAL MEDICAL CENTER AP OPEN INVOICE LIST THRU DUE DATE OF 05/15/12 RUN DATE: 05/03/12 TIME: 10:40 .. II CLS INVOI'CEII.........TRN DT.INV DT.DUE DT.CK DT..PC.......GROSS.....DISC......NO-PAY........NET VEND ..NAD...............,........... . / 34.50/ 20.17 198.86 ./ 256.46 ./ 1418.23/ 576.51 ./ 117.21 .// 4895.03/ 538.43 757.60./ 617.88/ 182.92 ...... 2197.83,/'" 131.24-; 13.82 1016.40/ 175.02 /' 60.11 ,/ 985.84 1818.19../' 738.83/ 84.11./ 819.45/ 550.99 ;" 1153.63 :;. 819.45 -475.96/ -139.00/ -191018./ -15. 54,/'" -214.88..... 11.52/ 95.17/ 3.02.... 10197 .28 ~ 6310 53 42662.37 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 34.50 20.17 198.86 256.46 1418.23 576.51 117.21 4895.03 538.43 757.60 617.88 182.92 2197.83 131.24 13.82 1016.40 175.02 60.11 985.84 1818.19 738.83 84.11 819.45 550.99 1153.63 819.45 -475.96 -139.00 -1910 18 -15.54 -214 .88 11.52 95.17 3.02 10197.28 631.53 42662.37 042312 041812 051012 042312 041812 051012 042312 041812 051012 042312 041812 051012 042312 041812 051012 042312 041812 051012 042312 041912 051012 042312 041912 051012 042312 041912 051012 042712 021412 022512 042712 042012 051012 042712 042312 051012 042712 042312 051012 042712 042412 051012 042712 042412 051012 042712 042412 051012 042712 042512 051012 042712 042512 051012 042712 042512 051012 042712 042512 051012 042712 042512 051012 042712 042612 051012 042712 042612 051012 042712 042612 051012 042712 042612 051012 042712 042612 051012 042712 042312 051012 042712 042312 051012 042712 042312 051012 043012 042612 051012 043012 042712 051012 043012 042712 051012 043012 042712 051012 043012 043012 051012 043012 043012 051012 043012 043012 051012 3308681 3308682 3308683 3308684 3308685 3309614 3313141 3314235 3314236 3086140 3317392 3325840 3325841 33286.13 3329584 3329585 3332785 3332786 3334467 3334468 3334606 3338432 3338563 3338564 3338565 3338763 CM75629 CM75630 CM75631 0711 1172 3341749 3341751 3348760 3348761 3348762 PHARMACEUTICALS PHARMACEUTICALS PHARMACEUTICALS PHARMACEUTICALS PHARMACEUTICALS PHARMACEUTICALS PHARMACEUTICALS PHARMACEUTICALS PHARMACEUTICALS PHARMACEUTICALS PHARMACEUTICALS PHARMACEUTICALS PHARMACEUTICALS PHARMACEUTICALS PHARMACEUTICALS PHARMACEUTICAL PHARMACEUTICALS PHARMACEUTICALS PHARMACEUTICALS PHARMACEUTICAL PHARMACEUTICALS PHARMACEUTICALS PHARMACEUTICALS PHARMACEUTICAL PHARMACEUTICALS PHARMACEUTICALS PHARMACEUTICAL CREDIT PHARMACEUTICAL CREDIT PHARMACEUTICALS CREDIT PHARMACEUTICAL RETURN PHARMACEUTICAL RETURN PHARMACEUTICALS PHARMACEUTICALS PHARMACEUTICALS PHARMACEUTICALS PHARMACEUTICALS TOTALS....................................... : M3866 MUSTAIN i ASSOCIATES COLLECTIONS MARCH W MARCH2012 043012 043012 043012 895.62 .00 895.62 -- TOTALS., . . . . . . . . . , . . .. . . . , . . . . " , . . . .. . . . ... , . . . : 895.62 .00 895.62 N1225 NUTRITION OPTIONS DIETICIAN W APRIL2012 042712 042712 042712 3000.00 .00 3000.00 .......... TOTALS....................................... : 3000.00 .00 3000.00 10709 ONESTAFF MEDICAL, LLC ,/ CONTRACT NURSE 5460 042412 041112 051112 2102.50 .00 2102.50 TOTALS..,..,.,............... ........ I........, : 2102.50 .00 2102.50 01496 OUTBURST ADVERTISING / EMPLOYEE PURCHASE W 13841 042712 040112 041512 34.70 .00 34.70 RUN DAq'E: 05/03/12 TIME: 10 :40 MEMORIAL MEDICAL cMER AP QPEN ~NVOICE ,LIST THRU ,DUE DATE OF 05/15112 PAGE: 7 APOPEN VEND#.NAME..........;.. ....... ..... ..CLS.INVOICE#........ .,TRNDT.INV DT.DUE DT .CKDT. .PC...... ,.GROSs.... .DISC.... .,.NO-PAY. ...... .NET OM425 ,OWENS << MINOR SUPPLIESCS iN SUPPLIESCS INV SUPPLU:S CS INV' SUPPLIESCS INV SUPPLIESPT SUPPLIES VARIOUS SUPPLIES VARIOUS SUPPLIES WOMENS CLINIC SUPPLIES CS INV' SUPPLIES VARIOUS SUPPLIES CS INV SUPPLIES VARIOUS P1102 PC MALL SUPPLIES ANESTHESIA 10032 P,HILIPSHEALTHCAllE SUPPLIES lCU SVR CONTRACT 4/28 ..5/27 T.OTALS.. _,'1'.'1 I"'.,' ~ ~., '_' ,",.... .'...'....1 II' ....t 1916841 1916861 1916891 1916940 1916946 1916962 1917007 1918064 1918094 1918475 1916111 1917218 041712 041012 05,0912 041712 041012 050912 041712 041012 050912 041712 041012 050912 041712 041012 050912 041712 041012 050912 041712 041012 050912 041712,041212 0,51112 041712 041212 051112 041712 041212051112 042312 040912 050912 042312 041012 051012 'TOTALS'". ._...... i.-. .>. ti,. ..,i........ I" I,..'. ,', ...: J81540470001 042312 041112 051112 ;TOTALS.:...... 't,t.. I..... It II... .'__. .,..... ...... .... .,j,: 924111034 042312 041112 051112 924120111 043012 0.41312 051312 TOTALS. . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . .. = 10718 QUALITY CAllE STAFF+NG, INC CONTRACT NURSE 1032 R105li RG << ASSOCIA'l'ES INC SALT DELIVERY R150? REGINA JOilI'J'SON TRAVELEXP - lU:!SSUEDCK D1080 RITA DAVIS FLEX SPEND REIMBuaSEMENT W 10221 S.T.E.D., 'INC. SUPPLIESPLANTOPS 10625' SARA SEGURA TRAVEL EXPENSES 10343 SCAN SOt!ND, IN,C' SUPPLIES MIa 0430,12, 040512 040512 'TOTALS.-..._..; .... II ,:.. .:... ,.-._._...., ii... t-.... I'.' ...': M 198804 041612 041212 051212 TOTALS.. ...u..;;;. ;".;.;.. ...;...;.;; .'.'.... .,...: 23873, 043012 0,43012 043012 TOTAL'S:, ..1'...... "1". Ii. .:i'.;.... ._. ;-" .,..'.... .-. '-f.: 23861 043012 043012 043012, TOTALS... tt.. i ;,.... .',Ii...' .:.',.;.. ".,'. .,.,i...... .,....: 1007061 043012 0,41212 051212 TOTALS.................;. ..,...................: 23871 043012 043012043012 T()ItIALS. .,.......... I It ....-..-. ,.',. .,...,.:.. ......,..: 100003021 042312041112051112 RUN DATE: 05/03/12 TIME: 10:40 CLS I'n'OICE#.........TRN DT.INV DT.DUE DT.CK DT..PC.......GROSS.....DISC......NO-PAY........NET VE!tD#'~"I"" II. ... I... I..... '.1... . lllV' 30.48 .00 30.48 MEMORIAL MEDICAL CENTER AP OPEN INVOICE LIST THiU DUE DATE OF 05/15/12 PAGE: 8 APOPEN TOTALS....................,....,...........,. : S1405 SERV1CE SUPPLY OF VICTORIA 53.38 .00 53.38 ./ SUPPLIES PLANT OPS W 700614270 043012 042512 051012 TOTALS.....I.I....,.... I" ..... II ......... I' II': 53.38 .00 53.38 S1800 SHERWIN WILLIAMS / DEPT REPAIR ER W 5176-3 042712 041612 051512 13.38 .00 13.38./ 5188-8 043012 041612 051512 56.59 .00 56.59 SUPPLIES ER 61. 68 ,,/' SUPPLIES ER 5261-3 043012 041812 051512 61.68 .00 TOT.ALS............'...,............. ..........: 131.65 .00 131.65 S1850 SHIP SHUTTLE TAXI SERVICE 15.00/ OUTSIDE SRV W 894406 042412 041212 051212 15.00 .00 OUTSIDE SRV ER 690004 042712 041812 050112 8.00 .00 8.00/ roTALS....'.,.'..".........'.....,.......... : 23.00 .00 23.00 D0350 SIEMENS HEALTHCARE DIAGNOS 176.55 ./ SUPPLIES LAB M . 971062961-1 043012 040512 050512 176.55 .00 /'" SUPPLIES LAB 971063968-1 043012 040512 050512 705.34 .00 705.34/ SUPPLIES LAB 971071808-1 043012 040912 050912 43.06 .00 43.06 TOTALS.............. .". II................,.,..: 924.95 .00 924.95 10699 SIGN AD, LTD. 350.00 ,- ADVERTISING 154585 043012 050112 051012 350.00 .00 TOTALS.................... ..t.................: 350.00 .00 350.00 S2903 SUN COAST RESOURCES, IOC 412.13/ FUEL MAR2012SCR 043012 040512 050412 412.13 .00 TOTALS. ...........................,.....,.,...: 412.13 .00 412.13 S2951 SYSCO FOOD SERVICES OF 1060.70/ SUPPLIES DIETARY M 204261761 043012 042612 051512 1060.70 .00 TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 1060.70 .00 1060.70 T1450 TAC UNEMPLOYMENT FUND UNEMPLOYMEN'l' W 23843 042412 041612 051512 12200.45 .00 12200.45/ TOTALS I. . . . . . . . I . . . . . . . . . . . . , . . . . . . . . . . . . . . . ... : 12200.45 .00 12200.45 T1900 TEXAS ELECTRICAL SUPPLY 271.75/ SUPPLIES PLANT OPS M 26501 042312 041112 051112 271.75 .00 TOTALS....................................... : 271. 75 .00 271.75 T2204 TEXAS MUTUAL INSURANCE CO 5994.00/ INSURANCE w 18169 043012 043012 051512 5994.00 .00 'l'O'l'ALS. . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . : 5994.00 .00 5994.00 S2679 THE ST JOHN COMPANIES, INC 22.95 / SUPPLIES CS INV M 07844025 042312 041112 051112 22.95 .00 TOTALS....... .'................. I.... I........: 22.95 .00 22.95 10677 THE SURGICAL EQUIPMENT PEO 1750.00/ EXT WRTY 3/30/12-4/1/13 1210610 043012 042512 042512 1750.00 .00 RUN DlTE: 05/03/12 TIME: 10:40 MEMORIAL MEDICAL CENTER AP OPEN INVOICE LIST THRU DUE nATEOF 05/15/12 PAGEl 9 APOPEN VEND#.NAME.......................... .CLS.INVOICE#........ .TRN DT.INV DT.DUE DT.CK 00. .PC...... .GROSS.... .DISC..... . NO-PAY ....... .NET TOTALS...................... .-......... 1.1.....: 1750.00 .00 1150.00 10732 THERACOM, LLC 650.00 ,/ OUTSIDE SRV WOMENS CLINIC 57474980-301 043012 040312 050312 650.00 .00 TOTALS. . . . . . . . . . . . . . . .' , . . . . . . . . . . . . . . . . . . . t . . : 650.00 .00 650.00 10192 THIE v" INSURANCE DOWN PAYMENT 23850 042712 042512 042512 9268.00 .00 9268.00/ 1ST PYMT 5/10/12 23851 042112 042512 042512 4118.00 .00 4118.00 TOTALS....................................... : 13386.00 .00 13386.00 T0801 TLC STAFFING 1194.16 .,/ CONTRACT NURSE W 10076 042412 041012 051012 1194.16 .00 TOTALS....................................... : 1194.16 .00 1194.16 TUOO TORCH 2000.00,......- SUBCRIPTION HIM - 2012 & W FND12-26 043012 042912 051512 2000.00 .00 TOTALS...........,............,....... ,......: 2000.00 .00 2000.00 T2200 TTCF REGISTRATIONER 23870 043012 043012 043012 50.00 .00 50.00 ".- TOTALS............,........................,. : 50.00 .00 50.00 Ul054 UNIFIRST HOLDINGS LAUNDRY MAINTENANCE W 8150566832 041612 041012 051012 32.54 .00 32.54 / TOTALS.. I........................,..... i.....: 32.54 .00 32.54 Ul064 UNIFIRST HOLDINGS INC LAUNDRY HOSPITAL LINEN 8400124372 041612 041012 051012 954.79 .00 954.79/ LAUNDRY HOUSEKEEPING 8400124373 041612 041012 051012 182.19 .00 182.19/ LAUNDRY PLAZA 8400124374 041612 041012 051012 193.86 .00 ' /' 193.86/ LAUNDRY DIETARY 8400124375 041612 041012 051012 131. 76 .00 131. 76 LAUNDRY OB 8400124376 041612 041012 051012 86.70 .00 86.70-j LAUNDRY HOUSEKEEPING 8400124377 041612 041012 051012 52.03 .00 52.03 LAUNDRY HOSPITAL LINEN 8400124582 041712 041312 051212 731.77 .00 731.77/ LAUNDRY SURGERY 8400124583 041712 041312 051212 414.89 .00 414.89/ TOTALS..........,..."...........,....... 1'1...: 2747.99 .00 2747.99 Ul056 UNIFORM ADVANTAGE 114.91/ EMPLOYEE PURCHASE W 4271200 042712 012712 022712 114.91 .00 EMPLOYEE PURCHASE 4390030 042712 040312 050312 154.89 .00 154.89.......... EI.fPLOYEE PURCllASE 4403606 042712 041312 051312 173.87 .00 173.87/ TOTALS....,.................................. : 443.67 .00 443.67 10172 US FOOD SERVICE 3814.56 ;; SUPPLIES DIETARY 3156970 043012 042612 3814.56 .00 SUPPLIES DIETARY 5825290 043012 041212 050112 29.93 .00 29.93 TOTALS..................... I..'..............: 3844.49 .00 3844.49 V0555 VERIZON SOUTHWEST TELEPHONE M 1977697041912 043012 041912 051412 53.38 .00 53.38 / ---- ~ llUN DATE: 05/03/12, TIME: 10:40 MEMORIAL MEDICAL CENTER ~P OPEN INVOICE LIST THRUDUE DATE OF 05/15/12 PAGE: 10 APOPEll' .JEND#.NAME.. n.... ............ ...... .CLS.INVOICE#........ .TRND'1' .'INV D'1'.DUE DT,.CK D'1'..~C...... .GROSS.... .DISC...... .NO-PAY..... ...,NE'l' TELEPHONE TELEPHONE TELEPHONE V0559VERIZON WIRELESS SUPPLIES IT B1820 VICTORIA BROOME CONTINUING EDUCATION WlO05 WALMARTCOMl1UmT1 MISCCIiARGES VARIOUS DEP'l' W 10902 YVONNE FELKINS TRAVEL ExPENSES 5521567041912 5522646041612 5525926041612 043012 041912 051412 043012 041612 0,51112 043012 041612 051112 TOTALS... It", It ..._,.......... ...t.j,.... .~... '.. t',.. ,',...: 302692 6122462759 TOTALS.. f... ,,' "..... I.... ....... "..-'. '.1' ....'.. ." ,",-,: 042312 040912 0,50912 042412 041612 051112 23872 043012 043012043012 TOTALS. . 1:-' .; . . ".It .' t . i.;i . t'" . ,'". . . 'f t. _,'t_. .. ,',',_. ,It:' '",,' t.' : 0315-0413 TOTAL-S..'........... ._............ ....-...,..... -I ,it ..: 042412042312 051212 23870 043012 043012 043012 TOTALS:,.. ..'. ,"" Ii ",...".',.... i 'f .-.,j~ '."lo.-,... "" .'. ;;.: GRAND TOTALS.... n. n . . . .. . . . . . . . . .. . . . . . . . . . : Ct{s ~'ttg~30 TO ~ 1~8 3a'1 \jO I'D $ ---- ~ ll\i ;t.3 -, ~ '4g?'l{\ :U14*i~4;l. .t:t 1 LIt ~3DO .' tJM~~ f)d~/~ Michael J. J(~ Oa~hit)tm County Judge Dat~:.... .">-~- J '~ APPROVED MAY 0 3 2012 COUNTY AUDITOR :~~ '1--( q /1 S :0: 9.V: / J4i~{ .00 187224.32 Ccrf"ec-4:o.... [<'77.'14.( p~ 1 . + I( ~1.i'i f <'1(,.I.i6~ '-0 t rec:.j;\o t) , 'f>~ 2- ,+-/3i .7,.$ CO<'tf!.e. ,.J:c,n{. . ~~6.<f5) ~~"7 + '1 (VHi ( )1/i,4~) C.Cf'f'e.c.-t"o'C'\$ + ~1DS.gg ~~\O < ~'<1~) +'i'l. q5 4,j.43 111.33 60.50 268.64 19.99 232.07 252.06 23.50 23.,50 826.56 826.56 6().95 60.,95 187224.32 .00 .00 .00 .00 43.43 .... '.,..., ID~.S7 ~ 60.50 - ---U8-M-- ~" 5 .<i/'if .00 .00 .00 / 19.99./ 232.07 252.06 .00 .00 23.50 ,..... 23.50 .00 .00 826.56 ,/ 826.56 - -\g1, ;? ~ ~ . S I V RUNDAT,E:05/03/12 UME:07:53 ,MEMORIAL MEDICAL CENTER EDIT LIST FOR PATIENT, REFUNDS ARID=OOOl PAGE 2 APCDEDIT ~'PATIENT NUMBER PAYEE ,NAME DATE *iIi~;;;~..._,''''_ .~"'_"''',-'' -,- ..,......._'...,-.. --,- ."......,-~,"";,......... ..'-- ..'- ..._- ......... ---...... --.......-.... --- ---.........-.... .... -.-"" .....-... ...._........_,-~- 1050312 l~O.OO / PAY PAT AMOUNT. CODE TYPE DESCRIPTION 58.68 / 302.25/ 47.20/ 1027.00 I 92.72 I 612.00 I GLNUM ARID=O,OOl TOTAL _.............. -'-.. ':'" '-.__""_ ....:..... _._,,,,, _;'_... ____ ~._.............. ..,_~... __ "'-_._" ....~,_~__...... ...'_"!' _, __........... ",_._ ~.... .'............ _'''',~__'_.. ~ _'_ ioo __ ","_,_ _'_,~,_._..." ............ ..'_...... ...__'.,..... ~_... __._... _._......... ..._........ ....... ..'..... 2319.85 ............. ..-- -_.'... ...-.. ................ --- ......--.. .-. ........ .......,....- ....- ..-.. ..'" ..'-_.. .:-:. ....'............ -...-...... .,.."" -- "'.-." __.. ..... _.__." __ -..... _,_ ---:.-'''' ...-..... .'.._" ___...... __ _i__ __ __..... .'."'''' __...... ...... TOTAL 2319.85 .~ APPROVED ." '..Ii '\~ ('I I' .~ .:.,-<t: e,lJ;S # 1'1'63;2. 5 +'0 'tf lY &'33/ COUNTY AUonOR /MttdJ~ ~ Michael J. Pfeifer Oalhoull County Judge D~t~~~_5 -y- ) 'Z.-- -- RUN DATE:OS/04/12 T!ME:U:36 MEMORIAL MEDICAL CENTER ,EDIT LtST FOR BA'l'CH556 07~3 CRT#556 TRANSACTION SEQUENCE PAGE 1 GLEDIT ACCOUNT A.H.A. SEQ. NUMBER NUMBER TRANS DATE JOURNAL AMOUNT SUB-LED REFERENCE MEMO G.L. ACCOUNT DESCRIPTION ',,, d. .. , .. H' . ,. .... -," .. ............................... -... ...-...... "'--.-.- --......................................... -.- -.- --.... --... -- -----.-...... ---..... --,;;.,- _......... -,--'" -'.!'" ....... ----- -- .'............. _... .....-.-_..... ~.'-'':'' ....-- "','-"'" --... .-...... -.-:"'''' ~- .-," -:- -,-'" ~_......... 1 2000,0000 2 40130060 05/04/12 PJ 05/04/12 PJ 1,280.OllCR H1100 1,280.00 H1100 23874 23874 HAYESELEC'l'RIC SEIWlCEINV D'l'=05/04/12 JlUE= 0 50412 HAYES, ELECTRIC SERVICE REPAIRS DEPARTNENTAL-DIETA 60130060 2200 47748 ;t7 ~a /'-5 - - - - -- - - - -R E t AP- - -- - - - - - - JOURNAL mo COUNT DEBIT PJ 1205 2 1,280.00 'rOTAL 2 1,280.00 CREDIT 1,280.00 1,280.00 AlP TOTAL 1,280.00 ACCOUNT TOTAL lU:CAP ON NEX'l'EiAGE Ctdill'fe33;;" APPRO\liD MA~ 0 ~ 20\2 COUNnAUDttOR --~~~ Michael J. Pfeifar path, Qt~n Cou,nn,I, Judge Date;C-- Co, ,_ '3 " ' . ~-dJ~ RUN DATE: 05/09/12 TIME: 10:09 VEND#.NAME.......................... .CLS.INVOICE#........ .TRN DT.INV lYr.DUE DT.CK DT. .PC..... ..GROSS.... .DISC..... .NO-PAY....... .NET MEMORIAL MEDICAL CENTER AP OPEN INVOICE LIST THRU DUE DATE OF OS/22/12 PAGE: 1 APOPEN A0401 ABBOTT NUTRITION 86.00 .00 86.00 .,/ SUPPLIES NURSERY 937984291 042712 041912 051812 TOTALS.................................. -.....: 86.00 .00 86.00 A1490 ADVERTISING ON AIR 165.00./' ADVERTISING 297894 050712 042012 052012 165.00 .00 TOTALS.....".................,......... '_'....: 165.00 .00 165.00 A1226 AHRMM 125.00/' MEMBERSHIP DUES 23882 050712 050712 050712 125.00 .00 TO'l'ALS.................,.'................... : 125.00 .00 125.00 A2276 ARTHROCARE CORPORATION 1193.38 V" SUPPLIES SURGERY M 90906979 042312 041812 051812 1193.38 .00 TOTALS....................................... : 1193.38 .00 1193.38 B1075 BAXTER HEALTHCARE CORP 196.9g/ PHARMACEUTICALS M 37126264 042712 041612 051612 196.99 .00 SUPPLIES CS INV 37159356 043012 041912 051912 72.03 .00 72.03 / FLEX SPEND REIMBURSEMENT 37162113 043012 041912 051912 364.56 .00 364.56 v' TOTALS. . . . t, . . . . . . . . . . . . . . . . . . . . . . . t . . . . . . . . . . : 633.58 .00 633.58 10599 BKD, LLP / AUDITING FEES 155547 042712 041612 051612 3919.15 .00 3919.15 TO'l'AlrS. . . . . . . . . . . . . . of . . . . . . . . . . . . . t" . t . . . . . . . : 3919.15 .00 3919.15 C1030 CAL COM FEDERAL CREDIT UNI EMPLOYEE DEDUCTION W 18170 050812 050812 050812 25.00 .00 25.00 ,,/ TOTALS.... II ,'.........,....., II.. .',.... '_' I"': 25.00 .00 25.00 Z0850 CARMEN C. ZAPATA-ARROYO SPEECH MARCH/APRIL 2012 W 23887 050812 043012 052012 225.00 .00 225.00/ TOTALS....................................... : 225.00 .00 225.00 10350 CENTURION MEDICAL PRODUCTS SUPPLIES CS INV 90999735 042312 041612 051612 467.09 .00 467.09./' SUPPLIES CS INV 91001658 042312 041812 051812 337.77 .00 337.77 ,,/' SUPPLIES CS INV 91004172 042712 042312 052212 533.56 .00 533.56 ...- TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 1338.42 .00 1338.42 C1410 CERTIFIED LABORATORIES SUPPLIES HOUSEKEEPING M 706928 050712 042412 050412 139.18 .00 139.18 /' TOTALS....................................... : 139.18 .00 139.18 A1292 COASTAL HARDWARE SUPPLIES PLANTOPS W 068503 042712 041712 051712 39.34 .00 39.34/' DEPT REPAIR 068538 042712 041912 051912 25.47 .00 25.47 ,/ TOTALS....................................... : 64.81 .00 64.81 C2510 CPSI SUPPLIES PFS M 7232152 050812 043012 043012 124.80 .00 124.80 ./ RUN DATE: 05/09/12 TIME: 10:09 MEMORIAL MEDICAL CENTER AP OPEN INVOICE LIST THRU DUE DATE OF 05/22/12 PAGE: 2 APOPEN VENDII.NAME........... ................ .CLS.INVOICEII........ .TRN DT.INV DT.DUE DT.ex DT. .PC...... .GROSS.... .DISC..... .NO-PAY....... .NET TOTALS..................."..........,. ........: 124.80 .00 124.80 10006 CUSTOM MEDICAL SPECIALTIES 846.66 V" SUPPLIES CT SCAN 135847 042312 041612 051612 846.66 .00 TOTALS........,........ I.'............. ,.,..,.1 846.66 .00 846.66 10368 DEWIrr POTH & SON 57.31/ OFFICE SUPPLIES PLANT OPS 330003-0 050712 043012 051512 57.31 .00 OFFICE SUPPLIES HR 330037-0 050712 043012 051512 223.25 .00 223.25~ OFFICE SUPPLIES VARIOUS 330061-0 050712 043012 051512 273.54 .00 273.54 OFFICE SUPPLIES SURGERY 330097-0 050712 043012 051512 9.47 .00 9.47 ;::: OFFICE SUPPLIES BUS DEV 330183-0 050712 050112 051512 11.70 .00 11. 70 OFFICE SUPPLIES HIM 330268-0 050712 050212 051512 130.88 .00 130.88 ",.-- OFFICE SUPPLIES LAB 330303-0 050712 050212 051512 143.49 .00 143.49/ OFFICE SUPPLIES OB 330490-0 050712 050312 051512 10.00 .00 10.00/ OFFICE SUPPLIES SURGERY 330629-0 050712 050412 051512 32.07 .00 32.07 - OFFICE SUPPLIES PFS 330637-0 050712 050412 051512 52.14 .00 52.14 ,-- '1'OTALS. . . . . . . . . . . . . , . . . . . . . . . . . , . . . . . . . . . . . " . : 943.85 .00 943.85 D1752 DLE PAPER & PACKAGING FORMS W 6597 042712 042112 052012 404.53 .00 404.53 ,,/ TOTALS....................................... : 404.53 .00 404.53 M2500 ED MELCHER CO DECON W 0620 043012 041912 051912 12.29 .00 12.29/ TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 12.29 .00 12.29 10003 FILTER TECHNOLOGY CO, INC 741.96 / SUPPLIES PLANT OPS 70270 042712 041912 051912 741. 96 .00 SUPPLIES PLANT OPS 70413 042712 041912 051912 200.71 .00 200.71 ../ TOTALS. . . .. . , .. .. . . . . . . . . . . . .. . . . . . . . 'of' . . . . .: 942.67 .00 942.67 F1400 FISHER HEALTHCARE SUPPLIES LAB M 0204621 043012 041712 051612 672.48 .00 672.48 / SUPPLIES LAB 0204661-1 043012 041712 051712 69.82 .00 69.82/ SUPPLIES LAB 0421093-1 043012 041812 051812 969.43 .00 969.43/ TOTALS...............................,....... : 1711.73 .00 1711. 73 W1300 GRAINGER SUPPLIES PLANT OPS M 9806710936 042312 041812 051812 214 .19 .00 214.19/ TOTALS.............................. .1.......: 214.19 .00 214 .19 G0302 GREAT AMERICA LEASING CORP EDOCFLOW SYSTEM 12173200 043012 042412 051912 1973.80 .00 1973.80/ TOTALS. . . . . . . . . . . . . . . . . , . . . . . ,-, . . . . . t . . . . . . _f . : 1973.80 .00 1973.80 G1210 GULF COAST PAPER COMPANY 175.21/ SUPPLIES HOUSEKEEPING M 379437 042312 041712 051712 175.21 .00 SUPPLIES HOUSEKEEPING 379451 042312 041712 051712 111.27 .00 111.27 ./ SUPPLIES HOUSEKEEPING 379454 042312 041712 051712 49.45 .00 49.45 '/ DEPT REPAIR HOUSEKEEPING 380159 042712 041812 051712 100.00 .00 100.00 RUN DATE: 05/09/12 TIME: 10:09 MEMORIAL MEDICAL CENTER AP OPEN INVOICE LIST THRU DUE DATE OF OS/22/12 PAGE: 3 APOPEN VEND#.NAME...........................CLS.INVOICE#.........TRN DT.INV DT.DUE DT.CK DT..PC.......GROSS.....DISC......NO-PAY........NET TOTALS....................................... : 435.93 .00 435.93 H0030 H E BUTT GROCERY 201. 95/ SUPPLIES DIETARY M 135764 042312 041712 051712 201.95 .00 TOTALS....................................... : 201.95 .00 201. 95 B1050 HAVEL'S INCORPORATED 95.45/ SUPPLIES RADIOLOGY M 969501 042312 041612 051612 95.45 .00 TOTAL'S."..................................... : 95.45 .00 95.45 10740 HEATHER DAVALOS 23.501 CONTINtTING EDUCAi.l'ION 23875 050712 050312 050312 23.50 .00 TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . I . . . . . . . : 23.50 .00 23.50 I0415 INDEPENDENCE MtD!CAL 68.76 ) SUPPLIES CS INV 26425131 042712 041812 051712. 68.76 .00 TOTALS................ II..... 11.11 11.11......: 68.76 .00 68.76 I0950 INFOLAB INe 2368.67/ SUPPLIES BLOOD BANK/LAB M 3108575 043012 041712 051712 2368.67 .00 TOTALS....................................... : 2368.67 .00 2368.67 Il100 INSTRUMENTATION LABORATORY 2327.08 ,/ SUPPLIES LAB M 9101008126-1 043012 041712 051712 2327.08 .00 TOTALS. . . . . . . , . . . . . . . . . .'. . , . . . . . . . . . . . . . . . . . . : 2327.08 .00 2327.08 I1260 INTOXIMETERS INC SUPPLIES LAB M 359846-1 043012 041712 051712 186.75 .00 186.75 0/" TOTALS. . . . . . . . . . . . . . . . . .. . .. . . . . . . . . . . . . . . . . . : 186.75 .00 186.75 10632 JACKSON NURSE PROFESSIONAL / PROFESSIONAL FEE L&D 46454447 050712 042112 042112 2512.00 .00 2512.00 TOTALS...................... II............,.. Z 2512.00 .00 2512.00 10341 JENISE SVETLIK TRAVEL EXP OB 23880 050712 050412 050412 160.95 .00 160.95/ TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 160.95 .00 160.95 Jl400 JOHNSON & JOHNSON 493.80/ SUPPLIES SURGERY 907618967 042312 041812 051812 493.80 .00 SUPPLIES SURGERY 907646924 043012 042312 052212 668.86 .00 668.86/' TOTALS....................................... : 1162.66 .00 1162.66 G0325 KIM CORMIER FLEX SPEND REIMBURSEMENT W 23874 050712 050412 050412 240.06 .00 240.06 ,/ TOTALS. . . . . . . . . . . . . . . . . . . . . . . , I . . . . . . . . . . . . . . : 240.06 .00 240.06 Dl033 LAURA DAVILA 705.00/ FLEX SPEND REIMBURSEMENT 23876 050712 050412 050412 705.00 .00 TOTALS. . . . . . . . . . . .. . . .. . . . . . . . . . . ... . ... .. . . . : 705.00 .00 705.00 S1102 MARLIN ,SAYERS 28.97 / TRAVEL EXP PLANT OPS W 23879 050712 050312 050312 28.97 .00 RUN DATE: 05/09/12 TIME: 10:09 MEMORIAL MEDICAL CENTER AP OPEN INVOICE LIST THRU DUE DATE OF OS/22/12 PAGE: 4 APOPEN VEND#.NAME.......................... .CLS.INVOICE#........ .TRN DT.INV nT.DUE DT.CK DT. .PC...... .GROSS.... .DISC..... .NO-PAY....... .NET TOTALS. . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . .. . .. . : 29.97 .00 28.97 M2659 MERRY X-RAY- SAN ANTONIO 1406.52/ SUPPLIES CT SCAN M 473158 042312 041812 051812 1406.52 .00 TOTALS............,........, .......,.........: 1406.52 .00 1406.52 10647 MICHAEL J. DICLEMENTE, MD FINAL REVENUE Gt1ARAm'EE 23876 050712 050412 050412 9675.81 .00 9675.81 ,./ TOTALS...................................,.... : 9675.81 .00 9675.81 M2827 MINNTECH CORPORATION 186.00 ,/ SUPPLIES SURGERY M 1362817 042712 041912 051912 186.00 .00 TOTAL:S........ .'......... ...................... t.: 186.00 .00 186.00 M2621 MMC AUXILIARY GIFT SHOP EMPLOYEE PURCHASE W 23877 050712 050712 050712 227.87 .00 227 .87 ~ TOTALS....................................... : 227 . 87 .00 227 . 87 10441 MMC EMPLOYEE BENEFITS MONTHLY ADMIN FEES 18168 050712 043012 050112 14979.25 .00 14979.25 ~ WEEKLY CLAIMS 18173 050812 050912 050912 26097.89 .00 26097.89 "./ TOTALS....................................... : 41077 .14 .00 41077.14 10709 ONESTAFF MEDICAL, LLC 2131. 50 / CONTIlACT NURSE 5499 . 042712 041812 051812 2131.50 .00 TOTALS.,.... _" II.................. .,...........: 2131. 50 .00 2131.50 OM425 OWENS & MINOR SUPPLIES CS INV 1920018 042312 041712 051712 322.07 .00 322.07/ SUPPLIES MEDSURG 1920044 042312 041712 051712 113.61 .00 ./ 113.61./ SUPPLIES SURGERY 1920278 042312 041712 051712 740.40 .00 740.40 SUPPLIES VARIOUS 1920281 042312 041712 051712 2167.72 .00 2167.72~ SUPPLIES MEDSURG 1920499 042312 041812 051812 136.04 .00 136.04 SUPPLIES CS INV 1920702 042312 041812 051812 141. 64 .00 141. 64~ SUPPLIES VARIOUS 1921098 042312 041912 051912 1726.37 .00 1726.37 TOTALS................,..'.....'.,'.........f. : 5347.85 .00 5347.85 P0706 PALACIOS BEACON 132.00/ ADVERTISING w 23883 050712 033112 043012 132.00 .00 TOTALS.................................;..... : 132.00 .00 132.00 Pl100 PC CONNECTION SALES CORP SUPPLIES IT !II 48992123 043012 042012 051912 2250.94 .00 2250.94/ TOTALS. . . , . . . . , . . . . . I . . . . i . . . , . . . . . . . . . . . . . 'f . : 2250.94 .00 2250.94 10032 PHILIPS HEALTHCARE SUPPLIES ICU 924152773 043012 042012 051912 66.84 .00 66.84 /' TOTALS....................................... : 66.84 .00 66.84 P2200 POWER ELECTRIC DEPT REPAIR ER W 158619 042712 041812 051812 21. 76 .00 21.76/ RUN D~TE: 05/09/12 TIME: 10:09 MEMORIAL MEDICAL CENTER AP OPEN INVOICE LIST THRU DUE DATE OF OS/22/12 PAGE: 5 APOPEN VEND#.NAME...........n............. .CLS.INVOICE#....... ..TiN DT.INV DT.DUE DT.CK DT. .PC..... .'.GROSS.... .DISC..... .NO-PAY....... .NET ./' 34.03 55.79 DEPT REPAIR ER 158633 042712 041912 051912 34.03 55.79 .00 .00 TOTALS....................,.................. : P1725 PREMIER SLEEP DISORDERS CE 2250.00/ PROFESSIONAL FEE CARnIO M 111-12 050712 050312 051512 2250.00 .00 TOTALS....................................... : 2250.00 .00 2250.00 R1045 R & D BATTERIES INC 53.41/ INSTRUMENT REPAIR MEDSURG M 971268 042712 041912 052012 53.41 .00 TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . t' . ; 53.41 .00 53.41 Rl050 R G , ASSOCIATES IHe 196.80 .....- SALT DELIVERY M 199177 042412 041912 051912 196.80 .00 TOTALS. . . . , . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . : 196.80 .00 196.80 R1268 RADIOLOGY UNLIMITED, PA READING FEES W 23885 050712 041012 051012 610.00 .00 610.00/' READING FEES 23886 050712 022912 032912 595.00 ;00 595.00 /' TOTALS....................................... : 1205.00 .00 1205.00 10626 RAUSHANAH MONDAY TRAVEL EXPENSE 23878 050712 050312 050312 63.83 .00 63.83 ~ TOTALS. . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . , . . . . . . . : 63.83 .00 63.83 10664 SAGENT PHARMACEUTICALS, IN 1008.00 /' PHARMACEUTICALS 240403 050812 040412 050412 1008.00 .00 TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 1008.00 .00 1008.00 S1800 SHERWIN WILLIAMS SUPPLIES ER W 5325-6 043012 041912 051812 56.59 .00 56.59,"'/ SUPPLIES ER 5410-6 043012 042012 051912 56.59 .00 56.59 ./ 'l"OTALS......... '....................... ",......: 113.18 .00 113.18 S2001 SIEMENS MEDICAL SOLUTIONS SRV CRT ULTRASOUND 4/18-5 M 95676970 050812 041812 051712 941.58 .00 941.58 .;"" TOTALS..............,......... "..............: 941.58 .00 941.58 S2400 SO TEX BLOOD & TISSUE CENT SUPPLIES CREDIT BLOOD BAN M 20121784-1 043012'041712 051712 -972.00 .00 -972.00............. SUPPLIES BLOOD BANK 20121852-1 043012 041712 051712 9670.00 .00 9670.00 TOTALS. , . . . . , . . t" . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 8698.00 .00 8698.00 S3940 STERIS CORPORATION INSTRUMENT REPAIR SURGERY M 4238624 042712 041912 051912 126.34 .00 126.34 ~ TOTALS....................................... : 126.34 .00 126.34 -10735 STRYKER SUSTAINABILITY 134.64/ SUPPLIES SURGERY 1616730 042712 042012 052012 134.64 .00 TOTAt.S, . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 134.64 .00 134.64 W1131 SUE WILLIAMS 332.86 ,../' FLEX SPEND REIMBURSEMENT 23881 050712 050412 050412 332.86 .00 RUN DATE: 05/09/12 TIME: 10:09 MEMORIAL MEDICAL CENTER AP OPEN INVOICE LIST THRU DUE DATE OF OS/22/12 PAGE: 6 aOPEN VENDII.NAME.......................... .CLS.INVOICEII........ .TRN DT.INV DT.DUE DT.CK DT. .PC...... .GROSS.... .DISC..... . NO-PAY ....... .NET TOTALS. ..,............,......................: 332 . 86 .00 332.86 T0500 TEAM REHAB 15000.00 ,,/ INTERIM BILLING W 23889 050812 050812 050812 15000.00 .00 MONTH OF APRIL 23890 050812 050812 050812 7673.88 .00 7673.88 ,,-/ TOTALS. . . . . t" . . . . . , . . . . . . . . . . , . . , . . . . . . . . . . . . ,: 22673.88 .00 22673.88 S2679 THE ST JOHN COMPANIES, INC 20.00 / SUPPLIES lCU M 07849539 042712 041812 051812 20.00 .00 TOTALS........... II.. II.....................,: 20.00 .00 20.00 T0801 TLC STAFP'ING 3795.33/ CONTRAC'l' NURSE W 10093 043012 041712 051712 3795.33 .00 TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . I 3795.33 .00 3795.33 T1724 TOSHIBA AMERICA MEtICAL SY 9874.50/' SRV CONTRACT C'l' SCAN 5/20 10005814 050812 042012 052012 9874.50 .00 '1'OTALS.......................,. f.............: 9874.50 .00 9874.50 U1054 UNIFIRST HOLDINGS LAUNDRY MAINTENANCE W 8150567555 042312 041712 051712 32.54 .00 32.54 ..-/ 'l'OTALS....................................... : 32.54 .00 32.54 Ul064 UNIFIRST HOLDINGS INC LAUNDRY HOSPITAL LINEN 8400124725 042312 041712 051712 676.74 .00 676.74/ LAUNDRY HOUSEKEEPING 8400124726 042312 041712 051712 182.19 .00 182.19/' LAUNDRY PLAZA 8400124727 042312 041712 051712 160.39 .00 160.39/ LAUNDRY DIETARY 8400124728 042312 041712 051712 131. 76 .00 131.76/ LAUNDRY OB 8400124729 042312 041712 051712 86.70 .00 86.70"""""'- LAUNDRY HOUSEKEEPING 8400124730 042312 041712 051712 48.68 .00 48.68/ LAUNDRY HOSPITAL LINEN 8400124934 042712 042012 052012 898.37 .00 898.37/ LAUNDRY SURGERY 8400124935 042712 042012 052012 348.59 .00 348.59 ~ LAUNDRY HOSPITAL LINEN 8400125288 043012 042712 051712 759.55 .00 759.55 -- LAUNDRY SURGERY 8400125289 043012 042712 051712 348.59 .00 348.59 /"' TOTALS........... I" ..........1.. ,.'....1.....: 3641.56 .00 3641.56 U1056 UNIFORM ADVANTAGE EMPLOYEE PURCHASE W 4412551 042712 042012 052012 372.81 .00 372.81 ,...- TOTALS................. I....... I.............: 372.81 .00 372.81 U1350 UNITED PARCEL SERVICE 399.03 ,,/' SHIPPING CHARGES W 0000778941162 043012 042112 051812 389.03 .00 TOTALS..,...................... I.....'.....,..: 389.03 .00 389.03 U2000 US POSTAL SERVICE POSTAGE 23888 050812 043012 043012 1000.00 .00 1000.00/, TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : 1000.00 .00 1000.00 10394 WILLIAM E HElKAMP, TRUSTEE EMPLOYEE DEDUC'l'ION 18174 050812 050812 050812 400.00 .00 400.00 ......- TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . .. .. . . . . .. . .. . . .. .. .. : 400.00 .00 400.00 10429 WILLIAM E HEITKAMP, TRUSTE /' EMPLOYEE DEDUCTION 18172 050812 050812 050812 495.00 .00 495.00 TOT'ALS. . . . .. . . .. . .. . .. .. .. .. .. .. . ... .. .. .. .. . ..... . .. .. . .. .. .. .. .... : 495.00 .00 495.00 " GRAND TOTALS........................, ~ . .. .. . . . . . . : 145983'.32 .00 ~~s #- J 4g 333 -fo JJ /q<6401 ~ df4?>3J8 APPROVED MAY 0 9 2012 COUNTY AUDITOR .JJlirJ-"f~~ MI~A.:"~1i;;t ,..~, ~_ ' ;F\..t~."";:. " ;';;:~';i'~r, . ~a., "'I,... l .', 'i OOtt3,.,"f;ii_~JJ::tdge .._~""-'-'-'~ U5983.32 .,.,/ .- RUN DATE:05f08/12. TIME: 15:05 PATIENT NUMB,El\ PAYEE ~ ...........i. "",'_... '''; .i..... _~._._ ~ _,'..;.;;".........:-'_ _.~...;' .._'.. __ '1Ii.,_ ............ ____... -'~... ~_-' -..'-... ..'...';'.. .."........ -'..... --....'--.. .'"" "!' -.-" -'.;;;.._~,-:...,+ -:~.~'.;,;.;;;:...,_.,_."........ -- ...,::;-... -- ..--" ~''''i'-- .....-. ......-.. ""----.-"'" --';.,,-..'-,. MEMORIAL MEDICAL CENTER EDIT LIST FOR PATIENT REFUNDS ARIDi=O,OOl pAGE, 1 APCDEtlIT DATE PAY PAT liMotlN'r C()DETYl'E DESORiPTION GLNUM 050812 1576.60 I <t' .. '& 050812 55.14/ 050812 1132.001 050812 JOg .00 ;' 050812 183.20 " 050812 53.20 I 050812 67.00 I >_>1' 5,O.OOj 28.28/ 28.89 I 11. 60 J 12.05 / 10.2.0 I 551.87 / 050812 68.47 I .. w,;, 05,0812 .561..80 I RPN DAft: 05/09/12 TtMt: 15:05 MEMORIALMEDtCAt CENTER. ~OIT ~IST fOR PATIENT, REFUNDS ARID=~001 PAGE 2.. APCDEDIT . PATIENT NUMBER PAYEE NAME DATE PAY PAT AMOUNT CODE T1PEDESCRtPTIOR GL NUM 050812 41.40 .I ,--..-.-"'" -- ~'-""""", .....-.... ... --.. _.. ...-_......... -- -... --.. --............... ................................. ..................... ..-.... ARtD=OOOl TOTAL 4740.70 .. ~.-- ..,..... -.--" -- ...-... ..-... -.... -.-" -.... ---"--- -- ...... -'" --.........- ---.. -... ..'..- ..'....... -,- -'.... .-. --- ....... --.. ...-.... -,-.-.... --.... .....;. ...-:,,,,";;'---" ...... ....-...-... -,.-';,;. -..-........ --.. ......- .... ..........-...- --...... TOTAL 4740.70 J Cks *" )yg Y Dc?- -+t> APPROVED MAY 0 9 2012 COUNTY AUDITOR .#= 14& <<..J /8 "~.::..:,::,:.;i:.."'''''_,""..'''~m.'"::;,;:',~,,,,,,-__ 86,' ,", ,~:eleO " . ~;lI:.:,;~:!noOtlnoYreO ,ef!~Jd "rleeqoUIV lfWi~Qffi MIchaE!l J. Flleifer · · Oalhoun CQuntyJudge Date: "6 -}5 .~ l~ .' Run Date:04M/i2 Time: 11:09 ,MEMORIAL MEDICA1CENTER Payroll Register ( Bi . Weekly ) pay Period 03/23/12-04/05/12 Run# 4 Dept. Sequence Department 050 Page P2REG L_ E III pI 0 ye e----.-....- 'r im,e ,------------.---------...,..-,-.,--.-.-----.-*-. De dil c t J o',ns ----....--...-..,--...-... INum/Type/Name!pay/EXemptlPayCdOept His IOTI5HlWEIHOlcBI Rate GrosslC(lde AIl\(lunt I *. ~,.'_,,,,.,,,'_ ...;...... .''''M __ _.._ ".__ _*.. "'",W" __.. _........ __ ........ ...w.................. __.. ,,'''''''_ ,,:._" .'_.. --........ -- ....... i...... "",- --".... --.... -.--.. .-.-..........-.... -- "...... ~';"-'...... -.-.'-": ~_.......... 050 9.50 N N N N 10.0000 95.00 FEDT1Ix T5A-R Total: 9.50 ---. -- --- - - -.-- - (Gross: 95.00 .16 FICA,M 6065 Deductions: l.39FIClI'O 3.99 12.7B Net: 82.22 ) .__ pa y.c 6 de 5 urn ma r y ,.___.__...._______.____.____._____......,.L De d uc t ion s S u in ma r y _______.___._t IpayCdOescription Hrs IOTlsHIWEIHOICBI Gross I Code AItlount I *..........;;.. _....... ._...::. .."".. ....... .._...__ ...o... .....'.:__...... ___,_""...... __ ..-w.... __.. __... _.,.._ ",__" ._... ....... ";,_ _:...."- ..,_~... ",~_ ..... ,:,.,;_..,_~......... __ _....... .w..._......... __.. __.. _,_" "'-,- -_... ..... ---:-.... ._w * 9.50 N N N N 95.00 AIR CAFE 'C CAFS-H CAFE -P CREDUN FEDTAX FLEX 5 GIIT S GTL LEAF PR FIN STUDEN 'I'SA.C TUTION AWARDS CAF,E '- D CAFEcI CANCER DENTAL ,76, FICA-M FORT D GRANT .a05p. I MISe REPAY T5A.l TSA-P tlW/1I0S BOOTS CAFE,-F CAFE. L CLINIC DENF 1.39 FICA-O FUTA GRP' IN 10 TFT ornER 5T-TX TSA-2 TSA-R 3.99 6.65 L,.______,_______ DepartilfentTotals: 9.50 .._-,-. ( Gross: 95.00 Deductions: 12.7.8 Net: 82.2.2) I Check.sCol\Il1:r-FTPT 1 Other Female 1 ,Male Credit OverAltlt ZeroNet. Term Total: 1 I .. -- - .'-,_. ---,. -.. - -. __. -- -. - -. -.. - ---,.". - ---,- -...-. - - .'-. ..- -'.-. -, -- -- - - - - - --_. - - -- -., -'.- - -'. -. ,-. - - -. - -. -,- _. - - - --- -- - -- --. ---.' - .--* G\r~.:!t. .' . ~'jifsL/ " {I ,~/J..J,;..A' J .-(<'" J ,..l~. .)~.../ l.... - L)'~-" /,'. ,"n () ',"} 1 ", i ,/pI. ild..--LL;7(:\ ' :{ - I 'i,>~~;'r !'j{/"" ,~' ' ~ , i) ~/T iU; 1 l",;......, ,? ".", 't./'" c,..x.? " .~ p '(,' ,UP. "'I""'.,' A, ' ,-,..J' "t1--' . ;:U.../ U /t.?~V ,. 'Zl" '03' " Run Date : 04/18/12 Time: 11:00 MEMORIAL MEDICAL ,CENTER payroll Register ( ai -Weekly ) Pay Period 03/23/12 - 04/05/121<00# 3 Dept. Sequence Departmel1t0.50 Page P2REG *__ Em p 1 (j ye e .--..*-. Tim e _----.-------.---------------...-------.---d'-- De dUe t io n S ___________..__,___,___.__.1 I Num/Type/Name/pay /Exemptl PayCd DeptHrs lOTI SHI WEI HO I CB I Rate Grossi coile Amount I *.... w ~,_'_ ___ w".. .'.w..',_" ..'_," __.. ..,*_ __:._" __...._.. ~.... _",_"" ~.. _,__...........;,.. ...:"'.... __........ _~_.. .;.-.__:~........ ..__.~:... ..'"".M""""""" __..;;, '" ...-...... --.... "',--....... ............ ..,--.. M........,...... t 050 -9.50 N 10,0000 -95.00 FEDTAX -.76 FICA.M .1.38 FICA-O -3.99 TSA-R -6.65 N N Total: -9. 50,lw* 'Net pay -ve (Gross: Deductions: -12.18 -95.00 Department Sutnma.ry Net: -82,.22 I *--P a y Co. d e Summa r y .-------------.--------------------------*-- D ed u c t i o.!I sS u m ma r Y __,,_______.-1 IpayCd Description H.rsIOTISHlwEIHOlcBI Gross I Code AmoUnt I t"..... .....,.. ............._.. __..._ ..__.. _.. ....... ..... "-M "'__ _..'".. __ _.. M,M"" __ _."""""" __ ~ ..:_.... ..._,_ __,_,,_" __ ___.. ..+._ _'_.... ,__.... J.,";; ....... ....-., "'''_''.__'__ ';".. ..'_;' ",'M"" ..:.:. ...M.;,......: .o__.. .....' _.. ___.. M'. -9.50N N N - 95 ,00 A/R CAFE.C CAFE-H CAFE- P tREDON FEDTA>: FLEX S GIFT S GTL LEAF PR FIN STUDE>> TSA-C TUTION AWAlUlS CAF.E-D CAFE-I CANCER DENTAL - .76 FlCA'M FORT D GRANT HOSP- I MISC REPAY TSA-l TSA-P UW/Ho.S BOOTS CAFE-F CAFE-L CLINIC .DE'P- LF -1.38 FICA-O -3 ;99 FUTA GRp. IN ID TF'r . OTHER ST-TX TSA-2 TSA-R -6.65 ,L_m---__-___ Depar~mentTotals: -Mo .----.. ( Gross: -95.00 Deductions: -12.78 Net: -82.22 ! I Checks CO\lnt:- FT PT Other Female Male Credit 1 Overllmt ZeroNet Term Total: I t ~.,..,. .... -,--" -,-,--',-,,:", "'--,. _,_.. .__" _.___ ...w __ "'_.__ "_,,: .'.,; _.,_...... _, _0':';_:' _"_....... __'__.. __ _,_...... _'~._ .~_.. __.......... _:_ -:: ~;_'_.. 0:. ___...... ___...... ..... ...__.. ..'w.. ___.. __._"" __... ....-.... t' Department 065 MEMORIAL MEDICAL CENTER Payroll Register ( lli-weekly I Pay Period 04{06/12 - 04/19{12Ruh# 2 Dept. sequence Page P2REG . Ruh,Date: 04{18/12 Time: 11: 34 ..__ Em p 1 bye, e _____*__ Tim e-------.------.----.-------------------.------..- D ed ue t i 0 !l s',---,-,-------------_..--* I Num/Type/Name/Pay/Exempt! Payed Dept HI's I OT I SH IWE I Hol Cll I Rate Gross I Code Amount I t _ _ __ _ _ ___ _ _ _ ____ - - - - - - - - ',- - _ - - - ..- - - - - - - - -- --- - - - - -- - --,' - -- - -. - -- - --',"- - - - --- -. ... -, -- -.,.,_.'- -- - --- - -'- - - - --- - - -- --- - -,- - - - - - -- - - --,* 065 065 065 Total: 1,6.00 N N N N7.7000 3.00 N N N N 8.7000 45.00 N N NN 8.9500 64.00---------------- ( Gross: 123.20 26,.10 402.75 552.05 FlCA-M 8.00 FICA'O 21.19 oTHER TSA-R 38.64 230.71 Deductions: 300.60 Net: mAS) Department$u1lllllary *--P a y C qd e Sum ma r y ---------------------.---------..-----.--*-- D ed \let i on s S \l mm ar y ---.--....'-.* I payCdDeseription Brs IOTlsH1WE!HOlcBI Gross I Code Amount I *- __.. __ _ _ __. ___ _. _ _ _ _ _ __.. __.. _ _._.. _. ... _.._ '._ _. __ _. _ _ _ _,_ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _1__ _ _,_ _ __. ___ __ __ _ _ _ _. _ _ ___. -- - -- -_- - - -. - --, -. - -, - - __I 1 Jtl:GULAA PAY-S1 16.00 N N N N 123.20 A/R AWARDS BOOTS 2 REGULAR PAY-S2 3.00 N N N Ii 26.10 mE-C CAFE-D CAFE - F 3 REGULAR PAY,S3 45.00 N N N N 402.75 CAFE-H CAFE- I CAFE-L CAFE -P CANCER CLINIC CREDtJN DENTAL DEP-LF FEDTA>: FICA-M 8.00 FICA-O FLEX S FORT D FUTA GIFT S GRANT GRP- IN GTL HOSP' I IOTFT LEAF MISC OTHER PRFIN REPAY ST-TX BTODEN TSA-l T$A.2 TSA-C TSA-P TSA,-R TUT! ON U\'1/HOS 23.19 230.77 38.64 .---.-.------..- Department Totals: 64.00------- (Gross: 552.05 Deductions: 300.60 Net: 2S1.45 ) ! Cheeks Count:. FT PT lOther Female Male Credit OverAmt Zer6Net Term Total: 1 I .. ---.................. -- --....-.............. --........ --.. -...... --.............. --.............. --............................................ --......................-................-..-.... ..-,..-.. --.. ----- --.....-* czJ:!.-. ~- l~ (4$ "S;; ~ ~. Run Date: 04/24/12 Time: 13 :16 Final Summary MEMORIAL MEDICAL CENTER Payroll Register { Bi -Weekly I Pay Period 04/06/12 - 04/19/12 Run# 1 Page 82 P2REG t__ Pay Cod e S urn mar y ____________._______,____________________t__ 0 e due t ion s Sum mar y _____________t I PayCd Description Hrs IOTISHIw&IHOICBI Gross I Code Amount I t .__..... ~ ___.....___... .................... __ _........... _...__.... __.. ............,__.... ___..__ _____..__......... __ ....t___.... _~_.. ___.... ___ _____ _..._.... __.......... __.......... __ ___.._ ..___ t 1 1 1 1 2 2 2 3 3 3 C Il Il I I K K M P P X X Z P REGULAR PAY-S1 RIlGULl!R PAY - Sl REGULAR PAY -Sl REGULAR PAY - S1 REGULAI1'PAY-S2 REGULAR PAY-S2 REGULAR PAY-S2 REGULAR PAY-S3 REGULAR PAY-S3 RIlGULAR PAY-S3 CALL PAY EXTRA WAGES llXTRA WAGES INSERVI CE INSERVI Cll IlXTENDED- ILLNESS-BANK EXTENDED- ILLNESS - BANK MEAL REIMBURSEMENT PAID-TIMB-OFF PAID-TIME-OFF CALL PAY 2 CALL PAY 2 CALL PAY 3 PAID TIME OFF - PROBATION 6702.50 N 1303.50 N 159.75 N 82.50 Y 2326.25 N 135.00 N 55.50 Y 1440.50 N 96.75 N 56.25 Y 2509.75 N N N 114.50 N 2.00 Y 48.00 N 148.00 N N 252.00 N 1036.00 N 64.00 N 90.00 N 96.00 N 8.00 N N N N N N N Y N N N N N Y N N N N N Y N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N 120177.51 A/R 771.27 AWARDS BOOTS 41554.00 ,.eMIH 660.26~&-De38;94CAFE-F 3942.96€AFll-a 1&2~;82.CAFIH 280.7B:CMIH 2731.10 GAFll-P 444.30 CANCER 12.68 CLINIC 45032.15 CREDUN 25.00 DENTAL 475,30DIlP-LF 3875.24 FllDTAX 31202.58 FICA-M 4107.43 FICA-O 19S8.3 5JILEX S 1547 . 74 FORT D FUTA 33133.62 GIFT S 100.00 GRANT GRHN 3565.65 GTL HOSP-I 4110.00 ID TIT 2195.61 LllAF MISC 40.00 OTHER 5019.50 PR FIN 443.64 REPAY ST-TX 368.66 STUDB>> T8A-l TSA-2 645.00 T8A-C TSA-P T8A-R 3110,10 TUTION UW/HOS 78.00 716,64 3273,60 22.00 3591.51 19529.46 128.00 180.00 288 . 00 164.00 HILl>! 50.00 237.36 11897.43 129.26 2005.92 20669.70 t____________________ Grand Totals: 16726.75 ------- ( Gross: 295280.66 Deductions: 88286,55 Net: 206994.11) I Checks Count:- IT 157 PT 21 Other 28 Female 176 Male 30 Credit OverAmt 16 ZeroNet Term Total: 206' t...... __.... __........ __................._...... ........................................................... __ _ __................................. __............ __...... __.. _. _ _ __ _. _ _ __ _ _ _ _ _ _ _ _ _.. _ _ . ____ ~. _ _ * / 31,202.58 29,542.89 ,// ./ 8,237.88 COMBINED TOTALS FED TAX FICA 0 FICAM TOTAL 69,983.35 IJUG U .' l:,.),() j'l ~. ;~: (J ;~~: ;,',!. "i ~,~ j . .;'.> /[. :~~l . .~.~ ;:.f "- ," t~':'; ) :: ) '/ ClUJ 6d1)(;j .:;~' ~ ~' RunDate:04!30/12 Time.: 11 :07 Department 005 MEMORIAL MEDICAL CENTEIi. Payroll Register ( Hi ~Weekly l Pay.Period 04/06/12 . M/19/121i.u.n# 3. Dept. SeqUence Page P2REG L, B m ploy e e __',eL.T i ni e_"_~u.._._~u~.:_'_'_u",_'_u__uu______'*__ bed tiC t i a n s _.-----c---c.-.u------.-.* INum/TypelName/PayIExemptlPayCd Dept lirs IOTISHJilEIHOICBI Rate Gross .ICade Alnbunt . I *....... ~'M:~'_ _"w _.,"',;",; ""~':;; .....,. .''''':'',_*';'' ......._..,. .'..... __....,... w.. w.,.,.., ...,. _....-,.,.,.,... "'W" __w.... _,_" __,.,.,. _ _,","'" t',.,. _,,_'"___'',.''''''''' -,. ..W,"" ".,..,...,.;,. _,w.. ....... -," ",w.. ..,,;....... _-,. '';' -...;:;..,. t Department Summary 005 8.00 N N N N 22.7800 182.24 FIClI-M 3.51 FlCA-O lQ.17 TSA-R 16..96 005 N N N N 60.00 Total: 8.00 "',w"" ,.'....., ....'. .;,,~..-- ( Gross: 242.24 Deductiolls: 30..64 Net: 21.1..60 ) *__ pa y Co de S u mm a r y _.-u-.________.-.--__-.-..u__~-um---*-- 0 e due t i an s Sum III a r y _____m____._.* I PayCd Description Hrs IOTlsHIWEIHOlcBI Grass I Cade Amaunt I * .. _. ,. .. .. ,. .. ,. .. ,. '" ,. _,.. ,..~ _w ,. ,. ,. .. ,. ,. ,. .. ,. .. ,. .. .. .. ., ,. W"w _:_ ,;,,_ ,. _.',.;",. w',.. .;; _.:_,. .. ,... .. .;. ,. ,,; .,. ..;~ .. '. .. ...:.. .. .,; ,. ., ,,;.. - ,.,.,..t ,.';':-.. ,. "'" ,.; ;;. '".w :.. ..^- .. ",. ..;~ '- ., ., .'.. ~ .. .. .. .. ".- .. .. .. .. - - ... .-,. -.... ~ .., - .,. .,. '.- - .,. ..,'- .., .., *. E P EXTRA WAGES PAlb-'l'IME-OFF N 8.00 N 66.00 182.24 AIR CAFE - C CAFE - H CAFE- P CREDUN FEDTAX FLEX S GIFT S GTL LEAF PRFIN. STUDEN TSA-C TUTION AWARDS CAFE~D CliFE-I CANCER .DENTAL FICA,M FORT b GRANT HOSP- I MISC Ii.EPAY TSA-l TSA-P OW/HaS BOOTS CAFE - F CAFB CLINIC DEP-LF . 3.51FlCA-O FUTA GRP - IN 10 TIT ornE!< ST-TX TSA-2 TSA'R 16.96 N N N N N N 10.17 *--------,-----. Department Totals; 8.00 "--'-- (Gross: 242.24 Deductions: 30.64 Net: 211.60 I I ChecksCount:- IT 1 PT Other Female 1 Male Credit Overlimt ZeroNet Term Tot~l: 1 I Y';," _'_-:'___ - __ ___~- _-:,.,_':' -:_,__ __ ~-~ ..,_":._ .'::,'___'_ __ - .'. ...,:-.;. "','~ - _____.._ -:' ___ __,__'..,-,.'_. _'_.__'. _. - - __'_ - _. ___-.__ ...'_ ___....... - _'.:... _...._ ___ .....____ __ _.__._...._ - - - ___ - __ _'f ~ 1-- Ia J1 S-7 ~l ~. . ~. Tax Payment Report Worksheet EFTPS Voice Response S, (photocopy this worksheet for future use.) IL;~~I You dial: EFTPS responds: You enter: Li~8 EFTPS prompts: 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) "Enter your 9-digit Taxpayer Identification Number" ITI IJ[] [kJ [Q] [QJ rn rnm [IJ (9-digit Employer Identification Number) ~ L~}=..J "Enter your,4-digit PIN" EFTPS promts: You enter: digit Personal Identification Numb 11::;:~fi1 EFTPS prompts: You enter: lists the Main Menu Selections Press 1 (to initiate a tax pryment) 1L:i!21 EFTPS prompts: You enter: EFfPS responds: "Enter the Tax Type number followed by the pound (#) sign." m rn [Z] 110 0 (3- to 6 digit tax type number from the IRS Tax Form-Tab'l'e'lnAppendix A) "You entered Tax Type/Tax Description (Based on the selection in step #5) ~ EFfP$ 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 the 4-digit Tax Filif!g Period starting with the year followed by month'" CD [D IJ[J [E:] (Valid 4-digit Tax Period base~ on IRS Tax Form Table in AppendixA) ~ EFfPS prompts: ,...>'~ You enter: "Enter the payment Amount followed by the pound (#) sign." (You must enter cents even if you are reporting a whole dollar amount.) $DD,DoLIlTI,Q[JITII3J.m~ (Your payment amount cannot exceed $99,999,999.99) ~ EFTPS prompts: Enter the 2-digit Verification Code.1' o D Verification Code* *(See Appendix E fOf Verification Co~e Calculation) g EFfPS resppnds: " \ /\)\9/\~\~ >'\ ' \ 'fIJt1t\,v 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 one business day in the future). . UilGJ IJLlIIlOJ IT] (6-digit tax payment settlement day in MMDDYY format) ~!lXW~l~U\1AV\t 1(- ~ OI~4Lt1(il ~ '0 . ~ CC(J!hd ...vvv" , ;;;/, f ,." ... ~ . (Continue) f!!': ~Run Date: 05/08/12 Time: 09:23 Final Summary MEMORIAL MEDICAL CENTER Payroll Register ( Bi-Weekly ) Pay Period 04/20/12 - 05/03/12 Run# 1 Page 83 P2REG *__ Pay Cad e Sum mar y -----------------------------------------*-- D e d u c t i an s Sum mar y ___.n_____..* I PayCd Description Hrs IOTlsH!WEIHOICBI Gross I Code Amount I * ~ - -. -. -....- - - - - -.. - - -- - - - --- - ~ -... - ~ -- - - - - --- - - - - -- - -.. -... - - -- -.... - -~ - - - -.... - -* --- _..~.. ~_.. -.. -.. - - - -...... -- -........... -- - -.. - - - ---- - -.. -.. - ~ ~-* 1 1 1 2 2 3 3 C C E E F I I J K M P P X Y Z REGULAR PAY-Sl REGULAR PAY -Sl REGULAR PAHl REGULAR PAY-S2 REGULAR PAY -S2 REGULAR PAY-53 REGULAR PAH3 CALL PAY CALL PAY EXTRA WAGES EXTRA WAGES FONERAL LEAVE INSERVICE INSERVI CE JURY LEAVE EXTENDED- ILLNESS - BANK MEAL REIMBURSEMENT PAID-TlME-OFF PAID-TIME-OFF CALL PAY 2 YMCA/CURVES CALL PAY 3 7234.25 N N N 1420.00 N N N N 98.25 Y N N 2451.50 N N N BU5 Y N N 1551.00 N N N 9B.50 Y N N 48.00 N N N N 2253.50 N N N N N N N N 1 N N N 24.00 N 1 N N 154.00 N 1 N N 4.50 Y 1 N N 8.50 N 1 N N 258.00 N 1 N N N N N N 22.00 N N N N 854.00 N N N 160.00 N N N N N N N 96.00 N N N 127836.60 43579.66 2767.16 47755.49 3570.14 34784,81 3782.40 96.00 4507.00 446.50 785.00 230.56 4038.86 119.57 204.59 5400.34 67.00 361,96 16069.02 320.00 30.00 288.00 A/R CAFE-C CAFE-H CAFE-P CREDIlN FEDTAX FLEX S GIFT S GTL LEAF PR FIN STUDEN TSA-C TUTION 715 . 52 AWARDS 660.26 CAFE-D 7812.50 CAFE- I 444.30 CANCER 25.00 DENTAL 31330.62 FICA-M 1547.74 FORT D 180.41 GRANT HOSP- I MISC 443 .64 REPAY TSA-l TSA-P UW IHOS BOOTS 837.50 CAFE-F 280.7B CAFE-L 12.68 CLINIC 487.20 DEP-LF 4133 .1!)FlCA-O FUTA GRP - IN 4187.50 10 TFT 40.00 OTHER ST-TX TSA-2 TSA-R 410.14 50.00 237 . 36 11972.03 129.26 2647.32 20766.05 *-..___m___________ Grand Tatals: 16821.75 .."---- (Gross: 297040.66 Deductians: 89351.05 Net: 207689.61.) I Checks Caunt: - IT 157 PT 23 Other 27 Female 175 Male 32 Credit OverAmt 14 ZeroNet Term Tatal: 207 I t..... _ ~ ~. .__.. _.... ~_ _~ ~~ _...... ____ _ _... _ _ _ _ _ _ _ _ _.. _ _ _ _ _ _ _ __ _ __.... _ _ __ _ _ _ _ _~. _ ~..... __ __ _ _ __ __ _ _ ~ _ _~ ~ ~___.. _.. _ __ _.. _ _ _ _ _ ____ _ _ _.._.. _ _ _.. __.. __ _..i 1J 1JJJ,( ." fl tP\ "10 : HUe 0 ; 11 7--'1 I '" o. ) ")'JO..ed.._.-. ~ ci--le(fl ,L(:~ ~,q L{ *L{ * q~ .~. .. Tax Payment Report Worksheet EFTPS Voice Re~ponse S, (Photocopy this worksheet for future use.) ~ 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) ~ EFTPS prompts: You enter: "Enter your g~digit Taxpayer Identification Number" [LJ1Jl]~[QJ[QJmrnmm (9-digit Employer Identification Number) ~ ..:::h~~': EFTPS promt~: You enter: "Enter your 4-digit PIN" digit Personal Identification Numb ~l(~...t-. EFTPSprompts: 'f't::..~ You enter: Press 1 (to initiate a tax pryment) Lists the Main Menu Selections W EFTPS prompts: You enter: EFTPS responds: ~ EFTPS prompts: You enter: "Enter the Tax Type number followed by the pound (#) sign." rn [fZ] [ZJ fI DO (3- to 6 digit tax type numberfrom the IRS Tax Form-Tabie"'i'nAppendix A) "You entered Tax TypejTax Description (Based on the selection in step #5) "Enter Tax Payment Type" 1 digit number Tax Payment Type (Tax Payment Type specific to Tax Form Code in Appendix D) ,iJ~: EFTPS prompts: I Enter the 4-digit Tax FiIi~g Period starting with the year fo lowed by ~onth' . You enter: m OCJ I![] [li] (Valid 4~digit Tax Period base~ on IRS Tax Form Table in Appendix A) ~l:. EFTPS prompts: "Enter the payment Amount followed by the pound #) sign." (You must enter cents even if you are reporting a whole dollar amount.) You enter: DD'D41w=J,aJl1EJfXl.mm (Your payment amount cannot exceed $99,999,999.99) . EFTPS prompts: Enter the 2-digit Verification Code." DO Verification Code* *(See Appendix E for Verification Cod.e Calculation) g EFTPS responds: "Enter the 6-digit tax payment settlement date by month, day, year." (Note, the next business date you enter must be at feast one business day in the future). You enter: mGJ rTll""/;lm []:I (6-digit tax paYitmt ~ment day in MMDDVY format) Dsl.l.LGf Ie>- 1 f) Q 'I "l J A-tA r\l 0 tl d- \/Y)ft\0 p~~ rvv\. Nit1.~1lk1\*:a- (Continue) ~ CcUlei1. ~"-" .~ ) t:1._1 t ~ BUDGET ADJUSTMENTS: A Motion was made by Commissioner Finster and seconded by Commissioner Lyssy to approve all budget adjustments. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. ! :b )> :b - )> :b - ~ ~ )> - ~ a: s: ~ a: CD s: ~ a: s: m: =- m m: a. m m: ~I=- m ~ ~ ::::l m ~ I=- ~ ..... C'll z ,,: ~ ..... 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"U W W III '0 '0 iIt ~ co o _ ...... ..... ..... - (1) 0 0 {/'} {/'} 0 iIt {/'} "" UI UI co{/'}"" W 0 0 00000 UI UI coo 0 - ",. ~za ~za --~-- ~~i!i i~i!i {/'} {/'} ..... {/'} {/'} ~~WQ)01 =-=-= iIt{fl =-=-; 00000 !!l=:!If!!: ..... ..... !!li:il iIt ~ 00000 iIt ~ co co 0 0 8..90..9.9 0 0 co~ :::t m J:- :la - Z C') Cc:-:t J:-= ~:I: "':1: ::r' _ C ~ ii1~ c. _ D) = ~Z s:....., D) = '<~ N .... Jac:-:t N= 0= ..J.= N.... = = = en ....., .... :1:> m= J:-c... 22= z~ C').... "':1: ~....., !!IZ :la.... m> C')-a C-a ~= :::a = -= m> C ..... C..... C') _ m~ ....... -< m J> :::a .. N o ..J. N PUBLIC DISCUSSION: Judge pfeifer read aloud a letter from Lighthouse 2911 Reverend Paul Beard, Executive Director, who expressed their appreciation for allowing the usage of the fairgrounds pavilion for their Coastal Bands Bash. Rhonda Kokena announced that Bob Ashton with the State Comptroller Office says Calhoun County is one point away from getting the gold this year again with Transparency. A couple of changes need to be made to the County Website. There is no physical address on the homepage and for local government the contact on the web page says County Clerk. Judge Pfeifer announced that Warriors Weekend was a success. Court was adjourned at 11:55 A.M. .* LIGHTHOUSE 2911 LIGHTHOUSE 2911 P.O. Box 852, Yoakum, Tx 77995 361-293-1350 lighthouse2911@msn.com www.lighthouse2911.org May 11, 2012 The County of Calhoun 202 S. Ann, Suite A Port Lavaca, TX 77979 _ ~C.._ <<- _._. _ _._,~ .......__...__ _.~.-c.~-.. Dear Friends: Thank you for allowing us to use your fairgrounds pavilion for our Coastal Bands Bash. We appreciate all the work that was done to prepare it for our use. It is only through the continued support of good friends like yourself that we are able to help, the youth and their parents in the area. I j; I; The youth are now looking forward to the end of the school year and we are planning Summer Camp for them which will be June 18-20. We continue working with them throughout the summer with PALS classes and activities. Thank you for helping make this another great year for LIGHTHOUSE 2911 and the youth and families we serve. Thank you again for joining us in this important work that we can all be proud of. We hope to hear from you again soon. Sincerely, ~J2/~ r.:-:~..~ .,..... -_ ---. .-- ~ -_....... _,. ....- ---.:-:::-~ -Rev.~PauIBeara' ~.- Executive Director ~-- "''--'' _:-:-- * No gifts or services have been provided in exchange for this gift.